Current State of Health Bills

From Moveon.org :

Here's where we are:

The House of Representatives passed their bill last month. The Senate is aiming to pass its version before Christmas.

Overall, both pieces of legislation would do four major things:

• Create a "Health Insurance Exchange." The bills create a one-stop marketplace where people can choose from various insurance plans, including the public option. The details aren't set yet, but initially the Exchange would likely be open to the self-employed, people without insurance at work, and small businesses.¹ The key with the Exchange is that it brings "the bargaining power and scale that's generally accessible only to large employers" to individuals—and with that, lower costs and better options.²

• Provide insurance to over 30 million more people. The House bill would expand coverage to 36 million people by 2019. The Senate bill extends coverage to 31 million.³

• Outlaw discrimination based on pre-existing conditions and gender. Insurance companies will have to stop denying coverage to people with "pre-existing conditions." And they won't be allowed to charge women more than men for the same coverage.⁴
  


• Eliminate coverage limits and price-gouging. The bills differ on some details, but in general would place limits on how much people have to pay for health care beyond their premiums. They both cap out-of-pocket costs and ban insurance companies from setting limits on how much health care they'll cover for a person each year.⁵

Of course, the devil is in the details, and much in these bills still needs work.

Here's what still needs to be fixed:

• Both bills leave millions uninsured. The House bill leaves 18 million without insurance in 2019; the Senate bill, 24 million. Neither comes close to the vision for universal coverage so many of us fought for for years. We'll all need to fight to continue to expand coverage in the bills this year, and in the years to come.⁶

• The Senate public option is weak, and conservatives are pushing to make it weaker. The public option is a core piece of reform that will create real accountability and competition for private insurance—and that's why it's at the center of such a huge fight. While the House bill creates a national public option, the Senate lets states opt out, denying their residents access to it. Plus, conservatives are working to weaken it even more. We're all going to have to fight hard for the strongest version possible.⁷

• Many reforms don't start quickly enough. While some pieces of reform go into effect right away, the larger structural changes are not scheduled to go into effect until 2013 (House bill) or 2014 (Senate bill). This includes the Exchange, the public option, and subsidies—the major ways coverage will be expanded.⁸

• Required insurance could still be too expensive for many. Both bills require virtually all Americans to have insurance. But the caps on how much we're expected to pay are way too high, and the subsidies are way too low. Many progressives are working to fix this, but it's going to be a significant fight.⁹
  

• Reproductive rights are severely restricted in the House bill. An egregious anti-choice amendment in the bill virtually prohibits anyone purchasing insurance in the Exchange from buying a plan that covers abortion—even if paid for with their own money. We need to make sure the final bill doesn't include this rollback of reproductive rights.¹⁰

• The Senate bill could discriminate against lower income workers. The current Senate legislation retains a version of what's called the "free rider" provision, which essentially penalizes employers for hiring lower income workers. This provision needs to be fixed before the bill is finalized.¹¹

Check out more about the House bill here and the Senate bill here or here, and see what the impact of reform would be in your state here. If you want to read the full bills, for the House, click here or here (PDF), and for the Senate, here or here (PDF).

Breast Cancer Screening- Why so much controversy?

I really do not understand all the controversy about the new USPSTF recommendation on breast screening. Actually, I do. I just read an article by Gerd Gigerenzer of the Harding Center for Risk Literacy and colleagues who document the statistical illiteracy of patients and doctors. People in around the world (not just Americans) do not seem to have knowledge of basic statistics and math. We do not understand risk, and what the purpose of screening for disease is. It starts very young, as we do not teach our children the basics of statistics in school.

This combines with a medical-industrial complex that makes us believe that everything modern medicine has to offer is good. Doctors are as guilty as anyone else. We have all come to believe that tests, medicine, and procedures are good. The problem is that modern medicine rests on science, something the previous witchdoctors did not do. If we are going to continue to practice modern medicine, that is based on the science of medicine, then we have to start accepting that all tests and medicines are not always good.

Combine this with the fact that our medical costs are skyrocketing to a level we cannot afford. Indeed the problem with the current health care reform (which I support) is that no one wants to ration care. But, we already ration care. Rationing is not a bad thing: it protects us from unneeded, expensive, and possibly harmful tests and treatments. We have to start realizing that we cannot expect to get every test under the sun whenever we want it. It costs too much, and it probably causes more harm than good.

Let’s all start to educate ourselves on the basics of risk and modern medicine:

• The biggest risk factor for death is being born.
• There are treatments and tests that can harm us.
• Let’s start talking about effective care that acknowledges the limits to medicine.

Check out the Harding Center for more education on risks. (and show this to your doctor.)

Looking for unbaised health reform analysis?

If you want information on health reform from a non-biased organization, that uses research to compare different options, here you go:

RAND: Health COMPARE: Analysis of Options: Policy Options Dashboard

Read 'Zeitoun,' by Dave Eggers - A True Story of Monumental Significance

I just finished reading Zeitoun by Dave Eggers. Eggers is my favorite author and his writing style comes through again for me. He writes a non-fiction story like a novel. It is constantly flowing and moving, like his other books. He weaves the character's background and history into the story, in a way that sounds like it took years of research and conversing with each person in the book.

