The Hesperian Foundation

In a world where Bechtel wants exclusive rights to water in Cochabama and where Monsanto wants a monopoly on all the seeds in the world with their one time and die product, it's gratifying to find someone looking globally without greedy eyes.

Don't kid yourselves either. This free downloadable information could be invaluable in rural areas cut off by storms, fallen trees and no way to a medical provider. 

The Hesperian Foundation is a non-profit publisher of books and educational materials that help people take the lead in their own health care and organize to improve health conditions in their communities. Simply written, heavily illustrated, and developed in collaboration with groups around the world, our books contain a wealth of life-saving information on diagnosing and treating a broad range of health problems.
                                            

In the late 1960s and early 1970s, a group of health activists in Ajoya, Mexico compiled a notebook of treatment information for common medical problems in their village. The notebook came into great demand not only in Ajoya, but also among health workers from neighboring communities. In 1973, the notebook was reproduced as a comprehensive and revolutionary health-care manual titled Donde no hay doctor (Where there is no doctor).

Around this time, an organization was founded in California to distribute the book and begin work on an English version. Where there is no doctor was first published in 1977 and is now considered by many to be the "bible" of primary health care for community health workers and villagers in poor countries around the world.

 

2007 edition of Where There Is No Doctor – now available! This 2007 reprint includes new material on preventing the transmission of blood-borne diseases, how HIV/AIDS is reflected in many health issues, and basic Antiretroviral treatment information, as well as updated information on children and aspirin, stomach ulcers, hepatitis, malaria treatments, etc. Download here!

 

Our Philosophy

We live in a world of stark extremes. While those in rich countries benefit from the latest medical technology, millions of people still suffer and die from preventable and curable diseases.

Poor people throughout the world lack basic health care because it is priced beyond their means or because services are too far away. The affordable services that do exist are being threatened by global economic policies that force governments to cut budgets for health, education and social services.

We believe the following:

• Health is a fundamental right for all people.
• Health information should be shared.
• People can and should take the lead in their own health care.
• Women and men with little or no formal education can understand, apply and share medical information if it is presented simply and appropriately.
• Educational materials are most effective when the people who use them are involved in their development from the beginning stages.
• Health programs should be practical, accessible and respectful of the knowledge, experience and resources already existing in communities.
• To achieve good health, communities must address the underlying causes of poor health, such as: poverty, discrimination, harmful traditional beliefs and unjust social structures.

Our open copyright policy

To facilitate translations/adaptations of our materials, the Hesperian Foundation has an "open copyright" policy. This means that we will grant permission without charging any permissions fees, royalties, etc. to translate/adapt our materials so long as the following conditions are met:

1. that your edition is distributed at no cost or for production cost only, that is, not-for-profit;
2. that you allow others to reproduce/adapt your edition with no fees, royalties, etc. so long as they too do so at no cost or for production cost only, that is, not-for-profit;
3. that you include full contact information for the Hesperian Foundation on the copyright page of your edition;
4. that you send us three copies of the finished book (two for our library, one for the author);
5. that you send us your contact information so we can post it on our website and provide it to people who want to find your edition; and
6. that you keep us updated with your current contact information so we can send you corrections/updates etc. as they are generated for future editions or reprints of your book. If you wish to produce a commercial edition, i.e. one that will be sold for profit, containing any of our materials, you will need to write to us for permission. Without permission, you will be in violation of the international copyright laws.

 

Posted SwanDeer Project at 6:09 AM PST

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WASHINGTON SATE SENATOR UNVEILS COMPREHENSIVE HEALTH CARE REFORM BILL

JOINING WISCONSIN, STATE IS POISED TO TAKE ON LEAD ROLE IN NATIONAL REFORM DEBATE

Olympia, WA – At a press conference this morning at the State House, in Olympia, State Senator Karen Keiser (D, Des Moines) unveiled an ambitious new bill, called the Washington Health Partnership, that would bring health care to all Washingtonians and introduce new measures to reduce costs and increase quality of care.  At her side was Wisconsin State Senator Jon Erpenbach (D, Madison), author of the Health Wisconsin reform package on which Keiser’s legislation is modeled.

At the conference, Sen. Keiser characterized the spiraling cost of health care for families across the state and the nation as a “major crisis” and  proclaimed,  “The Washington Health Partnership will make health care affordable and accessible to everyone.”

Under the Washington Health Partnership, coverage would be extended  to all residents not already eligible for public programs like Medicaid and Medicare.  The bill would create a public pool of funds paid for by employer and employee payroll deductions and distribute these funds directly to existing coverage networks.  After contributing a payroll deduction of between 2-4% of social security wages, employees would pay no premiums and be free to choose from a wide range of private health care providers.

Proponents point to the savings generated by the bill’s funding mechanism as one of its primary merits.  According to Sen. Keiser, the increased purchasing power created by the pooling of funds and the accompanying consolidation of providers’ administrative costs would generate savings of over a billion dollars a year in health care expenditures. 

In Wisconsin, an independent study by the Lewin Group projected that these cost-saving measures would save families an average of $750 a year on health care expenditures, trim costs for employers that currently offer health benefits by an average of 15%, and save the state $13.8 billion dollars on health care spending over the next ten years.

Sen. Erpenbach also highlighted the freedom to choose among providers as another selling point for the bill.  “This is not the government stepping in and telling you which doctor you have to use.   This is .”

The Washington Health Partnership package was submitted to the State Senate at today’s meeting of the Senate Health and Long Term Care Committee.  Healthy Wisconsin was passed in the State Senate last July but voted down by the Republican-controlled Assembly and is slated to be resubmitted this year.

If passed, the two bills would mark the first two instances of states providing a public funding mechanism to provide coverage for all of their residents.  According to Adam Thompson, a senior Health Care Policy Specialist with the Progressive States Network, a group that tracks health care reform efforts in states across the nation, “Everybody is looking the Massachusetts and California right now on health care, and those states are making .  But the real action is in Washington and Wisconsin.  These are the bills that are going to change the way we think about health care."

Posted SwanDeer Project at 4:16 PM PST

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Heidi Sopinka, 10/26/07 

What could be a more eco-righteous symbol of the hippie vegetarian movement than a block of tofu?

As it turns out, the gentle bean has become somewhat of a blood crop in South America. A recent article in The Daily Telegraph uncovered that land-rights activists are risking death, while vast swaths of rainforest are being felled to provide land for the booming soy industry in Brazil (now surpassing the United States as the top soy exporter in the world).

With the added issues of widespread genetically modified and pesticide-laden crops, along with the documented dangers of eating too much unfermented soy, just how green is the soy bean?

... From fast food to pet food, soy is wall-to-wall in our edible products.

And while organic fermented soy can be good in moderation, eating a tofu burger and washing it down with a glass of soy milk on a daily basis could prove hazardous to your health. Although the lauded Asian diet has incorporated soy for centuries, it has never included the large amounts of unfermented and heavily processed soy products consumed in North America that have toxicologists worried.

