Experts push for Orwellian maintenance over Americans’ health

George Orwell’s Nineteen Eighty-Four is one of the best and most important books ever written. This is not hyperbole. It’s as close as one can ever get to an objective statement about a novel.  In addition to Orwell’s lean, elegant prose, it is impossible to imagine a more insightful or prescient book about the nature of a truly socialist government.  Except for failing to include mass starvation, Orwell accurately predicated just about every aspect of North Korea.

One of the powerful imagines George Orwell created was a sense of being under constant scrutiny and control.  Poor Winston Smith, doing his government-mandated physical exercises in front of his government-mandated two-way television, was stridently scolded for failing to implement properly his government-mandated “jerks.”  (I’ve never quite known what those “jerks” were, but I assume that they were push-ups or jumping jacks.)

Two-way television, of course, was an unheard of idea in 1948.  Now every iPhone has it, and every computer can have it.  The future is the present.  Oh, and the bit about having the government modern every individual’s lifestyle and health choices?  We knew that was coming down the pike when the government passed ObamaCare.  The government that controls your health care controls you.

One aspect of health care, of course, is weight.  Despite the fact that studies show that “obese” people can be perfectly healthy, our betters and wisers in the worlds of academia and politics want to slim the government health care budget by slimming you — and they think that coercive government force is a good way to achieve this goal:

Federal agencies should step in if industries that promote high-calorie foods to children do not implement common nutrition standards within two years, the influential Institute of Medicine (IOM) said Tuesday.

The recommendation came as part of a 478-page IOM report on the U.S. obesity epidemic that outlined broad policy changes the panel says are necessary to stave off a healthcare crisis.

The changes are aimed at a complete overhaul of the United States’s “obesogenic” environment, the panel wrote.

“People have heard the advice to eat less and move more for years, and during that time a large number of Americans have become obese,” panelist Shiriki Kumanyika of the University of Pennsylvania said.

[snip]

“The average person cannot maintain a healthy weight in this obesity-promoting environment,” she said.

Strategies like a possible soda tax and new zoning laws to encourage walking and biking are designed to “reinforce one another’s impact to speed our progress,” said panel Chairman Dan Glickman, a former secretary of Agriculture.

The food and beverage industry, as well as its marketers, must cooperate or face possible federal intervention on issues like childhood nutrition standards, the panel warned.

Ace treats this idea with the disdain it deserves, but I’m not sure his voice of reason is being heard outside the Church of Conservative Ideology.

I do wonder, though, if there isn’t a good political campaign to be made of reminding people that Obama’s going to take away their ice cream cones, sodas, hot dogs, and hamburgers.

 

A sense of gratitude and wonderment

My mother is a testament to the wonders of modern medicine.  But for the drugs, surgery, and implanted equipment upon which she relies, she would have been dead a long time ago.  Perhaps even more importantly, to the extent that she’s not dead, she has a fairly good quality of life.  Thanks to cataract surgery and high tech glasses (trifocals, anti-glare coating, etc.), she has twenty-twenty vision.  Thanks to teeny little hearing aids that are practically invisible, she’s not deaf.  Thanks to state-of-the-art pain medicines, delivered via state-of-the-art technology, she tends to forget that she once suffered from chronic pain.  She also takes medicines that control the pain and nausea associated with all the other medicines she takes just to stay alive.  She is a walking wonder.

What’s truly amazing about my mother is that she takes all of this for granted.  She is peculiarly unimpressed that modern medicine has her alive and functioning, even though she’s basically held together by glue and spit.  She’ll periodically complain about past or present sufferings, but I never hear from her an awed exclamation about the absence of pain in her life, or about the joy of twenty-twenty vision, or about the pleasure of hearing her grandchildren’s voices, or about the fact that she’s alive at all.

I’m quite different from my mother in this regard.  I’m am constantly overwhelmed by the wonders and miracles that see me alive and kicking (and doing some pretty damn fine kicking on my good days, if I do say so myself).

Modern medicine means that, a long time ago, when I needed emergency surgery, I got that surgery rather than hemorrhaging to death.