His great writing sets the stage for a fantastically unbelievable story of what can happen in our country when our government does not serve us. Zeitoun stuck around in New Orleans when Katrina hit, and his accounts of the post-storm happenings gave me the first true sense of what was going on there. The story then weaves in another whole issue: the plight of Arab-Americans in the post 9-11 world. The story reminds me that our government needs to serve and protect us, but also needs to be kept in balance with itself.

The book is a condemnation of what can happen when authority go unchecked and does not serve the people. To me, it is also a reminder of some of the catastrophes that went on while the worst President in our Nation's history was in power.

Please buy this book at McSweeney's or Amazon. Proceeds benefit the Zeitoun Foundation, which funds several organizations working in the New Orleans Area.

More form the NY Times: Book Review - 'Zeitoun,' by Dave Eggers - Review - NYTimes.com

Coca-Cola sponsoring Family Physician's Organization's Massive Harmful Industry Alliance

I guess McDonald's sponsorship wasn't enough. Now the American Academy of Family Physicians (AAFP):
"We've made a conscious effort to diversify our sources of revenue," Heim said. "This is the first of what we hope will be many Consumer Alliance agreements. We're looking across a broad spectrum. This is just our initial partnership."

Coca-Cola Grant Launches AAFP Consumer Alliance Program -- AAFP News Now -- American Academy of Family Physicians

"Consumer alliance agreements." What kind of stupid term is that? This an "industry" alliance. How dare you call it a "consumer" alliance?
A few years ago the AAFP partnered with McDonald's on its obesity project. Now Coca Cola. Who's next? Frito Lay? So we can have education program on picking which chips are best for you? Mars? So we can educate you on which candy bars to buy?

The AAFP should take the advice of someone Micheal Pollan posted on his NY Times website:
"Eat foods in inverse proportion to how much it's lobby spends to push it." -Krik Westphal

Meanwhile, some lawmakers are starting to get it: "I don't think that most parents truly appreciate the role soda pop has in causing weight gain," California State Senator Padilla said.

Calif. lawmaker plans hearings on soda-obesity link

I hope the AAFP changes this direction. Substituting one industry (Big Pharma) for another (Big Food) will not help our patients. How many mistakes does it take? First med organizations partnered with the smoking industry. Then (and now) pharmaceutical industries. Now Big food industries. When will we start to reframe what our medication organizations do? How about we start medical organizations that don't rely on industry funding? Join the National Physicians Alliance.

Big Food vs. Big Insurance

Op-Ed Contributor - Big Food vs. Big Insurance - NYTimes.com: "the government is putting itself in the uncomfortable position of subsidizing both the costs of treating Type 2 diabetes and the consumption of high-fructose corn syrup." -Michael Pollan

"One of the leading products of the American food industry has become patients for the American health care industry." Doctors promote this by believing that drugs are better than vegetables.

"There’s more money in amputating the limbs of diabetics than in counseling them on diet and exercise." I would say A LOT more...

"Terms like “pre-existing conditions” and “underwriting” would vanish from the health insurance rulebook — and, when they do, the relationship between the health insurance industry and the food industry will undergo a sea change."

On his major thesis- that the health industry will force the food industry to change- I'm not so sure I agree. The private health sector is too fragmented. They don't know whether a person on their plan will still be their in a year when the employer or employee changes jobs. I don't think they have enough steak in the game to force big changes in the food industry. They may start offering more exercise and nutrition counseling, but I don't see them going further.

To reform the food system, we would need to take on the food system. This is a good job for the HHS secretary, the Surgeon General, and the rest of us.

The gatekeeper and the wizard, redux -- Kamerow 339: b3624 -- BMJ

Health care reform will not work without moving primary care to the center of health care:
The gatekeeper and the wizard, redux -- Kamerow 339: b3624 -- BMJ

America's Character: Defining Health Care as a Moral Issue

I loved Obama's speech last night.

He had many excellent frames. I've been advocating for him to use George Lakoff's frame's of health care and he did just that.

A classic frame was talking about the public option like public colleges: "But by avoiding some of the overhead that gets eaten up at private companies by profits and excessive administrative costs and executive salaries, it could provide a good deal for consumers, and would also keep pressure on private insurers to keep their policies affordable and treat their customers better, the same way public colleges and universities provide additional choice and competition to students without in any way inhibiting a vibrant system of private colleges and universities. "


Most importantly he brought health care from a policy issue to a moral issue. He first brought up stories of people who can't pay for their health care. You can see another example, of a boy's family who can't pay for his cancer care here:


He then brought up Teddy's letter on why a fellow American thought that his fellow Americans should have the same access to care that he did.

