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McCamy Taylor

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Member since: Tue Nov 9, 2004, 06:05 PM
Number of posts: 14,620

About Me

Here is my fiction website: http://home.earthlink.net/~mccamytaylor/ My political cartoon site: http://www.grandtheftelectionohio.com/

Journal Archives

Psych Assoc.(Once Labeled Being Gay as a Disease) Says Your Sleep Apnea is All in Your Head

When science intersects with money, science gets tossed out the window. We see this with global warming deniers. The same is true of medical science. There is no medical textbook as politically---and economically---controversial as the DSM---short for Diagnostic and Statistical Manual of Mental Disorders. In its earlier incarnations, the DSM labeled homosexuality a mental illness. In 1986, seventeen years after Stonewall, the “disease” of being gay was removed from the list of psychiatric disorders. In DSM IV, homophobia is now a disease.

Volume five of the DSM is currently in the works. The disorders described in the book will have a massive impact on health care for years to come, since your doctor (family physician as well as psychiatrist) can bill your insurance for treating you for one of these problems. They will also allow Big Pharm to make (even bigger) profits, by selling drugs to treat these disorders. But at what cost to you, the patient/health care consumer?

In case you have missed my previous journals on OSA (Obstructive Sleep Apnea), sleep apnea is the most common unrecognized disease in the US. The incidence has risen from about 4% of Americans over 40 to an estimated 15% of all adult Americans in recent years. Though the disease is becoming increasingly common, thanks to our obesity epidemic and the aging of the population, diagnosis of the condition is still a huge problem. Less than 1 in 5 people with OSA know that they have it.

http://journals.democraticunderground.com/McCamy%20Taylor/462

Untreated OSA leads to 1) increase in car wrecks 2) lost work productivity 3) increased utilization of health care resources 4) heart disease 5) high blood pressure 6) stroke 7) depression 8) migraine headaches and other pain disorders. It causes bright children to perform poorly in school. It makes people crabby (due to chronic lack of sleep) so that they are more likely to anger easily. It causes erectile dysfunction in men and a loss of libido in women. Who wants to have sex when they have not had enough sleep in years? Show a victim of untreated OSA a bed, and all he/she wants to do is sleep.

Right now, there are a bunch of people in this country being treated for a variant of bipolar disorder (one in which there is no actual mania), because no one has thought to check them for sleep apnea. They are given psychiatric medications that help their emotional symptoms but which do nothing about the damage to their hearts, lungs and brains. These medications generally cause weight gain, which makes the OSA worse. And they do nothing to improve road safety. Remember, untreated sleep apnea sufferers drive like a drunk driver even when sober. Treat the sleep disorder, and their driving returns to normal. Treat their emotional symptoms without addressing the sleep disorder, and they continue to be a menace to themselves and to everyone else on the highway.

The economic costs of untreated OSA are staggering.

Hundreds of billions of dollars a year are spent on direct medical costs associated with doctor visits, hospital services, prescriptions, and over-the-counter drugs. Compared to healthy individuals, individuals suffering from sleep loss, sleep disorders, or both are less productive, have an increased health care utilization, and an increased likelihood of accidents.


http://www.nap.edu/openbook.php?record_id=11617&page=137

Hundreds of billions of dollars. Note that these are hundreds of billions of dollars that flow into the hands of health care providers for treating the symptoms of OSA rather than the disease itself. Hmm. Maybe there is a sound economic reason that no one bothers to improve the rate of sleep apnea diagnosis and treatment in the U.S.. If we had a single payer cradle to grave system that rewards disease prevention, we might be more interested in treating the disease and cutting the costs associated with it. But since “the best health care system in the world” is driven by the money that can be made from fee for service, there is little economic incentive for health care researchers to come up with ways to prevent disease and a lot of economic incentive to come up with ways to treat the complications of disease. For instance, if undiagnosed OSA is a huge cause of erectile dysfunction and you make Viagra, do you really want all those customers to get their sleep disorder under control?

Now, the American Psychiatric Association appears poised to treat even more of the symptoms of OSA with Band-Aid medicine. Among the changes being considered for the new DSM

http://www.star-telegram.com/2012/01/28/3695134/effort-to-broaden-mental-illness.html#tvg

I. Adult Type ADHD Loosening the diagnostic criteria for adult type ADHD. Right now, you have to have shown symptoms before the age of 7 to qualify for (very expensive) medical treatment with stimulants and other drugs. The new DSM will eliminate that criterion, meaning that if the OSA you developed as a middle aged adult has you feeling out of it---can’t concentrate, can’t remember, can’t do your work, all signs of sleep disorder---you can now skip the sleep study you so desperately need and go straight on to speed.

And ADHD treatment is huge business in this country.

Using a prevalence rate of 5%, the annual societal ‘‘cost of illness’’ for ADHD is estimated to be between $36 and $52 billion, in 2005 dollars. It is estimated to be between $12,005 and $17,458 annually per individual.


http://www.cdc.gov/ncbddd/adhd/data.html

Don’t look now, but ADHD is about to become even more “prevalent.”

On the plus side, all those stimulants may offset the weight gain from the bipolar medication. They may even make the underlying OSA better, if enough weight is lost. However, diet pills and a weight loss diet would be much cheaper.

II. Frigid 2.0 The DSM will create a new mental health diagnosis for women that isn’t really new at all. Remember when women who would not put out were labeled frigid? Those days are back. If you are a woman who is not interested in sex, you will now be referred to a psychiatrist. The psychiatrist almost certainly will not perform a sleep screen on you and he or she will not order a sleep study to see if your decreased libido is a natural response to your lack of sleep. Instead, you will receive counseling and medication. What medication? I am sure that Big Pharm can come up with something, so that you can have more sex before your (premature) stroke puts an end to your sex life completely. Or maybe you will see an ad on television that promises that “Viagra for Women” can make you feel like a real woman again. Go to your FP, and he or she will write you a prescription---which will be much simpler and quicker than trying to do a sleep history and ordering a sleep test. And cheaper, too, for those tens of millions of Americans without health insurance.

