But what about those of us who can’t go to the doctor? What about those of us who won’t go?It is not easy to sit in a chair and let someone shoot a laser beam at your eye. You can’t really see it and what you feel is not what you think you would feel. My problem the first time was my thick cornea. I was sent to a specialist in narrow angle glaucoma who had me take a sonogram of both eyes. The one still sore from the 15 times the laser didn’t make it through is in better shape than the other one. It is closer to the narrow angle problem and it has a cyst in it. After that information I was nauseous for an hour. How do you get a cyst in your eyeball? I was told it is common and it is from fluid build up. So I think I am lucky to have this medical care that started when the doctor said my eye pressure was high. Nothing akin to blood pressure but it was raised at the thought of having to have eye surgery.

What would I have done without insurance had I discovered I had an eye problem? Perhaps I am not to proud to see what kind of government assistance I could get to cure my ills. Years ago a younger friend of mine was in college with no insurance when she was rushed to the hospital with a brain aneurysm.  They took pictures of her head and brain and when she was able she told them this ran in her family. People lived with these aneurysms that usually kill. She was lucky they found it but she needed surgery.

When the hospital found out she had no insurance they put her out. Literally put out a woman who could die any moment because she could not pay. Fortunately one of the doctors told her to go to another hospital with a doctor who would be willing to do a surgery to save her life. Before she could do any of that she would have to sign up for Medicare or Medicaid, I don’t remember which one. She had the surgery which was quite successful. It took a few years  but she returned to almost normal. Well normal enough to go back to school to get a double degree in Math and Astro-Physics, her passion.

We all pushed her to get on the government dole for the surgery. We all told her there was no shame in doing this to survive. But one of the women who pushed her as hard as I did is now dying because when she was laid off and had no insurance she did not try to get government help when the breast cancer that had gone into remission returned bringing bone cancer that ravaged her entire body. She can no longer walk, there are no more operations for her to have. The only way any of us found out she was ill was when she collapsed and was taken to a hospital. It has been downhill for her since. She says she never told her friends because she didn’t want to worry them and she had no insurance. Pride comenth before the fall and it is leading to her death.

The eye surgery will help but it will leave my eyeball in pain and sensitive to light for a few days. But I will be able to see, I will be alive and looking forward to writing more and more and not dictating to some machine or assistant as I envisioned myself doing when I first found out there was something wrong with my eyes. Do not let lack of finances kill you. Do not let pride take away your life. There are many people with health insurance who never check out a thing and are shocked to find out they are very ill. Take care of your health and that way you will be able to live a full life.

Sure enough, literally smack-dab in the center of the terminal is an enclosed, glass-walled chamber where smokers light up and puff away to their heart’s content. (That’s probably a bad choice of expressions in light of the activity we’re discussing.) What struck me was that through the grey misted air, they appeared as caged zoo animals, pacing in their restricted area, engaging in behaviors not accepted by the reminder of the population, while kept at a safe distance from those they could harm upon accidental release.

I found the whole thing to be incredibly sad.

Let me head off the armies of hacking militant, wheezing smokers who, even before they have finished reading this piece, are racing to computers to fire off angry missives about how I am insulting them. My comments are not as much levied at those who have chosen to engage in this habit as much as at the society that determines what is appropriate and what is not. Mores change and smoking, once considered “the cat’s meow,” is now considered gauche, existing in a strange societal limbo – scorned yet legal.

I am allergic to tobacco smoke. Moreover, having previously lived with a smoker, the stench that permeated and saturated everything from clothing to carpeting invoked regularly my gag reflex. So, I’m A-OK with the act being isolated. Yet, what is not tolerable to me is that it appears that we – the “Proper Members of Society” – are forever judging others in a misguided effort to feel better about ourselves, while ignoring our own annoying foibles.

Civility’s spotlight, although not shifting from the nicotine user, has lately expanded to include the overweight. As with users of cigarettes, behind their backs, we shake our heads and whisper to our “normal” friends, “It’s a shame that they don’t take care of themselves. I’d never let myself look like that.” We wag our fingers and click our tongues, satisfied that we are “better than that.”

It’s probably human nature to try and elevate oneself by putting down others. I know in my lesser moments that I am not immune. However, it seems that each and everyone of us has habits of which we would not want exposed to bright sunlight. Creating new sub-classes determined by what one eats or smokes is divisive, and we’ve got plenty of that going around.

I’ve got bad habits. You do too. It’s not a reflection of self-worth; it is a method by which each of us is trying to make it through the day without collapsing under the weight of its stress. I’m not advocating abandoning personal responsibility and “let it all hang out;” quite the contrary. The process of growth is the cycle of “identify, adjust, and modify.” It seems if each of us spent a tad more energy striving to be an example instead of a judge, it could alter the atmosphere just enough that we wouldn’t need a cigarette – or bag of chips – quite as often.

About the author: Scott “Q” Marcus is a THINspirational speaker and author. Since losing 70 pounds over 15 years ago, he works with overloaded people and organizations who are looking to improve communication, change bad habits, and reduce stress. He can be reached for consulting, workshops, or presentations at 707.442.6243 or scottq@scottqmarcus.com. He will sometimes work in exchange for chocolate.

I don’t hate dentistry but how many people actually like to go? When I was eight I had a cavity filled and two days later the filling had to be taken out because the gum had abscessed and the dentist had not noticed it. It was a a horrifying experience in the days before good modern dentistry and the pain made me stay away from the dentist and lots of sweets for years. It was ten years before I made another trip to the dentist and at least 18 before I had another cavity. Thanks to the breathing I learned in Lamaze classes before I had my children I learned how to deal with pain. But the dentist or oral surgeon or anyone that works with teeth is still a reminder of a time when the needles seemed bigger and the drugs less powerful.

So I sat in the chair, my blood pressure had risen to 173 over 90 but they said the gas would calm me. And it did. I kept my eyes closed the whole time and prayed they wouldn’t talk about what they were doing. Hearing a doctor or a dentist talk through procedure is  nauseating for me. If I had wanted all that information I would have studied medicine instead of acting. Fortunately this oral surgeon did not talk a lot about anything, but he put a lot of pressure on my mouth. When it was over he explained that it took a few minutes longer because he had a hard time sewing up the sinus cavity that my tooth had been attached to. An infection was starting there. I didn’t care. It was over and now on to pain pills and sleep.

Of course the last few days I haven’t been my normal self. Two days of pain pills was enough and now, pain pill free and pain free, I find the nausea of the pencillan the most aggravating. Today I am feeling a lot better although I look like a lopsided chipmonk with this one swollen jaw.

But I go back to why not fill the tooth and save it. It would require not only a root canal but a cap and a crown. Ever try to argue with the insurance companies about that? Root canals are painful unto themselves. This was easier and simpler since most people don’t have all their wisdom teeth. A friend said I would be much lighter. It was a joke but my wisdom tooth was quite large. I saw it and understood why I needed a lot of gas to take away the anticipation of pain.

So I am trying not to get food in the space, trying not to play with it with my tongue and trying to follow all the rules the oral surgeon gave. I can’t blow my nose until next Tuesday. If I do it might burst the stitches in the sinus cavity. If I sneeze I have to do it with my mouth open. And there is the rinsing my mouth out with salt water every few hours. Still I think I am better off without the tooth that was not over another one. I was attached to it for it was mine and until recently in good condition. Maybe my sinuses will bother me less now that it is gone.

