For those eager to turn healthcare over to the government, the LA County King-Harbor hospital should serve as a cautionary tale.

Besides killing patients (whatever happened to “First, do no harm”?), it staffed itself with criminals.

More than 10% of the Martin Luther King Jr.-Harbor Hospital employees whose backgrounds were examined by the county had criminal histories, according to a long-awaited analysis released Monday that also found the King nurses provided inferior care.

The hospital had about 1,600 employees when the background checks were conducted a year ago, according to the report by the auditor-controller’s department. Of those, 1,356 had their backgrounds examined, and 152 of those came back with criminal or arrest records.
The number is far larger than the 17 employees with criminal histories that the county has previously acknowledged and included convictions ranging from misdemeanors (but not most vehicle code violations) to serious felonies.

“If 10% of the employees in my office had criminal records, I’d have a big problem,” Supervisor Zev Yaroslavsky said. “My level of frustration is very high.”

The report was done at the behest of the Board of Supervisors after The Times reported that the county’s Department of Health Services had fallen short of supervisors’ promise to “wipe the slate clean” of problem employees.

When federal regulators forced the closure of inpatient services at the hospital a year ago, supervisors blamed their own employees for the regulators’ finding that the hospital did not meet minimum standards for patient care.

In the cases of 99 of the workers with criminal records, county managers determined that the crime did not prevent the worker from continuing on the job. But the auditor-controller questioned the reasoning used to make that determination. In one case, for instance, county managers decided that it was not a problem that a custodian had been convicted of first-degree burglary and felony grand theft.

A PSA only he could do.

Maggie’s Farm:

Yet one more manufactured, over-hyped  crisis is being debunked.

Nowadays you can define anything you want as pathological. And this whole new fashionable category of “at risk” silliness expands things to include everybody.

For example, at middle-age I am “at risk” for obesity. Not wanting to be fat, I decided not eat carbs and I do a tough daily workout. It’s not too complicated.

Prosperous nations have lots of fat people. More of them than poor nations, although poor nations have plenty of them too. The reason is that humans have a weakness for carbs. Thus being trim and fit is a sign of self-control, but being heavy is a time-honored sign of prosperity.

If you want to see fat people, go to Disneyworld and get grossed out. There are Americans there so fat that they have to ride around in motorized chairs, like King Kamehameha. God bless ‘em. The world needs more fatties, in my opinion. It means people have plenty to eat, but I don’t like to have to look at them. To be evenhanded, however, I find anorectics even more disturbing.

I happen to feel that excess fat in women is unattractive, slovenly, and unsexy. Somewhat less so in men: some stout men are cool, like Teddy Roosevelt was. Anyway, we have been subject to much brouhaha about obesity in recent years. Big health crisis, etc.

Read on.

The cleanliness of most NHS hospitals in England is threatened by frequent invasions of rats, fleas, bedbugs, flies and cockroaches, a report claims.

Opponents of physician-assisted suicide are fired up this summer, and rightfully so, over an ethically questionable provision of the Oregon Health Plan.

The conflict came to light in a recent report in The Register-Guard of Eugene. The newspaper described the sad plight of Barbara Wagner, a 64-year-old Springfield woman with lung cancer.

After her oncologist prescribed a cancer drug that would cost $4,000 a month, the newspaper reported, “Wagner was notified that the Oregon Health Plan wouldn’t cover the treatment, but that it would cover palliative, or comfort, care, including, if she chose, doctor-assisted suicide.”

That presents an unacceptable conflict. The state health program should not be in the position of denying chemotherapy to terminally ill patients while offering to pay the cost of helping them die.

VIDEO HERE

 Caitrin Nicol

In storage at the Museum of Fine Arts in Boston is the secret to what one professor calls “the first Down Syndrome Association in the history of the world.” In 1982, Dr. Brian Stratford, a specialist in developmental disabilities at the University of Nottingham, suggested in the journal Maternal and Child Health that the Italian Renaissance painter Andrea Mantegna used a little boy with Down syndrome as the model for his Christ child. Stratford made a “clear characteristic diagnosis” of the baby based on his distinctive facial features and the shape of his hands and toes.

The curator at the MFA dismissed this theory, attributing the work to an unknown, less technically astute follower of Mantegna, and calling the resemblance to a child with Down syndrome accidental. In the meantime, however, Stratford heard from a history professor in Rome. The Gonzaga family of Mantua, Mantegna’s sponsor, had a boy with an unidentified “sickness,” she said, and one of the artist’s own fourteen children shared this condition—a not insignificant factor in Ludovico Gonzaga’s choice of Andrea Mantegna as his court painter.

Gonzaga and Mantegna appreciated the humanity of these children whom some might have preferred to hide away or let die, and that shared sensitivity gave them a “sense of purpose” with respect to disability which Stratford regrets has been all but forgotten by our society: “Perhaps Mantegna saw in this child something beyond the deficiencies which now so occupy our attention and perhaps then, the qualities of love, forgiveness, gentleness, and innocence were more readily recognized. Maybe Mantegna saw these qualities as more representative of Christ than others we now regard so highly.”

Down syndrome is a developmental disability resulting from an extra copy of the twenty-first chromosome. It is the most common single cause of human birth defects, occurring in about one in eight hundred births. Symptoms include mild to moderate mental retardation, lower muscle tone, an approximately forty percent chance of a congenital heart defect, and lesser but significant risks of gastrointestinal disorders and leukemia.

