The title is an overstatement. That continuing talk of Cornyn’s imminent demise doesn’t quite rise to delusional. The fact is, the more you talk about Cornyn’s weakness, the more it becomes a reality. So you can’t fault them.
But if Burka and BOR and others think Cornyn is actually going to be taken down by absolutely anyone (short of say, Lance Armstrong…jk, kind’ve), then they must be masochistic.
Following the HB&S poll commissioned by the DSCC, comes word of a SuveryUSA poll showing even worse unfavorable numbers for Senator John Cornyn.
The Dems hope to replace Cornyn? Per Roll Call (h/t Political Insider) we’re talking about two-time Lt. Governor candidate (and loser) John Sharp, Nick Lampson, and attorney/fundraiser Mikal Watts.
Two points:
Are you kidding me? SuveryUSA has consistently overstated Cornyn’s unfavorables. Internal polls, Scripps-Howard, and this Hamilton-Beattie poll all show statistically significant lower unfavorables. Check this November Cornyn-Hutchinson favorable-unfavorable.
Who are the Dems going to put out there? As Political Insider points out - there’s almost no chance the Dem candidate will have better favorables or name recognition than Cornyn.
John Sharp is conservative Democrat. His credentials include: a nearly decade old time as state comptroller and two failed bids for lieutenant governor. The definition of used goods.
Mikal Watts? A wealthy, proven fundraiser. That’s no chance you’re going to be able to out spend Cornyn and the Republican establishment. So are you going to trade whatever Watts brings to the table funding wise, for his novice status? His name being thrown in can’t be anything but a tip of the hat to his service to the Democratic Party in South Texas.
Nick Lampson is a proven politician and fundraiser, driven out of the House by Tom Delay’s redistricting. He got considerable statewide/nationwide exposure from his run for Delay’s old 22nd seat. But, I don’t care how conservative the 22nd is or how much conservative money went into the 22nd, the fact is his performance against Shelly Sekula-Gibbs was abysmal!
42% for a write in candidate with a hyphenated name? (And I’m not kidding that that was a hindrance to people voting for her). I mean, it’s understandable why Nick Lampson would be interested in running for Senate, it is hard to imagine him holding onto his seat. But 42%? To a candidate like Shelly Sekula-Gibbs? In one of the most favorable midterm years for the Dremocratic party of all time? And you think that sets up Nick Lampson to win a statewide election? In Texas?
See…dreams of splitting Texas’ Senate seats almost rise to the level of delusional.
The caption isn’t really fair. Let’s be clear, these in store clinics have major retailers merely acting as landlords.
Change draws criticism. And the fact is these in store clinics are expanding, despite whatever small signs otherwise, and putting new pressures on traditional health care delivery models.
Should current market forces continue, the world’s largest retailer said up to 2,000 clinics could be in Wal-Mart stores over the next five to seven years.
Wal-Mart said the effort marks an expansion of a pilot program it started in 2005, when it leased space within its stores to medical clinics. Currently, it said 76 clinics are operating inside Wal-Mart stores in 12 states.
I can’t be an advocate for letting free market forces run rampant across health care (okay, that is a little hyperbole on my position), and find huge fault in these clinics. Clearly they’ll thrive or falter based on the way patients take to them as consumers. Arguments otherwise fall flat:
Retailers contend that the clinics are convenient for consumers and are particularly appealing to the uninsured. I don’t see how a clinic lodged in a big-box retailer is more convenient than a free standing walk-in clinic. And even clinic operators have already found that lower-income uninsured consumers are the slowest adopters of these pay-for-service clinic models.
Proponents of the idea contend that if there wasn’t a demand they wouldn’t be in business. And that’s just not a good enough reason. Internet pharmacies claim they fill a need but are still considered by many to be a bad solution to a struggling health care system. Is cheap, fast and in-and-out in 15 minutes really the best mission statement for a business offering medical care?
But why not? Because it’s impersonal? Because it’s dangerous? An eyebrow raising argument (And yes, I know all the challenges in quantifying preventable patient morbidity and mortality. See here, here, and here).
Look, what is and isn’t an acceptable “mission statement” or business model will, and should rightly be, determined by those making use of it. Not by high thinkers, pundits, and those with potentially conflicting interests. If these NP staffed clinics turn out to be cheaper, more convenient, and provide an acceptable quality then patients will make use of them; if the clinics fall flat on those goals, they’ll fail.
