What can you do?

Alan came back from a short fishing trip yesterday, which took him through western Michigan. Our many commenters who hail from that whiter, Dutchier, more pious part of the state can attest it has a lot in common with northeast Indiana — Fort Wayne with more blueberries, if you will.

Alan has a tolerance for commercial radio that I lack, so I rely on him to report on that front of the culture. He skipped around the dial, where every other talk station had a heavy Christian underlayment and a tone of barely muted hysteria and fury; the key phrase was “what can we do?” What can we do to stop them from bringing the terrorists to New York? What can we do to get Larry David arrested for pedophilia? (If you saw last week’s “Curb Your Enthusiasm,” you know what I’m talking about, although all of HBO came in for condemnation.) What can we do to stop the Communist/Marxist/Stalinist takeover of health care? And so on.

Someone was promoting this book: “Green Hell: How Environmentalists Plan to Control Your Life and What You Can Do to Stop Them.” Hank Stuever made some funny throwaway comments about subtitles the other day, in the context of praising a nonfiction narrative that was so good, it didn’t even need one. (It was “The Good Soldiers,” if you’re wondering, and if you ordered it through the Kickback Lounge, I’d be obliged.) Green Hell’s reminds me of those idiot meetings we used to have in my newspaper days, when our overlords would pound into our heads that it’s not enough to simply tell a story, we must cover that “and what you can do about it” angle or risk endangering their end-of-year bonuses. I wonder if smart people on the right took enough MassComm or semiotics classes in between their MBA work to understand the pitch underlying “and what you can do about it.” Because the answer is right there on the book’s cover, although not spelled out: Buy this book, for starters. Or watch my show. I used to think Blue America was angry in the last days of the Bush administration, but that anger is like a demon that simply found another host. And a mouthpiece, but we will speak no more of she-who-must-not-be-named today.

Except this: One of my Facebook friends says she-who is book-touring through the Fort today. I figured she’d be at one of the mall bookstores, or some other venue that could handle the crowds, and she is, sort of — she’ll be at Meijer. For you non-Midwesterners, Meijer is a regional Wal-Martish big box. I guess I knew they sold books there, but it’s not like it’s a big part of their product lineup. But they are indisputably Real America, and she-who’s not even going at the one I used to patronize, in the southwestern suburbs. She’s going to the north-side Meijer, even realer Real America. They may have a hitching post outside for Amish buggies; a lot of businesses up that way do. Photo op alert.

Ain’t gonna study culture war no more. At least not today.

In lieu of bloggage today, a question for the crowd: How are you coming down on the mammograms-at-50-not-40 question? I’m curious because I have long suspected what is being said out loud today, that for women without a family history or other high-risk genetic indicators, having yearly mammograms before 50 is like chicken soup for a cold — it won’t hurt, but it probably isn’t doing any good, either. However, I’m willing to accept that I could be wrong, and I’m wondering what the wisdom of the comment section might turn up. It strikes me as a perfect example of why health-care costs are so high — we all want the Cadillac, but at Yugo prices. So: Anyone?

Posted at 11:00 am in Current events |

90 responses to “What can you do?”

  1. Marlene said on November 19, 2009 at 11:11 am

    Pretty sure I wouldn’t be here today if I didn’t get a baseline mammogram at age 38 and then annually starting at age 40 – no family history or risk factors. I was diagnosed at age 44, treated for a year, and have been cancer-free for over 4 years now. I don’t think I can really say more than that.

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  2. Julie Robinson said on November 19, 2009 at 11:17 am

    Not just a hitching post, but a covered shed for the horses and buggies. And the Amish buy more junk food than anyone I know.

    No breast cancer in my family so I go a little longer than a year. The other shocking part of that study was that doctors aren’t supposed to talk about self exams anymore. I think that takes mine all of 15 seconds. I really don’t get it.

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  3. John said on November 19, 2009 at 11:24 am

    New metric for female objectification: Amount of time required to perform a BSE.

    Tip of the hat to Julie!

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  4. moe99 said on November 19, 2009 at 11:39 am

    My younger sister, who was 37 at the time, had her breast cancer detected via a mammogram. It saved her life. We have a paternal aunt who had breast cancer but that was not enough of an indicator, even in prior times. So, no, I am not on the bandwagon on this, even though the plural of anecdote is not data.

    And I actually wish that given the sharp increase in lung cancer rates, particularly those for women, that chest xrays, or better yet CAT scans would become part of a regular health plan. My chest xray in 2005 was clear. 4 years later, not so much. Off to round two of chemo today. 6 or 8 hours depending on how fast they get the solutions down.

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  5. Jeff Borden said on November 19, 2009 at 11:44 am

    What can you do? I recommend a large Scotch rocks. It works for many different maladies.

    Rightwingers are, of course, not alone in their love of vitriol. I despised George W. Bush and his ghastly administration. A Manchurian candidate could not have done as much deep damage in such a short period of time as this group. I hope the afterlife Mr. Bush and his crew talk about so frequently is real, because they certainly have escaped justice in this world.

    That said, I hated Bush for what he DID. Ginning up a war with Iraq, wiping his ass with the Constitution by abolishing habeas corpus and giving himself the power to declare anyone of his choosing an “enemy combatant,” withdrawing from the Geneva Conventions, sending off too few troops with too little effective equipment, politicizing the war for electoral gains, slashing taxes but increasing spending at a rate that would make a Democrat blush, etc.

    So much of the rage on the right today is unfocused. Yes, they hate Obama with a fierce passion, though most of these yahoos have a hard time saying exactly why aside from those vague terms of “socialism.” But they also hate many of their own. Fricking Lindsey Graham has been censured by one of the county GOP organizations in South Carolina for being too liberal. Republican Roy Blount in Missouri has been heckled and harassed at constituent meetings by the tea party crowd.

    As a liberal, I’m deeply disappointed in President Obama so far across a wide range of issues. I’m disappointed he did not throw himself into pushing for the best health care reform, that DADT is still the rule in the military, that Guantanamo remains open, that we are escalating a war in a nation that has never been brought under control by a foreign power, that too many Bush era policies have yet to be reversed. If I were a conservative, I would undoubtedly attack him for the deficits related to the stimulus package, the efforts at health care reform, the lack of a firm policy in Afghanistan. These are real arguments.

    But when I listen to a lot of these callers on our local yahoo radio, these are not arguments I hear. Instead, it’s all about how we are “losing” our country, or how we are marching toward socialism, or how Obama doesn’t really love America and, hey, by the way, you know he’s a Muslim and an appeaser.

    These arguments are not supported by facts. They are driven solely by anger, hatred and fear. Now, I fully expect dedicated capitalists to cash in on that feeling, whether it’s Fox News or Rush Limbaugh or any of the knuckle-draggers who periodically turn out silly books. What is genuinely sad, however, is the loving embrace the Republican leadership is giving this unfocused malice.

    Here in Illinois, where the Democratic Party scuttles around the shadows like a cockroach, I would seriously have considered casting a vote for a Republican senatorial candidate if someone spoke some sense. Instead, every single one of the GOPers seeking Obama’s old seat has pissed his pants over the idea of transferring Guantanamo prisoners to a maximum security prison in Thomson, Ill. Every single GOPer has engaged in the most shrill fear-mongering relating to health care reform. I cannot take any of them seriously.

    This, I guess, is what I am pondering. When will I ever be able to take the national Republican Party seriously again?

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  6. Kim said on November 19, 2009 at 11:50 am

    I can remember when doctors were very leery about giving any type of x-ray very often. If I recall correctly, it was because they thought they did damage. Now, you are blasted with them for everything, sometimes more than once. I try not to be paranoid, but except for biannual dental x-rays- I steer clear.

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  7. Peter said on November 19, 2009 at 11:54 am

    On a professional note; Moe, could you let me know what you like and don’t like about your chemo facility? I’m doing one now, and the hospital and I have different opinions on what helps people pass the time – they want one large screen TV and fake windows – I’m thinking more of individual flat screens and headsets and lower ambient light.

    Sorry Nance, I still have room to vent about our Alaskan Friend – the NYT has an article today on the fashion consultant who was brought in to help you know who, and I think the article does a pretty good job of describing what had to be done and why it came out $$$. There are two items in the article that made me wonder, however:

    1. The kids were told that we’re taking a trip to Ohio to celebrate the ‘rents wedding anniversary. C’mon, who takes a romantic trip to OHIO? Can’t imagine many folks in the Last Frontier salivating about going to Dayton.