"On issues like these, Ted Kennedy's passion was born not of some rigid ideology, but of his own experience. It was the experience of having two children stricken with cancer. He never forgot the sheer terror and helplessness that any parent feels when a child is badly sick. And he was able to imagine what it must be like for those without insurance, what it would be like to have to say to a wife or a child or an aging parent, there is something that could make you better, but I just can't afford it. "

Continuing he puts health care in the frame of the Family of Americans:

"That large-heartedness -- that concern and regard for the plight of others -- is not a partisan feeling. It's not a Republican or a Democratic feeling. It, too, is part of the American character -- our ability to stand in other people's shoes; a recognition that we are all in this together, and when fortune turns against one of us, others are there to lend a helping hand; a belief that in this country, hard work and responsibility should be rewarded by some measure of security and fair play; and an acknowledgment that sometimes government has to step in to help deliver on that promise."

Keep talking about health care as a moral issue. It IS in our country's character to get everyone health care. Keep telling the stories of friends and family who were denied by insurance companies for life saving care. We are here to end that, because that is not the way we live in America.

"We did not come to fear the future. We came here to shape it. I still believe we can act even when it's hard. ... I still believe we can do great things, and that here and now we will meet history's test. Because that's who we are. That is our calling. That is our character."

Thank you President Obama, for speaking to our hearts.

My patient's can't wait any longer.

President Obama,



When you speak tomorrow night, speak of all the people in this country who have an illness and cannot get care because they cannot pay for it. This is not right in our country. We need to pass your American Health Care Plan to insure everyone of our siblings, friends, parents, and children. Every day from now until health insurance reform passes, you should read a letter from someone suffering because of lack of health insurance. The people will win over the insurance companies. Our country is great and we can achieve the right of quality, affordable healthcare for ALL.

Reducing potential bias in industry-funded nutrition research. My Letter to the Editor:

Reducing potential bias in industry-funded nutrition research -- Lesser 90 (3): 699 -- American Journal of Clinical Nutrition

In the above article I point out the fault in previously published guidelines on nutrition industry - research interactions. Instead of the industry policing themselves with guidelines, I argue that the journal editors should make and enforce policies on industry collaboration in nutrition research.

I cite several policies by other medical journals that the nutrition journals could adopt to increase the integrity of nutrition research.

The response to my letter was from Mr. Hentges. He side stepped most of the issues I brought up. He could not defend his group's initial argument that industry is more likely to have better results in their research. He also did not respond to my idea of stricter journal editorial policies.

However, he did agree with me that increased full disclosure of conflicts of interest would benefit research. But, he did not further back up this claim with action. His own conflict of interest statement states that he is the director of ILSI supported by North America "industry membership." Full disclosure would mean stating all the food industries that ILSI is funded by. Surely readers might want to know if he is funded by Coca Cola, Kraft, and the other food giants. These details used to be on their website, but I could no longer find it.

I will continue to view industry-funded nutrition research skeptically. You should to. Now it is time for journal editors to reform their policies.

Support the American Health Plan:

The solution to the villainous control of health by insurance companies

YouTube - How Dems Are Failing to Sell Health Care Reform - George Lakoff

We need to start talking about how insurance companies and HMOs have harmed the care of many of our family members and friends. The American Plan, proposed by Obama and the Democrats will guarantee every American the right to see their doctor. It will put health back in the hands of Americans and their doctors and nurses. Are you for or against the American Plan? If you are for it, you better call your representative and Senator. If not, the evil insurance companies will win again.

We need to start talking differently about health care. NOW.

Why Doctors Need to be involved in the Health Care Debate:

Politicians don't know what they are talking about.

I'm following this debate about end-of-life care in the news. Basically, there is a provision in the House bill that adds Medicare coverage for you if you want to go to your doctor and discuss end-of-life care. My research shows it's a good idea to talk to your doctor while you are healthy, to discuss what types of medical interventions you would want if you became seriously ill.

Great idea! Right? Except it is blown into a conservative message of "the government is trying to kill you." The problem is the Democrats do not know how to defend it because they do not really understand the issue. Even Obama fumbled with it.

As physicians, we care about choice and honoring patients personal wishes. Often what happens is that people end up attached to tubes, never having the discussion with their doctor. The default is to keep them attached to tubes and sedated. Then the decision is put on the family to decide what to do with their elderly parent.

The idea of this provision is to have the doctor know ahead of time what the patient would want, so the decision is easier later on.

Honestly, it is discussion that should happen more. Maybe it doesn't happen because Medicare does not pay for that type of discussion. Thus, paying for these sessions is a good idea.

This exemplifies why doctor's need to be in this debate: to give the real story of what is happening every day. Obama should find doctor's and have them out on the road speaking for this reform. I'm not sure he is capable of it himself. So get involved doctors: www.npalliance.org




Debate Continues Around End-Of-Life Care - Kaiser Health News

Best Hospitals = Best Healthcare?

US News just released it's annual "best hospital's report. The current hospital I'm affiliated with, UCLA, is #3. But, all I've heard since I got here is that all the hospital does is do really expensive medical care, like transplants and ICU care.

So this begs the question, do al these hospitals overall increase health at a reasonable cost?

There are probably great differences in this group. For instance, Mayo is known to try to provide cost effective care.

What I really want is for US News to rank hospitals on the cost effectiveness for their care. If they did, hospitals with a large amount of primary care outreach would be high.

Best health care should be defined as what a hospital system does for the health of their community, not how highly rated their sub-specialties are.