What could have sickened me was an article that broke just after the healthcare bill’s passage. The Associated Press reported that Republicans originated and supported the health insurance mandate in President Obama’s healthcare reforms. The mandate is now behind Republican cries of “Armageddon” and “the end of the American way of life,” to the extent there is anything behind those bleats beyond hot air.

According to the AP report, Republicans crafted the mandate during the 1990s as a private sector alternative to Clinton era healthcare reform proposals. At that time, Republicans didn’t see the mandate as socialism but instead called it taking responsibility. The individual insurance mandate is at the core the Massachusetts reform plan that Mitt Romney signed as governor and newly elected Senator Scott Brown supported as a state legislator.

What’s sickening to me isn’t that Republicans would so blatantly flip-flop strictly for political advantage and predict disaster from a policy they once championed. I’m appalled that during a 14 month fight for its political life, the Obama White House didn’t uncover and use the Republicans’ flip-flop against them. Unlike the arcane and windy arguments Obama and his team put forward to support healthcare reform, here was a sound bite sized argument that would put Republicans on the defensive about their opposition to reform they once championed.

At least one progressive political group uncovered Republican mandate support ahead of the AP, so why didn’t the White House? Heads should roll for failing to unearth such a tasty political truffle nestled right under their noses. Getting the healthcare bill passed doesn’t excuse the failure. There are plenty more tough battles to come – over financial reform and climate change, for starters – and the White House can’t afford to miss this kind of low hanging political dynamite, especially in an election year. Get some people in there who are smart enough and work hard enough to do the job right and give Obama the support he deserves.

Totally globalized native New Yorker and former broadcast news producer Muhammad Cohen is author of Hong Kong On Air, a novel set in his adopted hometown during the 1997 handover about television news, love, betrayal, financial crisis, and cheap lingerie.

Upon hearing me make my way, my wife got me a cup of coffee, generally a prize for the last one getting up. I gave her a kiss and sat down, feeling odder by the second. She sensed something was wrong and asked and I told her I didn’t feel good. I was slurring my words and having trouble concentrating. After not meeting her request of sticking my tongue out straight, she brought me a pair of shorts, called out doorman and BAM, I”m in the ER.  By this time I don’tt know my name, social security number, what day it is, nothing. Well not quite nothing. Oddly, all I remembered was that I had a hair appointment that day and kept telling the docs and nurses that I couldn’t stay, I was supposed to get a haircut.

Three days later most of my long term memory had returned bit I had lost all short term memory. Major league scary. I’d also developed an eye tic and my left leg dragged. Thankfully, after a couple of months of rehab, the tic is gone and most of the left leg dragging has disappeared but I lost half of my vocabulary. It’s frustrating having to ask the name of things but it’s starting to come back. Beats the alternative by a long shot.

Will I ever write again? Remains to be seen. Thankfully I have a five book backlog. I lose concentration when going over an edit but my editor is working with me extra hard. This is the longest piece I’ve written to date but I’m going to use Brother Bobs site as practice so I’ll be posting regularly. 

One thing I’m absolutely sure of—STROKES SUCK.

John Armor, Esq.
Box 243, 421 Kettle Rock Road
Highlands, NC  28741
828.200-0320
John_Armor@aya.yale.edu
www.TheseAreTheTimes.us

So, let me make one thing clear: childhood obesity begins in adulthood.

At first blush, that makes as much sense as the bumper sticker that proclaims, “Insanity is hereditary. You get it from your kids.” Of course, that placard is humorous; the wellbeing of society is anything but. The unvarnished truth is when we get down to brass tacks, children to not become obese by choice, but rather by the (in)action of adults.

Before, with great high dudgeon, mothers and fathers converge upon this establishment carrying pitchforks and hoisting torches shouting for my removal, let me add with great haste (spoken as a father as well as a formerly obese child), that I am not placing fault entirely on the parents. Oh, indeed, there is blame to spread far and wide. However, we are the primary and first decision makers for our children. We set them on their path. We instill upon them our moral guidelines. We are the where the buck – or cookie – stops.

I know that in today’s two-working-parent-I-am-really-exhausted-at-the-end-of-the-day world, fighting the influences heaped upon our offspring is overwhelming. I grok that these influences are powerful, selfish, misguided, even mal-intended. Yet, I think that as a society, we stand in a circular firing squad aiming at those on either side; in effect – pardon the mixed metaphor – fiddling as an overweight Rome burns in its own deep fryer.

Parents place fault with the media for an endless wave of advertising aimed at those too young to discern accuracy from hype. The media passes it to the schools for poor meal choices and vending machines full of sugar. Our educational system holds responsible government for inadequate funding, forcing subsidized income provided by the vendors who place the goodies in the machines, who then shout, “lack of control” at the parents. Circle complete; nothing is accomplished.

We have seen the problem and it is all of us. Someone has got to do something; no longer can we wait for “the other guy.”  It therefore stands to reason that since my children are the most important people in my life, I am the end of their line. I must step forward first, figuratively and literally.

I resolve, that before I collapse on to the softness of the couch at the end of a long day, I will take a 10-minute walk with my kids, giving them the example of activity and the support of listening. I promise to not bring into our house any product whose label has as its primary ingredient, sugar (or any kind of “-ose”). I agree to eat a little less and pay attention a little more. In effect, I will stand taller, striving to be the example I want my children to become.

Role models are not without flaws; however, they take responsibility for them and continually attempt to improve. That’s an objective good for children of any age, no matter how wrinkled they might be on the outside.

John Armor, Esq.
Box 243, 421 Kettle Rock Road
Highlands, NC  28741
828.200-0320
John_Armor@aya.yale.edu
www.TheseAreTheTimes.us

Yet, once in a while, something crashes through that dense wall of denial and I can no longer avoid looking.

Today, at a very powerful, presentation, I learned that the three leading causes of death in the U.S. in 1900 (Pneumonia, Influenza, and Tuberculosis) are not even in the top five 100 years later (heart disease, Cancer, and stroke). In effect, over the span of an extended lifetime, our biggest health concerns have shifted from being “attacked from the outside” to being “attacked from the inside.” That’s a powerful bit of data.

Part of the reason is that we are now under constant, unending, on-going, chronic stress. Sure, we’re not fighting off saber-tooth tigers anymore; but we pay too many bills with too few dollars, or we attempt too many things with too little time, or both, or more. Our body can’t perceive the difference between “saber-tooth tiger stress” and the “IRS is on the phone for you” stress. All it understands is that something is a kilter; we are under pressure. (Whether the stress is caused by actual or perceived events makes no difference; we respond the same.)

Couple that fact with the detail that our modern diet is so out of whack that nutritionists refer to it as “hyper inflammatory.” That means that when threatened, our body throws the preverbal kitchen sink at almost any problem. Instead of marshalling a couple of “antibiotic soldiers” to quell a minor disturbance, it delivers an entire, heavily-armed, fully equipped battalion. Once the threat has been eliminated, those extra soldiers hang around with nothing to do – except leave waste products. Blend that with our constant stress-level, and well, we’ve got bunkers of waste-producing soldiers camped out all over our insides, lining our cells with all sorts of unnecessary non-disposable nasties.

Since stress is beyond our control, we cannot dispel it and send the soldiers on leave. Rather, we can only disarm the situation by thinking differently, moving more, and changing how we eat.

Here’s where today’s talk made its impact on me. Eric, the presenter, offered clear, easy-to-implement ideas to begin to reverse the course. Take some Fish Oil, increase Vitamin D, drink Green Tea now and then. He was honest; it’s not a panacea; it’s merely a few doable actions that can improve one’s heath. They are things I can do right now – and I did.