III. Bitch We all get crabby when we are deprived of sleep, right? People with untreated OSA are a bundle of nerves. They used to shrug off stress like water from the back of a duck, but now every little thing gets them down. And mad. Well, guess what? Having three “bitchy” episodes a week will now qualify you for psychiatric care. And once again, no one will notice that you are slowly killing your heart---until you show up one day in the emergency room with full blown congestive heart failure.

These three “mental health disorders” also happen to be some of the most annoying symptoms of OSA. People who do not know that they snore or stop breathing at night will notice if they lose interest in sex, have diminished work performance or can’t get along with their family. They will see ads on television telling them that a pill can make their lives oh so much better. They will go to the doctor demanding medication. The doctor will prescribe said medication. If the first pill does not work, they will try another. If the second does not work, they will be sent to a psychiatrist who will prescribes experimental drugs. Their eventual sleep apnea diagnosis will be delayed for years, giving them plenty of time to develop more medical complications—or die on the road, maybe taking a few innocent passengers in another car with them.

I can see why the APA has considered making three new mental health diagnoses. They probably see millions of people who suffer from these three symptoms, and they think Ah ha! It must be an epidemic. Let’s treat it. But there is no epidemic of 1) bitchiness 2) frigidity 3) poor mental concentration. There is an epidemic of one condition that causes these three symptoms. And the APA is about to make it that much harder for the people suffering from OSA to get the care they need, by slapping them with the label of “mental health disorder”, ignoring the fact that our minds and bodies are intimately linked.

The APA will be guilty of medical malpractice if they do not attach a diagnostic criteria to each of these new three mental health disorders. Under each heading, in big bold letters it should say Must exclude sleep disorder such as OSA before this diagnosis can be made.

Will they? They don’t include this in DSM IV (the current version).

Inexplicably, the most widely used criteria for ADD/ADHD diagnosis, (the American Psychiatric Association’s ‘DSM IV’), does not include sleep disorders as part of the symptomatology. However, research does suggest that (out of 1822 cases) 48% of those diagnosed with ADD/ADHD had been or still were bed wetters.


http://nobedwetting.com/p-add-adhd.htm

Posted by McCamy Taylor | Sun Jan 29, 2012, 05:38 PM (7 replies)

In America, Dogs Get Dental Implants, Man Can’t Get Infected Tooth Pulled

I just saw something in the newspaper that blew my mind. You can now get dental implants for your pooch, when his teeth get broken or fall out. No, this is not an early April Fool’s prank. I did a Google to make sure. For around $2500-3000, your veterinary dentist will fix your dog up with a brand new tooth so that he does not have to feel embarrassed when he bares his fangs at the mailman.

This ad struck a nerve, because I see folks all the time in my family medical practice who can not afford to visit a dentist, even for the simplest, cheapest tooth extraction. Occasionally, I will treat the same dental abscess two or even three times with antibiotics, before my patients can get the decayed stump pulled. Forget about a crown or a root canal. These are folks like the man who recently died of a dental infection, because he could not afford the antibiotic that a doctor prescribed.

"'The (doctors) gave him antibiotic and pain medication. But he couldn't afford to pay for the antibiotic, so he chose the pain meds, which was not what he needed,' Collins said. Doctors told Willis' family that while the pain had stopped, the infection kept spreading -- eventually attacking his brain and causing it to swell."


http://main.aol.com/2011/09/03/kyle-willis-cincinnati-ma_n_947810.html

This young man’s death was shocking---but not surprising. It has happened before. In 2007, 12 year old Deamonte Driver died from complications of an abscessed tooth, after his mother was unable to get dental care for him.

http://www.huffingtonpost.com/marian-wright-edelman/deamonte-drivers-dental-care_b_831705.html

Medicaid is supposed to help the poor get necessary health care in this country, but Medicaid offers little or no help for most dental problems, especially for adults.

http://www.wisegeek.com/does-medicaid-cover-dental.htm

"My granddaughter, who is a single mom and lives in Louisiana, recently got a medicaid card saying dental was provided. However, when she called for an appointment they told her all they provided for a 20 year old is dentures. How ridiculous is that? She needs dental care. Where can she get free dental care in Louisiana?"

Yes, I have seen that. Young adults who are having all their teeth extracted and dentures fitted, because that is all that their “insurance” will cover. This is not at all uncommon in the public clinic where I work.

"Don't come to Texas if you are on medicaid and over 21 years old. You don't get dental on medicaid, or any help with your dental care, broken teeth or toothaches. Missing teeth, nothing. Dental colleges are 50.00 or 200.00 fee. Who in the world who gets ssi and s.s can afford that? You have to live in a certain area to get help from clinic.

"My daughter's teeth are all broken off because of the meds she takes, but there's no help in Dallas, Texas. She is on medicaid and has to go to the hospital for toothaches, and medicaid does not pay for a hospital visit for a tooth pain, so they turn it over to the credit bureau. What a joke it is."


Hmm. No wonder so many of my patients end a visit by saying “Oh, by the way, I have this infected tooth, and I can’t afford to see a dentist. Can you give me something for it?” Why is an infection a medical problem if it happens on your arm but a “cosmetic” problem if it happens in your mouth? "Bad" teeth are not the same as "bad" hair. Folks with missing teeth can not get proper nutrition. Chronic dental infections have been linked to heart and other problems. They cause lost time from work and can make it impossible to get some jobs. And, in the worst situations, "bad" teeth can kill you. That's why the Department of Veteran's Affairs has a special Homeless Veterans Dental Program.

"The dental needs of homeless Veterans are well documented. In surveys listing and ranking the 10 highest unmet needs for homeless Veterans, dental care was consistently ranked by homeless Veterans as one of their top 3 unmet needs, along with long-term permanent housing and childcare. Dental problems, such as pain and/or missing teeth can be tremendous barriers in seeking and obtaining employment. Studies have shown that after dental care, Veterans report significant improvement in perceived oral health, general health and overall self-esteem, thus, supporting the notion that dental care is an important aspect of the overall concept of homeless rehabilitation."


http://www.va.gov/homeless/dental.asp

We love our veterans, and so we make sure they have dental care. We love our dogs, and so we have vet dentists. If we really loved the poor and the chronically disabled and the unemployed, wouldn't we do something about their teeth, too?
Posted by McCamy Taylor | Sun Jan 15, 2012, 07:48 PM (35 replies)

Carlyle Group: $16 Billion in Debt in 2008, Now Flush in Cash.

