Friday, September 4, 2009

The Bankrupt Republic: A Healthcare Fairytale, Part Two

Medical care is a big business and big business loves to manage medical care. There are three healthcare myths conservatives in the United States love to perpetuate. Usually they do this because they do not want the current system changed. Many believe it does not need to be changed. They are clever people and they are successful in provoking action because they know how to stir up fear. Conservatives love to say that they do not want someone between their doctor and themselves, influencing decisions that affect their health. They are also fond of creating visualizations of acute rationing of medical care throughout the country.  The last fear tactic recently gained much attention nationally. It causes violent emotional reactions because no one wants to hurt someone they love, by having a person or group of people discuss end of life decisions with them. Death panels, those two words strike fear into most people’s hearts like Darth Vader’s appearance in Star Wars. Conservatives love to throw around those two words like rice at a wedding.  I might actually be able to sympathize with their conservative position if I did not already know that all three of these situations exist in our current system.

About a decade ago, my mother discovered she had cancer. This was not entirely unexpected. My mother was indoctrinated into the smoking culture when she was 16, long before it became unfashionable. Malignant tumors were found in both of her breasts and to make matters much worse the cancer had decided to use her lymphatic system to further explore her body. She was T4, N3, M1, which is a Stage IV classification. That translates into something very, very, very bad. The proscribed course of action was a double mastectomy with radiation and chemo treatments to follow. The treatment needed to be aggressive and the possibility of cancer return was extremely high. My parents had insurance through my father’s company. Insurance covered most of her treatment, but it would not have covered enough of it to prevent bankrupting my parents. Luckily, my grandmother had money saved that allowed my mom to get the treatment she needed without putting undue financial stress on my parents.  If my mother had chosen the most aggressive treatments, at cancer centers, experimental techniques, alternative therapies, or simply wanted different course of action, her insurance provider would not have covered most of those choices.

Sometime, probably a long time ago, health management organizations, insurance providers, pharmaceutical companies, and to a much lesser extent physicians had mulled over my mother’s very situation. Well, not her situation, they are not prophets, but a hypothetical situation exactly like hers. They would have crunched numbers, weighing profit versus loss, played the probability game, accessing risk, and decided exactly how their results needed to be spun to hospitals, doctors, and patients to make them palatable. My mother and her doctor were able to make decisions, but only the decisions that were deemed permissible, by people my mother and her doctor did not even know. My mother’s case is far from unique.

Every possible medical and pharmaceutical circumstance has already been weighed and vetted through a panel that determines the course of action that has least impact on their business. If you are conservative and do not want people meddling in your medical life, you need to wake up. They already are and they have no interest in helping you or making you well. Hospitals and medical facilities are businesses. They are interested in minimizing costs and maximizing profits for themselves. The fact that people are involved is almost incidental.

My parents had health insurance and my grandmother helped to pay for expenses their coverage did not take care of. As long as you can pay, the system will help you.  You could use your savings, run up your credit cards, borrow money from banks, and take out a second mortgage against your house. It may burden you with a horrible financial condition, but you can get care. What happens under our current system if you were in my mother’s position, but did not have insurance?  If you cannot pay at all or if your resources are limited, you will find your choices evaporate quickly.  Many health care providers and hospitals will take a certain percentage of pro bono cases, but that number is limited and they certainly cannot help all the souls in need of care.  If you cannot find a provider that will help you, emergency care is your only option.

Emergency rooms will care for anyone who is sick, but they do not conduct preventative care, and they are not equipped for extended care. If your ailment cannot be dealt with quickly and effectively in the emergency center you would need to be admitted to the facility or hospital and you would be at square one again. You might even be able to get care for a time if admitted to the hospital, but eventually if you could not pay the expenses, the facility would be forced to cut you off. Health care is already determined according to economic factors. Rationing already exists in our healthcare system, but if you have money to pay for care, you do not see the rationing.

Over 46 million people do not have insurance in our country. How are they supposed to pay $ 50,000-$100,000 for cancer treatment?  As many as 37 million live below the national poverty level. How are they supposed to get care? Conservatives say they don’t want rationing, but they do little to stop it from happening in the current system. The truth is they really do not care about most people or what happens to them. They care about themselves and their own care. Most conservatives in this country are WASPs and they have no interest in minorities, those who are disadvantaged, or people who are different from themselves.

After my mother received treatment, she seemed to go into remission for a time. It did not last that long.  In one of her follow-up visits, they found her cancer had returned, and it had returned with a vengeance. It was everywhere. The cancer was a bit different now, it covered some of her skeletal structure in her legs, her rib cage, her hips, and on her skull and it was spreading. She could have opted for further, more aggressive treatment at a cancer center. Short of a miracle my mother was going to die of the damage cancer was inflicting on her body. The insurance providers would not pay for more treatment. My mother’s condition was now considered terminal and it would not be effective to pursue treatment. My mom’s own death panel chose her options for her, deciding whether she was worthy of life or death. My mom did not want to have to go through more treatment anyhow, so it did not matter. Planning for end of life care began.

