“In teaching the medical student the primary requisite is to keep him awake.”
Chavalier Jackson

Nigeria’s First Bird Flu Death

Wednesday, January 31st 2007
Health NewsAvian FluInternational

The title says it. A 22 year old woman from Lagos has died from H5N1 in Nigeria.

That brings the death total from avian flu to 164.

Aren’t We On The Same Team?


Healthcare PolicyHealth NewsPoliticsUninsuredLawHealthcare CostsInsurance


The Governator Was In The Hospital To Get His Horn Transplanted…

California GOP legislators have submitted a counter proposal to Schwarzenegger’s health plan.

Schwarzenegger’s plan would…expand government spending, but he would mandate that all but the smallest employers provide coverage or pay into a state pool that would offer subsidized policies.

The governor’s plan would also impose a tax on the profits of hospitals and doctors in exchange for higher reimbursements on state-funded services.

Obviously that second paragraph has caused some concern for health care providers. Of course the Republican (or the true Republican) plan has little chance of gaining any traction in a state dominated by Dems. However, the article raises some hopeful news about the proposed provider tax,

While the plan is not likely to gain much traction in the Democratically controlled Legislature, minority leaders made it clear they will not support a new tax to pay for more health care — a critical position because Republican votes would be needed to achieve the two-thirds majority for passage of a tax.

“We do not believe we need one,” said Sen. Dave Cox, R-Fair Oaks (Sacramento County). “I can’t imagine we would be voting for it.”

While I have endorsed pay-or-play mandates as a part of any compromise health care reform, how can any physician or physician in training endorse a provider tax?

One of the greatest concerns about health care in this country should be the death of primary care, which is largely tied to reimbursement issues. PCPs have some of the highest overhead-to-earning ratios and since the tax would be on gross practice revenues this would be a terrible thing for the earning power of primary care (which, as said, is already in semi-bad shape).

Chinese Harvesting Organs…Still


Health NewsLawInternational

Well, my last impression was they were going to try to cut down on this (also see: this post). However, a report from a former Canadian official says the military is harvesting organs for sale from LIVE PRISONERS (not just the ones who are executed).

[The] report, released today, includes interviews with organ recipients in 30 countries and Canadian hospital staff who cared for more than 100 patients who had undergone suspicious transplant surgeries in China.

“The involvement of the People’s Liberation Army in these transplants is widespread,'’ Mr Kilgour said at a press conference.

Like many civilian hospitals in rural China, military hospitals turned to selling organs to make up for government funding cuts in the 1980s, the report said.

But military personnel could operate with much more secrecy, it said.

“Recipients often tell us that even when they receive transplants at civilian hospitals, those conducting the operation are military personnel,'’ the report said

.

Bush’s Health Care Plan


Healthcare PolicyHealth NewsPoliticsUninsuredHealthcare CostsInsurance

Managed Care Matters doesn’t like Bush’s health plan.

Insurance companies work very hard to not cover anyone with a current or past health care condition that may at some point in the future lead to claims. They are not purposely being bad; if they cover everyone their competitors won’t, they will soon find themselves bankrupt. Moreover, the individual insurance companies are “insurance” companies - and insurance is the spreading of unforeseen risks among a large number of policyholders.

Anyone with a pre-existing condition does not belong in a pool of those with no pre-ex conditions.

But they still need health care and a mechanism to fairly pay for same.

And therein lies the problem with Bush health care. His plan seeks to use the insurance markets and tax policy to reduce the number of uninsureds, who will use tax credits to fund their new insurance plans.

Except no one will sell them a plan if they have a pre-existing condition.

Earlier Mr. Paduda called it,

Bush’s plan relies on the incredibly screwed up individual health insurance market. You know, the market that won’t cover your eyes if you had pink eye, or your ankles if you sprained one a few years back, or your heart if you take Lipitor. I’m not blaming the insurance companies; they operate in the Alice-in-Wonderland system as best they can. And if they start acting altruistically they go bust.

If there isn’t supply, creating demand won’t solve the problem. And if there is supply, it has to be at a price level that consumers can afford.

