Where's the Outrage?

I posted this several years ago. I think that it is worth posting again.(Besides I don’t know what to make of Rick Santorum.)

When Sarah Palin wrote, “the America that I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s ‘death penalty’ so his bureaucrats can decide, based on a subjective of judgment of their ‘level of productivity in society,’ whether they are worthy of healthcare. Such a system is downright evil,” I got physically nauseated. The only reason that former Governor Palin said this was to derail healthcare reform and to try to elevate her own status in the conservative movement. The statement had no basis in reality. My nausea stems not from a lie but from this person, unknowingly, making my job harder. Speaking with real patients about real end-of-life issues is incredibly difficult.

The following is an example of an end of life discussion. It has been fictionalized to protect patient’s privacy. A 80-year-old man presented after a fall at home. The patient had been in declining health for some time. He has an abnormal heart rhythm and congestive heart failure. He is on blood thinners because he is at increased risk of developing clots in his heart. The patient is awake and alert on arrival. A CT scan is obtained of his brain which reveals blood between the brain and the skull — subdural hematoma. The patient is admitted to the intensive care unit for observation. Medications are given to reverse his blood thinners. The patient does well overnight in a repeat CT scan (standard practice) performed to see if anything new has shown up. The patient has a new contusion (bruise) on his temporal and frontal lobes.

The patient, who was lucid throughout the night, is now somewhat confused. He is having some problems finding his words. His son, who is an orthopedic surgeon, had been with the patient through the night. The son is now extremely concerned. He wants to know what happened. I review the CTs with him and point out that the contusion is in the area of the speech center of the brain. This should explain his difficulty finding words.The son wanted a repeat CT scan, in spite of the fact that the second scan was only completed four hours ago. I asked whether, if we find a surgical lesion (something that can be operated on), he would like me to call a neurosurgeon. I asked if he wanted his father to undergo brain surgery if it is necessary.

I think this question is more than reasonable. Thankfully, the son never had to make that decision. The repeat CT scan was the same as the second scan. Neurology was consulted. Over the next several days, the patient slowly improved and was able to be discharged to a rehabilitation center.

You know our society is in trouble when a physician has not thought about end-of-life issues concerning his 80-year-old father who has a bad heart. From a medical standpoint, I just want to do what is right for the patient, which is to follow that patient’s wishes. Yet so very few families have talked about end-of-life issues. You don’t want to be in the position of the son where you’re having to make a decision while looking at a CT scan in the middle of an ICU. Instead, you would like to be able make decisions in the privacy of your physician’s office.

I deplore any politician that makes this situation harder. Emotions are overwhelming when families are faced with these types of decisions. Exploiting end-of-life issues for political gain should get those politicians a special place in Dante’s Inferno.

Tags: Congress, Healthcare by ecthompson md
6 Comments »

This is a very cool finding which is obvious to everyone who has studied babies. Sometimes it seems as if they are staring at your lips. They are playing with your lips while you are talking. Now, we know what they are doing.

From WaPo:

Babies don’t learn to talk just from hearing sounds. New research suggests they’re lip-readers too.

It happens during that magical stage when a baby’s babbling gradually changes from gibberish into syllables and eventually into that first “mama” or “dada.”

Florida scientists discovered that starting around age 6 months, babies begin shifting from the intent eye gaze of early infancy to studying mouths when people talk to them.

“The baby in order to imitate you has to figure out how to shape their lips to make that particular sound they’re hearing,” explains developmental psychologist David Lewkowicz of Florida Atlantic University, who led the study being published Monday. “It’s an incredibly complex process.” (more…)

Tags: Healthcare, Science by ecthompson md
No Comments »

Lee Evans, along with John Carlos Rogers and Tommie Smith, made a political statement against racism in the 1968 Olympics. Now Lee Evans has brain cancer. I don’t point this out so we can all go to the Internet and click on a button in order to raise money on his behalf. Instead, I point this out because by the year 2011, everyone should have healthcare. Whether it is a famous Olympic athlete or the average American worker, we shouldn’t have to worry about bankrupting our families simply because we have a bad disease.

The Nation has more:

Lee Evans needs our help. The Olympic Gold Medalist and political activist, who exploded all records in the 400 meters at the 1968 Olympics, has been hospitalized with an aggressive brain tumor. The prognosis for the 63-year-old Evans is not good. As his fellow 1968 Olympic activist John Carlos said in an e-mail, “All of our teammates want to go out and say some prayers. All there is left to do is pray.”

But the situation is made far worse by the fact that Lee Evans, after four decades teaching and coaching at schools ranging from the University of South Alabama to Nigeria, doesn’t have health insurance. This has meant, according to Lee’s sister, Rosemary, that he has been terribly mistreated during his hospitalization. Rosemary said to me, “I heard his doctor in the hall and I heard him say he wished [Lee] had been transferred somewhere else because he didn’t have insurance…. Lee is in intense pain. Not even morphine is helping. He hasn’t eaten in several days, yet there was no IV in his arm when I first went into his room. He’s lying in his filth and nothing is happening. If family members aren’t vigilant… If we aren’t vigilant, I don’t know what would happen.”

More here.

Tags: Healthcare by ecthompson md
3 Comments »

I know that there are some Americans who believe that the swine flu is nothing more than a hoax perpetrated on the American public. I saw some children who were extremely sick from this flu. It wasn’t a hoax.

From USA Today:

The Centers for Disease Control and Prevention has confirmed three cases of a new flu virus, which originated in pigs but apparently spread from person to person, in three Iowa children.

However, there’s no reason to fear the beginning of a new pandemic, says Arnold Monto, a flu expert and professor at the University of Michigan School of Public Health.