Not only are simple ideas usually the best, but, now knowing what I’ve learned, they don’t stress me out as much as doing nothing.

I was in my mid 20s at the time and working as an Avocation Specialist for Job Corps in Atlanta, Georgia. I taught drama and speech, crafts and painting, took students on sports related field trips (don’t ask me why but their favorite was Live Atlanta Wrestling which I never went to but sat outside and read to the background of screams for blood and beatings), and played a mean game of volleyball, the only sport I was ever any good at. My 411 pound friend was often on my team and I have to say we usually won our games and were something to contend with.

Being easily bored with my 2pm to 10pm job I created new evening activities for the all girls Job Corps. Besides art exhibits, pool competitions and the occasional play I conducted an exercise class. We worked out and discussed food options since the menu at the corps was not only bad but carbohydrate heavy and the only places nearby to get food were bars, bar-b-que joints and fast food places.

The happy go lucky 411 young woman wanted to join but I was skeptical. I gave her a few exercises to try on her own until the doctor approved her working out. She confessed that she didn’t want regular exercises and was hoping I had a miracle for her. I replied that I had one exercise that was sure to work. It was called pushing away from the table. She was insulted.

This young woman ate a lot because of her size and because of her upbringing. Both her loving parents were large but nothing like her. Once a week they sent her baked goods such as layer cakes with thick frosting, homemade fudge and brownies and, her favorite, oversized lollypops. I didn’t believe the rumors about her weekly packages until I saw her open one myself. Along with new socks and underwear there appeared a double fudge cake and several suckers. She got upset because there were no cookies.

The nurse on duty called me in one day to tell me that the girl had been sick with a cold and the doctor, meeting her for the first time and amazed at her weight, had put her on a diet. It was requested that the staff counsel her if we saw her eating anything she wasn’t supposed to. We didn’t see much and thought she was doing well. Turns out she was leaving the grounds to seek comfort food. They had asked her parents to stop sending the weekly boxes and she had become distraught. She took what little pocket money she had and would walk 12 blocks to a fried chicken establishment. There she would sit and eat a meal for three people before walking back. She would arrive covered in sweat and everyone from security guards to students thought she was taking matters in her own hands and taking long walks to exercise. It was one of the security guards who saw her there while he was on a lunch break. He said she ate like she was starving. In her mind she probably was since she found the portions they gave her in the Corps cafeteria too small and too filled with veggies.

After a month of her sneaking food and taking long walks the doctor decided to do extensive tests on her. Every organ was in perfect condition, her sugar which had never been high was better than normal and there were no signs of heart disease, high blood pressure or liver ailments. She didn’t have thyroid problems, she didn’t have tooth problems or gum disease. She was in perfect health except for the fact that she was extremely obese.

And she proudly told everyone, she had lost weight. She had lost one pound. She was very happy with herself.

For the rest of her stay at Job Corps her parents sent monthly boxes. The doctor gave up trying to help her diet. They couldn’t force her to loose weight anyway.

I, on the other hand, had to deal with her on a more complex level. As I said she was a happy, self assured person and was easily elected President of the student council. That meant whenever I took the officers to meetings with other Job Corps she had to go. I would apply at the Corps motorpool for a van instead of a car so as to make it comfortable for all four students. More than once all the vans were signed out and I had to take a small car. This presented the problem of who sat where. Worse than that was the site of the meetings: an all you can eat buffets crammed with fattening food. While the other young ladies took a choice of a small helping of fried chicken, pork chops or honey glazed ham, she got a piece of all three. I saw her and saw how the young men from the other Job Corps were looking at her. I mouthed “Put two pieces of meat back” from across the room and although she acquiesced she was not happy. All the way back to Atlanta she complained about being hungry. When we stopped for gas she purchased a large candy bar. This on top of the cake and pie she had for dessert.

When I left Job Corps after two years she was down to 405. She had decided to go on a diet. Why? Her boyfriend of six years had dumped her. She thought that losing weight would get him back. I told her that losing weight would open doors for her to a better life. But that was not what she wanted to hear. She was a young woman in an age defined by looks. She had no sense of self when it didn’t involve food or a man. She had always been fat and happy. Did losing her fat really mean losing her joy?

I don’t know what happened to her but whenever I see commercials for weight loss reality shows I think of her. At some point her healthy heart was probably going to say enough, she was going to start breathing hard after long walks and considering her sweat tooth, diabetes would not be far behind. Or would any of this happen just because she was overweight? Perhaps she learned to take care of herself, perhaps she got down to 300 pounds. Perhaps she developed amazing self esteem again. I struggle with the 50 pounds that I have put on since Job Corps, marriage, two children and a sedentary job. This girl moved and I still don’t move as much as she did. She fed her beast but she worked out all the same with her walks and her volleyball.

We all need to move more, to push away from the table more, and to push back from the computer. Long walks when you can’t run are there for the taking and so is good health. We are a fat society but we are not happy. The carrot that dangles before us with promises of better nutrition and looks is not enough. We must find the pleasure in what it means not to be obese. But we must find it in ourselves. Otherwise we miss the point of good health and good living.

Totally globalized native New Yorker and former broadcast news producer Muhammad Cohen is author of Hong Kong On Air, a novel set in his adopted hometown during the 1997 handover about television news, love, betrayal, financial crisis, and cheap lingerie.

We welcome your thoughts and comments.

Do you think there should be a Magic Pill for Everything?  A fix for something that will naturally happen?

At the 1994 funeral of Richard Nixon (which I watched in Beijing during my first visit to China, right before cycling to Mao’s tomb in Tiananmen Square), I understood why all the living ex-presidents, regardless of party, and incumbent Bill Clinton felt obliged to attend. But when Clinton took the podium and said good things about Nixon, it taught me a key lesson: Clinton and Nixon and the rest of the politicians at that funeral were all on the same side, and that wasn’t the side I was on. I’m still hoping that someone on my side has finally gotten into the White House, and that they will deliver change we can believe in.

Totally globalized native New Yorker and former broadcast news producer Muhammad Cohen is author of Hong Kong On Air, a novel set in his adopted hometown during the 1997 handover about television news, love, betrayal, financial crisis, and cheap lingerie.

By Alan Caruba

At age 72, I have been spared major injuries and sickness. Other than birth, I have never spent a night in a hospital, but I paid a visit a few years back for a common ailment of men of my age. I was in and out of surgery the same day.

In Monday’s early morning hours, still almost asleep, I had an accident that put me on the floor with a shoulder full of hurt. I went back to bed and when the sun came up I called the local rescue squad to take me to a nearby hospital, one of the best in the state. I know this because in the final decades of my parent’s years, both were fairly regular visitors. It is a penalty of aging that our bones break and other misfortunes occur.

When I got up on Monday morning after a fitful few hours, I took a look at my swollen shoulder and said to myself, “busted clavicle, deep hematoma.” The latter is a medical word for a bruise.

The emergency area was nearly empty when I arrived. Prior to that, I had to give the EMS officer information so that the trip could be charged off to Medicare. Same thing at the emergency area. More information. You hand them the cards from Medicare and AARP and they look relieved.

X-rays followed and a visit from a physician who, for some reason, thought I should have my heart checked out and Lord knows what else. They had already hooked me up to an EKG machine so I assumed that was sufficient.

I said, “Doctor, we both know I have a busted clavicle and a hematoma. Nothing but a lot of rest will heal it, so I want to go home.” Hospitals make money off of testing you for things unrelated to your actual problem. It’s also called “defensive medicine” in the event you have the bad manners to die from something else while in their care.

