Health Care Reform

I haven't blogged about the health care reform bills going through Congress (nor anything else for that matter) because I've been doing what good medical students do, and have had my head in a book (or my hands inside someone's body) for the last three months now. This probably won't change.

But, as I take a five minute break from studying cardiology, I wanted to share with you this:

The New York Times (7/30, A19, Goodnough) reports that the Massachusetts legislature "failed to restore enough money to the budget to provide full benefits for 30,000 legal immigrants." But, lawmakers did "provide for partial coverage, relieving some supporters of the program, who had feared that the cuts would be deeper." The legislature had "eliminated health insurance for the immigrants, which cost about $130 million a year" in order to cover the state's budget deficit. Now, $40 million will be restored, "leaving unclear just how much care the affected immigrants would qualify for." At issue is coverage for "permanent residents who have had green cards for less than five years." Currently, "the affected immigrants are covered under Commonwealth Care, a subsidized insurance program for low-income residents." Under federal law, "the 30,000 immigrants affected by the loss of coverage do not qualify for Medicaid or other federal aid." But, "Massachusetts is one of the few states...that nonetheless provide at least some health coverage for such immigrants." [emphasis added]

The reason I point out this article is that this is what we must come to expect from any government intervention in health care. If Washington D.C. is going to draft a new health care system for America (and they are), then whether you like their plan or not, you better be ready for this to happen to you sometime down the road.

In any system where politicians decide funding, cuts will come based on what is expedient politically. In any system where funding comes from a government that also funds other sectors, cuts will come based on what is fiscally necessary at that moment. When they are together (as we see in Massachusetts and will undoubtedly see in any national plan), cuts come from either or both of those reasons.

This means that nobody is guaranteed coverage, or the same coverage, from year to year. While yes, some people who may not have any coverage now will be covered, WHAT will be covered is not guaranteed. And for those who have coverage now, the same goes. So, in a system where it's already hard enough to understand what your insurance covers and what it doesn't, how will you feel if those rules change yearly?

That may be palatable now, but wait until you get sick. Maybe this year you can get your medicine, but next year, who knows?

ADD

Attention deficit disorder is an interesting thing. Who draws the line between the daydreamer and the kid with a problem? The regular young boy and the one whose hyperactivity is pathologic?

Med school teaches you interesting things. In Behavioral Science I learned that you must be diagnosed by age 7 to have ADD. However, from Student Affairs, I learned that many medical students are diagnosed with it when they get here.

I guess there are exceptions to every rule.

The reason medical students get diagnosed is because many students have ADD, but function highly, and therefore compensate through school. It isn't until the fast pace and time crunches of medical school that their compensation fails and the pathology shows.

Of course, there are imposters too. About 8 - 10% of students in undergrad use stimulants that are for treating ADD as study aids. This off-label use is unethical and illegal, but rampant. The stresses of medical school are greater than undergrad, and so are the pressures to use these stimulants to get ahead.

My school does not grade on a curve, yet I believe we still have at least 10% of my class using Adderall illegally.

--- Sent with System SEVEN - the new generation of mobile messaging

Tea Party Pictures

Well, it's over ... or has it only just begun? Is it begun or began? Shifting thoughts is a flight of ideas ... flight of ideas is a classic sign of bipolar disorder, manic episode. Am I manic? But I digress...

yesterday was my first protest. I guess I am no longer a virgin protester anymore. Quite the experience. I got there about 4pm (the official start time of the tea party) and police/security had already stopped letting people into the plaza. Supposedly, from information on the web, Jones Plaza has official capacity of 5000 people. After that the fire marshall closes it. My only guess is that there must have been over 5000 people there because I could not get onto the plaza.


However, the sidewalks were just as packed. Everywhere I turned people stood shoulder to shoulder, some with placards and signs, listening to the speakers and cheering. Businessmen in suits and ties and women in skirts and blouses stood side by side with rednecks in overalls holding misspelled posters. This was definitely not a one-party, one-socioeconomic class group of protesters.