America's Best Hospitals: the 2009–10 Honor Roll - US News and World Report

Family Physician Nominated for Surgeon General

Dr. Regina Benjamin could be the boost primary care needs to improve the health of this country.
This is very exciting.

Obama Names Dr. Regina Benjamin New Surgeon General - ABC News

Hospitals give healthy food more operating room

"These enhancements gave diners more choices but not necessarily healthier ones, said Dr. Lenard Lesser, a member of the National Physicians Alliance's Policy Committee...

"When you tell a patient he can't eat a hamburger and fries, and he walks out of your office and sees hamburgers and fries, what message are you sending?" he added. "

Hospitals give healthy food more operating room - MarketWatch

Posted using ShareThis

Health Care's New Model: Don't Just Do Something, Stand There

Promoting High Quality Care will require organization around primary care.

In this great article in the New Yorker, Dr. Gawande shows how we need to come together and provide high quality care. This usually means less tests, consultants, and procedures.

Annals of Medicine: The Cost Conundrum: Reporting & Essays: The New Yorker

The best idea I have heard on organizing physicians around quality care is from Brownlee and Fine (excerpted by Dr. Colin Kopes-Kerr, MD, JD:

"Primary Care for All will require new infrastructure at the regional, state, and federal levels to support universal access to primary care health centers... Each community or region will need a Primary Care Board, which can contract with primary care practices to provide effective, efficient care... Each state will also need a Primary Care Trust to plan and oversee the functions of primary care practices. The Federal Government will need an Assistant Secretary for Primary Care in the Department of Health and Human Services to bring focus and direction to the many agencies inside the Department that are concerned with primary care."

"Primary Care for All is not a proposal to change what most Americans have now. Instead, it brings together three existing systems that currently provide primary care, and out of them creates a primary health care infrastructure that cares for all citizens"--existing private primary care practices, community health centers, and vertically integrated accountable health care organizations like Kaiser Permanente. They see the continuation of a healthy tradition of private practice is "necessary for critical check and balance on the integrity of a more public system."

There are two possible methods that could be used to finance Primary Care for All. "The simplest method is for all payers (including Medicare and Medicaid) to put $400-500 per beneficiary per year into a Primary Care Trust--a state-based, non-profit, private public partnership, responsible for paying all primary care practices on a risk-adjusted, capitated basis. These funds would pay for the primary care of all Americans, not just the uninsured...People without health insurance would also be required to pay into the Primary Care Trust, but would receive tax credits for doing so. Those living in poverty would receive public subsidies for primary care, to be funded either by tobacco and alcohol taxes, or taxing employee health benefits."

The alternative payment mechanism would involve the use of Community Health Savings Accounts. "Like HSAs, Community health Savings Accounts are high deductible health insurance policies linked to tax advantaged savings accounts owned by the individual. Where they differ from HSAs is that policy holders would be required to make monthly payments out of their savings account to a certified primary care practice chosen by the individual."

"Why pay primary care practices through the Primary Care Trust? The Primary Care Trust approach is intended to produce an equitable and effective infrastructure, and reduce or eliminate regional disparities in the type and amount of care people receive." In addition there is a need for a single set of quality and service delivery measures, and population-based outcomes measures selected by the wisest among us. The important characteristic of this system is that physician reimbursement will no longer be on a fee-for-service basis. Like original sin, this single flaw at creation doomed us to the health care we have now.

As do most analysts of health reform, Brownlee and Fine expect to encounter work force issues--like a need for 25,000-50,000 more primary care physicians. They accurately comment, "The optimal supply of primary care physicians and practices for a given population, and the ideal composition of the primary are team is not known at present." They go on to speculate that "[S]ome of the immediate need for more primary care physicians will be relieved by improved organization or primary care practices, and by increased use of physicians assistants, nurse practitioners, case managers, and my favorite alternative, Community Health Workers.

Brownlee and Fine conclude, "Financing health care system reform can succeed best if it is accompanied by focused improvement in primary care delivery and organization. The development of Primary Care for All presents an essential and affordable first step toward an effective and efficient health care delivery system, and sustainable health care reform.

Wide Support for Public Option Health Plan

The people support it (even 50% of republicans) and doctors support it. Politicians: don't be weak. Pass health reform with a strong public option!

In Poll, Wide Support for Government-Run Health - NYTimes.com

Healthy Burger King?

Nice steps Burger King.
Making smaller portions and substituting apples for fries.
But, Burger King won't really be healthy until they take the burger off the main course.
What about offering beans and kale? That would be having it my way.

Burger King crafts three more better-for-you kids' meals | Healthy Food Options | QSR Web

Away We Go

I just got back from a sneak preview of Away We Go. It's the movie I've been waiting for for a year. My favorite director (Mendes) with my favorite writer (Eggers).

It was everything I wanted... great cinematography, acting, and writing. About a couple just trying to find out how to do the right thing. I think the answer is that you just do what you think is best at that moment, and as long as love is there, that's the best you can do.

John Krasinski, Maya Rudolph, and Dave Eggers answered questions afterwards. A great event.