And, in my case, they love to tell me about my high blood pressure. I have always had high blood pressure. It is the silent killer and, frankly, I am going to be very annoyed when it finally gets me. Until then, like my late Mother who lived to age 98 and also had high blood pressure, I am not going to worry about it. I maintain a moderate diet and even exercise daily on a treadmill.

I was impressed by the nurse who drew a blood sample and did the EKG; pleasant and efficient. The young man who took the x-rays was the same.

I have heard that the one area where jobs are still available is healthcare and I believe it. This is particularly true because much of the U.S. population is aging.

How sad that, as this occurs, the Obama administration and Democrats in Congress want to strip a half-trillion dollars out of Medicare, add several thousands more to the rolls of the rapidly insolvent program, and tack on a whole bunch of excise taxes for medical services and stuff. We shall all be paying a lot more for insurance and health costs.

No one has ever explained why because it is essentially irrational. Those who do offer explanations are lying through their teeth. By federal law, no one who shows up at an emergency room can or will be denied care.

If ever there was a government more determined to make life a misery for its citizens, I cannot recall one like the present administration. Under Obamacare, would the rescue squad have to cut back on its hours of service? Would the x-rays be deemed optional? Would I get the pain pills the same day or would a panel of bureaucrats decide if I really needed them?

It took Obama three days to find a Tele-Prompter to tell him what to say after the Christmas day attempted bombing. And then he had to come back the next day because the Tele-Prompter got it wrong. His Secretary of Homeland Security got it wrong, too, the first time.

Thanks to the pain pills, I have been in a pleasant fog since Monday, but I have the nagging suspicion that the President has been similarly disengaged since the day he took the oath of office.

Other than finding ways to plunge the entire nation into debt and impose new taxes, I cannot think of a thing he’s done of any real use to any of us.

If this keeps up, the whole nation will be in the emergency room.

Alan Caruba writes a weekly column posted on the Internet site of The National Anxiety Center – he blogs daily at http://factsnotfantasy.blogspot.c

 So we need Hillary. We need someone who will get in there and burn these namby pamby conservative Democrats to the ground and push the obstructionist Republicans to the side.  We need someone not afraid to get dirty. Barack is looking a little too crisp these days, a little too polished while Harry Reid and the boys look like they have gone though a war. They have. They have had to fight without a commander. Mr. President, get in there and fight for us! Don’t take this watered down garbage that is now  passing for reform. Make Joe Lieberman accountable. The man got a million dollars this year from the insurance companies. He is as tainted as any Tammany Hall politician ever was.

I voted for President Obama, but I was afraid of one thing, he wouldn’t get in there and do the dirty work. He would leave that to others. I am a little that way. I let others do the hard gritty work while I point the way. That works to a point but then you have to join the fight. We need the President to put himself on the line for the Americans without health care. He needs to go for an all or none position on this one. My very trepidation about this President seems to be playing out…he might not be capable of getting down in the mud and fighting when the going gets tough.

Hillary could. We knew this. We saw it in the debates. She does do the hard work. She fights like a dog. And man do we need a dog now. We need someone who will not sell us down the road for a legislative victory and then wave the bill around, proclaiming Victory. Neville Chamberlain never erred so gravely by appeasing those who did not wish us well. While we will not have a World War if we lose this fight, we will have massive casualties.

William Hazelgrove writes in Ernest Hemingway’s attic. His latest book is Rocket Man.

Said I, adjusting rose-colored glasses, “I disagree. None of us know how much time we have, but good health allows us to enjoy it as long as possible.”

Came the reply, “Personally, I think good health is merely the state of dying at the slowest possible pace.”

Clunk. Ouch. End of bizarre conversation.

That said, in light of all the discussion lately, I’ve got a thing or two to say about a thing or two about health care. Since my column is not political in nature, I’ll attempt to steer clear of that sticky widget. Yet, I’m assuming, no matter one’s political leanings, we agree that something is unwell within our health care system.

They say, “Figures don’t lie, liars figure.” So knowing I could be stepping into an ugly morass, I still wish share a few statistics that I find particularly noteworthy.

According to the 2006 revision of the United Nations World Population Prospects report, for the period 2005-2010, our country ranks 33 when it comes to infant mortality. We are sandwiched between New Caledonia and Croatia.

On the other end of life, from our own CIA’s World Factbook, last updated April 2009, our life expectancy is 50th. A child born in the U.S. today will likely be around for 78.1 years.  Combine those statistics with the staggering fact that the Organization for Economic Cooperation and Development (a group representing 30 wealthier, industrialized countries) computed that the United States spent $7,290 per capita on health care, ranking it first among the countries studied.

Might just be me, but I don’t think we’re getting our money’s worth.

Whether the solution is public option or private health insurance is not the issue I’m trying to address. Yes, what our government does might indeed affect us for generations far beyond our (hopefully extending) lifespans. Yes, there is much to be corrected.

But, quoting Cassius, “The fault, dear Brutus, is not in our stars, But in ourselves…” It’s easy to pronounce and pontificate about what “they” should do, it’s quite another little something to step to the platform, roll up our sleeves, and actually take action. Irrespective of legislation regarding “single payer” or “pre-existing conditions,” we must each make a difference in our own lives by establishing good health as a higher priority in day-to-day decisions.

This does not mean uproot and rebuild your entire routine, throwing every habit into the waste bin.  Make a small stand if that’s all you can do but make it now. Opt for less processed food. Lower your sugar intake. Park your car at the far end of the lot. Small steps done regularly have more impact than big steps done intermittently. In other words, it’s better to get out and walk around the block — and really do it — than it is to promise to run a mile someday soon but never get around to it.

Find an excuse to act in a healthier fashion. It feels good; it’s even patriotic.

About the author: Scott “Q” Marcus is a THINspirational speaker and author. Since losing 70 pounds 15 years ago, he conducts speeches, workshops, and presentations throughout the country. He can be reached at  scottq@scottqmarcus.com or you can follow him on twitter at twitter.com/bestdietingtips

Most of the people who write for this website are male and I want this to have some effect on you as something more than a woman complaining about a female health issue. The new study suggests some major changes in the way women are screened for breast cancer. Instead of starting to have mammograms at the age of 40, they are saying women should start at the age of 50. They added that after 50 women should only have the test every other year. This study concludes with the strangest statement of all: this change of procedure could lead to more deaths from breast cancer. Some doctors agree that there is too much testing, too many biopsies and too much stress on women when a doctor says they found something on the mammogram and you need to have further tests. For the insurance companies it’s a way to refuse paying for treatment. For some women it could be a death sentence.

What is commonly considered a female problem becomes a family issue when someone you love is diagnosed with breast cancer. Suddenly jokes about boobs and breast implants and what a nice rack disappear and you are sure exactly what you should say. Caring men adjust to the situation by understanding and giving support. Insensitive morons can’t believe it is happening to them. That their woman might loose her breast. I know of a couple who split up because the man couldn’t stand the thought of his wife being breastless. Another husband wasn’t able to handle taking care of his spouse and the kids doing the chemotherapy that followed. My right breast is smaller than my left because I had an operation after they saw something on a mammogram. After several more mammograms, sonograms and other tests they removed what they found It was pre-pre-cancerous they told me and I knew I was extremely lucky. The surgeon said she took out a lot of tissue because she wanted to make sure she got it all. It did not matter to me or to my husband that in the future one side would be a little off, a little less full. I would be alive and well.

