Wednesday, March 25, 2009

Health-Care Reform Smackdowns!

To paraphrase President Obama, fixing our busted health care system isn’t going to be easy. Or quick. But in a twisted kind of way, it can be entertaining to watch. Sort of like professional wrestling. Or watching a NASCAR race for the crashes.

All signs point to the FDA as the first major casualty, and it can’t come soon enough for me. This poor excuse for a government agency (amid all other poor excuses for government agencies) looks like it’s going to be ripped in two. Because it can neither keep our food supply safe nor test and approve drugs adequately and in a timely fashion, the chorus is growing to create two agencies – one that handles our food supply and one that deals with medical products.

On the food side, the Tainted Peanut Butter Debacle pretty much sealed the deal for any kind of credibility the FDA may have over our food safety. It didn’t help that it came on the heels of contaminated spinach, lettuce, jalapenos, pet food and infant formulas.

And in their medical division, case after case keeps rolling in about corruption, either by pharmaceutical companies that did not perform adequate testing of their products or buried their bad press; or by researchers who planted glowing - albeit forged - studies in medical journals so they wouldn’t lose their funding. I’ve lost count of how many pharmaceutical companies are being sued in class-action suits about poorly studied medications that either caused deaths or serious injury.

For instance, the diabetes drug Avandia has been shown to increase people’s risks for heart attacks. Apparently, GlaxoSmithKline, the pharmaceutical company that makes the drug, knew about this for years before actually getting around to telling us. (Oops.) And several years ago, the FDA buckled under pressure from Congress to get Merck to pull its painkiller, Vioxx, from the market also for causing number of heart attacks among its users.

The FDA’s continual refrain is that they are understaffed and under-funded. But the food side is continually getting short shrift. According the Institute of Medicine, this year the FDA will spend $.73 on food safety for every dollar it spends on drugs. One expert said that an agency that [theoretically] assures the safety of complex, $3000-a-month biotech drugs should not also have to regulate $3 jars of peanut butter. But in straining to do both tasks, they have done neither very well.

Donald Trump would have fired them a long time ago.

So Barack Obama raised hopes of an agency divorce when he placed two public health specialists at the head of the agency and appointed an advisory group to study our ancient food safety laws.

If she were to be confirmed, Margaret Hamburg, former NYC Health Commissioner, would be the FDA commissioner. For her deputy, she has chosen Joshua Sharfstein, a prominent pediatrician and outspoken critic of children’s cold medicines.

According to an interview by the Associated Press, this combination of appointees prompted Peter Pitts, a former FDA official, to speculate that Hamburg would run the food safety division of the FDA and that Sharfstein would move over to run the medical side of the street.

Big Pharma executives couldn’t be more pleased at this possibility. They believe that peeling the medical division off from the FDA could speed up lagging drug approvals, which have become bogged down because of all of that pesky food safety stuff. They also believe that public outcry over food contamination (I know – what nerve we have to expect untainted food!) have made FDA officials even more hinky about drug approvals.

But pharmaceutical advocates are keeping their happy dances to themselves. “Every CEO that I know in health care is in favor of this, but none that value their share prices will go on the record for fear of retribution from the FDA,” said Steve Brozak, president of WPB securities, an investment brokerage focused on drug and biotech companies.

Other than to say that “the status quo is unacceptable,” pharmaceutical lobbyists would not comment on the possibility of a new drug agency. The FDA itself is keeping mum as well.

If the agency has irreconcilable differences and a divorce is granted, look for a big fight on Capitol Hill. It would mean our rejiggering of committees, which means power shifts and people who will not be so willing to give up their power. This should be good.

Of course, splitting the two agencies could backfire. Instead of one bogged down, under-funded and understaffed agencies, we could have two bogged down, under-funded and understaffed agencies.

But I hope not.

Next up on Saturday Night Wrestling is actually more of a stealth battle between the health-insurance industry and Congress.

And somebody has been reading Sun Tzu’s “The Art of War.”

The health insurance industry made the opening gambit by appearing to offer a concession: they are willing to give up the practice of charging higher premiums for people with pre-existing conditions. But wait. This is not exactly a concession if you think about it. If Congress wants to run its own insurance plan, they would put themselves in competition with the health insurance agency. So why wouldn’t companies like Blue Cross want to make themselves look more attractive to consumers by looking like good guys for not charging your mother higher premiums because she has diabetes?

Congress? It’s your move.

Wednesday, March 04, 2009

Return of the Killer Brassiere

Some of you may remember last year’s unfortunate encounter with the Killer Brassiere.

Well, it’s back, and this time, it’s personal.