Eventually my wife and son came to see what all the ruckus was about. By that time people had started to leave, and it was easier to move around the plaza and listen to the speakers. Many people had children holding posters. Organizers passed out petition lists to take roll and set up tables to sell shirts and bumper stickers. Entrepreneurs sold tea bags or buttons.

All in all, a wonderful experience, and hopefully the beginning of continued discontent. Yesterday's tea parties were the rumbles before the earthquake. Three men on the light rail heading towards the protest had a conversation about the tea party and one said,

"the American Revolution started with the Boston Tea Party and escalated to violence in the name of American liberty and values. These tea parties are the equivalent of the Boston, but are Americans ready to take the next step if necessary?"

That is an interesting question.

More pictures:
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pic 12 pic 13 pic 14 pic 15 pic 16

Houston Tea Party

For those of you who don't know, today is a big day. Yes, today is April 15th, tax day, but that has significance for the way we are protesting those taxes and pork.

A grassroots organization, the Tea Party Society, started organizing tea parties -- protests -- around the country in response to the wanton spending that our leaders in Washington d.c. Have done. Not just since Obama took over, but during the Bush regime as well.

Most people's boiling points were hit when the stimulus package was passed. It makes me mad (as you've heard me say) that Obama promised to have every bill wait five days before signing so the public could read and react yet he has kept his promise on NOT ONE BILL.

Also, although $787B of ''stimulus'' was passed, not a single person (not even Mr. Obama) read the bill in it's entirety before signing it into law. In addition, much, if not more than half, of the funds will not be paid out in 2009. That's quick stimulus!

So here we are, over 5000+ strong, in downtown Houston, one of hundreds of cities around the country holding these protests, to tell people that we're sick of this outrageous spending.

If you have time, come down to 601 Louisianna in Houston, Jones Plaza, and join the movement. Visit http://www.houstontps.org/ for more information. Facebook page here.

Pictures to come!
--- Sent with System SEVEN - the new generation of mobile messaging

Sounded the Klaxon

This morning I was reading my American Medical Association news briefing, when one of the authors said this (in an article about atypical antidepressants):

But, "in November, an expert panel advising the FDA on pediatric drug safety sounded the klaxon over the rising use of atypical antipsychotics among kids, and faulted the FDA for failing to issue warnings strong enough to stem the tide." (emphasis added)

I've always considered myself pretty adept at the English language; surely not the wisest and most talented master, but it has been one of my few talents. I've read numerous books, news articles, etc., and never come across this phrase.

So, on reading it this morning, it immediately jumped out at me. It sounded like a Star Trek character ... and I almost thought it was. My first search on Google returned a webpage talking about Klaxons as some type of alarm in the Star Wars universe. However, I doubted that the author of a news briefing would allude to obscure Star Wars alarms, no matter how happy George Lucas would be, and kept digging.

The next link was a memoir of a soldier in the 1960s who mentions a klaxon and describes it as a warning siren on his ship. This sounded more reasonable, so I took off to Merriam-Webster to see if he could shed any more light on this alien subject.

Mr. Webster calls a klaxon a

used for an electrically operated horn or warning signal

That old soldier was right.

So now "sounding the klaxon" makes sense. Sounding a warning siren. However, I think I'll always have a funny picture of George Lucas in a Sith outfit ringing a bell every time I hear it.

What Religion Are You?

Stumbled across this fun 20 question religious quiz. Then the program rates how well you fit into different religions.