Had we followed this new study I would have not had a mammogram that year. I was 51 when they found the lesion. If my first mammogram had been at 50 the way the insurance companies want to play it, I would not have had a test at 51 and by 52 I might have had full blown breast cancer.

Then there are my friends who found out they were in the early stages of cancer because they got tested every year after 40. They could have died or become severely ill before they reached the age of insurance consent for mammograms.

The problem with this study is that there are already several women who do not get breast cancer screenings when they should. Many are afraid it is painful or that the technicians will find something. No woman likes to have her breast crushed in what reminds me of a vice grip attached to a camera. It’s not so much painful as it is uncomfortable. The most painful thing about it is waiting to find out if they found something wrong. Most times it’s just a blur on the film. Still returning to have it done again is nerve wrecking.

After the surgery I had mammograms every few months for at least two years. Nothing returned. For some reason I got cocky and forget to get a mammogram one year. When I finally did the technician, who had worked with me before, reminded me that I had to keep up the practice. Now I mark my calendar, I make the time.

There is a scar and a deflated area on my breast that reminds me each day how close I came to having cancer. I was so down after the surgery that to pull me out of the doldrums my husband made a joke and started calling the breast with the scar his favorite.

I am sharing this extremely personal bit of information to rally support for women who are feeling put upon by the insurance companies for doing this study and for the women you love who may someday need the care of a supportive male to get through a bout with the biggest cancer killer of women. And although the odds of men having breast cancer are small there is always still a chance when someone as macho as Shaft can get it. We must take care of each other. We must learn to care. And we must definitely fight the powers that be over this new study.

You field a few more questions and call it an antacid. Now you are slouching on the couch as you are hit with middleaged and elderly people toddling around able to just have a ball while taking drugs for incontinence, constipation, depression, COPD, Alzheimer’s, arthritis, joint pain, chemotherapy side effects, migraines, strokes, heart attacks, cholesterol…you name it. By the time Elf is over you feel like slitting your wrists. Since when did drug advertising become so heinous and pervasive?

 And these are not just benign pitches to take their drugs. These are you better take these drugs or else! Take the black and white pitch of the guy who did not take his cholesterol medicine until it was too late. He had a heart attack and he tells us to know be stupid like he was…TAKE YOUR MEDICINE. Well, the pharmaceutical industry posts billions in profits. We know why. Are we ever more vulnerable than on the issue of health?

 Back to the men who are taking all sorts of drugs so they can get it on anytime or anywhere. We see a couple skipping through Paris, on a boat cruise, a woman holding her high heels while Don, Harry, George leans back from reading the paper with a small smile. We assume that this drug has just turned them into lovers on a tear to just do it whenever they can. The kicker of this advertising is everyone keeps getting younger and younger! The suggestion is hey, this can happen to you at anytime. For men this is nothing short of terrorism.

You could say it is for our own good. But is it? We are an overmedicated society as it is. We reach for a pill to cure just about everything and are rarely told to change behavior or habits that might be causing our maladies. The drug industry is interested in one thing…scaring us to the point of taking their drugs or enticing us with the promise of a chemically altered existence that will usher in a second utopia (see couple in bathtubs holding hands.)

We do not need to be reminded of the ticking clock that is our mortality. We don’t need to be told that one day when the mood hits us our performance might be off the mark. We know these things. We know it the moment we hit the antiseptic waiting room of some doctors office. We sure as hell don’t need to be explaining to our children why a  man is sitting in a bathtub next to a woman outside when he could just as easily take a shower inside. Preferably a cold one.

William Hazelgrove writes in Ernest Hemingways Attic. His latest novel is Rocket Man

http://www.billhazelgrove.com

http://www.freado.com/player/bookplayer.php?contentid=4738&authorid=3736&preview=1

The damn was contentious from the start. Men died. The temperatures reached one hundred and thirty degrees. The contractors had strict deadlines and safety was not a premium. Men fell to their death, died from heat exhaustion, dynamite, trucks, steam shovels. But the work went on. Herbert Hoover made a speech at the ground breaking that went nowhere. People didn’t believe in him. FDR took over and immediately changed  the name to Boulder Dam. No one wanted to think about Herbert Hoover now that unemployment had hit twenty five percent. The workers went on strike for better conditions and the construction companies hired more men and broke the strike. The work went on.

We now face another huge public works project. Maybe the biggest change in our lifetime of the relationship to the government to the individual. Huge. Sprawling. No precedent. Rancorous. One side seeing salvation while another side sees socialism. Insurance companies have dug in while the Democrats and President Obama see this as their greatest victory or their Waterloo. Meanwhile people die for lack of insurance. People die from bad health insurance. The work goes on as we roll to the Senate.

Seventy some years later the Hoover Dam stands not only as a dam but a monument. It is a monument to what the American people could accomplish in the very worst of times. The damhas provided electricity and water to the West for decades and stands as an amazing technological achievement. No one doubts the wisdom of building the dam now. One hundred and sixty five men died in the construction.

The question for us now is what is going to be our Hoover Dam? What good will come out of The Great Recession? We will become historical. People will watch PBS specials on our time and they will point to moments where we pulled together and out of the darkness produced something very good. They will cover the bitter debate, formations of new political parties, the election of a man that could only have occurred during extraordinary times. But what will our Hoover Dam be? What will outlast us as our legacy to the triumph of human will over disaster and prove that we did something as enduring as a concrete dam providing light and water…if not life.

It has to be the gift of Healthcare for our people.

Wiliam Hazelgrove writes in Ernest Hemingway’s attic. HIs latest book is Rocket Man.

http://www.billhazelgrove.com

Or you have just gone into surgery and emerged minus an appendix and after all is said and done there is a bill for fifty thousand dollars then Frank swings back into action and tells the hospital that they need to knock it down to thirty thousand. That’s what Frank does. He decides what an insurance company will pay and the average is thirty percent that he knocks off the bill.

Imagine if someone came in and lopped off thirty percent from your paycheck just because. Or you have just charged a client to do their taxes or prepare their will or remodel their basement and you have figured your costs and then a middleman comes in and goes, nope, we get thirty percent of that and you are just out.

So what do the hospitals and doctors do to compensate for this thirty percent hit? They factor it in on the front end and crank up their fees and so when the bill appears it is thirty percent higher than it should be. So who really pays for that thirty percent extortion which is what it is…YOU DO! You know that bill you get after you have paid your monthly premium, you know that bill that is thousands of dollars even though you have health insurance and have paid in and now you get a bill. You arepaying  the thirty percent fraudulent charge. Your credit gets trashed. Ultimately  you are the one who pays for Frank’s shiny sports cars and his kids top flight education and his stocks and bonds and his large home. You pay for this thirty percent whack off the top. You would be better off working for the mafia, even they don’t take thirty percent.  

William Hazelgrove writes in Ernest Hemingway’s attic. His latest book is Rocket Man.

http://www.billhazelgrove.com

You cannot have a country where some people get the best healthcare and others get none. You cannot have forty six million people without healthcare coverage while others enjoy the very best places like Mayo clinic. It is simply not fair. Not when we can give this right to everyone. The pursuit of happiness must include health. We cannot offer a public option that will only ensure those who can qualify–it is time for the bold step. It is time to INSURE EVERYONE. Like FDR and like Lincoln it is time for Obama to right the wrongs that have been perpetuated by greed and by the immorality of putting a price tag on a person’s health.

