Posts Tagged ‘The New York Times’

Irresponsible Medicine

Thursday, May 26th, 2011

Are they insane? Have our elected leaders never heard of evidence-based medicine? What kills me is that our congresswoman, Tammy Baldwin, makes universal health care her signature issue, but we never, ever hear her resolving to create a medical system that emphasizes health. It is always about more medicine at all costs. Let’s face it folks, more medicine is bad. Less medicine is good. What we need is a federal spending paradigm that emphasizes health over health care. That starts with creating healthy, active, community environments and continues with a medical system that is less hubristic and positively non-heroic.

Universality of medical coverage is certainly a necessity, but it must be done right.

In the first instance, active community environments, doing it right means winding down spending on unhealthy infrastructure such as paving and power plants, and instead focusing on creating healthy, people & community oriented places. Less pavement, more green. Less distance, more convivial interactivity. In short: healthy communities, not sprawl. (Unfortunately, on this front, all we got with the “recovery” money — when Democrats were fully in control — was just more money for more sprawl-inducing highways; crumbs for anything healthy.)

In the second instance, it means looking at health systems which de-emphasize medicine and emphasize healthy living. It also means judiciously applying medicine only where the evidence merits the application of medicine. The fee-for-service model is harmful, at best; deadly in all too many instances. Gawande’s thesis rings true for my spouse who has practiced in for-profit, non-profit and government medical systems; the amount of waste that goes into uncoordinated wheel-spinning on the for-profit side is unconscionable. In a fully-accountable medical system (typically government-run), you have much more of a focus on the patient, with positive outcomes. Profit should not have an overriding role in medicine. Or at a minimum, profit should only derive from population-wide improvements in outcomes.

If US senatorial candidate Rep. Baldwin wishes to impress her constituents in this district & state — a leader in the most cost-effective health care delivery in the country (examples of excellent health care at reasonable costs exist right here in Wisconsin; see p. 7 of the Gawande article above) and active community environments (Madison routinely ranks high on every measure of biking & walking) — she should make patient-centered, evidence-based medical delivery and active community environments the center-piece of her campaign. She could begin a Ryan-style campaign that delivers both cost savings and quality improvement to Medicare & Medicaid now. It is time to call the Republicans on their savage cost-cutting. The thing is, if Democrats were in the least bit savvy, they could show that better health can be delivered at lower costs. So far, I haven’t seen that.

Unfortunately, in the world of Democratic politicians, an ounce of prevention means less government spending — anathema to them, even when less is more.

Update 1: Death Panels & Rationing & Bears! Oh My! Here is a very, very powerful series of views on how we could “cut” Medicare/aid while improving health. There are over a trillion (with a ‘T’) $$ in savings from very low-hanging medical fruit here. Easy fixes. No deathpanels required. Heck, no exercise, no diet change even! And none of it is new. I’ve heard some variation of virtually all of these solutions from several friends/family members who are involved in the medical system in one fashion or another over the course of decades. And still, our good liberal politicians resist good sense. That the troglodyte right blocks out the truth doesn’t even need to be stated. But when the people who claim to be smart liberals block out good information, we are in trouble…..From January 2008 to January 2011 they had it all….And squandered it.

 

The Sustainability Mirage: A NYT Update

Friday, March 19th, 2010

Back in January I had an article published entitled “Madison’s Sustainability Mirage,” thesis of which was, all the groovey-green gizmos in the world won’t make a hill-of-beans difference as long as we keep siting “green buildings” in car-mandatory places. Looks like the smart gate-keepers at the NYT just figured it out, too.

Paving As Disease Vector: Road Salt in Drinking Water –> Heart Disease

Friday, January 22nd, 2010

Our paving proclivities have many well-known deleterious effects on our environment (urban heat island, capping off aquifer recharge areas, energy intensive construction, car promotion, ugly places, etc). Direct health effects on humans can be somewhat difficult to establish (e.g., high correlation between chronic diseases and car-mandatory, over-paved places, but direct causal links sometimes too diffuse to nail down).

