Category: Health

The US has a history of enthusiasm regarding whatever is new and shiny from the pharmaceutical industry (see Book review: Bad Pharma, about a book by a British doc). So it isn’t surprising that the CDC recommends emergency use authorized COVID-19 booster shots for anyone 5 or older:

People ages 5 years and older are recommended to receive 1 bivalent mRNA booster dose after completion of any FDA-approved or FDA-authorized monovalent primary series or previously received monovalent booster dose(s). This new booster recommendation replaces all prior booster recommendations for this age group.

Note that the difference between FDA-approved and emergency use authorized is now irrelevant. The CDC also recommends flu shots for all Americans 6 months and older.

Let’s check in with Science in Denmark. The COVID-19 shots are recommended for those age 50 and older. What about the flu vaccine, that cornerstone of American public health? Denmark says it is for the old and the young:

We recommend influenza vaccination for everyone aged 65 and over as well as for persons with certain chronic diseases, children aged between 2 and 6, pregnant women in the second and third trimesters and staff in the healthcare and elderly care sector and selected parts of the social services sector.

Let’s go to the UK and see what Science has decided there. The flu vaccine is for those 65 and older and also children from 2 to the end of “primary school” and, depending on how much they have left over, maybe some child in secondary school (Science is all about the leftovers!). How about the miracle COVID shots? A “1st booster” for those 16 and older and “seasonal booster” for those over 50.

As a humble engineer, of course, I cannot say which of the policies described above is best. But I am capable of noticing that they’re different, which is not what one would expect for policies for which a Scientific basis is claimed.

Maybe we should celebrate diversity, as London did in 2015:

Let’s see how the War on Cancer that Richard Nixon started is going… “In gold-standard trial, invitation to colonoscopy reduced cancer incidence but not death” (STAT):

For decades, gastroenterologists put colonoscopies on a pedestal. If everyone would get the screening just once a decade, clinicians believed it could practically make colorectal cancer “extinct,” said Michael Bretthauer, a gastroenterologist and researcher in Norway. But new results from a clinical trial that he led throw confidence in colonoscopy’s dominance into doubt.

The trial’s primary analysis found that colonoscopy only cut colon cancer risk by roughly a fifth, far below past estimates of the test’s efficacy, and didn’t provide any significant reduction in colon cancer mortality. Gastroenterologists, including Bretthauer, reacted to the trial’s results with a mixture of shock, disappointment, and even some mild disbelief.

… So Bretthauer, of the University of Oslo and Oslo University Hospital, and several colleagues started one a decade ago, recruiting more than 80,000 people aged 55 to 64 in Poland, Norway, and Sweden to test if colonoscopy was truly as good as they all believed. Roughly 28,000 of the participants were randomly selected to receive an invitation to get a colonoscopy, and the rest went about their usual care, which did not include regular colonoscopy screening.

The researchers then kept track of colonoscopies, colon cancer diagnoses, colon cancer deaths, and deaths from any cause. After 10 years, the researchers found that the participants who were invited to colonoscopy had an 18% reduction in colon cancer risk but were no less likely to die from colon cancer than those who were never invited to screening.

Five colonoscopies will cost our society (private insurance or Medicaid/Medicare) about the same as 5 cruise vacations. Is it still worth getting 5 colonoscopies before finally dying (maybe of colon cancer)? Wouldn’t we be better off if we invested these resources in something enjoyable? “Pfizer CEO Albert Bourla tests positive for Covid-19 again” (CNN) can inspire us. His reported COVID-19 symptoms were exactly what same-age rednecks who never got any shots or pills reported. However, unlike the rednecks, he followed the Science and, pumped full of multiple “vaccine” shots and an experimental pill, went through COVID-19 in a state of grace.

Now colon cancer screening can go through the same statistical mill as breast cancer screening via annual mammograms. Here in the U.S. we convinced ourselves that annual X-rays were helpful. Then we realized that the improved 5-year survival rates for breast cancer were primarily due to treating “patients with breasts” (formerly known as “women”) for cancer when they didn’t have cancer. Since these victims of overdiagnosis never had cancer to begin with, they were unlikely to have died of cancer 5 years later. “Benefits and Risks of Mammography Screening in Women Ages 40 to 49 Years” is a 2022 article explaining the settled Science:

The American College of Obstetricians and Gynecologists (ACOG), American College of Radiology (ACR), American Cancer Society (ACS), National Comprehensive Cancer Care Network, and U.S Preventative Services Task Force (USPSTF) all reach different conclusions about when and how often to recommend screening mammography. Each organization places different relative weights on the benefits and risks of screening and uses different standards for evidence.

“This Teen Was Prescribed 10 Psychiatric Drugs. She’s Not Alone.” (New York Times, yesterday):

One morning in the fall of 2017, Renae Smith, a high school freshman on Long Island, N.Y., could not get out of bed, overwhelmed at the prospect of going to school. In the following days, her anxiety mounted into despair.