In September, 2008, the Carlyle Group went on CNBC and urged “fast approval” for W.’s multi-trillion dollar bank bailout. Their reason? So they could help taxpayers.

http://piggington.com/carlyle_group_urges_fast_approval_of_bailout_so_it_can_help_taxp

Excuse me for a second while I pick myself up off the floor where I have been laughing my ass off. The world’s biggest, baddest vulture group helping U.S. taxpayers? I think not. The only thing that Poppy Bush’s employers know how to help is themselves.

Last year, the Carlyle executives paid themselves huge bonuses. They paid their stock holders huge dividends.

http://www.guardian.co.uk/business/2012/jan/11/carlyle-founders-land-400m-payday

And yet, just a couple of years ago, Carlyle took a huge hit during the mortgage meltdown crisis. A huge hit that the mainstream media attempted to downplay as just a “egg” dropped on the kitchen floor. A $16.6 billion dropped egg.

http://www.reuters.com/article/2008/03/14/sppage012-n13616366-oisbn-idUSN1361636620080314?sp=true

That was one huge default. Lucky for Poppy Bush that his son created a massive media distraction in the form of the sacrifice of Bear Sterns at exactly the same time. For those who do not remember the Bush 1 administration, one of Poppy’s favorite ways to deal with bad news was to create a fire somewhere else and hope that the smoke kept the public from noticing his own raging inferno.

So, where did the Carlyle Group get the $16 billion that it needed to pay off its creditors? Where did they get the money to pay huge bonuses to their founders last year, when, just three years ago, they were circling the bottom of the toilet?

No one wants to say.

But plenty of people are speculating. Some think that the bailout of American International Group was an under the table bailout of the Carlyle Group.

http://www.nowpublic.com/world/feds-aig-bailout-henry-kissinger-carlyle-group-get-150billion

Where did the AIG bailout money go?

”There are also undoubtedly non-bank beneficiaries to this bailout - and we’ll find out who they are eventually when they get named to the Forbes’ wealthiest people list (if the magazine is still in print) and their fortunes shadow Bill Gates and Warren Buffet combined but for the sake of maintaining this chaotic but survivable world we live in I would be indifferent to their success.”


http://santopoliti.tumblr.com/post/85240720/where-did-the-aig-bailout-money-go-what-they-dont

Yeah, that’s what I think, too.

Note that under intense pressure from the public and Congress, AIG released a partial list of where some of its bailout money went.

http://www.nytimes.com/2009/03/16/business/16rescue.html

Would love to have the complete list. Because I have a sneaking suspicion that Bush Jr. was not just setting up the world’s biggest political slush fund for the 2010 elections. He was also trying to save his Poppy’s company from shame and ruin.


Oh, and if you missed it, here is an old journal of mine from DU 2 called “The Carlyle Group is Run By Zombies That Want to Eat Your Brains”

http://journals.democraticunderground.com/McCamy%20Taylor/381
Posted by McCamy Taylor | Wed Jan 11, 2012, 07:45 PM (2 replies)

Better Than Drive-In! Six Zombie Republican Candidates In A Circular Firing Squad Armed W/ Shotguns!

Q: How is a Republican presidential candidate different from a zombie?

A: Trick question. He isn’t!


I have to admit, that I have had more than a few chuckles over this year’s Republican presidential primary. The circular firing squad is a delight to watch. The candidates have killed each other so many times now, that every one of them is a dead man walking, propped up only by the seemingly unlimited amounts of good money that Super Pac donors are willing to throw after bad to some really bad candidates.




Recall that in 2008, the corporate media under the direction of the RNC borrowed from the dirty political tactics of CREEP, the infamous committee to re-elect Dick Nixon. The CREEP playbook was written by a then not-yet-senile Pat Buchanan.



Karl Rove and others cut their political teeth in the 1972 campaign, when false press releases were sent out from one Democratic primary candidate sliming another candidate and the front runner, Ed Muskie was slipped a tab of acid, if Hunter S. Thompson is to be believed.

In 2008, we saw right wing webmaster, Matt Drudge, publish a photo of Obama in a dress---and claim that he got it from Hillary. We had mainstream media correspondents claiming that Clinton called Obama a Muslim when she said the exact opposite. We saw Edwards called a loser and a racist for running for president. We saw Rush Limbaugh praying for a repeat of Chicago, 1968----

And instead, we saw Democratic unity, as Clinton hopped aboard the Obama campaign train and later join his cabinet as Secretary of State.

There is some very satisfying karmic justice being handed out this year. All thanks to the Supreme Court of the United states which ruled that anyone in the world has a Constitutionally guaranteed right to pump as much money as he wants into any election in the name of freedom of speech.



All that cash works exactly the way that brains do for a zombie. Say, one candidate manages to get ahead in Iowa by airing a bunch of really nasty attack ads on his opponent. Does his opponent lie down and die from his mortal wounds? Hell, no! He gets handed a few million dollars and he is back on his feet again, launching his own attack---



I haven’t read what the corporate media pundits have had to say about tonight’s New Hampshire campaign. Because their opinions don’t mean shit. Yes, Romney shot himself in the head with a loaded double barrel shot gun.

“I like firing people.”



Political death, like Muskie’s tears? I don’t think so. Just stuff a few million in cash in that big hole in the back of his skull, and he is ready to hit the campaign trail again. Same for “I don’t want to improve the lives of Black people” Santorum and “I agree with what Rick said” Newt. These guys have tripped over their own tongues so many times that it is a wonder their handlers even let them out to speak. And why do they bother? Why get on national television and make fools of themselves for not knowing the names of the cabinet positions they want to axe? All they really need to do is hold out their hands as they shuffle through the crowds and mutter

“More brains. More money. More votes. Arrrr!”