Individuals with Down syndrome generally have outstanding social skills and in a supportive setting can be fairly high-functioning. Due to improving medical care, the life expectancy for someone born with Down syndrome has increased from twenty-five in the early 1980s to more than fifty today. In many other ways as well, a child born with Down syndrome today has brighter prospects than at any other point in history. Early intervention therapies, more inclusive educational support, legal protections in the workplace, and programs for assisted independent living offer a full, active future in the community. Adoption agencies report a high demand for children with Down syndrome.

However, the abortion rate for fetuses diagnosed with Down syndrome tops ninety percent. The alphafetoprotein maternal blood-serum test followed by amniocentesis are standard practice in prenatal care for women over thirty-five, who have an elevated risk of conceiving a baby with Down syndrome. Eighty percent of babies with Down syndrome are born to younger women, however, due to their higher overall fertility rate, and the American College of Obstetricians and Gynecologists (ACOG) recommended in 2007 that all pregnant women be offered screening for Down syndrome. While ACOG insists on its neutrality with regard to abortion, it is not difficult to interpret this move as an effort to reduce the number of individuals with Down syndrome who are carried to term.

Read on.

Nelson Mandela recently celebrated his 90th birthday. A huge rock concert was held in London’s Hyde Park as a fundraiser for Mandela’s AIDS charity.

But the tragedy of South Africa’s AIDS epidemic could have been averted  by Mandela.

We quote from the 4-hour PBS documentary, The Age of AIDS.

NARRATOR: As in the West, gay activists were among the first to warn that aids was coming.

EDWIN CAMERON, AIDS Law Project: I got infected, as thousands, hundreds of thousands of comparable gay men in Sydney and San Francisco and elsewhere. But it was already plain at that stage that there was a heterosexual African epidemic, which was going to surpass the epidemic amongst people like myself.

ZACKIE ACHMAT: We started an HIV prevention program, trying to speak to people about it, trying to say to people to use condoms, and so on.

NARRATOR: In the black townships, the activists met resistance.

MANDLA MAJOLO: People from outside come into your community, telling you how to behave, especially if they are whites and you’re black, and you can easily look at it as if they think that you are irresponsible sexually. And once you reach that feeling, you start to build walls.

NARRATOR:In pockets across the nation, like rural KwaZulu-Natal, people began to die from AIDS. Increasingly, they were women, infected by their husbands and lovers who’d worked in the mines.

D.E. NDWANDWE, Nurse, KwaZulu-Natal: We used to get more males than females, but eventually, there was a change and we got more female patients than males, you know, such a change that we actually had to change the accommodation at some stage, use the people who worked for females and use the other ward for males.

NARRATOR:For four years after Mandela’s release, the apartheid leaders and the ANC were consumed with the transfer of power. In that political vacuum, an opportunity to stem the epidemic was slipping away.

SALIM ABDOOL KARIM, M.D., University of KwaZulu-Natal: In a way, the complex political transition, the lack of credibility of the apartheid government at that time, which was disintegrating, in effect, and the new government was yet to be installed- and the new government had all kinds of challenges, not least HIV.

NARRATOR: In poor, crowded townships like Soweto, the epidemic accelerated. doctors at the nation’s largest hospital were soon overwhelmed.

GLENDA GRAY, M.D., Baragwanath Hospital, Soweto: It was just hemorrhaging. And we just watched this- this thing explode in our face.

NARRATOR: Babies were being infected by their mothers through childbirth and breast feeding.

Dr. GLENDA GRAY:As HIV became more frequent and more commonplace in children, and as they needed more and more care, the ICUs in the country also made decisions not to admit children with HIV into their ICUs because it was terminal, and we needed to keep the beds open for children who had better prognosis. HIV became the new apartheid in South Africa. You know, we discriminated not on race anymore, but on HIV status.

Nurses were burnt out. Doctors didn’t care, as well, you know? “Why should I care when the government doesn’t care?”

NARRATOR: In May 1994, when Nelson Mandela became South Africa’s president, he saw his job as reconciliation, holding his fractured nation together. Activists hoped he would also make time for AIDS.

EDWIN CAMERON:At the time I chaired a national convention on AIDS, my co-chair and I made every effort we could to get an audience with President Mandela, and we didn’t succeed. We got an audience instead with Deputy President de Klerk, and Deputy President Mbeki joined the meeting.

NARRATOR:Mandela delegated AIDS to his deputy, Thabo Mbeki

Mbeki, Mandela’s eventual successor and SA’s current leader, became convinced that HIV was not the cause of AIDS and thwarted efforts to deal with the crisis.

In the US, Senator Jesse Helms was blocking efforts to send aid to Africa, primarily on moral grounds. Then he got a visit from singer, Bono. Billy Graham’s son, Franklin, was also advocating help for Africa.

Then Bush stepped in, doing what Bill Clinton never did: act.

NARRATOR: Bono’s activism was backed by his own Christian faith. Franklin Graham took notice.

Rev. FRANKLIN GRAHAM: Bono has a pretty significant level of biblical understanding. He’s read the Bible. Not once, but I think he’s read it many times.

BONO: I was offended to discover that the religiosity of this country was not available to the AIDS emergency, so I asked to meet as many church leaders as I could and used examples from the Scriptures. You know, “Isn’t this the leprosy of the age,” I argued. “Isn’t this what,” you know, “the Christ spent his time with?” And yet the church now is walking across the road and looking the other way.

NARRATOR: With Franklin Graham’s support, Bono came to Washington to meet Jesse Helms.

BONO: Jesse Helms is a tough guy, but he’s also rigorous, from his point of view. So you know, Christ only speaks of judgment once, and oddly enough, it’s in regard to the poor. I think it’s Matthew 23. It’s the famous lines, “I was naked and you clothed me. I was a prisoner and you visited me.’ And then they say to Christ, “What are you talking about? You weren’t.” “I was sick and you came to me.” And he says, “No, no, I wasn’t. But as much as you do this to the least of these, you do it unto me.” And that’s a very powerful piece of Scripture.

