Category Archives: Healthcare

Revisiting the week

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This afternoon I went to the fifth lecture in five days. Each one was different, not only in content, but even more in presentation. As a former Toastmaster I found this fascinating. The first lecture, on healthcare, used Powerpoint as a guide for herself, to make sure she covered all of her points. She went so quickly on some of them I didn't have time to finish reading.

BTW, the New Yorker has an excellent article about healthcare by Atul Gawande in the current issue. Even though I have been working for a single payer system his argument makes tremendous sense to me. 

The second lecture, on government regulation, used no visual aids but gave us several handouts: one of her columns; a memo from Rahm Emanuel about regulation sent out on January 20; a diagram of the regulatory process; and information about her book, The Regulators, all interesting and useful.

The third lecture, about our foreign policy, used some very old, stained and faded overhead projector slides, along with bad jokes and lots of sarcasm. A professor who has won several teaching awards probably felt the need to entertain us. Do you get that I hated him, jokes and all?

Friday afternoon, the fourth lecture was given by a retired general. He was wonderfully organized, very pleasant and gave a good lecture about stuff I never thought about. Can't ask for more than that.

These lectures were all part of the Osher program at Pitt. Today I went to a presentation at CMU (Carnegie Mellon), the other big one here. This was about Arthur Szyk, (pronounced shick) an almost forgotten artist who lived from 1894 to 1951, and who created amazing illustrations of books from the bible and equally amazing illustrations responding to events of World War 2. There is an excellent website about him here and more illustrations of his work here.

This lecture was held at the Tepper Business School at CMU in a room with a monitor in front of each very comfortable chair. The illustrations appeared on each of the monitors as well as a large screen at the front of the room. It was a wonderful luxury to be able to look closely at each of the pictures. 

Most people have never heard of Szyk, or never heard his name pronounced so didn't realize who he was. I was always looking for beautiful books, even as a child, and remember seeing his Andersen's Fairy Tales and Rubiyat of Omar Khayyam, as well as his Hagaddah. I wish I owned copies of them.

Back to the books

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My Osher program began this week with two lectures on Wednesday, one yesterday, which I left a few minutes early to go to my Japanese art history class, (I'm still at it), and there will be another one this afternoon. All of the lectures are about various aspects of our current political and economic situation. They are given by guest experts or experts from the University of Pittsburgh. The first lecture, given by a distinguished professor, was about health care and the Obama administration. In the afternoon the lecture was given by a guest, Cindy Skrzycki, who writes on regulation and the executive branch of the government for Bloomberg, formerly for the Washington Post. Yesterday morning another distinguished professor spoke on foreign policy issues. This afternoon a guest expert will speak on military issues.

I learned a lot from the lecture about regulation, the one in which I thought I had the least interest. She explained how regulation affects all of our lives (and it does); how regulations are promulgated; how they are created or changed by lobbyists and special interest groups; how we can, and should, become aware of pending regulations and voice our concerns. For your information, read more from Cindy Skrzycki here (scroll down), find info about new regulations and how to comment here.

The other two speakers were good, but offered rather bleak views of their topics. Both reviewed the existing situation and what Obama has said and done up to now. After reviewing the healthcare situation in a very pessimistic manner, the speaker, almost in passing, said she was for a single payer system, but didn't think it would ever happen. She is one of many health care professionals I've met who seem to share this same point of view. I hope they are wrong.

Open letter to John McCain

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 Dear Senator McCain,

Last night in the debate you said:

Well, I want to make sure we’re not handing the health care system over to the federal government which is basically what would ultimately happen with Senator Obama’s health care plan. I want the families to make decisions between themselves and their doctors. Not the federal government.*

So, Senator McCain, what I want to know is:
How do you reconcile this with your stand against a woman's right to choose?
Do you not consider women part of families?
Or do you think women are not capable of making decisions between themselves and their doctors?

What about
providing information about contraceptives? We keep giving men more
ability to produce babies. Shouldn't we be giving women the right not
to have those babies? And having their health insurance pay for contraceptives just as it pays for Viagra?