Dave Eggers signed my book before the movie. He wrote, "Lenny-
My apologies in Advance
Your true friend,
Dave Eggers"

Away We Go | Film Overview | Focus Features Movies |

Soda Tax: Keep the Movement Going

Michael F. Jacobson: Fizzy Math: Tax Soda to Pay for Health Care and Prevention

Sugary Beverages: Stop the Tax Loophole

In addition to these proposals, the government should remove the tax loophole for sugar sweetened beverages. Currently these beverages receive an advantage over other foods, because tax payer money goes to subsidize the corn syrup used to produce them. The states can counter this reverse tax, by charge a few cents on each ounce sold. The money can be used to promote healthy foods.

Nutrition Experts Propose New Class of Low-Sugar Beverages to Reduce Role of Sugary Drink Consumption In Obesity and Diabetes Epidemics - April 20, 2009 -2009 Releases - Press Releases - Harvard School of Public Health

How should we tackle Obesity?

On February 26th a large, well designed trial comparing different weight loss diets was published in the New England Journal of Medicine. It was a good behavioral intervention over two years. They compared high and low protein, high and low fat, and different amounts of carbohydrates. The result: no difference in weight loss between any of the diets. Overall, the participants lost 6.5-9 pounds at the end of 2 years. This is a mild, but significant reduction.

We have now had a bunch of trials that show that many different diets "work", but only modestly. If we try and take these interventions into the clinical (i.e. non-research) world, we will likely have even less success.

So what do we take out of this? The editorial by Martijn Katan (linked to below) says it best:

"We do not need another diet trial; we need a change of paradigm."

He goes on to talk about how behavior change is hard, and we will only be effective if we work at a community level:

"Like cholera, obesity may be a problem that cannot be solved by individual persons but that requires community action. ...the apparent success of such community interventions suggests that we may need a new approach to preventing and to treating obesity and that it must be a total-environment approach that involves and activates entire neighborhoods and communities."

I have been advocating for this for some time. Obesity treatment (via dieting) is not the answer to this large public health problem. Obesity prevention through large scale public health research and interventions is the answer. Let's start taking responsibility for our laws, policies, and community designs that contribute to obesity. Let's all work together to make our communities healthy places for our children, spouses, friends, and parents to live in.

NEJM -- Weight-Loss Diets for the Prevention and Treatment of Obesity

Influence of corporate money on study of nutrition questioned

The nutrition industry is already inheriting some of the biases of the pharmaceutical industry:

TSN Influence of corporate money on study of nutrition questioned

Obama links food systems, our country's health, energy policy and the built environment

"I was just reading an article in the New York Times by Michael Pollen about food and the fact that our entire agricultural system is built on cheap oil. As a consequence, our agriculture sector actually is contributing more greenhouse gases than our transportation sector. And in the mean time, it's creating monocultures that are vulnerable to national security threats, are now vulnerable to sky-high food prices or crashes in food prices, huge swings in commodity prices, and are partly responsible for the explosion in our healthcare costs because they're contributing to type 2 diabetes, stroke and heart disease, obesity, all the things that are driving our huge explosion in healthcare costs. That's just one sector of the economy. You think about the same thing is true on transportation. The same thing is true on how we construct our buildings. The same is true across the board. For us to say we are just going to completely revamp how we use energy in a way that deals with climate change, deals with national security and drives our economy, that's going to be my number one priority when I get into office, assuming, obviously, that we have done enough to just stabilize the immediate economic situation."

Swampland - TIME.com � Blog Archive The Full Obama Interview �

TOP 5 REASONS OBAMA SUPPORTERS SHOULDN'T REST EASY

1. The polls may be wrong. This is an unprecedented election. No one knows how racism may affect what voters tell pollsters—or what they do in the voting booth. And the polls are narrowing anyway. In the last few days, John McCain has gained ground in most national polls, as his campaign has gone even more negative.

2. Dirty tricks. Republicans are already illegally purging voters from the rolls in some states. They're whipping up hysteria over ACORN to justify more challenges to new voters. Misleading flyers about the voting process have started appearing in black neighborhoods. And of course, many counties still use unsecure voting machines.

3. October surprise. In politics, 15 days is a long time. The next McCain smear could dominate the news for a week. There could be a crisis with Iran, or Bin Laden could release another tape, or worse.

4. Those who forget history... In 2000, Al Gore won the popular vote after trailing by seven points in the final days of the race. In 1980, Reagan was eight points down in the polls in late October and came back to win. Races can shift—fast!

5. Landslide. Even with Barack Obama in the White House, passing universal health care and a new clean-energy policy is going to be hard. Insurance, drug and oil companies will fight us every step of the way. We need the kind of landslide that will give Barack a huge mandate.

If you agree that we shouldn't rest easy, please sign up to volunteer at your local Obama office by clicking HERE.