    2. A lot of the $$$ was spent on dressing the rest of the family – they didn’t bring anything to the convention. I don’t want to go class warfare on this one, but I think your typical American would relate that your typical Alaskan doesn’t have a lot of evening wear in the closet, so they could have gone on stage as is or had a story about buying suits and dresses for the big photo op and I don’t think anyone would have had a problem with that. Just sounds like it was mishandled all the way around.

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  8. Jen said on November 19, 2009 at 12:14 pm

    I’m all for breast cancer screening! My mom was diagnosed with breast cancer at age 39, and it had already spread to her lymph nodes. She had NO family history (that she knew of – her mother was adopted so we have no idea what’s lurking in her genetics). However, it seems to have a genetic component – her sister was diagnosed a couple years later.

    However, they didn’t find mom’s cancer on the mammogram – it was through a breast self-exam, which the task force also said isn’t important to do. My mom would beg to differ, I’d think – I’m pretty sure she’d be dead if she waited for those guidelines. I know that’s all anecdotal, but from what I could tell the task force’s recommendations were all statistical, saying that even though some lives will be saved, not enough lives will be saved to justify the cost. From a statistical standpoint it does make sense, but I’m sure that the people who have been saved by earlier screening think that it was worth the cost. When you bring people into the equation instead of just numbers, I think that the whole situation changes.

    I did an article about local/regional reactions by doctors, and they’re all pretty confused about the new recommendations, especially the one saying that breast self-exams and clinical breast exams are worthless. Yeah, they’re not the best way to find breast cancer, but they can help and they don’t cost anything.

    Personally, I’d like groups to invest more into finding better screening and prevention methods. I’ve heard promising things about breast ultrasounds for detection, especially in younger women, and giving Tamoxifen to women with a heightened risk of breast cancer to reduce the chance of getting cancer, so with my family history I’m hoping that they keep working on that!

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  9. Julie Robinson said on November 19, 2009 at 12:15 pm

    Um, I meant that’s how long it takes my doctor to ask me if I do BSEs. Fifteen seconds would not be an adequate time.

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  10. moe99 said on November 19, 2009 at 12:23 pm

    Peter, I second your suggestions. I’m in a room to myself with either a view of the sound to the west or the cascades to the east on non cloudy days. I value privacy and that should be the highest goal, so yes to flat screens w headsets and ambient lighting. Fold out walls in rooms w more than one patient would be nice as well as private attached bathrooms.

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  11. mark said on November 19, 2009 at 12:24 pm

    To those of you with breasts that require examination, good luck and good health. My fear for you is that the new guideline is the first faint handwriting on the government health care wall. The reasons given for the recommendation were about saving money, which requires weighing lives in dollars.

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  12. Connie said on November 19, 2009 at 12:34 pm

    Yes for annual mammograms. My mother died of stage 4 breast cancer at the age of 57, 8 years after her mastectomy. I am several years past the age at which she had her initial diagnosis.

    I worry more about cerebral aneurysms. My mother survived one, her two sisters each died of one 20 years apart. Every dr to whom I have spoken says cerebral aneurysms are not genetic. Then how do you explain this?

    Had a fire drill break between the first and second paras. Ah, the joys of working in a large public building. I have just been informed it was due an over microwaved lunch setting off the smoke alarms.

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  13. Jolene said on November 19, 2009 at 12:35 pm

    The flap over the mammography issue has been making me crazy (OK, crazier) because it seems to illustrate how poorly we deal w/ data and the normal process of collecting research evidence, analyzing it, and making adjustments in policy on the basis of an imperfect but improving-over-time database.

    As I understand it, we are conducting nearly 2,000 mammograms in under-50 healthy woman for every case of breast cancer that is detected. In terms of aggregate health care costs, that strikes me as a poor use of resources.

    As Moe points out, lives have been saved due to early detection of cancer in younger women, and, of course, our own lives and the lives of those we love are most important to us. But, according to an Institute of Medicine study published in 2000, nearly 100,000 people die in U.S. hospitals each year due to preventable medical errors. Ten years later, the lessons of that report are not yet fully incorporated into the practice of medicine. Note that this does not have to do w/ access to care; it has to do w/ the quality of care provided in our health care system. Restricted access leads to even more deaths–45,000/year according to a study by Harvard researchers published just a couple of months ago.

    It’s hard for me to believe that addressing these problems shouldn’t be a higher priority than providing expensive testing that is likely to produce little in the way of public health benefit. I know that sounds harsh (and I’m thinking, especially, about you, Moe), but it seems to me a valid point of view.

    Kathleen Sebelius, in my view, really stepped in it yesterday when she said that the government wasn’t advocating changes in practice and that women should discuss their options w/ their doctors and do whatever seemed best to them.

    If we are ever going to have a better, more cost-effective health care system, it’ll be because we have looked at lots and lots of data to find out what works best for whom. Acting as if that isn’t so and as if there are no questions about priorities doesn’t help anyone. Sebelius had obviously been getting beaten up about the new consensus panel recommendations, and, rather than explaining what the results meant and how they might be intelligently used to inform practice, she whiffed. A big disappointment.

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  14. nancy said on November 19, 2009 at 12:36 pm

    I’m with Peter on the chemo rooms. One big screen tends to be tuned to the Ellen DeGeneres show or CNN Headline News, and if there’s any experience that would call for Fred Astaire movies, it’s chemotherapy.

    Mark, I’m making a raspberry at you. Do you think insurance companies don’t weigh lives in dollars? Please.

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  15. Sue said on November 19, 2009 at 12:36 pm

    mark, no concern trolling on this issue, please. Especially when, rightthisverymoment, insurance companies are putting up roadblocks at least as big as this one in the form of coverage denials, rescissions and past history excavations, without even needing a silly report to hide behind.
    Oh, and everyone can get breast cancer, and die from it too. So, everyone, on the count of three… check yourself out.

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  16. nancy said on November 19, 2009 at 12:38 pm

    Only in the Midwest is lunch eaten at 11:30 a.m. (When I went to work at 5 a.m., I routinely lunched at 10.)

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  17. 4dbirds said on November 19, 2009 at 12:39 pm

    Carrying over from yesterday, I’m sending positive thoughts for your results Jeff TMMO. You state “i love mod­ern med­i­cine”. I do too. My daughter would be dead without it. She’s survived a rare form of leukemia AND getting hit by a car.

    My opinion on the guidelines for cancer screenings are somewhat mixed. I work on a huge cancer screening study and some of the things we’re finding is that, screening doesn’t really reduce mortality. The devil is in the details and the results are different with different cancers. Colon cancer screening is highly effective because they take out those pesky polyps while they’re at it. Prostate screening is not so effective. I think Orac has an excellent post up about screening. He’s an oncologist who specializes in breast cancer.


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  18. LAMary said on November 19, 2009 at 12:41 pm

    Jezebel gave this link to a breast cancer awareness video that one of our sister hospitals produced.


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  19. LAMary said on November 19, 2009 at 12:55 pm

    “Only in the Mid­west is lunch eaten at 11:30 a.m. (When I went to work at 5 a.m., I rou­tinely lunched at 10.)”

    The cafeteria here at the hospital starts serving lunch at 10 and it’s pretty crowded then. We have people on all sorts on shifts.
    When I first moved to Los Angeles, I was struck by a sign on a restaurant at the beach near Pacific Palisades. It read, “Serving Breakfast 9-1.” Not brunch. Weekday breakfast. At the beach. Nice work if you can get it.

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  20. Jolene said on November 19, 2009 at 12:59 pm

    She had NO fam­ily his­tory (that she knew of — her mother was adopted so we have no idea what’s lurk­ing in her genet­ics). How­ever, it seems to have a genetic com­po­nent — her sis­ter was diag­nosed a cou­ple years later.

    I’m glad your mother’s cancer was detected, Jen, but the “no genetic history” doesn’t really apply in her case. In fact, her sister’s cancer suggests that genetic factors may have been involved. Perhaps recognizing that she didn’t know her genetic history would be enough of a motivation to pursue testing, but as a basis for public policy, such exceptions should be treated as just that–exceptions. The number of women who don’t know who their mothers are is vanishingly small, certainly too small to be consequential in making health policy–whether such policies are made by public authorities or private insurers.