Modern medicine means that I didn’t die of hyperemesis gravidarum during either of my pregnancies.  Charlotte Bronte wasn’t so lucky.

Modern medicine means that I didn’t die when I was delivering one of my children, despite the fact that things went wrong.  And thanks to the epidural I had, not only did I not die, but I didn’t even realize that something had gone wrong.  (The kid was all right too!)

Modern medicine means that, although nature intended me to be practically blind, I not only see thanks to my glasses but, when I put my contacts in, I look gorgeous and I kick butt at martial arts.

Modern medicine means that, thanks to over-the-counter products, I have ridiculously young looking skin for someone my age.  (And yes, I’m boasting.)

And that’s just medicine!  I have iPhones and iPads welded to my hands; telephones in every room of my house; cars that talk to me; machines that wash my clothes and my dishes, and then dry them too; a computer system that has me actively connected to most of the world, 24/7; and that’s just the beginning.  The wonders of technology permeate every aspect of my life, including the allergy free pillow on which I rest my head at night.

Despite the fact that I grew up in this modern world, something that distinguishes me from my mother, who is old enough to remember little European villages that had no cars, I’ve never become blase about the wonders of science and technology.  I am endlessly grateful for the manifest benefits these things have brought to my life.

This sense of gratitude is, I think, part of why I am so proud to be an American, specifically, and part of the western tradition, generally.  All human beings have the capacity to create, but it is the West that had the curiosity and America that had the driving competitive energy, to take theory and make it fact.  Put another way, man has long dreamed of flying, but it was Orville and Wilbur, two American hobbyists, who made flight a practical reality.

Of flight surgeons and physicals

When we met the Blues, one of the people we met was the team’s flight surgeon, who struck me as a lovely young woman:  warm, dedicated and intelligent.  I’m sure Neptunus Lex wasn’t talking about her when he wrote this hysterically funny post a few years ago.  (And no, I didn’t go hunting that post down.  NL conveniently linked to it as part of another post about the fact that General Petraeus has been successfully treated for early stage prostate cancer. )

Also, if you’re already at NL’s site, check out this post about the increase in violent crime in Chicago.  Every point is excellent.

Deconstructing the Obama health care plan

Okay, it’s actually called the Kennedy bill, but it’s the realization of Obama’s insistence on the federal government forcing and funding mandatory health insurance.  Keith Hennessey, in addition to giving links for you to read the bill yourself, explains the substantive parts of the bill, as well as the probable practical and economic effects the bill will have.  As to the latter, here are just a few things Hennessey gives us to worry about:

  • The government would mandate not only that you must buy health insurance, but what health insurance counts as “qualifying.”
  • Health insurance premiums would rise as a result of the law, meaning lower wages.
  • A government-appointed board would determine what items and services are “essential benefits” that your qualifying plan must cover.
  • [snip]

  • Those who keep themselves healthy would be subsidizing premiums for those with risky or unhealthy behaviors.
  • [snip]

  • The Secretaries of Treasury and HHS would have unlimited discretion to impose new taxes on individuals and employers who do not comply with the new mandates.
  • [snip]

And while Hennessey points out the flaws in the bill, the Wall Street Journal explains all the false data and unsupported assumptions that drive the bill.

I have a different question.  In 1994, when the Clinton’s first tried to created government health care, conservatives launched the brilliant Harry and Louise ad campaign.  (To the extent Harry and Louise have returned, they’re now demanding nationalized health care, which is beyond scary.)  Why haven’t I heard about a single ad initiative aimed at the average American to help him or her understand that there is a disaster in the making here?  Is it because, with DVRs, people no longer watch commercials?  If that’s the case, how in the world do we circumvent the Obama media and get solid information out to ordinary people?

Obama administration continues to refine its priorities

Today’s news stories help to clarify Obama’s and the Democrats’ priorities:

Money for parties?  Check.

Assistance for politically friendly papers that the American public refuses to read?  Check.

Money for soldiers wounded in the service of their country?  What!  Are you kidding, dude?  No way!