“I don’t think this is anything to worry about for the moment,” Monto says. “We have known that swine viruses get into humans occasionally, transmit for a generation or two and then stop. The issue is whether there will be sustained transmission (from person to person)- and that nearly never happens.”

The CDC has counted a total of 18 cases of this new virus, an influenza A strain known as S-OtrH3N2, in two years. That suggests that it’s not spreading quickly or easily, says William Schaffner, a professor at the Vanderbilt University School of Medicine and spokesman for the Infectious Diseases Society of America.

Tags: Healthcare by ecthompson md
No Comments »

This is exactly what I have been saying about Romneycare. We have to do better.

From Physicians for a National Health Program:

While the Massachusetts health care reform in 2006 reduced the number of people who are uninsured in the state by about half, it did so at a high price and is unsustainable over the long haul because of skyrocketing costs, a group of Boston-area physicians and researchers say in a new report released today. The results do not augur well for the similarly structured Affordable Care Act, they say.

The report, titled “The Massachusetts Model of Health Reform in Practice,” presents data showing how the Massachusetts law has resulted in a surge in the sale of skimpy, inadequate insurance policies with high deductibles, along with a sharp rise in health care premiums for individuals and small businesses.

The authors also document how the law has created a financial crisis for the state’s safety-net hospitals and community health centers by cutting their public funding and redirecting the money to subsidize the purchase of private insurance policies.

The financial burden of the reform has fallen disproportionately on lower-middle-class families, they say. Meanwhile, the number of uninsured is once again on the rise.

Those are just some of the findings in a new, exhaustively documented report released today by Mass-Care and the Massachusetts chapter of Physicians for a National Health Program. The report, which is extensively illustrated with tables and graphs, draws on hundreds of sources, including academic studies, government statistics and surveys, in the most comprehensive compilation of its kind.

Other findings include the following:

• The use of high-deductible health plans more than tripled for residents with private insurance
• Good health insurance coverage at small businesses all but disappeared after the reform
• Most of the gains in the number of insured represented a shift of patients from the state’s former Free Care Pool to costlier private insurance programs, where the patients sometimes face new co-payments and premiums that impede their access to care
• The reform did not reverse the growing use of the state’s emergency departments
• The rate of personal bankruptcies linked to medical debt has not significantly decreased

Benjamin Day, executive director of Mass-Care and the study’s lead author, said, “Based on what we’ve seen in Massachusetts, and given the similarities between our state law and the new federal law, it’s reasonable to expect a similar course for the Affordable Care Act: a significant initial expansion of insurance coverage and a moderate improvement in access to care.

“However, by not addressing any of the underlying problems of the health care system – its uncontrollable costs, high levels of inequality, and high administrative costs associated with having multiple private insurers – we will see a worsening cost crisis for the rest of the population and a failing safety net for the most vulnerable populations,” Day said.

The report finds that small businesses were hit particularly hard by health reform. Quality coverage for small business employees all but disappeared over a few short years after reform – while the share of all insurance plans with high deductibles tripled – and health care premiums for small employers rose more rapidly after the reform than in other states (7 percent faster for individuals and 14 percent faster for families).

Dr. Rachel Nardin, chief of neurology at Cambridge Hospital, assistant professor of neurology at Harvard Medical School and co-author of the study, said, “The Massachusetts reform built on a complex blend of public and private insurers, adding to the administrative complexity and cost of the system. To achieve cost-effective, high-quality and truly universal care, we need a single-payer system.”

Nardin’s views echo those of other Massachusetts doctors. The Massachusetts Medical Society’s newly released 2011 survey of physician attitudes toward health reform showed 41 percent of the respondents would select a single-payer system as their first choice for national reform, versus 17 percent who would prefer the Affordable Care Act model. Support for single-payer reform rose 7 percentage points in the year since the last survey.

Tags: Healthcare by ecthompson md
No Comments »

A few facts:

Tags: Healthcare, Party Politics by ecthompson md
No Comments »

As a doctor, I live and breath healthcare. I’m one of those doctors who is smack dab in the middle of healthcare. I can’t do my job without a hospital. As a trauma surgeon, I need the support structure that a fully equiped hospital provides. Because I live in the Blue Ridge mountains, I take care of people from all around this beautiful country. Thousands of people come here to see the mountains. Thankfully, only a few injure themselves while they are here.

Currently, I’m taking care of a young man who lives in Florida. He crashed his motorcycle. He had a terrible head injury which required emergency neurosurgery in order to evacuate an expanding epidural hemorrhage. The patient has insurance. He is now much better and we need to figure out how to get him back to Florida. Here’s where the “fun” begins.

So, for 3 days the hospital social worker is trying to find a rehab facility to take care of this patient. Then we need to make sure that this facility takes the patient’s insurance. Next, we have to make sure that the insurance company will pay for the patient’s rehab and transport to Florida. Finally, and this is really choice, the facility requires the sending doctor to find a receiving doctor. Have you ever tried to get a single MD on the phone? Now, try to get two doctors together at the same time. (I have been waiting for a return call for more than an hour. Just waiting…)

This is nothing but a huge waste of time. All of this needs to be streamlined so that the patient is taken care of effectively. We need a system that is designed around the patient.

Tags: Healthcare by ecthompson md
1 Comment »

It is clear that one of the greatest challenges to healthcare is obesity. Even if you’re not fat or overweight, Americans are getting fatter by the minute. Don’t believe me. Go to any mall, sit down and watch. It shouldn’t take long before the enormity of the problem begins to sink in.

From USA Today:

“Obesity is going to be a leading driver in rising health-care costs,” says Kenneth Thorpe, chairman of the department of health policy and management at Emory University in Atlanta. Thorpe did this special analysis on obesity for America’s Health Rankings, the 20th annual assessment of the nation’s health on a state-by-state basis.

