August 21, 2009
August 20, 2009
SRO: PEOPLE TO WATCH
“THREE,” the third annual fall show by artists at Margin Gallery and Collective, co-founded by Nima Taradji of Evanston, will open Sept. 4 at 1915 S. Halsted St., Chicago. Taradji also co-founded Hello Artichoke, another cooperative gallery in Los Angeles, where he worked as a commercial photographer, shooting celebrities in art, music and modeling. He later took a break from commercial photography to attend law school in Chicago. Besides the photographs of Taradji and others, “THREE” will include paintings, drawings, ceramics and metalwork. An artists’ talk will be held at 7 p.m. Sept. 4 and an opening reception between 6-10 p.m. Sept. 11. Gallery hours are 5-9 p.m. Fridays, 12-7 p.m. Saturdays and 12-5 p.m. Sundays. Visit www.margingallery.org.
August 19, 2009
Sen. Mitch McConnell’s No. 1 idea for fixing what ails our health care system is to limit the rights of those maimed by medical malpractice.
But states that have enacted curbs on what McConnell calls “junk lawsuits” have yet to see the cost savings promised by McConnell and other proponents of tort reform.
Medicare spending rose 24 percent in the three years after punitive damages were capped at $250,000, according to the Dartmouth Institute for Health Policy.
One of the most expensive health-care markets in the country is the Texas city of McAllen. Only Miami, which has much higher labor and living costs, spends more per person on Medicare.
Boston surgeon Atul Gawande visited McAllen and wrote an account for The New Yorker, “The Conundrum: What a Texas town can teach us about health care” that’s required reading for anyone trying to understand this admittedly baffling topic.
One night at dinner with six local doctors he asked why the average cost per Medicare enrollee had soared from $4,891, about the national average in 1992, to almost twice the national average of $15,000 per enrollee in 2006.
For perspective, the per capita income in McAllen is only $12,000.
Several of the physicians said doctors practiced defensive medicine to protect themselves from the city’s especially aggressive lawyers; they ordered extra tests and procedures which drive up costs.
But what about the strict limits on malpractice damages. Haven’t lawsuits gone down?
“Practically to zero,” one of the docs said.
What’s finally revealed is that doctors in McAllen are heavily invested in medical technology and imaging and surgery centers. They order lots of tests and procedures because they directly profit from them. They think of what they do as a business.
The critical choice facing this country is whether health care will continue to go the way of McAllen or whether it can be guided toward a Mayo Clinic model in which doctors work together to deliver the best care with the fewest tests and procedures.
We should all hope the Mayo model wins because the outcomes for patients are far better. Also, at the current rate, health care costs will soon eat up so much of the federal budget that this country will no longer be able to afford to defend itself.
The Texas experience with malpractice is not unique. Researchers at the University of Alabama at Birmingham surveyed 27 states that have limits on non-economic damages and discovered no savings for health care consumers.
McConnell is offering a few other of what he calls “common sense” ideas. He favors some insurance reforms, such as covering pre-existing conditions, and incentives for living a healthful lifestyle.
He also says individuals buying insurance should be entitled to the same tax deductions as companies buying insurance for their employees.
McConnell acknowledges that health care reform is necessary, but his prescription is mostly a placebo.
To read the NewYorker article, “The Conundrum: What a Texas town can teach us about health care,” go to www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande.
August 19, 2009
“Death panels” is such an excellent term. You know exactly what it means, and therefore you know you’re against them. Debate over. This term more than anything else seems to have unified the opposition to the Obama health care proposals. It fuels the anger that has essentially shut down “town hall” meetings intended for the discussion of the issues.
Of course the term is inspired by a lie. There are no conceivable plans to form “death panels” or anything like them. The Obama plan, which has some bipartisan support, doesn’t seek or desire to get involved in any decisions about who should live and who should die. But now we hear “death panel” repeated so often that the term has taken on a sort of eerie reality, as if it really referred to anything.
I think we’re all in favor of counseling and palliative care being available to the terminally ill. As a man who has been very near death myself in the last few years, I have made it clear to my wife and physicians that I have no desire for my life to be prolonged unreasonably by artificial means. To be kept alive by mechanical methods after any meaningful form of life remains to me is a horrifying thought. It would make a parody of the fullness of my life, to myself and others.
All I desire is that extreme measures simply be discontinued. This does not involve anyone “pulling the plug” on me, or having to feel responsible for my death. It means that my body is being allowed to come to the end of its natural duration, and that I will die. I am content to die. People have been doing it for long time.
It’s only in recent decades that the technology has existed to prolong the “signs of life” indefinitely. Doctors for ages have reached a point where they inform families, “there is no more that can be done.” In these modern times that is much more that can be done, but to what end? To prolong a life that has been emptied of purpose, activity, accomplishment, joy? To extend the suffering of our loved ones? To receive treatment that is potentially more expensive than everything that has gone before? What is the purpose?