Posted by McCamy Taylor | Wed Jan 11, 2012, 03:32 AM (0 replies)

JAMA Watch Jan.11,2012: Moderate Marijauana Use is NOT Bad for Your Lungs

This weeks most interesting article is one in the research section about the effect---correction, the lack of effect that moderate marijuana smoking has on the lungs.

Before I get to the study results, a few words about how to evaluate research papers. If the study is a medical one, the most important thing is how was it conducted. The best studies are prospective, meaning that you take a group of people---the larger the better---and you follow them for a time----the longer the better---to see what happens to them. Along the way, you measure lots of things of interest. So, for example, you can measure cholesterol on day one and see if this seems to predict heart disease development over the course of the study. Much of what we know about chronic disease prevention comes from these types of research projects, of which the Framingham Heart Study is probably the best known.

A quicker, dirtier way to do the same type of research is a retrospective study. In this, a bunch of people who have a disease are questioned. A bunch of people who do not have the disease are also questioned. If a lot more of the people with the disease answer "yes" to the question, then you have an association. Remember, association is not causality. People with heart disease are also more likely to have had a stroke than folks without heart disease. That does not mean the stroke caused the heart disease. Retrospective studies are often flawed, because sick folks are more likely to remember things---like, say, the summer they worked with asbestos---than healthy folks are.

In the article "Association Between Marijuana Use and Pulmonary Function Over 20 Years" the researchers followed over 5000 men and women for two decades as part of the Coronary Artery Risk Development in Young Adults (CARDIA) project. Along the way, many pieces of information were collected, including how much tobacco was smoked and how much marijuana was smoked. The authors then compared this data to measures of lung function. Since many of those studied used both, the authors used statistical software that is able to take multiple possible factors and see how each is associated----or not associated---with different potential outcomes.

The results: tobacco cigarette smoking use was associated with reduced lung function. No surprise there. The more interesting finding: marijuana use was not associated with decreased lung function. Low level use (2 times a month or less) was actually associated with better lung function, while even heavy (i.e daily ) use did not significantly affect the lungs. However, heavy use was rare in the study, meaning that the findings here may not be valid.

Now, remember how I said that association does not equal causality. It is possible that low level use of marijuana strengthens the lungs in some way. But it is just as likely that other health or lifestyle differences associated with low level marijuana use (say, for instance, a healthy, more organic diet or living in a less polluted part of the country) could explain the lung findings.

So, don't walk away from this study thinking that two joints a month will give you the lungs of a marathon runner. On the other hand, if you need to use marijuana occasionally to control pain or glaucoma or nausea, you probably are not damaging your lungs.

Love the authors final paragraph, in which they admit that medical marijuana is beneficial for pain, appetite and other uses. The medical establishment is more than ready to start prescribing the drug. Now, if we could only convince government officials that the health and comfort of Americans is more important than the Prison Industrial Complex's ability to make money incarcerating low risk "offenders" whose only crime is smoking weed.
Posted by McCamy Taylor | Tue Jan 10, 2012, 06:40 PM (0 replies)

JAMA Watch Jan. 4, 2012: I read what the AMA is writing so you won't have to.

In the interest of the public health, I am going to start posting summaries of significant articles from JAMA the Journal of the American Medical Association, because it is widely read by U.S. physicians, and it has lots of influence on physicians in the U.S.--and sometimes the lay public. Recall that the editor of JAMA was given the boot during the Lewinsky Hearings for publishing a study done at a southern college which revealed that the majority of bright, educated southerners really do think that oral sex is not sex. Overnight, the Internet went from "Only a moron would try to claim that oral sex isn't sex" to "Of course, in some parts of the country 'sex' does not mean 'oral sex'. That is a scientifically proven fact."

Most of the stuff in JAMA isn't that much fun. A lot of it goes something like "Rhesus monkey pancreatic RNA useful in decreasing human aveolar diffusion in vitro tests" and crap like that.

Here are this weeks offerings of stuff you might want to know. There is a four article special on controlling health care costs.

1. "Reversal of Established Medical Practices: Evidence to Abandon Ship" In a nutshell, lots of things that doctors have been doing for a long time are not doing their patients any good, but people keep having them done because they are "The standard of medical care." The authors site the example stenting diseased coronary arteries that are not causing any symptoms. 84% of the stents performed in this country are of this type--and studies show that they do not do the patient any lasting good and probably isn't any better than placebo procedures at reducing angina (non fatal chest pain). The near universal use of hormone replacement therapy in any woman who had insurance is another example cited. So is verterbroplasty. These are treatments doctors have used for years because they ought to work, if you think about the physiology. However, health often does not make sense. There are too many factors at play. Sounding good does not take the place of clinical studies--and I am not talking the kind of sham circus performances that the company with the patent often stages with the help of a highly paid physician investigator.

Moral. We waste an awful lot of money on snake oil.

2. "What are the Health Care Cost Savings?" Did you know that if our health care spending continues at its present rate, one of every two dollars in the U.S. will be sucked up by the Medical Industrial Complex in 2080? Did you know that U.S. health care spending is the world's fifth largest economy?

Yeah, I agree. It is time to trim the fat. But where do we start? Malpractice caps, limiting insurance company profits, increasing use of generic drugs, letting preemies die (eeks!) will not do the trick.How do we start? The authors suggest tertiary prevention. Tertiary prevention means going after the cow when it is out of the barn and attempting to lasso it before it can run across the road and get run over by an eighteen wheeler. It makes good money for the cowboy doctors riding the horses in chaps and spurs carrying the lassos, but it would still be a lot cheaper to hire one pimple faced teenager to keep the barn door closed. That is what is known in the public health profession as primary prevention. The problem is primary prevention does not do anything for the years of medical neglect that our nation's middle aged and elderly have already suffered. The implication of tertiary prevention is you pay the family doctors to keep the patients from needing the much more expensive care of the specialty doctors. However, family doctors will have little control over whether or not the new patients 50 pack/year smoking history has given him a bad heart, emphysema and lung cancer. Meaning that the only way to give the appearance that you are "saving" money is to make sure that you do not accept any sick patients. See article 4 below.

