Medical Record Access Could Improve Medical Care For All

Let's not squander this great opportunity! Medical outcomes are unknown for each of us and collectively, they are impossible to predict.

As Americans consider taking control of their health care records and ponder the future of medicine, the President is seeking to allay fears of the unknown future costs of medical care.

As the President says, if Americans can pay less with a public health care system, then they "need to know that". If health care insurance companies are saying they have nothing to fear from public health care alternatives, then they should welcome the competition. Let's call their bluff!

Yet, at the same time:

"- 46 million Americans remain uninsured;
- 20 thousand people continue to die each year because they are uninsured;
- Elderly Americans continue to make the choice of whether they should eat or buy medicine;
- Health care costs continue to bankrupt American families."
Huffington Post

It stand to reason that health care in a single-payer public system could become as popular as public schools. There are still private schools all over the place, but public alternatives are useful to the vast majority. I think the change would be welcome. As this doctor says in the Huffington Post in favor of a public alternative:

"I challenge the AMA leadership to cite a single example of an industry where involvement by the government has lead to the elimination of private enterprise. This has not been the case with the creation of public police forces in the second half of the 1800's (private security companies still exist), we have a robust system of public and private colleges existing the same market, and bookstores still sell books despite the presence of public libraries."
Huffington Post

And as for modernizing medical records, according to Esther Dyson, the well-known internet advocate:

"a typical thief would much rather get into your bank account than into your health record (despite some recent health care/identity theft stories. most medical fraud is not at the expense of individuals)."
Huffington Post

Being able to access records quickly could help doctors coordinate care. It could prove very useful for doctors and hospitals, making them more competitive and improving medical standards. That would benefit everyone.

Here's an interesting article in the Wall Street Journal about current healthcare plans in America.

Evidence Prompts ACLU To Take Rights Case -- In St Louis!

Air travelers in America have reason to be more vigilant and careful than ever.

The ACLU's involvement in the case of an American passenger who recorded a harrassment by civil authorities in St. Louis is most welcomed. The authorities are clearly abusing their power again, and I believe this article in the New York Times. Why would a passenger make up a charge like this?

An experience of my own corroborates this. Unfortunately, I did not have a telephone recording as proof to back me up. I was a defenseless, exhausted traveling 24-year-old when it happened. I was taken away from my husband and left in a windowless bare office at JFK Airport for at least two hours, probably longer, with only a police officer carrying lots of major weapons checking on me every hour. There was no bed, bathroom or food. This after a punishing flight.

Finally, I was released and found that my husband, well-educated, even then a top scientist hired to fill an educational gap here had been detained against his will for hours as well and then allowed to leave. My husband and I were both entering the country from England to live in the United States. I'm from Canada, and I don't think such flagrant disregard for human rights would happen there. Both of us had already received long-awaited elite American "Green Cards". No reasons or apologies were ever offered for the shocking treatment and staggering lapse in courtesy similarly given to both of us. We were obviously supposed to forgive and forget this inhuman treatment, having been pushed into those offices like criminals or dogs. It made me like America less.

Have I ever forgiven America for this? A resounding, definite NO! Of course, not. That was inexcusable treatment. Why bother going through paperwork for citizenship if that's the treatment I might get?

When did it happen? Oh, 1980! Have I ever to this day been given a rational explanation for it? No! Do I think it's any better now? Don't know, but this story has me thinking about it again and doubtful.

It saddens me if this is still happening, and if it's spread within America now. Good luck to the ACLU. If only there could have been a happy ending to my story.

Diet Excuses

“I will be able to diet tomorrow when I have time and money.”

Five "diet excuses" are hiding in that innocent-sounding sentence.

• “I” – She/he can diet but I can’t, at least, right now.
• “will be able to” – it’s too hard now to diet
• “tomorrow” – it’s always in a plan for tomorrow, not today
• “time” – don’t have time to diet today
• “money” – can’t afford to diet today.

Daily bread is always food for thought, isn't it?



Courtesy FitShack

Can President Obama Inspire Responsible Health Care?

Let's hope the President whips the AMA today into at least a better attitude. In a general letter protesting against the creation of a single-payer system, the AMA "couldn't get through the second paragraph before bringing up the issue of physician reimbursement."

In his so-called "magisterial" article in The New Yorker, Atul Gawande says that health care professionals of all stripes must unite to pull down health care costs for "all" consumers. He says,

"The overarching goal of health-care reform is to establish a system that has three basic attributes. It should leave no one uncovered—medical debt must disappear as a cause of personal bankruptcy in America. It should no longer be an economic catastrophe for employers. And it should hold doctors, nurses, hospitals, drug and device companies, and insurers collectively responsible for making care better, safer, and less costly." [New Yorker].

Who wants the current pattern of "routine cruelty"? Why not strive for compassion and focus? How will doctors at the AMA ever be able to make it up to the President for the pain and suffering he saw his sick mother experience?

GOOGLE RULES

In case the next table is illegible, here is a summary of tips to help fine tune searches. Try changing search words from:

"how 2"-----to-----"how might one"

"when was"-----to-----"in which year"

"when do"-----to-----"under what condition(s)"

"how did the"---to-----"in what way did the"

"why"--------to--------"for what reasons"



Courtesy, Digg.com

Maybe a directory of search tips is what's needed, or maybe Google could help suggest stock search phrases the way it offers spelling corrections with each search. What search has to do with "intelligence" is not clear. Perhaps saying "faster" and "slower", or "more" and "less" effective would have conveyed the same point without controversy. For example, when we want a phone number, usually we just want the quickest and easiest way to get it.

Sometimes searching brings many interesting results to focus that wouldn't ever have been found except by accident. Who knows how many innovations of the future will be discovered on search engines?