The United States does right itself. We do make adjustments to our democracy. Now is the time to make sure that we do the thing right. No half measure. Give everyone the right to choose their healthcare by offering the public option to everyone. Then we can say that there has been true healthcare reform. That we did insure those who need it most. We cannot let the insurance companies twist this thing away. They will. They  will find every loophole and insure their monopoly. It is time to go for broke. It is time to fix what has been wrong in our country for so long where some people live and others die simply because they cannot afford to get healthcare or worse they have become a number on an insurance companies spreadsheet.

This is our moment to really ensure we all have the same rights. We should all have the right to health. We should all have the right to the pursuit of happiness.

William Hazelgrove is the Hemingway writer in residence. His latest novel is Rocket Man.

http://www.billhazelgrove.com

 Any industry that spends that kind of money to fight change is up to no good. On this we can agree. They are making so much money that they can blow twenty eight million a month  to fight legislation that will give more Americans healthcare. This is evil. And we know it is evil. Somewhere people got inside the government and have gotten between the people and their elected leaders who job it is to protect the common good. We know this because of the one percent that is keeping all the money in this country now. We know this because Wall Street is giving away billions in bonuses again. We know this because forty six million people are without healthcare.

Imagine what seven million dollars a week can buy. How much influence can be pedaled around the halls of congress with that kind of money. How many people can be bought. Times are hard and here is an industry spending a million dollars a day to defeat legislation that is for the COMMON GOOD. This is not politics even though it has been painted that way. This is about human health and who should have access to it. It is amazing we even debate the question when the obvious answer is EVERYONE SHOULD HAVE THE RIGHT TO HEALTHCARE.

 Do not trot out the words socialized medicine. It is meaningless. We sure don’t’ say that about Medicare. We don’t say that about any of the services we enjoy like public education. That is SOCIALIZED EDUCATION. My grandfather went to the University of Virginia at a time when very few people could go to college. There were no student loans. No GI Bill. There was no socialized education. If you were wealthy you went to college and if you were not then you went to work. Was that fair? The people who went to college thought it was fair.

So if you wonder if this about people fighting against socialism or to retain the quality of healthcare then guess again. Follow the money. The money leads to the insurance companies. Seven million a week. This is about greed. This is about the very worst of American capitalism influencing our government in what should be it’s finest hour. A million bucks a day spent against our people…women, children, men…Americans. How do these people sleep at night?

William Hazelgrove writes in Ernest Hemingway’s attic. His latest book is Rocket Man.

By

I‘m all for doctors. To me, there is no more valuable service on this earth than the professional care administered by a qualified practitioner of the medicinal arts. I don’t particularly enjoy going to the doctor (they always lecture me about smoking) however I can’t think of too many things more comforting than the knowledge that an experienced doc is close at hand should I get a treble hook in my eye, shoot myself in the thigh, or get my foot stuck in mouth.

Being from the Missouri Ozarks, I grew up with a lot of “untraditional” home medical practices. We always figured that there was no need to waste the doc’s time if you could fix it yourself – kinda’ the same theory as changing your own oil on the family Chevy. It’s not that tough a job and the pros have more important stuff on their minds.

Nothing is worse than a hypochondriac (unless it’s a sick hypochondriac) and so, like I said, we often doctored ourselves. Bee stings were treated with a baking soda poultice. If you had a sore throat, you got a long Q-Tip and swabbed your throat with merthiolate. Chigger bites? Dry them up with toothpaste (preferably Crest). If you cut yourself, you doused the gash in hydrogen peroxide and connected the escaping folds of skin with duct tape. If you got strains or sprains or bone aches, you just sprayed some WD-40 on the afflicted area.

Many people dislike my usage of WD-40 on creaking joints. A friend of mine just about had a conniption fit when I sprayed a bunch of the stuff on her blown-out knee, but the pain was relieved within forty-five seconds and now she swears by this all-purpose rusty-nut buster/blown-out ACL remedy.

As an aside, WD-40 is also a pretty good scent to spray on nightcrawlers. The catfish seem to love it, and as an added benefit they don’t squeak when you cut into them

So, I’m all for docs. What I’m against is socialized style medicine ala El Presidente Obama. Both he, and the flaming liberals who sip at his tankard of Koolaid, seem to feel we should follow the lead of rotting countries like England and Canada and dispose of the advances in medicine that occur when physicians and surgeons and such are allowed to practice their arts in a free market economy.Those Socialist types would prefer that everyone have access to free health care, even if the folks who run the el-cheapo clinics can’t speak but about ten words of English and nine of those are “You want buy pretty brass elliefant? Only twenty dollar.” Have we forgotten that it was the government who gave us Amtrak, the U.S. Post Office, The IRS, Cash for Clunkers, and thousands of other enterprises and programs that work about as well as teats on a bull?

There is much discussion over a “public option,” but lets just face facts here. The entirety of Obamacare is nothing but a giant public option. The quality of care will plummet, and rationing is a given. You best hope you only have Stage One cancer at the time of diagnosis, because by the time you get a second appointment you will either be pushing Stage Four or pushing up daisies. You will wait, and wait, and wait, and it’s very possible that you will end up paying more for the privilege.

There are really only two goals behind federally mandated health care programs. The first is control. The current crop of clowns feel that they should control your every move, monitor your every whim. They believe they should not only tell you how to handle your health concerns, but also be allowed to pry into the most intimate details of your life. What’s more, if you refuse to participate, you will either be fined or tossed in the pokey.

The second goal is the outright destruction of the companies that offer health insurance. There is no way a private insurance company can compete against government insurance. If they even try, they will be fined and regulated up the wazoo. Seriously, how can a private insurance company make a profit if they have to cover those with pre-existing conditions for a minimal sum? This is a little like saying car insurance companies have to provide you with low-cost insurance after you’ve smashed your Camaro into a bridge.

Thanks to the liberals in Congress, there is a very good chance that government-run health care will be a reality. Over fifty percent of Americans don’t want it, but that matters not a whit to the folks in Washington. They view themselves as an aristocracy, and besides, they won’t have to use the crappy programs that you’ll be forced to endure. Your health care, if the government programs become a reality, will be provided by organizations devoted to providing the least amount of care at the cheapest cost and making big bucks by getting chintzy on service, I’d just as soon give my cash to a joint boasting a sign reading “Bar, Grill and Mortuary.”

Sadly, for America, it looks like some version of Obamacare will be a reality. The wishes of the citizens don’t matter, for we have a man in the White House who was suckled on the milk of radical socialism.

My suggestion, is that you stock up on baking soda, merthiolate, Crest, and WD-40.

You’re gonna’ need them.

We are a nation fully settled by government. The terrain ahead is both crowded and costly.

Here are pertinent observations from two accomplished political veterans at a forum Tuesday night at Harvard’s John F. Kennedy School of Government. The question, from David Gergen, was what advice the panelists, former Reagan advisor Ken Duberstein and former JFK advisor Ted Sorensen, both of whom had been supportive of Mr. Obama in 2008—Mr. Sorensen campaigned with him in the primaries and the general election—would now give the president.

Mr. Duberstein said, “Don’t overload the circuits,” sequence your actions, don’t attempt too much too quickly, or too completely. Then, modify the tone. “In campaigning, you try to annihilate your opponent. Governing, you try to make love to your opponents, as well as your allies.”

Mr. Sorensen disagreed with the first point—he thought the circuit board was already overloaded when Mr. Obama was handed it last January—but not the second. On the issue of tone, he had told the Obama transition team, “Stop campaigning. You’ve been campaigning for years, and of course you’ve been in perpetual campaign mode, and [Bill] Clinton more than anyone else set that pattern of the permanent campaign. But once you’re president you don’t need to worry” about what’s on the front page of the Washington Post or how some mayor reacts to some appointment. You’ve got to think bigger than that, more expansively.