If the medical community’s (and other opponent’s) fear is that these will be forced on patients by third party payers, as a potentially dangerous (but cheaper) alternatives to more traditional medical services, then that is where the argument should be. The argument shouldn’t be over the very existence of these clinics.
Bird flu has largely flown off the radar of the Western world, but people are still dying from it nearly every week in Indonesia.
Bird flu has killed at least 172 people worldwide since it began its spread through Asian poultry in 2003, according to WHO. Most human deaths come from contact with infected birds, but experts fear it could mutate into a form that spreads easily among people.
At current we should be worried because Indonesia isn’t playing well with others over the issue of studying avian flu.
Indonesia has refused to share its samples of bird flu virus with the World Health Organization since January. Jakarta fears a vaccine produced from its specimens would be out of reach for its own citizens - too expensive and controlled by wealthy nations.
Some global health officials have accused Indonesia of holding the virus hostage and keeping experts from monitoring whether the bug is mutating into a dangerous form that could potentially spark the next pandemic that kills millions.
This article doesn’t provide nearly enough to be able to adequately judge what is going on here. For instance, does Indonesia want some sort of specific guarantee about “fair” access to any bird flu vaccine, to set its own price per unit?
I’m not sure what sort of guarantee is possible. All I can imagine is Margaret Chan meeting with Indonesia officials:
“Okay…okay, now pinky swear…no one in big pharma gets to touch this H5N1 sample unless they promise…no, no, not just promise but swear on their mother’s grave…that they’ll give us a good deal on any vaccine they develop.”
Or are they just being ornery and trying to make a point about the “exploitation” of poor countries. In that case: boo hoo.
While they bicker, avian flu slips further and further from the world’s concern. Good riddance to another false alarm.
John Cornyn isn’t exactly a household name in Texas. Which has fueled speculation amongst Texas Democrats, and those just interested in politics, that he might be vulnerable (however you want to define that) in his 2008 re-election bid.
All The Talk Of The 2008 Race Might Be Moot:
John Cornyn May Be Gonzalez’s Replacement As AG
(Note: I’m being serious in the caption above)
Over the past several days that talk of a Democratic Texas Senator has heated up. It has done so for several reasons: the numbers don’t bode great for Cornyn, Cornyn isn’t exactly getting ready to race money wise, and the national party and committee are targeting Texas.
The Spurs have gotten the typical ‘end is nigh’ reaction from some in the media and certainly from fans. The Denver Post published ‘Spurs Are On Their Way Out‘ after just a single game,
With a 95-89 victory everybody else in basketball will regard as an upset, the Nuggets sent an unmistakable, undeniable message to Tim Duncan and the once-great San Antonio Spurs.
It’s over for you.
Once, as every bone in the body of San Antonio big-shot artist Robert Horry creaked as he raised himself from splatting on the floor, I swear you could see the AARP card slip from his pocket. The Spurs are old. They’re ornery. They won’t go quietly. But their roster has too much mileage to make a long playoff run.
Ridiculous says I. Mark Kiszla, the author, needs to do more research than just glancing at the television as he downs another beer. Duncan gave less than 35 minutes/game, the lowest figure of his career. Some of the oldest players on the team looked fine in Game 1 - Horry, Finley, Vaughn. Michael Finley, the knees who Kiszla should’ve heard creak, was arguably the best Spur on the floor.
Indeed, after the first quarter of Game 2 I wouldn’t say the Spurs look old. The Spurs do look slow on the defensive end but not on offense. They’re getting out and running some.
It is an ugly game, by both teams. The Nuggets have looked disjointed on offense. Which has more to do with them than the Spurs rotations or defensive presence. However, the Spurs’ defense has been helped by officials who have their whistles stuffed in their pockets. The Nuggets are playing pretty good defense at the rim. Nene is playing pretty good defense on Tim - I didn’t think a repeat of what Timmy did (or more accurately, didn’t do) in Game 1 was possible, but the way they’re defending him right now we may see another 14 point game.
That would be disastrous, even as we lead at the end of the first. Nevermind, that a performance like that would be a bad birthday present for Tim Duncan, we simply cannot win without Duncan stepping up. The Nuggets can’t continue missing open shots. True, the Spurs picked it up as the 1st quarter went on, but we’re going to need a better defensive performance and bigger offense from Tim.
Carmelo Anthony & Allen Iverson have shot 2-for-12 from their own missteps, not because of the pressure the Spurs are putting on. The Nuggets have turned the ball over an inordinate amount from simply sloppy play, no because of the pressure the Spurs are putting on.