“There is a tsunami of chronic preventable disease about to be unleashed into our medical-care system which is increasingly unaffordable,” says Reed Tuckson of United Health Foundation, sponsor of the report with the American Public Health Association and Partnership for Prevention.

One of the things that we have to do is simply eat better. I understand that’s easier said than done. It is much easier to grab a hamburger than it is to fix a healthy meal. Yet, we have to figure out a way to make it easier and more efficient to eat healthy. Harvard has come up with a guide called the healthy plate – this is a start.

Did you see that Denmark just instituted a fat tax? This is what we need. We need to encourage Americans to eat healthy. In the long run it is best for all of us. (I’m waiting for the usual objections from conservatives – liberals always want to tax x, y or z. This isn’t true. If they have a better idea, I’m all ears.)

Denmark has introduced what is believed to be the world’s first fat tax – a surcharge on foods that are high in saturated fat.

Butter, milk, cheese, pizza, meat, oil and processed food are now subject to the tax if they contain more than 2.3% saturated fat.

Some consumers began hoarding to beat the price rise, while some producers call the tax a bureaucratic nightmare.

Tags: Healthcare by ecthompson md
2 Comments »

I’m not sure about you, but I was shocked when Ron Paul, a physician, was asked about a patient without insurance who was seriously injured. There were at least a few people in the audience who yelled, “Let ‘em die!” I commend Ron Paul for not playing to the crowd.

Think Progress interviewed several students on the conservative and religious Liberty University campus on this scenario. I’m very happy to hear their answers:

KEYES: (editor’s note: Keyes is the TP interviewer) In the debate on Monday, there was the question of whether or not a 30 year old who doesn’t have health insurance and gets in a major accident, we ought to just let him die or we ought to provide care for him. What do you think would be the Christian thing to do?
STUDENT 1: Definitely to give him care, no matter what your age is.

KEYES: What do you think the Christian thing to do there is?

STUDENT 2: If he didn’t have health insurance?

KEYES: Yeah.

STUDENT 2: I would say take care of him.

KEYES: Do you think it’s un-Christian to be letting uninsured people die? What would you do?

STUDENT 3: Why would someone let anyone die just because they can’t pay for something? That’s the thing I don’t understand. Me and my family, we’re financially impaired right now, we’re in a shelter. We have insurance and all that, but at the same time for those who don’t have insurance, what’s the point of killing someone, taking a life, just because they can’t pay for something? It’s like going to a hospital, charging millions of dollars to have an operation to save someone’s life, they can’t pay for it, okay so we’ve got to kill them? We can’t save a life because they can’t pay for it? That doesn’t make any sense to me, I don’t understand.

KEYES: Do you think that’s a Christian thing to let an uninsured person die?

STUDENT 4: Absolutely not. I don’t see how that’s Christian in any way. I mean “Christian.” I think everyone has the right to life, including I don’t agree with capital punishment, I think that those people also have a right to life.

KEYES: What do you think the Christian thing to do there would be?

STUDENT 5: I believe provide care for him. I believe we should provide some care for him.

KEYES: What do you think, do you think that it would be Christian to let uninsured people die?

STUDENT 6: I don’t think it is. I think that they should work towards making sure that people no matter what should live.

STUDENT 3: I bet if Jesus came back right now, all them politicians, all them doctors who had to do something like that would probably give their life to Christ because they felt so bad about themselves. Because they knew that they took a life just because someone couldn’t pay for it.

Tags: Healthcare, Party Politics, Religion by ecthompson md
No Comments »

Elizabeth Warren is running for Senate in Massachusetts. I simply love Elizabeth Warren. The professor is smart. She’s thoughtful. The biggest question I have about her candidacy is whether she can be tough in the trenches. Politics is a tough business. Will she be able to throw elbows when necessary? From time to time on this blog, I will endorse a candidate who I feel will represent the American people and fight for the middle class. My endorsement comes with more than simply lip service. I am sending a cash donation to her campaign – today.

Creating jobs is key to our recovery. I simply don’t understand how giving corporations, already fat with corporate profits, more tax breaks is going to give them incentive to create jobs. I think it is clear that many of these corporations have created jobs overseas but have not done so here in the US. Gov. Rick Perry has been touting his record for job creation. Unfortunately, he’s creating a bunch of minimum wage jobs. A review of the data reveals that he has doubled the number of minimum wage and low-wage workers (making less than minimum wage) since 2007. We need to create quality, living wage jobs.

The American Society of Pediatrics releases a statement which corrects the false and misleading statements that come out of the mouth of Michele Bachmann. While there is so much misinformation coming out of the Republican debates, Michele Bachmann seems to lead the charge. Her recent statement that the human papilloma virus (HPV) vaccine causes mental retardation is simply a scare tactic. There are no data in the literature to support this. None. There are lots of valid reasons for opposing a “mandatory” vaccine. Personally, I support the vaccine because it saves lives. This vaccine can potentially save over 4000 women a year from dying from cervical cancer.

One of the things that I found most interesting about us Americans is that we can hold diametrically opposite views at the same time. We can go to church on Sunday and we can read the Bible. We can believe that we are our brother’s keeper. We can believe in recycled passage that we should love our brother as ourselves. Yet, we can somehow also believe that a person dying on a ventilator without medical insurance who has a treatable disease should be unplugged. I don’t get it. Yet Tea Party supporters actually shouted during a recent CNN debate, “Let him die.” Ironically, one of Ron Paul’s chief strategists Kent Snyder died recently. He was uninsured and broke. Ron Paul’s answer to health care reform is to let churches and charities chip in and help out. It sounds nice. But in actuality churches do not have the resources to support over 50 million Americans without health insurance. Kent Snyder’s friends have donated over $40,000 towards his $400,000 medical bill. This is an excellent example of how charity can and does fall short.

