I just downloaded Picasa, as a means of shrinking down my photos so I can post them. It works! Yay!
Happy lead year!

Happy leap year! How nice, we get an extra day to the year. Now, if we can only figure out how to add a few more hours onto each day….

Photo courtesy of Stock.XCHNG

If you are not weary yet of press releases, here is another one from the Center for Health and Gender Equity. Apparently, our government officials, or at least the ones who hold the purse strings to PEPFAR (no names mentioned) think that family planning is anti-life.

I’m not really sure whose life they are talking about. The potential fetus who may be conceived if the HIV infected woman has unprotected sex and doesn’t use any time of contraceptive? Are we now going from embryos to “possible embryos.”

As far as I know, HIV is spread by having unprotected sex, among other routes. HIV is also transmitted from mother to baby. Being ill with a disease like AIDS, to say nothing of the socioeconomic impact, isn’t really the best time for most women to think of starting a family, adding to their current family, or getting pregnant accidentally. To say nothing of how many women die of pregnancy/childbirth related causes in developing countries, or die from botched illegal abortions.

But somehow, providing reproductive services is “contrary to PEPFAR’s life saving principles.” Hmm, let’s see how many little chickadees the Bush girls produce once they get married. And how odd that George himself only had 2 children, and twins no less, that were the product of a single pregnancy. Why is it okay for people living in wealthy nations like the U.S. to have access to family planning, but it’s not okay for women in poor nations (and arguably the ones who need it most) to have the same benefit?

However, I know we’ve heard a lot of this gibberish before, but twisting together family planning with HIV infection, and calling it “anti-life” goes beyond absurdity.

U.S. Health, Rights Leaders Decry Department of State Position that Family Planning is Anti-Life, Demand Response

(Washington, D.C.)-As the U.S. House Committee on Foreign Affairs deliberated over legislation to reauthorize the President’s Emergency Plan for AIDS Relief (PEPFAR) this week, U.S. health and rights organizations objected to the State Department’s opposition to a draft version of the bill regarding a provision that would have allowed PEPFAR funds to be used for family planning to prevent HIV transmission.

How difficult is it to get this right? They try to do something helpful, but in the end, put up hoops and inundate everything with this abstinence only nonsense. How many times do they have to be told, that abstinence-until-marriage programs do not address the needs of the populations who are currently most at risk for getting infected with HIV (hint: women who are ALREADY married, but have husbands with wandering organs and/or who are at risk for sexual abuse).

Another thing is the obsession with sex workers. If you ignore sex workers, or try to muscle them out of HIV programs, you may as well pack up shop and leave. Sex workers exist, like it or not, and if you don’t treat them and make sure they protect themselves, they are one group that is capable of spreading the virus like there is no tomorrow.

And just to add–perhaps Mr. Bush and his prudish friends, who can’t bear the sound of the word “prostitute,” might like to come up with an alternative means of making a living for these people. What does he plan to do, right now, right at this second, to help several thousand poor illiterate women who have no means of supporting themselves? Or the girls out there who are making money to feed their families with the only thing they have–their body?

Well, I’m waiting. Come on guys, let’s hear it. Are you packing your bags and heading overseas to give these women (and men) jobs? Are you setting them up in school or in a place to learn skills? Are you going to give them money to live on so that they don’t have to peddle their bodies for cash (or dinner, or medicine for their infant, etc)?

It sounds so noble to come out against prostitution, and to have recipients of PEPFAR funding pledge their opposition to prostitution, but in reality, the vast majority of people working as prostitutes in developing nations probably aren’t doing it as a lifestyle choice. It’s a lifestyle necessity, so maybe instead of trying to pretend they don’t exist or moralize them away, it may be more useful to do something constructive about it.

And as far as abstinence, you know, you never hear Bush talk about his daughters’ virginity. Are they abstinent until marriage? Are both of them pure and pristine? Was GW Bush or Laura before marriage? How about all the other holy rollers? How about their kids?

Anyway, this diatribe is leading up to a press release about the latest from PEPFAR.

U.S. Congress Introduces New PEPFAR Bill: Two Steps Forward, Three Steps Back

Center for Health and Gender Equity praises removal of abstinence earmark and support for female condoms; criticizes ambiguous abstinence language, compromise over family planning language, and re-insertion of the anti-prostitution pledge

The Center for Health and Gender Equity (CHANGE) is a US-based non-governmental organization that seeks to ensure that U.S. international policies and programs promote sexual and reproductive health and rights through effective, evidence-based approaches to prevention and treatment of critical reproductive and sexual health concerns, and through increased funding for critical international programs and institutions.