The leader of the nation’s largest veterans organization says he is “deeply disappointed and concerned” after a meeting with President Obama today to discuss a proposal to force private insurance companies to pay for the treatment of military veterans who have suffered service-connected disabilities and injuries. The Obama administration recently revealed a plan to require private insurance carriers to reimburse the Department of Veterans Affairs (VA) in such cases.

“It became apparent during our discussion today that the President intends to move forward with this unreasonable plan,” said Commander David K. Rehbein of The American Legion. “He says he is looking to generate $540-million by this method, but refused to hear arguments about the moral and government-avowed obligations that would be compromised by it.”

The Commander, clearly angered as he emerged from the session said, “This reimbursement plan would be inconsistent with the mandate ‘ to care for him who shall have borne the battle’ given that the United States government sent members of the armed forces into harm’s way, and not private insurance companies. I say again that The American Legion does not and will not support any plan that seeks to bill a veteran for treatment of a service connected disability at the very agency that was created to treat the unique need of America’s veterans!”

Commander Rehbein was among a group of senior officials from veterans service organizations joining the President, White House Chief of Staff Rahm Emmanuel, Secretary of Veterans Affairs Eric Shinseki and Steven Kosiak, the overseer of defense spending at the Office of Management and Budget (OMB). The group’s early afternoon conversation at The White House was precipitated by a letter of protest presented to the President earlier this month. The letter, co-signed by Commander Rehbein and the heads of ten colleague organizations, read, in part, ” There is simply no logical explanation for billing a veteran’s personal insurance for care that the VA has a responsibility to provide. While we understand the fiscal difficulties this country faces right now, placing the burden of those fiscal problems on the men and women who have already sacrificed a great deal for this country is unconscionable.”

Chipping away at liberals’ belief in Obama’s program *UPDATED*

For reasons too complicated to explain, I have more than a passing knowledge about medical informatics — or, in simple terms, the trend to put all patient records in computerized systems.  That’s why, at a soccer game, a young woman who is clearly an Obama supporter asked me what I thought of the move to put all American medical records in a federal database.  “What harm can it do?” she asked.

We both agreed that a comprehensive federal medical database probably couldn’t harm people financially, the way identity theft scams can.  I suggested to her, though, that federal control over medical records — could harm people in much more significant ways.  For example, I said, a 50 year old, vital man, might not want the feds responsible for keeping secret the fact that he has to use Viagra.  Likewise, I said, no one wants information about their hemorrhoids to go much beyond their own doctor.  Hackers, I pointed out, could easily blackmail or humiliate people with information such as that.

Further, I said, it’s not only, or even primarily, the big diseases like cancer or AIDS that are the problem.  For most people, privacy means keeping around them a zone in which they forever function like a healthy young person, free of warts and erectile dysfunctions and fibroids and whatever other systemic failures people don’t want to admit to having.

She was much struck by this argument.  She certainly agreed with me that the average citizen would be wise not to trust the government with his or her secrets.  She understood, as I do, that government loses control of secrets, that a hostile administration may give away secrets, that individual government employees abuse secrets and that, by the nature of government, too many people know the secrets.

The gal pointed out, though, that we already give that same information to insurance companies, hospitals and doctors offices, and that they too have that information on their computer systems.  That’s different, I explained.  In those cases, there’s a one on one quid pro quo that precedes the entity’s taking on and computerizing that information.  Thus, I, personally, agree to go to that doctor and I acknowledge that, as a necessary adjunct to my treatment, the doctor needs to create and maintain my medical records.  Likewise, I choose to have insurance and, as part of that agreement, I also agree that it is reasonable for the insurance company, before it pays for my health care, to know what’s wrong with me.

With a federal database, though, I don’t get to make that agreement.  The federal government, as it just did, dictates by legislative fiat that it is entitled to create and control these records — and, being the government, to lose, abuse, publicize, sell or, ultimately, use these records as a justification to deny me medical care entirely.  There is no quid pro quo here.  There is no contract.  There is simply a federal government using its vast power to access and control, not only my big secrets (assuming I have any), but my little, humiliating secrets, the ones that knock down the sphere of physical inviolability all of us like to believe we have around ourselves.