Hard to argue with this. However, I think it is a matter of what the expectations for the plan were. This isn’t a universal coverage plan and I’m not sure how it can hurt (although that might be my lack of understanding).

The City of “Lights”?


InternationalOther ScienceGlobal Warming

The IPCC report to be released soon, which I’ve shaken my head at, will prompt the Eiffel Tower to turn off its lights for five minutes the day the report will be released.

The Eiffel Tower is to turn its famous night-time illuminations off for five minutes on Thursday to help draw attention to energy consumption and the environment on the eve of the release of a U.N. report on climate change.

The IPCC report is basically a giant literature review. Yet somehow it prompted those who collaborated on it to conclude that it was 99% likely (God knows how they came up with that figure) that man made fossil fuels were the cause of Global Warming. In one light perhaps that speaks to the strength of the evidence. In another, quantifying the odds that man is causing Global Warming, so specifically seems ridiculous.

As I’ve made clear though, that isn’t my point of contention. My point of contention is the confidence they present in their models on the consequences of Global Warming. Would you really care that the earth is heating up if the consequences weren’t going to be tragic? Of course not.

We need to judge the level of accuracy with which these models are being presented to the public and whether the level of freak out going on is really in line with the level of certainty that the experts can speak to what is going to happen.

But apparently criticism for the level of alarm being presented (considering there is no all inclusive GCM which can even get what happened in the past all right) isn’t what is in question. Apparently the level of freak out has been actually suppressed (scary to think what is could be) by the Bush administration.

“High-quality science [is] struggling to get out,” Francesca Grifo, of the watchdog group Union of Concerned Scientists, told members of the House Oversight and Government Reform Committee. A UCS survey found that 150 climate scientists personally experienced political interference in the past five years in a total of at least 435 incidents.

“Nearly half of all respondents perceived or personally experienced pressure to eliminate the words ‘climate change’, ‘global warming’ or other similar terms from a variety of communications,” Grifo said.

Rick Piltz, a former US government scientist, told the committee that former White House official Phil Cooney took an active role in casting doubt on the consequences of global climate change. Piltz said he resigned in 2005 as a result of pressure to soft-pedal findings on global warming.

O.J. Mayo Was Set Up

Tuesday, January 30th 2007
Uncategorized

…as much as it is easy (and fun…don’t forget fun) to make fun of the state of West Virginia, I’ll refrain from passing undue judgment on the referee in the following video.

In case you don’t know, O.J. Mayo is perhaps the nation’s most highly touted high school basketball player. Stunningly, he has committed to the University of Southern California. We’re talking, perhaps Top 10 team in just a year. It goes without saying O.J. will only play for one year before scooting for the NBA. Despite that, Mayo had USC fans (myself included) excited about basketball.

In anycase, the kid is a true talent and from all scouting and words written unselfish with the ball and just a general team player. In the media he has been known to have somewhat of a mouth, but as far as I know he’s never been in trouble with the law or authority and he certainly doesn’t have a selfish attitude on the basketball court.

O.J. made national headlines when he got ejected from a game and appeared to knock over a referee.

But forget all that. Try to watch this video without knowing anything about Mayo except that the team he is playing is his high school’s archrival.



Those Are Sketchy Calls

I wasn’t there. I’m not a ref. But we need to realize that this is West Virginia high school basketball. We’re not talking NBA ref skills (or scruples) here. Indeed, this is what referee Mike Lazo had to do to become a ref.

I have two points. While it certainly doesn’t look like Mayo was taunting the opposition before the first technical, we obviously cannot know that for sure from the video. What I will call ridiculous though is that the ref with the best view and closest to the alleged taunting wasn’t even the one who called the technical.

And it is a giant mystery (besides it being a flopping act as bad as Manu or him tripping over his own feet), how Mike Lazo managed to fall down.

I’m convinced from this video this was a set up. I wouldn’t even fault Mayo for bad choices. Seriously, to fault him for, say, not staying far enough away from the ref? I’m as mild mannered as they come and there’s nothing there I could’ve chastised myself for when I played HS basketball.

p.s.
I can also dunk just like that.