I haven't seen anything in the media about this. I know it's not the most important issue facing the country at this time (women's issues are never the most important). But I think it speaks to your judgment when you can blithely make a statement without considering all of its implications. Women want to know what you really mean when you say you want families to make decisions together with their doctors.

*This quote is taken from the New York Times transcript of the debate found here.

Health and the Environment

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I took the day off from planning my trip (and writing about the last one) to attend a conference on "Women's Health and the Environment." What a worthwhile day this was. Although I often worry about cancer, my family has an extensive history of it, I never thought much about the part the environment plays, or the part it must play in autism and ADHD. This was really an eye opener for me. Being a lazy writer and reporter I rely on you to follow the links I'm providing. This is an important subject; we should all seek to have a better understanding of what is going on.

The conference was sponsored in part by Teresa Heinz, who also gave the opening address. She was marvelous. I was immediately captivated when she declared: "The more we can ask the more we can make healthy choices, and here's
why: ignorance kills and knowledge saves lives. Preventive medicine is
part of knowledge." She stressed the importance of preventative medical care for all, and talked about how our healthcare system was broken, one of my favorite topics. For more of what she said go here.

The theme of the conference was: New Science, New Solutions. The keynote speaker, Nancy Nichols, talked about growing up in Waukegan, Illinois, and how, as children, she and her sister played on the shores of Lake Michigan on what later was identified as tons of PCBs and at least three huge superfund sites. Both of them developed rare cancers when they were in their forties, her sister dying from a rare form of ovarian cancer. Needless to say, I was probably drinking the water in Chicago that came down from Waukegan.

An "Air and Water" panel and a "Food and Personal Care Products" panel gave us more information than I really wanted to know, about how our food is produced and how chemicals found everywhere in our lives are never tested for safety. It almost makes me want to stop eating–a very big statement for me.

I'm not going to tell you everything I learned. The conference website will have podcasts of all of the speakers. I'll let you know when they are posted and hope you will listen to them. And I'll talk about this again.

Celebration

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I passed my stress test–even impressed the doctor with how well I did. This kind of nuclear stress test–they inject you with something radioactive then measure how much accumulates in your heart while you are on the treadmill–evidently is able to show whether you have any blockages. They assured me I was fine and should be able to do whatever I wanted, including going to China and Japan as I had planned. This is the happiest day I've had since I had the problem in New York a month ago. It's been a hard month, psychologically, especially after Tim Russert's sudden death. My pacemaker required some adjustment, which is probably why I haven't been feeling so wonderful all this month. Pacemakers are supposed to make you feel good.

I've been continuing with my exercise program–leg exercises, walking, and finally got back to the health club yesterday. I haven't been able to do my usual 3 miles, only 2 miles each time this month. I'll try again the next cool morning we get here.

Last week I wrote about a wonderful painted house we looked at on Pittsburgh's North Side. You can read about it and see pictures here.

Another healthcare rant

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It's been three weeks since I got out of the hospital. I have received two different survey forms to fill out, one telephone survey and two cards, one get-well, one thank you, from my healthcare "concierge." What I want to see is my EOB–Explanation of Benefits–the paperwork you get from Medicare letting you know what the "provider" is charging, what they are actually allowed to charge and what my co-pay will be. Until now I've never come close to my "out of pocket" maximum. I suspect this year will be the first time.

When people, usually Republican people, write about Medicare, or Medicare-like healthcare, the complaint is always made that we don't pay attention to those bills or how much we spend on medical care. I pay close attention to those bills, when I get them. It would be helpful if they came promptly and also if they clearly identified what service was provided. My hospital stay was OK. I am grateful they were able to make a diagnosis quickly and do what needed to be done. Now I'd like to know what all of this costs.

BTW, how do you like the way I've deal with all that jargon?

One more thing: those EOB's do not come from the government. Mine come from one of those private medicare advantage insurance companies.

