A reporter asks John McCain whether birth control should get the same insurance coverage as wang stiffener (the scientific name), a legitimate question about health care coverage in America.
Here’s his response:
You can see why McCain doesn’t favor negotiating with Iran. Just mention Viagra and you can run roughshod over the guy - we’d be in a literal dick-measuring contest by day’s end.
One of the joys of being an underinsured/sometimes uninsured, but healthy, 25-year-old: every time new insurance asks me for a family doctor or a shot record, I don’t have A and I have no idea how to get B. I’m the asshole who shows up and continually has to ask if it’s okay if I don’t know answers to any number of questions about my medical history, but I’m sure I got all my shots at some point since the early 80s.
Salon has a story on the death of the family doctor (not the literal death of the actual family doctor, which is a rather touching Hallmark TV movie), which made me think about the medical histories of those in my age bracket. I’ve lived six different places in the past six years (so I’m also the asshole who’s apparently a bigger credit risk), with whatever doctor I could find whenever I needed said doctor’s care. Most of it was Urgent Care for various bugs and a sleep center for a bout of insomnia I’ve had for about a year now. I’ve had no primary care/family physician, largely because routine checkups take absolutely forever to schedule, and most of the doctors in said categories are out in the suburbs near the nice schools and the families with the kids and the insurance and whatnot. And it’s a common story across many of my friends, particularly those who grew up without regular insurance - a family doctor, even simply a routine doctor is a luxury we really don’t have.
What we need, and most of us want, is the Norman Rockwell version of a concerned, empathetic family doctor we can trust to sniff out the rare or serious illness, manage the ordinary, while also being a medical cleric who knows his patients. What we need is a family friend to whom we can turn for reassurance, comfort and, yes, even bad news.
But primary care physicians—those trained in family medicine and general internal medicine—are an endangered species. It’s only a bit of hyperbole to say that, if the trend continues, the family doctor will become a fond memory, a nostalgic reminder that the medical system once had a more human face and sense of community.
Of all the various elements of the 1950s that conservatives are trying to bring back - women in the kitchen and out of the work force, sexual prudishness, the overuse of the word “keen” - this is the one that it would be great for them to actually fight for, tooth and nail. We’re never getting milkmen back again, but having a personal doctor who knew you and the mole on your back and your lack of gastrointestinal tolerance for enriched breads was a really, really good thing that “the market” has largely done away with. You make more money being a specialist, and you still get paid for the initial consult when someone comes to you for back pain that’s actually a tumor.
My knowledge of medical ethics doesn’t extend much beyond confidentiality, but it seems that there’s a difference between shilling for the great appendectomy you got and shilling for the great facelift you got.
The mechanism of reward for endorsements should always be made known, and perhaps some sort of restriction put on how soon a patient can endorse a doctor’s treatment (i.e., after they’ve healed), but for voluntary cosmetic procedures it doesn’t really seem as if there’s a great moral quandary about people saying they got a great service, the same way they would say they got great aluminum siding or attentive service at a store.
Of course, you then run the risk of market-forces conservatives pointing to this and declaring that medicine can be a function of the marketplace, by gum, leaving the rest of us to wonder how fast we can pick up a wi-fi signal to look at YouTube videos for the best doctor in our area to stop us from vomiting blood. We can even make it a competition, as long as I can also look up Super Mario speed runs.
Why can’t these fundies just do their flipping jobs? Ashleigh Haberman and Erica Schaub were married in Canada. They went to Spectrum Health South Pavilion Urgent Care Center in Grand Rapids, Michigan, where Schaub, accompanied by Haberman, sought care for a nagging cold.
They went into the exam room and instead of a diagnosis and advice, once Haberman identified herself as Schaub’s partner, the couple got an earful about same-sex marriage.
But instead of her symptoms, they say the doctor was more interested in the couple’s relationship and how they felt about the recent California ruling allowing same-sex marriage.
“And he proceeded to give his opinion on how he felt that marriage, gay marriage, shouldn’t be called a marriage because it’s a religious based word, and he’s a Christian, and there’s no way that marriage could be considered legal in the gay sense,” said Haberman.
While the couple’s marriage is not legally recognized in Michigan, they say that’s not the point, rather, the doctor’s office is not the time nor place for a debate. They were there for an exam - not a lecture on lifestyle.
WOOD-TV News has the video. As a result of the brouhaha, Spectrum Health put out this public statement:
“Spectrum Health takes the care and treatment of its patients very seriously. We expect our physicians and staff to provide high quality care in a professional manner. We received an e-mail concerning a patient visit this morning and we have begun a thorough investigation of this matter. We will review all aspects of this issue. Once this is complete, we will take appropriate action. We are just beginning this review of this matter and must follow the laws protecting patient confidentiality and the rights of employees. Therefore, we will not comment further at this time.”
