McCamy Taylor's Journal
Member since: Tue Nov 9, 2004, 06:05 PM
Number of posts: 16,539
Number of posts: 16,539
Here is my fiction website: http://home.earthlink.net/~mccamytaylor/ My political cartoon site: http://www.grandtheftelectionohio.com/
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First off, let me make one thing clear. This diary is about the United States and other so called first world countries. If you are poor and in pain and living in a third world country, your pain will not be treated. Period. Because international drug policy says that morphine (which is dirt cheap) is much too dangerous to put into the hands of health care workers in poor countries. They will divert it to the black market (we are told). And so their patients dying of cancer get acetaminophen and a pat on the hand and a “Maybe if you were good in this life you will be reincarnated into a new life in a more prosperous country and you won’t have to suffer this way next time.”
Ok, enough about our neighbor’s problems. Let’s talk about our own problems. What’s that you say? You are not poor? You are not in chronic pain? And none of your friends or family are poor or in chronic pain? That’s what we call denial. Or willful blindness. Because the woman waiting on your table at Waffle House has two eroded knees. She can barely hobble out of bed each morning, but she spends all day on her feet for tips and minimum wage. She pours your coffee with a smile, even as her hydrocodone wears off. She won’t take another pill until she gets home. It is going to be a long day. The doctors want her to get knee replacements, but she does not have insurance. And if she gets insurance, she won’t be able to afford to take off work for the surgery, because she does not have disability insurance. The hydrocodone allows her to go to work each day so she can pay the rent and buy gas and groceries and take care of her kids.
She knows her doctor secretly thinks of her as a drug addict. She has seen the pharmacist roll his eyes when she comes in for her monthly refill of hydrocodone. She does not list her pain medication when she sees other doctors for fear of what they will think. Because pain is shameful and people who get treated for pain---unless they are children (innocent) or cancer sufferers (unfortunate)---are weak and selfish and should be ashamed of themselves.
Your Waffle House waitress is not alone. The woman working the cash register at Walmart has carpal tunnel syndrome. If she slows down while checking you out, you fume. You tap your foot. She is going as fast as she can---she can’t afford treatment for her carpal tunnel syndrome so she relies on pain medication to get through the day---but your time is valuable. If she can’t keep up, Walmart should fire her and hire someone younger and healthier---
An aside. The recession of 2008-2010 was a godsend to industry which adopted a first hired first fired policy. A fair number of 40 and 50 something middle managers with some seniority and a good salary and benefits with health problem found themselves downsized and reduced to waiting tables, flipping burgers and checking groceries. Jobs that were much more physically demanding than the jobs they lost, jobs with no benefits. That’s how I met them. I was doing family practice at a county clinic at the time. I met a lot of people who had always had good jobs and good benefits until the recession. For the first time in their lives, they had to hold their noses and seek publicly funded health care. And among their many medical problems, chronic pain was often near the top as a barrier to returning to the high paid with benefits work force.
But enough with the up close and personal. What about the public health? What about our right to live in a country where there is no drug addiction problem adding to crime and the rising cost of uncompensated health care? What about our right to make sure that no pill pushers sell our babies prescription drugs without a prescription?
The medical director of a large, county funded clinic for the uninsured stated publicly that “Poor people should not have their pain treated with opiates. They will be tempted to sell their medication.” That doctor was not being cruel. She was looking out for the public health. She was determined to stop the flow of drugs at its source---the waitress who works at Waffle House. The cashier who works at Walmart. The former realtor who kept putting off her knee replacement surgery when she had good insurance because she did not want to miss work but who started slowing down because of the pain so she got downsized and now that she is out of work and has time to get her knee replaced has no insurance, so all she can afford is pain medication. I’ll bet you didn’t know that woman is a (potential) drug pusher. Public enemy number one.