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  21. 4dbirds said on November 19, 2009 at 12:59 pm

    “Only in the Mid­west is lunch eaten at 11:30 a.m. That’s standard lunch time in the army also.

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  22. Ellen said on November 19, 2009 at 1:00 pm

    She (SP) will be at a Border’s in Noblesville, so don’t know about drawing any socio-economic conclusions about appearing at Meiers.

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  23. Jeff Borden said on November 19, 2009 at 1:00 pm

    It’s not just the huge health care companies getting a sloppy French kiss from the GOP. Efforts to rein in those ludicrous and incomprehensible credit card interest rates also are being blocked by the Party of No.

    I will repeat my earlier question: When will I be able to take the Republican Party seriously? These people belong with Ringling Bros. Barnum & Bailey. I fully expect to see them in floppy clown shoes and red nose wielding a bottle of seltzer.

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  24. Jolene said on November 19, 2009 at 1:25 pm

    Thanks for the link, 4dbirds. Very thorough and clear explanation of the new recommendations. Very much worth the time to read all the way through. Am going to pass it around.

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  25. basset said on November 19, 2009 at 1:29 pm

    I was over in West Michigan this weekend myself, didn’t hear any local radio but some of the conversation at an outdoor store in Baldwin was quite enough, thanks.

    got my buck seven minutes into legal shooting time on opening day… just a spike but he’s going to be good eatin’ and the season back home in Tennessee opens this Saturday.

    went into the Meijer’s in Big Rapids Sunday night and the greeter asked us “Did ya get one?,” which seemed to be the standard line for anyone wearing orange or camo.

    for those not in Michigan… the first day of deer season is a huge cultural event, about 750-thousand hunters bought licenses this year and going to “camp” is a widespread manly ritual. the down side is that it attracts way too many hunters who just go to party and shoot at whatever moves… when I worked in Cadillac we had an office pool every year on how many hunters would get killed, usually it was mostly shootings with a few heart attacks and treestand falls thrown in.

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  26. coozledad said on November 19, 2009 at 1:46 pm

    basset: Somebody keeps putting tree stands up on our place, and I keep pulling them down. Pretty soon, I’m going to have to rent storage for them. Down here, it seems to be the dog hunting that results in more fatalities.

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  27. Jeff Borden said on November 19, 2009 at 1:59 pm

    The experience is similar in Wisconsin. In fact, the first day of deer season is usually a school holiday. If they don’t declare it, they will simply have a lot of empty desks.

    Culling the herds of deer ought to be a priority. While lovely to look at, they are incredibly destructive and are breeding wildly out of control because there are so few predators. I’ve been advocating large-scale deer hunts with the provision that the meat be donated to food pantries, etc.

    My dad was startled out of his skin a few years ago when he walked into the attached garage and startled a buck munching on a bag of birdseed under dad’s work bench. The deer was so spooked he pulled the work bench out of the wall with his antlers and deposited it on the hood of mom’s Taurus as he was bolting. This, by the way, is a typical suburban neighborhood 30 miles south of Cleveland.

    Rather than let these poor creatures starve, or let them kill dozens of people by running into highway traffic, isn’t it better to harvest them with a clean shot?

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  28. Jeff (the mild-mannered one) said on November 19, 2009 at 2:02 pm

    Norman Cousins made a very strong case for Marx Brothers movies in chemo treatment, ideally “Duck Soup” (this was before Woody Allen made that film a panacea for ethical maladies). Can’t think of the book title, but it was the story of how he believed he — along with modern medicine — laughed his cancer into remission. But i like the Fred Astaire idea.

    Peter, i can think of few romantic getaways better than “Beautiful Ohio.” Why, we have everything from the Cuyahoga River to the, uh, Mad River. And much, much more, all in a family budget. You could stay in a hotel, or even a motel, and we have restaurants that serve breakfast, lunch, and dinner . . . even restaurants that let you order breakfast *any time of day*.

    Now how much more romantic can you get than that? Oh, and we have way too many hot tubs for one of the most obese states in the Union. There ya go.

    Update — “Anatomy of an Illness, As Perceived By the Patient” was the book title. That is all.

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  29. brian stouder said on November 19, 2009 at 2:07 pm

    Say – in addition to the governor, we have Andrea Mitchell ‘live from Fort Wayne’ right now.

    And as a bonus – Andrea asked a newsworthy question of the governor here in Fort Wayne (regarding her reaction to Senator McCain’s strong defense of his staffer, against what the governor said about her) – and the governor went into full Tina Fey mode – almost literally ducking away from Andrea, while enunciating a vacuous non-answer

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  30. Laura said on November 19, 2009 at 2:15 pm

    I had breast cancer at 45. More than a few of my friends and neighbors also had breast cancer in their 30s and 40s. If I know so many young breast cancer survivors in my little sphere, I’m fairly certain anecdotal evidence (largely dismissed by the study) holds real weight. True, most women won’t get cancer; but some will. Do we really want to shorten any lives?

    Btw, when I was going through chemo, my husband brought in movies for us to watch. I can’t remember most titles, but I do remember watching “Hustle and Flow.” Not exactly “Beaches” material.

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  31. mark said on November 19, 2009 at 2:16 pm

    Sorry to draw a rasperberry. Insurance companies do weigh lives in dollars, but not as often and not in the same way that government will. Insurance companies mainly weigh actuarial predictions of use or care that will be provided against value of premiums charged. They don’t particularly care about outcomes other than expense. Dying on the table saves them the expense of post-op care and rehab, etc.

    Their premiums are not a limited resource with which they attempt to achieve maximum wellness, which is what I think government will (and some would say should) do. Depending upon how limited the resources,choices will be made about, for example, less breast cancer screening to allow money for more diabetes testing. And yes, we will examine how much we will spend to keep the very old and very sick very old and very sick a little bit longer, and the comparable societal wellness that could be achieved by allocating the money elsewhere.

    Insurance companies ration care but, with a couple of exceptions, they tell you about it up front and it is a part of what you (or your employer decides to purchase. Annual and lifetime limits, pre-existing illness exclusions and area of treatment exclusions are the big three. After that “medical necessity” and “experimental” are the rationing or limiting issues that patients may encounter and fee schedules or reasonable and customary charges limit the docs.

    Do you really think that government won’t do the same, but with the additional criteria of comparative benefit and political pressure? The political pressure issue will work out well for mammograms, even if, as Jolene suggests, the science may not suport the preference. Breasts are sacred.

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  32. Jolene said on November 19, 2009 at 2:21 pm

    Jeff, you might be interested in this WaPo feature article re the overpopulation of deer in the DC metro area. It’s a big problem here, the most recent evidence of which was the deer that, literally, wandered in the lion’s den at the National Zoo. It’s a good article w/ lots of discussion re the origins and scale of the problem, and efforts by wildlife efforts to address it. There was a follow-up web chat w/ Liza Mundy, who wrote the article, and a Dept. of Agriculture wildlife guy.

    And, bringing together the excessive number of deer in so many areas and what happens when clueless people start firing at them is this sad story.

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  33. Sue said on November 19, 2009 at 2:23 pm

    Jeff Borden, the Dems do not get a pass on the credit card b.s. They are just less open about the fact that they have been purchased by the credit card lobbyists.
    Christopher Dodd postures and brags and still manages to make the least progress possible, because he has interests besides consumers to represent and he doesn’t want us to know that. He ought to be ashamed of himself.
    At least the Republicans are clear about who they’re representing.

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  34. Jeff (the mild-mannered one) said on November 19, 2009 at 2:26 pm

    Jolene – thanks. May i commend again “Beyond Fair Chase,” a short booklet/long essay that is findable online, for anyone dealing with hunters and hunting issues. The moron in the last link obviously did not have clear identification of his target, and could not have been making an ethical shot in any case, deer or not.

    Saw a beautiful 14 pointer on the bike path behind my house last night. Made me think of the bottle of Jagermeister in the freezer . . . but never got to it. Maybe tonight!

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  35. nancy said on November 19, 2009 at 2:35 pm

    There’s something so delightfully absurd about a room full of people hooked up to chemo infusers watching “It’s Hard Out Here For a Pimp” that I think it belongs in a movie somewhere.