The solution to the nursing shortage is simple–pay instructors more money. How is it that no one thought of that before?

That is one of the politically correct responses to the late great shortage of nurses, that it is merely a matter of not enough slots in school and a lack of instructors.

This article appeared in October 2007, and I never got around to linking to it. But it is from Health Care blog, which says that it will tell you everything you ever wanted to know about healthcare but were afraid to ask. This particular article was penned by Maggie Mahar, and it is entitled: HOSPITALS: Why We Don‘t Have Enough Nurses (It’s Not Low Wages)

Consider this: In the San Francisco area, a nurse with a bachelor’s degree can hope to start out with a salary of $104,000. The salary for a nursing professor with a Ph.D. at University of California San Francisco starts at about $60,000.

This goes a long way toward explaining why nursing schools turned away 42,000 qualified applications in 2006-2007—even as U.S. hospitals scramble to find nurses. We don’t have enough teachers in nursing schools and the fact that the average nursing professor is nearly 59 while the average assistant professor is about 52 suggests that, as they retire, the shortage could turn into a crisis. The most recent issue of JAMA (October 10, 1007) reports that in 2005 we had 218,800 fewer nurses than we needed and by 2012, it’s estimated that we’ll be short some 1 million nurses.

So according to Mahar’s report, nurses are now all making 6 figure salaries when they are fresh out of school, and the only reason that there is a nursing shortage is that there just aren’t enough teachers or schools to train them.

There are a few hospitals in the Bay Area, notably Kaiser facilities, that are organized by the CNA and pay high wages. Although, someone fresh out of school is not going to get top dollar instantaneously. Even at Kaiser, which is probably the highest paying, a new grad may earn $40/hour, which is good money to be sure, but doesn’t translate to $104,000 (where on earth did she get that figure from?) It’s more like $80,000.

And that’s Kaiser. Small hospitals don’t come near that figure, and once you leave the heart of the Bay Area, wages vary considerably. So Mahar is using a small sliver of very high paying facilities in one small section of the U.S. (and still overinflating the amount for new grads) and using that as a basis for her argument–that salary is not a reason for the nursing shortage.

Hospitals have had to raise nursing salaries (as well they should), not just because nurses are scarce but because, in our chaotic hospital system, the work can be extraordinarily stressful.

I hate to break this to Mahar, but nursing has always been stressful. And chaotic. And nurses have always been for the most part, treated poorly. This is nothing new, and most hospitals are not jumping on the bandwagon to improve either salaries or working conditions. Perhaps Mahar might remove her blinders and look at the salary stats in other part of the country, or even in California. For example, new grads in Florida (and this reported from a recent new grad) are making $16/ hour. Now isn’t that a stimulus to go into nursing. The average nursing salary nationwide is about $50,000–that’s averaging out the very high and the very low.

Mahar is also ignoring the fact that isn’t just money which keeps nurses out of teaching. The climate of academia can be just as stressful as working in a hospital, albeit in a different manner. There’s the pressure to publish, to kiss ass, to deal with students and university politics, etc. Universities also want their nursing professors to have a PhD, and many nurses just aren’t interested in going to school for that long, just to teach. If they do get a PhD, they can get a more interesting job. An advanced degree in nursing can open the door to a lot of different opportunities, and teaching just isn’t high on the list of being either well paid, or all that enticing.

Many of the nursing programs that have these huge lists of applicants are state funded universities or community colleges. The schools are cheaper, so people apply there first. I wonder if private universities have long lists to get into their nursing programs. It has always been harder to get into state schools, even back in the early 80s when I was attending. So this really isn’t anything new, although this small part of the nursing shortage is being targeted and highlighted.

Mahar also didn’t mention nurses leaving the profession, or hospital jobs, another source of the chronic vacancies. She also didn’t mention how some hospitals have very low turnover and vacancy rates, despite the nursing shortage.

All in all, its a rather myopic little ditty of trying to explain the nursing shortage in 10 words or less.

I suppose you always have to take the work of anonymous experts with a grain of salt, especially when they predict the future. That goes for named experts as well. I was trying to find information about Mrs. Gooch’s Natural Health Food Stores, and when they were bought by Whole Foods and when the name was changed, and I came across an article in the NY Times from 1996. It was a rather silly article, but this prediction was worth repeating here:

Safeway at the Marina in San Francisco stocks dozens of items similar to those sold by natural-foods supermarkets, and experts predict that within 10 years it will be difficult to tell a Whole Foods from a Safeway.