And he was very moved. Even emotionally, he kind of welled up. And as I was leaving the room, he said - big Southern- big, tall, Southern old boy, you know, just this amazing character- he said, “I want to give you a blessing.” And he put his arms around me and then he gave me this blessing. And I take such- I take blessings pretty seriously. And I went out and of course told the assembled press what had happened, and they couldn’t believe it.

I’m very humbled. I’m having my world turned upside down, and I’m surprised that people should be so generous in letting an obvious outsider in.

Sen. JESSE HELMS: You’ll never be an outsider. You’ll always be a friend.

Rev. FRANKLIN GRAHAM: He respected what Bono was telling him, and Senator Helms changed his position to where opposing funding for HIV/AIDS, he became an advocate for funding.

Pres. GEORGE W. BUSH: Thank you all. Bono, I appreciate your heart. Let me tell you what an influence you’ve had. Dick Cheney walked in the Oval Office, he said, “Jesse Helms wants us to listen to Bono’s ideas.” That’s pretty-

BONO: And he was very well informed about it. I was surprised that he knew- you know, he knew as much as he did. And to be fair to President Bush, he really responded, and he responded in a way that no one could ever have imagined.

NARRATOR: Dr. Anthony Fauci, a top scientist from the NIH, was summoned to the White House. They wanted a plan on AIDS.

Dr. ANTHONY FAUCI: It was driven by the president. He said he wanted it to be feasible, he wanted it to be bold, and he wanted it to be accountable.

NARRATOR: Bush was also getting advice from Franklin Graham, one of his spiritual advisers.

Rev. FRANKLIN GRAHAM: I tried to encourage him to- first of all, in most of Africa, not only do you have a church, but there are church-related hospitals. And we need to enlist these churches in this fight against HIV/AIDS. And we don’t need to be pouring this money into some of these governments, who are going to squander the money.

NARRATOR: A plan emerged. It would draw on both religious and government health services already in place.

Dr. ANTHONY FAUCI: Therapy prevention care for HIV can really work under these circumstances, if you do it the African way. Don’t parachute in your own preconceived notion about how things can be done, do it the way the Africans feel that they can do it.

The White House staff said, “We believe you, Tony, but you’re a white American who works for the federal government. We want to hear, is this thing feasible from people who are in the trenches.”

NARRATOR: Fauci reached out to Uganda’s leading AIDS specialist to convince the White House staff.

PETER MUGYENYI, M.D., Joint Clinical Research Ctr.: They were very skeptical that infrastructure would not support anti-retroviral therapy on the African continent. They even went to some extremes of saying that the continent do not even have clean water.

NARRATOR: In January 2003, the plan was still behind closed doors. With a looming war in Iraq, there were worries about the White House’s priorities.

BONO: I said that to President Bush. You know, I said, “Look, paint them red, white and blue, if you want, but these drugs are the best advertisement you’re going to get right now, and that might be important right now.” And so, you know, above the moral imperatives comes the political imperative to some people. So fine, whatever brings you to the party.

NARRATOR: As the president arrived for his State of the Union speech, everyone expected him to issue an ultimatum to Saddam Hussein. They were not prepared for what came first.

Pres. GEORGE W. BUSH: Today, on the continent of Africa, nearly 30 million people have the AIDS virus, yet across that continent, only 50,000 AIDS victims - only 50,000 - are receiving the medicine they need. I ask the Congress to commit $15 billion over the next five years, including nearly $10 billion in new money, to turn the tide against AIDS in the most afflicted nations of Africa and the Caribbean.

Dr. PETER MUGYENYI: That sounded like melodious music. From there onwards, things would never be the same. And that was victory for the people who were suffering and who were now going to have hope.

The entire documentary is online in multiple video formats.

Dr. Sherwin Nuland, medicine’s best-known historian, was visiting with Dr. Michael DeBakey three years ago when the then-96-year-old surgeon left the room to attend to some business.

Taking advantage of the moment to tour the room’s extensive collection of memorabilia — the honors, photographs and mementos from an illustrative career that spanned eight decades — Nuland stopped to reflect on two antiquarian charts of the history of medicine.

“As I studied the charts, it occurred to me that no face on them was any more important in the history of medicine than DeBakey himself,” said Nuland, a retired surgeon at the Yale University School of Medicine and author of Doctors: The Biography of Medicine. “I can’t think of anyone who’s made more of a contribution to the field of medicine.”

Michael Ellis DeBakey — internationally acclaimed as the father of modern cardiovascular surgery and considered by many to be the greatest surgeon ever — died Friday night at The Methodist Hospital in Houston. He was 99.

Methodist officials said DeBakey died of natural causes. He was taken to the hospital after his wife, Katrin, called 911, and he was pronounced dead shortly after arriving, said Dr. Marc Boom, executive vice president of Methodist.

Atul Gwande, a third generation doctor and author, writes in the New Yorker about a woman with an uncontrollable itch on her scalp. Uncontrollable to the point that she scratched herself clear into brain tissue and had to be institutionalized for a time.

Doctors had no answers.

When she took a biopsy of the itchy skin, it showed that ninety-six per cent of the nerve fibres were gone. So why was the itch so intense?

Oaklander came up with two theories. The first was that those few remaining nerve fibres were itch fibres and, with no other fibres around to offer competing signals, they had become constantly active. The second theory was the opposite. The nerves were dead, but perhaps the itch system in M.’s brain had gone haywire, running on a loop all its own.