Given the constant doomsaying of the NYT, wouldn’t the above be a sign of mental health, rather than of mental illness? Ms. Smith was informed that the Earth was melting and that her home in Long Island would be reclaimed by the ocean. Ms. Smith was informed that U.S. democracy was at an end and that Donald Trump would be ruling as a dictator indefinitely. Only a fool wouldn’t be anxious and desperate after reading these truths.

Intervention for her depression and anxiety came not from the divine but from the pharmaceutical industry. The following spring, a psychiatrist prescribed Prozac. The medication offered a reprieve from her suffering, but the effect dissipated, so she was prescribed an additional antidepressant, Effexor.

A medication cascade had begun. During 2021, the year she graduated, she was prescribed seven drugs. These included one for seizures and migraines — she experienced neither, but the drug can be also used to stabilize mood — and another to dull the side effects of the other medications, although it is used mainly for schizophrenia. She felt better some days but deeply sad on others.

Her senior yearbook photo shows her smiling broadly, “but I felt terrible that day,” said Ms. Smith, who is now 19 and attends a local community college. “I’ve gotten good at wearing a mask.”

Here’s her list of meds:

Let’s keep in mind that these are the same folks who say that they can tell when it is time for a teenager to transition, via drugs and irreversible surgery, to a different gender ID (from among the 74 recognized by medicine). And their brothers, sisters, and binary-resisters in other branches of medicine claim to know when it is time to shut down schools, forbid those who aren’t employed in marijuana stores from going to work, order the general public to wear masks, force people to take experimental drugs, etc.

This story, at least, seems likely to have a happy ending:

Her definition of success has changed. too. Whereas she had once thought about “being a doctor or a lawyer or things like that,” she said, now she works in a plant nursery and is applying to a four-year college with a focus on environmental and wildlife sciences.

“I like working with my hands,” Ms. Smith said. “I don’t want to work at a desk, and that’s what I thought I should be doing.” She added, “I’m not the same person that I was a year ago.”

…. but Science doesn’t have a problem with an upcoming gathering of more than 275,000 mostly shirtless adults at Southern Decadence (September 1-5, 2022). Neither the CDC nor Louisiana’s public health officials, who eagerly shut down the New Orleans Public Schools, have made any attempt to shut down this event due to the potential for spreading SARS-CoV-2, monkeypox, and any other viruses that can spread from one shirtless human to another.

Science closed the Atlanta kindergartens as recently as January 2022 (NYT), but Science will soon welcome 100,000+ adults for all-day/all-night parties during Atlanta Black Pride.

Everything that the CDC says or does is, by definition, scientific. Science requires that hypotheses be tested and data gathered. The CDC is now offering scientific advice on how to have sex in group settings without contracting monkeypox. Ergo, the CDC must either be running its own bathhouse or gathering data in a bathhouse run by others. Let’s look at “Safer Sex, Social Gatherings, and Monkeypox” (CDC, August 5):

Spaces like back rooms, saunas, sex clubs, or private and public sex parties where intimate, often anonymous sexual contact with multiple partners occurs—are more likely to spread monkeypox.

Unless the CDC is running a bathhouse, how has it determined, scientifically, that the bathhouse lifestyle is more likely to spread monkeypox than some other lifestyle?

Condoms (latex or polyurethane) may protect your anus (butthole), mouth, penis, or vagina from exposure to monkeypox. However, condoms alone may not prevent all exposures to monkeypox, since the rash can occur on other parts of the body.

Where is the CDC doing its scientific testing with condoms?

Consider having sex with your clothes on or covering areas where rash is present, reducing as much skin-to-skin contact as possible. Leather or latex gear also provides a barrier to skin-to-skin contact; just be sure to change or clean clothes/gear between partners and after use.

Has the CDC tested washed versus unwashed leather and latex gear to determine, scientifically, if the suggested cleaning makes a difference? Where has the CDC done the experiments of a leather party versus a non-leather party and a clothes-on versus a clothes-off party in order to have a scientific basis for the above statements?

A rave, party, or club where there is minimal clothing and where there is direct, personal, often skin-to-skin contact has some risk. Avoid any rash you see on others and consider minimizing skin-to-skin contact.

The CDC has done experiments with laypeople and discovered that they are able to recognize rashes in dimly lit clubs? If it doesn’t run its own bathhouse, how can the CDC know that “see and avoid” is an effective means of avoiding monkeypox?

Separately, what would the CDC’s bathhouse be called? All of the people on the “Meet the Staff” page appear to identify as “women”. Would it make sense to have a bathhouse for the 2SLGBTQQIA+ named after a woman?

I already suggested that “Karen’s” be the name of a restaurant chain in which masks and vaccine papers are required. So the CDC bathhouse can’t be named after those who would seek to keep others on the path of righteousness. The CDC is headquartered in Atlanta and is run by the Feds. Combining that fact fact with the above text, how about “Sherman‘s House of Latex”?