Now I imagine that a Safeway in that bastion of natural and organic and overpriced items is probably the cream of the crop of Safeways, but still, you just don’t look at what a store has added to its inventory, but what it hasn’t removed. Safeway couldn’t even begin to compare to Whole Foods back then, and now 11 going on 12 years later, Safeway still can’t compare to Whole Foods. Sorry experts, but your prediction has fallen short. The only person who can’t tell a Safeway from Whole Foods is one who is blind, deaf, has no sense of smell, and no sense of taste. The two establishments remain as far apart as George Bush and Mahatma Gandhi.

It is interesting to note that even though they fall short, it is Safeway that is striving to be more like Whole Foods, and is stocking their shelves with foods that are less tainted and noxious than their normal fare. Whole Foods, I must emphasize, is not trying to be like Safeway.

Aside from the inventory that you might see when strolling down the aisles, the atmosphere is just so different. I can spend hours in Whole Foods, but I start to feel like I’m going to have a convulsion if I spend more than a few minutes in a Safeway. When I lived in Seattle, I used to sometimes go into a Safeway to use the Bank of America ATM, and I was never tempted to go beyond the front door and look around. Never got the feeling of “oh, while I’m here, I may as well get some onions….” whereas in Whole Foods, I can’t imagine walking in just to use an ATM and not being pulled in a hundred directions to all the lush offerings. To say nothing of the cosmetics and bath section.

Anyway, the experts blooped on this one. To me, Whole Foods represents a healthy lifestyle, healthy food, and being conscious of what goes into your body as well as the impact on the earth. Safeway is just the opposite. To me, it represents one of the primary causes of obesity and disease—the heavy duty marketing of junk food, the sale of meat and poultry laden with hormones and antibiotics, and processed foods that need an organic chemistry textbook to decipher the ingredients.

Sorry to keep going on and on about spam, but some of this is just so ridiculous. I can’t believe that anyone really goes to these spam sites and buys these products.

One just came into my email box a few minutes ago:

A Real Man should have a Real Cock.

I don’t know many men walking around with a fake cock. In fact, I’ve never met one. Do most men have fake ones, and we are just unaware of it? Some sort of alien experiment that has been going on–implanting earth men with fake cocks, so now they are in dire need of real ones?

Does it have to do with the aliens landing at Roswell, New Mexico in 1947?

Say, now wouldn’t this make a good B Sci Fi movie. The fake cock from outer space…

I think I’m losing my mind from reading so much spam. But hey, this is medically related, isn’t it?

Low recipe generic Testosterone! Up to 5 times more semen!

Wow, do you think I can just pass that one by?

There were 195 spams in my regular email box this morning, and 214 in my blog comments. I am currently looking into more effective filters. Spam be damned, you are not going to win.

Whoever does the Google designs for holidays is one of the most talented artists I’ve ever seen. And imaginative. Today’s Google defies the word sweet, and it is so clever how the Google name fits into the picture. Or I guess that’s vice versa, how the pictures forms the word Google.

Just when you thought that you couldn’t hear anything worse about the insurance industry, along comes the clincher that wins the pie in the sky. If there is actually pie in the sky, that is.

Blue Cross would like to enlist healthcare practitioners in a witch hunt, to seek out those infidels who dared to lie on their insurance applications. Those lowlifes who did not claim all, who failed to mention that they had their tonsils removed 50 years ago, or that they were treated for leukemia in 1965 and it has never returned so they kind of thought themselves cured and not worth mentioning the disease.

From ABCNews:

“Any condition not listed on the application that is discovered to be pre-existing should be reported to Blue Cross immediately,” according to the letter obtained by the newspaper

Other than the fact that Blue Cross wants doctors to break patient confidentiality, there are 3 amazing things to note in this story.

1) Blue Cross was recently fined $1 million for unfairly revoking coverage to scores of its policy holders. You’d think that they’d lay low and keep a low profile until the fuss blows over.

2) The reason that people may be withholding this information is that they fear that they will be denied insurance. Blue Cross, did that ever cross your mind?