The second theory seemed less likely. If the nerves to her scalp were dead, how would you explain the relief she got from scratching, or from the local anesthetic? Indeed, how could you explain the itch in the first place? An itch without nerve endings didn’t make sense. The neurosurgeons stuck with the first theory; they offered to cut the main sensory nerve to the front of M.’s scalp and abolish the itching permanently. Oaklander, however, thought that the second theory was the right one—that this was a brain problem, not a nerve problem—and that cutting the nerve would do more harm than good. She argued with the neurosurgeons, and she advised M. not to let them do any cutting.

M did have the nerve cut and it worked for a while, but then the itch returned, just as intense.

A new scientific understanding of perception has emerged in the past few decades, and it has overturned classical, centuries-long beliefs about how our brains work—though it has apparently not penetrated the medical world yet. The old understanding of perception is what neuroscientists call “the naïve view,” and it is the view that most people, in or out of medicine, still have. We’re inclined to think that people normally perceive things in the world directly. We believe that the hardness of a rock, the coldness of an ice cube, the itchiness of a sweater are picked up by our nerve endings, transmitted through the spinal cord like a message through a wire, and decoded by the brain.

In a 1710 “Treatise Concerning the Principles of Human Knowledge,” the Irish philosopher George Berkeley objected to this view. We do not know the world of objects, he argued; we know only our mental ideas of objects. “Light and colours, heat and cold, extension and figures—in a word, the things we see and feel—what are they but so many sensations, notions, ideas?” Indeed, he concluded, the objects of the world are likely just inventions of the mind, put in there by God. To which Samuel Johnson famously responded by kicking a large stone and declaring, “I refute it thus!”

Still, Berkeley had recognized some serious flaws in the direct-perception theory—in the notion that when we see, hear, or feel we are just taking in the sights, sounds, and textures of the world. For one thing, it cannot explain how we experience things that seem physically real but aren’t: sensations of itching that arise from nothing more than itchy thoughts; dreams that can seem indistinguishable from reality; phantom sensations that amputees have in their missing limbs. And, the more we examine the actual nerve transmissions we receive from the world outside, the more inadequate they seem.

Our assumption had been that the sensory data we receive from our eyes, ears, nose, fingers, and so on contain all the information that we need for perception, and that perception must work something like a radio. It’s hard to conceive that a Boston Symphony Orchestra concert is in a radio wave. But it is. So you might think that it’s the same with the signals we receive—that if you hooked up someone’s nerves to a monitor you could watch what the person is experiencing as if it were a television show.

Yet, as scientists set about analyzing the signals, they found them to be radically impoverished. Suppose someone is viewing a tree in a clearing. Given simply the transmissions along the optic nerve from the light entering the eye, one would not be able to reconstruct the three-dimensionality, or the distance, or the detail of the bark—attributes that we perceive instantly.

So the new theory posits that the brain takes some sensory input data, and then based on prior experiences, creates a perception. Most of the time, it works. But with such things as phantom limb syndrome — where an amputee feels pain in a missing arm or leg — the brain gets it wrong.

Could a similar thing be causing the itch?

The article mentions Dr. V. S. Ramachandran, a neuroscientist at UC San Diego, has done trailblazing research on how the brain maps the body. His book, Phantoms in the Brain, is a fascinating read.

And here’s a video.

Quick, someone alert Michael Moore. And Obama. And the rest of the Democrat/socialist party.

The man who devised Canada’s healthcare system has wised up.

Castonguay’s evolving view of Canadian health care, however, should weigh heavily on how the candidates think about the issue in this country.

Back in the 1960s, Castonguay chaired a Canadian government committee studying health reform and recommended that his home province of Quebec — then the largest and most affluent in the country — adopt government-administered health care, covering all citizens through tax levies.

The government followed his advice, leading to his modern-day moniker: “the father of Quebec medicare.” Even this title seems modest; Castonguay’s work triggered a domino effect across the country, until eventually his ideas were implemented from coast to coast.

Four decades later, as the chairman of a government committee reviewing Quebec health care this year, Castonguay concluded that the system is in “crisis.”

“We thought we could resolve the system’s problems by rationing services or injecting massive amounts of new money into it,” says Castonguay. But now he prescribes a radical overhaul: “We are proposing to give a greater role to the private sector so that people can exercise freedom of choice.”

Gasp!

Castonguay advocates contracting out services to the private sector, going so far as suggesting that public hospitals rent space during off-hours to entrepreneurial doctors. He supports co-pays for patients who want to see physicians. Castonguay, the man who championed public health insurance in Canada, now urges for the legalization of private health insurance.

In America, these ideas may not sound shocking. But in Canada, where the private sector has been shunned for decades, these are extraordinary views, especially coming from Castonguay. It’s as if John Maynard Keynes, resting on his British death bed in 1946, had declared that his faith in government interventionism was misplaced.

What would drive a man like Castonguay to reconsider his long-held beliefs? Try a health care system so overburdened that hundreds of thousands in need of medical attention wait for care, any care; a system where people in towns like Norwalk, Ontario, participate in lotteries to win appointments with the local family doctor.

Years ago, Canadians touted their health care system as the best in the world; today, Canadian health care stands in ruinous shape.

Sick with ovarian cancer, Sylvia de Vires, an Ontario woman afflicted with a 13-inch, fluid-filled tumor weighing 40 pounds, was unable to get timely care in Canada. She crossed the American border to Pontiac, Mich., where a surgeon removed the tumor, estimating she could not have lived longer than a few weeks more.