The Impressive Valerie Jarrett

Valerie Jarrett, Wikipedia

Valerie Jarrett appeared today on the "Conversations with Judy Woodruff" Show on Bloomberg TV and I want to say I am very favorably impressed with her intelligence and education and smooth looks. Jarrett has held a series of important, high-paying positions and directorships and is a smart choice as Oval Office adviser.

Valerie Bowman Jarrett (born November 14, 1956) is a Chicago lawyer, businesswoman, and civic leader. She is best known for her role as an advisor to President Barack Obama. Jarrett is a Senior Advisor and Assistant to the President for Public Engagement and Intergovernmental Affairs for the Obama administration. Prior to that she served as a co-chairperson of the Obama-Biden Transition Project.

Early Life: Jarrett was born in Shiraz, Iran, to American parents James E. Bowman and Barbara Taylor Bowman, where her father, a pathologist and geneticist, ran a hospital for children...

As a child she spoke Persian and French.

Education: Jarrett graduated from Northfield Mount Hermon, a New England boarding school, in 1974. She earned a B.A. in Psychology from Stanford University in 1978, and a Juris Doctor (J.D.) from the University of Michigan Law School in 1981.

Personal Life: In 1983 Jarrett married Dr. William Robert Jarrett, son of famed Chicago Sun-Times reporter Vernon Jarrett and has one daughter....separated in 1987, and divorced in 1988. Jarrett died of a sudden heart attack in 1993".

Professional Career: "She was the CEO of The Habitat Company, a real estate development and management company which she joined in 1995....Jarrett was a member of the board of Chicago Stock Exchange (2000–2007, as Chairman, 2004–2007). She is also the Chairman of the Board of Trustees of the University of Chicago Medical Center, Vice Chairman of the Board of Trustees of the University of Chicago and a Trustee of Chicago's Museum of Science and Industry.Jarrett serves on the board of directors of USG Corporation, a Chicago based building materials corporation." (Wikipedia)

Having to work with Larry Summers must be a challenge after he famously "said that women may somehow be innately less able in science and maths than men are".

Her obvious ability to be very articulate and battle through sexism and stereotypes are proving useful.

"Manhattanhenge"

Gawker.com

The view from 42nd and 3rd yesterday evening, when the setting sun aligned with streets in Manhattan to create the yearly event known as "Manhattan Solstice" or "Manhattanhenge". [Image via jonbell has no h's Flickr.]

My question is: If it happens to be cloudy, is that it for entire year?

So Much For America's Ideal Medical System!

Americans are afraid both that they won't be covered by private medical insurance, and they are also scared that others won't be able to afford medical care. That would be laudable if only the current quality of care were more successful. But there are a great many inefficiencies in the system. It's far from perfect.

For the AMA status quo to be against a public plan (in HuffPost) without caring about all those millions of uninsured smacks of elitism. Doctors are paid to care, but they officially don't have to care for the uninsured. How contradictory is that? They certainly appear to be advocating a class of "untouchable" uninsured!

If you don't trust what I am saying, read this article by uninsured writer, Bob Cesca, and how he got there. Compare that to the wages of the medical "insurance company" CEOs. Have to keep those CEOs paid, huh, or else they might not "work"...

Speaking of "work", there is an article from CNN today that details a student's ability to diagnose her own disease. As it happens, it was part of a high school biology class. She learned how to appreciate her abnormal slide of her own self as her pathologist had failed to notice. How revealing is that? Of course, doctors fudged it, saying it's just a normal mistake. Happens all the time, or so doctors would have us think. Exactly!

How many other times has misdiagnosis happened, or that pills have been incorrectly dispensed with fatal results in America? How many patients die as "unknown consequences" of physician mistakes? If doctors are human, and make mistakes, then why aren't methods and controls and accountability important, as part of the larger medical system? Then again, who says doctors and the AMA even care for the sick and uninsured, or have good between-doctor communication and oversight? It's just a rosy domestic mainstream fantasy. American doctors and insurance companies have the power; the uninsured and the sick have clarity and bear all the pain. Tell me that's fair. Tell me that's "caring for the sick." Just don't even think it's the best medical system in the world!

Italy's New High Speed Rail Line

"Company officials estimate that a trip from Rome to Milan, about 350 miles by rail, will last three hours and that trains will be able to travel up to speeds of 225 miles an hour. The billion-euro project, spearheaded by the head of Fiat and Ferrari, Luca di Montezemolo, includes investors like the French rail company S.N.C.F., and hopes to produce trains that are mostly constructed from recyclable materials and consume 15 percent less energy than current high-speed trains.

Italo’s fares will be competitive with those of Trenitalia (www.ntvspa.it), which charges $58 for a ticket from Rome to Milan."
NY Times.

Why can't North America get its act together and build this? Having long admired Italy's admirable new rail lines, like one we were in from Rome to Venice, we know they would be more popular if available here.

Best Hubble Space Telescope Photos

The online site of the Smithsonian Museums has made a photo site of best pictures now that the Hubble space trip is over. These photos show nature at its perfect best. A rare sight of heaven to behold!

smithsonian.com. Click for more photos.

Here is another link to Hubble photos at Boston.com

Of course, here is my earlier blog entry on the same topic. Can't get enough of these pictures!

Contraception And Abortion Rights In America Aid Women

Contraception and abortion are still hot-button topics in America, thirty-six years after Roe v. Wade legislation passed legalizing early abortions in 46 states. Men especially need to chill out when it comes to abortion, understand it and have fewer emotional conflicts about it. They could learn why, when, how and which women get abortions.

Most women are surprised to hear that men have those inner conflicts because having a baby is of immediate importance to women's lives and their futures, both collectively and individually. Couples usually do find abortion difficult despite having consensually taken part in unprotected sex (although sometimes pregnancy can be a failure of prescription contraceptives.)