My grandmother had taken out in insurance policy on my mother, which she cashed in early to pay for the extensive care she would need while her life was ending. I’m not going to recount the months of struggle she had. No one can truly know what that is like, unless you have to go through it and I would not wish that on my worst enemy. I can tell you that the end of life process was well orchestrated, professional, and full of people in the medical field who cared about people. The doctors, nurses, CNAs and staff were wonderful. The people who give hospice care are some of the most generous and caring people in the world. My mother was well informed of her choices, her options, and believe me those people would have done anything to help her or to help us. My mom was 58 when she died. She was not only the person that brought life to me; mom was one of my best friends. I’ll tell you a secret. Death panels exist now, but they do not only target the elderly. They really do not discriminate at all. No one likes to talk about them, that kind of talk would be bad for business.

Mom taught me many things while she was here. In a sense, she will always be here while I am alive because she is a part of me. She left me quite a legacy. She taught me to learn as much as you can in life, love as often as you dare, and to help others to become free. I can understand wanting to be able to make your own decisions with your doctor. Nobody likes someone poking his or her head into business that is not their own business.  I do not like the idea rationing healthcare services either. Who would? I certainly do not like death panels. It is silly for conservatives to fear these things from an alternate health care plan. If they did exist in a new plan they would just be a continuation of the ever-prevalent corporate mentality that pervades our medical culture. To deny that they exist now, under our current system, well that would just be a lie.

The future of libraries, with or without books

Though I do love bound  books and they will always be part of our personal library, I look forward to the new innovations for libraries detailed in this article.

Warmest Arctic temperatures for 2,000 years, says new study

More scientific evidence of our crimes. It's time to pay the toll and I'm pretty sure this toll booth doesn't except token change.

Tuesday, September 1, 2009

The Class-Film Review

The Class was so much more than I expected. Is it a documentary? Is it just a movie? Is it something else? When I started watching the first scenes of the film I wasn’t really sure I was going to like it; these people were as flawed as the person you sit next to on the bus, the ones you stand behind in lines, the ones you return to each day at work. The school, the teachers, and the students were almost too real for their own good. Once you get over that initial reaction, you quickly settle into the film and the all too realistic world it creates. The film follows one year at a high school in Paris, France. Many of the students at the school are immigrants or underprivileged for one reason or another. Francois Beguadeau, a former teacher and the writer of the book this is based on, plays an educator Mr. Marin. His character is the glue of this piece and his passion and direct knowledge of the material enhance each scene. One reason each frame has such emotional impact is that most scenes are improvised on some level and that opens up opportunities for exploration and discovery you can’t pull from scripted dialog. The depth of character development of the students, their families, the teachers, and the staff keep you vested in what happens throughout this film. The actors tell their stories with their eyes, their faces, and their bodies, never relying too heavily on the spoken word to convey what they need to say. No one is perfect in this film. Not Mr. Marin, not his students, not the principal, or the families, but they are not displaying the fake imperfections of a Hollywood story, they are reflecting the imperfections we hold in ourselves back at us, and that gives The Class the power and relevance it has. The special features included with this DVD are well worth watching. They provide a tremendous amount of insight into how the book was adapted to screen and how the scenes were put together with such realism. A remarkable addition to cinema and a film I wish more people in the US would choose to see. We will be adding this one to the collection as soon as we can. 5 full bodied stars

The Descent-Film Review

The Descent is pure horror escapism and I’m OK with that. Six women head out on a spelunking trip as a form of therapy, to bury their emotional demons. They get much more than they ever bargained for. The tension in this film is taut and from the beginning, you know something is not right about these caves. They find blood, bone collections, and see things that move in the darkness, but it is easy for them to shrug it off. The claustrophobia of the small caves, the fear of darkness, and the restriction of air movement can make any person paranoid, can’t it? They wish. What they find once they are trapped in the cave system is even more frightening and leads to a non-stop, action packed, horrorfest. Visually this film is perfectly created and the makeup, lighting, and creature effects are more than convincing. The actors did a lot with the tiny amount of dialogue they had and they sell the expansive action sequences. The Descent has more twist and turns, than a roller coaster ride and exudes fear, terror, and hopelessness. 3.5 dark stars out of 5 that will pull you right in.

Paycheck-Film Review

Paycheck was not perfect, but people need to cut it more slack than they do in the reviews I have read. I was happy with the pace of the film, the overall plot, and was glad the film did not rely too much on dazzling special effects. Ben Affleck assumes the role of a well paid reverse-engineer in the not too distant future . As part of his contract, he has his memory wiped after each job, to protect the company he works for. He takes an unusual assignment, but something goes wrong and he has to figure out just what has happened, without having memories from that time to work with. He gets an envelope of objects mailed from himself, which helps him to slowly unravel the puzzle, all the while being chased by thugs tying to kill him. Ben Affleck was great in this role and Uma Thurman’s character was a good romantic compliment to the lead. Their chemistry is a bit odd, but I think it was supposed to be that way. I would agree with critics that the film lacked significant character development, the thrill sequences were beyond believable, and the advancement of the plot relies too heavily on random events spawned by the little envelope of clues, but what do you expect, it is a scifi/action movie. Paycheck was a fun, thrill packed sci-fi mystery, something that does not come around too often. 3.5 stars out of 5.

