Okay, this is a little advertising for the allnurses.com website. But I thought it was a nice video, and I really do think it is a great nursing website. And to answer the next question, no, I have nothing at all to do with the site. I have gotten some great information from there, keeps me up to date on nursing issues, but I am in no way affiliated with the website.

I’ve been a little slow in posting, due to the usual excuses. But now I have a new one–the heat. We are in the middle of record breaking heat. Not fun if you don’t have air conditioning. It’s projected to last a few more days, with tomorrow being the pinnacle and then gradual lessening to normal seasonal temps. This is quite a switch from last summer, when it was unseasonably cool and rainy, and winter started in August (or so it seemed).

My house does stay reasonably cool, even with the temps nearing 90, and only really starts to feel a little too warm by mid-afternoon. But I do feel like I’m moving slower than a garden slug, and everything takes twice as long to get done. Plus some things just aren’t getting done because its too hot inside and out.

On a positive note, my “crops” are growing like gangbusters. They love this weather. The broccoli is about 3 feet high, these tiny cabbages I planted late doubled in size in 2 days, and the tomatoes are ripening with unprecedented speed.

Whatever happened to responsible reporting? Or do I have to keep repeating the words of Winston Churchill, who remarked that the “American press is vulgar and without substance.”

The media’s reaction to the swine flu has been a combination of misleading, fear-mongering, withholding essential information, downplaying real facts, and reveling in the in the obscure.

Take this leading paragraph from Bloomberg, supposedly a reputable source:

The first human trials of a swine- flu vaccine are set to begin in Australia tomorrow as deaths and infections from the H1N1 virus mount worldwide, intensifying demand for a protective shot.

Reading this, you’d think that it was the Black Plague all over again. Who, exactly, is intensifying the demand? Drug companies, who are biting at the bit to make and sell hundreds of millions of doses? The public isn’t “intensifying” their demand, unless they’re dumb enough to get caught up in the sensationalism. Look at how many people get the regular flu vaccine–yeah, not very many. Maybe if the hype of swine flu is elevated, and the danger exaggerated, they can sell more doses.

And notice, they very nicely leave out that in virtually all cases, the people who died had a serious underlying medical condition. They may have soon died anyway, or were susceptible to any infection that came along. But that interferes with the sensationalism of the sentence. The death toll mounts–wow!

Now, another totally misleading paragraph.

Swine flu, known as A(H1N1), has sickened so many people worldwide that the WHO has advised health authorities to stop testing suspected cases and report only hospitalizations. How much vaccine can be produced, how fast, and how effective it will prove to be are still unknown as the pandemic virus spreads.

Well now how does the spread compare with regular flu? This paragraph makes it sound like millions have been infected and died. The “regular” flu is almost never confirmed either by lab testing–too many cases–so this is standard procedure for something like the flu. And notice how they insert the word “pandemic” before virus, as thought they’re trying to make it sound worse than it is. Why not emphasize instead that pandemic simply applies to spread across national borders and has nothing to do with virulence. Oh, but that might be called responsible journalism and we wouldn’t want to have any of that.

And the vast majority of people are never hospitalized for the flu, swine or otherwise. Most also never go to the doctor because in the vast majority of cases, it runs its course, responds to simple treatment like rest and aspirin, and then its over. That is the case for most people who have had the swine flu. They don’t need medical care, and so the cases can’t be counted. Now how difficult is that to explain?

Finally, another segment from the great piece of health journalism:

Hundreds of Deaths

A total of 94,512 laboratory-confirmed cases of the swine flu, resulting in 429 deaths, had been counted as July 6, according to figures released by the WHO before it stopped issuing tables showing cases in all countries with the virus.

So again, no mention of who these people were, or that most of them were quite ill to begin with. And how does the percentage of those dying from swine flu compare with those dying from regular flu? Is it more, less or the same? Come on, guys, can you do a little research?

Also, these numbers are quite tiny in the grand scheme of things. There are over 6 billion people on the planet, and roughly 95,000 have been recorded with swine flu. And 429 died.

Not to be a total spoil sport, it is true that the virus can mutate to a more virulent form, but we haven’t seen a shred of evidence of that. In the meantime, with the lack of any evidence, a small death toll, and the victims generally being those with serious medical conditions who are vulnerable to any sort of bacterial/viral infection, the media is doing its best to keep the public uninformed and stir up fear.