Gandhi

I just finished watching the epic moving Gandhi. It was my first real history lesson in this saint's life. There are a few morals and values from it that I will always remember:
- Non violence works. Tyrants ultimately fail. The focus should not be WHEN they will fail; rather that they WILL FAIL. An individual's life is only a short part of the history of good and evil in the world. An eye for an eye makes the whole world blind. We must not preach revenge.
- Patience is a virtue. I often try to get things done quickly. (My mother taught me this.) But, true change takes patience. I will strive for more of it.
- True change requires collaboration with all. A great person can be effective. But a great person can have an even greater impact if he collaborates and joins with others.
- Religion can be great, if we realize that no religion is better than another. We are all Hindu, Jews, Buddhist, Muslim, and Christian.
- A free media is probably one of the most important parts of democracy. Any restriction on media should be dealt with in a serious (non-violent) way.
- Humor is a good trait of a great man.
- Hollywood is important because they make great movies.

I vow to try to work all of these into my daily life, in honor of Gandhi.

NY Times: Organized Medicine and Industry

Until organized medicine (The American Medical Association, The American Academy of Family Physicians, etc.) gives up ties with industry, patients trust in these organizations will continue to erode.

If you want to do something about it, join a medical organization that does not take industry money: The National Physicians Alliance.

Washington
Psychiatric Group Faces Scrutiny Over Drug Industry Ties
By BENEDICT CAREY and GARDINER HARRIS
Published: July 12, 2008
Probing into the financial relationship between drug companies and psychiatrists, senators are demanding that the American Psychiatric Association give an accounting of its financing

The King of Questions

I named this blog "Question Everything", as I believe asking questions is one of our primary responsibilities as citizens and humans. Asking the proper questions of our leaders allows us to unearth their intentions and discover their values. Asking the right questions can lead to advocacy and improvements in our systems. Without the questions our society stagnates and does not progress.

There was no better questioner than Tim Russert. I watched Meet The Press as much as I could. I often planned my Sunday around it, but would skip it if Russert was not on that week. Russert was a true journalist, as he was impartial, tough, smart, and did his research. There is no one who could get to the bottom of an issue like he could. There is no journalist that did more to bring honesty to politics.

I do not know how we will navigate through difficult political issues without him. As a fan of good questions, I do not know how I will find another role model. Mr. Russert, King of Questions, I will miss you.

Red Soc Flyover Waste

Boston Red Sox - Air Force cutback still allows roaring fly-by at game today - The Boston Globe

Do we really need to spend $100,000 on a flyover a baseball game for a few seconds? Imagine how many lives we could save with that much money in a quality health care system....

10 Things You Should Know about McCain

from Moveon.org:
1. John McCain voted against establishing a national holiday in honor of Dr. Martin Luther King, Jr. Now he says his position has "evolved," yet he's continued to oppose key civil rights laws.1
2. According to Bloomberg News, McCain is more hawkish than Bush on Iraq, Russia and China. Conservative columnist Pat Buchanan says McCain "will make Cheney look like Gandhi."2
3. His reputation is built on his opposition to torture, but McCain voted against a bill to ban waterboarding, and then applauded President Bush for vetoing that ban.3
4. McCain opposes a woman's right to choose. He said, "I do not support Roe versus Wade. It should be overturned."4
5. The Children's Defense Fund rated McCain as the worst senator in Congress for children. He voted against the children's health care bill last year, then defended Bush's veto of the bill.5
6. He's one of the richest people in a Senate filled with millionaires. The Associated Press reports he and his wife own at least eight homes! Yet McCain says the solution to the housing crisis is for people facing foreclosure to get a "second job" and skip their vacations.6
7. Many of McCain's fellow Republican senators say he's too reckless to be commander in chief. One Republican senator said: "The thought of his being president sends a cold chill down my spine. He's erratic. He's hotheaded. He loses his temper and he worries me."7
8. McCain talks a lot about taking on special interests, but his campaign manager and top advisers are actually lobbyists. The government watchdog group Public Citizen says McCain has 59 lobbyists raising money for his campaign, more than any of the other presidential candidates.8
9. McCain has sought closer ties to the extreme religious right in recent years. The pastor McCain calls his "spiritual guide," Rod Parsley, believes America's founding mission is to destroy Islam, which he calls a "false religion." McCain sought the political support of right-wing preacher John Hagee, who believes Hurricane Katrina was God's punishment for gay rights and called the Catholic Church "the Antichrist" and a "false cult."9
10. He positions himself as pro-environment, but he scored a 0—yes, zero—from the League of Conservation Voters last year.10

http://pol.moveon.org/mccaintruth/

It's not all about the Presidential Election

Last week I was sick and got to watch lots of MSNBC all day. 80% of the coverage was debating and analyzing who was up and who was down in the presidential campaign. There must have been an hour of analysis on each sentence a candidate said.

Our Presidential Race is important, but what about everything else going on in the world. There was only a minute (if that) each hour devoted to the troubles in Tibet, and none to other world issues like Darfur:
Dropping the Torch - New York Times

I do not have a radio while living here in DC for the month, so I miss the balanced news coverage of NPR. At least I can watch BBC News at night which gives a more realistic account of the happenings in our world.

Healthy Foods in Canadian Hospitals

Nova Scotia News - TheChronicleHerald.ca

’Every day is the perfect day to stop serving fries and doughnuts. Every day is the perfect day for a health care institution to lead by healthy example.’