The Canadian government pays for U.S. medical care in some circumstances, but it declined to do so in de Vires’ case for a bureaucratically perfect, but inhumane, reason: She hadn’t properly filled out a form. At death’s door, de Vires should have done her paperwork better.

UCLA researchers discovered that an FDA-approved drug reverses the brain dysfunction inflicted by a genetic disease called tuberous sclerosis complex (TSC). Because half of TSC patients also suffer from autism, the findings offer new hope for addressing learning disorders due to autism.

Using a mouse model for TSC, the scientists tested rapamycin, a drug approved by the FDA to fight tissue rejection following organ transplants. Rapamycin is well-known for targeting an enzyme involved in making proteins needed for memory. The UCLA team chose it because the same enzyme is also regulated by TSC proteins.

“This is the first study to demonstrate that the drug rapamycin can repair learning deficits related to a genetic mutation that causes autism in humans. The same mutation in animals produces learning disorders, which we were able to eliminate in adult mice,” explained principal investigator Dr. Alcino Silva, professor of neurobiology and psychiatry at the David Geffen School of Medicine at UCLA. “Our work and other recent studies suggest that some forms of mental retardation can be reversed, even in the adult brain.”

Jonah Goldberg on the Senate privatizing its restaurants. 

This was a painful decision for many Democrats who believe that privatization can’t be justified simply because it delivers better service and higher quality for less money. “What about the workers?” they cried. Apparently, some Democrats feel that the top priority in the restaurant business is to generate paychecks for people who are bad at their jobs.

Feinstein, head of the Senate Committee on Rules and Administration, was forced to deal with reality. “It’s cratering,” The Washington Post quoted her as saying. “Candidly, I don’t think the taxpayers should be subsidizing something that doesn’t need to be. There are parts of government that can be run like a business and should be run like businesses.”

Yes, yes, go on, Dianne. Run with that thought. Explore it, as the therapists say.

Perhaps you might meditate on the District of Columbia’s public school system, which spends roughly $14,000 a pupil in exchange for one of the worst educations in the country. Every year, one of the greatest mysteries in the nation’s capital is whether textbooks have been delivered to the right kids, or even to the right schools. It can take until Christmas to get it all worked out. FedEx Corp., meanwhile, can tell you where any of its millions of packages are in more than 100 countries, right now. (Why not just FedEx the textbooks to the kids?)

Or you might ponder the hilarious example of New York’s OTB. For most of the last 40 years, these state-run betting parlors have actually lost money. Apparently, the house always wins - except when the government is the bookie.

Look wherever you like, it’s not as if there’s a shortage of examples. And more are on the way.

Indeed, all augurs point to a tsunami of government ambition in the years ahead, particularly if Barack Obama wins in November. Obama promises a national health-insurance plan overseen by the kith and kin who serve the Senate its navy bean soup.

He believes that the failure of public schools - like DC’s - is largely attributable to the under-funding of education. DC’s schools already are among the best-funded and worst schools in the country. By all means, let’s have more of the same!

And he’ll celebrate it as change!

A quarter of a century after the outbreak of AIDS, the World Health Organisation (WHO) has accepted that the threat of a global heterosexual pandemic has disappeared.

In the first official admission that the universal prevention strategy promoted by the major AIDS organisations may have been misdirected, Kevin de Cock, the head of the WHO’s department of HIV/AIDS said there will be no generalised epidemic of AIDS in the heterosexual population outside Africa.

One could argue that the lack of a pandemic in the West was the fruit of the awareness campaign, not the lack of a credible threat.

In Russia and South Africa, AIDS could have been avoided if their governments had acted competently. Both nations saw the disease spread long after it had become known in the rest of the world.

The San Fernando Valley’s Olive View-UCLA Medical Center, long viewed as the “crown jewel” of Los Angeles County’s public hospitals, was fined $50,000 by state health officials Wednesday in connection with two patient deaths late last year.The fines are the first for Olive View and come just six months after the state Department of Public Health launched an investigation at the hospital after a surgical device caught a patient on fire and another patient died from oleander poisoning when an Office of Public Safety commander refused to pick up an antidote at a nearby hospital.

The two $25,000 fines for two incidents at the public hospital in Sylmar are Olive View’s first. Among the fines handed out Wednesday, Scripps Memorial Hospital in San Diego was the only other hospital in the state to receive more than one.

Isn’t there an evil corporation to blame for this?

I’d like to believe this…

When older people can no longer remember names at a cocktail party, they tend to think that their brainpower is declining. But a growing number of studies suggest that this assumption is often wrong.

Instead, the research finds, the aging brain is simply taking in more data and trying to sift through a clutter of information, often to its long-term benefit.

The studies are analyzed in a new edition of a neurology book, “Progress in Brain Research.”

Some brains do deteriorate with age. Alzheimer’s disease, for example, strikes 13 percent of Americans 65 and older. But for most aging adults, the authors say, much of what occurs is a gradually widening focus of attention that makes it more difficult to latch onto just one fact, like a name or a telephone number. Although that can be frustrating, it is often useful.

“It may be that distractibility is not, in fact, a bad thing,” said Shelley H. Carson, a psychology researcher at Harvard whose work was cited in the book. “It may increase the amount of information available to the conscious mind.”

For example, in studies where subjects are asked to read passages that are interrupted with unexpected words or phrases, adults 60 and older work much more slowly than college students. Although the students plow through the texts at a consistent speed regardless of what the out-of-place words mean, older people slow down even more when the words are related to the topic at hand. That indicates that they are not just stumbling over the extra information, but are taking it in and processing it.

When both groups were later asked questions for which the out-of-place words might be answers, the older adults responded much better than the students.