RN Pathways is an interesting venture. I’ve never really looked at it until right now.

This is their description:

RNpathways is the video channel for www.RNpathways.com, the most unique nursing organization in the United States.

At RNpathways, we are passionate about nursing. We’ve created the premiere online destination for nursing career management. On our site, you’ll find comprehensive information about career paths, education, nursing issues and informative industry news. Our goal is to empower nurses and allied healthcare professionals with information to make the right career decisions.

NPR has an interesting article/audio about the Japanese Medical system. It is very affordable, extremely high quality, and definitely slanted in favor of the consumer. The downsides are primarily for the physician and hospitals, because payment is too low. However, the article doesn’t specify if there are “cost burdens” for the physician, such as exorbitantly expensive cost of medical school ( a problem here), exorbitantly expensive premiums for malpractice insurance ( a problem here but I doubt it is in Japan), etc.

Coupled with a healthier diet and lifestyle (they are still a lot thinner than Americans and hopefully won’t replace their healthy eating habits with American fast foods), the Japanese healthcare system works–for the most part. No system is perfect, but this one seems to be lot more functional than ours.

I am so glad that I am no longer a bonafide healthcare worker for many reasons. But one reason looming now is the increasing pressure on healthcare workers to get flu vaccines, even though compliance among doctors and nurses is very low. One has to wonder about that…but that’s another story.

But right now, we have the infamous H1N1 influenza which has become pandemic. And while the media stories, in their attempt to sensationalize and milk this for all its worth, often skim over or completely neglect to clearly explain what pandemic means. The terminology has nothing at all to do with virulence or death rates. It simply means that a disease has spread across a certain number of national borders.

So seasonal flu is pandemic during the winter. Common colds are pandemic. And so on.

But the “call” is for healthcare workers to get vaccinated first, when and if an H1N1 vaccine ever emerges from the lab. I’m sure it will be “voluntary” but the push will be on to force healthcare workers to be guinea pigs get their shot.

I’ve said this before and will said it again–of course one needs to keep an eye on the swine flu and track it. That said, the virus is thus far behaving like any other flu. The death rate is very small, and those who died from flu had underlying medical conditions. A bout of the “regular” flu would have had the same effect.

So no, I would not get a swine flu vaccine if I were still actively working in healthcare. Nor would I get the regular flu vaccine. I’ve never had the flu that I can recall, or a flu vaccine, so why change what seems to be working?

However, there are some alarming trends that even the mainstream media is reporting. First, we are not likely to see a vaccine until the end of the year. That is good news, because by then it will be winter, and we will be able to see if the predictions are correct–that the swine flu will return in the fall. Also, it may be that it stays at its current level of virulence which would negate the urgency of a vaccine.

But here’s where it get worrisome. From the LATimes:

Some preliminary studies have suggested that vaccines made from the pandemic virus do not stimulate as strong an immune response as seasonal flu vaccines, Kieny said. That suggests that vaccines will require larger-than-normal doses of antigens or two doses of vaccine — both of which will strain the supply. Alternatively, the virus could be mixed with adjuvants, which increase the body’s immune reaction to the viral antigens. But those combinations would require additional safety testing. Either way, a fully licensed vaccine is unlikely to be available before the end of the year.

So they’re talking larger than normal doses, and two shots no less. Plus adding in a cocktail of ingredients to increase the body’s immune system. Uh, are we talking major safety issues here? Possible vaccine reactions that can overwhelm the risk of the flu? Especially if the H1N1 remains at its current level of virulence and poses no greater threat than the normal seasonal flu? Especially when there are many ways to prevent getting sick in the first place, without a vaccine?

The next part of this is even worse:

Kieny noted, however, that many countries have provisions in their laws for emergency situations in which a vaccine could be widely used before licensing if preliminary studies indicate that it is safe and effective. If that occurs, she added, it will be very important to increase post-marketing surveillance to detect potential side effects.

Use before licensing if preliminary studies indicate safety? Emphasis on the word preliminary.

Bleech. This is disturbing. It’s one thing if there’s an epidemic similar to the bubonic plague in the Middle Ages, which seemed unstoppable and seemingly killed everything in its path. Then the risk of an untested vaccine is outweighed by the risk of illness. But unless the H1N1 turns into something like the 1918 Spanish flu, then there is absolutely no reason to push this vaccine on anyone before it is ready. I know, Pharma’s got to make a profit.