[True Hoops on the setup]
[FoxSports incident story]

H/T Trojanwire

The Camera…


MiscellaneousSpace

…that helped capture what I have been convinced is the most important image ever recorded has shut down.

The newest and most heavily used camera on the Hubble Space Telescope shut down over the weekend and appears to be permanently damaged, NASA said Monday.

Though other cameras on Hubble remain operative, the Advanced Camera for Surveys, which is used to peer back to the earliest and most remote galaxies in the universe, appears to be irreparable…

The newest and most heavily used camera on the Hubble Space Telescope shut down over the weekend and appears to be permanently damaged, NASA said Monday.

Though other cameras on Hubble remain operative, the Advanced Camera for Surveys, which is used to peer back to the earliest and most remote galaxies in the universe, appears to be irreparable

I’ve posted on this before but I believe, as many have claimed, that the Deep Field images (especially the Ultra Deep Field) taken by Hubble (and specifically the ACS) are the most telling images ever.


This Image Has 10,000 Galaxies In It

The Deep Fields were the furthest any human had ever looked into the universe’s past in the visible spectrum. Some of the light from galaxies in the image above (and even those little specks that might just be scratches are galaxies representing millions of stars) is from just 700 - 800 million years after the Big Bang. Far, far before the sun or earth even existed.

That is amazing in and of itself. However, what makes the Ultra Deep Field image the most important/amazing image ever is what it tells us about our place in the universe.

As mentioned, there are more than 10,000 galaxies in that picture above. But this image isn’t a sweeping survey of the universe. Far from it, as NASA says,

Looking into the Ultra Deep Field is like peering through an eight-foot-long soda straw.

The Hubble telescope was peering into a tiny portion of space. Now, the light from these galaxies obviously isn’t visible to the naked eye. Indeed, the vast majority of these galaxies aren’t even observable in the visible spectrum with ground based telescopes. However, consider that if these galaxies were visible you could go outside, look up into the night sky, hold a tennis ball at arm’s length and probably obscure all of them from your view.

10,000 galaxies. Perhaps trillions of stars. All in a relatively teeny tiny section of the universe.



I’ve Posted This Video Before, But Watch It Again

The observable universe contains an estimated 80 billion galaxies. But no matter how big the galaxy is (and even the current thought based on this paper has its major critics) we clearly cannot observe all (perhaps even most of it). Indeed, imagine what it says for our place if the universe is infinite.

But 80 billion, infinite, 78 billion light years (as a radius). They’re numbers. They’re nothing. When you read them they allow your mind to no more grasp the TRUE size than if you read pseudopseudohypoparathyroidism.

If the Ultra Deep Field does anything it is to put the size of the universe in slightly more visual terms.

Unfortunately the camera responsible for the majority of the Ultra Deep Field has cronked out. Get a visible light camera of similiar power and capabilities up and working NASA!!

Grand Rounds Is A Burden…


Health NewsGrand Rounds

…on your server that is.

Envision 2.0 is running slow as I write this. Perhaps because all of the Grand Round link backs. In anycase, it is a very interesting topic this week: health care consumerism.

TV Drug Ads Tug At The Heart


Healthcare PolicyHealth NewsPharmacuticalsDTC

Hmmm…yes, this is all pharm’s problem that this is what works. It says nothing about the actual viewers.

“Ninety five percent of the ads are using positive emotional appeals — people looking happy after taking the drugs,” Frosch says. The commercials, he says, present “a very black and white portrait of the benefits of prescription drugs — ‘Take this drug and everything is going to be back in order.’”

For instance, one commercial pitching Valtrex for genital herpesherpes shows a young woman first saying, “Living with genital herpes can be a hassle.” After taking the drug, the final scene shows her kissing a partner in the surf, with Rio de Janeiro in the background.

“Lifestyle changes are sometimes mentioned as an adjunct [to taking the drug],” Frosch says, when in some cases changing behavior — such as exercising more to reduce high cholesterol — might actually prevent the need for the medication.

But they found that no commercials mentioned lifestyle change as an alternative to the medication.

Mighty Morphin’ Power Rangers


MiscellaneousVideoPublic Domain Film Fest

I missed this week’s Public Domain Film Festival addition. Truly it was because I had an exam today. But we’ll pretend that I was simply too embarrassed.

