Monday, July 30, 2007
Deb: Deb Macro
IM IN UR MEDICAL CENTER, CONSUMIN UR RESOURCEZ.
In other words, I’m off to Yet Another Ultrasound.
If I’m still in a crappy mood when I get back, maybe I’ll talk about how using a bad system to one’s own advantage doesn’t make the system good. Then all of you can misunderstand me a second time this morning. Or maybe I’ll just go make something for the shop. Or clean my house. Or something.
3 weeks to go. Can you tell?
Deb: One more time.
I’ve seen multiple posts this morning mocking people who want the government to run the heath care system, so I’m going to jump in and touch this particular live wire one more time. Just for fun. Again with the understanding not necessarily equaling agreement, OK? Though if you think I want the TSA to come to your house and watch you eat, I’m going to lobby for mental health benefits to be added to whatever plan we wind up with. Because I’d much rather wipe out all of what’s there and start over, but that ain’t gonna happen. We’ll have some sort of minimal government scheme soon. If we really work at it, we can make sure that it costs a lot and doesn’t do anything, like in Massachusetts. And won’t that be fun? Nothing I love like a moral victory.
Honestly, I’m way, way more baffled by the folks who hate the idea than the ones who love it, because I’m pretty sure 9/10ths of the motivation is pretty damned easy to grasp: people are afraid. Health care is very, very, very expensive, and health insurance is very, very, very expensive, and even if you can afford the insurance you run into problems with being able to afford to use it, you run into problems because it has limits, and you run into problems getting it at all in a lot of places. Given that a single sudden illness can easily undo years worth of work if you’re uninsured, and sometimes accomplish the same thing even if you are insured, I think it’s entirely logical that folks are looking for a safety net. They aren’t thinking about whether it’s the most efficient thing economically, they aren’t thinking about whether that means the government will be too far up in their personal lives, and they aren’t thinking about whether, in the long run, research and development will suffer.
They’re thinking about what happens if they get sick.
I’m going to say this one more time, with emphasis: It is entirely rational to fear losing everything you own to a random event.
And until you come up with a better idea than shrugging your shoulders and pointing out that you shouldn’t be poor, then, and a better idea than trying to pretend that health is totally under the control of the individual (in which case, having the TSA watch you eat would make sense, really, wouldn’t it?), and until you come up with a better idea than preaching about how government is bad and then using it to mandate what people buy, and until you come up with a better idea than babbling about free markets while vigorously defending a system that’s anything but, I’m going to go right on understanding the single-payer proponents. Because misguided as they are, I like that they give a damn.
I recommend you start by working out for yourselves why Medicare = good and government health care for younger people = bad. I rather suspect it has something to do with vote counts, but don’t let my interpretation get in your way. If you can explain that one to me, maybe we have a place to start with a market solution, after all.
Saturday, July 14, 2007
Deb: You think that’s bad, you ought to try getting birth control.
Thursday, July 12, 2007
Deb: In the “you have *got* to be kidding me” category this morning…
Subcategory: Paternalistic Bullshit, we have this wonderful fellow the NYT found to tell us about how the uninsured are different from you and me. Because the way that people who haven’t had insurance tend to go all crazy and actually, you know, go to the doctor once they have it can’t possibly be because if you’re not so much affording the insurance, you’re probably not so much affording the doctor (never mind the fear of discovering the feared pre-existing condition...all incentives are aligned against seeing a doc when you’re uninsured lest you become uninsurable, never mind the bills you can’t pay). No, it’s because you’re stupid:
The uninsured, he said, were very different from the insured people in the study. They had much less education, their incomes were lower, they were more likely to smoke and to be depressed.
The researchers accounted for differences with statistical adjustment. But, Dr. McClellan said, statistics can never completely solve the problem of large differences between groups.
For example, he said, the characteristics of the uninsured are also correlated with caring more about the present than the future. A trait like that, he added, “may lead to the need for more medical services down the road.”
That does not mean that the uninsured do not need health insurance, he said, but it does raise the question of what is the most effective way to provide it. For example, instead of just paying for doctor visits and leaving it to patients to find doctors and seek care, it may be better to also provide case managers who will contact patients and prompt them to take medications like drugs for high blood pressure or to report on their blood sugar levels if they have diabetes.
That’s right. If you’ve been uninsured, you’re too irresponsible to be allowed to see a doctor in peace. You need someone to harass you day and night about what an unhealthy asshole you are.
I am so very fucking tired of people being so very fucking sure that financial problems are 100 percent generated by stupidity. And I am so very fucking tired of people assuming that health problems are generated 100 percent by stupidity. In fact, right now I think I’m 100 percent tired of people. No. Make that 99.44 percent tired of people. (Ha!) Because there are a few people left, hiding somewhere in America, who just want to be left alone *and* are willing to extend the same courtesy to the rest of us. Them, I’m OK with. The rest of you can go to hell.