Well, remember the smallpox vaccine of a few years ago? And the swine flu vaccine of the late 1970s? We should not forget those lessons.

At any rate, thanks guys, but no thanks.

So, instead of coming up with a really viable and feasible healthcare reform plan of their own (you know, one that might reform the insurance industry, mandate insurers can’t cancel policies just because, raise rates because the CEO thinks two private jets are insufficient and wants to expand the fleet), they are spending their energy putting together an anti-healthcare reform website. Way to go, guys.

From Politico:

The Republican National Committee launched a website Thursday to harness grassroots opposition to Democratic health reform plans moving through Congress.

The website, BarackObamaExperiment.com, is the first in a series of Republican efforts to reach out to voters and give them ways to contact lawmakers, radio shows and newspaper editorial boards. It paints Obama’s health care
efforts as a risky experiment the country can’t afford.

“The Democrats want a government-run health care system that will control your health care, your treatments, your medicines, even what doctors you see. This grand experiment on America is a risk our country cannot afford to take,” RNC Chairman Michael Steele says in an introductory video on the website.

Are they offering anything as an alternative? Anything in its place? Or is it to “just say no” to the Obama plan.

The article notes that Republican consultant Alex Castellanos feels that healthcare reform is moving way too quickly. Too much, too soon. Well, the Republicans had 8 years to do something, and did nothing. In fact, healthcare is in worse shape than ever. Castellanos is quoted as writing “This is 20 percent of our economy. This is our health care and our future. If we screw this up, it could last for generations.”

Now that sounds familiar. I guess that’s just what they Republican admin was thinking when they squandered the surplus left from Clinton, and put the nation trillions into debt. Did they give pause and think about it? Or how many generations it may take to pay off the debt and get our nation up and coming?

So guys, put some action where your mouth is. Let’s see your healthcare reform plan, and tell us why it is superior to anything that Obama has come up with. Show us how it will work better, save money, and be for the good of all Americans.

I’m waiting….

Several other blogs have also reported in on this story, which is really quite remarkable when you think about it. Most times, bureaucrats never get caught with their pants down.

The Wall Street Journal Health Blog has a short story about this, as does The healthcareblog.

But I haven’t seen any feedback yet from the California Nurses Association. I’m curious about their views on this. Can go either way with them!

Well, not in THAT sense. But Governor Arnold has cleaned house at the California Board of Registered Nursing. I can’t say that I have any sad feelings about it. BORNs exist simply to keep themselves in business, and have been a major obstacle to simplifying and improving licensing–like having one database in the US for all registered nurses and one license.

I have fortunately, had to have little dealings with them. But again, they exist to collect money to pay their salaries, and do as little work as possible. For example, in CA, it cost the same extravagant fee to keep a license active or inactive. Really fair, huh.

They have also been known to tack on extra diddies for people applying for CA licenses. A friend of mine who graduated from an accredited nursing school, had an RN license in good standing, and several years experience, was told that they couldn’t issue her a license because she lacked “sociology 101.” Like not having the basic soc course had interfered with her work thus far, and having to return to school to take this basic class was going to benefit California.

Anyway, here’s what the LA Times has to say:

Gov. Arnold Schwarzenegger replaced most members of the state Board of Registered Nursing on Monday, citing the unacceptable time it takes to discipline nurses accused of egregious misconduct.

He fired three of six sitting board members — including President Susanne Phillips — in two-paragraph letters curtly thanking them for their service. Another member resigned Sunday. Late Monday, the governor’s administration released a list of replacements.

The shake-up came a day after The Times and the nonprofit news organization ProPublica published an investigation finding that it takes the board, which oversees 350,000 licensees, an average of three years and five months to investigate and close complaints against nurses.

During that time, nurses accused of wrongdoing are free to practice — often with spotless records — and move from hospital to hospital. Potential employers are unaware of the risks, and patients have been harmed as a result.

Three and a half years to investigate a complaint? Pray tell, what the hell are they doing all day? There are not all that many complaints, and they have little else to do–in fact, their main reason for being is to investigate complaints and discipline wayward nurses.

Good for you Arnold. Maybe a shake-up might get them off their butts and make the CA BORN a viable institution.

According to womenshealth.gov, black American women have the highest rates of being overweight or obese compared to other groups in the U.S. About four out of five are overweight or obese.