“For the young people, it’s as if the distraction never happened,” said an author of the review, Lynn Hasher, a professor of psychology at the University of Toronto and a senior scientist at the Rotman Research Institute. “But for older adults, because they’ve retained all this extra data, they’re now suddenly the better problem solvers. They can transfer the information they’ve soaked up from one situation to another.”

Scratch the surface of virtually any liberal political initiative and you’ll find a sick need to mind other peoples’ business. Perhaps some day they’ll discover a “busy body” gene and we’ll indeed enjoy a new politics.

Alas:

As someone who commutes by bicycle into Manhattan, I would normally applaud any scientific rationale for more bike lanes. But some calculations in the new issue of the Lancet make me uncomfortable. The authors argue that policies promoting cycling and walking are good for the planet because they could reduce obesity — and obesity, the authors calculate, contributes to global warming.

Do we really need to give fat people one more reason to feel guilty?

The Lancet authors, Dr. Phil Edwards and Dr. Ian Roberts of the London School of Hygiene and Tropical Medicine, crunch the numbers and conclude:

Compared with the normal weight population, the obese population consumes 18% more food energy. Additionally, more transportation fuel energy will be used to transport the increased mass of the obese population, which will increase even further if, as is likely, the overweight people in response to their increased body mass choose to walk less and drive more.

Urban transport policies that promote walking and cycling would reduce food prices by reducing the global demand for oil, and promotion of a normal distribution of B.M.I. [Body Mass Index] would reduce the global demand for, and thus the price of, food. Decreased car use would reduce greenhouse gas emissions and thus the need for biofuels, and increased physical activity levels, would reduce injury risk and air pollution, improving population health.

Sure, exercise has lots of benefits. But would more exercise really lead to less obesity, or would the exercisers just get hungrier and eat more? Check out this article by Gina Kolata, my Times colleague and the author of “Rethinking Thin.”

Liberals fear/despise the government when it save lives by intercepting phone calls from terrorists into the United States. Trust issues and all that.

So why trust that same government with a healthcare monopoly? Consider this:

Did you hear that San Antonio Metro Health District has decided to create a surveillance program of the lab results on its residents to identify diabetics who aren’t keeping their indices to government-approved levels?

Health officials there are initiating a program to make it mandatory that all laboratories electronically turn over hemoglobin A1c results (along with the people’s names, addresses and dates of birth) to its government agency for a database of diabetics.

Got that, sweetpea? Uncle Sugar is watching your blood.

A new study shows how sounds are amplified in the inner ear, a finding that could explain how hearing loss can result from genetic mutation or overdose of drugs.

St. Jude Children’s Research Hospital investigators have found that an electrically powered amplification mechanism in the cochlea of the ear is critical to the acute hearing of humans and other mammals. The findings will enable better understanding of how hearing loss can result from malfunction of this amplification machinery due to genetic mutation or overdose of drugs such as aspirin.

Sound entering the cochlea is detected by the vibration of tiny, hair-like cilia that extend from cochlear hair cells. While the cochlea’s “inner hair cells” are only passive detectors, the so-called “outer hair cells” amplify the sound signal as it transforms into an electrical signal that travels to the brain’s auditory center. Without such amplification, hearing would be far less sensitive, since sound waves entering the cochlea are severely diminished as they pass through the inner ear fluid.

How dare they offer cheap prescription drugs? 

It looks as if local retail giant Target is playing a game of “keeping up with the Joneses” with rival Wal-Mart.

After Bentonville, Ark.-based Wal-Mart Stores Inc. announced Monday it would launch the third phase of its low-cost prescription drug program, Minneapolis-based Target Corp.  said it would follow suit.

Wal-Mart said in a release that Wal-Mart Stores, Neighborhood Market and Sam’s Club pharmacies would now fill prescriptions for as many as 350 generic medications at $10 for a 90-day supply.

A spokeswoman for Target said that the retailer “understands the challenges guests are facing in the current economic environment,” adding that the company would match Wal-Mart’s programs.

In 2006, when Wal-Mart launched its $4 generic prescription drug program, Target followed suit a few days later.

Time after time, pundits describe the American healthcare system as “broken.” That some 45 million Americans do not have health insurance is taken as a major societal failure.

Lack of insurance is often confused with lack of healthcare; recently on American Idol’s fundraiser, Simon Cowell claimed that 45 million Americans have no healthcare. But they do. And of the 45 million without insurance are many young people who choose not to buy it.

So how broken is our system?

Despite ever-increasing healthcare costs and widespread dissatisfaction with the U.S. healthcare system, a majority of Americans remain satisfied with what they pay for their own healthcare, the quality of the healthcare they receive, and their healthcare coverage.

Gallup’s annual Healthcare survey, conducted Nov. 11-14, finds 57% of Americans saying they are satisfied with the total cost they pay for their healthcare, while 39% are dissatisfied. These percentages have been quite stable in recent years, after a slight dip in reported satisfaction between 2001 (64%) and 2002 (58%).

Stephen Bainbridge has thoughts on what it all means and why Democrats are backing off their promise of universal healthcare.

And those 45 million? Watch the movie.

Control freaks, through and through:

Democrats have made affordable health care a mainstay of their election agenda, but apparently only if you’re willing to get insurance through the government. Witness their stealthy assault on Americans who prefer the private-sector option of Health Savings Accounts.

This week, the House passed legislation that included a provision to require every HSA transaction be reviewed and verified as a legitimate medical expense. Democrats say this is to ensure that consumers are using their tax-free withdrawals for a knee replacement, rather than a new iPod. In reality it adds a layer of bureaucracy that could sharply reduce the appeal and cost savings of HSAs.