    The problem with deer is, they’re territorial. Yes, they’re very destructive and, as Jeff’s anecdote illustrates, can dump a toolbench on your mom’s car. But you can’t allow deer hunts in populated areas for obvious reasons, and those roundups various entities try from time to time always turn into a comedy of errors. If only we could persuade them all to move to the country in September — problem? Solved!

    Whenever I hear people talk about donating game to food pantries, I think about the food-pantry patrons I’ve known, who are lucky to have the simplest knowledge of cooking and even the most basic equipment. I imagine many of them would feed venison to their dogs.

    Basset, do you hang your deer before you dress it out? I’ve been told time and again that’s the difference between venison to swoon over and the freezer-burned cuts I’ve had foisted upon me in the past. When we visited the Up North farm of our fellowship director in Ann Arbor, his unheated breezeway had several ducks hanging from the rafters, gutted but otherwise still wearing their heads, feet and feathers. He made a mean duck breast, so I take his word for it.

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  36. Linda said on November 19, 2009 at 2:44 pm

    Mark, this is not the first shot in the Obamacare health war. It is much like the recommendation that the National Cancer Institute gave in 2008 re: prostate cancer exams. Some medical professionals and researchers fear that the threat of false positives and overtreatment can do more harm than good.

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  37. Laura said on November 19, 2009 at 2:54 pm

    When my husband had a heart attack last April, we watched “The Assassination of Jesse James by the Coward Robert Ford” while he was in the hospital. We always go for the light-hearted stuff.

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  38. Jen said on November 19, 2009 at 2:59 pm

    The thing is, Jolene, my grandmother is 79 and has never had breast cancer, but both of her daughters had it, and got it at the same age, in their late-30s. Regardless of what the experts say, I’m so incredibly thankful that they both were diligent and caught it early enough that they’re both still alive and kickin’ today. And, of course, with our terrible family history, they’ll be checking my sister and me for breast cancer like crazy. However, I worry about the women like my mom and aunt, who don’t have the advantage of a family history of breast cancer to tip them off that they need to watch out for it.

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  39. Jeff Borden said on November 19, 2009 at 3:06 pm


    I agree with your point, but even Chris Dodd, D-Banking Industry, is arguing against these ludicrous and unsupportable interest rates. It’s awfully late for Dodd, but at least he is speaking up now.

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  40. coozledad said on November 19, 2009 at 3:06 pm

    Nancy: There’s a passage in John Lanchester’s The Debt to Pleasure where someone tells the protagonist that for fowl, you permit them to hang until the first maggot hits the floor.
    I never ate any decent venison, either, but the chefs who prepared it were all from the school of preemptive parasite cookery.

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  41. Jolene said on November 19, 2009 at 3:24 pm

    Regard­less of what the experts say, I’m so incred­i­bly thank­ful that they both were dili­gent and caught it early enough that they’re both still alive and kickin’ today. And, of course, with our ter­ri­ble fam­ily his­tory, they’ll be check­ing my sis­ter and me for breast can­cer like crazy.

    Yes, with your family’s history, you should certainly be checked early and someone like your mother and aunt, whose history is unknown, should also be tested. But, again, there are very few such women. I think it’s safe to say that if every single woman who was adopted as a girl (and hence had no way of knowing her mother’s medical history) was given a mammogram every year between the ages of 40 and 49, the effect on cancer detection and survival rates would be practically non-existent. Such instances are, in population terms, very rare.

    I don’t want to sound cruel by emphasizing statistical arguments, but, really, we can never fix the things that need fixing in this world if we don’t look at the data as objectively as we can. Far, far more people would be saved from premature deaths due to cancer and other smoking-related illnesses if we banned cigarette smoking than by the most rigorous mammographic screening program imaginable.

    There’s a ton of psychological research showing how poorly we mortals are at processing statistical information compared to the vivid experiences we all have, but the fact that are brains work so badly in this regard is all the more reason to try to understand the available data as thoroughly as possible and to assess its meaning as dispassionately as possible.

    4dbird’s source, by the way, has a new post analyzing the responses to the new guidelines. As with the other one, very much worth reading.

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  42. Rana said on November 19, 2009 at 3:28 pm

    On the topic of mammograms – my personal opinion, as a 39-year old who had her first “baseline” one this year, and whose mother had a lump, and whose grandmother had a double mastectomy for unknown reasons (she wasn’t one to talk about her health), is that I’m glad that my doctor recommended it. Now, since the result was clear, I feel that having one taken every year would be unnecessary – but every five? Definitely.

    My problem with the way this debate – like so many – is framed, is that it’s so either-or. Either we fund yearly mammograms starting in the 30s, or we only fund mammograms for high-risk women who are in their 50s or older? Surely there’s some middle ground in here.

    And that’s one thing that I really get teed about when it comes to payment protocols set by insurance companies – people are not identical cogs, even when you screen out pre-existing conditions (however that’s defined). I’m a patient who takes Crestor and Allegra – and those work perfectly for me in a way that other alternatives, such as Lipitor and Claritin do not. And the reverse is true. In those ways I am expensive. But in others, like diabetes, I’m a zero on the balance sheet. Yet the protocols don’t work that way. They work entirely in terms of averages, but instead of averaging costs they average people. And the result, frequently, is that people who would benefit from a given treatment are denied it, because they fall outside the statistical average.

    Take the cervical cancer vaccine – what it’s good for is for people who have not yet been exposed to those viruses. This group includes men as well as women, and it includes both pre-pubescent children and adults in their 60s. But, because of the way that insurance companies average things, the only people who are in the “recommended” group – and therefore, the only ones who get covered – are women in the 14-26 age range. This makes no sense – a woman who has slept with many partners at age 23 is covered for this vaccine, though it would do her no good, while a 27-year old virgin is out of luck, though she would benefit from it.

    Bottom line: I don’t trust insurance companies to balance costs by creating average patient protocols. Better would be to create incentives (such as paying doctors salaries instead of by-service fees) for doctors to work with patients to create customized treatment regimens that save costs across the life of the particular patient.


    On Green Hell – I’d be interested to see what impositions they’re railing against. Somehow I suspect that they’re aiming at the Hummer crowd – whom I’ve always found a little weird. How on earth owning a poorly made gas guzzler that puts you in hock to the oil companies and their partners in the Middle East came to be seen as a symbol for red-blooded American freedom has always puzzled me.

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  43. Jolene said on November 19, 2009 at 3:37 pm

    My prob­lem with the way this debate — like so many — is framed, is that it’s so either-or. Either we fund yearly mam­mo­grams start­ing in the 30s, or we only fund mam­mo­grams for high-risk women who are in their 50s or older? Surely there’s some mid­dle ground in here.

    But that’s not at all what the revised recommendations say. They say that for asymptomatic women under 50 with no other risk factors, annual mammography provides no benefit, that for women between 50 and 75 a mammogram every two years does provide benefit, and for women over 75, the data are unclear. So it’s far from an either/or situation.

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  44. Jenflex said on November 19, 2009 at 3:43 pm

    Mark: what do you mean insurance companies’ premiums are not a “lim­ited resource with which they attempt to achieve max­i­mum well­ness”? They sure as hell do try to achieve maximum wellness…to their bottom lines.

    Seriously, there is no profit in keeping people alive, and healthy, just as there is no profit in maintaining parks, or investing in education (at least, in the short-term).

    These are just some of the things many of us believe are worth having, as citizens. And where no other private systems are capable of protecting, cultivating, or ensuring these things, it is our job as citizens to adapt our government (by, of, for, etc., etc., etc.) to achieve these ends. What other way is there?

    I don’t think anyone is arguing that government will do a perfect job, but you can’t convince me that the private sector is doing a great job either…and its shortcomings are just as transparent as government’s.

    A little more about health care, and rationing rationally, that I found interesting:

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  45. Jeff Borden said on November 19, 2009 at 3:44 pm


    And in a marvelous twist of schadenfreude, the Chinese now own Hummer. I recall one Hummer dealer in the months after 9/11 crowing that driving one those big guzzlers was like “driving the American flag.” Not any more.

    Personally, I have no beef with big vehicles. I’m 58. I grew up with massive automobiles. But if I’m going to drive a guzzler, I would prefer it be a sleek, low-slung, sexy piece of high performance machinery rather than a tackle box on wheels.