Well, okay, you’ve probably seen these stats before. Maybe as a nurse or doc, you’ve spent a lot of time counseling patients on weight, or treating them for conditions that stem, at least in part, from excess weight.

Now, one in four black women, 55 years of age or older, has diabetes. That’s type II diabetes, which is directly related to lifestyle, primarily obesity.

The reason I am bringing this up is because of Obama’s pick for Surgeon General. You can read all about her qualifications, and she seems like a devoted family practice physician who would like healthcare for all.

However, at the risk of being exceedingly un-PC, the woman is overweight. Noticeably overweight. And yes, it was the first thing I noticed when I saw her photograph–sorry if I couldn’t look past it and be totally gender, color and weight blind–but what I saw was an overweight black woman.

Some people feel her credentials are weak, given that her career has been largely concentrated in a small rural area serving the poor. But the Surgeon General is less about credentials and more about image. I think her credentials are just fine, and even bordering on the heroic. However, the Surgeon General is a public figure who has little power but who is supposed to set an agenda.

Now I’m not the only one who’s noticed her extra weight, but many defenders of Dr. Benjamin have jumped on the bandwagon, calling detractors racist among other things, or that overweight people can be healthy, or that the woman is simply big boned, or that we place too much emphasis on appearance in our society, or that we should be looking at her qualifications and not her weight, and so on.

But we can blather all we want about it, but the fact remains that this woman will be in the public eye. She will mount the podium and speak on public health issues. Aside from access to healthcare and insurance coverage, the #1 health issue facing this country is overweight and obesity. And if the nation slimmed down, the need for many healthcare services would dramatically decrease. Preventive health will be the most life saving and cost effective proposition, but will people really take an overweight Surgeon General seriously?

Again, it is about image. Public eye. TV appearances. Public talks. Speaking to schoolchildren. No one is going to look at this overweight woman and think, “gee, maybe there’s a genetic reason why she’s fat. Or maybe she works out five days a week and runs 80 miles a day but just can’t shake the weight off.”

Or “she probably really eats healthy, never goes to MickeyD’s, eats broccoli every day, and shuns Frosted Flakes. It’s just a problem with her thyroid.”

And that’s what a lot of the people defending her have zeroed in on, as well as the fact that it’s somehow “normal” to be overweight “at her age.” Or that we should “consider her age, and the average weight of African American women of that age.”

Uh, that’s exactly what we don’t want to do. Black women should not be looking at her as a role model and thinking that “well if the Surgeon General herself is overweight, then nothing wrong with me carrying around all these extra pounds. Surely the doc wouldn’t be tilting the scales if it was such a bad thing.”

It is a big deal, considering the stakes at hand. The job of the Surgeon General is to get an agenda across, and one of our primary health agendas is to reduce preventable diseases. She says herself, that many of her family members died of preventable diseases like diabetes and lung cancer. I can’t imagine her discussing diabetes, and the need for lifestyle changes, if she seems incapable of managing her own weight. And even if she is the picture of health, with normal blood pressure, blood sugar, etc., the public is going to still see a fat woman. There, I said the “f” word, but that’s way it goes. That’s the reality. And I’m being kinder than many of the comments I’ve seen posted about her weight.

There are thousands of physicians out there that Obama could have tapped. It would have been nice for him to have selected a physician who is truly involved in preventive health. And one who looks the part, that can serve as a role model.

So again, I know that this is so un-PC, but the feeling that the pick must be a minority, or a woman, or both, should not supersede common sense.

For those of you interested in the world of cancer, check out Dr. Len’s Cancer Blog. The Dr. Len I am referring to is J. Leonard Lichtenfeld, MD, MACP – Deputy Chief Medical Officer for the national office of the American Cancer Society.

His blog is interesting and provocative, and he’s not afraid to speak his mind. I admit, I’m a bit biased because I’ve interviewed him on more than one occasion for various and sundry articles, and he is a great guy and extremely knowledgable about a wide range of cancer issues.

No, just in case you were wondering, I have no ties to the American Cancer Society, and absolutely nothing to disclose. I just like Dr. Len and his blog, and think its a great resource. I happened to think of it right now, because I was doing some research and his blog popped up.

Sounds like some sort of expose. Either that or a made for TV movie.

But that apparently is the new incarnation of the Nurse Advocacy Center, which I blogged about the other day. The Center which closed its door amidst “a great legal crisis,” give or take.