3. "How will the affects of the Affordable Care Act be monitored?" Good question. The author suggests measuring how much preventable mortality drops----not the easiest thing to do, since sudden access to health insurance will not reverse a lifetime of health neglect. The drop in preventable hospitalizations should occur more rapidly as more of us get our diabetes controlled in an office rather than an emergency room when we finally go into diabetic coma. Third, how many people will actually get health care that they can afford to use out of their new health insurance? I'm betting that there will still be a huge number of people who will not be able to get the care they need, thanks to high deductibles, co-payments and limited provider directories. Fourth does the cost of health care per person go down to Western European levels? As with one above, expect a lag.

4."Withholds to slow Medicare spending: A Better Deal Than Cuts" A better deal if you belong to a huge multispecialty medical practice that cherry picks healthy, rich elderly patients, maybe. Remember HMO withholds? I do. They were a crock of shit. Doctors were told "We will reduce your fees by (anywhere from 5-50%) and if you are very frugal, you will get that money back. " Doctors are no fools. Indeed, they are some of the brightest folks you will meet. Tell them something like this and they immediately go full Titanic mode, jettisoning the sick folks from their practice and hanging onto the healthy. Yes, they do. My practice absorbed a lot of these orphan cancer and heart patients in the mid-nineties when their regular family doctors suddenly discovered that they did not have the skills necessary to treat these kinds of people. Or, they suddenly had the skills necessary to take the place of the oncologist and cardiologists. Remember, referral denials are not intended to make patients do without necessary care. That would lead to malpractice suits. Docs who refuse to refer knows that their patients will get on the phone to their insurer and find a doctor who will.

OK, I will get down from my soapbox. What do the authors suggest? One, base payments on the cost savings (or excessive spending) of care providers in a specific geographic region. Which is bullshit. Who is going to set up practice in an area with a lot of poor folks, knowing that poor folks are also sick folks, and therefore the doctors who spend long agonizing hours trying to improve the lives of America's least fortunate---like the minorities that live in the petrochemical industry's pollution---will be penalized for doing so? This is nothing but regional discrimination. Boundaries would be drawn to keep the poor and minorities in areas that would remain woefully under served. Second option? You guessed it. Let savvy doctors join huge multi-specialty groups that will vow to keep down costs by eliminating waste but which will actually cherry pick their way to riches.

Moral: watch out for financial arrangements suggested by doctors (Yeah, I am one. Want to make something of it?) They are not ready to give up on their six and seven figure salaries yet, and if they can find a way to get rich quick and then quit practice, many of them will do it.
Posted by McCamy Taylor | Mon Jan 9, 2012, 11:25 PM (7 replies)

Food Fight! (Or Why Won't Obama Have to Go Negative Next Fall? A: Because the GOP Already Did It!)

Added intro: Why should a Democrat care if the GOP presidential primary has entered meltdown mode? Obama's style and personality do not allow him to go negative. This year, he will not have to. Democrats will have plenty of "negative" material to use about the GOP nominee---and they can credit it all to other Republicans! How sweet is that?



Long post, but hey? Who ever wants a food fight to end? They are so much fun---if you are a spectator.

Mitt Romney has been the presumptive GOP nominee since McCain’s defeat in 2008. Everyone knew he would run again and (most likely) win his party’s nomination. He should have been in good shape. A former governor, he could boast about having “executive experience”. As someone who oversaw an attempt at health care reform, he was ready to tell America “I can give you what you want better than Obama can.” Since he was a Republican from a northeastern state, he would not have a lot of right wing ideological baggage to dump before heading into the general election. Romney was the guy who could hit the ground running along the line on the center of the road….

So, why does Romney look so weak? Why is he in a virtual dead heat with Rick “Man on Dog” Santorum, one of the most pathetic politicians the GOP has ever produced? How come Ron Paul---a certified libertarian loon---is nipping at his heels? Why is Newt---a Republican’s Republican---stalking him, ready to launch a pie square at Romney’s chiseled features the moment he looks over his shoulder? Blame the Super Pacs.



How did the GOP go from being the party which never ever criticizes another Republican during the primary to the food fight in Animal House? Two words: Citizens United. Those two words hit the scene in January 2009. They were followed the very next day by two other words that have changed the face of politics in America. Super Pacs. The speed with which Rove and others formed their Super Pacs suggests that Citizens United came as no surprise to them. The case at the center of the controversial ruling began when the Bush administration decided (for the first and only time) to enforce federal election financing rules in a case involving attack ads against Hillary Clinton. Why would the Bush administration attempt to enforce federal election rules for the benefit of a woman that the GOP hates? Maybe so that Rove and others could announce their newly formed Super Pacs before the ink was dried on the Supreme Court’s ruling.

Super Pacs were the winner of the 2010 election---and the U.S. lost. By running attack ads against incumbents, the GOP managed to propel a bunch of bat shit crazy Republicans into office. If they could get a posse of Tea Baggers elected, surely the Super Pacs could get one white man installed in the White House…

Or maybe not. The problem with Super Pac money is there is so damn much of it. And it can only be used on negative (attack) ads. Every company in the world is free to form a Super Pac. There is no limit on the amount that can be spent. Hell. China could form a Super Pac to fund a candidate and the Supreme Court would give it a big thumbs up. Remember, Justice Stevens warned the others that the ruling would allow unlimited foreign money in U.S. federal political, and Scalia and the others responded with a big Don’t care!. And if we are talking about all the money in the worldthat is a whole lot of cash just waiting to be spent on the Republican Party primary Battle Royale in which the last man standing is the winner:



Thanks to the Gang of Five, the Republican presidential primary has now entered its Warring States period. The Warring States era in China was the six hundred years of chaos that occurred as various kingdoms battled to see who would come out on top.