Tuesday, July 03, 2007
Deb: One out of one Jedis agree.
Saturday, June 30, 2007
Jay: Confirmation Bias
It’s the reason the autism myth about thimerosal just won’t die:
“Hope is a powerful drug,” says Jim Laidler, a Portland scientist and father of two autistic boys who jumped ship from the vaccine conspiracy a few years ago. In reality, autism has no cure, nor even a clearly defined cause. Science takes its time and often provides no definitive answers. That isn’t medicine that’s easy to swallow.
Guess the misguided will just have to wait for gene-altering nanobots or theraputic viruses or something. Then they can modify the genetics their kids got from
them the MMR vaccine.
Friday, June 29, 2007
Deb: I want to print out this post and make copies and bring them to the hospital, just in case.
I’ve never talked much here about what happened when Sadie was born, but it was more than a little rough, and it was made more than a little bit worse by exactly the sort of thing that he’s put in that second example. The doctor and the nurse stood in front of me and argued about whether or not I needed to be treated for preeclampsia. The doctor won, I got the mag, and the next 24 hours are a long blurry nightmare in my memory. So far as I can remember (and you’d think this would have taken place before they started it, so I would remember it), nobody every *directly* said, this is what you have, and this is what we’re going to do. I more or less followed the conversation, being the type who reads too much, but I was assuming all along that the nurse was right and the whole mess was more precautionary than anything. It’s only very recently that I realized why everybody looked at me funny when I tried to ask them if I’d actually had preeclampsia (not that I was pushy about trying to clarify, as the whole thing to my mind is still best forgotten) (and yes, I realize that’s sort of sad, but childbearing is a bitch sometimes). You see, they put these new summary pages in our charts, and I was reading over the nurse’s shoulder and saw right there History of Severe Preeclampsia.
Well, then. Nice to have that cleared up.
Deb: Look, it’s just not that hard to understand how socialized health care could look good to people.
If you’re in a sweet spot in the system as it stands right now, it’s the best thing in the world.
If you’re not, it looks just a little different. OK? And going on at length about how you should get yourself into the sweet spot, then, you asshole...well, it doesn’t make it look any better.
Weirdly enough, I’ve become much more tolerant of a lot of things over the last few years, and other people’s political views are one of them. It makes complete sense to me that there would be a large number of people who really think that getting the government even more involved in things would help. They haven’t yet lost their faith in the government’s ability to do good, and I almost envy them, because that faith would be nice to have sometimes.
The thing is, I think the battle between government-run and privately-run is missing the point. The real problem is with the whole way we think about health. And until we’re ready to look at what we expect out of the system and adjust our expectations to something a little less insane, neither one is going to work.
Because it’s the entire conception of what it means to be healthy that’s fucked. How we pay for it is a sideshow.
Saturday, June 16, 2007
Deb: PSA: Dictionary, blogosphere.
I’m spending my free time today trying to think of something appropriately drastic with which to threaten the next person who claims the free market can fix healthcare in this country unless that individual is willing to admit that “free market” properly means killing Medicare, Medicaid, the FDA, government-based physician licensing, and all the other stinky regulation that makes the market not, in fact, free. Nowhere in the definition of “free market” does it stipulate that “free market” means manipulating the regulatory environment until the “deserving” (read me, mine, and the people like me) are properly served and everyone else is left to be accused of wrecking the system through their irresponsibility and sheer ickiness.
We already have government-run healthcare. In order not to have government-run health care, you have to stop the government, you know, running it.
Friday, June 08, 2007
Deb: The Cranky: Health Edition
I’m a serious overconsumer of health news, partially because I’m actually interested, but mostly because of the car-wreck-y goodness of any discussions of disease, health, health care, insurance, and so on. Nothing brings out the irrationality like health/health care discussions because the argument isn’t abstract: we’re all a bit afraid that we’ll die sooner than we might if the thing were optimized. The fact that it’s driving us all bankrupt doesn’t help, of course.
Anyway, since Kevin, M.D. is kind enough to host this wonderful collection of medical feeds, I’ve got to give in to my compulsion to go scan through them every now and again. Good stuff culled from the latest look:
*Amazing research into the genetic basis for seven common diseases. Sadly, the most surprising part about the article (well, other than that the research is British, everybody knows that the fucking commie British don’t have medical researchers) is that the NYT actually missed the opportunity to point out that the hypertension and the diabetes are still your fault, you fat slob. Except that they aren’t, necessarily, but just try telling the media that. Fuckers.
*Ground beef, in a tube? Bad idea.
*Yet another article good for inducing mommy-guilt. *sigh*
*Title of the Day: With An Alli Like This, Who Needs Enemas?