Sandy Summers has now simply reopened the Center under a different name, the Truth About Nursing, but all else appears to be identical. It is run by Sandy and her husband, as was the Advocacy Center, with a small board of directors. I’m assuming that there’s some crossover–that some of the board members have made the switch. I really didn’t have time to check and compare names.

The layout of the website is identical, even down to the color scheme. Much of the archived material, such as movie reviews and profiles of famous nurses, has simply been moved over to the new site.

So for those nurses who mourned the loss of the Advocacy Center, never fear, it is back. Just with a different name.

Since the center is essentially back online, it really makes the explanation given on the old website all the more puzzling. But you know, in the grand scheme of things, it really doesn’t matter.

“Everyone over the age of 55 should take drugs to lower their blood pressure – even if their reading is normal, a leading doctor has recommended. Professor Malcolm Law’s research found the medication cut the risk of heart attacks and strokes regardless of a person’s blood pressure.”

That wondrous comment above came from the Mail online, although it can be found in various and sundry places on the web. I had been meaning to write on this sooner, but it somehow got lost in my drafts.

But “studies” like these, and marvelous “recommendations” for “preventive” health like this nonsense is what makes people suspicious of doctors and the healthcare establishment in general. Malcolm Law sounds like a pharmaceutical salesman, out to make a huge commission by trying to persuade people to take drugs that they neither want nor need. This so-called heart specialist apparently thinks that it is okay to expose healthy persons to the side effects of these drugs, which can be quite profound, as well as the expense.

Basically, the man is either on someone’s payroll or is just profoundly unqualified to be practicing medicine. Perhaps Dr. Law would like to put me on anti-hypertensives. My resting blood pressure is about 90/65. How much lower does he think it should go?

My goodness, how do people manage to stay alive without taking anti-hypertensives? How has the human race survived this long without them?

These comments are priceless:

‘Our results indicate the importance of lowering blood pressure in everyone over a certain age, rather than measuring it in everyone and treating it in some,’ he said.

I love it–one size fits all medicine. Age should be the deciding factor, not any of the individual characteristics of the person. As I said, would Dr. Law think that I needed to lower my blood pressure? Does he realize that there are hundreds of millions of persons on this planet over the age of 55 who are healthy, fit, have a normal blood pressure and who will not die of heart disease. And in fact, if they take the advice of the wonderful Dr. Law, they may instead end up suffering from depression, fatigue, impotence–all known side effect of anti-hypertensive drugs.

He added that the pills were relatively cheap and the side effects could be minimised by combining low doses of three blood pressure lowering drugs into a single tablet.

So would he like to foot the bill for drugging the world’s over 55 population? And take responsibility for the side effects? I wonder how old Dr. Law is, and if he is following his own advice.

Now here is a great quote from the guy, which really shows his intelligence. Or perhaps, he really has nothing to say to support his views so he had to fear monger (nothing like adding swine flu to the mix).

Addressing concerns about ‘ medicalising’ the population, he said: ‘If, for example, swine flu was serious, we would want to vaccinate everybody. You wouldn’t want to try to assess who is at highest risk and only vaccinate them. We see this as analogous.’

So is he really saying that he sees no difference in offering a vaccine to everyone in the case of an outbreak of a very serious and lethal virus, and one that is airborne and highly infectious–and trying to force healthy people with normal blood pressure to take medication to correct a problem they don’t have? Or even if there blood pressure is a little on the high side, not to try to first correct it with lifestyle changes and diet?

On another website, it says that Law and his co-author Nicholas Wald hold patents (granted and pending) on the formulation of a combined pill to simultaneously reduce four cardiovascular risk factors, including blood pressure. So it does appear that Dr. Law and his co-conspirators are really out to make some money.

Thanks, but no thanks. I think I’ll pass on the Law and Wald wonder pill and stick to the tried and true of staying healthy–you know, those old fashioned ideas of staying slim, exercising, eating healthy fresh food–obviously thinks that Dr. Law would prefer we all forget about.

Yes, much hoo-ha over a “new” study which shows that calorie restriction in monkeys gives them that something extra. They age more slowly, look like young babes even though they’re senior citizens, and seem to have escaped the so-called age related diseases. An article in the LA Times is gushing over this discovery like it was the discovery of the proverbial fountain of youth.