A key player here is Ways and Means Health Subcommittee Chairman Pete Stark, whose main purpose in politics is to give the U.S. a government-run health-care system. He is a known opponent of HSAs – once comparing them to “weapons of mass destruction” – because they introduce more individual choice into the health-care marketplace.

Pushing for the provision was a company called Evolution Benefits, which has patented a system for the substantiation of health-care expenses. Evolution’s lobbyist, John McManus, was the former staff director of the Health Subcommittee under Republican Bill Thomas. The company first lobbied for the HSA provision, then withdrew its support when Republicans began to focus on its role. But Ways and Means Chairman Charlie Rangel helped make sure the provision was in the bill, which passed largely on partisan lines.

Liberals claim HSAs are insurance for the “healthy and wealthy,” but there’s little evidence this is true. How they work is that an employer or individual first buys a cheap, high-deductible policy for large, unexpected medical costs. Then the insured can open an HSA and make an annual contribution up to $2,900 for an individual in 2008, which he can use to pay for ordinary health needs. Savings not spent in any given year can build up tax-free.

This is health insurance many Americans can afford, and it doesn’t force those who have better use for their scarce dollars to buy gold-plated insurance with special-interest mandates (cover the chiropractors!) that Democrats want to force on everyone. HSAs also give consumers more reason to care about prices, bringing much-needed market discipline.

Since HSAs were created in December 2003, 3.2 million HSA accounts have been opened, covering 4.5 million Americans. Nearly a third of new HSA users previously had no insurance and bought coverage on their own. Thirty-three percent are small businesses that had not previously offered coverage to their employees. Isn’t this what good progressives claim to want?

This accords with the angry reaction of Boston’s mayor when some retailers started offering low-cost clinics inside their stores. Our post on that is here.

George Orwell would laugh, darkly, at this.

Ana Puente was an infant with a liver disorder when her aunt brought her illegally to the U.S. to seek medical care. She underwent two liver transplants at UCLA Medical Center as a child in 1989 and a third in 1998, each paid for by the state.

But when Puente turned 21 last June, she aged out of her state-funded health insurance and was unable to continue treatment at UCLA.

This year, her liver began failing again and she was hospitalized at County-USC Medical Center. In her Medi-Cal application, a USC doctor wrote, “Her current clinical course is irreversible, progressive and will lead to death without another liver transplant.” The application was denied.

The county gave her medication but does not have the resources to perform transplants.

So, it’s back to Mexico, right? Oh, no, señor.

Late last month Puente learned of another, little-known option for patients with certain healthcare needs. If she notified U.S. Citizenship and Immigration Services that she was in the country illegally, state health officials might grant her full Medi-Cal coverage. Puente did so, her benefits were restored and she is now awaiting a fourth transplant at UCLA.

Read how the prolonged closure of a nuclear reactor in Canada affected the health of American women, among others.

by J.C.Phillips 

Paul and his wife are small business owners. They are good people, the kind of quiet patriots Ronald Reagan described in his 1981 inauguration address. They work hard, love their country and, oh yes, they happen to be self described liberals. They are also my friends.

Twenty years ago when they began their business, they decided that providing full health coverage to all their employees was going to be a priority. The state does not require that they provide coverage (not yet anyway) it was just a part of their business philosophy. They even included it in their corporate by-laws. If need be, they were willing to cut into their profit margin, and indeed they have made less money over the years than they would have otherwise. At the same time, however, they have remained true to themselves and have managed to secure a good and loyal work force along the way.

Paul told me of one particular employee that came to him requesting to be paid in cash what Paul was paying for his insurance premium. He was buying a house and needed the extra money. He would make his own arrangements for health coverage. Paul declined. A few weeks later, the employee was in an accident that required a hospital stay. The insurance picked up the majority of the tab, leaving the employee with a small co-pay. Paul chuckled a bit when he remembered that the employee never even said thank you.

What remains unclear is why exactly Paul is due thanks. Paul used a broker to find an affordable health plan and then deducted part of his employees’ salary each month in order to pay for it. Thus highlighting the rather annoying habit liberals have of deciding what is best for everyone else, using someone else’s money to pay for it and then patting themselves on the back. 

There are approximately 9 million people in America that can afford health insurance but choose instead to remain uninsured. (9 million and 1 if you include Paul’s ungrateful employee). The primary reason is that they are young and in good health and would rather spend their hard earned money on other things (like new homes) rather than on premiums for insurance they do not believe they need. It is, I am afraid, a rather conservative notion that free people should be able to spend their money in whatever way they see fit and suffer the consequences of those decisions.

In fairness to Paul, he is concerned – and justifiably so — that many of his employees would not purchase their own insurance choosing instead to gamble that they wouldn’t get sick. While we have no way of knowing exactly how much this accident would have cost this employee, hospital stays are expensive. It is a safe bet that it would have been a wheel barrel full; it may have ended up costing him his new home. (Of course, if the employee failed to pay his mortgage the result would be the same so perhaps Paul should also begin holding back a portion of his employee’s paycheck in order to pay his rent as well.)

Accidents or the onset of sudden illness can be catastrophic. Ideally, that is what insurance is for. One of the problems with our current healthcare system is that insurance has become the means of payment for any and all health concerns. The cost of my homeowner’s insurance policy is high. How much more expensive would it be if in addition to covering me for fire and earthquakes it also paid the gardener for cutting my grass and maintaining the sprinkler system, the painter for removing the rust on the gate, and if it reimbursed me for replacing light bulbs? 

One of the fixes for our health system being bandied about favors Paul’s philosophy of mandating coverage for everyone, forcing others to foot the bill and then patting themselves on the back for a job well done. 