No, that isn’t an artist’s rendition of the recent GOP primary in Iowa. That’s a bunch of long dead Chinese guys trying to kill each other in their frenzy to become the Big Boss. But it could easily represent Newt (who has now decided to go negative) and Romney (who already went negative) and Rick and Ron and Rick and all their super-duper political weapons of mass destruction which were bought and paid for by Big Oil and Big Banks and Big Pharm and Big Agriculture and everyone else who is willing to pay for the right to choose the next Secretary of _____.

Super Pac money means a lot of things (besides never having to say you are sorry for your serial adultery or your racist newsletter or your sheer idiocy). Super Pac money means that the corporate media can not anoint a candidate, as they did back in 2008 with John McCain and insist that Republican voters hold their noses and vote for him. In the old days, when NBC declared your campaign dead and buried, folks stopped giving money and that was that. Remember how John Edwards second place finish in Iowa was used to hammer the nails in the coffin of his campaign? The press tried to do the same this year. So far, the only Republican candidate they have managed to shoot down was Herman Cain, for the crime of being Black. (The sex part was obviously not important since Newt is still in the race.) The rest just keep holding out their hands and getting more cash from the rich/corporate donors. And as long as the money keeps flowing, the campaigns keep chugging along, like the Little Train that Could.



Except make that a great big shiny nuclear powered red train. And put six of them on the same track trying to get to the finish line first…



Super Pac money can not be used to tell the world about the greatness of the guy who has promised to cut back federal regulations for your industry. It can not be spent on television ads that show your white male candidate kissing babies and walking on water. No, it has to be spent on ads in which one Republican (Romney) accuse other Republicans (Newt) of going “Whoops!”

&feature=related

Or this one from Romney about Perry:



Romney's ads have been so much fun to watch (and so productive at the Iowa caucuses) that Newt Gingrich has decided to join the food fight:



http://www.latimes.com/news/politics/la-pn-gingrich-romney-liar-iowa-caucus-20120103,0,7578014.story

Romney is not the only one flinging lime Jello across the crowded cafeteria . A group representing “did not even make a blip on the radar screen” Huntsman has purchase $300,000 worth of anti-Romney ads for New Hampshire:

http://swampland.time.com/2012/01/03/anti-romney-ads-why-the-deafening-silence/



Here is a great graphic (all ready for the Dems to use next fall) courtesy of Ron Paul. If anyone knows where I can get this one as a bumper sticker, please let me know.



Another great graphic from Ron Paul:



Here is an excerpt from a Ron Paul anti-Romney radio ad:

"Mitt Romney can't fight against ‘Obamacare’ because he supported the same mandates and government takeovers as governor of Massachusetts. Romney can't stand up against more bailouts because he supported them. He can't lead the charge to shrink the government because he has grown it."


http://www.politico.com/blogs/burns-haberman/2012/01/ron-paul-runs-antiromney-radio-ad-109455.html

That’s a radio ad, because it’s cheaper. Ron “No more welfare for anyone even companies” Paul is probably not rolling in corporate cash. But lots of the others are. Recall that Perry entered the race with six---count ‘em six Super Pacs. All of them paying for ads like this anti-Romney ad, “The Truth is Not for Sale”, from Perry

http://www.therightscoop.com/new-rick-perry-ad-addresses-romneys-10000-bet/



And this double barreled ad from Rick Perry attacking both Newt and Mittens:



http://www.texastribune.org/texas-politics/2012-presidential-election/perry-ad-hits-newt-mitt-on-health-care-mandate/

I have always been a big fan of kitten fighting graphics like this one:



But I am beginning to enjoy the Mittens fighting graphics, too!


Posted by McCamy Taylor | Wed Jan 4, 2012, 03:03 PM (1 replies)

How Super Pacs are KILLING the GOP.

Super Pacs have accomplished a miracle. They have persuaded Republican candidates to savage each other in the primaries the way that Democrats have always savaged each other in the primaries. Why this new found blood thirst? Simple. In the old days, Republican candidates had to raise money from a bunch of wealthy Republicans who believed that you should never give the opposition party any ammo to use in the general. So, the GOP candidates confined their snarkiness to the Democrats.

Now, any Republican can hold out his hand to any US or International Corporation and say "Gimme money and I will give you the Secretary of ______ (insert cabinet position that interferes with your ability to make insane amounts of money)"

Since there are a gazillion companies around the world that want to make insane amounts of money, it is easy to get funding. Even if you are a serial adulterer (Newt), a "submissive" wife (Bachmann) or a certified loon (Santorum, Paul).

Super Pacs have a second unintended effect of making it very hard to clear the field of candidates. In the old days, when your poll numbers went down, your money would run out and you would quit. Or (more likely) when the corporate media declared your campaign over (as it did John Edwards campaign after his second place finish in Iowa) the money would stop rolling in and the candidate would be forced to quit. Well, in our new improved Super Pac funded era, the polls don't mean shit and neither does the corporate media. Nowadays, money speaks louder than words, and under the Super Pac system, the money never runs out. Never! Not as long as the donors are still solvent. These companies have shelled out millions already. They want a return on their investment, damnit!

And as long as there is money, the Republican presidential contenders will continue to Run, Baby, Run! Even if they have no hope of winning, a strong showing in the primary will boost their political status. Check out Herbert Cain, if you doubt me.

Posted by McCamy Taylor | Tue Jan 3, 2012, 01:12 PM (3 replies)

Back of the Bus (Warning, Heartbreaking Graphics)

For those younger than 40, the phrase "back of the bus" might not mean much. If the buses of your childhood were all bright yellow as in school buses, you probably preferred sitting in the rear, away from the eyes of the driver.

For any American over 50, the phrase "back of the bus" has a whole different meaning. During the days of segregation, African-Americans were expected to ride in the back of the bus. If the whites ran out of room in the front of the bus, Blacks were expected to give up their seats. Blacks were not even allowed to walk through the front of the bus on the way to their ghetto in the back. They had to pay the driver, then exit, then go around to the back door. Sometimes drivers (white) would take their money and then speed away before they could get to the back door. Ha ha. Very funny. Look at that ____ run. This from the days when hunting Blacks was considered a sport by some in the U.S. and whole families attended lynchings and commemorated the event with group postcards.