Good news! The GOP is looking out for your kids. One Republican is floating a plan to have Medicaid stop paying for opiates. Cut off the supply, that will dry up the demand. Several states have already capped the amount of pain medication that Medicaid covers. That should help with the awful problem of the working poor selling their pain medications. If we eliminate the ACA, a lot of people will lose their Medicaid benefits, making it even harder for them to obtain pain medication—and if they can’t get medication for their pain, they won’t be tempted to sell it. If we dismantle the Veterans Administration which treats a lot of chronic pain—being blown up by a land mine can have lasting, painful effects---that will further reduce the supply.
Poor people were not put on this earth to enjoy themselves. They were put on this earth by God to remind us that the wages of sin---and being born female or Black or Latino or joining the military and being sent off to fight in a foreign war---are suffering and poverty and pain. They were put on this earth to change the sheets in our luxury hotels and trim the lawns at our golf courses and clean dishes in our four star restaurants. And they will do all this while their knees, backs, hands are killing them, because their suffering is their atonement for the sin of not being born among the Elect. God loves the Trumps of the world and He hates the poor and every time a rich person crushes a poor person under his foot, God gets a great big grin across His bearded white face. Amen. So sayeth Calvin.
Yes, that was sarcasm. Now, some honest emotion. Be careful. What follows is true and may make you cry or at least want to punch something.
Put yourself in someone else’s shoes. A hard worker who, for no fault of her own, was standing in the wrong place when a truck at her job went into reverse instead of forward. She got crushed. Her neck was broken. Through some miracle, she was able to regain the use of her arms and legs, but from that moment on this 20 something lived in chronic pain. Her neck injury also made her blood pressure unstable. That plus her pain would drive her blood pressure up dangerously high.
One day, while in the emergency room for one of her hypertensive crises, she overheard the emergency room physician refer to her as an N-word junky. She left. She called her family doctor. In tears, she described what had happened.
The American health care system, the so called best system in the world failed that woman. It shot her in the heart. It made it impossible for her to ever trust a doctor again. Because that emergency room doctor was not looking out for her good. He was looking out for the public good.
There is no easy solution for the problem of opiate addiction in this country. But there is an easy solution to the problem is stigmatizing people who have real pain for seeking relief from their pain. You wouldn’t deny a poor asthmatic an inhaler because she might sell it. Why deny your Waffle House waitress treatment for her pain?
Posted by McCamy Taylor | Sat Dec 17, 2016, 09:29 PM (22 replies)
I have been in denial. I think a lot of us have been in denial. The loss was too great. The change too abrupt. It was too much to process. We denied. We raged. We bargained.
“The recount will come up with a different number.”
“The president will invalidate the election”
“The electors will do the right thing---“
If doing the right thing were still on the table, we would not be where we are now. We are a long way past “doing the right thing.”
The last time I remember feeling this sad and angry and helpless was during the Reagan administration, when Ronnie refused to fund AIDs research, because he claimed the disease was God’s righteous punishment of gays. Lots of friends died…
Today, while looking at the infamous photo of an American dentist gloating over the corpse of Cecil the Lion, I found grief. It’s been somewhere close by ever since the election. Just behind my left shoulder, always just out of sight. I have tried to keep myself busy. Think positive thoughts. Make plans. Don’t mourn, organize. We’ve overcome worse than this----
And then, while scrolling through an online paper, I saw Cecil and the hunter. The pain was sudden, sharp and visceral. My eyes stung with unshed tears. This, I thought, is why we are where we are. Because there are people like this hunter who smile for the camera and boast about killing innocence and beauty and freedom and pride. They grind all that is good in the world under their boot-heel.
I am crying for Cecil and our democracy. I am crying for nature and for the future. Some part of me is even crying for the hunter and Trump----because what kind of horrors must a human being endure to make him boast of being a monster? But most of all, I am crying because I must.
Too long a sacrifice Can make a stone of the heart.
There is no beauty in what Trump has done. Only loss and sorrow. And so, to paraphrase
We “Are changed, changed utterly: A terrible sorrow is born.”
Posted by McCamy Taylor | Sat Dec 17, 2016, 04:42 AM (1 replies)
No, I am not speculating. The match is on. Trump threw the first punch when he called Taiwan. China responded with a show of military strength over the South China.