But really, this is nothing new. Calorie restriction has been discussed and studies for decades.  The article even says that:

Evidence has been mounting for years that the practice of caloric restriction — essentially, going on a permanent diet — greatly reduces the risk of age-related diseases and even postpones death. It has been shown to significantly extend the lives of yeast, worms, flies, spiders, fish, mice and rats.

A lot of people have also practiced calorie restriction, with varying results, although it is safe to say that the vast majority of healthy centurians are not overweight.

But what makes this study so special? Beats me as to why it is even news.  The article goes on to say that the “study comes as some validation to the cadre of several hundred true-believing Americans who profess to practice caloric restriction in their daily lives.” Well, it may add more evidence, but again, this isn’t exactly a news-breaker. It’s just a repeat of what’s already been studied. This time it was done in primates.

Now, if it was a study with human subjects, and they had some profound results, that would be a different story.  But all this study is doing is confirming findings of other research in non-human subjects, and still unable to answer a multitude of questions about calorie restriction. Should I or shouldn’t I?

The Nurse Advocacy Center has a notice on its website that “The Board of Directors of the Center for Nursing Advocacy has decided to close the Center in the near future.” If you click on the link, it gives you a little bit more information about the decision.

The Board of Directors of the Center voted in December 2008 to close the Center. We have posted this information on our Web site. This decision was made after careful consideration of the mission and values of the Center and the ability of the Center to achieve them under its existing operating structure.

It is important for you to know that this decision was a difficult one and was the result of thoughtful deliberation on the part of every Board member. The Center’s records were in disarray, the Center’s taxes had not been paid for years, serious matters had been hidden from the Board of Directors, and the Center was in legal crisis. Indeed, after considering all the options, we felt that we were legally required to dissolve the Center as a corporation.

This is a very strange note to say the least. The Nurse Advocacy Center is a small organization that was started several years ago to serve as a “media watchdog.” Their goal was to try to having nursing shown in a more realistic and positive light in the mass media. While I think their mission was worthwhile, their execution of it was frequently overdone and they didn’t seem to know how to pick their battles.

At any rate, the reasons given here are quite bizarre, considering the size and nature of the organization. Basically, it was run by Sandy Summers and her husband, with a small board of directors. But the language used here is quite provocative–records in disarray, taxes not paid for years, legal crisis, secrets kept from the board. It’s not like this was a huge multinational non-profit, where millions in donations and grants were passing through, and an army of workers was needed to keep track of the paperwork.

However, a short article in the American Journal of Nursing may shed more light on it.

Founder Sandy Summers told AJN by e-mail, “I believe this was the result of my differences with a small faction of the board whose concerns were misplaced or fairly minor, since our records were in order and nonprofit charities like the Center don’t generally pay taxes (I regret that we owed $17 in sales tax).”

It sounds like there may have been some disagreements between Sandy and her board members, and perhaps a little more heated and volatile than she lets on. At any rate, the doors to the Advocacy Center are padlocked, although the website is still up and running.

That’s what Mr. Health Insurance exec says to the following questions–I don’t want a public plan to compete with me, I don’t want any type of insurance reform, and I don’t want to change my wicked ways.

The yes response? That we’ll continue to be unethical and rip off consumers as much as possible.

Now I’m not being unduly harsh towards insurers, but really, they are gritting their teeth at the mere mention of healthcare reform, except if a law is passed requiring people to purchase private insurance. But according to this article in the LA Times, they seem rather offended that anyone would even ask them to cease and desist highly unethical practices.

Executives of three of the nation’s largest health insurers told federal lawmakers in Washington on Tuesday that they would continue canceling medical coverage for some sick policyholders, despite withering criticism from Republican and Democratic members of Congress who decried the practice as unfair and abusive.

The hearing on the controversial action known as rescission, which has left thousands of Americans burdened with costly medical bills despite paying insurance premiums, began a day after President Obama outlined his proposals for revamping the nation’s healthcare system.

It is amazing to listen to their utter arrogance and defiance. Screwing the public is fair game to them. All they want is to collect premiums, but Lord help you if you actually get sick and need them to pay. Then they find all sorts of ways to get rid of you. Basically, they only want to insure healthy people who will send them a check every month and who will never utilize their services.