Of course I am in favor of life-saving intervention when it was appropriate. Some days after my first jaw surgery for cancer, it appeared to be a success. The cancerous area had been removed, my jaw had been reconstructed using my fibula bone, the wound had been closed, my appearance was acceptable, my tongue and vocal equipment was still functional, and there was reason to believe I would be able to speak–perhaps not on television any longer, but well enough to be understood by anyone caring to try.
I was actually in the process of being returned home. My body from the neck down was perfectly healthy. Suddenly, catastrophic bleeding began. A carotid artery near the surgery site ruptured. It was sheer good chance that this happened at the hospital and not at home, where I would certainly have died.
It was touch-and-go. The bleeding seemed impossible to stop. The affected tissue had been weakened by radiation. Only within the last year has my wife informed me that at one point it appeared I had died. She sensed I was still alive, and asked the doctors to keep working. I am happy that they did. The bleeding was finally staunched, my breathing was maintained with a tracheotomy, I was in critical care, but I lived and am here today to write this.
Of course I am happy that heroic measures were made to save my life. It was still worth living. I had a sound mind in an (otherwise) sound body. I received excellent medical treatment, which we all have a right to. I had good insurance coverage. I am not willing to say that the millions of Americans who cannot afford insurance would have been left to die, but throughout the course of their lives they would have lacked much medical care they needed. And we’ve all heard stories of hospital refusing admission to people without coverage. I think it would be difficult to check into many hospitals for cancer surgery if you had no insurance.
The notion of “universal health care” does not mean “socialized medicine.” It means just what it seems to mean. America is the only developed nation on earth that does not provide it. Why does it inspire such virulent opposition? Who is behind it? It is opposed mostly from the far right, whose enthusiasm seems to be encouraged by financial support from some (not all) insurance companies. Those companies have priced American insurance out of the reach of millions.
One result has been that our national life expectancy ranks 42nd among all developed nations. We spend more on medical care than any other nation, and get less than 41 of them. These figures are pretty clear.
I don’t pretend to know if this information is available to the angry people who have shouted down their representatives at town hall meetings. I think I do know where their anger is fed. The drumbeat of far-right commentators fuels it. Their agenda is not health care, but opposition to the Obama administration. It takes the form of demonizing Obama. It uses the tactic of the Big Lie to defame him. An example of this is the fiction, “he wants to kill your grandmother.” Another is the outrageous statement that he is a racist who hates white people. A person capable of saying that is clearly unhinged and in the grip of unconditional hatred.
This brings us full circle to the term “death panels.” As nearly as I can determine, it first gained circulation when it was used by Sarah Palin. She employed it on her Facebook page. It is a term of genius, as demonstrated by how quickly it has entered into common usage.
There’s something a little…too perfect…about it. Did it spring into her mind in an instant, while she was typing away on Facebook? It has the feel of having been coined or crafted. She would have been the ideal conduit for it. As a sitting governor, it would have been inappropriate for her to make policy statements on her Facebook page. As a private citizen, she remains as visible as before, and every change on her Facebook page is subjected to minute scrutiny. Now she is reportedly adding Twitter to her means of self-expression.
These are ideal platforms. While a speech must create a context for a political claim, the nature of such net outlets allow her to toss out zingers that seem, but are not, complete ideas. If one were a right-wing strategist, one could think of no better conduit for the term “death panels” than Sarah Palin’s Facebook page. There it achieved instant publicity, and it was not what she said about “death panels” but the fact that she said it that achieved notoriety.
I’m not saying she coined the term. For all I know, it appeared for the first time elsewhere. She is responsible for its fame. Whether she coined it or heard it and merely passed it on, it rang a loud bell with her, and fit nicely into her anti-Obama agenda. What did it mean? Why should she ask? It refers in real life to policies that she herself has advocated. But her interest was not in health care. It was in Obama.
“Death panels” is an example of a meme. A meme is a word, phrase, saying, idea or belief that passes from one mind to another. The Domino Effect. Alligators in the sewers. Blondes have more fun. Tax and Spend. The New Frontier. When the going gets tough, the tough get going. Swiftboating. Where’s the beef? The King of Beers.
A meme succeeds because it survives and reproduces. It works. It has utility. It can define an issue in the desired way. It is almost impossible to refute, because it seems to open and close the subject simultaneously. Even a single adjective is fatal to it. It admits of no qualifiers: “When the going gets tough, the tough, if they want to live to fight another day, reevaluate the situation.” How’s that for a lousy meme?
I saw a documentary last year about Lee Atwater, the strategist for the Reagan and George H. W. Bush campaigns, the mentor of Karl Rove and George Bush. The man was a brilliant creator of memes. Among his coinages were “Whitewater,” which inspired a $70 million federal investigation into a $28,000 financial loss. He made “Willie Horton” a code term. He got many people to believe “Michael Dukakis opposed the Pledge of Allegiance.” He was capable of outrageous invention, as when about the Willie Horton ad he said with a straight face: “I don’t think a lot of Southerners even noticed there was a black man in that ad.”