Who decided to pit Trump against China? It was Putin’s idea. Putin needs to continue selling Russian oil to its biggest customer, China. If China becomes energy self-sufficient, Russia goes broke—again. The way it was at the collapse of the USSR, when the Soviet leaders were tossed out of office. If Russia goes broke, Putin will be tossed out of office---and he likes being Czar for Life. So Putin came up with a plan. Get the U.S. and China in a cage and make them fight. Make the South China Sea so hot that China cannot drill for oil. Set the Sea on fire and watch it burn.
That show of military force was a bad move, and it could have ended badly for China, giving the U.S. an excuse to increase its provocative military presence in the South China Sea. But then someone in China decided to stop flailing around wildly and use strategy instead.
Shares of U.S. automakers General Motors and Ford Motor Co. skidded on Wednesday after a Chinese official warned the government could slap a penalty on an unnamed U.S. automaker for monopolistic behavior.
Touche, China! How will Trump respond? The auto industry that he promised to save is now threatened because he is acting like a dick in order to prop up the price of oil. Russian oil. Is that good business? No. Is that good politics? No. Can China hit him---and the United States---again and again right where it hurts? You bet.
So, who wins if you put China and Trump in a cage match? Putin. Who loses? Anyone who works for a U.S. firm that does business with China.
“If Trump wrecks Sino-US trade, a number of US industries will be impaired. Finally the new president will be condemned for his recklessness, ignorance and incompetence,” the newspaper said in an editorial.
The Trump administration could launch trade actions against China's steel sector under the WTO or otherwise, to try to put pressure on China to negotiate trade restraints, but the outcome of any such negotiations would be highly uncertain as Beijing has many options for possible retaliation. For example, China can replace Boeing jets with Airbus and US soybeans with those from South America. A trade war will also jeopardize progress with the US-China Bilateral Investment Treaty, which is currently under negotiation.
Chinese analysts say China has plenty of leverage to retaliate against Mr. Trump. One prominent target is Boeing, whose Seattle plant Xi Jinping, China’s president, visited in September 2015.
Posted by McCamy Taylor | Fri Dec 16, 2016, 04:30 AM (1 replies)
Maybe someone out there listens. Back in 2014, I wrote about how my patients could no longer afford outpatient pneumonia treatment, because the most effective generic drug (at that time) indicated for pneumonia treatment, doxycycline had gone from being a $4 drug to a $50 plus dollar drug.
How does an old dirt cheap generic suddenly increase its price ten times? The manufacturer claimed to have a monopoly on the precursor ingredient, meaning that it could keep any other generic company from making or selling the drug. Ugly, but I guess it’s legal.
However, twenty state attorney generals are now saying that it was not that simple.
The suit focused on two drugs, the antibiotic treatment doxycycline and the diabetes drugs glyburide. But it added that the scheme went far beyond those two treatments and could include more drugs.
The lawsuit said the investigation began in July 2014 and was initiated by the state of Connecticut, which “uncovered evidence of a broad, well-coordinated and long-running series of schemes to fix the prices and allocate markets for a number of generic pharmaceuticals in the United States.”
On Wednesday, federal prosecutors made similar claims against two former executives at Heritage Pharmaceuticals, one of the companies named in the suit, accusing them of engaging in a price-fixing scheme for the same two drugs.
“It blows that entire assumption out of the water,” he said, “when you hear that generic companies are getting together to increase prices.”
The world was shocked when they realized how expensive Epi-pens are. The manufacturer claimed the steep price was justified, because it was cheaper than an emergency room visit--- stupid logic if you consider that when you use an Epi-pen you then have to go to the ER for follow up treatment. And, of course none of us will forget the sense of sticker shock we experienced when a greedy exec raised the price of Daraprim from $13 to $750---because he could.
Or thought he could. The generic drug industry is probably angry as hell at him for blowing the lid off their ongoing scam. They probably thought no one would notice that doxycycline only increased its price ten times. But if you are a doctor treating people without insurance or jobs, you notice when they come back to you still coughing to complain “Doc, I couldn’t afford that antibiotic. You said it was a generic. But the drug store wanted fifty bucks for it!”