Five things that the Tea Party will cheer for. Yuck.

A trader for the Swiss bank UBS has lost over $2 billion. How is this possible? Not $200,000 or even $2 million. This guy somehow lost $2 billion!!!

Bank of America is fined for firing a whistle blower. This guy informed investigators of the widespread fraud in Countrywide. He was fired? He deserves a Medal of Freedom!

The Rick Perry problem.

New evidence reveals that News Corp directors knew of the US hacking over a decade ago.

As soon as I saw that solar power company Solyndra went under, I knew that the sharks would be circling. The $535 million taxpayer loan is plenty of reason for us to question the wisdom of lending them money. Now, there is the finger pointing. Did the administration push the loan through without the “proper” review? I think that everything should be reviewed but that we must not lose sight of the purpose of government loans. The government needs to take big gambles in the name of the American people. We need to push the envelope. If business were going to support these long shots they would have already, but business is always going to lean toward safe and trendy.

Paintings of banks on fire are selling like, well, hotcakes.

What’s on your mind today?

Tags: Corporate Wrongs, Healthcare, Party Politics by ecthompson md
11 Comments »

If we watch the mainstream media, we are completely led astray. The above clip is one of the best examples that I’ve seen in a little while. The new census/poverty numbers came out yesterday. It should be no surprise to anyone that poverty increased in this country. The increase in poverty is a result of multiple different factors, not the least of which is our ongoing recession (technically it’s an economic slowdown , but it feels like a recession to me). Because of an unemployment rate of 9.1% and the huge burden of chronic unemployment, the number of Americans who are uninsured in the United States has risen to approximately 50 million.

CBS, in their infinite wisdom, decided talk about healthcare reform with Sen. Orrin Hatch, who believes that health care reform should be addressed by the states, and Sen. Bernie Sanders, who believes that we should have a single-payer system. They approach the subject as if there are only two sides to the story. CBS does not give you the prerequisite background about the healthcare reform debate and subsequent legislation’s getting derailed early and never really getting back on track. The final piece of legislation was a watered-down piece of used tissue, little more than insurance reform.

There are several things to fault about this piece but I’ll focus on the fact that the moderator never asked Sen. Hatch how states that are strapped for cash can take on the additional burden of healthcare. That would seem to be a simple question which would directly address Sen. Hatch’s “plan.” A second and follow-up question, which was never asked, would be whether or not you should have the same benefits if you moved from one state to another. Why should moving from Texas to North Carolina change what is covered? If the answer is that your healthcare benefits should not change and your healthcare benefits should be able to move with you anywhere throughout these wonderful 50 United States, then the state solution is not possible. This is a simple nonconfrontational question which could easily been asked and then we could have seen how Sen. Hatch answered it.

Finally, one of the big problems I have is over the last 20 years all of these politicians have been schooled on how to “answer” questions on TV. I’ve been to these classes. The bottom line is you don’t ever answer the question. You walk into the interview with three things that you want to say. No matter what you are asked, you ignore the question and steer the answer back to one of your three points. This is one of the major problems with politics today. Nobody directly addresses the question that is asked. Instead, the politician throws out some gobbledygook before he/she can get back to one of the three points that they want to make. This has to stop. If we are ever going to get meaningful legislation out of Washington, our state capitals or anywhere else, we’re going to have to have a meaningful debate. We can never have a meaningful debate if we are simply talking past each other and racing towards our talking points.

Tags: Economy, Healthcare by ecthompson md
3 Comments »

• If you read just a little bit about the Great Recession, then you know that whenever one of the big Wall Street firms was in trouble, Bear Stearns, Lehman Brothers and even Morgan Stanley, they all at one time or another called Warren Buffett for an emergency loan. So it is interesting that Bank of America just got an infusion of $5 billion from Warren Buffett. Bank of America is having trouble fending off lawsuits over its Countrywide acquisition. It appears that several parties believe that countrywide acted in a fraudulent manner and continue to sue countrywide for large sums of money, with which Bank of America needs to settle. Warren Buffett’s infusion of cash does help.
• Hispanics are currently the largest minority group in college. They have just recently surpassed Blacks. All I can say is that we need more Americans in college. We need more Americans to graduate college. We need more government loans and grants to help pay for the ever-increasing expense that is college.
• Ben Bernanke, the Fed Chairman, and the rest of the world’s financial gurus are all gathered at Jackson Hole, Wyoming. This is the annual Fed meeting. This is the meeting where you would expect a lot of discussion and then finally a brilliant intervention to fix what is ailing our economy. Don’t expect it. With Republicans mired in reactionary policies which are going to hurt the economy and the Democrats mired in indecision, as usual, the Fed is stuck in molasses.
• Pakistan is becoming the new wild wild West.
• The US economy is growing, although it is growing at a very slow pace.
• One of the few programs that the government has instituted to help homeowners was buried in the Trouble Asset Relief Program. Over $45 billion was set aside to help homeowners fend off foreclosure. Only $2 billion of that has been used. Somehow, that money is going to be rolled back into the treasury in order to pay down the deficit.
• The manufacturing sector expanded modestly this month.
• Our own obesity is starting to cost us billions of dollars. Estimates that obesity is going to cost us over $66 billion by the year 2030 are hard to swallow (pun intended). As we struggle with our healthcare costs, we’re going to have to address the obesity crisis in the United States.