Once I recovered from the first attack, which resulted in a bruised rib and a bruised ego, I thought, “Nah, this couldn’t possibly happen a second time. Now that I know not to wear it to the chiropractor, why not put it on again? After all, it’s so…cute. Just sitting there so innocently in the bureau drawer, staring up at me with those twin cups, the underwires forcing them into a permanent smile. Aww, come on, it seemed to say. You’re tired of those other bras, aren’t you? After all, aren’t they a little…boring? Childish? Utilitarian? Like something a pioneer woman would make out of some scraps of muslin and hay? Or something you wore when you were eight and thinking that someday you’d have breasts worthy of something more grown up? And it’s only a matter of time before you backslide all the way to…dare I say it…going without? Come on. It’s the 21st century. The braless look went out of style along with ribbed bodysuits back in the ‘70s.

So, OK, I succumbed. And never gave it another thought until yesterday.

I was having some work done on my neck at the physical therapist’s. (In my world, “getting work done” means a manual adjustment, not a doctor manually injecting injectables beneath my skin to plump up anything that needed plumping.) Part of the treatment involves adjusting the vertebrae in my upper back. To do this in the softest and most effective way possible, I lie on the table face up, my PT puts a pillow over my chest, slips a vertically-rolled small towel beneath my back, and, after I’ve taken a deep breath and exhaled, he presses down on the pillow. I heard the usual noises of relief coming from my back: crunch, crunch, crunch, crunch, cru…


That noise came from my breastbone.


If I remember correctly, that noise was coming from my mouth.

My PT asked me if I was OK, and I had to say, “No, I don’t think so.”

I told him what happened. He smiled. And then he laughed.

The killer brassiere rides off into the night…

Then, much as it hurt, I had to laugh, too.

He did the usual checks to make sure nothing was broken or whacked out of place. Bend this way. Bend that way. But no, it was just another $#@%!! brassiere-induced bone bruise, this time, on my sternum and upper ribs. (Wonder what code that would be on the insurance form? I can just imagine my insurance company’s customer service department in India calling the doctor: “What is this line item ‘BBB?’ I do not understand this ‘BBB.’)

And when it was determined that I would live, he set me up with an icepack and told me to take it easy the rest of the day. That I’d be fine in a couple of days.

Then he made me laugh again, the bastard. “It can’t hurt when I laugh, Tom!” I whined. “That’s my job!”

It also hurts when I talk. When I walk, when I turn over in bed, when I get dressed…but the talking thing really bugs me. That’s my job, too. Once again, I’m relegated to the keyboard instead of the microphone. Because, as you know, ain’t nothing gonna stop my words from flowing.

And the offending undergarment? I’ve exiled it to the bathroom towel rack. I haven’t yet decided its fate. Our culture’s common wisdom says that in the women’s rights movement, despite the icon of the burning bra, not a single foundation garment was set aflame.

I’m thinking of making this one the first. Anyone care to join me around the bonfire? I’ll bring the marshmallows.

Sunday, March 01, 2009

My First And Last Lap Dance

Some people have said that when women get to be “a certain age” they become invisible. However, I didn’t think they meant that I would literally disappear.

I had just finished taking my aqua jogging class at the local YMCA last Monday evening. Afterward, several of our class members, including the instructor, hit the hot tub. This tub is about as big as the average mall parking space, so it can seat quite a number of people comfortably. And since it was “prime time” at the Y, quite a number of people were sitting comfortably. It wasn’t packed to the gills, I mean, it could fit a good number of other tubbers before it reached some kind of health code limit, whatever that might be.

We were happily enjoying the heat and chattering on when a few more people came in. These were members of a local institution that houses developmentally disabled adults. A few days a week, they are brought by so they can swim or participate in other activities.

It might bother some people, but not me.

So a few of the guys lumbered down the hot tub stairs. There was plenty of room for them to take a seat along the benches. But one of them came over to my side of the tub and sat on me. Not just brushed up or bumped against my leg, or even slightly overlapped the outside of my thigh. But he literally sat right on top of me. And he had no awareness that I was not a bench but an actual human being. I know he can’t help it, but still. A man came into the hot tub and sat down right on top of me. I’m sure this happens to some people all the time, but not to me. I’m just not used to being furniture.

I sort of slithered out from under him and said, “Excuse me,” but his face registered nothing. After a minute or so, I left, and the women from my class followed right behind me. We exited like wet ducklings all in a row, walking down the corridor that leads to the women’s locker room. I knew that the woman closest to me had some experience with this population, so I said to her, “that guy sat on me.” She nodded, and said that she knew, and thought it best that we discreetly left before anything else happened.

When we all reach the door to the locker room, I told them about my experience as an inanimate object. The instructor turned to me with a big smile. “He gave you a lap dance!” she said. “Did you give him a tip?”

“Darn,” I said. “I left all my singles in my other bathing suit.”