But one emerging health threat might end up being the biggest direct killer of them all:  Road salt in drinking water (You didn’t think the salt just magically disappeared come March, did you?). The New York Times just published an article about the mounting scientific & public health concerns about salt in our diets vis-a-vis hypertension.

And think about it: the more the city paves, the more it must de-ice. And that means more road salt forevermore.

And that salt does eventually make its way into our drinking water.

Though road salt was never mentioned in that NYT article as a possible culprit, hydrogeologists and water utility operators in the US and Canada have been alerting us to the rising levels of NaCl in our drinking water sources for some time. This 2001 article from Stormwater: The Journal for Surface Water Professionals surveyed studies from across the US and Canada about road de-icing practices and the resulting build up of NaCl in drinking water supplies. They came to this conclusion:

Applying road salt in deicing operations could create significant adverse health, environmental, and infrastructure problems. Equally troubling is the fact that New York State applies up to 298 tons of road salt/lane-mi./yr. in the unfiltered drinking-water—supply watersheds for more than 9 million citizens. This level of salt use jeopardizes the health of consumers having heart or kidney disease, destroys protective vegetation and soil, and corrodes automobiles, bridges, and other infrastructure.

Apparently Canada has even declared road salt a toxic substance for the very same reasons:

Based on the available data, it is considered that road salts that contain inorganic chloride salts with or without ferrocyanide salts are entering the environment in a quantity or concentration or under conditions that have or may have an immediate or long-term harmful effect on the environment or its biological diversity or that constitute or may constitute a danger to the environment on which life depends. Therefore, it is concluded that road salts that contain inorganic chloride salts with or without ferrocyanide salts are “toxic” as defined in Section 64 of the Canadian Environmental Protection Act, 1999 (CEPA 1999).

Wow. And according to that same Health Canada report, here’s how it happens:

Road salts enter the Canadian environment through their storage and use and through disposal of snow cleared from roadways. Road salts enter surface water, soil and groundwater after snowmelt and are dispersed through the air by splashing and spray from vehicles and as windborne powder. Chloride ions are conservative, moving with water without being retarded or lost. Accordingly, all chloride ions that enter the soil and groundwater can ultimately be expected to reach surface water; it may take from a few years to several decades or more for steady-state groundwater concentrations to be reached. Because of the widespread dispersal of road salts through the environment, environmental concerns can be associated with most environmental compartments.

So we won’t experience the full effect of Mayor Pave’s paving spree on our heart health for a few years, though we do know that salt concentrations in Wisconsin’s drinking water have been going up right along with increased salt applications.

The [US Geological Survey] study found the rising levels were consistent over the past two decades with more use of road salt and the expansion of road networks and parking lots that get deicing.

More paving = More salt.

More salt = Decreased heart health.

How many reasons do we need to scale back the paving?

Obama Purges a Defender of our Constitution

Friday, November 13th, 2009

Obama just canned the guy who, as reported in this NYT article,

“drafted executive orders banning torture and ordering the Guantánamo prison closed within a year. Over the objections of the Central Intelligence Agency, he recommended the release of Justice Department memorandums describing aggressive interrogations.”

He crossed the CIA, therefore, he must be purged.

Of course, we know this has been in the works for some time. The speculation was that he would be canned as Jesus H. Obama lurched ever rightward in expanding Herr Busch’s abusive, constitution-shredding policies.

I’m surprised that I’ve beaten Greenwald to the punch on this one, but I expect he’ll have a well-researched jeremiad on this by tonight.

Afghanist Nam

Monday, August 24th, 2009

Hey look, here’s another one! The really, really, smart people over at the NYT just figured out what I’ve been saying all along about President Jesus H. Obama’s War.

It is just amazing how the people of the poorest nations on earth have been able to beat the mightiest military forces ever assembled. Not once, not twice, but several times during my lifetime. There should be some courts martial for basic military incompetence. Then there should be some good ol’ fashioned show trials of the politicians who started & stoked these inane wars in the first place. I wonder when the tough guys will figure out that you can’t win wars–no matter how mighty the military–when you don’t have morality on your side.