Jill St. John as Tiffany Case in the James Bond movie – Diamonds Are Forever

• A new planet has been found in another galaxy. This planet is made entirely of crystallized carbon – it’s a diamond. How cool is that?

Tags: Economy, Healthcare, Pakistan, Race, Science by ecthompson md
No Comments »

• Mitt Romney has proved himself to be the Republican front-runner by pulling in $18.25 million. He still seems to be confused about whether the Obama administration made the economy worse or not because he’s flip-flopped.
• I don’t understand the country’s conniption over the Casey Anthony verdict. Some people were simply apoplectic. We need to get a grab on reality. We need to be upset over Republicans’ refusal to renew the debt ceiling. We need to be upset at the fact that Republicans are refusing to stimulate job growth which would ease the symptoms of this economic slowdown for millions of Americans. We need to focus less on the sensational trials and more on the fact that jobs are being shipped overseas and wages are stagnant and have been for more than 20 years.

• Huge dust storm envelops Phoenix. The airport was shut down for over an hour. Now, that’s a dust storm.
• Mentally deranged man is being detained for mental health evaluation after threatening to kill the President.
• When I was on the air regularly, there are times when I was talking and it seemed to me that I was not as engaged in what I was talking about as I should’ve been. I think the same thing happen to Republican presidential candidate and former Senator Rick Santorum. He stated, on-air, that “they (the Obama administration) created only 240 million jobs.” Misspeaking is not his only problem. The problem is that his error was pointed out and he doggedly stuck to it. He didn’t realize that he was off by a factor of 100. The total number of jobs in the United States is only about 130 million. Our population is only 311 million. To me, the take-home lesson is be aware of the facts and if you make a mistake correct it.
• To everyone who follow sports, it was clear that Roger Clemens had taken some sort of performance enhancing drug. Yet, he sat in front of Congress and simply lied. Now, his trial for perjury begins. I think it is a separate question whether drugs should or should not be allowed in professional sports. The question is should you be able to sit in front of Congress and lie like Jim Carrey‘s character in the movie Liar Liar.
• America’s education system is in a sad state of affairs. Many students are not learning the information that is necessary to make them successful in this hyper-competitive, technology-based society. So, it is extremely disheartening to find out that over 150 teachers and principals in Atlanta have been caught up in a cheating scandal. As a reflex, I would like to take the side of the hard-working teachers and principals, but there really is no excuse. I understand they’ve been put under increased scrutiny and pressure and have not been given the resources to adequately complete their tasks, but there is no excuse.
• American businesses are sitting on cash. A lot of this cash could be used to expand business and hire workers but it isn’t happening.

• A study by the Labor Department was supposed come out four years ago. This study was supposed (may need a subscription) to look at workers who have lost their jobs and have been “retrained” to qualify for higher paying jobs. I’m not sure we need to study. I think it is pretty clear that once a middle-aged worker loses a manufacturing job the majority of these workers end up in the service sector which cuts their pay approximately in half.
• A new study questions whether too many angioplasties are performed in United States. All I know is if I’m having chest pain and I have other signs and symptoms of a heart attack I want an angioplasty by a qualified cardiologist because that could save my life. Also, when you have a patient that comes back to the ER with recurrent chest pain and you can’t find an etiology and cardiology is finally consult it and finds a mild coronary artery lesion should they stent that as the possible problem for the chest pain? I’m just asking.
• The online magazine Mother Jones has a section of a huge graphic called Capital Gain which simply asks the question of whether Congress can really represent the American people. With the median net worth of American families being approximately $120,000 and the median net worth of the members of Congress being $912,000. In our general population one and 22 Americans are millionaires. In Congress, nearly half of every congressman is a millionaire. The combined net worth of the top 10 members (richest members) is $2.8 billion. All 10 of these members voted to extend the Bush tax cuts. So, does Congress represent us?

So what articles are you following? So what’s on your mind?

Tags: Business, Congress, Economy, Education, Elections, Environment, Healthcare, Sports by ecthompson md
9 Comments »

The Swing

• I took some golf lessons with my grandson yesterday. We then played a couple of holes of golf. Playing with a seven-year-old is clearly different than playing with my normal partners.
• President Barack Obama announced a loose timetable for withdrawing troops from Afghanistan. I’ve talked about Afghanistan on a number of occasions on this blog. In 2006 and 2007, I referred to Afghanistan as the “good war.” That was probably a little naïve. If our goal remains to make sure that there is no sanctuary for Al Qaeda, I’m not sure that we’ve achieved that goal. I don’t think that we have the ability to remove lawlessness from the world. (Al Qaeda will always look for pockets of the world where government intervention is minimal. There remain vast spaces of Asia, Africa and the Middle East where this is still true.) So maybe our strategy should be to infiltrate pockets of extremism and strike when they become a threat. Anyway, I believe that President Obama has made the right step in drawing down our presence in Afghanistan.
• The McKinsey healthcare study has been widely panned. I think that healthcare needs to be a basic right in the United States. We need to extricate employers from the health-care system. Employers need to stick to what they do best. We need to be able to pay for basic healthcare services (we can argue or discuss what those basic healthcare services are) through a government based program.
• Denny Green, as coach of the Arizona Cardinals, had a famous tirade after losing a game. He stated, “They are who we thought they were.” I think the same can be said for Godfather Pizza CEO and Republican presidential candidate Herman Cain. The former CEO was asked about oil production and he said his solution would be to appoint oil executives to a commission or a board and they would tell him which regulations they would follow. Mr. Cain, we have been through this before. This was a core belief, a core principle of George W. Bush. Let industry police themselves. Sounds good, if it weren’t for all that money they would make by skirting the rules. Bush implemented such policies in Texas as governor and of course he implemented the same policies as president of the United States. What we got was lawlessness. Air quality worsened. Water quality worsened. Oil prices increased. The reason that we had several food recalls was that we weren’t policing the food industry any more. They cut corners and people died. We saw none of the benefits that Republicans have touted.
• More on the Justice Clarence Thomas ethics scandal. I have no idea how we can make this guy resign. He will not bow to pressure. Congress has little or no stomach for true investigations. Everything seems to turn into a political circus on Capitol Hill. I doubt the Justice Department wants to take on something so controversial. Therefore, Justice Thomas and his shady ethics will continue.
• Oh, let’s get back to Herman Cain. He’s happy to play the race card whenever it suits him. I think that suggesting that Jon Stewart is attacking him because he’s Black is not a good strategy. I think when you say something stupid like all bills should be no longer than three pages, you should expect to be late-night fodder.
• House Majority Leader Eric Cantor is pulling out of the deficit reduction talks. I think it’s a wise move. If you have no intention of compromise you shouldn’t take part in a discussion which requires compromise.
• Harvard study finds that peanuts are good for you and potatoes, not so much. If you want to stay slim, stick with peanuts.
• It appears the United States and several industrial allies are going to tap their oil reserves to release somewhere around 60 million barrels of oil over the next 30 days in order to compensate for the loss of Libyan oil.

