Monday, March 22, 2010

219 Democrats

With gangs of protesters roaming Washington, D.C. this weekend, and Republican congressmen egging them on by holding up "Kill the Bill" signs from the Senate balcony (see slideshow), with spitting and name-calling, with emotions and political influence tangled up together on both sides of the abortion debate, the Senate's health-care bill narrowly passed in the House of Representatives on Sunday with 219 votes (all Democrats).

On Tuesday, President Obama is expected to sign the bill, as the men and women of Congress continue to hash out the details of reconciling the Senate and House versions. It seems that health care reform is all over but the shouting, and there's been plenty of that already.

I've been in favor of health care reform for a long time, primarily because I believe that it would keep Americans healthier and protect them financial ruin if they do become seriously ill. Thirty-two million uninsured Americans will be covered by this new bill, easing the considerable logistical and financial strain that the uninsured place on our emergency rooms and hospitals when they don't have access to regular medical care that can keep them out of the ER and hospital in the first place.

The bill will also make health insurers take more responsibility for the people who pay their premiums. Health care insurers will now be required to invest in preventing disease (and ultimately saving money on health care costs) by covering annual check-ups and and childhood immunizations. Reform will create larger pools of payees, including healthy young adults, to offset the costs of treating the patients who have expensive (often chronic) illnesses, and eliminate the lifetime cap on how much health care an insurer will provide to a patient. (Note to uninsured twenty-somethings who will now need to purchase health insurance: some day you, too, will have an expensive and/or chronic medical problem, for which you deserve - and no doubt will demand - quality care.)

Recent headlines such as "Eight healthcare lobbyists for every member of Congress" (Fierce Healthcare) and "Big Jump in Blue Cross Premiums Sparks Outrage" (San Francisco Chronicle) have made it clear that health care consumers have had little influence, and their needs have not been met, under the current insurance system. It was time for some legislation.

The Washington Post has an interesting chart showing how the House members voted, how much funding they get from the health care industry, and the percentage of uninsured people in their districts. Wondering how reform will affect you? The Post's interactive graph explains the costs and benefits of the bill, based on your income, marital status, and the size of your family.

Wednesday, March 17, 2010

Going Green

In honor of Saint Patrick's Day (but not before suggesting that you read some glorious Irish poetry by William Butler Yeats instead of drinking green beer this year), I want to write about the other way that people take pride in all things green: the huge popularity of the "green living" movement in the United States. 

I'm all in favor of reducing pollution and environmental toxins by supporting local farmers and organic foods, using nontoxic household cleaners, and eliminating the use of plastic shopping bags in stores (as San Francisco legislated a while ago). Organic cotton baby clothes? Sustainable bamboo flooring? Bring it on!

I have my favorite green sites, like the lovely, soothing Low Impact Living. But I don't think this trend goes very deep for most people, and sometimes it rings false to me as well.

Consuming less, not buying more, can truly help the environment by, among other things, decreasing the (fossil fuel) energy demands of producing and shipping products, and decreasing the amount of things that end up in a landfill (if you feel guilty about tossing old things out, check out Freecycle). Much harder than buying is getting rid of things, and making space (literal and figurative) for what really matters in life: health, family, friendships, adventures.

The green movement is both an ideology and a marketing tool for new products (if it's "green," it sells).  To a degree, buying green can help you live a healthier life as well. But it's important that consumers don't bury their sense of public responsibility under a mound of green products. Because no matter how many bottles of Method nontoxic cleaners I might buy, my choices won't outweigh the public health benefits of one new worker safety rule by OSHA, or an increase in the number of food inspectors employed in a state.

Thursday, March 11, 2010

Going Screen-Free, or Trying To

An analysis of two studies of about 4,000 adolescents found that the more "screen time" these teens had, the less attached they were to parents and peers. Teens who spent a lot of time in front of the computer or watching TV were less attached to their parents, and teens who spent a lot of time watching TV were also less attached to their peers, according to a recent article in the Archives of Pediatrics and Adolescent Medicine.

I've been thinking a lot about children's attachment to parents and peers lately because I'm reading Hold On to Your Kids: Why Parents Need to Matter More than Peers by Gordon Neufeld and Gabor Mate, an excellent explanation of the advantages and perils of these relationships. In the book, the authors argue that if children do not form adequate relationships with their parents or other responsible adults, they will form inadequate and destructive relationships with their peers instead.

Although I don't agree with all their arguments, and the book carries a faint whiff of disapproval towards mothers (but not fathers) who work full time, it has made me stop and think about how to carve out more one-on-one time with my own children. TV time watching reality shows together does not really count, even though my kids now know who "Boston Rob" is, that charming devil.

So, we're off to the great outdoors and the art supply store (or, since my kids like to paint rocks and decorate shells and pine cones, the art supply store that is the great outdoors), to find better ways to spend time together. And when TV Turn-off week rolls around again in April, we'll be going screen-free, playing board games, making art projects, and perhaps getting the homework done sooner than the night before it's due.

Monday, March 8, 2010

The Shot that Stops Cancer

Although sexually-transmitted human papillomavirus (HPV) infections can cause certain cancers and genital warts in both men and women, the link between HPV infections and cervical cancer makes these viruses especially dangerous for women. For that reason, the CDC added the HPV vaccine to its schedule of recommended vaccines a few years ago. Today, girls and young women can receive an HPV vaccine to prevent infection with the viruses that cause 70% of all cervical cancers (ideally, a girl is vaccinated before she becomes sexually active).

In the past, the CDC has recommended the HPV vaccine only for girls and young women. Boys and young men, who (clearly) often pass on HPV to women, were not vaccinated. Earlier this year, however, the CDC changed a footnote in its HPV vaccine recommendations to include boys and young men.

The CDC's 2010 recommended immunization schedule rather mincingly states that "HPV4 [one of the HPV vaccines] may be administered in a 3-dose series to males aged 9 through 18 years to reduce their likelihood of acquiring genital warts," no doubt to persuade parents of boys that the HPV vaccine can directly benefit their sons. Vaccinating boys, however, also helps prevent cervical cancer in their future female sexual partners.

A recent study in Pediatrics by immunization expert Dr. Gary Freed found that about 11% of parents refuse some vaccines because of concerns that the vaccine might cause health problems or autism in their children. These vaccine safety concerns have been disproved by numerous studies but persist among some parents nonetheless.

I suspect that, in an era of frequent vaccine refusal by parents, the CDC and its advisory committee, ACIP, decided that it was easier to "sell" parents of boys on the HPV vaccine if they said that the vaccine protected their boys from genital warts than if they said that the vaccine would protect their sons' future girlfriends and wives from cancer.

When parents consider getting the HPV vaccine for their boys, perhaps they should ask themselves this: if you could take one small step to prevent cancer in someone else - wouldn't you?