Mr. Gergen: “Do you think [the president] is still campaigning too much?”

“Yes,” said Mr. Sorensen. “I think that he’s a remarkable speaker, but his speeches are still largely in campaign mode. I think he was surprised by the unanimity of the Republicans in Congress against his program, and probably feels he has to be in campaign mode,” but “he’s got a long time before he has to start his re-election campaign.”

I’m not sure the White House can tell the difference between campaign mode and governing mode, but it is the difference between “us versus them” and “us.” People sense the president does too much of the former, and this is reflected not only in words but decisions, such as the pursuit of a health-care agenda that was inevitably divisive. It has lost the public’s enthusiastic backing, if it ever had it, but is gaining on Capitol Hill. People don’t want whatever it is they’re about to get, and they’re about to get it. In that atmosphere everything grates, but most especially us-versus-them-ism.

***

The biggest thing supporters of a health care overhaul do not understand about those who oppose their efforts, and who oppose the Baucus bill, which has triumphantly passed the Senate Finance Committee even though no one knows exactly what is or will end up in it, is the issue of context.

The Democratic Party and the White House repeatedly suggest that if you are not for the bill or an overhaul, you don’t care about your fellow human beings and you love and support the insurance companies. Actually, no one loves the insurance companies, including the insurance companies. They attack aspects of various bills but seem unable to defend themselves, which is why you haven’t seen any 60-second spots explaining that they actually perform a public good, which they do, however imperfectly, frustratingly, mindlessly and passive-aggressively. An industry that always seems to have to be embarrassed into doing the right thing is an industry that is unlovable. But the Obama administration’s strategy of making it “the villain” in “the narrative” will probably not have that much punch because . . . well, again, who likes the insurance companies? Who ever did?

People who oppose a health-care overhaul are not in love with insurance companies. They’re not even in love with the status quo. Everyone knows the jerry-built system of the past half-century has weak points. They just don’t think the current plan will shore them up. They think the plan would create new weak points and widen old ones. They think this because they have brains.

But even that doesn’t get to the real subtext of the opposition. Yes, the timing is wrong—we have other, more urgent crises to face, and an exploding deficit. And yes, a big change in a huge economic sector during economic crisis is looking for trouble.

But a big part of opposition to the health-care plan is a sense of historical context. People actually have a sense of the history they’re living in and the history their country has recently lived through. They understand the moment we’re in.

In the days of the New Deal, in the 1930s, government growth was virgin territory. It was like pushing west through a continent that seemed new and empty. There was plenty of room to move. The federal government was still small and relatively lean, the income tax was still new. America pushed on, creating what it created: federal programs, departments and initiatives, Social Security. In the mid-1960s, with the Great Society, more or less the same thing. Government hadn’t claimed new territory in a generation, and it pushed on—creating Medicare, Medicaid, new domestic programs of all kinds, the expansion of welfare and the safety net.

Now the national terrain is thick with federal programs, and with state, county, city and town entities and programs, from coast to coast. It’s not virgin territory anymore, it’s crowded. We are a nation fully settled by government. We are well into the age of the welfare state, the age of government. We know its weight, heft and demands, know its costs both in terms of money and autonomy, even as we know it has made many of our lives more secure, and helped many to feel encouragement.

But we know the price now. This is the historical context. The White House often seems disappointed that the big center, the voters in the middle of the spectrum, aren’t all that excited about following them on their bold new journey. But it’s a world America has been to. It isn’t new to us. And we don’t have too many illusions about it.

This week Rep. Paul Ryan, the ranking Republican on the House Budget Committee, spoke, in an interview with the Daily Beast’s Lloyd Grove, of the real-world consequences of what Washington is on the verge of doing. He said he believes the Baucus plan is “the absolute height of fiscal irresponsibility,” adding that “the shame of it all is we could actually fix what’s broken in health care without breaking what’s working, and without creating a huge new entitlement program that will accelerate the bankruptcy of this country.”

He does not believe the Baucus bill would reduce the deficit over the next 10 years. “Congress has a pattern of passing cuts to pay for bills and then restoring the cuts once the bill has been passed. It’s crystal-clear to me that the ‘pay-fors’ in this bill will not survive and we will have created a huge deficit-funded liability.” He spoke of what the likely end of Medicare Advantage, the government-subsidized private insurance program on which millions rely to supplement their coverage. He said the Obama White House has even forbidden its officials from discussing that program’s fate under various health-care bills. He charged that Democrats “hate it anyway, because it’s private, so they are killing a program that they never liked in the first place.”

Mr. Ryan is 39 years old, though he’s serving his sixth term in Congress. In his comments on the health care plan he sounded like a veteran, like someone who thinks he has seen the terrain ahead, seen that it is both crowded and costly.

·         About Peggy Noonan
Peggy Noonan is a columnist for The Wall Street Journal whose work appears weekly in the Journal’s Weekend Edition and on OpinionJournal.com.

She is the author of eight books on American politics and culture. The most recent, “Patriotic Grace,” is to be published in October 2008. Her first book, the bestseller “What I Saw at the Revolution: A Political Life in the Reagan Era,” was published in 1990.

She was a special assistant to the president in the White House of Ronald Reagan. Before that she was a producer at CBS News in New York. In 1978 and 1979 she was an adjunct professor of journalism at New York University.

Bob has completed his excellent book and is now trying to sell it. As the wise guy said “Anybody can write a book, but it takes a genius to sell it,” and part of the sales process will be for Bob to have a nice plump website full of thoughts about cancer.

These are mine. Please post some of your own so that Bob can add them to his website too.

*  *  *

I have known a lot of people to die of cancer. I am talking personally here. Not about celebrities or friends of friends I have never met, but people I have spoken to or who are related to me.

Despite the statistics which supposedly show an ever-increasing success rate, that is not my personal experience. I watch films on DVD and I see hospitals positively gloating in bright, shiny, intelligent, irrefutable medical and surgical gizmos. They are not my experience of the real world either. Product placement is great, but it hasn’t reached any UK hospital near me.

My experience of conventional medicine is this. The consultant looks over at the patient and says “This is what we are going to do ….” As my friend Margaret Gillies used to say “Is this the ‘I’ part of ‘we’ or is this the ‘you’ part of ‘we’, or will we be working together on this one?” In this case it is the medical professionals’ part of we. They are going to do it to you and you are going to lie there and take it. They are going to give you their best shot and you are going to live with the consequences.

I cannot say how it works in the US, but in the UK (with the worst national record of treating cancer in Europe) there is even a stage before this. “Mr. Smith, we do not know what is wrong with you. We are going to have to conduct some more tests.” Yes, those are the medical professionals who will be conducting the tests, not the patient who will be having things scanned and extracted.

Usually, the family, the friends, the postman and the cat know that Mr. Smith has cancer before the medical professionals do, or own up to knowing it at least. “It’s a benign polyps, they say. No sign of cancer.” And they may continue saying that for another two years

That was exactly what happened to my brother Bill, a truly lovely person who didn’t deserve any grief in his life and who managed to accumulate more than his fair share.

Once upon a time Bill was a Hull trawlerman. There is no job in England tougher than being a Hull trawlerman. However, the Hull fishing industry collapsed and he had to look for other work. He ended up in a quarry which, as you might guess, was full of fine carcinogenic dust. Bill, being a quasi-macho Northern bloke, failed to wear his dust mask. It actually didn’t matter. The dust mask he was given was next to useless anyway. After a few months he developed a chronic croak which would have served him well if he had nurtured ambitions to be a rock star, but wasn’t so much use at home. Thirty years on, his voice deteriorated rapidly, he lost significant amounts of weight with no plausible explanation, and he felt uncharacteristically weak much of the time.