Women get abortions when they feel they have no choice. They may not have the energy, the internal emotional makeup, or the money, to carry a baby to term or to raise another child. They may not feel old and established enough to care for it. They might have been abused. Some, if not most women carrying babies, will want to carry their babies to term, or will provide prospective adoptive parents with a child as a surrogate mother. But these are all personal experiences and choices. The constant, daily experience of pregnancy determines a mother's right to choose and she should prevail. Her life should always be considered more valuable than that of an unborn baby.

Here, then, is a guide that I, as a woman and mother, have listed to try to help men especially, and women, understand the thoughts and emotions women generally experience at one time or another about the controversial topic of contraception and abortion:

1) Women want and need to be able to make personal choices as far as how they use their own fertility, for their own health and careers and lives.
2) Fertile women create ova every month, can therefore create babies every month. They all are aware of this if they are fertile, as most women are.
3) They cannot raise all the babies they could theoretically make.
4) Men sometimes threaten abortion to frighten women, like a weapon.
5) There are many children who could be adopted by those needing to raise a child.
6) There are many children living in families who cannot afford to raise them already.
7) A baby is a gift, and it must be treated well by a responsible adult.
8) Children are expensive to raise and educate.
9) Children are physically demanding and difficult to raise.
10) Children need a parent to raise them, when they are young.
11) Women who have been victimized by men and will not have the resources to raise a child need to be able to abort, if necessary for the health of the mother.
12) Anyone who thinks a raped woman should be forced to carry a child to term is inhuman. If she does so, it should be 100% her own choice. In this case, she might not know and approve of the composition of the father's genetic background.
13) Babies can incur health and education costs that even responsible, working parents cannot afford.
14) Abortion is a serious operation that a woman(or a couple)decides heavily. Abortion is not always a decision of "the couple." Since up to a third of babies are born to single women, it can be up to a woman to decide if she can raise a child and wishes to continue the pregnancy.
15) Assuming a woman takes an abortion lightly diminishes a woman's intelligence and her vision of her future.
16) Some babies are faceless, brainless, would be born dead, or could endanger the mother's life. There is no reason then for a mother to carry the baby any longer than she wants to.
17) Women will always want abortions for one reason or another, and if they can't get them safely and legally, they will, nevertheless, still have the need for them and get them done somewhere.
18) "Plan B" is an over-the-counter drug to prevent pregnancy (and possibly an ensuing abortion) in America if taken within 72 hours of unprotected sex. It costs about USD$44.99 at Target (request at prescription counter), WalMart, drugstore.com, and free at Planned Parenthood. "Plan B", also known as the "morning after" pill, is not the same as RU-486, a pill that causes an abortion. Here's a good slideshow of sex myths at Health.com linked here.
19)Contraceptives (to control the frequency of pregnancies) are popular prescription-based drugs, and should be available from your doctor and bought in any pharmacy, regardless of personal views held by your doctor or those behind the front counter (who have no part raising and paying for the children of buyers. In my view, one shouldn't judge the morals of women and deny them of prescription-based drugs to prevent pregnancies.)
20)"The purposeful lying done under the name of “abstinence education” in American schools is no help, either. European young people are about as active sexually as Americans, but they are not lied to about contraception in school. Teenage American girls are seven times as likely as French girls to have an abortion, for instance."
The Daily Beast, Alterman, E. "The Truth About Abortion"

Once a man has successfully impregnated a woman, he must have respect for the fact that the baby's future is the mother's prerogative. She is carrying and feeding that fetus from the first moment of conception, and making daily sacrifices and changes in her life. It is usually, in most cases and universally, the mother with primary responsibility for physically raising a baby for many years.

There are many children in need of foster care and adoption. Mothers carrying babies are well aware, and need not be lectured on abortion if they so choose. That's a bit late, very insulting and sometimes misinformed.

Whoever thinks a mother is anti-life needs to be realistic, and have more compassion and consideration for the value of her life. The lives of women have been profoundly changed and improved with family planning legislation, and American women should be proud of gaining more control over their own futures and their own choices.

In conclusion, there aren't any good cases against contraception and abortion if those choices are made, in my view, and these are my views. If I still haven't persuaded you and you think differently, please make your views known in a blog, or comment.

Cider House Rules, by John Irving, a novel on the same topic is very moving. It's also a great movie.

Credit Is Due, If True

"After months of complaints by university groups and scientific organizations, the State Department is acting to speed up the delay-plagued visa process for foreign graduate students and post-doctoral researchers, an official said Tuesday.

The official, David Donahue, the deputy assistant secretary of state for consular services, said the department started attacking the backlog of requests on Friday. “I am not sure when we will get all of them cleared up,” he said, but eventually routine requests should be dealt with in two weeks.[mine] He said the department had brought in extra staff to handle the applications and had revised procedures to speed reviews."

The New York Times, June 2, 2009

Pelosi wins "Legislator of the Year" Award

Nancy Pelosi, U.S. Speaker of the House, fresh back in Washington from a trip to Shanghai was honored today, June 2, 2009, with the well-deserved "Legislator of the Year" award.

Craig Barrett, Chairman of Intel Corporation, and a leader of the Task force on American Innovation presented her with the award "in honor of the Speaker's outstanding leadership, commitment and vision in the increase of federal funding of basic research in the physical sciences."

In addition to Speaker Pelosi and Craig Barrett, confirmed guests included U.S. Rep. Bart Gordon, Chairman of the House Science & Technology Committee, U.S. Rep. Anna Eshoo (CA-14th), and Norman Augustine, retired CEO and Chairman of Lockheed Martin Corp.