This week’s public domain film festival movie is the Mighty Morphing Power Rangers movie.


Bird Flu In Japan

Saturday, January 27th 2007
Health NewsAvian FluInternational

Bird flu in chickens on a Japanese poultry farm is serotype H5N1.

Initial tests had shown the chickens on the farm in Miyazaki prefecture were infected with an H5 subtype of bird flu virus, but further testing had been needed to determine whether it was the feared H5N1 strain.

There have been no reported cases of human infection from the virus in Japan.

Local officials were in the process of culling all 50,000 birds on the farm after 3,200 of them died of the disease. Another 50,000 at an adjacent farm will also be slaughtered as a precautionary measure, a local official said.

What’s The Point In Having Power If You Can’t Use It To Crush Your Enemies?!


PoliticsMiscellaneous

Tom Delay’s former man in Texas, is apparently laying the smack down. Texas House Speaker Tom Craddick, is seeking revenge on those who tried to deny him a new term as Speaker following in this new session (after November’s elections).

His main challenger as speaker, Waxahachie Republican Jim Pitts, was ousted from his chairmanship of the budget-writing Appropriations Committee and removed entirely from the powerful panel.

“In spite of his repeated assurances to members of the House and the public that there would be no retribution, it appears that the speaker has chosen retaliation over reconciliation,” Pitts said in a statement.

Since I’m sure you’re so up on Texas politics,

Craddick beat back a challenge from Pitts, his former lieutenant, on Jan. 9 as the legislative session opened. The long day of infighting ended with Pitts’ capitulating, having lost a decisive procedural vote. Craddick, R-Midland, was re-elected to a third term.

The procedural vote which was lost? A move to make the vote for Speaker by secret ballot, so that Craddick could not retaliate against those who voted against him.

In anycase, why would I post this (beyond just interest in my state’s politics) because Craddick, as Speaker, was instrumental in the famous Texas redistricting in 2003. The redistricting constructed the state’s congressional districts so that they strongly favored Republicans.

Of course Delay/Craddick’s redistricting efforts did not save my old representative, Henry Bonilla (R), as his district was the only one ruled to violate the Voting Rights Act by the Supreme Court. See the Election 2006 Open Thread.

AD ASTRA PER ASPERA


MiscellaneousSpace


To Grissom, White, & Chaffee

On this day - January 27th - in 1967, during a systems test run, the cabin of the capsule which was eventually supposed to carry Virgil Grissom, Ed White, and Roger Chaffee into space as Apollo 1, burst into flames.

All three perished.

Their sacrifice, although a terrible price, made space flight safer for all to follow. Indeed, some argue the redesigned and insulated wiring, which followed the fire, was key to allowing the astronauts on the famous Apollo 13 mission to shut down the command module (to save power) and then to safely turn it back on in order to reenter the earth’s atmosphere.

What Does Obama See Health Care As?

Thursday, January 25th 2007
Healthcare PolicyHealth NewsPoliticsUninsuredSingle Payer

Obama has called for everyone to have health care within six years.

Every American should have health care coverage within six years, Democratic Sen. Barack Obama said Thursday as he set an ambitious goal soon after jumping into the 2008 presidential race.

“I am absolutely determined that by the end of the first term of the next president, we should have universal health care in this country,” Obama told a conference of Families USA, a health care advocacy group.

A general plea, trumpeted by many. But Obama hasn’t shown a lot in terms of how he actually thinks universal coverage should be achieved. That is to be expected, with his hat already in the ‘08 race (although he’s burning oftly brightly, which plenty of times means quickly), but even back in Illinois he wasn’t sure what he wanted to do.

[Senate Bill 1430] would create a bipartisan Health Care Reform Commission (HCRC) to oversee the gathering of comments from the public and recommendations for a universal-access health care plan.

The bill does not describe a specific plan. The HCRC, operating under the auspices of the Illinois Department of Public Health, would develop a plan based on comments from the public. The process would occur over several years and in three stages.