*More evidence that Mitt Romney lives in a world all his own. I’d add that it’s a bit disingenuous to call making it illegal not to carry insurance “covering everybody” even if it did. Whether or not you like any of the Democrats’ plans, Mitt’s is certainly not some magical solution to all of the insurance ills of the world, at least not in its current form, and I can’t see how it ever could be, quite honestly. (I will admit to being intrigued by all the extra plans that are being offered here now, though I’m holding off really looking at them until after the final vote on what has to be included. Because they’re selling the plans, but there are a couple of things that are still up in the air, so far as I know, like whether drug coverage will be compulsory. The thing that makes me nuts about this is that the government telling the insurance companies what they have to sell and the consumers what they have to buy is not, in any way, a free-market solution and I’m sick of hearing that it is. Buy a dictionary, blogosphere.) (Also, this sort of thing is why Romney doesn’t have an icicle’s chance in Arizona. Plus he has this effect on a lot of people. Including me.)
*You know what the biggest problem with this is? The definition of “healthy” is by no means settled, consistent, or the same for every individual. And if you define “healthy” as “produces a ‘normal’ weight individual,” then by definition the overweight can’t be healthy. If you’re defining “healthy” as “follows the USDA Food Pyramid,” then you’re trying to kill SarahK and I just won’t stand for that. So until somebody can talk sense about what “healthy” is, lay off, mmmmkay?
Wednesday, May 16, 2007
Jay: Sex Insurance
Quite possibly the best thing Arnold Kling has ever written. He understated some details, but generally it’s an excellent parable.
Friday, March 23, 2007
Jay: Snipped Into Senility
This is amazing, but perhaps not so odd once you stop and think about it, and see what the likely mechanism is. Why would your bloodstream not think that sperm is an alien invader?
Luckily I am not the one who will be getting “fixed,” since they’ll be in there evicting number three anyway and can close the factory at no additional cost. If I want another kid, I’ll need an additional wife, and line marriages aren’t exactly traditional in these parts.
It’ll be interesting to see what a more formal study shows. It’s just one more indication of how little we know yet, medically.
Thursday, March 22, 2007
And in 1993 it was something like 205. Go figure, since that was about 70 pounds ago.
For some reason the card didn’t show my sugar results, apart from the implicit reasonableness I can assume from the “looks good” reaction.
Tuesday, March 20, 2007
Jay: Getting Testy About My Health
Speaking of being curious, I had a physical recently, and as mentioned here, was declared healthy. Barring the results of the blood tests.
That was all the normal stuff like blood sugar, cholesterol and whatever, some kidney function stuff, and uric acid. the last one I think he threw on there because he saw what my right big toe looked like. I was having a gout attack, which had just flared way up and I hadn’t identified as such yet. It hasn’t completely gone away, but at least it’s milder. As was the case when I got the blood drawn, which would explain that not being a concern.
Ironic that it should happen right after we discovered cauliflower* is our new favorite vegetable, as it’s one of the worst offenders for purines. We’d recently had both that and asparagus in quantity.
Anyway, I hadn’t gotten results yet, and figured any day now I’d get a call ordering me to hurry in for some insulin or artery anti-hardeners or something.
Since Deb was there today, she asked if they’d gotten the results. The doctor couldn’t remember the details offhand, but nothing had been bad and he’d given it to the girls to send out to me. Cool!
I’ll still be interested to see the numbers, but what a relief. Not that it’s that big a surprise; I always confound people medically.
* Cauliflower turns out to be a good substitute for potato. I baked a chicken this weekend, tastiest yet, but we only had two marginal potatoes left. Baked those to split between us. My gravy was also the best yet, and given the limited gravy venue, we used it on cauliflower too. Yum!
Wednesday, March 07, 2007
Jay: Clean Bill of Health
So far, anyway.
I had my annual physical this morning. First one in I think it’s been five years. Yeah, because I started blogging February 25, 2003 - completely forgot to post about my 4th blogiversary several days ago - and had been seeing this doctor since before then. It’s kind of nice getting such a long time with the doctor. I still need to lose weight, or more weight, as the case may be, but I appear to be in excellent health. That’s barring anything that may turn up when in urine and blood tests. The latter needs to be fasting, so I have to drop by another day after not having had coffee in the morning. He suggested Sunday morning. I’d not have guessed the lab was open then.
In the past my blood tests have always come back perfectly okay for sugar, borderline or better for cholesterol and high on the good stuff, and okay for whatever else, like kidney function.
My blood pressure today was 120/84, and earlier it was 128/86 for the nurse. He said he’ll “never understand” my blood pressure. Heh.
I am free of co-pays until July 5th. Yay! Except last I knew my plan didn’t cover physicals, like, at all, so I’ll presumably get hit up for that. Oh well.