When seeking out soy, look for products that are labelled "organic soy," which means they are genetically unaltered and pesticide-free. Fermented soy products, including miso, tempeh and tamari sauce, are healthy choices (the fermentation process removes the phytates, trypsin inhibitors and hemagglutinins, which can cause clots).

Posted SwanDeer Project at 8:44 AM PDT

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By very apparent and logical definition, insurance companies cannot maximize profits unless they deny claims.

Most of us can help insurers stay in business by restricting ourselves to Tylenol, bandaids and cough syrup. Oh, and by paying our exorbitant monthly health premiums which of course we don't get to apply toward payments on Tylenol, bandaids and cough syrup.

We're not team players when we get so sick that T,b & cs are no longer sufficient and we need major medical care.

Now we've joined the economic terrorists looking to put our patriotic self-serving capitalist wart hogs out of business with i.  p. m. d's (improvised personal medical disasters).

So when that smart-looking but dumb-talking blonde  tells us that frivolous lawsuits are the problem, she's being stereotypical and joke-worthy (and I'm not trying to make jokes or belittle blondes in the usual manner.)

Reference Eric Haas via Common Dreams

1. The Health Insurance Market - as a business enterprise market - is lucrative ... VERY lucrative.

    

2. The easiest path to lucrative profits is the denial route. It makes the most logical and common sense. If you're Dad or Mom ran a mom & pop-size insurance company in the neighborhood, profitability would be in collecting mucho premium and not having to spend mucho on claims.

    

3. While this sort of debate goes on and we can't seem to make up our political minds about health care problems we're currently being tempted not to force insurance companies out of the frivolous denials business.

   At the same time we, our families, our neighbors and our community perhaps are literally dying for lack of coverage that gets us through the doors of clinics and hospitals.

    

4. Insurers then by definition live in fear - not of frivolous lawsuits - but of being stuck with too large a share of sick customers in their own customer base.

    

5. We are forced into participating in a public policy wherein we have a discriminating benefit because of our income or our employer or whatever reason permits us to live covered by health insurance. Meanwhile, our neighbors - in this wonderful on-going pattern of living with a corporate capitalism that behaves badly in pursuit of profits - doesn't have insurance, can't afford to buy insurance, yet has to listen to TV insurance liars tell him

   "Too bad you can't afford insurance. Now vote against this referendum cause we want to protect you from ... from ... well, just in case anybody wants to sue us."

    

Health insurance companies are playing us in a lose-lose game, where we are the exploited and the exploiter together. They exploit our family responsibilities. I know that I couldn't live with myself, if I didn't provide my wife and daughter the insurance they need to get health care. But, having aided them (and me), I participate in the national Sophie's Choice.

How do I face my uninsured neighbors now?

Damned if I do, damned if I don't.

Thanks for the talking points Eric. Dear Readers click on the link and read the whole article, especially if you think frivolous lawsuits might be the big problem.

And ... if you're seeking more of this sort of outraged entertainment, wait until the stories break describing the different frivolous reasons why casualty insurers can't pay for fire damaged homes you know where.

Insurance is all about risk. Communities of at-risk people willing to pool resources to protect each other.

These "communities of insureds" - under the current system - are asked to bear and share the greatest portion of risk. The insurance companies who have supposedly united these communities do not want to share and bear any of that risk

... no matter the caring, helpful and open-handed images and put-back-together houses their advertising implies.

Posted SwanDeer Project at 7:20 AM PDT

Updated: Saturday, 27 October 2007 8:08 AM PDT

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KING COUNTY, Wash. – Dave Pear's speech is halting and he stumbles through his thoughts even though he has a spiral-bound binder of notes in his hands to prompt him. He repeats himself at times and gets frazzled with a brain that simply won't cooperate after too many concussions from his days on the football field. But there is one thing that can't be stopped as the 54-year-old Pear grapples with a life stunted by a game that has crossed the thin line from love of his youth to loathe of his middle age.

Frankly I do not remember Dave Pear who played in the NFL from 1975-1980. But then, now that I'm past 60 with back, knee and joint pain that is never far away, don't think I won't recall Dave Pear from time to time and thank fate that I never realized my teenage dreams of playing pro-football.

SI.com Photo Gallery - Roy Williams, Dallas Cowboys

"The NFL destroys families," Pear said. "I wish I had never played." Those 10 words, combined with the fact Pear wouldn't let his now-adult son play football, speak volumes from a far-reaching two-hour interview at Pear's home. It's a pretty house in the foothills overlooking Lake Washington in the suburbs of Seattle, the kind of place where anyone would be happy to retire.

The Pears are selling, downsizing in hopes of dealing with mounting medical bills to treat Pear's back and neck problems. Next to the reclining chair Pear sits in during the interview, while struggling to look comfortable all the while, there's a baking dish full of different medications.

Provigil, Neurontin, Lamictel, Trileptal, Baclofen, Vicodin and Ibuprofen are part of an alphabet soup of medications no one would dare sample if they weren't required. Depending on the time of day, Pear takes one pill to keep focused, another to calm him down and a bunch of them to keep the pain at bay.

There's also a list with the meds, laying out a regimen Pear must follow eight times a day as he swallows 38 pills a day. Even with samples that his doctors give him to defray the costs, the bill for the medications comes to approximately $1,000 per month.

Moreover, one doctor told Pear that in order for him to get the first of two hip replacement surgeries he will need soon, he must quit taking the Vicodin, which happens to be the best pain reliever. Unfortunately, the Vicodin has a side effect of interfering with the healing after joint replacements, Pear said.

With more medical bills to come, downsizing commences even as Heidi works two jobs. She teaches aerobics part-time while also maintaining a sales job. The flexibility allows her to tend to her husband as much as possible as he goes from one doctor's appointment to another.

I work in the DSHS office in northern Pacific County. I recall around 2000 or 2001 interviewing someone I assumed to be just a big ole wounded adult male whose name I recognized as the same as that of a former Oakland Raider I remembered (long time football fan that I am.)

But it wasn't a coincidence with identical names.

It was the real guy, a man who spoke of the Raiders of the 70's with recollections loaded with longing, smiles and tears. He casually dropped the names of Raiders I had not thought of in years: Lyle Alzado, Ben Davidson, John Madden, Ted Hendricks to name a few.

But this former Raider was never a celebrity; still somewhat a big guy, but not as much bigger than me as he was when he was a gladiator.

Now, he was just passing through the area and wanted to ask about whether or not he would be eligible for medical coverage and food assistance. He was in pain, weak as hell and floating in and out of control of his fragile weeping.

And that was the first time I was glad and no longer embarrassed that although I could throw a mean spiral in high school, I was nowhere near being able to play even college football.

In the late 1990s, he [Pear] risked a large portion of his wife's inheritance on high-risk stocks that crashed. He also took his pension at 45 (the NFL Players Association no longer allows that) to defray costs. The pension doesn't go very far.