3) They must be truly living in an alternate reality if they think practitioners are going to supply them with that information. Aside from breaking confidentiality (and a patient may have grounds for a lawsuit), the physician will lose money from the deal. If patients lose their insurance, they are less likely to visit their physician, or to even have a primary physician. Thus, everyone loses out except Blue Cross.

They may look pretty enough to eat, but you really don’t want to be swallowing drugs spotted with paint. Do you? Or maybe you’ve already gobbled some down. It wouldn’t be all that unusual, according to this article from the Associated Press:

SAN JUAN, Puerto Rico (AP) — The first warning sign came when a sharp-eyed worker sorting pills noticed that the odd blue flecks dotting the finished drug capsules matched the paint on the factory doors.

After the flecks were spotted again on the capsules, a blood-pressure medication called Diltiazem, the plant began placing covers over drugs in carts in its manufacturing areas.

But the factory owner, Canadian drug maker Biovail Corp., never tried to find out whether past shipments of the drug were contaminated — or prevent future contamination, according to U.S. regulators.

Thirteen of the 20 best-selling drugs in the United States come from plants on this island. But an investigation by The Associated Press has found dozens of examples over four years of lapses in quality control in the Puerto Rican pharmaceutical industry, which churns out $35 billion of drugs each year, most of it for sale as part of the $300 billion market in the U.S.

This is pretty sad, if you ask me. How much money do pharma companies rake in, and they can’t even keep paint off their capsules? And the FDA–gee, maybe if they’d stop worrying so much about searching for elusive boxes of contaminated chamomile tea, ie, trying to put the herb and alternative medicine market out of business, they might find time to do their job.

This is another juicy little quip:

The FDA issued a warning letter to Wyeth in May 2006, after consumers reported finding machinery pins inside bottles of Effexor, a leading depression treatment, and the heartburn drug Protonix. The letter expressed concern that the plant was not “able to detect that the affected equipment was missing some of its parts.” The Madison, N.J.-based company faulted mistakes by workers who packaged the drugs.

They issued a warning letter after machinery pins were found in medication boxes. A warning! And such powerful language. Did the machinery need to be inside the drugs for them to take a little action? How about shutting down the factory? What about levying a stiff fine against Wyeth for not meeting quality controls? And maybe hiring workers with a little more intelligence, or teaching them the difference between a machinery pin and a capsule of medication.

There is no excuse for quality control at factories to be of the highest standards, and to be standardized across the board. No excuses. Every factory must meet them or be shut down until they do. And the companies should have to pay a stiff penalty for carelessness like this. And the FDA needs to do its job, not sit around and write wimpy little letters.

The article also says that some plants in Puerto Rico are three decades old. I guess that they haven’t been renovated since then, although I’m sure that none of the executives uses a company bathroom that’s gone 30 years without a tune-up, or has an office that hasn’t been redecorated in that time.

I really missed the “regular” New Year, as I mentioned before, due to the illness creeping up on me. So here’s a second chance to get started on a fresh new year, with all sorts of resolutions (private!!!) that I hope to keep.

This is the Year of the Rat, and the Chinese year 4706 begins on Feb. 7, 2008. A rather long civilization, almost 5,000 years old.

Is there anyway to give up Spam for Lent? Or how about spammers giving up your evil and obnoxious practice for Lent? God will love you and the world will be a better place.

Happy Mardi Gras. What I can’t believe is that tomorrow begins Lent, which means that Easter is not all that far off. Because I was so sick, January feels just like a black hole that never was, and Christmas just a blur. Did we actually have a New Year’s? I guess so, because now I’m writing 2008 on my checks.

Well, I feel that I at least have a second chance to celebrate New Year’s. Feb 7 is the Chinese New Year, and since I’m no longer coughing or feeling like every organ in my body is in malfunction mode, I think I’ll celebrate. Bring in the NY, write my resolutions, and get started on a fresh new year. This just seems like a practice session right now.

I hope that a lot of visitors came to New Orleans to celebrate the Mardi Gras. It is so hard to believe, that in a nation as rich as ours, that the city has not been rebuilt and that residents are still struggling with a host of problems. Umm, have the levies been fortified to withstand a Category 5 hurricane? Has anything been done to strengthen the city so that flooding can be minimized should another hurricane strike (and it will, eventually).

But not to get off on a tangent…I don’t want to spoil the Mardi Gras fun. I’m glad that the city is somewhat functional, and able to host their trademark event.