I doubt I shook this gal’s faith in Obama, or the Democrats, or even the spendulus plan.  But I like to believe I made her think. And maybe once she’s done thinking about this, she’ll start thinking about something else too.

UPDATE:  A little off topic, but a good reminder that you should never, never, never trust the government with your secrets.

NHS leaves British women in pain

From Genesis 3:16 (after the expulsion from Eden):

To the woman He [God] said,
“I will greatly increase your pains in childbearing;
with pain you will give birth to children.

I’m feeling Biblical after having read a story about another one of the “miracles” of universal healthcare, as in effect in Britain:

Hundreds of women are being forced to give birth without proper pain relief because of staff shortages at an NHS hospital.

Mothers-to-be are being denied epidurals – which numb the body from the waist down  – because of a lack of anaesthetists.

[snip]

The failure flouts guidance from four Royal Colleges, including the Royal College of Midwives and the Royal College of Obstetricians, that women should have access to an epidural within 30 minutes of requesting one.

It adds to mounting concern about the quality of NHS maternity care, with midwives in some hospitals expected to attend to three women in labour at the same time due to staff shortages.

I like epidurals.  Epidurals are good things.  I know there are some women who want to have the full experience of childbirth, but have two long, long labors, one mostly without an epidural, and one entirely with an epidural, I know what my preference is.  Those poor women.  But what can you expect in a medical environment that doesn’t adequately reward people to go through the long, hard slog of becoming a doctor?

Brave? Yes. Unique? No.

If you stop at the first paragraph of this AP article, you might think that Teddy Kennedy is the only person on earth who has ever faced a cancer surgery as daunting as the one he underwent (emphasis mine):

Bravery in the face of cancer? Sen. Edward M. Kennedy has given it new meaning. Few things require as much courage as being wide awake and aware, lying perfectly still for hours, while surgeons methodically slice out bits of your brain.

In fact, although this approach to surgery is not common, Teddy is by no means the only one who has done it:

To avoid cutting through vital areas controlling speech, doctors often return the patient to consciousness and stimulate tissue in the planned surgical path with a probe.

“We’ll have them do language tests like hold up pictures, name objects, repeat words, hold a conversation,” Ewend explained.

After that, the patient is usually put back under while the tumor is cut out, which takes about three to four hours.

However, Kennedy was awake for the removal of the tumor, his doctor’s statement says. That usually means local rather than general anesthesia.

His head would have been in a vise-like device and he’d have to remain very still for hours while the doctors poked, probed and sliced away the cancer, using his responses to guide them.

“That’s the best way you can determine if you’re incurring neurological impairment” as the operation proceeds, said Dr. Kevin McGrail, neurosurgery chief at Georgetown University Medical Center.

“It’s a safe way to do the operation, but it can sometimes be very stressful on the patient,” who is aware of what’s going on even though it is not painful, he said.

As it happens, I am extremely impressed by the fact that Teddy was willing to do this, although I can understand the motive too: the best surgical outcome. Frankly, I don’t know if I could have done that, even sharing his motive. Let me say again, therefore, that I am not writing this to denigrate Teddy’s courage in the face of what seems to be an incredibly uncomfortable and frightening procedure.

My beef — as it almost always is — is with the way in which the media spins things like this (and I’m confident that the spin would have been . . . um, different if Cheney had been the one undergoing surgery). That first paragraph makes it sound as if Kennedy is unique in the history of cancer patients and that no one, absolutely no one, has ever demonstrated this type of courage before. Courageous? Definitely. Unique? Only in AP’s eyes, and that’s true despite the fact that their own article gives the game away.

On the subject of bravery in surgery, I’d like to recommend to you Fanny Burney’s experience. She was a late 18th/early 19th century courtier and writer in England who, in 1811, underwent a radical mastectomy — without anesthetic. Here is her description of that surgery (which is not for the faint of heart):

Yet – when the dreadful steel was plunged into the breast – cutting through veins – arteries – flesh – nerves – I needed no injunctions not to restrain my cries. I began a scream that lasted unintermittingly during the whole time of the incision – & I almost marvel that it rings not in my Ears still! so excruciating was the agony. When the wound was made, & the instrument was withdrawn, the pain seemed undiminished, for the air that suddenly rushed into those delicate parts felt like a mass of minute but sharp & forked poniards, that were tearing the edges of the wound – but when again I felt the instrument – describing a curve – cutting against the grain, if I may so say, while the flesh resisted in a manner so forcible as to oppose & tire the hand of the operator, who was forced to change from the right to the left – then, indeed, I thought I must have expired.