    I guess the Hummer is more macho. One of our friends has been known to yell at Hummer drivers, “Your dick is still small.” This is not a course of action I would recommend, given the crushing power of the H-1, but so far, she has yet to be rolled over.

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  46. Lex said on November 19, 2009 at 3:46 pm

    I delved a bit into this issue (mammograms) when I covered medicine a couple of years ago, and absolute clarity was absolutely not to be found.

    I suspect that in years to come genetic markers will become much more important in prioritizing and scheduling testing, but we ain’t there yet, and that’s just my layman’s guess anyway.

    The first girl I ever fell in love with is having surgery on the 25th for ductile carcinoma in situ, so y’all say a prayer. I won’t mention her age, but let’s just say that despite a lack of family history, it’s a good thing she didn’t put her first mammogram off ’til 50.

    And in the big picture, I’m with Jolene: Let’s go after the big problems first, particularly when we know what they are and know what we can do and know that a lot of what we can do yields a big bang for the buck.

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  47. Jenflex said on November 19, 2009 at 3:53 pm

    OK, Mark, now I’m just foaming at the mouth. Sorry. But, how many in the nn.c crowd actually have a choice about health care? As in, can make informed, rational decisions, and trade-offs, about what coverage they do and don’t want? For my part, I just feel grateful that I still trust my company’s health care enough not to be terrified of all the small print…and the only evidence I have shoring up that trust is the experience of a 7-day hospital stay, including 3 in ICU, which didn’t bankrupt me.

    But what choice do I have if that weren’t the case? My husband isn’t working right now, so I sure-god guarantee you if my insurance sucks, we’d still have it, or I’d be looking for whatever policy made sense by the only metric that hits home regularly…and that’s the premium cost. These are not conditions that predispose people to act rationally in their own best interests. There’s not a private-sector, profit-motivated company in existence that could resist that opportunity, and there’s never yet been a legislator smart enough to regulate away the creativity those entities can muster, when the profit incentive is there.

    Sorry for the rant. This touched a big nerve.

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  48. Dorothy said on November 19, 2009 at 3:59 pm

    When I had my first miscarriage in 1981, and just got home from the hospital, I just wanted to lay on the couch and get lost in something to keep my mind occupied on something besides the baby I wasn’t going to have. Coincidentally a movie on that day was an early Stephen Spielberg made-for-television one called “Duel.” That did the trick! Nowadays if I come across it and leave it on, I’m immediately transported back to that day, and I think of the grilled cheese sandwich and bowl of soup my hubby made for me, and the soft head of my cocker spaniel as she snuggled next to me on the couch.

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  49. Jenflex said on November 19, 2009 at 4:01 pm

    Dorothy, thanks for the visual. I feel human again. Dogs are the best when you’re not feeling well.

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  50. Jolene said on November 19, 2009 at 4:21 pm

    Forgive me for using up so many electrons today, but the issue of medical decision-making is one that really gets me going. And it’s an issue that I actually know something about; my own health history, my professional training and experience, and simple interest in the topic have kept me in touch w/ research in this area over a fairly long period. No one would ask me to testify before Congress (or anyone else) on this topic, but if I were asked to arrange Congressional testimony, I would know which experts to call on a number of topics.

    In all the noise about health care over the past few months, we’ve heard over and over that the benighted plans being developed by Democrats in Congress and the Obama administration would “put bureaucrats between doctors and their patients”. I exaggerate only slightly when I say, “We should be so lucky.”

    One of the most well-documented facts in the study of the delivery of health services is that prevailing medical practices vary widely across geographical areas and health care settings in ways that cannot be linked in any reasonable way to variations in patient populations. Rates of hysterectomies, tonsillectomies, and coronary bypass operations are just a few of the procedures for which frequencies vary inexplicably. The frequency with which MRIs are carried out is more closely related to whether the facility is physician-owned than to any detectable difference in need.

    Only a few doctors get any serious training in statistics and research methods, but most manage to acquire a lot of confidence in their judgment nonetheless. I don’t want to be doctor-bashing. Becoming a doctor is hard, and I have no doubt that most doctors strive mightily to do the best for their patients. But, like the rest of us, they are overly influenced by what is in front of their noses, as opposed to broad patterns of data that are genuinely informative. They do what they know how to do and what their nearest colleagues recommend. Only a few have the time, motivation, and expertise to really assess the relative effectiveness of treatments. That’s one reason the pharmaceutical industry and the medical device manufacturing industry have so much influence.

    There is no way to get around these problems w/o adopting standards of some sort for the practice of medicine, and more and more organizations are beginning to recognize this.

    I’m not providing a lot of sources here, but I’d be glad to if anyone is interested. There are, though, two recent pieces in the popular literature that talk about the problem of variations in care that are not medically justifiable and about efforts to make medical decision-making more systematic in clear and valuable ways. If you are interested, check out:

    The Cost Conundrum: What a Texas Town Can Teach us about Health Care, by Atul Gawande in The New Yorker

    Making Health Care Better, by David Leonhardt in The New York Times

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  51. Christy S. said on November 19, 2009 at 4:36 pm

    OK, I know I should be deeper than this considering we’re talking life and death here — but Julie: is it true the Amish buy a lot of junk food?

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  52. 4dbirds said on November 19, 2009 at 4:37 pm

    Jenflex, from comment conversations with Mark, I don’t think he gives one big rat’s rear about real human situations. In his view people should be responsible and have the money in the bank for medical emergencies. He carries a high deductable insurance policy, something he’s extremely proud of but I think if he really had to use it, he’d find it’s crappy and won’t cover all that he thinks it will. After my daughter’s cancer treatment and accident treatment, I’ve learned a thing or two about insurance and how they find every reason not to cover things you think are covered.

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  53. mark said on November 19, 2009 at 4:51 pm


    I think I was agreeing with you about insurance companies. They care about a profit and about health only tangentially and to the extent it impacts profit. That’s what they do. You can hate that if you want, but I don’t hate my dog because he isn’t a cat.

    I suspect lots of people here have choices about their health care. Not necessarily easy choices but buying a home isn’t easy or cheap either. Some don’t. As I have said many times, I’m all for helping those who don’t have choices, need help and want help. You all could have that kind of a program any time you want. But you want control over the 70% or so who are happy and don’t need help as well.

    Nancy set up the issue well, I think: “We all want the Cadillac, but at Yugo prices.” The reality is that we can’t afford to give everybody a cadillac and those who have anything else don’t want a Yugo. So were going to give everybody a Ford Escort and try to convince them it’s as good as a Cadillac.

    Jolene makes a lot of good points about the direction things have to go. I want the market (meaming individuals, doctors and payors making millions of separate, case-specific decisions), not the government, running that process. The government has total control/responsibility over health care on Indian reservations. Take a look at how that is working out.

    While I still think major reform will not get out of Congress, if it does, I’ll drop the catastrophic coverage that I like, chose, can afford and fits my needs, and pay the small fine for being uninsured. If I get something bad, I’ll sign up, since pre-existing illness exclusions are evil and will be banished.

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  54. Jeff (the mild-mannered one) said on November 19, 2009 at 4:54 pm

    Just read Brian’s very kind comment re: Neuhaus from yesterday, and thank you. Now to ruin that persona . . . as for Health Care Policy/Insurance, i think this all comes down to three problems: insurance companies are idiots (just got word of another denial in the mail TO-day, howdy back atcha, Aetna, may you fall in your namesake), politicians are idiots, and most people when it comes to their own preventive care and maintenance are idiots.

    And you really can’t change those three facts, much. So the challenge is to pass a system of coverage that takes those three realities into account, and allows medical care to take place without writing a blank check for every researcher with a theory to turn their protocols into a new civil right. Reid’s plan doesn’t work for me because my read is that after 10 years you’d have more people without coverage than you have right now. The only vigorous counter-argument to that assertion, which has it’s own cruel logic, is that if we stay with the status quo, we’ll have twice as many uninsured as that by 2020.

    Look at the French national program of health care delivery, he said again.

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  55. Jenflex said on November 19, 2009 at 4:55 pm


    I don’t want control over 70% of people if they are happy for rational reasons. What I’m saying is that in most cases, “happy and don’t need help” just stands for “blissfully ignorant and, so far at least, lucky.”

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  56. beb said on November 19, 2009 at 4:59 pm

    I’m late to the party wishing moe the best on this stressful day. Maybe a portable DVD player with headphones would help over a communal TV.