I found this article on a website, which is not available unless you subscribe, so I can’t supply a link. But anyway, it was about the growing and proliferating pasttime of heading overseas for medical care. Many of the people who travel overseas have been denied insurance here, or who have insurance but their out of pocket expenses far exceed the cost of getting care in another country.

Anyway, the last paragraph of the article would have been hysterical, if it wasn’t so pathetic:

The medical tourism industry has caught the eye of congress. Last year, the Senate held a hearing on the globalization of health care to determine what is at the root of the growing trend. It found the ease of international travel and the growth of quality care facilities in developing countries plays a role, as well as soaring costs of medical care in the United States.

Uh, did they really need to hold a hearing to figure out what an intelligent 12 year old might have told them? Isn’t it obvious why people are seeking alternatives? Are they just dense, or do they have to put on a hearing for show, so they can come up with some “solutions” and “proposals?” Hint–do something to make healthcare more affordable here, and make sure everyone has decent coverage, and guaranteed, medical tourism will take a nosedive.

Is this good news or bad news? I tend to think good news, since the so-called universal health plan touted by Gov. Schwarzenegger (formerly enemy #1 of nurses) is not universal at all. It merely forces consumers to purchase health insurance, without any provision for reforming the health insurance industry itself.

So no, it sounds like this needs to go back to the drawing board, and come up something that the people living in the state really want. And no, sorry Sen. Nunez, but “anything” is not better than nothing. The anything that you are purporting will cost people money–a lot of money–and does nothing to solve the problem of affordable healthcare and comprehensive coverage. All is does is increase the ranks of people with health insurance, but it doesn’t increase the quality, rein in the escalating costs, do anything to keep the insurance companies from downsizing coverage and increasing premiums, or do anything to promote preventive care and healthier living.

And the sad thing is–once we have an “anything” in place, there is less incentive to do anything to reform healthcare.

This is a press release from the Foundation for Consumer and Taxpayer Rights (you know that the insurance industry gets squeamish over names like that). It came in on my email, so I don’t have a link.

CA Senate Stops Mandatory Health Insurance Plan

This afternoon the California Senate Health Committee stopped the mandatory private health insurance plan backed by Governor Schwarzenegger and Assembly Speaker Fabian Nunez. The legislation failed to limit how much policyholders would have to pay or define the benefits they would receive.

Forcing people to buy an insurance product they cannot afford or rely upon is not health care reform. The question is what comes next?

At a marathon hearing last week, Speaker Nunez lashed out at FTCR’s staff for showing senators the legislation’s fatal flaws. This morning we responded to the criticism that anything is better than nothing in the Sacramento Bee.

ON AIR: KXTV-SAC (ABC), Mandatory Health
Insurance in CA Faces Stiff Resistance:

As we noted, “If anything is better than nothing, why not simply remove from the legislation the most controversial and draconian provision: requiring all Californians to show proof that they have a private health insurance policy?”

The legislature should immediately address the need for universal children’s health coverage, fairness in the insurance market, and subsidies for uninsured patients.

A poll commissioned by our sister group the Campaign for Consumer Rights showed that mandatory health insurance was a big loser with voters once voters were told they might have to pay. By contrast, reigning in insurers and subsidizing care for the poor had popular support.

The marriage of convenience between the medical-insurance complex and politicians seeking more time in office via Prop 93 failed to address the single most needed health reform: cost-controls on an out-of-control industry. This issue must be addressed in any genuine systemic overhaul.

If the legislative debate ends today, voters can still have the last word on health care reform, as they would have on the Governor and Speaker’s proposal.

Three possible paths to reform via ballot measure exist:

* The first option is that insurance premium regulation and sensible rules for the market can be coupled with reforms legitimized in this year’s debate, such as requiring insurers to sell to all patients regardless of pre-existing conditions. FTCR has a draft of this ballot measure. It includes opening up government officials’ coverage to all Californians through an existing public payer that bypasses insurers. This provision had 81% support in the recent poll.

* Second, single payer advocates are considering another run at California voters. They would have to modify their proposal to make it more politically palatable but a recent poll already shows majority support in California for the notion.

* Third, a middle way proposal between single payer and the status quo could develop into a ballot measure. This would be a public utility type model that closely regulates the cost of all private health care providers in order to make health care affordable and available to all. This option would include subsidies for those who cannot afford coverage to buy it, such as exists with lifeline telephone and electricity service.

We are prepared to make our case to voters about the right way to reform the health care system: reducing waste, fraud and greed in order to give care to everyone. With your continuing support, we will prevail.