"My pension is a car payment," said Pear, who receives $484 per month from his six-year NFL stint (1975-80) with the Baltimore Colts, Tampa Bay Buccaneers and Oakland Raiders.

The problem is that under federal law, someone who takes pension early is no longer allowed to get disability. That decision has potentially cost Pear hundreds of thousands of dollars because the disability benefit is so much greater than his pension.

Pear said he was duped into taking his pension rather than continuing to wait for disability. The NFLPA flatly denies that, but Pear emotionally contends otherwise. "They cheated me and my family out of more than $1 million in disability payments we should have received over the years," Pear said.

"The law makes it so that you can't double dip," said Miki Yaras-Davis, director of benefits for the NFL Players Association.

"I got involved in this because I wanted to help people. That's what we're trying to do, but there's a limit to what the law will allow me to do based on the decisions that people make." The other issue for players such as Pear is that until recently, when the NFL and the NFLPA agreed to use the Social Security standard for disability to determine who gets benefits, the standard seemed unduly high.

Read the entire article at Yahoo Sports At your next Saturday afternoon pork out or Monday night gathering, sip a few and chomp a cheeto for and on behalf of gladiators who mostly have little idea of what awaits them in a world of big hits and small returns. 

Posted SwanDeer Project at 8:20 PM PDT

Updated: Monday, 24 September 2007 8:06 PM PDT

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Why we ever let insurance companies turn our national personal health into an asset of profits is beyond me. Even if we had no vision, surely we could have and should have done something long before this.

Insurance companies may very well be the biggest crooks and liars in the nation - certainly the biggest lying and crooking segment of our corporate capitalist fraud.

Excerpt from The Boston Globe via Common Dreams.org

Health Reform Failure

Health reform built on private insurance isn’t working and can’t work; it costs too much and delivers too little.

At present, bureaucracy consumes 31 percent of each healthcare dollar. The Connector - the new state agency created to broker coverage under the reform law - is adding another 4.5 percent to the already sky-high overhead charged by private insurers.

Administrative costs at Blue Cross are nearly five times higher than Medicare’s and 11 times those in Canada’s single payer system. Single payer reform could save $7.7 billion annually on paperwork and insurance profits in Massachusetts, enough to cover all of the uninsured and to upgrade coverage for the rest of us.

Of course, single payer reform is anathema to the health insurance industry. But breaking their stranglehold on our health system and our politicians is the only way for health reform to get beyond square one.

Dr. Steffie Woolhandler and Dr. David Himmelstein co-founded Physicians for a National Health Program and are primary care doctors at Cambridge Hospital.

Posted SwanDeer Project at 7:35 PM PDT

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The rules to play by are hidden in one corner under a bag of sh*t - precisely where the corporate capitalists and their lip service want them. That corner is the one least likely visited by anyone with a fuse short enough to be lit by awareness of snake oil marketing and market manipulation.

I see the most rapid solution as that of moving the discussion out of the realm of governmental political discourse and into the realm of word-of-mouth indignation at specific corporate practices or specific corporate entities themselves.

Scale and size are more important in generating publicity and ill will toward a corporate entity or practice rather than a hope for some direct legal action against a specific illegal, unethical or self-serving corporate behavior.

As a union member, I stopped shopping at Walmart a few years ago. In fact my cheap computer here is the last thing I've ever purchased at Walmart.

Walmart's treatment, manipulation and abuse of it's employees is now sufficiently imbeded in public awareness that there has been an impact.

I'm not satisfied with the size of that impact and wish that the corporate reputation were more sufficiently sullied as to facilitate some dictation to Walmart by a coaliton of labor and consumers. But for now it will do.

Gathering, rallying and organizing potential boycotters - or the threat or imminence OF a specific boycott - are things I see as having the potential of waving a club at market abusers.

But none of what I write can I suggest as viable solutions because of the simple fact that we as market participants, as corporate marks, as rubes, consuming gullibles and manipulatees are left to our own devices to get the shell gamers to play more fairly.

This because economic think tanks are not trustworthy. Their funding sources and all that.

Back to Open Markets. I personally do not see the open market as even a legitimate source of delivery of health services and health care. In having already put our communal health condition at the mercy of an open market, we seem to have made of health and well being a commodity - the ownership and distribution of which can be obtained, monopolized and ... to quote your word ... rationed.

Our health, our health care and especially that heroic life-saving aspect of health care where our collective skills are superlative (as opposed to preventative health care where our collective skills are inadequate) are something of which we need new dialogue ...

... to discuss whether it belongs in the open marketplace at all ...

or not ....

I think not.

Posted SwanDeer Project at 8:13 PM PDT

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Mary makes a well-written case for Single Payer health insurance at Pacific Views today.

"America's health care system is imploding. Despite the fact that America devotes more of its GDP to health care than any other developed country, the real outcome for a significant portion of our country is miserable. And despite all the initiatives that claimed to fix the problem, the problem is getting worse."

As someone who administers state Medicaid in Pacific County and who becomes aware of as many uninsured citizens in an hour as an enterprising researcher could find in a day, I consider the above seriously understated.

"Getting worse" actually means something far fouler smelling than what you see in Sicko.

"Universal health care is particularly unsuited for a market-based approach because people are unable to do a lot of comparison shopping when they are sick and the overwhelming need for health care is when someone is sick, not when they are well."

A market-based approach in this country is the failed altruism of corporate capitalism which for decades has trumpeted the idea that the market could and WOULD take care of society's poor. That by definition is an impossibility given the formal constitutional definition for a "corporation."

That definition literally justifies - even encourages - a single-prioritized bottom-line profit-based approach to enterprises supposedly created to accomplish public good because individuals and small communities cannot create sufficient capital to accomplish it by themselves. It's an approach that has everything to do with some sort of corporate right (a la a human citizen/person's right) to the pursuit of happiness - precisely because corporate pursuit of happiness is pursuit of profit, not public good. It would be like giving a giant leech a constitutionally guaranteed right and protection to suck up the life blood of  every citizen and community.

... unless of course one "conservatively " defines "public good" as equal to what's good for business.

                                                           foto:bigpicture.typepad.com

I'm against any kind of market-based approach to universal health care.

Our objective should not be the highest priority is what's good for business in this regard. That's the attitude immediately and transparently  revealed  as harmful and inadequate when ideologically, an American president attempted to suspend minimum wage in the Katrina disaster area;

when he immediately asserted opportunity for profit before securing a disaster area;

- suggesting that the public good is best served if profits are prioritized first.

It borders on oxymoron to even suggest that government should be run as a business first and foremost. One primary reason is that profit unreasonably gets asserted as more important than the public good.

Bushco has amply demonstrated the failure of corporate capitalism to successfully care for its citizens or even to wage war (as if waging war were a constitutional obligation rather than  national  expediency) in the most economically wise and efficient manner. The Medicare D Supplement in reality is a massive act of corporate capitalist foolishness birthed by greed and lobby payments - not honest public discourse on the highest public good.

