The Lost Month: Migraines take a toll

"Businesses lose approximately $13 billion per year due to migraines, according to a study published in the April 1999 issue of the Archives of Internal Medicine. In addition, the National Headache Foundation estimates 157 million workdays are lost annually because of the pain and associated symptoms of migraines."

If you suspect, as many Americans do, that drug companies are not interested in curing illness, merely treating it--with perpetual cycles of expensive newly-patented drugs, then migraine would be the place to start looking for evidence. My wife has suffered from migraines for 40 years. They have now reached a level of frequency that renders impossible the type of paid employment she used to take for granted. In other words, migraines have rendered her unable to hold down a job in her field. She is disabled, by migraines.

And nothing that the medical community has done in the last 40 years has helped. Indeed, it is now more difficult and more expensive to get relief from the pain of migraine than it was 40 years ago. Believe me, my wife has not been sitting around waiting for a cure. Whenever she has been well enough she has vigorously pursued every lead, however improbable, in the quest for a cure. On more than one occasion attending physicians have ridiculed her for even mentioning research aimed at a cure.

So where did the last month go? It was spent holding down the fort, coping with a bad cycle of migraines and their fallout for the patient, her work, her family, and her friends. In this we were not alone. All across this country millions of people suffer with this disease, calling in sick, losing work time and personal time, depleting bank accounts with hospital visits and pharmacy bills, and wondering, in the occasional moments of clarity between bouts of pain: why hasn't someone figure out how to fix this?
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Hacking Democracy: Some Things Were Not Meant to be Computerized

As a crucial election draws near in America, the debate over computer voting systems is again getting attention, notably from tonight's airing of Hacking Democracy on HBO. However, from some of the reviews of this program (like this one in the Boston Globe) it is clear that even well-educated and otherwise intelligent people don't "get" the problem.

The most vital ingredient in a fair election is trust. The current generation of electronic voting machines are already untrusted (and you can trust security expert Bruce Schneier to provide authoritative analysis of why this is).

Critics of current systems have advanced numerous approaches to making future electronic systems trustworthy. While this is laudable, I contend that the goal is not achievable. No hardware programmed by people will ever deliver the same level as trust as a system of voting based on hand marked paper ballots. To imply, as the Globe's critic seems to do, that electronic systems are no more problematic than their predecessors, is to miss the point. There is a known history of addressing and resolving past problems to the point where the electorate accepted the outcome as fair.

Certainly the replacement of hanging chads with software bugs is not a step forward, but reverting to pencil and paper is not necessarily a step backward. And objections to analog voting methods based on the need to get quick results simply don't cut it as far as I'm concerned. For myself, and quite possibly a majority of voters, a reliable result at 5PM the next day beats a dubious results about 2AM.

So, for the record, and after very careful consideration, my position is that the use of programmable electronic devices to cast votes is not now, nor ever will be, as trustworthy or as verifiable as it needs to be for elections thus conducted to be considered fair.

Ignorance in Power is a Nightmare Scenario

Forget "ignorance is bliss" when it comes to those in power. Ignorance among the powerful is deadly. How deadly? Try 655,000 lives. That is the number of Iraqis who died since 2003 who might still be alive but for the US-led invasion, according to a survey by a US university.

Could ignorance kill more than half a million people in three years? Yes, if you invade a sovereign nation based on bad intelligence, guided by a flawed understanding of history and military strategy.

Could the number of people killed by this ignorance be wrong? Well, consider the follow-up story describing reactions and the rationale. The instigator of the invasion, President Bush, says "Six-hundred thousand or whatever they guessed at is just...it's not credible."

But the report was prepared by the Johns Hopkins Bloomberg School of Public Health which is hardly a group of dummies. It was peer reviewed by The Lancet, one of the most respected scientific journals in the world. The survey uses techniques relied upon in many fields, specifically adjusted for the given task, based on past efforts and critiques thereof.

The ignorance lies in simply rejecting such a study as not credible. You can disagree with it for sure, but to reject it outright shows a lack of understanding of scientific methodology. The next thing you know the President will be rejecting evolution as "just a theory." Hmm, like that other theory called gravity. Or is our President ignorant of that one as well?