If you agree, work with me and the National Physicians Alliance to make Hospital Food Healthy. Have ideas about what is healthy food for a hospital?
Let me know.

Compare Candidate Health Plans

I am sad that Kucinich and Edwards dropped out, as they had the best and 2nd best plans, respectively.
Here is a comparison of all the current frontrunner's plans from my organization, the National Physicians Alliance:

National Physicians Alliance - 2008 Presidential Candidate Health Plan Report Card

Anti-Pharma Rant by Bill Maher

Bill Asks for someone to stand up for spinach. I DO! (although I stand up more for kale)

Loans that change lives

I just made a loan to someone in the developing world using a revolutionary new website called Kiva.

You can go to Kiva's website and lend to someone in the developing world who needs a loan for their business - like raising goats, selling vegetables at market or making bricks. Each loan has a picture of the entrepreneur, a description of their business and how they plan to use the loan so you know exactly how your money is being spent - and you get updates letting you know how the business is going. The best part is, when the entrepreneur pays back their loan you get your money back - and Kiva's loans are managed by microfinance institutions on the ground who have a lot of experience doing this, so you can trust that your money is being handled responsibly.

I just made a loan to an entrepreneur named Hameedan Bibi in Pakistan. They still need another $225.00 to complete their loan request of $700.00 (you can loan as little as $25.00!). Help me get this business off the ground by clicking on the link below to make a loan to Hameedan Bibi too:

http://www.kiva.org/app.php?page=businesses&action=about&id=30814&_isc=

It's finally easy to actually do something about poverty - using Kiva I know exactly who my money is loaned to and what they're using it for. And most of all, I know that I'm helping them build a sustainable business that will provide income to feed, clothe, house and educate their family long after my loan is paid back.

Join me in changing the world - one loan at a time.

Juno Love?

"In my opinion, the best thing you can do is to find a person who loves you for exactly who you are. Good mood, bad mood, ugly, pretty, handsome, what have you, the right person will still think that the sun shines out your ass. That's the kind of person that's worth sticking with." -Juno



Movie of the Year?
A great story about love. Go see it!

Is It Healthy? Food Rating Systems Battle It Out - New York Times

Is It Healthy? Food Rating Systems Battle It Out - New York Times

We need to create a government sanctioned system. The food industry thrives off of confusion. When consumers get confused with multiple messages, they just throw up their hands and buy whatever.

Check out the British Food Standards Agency (traffic light picture on the right) for a good example:
http://www.eatwell.gov.uk/foodlabels/trafficlights/

Don't Make the Vegetables Sad...Take them home

It's Fig Season

I love figs!
Buy them fresh while they are in season.
Yum.

Cornell Only Top 10 Ivy

Our Third Annual College Rankings

A new college ranking technique that uses things that really matter: social mobility, research, and service.

Yes, Vegetables

Click Here to Read a NY Times article on Epidemiology

An interesting article by Gary Taubes, where he asks, "Do we really know what makes us healthy?

The answer is YES: vegetables. Taubes and I agree on that, and that is what public health should focus on.

Forget Childhood Obesity

I just finished watching the movie Blood Diamond. I spend my time worrying about our children in this country who are becoming obese. They are positioned to live horrible lives of disease.

But, what about the children of Africa and other parts of the world? The movie shows how our want of resources from Africa, in this case, diamonds, causes civil war. The civil wars cause villages to be shot to death, women to be raped, and children to be drafted into armies to learn to kill.

I also just read What is the What by Dave Eggers. It tells the story of a boy running for his life through Sudan in the previous civil war. The stories are of young children who are refugees for their entire life. Others get drafted and trained into killing machines. Children are becoming killing machines! By the time they are 12 they have seen more murderers and rapes than any of us ever will.

I try to think everyday about what I do and how it affects others. Why can't we all just think about what our actions have? It's called mindfulness. Whether it be diamonds, ivory, or oil. Our habits are helping to cause a lot of this. Why can't we help others? Why can't we stop worrying about ourselves and start caring about others? There is so much going on in the world and if we just think about it all the time, and just started caring, maybe we could save some lives. But instead we just watch our celebrity shows, Fox News, and get drunk.

I have to start asking myself: Is childhood obesity that bad? At least our children aren't becoming murders after watching their fathers get shot and their mothers raped.
The child is the jewel.
I cry.

Oxfam America: Conflict in Darfur

Burger Companies Giving Money to Politicians

Get Active on the Farm Bill.
www.oxfamamerica.org

Hillary's Health Plan

HillaryClinton.com - American's Health Choices Plan

I am not a huge fan of Hillary, but I think she may have a good idea here. The plan basically allows anyone to keep their own health insurance or buy into another. This is a major point for many who have insurance and are scared of a change.

The best part is that it allows you to buy into a government-run plan with no private insurer. This is what those at the Rockridge Institute call a strategic initiative. It allows more and more people to get on a government-run plan (like Medicare). Then we can prove to people that a Medicare-like plan is better than their private plan. Hopefully, this will switch more and more people over to a Medicare-like plan, bringing us on to a path of Medicare for All (single payer).