Speaking "capitalistically" and "market-basedly" we do not - when our house catches fire - call the fire department and make arrangements to pay a deductible before they will come. Our taxes have already paid for that.

... or if we hear an intruder in the house, we do not call the police and negotiate a deductible or co-pay term before they come out to keep us safe. Our taxes pay for that.

... Why the hell do we do that to ourselves regarding our most precious personal asset - health?

"Because taxes could go up," defenders of the market-based capitalist religion declare.  To which even non-MBA's like me who have spent hundreds of hours at the kitchen table working out budgets reply,

 "It's all in the budget priorities. We must be spending too much somewhere else, eh? Like perhaps on a paranoid and insecure  but profit-driven wide-eyed defense and weapons industry? 

The assumption is false and we are asleep. Market-based corporatists want us to stay that way.

It is all about bull shit ...the selling of bull shit ... the buying of bull shit ... the lying about bull shit ... and the harming of an entire society by overdosing on bull shit.

When a wild-eyed elderly woman comes into my office saying she's heard terrible horror stories about socialized medicine in Canada I'm ready to throw up or throw my hands in the air.

Think about it. 

 Great Britain apparently (at least per Sicko) launched their version of socialized medicine right after WW II when they were not far removed from financial insolvency.  They ain't even come close to scrapping it.

Why not?

Well hell, because maybe what they've got - what Canada and France have - works fine enough that their national public good and well-being far outweighs whatever problems come up. Regardless of American corporate lies, those problems certainly are not the nightmares our  lobbied-and-prompted politicians, insurers and care providers constantly try to scare us with.

How DO they pay for it? With taxes of course.

Why COULDN'T we pay for it with taxes?  We could, of course.

We might have to give up or cut back to reasonable levels some other kind of spending - like defense.

Of course we could and of course we should.

Those opposed to cutting back military spending are not driven by fear of a massively global military monolith with resources approaching a trillion dollars and planning an all-out attack and invasion of our homeland.  They are driven by a fear of loss of profits.

Get the terrorists yes ... but with honest police work and funded actions appropriate to legitimate need as a wise economic response.

But do we really need full-monte massive military assaults with nukes, 37 divisions plus the 4th, 5th , 6th, 7th, and 8th Fleets and the 98th, 99th and 100th Bomber Wings ... hell no!!

But of course that's another story to debate elsewhere whenever we get serious about sourcing and budgeting much more important issues, like being 37th in global health effectiveness.

Besides, that attack and invasion has already occurred.

It began years ago when we naively swallowed corporate bait and philosophy - without any critical thinking or understanding that lobbyists were serious (they always MEANT business) - hook, line and sinker.

We were attacked and invaded by corporate sharks who only got more openly savage about it after 2000 when Dirty Dingus McBush open the trapdoors and helped the corporate Trojan Horse drop a massive pile of stinking biscuits smack dab in every living room and homeless shelter in America.

So in terms of market-based medicine for America, our medicine-based marketing sharks would be the ones in ICU if we ever woke up,

if we ever narrowed our wide-eyed naïveté

and went shopping for a better system.

Michael Moore struck a nerve in his new documentary, “Sicko,” when he extolled the virtues of the government-run health care systems in France, England, Canada and even Cuba while deploring the failures of the largely private insurance system in this country. There is no question that Mr. Moore overstated his case by making foreign systems look almost flawless. But there is a growing body of evidence that, by an array of pertinent yardsticks, the United States is a laggard not a leader in providing good medical care.

... Insurance coverage. All other major industrialized nations provide universal health coverage, and most of them have comprehensive benefit packages with no cost-sharing by the patients. The United States, to its shame, has some 45 million people without health insurance and many more millions who have poor coverage.

... Access ... Citizens abroad often face long waits before they can get to see a specialist or undergo elective surgery. Americans typically get prompter attention ... The real barriers here are the costs facing low-income people without insurance or with skimpy coverage. ... even Americans with above-average incomes find it more difficult than their counterparts abroad to get care on nights or weekends without going to an emergency room.

... Fairness. The United States ranks dead last on almost all measures of equity because we have the greatest disparity in the quality of care given to richer and poorer citizens.

... We rank near the bottom in healthy life expectancy at age 60, and 15th among 19 countries in deaths from a wide range of illnesses that would not have been fatal if treated with timely and effective care. The good news is that we have done a better job than other industrialized nations in reducing smoking. The bad news is that our obesity epidemic is the worst in the world.

... Quality. In a comparison with five other countries, the Commonwealth Fund ranked the United States first in providing the “right care” for a given condition as defined by standard clinical guidelines and gave it especially high marks for preventive care, like Pap smears and mammograms to detect early-stage cancers, and blood tests and cholesterol checks for hypertensive patients. But we scored poorly in coordinating the care of chronically ill patients, in protecting the safety of patients, and in meeting their needs and preferences, which drove our overall quality rating down to last place.

... With health care emerging as a major issue in the presidential campaign and in Congress, it will be important to get beyond empty boasts that this country has “the best health care system in the world” and turn instead to fixing its very real defects. The main goal should be to reduce the huge number of uninsured, who are a major reason for our poor standing globally. But there is also plenty of room to improve our coordination of care, our use of computerized records, communications between doctors and patients, and dozens of other factors that impair the quality of care. The world’s most powerful economy should be able to provide a health care system that really is the best.

Posted SwanDeer Project at 10:56 AM PDT

Updated: Sunday, 12 August 2007 7:36 PM PDT

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By AMY ROLPH
P-I REPORTER Friday, 07/13/07

Don't be surprised if bike lanes on Seattle streets are a little empty this weekend. The bicyclists will be back -- they've just gone to Portland for a day or two.

About 9,000 bicycle enthusiasts will be leaving the city on two wheels for Portland on Saturday morning, the official start of the Group Health Seattle-to-Portland Bicycle Classic.

Those who complete the trek will pedal more than 200 miles before crossing the finish line in Halladay Park in northeastern Portland.

Most riders are expected to take two days to complete the journey, though about 2,200 participants have said they plan to make it to Portland in one day.

About 18 percent of the cyclists signed up are first-time riders, Cascade Bicycle Club spokeswoman M.J. Kelly said.

"The casual cyclist who does some training can definitely do this," Kelly said.

The bicycle club coordinates the event, which is in its 28th year. The first year, 183 bicyclists participated.

Posted SwanDeer Project at 6:19 AM PDT

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Where best to learn about the real world, once a week in church or everyday out where the fish jump out of the water, the birds & bees procreate without a preacher's permission and where reality's rubber tire rolls down the road?

But then let the literalists have their way, stand back and watch the foolishness crop up like weeds in the garden. Why not teach Creationism and Evolution side by side then let the kids decide?

Posted SwanDeer Project at 6:48 AM PDT

Updated: Sunday, 24 June 2007 6:53 AM PDT

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Between a rock and a hard spot. Damned if you do and damned if you don't?