Seagate Service Impresses

My how hardware support has changed. Used to be that when a hard drive died it was just hard luck; but recently I experienced problems with a Seagate hard drive that proves things have become much closer to the way they should be.

The drive is a 250 gigabyte Barracuda 7200.8 that I bought some time ago ago when I saw it on sale somewhere (the vagueness is intentional, as you will see). I must have figured I would eventually use it as an external drive to archive files. Well, the eventual day came yesterday and I plugged it into a USB drive enclosure. I plugged that into my main desktop machine, an IBM ThinkCentre P4HT, and fired it up. Everything worked fine.

(BTW, the IBM is now a Lenovo and I am pleased to report that the excellent IBM online support appears to have transitioned nicely to the new company, with lots of information about my system available at the click of a button.)

The Seagate drive formatted fine and I started to copy some files over. All went well but there was an occassional high-pitched click, barely audible, and only traceable to the Seagate drive by using a handy paper ear cone (old car mechanic trick). I figured it was no big deal and began a large copy operation [about 180 gigabytes] from a Maxtor USB drive to the Seagate. Next morning I checked the copy operation and it had completed successfully, but the Seagate drive was now making a sound much closer to the dreaded "katink katink" that can herald a drive failure.

Aaaargh! I had no recollection of where or when I bought the drive. How would I be able to exercise my warranty rights? Was the warranty still good? I surfed to Seagate support onthe web and clicked on Warranty. Wow! With a few keystrokes I had confirmed, via serial number, that the warranty was still in place (Barracuda's appear to come with a reassuring 5 year warranty). Furthermore, I was offered a chance to check out the drive's status via a web page. One Active-X control later, a basic check had reported a healthy drive. But a more intense check was offered. I launched it and was soon told the drive was damaged. Not only that, an automated return process was initiated right there.

I was given the option to send in the drive and get a replacement, or pay a modest fee and get a replacement before I sent in the bad drive (the bad drive going back in the prepaid box that came with the new drive). If the drive had been mission-critical I would have used the paid option and thought it good value for money. As it was, I figured I could save a few bucks and just send in the damaged drive. I did that and got a replacement in short order. Kudos to Seagate for making the painful as painless as possible.

The First Victim of Fundamentalism is Irony

"An Iraqi militant group led by al-Qaeda has threatened to massacre Christians in response to remarks about Islam by Pope Benedict XVI that have caused offence across the Muslim world. The Pope quoted a 14th Century Byzantine emperor who criticised the teachings of Mohammad for endorsing the use of violence."

The Times of London.

Whacking Waste: A Hopeful Sign?

So, America now has a Healthcare Administrative Simplification Coalition. Anyone who has been to a doctor recently knows administrative simplification is sorely needed. Patients in the "American healthcare system" are already familiar with the endless but very unsystematic duplication of data input, output, and storage. So it is no surprise that a study [conducted by the MGMA Center for Research] recently revealed that "the increasing complexity and redundancy on the business side of healthcare is costing the industry billions of dollars a year." As an example, for a 10-physician medical group, those wasteful ways translate into nearly $250,000 annually.

Much of the waste generated in our system is a result of administrative busywork or redundancies that add no value to the patient, provider or payer,” said William F. Jessee, MD, president and CEO of the MGMA. “By reducing administrative complexity, we can reduce costs and enhance access to care.” Click here for more.

BTW, the new coalition is made up of the American Academy of Family Physicians, the American Health Information Management Association, and the Medical Group Management Association.

One thing healthcare in America has plenty of is organizations with long names. Hopefully they can do something about the mindless mess that free market philosophy has made of health care management.
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Weasel Words Will Come Back to Bite You

When you avoid telling the whole truth, using "weasel words" to shape the facts to your own agenda, your credibility may perish as a result, never to be resuscitated. It is now pretty clear to all but the most rabid George W. Bush supporters that our President shaped the truth like an explosive charge to launch his war on Iraq.

One of the many blowbacks from GW's atrociously misguided attempt to manipulate reality to his own ends is that a lot of people now believe he is attempting to rig the November 2006 elections by manipulating gas prices. Gallup found 42 percent of survey respondents agreed that the Bush administration "deliberately manipulated the price of gasoline so that it would decrease before this Fall's elections."

