While driving back from San Diego on Wednesday and cleaning up my apartment on Thursday, I listened to a lot of talk and news radio. I also watched a lot of CNN in my hotel while looking for apartments. There were a few items that struck me for one reason or another, and I'm having a mellow evening in tonight, so I thought I'd share.www1.va.gov
1) California Health Care -- Some minor conservative bloviatrix was going off on how horrible the legislature's and guber-nator's new plans for expanded/mandatory health care were. When, she asked, has the government ever run a good health care system?
Kudos to the veteran who called in and shut her up with tales of his excellent experiences at the VA. I've worked at VA's and, in general, they provide good care. Many are associated with teaching hospitals, and therefore have faculty, residents, and students from first rate universities. Also, most people who work at VAs could earn more money elsewhere -- but it's hard to imagine anything more rewarding than treating people who defended this country, with the possible exception of treating those who are still on the front lines.
By the way, the biggest knock on the VA system is that there is often a wait for procedures. Guess what -- that's what happens in a system where things are rationed. In the national health care system (or lack thereof), its the largely voiceless poor who have to wait, because we ration on wealth, privilege, and insurance.
For the record, Medicare is also a highly efficient health system, at least by administrative standards. Medicare overhead is only 2% of costs, comparted to >10% in private insurance plans. My biggest problems with Medicare: (1) the unnavigable perscription plan and (2) when the government picks up the tab at 65, there is no incentive for insurance companies to pay for long term preventative measures.en.wikipedia.org
2) Kareem Abdul Jabar was on a news channel promoting prostate cancer awareness. Great. Then he told everyone to go out and get a PSA checked. Not so hot. Loathe though I am to dispute the omniscience of a celebrity, in this case I prefer the recommendations of the US Preventative Health Service Task Force (you can google it). Neither digital rectal exam (with the snapping glove noise) nor PSA has clearly been shown to decrease mortality as a screening technique. They are probably best used in males over 50, and perhaps African-American males over 45. As with most medical techniques, they are best performed in collaboration (pun completely intended) with a primary care physician who knows your medical history.
Next time you have a basketball star discuss health care, have him or your staff do a little research. And get Dr. J.www.thebreastcancersite.com
3) The rate of detection of breast cancers dropped. Read that sentence carefully. We are DETECTING fewer. It remains to be seen if there actually ARE fewer, or, more importantly, if fewer women are/will die from breast cancer. I am hopeful that this is good news, but don't get too excited yet. Most of the effects are attributed to the decreased use of hormone replacement, which appeared to speed the growth of some cancers. If, without hormone use, we merely find the cancers later, it may or may not be a good thing. I'm crossing my fingers, though, that some lives are being saved.
4) I feel bad for Dr. Laura's son. I believe I've mentioned that I listen to Rush and Dr. Laura as part of my "liberal recon". Usually, I find them hysterical in a "Theatre of the Absurd" kind of way. Sometimes, I hear some points that allow me to better prepare for arguments with the right wing. Occasionally, to my surprise, we agree on something. Sympathy, however, was new.
Laura Schlessinger, PhD (physiology), opens most segments of her show with some form of "I'm Dr. Laura Schlessinger, proud mother of an American Solder...Hooah!". So proud that, in answering a caller, she mentioned that her greatest regret in raising her son was that she hadn't home schooled him. Imagine that you are her son, and you hear this. I'd be sitting there wondering what defect my allegedly proud mother had seen in me that made her wish I'd been schooled differently.
You may say that this is a needlessly harsh way for him to take such a comment, but many young (and some older) people hear it exactly thus. (The truth of this was highlighted to me in a conversation the other night.) The fact is, there is no control experiment for our lives. If she's proud of who he is, she's stuck with how he got there. My parents occasionally expressed comparable feelings about things they've done, and I about things they "did to" me. Regrets are a part of human nature, but I think it's safe to say you needn't tell your child, and you shouldn't tell a national radio audience.
By the way -- I don't know Deryk Schlessinger well enough to be proud of him, but I am grateful for his service and protection.www.state.sd.us
5) "It wasn't a stroke or a heart attack." Sorry, this is an deceitfully consoling statement when the person had an intra-cranial hemorrhage, one of the few things more dangerous than either. It's a bit like saying "He wasn't hit be an M-16 or an AK-47" when you know God Damn well it was Howitzer! Trust me -- the last time I was around a brain hemorrhage, I ran the code and took care of the gentlemen for the first of his months in the ICU.
The comment was made, of course, in reference to Sen. Tim Johnson of South Dakota. For those who aren't following politics, the senate is currently split 49 Democrats, 49 Republicans, and 2 Independents, who by caucusing with the Democrats give them control. If Sen. Johnson were to be replaced by a Republican, the caucus numbers would be 50-50, with the tie-breaking vote going to Vice-President Cheney, effectively giving the Republicans the majority back.
One conservative commentator actually began to discuss the options if "Sen. Johnson were incapacitated, or God forbid, to die..." Fine by him if God allows incapacitation -- how nice. The political issue is that by SD law, the governor, who is a Republican, would get to appoint a replacement if the need arose. Conventional wisdom is that he would appoint a Republican. The commentator actually suggested that Sen. Harry Reid would somehow force Sen. Johnson to stay alive on a respirator, if needed, to keep him alive and prevent a Republican appointment. Didn't the Terry Schiavo case teach these people to stay out of health care?
By the way, I'm hoping for something that seems a given in the politics of a republic, but is tragically rare in the US. That would be someone giving a shit about actual representation. The people of South Dakota elected a Democrat -- so it seems he should be replaced with a democrat. "But they elected a Republican governor, so they must have wanted any replacements to be Republicans!", you cry. Um...right. I've got you twice on this one: (1) I guarantee you that no one was thinking about Senatorial brain hemorrhages when they voted for governor and (2) the best data to show what South Dakotans want in a federal legislator would be the 2006 election, where they sent and incumbent Democrat back to the House of Representatives.
In truth, the appointment I have the most respect for in these cases is the Congressman/woman's spouse -- as in Missouri when Jean Carnahan replaced her husband. Really, what you should want is someone whose actions/representation would be closest to the deceased legislator. Who better than their spouse, who is usually (Clinton's aside) not someone with specific political aspirations of their own?
I think the increase in hits on my blog the past couple of days has to do with my pending guest appearance on Dan-Nation. I'm a little nervous, but looking forward to it. I hope you'll join us -- and continue to check in on my blog occasionally. Have a great night -- I'm off to research a few of the early questions.