 

AP via Huffingtonpost.com

MARILYNN MARCHIONE  |  AP  |  May 21, 2007 10:09 PM EST

— A widely used diabetes pill raises the risk of heart attacks and possibly death, according to a scientific analysis that reveals what some experts are calling another Vioxx-like example of the government failing to protect the public from an unsafe drug.

More than 6 million people worldwide have taken the drug, sold as Avandia and Avandamet, since it came on the market eight years ago to help control blood sugar in people with the most common form of diabetes. About 1 million Americans use it now.

Pooled results of dozens of studies on nearly 28,000 people revealed a 43 percent higher risk of heart attack for those taking Avandia compared to people taking other diabetes drugs or no diabetes medication, according to the analysis published online Monday. The study, published by the New England Journal of Medicine, also found a trend toward more heart-related deaths.

 

The findings are frightening because two-thirds of diabetics die of heart problems, so a drug that boosts this possibility is especially hazardous for them.

Still, the actual risks to any single patient appear small. Diabetics should talk to their doctors before stopping any medication, said a statement issued by the American Diabetes Association and two groups of heart doctors.

Avandia's maker, British-based GlaxoSmithKline PLC, disputed the results of the analysis but acknowledged that its own similar review found a 30 percent increased risk _ information it gave last August and possibly even earlier to the U.S. Food and Drug Administration. But the company said that more rigorous studies did not confirm excess risk.

FDA officials issued a safety alert on Monday and said they likely would convene an advisory panel, but planned no immediate changes to the current side effect warnings on the drug's packaging.

Several members of Congress expressed alarm. Rep. Henry Waxman, D-Calif., chairman of the House Committee on Oversight and Government Reform, announced a hearing for June 6 on FDA's role. On the Senate floor, Charles Grassley, R-Iowa, criticized the agency for not acting more swiftly.

"Do we have another Vioxx on our hands with Avandia? I am not sure, but I intend to find out," he said, referring to the blockbuster arthritis drug withdrawn in 2004 because of safety problems. "Tens of millions of prescriptions have been written for Avandia, and Medicare and Medicaid have paid hundreds of millions of dollars for this drug."

Avandia is used to treat Type 2 diabetes, the most common form of the disease, which is linked to obesity and afflicts 18 million Americans and 200 million people worldwide. This form of diabetes occurs when the body does not make enough insulin or cannot effectively use what it manages to produce.

Avandia, or rosiglitazone, helps sensitize the body to insulin and was considered a breakthrough medication for blood-sugar control. It also is combined with metformin and sold as Avandamet. Only one other drug like it _ pioglitazone, sold as Actos and Actoplus Met by Takeda Pharmaceuticals _ is sold in the United States.

Avandia had total U.S. sales of $2.2 billion in 2006, slightly trailing $2.6 billion for Actos, according to IMS Health, a healthcare information company. About 13 million Avandia prescriptions were filled in the U.S. last year. A one-month supply of Avandia sells for between $90 and $170.

GlaxoSmithKline also has been testing Avandia to try to prevent diabetes in those at high risk of it, and, in separate studies, to prevent Alzheimer's disease.

However, the new analysis casts a pall on its prospects for prevention as well as treatment, many specialists said. The study was led by Dr. Steven Nissen and statistician Kathy Wolski at the Cleveland Clinic. Nissen accepts no personal fees for consulting for any drug makers.

While the analysis doesn't spell out the actual the rate of heart attacks among Avandia users, the 43 percent excess risk is in line with what a similar analysis found for lower doses of Vioxx use, Nissen said. Another context for that number: Heart attack risks are lowered about 25 percent by cholesterol-reducing statin drugs _ ample reason to prescribe them.

The Avandia studies Nissen analyzed were not designed to look for heart risks and many of them were so short _ some only 24 weeks _ that risks may only appear over the longer term, he said.

Dr. David Nathan, chief of diabetes care at Massachusetts General Hospital, agreed.

"This analysis is just scratching the surface of what may be there. It needs to be taken seriously," said Nathan, who reviewed the paper for the medical journal and has no financial ties to any diabetes drugmakers.

The situation "reflects very badly on the FDA and on Glaxo," Nathan said. "It's the FDA's responsibility to be monitoring this stuff."

The drug "represents a major failure of the drug-use and drug-approval processes in the United States," Drs. Bruce Psaty and Curt Furberg wrote in an editorial in the New England Journal. Psaty is with the University of Washington in Seattle and Furberg is with Wake Forest University.

When the drug was approved, evidence of its benefits were "at best mixed," wrote the two doctors. Both have been frequent critics of the FDA's failure to spot dangers in the drug approval process and its conduct involving Vioxx.

Avandia's label already warns about possible heart failure and other heart problems when taken with insulin. The drug also raises LDL or bad cholesterol, and can cause fluid retention and weight gain. Glaxo also has reported some patients suffered more bone fractures, swelling of the legs and feet, and rare reports of swelling in the eye that can cause vision problems.

However, in a conference call Monday, Dr. Lawson McCartney who leads Glaxo's diabetes drug development, said: "We remain very confident in the safety and of course in the efficacy of Avandia as an important diabetic medicine."

Dr. Robert J. Meyer of the FDA's Center for Drug Evaluation and Research, also defended the agency's actions, saying information about risks is not clear-cut.

"We've tried to weigh the risks of going forward with an uncertain message ... with the level of uncertainty about the safety signal before us,"

Glaxo's shares trading in the United States closed down $4.53, or 7.9 percent, at $53.18.

Nissen used publicly available information from an earlier $2.5 million Glaxo settlement with the state of New York to do his study. He also led earlier research that derailed a similar diabetes drug, Pargluva, that seemed headed for FDA approval until safety issues emerged. A fourth drug in the same class, Rezulin, was withdrawn in 2000 after it was linked to liver problems.

____

On the Net:

New England Journal: http://www.nejm.org

GlaxoSmithKline: http://www.gsk.com

Glaxo clinical trial registry: http://ctr.gsk.co.uk

Food and Drug Administration: http: http://www.fda.gov

Avandia's label: http://tinyurl.com/2qzhfe

Diabetes information: http://www.diabetes.org

and http://diabetes.niddk.nih.gov/

Posted SwanDeer Project at 7:59 PM PDT

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Ain't we all been there? Well, most of us who scare the hell out of our bathroom scales when they see us coming?

Excerpt: Read the entire article at Newsweek online 

The Astrology Diet
In "Zodiaction: Fat-Burning Fitness Tailored to Your Personal Star Quality," trainer Ellen Barrett and astrologer Barrie Dolnick promote an exercise and eating plan based on the 12 astrological signs. Scorpios are "fiery" and need "cooling foods," says Barrett. "It sounds fun, but there's no scientific backing for it," says the ADA's Andrea Giancoli.

The Blood-Type Diet
In "Eat Right 4 Your Type," Peter D'Adamo, a naturopathic doctor, argues that people should eat according to their blood type. A type A, he eats lots of fish and avoids processed meats. "There's no evidence that different people with different blood types need different diets," says Willett. So what's the appeal? People "think it's more personal than other diets," says Giancoli.

