Archive for Medicine

Apartheid State Update

Another in the occasional briefs on Israel’s official, stated policy of treating Palestinians as some sort of lesser being. [For those blind to irony, duck! That was a big, steaming pile heading right at you.]

Today, December 11th 2009, a newborn baby girl suffering from a heart condition was transferred to the Tel Hashomer hospital in Israel from the Nasri Children’s Hospital in the Gaza Strip for immediate medical treatment.

The Head of the DCO in Gaza, Col. Moshe Levi said: “The District Coordination Office routinely coordinates and absorbs the many patients that are transferred from the Gaza Strip into Israel for medical treatment. This incident is an example of the many incidents that the DCO deals with on a daily basis and acts to help and save human lives in the humanitarian framework of the State of Israel. We view this with much importance and concentrate many efforts in the humanitarian realm and the transfer of patients from the Gaza Strip to Israel for medical treatment.”

In 2009, ten thousand sick patients and their escorts were able to leave the Gaza Strip in order to receive medical treatment within Israel and the Judea and Samaria region.

Yes, yes, very charitable, we’re sure. But we all know Israel does this sort of thing only to harvest the organs of Palestinian children. [See irony warning above.]

Ten thousand patients? And have we been told about a single one on the evening news or in the pages of the major newspapers? [No irony here, if you’re unsure.]

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About That AMA Endorsement [UPDATED]

Not so fast, doc:

Some AMA members are outraged that the group’s trustees made the endorsement without the formal approval of the organization’s House of Delegates.

The American Medical Association’s much-touted endorsement of the House health care reform bill has triggered a revolt among some members who want the endorsement withdrawn.

Some members are outraged that the group’s trustees made the endorsement without the formal approval of the organization’s House of Delegates.

On Monday, delegates will vote on a resolution offered by some members that, if approved, will withdraw the AMA’s endorsement of the bill.

Needless to say, I just listened to an NPR report in which the AMA’s endorsement (as well as AARP’s) got high billing. Curiously, the same report said that it was unlikely that the bill would get bipartisan backing—without noting that the opposition is plenty bipartisan, if that’s actually a benchmark of anything.

And anyone with half a brain (sadly, that excludes Democrats) knows that the AARP has been bought off, anyway:

AARP’s seal of approval provided welcome cover for conservative lawmakers, many of whom have long desired a Medicare overhaul but were afraid to risk the wrath of seniors. Now they could vote for a bad bill and tell older constituents that it was okay with the nation’s largest organization of older people.

Why would AARP, with 35 million members over 50 years old, support Medicare legislation that does more harm than good? In its defense, AARP denies that the law threatens the traditional Medicare program in any way. The organization believes it was “important to establish a Medicare drug benefit,” even if the law isn’t “perfect.”

The watchdog group Public Citizen thinks there may be other reasons for AARP’s support. After doing some research, it found that, in many ways, AARP is more of a business than an organization of and for seniors.

According to Public Citizen, AARP derives about 60 percent of its annual revenue from the sale of health care products (membership dues make up only 29 percent of AARP’s income). It sells insurance plans underwritten by such companies as UnitedHealthcare and MetLife, markets them to members under AARP’s name, and is paid royalties for each policy sold.

In addition to health insurance, AARP sells mail-order prescription drugs and offers prescription drug discount cards. AARP also sells its membership lists and advertising space in its magazines to pharmaceutical and health insurance companies.

Yes We Ca-ching!

It’s not personal, geezers, it’s business.

UPDATE
Soon to come: retirement homes, with bars!

Today, Ranking Member of the House Ways and Means Committee Dave Camp (R-MI) released a letter from the non-partisan Joint Committee on Taxation (JCT) confirming that the failure to comply with the individual mandate to buy health insurance contained in the Pelosi health care bill (H.R. 3962, as amended) could land people in jail. The JCT letter makes clear that Americans who do not maintain “acceptable health insurance coverage” and who choose not to pay the bill’s new individual mandate tax (generally 2.5% of income), are subject to numerous civil and criminal penalties, including criminal fines of up to $250,000 and imprisonment of up to five years.

Move over Bloods, Crips, and MS-13—here come the Welks.

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Shortness of Breath

Offered without comment:

The UK Lung Cancer Care Coalition, an umbrella group composed of doctors, charities and private health firms, says UK care lags behind Europe.

It says too few patients are receiving treatment, such as chemotherapy or surgery, because of staff shortages.

The government says it already recognises that more needs to be done to improve lung cancer services.

The report says in some parts of the UK, as few as 10% of patients are receiving any form of treatment and nationally the figure is only 51%.

One of the major problems is a lack of access to surgeons - there are only 44 full-time positions for more than 240 separate teams.

The shortfall means that some patients who would be eligible for treatment are being turned down, the report adds.

Five-year lung cancer survival rates are still below 9% in the UK, compared with 12.3% across Europe on average.