“I don’t think this issue is going to go away,” said Senator Barack Obama (D-Chicago), the senate bill’s chief sponsor. “This probably won’t be dealt with during the fall veto session, but I think it will come back in the next general session in January.”

Nice talk, getting everyone down at the table to discuss the issue (although Obama’s Senate version of the bill actually failed), but certainly far from decisive.

Obama is back to the rhetoric and photo ops, as he said in speech on January 25th,

“I want to hear people’s ideas about how we can achieve that goal.”

I understand you can’t expect more from a candidate already running. He can’t be calling for say, mandates, and dabbling in specifics years before the election, but this seems to be a theme even when he isn’t running.

While he hasn’t come down hard against it, he doesn’t seem to be a fan of ‘true’ single payer,

“Everybody who supports single-payer healthcare says, ‘Look at all this money we would be saving from insurance and paperwork.’ That represents 1 million, 2 million, 3 million jobs of people who are working at Blue Cross Blue Shield or Kaiser or other places. What are we doing with them? Where are we employing them?”

Just weeks into his candidacy (and a year-plus from election day) I am no longer convinced Obama can win. I was never convinced that Obama was going to win, but now I really am saying I question whether he even has a shot. If I’m wrong though, I suppose we’ll learn more about what Obama thinks the solution to America’s health care crisis should look like. With Hillary also blowing the health care theme horn, and even President Bush speaking to it, it certainly looks like the 2008 race will feature such as its primary domestic theme.

A Complete Lack Of Understanding Of The Situation


Uncategorized

Yahoo! has a set of Woodward & Bernstein’s running down the Reggie Bush scandal. It is hard to keep to claim an unbiased look at the reporting going on which makes the large amount of criticism I’m about to level seem more questionable than it is.

Yahoo! is reporting that there might be taped conversations of Reggie Bush or his family discussing money and gifts they received from Lloyd Lake.

Yahoo! Sports has learned that LaMar Griffin spoke with federal investigators in the spring of 2006 and acknowledged the existence of the tapes. In an appearance before a grand jury on Jan. 12, 2007, Lake’s mother – Barbara Gunner – testified that she had heard portions of tapes made by her son, in which LaMar Griffin states that Bush intended to repay New Era Sports financiers “their money,” as well as for a car that was purchased for the former USC running back.

Yahoo! can only cite several anonymous sources as stating the tapes exist, and yet they literally cannot narrow the content of the tapes down more than saying that they have Reggie Bush and/or his family.

So, the first fault, in this reporting and the general reaction in the blogosphere:

1. Currently, no one has a gooddamn clue what is actually on these tapes.

But you wouldn’t know that here or here. As usual ESDBS has a more reasoned view on the situation and puts the clamp on Yahoo!’s, at best, unethical overreliance on the most flimsy of facts and sources.

In anycase, while I will concede, as Orson says, that Bush being declared ineligible for 2005 got more probable with Yahoo’s story, it still isn’t likely. I’ve already mentioned reason number 1 why that is the case. Now, let us imagine that EVERYTHING the dumb asses editing Yahoo! sports have let slip onto the web is actually true.

The most detail the story offers comes in the reporting of Lloyd Lakes’ mother (yes, his mother) reporting she had heard the tapes her son made and more specifically that the tapes had LaMar Griffin, Reggie’s step father, promising to pay back money to Lake which had been used to help buy Reggie a car.


The Path To Dismissed Games Is Still Long And Rusty

Okay, so the image isn’t entirely accurate. USC escaping sanctions is much more likely to happen than Reggie Bush getting declared retroactively ineligible, which could still have dire consequences in terms of games USC might have to pretend like it never played.

But seriously, for Bush to be declared ineligible, two things need to happen. One, Reggie needs to be on the tape himself talking or they need to find paper evidence tying what LaMar says on the tape to his step son. That might seem overly obvious, especially for the type of morons who have already “imagined” what the tapes might actually said and condemned Reggie in op/eds, but it turns out it isn’t. Two, the tape and verification of its authenticity (i.e. Lake testifying) need to get to the NCAA.