 

Single-Food Diets
Grapefruit. Cabbage Soup. Pineapple. Single-food diets are perennial favorites. "They keep coming back," says Giancoli, who admits she tried single-food diets—including her own popcorn diet—before becoming a registered dietitian and trying (gasp!) a balanced diet and moderate quantities. Eliminating complete food groups can lead to nutrient deficiencies. The body needs protein, for example, to build and repair muscles.

The Maple-Syrup Diet
Sounds yummy, but this draconian plan doesn't allow pancakes. Instead, it asks dieters to drink a concoction of 2 tablespoons of maple syrup, 2 tablespoons of lemon juice, a pinch of cayenne pepper and a cup of water. The diet seems new because Beyoncé said she used it to slim down for "Dreamgirls." But it actually took off in 1976, when Stanley Burroughs wrote "The Master Cleanser." "The really critical thing for weight control is to find something we can live with for the rest of our lives," says Willett. "That would not be maple syrup." The ADA's Susan Moores worries that the diet can interfere with the body's balance of sodium, potassium and fluids. It's particularly detrimental, she says, for kids, teens, pregnant women and nursing moms.

Detox Diets
"For some reason, people think our bodies are full of all kinds of toxins," says dietitian Tara Gidus. Some detox diets, including "21 Pounds in 21 Days," call for "cleansing" with colonics. Translation: enemas. The problem with using them to clear the colon of waste: "it's not really waste at all," says Northwestern University gastroenterologist Alan Buchman. "What people describe as 'toxins' include the normal metabolic products of digestion and the normal bacteria that produce vitamin K and folic acid—and other substances that keep the colon healthy.

Posted SwanDeer Project at 7:00 AM PDT

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Learn about the latest information on family health and safety at the Shoalwater Bay Indian Tribe’s annual Health Fair.

More than 30 vendors will be on hand from 1 to 4 p.m. Friday, May 18 at the tribal gym. Topics will include exercise and nutrition, HIV and AIDS, diabetes prevention and management, dental health, how to quit smoking, how to prepare for an emergency, behavioral health and chemical dependency.

There will be regular prize drawings, and activities and prizes for children.

The fair is sponsored by the Shoalwater Bay Indian Tribe and the Shoalwater Bay Wellness Center. The wellness center offers medical and dental care, and behavioral health.

Follow signs from Highway 105 to the gym, located on the Shoalwater Bay Indian Reservation.

Posted SwanDeer Project at 7:12 AM PDT

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I wrote about this a few years ago on D aily Kos  shortly after passage of the Medicare Bill in the middle of the night when Republicans & Associates approved corporate pillaging of the Medicare System. The article was entitled Why Your Medicare D. Is So Dang Dumb. 

Times: Private Medicare plans use 'improper tactics'

Published: Sunday May 6, 2007

The New York TImes via rawstory.com 

According to a story in tomorrow's New York Times (reg. req.), officials and consumer advocates are concerned that insurance companies are using "improper hard-sell tactics," such as trips to Las Vegas, to sign up Medicare recipients in private health care plans known as Medicare Advantage plans.

Advocates of the popular plans say they help coordinate care and can offer extra benefits, such as discounts on eyeglasses and dental care. However, in many cases they are more expensive for both patients and the federal government, and they have also found to be subject to fraud and abuse.

Excerpts:

 

In Mississippi, George R. Dale, the state insurance commissioner, said, "Abusive Medicare insurance sales practices are spreading rapidly throughout the state." State Sen. Terry C. Burton, a Republican, said, "My office is receiving calls daily from seniors who have been victims of unscrupulous salespeople."

..... These "private fee-for-service plans" allow patients to go to any doctor or hospital that will provide care on terms set by the insurer. But some patients have found that they have less access to care, because their doctors refuse to take patients in private fee-for-service plans. Moreover, those plans may be more expensive than traditional Medicare for some patients, because the co-payments for some services may be higher. And economists say that the cost to the government is also higher because, in many counties, Medicare pays private plans more than the cost of traditional Medicare.

..... In Georgia, two insurance agents were arrested last month and accused of conspiring to defraud Medicare beneficiaries. "The agents signed up unwilling consumers and even deceased individuals for private Medicare plans," said John W. Oxendine, the Georgia insurance commissioner. "This appears to be a national problem, based on my conversations with insurance officials around the country."

The full story can be read with a New York Times registration at this link.

Posted SwanDeer Project at 7:01 AM PDT

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Lifestyle changes driven originally by take the RealAge.com test are having an intitial dramatic impact. The incredible dietary change resulting from Lietta's research and committment to change has been augmented by my own promise to exercise frequently.

At work - where I'm authorized a morning and afternoon break, I stopped sitting and reading and committed to walking. 7 1/2 minutes from the office and 7/12 minutes back morning and afternoon. Add to that a 15 minute walk during my lunch hour and the results have been very gratifying and motivating.

Not only are my clothes already fitting better, but my internal sense of health, energy and mobility are readily apparent moment to moment.

Check out the following article from McClatchy Papers via the Olympian 

[Excerpt]

Walk 10,000 steps a day and count on losing the weight

James A. Fussell
McClatchy Newspapers

Many of today's fitness regimens recommend walking 10,000 steps per day. There's only one problem: Almost nobody knows how far that is.

Do you burn 200 steps puttering around your house in the morning before work or 1,000? Does a walk around a city block knock off 5 percent of your daily goal or less than 1? Sure, you can guess or try to count all your steps, but that's inaccurate at best and annoying to say the least.

Recently, in the name of good health, we bought a pedometer and measured various daily activities step by step. Walking the dog around the block? Going to the grocery store? Two hours of clothes

shopping at a local mall?

We know how many steps it takes. But we didn't stop there. Just for fun, we set out to find how far we'd go if we walked 10,000 steps all at once.

The answer: much farther than we thought. With our 10,000th step, we wound up more than 5 1/2 miles away.

We can hear your incredulity now. But relax. You don't have to do it all at once. Remember, every step counts.

But why even bother trying to get 10,000 steps per day?

Two words: your health. And, yes, just by walking, you can make significant gains - or losses.

The idea of walking 10,000 steps per day is enjoying a renaissance in the United States. It originated in the 1970s with Japanese researcher Yoshiro Hatano, who advocated walking to help slim down his increasingly obese country.

Today, walking has gained popularity for many reasons. It's easy, there's no equipment to buy and, unlike jogging or other high-impact exercises, there's virtually no risk of injury.

And talk about health benefits. A University of Tennessee study published in the journal "Medicine and Science in Sports and Exercise" revealed women who averaged more than 10,000 steps per day had 40 percent less body fat and waist and hip measurements that were more than 8 inches narrower than those who averaged fewer than 6,000 steps.

Then there's the Amish. Researchers measured the daily steps of 98 Amish adults and found that men took an average of 18,425 steps and women took 14,196. Compare that with 3,000 to 4,000 steps for the average American adult, and it is easy to see why only 4 percent of Amish adults are considered obese compared with 31 percent of the general American population.