Both are significantly lower than America’s five-year survival rate.

For now.

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Cure Breast Cancer—Ask Me How!

The Palestinian cure: get yourself a man!

Fatenah, which tells the fictional story of a young seamstress from a Gaza refugee camp, is the first commercial Palestinian animation film ever made.

The heart-wrenching tale follows Fatenah’s pain and humiliation as she struggles to leave Gaza for treatment after finding few Palestinian doctors willing to help.

At first, one doctor suggests she loosen her bra, while another says her condition will probably go away once she marries. It takes six months for Palestinian doctors to treat her concerns seriously and diagnose her with breast cancer.

Fatenah becomes tied up in Israeli and Palestinian bureaucracy, denied treatment until it is too late. It is a devastating tale that Habash said is not unique.

“The Shata refugee camp, which exists in Gaza … represents any refugee camp and [Fatenah] could be any woman,” he said. “The story could happen again.”

I find it curious how Palestinian health care (or lack thereof) sounds like the National Health Service, or any other government-run health plan.

But that’s for another time. I didn’t know (but should have guessed) that the Palestinians were just as backward about breast cancer as they are about pretty much everything else.

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Bring on the Men in White Coats

When I joked yesterday that the White House photo (fl)op with all the doctors in white coats could have been staged, I was damned near right:

President Obama yesterday rolled out the red carpet — and handed out doctors’ white coats as well, just so nobody missed his hard-sell health-care message.

In a heavy-handed attempt at reviving support for health-care reform, the White House orchestrated a massive photo op to buttress its claim that front-line physicians support Obama. …

The physicians, all invited guests, were told to bring their white lab coats to make sure that TV cameras captured the image.

But some docs apparently forgot, failing to meet the White House dress code by showing up in business suits or dresses.

So the White House rustled up white coats for them and handed them to the suited physicians who had taken seats in the sun-splashed lawn area.

If the lab coats were fake (did they say Casey, Kildaire, and Welby on them?), isn’t the next revelation that the doctors were also frauds? Or even human? They can do incredible things with styrofoam these days.

How long before President Obama trots out Professor Irwin Corey to promote his education reform?

“Why do I wear tennis shoes? That’s a diffficult question, so to make it easier I’ll divide it into two parts. First: Why? Why is a question of incredible depth and subtlety, one that has engaged and frustrated the great philosophers from Socrates up through the modern age. To even attempt to answer would be to insult this great and brilliant tradition by suggesting that someone like myself deserves to be among their august company even for the briefest moment. Now, as for the second part of your question: Do I wear tennis shoes? Yes.”

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Our Dysfunctional Health Care System

Under President Obama, we can expect to see very little more of this:

AMERICANS Elizabeth H. Blackburn, Carol W. Greider and Jack W. Szostak won the 2009 Nobel Prize in medicine on Monday for discovering a key mechanism in the genetic operations of cells, an insight that has inspired new lines of research into cancer.

Yeah, but only rich white people get cancer, right? So, they’re only looking out for themselves. It’s more important for an illegal Guatemalan alien to get his annual physical and for granny to take one in the back of the head than it is for American doctors to lead the world toward a cure for cancer.

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First, Do No Harm

Like many of you, I’m sure, talk of “health care reform” (ditto “education reform”) is enough to make me spin my radio dial from NPR to anything else, even the ethnic station on AM that plays Slovakian pop.

But we probably have to start paying attention.

So I went to the horse’s mouth (must resist urge to refer to him as other end…):

I have made a firm commitment that health care reform will not add to the federal deficit over the next decade. To keep that commitment, my Administration has already identified how to pay for the historic $635 billion down payment on reform detailed in our budget. This includes over $300 billion that we will save through changes like reducing Medicare overpayments to private insurers, and rooting out waste in Medicare and Medicaid.

However, any honest accounting must prepare for the fact that health care reform will require additional costs in the short term in order to reduce spending in the long-term. So today, I am announcing an additional $313 billion in savings that will rein in unnecessary spending, and increase efficiency and the quality of care – savings that will ensure that we have nearly $950 billion set aside to offset the cost of health care reform over the next ten years.

Hey, sounds great! Reducing overpayments, rooting out waste—count me in. Reduce away; root out at your earliest convenience.

What else?

These savings will come from commonsense changes. For example – if more Americans are insured, we can cut payments that help hospitals treat patients without health insurance. If the drug makers pay their fair share, we can cut government spending on prescription drugs. And if doctors have incentives to provide the best care instead of more care, we can help Americans avoid the unnecessary hospital stays, treatments, and tests that drive up costs.

Uh-oh.

I detect the double whammy of ignorance and intimidation.

We covered the ignorance part months ago, but here’s a reminder:

Thousands of newly insured Massachusetts residents are relying on emergency rooms for routine medical care, an expensive habit that drives up healthcare costs and thwarts a major goal of the state’s first-in-the-nation health insurance law.