Turns out there isn’t a whole lot of incentive (besides bitterness) for Lake to talk to the NCAA. It took a subpoena for him to even produce the tapes. The NCAA probably will not use any of Lake’s Grand Jury testimony and if he talks with the NCAA he will never have another pro or college football sports memorabilia deal ever again.

Actually, for all that has gone down he might not have one ever anyway, but still, there are reasons including his ties to football that could easily dissuade him from talking to the NCAA.

Back to point one, however. Reggie’s parents admitting to taking money and favors from Lake and Michaels and others clearly violates NCAA rules in and of itself. But I’m telling you,

2) The NCAA is not going to take away all of Bush’s 2005 season because Reggie’s step father admits the family took money.

Anyone who thinks they will does not understand the politics of the situation.

And they will not accept LaMar Griffin saying Reggie took money as the say all and end all piece of evidence. Reggie needs to be on the tape himself, or there needs to be a paper trial (say the car’s papers) tying Reggie to the things LaMar says.

Indeed at this point, even with the tapes, I personally think the credit card receipt signed by Reggie Bush at The Venetian, that Yahoo! claims to have is the most damning evidence.

$623.63 for a hotel stay by Bush at the Venetian Resort & Casino in Las Vegas from March 11-13, 2005, charged to Michaels, according to a document signed by Bush.

The receipt is for a charge to Michael’s credit card but signed by Bush. The NCAA will not declare Bush ineligible over $600, but just from the quality (or lack thereof) reporting done for the “tape” story you have to currently put way more weight on a physical piece of evidence Yahoo! has actually seen.

This report makes the situation look darker, but people are behaving like it has clouded the whole sky. At least hear what is on the damn tapes before you do that. And no matter what you imagine “fair” is understand that the USC football team is not the Hawaii Men’s Volleyball team.

I promise you Brand and whoever is in charge of enforcement wish they could avoid touching this issue with a ten foot pole. Yahoo! and some other media outlets are going to force their hand perhaps (we’ll see what is on these tapes), but, to make it clear,

3) The NCAA does not want to make USC “forfeit” all of its 2005
games and its 2004 National Championship

Finally, the stupidest comment of all that is being made is that Reggie Bush will forfeit his Heisman. It took people a while to catch on - I swear this story has educated people - but if you’re still in the dark, the NCAA has NOTHING to do with the Heisman trophy. Any Reggie Bush retroactive ineligibility ruling has absolutely no direct bearing on Reggie’s Heisman.

Journalists love quoting the rule from the Downtown Athletic Club stating that a player must be in good standing to win the Heisman. Certainly, if Reggie became ineligible it would appear to violate that rule.

But for a deeper grasping of the situation you need to realize that,

4) The decision on whether to allow Bush to keep his Heisman will be a
political and PR one and will have very little, if anything, to do with the letter of the
Downtown Athletic Club’s rules

If Reggie becomes ineligible for his junior year the DAC WILL ignore the rule unless they feel it is a good public prestige move not to. As long as Reggie’s popularity stays up (and I can’t imagine even this scandal denting it too much) I think that will be the case.

That is the actual score. Facts in the situation which apparently escape any number of pundits and journalists.

We are a long way from Reggie Bush getting declared ineligible and USC “forfeiting” previously decided games. We are even further from USC having forward looking sanctions handed down. And we are even further, further from Reggie Bush losing his Heisman. So while I, like many Trojan fans, am rubbing my hands together tensely, I am far from freaking out (which I might do if USC loses the 2004 National Championship).

About The Blog


Medicine, healthcare policy, and random commentary from a medical student still on the naive side of the fence.
I'm a third year medical student in Texas.

I did my undergrad work in USC's School of Cinema-Television Cinematic Arts. I have a Bachelors of Fine Arts in Writing for Screen & Television. I loved it, but a future of waiting tables and taking meetings with B-List producers was not for me.

This blog is ostensibly to discuss healthcare policy and maybe educate a few of my fellow medical students. But it will stray into current events, politics, and other science topics when they draw my interest



Other odd notes about me:

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Nothing on this website is to be taken as medical advice. Please seek counsel from a physician for any questions regarding your health.
Nothing on this website is to be taken as medical advice. I am not a physician. Please consult a physician concerning any health related questions.

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