Category: Health

Don’t take health advice from the ignorant

by philg

“Why So Many Tennis Players Don’t Want the Covid Vaccine” (NYT, August 30) describes a heretic and a suspected marrano:

Third-ranked Stefanos Tsitsipas caused an uproar in his native Greece this month after he said he would get vaccinated only if it were required to continue competing.

“I don’t see any reason for someone of my age to do it,” said Tsitsipas, 23. “It hasn’t been tested enough and it has side effects. As long as it’s not mandatory, everyone can decide for themselves.”

Giannis Oikonomou, a spokesman for the Greek government, said Tsitsipas “has neither the knowledge nor the studies nor the research work that would allow him to form an opinion” about the necessity for vaccination, and added that people like athletes who are widely admired should be “doubly careful in expressing such views.”

Top-ranked Novak Djokovic has drawn scrutiny for his approach to health issues throughout the pandemic, and has declined to disclose his own vaccination status. Djokovic said it was a “personal decision” when asked about vaccine protocols on Friday. “Whether someone wants to get a vaccine or not, that’s completely up to them,” Djokovic said. “I hope that it stays that way.”

My favorite part of the above is the idea that nobody should listen to the 23-year-old Tsitsipas on the topic of maximizing personal health. From ATP:

(Having chosen to live in tax-free Monte Carlo (Greece, like nearly all of the world’s countries besides the U.S., doesn’t tax non-resident citizens), is it possible that Mr. Tsitsipas could obtain a New York Times stamp of approval as an expert on minimizing tax liability?)

From whom should we take health advice, if not Messrs. Tsitsipas and Djokovic? How about Assistant Secretary for Health in the U.S. Department of Health and Human Services? Here’s Dr. Rachel Levine:

Except in South Dakota and Florida, state governors have held themselves out as experts on public health, confident that muscular government action can, for the first time in human history and contrary to W.H.O. guidance through 2019, stop a respiratory virus. Let’s look at JB Pritzker, the governor of Illinois? He’s issued nearly 100 executive orders so far regarding health in the time of COVID-19. My favorite, of course, is Executive Order #3 (March 12, 2020):

WHEREAS, in late 2019, a new and significant outbreak of Coronavirus Disease 2019 (COVID-19) emerged; and,

WHEREAS, it is necessary and appropriate for the State of Illinois to immediately take measures to protect the public’s health in response to this COVID-19 outbreak;

THEREFORE, by the powers vested in me as the Governor of the State of Illinois, pursuant to Sections 7(1) and 7(12) of the Illinois Emergency Management Agency Act, 20 ILCS 3305, I hereby order the following:

Section 1. The application submission deadlines in the Cannabis Regulation and Tax Act and implementing regulations for submitting in-person applications by March 16, 2020, are suspended as follows:

(summary from the index page: “CANNABIS APPLICATIONS — The deadline for cannabis grower, infuser and transporter license applications is extended, and applicants are now allowed to mail completed applications, rather than submitting in person.”)

Can we see a photo of the heroic health expert governor who protected Illinois residents from a potential shortage of health-promoting marijuana during the global pandemic?

(Perhaps Governor Pritzker is an expert who contributed to CNN’s “Why does smoking pot give you the munchies?”)

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The first computerized medical diagnosis systems (late 1950s)

by philg

“The Automatic Digital Computer as an Aid in Medical Diagnosis” (1959, Crumb and Rupe) is an interesting example of hope versus reality. Computers will turn medicine into a science and they’ll also save money.

The authors predicted that computers in medicine would “contribute to the good of mankind”:

What do we have, 60+ years later? Epic, whose primary function is making sure that the providers get paid!

Were these authors the pioneers? No! The references include a 1956 punched card-based diagnosis system for diseases of the cornea (TIME).

The comments on the article are interesting. Then, as now, we don’t know if computers are useful in medicine because we don’t know how often human doctors are correct:

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Oshkosh: the diabetes organization sells soda

by philg

#OnlyInAmerica: the Juvenile Diabetes Research Foundation sells Pepsi, Mountain Dew, and other delicious drinks in 20 oz. bottles.

What you’ll look like after a week of event food…

The EAA bookstore has a section for the mentally deficient:

Always a good question to ask…

A T-shirt that probably won’t sell out…

Airbus A400 from Germany:

So far a great EAA AirVenture! Yesterday the stream of text messages probably did not bring too much cheer to those in tents:

The radar at 10:35 pm:

(KOSH is in the bottom right, surrounded by a dashed red line for the airshow temporary flight restriction.)

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#Science says masks are the best thing that ever happened to children

by philg

Parking a warm saliva-soaked mask in front of a child’s mouth all day isn’t the most obvious way to protect children from exposure to bacteria and viruses. And “Experimental Assessment of Carbon Dioxide Content in Inhaled Air With or Without Face Masks in Healthy Children” (JAMA Pediatrics, June) heretically suggested that children might be better off with an unobstructed airway.