Dance of the Dead-Film Review

Dance of the Dead was a good movie, but it is probably not for everyone. It was a bizarre, over the top, zombie thrill ride, and fortunately, it does not take itself too seriously. I would suggest going into this film with that same attitude. It is very tongue in cheek and full of campy moments, and it is full of all kinds of jokes making fun of the zombie genre. Just about every character is a carbon copy cliché, or at least you think they are and that is part of the charm of this unusual piece. I knew I was going to like this film when zombies started launching from their graves like toast from a toaster. It has good production values, and average gore, but the makeup and dialog could have used a bit more work. The plot is very thin and there are plenty of plot holes, but it is supposed to be that way. This story is all about following a ragtag group of high school characters as they try to kill as many of the undead as they can and save as many people in the town as possible, all the while allowing social and political commentary to thrive. I would not classify this movie as scary, but I jumped out of my seat once or twice and this production had plenty of tension to keep you on the edge of your seat. A solid 3 stars out of 5.

Monday, August 31, 2009

The Geeks Shall Inherit the Earth...or will they?-Disney to buy Marvel for $4 billion

I would always wish Stan Lee the best. He has brought so many good things to our world and he and his artists have been able to tackle many difficult social subjects, while others stood silent and did nothing. I know he is happy about the deal, but I'm not. As much as this deal may be good for both parties, I'm not looking forward to Disney's family friendly hands being on Marvel's catalog of characters. Disney does not really have the guts or the intellect to handle the material graphic novels cover with each issue. The Marvel universe may have been party to many blockbuster successes but its true heart is not meant to cater to the meek masses. The geeks shall inherit the Earth, but not with Disney at the helm.

Lovesome Leopard Plant

The Leopard Plant has unusual foliage and bright flowers. I have two of them in the garden, on either side of the slate walkway, and they work very hard to be happy in the semi-sunny spot I've put them in. I hope to propagate more for the shade gardens we are building in the back yard. The leaves are large and heart-shaped, dark green on the top, and purple on the bottom. The leaves are dappled with spots and I'm imagining that's where the name comes from. They make a statement in any garden and grow to about three feet in each direction, so plan for their size upon maturity. They thrive in shade, but will tolerate more sun if you can tolerate their propensity to droop in harsh heat. I would advise against putting them in direct afternoon sun. They like to be watered often if they are in a sunnier spot, but don't over water them, as this can lead to disease or rot. The flowers are normally bright yellow and are daisy like in appearance. They bloom very late in the summer season and in my garden in NH they are the last summer flower to bloom.

Sunday, August 30, 2009

A Busy Bee

Farmington Hayday was last weekend. The Town of Farmington has a end of summer celebration each year. There are all kinds of food vendors, music, activities, and all kinds of competitions. Some of the highlights are the rock climbing wall, the bed race(yes, we race beds here), the horseshoe tournament, and the dunking booth. This year's theme was "Remembering the 1950's," so we had a classic car show and an Elvis impersonator contest. The best part of the event is the fireworks show and that's the only part in which the two of us really have an interest. We had rain the night of the fireworks last week end, so they moved them to yesterday after dark. They are always grand, but this year they were spectacular.

Stan had to go in for a colonoscopy on Wednesday and he could not eat for the whole day Tuesday and could only have clear liquids to drink to keep him hydrated. It was a routine checkup and I think he will blog about it at some point, so I won't go into detail now. I got to spend time with our friend Amanda that day. We had breakfast at the fifties diner and ran a few errands while Stan was having the procedure done. We haven't seen Amanda, Aaron, her husband, or the kids since they went on their hiking vacation. I was nice to catch up.

We saw Val the next day. I can never see Val too often. She and her husband Noel just got back from their yearly vacation in Quebec City. They both had a good time and didn't really want to come back, but Val starts teaching soon and Noel has to get back to his job, so they couldn't stay forever. They were married in the city several years ago and have adopted it as their own. Stan and I have very fond memories of our stay there and hope to go back many more times. The photo above is in the Joan of Arc Garden where they were married. The second picture is the exact spot were they were married that day.

We were able to affix the porch roof in the back and Stan was able to finish the terraced steps in the backyard as well. The terraced steps still need to be landscaped, but getting them in was the hard part. Both will be very helpful during winter. If the roof is not there water dripping from the roof collects on the porch and freezes into a sheet of ice. The slope the terraced steps now occupy was problematic because it becomes a solid sheet of ice during winter and we were very afraid Katie will hurt herself. Greyhounds don't deal well with falls. I've managed to paint an poly one third more of the media room's floor; it is starting to come together. I also scraped and scrubbed one of the stoves cleaning it to prepare for cold weather. The four pellet pallets for our stoves arrived and Stan has managed to carry two ton of pellets into the house already! I love that man of mine!