    Something to think about. The Three Stooges: funny, not funny? I’ve heard that men mostly love the Stooges, which is strange because I’m not that into them but my wife and daughter just love them. I’m more of a Marx Brothers fan. I like the cerebral stuff in their comedy.

    As for Mammagrams, I’ll leave that to my wife to discuss because her previous experiences have been so dismal that she can’t bring herself to take another one. The problem, as I see it, is that we need a better way to screen for breast cancer, something that doesn’t involve as much pain and is better at eliminating false positives (my wife’s problem). Something like a blood test, or even a trained sniffing dog.

    Modern day x-rays, I think, use much smaller doses of radiation so more frequency exposures isn’t as much of an issue as before.

    Apparently “going rogue” can also mean going without underwear. I’d heard that called ‘going commando.’ Sadly, while being a maverick can be a good thing, going rogue really has no upside. There’s no definition of rogue that isn’t damning.

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  57. del said on November 19, 2009 at 5:12 pm

    I heard this quote on the radio from a Max Blumenthal editorial about she-who-must-not-be-named, and it reminded me of somebody in nn.c-land.

    The reason for her popularity is questioned, with this explanation:

    “The answer lies beyond the realm of polls and punditry in the political psychology of the movement that animates and, to a great degree, controls, the Republican grassroots — a uniquely evangelical subculture defined by the personal crises of its believers and their perceived persecution at the hands of cosmopolitan elites.

    By emphasizing her own crises and her victimization by the “liberal media,” Palin has established an invisible, indissoluble bond with adherents of that subculture — so visceral it transcends any rational political analysis. As a result, her career has become a vehicle through which the right-wing evangelical movement feels it can express its deepest identity in opposition both to secular society and to its representatives in the Obama White House.”

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  58. mark said on November 19, 2009 at 5:16 pm


    How comforting to know that you only want control over the people who make choices different from the ones you make for yourself.

    If you give government that kind of power over it’s citizens, you will be in constant peril from leaders who don’t share your preferences and priorities.

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  59. Sue said on November 19, 2009 at 5:26 pm

    “Breasts are sacred”?
    Did you have to go there?
    Are you being sarcastic, or revealing perhaps more than you intended regarding your attitude toward women, or making a joke that I missed completely?
    Considering that a whole lot of the male-dominated bunch currently deciding the fate of health care coverage in the US do not consider coverage for abortion or pregnancy important enough to include – at least not without a whole lot of yelling, as it stands right now – the idea that women have some magical sway over the issue by virtue of their boobs is laughable.
    Your last statement about being in constant peril goes directly against your previous point. Either we are going to get mammograms because dammit these are our boobs and we will stamp our feet really hard if we don’t get what we want! or we won’t get basic services because someone else is defining what a basic service is.

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  60. mark said on November 19, 2009 at 5:37 pm


    I was trying to be somewhat funny and failed. Breast cancer is a horrible disease for many reasons that you don’t need to hear from me. The fact that we research it and take preventative measures that may be disproportionate to a statistical analysis of risk is not irrational and certainly doesn’t bother me.

    The second point went to a larger issue, which is the right to control the personal choices of others. I think people have the right to control their own lives, including health care decisions.

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  61. Rana said on November 19, 2009 at 5:46 pm

    mark, I’m rather puzzled about how you got from jenflex’s initial point that most people lack the information and training needed to make medical and financial decisions at crisis points, and would therefore benefit from someone else setting out guidelines and regulations to her wanting to control 70% of the population. That’s a bit of a leap.

    I myself know that I’m not qualified to make complicated medical decisions for myself in most cases – although I am educated and good at doing article-review type research, I’m not a doctor. The best I can hope for is to become aware of possible options and to discuss them with my doctor to determine what would be a good outcome. So guidelines here would be appreciated, both so I can see what my options are, and so the doctor and I are on the same page.

    When it comes to the cost of different options, then it gets worse. First, how do I know what a “good” price is, for a particular treatment? Hospitals and clinics can be remarkably cagey about what things will cost until the bill comes, and then, when you look at what the insurance is willing to pay, how do you reconcile the inevitable difference? Insurance companies are also quite unwilling to tell you upfront what they’ll cover – the only way you can tell usually is by getting the bill. Neither party has any incentive to reveal these prices beforehand, and then you toss in the likelihood that if you live anywhere other than a large metropolitan area your choices of provider are severely limited.

    We have one private hospital in my area – the nearest alternatives are over an hour away in all directions – and there aren’t enough doctors in the area as it is. Add in the limits of your insurance provider list, and you’re pretty much stuck with whoever is accepting patients on your plan. Then toss in all the things that my insurance excludes, and it’s a surprise that I can even manage a basic check-up every year.

    Under these conditions, the idea that government regulation would control my decisions is hilarious. I have next to no control as it is, if I want health care. My “control” consists primarily of choosing whether to get health care at all. Having done that for the last decade previous, it’s a pretty stupid sort of option.

    So… control by insurance companies who don’t care if I live or die, control by doctors and hospitals who have a monopoly in my area, or control by the government. I’ve seen how the first two work – perhaps it’s time to try the last. It certainly couldn’t be any worse or more expensive than what I’m dealing with now.

    I also think the idea that we can “control” our health at all is laughable. Did I ever expect that one day I would have a freak bout of iritis, which would threaten my sight, require six months of treatment with an expensive medication, and put me on the watch list for insurance companies ever after? No. How could I? It’s not like we get little cards when we’re born saying that we’d better save up for that appendix surgery we’ll need when we’re 33, or budget for the prostate treatment we’ll need at 56. The best we can hope for is early detection, through regular exam visits.

    And that requires regulation to ensure that those visits are affordable and accessible. We can’t control our health – but we can regulate the tools that we have available to manage it.

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  62. coozledad said on November 19, 2009 at 5:48 pm

    beb: A side of Shemp Howard you may not have seen. Roger Ebert says WC Fields only made surrealist movies, lurching from one vignette to another without any apparent continuity, aside from his drive to remain liquored up. I still find this amusing, if only for the bar scene.

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  63. Julie Robinson said on November 19, 2009 at 5:52 pm

    Christy–the Amish around here that I see in stores always have their carts full of every kind of over-processed crap you can imagine. And many, many cases of Mountain Dew. As well as disposable diapers, though if I had to do laundry like it was 100 years ago, I’d go that route too.

    The local paper carries an Amish Cook column, and her recipes are full of canned this and processed that. It’s a myth that the Amish lead a nobler life just because they reject education and technology.

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  64. Sue said on November 19, 2009 at 5:53 pm

    Ok, Mark. (Deep calming breath)
    So, all this discussion made me think of this, for some reason: Have any of you read the occasional Dear Abby/Ask Ann Landers/Random Advice Columnist letter that goes like this:
    My husband went to his doctor and got a prescription for viagra and no one asked what I thought about it! I am outraged etc.!
    Talk about health care debate. I’ll bet either a rolling pin or a frying pan went airborne at some point.

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  65. Joe K said on November 19, 2009 at 5:55 pm

    Thought I would weigh in here on the Breast cancer discussion. I am Jen’s dad so I know her mother rather well. I’m sure in the hell glad she had a mammogram. You want Gov run health care? Be prepared for more of the same.
    Side note, got to brag a bit on my younger daughter. She just got hired at Sawyer-Colby college in New Hampshire as a systems librarian. She graduates next month with her masters from I.U. She did her undergrad and master in 5 yrs plus 1 semester. Mom and Dad are rather proud.
    Give me the Stooges, with Curly, Moe, and Larry. When they drill into Curly’s head or run a saw over his head and all the teeth on the saw are broken off, cracks me up every time.
    Pilot Joe

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  66. Sue said on November 19, 2009 at 6:00 pm

    Laurel & Hardy and Harold Lloyd for me.

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  67. brian stouder said on November 19, 2009 at 6:04 pm

    Peter Sellers; especially in a late-60’s movie called “The Party”

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  68. brian stouder said on November 19, 2009 at 6:31 pm

    Jeopardy clue under the category Definitive American Speeches:

    Hancock Avenue
    Gettysburg, PA 17325

    (today being the 146th anniversary, and all)

    (someday I’ll go to an event that they hold there each year at this time; a sort of uber-Lincoln Colloquium, only lots more expensive)

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  69. Jenflex said on November 19, 2009 at 6:43 pm

    Yes, Mark, in peril, but at least able to vote. We all still get to vote.