Atwater might have been proud of “Death panels.” Those two little words have derailed the town hall meetings, by stirring up such unruly dissent that legislators have been shouted down by their own constituents. The town halls were designed to promote rational discussion of health care, a dialogue between lawmakers and their constituents. They have failed. Now those two words threaten to derail the public option provisions of the Obama plan.
Do you know what the “public option” is? It would be the establishment of a federal fund to provide health insurance for those who cannot afford it or qualify for it. I have the feeling that if Jay Leno went Jaywalking among the protesters at a town hall meeting, even among those holding signs opposing the public option, he would find few able to define the term.
If you lack insurance coverage, are you opposed to the public option? If your premiums have increased so much that you can’t afford them, do you oppose it? If you have a “preexisting condition” that disqualifies you from insurance, do you oppose it? If it would provide you with equivalent insurance at a lower cost, do you oppose it? Most Americans, even those angry people at town hall meetings, now approve of MediCare. The public option would essentially make a system like MediCare available to the general population.
Would it replace private health insurance? Not at all. It would provide an option. Who opposes it? Do the math. The insurance companies do. It would provide price competition for their extremely profitable businesses. Price competition. It’s the capitalist way. Besides insurance companies, who else opposes it? The unwavering opponents of all things Obama.
Having arrived at a qualifying age thanks to the love and care of my wife and doctors, I am writing this as the beneficiary of the excellent heath care my insurance plan covered (until my illness exhausted its provisions). I am now covered under MediCare. I continue to get the same treatment as before–and as, for that matter, all members of the U.S. Senate and House of Representatives do, no matter what their age or political party. You should try it sometime.
August 7, 2009
August 7, 2009
FDA Commissioner Margaret Hamburg, MD, vowed that the agency would be more aggressive in enforcing food and drug safety regulations and quicker to act when a company breaks the law.
In a speech at the Food and Drug Law Institute, Hamburg said that some FDA enforcement actions over the past several years have been “hampered by unreasonable delays” and that there has been a “steep decline in enforcement.”
“In some cases, serious violations have gone unaddressed for far too long,” Hamburg said. “These include violations involving product quality, adulteration, and misbranding, false, misleading, or otherwise unlawful labeling, and misleading advertising.”
The new FDA — the one Hamburg took the helm of just eight weeks ago — will be much more aggressive and visible. “The FDA must be vigilant, the FDA must be strategic, the FDA must be quick, and the FDA must be visible,” she said.
Specifically, she said, the agency will do the following:
* Create a clear timetable for companies to respond to FDA inspection findings, generally no more than 15 days after the inspection. If the company fails to respond, the agency will issue a warning letter or take other enforcement action.
* Streamline the warning letter process by limiting legal review of letters to those that might actually present major legal issues, and prioritize the follow-up process on warning letters.
* Rely more on local, state, and international officials in food safety situations that require quick action.
* Be prepared to act “swiftly and aggressively” when dealing with significant public health concerns, possibly even before a formal warning letter is issued. The agency will no longer issue multiple warning letters before dealing with a violation, Hamburg said.
* If a company has corrected whatever issues were raised in a warning letter, the FDA will publicly clear the company on its Web site. Hamburg called it a “close out process.”
By beefing up its enforcement efforts, Hamburg said the FDA will ensure that “violations are taken seriously, that warning letters and enforcement actions occur in a timely manner, and that steps are taken to protect consumers in cases where immediate enforcement action is not possible.”
Since Hamburg took the helm of the FDA, the agency has been aggressive in cracking down on the makers of misleading or potentially dangerous products.
For instance, the FDA recently issued 65 warning letters to Web sites hawking phony products that supposedly prevent, diagnose, or treat the H1N1 (swine flu) virus — including a “virus killing” shampoo. According to Hamburg, 80% of the Web sites contacted by the FDA have removed the products.
Where 10 such products were popping up every day, the FDA is now aware of about two new ones a week.
Also, the FDA last week sent warning letters to companies that sell dietary supplements containing anabolic steroids, and posted a public health advisory warning consumers to avoid body-building supplements that contain androgen, estrogen, and progestin-related ingredients.
August 3, 2009
[…] Tort reform?!?! Really? And how exactly do you propose that we hold companies liable for making decisions that cost human lives? You know what actuaries do, right? They tell Ford that statistics demonstrate only 3500 of their new model cars will explode bc of the glitch they just found.
And, since there is no way to know which ones they are, the cost of recalling ALL would be 50 million. Whereas, thanks to tort reform, the cost of letting 3500 cars explode will be a maximum of only 5 million. What decision do you suppose they will make? Please, shareholders would sue the living tar out of any officers who chose to spend 50 million when they could have spent 5! Putting a cap on human life or injury is always a bad idea. Anyone who says otherwise need only consider their son or daughter in the exploding car.
When we are making decisions to limit the financial accountability a company may face, we must ALWAYS remember that money is the ONLY method we have to keep them in check. Business is amoral, necessarily so. In our country, healthcare is a business, so the same is true. Tort reform fails to consider this reality, thereby GUARANTEEING families will lose their fathers, and mothers; parents will watch their children die because it is cheaper for companies than recalling defective products.