Here's my results:

1. Church of Jesus Christ of Latter-Day Saints (Mormons) (100%)
2. Mainline to Conservative Christian/Protestant (97%)
3. Jehovah's Witness (95%)
4. Orthodox Quaker (80%)
5. Mainline to Liberal Christian Protestants (79%)
6. Eastern Orthodox (75%)
7. Roman Catholic (75%)
8. Orthodox Judaism (71%)
9. Baha'i Faith (63%)
10. Seventh Day Adventist (62%)
11. Islam (59%)
12. Sikhism (58%)
13. Christian Science (Church of Christ, Scientist) (53%)
14. Hinduism (52%)
15. Liberal Quakers (51%)
16. Mahayana Buddhism (42%)
17. Theravada Buddhism (41%)
18. Jainism (41%)
19. Reform Judaism (40%)
20. Unitarian Universalism (39%)
21. Neo-Pagan (35%)
22. New Thought (30%)
23. Scientology (29%)
24. New Age (25%)
25. Secular Humanism (23%)
26. Nontheist (19%)
27. Taoism (16%)


Glad to know I am whatever I think I am!

Congratulations!!

Congratulations to Dennis and the Diabetes Research & Wellness Foundation

Congratulations to Dennis and the Diabetes Research & Wellness Foundation (DRWF), winners of TBE Play For a Cause 2009!!

This year the carnage was fierce, and those who lead early saw their prospects sink as front-runners bowed out in the Sweet 16. It was then that Dennis soared to the top, thanks to near flawless picks in the Sweet 16 and Elite 8.

By the Final Four, only two remained. Fittingly, it was last year's winner, Sara, playing for Autism Speaks, against the newcomer -- the upstart -- Dennis and DRWF. Could this be likened to Sarah Palin vs Barack Obama? You make the call.

If UCONN won their final four game, the pressure would be on UNC to win. A UNC win guaranteed victory for Dennis. However, this year was meant for Change, and UCONN fell to a scrappy Michigan St. team before UNC ever took the floor. The win was Dennis and DRWF's, with the icing on the cake that UNC went on to claim the national championship and add points to the champ's total.

By the Final Four, only two remained

And, due to the idiosyncracies of March Madness (later rounds are worth more points), UCONN's loss and UNC's win not only took the win from Sara, but also vaulted four other players (including your's truly) over Sara. So sorry! Congrats also to Julie and the Ovarian Cancer National Alliance and Veronica and Now I Lay Me Down to Sleep, who came in second and third, respectively (so close!).

To the right are the final results:

Now, FOR PAYMENT OPTIONS:

I think it's easier to pay the whole $90 to the Diabetes Research & Wellness Foundation, on behalf of The Bleeding Ear Pool, then try to donate multiple small donations. However, if you would like your donation individualized for tax purposes, I will comply as best I am able.

1. You can send me cash or check ($10) per bracket
2. You can send $10 using credit card or paypal by following the link in the sidebar
3. I will send invoices via email to every contestant so that you pay via Paypal if you wish (and do not want to click on the link above). These will also serve as reminders. Also, if you pay via paypal, you will automatically get a receipt.

I will send in the donation as soon as I receive all funds. Hurry and send them ASAP!

Are All Charities Good?

With the success of another TBE Play For a Cause campaign evident, and the economy in throes, the non-profit organizations we play for have taken a larger place in my little brain lately.

Not all charities are created equal. This thought gained prominence when I stumbled across a blog about Diabetes while trying to help Dennis find a Diabetes charity to represent. This blog, Diabetes Developments, had a post describing the largest diabetes charities and their efficiency.

He steered me towards a great website, Charity Navigator, that gives you the information to make a good decision on who to support.

Look at diabetes organizations. The largest are probably the American Diabetes Association (ADA), the Juvenile Diabetes Research Foundation International, Diabetes Research Institute Foundation, Joslin Diabetes Center, and Diabetes Research and Wellness Foundation.

Charity Navigator lets you know how much of their budget is spent on programs (which is what you are donating to support), administration, and fundraising (yes, money to ask for more money). Granted, no charity can exist with $0 in admin and fundraising, because people who work full-time for these organizations must be compensated, and it takes money to advertise a cause to get people to support you. BUT, obviously an organization that spends 90% of its money on programs is more efficient than one that spends 70%.