Overwhelmingly elected by her colleagues in the fall of 2002 as Democratic Leader of the House of Representatives, Nancy Pelosi is the first woman in American history to lead a major party in the U.S. Congress.

Nancy Pelosi, Wikimedia

"The Pelosi Amendment" has linked bank funding internationally with environmental impacts of development projects. She has drawn attention to security threats associated with terrorism, attempted to link trade with China to increased human rights standards, voicing concerns on freeing the people of Tibet. Her influence has increased funding for international family planning programs.

Within America, she has successfully increased access to health insurance for the disabled, for those with HIV/Aids, and has assisted nonprofits create affordable housing, and many other rulings.

Here is an excerpt of her acceptance speech in the Capitol, courtesy of CNBC:

"Wherever I go, I tell people that if you want to know the agenda for this Congress, think of four words: science, science, science, science...

"In just the last two years we: -- Enacted comprehensive innovation legislation, the COMPETES Act -- Put America on a path doubling funding for basic scientific research -- Made college more affordable with the largest college aid expansion since the GI Bill -- Helped to provide more highly qualified teachers in the fields of mathematics, science, engineering, technology -- Established a public-private partnership to educate and train the next generation of mathematicians, scientists and engineers -- Extended the R&D Tax Credit -- Created a new Advanced Research Projects Agency for Energy (ARPA-E) to encourage high-risk, high-reward clean energy research "And that is just the beginning.

"Because innovation is essential to rebuilding our economy, the recently passed American Recovery and Reinvestment Act included: -- $3 billion for NSF to expand employment opportunities, improved facilities and equipment, and bolster math and science instruction -- $2 billion for the Department of Energy for basic research, laboratory improvements, and to support the mission of ARPA-E -- $360 million for the National Institutes of Standards and Technology for grants to help improve research science buildings at colleges and universities and $220 million for research fellowships, equipment and competitive grants -- A $500 increase in the maximum Pell Grant that will help make college more affordable for approximately 7 million students."

Congratulations, Speaker Pelosi!

"Ambush Makeovers": Fun to Watch

Here is a link to the "Ambush Makeovers," an America T.V. series of total cosmetic reinventions. Each project aired once a week on MSNBC. Before and after photos, well worth seeing, are linked here, available at:

http://www.msnbc.msn.com/id/23694559/?pg=1#tdy_ambush_makeovers

Here's a hot tip: All the photos can be seen at once, quickly, if you click "Print This". Some of these ladies were caught off guard, as a guess. The descriptions of their lives are a bit haphazard and they all sound like hard-working saints, making me feel "high maintenance" and a "big spender" in comparison.

Health Care: A Necessity Not A Privilege. Conflicts of Interest Abound In America.

Even small American firms are now being forced to give up health insurance for their employees. Many employers are saying they must do so because it's the last benefit to go before they lay off employees in this harsh economic downturn.

Doctors are in positions of trust from patients, and have the power to abuse that trust. In turn, they work within the framework of the health care system and want to work within a trustworthy and financially rewarding framework.

Conflicts of interest at the heart of doctor/patient relationships are contributing to unfairness and unnecessary expenses within the system. Until this unfairness is sorted out, those in prison get free medical care, while many patients go to the great effort and expense of travelling to Canada for cheaper drugs and going to Asia for cheaper medical treatments. Access of care, its convenience and its cost, can make doctors' orders difficult to obey. While offering to pay at least 50/50 of the payments and increasing co-pays would satisfy some employees, there is clearly the need for more nationwide health care reform.

President Obama's Administration has already,

"appropriated $19 billion in the stimulus package to help implement an electronic medical record system, and has set aside hundreds of billions to overhaul the health care system in the budget."
S.Stein, Huffington Post

"Doctors for America" are helping. A grassroots organization of 11,000 doctors from all 50 states, they are the voices of physicians in support of health care reform. The group will

"work to convey the ideas and experiences of physicians to achieve healthcare reform based on four key pillars:

1)affordable coverage,
2)expanded access to care,
3)high quality care, and
4)practice environments that allow physicians to focus on patient care."

Huffington Post"The Erosion of Employer-sponsored health insurance"

Some statistics about the American health care system remain quite shocking:

Private insurance overhead and profits eat up 20% and more of health care premiums while Medicare overhead (and no profit) is closer to 3%. There is big money to be made in health insurance. The top 7 "for profit" health insurers made a combined $12.6 billion in 2007-- an increase of 170.2% from 2003. The same year, the average CEO compensation package for these health insurance companies was $14.3 million. Pay packages ranged from $3.7 million to $25.8 million.

All of that money could have gone to paying for health care for children, cancer treatments or diabetes screening -- in other words, health care.

Despite fear mongering about government run health care, seniors aren't asking for their Medicare to be taken away. Quite the contrary. People with Medicare can choose between public and private plans that contract with Medicare and an overwhelming 80 percent choose Medicare's public plan over the privately contracted plans.
D. Cohen, Huffington Post

Who can be sure this isn't happening:

By federal law a doctor cannot refer patients to himself or to a business in which he has a significant financial stake, like a laboratory or imaging center... The reasoning is that such behavior can interfere with clinical judgment, decrease quality and increase costs.
The New York Times

An area of possible efficiencies of scale could be the doctor/patient referral system. Doctors are prohibited from being paid for referrals, yet America has a referral system that is too easily corrupted. There is so much pressure to generate referrals that lines become crossed....

A major driver of referral proliferation is that doctors are paid piecework. There is less of an incentive to increase volume if payments are bundled rather than discrete for every service.