He went to see a specialist. “You’ve got some polyps,” the specialist told him after running some tests, but they are benign. “Pop in and we’ll pop them out.”

I suspected otherwise. “Bill has cancer,” I told my mum who was nearly 90 by now and who had devoted herself to Bill’s welfare throughout her life since he suffered a level of brain damage as a child.

“Oh no, dear,” she replied, “the consultant assures us that there is no cancer there at all.”

“Ma,” I scoffed, “sudden weight loss, feeling ill, in pain. The consultant is an idiot.”

“Well that is what he said.” Not the idiot bit, apparently.

So Bill had some polyps taken out, and some more, and he lost more weight and he didn’t feel any better.

Eventually, my sister Sally decided to tackle the consultant. “We are concerned that Bill may have more than benign polyps,” she suggested tentatively.

The consultant swore, lost his temper, and threw her out of his office.

Brave man.

Sally and my other sister, Carolyn, got a second opinion. “Unfortunately, the growth now appears to be cancerous,’ the second consultant said.

Bill had a tracheotomy, which is to say that they cut his throat out and they put a separate tube through to his lungs to allow him to breathe.

Initially, Bill thought this was quite fun. He attracted a great deal of attention and had all his hospital visitors hanging on his every written word. Writing was not his strong point, but for all that attention he was going to stick with it.

The great worry in the family was whether Bill would ever manage to learn to speak with his new prosthetic device. He did, relatively quickly in fact. However, what nobody mentioned is that the plastic device they insert into your throat is an absolute abomination. Bill must have spent half his waking hours cleaning the part that was detachable. However, there was another part he needed to clean, and that was firmly built into his neck. To clean it he had to stick a brush down his oesophagus and twizzle it all around. He hated doing it, as did everybody else. If they weren’t careful, the plastic contraption disappeared down the hole altogether and Bill had to be dashed off to Accident & Emergency in the Hull Royal.

After a period of recovery, Bill fell apart, helped by acquiring a case of pneumonia for which he had to be hospitalised again, then the standard-issue Hull Royal Infirmary MRSA, then another hospital-acquired infection which eventually drowned him.

*  *  *

Twenty-five years ago, my father, at the age of 69, collapsed into a flower bed close to the house in outright agony. He too had been losing weight and not feeling well.

“We’ll do tests,” said the doctors.

Predictably, they couldn’t find anything.

For nearly two years they could not find anything. Eventually they announced that he had prostate cancer. Impressively, they were the last people to know by at least a year.

However, they did have a cunning plan. Their theory was that semen accelerated the growth of prostate cancer so they strongly suggested that my father be castrated. Such a course of action might have been motivational for someone wishing to build his nascent career in a sultan’s harem, but for a seventy-year-old dying man one had to have one’s doubts. The operation was a great success. My father deteriorated faster than ever and died six months’ later.

I suppose one could stand and admire the amount of accumulated wisdom and knowledge his medical team had acquired over the years, but my assessment is that you really have to be a special class of buffoon to be quite so moronically ignorant, and Hull Royal Infirmary seems to have bought its lemons in bulk.

Sadly, I can go on with cases like this for a very long time. In fact, out of my personal experience I can summon only my cousin who survived post-menopausal breast cancer and two friends who had hysterectomies as some sort of evidence that the medical profession can address cancer. Everybody else I know died after great worry, great optimism, great gadgetry, great cost and then “Sorry, the treatment is not working.”

On the other hand, I know personally almost an equal number of people to those who have died using conventional treatments who have recovered from cancer using alternative therapies.

But that is another story and I am sure I am imagining them anyway.

1. Develop a Project Scope – I would have carefully specified the problem to be addressed and identified all of the parties involved. including what parts of the government are affected as well as the populace. In other words, who is directly involved, indirectly involved, and not involved at all. I would also clearly identify the existing system(s) to either be modified or replaced.

2. Study the current system(s) – this would involve interviewing a wide spectrum of people involved with the existing health care systems, such as insurance carriers, hospitals and clinics, physicians and health care workers, malpractice attorneys, etc. Basically, anyone associated with the Project Scope. From this, a “Current Systems Analysis” is produced specifying the strengths and weaknesses of the current mode of operation. This includes what works well, what is deficient, and what is truly broken. Also, consideration would be given to cheating and abuses of the system, not just that it occurs, but why it occurs.

3. Specify Requirements – detailing what is needed from a mandatory, strategic, and tactical perspective. This would include the requirements of the American public, the government, health care providers, etc.

4. Review – “The problem well stated is half-solved.” Before we try to solve the problem, let’s make sure we have the Project Scope, Current Systems Analysis, and Requirements properly and carefully defined. If this is wrong, any solution devised to satisfy it will be wrong.

5. Develop System Approach – to satisfy the requirements, consideration is given to proposed alternatives, including modifying and/or correcting deficiencies in existing systems, devising whole new systems, or both. This would include the sub-systems and infrastructure needed to support them. Because of the enormity and complexity of Health Care, it would be wise to develop multiple solutions in order to propose alternatives with a recommended solution suggested.

6. Prepare System Evaluation – for each approach offered, a cost estimate is prepared (not just development costs, but implementation and on-going support costs as well), along with how it is to be financed, including a cost/benefit analysis (consisting of such things as break even points and return on investment). From this, we can put a price tag on each proposed solution and consider which one we can afford.

7. Review – all of the material thus far is assembled into an organized report with an executive summary highlighting the major points. This would then be presented to lawmakers in Congress for their review and deliberations. The outcome from this would be to accept it as is, ask that it be revised, or discontinued completely.

What I’ve just described is called a “Feasibility Study” as used in corporate America on a daily basis. No, it’s not cheap and can take some time to produce, but business people long ago accepted the fact that you must “look before you leap” into a major project. Yes, it would be tough to prepare, but I know nothing of substance that has ever been done without some sound research and planning, but as far as I can see, this has not been done by anyone, least of all Congress or the President.

Some politicians would argue that we don’t have time for a proper Feasibility Study. Interestingly, I hear this same argument from programmers in the Information Systems world who also don’t believe in the necessity of upfront planning and prefer hacking away at program code instead, leaving an ugly disjointed mess that never gets finished. The fact remains though, no amount of elegant programming or technology will solve a problem if it is improperly specified or understood to begin with. I contend we haven’t got time NOT to do this vital upfront work.

If our Congress went through the motions of building a true Feasibility Study, it would promote cooperation through effective communications, thereby eliminating partisan sniping; it would produce a proper solution for the right set of problems, and; it would go a long way to improving the trust in the government by the American people, simply by assuring them that the “T’s” were crossed and the “I’s” were dotted (that it has been thoroughly thought through).

I guess what concerns me, as well as a lot of Americans, is not so much what is being presented to us as much as the process by which it was developed which, to my way of thinking, was in a vacuum. If Americans don’t trust it, they will not embrace it and may even revolt against it.

Remember, it’s Ready, Aim, Fire; any other sequence is counterproductive. Then again, our attorney/politicians don’t know anything about management.

Tim Bryce is the Managing Director of M. Bryce & Associates (MBA) of Palm Harbor, Florida and has over 30 years of experience in the management consulting field. He can be reached at timb001@phmainstreet.com

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Copyright © 2009 by Tim Bryce. All rights reserved.