Here's how Charity Navigator stacks up the aforementioned diabetes organizations:



And, just so you know, here's how Heifer International, last year's winner, stacks up:



What surprised me was the ADA. They are so large, so well known, and looking at this, you find out that giving money to them is a waste. The money's better spent on one of the other diabetes organizations.

So next time you give, maybe you'll look a little first. It doesn't hurt to make sure your money is being used how you really want it.

TBE Play For a Cause 2009 Final Four Update

Well, we've gone through two weekends of March Madness, and found ourselves at the Final Four. Interestingly, just as this year's tourney has been different than the past four or five (very few upsets and few close games in the later rounds), this year's pool is very different from last year.

Last year, entering the Final Four, any number of people could win. Heifer International ended up coming from behind to take the crown by virtue of Kansas' championship over Memphis.

This year, Dennis, who hasn't even picked a charity yet, zoomed from the bottom to the top of the pack with his stellar Sweet Sixteen picking, and held on through the Elite 8. Conversely, many a soul, including yours truly, is out after picking Louisville or Memphis to win it all.

So, with the Final Four coming this Saturday, the race of 9 has now become a race of two. If UCONN wins it's Final Four game, and UNC loses to Villanova, then Sara and Autism Speaks wins the pot. If however, UNC beats Villanova, then nothing else matters and Dennis better figure out a charity to accept all our hard earned cash.

Congrats to all who've played, and made this year even better than last. Pick your side, for the battle will be fierce. UCONN and Autism Speaks vs UNC and TBA.

TBE Play for a Cause 2009 Group

For everyone who wants to join this year's "TBE Play for a Cause" March Madness pool, two announcements:

1. The pool at ESPN is created.

- go to http://games.espn.go.com/tcmen/frontpage to log in.
- if you have a previous screenname and password, you can enter them on the right

- otherwise, click "sign up for a free account."

- then fill in all the information to create an account. Remember! By doing this you are also entered (for free) in ESPN's $10,000 contest!

- once you sign in or sign up, click on the gold link to create a bracket.

- then name your bracket after the charity of your choice (this step is important!)

- after naming your bracket, click on the "My Groups" link in the middle of the page, and follow the drop down list to "Create or Join a Group"

- once you are at the Groups page, you should search for "TBE Play for a Cause 2009"


- click on the group, then you will see the group page. Enter "TBE" as the password, and join the group! You have entered the "TBE Play for a Cause" 2009 March Madness Pool!


2. Selection Sunday is this Sunday, March 15th, 2009.
- you can join the pool before then, but you cannot officially fill in your bracket (because all the teams haven't been set yet).
- therefore, REMEMBER TO FILL IN YOUR BRACKET THIS SUNDAY OR MONDAY!

That is all for now. If you have questions, drop me an email.

March Madness Pool 2009

I know this is a hard year, but we can still give

Everyone, it's that time of year again.

While I am busily learning medicine and working 12 hour days at the hospital, you will be watching all the action-packed basketball games that give truth to the monikor "March Madness."

As always, I'm rooting for BYU to NOT underperform, and make it out of the first round. I'm not saying they'll go all the way, but it'd be nice to see an 8 seed finally move to round 2.


Last year was the inagural "TBE Play for a Cause." Congrats again to Sara, the winner, and Heifer International, the charity for whom she played.

For those of you who did not enjoy the inaugural run, here's the background/rules. Every year for March Madness, people join pools. Every participant donates money to the pot, and the winner takes all the money. Last year, instead of just giving money to someone, I thought it would be wonderful to harness this economic power to do some social good.

Congrats again to Sara, the winner, and Heifer International

In "TBE Play for a Cause" each participant contributes $10 to the pot and chooses a charity to represent. Then he or she signs up at ESPN.com (doubling the pot, because you are defacto entered into ESPN's contest also) and joins my pool (for ease of keeping track of results daily). Each contestant receives points based on the number of games correctly picked -- using the same scoring rules that ESPN uses. At the end of the tournament, the pot will go to the charity of the winning player.

