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.
Monday, March 22, 2010
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.
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.
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?
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?
Saturday, February 20, 2010
What Does it Take to Be an Olympic Athlete?
I really love the Winter Olympics. My favorite sports to watch are downhill skiing, snowboarding, speed skating, and ice skating. I'll watch any winter sport that is fast, icy, and graceful. Not that I want to try them myself, as I am a middling skier, have never tried snowboarding, and go ice skating about once a year with the kids. But I'm impressed with the skill and athletic prowess of the Winter Olympics athletes, and the joy they can take in their sport: J.R. Celski, Rachel Flatt, Apolo Anton Ohno, Hannah Kearney, the pairs skating winners Shen Xue and Zhao Hongbo.
Something seems different this year, though. I cringed as I watched three skiers crash in the women's final of the alpine downhill - one of them tossed into the air at one point like a rag doll - while navigating a course that the commentators admitted might be too difficult for them. In that event, Lindsey Vonn skied her final, gold-medal run in pain, favoring her injured right shin on the turns. I've seen the footage of J.R. Celski bleeding on the track after a serious injury during the Olympic trials in September far too many times. Already, of course, one Olympic athlete, the Georgian athlete Nodar Kumaritashvili has died on a luge training run.
The competition is not just about the participants' athletic abilities and their psychological skills in focusing on the task at hand. It's also about their ability to risk and recover from serious injuries, in order to win on courses that seem to be designed to be as dangerous as possible.
The NBC commentators recite a litany medical problems for each athlete (past knee surgeries, back injuries, concussions, severe lacerations), citing them as evidence of the athlete's triumph over obstacles. I don't see it that way. To me, it seems like reaching the level of an Olympic athlete sometimes requires the athlete to be willing to take inhuman risks in the name of winning. Grace, athleticism, and perseverance - what I enjoy watching - are secondary. Is that sport anymore? Or something else?
Something seems different this year, though. I cringed as I watched three skiers crash in the women's final of the alpine downhill - one of them tossed into the air at one point like a rag doll - while navigating a course that the commentators admitted might be too difficult for them. In that event, Lindsey Vonn skied her final, gold-medal run in pain, favoring her injured right shin on the turns. I've seen the footage of J.R. Celski bleeding on the track after a serious injury during the Olympic trials in September far too many times. Already, of course, one Olympic athlete, the Georgian athlete Nodar Kumaritashvili has died on a luge training run.
The competition is not just about the participants' athletic abilities and their psychological skills in focusing on the task at hand. It's also about their ability to risk and recover from serious injuries, in order to win on courses that seem to be designed to be as dangerous as possible.
The NBC commentators recite a litany medical problems for each athlete (past knee surgeries, back injuries, concussions, severe lacerations), citing them as evidence of the athlete's triumph over obstacles. I don't see it that way. To me, it seems like reaching the level of an Olympic athlete sometimes requires the athlete to be willing to take inhuman risks in the name of winning. Grace, athleticism, and perseverance - what I enjoy watching - are secondary. Is that sport anymore? Or something else?
Friday, February 12, 2010
Is "Normal" Overrated?
I've been following the news around the draft proposal of the Diagnostic and Statistical Manual of Mental Disorders revision (the DSM-V), the psychiatric "Bible" used to diagnose, classify, and (often) justify medicating mental health disorders. The draft of the fifth revision is open for public comment until April 2010; the final version will be released in 2013.
The Association of Health Care Journalists' Covering Health blog has a quick overview of the topic, with links to an in-depth article on the changes by Benedict Carey in the New York Times. Two big changes in the DSM-V include:
Carey describes the DSM as "the guidebook that largely determines where society draws the line between normal and not normal." A person whose psychiatric problem creates a danger to himself or others certainly needs treatment. But the debate about how to classify Asperger's syndrome in particular brings up the larger question of how tolerant, or intolerant, we are of behavior that is simply different from the norm.
The blog neurodiversity.com, run by the mother of a teenager with an autism spectrum disorder, argues that diverse neurological conditions should be better understood and tolerated. Some people with autism spectrum disorders, irritated by how their conditions are misunderstood by the general public, call the rest of us "neurotypicals", bound by social conformity and a lack of creativity.
In an age that prizes - and benefits from - cultural diversity, shouldn't we allow for some neuro-diversity as well? A number of well-known people might have or have had Asperger's syndrome, including Albert Einstein, Bill Gates, and Isaac Newton. Certainly you can argue that they thought differently than the average person, but we have all benefited from their achievements.
The Association of Health Care Journalists' Covering Health blog has a quick overview of the topic, with links to an in-depth article on the changes by Benedict Carey in the New York Times. Two big changes in the DSM-V include:
- Describing Asperger's syndrome as a type of autism, instead of a separate diagnosis, under the umbrella term of autism spectrum disorder. Unlike people with severe autism, who have trouble with behavior, communication, and socialization, people with Asperger's syndrome, considered a high-functioning type of autism, have a much easier time functioning in society. People with Asperger's syndrome generally want to make social connections, but they have difficulty understanding social interactions.
- Providing a different definition for bipolar-like behavior in children. Carey points out that children with a bipolar diagnosis are treated with sometimes-dangerous antipsychotic drugs. An alternative diagnosis, "temper dysregulation disorder with dysphoria," would be treated primarily with behavioral therapy.
Carey describes the DSM as "the guidebook that largely determines where society draws the line between normal and not normal." A person whose psychiatric problem creates a danger to himself or others certainly needs treatment. But the debate about how to classify Asperger's syndrome in particular brings up the larger question of how tolerant, or intolerant, we are of behavior that is simply different from the norm.
The blog neurodiversity.com, run by the mother of a teenager with an autism spectrum disorder, argues that diverse neurological conditions should be better understood and tolerated. Some people with autism spectrum disorders, irritated by how their conditions are misunderstood by the general public, call the rest of us "neurotypicals", bound by social conformity and a lack of creativity.
In an age that prizes - and benefits from - cultural diversity, shouldn't we allow for some neuro-diversity as well? A number of well-known people might have or have had Asperger's syndrome, including Albert Einstein, Bill Gates, and Isaac Newton. Certainly you can argue that they thought differently than the average person, but we have all benefited from their achievements.
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