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  70. paddyo' said on November 19, 2009 at 6:59 pm

    Ahh, “The Party”! “Birrrrr-diieeeeee NUM-nums . . . ”

    I just read 67 straight nn.c comments here, and I have to say, today’s one of those great days when the level of commentary, discussion, debate keeps on rising. (Sorry to have broken that curve here . . . )
    Kudos to all, but most especially to the mammogram-or-no-mammogramers in today’s conversation. To each her own counsel, and damn the rest … says the son of a woman who caught and heeded her own lump too late and, after six years in remission, died a most difficult, metastasized-to-the-lungs death at 64, 20 years ago next summer.

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  71. MarkH said on November 19, 2009 at 7:11 pm

    All you need to know about Shemp:


    His name lives on in Hollywood lore as a euphamism for fakery on film. It came from the body doubles needed to complete Stooges’ films when Shemp died, so stand-ins have been called “Shemps” ever since. Sam Rami likes him, too.

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  72. Dexter said on November 19, 2009 at 7:11 pm

    No discussion of last Sunday’s “Curb…” here. Have you all signed off on HBO?
    Larry David ran the locomotive off the track and the whole train crashed onto middle American and right wing values, as well as a lot of just plain decent people. The episode had nothing to do with pedophilia but it was sort of slack-jawed horror when the killer bit started, and the show ended with the most droll humor imaginable. Talk about on the edge…I love HBO Sunday night programming, especially Curb, and extra-specially this season’s Curb. I don’t react much to TV programming, but I admit this episode was more than a little uncomfortable to sit through after the bomb was dropped. I can’t describe it, sorry…you’ll have to see in On-Demand or whatever.

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  73. John G. Wallace said on November 19, 2009 at 7:21 pm

    OK, I know we shouldn’t feed the zoo animals, but after writhing in abject horror after seeing the scene at Meijer in Fort Wayne regarding the imbecille we don’t name by name I had to comment on WANE-TV’s website.

    I was pleased to see a few other dissenting views. I am MoronFinder for the purposes of this discussion. I have to bow in the presence of true comic greatness to the poster JOE.

    MoronFinder · 1 hour ago
    What a missed opportunity – we had thousands of stupid people willingly gather in one spot. We should have at least marked them with a huge MORON stamp on their heads. At least that way normal people would know to talk slow, and not make any sudden moves.
    I loved hearing all the local mouth breathers reguritate the Glenn Beck and Rush crap about her standing for family values, conservative values. Uggggghhhh! Folks, she can’t run her own family, and she quit as Governor.

    Guest · 54 minutes ago
    Is it that she isn’t pretending perfection like most politicians that bothers you? A woman ( maybe it’s that) with a normal family with problems that the general population deals with every day? You must be dreaming if you think hers is the only political family with skeletons. Some just think its important to hide it! I think its refreshing that she doesn’t even seem embarrassed about it. Quitting as governer… she may have bigger plans. Report Reply
    +1 Vote up Vote down

    meggabad 17p · 1 hour ago
    Its over? GOOD!!! The less scum we have in our great city the better. Now if we could just get Steve Shine to leave, the air would be much cleaner to breath! BTW, I still love the “This is McCain Country” banner that Shine wasted the Rep.’s money on when Clinton visited the Grand Wayne Center during the campaign. Clearly Indiana is/was NOT!!! Nor is it dragon lady Palins. Report Reply

    1 reply · active 57 minutes ago 0 Vote up Vote down jake · 57 minutes ago
    In November of 2008 EVERY REPUBLICAN ON THE BALLOT won in Allen county. Mitch Daniels won reelection in Allen County by 22 points, John McCain won this county by 18 points… IT is McCain Country Report Reply 0 Vote up Vote down

    joe · 1 hour ago
    I can see meijer from my house. Report Reply
    0 replies · active less than 1 minute ago 0 Vote up Vote down

    chris · 1 hour ago
    Palin is a retard Report Reply
    0 replies · active less than 1 minute ago 0 Vote up Vote down

    REAList · 42 minutes ago
    damm you mean all the idiots in fort wayne gathered in one area and i missed it! this would of been fun to watch. this would of been very entertaining to see. Report Reply
    1 reply · active 38 minutes ago 0 Vote up Vote down

    slimshady · 38 minutes ago
    I’m with ya. Well did better than NY they had 8 people.

    The dumbing down of America is almost complete and it just takes five minutes watching TV or listening to talk radio to confirm the decline. We watch “reality” tv that has no bearing on reality. I had to visit a social security office last month with a family member and the old folks were on a rant as they had the unfortunate seats closest to the portrait of President Obama.
    One old guy turned to me and started ranting about the signs prohibiting firearms in the building. I told him I was fine with that as the agency breeds anger among desperate people and I would prefer a security screening instead of a sign and a sleeping rent-a-cop.
    He told me get ready because that “Marxist” will take away our guns. I responded that I was sure he supported Bush II and the “Patriot’s Act,” so he was willing to throw out Habeus Corpus at the urgings of an idiot.

    I then added that I was certain he had no clue what Habeus Corpus means, why he should care, and that before he listened to talk radio his definition of Marxist would be a fan of Groucho.
    I’m available for parties, especially tea parties. I think the tea party stuff is just a slang code-word so later that day they can enjoy t-bags. Mostly the guys.

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  74. paddyo' said on November 19, 2009 at 7:30 pm

    I second Dexter on “Curb” … it was brilliant, and how AM-radio ranters could’ve conjured up something to be outraged about is beyond me.

    Oh, well, wait a minute, I’d better take that back: I imagine we viewers ALL were taken aback, initially, when Mommie/TV show assistant casually remarks to Larry during a break in rehearsals for the “Seinfeld” reunion show (the central thread of this season) about the rash on her cute little daughter’s pussy — and, no, she’s NOT talking about the family kitty-cat.

    As you might imagine, it all goes very, very downhill from there — and in successively, laugh-out-loud funnier installments. Funny, I’ve found “CYE” harder to sit through with other gags than this one, but hey, Larry David is a decidedly acquired taste …

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  75. Jeff (the mild-mannered one) said on November 19, 2009 at 7:44 pm

    Brian, it’s called Remembrance Day, and it’s usually the Saturday closest to Nov. 19. I’ve been twice, and hope to go again. Many re-enactors, few tourists, very different vibe, in a good way. Worth the trip.

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  76. Jolene said on November 19, 2009 at 9:28 pm

    Brian: I thought of you when I saw this “best books” list a couple of days ago. According to The Atlantic, one of the top five books of 2009 is Lincoln: A Life by Michael Burlingame (available through the Kickback Lounge, of course). The blurb on the list says, “Measured, psychologically astute, authoritative when it can be, Michael Burlingame’s exhaustive narrative (2,024 pages!) is unafraid of ambiguity and indeterminacy. This is the life of Lincoln for our times.” The Atlantic has a link to a previously published review by Christopher Hitchens.

    When I went to the site to look up the title of this book, I found an article re mammography on the front page. It’s short, so easy to review. The blurb on top says, “Many are dismissing the new breast cancer recommendations as a hasty reversal of years of authoritative medical advice. But evidence weighing against screenings for women in their 40s has in fact been mounting for years.”

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  77. brian stouder said on November 19, 2009 at 9:29 pm

    Jeff – Gabor Boritt (a great favorite of mine) conducts a 3-day symposium at Gettysburg college, which I’ve always been tempted to attend, but it costs $350


    Then again, a person could indeed go there and do the Remembrance Day event, which this year features Richard Dreyfus


    Jolene – I am really, really enjoying Burlingame’s book(s); I’m 700 pages in, and have a long way to go (and I’m a glacially slow reader)- but it is by turns laugh-out-loud funny (lots of Lincoln humor is sprinkled throughout) and quite thought provoking.

    My only criticism is that Burlingame’s treatment of Mary Linclon embodies the classic white-male dismissal of her as a crazy shrew, and I had the great priviledge telling him just that, while going after Dr Burlingame about his flatly unfair treatment of Mary, and he gamely defended himself on all the points I raised.