I know this is a hard year, the economy is a maelstrom around us, and Barack Obama wants to socialize healthcare, but we can still give. $10 is the price of one entre at a middle-of-the-road restaurant, or food for 2 at McDonalds. It's the price for 1 day of parking in the Texas Medical Center where I work. I know you guys can give up one day of driving into work for a worthy cause.

Here is the rallying call: Come one, come all, to the second annual TBE Play for a Cause! Choose a charity! Fill your bracket! Let us help the less fortunate! May the best contestant win!

Welcome, March Madness 2009. We are ready.

Now I Lay Me Down To Sleep ...

Life has been as crazy as ever, and blog posts have been very scarce of late. That does not mean I have not written them in my head! Oh no! Usually I get great ideas for things to share, pontificate upon, etc., but because school and the hospitals keep me away from computers, the words never make it from my mind to my blog.

For two months before Christmas, I was on my Pediatrics rotation. Working with children was very rewarding, but one of the hardest parts of being in the hospital was that truly sick child -- the one that for whatever reason, was not going home.

Working with adults, when someone finally succumbs to their disease, you can chalk it up to their previous bad habits (like smoking, eating fatty food, not exercising, etc), but with children, it's either dumb luck (infection) or other people's problems (abuse).

The most depressing is probably seeing the newborns pass away. My newborn experience while on pediatrics was confined to the well baby nursery, and it was enjoyable to see happy parents with their new children. I also remember when my son was born, and the extreme joy -- no, spiritual experience -- that I had when holding him in my hands for the first time.

The dichotomy to all that joy must be the hurt when a baby dies, and historically physicians have encouraged parents who know their baby will be born with a fatal condition to terminate the pregnancy early and not grow attached to the fetus. A couple that attends church with us recently had a son with anencephaly -- a fatal condition where the child is born basically without a brain -- and chose to do the opposite of the physician's wishes. She bore him to term, they named him, held him until he passed, and buried him. It helped them gain closure to the experience -- especially given their belief that they can be together as a family in the hereafter.

Now there is a non-profit organization that helps parents that choose to gain closure like our church friends. Now I Lay Me Down to Sleep is a network of professional photographers throughout the United States that are on call 24/7 to take photos of families, parents, and the newborn during the short time the child is on this earth. Then they put the photos on an archival DVD for keepsake.

Wonderful. I wish nobody had to go through the death of a child, but if it happens, it's nice to know there are organizations and people like this to help. This year -- barring something monumental -- I will play in the second annual TBE March Madness Pool for them.

Chuck Norris Votes Utah #1

What happened to the good old days, where teams that went undefeated were awarded the National Championship? Oh yeah, ESPN and the BCS...that's what happened.


Congrats to Florida, for finishing a blemished season with an ugly win over a good Oklahoma team, but seriously, what the heck???

Tebow's great, and Florida's a good team, but if Stoops hadn't gone for it twice in the red zone in the first half, that last touchdown would have barely put them up, and the end would have had a much different tenor. Plus, Texas was clearly better than OK this season.

Utah beat Alabama 31-17, and Florida beat 'Bama 31-20. Utah beat Oregon State the week after USC lost to Mr. Rodgers in his neighborhood. So Utah's better in head-to-head matchups than Florida and USC, and Florida beat Oklahoma, so only Texas is really out of the loop.

So what's the truth? Well, the truth is that the BCS probably breaks the Sherman Antitrust Law, but it also probably has the pockets of people that would adjudicate that, as well as the hearts of many prosecutors and defense attorneys who would litigate it. The truth is the BCS will never give a school from outside those 6 arbitrarily magical conferences a fair shake. The truth is we'll never know who is truly the best team because the current system is WORSE than the bowl system ante-bowl-alliance.

No, scratch that last sentence. The truth is, Utah is the the true #1, for one simple little-known fact -- Chuck Norris plays for Utah. And we all know, Chuck Norris kills all who oppose him with sharp roundhouse kicks. You can't be national champions if you're dead.