A bundled-payments system is already in place for hospitals, dialysis centers and nursing homes. Extending such a strategy to individual doctors’ payments seems to be the logical next step.
The New York Times

Also, doctors in a study were unconsciously swayed by name-brand freebies in offices and prescribe them rather than the generic alternative. The New York Times says that pharmaceutical companies have agreed to a "voluntary moratorium on branded goodies" freely given to physicians. Unless drugs promise to be profitable, they are not made. Without international research and collaboration, new drugs would not be invented. "Without us [the original drug-makers], there can be no generic" as a drug company CEO said on CNBC. American drug-makers are offering certain drugs free, but is it simply a limited, well-publicized PR goodwill-generating stunt?

Which conflicts of interest bother you the most?

New Administration Opens Up About Initiatives On The Web

The White House has finally released an informative youtube.com video linked here about the White House and various branches of the government.




This video introduces American Government-associated content-rich websites, such as the White House whitehouse.gov, the government's Recovery website, Recovery.gov, about the "economic recovery," USA.gov offers general information and links and Flickr.com archives photos.

Former NC First Lady Hired: Merit or Pressure?

University of North Carolina hires the state's former First Lady. Was she hired in her own right through merit or did her husband exert political pressure?

Does it matter where a First Lady works, lives or travels? One state questions spousal influence.



Mary Easley (above) is the [former] First Lady of North Carolina and a professor of law at North Carolina Central University in Durham, North Carolina. Mrs. Easley earned her undergraduate and law degrees at Wake Forest University in Winston-Salem, North Carolina. After graduating from law school, she worked as a prosecutor for ten years and then maintained her own litigation practice. Her husband, Mike Easley" was Governor from 2001 to 2009, a Democrat.
Spock.com

North Carolina State University is a four-year public university in Raleigh, North Carolina with total enrollment in the sixteen campus system of 33,000 undergraduate students.

The University Chancellor of the system, James Oblinger, and mighty Erskine Bowles, ex-politician and UNC President want her to resign because of allegations of possible political pressure in the hiring decision. She has announced through her lawyer that she intends to stay on and keep her five year contract. It is not clear what she has done wrong, beside marrying a man who became Governor. It is not clear what political motivations there could have been. She doesn't appear to have a conflict of interest. An article in today's New York Times linked here claims she now runs a speaker series and a public safety leadership center at UNC.

On further inspection of the issue, though, it appears that the university Provost and Chairman of the Board of Trustees have just resigned. Here is a quote from the UNC alumni site:

"The provost cited among his reasons for resigning the professional and personal anguish caused by continuing newspaper reports implying that his hiring of Mary Easley was done under pressure and improperly influenced by political motives."

"Anguish"?...She currently holds the title of "Executive in Residence in the Office of the Provost." It would appear this is a web of problems we can't possibly get to the bottom of with this post, and it also looks like there are many political and personal issues about this couple making news.

Her husband, the former Governor, is being investigated:

"The News & Observer of Raleigh reported last week that Mr. Easley flew on at least 25 private jets provided by several businessmen while he was in office."
NYTimes

Now that the influence vs. merit issue is out in the open, it is likely to be watched by all the thousands of young girls in North Carolina now growing up, and potentially across the country. Finding a job now is tougher than it's been for years with unemployment on the high side.

A related larger issue is, do you agree or disagree that women married to politicians should sacrifice their careers when their spouses get elected? Males married to female politicians rarely, if ever, do that. Significant historically, the Vice-President's wife, Dr. Jill Biden, is continuing her career with a position in a university.

"As of 2009, she is an adjunct professor of English at Northern Virginia Community College, and she is thought to be the first Second Lady to hold a paying job while her husband is Vice President."
Wikipedia

Did North Carolina's former First Lady, Mary Easley, get her job on her own merit or through her husband's political pressure? Is this a Republican "right-wing conspiracy" against a former Democratic Governor? Comments welcome.

Cool Creativity

A cool website's linked here showing creativity applied to everyday items:















[http://www.allpics4u.com/artwork/creativity-stuff-all-around-us.html]

Full Disclosure

The trouble with having an open mind, of course, is that people will insist on coming along and trying to put things in it.
- Terry Pratchett

Since some seemingly innocent bloggers are not disclosing sponsorship, I have to say, just for full disclosure, that none of my posts are in any way, shape or form subject to reimbursement. This blog is purely a voluntary effort. As of today, viewers clicking the ads will have netted me all-time income of USD$4.88 in eight months when I get it. That's it.

On a related topic, news aggregator sites have me wondering how they will survive the founders. The sites don't make that much money, yet are worth a lot as far as educating society is concerned. In this new age, it is hard to know where knowledge is gained. Educators say it can be picked up from unexpected sources, formally and informally, recalled easily or not.

Long live the internet, and the human editors of special sites.

Pop Culture Website Review: whereitsat.com

If you're a movie buff, there's a nice map of American movie locations to see at a great new website, "Where It's At," whereitsat.com.

It's a fascinating map that shows where a smattering of movies, television shows and areas of pop culture interest were originally shot. You can see the photo and location showing where Napoleon Dynamite's high school was actually shot at Preston, Idaho, Dallas' Southfork Ranch, the Grey's Anatomy Hospital and so on. The site only covers locations in the United States, but it's fun and educational to browse and zoom in.

"House" the hospital series was filmed supposedly in the "Princeton-Plainsboro Hospital". As it happens, a new Princeton hospital is currently being built in Plainsboro. The aerial view often seen on the show is of Princeton University, the area around the Frist Campus Center. Oddly, the only Ivy League without a medical school was chosen to have one on a television show.

The movie Transformers was partly made here in Princeton. We actually saw Shia LeBeouf and others in Princeton while the movie was being made a year ago, 2008. It's thrilling seeing a movie being filmed, and it often happens here in Princeton, even if that fact isn't shown on this site.

Nevertheless, this site is highly recommended and will, it is hoped, be expanded in the future.