And attention older Americans: If you walk long enough, you could even trigger biochemical changes that grow new neurons in your brain. A study by researchers at the University of Illinois says three hours of brisk walking per day can help reverse brain shrinkage.

The rest of the article can be found at McClatchy Papers via the Olympian 

The other day, looking for a pair of work pants, I pulled out clothes from the back of my closet and found lots of pairs of pants. Only two of them still do not fit but all the others that did not fit before fit now. 

Voila!

Eureka!

But my wife told me, "You can wear any of those pants for working in the yard now that they fit again.

But if you wear any of those to your real job in town, don't come home." 

Posted SwanDeer Project at 2:47 PM PDT

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One Senator's Solution for Health Care Expansion

 by Julie Rovner NPR

Sen. Ron Wyden (D-OR) has been a longtime advocate for health care reform. His latest effort, the Healthy Americans Act, seeks to ensure that all Americans have health insurance coverage. He says the employer-based insurance model is "melting like a popsicle on a summer sidewalk." Courtesy of Sen. Wyden's Office

National Public Radio
[Excerpt] Click on NPR link to read entire article.

April 16, 2007 · Major social change often takes generations. It took 50 years for women to win the right to vote, and nearly 100 years to pass civil rights laws.

So it is not surprising that efforts to establish a health-care system that covers all Americans haven't yet borne fruit. Still, many advocates remain motivated to work toward a goal they know may not be realized during their lifetime.

Among the most tenacious health reform advocates is Sen. Ron Wyden, (D-OR). At a news conference in December, Wyden introduced the Healthy Americans Act — a bill three years in the making and his latest bill to provide every American with health insurance. And he sounded like a man in a hurry.

"Health care has been poked and prodded and blue-ribboned and it is time for action," he told the crowd assembled in the cavernous hearing room of the Senate Finance Committee, where Wyden serves.

Posted SwanDeer Project at 7:42 PM PDT

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We are tackling some lifestyle changes for ourselves and I tend to want to 'research' a thing before I actually start 'doing' a thing.

We both have quit smoking - he after 13 years, me after (I'm embarrassed to say) 40 years.

Okay that is done.

I'm giving attention to our food lifestyle, and shifting it to vegetarian. That is not new for me and I'm using my Bundelz blog to give that area of our life attention. We are both giving attention to some 'exercise' so to speak, just gentle stuff, nothing too heavy duty, so walking, gardening, that sort of thing.

For me, I find it's true that what I've lost in breathing capacity from smoking all these years has done harm. I don't have the capacity for much enthusiastic movement and need to build up what I do have via re-introduction to exercise regimen.

It' hard to believe I used to teach aerobics and was a trained dancer. If I were to gauge my capacity to dance, move, do aerobic exercises now....well, let's just say smoking has taken it's toll over the years. And it is far more noticeable to me now post menopause than it was during and before. Something about post-menopause has really thrown me out of whack. I should write to that someday.

Now that sustainable living is gaining popularity, I'm feeling enthusiasm about returning to the idea of 'frugal', 'meaningful living', 'off the grid', self-sustaining kind of homesteading type lifestyle. Oh, no, we aren't anywhere close to self sustaining, homesteading or otherwise, but I am fascinated with thinking we can head in that direction and have made many lifestyle changes since I began that project for us back in 2003.

My attention and activism to the military invasion and occupation of Iraq has consumed huge quantities of my time over the past 4 years. I am so disappointed that four years later we are still in Iraq - that is not something I anticipated and was most willing to give everything those first three years to do what I could to help bring it to a quick end.

But four years later, and I recognize I will have to give balance to my life to sustain over the long haul as it seems our military will be in Iraq for years, if not decades to come -- according to the very words of this President and Commander-in-Chief.

I think, then, this blog will be sprinkled with thoughts from our every day life, sometimes serious, sometimes political, sometimes light, sometimes simple, sometimes just the thoughts of a silly old woman.

Posted SwanDeer Project at 12:01 AM PST

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5 reasons to take naps

Thomas Edison, Napoleon Bonaparte, Salvador Dali, Winston Churchill, and Presidents Kennedy and Reagan had something in common? In fact, each of them enjoyed a regular nap.

While small children typically take naps in the afternoon, our culture generally frowns upon mid-day sleep; however, many people feel a mid-afternoon slump in mood and alertness, especially after a poor night of sleep. Many believe that this slump is caused by eating a heavy lunch. However, in reality, this occurs because we were meant to have a mid-afternoon nap.

Several lines of evidence, including the universal tendency of toddlers and the elderly to nap in the afternoon and the afternoon nap of siesta cultures, have led sleep researchers to the same conclusion: nature intended that we take a nap in the middle of the day. This biological readiness to fall asleep in the mid-afternoon coincides with a slight drop in body temperature and occurs regardless of whether we eat lunch. It is present even in good sleepers who are well rested.

Here’s what you need to know about the benefits of sleep and how a power nap can help you:

 

 

Red wine may contain the elixir of youth

Dr David Sinclair, one of the US researchers from Harvard Medical School in Boston, Massachusetts, said: "The 'healthspan' benefits we saw in the obese mice treated with resveratrol, such as increased insulin sensitivity, decreased glucose levels, healthier heart and liver tissues, are positive clinical indicators and may mean we can stave off in humans age-related diseases such as type 2 diabetes, heart disease, and cancer, but only time and more research will tell."

Ten Reasons to Drink More Water

I know you've heard this many times - "Drink more water!". Yet, 99% of the people don't heed this advice. Maybe if water was more expensive, people would pay more attention to consume enough of it on a daily basis. We are living in a dehydrated world of carbonated beverages, caffeine and alcohol. I bet you don't know how important is water for your health, figure and well-being. But drinking water is not just a trend, it's essential! Everything your body does it does better with a healthy supply of water, every system in your body depends on water. So here are 10 reasons why drinking water is good for you and why you should make drinking water part of your daily routine: 1. Get Healthy Skin 2. Flush Toxins 3. Reduce Your Risk Of Heart Attack 4. Cushion And Lube Your Joints And Muscles 5. Get Energized And Be Alert 6. Stay Regular 7. Reduce Your Risk Of Disease And Infection 8. Regulate Your Body Temperature 9. Burn More Fat And Build More Muscle 10. Get Well

Coffee and Health: Health Benefits of Coffee

Coffee has been a medical whipping boy for so long that it may come as a surprise that recent research suggests that drinking moderate amounts of coffee (two to four cups per day) provides a wide range of health benefits. Most of these benefits have been identified through statistical studies that track a large group of subjects over the course of years and match incidence of various diseases with individual habits, like drinking coffee, meanwhile controlling for other variables that may influence that relationship. According to a spate of such recent studies moderate coffee drinking may lower the risk of colon cancer by about 25%, gallstones by 45%, cirrhosis of the liver by 80%, and Parkinson's disease by 50% to as much as 80%. Other benefits include 25% reduction in onset of attacks among asthma sufferers and, at least among a large group of female nurses tracked over many years, fewer suicides.

