His dramatic return this week to cast the deciding vote for a crucial Medicare bill brought tears and cheers in the US Senate, even as some medical ethicists question Ted Kennedy’s decision to undergo life-prolonging (and expensive) surgery, chemotherapy and radiation.
On the New York Times Freakonomics blog, an internist involved in public health issues suggests Sen. Kennedy might have issued this statement instead:
“Because I am not a young man, the cancer in my brain will progress rapidly and is likely to incapacitate me in the near future. I trust that my doctors will do everything they can to prevent further seizures and to keep me in comfort. I will not endure extraordinary excess pain and suffering, while hundreds of thousand of dollars will not be spent on surgical debulking, radiation, and chemotherapeutic regimens which do not work.
“Modern medicine cannot cure my cancer, but it can keep me comfortable and free of pain. I have already contacted the Massachusetts General Hospital Hospice program.”
If such a suggestion seems heartless, it nonetheless reflects a crucial debate that has started about end-of-life care, which accounts for a significant percentage of Medicare expenditures.
Having failed to privatize Social Security, the Bush Administration is trying to wreck Medicare on its way out the door, but MDs are mad as hell, and they’re taking it out on Congressional Republicans.
The focus this week is on trying to undo a 10.6 percent cut in payment to care providers for millions of older Americans. Before the Fourth of July recess, the House passed a bill to prevent the Medicare pay cut by a vote of 355 to 59. In the Senate, Republicans blocked efforts to take up the bill, so the cut took effect on July 1st.
Now the AMA and its incensed members are targeting such former friends as Sens. John Sununu, Roger Wicker and Arlen Specter, who all voted against cloture.
As with the SCHIP legislation to expand children’s health care coverage, Bush and his allies are favoring the insurance industry over a government program that is working well for those who need it most.
If the new reimbursement rates were to stand, more doctors would be joining the legions of those who refuse to take on Medicare patients as economically unsound for their practices.
Perhaps the next step would be the “Ice Floe HMO” solution favored by one in three British doctors who would deny treatment to the old “if it were unlikely to do them good for long.”
Unless Republicans relent, as they almost surely will, members of the AARP are certain to send them a don’t-get-well message in November.
Syndicated columnist Bob Novak, writing about the surprising number of conservatives who are backing Democrat Barack Obama rather than Republican John McCain for the presidency, captured their widespread sentiment when he quoted one "Obamacon" with impeccable GOP credentials: "The Republican Party is a dead rotting carcass with a few decrepit old leaders stumbling around like zombies in a horror version of ‘Weekend at Bernie,’ handcuffed to a corpse." These Obama supporters hold no illusions about Obama’s liberalism, but they are so angry at the GOP, Novak writes, that they seek a "therapeutic electoral bloodbath."… [I]n a two-party system, when one party screws up royally, the voters reward the other party.’
(OC Register; emphasis added)
It’s actually quite affirming that some conservatives have decided to rebel against what the Bush administration and its abettors and enablers and are prepared, in the best traditions of democracy, to throw the rascals out.’
Because ‘conservative’ sure doesn’t mean what it used to. It doesn’t actually even mean ‘conservative’ anymore.
Obama has clarified his supposed opposition to allowing a woman to have a late term abortion in circumstances when the pregnancy causes the mother mental distress. (The Swamp) He does not think mere ‘mental distress’ is a reason to permit such an exception.
According to Linda Douglass, the Obama campaign’s senior spokesperson, the senator from Illinois was making a distinction in the magazine interview between medically diagnosed mental illness and the kind of mental distress that an unwanted pregnancy causes many a pregnant mother. (The Swamp)
He does think such an exception should be permitted in circumstances in which there is medically diagnosed mental illness — a position that still doesn’t please either side of the abortion argument. (The Swamp)
It turns out that while making the cycling video (thanks for the kind comments and emails!) I was bit by a spider. That bite turned into an adventure in itching the likes of which I had not endured before, but not near as bad as the shocking story of “M” told in this week’s New Yorker.