A better way to begin to deliver higher quality health care and lower prices might be to increase consumer incentives by increasing the number and type of products available. We might also consider removing government restrictions that would allow consumers to purchase their own policies that are not connected to their jobs – policies that follow them wherever they go, policies that they could purchase from any insurer in any state. Nine million and one consumers with money to spend, shopping for bare bones policies tailored to their needs would no doubt be in a position to demand lower prices. 

John Derbyshire at The Corner:

Healthcare:   The entire problem with healthcare is that it’s a risk-reward curve. How far do you want to (or: can afford to) let people go along the curve? About 95 percent of the healthcare that people need can perfectly well be supplied by nursing assistants with a couple of years’ training, or Third World providers like the ones I discussed.

When you climb up into the remaining five percent, you are in the zone where real doctors and expensive equipment are needed. Keep going and you enter the zone of million-dollar drugs, teams of specialists, experimental technology, and months of intensive care. A billionaire can of course travel all the way along the curve. Should the rest of us be able to? Our system is organized around the answer “yes.” This is probably untenable. Sooner or later you’re going to die. Get used to it.

Nutrition recommendations have lifted the cloud over eggs and the thinking now is that an egg a day is OK.

For much of the past 40 years the public has been warned away from eggs because of the risk of heart disease. Unhealthy serum cholesterol levels have, after all, been linked to increased risk of cardiovascular disease, and eggs are relatively high in dietary cholesterol.

The food police were wrong? Science isn’t perfect? Oy!

Some research has even questioned the connection between egg consumption and cardiovascular disease. A study published in the Journal of the American College of Nutrition showed that risk of cardiovascular disease in men and women did not increase with increasing egg consumption. In fact, it showed quite the opposite. From their findings of analyzing more than 27,000 subjects, they indicated that the egg consumers actually had lower serum cholesterol levels than those subjects who abstained from eggs.

The Harvard School of Public Health’s research showed the dietary cholesterol in eggs does not have a negative effect on blood cholesterol levels of healthy people. This and numerous other studies have shown there is no link between eating eggs and a higher risk of heart disease or stroke for healthy adults. Some recent studies have even shown that HDL (good) cholesterol increased when people ate an egg-supplemented diet.

* This is the operative statement. The others are inoperative.
— Ron Ziegler, press secretary to President Richard Nixon

Ryan Secrest told the American Idol audience last night that the country was suffering one of the worst flu outbreaks “in history.”

Dunno dawg, that sounds kinda pitchy, know what I’m sayin’? Let’s keep it real.

So far, 15 children have been hospitalized in Los Angeles County with the flu. And California has reported one death, of an Orange County child.

In 1918, a Spanish flu pandemic killed more people that WWI, some 50-100 million people (estimates have been raised in recent years.) In October of that year, 195,000 Americans fell victim.

One upside: crime rates in Chicago dropped by 43% as crooks were too sick to “work.”

If publicly-funded and operated healthcare is so much more efficient than the private sector, then why this?

Los Angeles County healthcare officials unveiled a draft cost-cutting plan Wednesday that calls for closing all but one of the county’s dozen clinics and reduces services at its six comprehensive outpatient health centers.

Officials said a $195-million deficit makes the cuts necessary even under a “best-case scenario” for the badly strapped public healthcare system. The county faces the threat of more reductions in state and federal aid in the next few months. Health department officials have privately floated the possibility of deeper cuts if the projected deficit grows.

The current proposal, if approved by the Board of Supervisors, would dramatically retreat from the county’s longtime role in providing primary care to the indigent. The clinics and comprehensive centers get about 400,000 primary care visits a year, nearly two-thirds from uninsured patients.

Officials said they plan for private, nonprofit clinics to step into the gap and provide care to most of the displaced patients for a lower cost than the public system. The county currently has contracts with private clinics, and those would be expanded.

Up to $400 million has been spent on new computers and software for classrooms, but the Los Angeles Unified School District has not tracked where all of the new technology has gone, officials said Monday.

Since 2004, the district has purchased 129,000 personal computers. But because of haphazard tracking, some classrooms still do not have enough computers for students, while others have computers but not enough software. Meanwhile, some school computers still are operating with outdated systems.

But officials have begun pushing for all district schools to have up-to-date instructional computer facilities, a plan to ensure that obsolete technology is quickly replaced, and tracking on how many personal computers are in which classrooms.

“Once we figure out what’s out there, then we can know how to fill the gaps,” said school board member Tamar Galatzan, who will introduce the resolution today. “We have software in one place and computers in another.”

I know…let’s turn over healthcare to the government because government monopolies are so efficient.

Oh, that’s harsh! But wait, there’s another $400 million LAUSD boondoggle — the high school built atop a toxic site.

And that’s not all — the very same LAUSD cannot pay its employees properly.

In the weeks leading up to the launch of a new payroll system, Los Angeles Unified School District officials had plenty of warning that the $95-million technology project would have serious problems.

Critical hardware had failed numerous times. Flawed data collected over decades proved difficult to clean up and input into the new system. Payroll clerks complained that training had fallen far short — more than 60 schools didn’t have a single staff member who’d received any training.

Still, consultants hired to implement the system urged the district to proceed as scheduled in early January 2007. Three days before the system was to begin, they urged the district in a report to “Go! Proceed . . . and go-live on January 1!”

Go live they did, plunging the district into a crisis from which it is only now emerging. Over the course of last year, taxpayers overpaid an estimated $53 million to some 36,000 teachers and others, while thousands more went underpaid or not paid at all for months.

$95 million plus $36 million to fix it. In the real world, where losing money means losing your job or your company, heads would roll.