Salon has a doctor writing about how even “socialized” health care is way too expensive because the emphasis is on “get sick, go to the doctor” instead of on prevention. Like pretty much all decent people outside of the U.S., he takes first world nations’ responsibility to see to the health care of all citizens as a moral given, much the way Americans see “socialized” education, roads, and fire departments as a given. So really, this is just an argument about the hows, not the whethers. It’s worth noting that Dr. Parikh uses Canada as his main point of comparison, and theirs considered one of the most inefficient universal health systems.
That said, I agree with him that an ounce of prevention really is worth a pound of cure in health care. Which is why I lose my shit watching wingnuts in D.C. redirect HIV aid from prevention to treatment, because I believe they think AIDS is a good disincentive/punishment for having sex and they don’t want to interfere with catching it. No matter if you can get AIDS drugs to every man, woman, and child who needs them around the world, you’ll save more lives if you blunt the spread of the disease through condoms and education. Few diseases, once acquired, have a magic bullet cure. To use a more mundane example, think about dentistry. They can do amazing things in that field, fix teeth that a century before would have fallen right out your head with a lot of pain attending. If you do lose your teeth, they can make new ones for you. But there’s no crown, no filling, no dentures that can equal the tooth you grew by yourself, and any dentist will tell you that. The disease of tooth decay wasn’t cured, really, but its worst symptoms were managed. Same story with heart disease, diabetes, and other illnesses that plague our health care system.
The problem is imagining a way to really get prevention at the forefront of a health care system. Dr. Parikh has ideas.
In case there’s any doubt, this should put it to rest: Tom Coburn is a giant fucking asshole godbag who probably gets a sadistic glee thinking of people suffering. To put some perspective on this, the constant battle on earmarking HIV relief funds is between treatment and prevention. Experts generally like to see the larger chunk go to prevention, because statistically it just saves more lives. (I know; I’m wildly simplifying. This is a blog post, not a doctoral thesis.) You can buy a lot of condoms for what a day’s worth of HIV drugs costs, and prevent a whole lot of transmission. But there’s not even a need to twist into moral pretzels about these hard choices, since the bill in question is an expansion of funding that was already there.
So why has broad bipartisan legislation seeking to more than triple the program’s funding to $50 billion caused such a rancorous fight?
Coburn and six other Senators are blocking the bill until the prevention money is redirected, though. Their reason? In sum: Look over there!
The Oklahoma Republican, along with six other social conservatives, has put a hold on the bill in the Senate, unless a provision is added to direct most of the spending toward treatment for HIV/AIDS rather than toward prevention and other priorities. Otherwise, Coburn said, “the vast majority of the money is going to get consumed by those wanting to help people with HIV, rather than [by] people with HIV.”
I just found out from listening to the Skeptic’s Guide to the Universe that Time magazine graciously printed a very good article about the crank-based questions about vaccinations. There are many things to love about this article, but what I think gave me a moment of dark humor was this part:
Some parents have taken to cherry-picking vaccines, leaving out only the shots they believe their children don’t need—such as those for chicken pox and hepatitis B—and keeping up with what they see as the life-or-death ones. But that can be a high-stakes game, as Kelly Lacek, a Pennsylvania mother of three, learned. She stopped vaccinating her 2-month-old son Matthew when her chiropractor raised questions about mercury in the shots. Three years later, she came home to find the little boy feverish and gasping for breath. Emergency-room doctors couldn’t find the cause—until one experienced physician finally asked the right question. “He took one look at Matthew and asked me if he was fully vaccinated,” says Lacek. “I said no.” It turned out Matthew had been infected with Hib, bacteria that causes meningitis, swelling of the airway and, in severe cases, swelling of the brain tissue. After relying on a breathing tube for several days, Matthew recovered without any neurological effects, and a grateful Lacek immediately got him and his siblings up to date on their immunizations. “I am angry that people are promoting not getting vaccinated and messing with people’s lives like that,” she now says.
Emphasis mine. We can all have a dark laugh at the fact that chiropractors are part of the problem—-why wouldn’t one form of crankery promote another?—-only because the little boy had no lasting damage. But what if he had? How many other small children are being put at risk because parents erroneously believe that vaccinations are bad because some guy in a white coat pretending to be a doctor said so? Or because they read that vaccinations cause autism on the internets? After all, the cranks yell louder than the people talking sense, which makes them more believable sometimes. (Believe me, I know—-both anti-choicers spreading misinformation about abortion and creationists spreading lies about evolutionary theory are very adept at dominating search engine results and seeming like they know what they’re talking about when they don’t.)
Information that isn’t surprising: Paranoia about vaccinations causing autism is groundless.