Have Sex, Live Longer

According to a spate of news reports on life extension that have spread across the internet like influenza just about everything out there ads a little time to your mortal coil. Wine, calorie reduction diets, low body temperatures have all made news for their ability to give you a few more good years on earth, and now, so too does sex. According to a 1997 study in the British Medical Journal men who have regular orgasms live longer. The also have a better sense of smell, reduced depression and improved heart function.

This article in Forbes list a few good reasons to keep knocking boots until your boots can knock no more.

So with pot helping Alzheimer's, red wine helping you age gracefully, and sex improving just about everything else, you have to like the direction modern medicine is going.

Sitting up straight is not the best position for office workers, a study has suggested.

 

Scottish and Canadian researchers used a new form of magnetic resonance imaging (MRI) to show it places an unnecessary strain on your back.

They told the Radiological Society of North America that the best position in which to sit at your desk is leaning slightly back, at about 135 degrees.

Experts said sitting was known to contribute to lower back pain.

Data from the British Chiropractic Association says 32% of the population spends more than 10 hours a day seated.

Posted SwanDeer Project at 12:01 AM PST

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Thinking that congress had your best interests in mind when they legislated the new Medicare Prescription Drug Benefit?

Think again.

I susbscribe to The Nation and take it to work to read during breaks and at lunch. Trudy Lieberman wrote a good explanatory *article about the Medicare D program - a boondogle that has stumbled right out of the gate in its implementation.

To understand why your new Med D prescription benefit is so complicated, confusing and expensive for your budget, you must understand one thing about the economic theory of the elected Republican majority at the national level.

"What's good for corporate capitalism is good for the country."

Medicare D is modelled on one of our classic corporate capitalist national failures: our commercial health insurance system. That's the vaunted one that under the most powerful economic force in the world has left us in 37th place globally in terms of effective and quality national health care.

That's the vaunted one that any system modeled after Britan or Canda or any other country where EVERYONE is covered would never exceed the vauntedness of corporate America's capitalist dream.

Here's how they did it ... and you must remember the power of lobbying in this country and how senators and congress persons can't decide how to vote until a corporate capitalist prompts their wisdom with cash.

These wise lawmakers chose some 260 private insurers (corporations who supported this scheme with lobby money given primarily to - you guessed it - Republican lawmakers. Republicans, you surely remember, are the majority in congress and therefore have the power to turn the scheme into law). These wise partisan lawmakers have forced you to choose one of those elite insurers.

Who are these chosen 260?

Why they're private pharmacy benefit insurers, HMO's, pharmacy organizations like Walgreen's, Long's and Wal Mart. You surely didn't think they are social-minded or populist organizations like the Grange did you? Naw ... these aren't social minded do-gooders. They're the profit-minded self-interested.

Our economically "wise" lawmakers have now made it legal for our government to send YOUR medicare money - I mean it, the actual money that would be used as your individual medicare benefit - to the corporation you have to pick from among the 260.

It's an automatic revenue the corporation will spend advertising or marketing costs for in order to out-muscle the competition and will include as part of the additional premiums you'll pay out of pocket in order to pay less for your medicines.

This is a free-market system run amok.

In some areas seniors have 40-50 choices of plans. The plans have confusing choices of options, many of which involve differing monthly premiums (ranging from $0 to $60).

There are combinations of deductibles.

There are combinations of co-insurance (your percentage/their percentage of the medicine's price).

There are options to try cheaper generic drugs.

There are "tiers" (levels of priority and/or allowability) based on copays, generics, preferred brands, non-preferred brands, specialty drugs ...

and whether you buy from an "in-network" pharmacy with discounts or "out-of-network" pharmacy with no discounts.

There is no standardized nomenclature (no set of names, concepts, options and plan definitions that are standard among all of the 260 chosen corporate medical monopolists.) One uses the phrase "co-pay"; another calls it "deductible".

What if we folks have questions?

Well, we can go on line to a web site with a complicated web answer-giver. If you're one of the 75% of seniors who have never gone on line - well, chin up! A whole new cyber adventure is out there just waiting for you to invest in another corporate hog-trough sector by buying a computer and joining the internet surfer society.

What's going to happen with this pick-your-pocket-because-you're-over-a-barrell scheme?

Remember, the Republicans got this doofus plan passed with a projected price tag of $400 billion - a little less than the current sub-total for war spending in Iraq and Afghanistan by the way.

But wait! We then learned that the Bush Administration told Medicare officials - in the tradition of Bill O'Reilly - to SHUT UP. They were told to keep the real cost which is in excess of $550 billion a secret.

What about the sacred chosen 260? All vendors are not expected to remain "competitive." That means that not all vendors are expected to survive in the free-market system.

No, the biggest sharks with the biggest teeth and the biggest lobby dollars will win the survival of the health insurance fittest. We'll see the 260 reduced to perhaps 10 survivors; mega-innsurers who will slug it out for all the leavings of those other 250 who just couldn't make it.

And instead of free-market capitalism we'll have closed-market monopoly based on sending Medicare tax dollars to friends of the Republicans.

Who might that be?

Well, United Health Group is spending 75 million on marketing and operations for this new Republican give away.

Aetna= $50 million Cigna: $40 million Humana (a midwest regional insurer)= $80 million. Pfizer's in there too. You know Pfizer ... Bob Dole sold his Viagra perspective for Pfizer.

But those investments are chump change compared to what happens when all the Medicare clients sign on to automatic directed payments to the chosen hog-trough recipient. This is the Republican American Way of course and whatever premium you pay to your chosen insurer will include recovery of that marketing money.

Then there's this: You'll hear words of wisdom from the Medicare RX Education Network and may receive mailings in envelopes bearing a return address of the U.S. Chamber of COmmerce.

You are forgiven if you mistakenly assume these are official government communications to you. They are not.

They have been allowed by Republican free-marketer politicans to use the government's official logos.

And if you run into something called "Medicare Today," you'll be seeing a creation of the Healthcare Leadership Council. Who's that you ask?

Well, a group of hospitals, drug companies, medical equipment makers and academic medicate centers joined up some 300 members. They then raised millions of dollars for "outreach" to get seniors to sign up and authorize one of them to receive government Medicare dollars earmarked in your name.

The 37th best medical care system in the world is 37th because that system functions in the tradition of Exxon-Mobil's double-digit billions of dollars quarterly profits. However, the 37th best medical care system is #1 in what is the truest priority: Turning billion-dollar profits while at the same time failing to adequately treat and protect all of its citizens.

That's the linkage between corporate lobbyists and corrupt politicians. That linkage and system is more and more revealing itself as foundational to the failed economic politics of contemporary corporate conservative Republicanism.

*Reference: The Nation, January 30, 2005 - KILLING MEDICARE by Trudy Lieberman who writes about healthcare for The Nation.

Posted SwanDeer Project at 12:01 AM PST

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