Though scratching can provide momentary relief, it often makes the itching worse. Dermatologists call this the itch-scratch cycle. Scientists believe that itch, and the accompanying scratch reflex, evolved in order to protect us from insects and clinging plant toxins—from such dangers as malaria, yellow fever, and dengue, transmitted by mosquitoes; from tularemia, river blindness, and sleeping sickness, transmitted by flies; from typhus-bearing lice, plague-bearing fleas, and poisonous spiders. The theory goes a long way toward explaining why itch is so exquisitely tuned. You can spend all day without noticing the feel of your shirt collar on your neck, and yet a single stray thread poking out, or a louse’s fine legs brushing by, can set you scratching furiously.
But how, exactly, itch works has been a puzzle. For most of medical history, scientists thought that itching was merely a weak form of pain. Then, in 1987, the German researcher H. O. Handwerker and his colleagues used mild electric pulses to drive histamine, an itch-producing substance that the body releases during allergic reactions, into the skin of volunteers. As the researchers increased the dose of histamine, they found that they were able to increase the intensity of itch the volunteers reported, from the barely appreciable to the “maximum imaginable.” Yet the volunteers never felt an increase in pain. The scientists concluded that itch and pain are entirely separate sensations, transmitted along different pathways.
Despite centuries spent mapping the body’s nervous circuitry, scientists had never noticed a nerve specific for itch. But now the hunt was on, and a group of Swedish and German researchers embarked upon a series of tricky experiments. They inserted ultra-thin metal electrodes into the skin of paid volunteers, and wiggled them around until they picked up electrical signals from a single nerve fibre. … When they introduced a tiny dose of histamine into the skin, however, they observed a sharp electrical response in some of these nerve fibres, and the volunteer would experience an itch. They announced their discovery in a 1997 paper: they’d found a type of nerve that was specific for itch.
Unlike, say, the nerve fibres for pain, each of which covers a millimetre-size territory, a single itch fibre can pick up an itchy sensation more than three inches away. The fibres also turned out to have extraordinarily low conduction speeds, which explained why itchiness is so slow to build and so slow to subside…
Now various phenomena became clear. Itch, it turns out, is indeed inseparable from the desire to scratch. It can be triggered chemically (by the saliva injected when a mosquito bites, say) or mechanically (from the mosquito’s legs, even before it bites).
And with that the article goes on to explore a fascinating new scientific understanding of perception.
Whenver I hear either of our presidential candidates shouting about health care reform I get a prickling senstion in my palms and a pronounced tic in my left eye. It’s not that we don’t have a need for health care and insurance improvements in our country - clearly there is work to be done. But I’ve been watching and participating in elections since Nixon’s day and all too often I’ve gawked as our Federal government’s well intentioned but ham handed attempts to “fix things” turn into a case of Ferdinand the bull trampling the flowers he was attempting to sniff.
I had another of those queasy sensations reading Lady’s Logic this morning, with a tale of woe from Barbara Wagner, a woman in Oregon suffering from cancer, who had to face off with the medical community.
Last month her lung cancer, in remission for about two years, was back. After her oncologist prescribed a cancer drug that could slow the cancer growth and extend her life, Wagner was notified that the Oregon Health Plan wouldn’t cover it.
It would cover comfort and care, including, if she chose, doctor-assisted suicide.
I would not blame our loyal readers if you thought that, by following the link above, you were about to either be Rickrolled or sent to The Onion, but the story is real. And it goes downhill from there. As the Lady Logician herself points out:
According to administrators of the state run plan, treatment of advanced cancer that is meant to prolong life or change the course of the disease is not covered. Excuse me….isn’t that why we WANT health care….to prolong our lives and change the course of diseases? No???? Silly me - what was I thinking????
This isn’t a case of bad doctors. This is a system following rules meant to improve the process which wind up veering off into realms better suited to science fiction. Follow the links and read on, my friends. Reality truly trumps cinema today.
June 4th, 2008 By SWARAAJ CHAUHAN, International Columnist
A drug based on an ancient Chinese herbal remedy, first used more than 2,000 years ago, holds the promise to save millions of children who die each year from malaria. “Within two years there might be enough supplies to meet the needs of everyone in the world suffering from malaria – up to 500 million people – at a 10th of the cost of existing drugs.” More here…
Three years after posturing over Terri Schiavo’s right to be kept alive after brain death, members of Congress are faced with real end-of-life questions in proposed legislation to force the FDA to speed up its drug-approval process and give terminally ill patients access to investigative drugs.
Last week they had to look into the eyes of a 12-year-old Maryland girl with inoperable liver cancer as her mother pleaded on her behalf.