The 2006 law requires nearly everyone to have health insurance, coverage the law’s framers hoped would ease overuse of ERs as the newly insured went instead to primary care doctors for non-urgent health needs.

Drug makers pay their fair share? Three members of my family take daily prescription medication, and this guy—sorry, President this guy—wants to start d**king around with their bottom line?

Medical industry executives, meet Chrysler investors: make sure you ask to see their scars.

Let’s ask ‘em:

Hospitals and other medical-industry groups are pushing back against President Barack Obama’s proposal to cut $313 billion in government health spending as the White House intensifies its effort to revamp the nation’s health system.

The sharp response from the hospital industry, which under the proposal faces reductions in subsidies exceeding $100 billion over 10 years, illustrates the administration’s challenge in winning the deep concessions from industry needed to pay for the overhaul. After agreeing in May to contribute to a $2 trillion reduction in health spending over 10 years, the hospital industry is now bristling at the prospect of more givebacks — this time, cuts that would be set in law.

“We’re certainly disappointed,” said Rich Umbdenstock, chief executive of the American Hospital Association, an industry group. “It will be very, very difficult for hospitals to live with cuts of that magnitude.” He said what concerns the group is that the cuts were being laid out before lawmakers have agreed on concrete proposals for reducing the number of uninsured.

But passing laws without reading the bill is what Congress does.

BTW, we in Massachusetts are not the only model for Obama to copy:

New York City offers a window into what could happen when payments to safety-net hospitals are cut. Already running at a deficit, the city’s public hospital system is looking at $150 million in state Medicaid cuts for next year. Next month, it will close some outpatient services, such as community-based primary and preventive-care offices.

Need an MRI?

The Access to Medical Imaging Coalition, which represents makers of medical-imaging equipment, said the administration’s proposed cuts “will impair access to diagnostic imaging services and result in patients’ delaying or forgoing life-and-cost savings imaging procedures.”

And if you think you can just self-medicate until this national nightmare passes, think again:

The pharmaceutical industry recently has been negotiating with the White House and Congress over how much it would contribute to the cuts, said several people familiar with the negotiations. Drug companies were initially asked to contribute $100 billion over the next decade, but pressed for their contribution to be closer to $60 billion, they said. The industry argued that giving up too much in payments would cut into spending to develop new drugs.

“Otherwise we might all just become generic drug companies,” said one industry official familiar with the talks.

Great. We’ll be reduced to pushing our carts up and down the aisles of Rite-Aid, tossing in generic Chemotherapy bottles.

pill

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Walking on Eggshells

I’ll confess to a certain ambivalence. DDT would solve a lot of problems in Africa. It would create more than a few, no doubt—but it would solve a whole lot more.

You want to explain it to them?

malaria

In 2006, after 25 years and 50 million preventable deaths, the World Health Organization reversed course and endorsed widespread use of the insecticide DDT to combat malaria. So much for that. Earlier this month, the U.N. agency quietly reverted to promoting less effective methods for attacking the disease. The result is a victory for politics over public health, and millions of the world’s poor will suffer as a result.

The U.N. now plans to advocate for drastic reductions in the use of DDT, which kills or repels the mosquitoes that spread malaria. The aim “is to achieve a 30% cut in the application of DDT worldwide by 2014 and its total phase-out by the early 2020s, if not sooner,” said WHO and the U.N. Environment Program in a statement on May 6.

Citing a five-year pilot program that reduced malaria cases in Mexico and South America by distributing antimalaria chloroquine pills to uninfected people, U.N. officials are ready to push for a “zero DDT world.” Sounds nice, except for the facts. It’s true that chloroquine has proven effective when used therapeutically, as in Brazil. But it’s also true that scientists have questioned the safety of the drug as an oral prophylactic because it is toxic and has been shown to cause heart problems.

Most malarial deaths occur in sub-Saharan Africa, where chloroquine once worked but started failing in the 1970s as the parasite developed resistance. Even if the drugs were still effective in Africa, they’re expensive and thus impractical for one of the world’s poorest regions. That’s not an argument against chloroquine, bed nets or other interventions. But it is an argument for continuing to make DDT spraying a key part of any effort to eradicate malaria, which kills about a million people — mainly children — every year. Nearly all of this spraying is done indoors, by the way, to block mosquito nesting at night. It is not sprayed willy-nilly in jungle habitat.

It’s no coincidence that WHO officials were joined by the head of the U.N. Environment Program to announce the new policy. There’s no evidence that spraying DDT in the amounts necessary to kill dangerous mosquitoes imperils crops, animals or human health. But that didn’t stop green groups like the Pesticide Action Network from urging the public to celebrate World Malaria Day last month by telling “the U.S. to protect children and families from malaria without spraying pesticides like DDT inside people’s homes.”