All is right with the world once more, however. The paper has been retracted by the editors. The only question is why humanity didn’t discover the healing power of full-time mask-wearing centuries ago.

Loosely related:

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The 18-year-old chooses a primary care physician

by philg

A local 18-year-old, raised on a steady diet of social justice messages delivered by unionized employees at the public school he has attended, asked his mom for help in choosing a primary care physician now that he has aged out of pediatrics.

Perhaps he didn’t absorb what the school was trying to teach. He told his mother that he didn’t want a female physician or a doctor of color because “they get into medical school easier.”

As it happens, mom is a cisgender female physician of color (Chinese-American, which is “of color” by today’s standards).

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Why not a one-month shutdown of casual sex?

by philg

PeterReed’s comment on Why don’t migrants get COVID vaccines at the border? (which references an Atlantic magazine article by a fat guy complaining that the righteous vaccinated Americans will be paying for COVID-19 treatment for Republicans (mentioned 12X in the article) who refuse to #FollowExperts and take the vaccine):

This future burden from lack of covid vaccine is no different than similar righteous talk about smoking, overeating or reckless lifestyle. It is convenient to bring this objection out now for a certain political view about vaccines, but better not bring it up about drug use or casual sex.

My response:

That’s a great point. https://www.npr.org/sections/health-shots/2021/04/14/986997576/once-on-the-brink-of-eradication-syphilis-is-raging-again : In certain circles of San Francisco, a case of syphilis can be as common and casual as catching the flu, to the point where Billy Lemon can’t even remember how many times he’s had it. “Three or four? Five times in my life?” he struggles to recall. “It does not seem like a big deal.” At the time, about a decade ago, Lemon went on frequent methamphetamine binges, kicking his libido into overdrive and silencing the voice in his head that said condoms would be a wise choice at a raging sex party.

If a hater were to complain that Mr. Lemon should have cut back on his recreational meth and trips to the local bathhouse so that our society’s spending on health care could be reduced, we would all condemn that hater.

Similarly, in https://www.usnews.com/news/health-news/articles/2021-04-14/stds-hit-record-high-again-cdc-says

Meanwhile, approximately 31% of chlamydia, gonorrhea and primary and secondary syphilis cases were among non-Hispanic Black individuals, although they accounted for only 12.5% of the U.S. population, according to the report. Men who have sex with other men were also disproportionately impacted by STDs, the report says.

These disparities likely aren’t caused by differences in sexual behavior, but “rather reflect differential access to quality sexual health care, as well as differences in sexual network characteristics,” the report says.

—————–

It is fine to shut down schools for a year or more, but it is certainly #NotOK to suggest telling people to have sex with just one other person (or none, in the case of many married individuals; see below) for a month so that everyone could be tested and treated.

I hope that we can all agree that nothing is more important than preventing deadly disease. A month with a single boring partner will be a sacrifice for a happy Tinder user, but, as with American schoolchildren, we should be able to find experts to tell us that he/she/ze/they can make up for this after the shutdown.

Readers: What is the justification for allowing this expensive and destructive plague of STDs to continue? (If the objection is that the shutdown won’t end the plague forever, the same can be said for coronapanic interventions, including the vaccines.)

Related:

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Mass vaccination campaign meets American health insurance (and Happy Freedom Tax Day!)

by philg

From my inbox:

An Explanation of Benefits (EOB) has been posted to your *** Plan online member portal. To log into your account and review your explanation of benefits (EOB):

Go to https://****.com/login

Enter your Username (email address) and Password

Click on the Claims tab at the top of the page, choose claims.
Member claims are listed by date, with the most recent claim appearing at the top of the list. To view an EOB, click on the claim you want to view, then click on the pdf icon under View EOB.

(name hidden to protect the guilty)

So an Explanation of Benefits is available from my vaccine shot? Let’s actually log in…

Even if the promised Explanation of Benefits did not exist, there was a page devoted to my Moderna shot. Two claims hit the insurer’s computer systems, one for $0 (the vaccine itself? Which Donald Trump arranged for the government to pay for?) and one for administering the vaccine:

The actual price is $33.50 to deal with me? But why bill $67? This is one of those rare situations in which there is no way to cheat the uninsured by hitting them with 2X or 5X the “negotiated” price that 98% of customers pay.

(Separately, I’m not sure how $33.50 makes this profitable for the clinic. They paid someone to build a web site where I could register and schedule, paid for a receptionist to check me in, paid an RN to ask me some medical questions, paid for a place where I could sit for 15 minutes after the vaccine, paid for people and systems to send this $67 bill to the insurance company, etc. Unless the Feds are giving them additional money for each shot, why do they want to be in this business?)