“Finding help for a sick child should be easy, but it isn’t,” said Anna Tomalis’ mother, who told them her daughter had been turned away from drug studies because she is not healthy enough. “For Anna, time is running out. She doesn’t have years to wait for these drugs to become available.”
The new bill is sponsored by Kansas Republican Sen. Sam Brownback and California Democratic Rep. Diane Watson. “What we need is a system that looks at the patient and their life-or-death situation, not at a bureaucracy and its needs,” says Brownback, a melanoma survivor. “This is deadly neglect, and it can’t continue.”
From the other end of the political spectrum, Rep. Watson cites the grass-roots movement that demanded experimental drugs for terminally ill AIDS patients, arguing that “anyone whose diagnosis amounted to being handed a death sentence” should “have an opportunity to try these drugs.”
Joke: Two computers got married. They had a baby computer. What was the baby computer’s first word?
“Data…”
Reality: A computer has now been “trained” to read peoples’ word images — which could be a boon to political consultants wanting to get into voters’ heads. And you think politicians pander a lot NOW..?
A computer has been trained to “read” people’s minds by looking at scans of their brains as they thought about specific words, researchers said on Thursday.
They hope their study, published in the journal Science, might lead to better understanding of how and where the brain stores information.
This might lead to better treatments for language disorders and learning disabilities, said Tom Mitchell of the Machine Learning Department at Carnegie Mellon University in Pittsburgh, who helped lead the study.
“The question we are trying to get at is one people have been thinking about for centuries, which is: How does the brain organize knowledge?” Mitchell said in a telephone interview.
Many Americans are unaware that most of the world considers Washington’s decades-old blockade and general treatment of Cuba to be - if not a war crime - certainly a case of human rights abuse.
For those interested in sampling the general mood, this article written by a former member of the Mexican Congress is a good place to start.
“As he has done repeatedly, U.S. President George W. Bush - so discredited in his own country and in some ways bordering on mental retardation - persists in harassing the Cuban people under the ridiculous pretext of advocating liberty in that nation, which has for almost half a century endured terrorist attacks financed and supported from the highest spheres of the U.S. government.”
“Years before they popularized the concept of weapons of mass destruction so hypocritically applied against the enemies of the empire (Saddam Hussein is the best illustration of this), U.S. leaders used such weapons against the island. From U.S. military laboratories along the Panama Canal, originated biological cultures destined to contaminate pig farms, destroy Cuban foodstuffs and reduce resistance from the people with hunger. What is was, then, was an attempt to punish Cubans for supporting the Revolution. In a broader context, what better example of the use of weapons of mass destruction is there than the U.S.-imperial economic blockade of Cuba?”
“although the conditions imposed by economically powerful U.S. interest groups will try to bind the hands of the next president of that country, the truth is that with the approach of almost-Democratic-candidate Barack Obama, the situation can turn and give way to a stable relationship between the two countries. Rebuilding U.S. relations with Latin America is necessary for us and for the U.S. itself, and this will be impossible without rebuilding relations with Cuba. Already John McCain, in an attempt to discredit Barack Obama, has accused him of lacking expertise in international affairs. This remains to be seen; but the truth is that the Republicans - and especially Bush - are expert only in leading their people into wars they cannot win.” Read the rest of this entry »
May 22nd, 2008 By DR. CLARISSA PINKOLA ESTÉS, Assistant Editor, TMV Columnist
Most every night, I stay up late-late, long after everyone else is sleeping. I fly over the internet, looking, looking, trying to find something beautiful or restorative to share with you here at TMV, so either you go to sleep with a beautiful idea or image, or wake up with one.
Tonight, finding something beautiful in this wide and groaning world, was easy. Because there is Jiang Xiaojuan, a young provincial policewoman.
Jiang is 29 years old and is the young mother of a little baby herself. Her child is under six months old, and is still being breastfed.
When the earthquake that killed over 50,000 people in China occurred, Jiang’s town was devastated. She put on her uniform and went out looking to help. She first found one weeping baby, and then another young infant… and took them to her breast.
She now is nursing five orphan infants whose mothers died in the earthquake. And she is nursing four other newborns whose mothers are homeless and traumatized… when a nursing mother is severely shocked, her milk flow, you might say, is shocked too and can stop flowing.