State attorney generals, can you please add generic Suprax to your list? That medication is older than the hills and my cash paying patients are still being charged $200 for it. Like doxycycline, it is more or less unique (only third generation oral cephalosporin on the market) and treats things that no other generic antibiotic treat---like resistant kidney infections---but that is no excuse for it being priced like a patent medication.
Posted by McCamy Taylor | Thu Dec 15, 2016, 01:38 PM (0 replies)
We saw it with W. Do I have to spell it out? Wars for oil---with lost American lives and spiraling national debt. Koch Brothers paid to stockpile crude. Alternative energy investments the sole prerogative of China which will be our new lord and master in a couple of decades when the crude runs out, our air and water trashed, our savings used up just buying fuel to keep us war and get us to work .
Anyone who can see the evidence of what Putin has done and who is not afraid---Because he is WHIT and MALE and CHRISTIAN and HATES GAYS---deserves what is coming.
The rest of us I feel sorry for.
It would be cheaper and easier just to gather together a trillion dollars, give it to Trump as a payoff. Fewer lives would be lost. Byut no, the greedy oil industry likes to pretend it makes its money.
Posted by McCamy Taylor | Sun Dec 11, 2016, 08:58 PM (6 replies)
No, Trump is NOT good for the economy. He will not help business owners. Trump, like W. has been installed with a mandate to raise the price of oil for his master, Putin's whose country's economy is almost completely dependent upon oil.
Remember what happened under. W., GE? Remember whatr happened to the airlines? Remember what happened to the cost of transporting merchandise to stores? Remember how much money consumers had left over to spend after they paid $4 a gallon for gas? Well, say hello to $5-6 a gallon gas. Putin will love you for it.
Posted by McCamy Taylor | Sun Dec 11, 2016, 08:51 PM (3 replies)
What is Trump's mandate from Putin, the man who hacked the election for him, the man who almost certainly has enough blackmail info on Trump and the GOP to make them his personal poodle slaves?
Russia's economy--like that of Texas---is dependent upon oil. Putin is just barely hanging onto power. If Russia's economic situation worsens, he could get tossed out. On the other hand, if Putin openly has Trump and the GOP in his pocket, if he can brag to his people "I can make Trump do anything!" and then has Trump go to war with one or two large oil producing nations---and Iran will almost certainly be one of them---without Russia having to lift a finger, sacrifice one of its own soldiers' lives or bear any international heat or budget deficit breaking expense, Putin will be the hero of Russia for all time.
Why has Putin been so open about what he has done for trump? Why is he leaving his finger prints all over everything, including the SOS pick--a personal friend of Putin? Because he hopes to win hearts and minds at home.
If, while convincing Russian that he is THE MAN, he breaks the heart of widows who lose their military spouses in the next war for oil or military personnel who lose their minds or lives, he could care less. If the US is sent in order die in suicide missions whose only purpose is to disrupt Iranian oil fields---so what? If we get entrenched in other land war, Putin will bear none of the economic or political cost--and he will reap all the reward.
The Pentagon is supposed to defend this country. We are under attack.
Oh, and btw, if you have not read "War Is A Racket" there is a link below.
PS, why the hell would Trump poke China with a stick over Taiwan? Answer, South China Sea Oil. If Putin persuades the US to launch war on two fronts, Iran and in the South China Sea, Russia will be sitting pretty all the way to the bank.
Posted by McCamy Taylor | Sun Dec 11, 2016, 08:47 PM (3 replies)
Are we up for it? Even though this is a battle that will be waged on the Internet, in the newspapers, on television and YouTube, it could get bloody. Jobs could be lost. Reputations could be trashed. Feelings could be hurt (yeah, that was sarcasm).
Chinese citizens, alarmed at being voiceless, at having no power to control their own lives and fates took to the streets. They were shot down. They died.
We are not being shot at--yet. But give our foreign master time. He'll get around to it. And his own citizens in his own country will applaud on cue.
How does it feel to be powerless? How does it feel to be third world? To know that your life and death is being orchestrated for the amusement of folks on the far side of the planet? How does it feel to be a participant in gladiatorial games for the amusement of Russia?