Note the date and location. Marion, Ind. 1930. That was only eighty years ago. Some of those kids may still be alive. Shouldn't someone comb through old newspaper and years book so that we can attach faces to the men, women and children who participated in these acts of murder (for which there is no statute of limitations)?

We all know about Rosa Parks, but the struggle to move up from the "back of the bus" is an old one. In 1884. Ida B. Wells-Barnett refused to move to the smoking car, which was the one designated for Black railroad passengers. She was forcibly removed from the train, while the white passengers cheered.



Several years later after three of her friends were lynched for daring to fight back when a rival white grocery store sent a mob to attack the Black men's grocery for the crime of stealing business, she wrote:

" The city of Memphis has demonstrated that neither character nor standing avails the Negro if he dares to protect himself against the white man or become his rival. There is nothing we can do about the lynching now, as we are out-numbered and without arms. The white mob could help itself to ammunition without pay, but the order is rigidly enforced against the selling of guns to Negroes. There is therefore only one thing left to do; save our money and leave a town which will neither protect our lives and property, nor give us a fair trial in the courts, but takes us out and murders us in cold blood when accused by white persons.


http://www.duke.edu/~ldbaker/classes/AAIH/caaih/ibwells/ibwbkgrd.html

"Become his rival" is in bold, because that is what "back of the bus" means. One demographic group steals the wealth of another through intimidation, which can take the form of both legal oppression and violence. When Black Americans had to sit at the "back of the bus" or risk being ejected and arrested, they were paid a small fraction of what whites were paid for their labor. They were ripped off by store owners, landlords. If they dared to rise above their station (uneducated menial labor) they were killed. Even after the Civil War, several generations of white Americans grew rich and prosperous thanks to the underpaid labor of the nation's African-American citizens.

http://foggyd.wordpress.com/2011/01/04/four-women-who-refused-to-give-up-their-seats/

Here is the story of Rosa Parks and three more women of color who refused to give up their seats. The author of the article writes:

"What was wrong with society at the time to think it was okay to force people to sit in certain seats just because of the color of their skin? Did we not learn a lesson from the Nazi treatment of the Jews?'

I am afraid that people all across the world have learned the wrong lesson from atrocities such as slavery in the U.S. and the holocaust. Slavery made plantation owners rich. Growing cotton was extremely labor intensive. The big plantations would never have survived if they had been forced to pay the field workers an honest wage. A century later, in Nazi Germany, the industrialists who supported Hitler (like our own Henry Ford) made a killing from the unpaid labor of Jewish prisoners. Right now, in America, a whole generation of young African-American men have been moved to the "back of the bus" through our criminal justice system which hands out harsh sentences for the "crime" of using certain drugs. Once in prison, these young men become slave labor. Out of prison, they are denied education grants and are forced to do unskilled, low paid labor for the rest of their lives.

When someone tells you "move to the back of the bus" he isn't simply saying "I don't want to sit next to you." He is saying "Because I am a ___and you are a ____, I have power over you. You had better listen to me and do exactly what I say, or you will suffer. And no one will do a thing to save you. They will cheer as I spit on you and hit you and drag you from the bus/train."

And the man (or woman) who tells us to move to the "back of the bus" has another message, one that is implied in the first. "You only have the power and rights that I choose to grant you. You only have worth and value if you have worth and value to me. That means you had better pick crops for a pittance wage. And you had better give birth to the dozen or so children that I need to run my farm or my business with minimal overhead. And when I have had a bad day, you had better not say a word when I take my anger out on you, verbally or physically. Because you were put on this earth to serve me. I own you. So get to the back of the bus. And don't you dare give me that look. Don't you dare object, even silently. Because if you do, I will denounce you to the world as unnatural, a devil bent upon destroying our society. I will paint myself as the victim and you as the transgressor. I will make your life a living hell."

"Back of the bus" is not a uniquely American problem. Here is an account of a Dalit---more commonly known as an Untouchable---who refused to give up his seat. Note that the "offended" party was Muslim, meaning that they do not even believe in the caste system. This was not a religious issue. They were not following the dictates of their Lord. They simply knew that they were more powerful and more important.

"Inhuman and cruel treatment of Dalits is practiced even by India’s non-Hindu communities, as experienced by Kiranbhai Parmar, a Dalit living in Ingoli village, Ahmedabad district, Gujarat. On his way home from work on 21 January 2009 at about 4pm, Kiranbhai took a vacated seat in a public bus while seven male members of the Khan family were standing inside the bus. One of the Khans called him a ‘dhedh’ (derogatory term suggesting lower caste) and declared that as long as the ‘Khan Sahibs’ (Khan Masters) were on the bus, a ‘dheda’ cannot sit. When Kiranbhai refused to give up his seat the seven men punched and kicked him.

"The Khan family belongs to the Pathan community, enjoying significant social status within the general Muslim community. After being threatened by them, the bus driver stopped the bus between the Trasad and Pisavada villages, and left Kiranbhai there, about 7km from his home village. The victim was able to get a three-wheeler and returned home at about 6pm, but pain from his internal injuries lasted several months.

"Kiranbhai went to the police station with his parents Hiraben and Natubhai Parmar, the next day, to lodge a complaint. They watched as an officer called the Khans to inform them of the complaint. They then accepted the family’s application but refused to register a case, advising them to go home; if they pushed on with the complaint, they said, the family would likely not be able to stay in their village. The Khan family later called them, offering to take no action against them if they took back their complaint; the Parmars refused.