As a mother who nursed til her offspring was practically old enough to go to school, and as the mother of a grown daughter who while nursing her own child also gave her nourishing milk to my ailing elderly father (expressed, not nursed)… I feel certain we stand with many mothers worldwide who salute Jiang Xiaojuan profoundly.
It’s a mystery women don’t often speak of publicly, what it’s like to nourish another human being… or many… from one’s own blood and bones. It is, one of the greatest honors in the world.
I think, despite the restrictive and suspicious regime of China, it’s people like Jiang who really represent the true spirit of modern China, the compassionate soul.
Tonight, it was easy to find a beautiful story to tell you. I would that it were as easy on all other nights too.
_____
CODA
(And no, some of you guys, she only nurses babies. Real ones.)
May 21st, 2008 By DR. CLARISSA PINKOLA ESTÉS, Assistant Editor, TMV Columnist
Very soon, Senator McCain is going to be releasing his medical records. He’s had bouts with cancer… There may also be some record of his recovery after being a prisoner of war many years ago.
To the older generation, a cancer diagnosis of any kind in any person was cause for great alarm, as cancer used to be whispered about as ‘the big C” long ago and was considered a certain death sentence.
Back then, often the docs doing exploratory surgery and finding metastasized cancer, didn’t even tell the person they had cancer. Often all the family could say afterward was that the doctor opened the person up, closed them up, and said Take them home and make them comfortable.
When I go to my hematologist who is also in the main, an oncologist, and as I sit there for my intravenous infusions for chronic anemia, I am surrounded by people receiving chemo for cancer. I have heard enough of their brave and fierce stories to know that there are a million stories to cancer, many kinds of cancer, and many different kinds of outcomes– including legions of long term survivors who outlived all their peers.
But what stands out most is a shift to a new and different attitude in current cancer fighters and survivors … one different than their elders. It’s summed up in the big buttons my doc gives out. The buttons say, CANCER SUCKS! One of my favorite old women who sits near me getting her chemo, wrote with magic marker under that phrase, her own: CANCER IS A FREELOADER: KICK ITS ASS OUT!
The drugs and intervening means we have today are far advanced of what used to be. Cancer is not a death sentence, but certainly a loud announcement that things hang in the balance, and a patient must decide to intervene in ways they see fit, right now. Not, later.
Yet, cancer appears to have become practically as common in the US, as the flu– albeit far more serious. The reasons why so many are afflicted by cancer is, despite tons of money poured into research, still an open question in many persons’ minds. We wish we understood its epidemic better. Yet, there are also a quantum number of persons walking around hale and fit, who have had cancer, or who have had two or more remissions.
So, with the important caveat, that no one can crystal-ball anyone’s longevity by looking at medical records and making generalizations, especially about 5 and 10 and 20 years survivors of cancer… still, in my mind as an analyst, before Senator McCain’s records are released, there are about 6 preliminary questions (the rest will be better answered when we see content and scope of records, and Q and A from/with his physicians)
1. Are these redacted records, summations, or the full ‘as-written’ accounts? This is important to know only because redacted or summarized records can give the appearance that it is a pick and choose process about what to place emphasis on, or not… what to put in, what to leave out.
2. Why has it taken so long to release the records? Some will question whether the records have been edited by the Senator, because it seems to have taken so long to release the records publicly.
May 17th, 2008 By DR. CLARISSA PINKOLA ESTÉS, Assistant Editor, TMV Columnist
Today is Armed Forces Day, though surely it’s ‘Unarmed Forces’ Day… soldiers back from war, who ought be celebrated also… treated with decency to mend up psychic wounds they carry… ones who display injuries just as much in need of healing as a shattered arm, loss of hearing, a leg no longer all there. Same symptomatology in many Post-Traumatic Stress Disorder injuries: shattered; loss of; no longer there in the way one once was…
Borrowing an image from welding, PTSD can also be seen this way: One or more strong welds have come undone; not from weakness in the welds or in the metal, but from the angles the strong welds have been bent to… the tonnage of stress-weight placed on the those welds–- far more bow and weight than this ’strongest of metals known to humankind’ can sustain.