Claude Monet's water lilies

• A reclusive heiress who recently died has left a Monet water lilies painting to the Corcoran Gallery of Art. I love Claude Monet‘s water lilies series.

Tags: Afghanistan, Healthcare, Military, Party Politics by ecthompson md
1 Comment »

• I was surprised at how nice it was to see Keith Olbermann back on TV.
• It is time that we honestly assess our obsession with pro sports. With state, local and federal agencies trying to cut back because Americans simply don’t want to pay more, why is Los Angeles looking for pro football team? Pro football even in the largest markets requires subsidies, huge subsidies, from the taxpayer. Their single largest expense is not their egotistical quarterback or their prized wide receiver. It’s their stadium. If we, the taxpayers, have to pay for the stadium then why don’t we get an opportunity to make some decisions on personnel and coaches and the direction of the team? Don’t get me wrong, I love football and basketball and tennis and golf, but if you’re going to aske me to shell out money for a stadium, then I should have a say in the team.

• Rory McElroy put the pedal to the metal and got an early lead at the U.S. Open. By Saturday, it was clear that he was going to win if he did not have another Masters-like meltdown. He did not. He rose to the occasion and cruised to victory. His meltdown at the Masters was really hard to watch. I am happy that he was able to get his mental game together. If he can avoid injuries, if he can keep his mind right, this young man has an opportunity to dominate golf for years to come.
• Finally, continuing on the topic of sports, Serena Williams has made a comeback at Wimbledon. She hasn’t played competitive tennis for almost a year. She won her first match, but it wasn’t easy. It is probably time to say that Serena is the best female tennis player of all time.
• A little bit more on Clarence Thomas. Justice Thomas seems to have some ethical problems. I have a problem with his wife involved with a Tea Party organization and a lobbying firm. Unless somehow she can prove that money given to her lobbying firm does not flow to her husband, this seems to be a conflict of interest. This whole thing just seems to smell funny.
• The fact that 93% of all top congressional staffers are white males is not really news. It proves that the more things change…
• In Libya, NATO bombs have gone astray, again. What is our goal here? To save innocent civilians?

• 18 months ago, I was standing in Athens with my wife. It was an incredibly peaceful, warm and inviting place. Now there are huge demonstrations as Greece is being asked by the European Union to tighten their belt.
• Suicide bomber kills 27 in southern Iraq. Six soldiers were killed two weeks ago in a rocket attack.
• In an announcement later on today, it is expected that President Barack Obama will announce that we’re pulling out of Afghanistan. I just wonder if this is going to be one of those symbolic pullouts or we really going to get all the troops out.
• We don’t need any new warnings on cigarette labels. This isn’t 1975. We all know the problems with smoking. Having pictures of some guy struggling to breathe in a facemask is not gonna stop people who smoke from smoking. Instead, we need for people who smoke to pay higher premiums because of their higher incidence of heart disease and pulmonary insufficiency. If cigarettes are going to be legal in this country, we’ve done all we need to do to inform the public of the dangers of smoking.
• Senator John McCain blames the huge Arizona fires on illegal immigrants. Now, it is true that we need to control our border. We need to know who’s coming and going in order for all of us to be safe. It is also true that there’s absolutely no evidence that illegal immigrants had anything to do with this huge, devastating fire. All I can do is shake my head. The senator knows better.
• Jon Huntsman has announced that he is running for president. In my opinion, several of these people, GOP candidates for president, are running now to set up a “real run” in 2016.

Tags: Afghanistan, Foreign Affairs, Healthcare, Military, Sports, Supreme court by ecthompson md
8 Comments »

One of the biggest problems with our healthcare system is that it is too complex. Some complexity is necessary. As a physician, I’m taking care of extremely complex problems. But we are talking about a system that pays for healthcare and not the system that delivers it. Make this thing easy for everyone to understand – Medicare for all. Roll all of the patients who currently get Medicaid into Medicare.  (Can you sell this on Capital Hill? I doubt it, but it is the right thing to do!) This way we control costs and continue to deliver the care that everyone wants. The direction that the White House is heading is completely wrong. It may be politically correct to try to walk this tightrope but it is wrong for the American people and it is wrong for those patients who depend on this program.