At times like this a president needs a good front man, which White House spokesman Tony Snow clearly is not. He said the survey raises the question, "if we're dropping gas prices now, why on earth did we raise them to $3.50 before?" Duh! Anyone who is in that 42% is likely to fire back "To deliver windfall profits to the oil companies so they can fund Republican candidates in the election." Snow seems about as fit for his job as Brownie was for FEMA. And Bush now has zero credibility with at least 42% of the country. Admittedly, two thirds of that 42% are registered Democrats. But a third are not. These are people for whom the joy of paying a lot less to fill up the car is not enough to overpower the sense that they have been duped.

Further proof that if you keep twisting the truth, people won't even believe you when you give them a straight answer.

Wally World of Wonder Drugs?

Okay, so I've been griping about the high cost of my blood pressure medication and then Walmart announces $4 drugs. And they are starting this pricing in Florida, where I spend quite a bit of time. Could that solve my problem?

I take six pills every day and they cost me $414 per month. Walmart's pricing would cut that to $24 if, and this is a big IF, the drugs I take were generics. Well, it turns out that two of my pills are generic. A third is a non-generic only because I take a time-release version (adding time release capabilities to a drug is one way that the drug companies extend their patent protection on proprietary drugs--like the time release version of Prozac that Eli Lilly came out with about the time that the original formulation came off patent).

So, it turns out that if I shift to Walmart in January, I could cut my monthly pill bill from $414 to $332, still way out of line IMHO, enough to lease a very nice Nissan.

However, I am seeing my cardiologist next month and will be pressing him for answers about the two most expensive drugs I take, Diovan and Inspra. The latter makes me feel ill (heart palpitations) and I am not taking it right now. (Let me know if you want to buy my excess supply--and if you are the FDA, try prosecuting me for it, the cause of citizens seeking sane health care pricing would love the publicity--middle-aged white arrested for selling heart drug.)

I will also ask my cardiologist what Diovan does for me that a generic cannot. If I could get a generic alternative to Diovan, substitute a generic statin for Lipitor, use something like Tenoric for the Atenolol and Inspira, I would achieve a $20 monthly pill bill at Wally World. Wahoo!

A Mercedes or Meds?

I just got back from buying a month's worth of drugs at Target. Price tag: $414.00. No, I don't have AIDS or cancer. I don't have diabetes. I am not overweight. I have high blood pressure, described as "essential hypertension" by doctors because they have essentially no idea why my pressure is higher than "normal."

My blood pressure has been on the high side of normal since 1987. For almost two decades I have taken pills every day. The number and price of those pills has risen from one 15 cent pill per day to six pills costing $13.80 per day. I don't feel any better now than I did when I first found out I had high blood pressure.

Of course, those pills might be keeping me alive, but they are also stressing me out. In today's paper I see that I could lease a nice Mercedes or Cadillac for $414 a month. Who knows, driving a nice car might do more for my blood pressure than the pills.

A Nice House or Health Insurance?

Yet another analyst is trotting out the claim that 17 million Americans who do not have health insurance live in households with annual incomes above $50,000 and "could likely afford health insurance."

Oh yeah? Maybe if they had inherited a house to live in. Devon M. Herrick of the National Center for Policy Analysis should consider this: Coverage for myself and my wife is costing me $1,096 per month, enough to pay the mortgage on a median-priced home in many cities in this country.

Don't believe me? Well the National Association of Realtors provides handy charts of median home prices. Suppose you and your spouse are both responsible, self-employed, fifty-something professionals. You have decent credit. With a down payment of just $6,000 and a 30-year fixed mortgage at 6% APR you can buy $188,200 worth of house.

That is the median price of a home in the South. You could afford to go above the median price in such desirable locations as Durham (NC), Pensacola (FL), Nashville (TN), and Atlanta (GA). Remember, median means that half of all houses in those places are going to cost less to buy than health insurance.

But what if you are making somewhere in the range of $55,000 per year? If the cost of your health insurance is equal to your mortgage it could disqualify you from buying a house.

Think of it. A nice house or health insurance? Surely that is proof positive something is seriously wrong with health care.