The word ’stress’ in this diagnosis, is not what we feel when driving in gridlocked traffic, nor when competing for a job, nor when we have ten kidlettes discharging candy in the back seat. PTSD stress means, among other things, the psyche has been injured in a sustained way by horrific experiences …so that deeply instinctive elements of psyche are overwhelmed or disabled ….as though they never existed, or have become unreliable for us to put full weight on, /or exist only in an unrelieved black set of memories and griefs.
Shaun Mullen, veteran, writes at Kiko’s House:
PTSD SCANDAL GETS WORSE
I went pretty deep the other day in “Exposed: A Silent Epidemic Is Killing Our Iraq & Afghan War Vets” I urge you to read both this article and accompanying think piece on the anatomy of PTSD if you care about the kind of homecoming the emotionally wounded veterans are receiving.
If the sense of anger and frustration I feel didn’t come through, then I wasn’t doing my job. But then neither is Dr. Norma Perez, physician in charge of PTSD program at a medical facility for veterans who told her staff to refrain from diagnosing the disorder because too many veterans were seeking government disability payments for the condition.
From a shocking article in the Washington Post: ” ‘Given we are having more and more compensation seeking veterans, I’d like to suggest you refrain from giving a diagnosis of PTSD straight out,’ Norma Perez wrote in a March 20, 2008 e-mail to mental-health specialists and social workers at the Department of Veterans Affairs’ Olin E. Teague Veterans’ Center in Temple, Tex. Instead, she recommended they ‘consider a diagnosis of Adjustment Disorder.’
“VA staff members ‘really don’t . . . have time to do the extensive testing that should be done to determine PTSD,’ Perez wrote.”
In case you’re wondering, adjustment disorder is a less severe reaction to stress than PTSD. Adjustment disorder has a shorter duration, hence is ‘easier’ and cheaper to treat.
Might I add there is a special place in hell for doctors who violate the Hippocratic Oath to save not tortured souls, but money.
This stunning memo from Dr. Perez, seeming to aim to ‘fix’ diagnoses the way horse races are ‘fixed’ in order to keep money in ‘fixer’s’ own pocket, suggests PTSD diagnosis be ‘downgraded’ to “Adjustment Reaction.”
In my experience as a shrink these past three-plus decades, Adjustment Reaction is a diagnosis for a child suddenly changing schools and having a hard time. Adjustment Reaction is a diagnosis belonging to a person going through a garden-variety, uncontested divorce.
Adjustment Reaction is not a diagnosis for men and women who have been to war, and who suffered serious ongoing or sudden trauma. Perhaps most telling in this shell game of diagnoses, treatment for diagnosis of Adjustment Reaction is most often not covered by insurance.
This means, injured vets of this war, would be thrown down into the same trench dug for previous vets, wherein government whistles and pretends agent orange exposure, for instance, is a figment of imagination, instead of a serious incremental illness. This means vets would be encumbered to pay for much needed medical help, from their own meager funds. This means vets will be left on their own -–for life– to deal with catastrophic injuries suffered while in employ of their own government.
Can a person, any person, feign PTSD? Yes, of course. There are scammers of welfare, there are scammers for Social Security benefits, people who are actually fit but lazy. However, most are not scammers. Our soldiers didn’t just slip in an aisle of the grocery store and become disabled. They went to war, a fighting, shooting, deadly war. They managed to come home.
Not all vets with PTSD are invisible to us: those men you see wandering on the streets in their cammies after their war service, they were no scammers either. If anything, the military system A.W., after war, has scammed many of them out of righteous and timely effective treatments for their most serious war wounds long ago.
Some observers might say, Yes, but they’re drug addicts and alcoholics. I’d say, Yes, many are. Now.
Given their lack of a required and timely medical care upon return from deployments, in many ways, since these soldiers didn’t have best medicine, they’ve been primed to settle for the poorest.
Even now, after so long, were they offered good medicine, solid compassionate treatment, many street soldiers might not accept it. Daily i.v. drip of cheap anesthesia can seem enough. To their minds, others on the street often understand more and better than any cleaner, better-dressed, well-fed outsider.
Too, a most poignant feature of severe PTSD is prevalent in the men who wander: they no longer have consistent touch with a core self. They might try but then refuse help, because the spirit and soul of the soldier is in some way still on duty, back on the Mekong delta or outside of Baghdad, or still in some way, marching NPD, Night Perimeter Defense… to keep all of us and their buds safe from harm.