An interesting afternoon

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Steve teaches a class about public health and aging for people getting a certificate in public health. Most of the students are healthcare professionals, but unfortunately, not doctors. They should be taking the class.  Today’s class was a discussion based on an article about limiting medical interventions for older patients (late 70’s and up). Steve invited me to come to the class and sent me the reading. While the argument generates lots of controversy it presupposes so many things that won’t come to pass in my lifetime, it becomes meaningless.

Simplifying the argument: In a more perfect world, where elders are respected and not the subject of so much prejudice, it should be possible to make a rule based on age, limiting what medicare would pay for in the way of technological interventions. When the class began I was the only one in favor of the argument. After a spirited discussion we concluded it would be best if medical decisions were made based on the individual and on science, whatever that means. Since I haven’t met too many doctors who look at the whole person and who don’t base their decisions on things like worry about malpractice suits, pharmaceutical company propaganda and the need to avoid death regardless of the patient’s wishes, I rather like the idea of a rule or concensus based on age. I don’t want to die hooked up to machines, like my mother. Nor do I want round the clock caretakers and being treated like a child. These seem to be today’s inevitabilities.

One of the biggest problems is no one wants to talk about death. We seem to think it will go away if we ignore it, or maybe, if we can just keep breathing, they’ll find some way to keep us alive forever. Instead, it creeps up on us and takes us in the most terrible, painful, undignified ways. It would help if we had a good, rational discussion about how we want doctors to treat us and how we want to die. We aren’t going to live forever; wishful thinking won’t make it so.

Family, Art and More Family

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My days here in NYC are going very quickly. On Thursday, Renee and I took the train out to Long Island to visit her other son and family. It’s a 60 mile trip and took 2 hours, each way. The Japanese must laugh hysterically every time they hear something like this. We had a lovely, too short visit. Train schedule was not very accommodating for us.

Yesterday I met Phyllis at the Rubin Museum. I really love that place, at the same time it makes me very angry. It’s a beautiful space, so wonderfully designed you feel like you are entering a temple of peace and beauty. Here is a story about the museum and how it was built. If you read it carefully, you will note one line, "…Donald and Shelly built their managed-health-care network, Multiplan…" I am angry about anyone who makes enough money on healthcare to build a huge art collection and then build a museum to use as a tax write-off, thereby screwing us, the public, all over again.

Even with my anger, I managed to enjoy the museum and the art. My all-time favorite piece is a huge applique you can see here. Phyllis, who has been a photographer most of her life, took me there to see photographs of Bhutan by Kenro Izu. Most of the photos were platinum/palladium contact prints made from huge negatives, taken with a custom made camera that weighs 300 pounds. Story about the exhibit here.

After this soulful sojourn at the Rubin I met up with Renee and we went to dinner with her brother and sister-in-law, so more family and lots of laughs. Renee and her family treat me like I belong to them. Having moved to the east coast with no family here except Robin, I have always been very moved by their efforts to include me in all of their events. I am truly grateful to be so accepted and loved by my daughter’s in-laws.


Healthcare, not insurance care

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I went to see Sicko this week, and also went to a meeting about single payer healthcare. I wasn’t going to go to Sicko; I figured it was preaching to the choir. I was amazed at how much he told me that I didn’t know before, and how it held my attention. As my movie rating system goes, this one gets top billing. I never thought about looking at my watch.

I’ve been fairly pessimistic about the possibility of getting single payer healthcare in my lifetime. Sure, I don’t need it: I have Medicare! But so much of our healthcare system is awful: wasteful, aggravating, totally irrational. Only the insurance and pharmaceutical companies benefit from our system. Even after seeing the movie, I wasn’t too hopeful. But the meeting I attended was overflowing with people, and most were committed to changing the system.

The internet is filled with information about single payer and universal healthcare. Jane Bryant Quinn has a wonderful article in this week’s Newsweek, dealing with the economics of a new system. Western PA has a website urging single payer for the state of Pennsylvania, and Healthcare-NOW is working on the national level. Take a look at this site for a comparison of the costs of the war in Iraq and what it would cost to cover everyone in the country. And for my friends who ask, "Do you want the government in charge of your health? Think of the post office," I can only reply, Do you want the insurance companies making billions of dollars from your healthcare? That money can only come from denying your needs.