Let’s go Spurs. Let’s pick up the defensive pressure. Let’s go Timmy. Let’s put the ball in the hole. We need this game.
*UPDATE*
Spurs Win!
Despite letting the Nuggets back in it in the final couple minutes, after controlling the game, I really don’t think this was a bad game. I don’t think it bodes for the Denver Post’s theory referenced above. The Spurs will win this series.
The Chronicle’s Texas Politics blog thinks the only sensible thing Perry can do is:
Perry has not said what he will do with House Bill 1098. Will he veto it, setting up what appears to be an inevitable showdown with the House and Senate?
[…]
Your blog wouldn’t be surprised to see him let the measure become law without his signature, especially now that the Senate softened it with a “sunset” provision in 2011.
Not that the massive margin by which the mandate is being overturned is a surprise. It has been expected. It was interesting living in a “progressive” state for a little while.
European astronomers have published the discovery of the smallest extrasolar planet yet. What’s making popular news however, is the fact that,
They say the benign temperatures on the planet mean any water there could exist in liquid form, and this raises the chances it could also harbour life.
“We have estimated that the mean temperature of this ’super-Earth’ lies between 0 and 40 degrees Celsius, and water would thus be liquid,” explained Stephane Udry of the Geneva Observatory, lead author of the scientific paper reporting the result.
The Gliese 581 super-Earth is in what scientists call the “Goldilocks Zone” where temperatures “are just right” for life to have a chance to exist.
The planet, which isn’t alone in orbiting Gliese 581, circles the star in just 13 days (watch a potential orbit around Gliese 581) but because its parent star is a red dwarf, and much colder than the Sun, the temperatures on it are likely to be within a nominal range for water to exist. Couple that with its ‘earth-like’ size, which increases the likelihood that it is rocky (most exoplanets are huge, and probably represent gas giants like Jupiter), and you have the general media paying attention.
Gliese 581 would be within this frame at Wikisky. Of course it isn’t visible with the naked eye with a magnitude of ~2.5.
After going to Austin and playing advocate for extending Texas’ CHIP enrollment period to a full year, I had this to say about the State’s Children Health Insurance Program,
Not even the most cold hearted libertarian can deny the state’s responsibility to say, abandoned and orphaned children. And with strict eligibility rules applied isn’t providing for children whose parents can’t just an extension of such?
But in a year when health care is shaping up to be the domestic issue - as I’ve already commented on here and here - an Opinion Journal piece criticizes any expansion of CHIP at the federal level, by citing some disturbing trends in how states are using the funds.
[Democrats] pronounce S[-CHIP] “underfunded”–and sure enough, 2007 funding already falls short of covering enrollees in 18 states by about $900 million.
But this “crisis” arose because some states have grossly exceeded Schip’s mandate. They are using the program to expand government-subsidized coverage well beyond poor kids–to children from wealthier families and even to adults. And they’re doing so even as some 8.3 million poor children continue to go uninsured.
Arizona, Michigan, Minnesota and Wisconsin cover more adults than children. In 2005 Minnesota spent 92% of its grant insuring adults, and Arizona spent two-thirds the same way.
The piece goes on to get on Clinton’s attempt to expand CHIP without establishing more accountability in keeping those who it wasn’t intended for off the rolls.
A bill introduced by Senator Clinton and Representative John Dingell would make all of this worse. It would index government Schip outlays to national health spending and growth in states’ child population. Without “quantifiable” progress–i.e., expanded rolls–funding drops. The legislation would also create incentives for states to expand Schip to the New York level of 400% of poverty. If this keeps up, a family will soon be eligible for Schip and subject to the Alternative Minimum Tax.
In other words, what began as a hard-cap grant to cover the working poor is evolving into an open-ended entitlement to cover whatever promises states make.
“will keep kids healthy, save lives, control costs, and end heartache and worry for so many parents. This plan is practical and fiscally responsible - it will honor our values and prevent kids from needing more costly healthcare in the future.”
Maybe. It is hard to fault a bill for not doing something outside its intended purview. So maybe we shouldn’t get on Clinton and Dingell’s plan for not limiting adult access to S-CHIP. But is 400% of the poverty line too high a level and does the new plan overfund S-CHIP?
We Can Spend Your Money For You! It Works Out Great!
True the federal poverty level is a joke. A remnant of an agricultural time, whose adjustment for inflation over the years has failed to truly reflect what equates with poverty nowadays. But as the Opinion Journal piece points out having families with children on CHIP and also paying the Alternative Minimum Tax is kind’ve ridiculous (and I don’t care how far the AMT is encroaching into “middle” America).