Tags: Healthcare by ecthompson md
No Comments »

• Netroots Nation (progressive blogger conference) is going on right now. This is the energy, the center of the progressive movement. Recaps can be found here.
• Speaker of the House John Boehner and President Obama have locked horns over the War Powers Act. President Obama believes the War Powers Act does not apply to action in Libya. I believe this is the same type of action that we saw from the Bush administration, where the president simply didn’t believe that he needed to follow the rules. Glenn Greenwald has more.
• A closer look at former Minnesota Governor Tim Pawlenty reveals more of the same in his economic policy. Tax cuts for the rich. Excuse me, huge tax cuts for the rich and pennies for the rest of us. All this is is repackaged trickle-down economics. We know it doesn’t work. We’ve experienced the pain of trickle-down economics.
• Recently a commentor on my blog suggested that Reagan was the “best” president with regards to the economy. I suggested that nothing was further from the truth. When you stack up presidents with regards to economic prosperity Reagan isn’t first or second. Looking at presidents from Eisenhower through Clinton, President Reagan ranks fourth. Reviewing a number of factors, including gross domestic product, real disposable personal income, unemployment, employment (job creation), inflation and deficit reduction, Ronald Reagan is not the economic powerhouse that conservatives would like us to believe. No president is perfect. No president has done everything right. Let’s not get carried away and think that President Ronald Reagan was an economic guru when, in fact, he wasn’t. By the way, if you’re wondering which president comes out as number one, it’s Bill Clinton.
• Too many CT scans are driving up medical costs. I always have a problem with the retrospective review suggesting that physicians have ordered “too many” CT scans. What were the clinical circumstances? Was the physician really in a quandary? Did the patient need reassurance?
• More voter suppression. Two former aides to a Maryland Governor have been indicted for voter suppression. We need to get a handle on this.
• There’s a fight in the Democratic Party over anonymous campaign contributions. On one hand, those who are idealistic about trying to clean up campaign finances would like to eliminate anonymous donations. On the other hand, we live in the real world and Republicans are killing the Democrats with a flood of campaign contributions from anonymous donors.
• Keith Olbermann may give Anthony Wiener a job.
• You remember when Michele Bachmann said that the lying King was nothing more than gay propaganda? This isn’t even close to the craziest thing that she’s ever said. Here are her top 10.
• If texting while you’re driving is dangerous, how about having sex while you’re driving?

Tags: Economy, Healthcare, Party Politics by ecthompson md
No Comments »

• I just saw Hangover 2. Seriously, why didn’t I just read a couple of reviews before going to see this huge waste of time? My favorite film critic of all-time said, “If you saw that earlier film (which grossed $485 million, so you may have), there’s not much need for me to describe the plot this time. It’s the same story.” Why didn’t I read his review and simply watch the original Hangover which was funny and original? The story of guys screwing up a bachelor party isn’t original, but the story was told in an entertaining and interesting way, the first time. Hangover 2 is simply changing the place and time and giving the same actors a little different venue, Bangkok instead of Las Vegas. Huge waste of time. Don’t see the movie anywhere (in the theaters, pay per view, HBO, Netflix or DVD). See the original or, better yet, see Risky Business which is a much better film and has basically the same theme.
• Wisconsin Supreme Court blows a huge raspberry at its lower court and overturns the lower court ruling. Not only is it okay to union bust but it is okay to skirt the rules while you do it.
• Spiderman the Broadway play finally opened Tuesday night. I was not on the celebrity list.
• Paul Krugman is an economist and should be forgiven for saying something with his outside voice that he should have said with his inside voice. Medicare saves money. Damn it. I typed it. Let’s just pretend that I didn’t type it and Krugman didn’t say it. Okay?!?
• Speaking of our health, watching TV increases our risk of diabetes, heart disease and early death.
• Capital gains taxes are on the lips of Republicans again… or, rather, still on their lips. It was multi-millionaire Herman Cain who stood on stage during the Republican debate and boldly stated that he doesn’t have enough money, that he needs more money. Let’s lower the capital gains taxes to zero so that he can take home more. Okay, so I’m paraphrasing. This is basically what Republicans have been saying for over 30 years. The problem is that the benefits of cutting capital gains taxes basically stop at the doorstep of the rich. The benefits don’t trickle down to the rest of us.
• House Speaker John Boehner may have broken the law when he paid an outside firm to defend DOMA.
• Former Blackwater guard sentenced to three years in jail. I’m still wondering when some of the top brass at Blackwater will be sitting for trial.
• The Senate votes to keep tax subsidies for ethanol. Republicans are happy to cut programs that help the lower and middle classes, but they can’t cut subsidies for industry.
• Remember, in 2008, the Republicans were always looking for someone else to get into the presidential race. In 2012, it looks like we are going to have the same thing. Right now, Republicans are looking to Sarah Palin and Rick Perry. Right now, Rick Perry is gearing up and testing the waters. I’m sure there is a good reason why he compared himself to a prophet. I just can’t think of one right now, can you?
• Dallas Mavericks are still world champions!!