Hubble Space Telescope Photographs Unseen Galaxies

nasa.gov: Two space shuttles and a rainbow

The Hubble Space Telescope is yielding fabulous pictures nineteen years from liftoff in 1990 aboard the Space Shuttle Discovery. The Hubble received several servicing missions, and the most recent one that launched on May 11, 2009 is yielding amazing new photos. A quick slideshow of Hubble Telescope photos in The Daily Beast would whet anyone's interest. The Hubble site itself, has the best, most gorgeous photos of all in the site's Gallery, in Picture Album. They can easily be made into wall photos, even wall murals.

There are new photos of the solar system, stars, nebulae, galaxies, and the universe.
These are fabulous photos, never seen before and wonderful explanations are given in Gallery Photos. This one's my favorite:



Here's a link to a smaller NASA page with the top 100 photos, and there are many other sites of these truly spectacular images showing up.

While we're on the topic of space photos, here is a link to wonderful pictures of the Northern Lights.


tivac.com: Aurora Borealis from space

Controlling Health Care Costs: On Over-testing

Unnecessary tests are being conducted for Americans, especially those with health care insurance. There isn't any current incentive in place to make doctors more efficient. In fact, physicians are rewarded for greater productivity (more testing) by insurance companies. Also, it helps shield them from possible lawsuits with charges of neglect. Tests are driving up health care costs, since many are unnecessarily excessive.

Unnecessary lawsuits, medical duplication of expertise and equipment, deciding which procedures, hospitals and doctors work best, providing financial incentives for efficiencies, promoting wellness are all possible areas of improvement that could be addressed by the new administration.

Those without insurance who must pay out of pocket will inevitably opt for the most efficient and cheapest alternatives, especially the latter. A complication is that doctors who know the most about the results of expensive routines and tests aren't accustomed to having to choose which is most effective, despite being best able to do so. They like being able to request lots of tests, and work with affluent patients on unlimited budgets, in general. It's what they are educated to do. It's more fun and more interesting because they find more results to interest them. Financial incentives for less testing would be a novel idea.

Patient choice of health insurance after major illness has begun being treated would prove to be popular. Major illnesses test insurance company payouts. Insurance companies determine treatment options and doctor choice and wield huge power. They, along with big pharmaceutical companies, are major drivers of health care. In America, they are the number one cause of personal bankruptcies. Patients and their families must pay for medical care for many years, having had little choice of doctor, hospital or knowledge of best procedural practices. With 50 million uninsured, America clearly does not have the best medical care for all.

Much work has been done to provide care for children, but many more steps must be taken to keep America competitive in the workplace. Legacy costs of health care and long-term care can only increase. Cost control is in everyone's best interest. Patients, especially affluent ones, would like to be able to travel around the U.S. to make use of the best doctors, but insurance companies usually prohibit payments for out-of-area treatments.

We know that according to David Brooks in The New York Times, President Obama's aides are talking about "game-changers":

"health information technology, expanding wellness programs, expanding preventive medicine, changing reimbursement policies so hospitals are penalized for poor outcomes and instituting comparative effectiveness measures."

It stands to reason that there is duplication of medical expertise and medical machinery around the country. It also makes sense that some physicians are more expert than others. Some doctors are at the same time more corrupt than others; they might over-test patients to pay for expensive medical machinery. Testing "comparative effectiveness" is optimistic and at the same time ambitious.

One would hope these new initiatives are sufficiently flexible to patient preference. New businesses in health information, wellness and preventive medicine might even be created and expanded.

There is further hope of change announced in "Health Costs are the Real Deficit Threat" by Peter Orszag, Director of the Office of Management and Budget in today's Wall Street Journal that

"this week a stunning thing happened: Representatives from some of the most important parts of the health-care sector -- doctors, pharmaceutical companies, hospitals, insurers and medical-device manufacturers -- confirmed that major efficiency improvements in health-care are possible. They met with the president and pledged to take aggressive steps to cut the currently projected growth rate of national health-care spending by an average of 1.5 percentage points in each of the next 10 years."

The financial incentives are compelling. Bearing good news, he says that

"It would reduce national health expenditures by more than $2 trillion over the next decade -- and could help to put roughly $2,500 in the pockets of the average American family every year."

With Medicare becoming every more expensive, and medical expenses being the nation's major cause of personal bankruptcy, how can the nation and lawmakers continue to ignore the challenge of medicine?

Why I Don't Love Guns

Connie Culp, recipient of face transplant before (top) and after being shot by boyfriend

Reading Meghan McCain's powerfully cute post in Daily Beast, honestly called, "Why I Love Guns" I expected better of a daughter of a Presidential hopeful. We are all brought up one way or another. Her story has elite nuances of privilege and entitlement, but she's forgotten the values of civility and equality. If we were all like her, we'd all use guns.

Here is the Second Amendment of the Bill of Rights of 1789 in the U.S. Constitution:

A well regulated militia being necessary to the security of a free state, the right of the people to keep and bear arms shall not be infringed.

This is a document fraught with ambiguities. It has long been subject to commentary and legal attention, as detailed in Wikipedia's long entry on the "Second Amendment."

When I read that amendment, written at a time when society was vastly different than it is now, an interpretation is clearly wide open. The amendment doesn't necessarily condone or recommend their use. Possessing guns doesn't force one to use them. If you do purchase an expensive item, you usually want to use it, right? Guns are weapons not useful for anything other than killing, unlike, say, knives or chemicals.

There are more healthy sports to practice, such as golfing on a short range that offer similar physical challenges. Gentler pursuits have always been more intellectually stimulating than violent ones disguised as harmless.