The liberal cry is for the eight million uninsured children. Disgraceful, I agree. But as seen above the issue really is beyond that. There is likely funding for those eight million children already in place if CHIP was properly funded and implemented by the states.
I may get myself into trouble here since I’ve spent all of a half hour educating myself on this bill but it seems that presenting Dillinger and Clinton’s plan as merely an expansion to cover those eight million children is naive and an oversimplification.
The New England Journal of Medicine published two perspectives and an editorial online today concerning the recent Supreme Court case which upheld the federal government’s 2003 ban on the intact dilation and extraction/partial birth abortion method.
Whatever my personal belief on abortion the editorials reveal an alarming, egocentric view of the abortion debate which is, unfortunately, all too common.
The ruling creates an intimidating environment surrounding pregnancy terminations at more advanced gestational ages. The decision to pursue a second-trimester abortion is never taken lightly and usually results only after anguished discussions among the patient, her loved ones, and her health care providers. Once the decision has been made to perform a second-trimester surgical abortion, the last thing a provider needs is to have to worry that the procedure could potentially evolve into a criminal act if a fetus in breech presentation should slip out intact through a partially dilated cervix. But this is exactly the situation created by the partial-birth abortion bill.
[A] federal statute outlawing the use of “partial-birth abortion” is constitutional, even though many members of the medical community believe that the procedure should be available when it is the safest option for terminating a pregnancy. No exception was made for protecting a woman’s health; only a threat to a woman’s life would excuse the use of the procedure.
Ever since the 1973 decision in Roe v. Wade, it has been understood that states may regulate pre-viability abortion and outlaw post-viability abortion completely, provided that the rules protect both the life and the health of the pregnant woman.
This balance reflects the view that a woman’s interest in preserving her own health should be protected more strongly than any state interest in preserving intrauterine life.
It isn’t merely a matter of physician’s framing the issue as one of their concern. My future profession, which tries so hard to present itself as the most selfless of all professions, often appears guilty of that I imagine. No, these are examples of how pro-lifers in general simply miss the most fundamental question.
The actual, current debate over abortion really does rise to the level of absurdity. You have two arguments being made which are, when you get down to it, unrelated. The two sides aren’t even talking about the same thing: Pro Choice: It’s a woman’s body Pro Life: The fetus is a life
And there in is the point. No one who defined a fetus as alive would be pro choice. At least I hope not.
And it isn’t like that debate is settled (at conception v. later). Indeed, getting more philosophical, the definition of when life begins may be fluid in the future.
And so for health care professionals, of all people, to get into the mundane argument of how the Supreme Court’s decision is bad, because it will change the way physicians practice, is…disappointing. Bring the debate to its most inherent level. There’s no pro-lifer to be convinced with the argument that “the government is intimidating physicians!”
The NEJM’s perspectives show a profound lack of perspective. They can’t accomplish anything except preach to the choir. In such a case, they’re a waste of paper.
One of the author’s of Point of Law has an op/ed in The Times pointing out how HIPPA’s patient privacy regulations hinder identifying the mentally ill who might be a threat to the community (h/t Kevin, MD).
Under HIPAA, it would have been unlawful for the psychiatric hospital that treated student Cho Seung-Hui, who shot 32 people at Virginia Tech university this week, to compare notes on his therapeutic progress, or lack thereof, with his counselors or dean. So effectively did the various privacy laws bottle up information that even a Virginia Tech official tasked with the monitoring of problem students is said to have known little or nothing about Cho’s lurid history of psychotic symptoms until after the fact.
First, I’m a strong supporter of privacy rights. Sometimes those need to be explicitly ennumerated - as with privacy concerning your health care with HIPPA.
Second, I’m not sure that HIPPA played a real role in the Virginia Tech horror. The loosely defined federal handgun rules concerning mental illness should’ve prohibited Cho from buying a handgun. But it wasn’t access to Cho’s history of mental illness that was a problem. It is really a question of how Virginia, and the gun dealer he purchased from in particular, enforced federal law.
Nor do I think, beyond limiting his access to weapons, that pundits can come up with what the Virginia Tech administration or local authorities could’ve done differently if they had had access to Cho’s mental health records. There’s a lot of talk of suicidal ideation, but the stuff being leaked out specifically from his time under evaluation (not including his creative writing endeavors) speaks nothing that he was a risk to others. The stalking, which got him his brief psychiatric evaluation to begin with, apparently involved no threats and no aggressive behavior.