An investigation by the House Subcommittee on Oversight and Investigations showed that health insurers WellPoint Inc., UnitedHealth Group and Assurant Inc. canceled the coverage of more than 20,000 people, allowing the companies to avoid paying more than $300 million in medical claims over a five-year period.

It also found that policyholders with breast cancer, lymphoma and more than 1,000 other conditions were targeted for rescission and that employees were praised in performance reviews for terminating the policies of customers with expensive illnesses.

Ya just gotta love ‘em.

Up North and over the border. Canada. Land of maple syrup, breathtaking scenery, wilderness, French speakers, terrific metro centers, and a mysterious health system. I say “mysterious” because most Americans really have no idea of how it works, and that goes for those who support and lament the Canadian system. I’ve heard people say its “terrible” but they haven’t a clue about it, while others say “that’s the way we should do it here,” and they haven’t a clue either about how the Canadian system works.

When many people fail to understand is that universal healthcare and a national system are 2 very different beasts. And while all industrialized nations, aside from the U.S., have some type of healthcare system that covers all residents in one way or another, they all differ. What they have in common is that no one goes bankrupt trying to pay medical bills, as is common here in the U.S.

But getting back to Canada, before one reviles or applauds their system, at minimum, it is important just to know what you are applauding or reviling. There is a short article in the NY Times which dishes a little bit on how the Canadian system actually works, and hopefully dispels some of the myths and misconceptions.

For example, Canadian physicians are not government employees.  They retain a great deal of control over when, how and where they work. Instead of being paid salaries, most of them bill provincial governments on a fee-for-service basis. Canadian hospitals are also autonomous institutions that are generally, but not necessarily, governed by local health authorities.

The article also discusses, albeit briefly, how the growing private insurance industry opposed publicly funded medical care for all but the poorest Canadians, but ultimately, they did not prevail.

The big news–which will hopefully die down and vanish along with Sarah Palin–is that Palin abruptly resigned her position as governor of Alaska. Her delivery of the announcement was perhaps the most bizarre aspect of it all–an incoherent rambling nonsensical “stream of conscienceness” which offered no real explanation for the resignation; delivered without any warning even to those closest to her; given in her backyard (with geese honking in the background) late afternoon and on the day before a national holiday weekend; without any really warning to the press for coverage.

Maybe Palin hopes to become Obama’s adviser on healthcare? Or on energy, which she considers to be her “specialty?”

Anyway, I don’t want to waste space on Palin, but Andrew Sullivan (perhaps the foremost Palinologist of modern times) has a great blog entry about her resignation. So many questions, so much speculation, so few answers. What exactly, would cause the woman to completely flip her lid?

Happy Independence Day! Don’t hear it called that very much, do we. I’m not doing anything special, and surprisingly, few people have been setting off fireworks in the neighborhood. It could be that they are strictly illegal in this community, which is basically a forest. Even though it is not dry and crispy, it is still dry enough for a fire to start. Personally, I am happy with the restrictions, as inexperienced people setting off fireworks can not only start fires, but cause harm to themselves, to animals, to their friends, etc. They are having fireworks tonight at the Marina, performed safely and by experts, and I actually think there is a place where people can set off their own–in a designated area.

Anyway, the 4th was never really one of my favorite holidays. By that, I mean its not something that I salivated for and eagerly anticipated. And really, I don’t know very many people who really really really love the 4th, other than its a day off from work and an excuse to drink beer and fire up the coals. And a good shopping day–always 4th of July sales.

However, July 4th was always a day that I tried to work. And why not? It was holiday time pay, and again, not really a holiday that I cared one way about or another. Fireworks are great, and if I worked days, even 7 to 7, there was still plenty of time to catch the show.

The same thing for Labor Day. Another day of barbecues and sales, and when I was a child, it meant that school was about to begin. But when I was working as a nurse, it was just another day for getting holiday time.

So happy 4th.

I’ve been trying to take advantage of warm and sunny (yes, it is true) weather and spend more time outside and away from the computer. Plus twitter has become a major time suck, as I feared it would, but I love it. So easy to put little tweets up.

Anyway, I had planned on getting up to date on blogging, but instead, got sucked into the fascinating news about Sarah Palin. Resigned from her job as governor? Released the news on the 4th of July weekend, in a hasty, totally incoherent speech (we all know that she can’t put a sentence together but for such an important announcement, one would think she would get a speech writer), with barely any media present? Something is brewing—perhaps the Palin scandal of the century.