Now that we find ourselves in our own Tiananmen Square, how will we act? Will we hide? Will we put our heads in the sand and hope that four years from now it gets better? Will we pray to escape notice? Will we overeat and binge watch television? Will we sit quietly and weep?
Will we resist? Will we fight?
Posted by McCamy Taylor | Sat Dec 10, 2016, 02:34 PM (2 replies)
Yes, I know that we have heard the phrase "worse than Watergate" many times. So many times, that we may have decided that "Watergate" is the new norm---government will always be corrupt, controlled by the rich, insensitive to the needs of the citizens.
But this truly is worse than Watergate.
In Watergate, all the key players were United States citizens. They could be investigated, tried, convicted and jailed by the United States government.
This really is worse than Watergate, because Putin is not a U.S. citizen. He is free to do anything, bribe anyone, threaten anyone. He can cheat, lie, blackmail, murder and otherwise attempt to overturn the democratic process in the country with impunity, because he is not a United States citizen.
Do you think Putin cares about threats to appoint a special prosecutor? Do you think he worries about impeachment? No. All he has to do is get Trump to appoint a Secretary of State who will launch more wars for oil and an Energy Secretary who will cut funding for alternative energy and an EPA Secretary who will make climate change discussions grounds for dismissal from employment with the U.S. government----
And then Putin can sit back and watch oil prices rise and his nation's economy (which is dependent upon the price of crude) will grow and the Russian people will call him a hero for saving them by staging a bloodless take over of the United States and his personal, secret fortune which is all oil based will make him the richest man on earth, giving him even greater powers to pull the puppet strings of people like Trump and Mitch McConnell and James Comey.
Even the press, which patted itself on the back for taking down the corrupt Nixon administration is powerless. Because Putin can control the press within Russian borders, meaning that no matter how biting John Dean's analysis or how spot on the New York Times' assessment of the treason, it will all be just sound and fury, affecting nothing---unless it spurs one man to act. I am talking about President Obama.
This is a national crisis of historic importance, and our window to act is very narrow. The President of the United States has been given unique powers to protect our country from attack by foreign governments for exactly this reason---because our court system, our prosecutors and the voters are powerless to punish people who can hide behind foreign borders (particularly when those foreign borders are protected by a big stockpile of nuclear weapons).
If the members of the press are hoping to get a Pulitzer Prize through their insightful coverage of the crisis--don't waste the ink. Or the electrons. This will not be Watergate 2016, because this is not Watergate. This is worse than Watergate.
President Obama, this is going to be your toughest test as President. Do you have the courage and judgment to see what needs to be done and do it? Do you have the political skill to see it through, to make the U.S. people understand why we must invalidate the recent election and investigate those who have committed treason? They will call you a would be dictator. They will launch character attacks. They will threaten your legacy. But what is one man's legacy compared to the fate of a country that is under siege by another country?
Posted by McCamy Taylor | Sat Dec 10, 2016, 02:13 PM (7 replies)
Been trying to figure out what it all means? Tom Price, orthopedist to head the Department of Health and Human Services. Affordable Care Act to be repealed---but not for two to four years. Vouchers so Veterans can get care outside the VA. Medicare going to be replaced by vouchers any day now (Paul Ryan swears it is true even though his Party does not have the balls to actually take away the health insurance of the 22 million people who got under the Affordable Care Act because it might cost the GOP the next midterm election so they hope that their right wing supporters will understand that these things take time and it's the thought that counts and if they are afraid to take away ACA insurance for fear of a voter backlash, how would they ever dare to touch Grandma's Medicare with all the political damage that would entail but Ryan still wants you to believe that the death of Medicare as we know it is coming down the pipeline.) Toss in a plan to deny folks on Medicaid any pain medication stronger than ibuprofen. And make sure that even when you dismantle the ACA, you keep the part that keeps insurance companies from discriminating against people with per-existing conditions, like osteoarthritis of the knee or hip----
Add it all up and what do you get?