Identifying those with the potential to carry out horrors like what happened on April 16th is incredibly difficult I imagine. I don’t think we can assign HIPPA or patient privacy concerns any real role in Cho “slipping through the cracks.”
My feelings are probably more mixed than most’s. Public smoking falls clearly within the boundaries of infringing on other’s rights. Which should be, largely, the only extent of liberty.
The cause and effect between second hand smoke and a whole plethora of health problems is clear. You shouldn’t be able to walk down the street swinging a machete shouting, “If you don’t want to get hit don’t come out on the street!” Admittedly that is an over the top analogy, but it is still relevant.
The real question is how far government should go in regulating smoking. It sends a few shivers down my spine when extending the ban to private places of business, where the public has a reasonable choice of whether to hand those businesses their patronage.
The good thing Spurs fans? Well the Mavericks got beaten up by the #8 team in the West on the same night. I was on a plane, so I’ll have to take Marc Stein’s assessment of why this Denver victory wasn’t just a fluke,
The Spurs? Manu Ginobili was snuffed out by the Nuggets’ team coverage, Tim Duncan was neutralized by Nene on a joga bonito day for the NBA’s Brazilians and Carmelo Anthony hit the hosts with the most composed playoff performance we’ve ever seen from him. Factor in the grit of a typically fearless-on-the-road Allen Iverson and you can’t help but believe that winning the opener in San Antonio is more significant for Denver this time than it was in 2005.
Sure he thinks it feels different, and Carmelo said the same. But everyone in SA knew this would be a tough series. The Spurs have the toughest path to the NBA Finals of any true contender. Denver is hot. But the fact remains we saw them take game one in 2005, before losing four straight to the Spurs. The fact remains the Spurs match up reasonably well with Denver. The fact remains it is still a fool’s bet that Nene can limit Tim Duncan like he did on Sunday for three more games.
Pop should’ve played some of Tony, Timmy, and Manu in the final game of the regular season. Which just happened to be against the Denver Nuggets. That blow out, even with the Spurs’ big three sitting out, not only gave Denver confidence, but because the Spurs didn’t play the game to win was a missed opportunity to get some practice against who we knew we would be facing in the first round.
Teams who win the first game of a seven game series, go on to win nearly 80% of those series. With that understood, I still don’t think the Golden State Warriors or the Denver Nuggets can pull off the upset. (At least I hope the Nuggets can’t).
It goes without saying that Wednesday’s game is now a must win for the Spurs.
“How To Break The Shoplifting Habit”
a.k.a. How To Get IBS Under Control
A Florida woman last week blamed her shoplifting on her Irritable Bowel Syndrome. Apparently the check out line was moving slowly, her IBS was acting up, and she had to get out of there…without simply dropping what she intended to buy.
Gallo reportedly told authorities that she could not wait in line because she has irritable bowel syndrome, according to the newspaper.
Gallo was charged with petit larceny and released Sunday from the Lee County jail on $500 bond.
You can’t get outraged at people for working towards their self itnerests. But you do have to love the decline in personal responsibility that this country has witnessed over the past several decades. From expansion of affirmative defenses to the increase in lawsuits, it really is depressing.
After the WHI study found all sorts of risks (higher cancer rates, CV events, etc.) tied to hormone replacement therapy for post menopausal women, the number of women undergoing HRT dropped. Now there is more circumstantial evidence that HRT is indeed associated with an increased risk of breast cancer,
“We can’t prove” that decreases in hormone therapy caused the decline in breast cancer, “but it is such a substantial reduction that you would need something big to have occurred to explain it,” said coauthor Dr. Rowan T. Chlebowski of the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center. “If it is not hormone replacement therapy, we still need to explain it.”
Independently, in an online paper in the journal Lancet, British researchers linked hormone replacement therapy to a 20% increase in the risk of ovarian cancer. They calculated that there were an additional 1,300 cases of ovarian cancer and 1,000 deaths in the United Kingdom between 1991 and 2005 resulting from the treatment.
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:
I've skied half the resorts on this list (Squaw Valley/Lake Tahoe, Snowbird/Park City, Whistler, Taos, Vail)
I "played" lacrosse in high school and through a club level team in college
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.
This blog is entirely self funded. It accepts no advertising or other supporting revenue. The author has no relevant financial relationships to disclose.
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"Please be more precise in your practice of medicine than you are in your blogging!"
- Mark Lanier