In the article, Ms. McCain sounds staggeringly aggressive: "Let's get something straight: Individual responsiblity and personal liberty are inherent Republican philosophies." Obviously, individual responsibility and personal liberty should be available to all and intrinsically non-partisan. Where did she get this assertion from?

"Simply removing guns from the equation does not solve the larger problem." I sharply disagree with this. The more guns there are, the more violence there is in society. It's that simple. Again obviously, without guns, no-one shoots anyone.

"Desperate people will make anything a weapon. We need to eliminate desperation, not guns." Sounds logical, but again, there's another side. Desperation is not a problem that can and should be solved with a gun. All of the social issues she mentions can't be improved with "guns" -- "poverty, inadequate health care, mental illness, joblessness, inadequate housing, and poor education." Social policies require much thought and deliberation. Government action is at the heart of changing social policy decisions.

Conflating gun ownership with improving social problems is irrational. How can brawn over brain possibly solve those issues? Look what the McCain family did in response to losing the federal election -- they picked up their guns. Nice. Good thing the McCains aren't in possession of bombs.

How can anyone say that guns in the possession of those with evil intentions aren't responsible for mass shootings? Perhaps she should remember the lady shown above, Connie Culp, whose face was transplanted after being torn up by a gun.

"to fire off a few rounds and get closer and closer to the desired target. This is one issue where I’m red through-and-through." It's kind of amusing that she politicizes target practice as if only a Republican should play a target game.

Since Miss McCain bases her gun use as a "right" approved by the Second Amendment, a comparison to Britain's Magna Carta of 1215 on which the Bill of Rights is modeled would be most useful. England has outlawed guns as an interpretation of the same document.

As can be guessed, the National Rifle Association (NRA) isn't ever going to support my site. They assert the importance of trained gun use and enjoy paying a lot for pro-gun lobbyists. Just saying. But that's okay. They're not like us.

Pfizer Offers A Free Drug: Small Step

Just a quick post to say that that Pfizer Pharmaceuticals announced today it is giving away Viagra for free to those who are unemployed and cannot afford it in a new program. It's terrific news for Americans. The point is that a major drug company is making a major drug available for free in America, thereby pressuring competitors.



It's a good idea if the makers of Cialis do the same. We'll see if major drug companies are immune to peer pressure. We'll also see if competitive pressures force drug prices down. It's a useful program to start somewhere, even if it's with a male stimulant drug.

Could Healthcare Reform Transform America?

On my last post, I mentioned at the end that "reform will have to be imposed on" the healthcare system to control costs if private companies don't do it. An interview with Steve Forbes on Larry Kudlow's CNBC show has just discussed this very topic. This is what they say private companies should do.


Steve Forbes

Steve Forbes says that if insurance could cross state lines, then competition between insurance companies would bring down prices. He advocates medical insurance companies offering catastrophic insurance at affordable prices. He also suggest offering medical insurance that is portable, rather than dependent on employers with the help of tax incentives. As it is now, medical insurance can determine hiring success in America.

With federally-run Medicare and Medicaid "running out of money" he says that we don't want any more government-involvement or else medical insurance companies will get extra money. (Menioned in my last post, they did in 2003 with the Medicare Modernization Act.) He thinks medical care is "antiquated" in the U.S. He approves of clinics -- "Docs on the block"-- to treat minor ailments, and mentioned that perhaps doctors could use email. Steve Forbes thinks that healthcare reform must be a grass-roots effort, not government-led.

Let's hope transformational change swiftly insures 50 million Americans. Are you optimistic?

Health Care Reform Will Benefit U.S. Economy

An interesting article called "Harry, Louise and Barack" in today's New York Times by Paul Krugman reminds Americans of the recent history of national health care management. This area promises to be one of the central contributions of the Obama administration to social policy and national living standards. Health care reform would also be an overall benefit to the economy.

Here's why: there is a toll cost down the road to ignoring the health of all. Health, like safety, is what protects society's weakest and sickest. Health care is an issue that is ignored until it becomes impossible to ignore. That's the nature of the beast.

In addition, health care costs non-profit as well as governmental organizations relied upon by the entire population increasingly significant overhead to pay health care costs. Profitable organizations aren't exempt from paying health care costs, either. These costs have risen dramatically in recent years, along with almost everything else. Health care costs continue to increase into the retirement years of employees.

Powerful special interests blocked long-term health care coordination and planning in 1993. Krugman mentions that "Republicans, after all, still denounce research into which medical procedures are effective and which are not as a dastardly plot to deprive Americans of their freedom to choose." We're talking about choices, but we're also talking about the sick, who sometimes have no choice but would do anything to improve their health.

It is irresponsible of physicians to expect patients to be able to choose procedures. Physicians have a responsibility to guide patients. Fear of being sued pushes many doctors to over-prescribe drugs and tests. This forces patients to choose prescriptions and services and thus, self-prescribe. Patient outcomes are less predictable if doctors can't be trusted to direct health care. Avoiding litigation becomes more important than optimal patient care in the current health care environment.


Peter Orszag

Peter Orszag, Director of the Office of Management and Budget, has said that "America spends far too much on some types of health care with little or no medical benefit, even as it spends too little on other types of care, like prevention and treatment of chronic conditions. Putting these together, he concluded that “substantial opportunities exist to reduce costs without harming health over all.”

These issues must be addressed by medical experts. Computerizing medical records will be the least of the problems for the staff. It's the doctors themselves whose attitudes must change and who must be persuaded to reform health care. Doctors should agree on medical procedures. They need to take a leadership role or else insurance companies or the government will increase in power. Presenting choices to a sick patient isn't the same as asking a well person to choose from hundreds of wallpapers. Patients deserve, quite appropriately, to be well-guided by doctors. They prefer to have a personal relationship with a doctor of their choice with the power and authority to treat them.

