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"Hop up on the table, Honey." mThat's how an x-ray technician addressed my 89-year-old mother-in-law in 2001, when we took her for knee x-rays. Mom, who had advanced osteoporosis and arthritis as well as confusion and heart problems, had long since given up hopping. When it became obvious that she needed assistance, the technician grabbed her arm -- as if pulling on another sore appendage would magically raise the rest of her onto the table. It didn't. This incident has become our personal mantra for expressing what is wrong with America's health care system. Having helped our four parents during their final years and having both had cancer ourselves as well as other medical problems, we have had experiences with five nursing homes, two personal care facilities and a half dozen hospitals. We've lost count of the doctors, drugstores and health insurance plans. All of us have had health insurance, though some policies were better than others. Nonetheless, we have experienced incident after incident demonstrating the waste, ignorance and apathy which is rampant in the system. Unable to list them all, I have been heretofore reluctant to write about a handful of them lest the reader be persuaded that the problem is with only that hospital, only that nursing home or only that doctor. There is, however, an increasing crisis of confusion, mismanagement and ill-preparedness which is at the core of our healthcare system. We are all familiar at least with the trend line if not the specifics for healthcare costs. According to WhiteHouse.gov, "The United States spends over $2.2 trillion on health care each year-almost $8,000 per person." That's sixteen percent of the economy. Healthcare costs are projected to increase to almost twenty percent ($4 trillion a year) by 2017. Meanwhile forty-six million Americans are without health insurance (14,000 more each day), premiums and co-pays are rising and more reasons are used to refuse coverage both to those willing to pay and thos

"Hop up on the table, Honey." mThat's how an x-ray technician addressed my 89-year-old mother-in-law in 2001, when we took her for knee x-rays. Mom, who had advanced osteoporosis and arthritis as well as confusion and heart problems, had long since given up hopping. When it became obvious that she needed assistance, the technician grabbed her arm -- as if pulling on another sore appendage would magically raise the rest of her onto the table. It didn't. This incident has become our personal mantra for expressing what is wrong with America's health care system. Having helped our four parents during their final years and having both had cancer ourselves as well as other medical problems, we have had experiences with five nursing homes, two personal care facilities and a half dozen hospitals. We've lost count of the doctors, drugstores and health insurance plans. All of us have had health insurance, though some policies were better than others. Nonetheless, we have experienced incident after incident demonstrating the waste, ignorance and apathy which is rampant in the system. Unable to list them all, I have been heretofore reluctant to write about a handful of them lest the reader be persuaded that the problem is with only that hospital, only that nursing home or only that doctor. There is, however, an increasing crisis of confusion, mismanagement and ill-preparedness which is at the core of our healthcare system. We are all familiar at least with the trend line if not the specifics for healthcare costs. According to WhiteHouse.gov, "The United States spends over $2.2 trillion on health care each year-almost $8,000 per person." That's sixteen percent of the economy. Healthcare costs are projected to increase to almost twenty percent ($4 trillion a year) by 2017. Meanwhile forty-six million Americans are without health insurance (14,000 more each day), premiums and co-pays are rising and more reasons are used to refuse coverage both to those willing to pay and thos

I want to commend, and cry over, what WP wrote: "What I am seeing in needy areas are things/conditions I thought only existed in previous distant centuries. The patient populations have been well described by Charles Dickens and depicted graphically by Giordano in his opera set during the French revolution…a stream of ragged peasants limping across the stage, right here in the United States, in 2009." I can vouch for it here in Vermont…right next to Dartmouth's great Dartmouth-Hitchcock Medical Center in Hanover, NH…where - at BEST - most Blue Cross/Blue Shield of Vermont clients CANNOT find a primary care physician (PCP) taking new patients… and where - at WORST - several women I know are choosing to die from their breast cancer because they cannot afford medical care and will not burden their kids or society. One woman has an MA in Counseling, and the other a PhD in Human Nutrition. These are not uneducated people… But they are most definitely poverty-stricken…and were poor before the 2008 global economic collapse.

Jonathan D. Smith, Department of Cell Biology, NC10, Cleveland Clinic, 9500 Euclid Avenue, Cleveland OH 44195. E-mail smithj4@ccf.org -----     -----     -----     ----- HDL-cholesterol is the "good cholesterol" because of its reverse cholesterol transport and antiinflammatory activities. However, HDL and apolipoprotein A-I can lose their protective activities through changes in protein or lipid composition as well as protein modifications. Assays for dysfunctional HDL could potentially be used as a criterion for preventative therapy.

I've contributed a lot to this discussion.  Perhaps I've been obssessive.  I'm concerned about the state of healthcare in this country, though.  I'm upset about the rampant myths and lies being tossed around about healthcare reform.  I'm concerned about all the lazy thinking we citizens are exhibiting. Misinformation, misunderstandings, bias, prejudice, narrowly self-interested polemics, anger, manipulations, and nastiness are badly hurting the process (and probable outcome) of healthcare reform debates and efforts. I can't NOT write long, detailed comments when I read stuff that's...well...WHACK!

"...biggest frustrations have been: getting properly diagnosed (my first endocrinologist said I had type 2, though I was GAD positive)"...

Molecular immunological approaches to biotherapy of human cancers--a review, hypothesis and implications.\nBecker Y.\nAnticancer Res. 2006 Mar-Apr;26(2A):1113-34. Review.\nPMID: 16619514 \n\nPolarized Th1 cells produce interleukin (IL)-2, IL-12 and interferon (IFN)-gamma, and polarized Th2 cells and the hematopoietic cells produce IL-4, IL-5, IL-6, IL-10 and IL-13. In healthy individuals there is a Th1/Th2 cytokine balance, but during microbial-induced inflammation the pathogens induce an overproduction of the Th2 cytokines that inhibit the adaptive immune response against the pathogen. A review of studies on the Th1/Th2 cytokine balance in humans harboring different tumor types revealed that tumor cells induce increased Th2 cytokine levels in patients' sera that can serve as indicators for the existence of tumors. I\n

A $10 billion investment in community health centers, expected to go to $14 billion when Congress completes work on health care reform legislation, was included in a final series of changes to the Senate bill unveiled today. The provision, which would provide primary care for 25 million more Americans, was requested by Sen. Bernie Sanders (I-Vt.).

"I think this is the civil rights issue of our generation: access to appropriate healthcare is a human right." ~Mad as Hell Doctors

Can health care organizations and physicians be incented to deliver the highest quality, safest, most reliable, most patient-centric care at the lowest possible cost without Atul Gawande reading the findings of the Dartmouth Atlas into the Congressional Record? I think they can, if they have a strong hospitalist program.

My "argument" against this guy's lazy, reactionary blog post is at the very bottom of the page, dated April 12, 2009. I think it's the longest comment he's received so far, too. Just look for a verbose passage. That's my rant against his reactionary, unsupported claims against NDs.

This study shows that by modulating the eicosanoid metabolism using a combination of n-3 fatty acids and cyclooxygenase-2 inhibitor, some of the signs and symptoms associated with a Systemic Immune-Metabolic Syndrome (SIMS) could be ameliorated.

civilrighthealthcare1.mp3 (audio/mpeg Object)