A fine welder does not throw broken welded metal onto the slag heap, and especially does not re-deploy it back into use, pretending OSHA made up its hazards and safety rules just for the heck of it. The rules about fatigued materials, even at the level of OSHA, are about preserving health and saving lives.
A fine welder repairs the welds that have come undone, often cleaning out most the old material and replacing it with new material that can and will hold well… there’s often a phase too, of ‘letting the metal rest’… but assuredly never again bending the strong metals under extreme pressures which are already well known to break the strongest welds.
The military arm of our government ought have no lesser standards, no less ethos.
At the close of the second of NPR’s two part look at how parents are addressing their children’s gender-identity issues which aired last week, Robert, the father of Violet, who is “absolutely certain” that she is “genuinely transgender,” explains how he finds himself “almost offended” when people suggest that he and his family have been too quick to embrace a transgender identity:
“It puzzles me because we even have well-intentioned parents who we care about and who know us … say, ‘Well she’s too young to know!’ Well, when did you know you were a girl? When did I know I was a boy? I knew my whole life, I can’t tell you exactly when, but it wasn’t like I was 10 and realized, ‘Oh gee, I must be a boy!’ ” Robert says. “What people fail to realize is they made that decision way earlier than that. It just happened that their gender identity and their anatomy matched.”
The story’s focus is a highly controversial treatment, monthly injections of a medication for preteen kids to postpone puberty and avoid developing the physical attributes of the sex they were born with. The family found a therapist and after a two-month evaluation, a gender identity disorder diagnosis was rendered; on a family vacation, Armand, their son, would “transition” to Violet, their daughter.
When I am asked how old I was when I realized that I was gay, I answer, “five.” How I knew when I was that young, I do not know, but that’s my honest answer. So my sympathies are with those parents. My sympathies are, however, complicated by the condition known as Body Integrity Identity Disorder. Also called Apotemnophilia, and Amputee Identity Disorder, I first learned of the condition in an 8,800 word Atlantic piece from December 2000, by Carl Elliott, titled A New Way to Be Mad:
I am on the phone with Max Price, a graphic designer in Santa Fe, who has offered to talk to me about apotemnophilia. (He has asked me to change his name and the details of his life and history if I write about him, and I have.) Price is a charming man, articulate and well-read, and despite my initial uneasiness about calling him, I am enjoying our conversation. I had corresponded by e-mail with a number of wannabes, but had not managed to talk to any of them until now. The conversation has taken on an easy intellectual tone, more like a discussion between colleagues than an interview. Price is telling me about his efforts to get doctors to adopt some guidelines for deciding when a person with apotemnophilia should have surgery. I am tossing out ideas, trying out some of my thoughts, and I wonder aloud about a relationship between apotemnophilia and obsessive-compulsive disorder. I ask Price whether he feels that his desire is more like an obsession, a fantasy, or a wish. He says, “Well, it was definitely like an obsession. Until I cut my leg off, of course.”
That brings me up short. I had been unaware that he had actually gone ahead with an amputation. “Ah,” I say. I pause. Should I ask? I decide I should. “May I ask how you did it?” Price laughs. “It was kind of messy,” he says. “I did it with a log splitter.” Read the rest of this entry »
May 9th, 2008 By DR. CLARISSA PINKOLA ESTÉS, Assistant Editor, TMV Columnist
According to my contact in Yangon, what pitiful supplies are on the ground, have no distribution whatsoever to any of the thousands of villages and tributaries in Burma hit into utter devastation by the tsunami/ cyclone. The Burmese, most poorer than poor before the tsunami, are going on their 6th sunrise without clean water, food, or shelter or medicines.
Meanwhile, it is certain, while the military government gets down their fiddles, the infants and newborns and toddlers grow dehydrated. Without adequate water and food, their mothers’ breasts will have run out of milk, and the children will die from dehydration, an entire generation of young will be gone within a week.
Than Shwe: You cannot keep others from knowing about the mayhem of your country. Burma is on satellite. The floods and the people and the animals can be seen dead and floating and bloated. The living can be seen by satellite also, picking through ruins, entire villages wiped out with no survivors.
Than Shwe, delaying allowing aid workers in, makes you only look more and more unleaderly.
Than Shwe, animals survive by adapting. Animals who can learn new behavior, survive the unforeseen.