Tags: Civil Rights, Economy, Healthcare, Party Politics, Sports, Taxes by ecthompson md
1 Comment »

• I know I haven’t talked about it. It’s really because I’m extremely nervous that the Dallas Mavericks are going to fumble this opportunity away. During the last 20 years, the Mavericks have had several extremely strong and talented teams. They’ve gone to the playoffs and, for the most part, have played extremely well. Then, they would come up against the Los Angeles Lakers or the San Antonio Spurs and wilt at crunch time. Now, in this NBA playoff run, the Dallas Mavericks have made critical play after critical play during crunch time. They have created turnovers instead of making turnovers. They are one game away from winning the NBA finals. Go Mavericks!
• I don’t understand why politicians just can’t admit when they’re wrong. Sarah Palin was 100% wrong about Paul Revere’s ride and the purpose for it. You can spin it. You can examine it. She was simply wrong. For some reason, there are boxes and boxes of Sarah Palin’s e-mails. Boxes? This is 2011, why won’t they be put on disks? Why is anybody concerned about Sarah Palin’s e-mails?
• Congressman Dana Rohrabacher wants our money back. He believes that Iraq should repay us for invading them. I think he should hold his breath until that happens. Craziness.
• Strenuous exercise may protect the brain against strokes. There are hundreds of benefits of strenuous exercise, which I need to get to, and this is just one of them.
• There’s lots of turmoil and disarray in Yemen.
• Two common substances appear to be linked to cancer. I’m not sure that it’s a surprise to anyone that formaldehyde has been linked to cancer.
• 10 years after the Bush tax cuts (happy anniversary) there’s no evidence that the Bush tax cuts did any of the positive things that the Bush administration claimed. Tax cuts do not pay for themselves.
• The Anthony Wiener saga continues. It appears that he exchanged a series of Twitter messages with a 17-year-old girl. None of the messages appeared to be inappropriate. The problem is, once you open that ugly can of worms the members of the press are all over you.

25 years ago Ferris Bueller’s Day Off debuted. One of the most enjoyable movies that I’ve ever seen. Where are the actors now? If you haven’t seen it, rent it this weekend. If you have, see it again. Pure fun. BTW, I just saw Kung Fu Panda 2. Now that was a ton of fun also. I highly recommend. I took my 7-year-old grandson, but it is fun without the grandson.

Tags: Healthcare, Iraq, Music, Party Politics, Taxes by ecthompson md
1 Comment »

• Sergio Garcia is fading at the Byron Nelson Championship in Dallas, Texas. Whatever he thought he fixed in his mental game isn’t fixed. Currently, Joe Ogilvie leads by one stroke.
• I find it interesting that Fox News has decided to keep Sarah Palin on the payroll since it’s clear that she is now exploring a presidential run. They dropped Newt Gingrich and Rick Santorum as soon as they were considering a presidential run but not Sarah Palin. Why? Is it that Sarah Palin isn’t really considering a presidential run? Maybe Sarah Palin is doing her Donald Trump bit and simply trying to drum up publicity for herself. She’s been able to cash that publicity in and make some significant money (just bought a new house in Arizona).
• No matter how much the public thinks that Paul Ryan’s budget balancing, Medicare killing plan is wrong for America, the Republicans are continuing to push it. If you’re in a hole, I guess you can do one of three things – stop digging, continue digging or try to climb out of the hole. Republicans have decided to continue digging.
• The LA Times has a nice and very long discussion on Bruce Ivins, who was the odd researcher accused in the anthrax killings. I’m still not convinced that this is the guy. Yep, he is weird, but being weird isn’t a crime.
• President Obama is in Joplin, Missouri today. My heart and prayers continue to go out to the residents of Joplin.

• I really dislike politicians who in front of the cameras in Washington talk about cutting this and cutting that but when they’re at home in front of their constituents they’re bashing the government for not doing more. Today’s example is Representative Lou Barletta of Pennsylvania. He voted to cut EPA funding; yet, in front of his constituents is complaining that the EPA is not doing more.
• Former Senator John Ensign is hoping that the Department of Justice cannot use incriminating e-mails which will surely land him in jail. Basically, as I understand it, the Senate Ethics Committee could obtain evidence in multiple different ways which may not be transferable to the Department of Justice. For more information on this legal conundrum read this.
• I continue to be amazed at how the Republicans are trying to sell this “cut and grow” idea to the American people. Republicans, including House Majority Leader Eric Cantor, continue to try to sell the American people on trickle-down theory. If all we did was cut this or that money would then roll down to small business and small businesses would thrive. Over the last 30 years we’ve tried this theory so many times and as a whole it hasn’t worked. The one thing that is clear with trickle-down theory is that the rich get richer.
• So far, I think the most interesting candidate on the Republican side is Mitt Romney. He’s trying to walk a tight rope. He’s trying to play up his credentials as a financial wiz but the same time separate himself from the Wall Street Christians and against that which nearly destroyed our economy. He has the same type of balancing act with healthcare. He can’t support the national healthcare reform that was passed by Congress last year or he’ll alienate many Republicans. At the same time, he’s trying to push his own credentials as a healthcare fixer because of what he passed in Massachusetts, which is almost identical to the national healthcare reform plan. Finally, lots of evangelical Christians are unsure if they can embrace a Mormon. It is difficult if not impossible to win enthusiastic Republican support without the support of evangelical Christians.
• The New York Times is trying to tell me that their coverage is so great that I should pay $35 per month for their award-winning reporting. It seems to me that the Wall Street Journal has outstanding coverage also. They’re asking me to pay a third less than the New York Times. What’s up with that? Are the Washington Post and the LA Times going to follow suit? One of the distinct advantages of the Internet was that I was able to access multiple different sources of information. Am I going to have to shell out money for this information? Is advertising revenue down that much?
• Everyone is not flocking to the theaters just because the movie is in 3-D. For some reason this is a surprise to Hollywood. (Psst, Hollywood… we will sit down and look at movies that are entertaining and enjoyable. More like Thor and less like the Green Hornet.) As a whole, I haven’t found the 3-D experience to be all that additive to a excellently written film. I just saw the movie Thor and I didn’t think that the three-dimensional qualities were helpful at all. BTW, I’m looking forward to seeing Kung Fu Panda 2. I really enjoyed the first one. I”m hoping that they, the producers, don’t screw this sequel up.

So what’s on your mind the Sunday afternoon?

Tags: Budget, Environment, Healthcare, Sports by ecthompson md
2 Comments »