    The thing is, Mary picked Abe and married down, and Abe chose Mary and married up – and if you subtract Mary from the equation, we lose President Lincoln, period. (He agreed with that, but only because, in his opinion, she DROVE him out of the home and onto the praries, where his ambition came to fruition). I think Mary deserves the benefit of every doubt, especially given that Burlingame spends about 30 pages pounding the living crap out of her on every conceivable front; and if you follow the footnotes he cites neighbors’ interviews from 1890’s newspapers and magazines (ie – tabloids!) and third-hand hearsay, etc. (I asked Dr Burlingame if he’d sign my book, and he said he would if he could borrow it; he had failed to bring copies of his book to the Colloquium!! I told him it would be an honor to assist him – but he musn’t lose my place!)

    This isn’t as wildly off-topic today as it might seem, if one reads the fairly astonishing level of hatred, xenophobia, race-baiting, and rabble-rousing of a mid-19th century political campaign.

    John G Wallace – did you hear Pat White today? In between all the heavy breathing about how amazinginly wonderful and magical and marvelous she is, he expressed great umbrage at Chris Matthews’ show for pointing out that the line of fans in Grand Rapids was “monochromatic”.

    But indeed, I didn’t see ANYthing but white faces on the coverage, both of Grand Rapids and Fort Wayne. It reminded me of the Angry White Boy conclave at IPFW, when we had the “town hall meeting” for Rep Souder.

    Governor Palin is nothing so much as a throwback.

    (and by the way – all this “Messiah” crap that dunderheads like Sean Hannity and his bobble-head listeners croak about is all the more hypocritical when we witness how they kowtow and genuflect to their Great Alaskan Goddess and Cultural Warrior Queen)

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  78. Jolene said on November 19, 2009 at 9:57 pm

    (and by the way — all this “Mes­siah” crap that dun­der­heads like Sean Han­nity and his bobble-head lis­ten­ers croak about is all the more hyp­o­crit­i­cal when we wit­ness how they kow­tow and gen­u­flect to their Great Alaskan God­dess and Cul­tural War­rior Queen)

    Not to mention St. Ronald of Reagan, who must be named in every GOP speech.

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  79. basset said on November 19, 2009 at 10:20 pm

    Cooz, what you do about the deer stands is take them, leave a note which says “if you want this back, call this number by this day,” and then, when they don’t call, sell the stand on Craigslist.

    Nance, the plan here was to hang this deer… and I’m no expert, it’s only my second one lifetime… for several days, but the weather was a little too warm (you want it just above freezing), so we cut him up and got him into the cooler. The next day, of course, the temp went down, so my brother-in-law left his deer hanging and will go back for it this weekend. It does help, something about enzymes in the meat; same thing as the “dry-aged” beef expensive steakhouses advertise.

    Meanwhile… had his ribs for dinner tonight, in the slow cooker with a little water, some bay leaves, and a couple of Oxo cubes. Just stripped the leftover meat back into the pot – once everything cools and I skim the fat, it’ll just need a few vegetables to be soup. Thank you, deer.

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  80. moe99 said on November 20, 2009 at 1:27 am

    Joe K, why do you think I chose my moniker back in the day? The three stooges epitomized high comedy for me in Defiance, OH.

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  81. Denice B. said on November 20, 2009 at 1:35 am

    I got my first mammogram at age 35, because I had two relatives with weird cancers. So I thought a baseline would be good for future reference. I’m 53 now. I got a mammogram 2 years ago, and was sent for a biopsy. Took a week or two to get that done. After two weeks of waiting for news and being worried and scared, the had me go to a surgeon for an open biopsy where I was to go in for surgery. So I waited for my appointment to see the surgeon, then I had to wait a few weeks for the surgery. After the operation, I had to wait a couple more weeks for the results at my surgeon’s office. It was all cancer-free. Thank goodness. The endless waiting caused horrible anxiety. Now, I am overdue for another mammogram and I just keep putting it off because of the worry and nightmares I had waiting to find out my fate from before has scarred me.–beb’s wife

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  82. Dexter said on November 20, 2009 at 2:22 am

    Palin’s book sold 300,000 copies in its first day but didn’t beat dan brown! read more about the palin’s gold mine
    about 8 hours ago from TweetDeck

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  83. alex said on November 20, 2009 at 8:16 am

    Best line from the local media coverage of S____ P____’s book tour:

    City resident Mark Little said he’s so genuinely tantalized with Palin and her book that he said “it will be the first book I’ve ever read.”

    And it’s not even a well-written one. The line, I mean.

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  84. beb said on November 20, 2009 at 8:36 am

    Hey, moe99, that was me, not Joe K. who asked about the Stoogies. And I’m embarassed to say it passed completely over my head that your handle may have been taken from Moe Howard. And I was wondering why a woman would pick a man’s name for her handle. There’s a nice, chronological, series of DVDs of the Stoogies out there. I got a one for my daughter’s christmas present.

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  85. crinoidgirl said on November 20, 2009 at 9:13 am

    Tina Fey for president!

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  86. ROgirl said on November 20, 2009 at 9:17 am

    Jolene, the Atlantic article clearly lays out the facts in a way that the initial announcement and subsequent coverage didn’t. I was struck by the parenthetical sentence in the article that the one lifestyle factor that may correlate with breast cancer is obesity.

    I went through a scare a few years ago and thankfully was given a clear bill of health. The waiting produced massive anxiety. The hospital left a phone message on Friday afternoon that they’d found something on my mammogram that they wanted to look into, and I had to wait until Monday before I could find out anything. Then I went in for more xrays, I had to wait while they examined them, and at that point was told I needed an ultrasound right away. I got the ultrasound and had to lie there in my gown waiting for the results. After what seemed like forever, I was finally told that everything was fine and I could leave.

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  87. SoCoGal said on November 20, 2009 at 9:41 am

    We can all point to a friend or loved one who had their life saved through early testing and treatment of a deadly disease. In fact, a 48-year-old friend of mine just had surgery for colon cancer, and the mass was so large it probably started growing when he was 35 or so, much too early an age for recommended screening. However I have refused further testing in the past as in my experience many tests were flawed. The last time I had a pap swear come back as bad, the Dr. wanted to do a biopsy. I refused, and asked her to re-test. The second test was fine. You never know you is handling your sample. Same with a lump in my breast: a second mammogram showed the same lump, but I refused a biopsy and visited my alternative practicioner instead. After that treatment, I had a third mammogram and they could not find a lump. My mother has benign breast lumps, so my guess is we are a genetically lumpy family. I also have fibrocystic breast disease, and I don’t do monthly self-exams because I can’t tell the diference between feeling my left boob and a sack of marbles. Am I foolish? Perhaps, but Western Medicine has a lot more to prove to me before I obey all their common (and frequently changing or conflicted) wisdom. I’ll stick with the diagnosis and treatment I receive from my alternative doctors and spare myself the cost (don’t forget you always have to take time off of work for consultations, testing and re-testing several times a year, not to mention co-pays and reduction of your lifetime insurance benefit cap) and worry.

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  88. Connie said on November 20, 2009 at 10:19 am

    BTW, for classic rock in West Michigan, tell Alan WLAV 97 in Grand Rapids.

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  89. Jolene said on November 20, 2009 at 10:26 am

    I agree, ROgirl, that the piece on mammography from The Atlantic is very well done. Shows how valuable good science writing can be. But reading it made me even madder at Secretary Sebelius for failing to explain the (relatively) new data and its potential implications for policy.

    Over the past couple of decades, an enormous amount of effort–and money–has been put into encouraging women to get mammograms, with outreach efforts to minority groups, non-native speakers of English, and other subgroups. Given that effort, it’s not surprising that people were shocked at this latest announcement and find it hard to accept.

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  90. brian stouder said on November 20, 2009 at 11:15 am

    I got the following joke email, which originally featured a racist punchline aimed at southwestern Americans and other non-white people in general; so I modified it for just one white person in particular

    Did you know???

    That the words “race car” spelled backward says race car.

    That “eat” is the only word that if you take the 1st letter and move it to the last, it spells it’s past tense: ate.

    And have you noticed that if you rearrange the letters in “Going Rogue by Sarah Palin” and add just a few more letters, it spells out: “Load your delusional ass and your enhanced fluffy-factual books back on your bus, along with yer ‘Going Commando” ex-future son-in-law, and head north on the AlCan highway until we see you no more.”

    How weird is that?

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