Our health insurer just sent an Explanation of Benefits. I went to see a doctor and she billed the absurd $528 that would have been charged to the unfortunate uninsured victim. The insurance company knocked this down to $123.75 so they paid $43.75 and I paid the $80 copayment (on top of the $30,000 per year that we pay in premium).

Except for catastrophes, it seems that nobody would need health insurance if health insurance didn’t exist and providers had to charge a retail price that had some basis in market reality. The person who can afford the $80 co-pay can also afford $123.75.

Related:

• “A $20,243 bike crash: Zuckerberg hospital’s aggressive tactics leave patients with big bills” (Vox): Paramedics took her to the emergency room at Zuckerberg San Francisco General Hospital, where doctors X-rayed her arm and took a CT scan of her brain and spine. She left with her arm in a splint, on pain medication, and with a recommendation to follow up with an orthopedist. … A few months later, Dang got a bill for $24,074.50. Premera Blue Cross, her health insurer, would only cover $3,830.79 of that — an amount that it thought was fair for the services provided. That left Dang with $20,243.71 to pay, which the hospital threatened to send to collections in mid-December.

News on one of my pet topics, the ability of hospitals to hit the unwary with bills for 5-10X what a service actually costs (i.e., what 95 percent of customers pay via insurance)… “She Was Told Surgery Would Cost About $1,300. Then the Bill Came: $229,000.” (NYT, May 21):

When Lisa Melody French needed back surgery after a car accident, she went to a hospital near her home outside Denver, which reviewed her insurance information and told her she would be personally responsible for paying about $1,337.

But after the surgery, the hospital claimed that it had “misread” her insurance card and that she was, in fact, an out-of-network patient, court papers said. As a result, Centura Health, which operated the hospital, billed her $229,112.13. When she didn’t pay, Centura sued her.

“I was scared about it,” said Ms. French, 60, a clerk at a trucking company, who eventually filed for bankruptcy. “I didn’t understand because I kind of relied on the hospital and my insurance company to work out what I needed to pay.”

This week, after a yearslong legal battle, the Colorado Supreme Court ruled that Ms. French did not have to pay nearly $230,000 for the spinal fusion surgery she underwent at St. Anthony North Hospital in Westminster, Colo., in 2014.

It took 8 years of litigation to shut down the conventional scam for this particular patient. How come?

Before her surgery, Ms. French signed two service agreements promising to pay “all charges of the hospital.”

Centura asserted that, because Ms. French was an out-of-network patient, those service agreements required her to pay the full rates, listed in a giant health system database known as a chargemaster — a catalog of the cost of every procedure and medical supply Centura provided.

In Centura’s view, the service agreements “were unambiguous and French’s agreement to pay ‘all charges’ ‘could only mean’ the predetermined rates set by Centura’s chargemaster,” the court said.

But the court found that Ms. French wasn’t responsible for paying those rates because she didn’t know the chargemaster even existed and hadn’t agreed to its terms.

Justice Gabriel pointed out that courts and commentators have noted that hospital chargemasters have become “increasingly arbitrary and, over time, have lost any direct connection to hospitals’ actual cost, reflecting, instead, inflated rates set to produce a targeted amount of profit for the hospitals after factoring in discounts negotiated with private and governmental insurers.”

“They have no basis in reality,” said Gerard F. Anderson, a professor of health policy and management and a professor of international health at Johns Hopkins University Bloomberg School of Public Health.

“The hospital cannot explain to anyone why they charge the prices they charge,” he said. “They are not based on costs. They are not based on accounting principles. They are fictitious instruments created by somebody in the hospitals.”

I still can’t figure out how the hospital’s behavior, despite being conventional nationwide, was ever considered legal in any state. It wouldn’t work for a car dealer to not tell a customer in advance how much a brake repair was going to cost and then charge that particular customer 5-10X what everyone else pays.

Some detail from the opinion:

Based on its understanding of the information that French had provided, Centura estimated that her surgeries would cost $57,601.77 and that after French’s insurance payment, she would personally be responsible for $1,336.90 of that amount.

Thereafter, and notwithstanding the fact that Centura had told French that her surgeries would cost $57,601.77 and that she would personally be responsible for $1,336.90 of that amount, Centura billed French $229,112.13, reflecting its full chargemaster rates. Centura did so because it determined that it had misread French’s insurance card and that she was, in fact, an out-of-network patient. Centura calculated the amount due after subtracting from the total charges the payment from French’s insurer of $73,597.35 and French’s payment of $1,000.00 (thus, the total amount that Centura charged was over $300,000.00, notwithstanding its pre-procedure estimate that the surgeries would cost $57,601.77)

The hospital’s victimization of this lady was far worse than the NYT article reports, in other words. Her insurance company actually paid the hospital more than the originally estimated fair cost of the services provided. But the hospital decided that it had found a clever opening to go after the patient for $229,000 extra.