I wonder if the goal of the American health insurance system is to make our federal tax system seem logical, clear, and simple. Happy Tax Freedom Day to everyone! (filing is extended this year to May 17 #BecauseCoronapanic)

Note that Tax Freedom Day, on which you stop working for the government (pay all of those government workers who sat home for the past year!) and begin to work for yourself varies from state to state. It is May 3 in New York, April 23 in Maskachusetts, and April 20 in California. It was April 5 in Texas and April 4 in Florida. Before World War I, Tax Freedom Day was in January:

As best historians can tell, the American colonists-turned-rebels-and-traitors were paying roughly 2 percent of their total income for all taxes. So they achieved Tax Freedom about one week into January while complaining that being British subjects was oppressive (the Brits, meanwhile, were shelling out huge $$ to fight with “Indians” on all of the borders).

How about going forward? If Presidents Biden and Harris spend $1.9 trillion every few months on coronapanic Band-Aids, would the “deficit inclusive Tax Freedom Day” move to mid-summer, or, for those here in MA, into foliage season?

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Cost of being continuously stoned: $7,400 per year

by philg

From “Medical marijuana patients just got huge win as N.J. court says company must pay injured worker’s bills” (nj.com):

The New Jersey Supreme Court dealt medical marijuana patients a big victory Tuesday, ruling unanimously that a construction company must pay for an injured employer’s medical cannabis bills.

The decision upheld an Appellate Division ruling from January 2020. That court said Vincent Hager’s former employer, M&K Construction, must foot the monthly bill for medical marijuana he uses to treat injuries he sustained on the job in 2001. As of early 2020, those costs were about $616 a month, according to court documents.

New Jersey’s medical marijuana patients have long complained of high costs. Prices have averaged between $350 to $500 an ounce. The law allows them to purchase up to 3 ounces each month, though most use less.

Only in America could we figure out a way for a literal “weed” to cost $7,400 per year per person!

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Pharma ads on TV will turn our kids into the biggest hypochondriacs in human history?

by philg

I like to limit my TV viewing to content targeted at 5-year-olds, generally streaming and ad-free. However, the kids sometimes hear about a big tennis tournament that is going on and ask to see parts of it. What do they see? About 30 percent of the ads seem to be for drugs that treat medical conditions afflicting older adults. Perhaps this isn’t surprising in a country where health care is 20 percent of GDP (and 40 percent of profits?). Each of these ads leads to a question: “What’s that for?” So they’re getting a much earlier education in all of the ways that the human body can fail than we Boomers did (we saw ads for cars, packaged food, toys, beer and wine, etc.).

I know a lot of people who are 10 to 30 years old and are afraid to leave their homes because of a virus that kills 82-year-olds. I wonder if these folks were already preconditioned to be anxious about their health by the preponderance of TV ads for medication.

I’m thinking that it will be even worse for kids currently 0-10. The only world that they’ve known looks like an Ebola clinic and, in addition to all of the masks, gloves, face shields, obsessive surface cleaning, and shutdowns of which they’ve become aware, they’re spent a lot of time at home seeing TV ads for all of the conditions that were considered serious prior to coronapanic.

Here’s an example…

Lots of good questions for an early reader… “What’s HIV?”, “What’s getting HIV through sex?”, “What’s people assigned female at birth?”

A still frame from the above in case it disappears from YouTube:

Another example:

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Medicare focuses on end-of-life because we do too?

by philg

The death of my father was sad, but it was also illuminating. Relatives who hadn’t paid much attention to my parents for years suddenly sprang into action, on hearing that my father had gone sharply downhill (perhaps coincidentally, but it was one week after the second Pfizer Covid vaccine shot).

People were desperate to show up in person, get on Zoom or FaceTime, or talk on the phone. The neglect of the elderly in America reached a state of perfection starting in March 2020. People who hadn’t visited relatives in retirement homes suddenly had a perfect excuse: #AbundanceOfCaution #BecauseCorona. Even when the inmates were released to meet friends and family on outdoor terraces in masks, the Coronarighteous refrained from visiting (often while posting on Facebook photos of themselves enjoying various activities with other potentially infected humans, going out to get food at/from restaurants #BecauseTooLazyToCook, etc.). All of that changed once my dad slipped toward unresponsiveness.

Apparently I am always out of step with my fellow(?) humans. I was happy to have talked on the phone with my parents every day or two for the preceding 10 years. I was happy that we’d been able to visit them (from Boston to DC) every few months, including amidst “the global pandemic”, over the same period. As it happened, I was also able to be there during my father’s final week, but I didn’t consider that essential or important compared to what had transpired over the preceding 10 years.

Folks often decry the huge expenses that Medicare is willing to incur even when it is obvious that death of the beneficiary is imminent (see “Medicare Cost at End of Life” for some data; as much as 25 percent of spending is during the last year of life). But now I’m thinking that this is a feature and not a bug. If Medicare is a reflection of ourselves and what is important to us, it actually make sense for Medicare to pull out all of the stops when the end is near and certain.

Readers: What have you seen in your own families when the end is plainly near for an older relative? Do folks who’ve not been interested in the soon-to-be-deceased suddenly come out of the woodwork?

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