I attempted no more to open my Eyes, – they felt as if hermetically shut, & so firmly closed, that the Eyelids seemed indented into the Cheeks. The instrument this second time withdrawn, I concluded the operation over – Oh no! presently the terrible cutting was renewed – & worse than ever, to separate the bottom, the foundation of this dreadful gland from the parts to which it adhered – Again all description would be baffled – yet again all was not over, – Dr Larry rested but his own hand, & – Oh Heaven! – I then felt the Knife tackling against the breast bone – scraping it! – This performed, while I yet remained in utterly speechless torture, I heard the Voice of Mr Larry, – (all others guarded a dead silence) in a tone nearly tragic, desire everyone present to pronounce if anything more remained to be done; The general voice was Yes, – but the finger of Mr Dubois – which I literally felt elevated over the wound, though I saw nothing, & though he touched nothing, so indescribably sensitive was the spot – pointed to some further requisition – & again began the scraping! – and, after this, Dr Moreau thought he discerned a peccant attom – and still, & still, M. Dubois demanded attom after atom.

Burney lived another twenty-nine years after that ordeal.

The mysteries of the human brain

Many years ago, I was talking to a friend of mine who was a medical student on his neurology rotation.  He related what was, to me, an amazing story.  The patient he saw that day was a fairly young man who had suffered a major stroke, resulting in an almost complete loss of speech (aphasia).  He could still form sentences, but the words were all wrong.  So, instead of saying “Can I have a drink of water,” he’d say “Cow book the drive blanket for tears.”  It was tragic.  What struck my friend, though, was when the doctor in charge asked the patient to sing “Twinkle, twinkle.”  My friend expected to hear nothing, or gibberish.  Instead, the patient sang the song word perfectly — and was able to do so with several other nursery songs.  That’s when I first learned that we store music, including lyrics, in a different part of our brain from language.

Because of my friend’s anecdote, I’ve always been fascinated by the intersection between words and lyrics.  I therefore read with interest a story in today’s New York Times about a singing therapy for aphasic stroke victims:

The technique, called melodic intonation therapy, was developed in 1973 by Dr. Martin Albert and colleagues at the Boston Veterans Affairs Hospital. The aim was to help patients with damage to Broca’s area — the speaking center of the brain, located in its left hemisphere.

These patients still had relatively healthy right hemispheres. And while the left hemisphere is largely responsible for speaking, the right hemisphere is used in understanding language, as well as processing melodies and rhythms.

“You ask yourself, ‘What specifically engages the right hemisphere?’ ” said Dr. Gottfried Schlaug, a neurologist at Beth Israel Deaconess Medical Center in Boston, who studies music’s effect on the brain.

Melodic intonation therapy seems to engage the right hemisphere by asking patients to tap out rhythms and repeat simple melodies. Therapists first work with patients to create sing-song sentences that can be set to familiar tunes, then work on removing the melody to leave behind a more normal speaking pattern.

But relatively little research has been done to understand how this type of therapy affects the brain of a stroke patient.

In a study completed in 2006, Dr. Schlaug and colleagues at Harvard tracked the progress of eight patients with Broca’s aphasia as they underwent 75 sessions of melodic intonation therapy. M.R.I. scans taken when the patients were speaking simple words and phrases showed that activity in the right hemisphere had changed significantly over the course of treatment.

“The combination of melodic intonation and hand-tapping activates a system of the right side of the brain that is always there, but is not typically used for speech,” Dr. Schlaug said.

He recommends melodic intonation therapy for patients who have no meaningful form of speech, but can understand language and have the patience for therapy sessions.

You can read the rest of the story here, including an interview with a stroke victim who re-learned speech through this technique.