Than Shwe, animals who do as they have always done, die.
Than Shwe, open your heart, if not your mind. Be known as a ruler who took care of his people in every way possible, rather than going down in history as the leader who stood by paralyzed and allowed holy people and helpless people, his own kith and kin, to die in misery.
CODA
I hear from my contact in Yangon, that the people on the ground in Burma are begging that international aeroplanes please fly over and drop supplies.
Than Shwe, if they fly, let them fly unmolested. Add no more horror to horror. It’s within your power. Choose honorific over horrific.
Than Shwe, the new respect you would receive then, would be remarkable.
This is our deepest prayer for you Than Shwe, and for the people of Burma… the Central Buddhist Precept:
John McCain says free enterprise will make it more efficient, Hillary Clinton and Barack Obama want to tinker with it, but the evidence keeps mounting that American health care is a disaster that keeps overwhelming not only the uninsured but those who have “coverage.”
The New York Times reports, “Many of the 158 million people covered by employer health insurance are struggling to meet medical expenses that are much higher than they used to be–often because of some combination of higher premiums, less extensive coverage, and bigger out-of-pocket deductibles and co-payments.
“With medical costs soaring, the coverage many people have may not adequately protect them from the financial shock of an emergency room visit or a major surgery. For some, even routine doctor visits might now take a back seat to basic expenses like food and gasoline.”
Meanwhile, none of the presidential candidates is willing to acknowledge that the American health care system is broken by massive inefficiency, insurer greed and widespread fraud.
Even before they win the presidency and wider margins in the Senate and House, Democrat leaders are undermining the campaign promises of Obama and Clinton by making it clear that the next Congress won’t follow through on even their watered-down proposals.
If voters want health care, they will have to hold their Congressional candidates’ feet to the fire by letting them know that they are really hurting and not being treated right by the clients of the health care lobbyists who are blocking reform. Better yet, they should brush aside all the nonsense about “socialized medicine” and get a national conversation going about a single-payer system.
Rising food and energy prices are scaring a lot of people. Not the folks at the Federal Reserve, though. They have found a revolutionary mechanism to address worries generated by these price increases. By creating its own preferred inflation measure, the so-called core rate, which factors out food and energy, the Fed can claim inflation is well under control.
Given that food and energy are core elements in sustaining human life, I used to be bothered by this curious approach to economic management. Now that I view the matter from a broader perspective, however, I see many valuable applications in other realms.
Take medicine, for example. Lots of people have cancer and heart disease. But a core rate of health, one that excludes these maladies, would improve our national health statistics dramatically at no extra cost to anyone.
In a related vein (so to speak), by excluding these unpleasant medical realities along with, say, diabetes and alzheimers as causes of death, the average American lifespan would be 102.6 years. And all without any more dieting or exercise. Yippee!
The weather. Boy, can that ever put people out of sorts. So why not just exclude temperatures over 80 degrees and under 70 degrees to get a core temperature of 74 degrees that’s reported on the local news every evening?
Crime! Poof!. Exclude murder, rape and assault from reporting of violent crimes, call what’s left the core crime rate, and there is no violent crime. Think of the money this will save on local police budgets.
Everything is beautiful when everything that isn’t is excluded. Thank you Chairman Bernanke for showing us the way. One thing, though. Could you loan me half a tank of gas and a couple of eggs until payd
Even as their presidential candidates debate differences between plans for universal coverage, Congressional Democrats are waving white flags in the coming battle to get anything done.
Leaders of the party that should gain decisive control in November, according to The Hill, are busy explaining the expected defeat of health care reform.
“We all know there is not enough money to do all this stuff,” says Sen. Jay Rockefeller, a Finance Committee member and an Obama backer. “What they are doing is … laying out their ambitions.”
New York’s Chuck Schumer, who is for Hillary Clinton, agrees, saying he is “not sure we have the big plan on healthcare…not sure that we’re ready for a major national healthcare plan.”
Why is it that Popes don’t usually visit the United States during presidential election years? Lucas Mendez writes for the BBC Brazil, “As neutral as the papal robe is, his messages can and will be used by the candidates … every time Benedict XVI opens his mouth, Democrats and Republicans will interpret and “spin it,” according to their own political ‘gospels’” Read the rest of this entry »