According to Krugman, a Nobel prize-winning economist, the Medicare Modernization Act of 2003 "both prevented Medicare from bargaining over drug prices and locked in huge overpayments to private insurers." If true, "heavy-handed corruption" is the descriptive phrase I would give to that pyrrhic victory of the Pharmaceutical Research and Manufacturers of America, PhRMA.

Quality is an indefinable good that varies with each patient, yet cost control and efficiency of medical care are immediate benefits to all. It is the responsibility of the healthy to care for the sick, but it is not necessarily the responsibility of the sick (and close relatives) to bear all possible costs. That mentality to me is unnecessary, misguided and exploitable.

Finally, let's look at the supposed trump card of "superior research." Not all biotechnological research is sourced and performed here in the United States. That is nationalistic propaganda advanced to gain American federal funding from tax dollars. Perhaps there is widespread fear by medical professionals that other countries are gaining health advantages from investments made by big American pharmaceutical companies. Most scientifically advanced nations already perform pharmaceutical research experiments. The field of biotechnology is replete with foreign companies and foreign university researchers sharing results of their experiments for American pharmaceutical companies, or others, to capitalize on.

Drug and medical test costs should be shared, with tax payer money deployed more efficiently. Litigation awards shouldn't be outrageous, especially to lawyers, and communication should be increased with the use of technological tools.

It will be up to doctors and medical insurance and pharmaceutical companies to get their acts together. They will have to communicate research results, cooperate, organize and focus on patient care in their disciplines, and co-ordinate that care to control costs. If they don't do so quickly, as they haven't voluntarily in the past, say, twenty years, reform will have to be imposed on them.

And that's all right, because popularizing doesn't always destroy, it can build. Like education and car-buying, health is collective in scope and individual in experience. Patient-based care rather than "greed-based" care is not just an ideal, it's a necessity for over 50 million Americans currently uninsured. Let's hope medical insurance quickly becomes affordable to those most in need. The President may have been accused of doing "too much" but time is of the essence as far as health care is concerned. Coordination of this particular medical emergency is key to the future success of America.

Red Hot American Real Estate

The following map shows real estate assets across America and reinforces visually what many real estate surveys have suggested.



The greater the concentration of high-interest lending in any metropolitan area, the “hotter” the color:

* Blue areas represent relatively fewer high-interest loans.
* Green to yellow areas have moderate amounts of high-interest loans.
* Red areas have the most concentrated number of high-interest loans.
Palantir Technologies Huffington Post

Here is the webpage link for details from the Center for Public Integrity.

Zillow is notoriously unreliable in the northeast, as they have been pricing houses under the market in many cases here. Yet the Wall Street Journal refers to Zillow in today's Wall Street Journal article, "House-Price Drops Leave More Underwater", possibly because they hadn't any better source. Zillow says that houses are worth less than their sale prices three years ago and 20% of mortgages in America are worth less than the current estimated price of a house. Worse, Mr. Humphries, vice-president at Zillow.com says that "Zillow doesn't include foreclosures in its pricing models."

Even if Zillow doesn't count what buyers might have paid since taking out a mortgage, this is supposed to be a conservative estimate, as my own experience with Zillow would corroborate. In our case, the Zestimate is way off since Zillow only doubled our down payment from fifteen years ago. Even our taxes and town name are incorrect.

Here's a table, even though it might not be that reliable, courtesy of the WSJ:

Basic Email Etiquette: Why Wait To Return Email?

When we use email, there are certain rules of etiquette that some abide by, but that other normally polite people seem to ignore completely. During the 28 or so years I've been emailing, it's changed a lot. Back then, I was emailing back to some business partners and learning how to make html commands. It was all so primitive in retrospect that I was happy to get a reply. At that time, just getting a point across was important, not grammar or command of the language, as most emailers then weren't that good at either, or even the English language at all, if they were foreign speakers.

Fast forward twenty years, and I am surprised how long it took for email to really take off, and I'm so glad it has. But here's the thing, when I try to communicate by email, some people take it casually. Email is not supposed to be taken casually. It's less intrusive than a telephone call. No one needs to drop anything to answer. But it's a lot quicker, and sometimes more reliable, than a posted letter.

As a note, it shouldn't usually require much time to answer. Sometimes, answering by email is far more efficient than calling by phone, if the email address is there, if the person at the other end is difficult to reach, and if the sender doesn't have much time or desire to talk. It's the modern-day equivalent of the hand-delivered note, and a friend should be replied to at the earliest convenience.

If an answer is desired quite promptly, and the other person seems to take forever to answer without a good reason, then emailing is not the best form of communication. Has the emailed forgotten or doesn't she want to reply? A few years ago there was a cocktail party to plan with some other mothers at school. Turns out the event was primarily being planned by two of us, and we decided to correspond by email. Here's how it went: I emailed, and then a few days or a week later would get a reply. I'd immediately reply and wait another week. What took six weeks could have been done more quickly if only the other mother had concentrated and answered my emails promptly, maybe in one day. For some reason, she wouldn't call me. Never again with her, I vowed, would I plan an event.


Amazon.com

Good etiquette is one of my interests. I've read nearly all the American books on etiquette and English ones like Debrett's. Debrett's has a wonderful online site here. As a teenager, I was happy to pore over Letitia Baldrige's book for hours and hours, as it seemed to answer so many burning questions I had. It was an early "guilty pleasure" and since it wasn't an assigned book from school, covered new ground. It's obviously never too late to learn more, as currently, I'm reading Margaret Sangster's classic 1904 book on etiquette, called "Good Manners For All Occasions" available at Amazon and antiquarian dealers.

Amazon.com

Have you ever had unexpected delays with email? Please let me know how it turned out.