The math is simple, really. Especially if you recall that Tom Price is an orthopedist who shot down federal legislation that would have funded a study to compare the efficacy of different treatment options, because (in his words) that was the first step towards "health care rationing". And especially if you understand that "health care rationing" is a buzz word (phrase?) for "under European style socialized medicine very few people get elective surgeries like knee and hip replacements but in the United States you can get one on demand--which is why orthopedists drive expensive cars".
Still trying to put it together? What do you think folks on ACA insurance will do when told that they will lose their benefits...in two years? What do you think people on Medicare will do if told they could lose their generous benefits at any moment? What will veterans do if given vouchers and told "Go out into the community and become health care consumers"? What will poor, working class people who take opiates like hydrocodone for their hip and knee osteoarthritis and lumbar disc disease so that they can go to work at Wall-Mart each day for another grueling eight to twelve hours on their feet--what will they do when the pain gets so unbearable that they can no longer work?
Answer: they will run (or maybe hobble) to their nearest orthopedist to declare "I am now ready for the lumbar diskectomy and fusion/total knee replacement/total hip replacement/shoulder surgery that you said I was gonna need one day and I said 'I want to put it off as long as I can, but now I'm afraid if I put it off much longer I won't be able to get it so when can you put me on the operating room schedule?"
There. That was easy. And best of all, the only people who will get all hot and bothered by the Trump plan to create a massive demand for expensive orthopedic (and other semi-elective surgeries) in as short a period of time as possible are the health insurers! And the GOP, which once danced to the tune of the health insurance industry (Bush ran on a platform of "My state passed the Patient Protection Act!" then, as soon as he was in office had AG Ashcroft strike down Texas' Patient Protection Act in federal court) has spent the last four years telling the faithful how bad the health insurance companies are and how they deserve to suffer for taking part in Obamacare. And how they will never ever give the health insurance industry a bailout (though lately there have been whispers that the GOP Congress might consider a bailout, something they will have to do once the nation's insurers get through paying for all that semi-elective surgery.
So, who stands to gain? Doctors and hospitals obviously. As a physician myself (thought not a lucrative surgical specialist) I urge my brothers and sisters to be circumspect. Even if you are raking in the cash, try to limit your conspicuous consumption. And remember that when the feeding frenzy is over, there will still be a demand for what you do, because people always need health care and the nation as a whole is getting older and sicker everyday.
Who else stands to gain? The manufacturers of all those artificial joints that are going to be inserted into all those people. I touched on the subject in my last journal. The company that used to make and sell the most artificial joints, Stryker, is owned by three siblings who are all billionaires thanks to their sire's inventiveness. They don't need any extra business. They will be fine. The new kid on the block, Zimmer, which is now the largest manufacturer of artificial joints--I am guessing that they will be relieved at being so popular. They have been snatching up other companies right and left. (See their acquisition history at wiki here https://en.wikipedia.org/wiki/Zimmer_Biomet ) And thanks to all the young, active (often obese) people who are now demanding new joints that can keep up with their active lifestyles, manufacturers of artificial joints are now facing an onslaught of artificial joint failures and lawsuits. Like these:
http://www.indystar.com/story/money/2015/10/23/zimmer-biomet-sued-10m-ex-sales-rep/74402816/ (whistle blower suit from former sales rep who says Zimmer gave gifts as bribes to doctors to encourage them to use Zimmer products---but wait! Chris Christie shut that down when he was AG, didn't he? See my last post)
Sigh. It was so much easier being a manufacturer of artificial joints in the old days when the recipients usually had one foot in the grave and were more likely to kick the bucket than run a marathon.
So anyway, don't despair! Trump does not want to take away your heath insurance. On the contrary. He is trying hard to get you to use your health insurance. And not for any old routine mammogram or cholesterol check, no. He wants you to get the very best that the health care industry has to offer. Hysterectomies for everyone! Weight loss surgery! Bladder suspensions! Sinus surgery! Tonsillectomy! The list goes on and on! Act fast! Operators are standing by the take your call---
Just think twice or maybe three times before you toss out your old knee and replace it with a shiny new one.
Posted by McCamy Taylor | Tue Dec 6, 2016, 02:13 AM (2 replies)