'On February 5 the Khans announced a gathering at the local mosque, where they decreed that, beginning on February 6, anyone who associated with Natubhai’s family or his two brothers’ families (Ishwarbhai being the elder brother and Galabhai the younger) by offering them work or selling or giving them any goods, would be fined 5000 rupees. The three families determined to stay and fight the boycott. However on February 9, the water pipes to the fields owned by the three brothers were cut off. On March 8, Ishwarbhai was badly beaten by 11 members of the Khan family after he rented a wheat threshing machine from a nearby village. The operator had stopped shortly after a call from a Khan who threatened to destroy the machine and burn the operator alive, and when Ishwarbhai called the police he was taken to Majid Khan’s home by an officer called Jasaratbhai. The policeman entered the house and allowed Ishwarbhai to be beaten with wooden sticks for about fifteen minutes before taking him back home. "


http://www.hrschool.org/doc/mainfile.php/lesson65/230/

Why does India have a caste system? Because those at the bottom are forced to do manual labor and jobs that no one else wants to do. In a free society, those with intelligence and determination, would get an education and better jobs. And then who would tend the fields? Who would shovel shit?



When you are told to move to the "back of the bus" you are also being told "Shovel my shit. And thank me for being allowed to do so."

U.S. buses are still segregated in some parts of the country. In Brooklyn, the B110 city bus is gender segregated, because that is what the Hasidic community it serves has requested this. However, it is still a public bus. Anyone can ride---and if any women gets on and does not move to the back, she will be told to do so, in violation of U.S. law which prohibits discrimination in public accommodations.

http://blogs.forward.com/sisterhood-blog/144674/

We have heard about gender discrimination in public places in Israel recently. This is not a new problem. Five years ago, an Israeli-American woman, Miriam Shear was beaten by a mob on a Israeli bus after she refused to sit in the back:

"I said, I'm not moving and he said, 'I'm not asking you, I'm telling you.' Then he spat in my face and at that point, I was in high adrenaline mode and called him a son-of-a-bitch, which I am not proud of. Then I spat back. At that point, he pushed me down and people on the bus were screaming that I was crazy. Four men surrounded me and slapped my face, punched me in the chest, pulled at my clothes, beat me, kicked me. My snood came off. I was fighting back and kicked one of the men in his privates. I will never forget the look on his face."

Shear says that when she bent down in the aisle to retrieve her hair covering, "one of the men kicked me in the face. Thank God he missed my eye. I got up and punched him. I said, 'I want my hair covering back' but he wouldn't give it to me, so I took his black hat and threw it in the aisle."

'Stupid American'

Throughout the encounter, Shear says the bus driver "did nothing." The other passengers, she says, blamed her for not moving to the back of the bus and called her a "stupid American with no sechel (common sense.) People blamed me for not knowing my place and not going to the back of the bus where I belong."


http://www.haaretz.com/woman-beaten-on-j-lem-bus-for-refusing-to-move-to-rear-seat-1.207251

Sound depressingly familiar? Ida Wells Barnett would say so, if she was still alive. So would Rosa Parks. Both women would likely be horrified to discover that they can now be required to move to the back because they are woman. You know, the group that makes less than men for doing the same work, making extra profit for corporate bosses, the group that disproportionately lives in poverty here and around the world, the gender which is expected to be an emotional punching bag for men who are also exploited by their bosses and who dare not say a word back to the guy they are really mad as so they take it home and take it out on the wife, enabling them to go back to work tomorrow and make their employer a little bit richer---

If you take away one thing, I hope it is this. God never told anyone to get to the "back of the bus."





Posted by McCamy Taylor | Mon Jan 2, 2012, 08:48 PM (11 replies)

GOP Halftime Show

There is so much to delight (and distract) Iowa’s Republican voters. Perry promises to let women die rather than allowing them to terminate their pregnancies. I can just see the proud little faces of the dead women’s orphaned kids.

(Big smile) “It’s ok. Momma’s up in Heaven with Jesus and the angels, ‘cause she wouldn’t kill our little (brother/sister). Li’l (brother/sister) is up there, too! Daddy, when do we get to go to Heaven so we can see them?”

If Santorum has his way, the kids won’t have to wait too long. President Santorum is gonna put his finger on the red button the minute he gets into office and bomb Iran to Kingdom Come. Since his target is Iran’s nuclear reactors, that means another Fukushima, this one located in the Persian Gulf. If the Royal Meteorological Society is to be believed, the prevailing winds will be from the southeast during the first month of Rick’s presidency. That means that most of the radioactive waste will go northwest to Kuwait and Iraq, contaminating their oilfields. However, the Saudi Arabian oil fields are just a hundred-fifty miles away across the water to the west. Wonder what that will do to oil prices? Wonder how much money the Koch Brothers will make on oil speculation if they know in advance that the Bushehr reactor is going to go boom?

Don’t want to see another war in the Persian Gulf? Gingrich is your man. His motto is make love not war---as long as the love he is making is not with his wife. The Newt has allowed the GOP to shed its stuffy, “no sex allowed” image. Yeehaw! Bring on the scantily dressed cheerleaders! On the other hand, Black men are still expected to keep it in their pants. That’s what you call traditional family values.

All the candidates agree that Medicare has to go. But Ron Paul is way out in front of the others with his desire to abolish Medicaid too. Medicaid is the state sponsored program that provides prenatal care to uninsured women and pediatric care (including immunizations) to uninsured children. Medicaid also helps pay nursing home bills. What will an America without Medicaid be like? More home deliveries, more kids with birth defects and diseases of prematurity like blindness, more measles, mumps, chickenpox, diphtheria, pertussis, meningitis and tetanus, more old folks found in their apartments three or four weeks after their death when neighbors notice the foul odor, more kids with cleft lips for other kids to laugh at----if you have always wanted a beggar on every street corner, you will love America under the rule of Ron Paul.

For those Iowa Republicans who prefer buxom to beefcake, Michelle Bachmann has all your S&M fantasies covered. A proponent of female “submission” you will never see her dressed up like this:



But if you are lucky, you might see her like this:



If only that annoying man from Massachusetts would get the hell off the playing field. Who wants someone so---so---bland and boring during halftime. Come on, Mittens! Birther is so 2008. If you want to wow the Republican voters, you need to come up with something more extreme. Remember how the crowd cheered Rick Perry for executing an innocent man in Texas? Maybe if you promised live, televised executions…
Posted by McCamy Taylor | Mon Jan 2, 2012, 12:54 AM (5 replies)
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