Okay, so cancel that order for DDT, and place a new one for Advil. ‘Cause that’s all they’re going to get.

[Editor’s note: I debated posting a picture I found of of a sick African child dying of malaria, but I think you get the point without it.]

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This Won’t Hurt a Bit

Talk about no good deed going unpunished:

There has been a 15 percent rise in the number of Palestinian patients whom Israel has interrogated and forced to provide information on Hamas or to serve as spies as a precondition to leaving Gaza for medical care, Physicians for Human Rights-Israel plans to tell the UN in Geneva on Monday.

According to the NGO, the proportions of applicants interrogated at the Erez crossing to northern Gaza rose from 1.45% in January 2008 to 17% in January 2009.

Uh-oh. Bad Israel!

Prime Minister Binyamin Netanyahu’s spokesman Mark Regev responded to the Physicians for Human Rights report, saying on Sunday it was obvious that people entering Israel from the Gaza Strip needed to be checked because of security considerations.

“There are unfortunately countless examples of people who have asked to come into Israel for medical reasons, and who have been exploited by terrorists,” Regev said. There has been a systematic exploitation by terrorists of medical requests.

Nevertheless, Regev said, “more than 13,000 Palestinians have come into Israel from the Gaza Strip for medical treatment, and the idea that Israel makes medical treatment contingent on intelligence cooperation is ludicrous.”

I don’t see why, but that’s just me.

Israel is providing medical care to the flea-bitten population of Gaza (”Paging Dr. Egypt, Dr. Egypt, please pick up the white courtesy telephone.”) and the UN sees it as an opportunity to stage an Inquisition.

I’m not surprised; I’m not even outraged. But I won’t shut up about this sort of crap. The UN probably knows how FOS it is—but it also knows that quantity of bogus accusations eventually outweighs quality. Just throw it against the wall and see what sticks.

PS: Just heard the BBC’s radio coverage of this story, and they elaborated every detail of the accusations. At the end, in an audible sneer, the announcer included not the categorical denial I quoted above, but something more like a justification. If that’s all about the story one knew, they would know less than half the story, none of it Israel’s.

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Palestinians are Not Good for Children and Other Living Things

Sometimes it’s hard to see humanity in an enemy that does its best to suppress that trait. You’d like to think Palestinians love their children, for example, but it’s hard to believe so when they put them in harms way so often—intentionally and purposefully—and teach them nothing but hate.

They don’t even care when their children get sick. They’re just not like you and me:

Hundreds of Palestinian patients have been trapped in the Gaza Strip, unable to travel abroad for crucial treatment for cancer and other diseases, because of political infighting between Gaza’s Hamas rulers and their Palestinian rivals.

Eight Gazans who were waiting to travel abroad have died since the crisis began in March, when the dispute shut down a medical referral committee that helps sick residents find treatment outside of Gaza, according to the World Health Organization.

Others are hanging on, waiting. Ten-year-old Ribhi Jindiyeh, a lymphoma patient, lies in bed at home, skinny and jaundiced, too weak to move. He underwent chemotherapy last year in an Israeli hospital, and when he returned home in January, he seemed better. But in March, he began urinating blood.

Gaza doctors can’t find the problem and give him infusions every two days to keep him alive.

Now, I’m no doctor, but… well, you get the point.

But, of course, even among the Palestinians, the people I condemn as inhuman, there is humanity:

“I want everybody to help my son - Israel, Fatah, Hamas, whoever,” Nevine said. “If they can’t help a sick child, who can they help? They should all pack up their bags and go home.”

Say that again, will you please: “If they can’t help a sick child, who can they help?”

Our Declaration of Independence declares:

That whenever any Form of Government becomes destructive of these ends [the rights of life, liberty, and the pursuit of happiness], it is the Right of the People to alter or to abolish it, and to institute new Government, laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness.

If Palestinian government can’t help a sick child, it is the right (and duty) of the Palestinians to alter or abolish it. There you go, Palestinians, free of charge.

Alas, they’re likely instead to get more of this:

And in late January, the West Bank government halted payments for medical care in Israel, saying the treatment was too expensive. Fatah health officials said they would only pay for Gaza residents to obtain cheaper medical care in Egypt.

In Gaza City, 12-year-old Mohammed Zibdeh, a brain cancer patient, waits for a permit to travel, breathing with the assistance of a ventilator device in his throat. Last year, doctors in an Israeli hospital worked to shrink his brain tumor with chemotherapy. Now Zibdeh has constant headaches, and his father, Riyad, 48, fears the tumor is growing back.

“I can’t help him, and he might be dying before my own eyes,” he said.

Aggie and I are both parents, and we hate, hate the Palestinians, or at least what they do. But I think I can speak for her when I say that our hearts melt for Riyad Zibdeh and his son Mohammed.

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