The plan has parts that I disagree with, such as the funding (tax credits), but I think the general idea is in the right direction.

We have the responsibility as a country to provide all with access to comprehensive medical care.

Security and Health for the New Year

Yesterday I was in Penn Station, New York, waiting for a train back to Boston. As I walked into the Amtrak waiting area there was a man laying on the ground in the middle of the station. People looked at him and stood around. He was breathing and most people assumed he was drunk or faking it. But in the post 9/11 world in NYC, one obviously thinks about whether a suspicious man in Penn station is a terrorist threat. After about 5 minutes, an Amtrak official saw the guy and tried to get an officer. Five minutes later, some soldiers came over with all their guns, and said they would get "an officer". They walked away and the Amtrak official came back, radioing and calling on his phone for a police offer. (Neither the soldiers, police, or Amtrak officials appeared to be operating on the same frequency.) All in all, it took about 25 minutes to get a police officer into the middle of Penn Station. They finally got an ambulance, who gave the guy a sternal rub and got him to stand up....so it turned out he was drugged up.

But, 6 years after 9/11 we still don't have high enough security to instantly address any threat. This week, I also learned of a friend who accidentally took mace on a plane.... twice. I personally took might pocket knife on a plane a few years ago (by accident). My point is that unless we have an Orwellian government we will never be totally secure from terrorism. So why should we as citizens have an almost one track mind when thinking about the direction of our country? I am not saying that we should not continue security and try and prevent terrorism. I am saying that we need to think broader about what we can really do to make happy lives for ourselves, our families, our country, and our world.

What can we do that will have greater effects our lives than just focusing on security from terrorism?

Recently my mother was diagnosed with breast cancer. She was fortunate, not only because it was found early, but because she lives in a rich country with skilled physicians and an insurance company who didn't deny her life-saving surgery. Cancer is one of the things that WE KNOW can affect our lives. Along with heart disease, and infectious diseases in the developing world, cancer is one of things that is ACTUALLY likely to affect our lives.

We know the root causes of early morbidity and mortality: smoking, poor nutrition, lack of activity in the developed world and lack of sanitation and infrastructure in the developing world. However, the real root cause of many of these factors is social inequality and poverty.

Lack of adequate health insurance in our country is such an important issue that the American Cancer Society has devoted much of its resources around the issue. Around the world access to care is an even bigger issue, but poverty confounds all these factors and causes millions of children and adults to live lives of suffering.

So instead of focusing all of our energy this year and trying to protect us from a terrorist, why not protect us from things that are much more likely to happen? Why not focus on promoting access to health care? Why not focus on providing proper nutrition and public health around our country and the world? Why not focus on reducing poverty and social inequalities?

And what do you think is the root cause of violence and terrorism? What caused the World Wars? What leads people to shoot people on the streets of our cities? Poverty and inequalities.

By fighting a new war against poverty and social inequalities we can prevent the most common things that may hurt us (disease) and the less likely (terrorism).

L'Shana Tova for a safe, happy, and healthy new year.
Let us all Be Active in fighting for a better world.

Colbert Nation Nutrition

A great interview on one of my favorite nutrition activists by one of my favorite comedians:
Watch the Video

Out Healthcare System is SICKO

I recently saw Michael Moore's new film, SICKO. It is a film I've been waiting for for many years. During college I came to realize that the only way we are going to improve health and care for our fellow human beings was to establish Medicare for All.

I found Moore's film interesting because it really did not go into the fact that we are leaving over 40 million of our fellow Americans with no health insurance, no care for them when they get cancer, and no prevention from developing lifestyle-crippling heart disease.

He focused on those of us who are insured, in a complicated insurance system that denies people care and does not support people having healthy productive lives. It is key that he focused on these people, like my family, who are doing well, until something happens and our insurance company denies us.

It is not until regular-insured Americans, like my parents, realize that they are at the mercy of these careless companies that things will change. Until we realize we are all in this mess together and do something to improve the health of all Americans, we will be stick in this SICKO system.

So, Mom and Dad, and all your friends, I'm waiting for you to see SICKO, and then do something about it. My patients and your country needs you:
href="http://www.michaelmoore.com/sicko/what-can-i-do/">

P.S. My favorite action item from Mr.Moore's website is: Eat fruits and vegetables and walk around. Congrats Michael for advocating this and for losing some weight.

Live Earth Misses Tip to Reduce Global Warming

The Live Earth Concert was a great concert series to raise awareness on global warming. It had lots of tips for reducing greenhouse gas emissions.

However, it forgot one big tip, as pointed out by the Integrity in Science Watch:
Absent from the discussion surrounding the event were the findings, reported in the United Nation Food and Agriculture Organization’s 2006 report, Livestock’s Long Shadow, that the livestock sector is responsible for fully 18 percent of global greenhouse gas emissions – more than the automotive industry, air travel, and all other forms of transport combined.

So eat less meat and save the planet!

Biking

Today it was hot (94). But, I decided to see how long it would take me to ride downtown to where I can catch the T (Boston's Subway) to work. 20 minutes! Not too bad. Will probably quadruple my overall commute time, but I'll get my workout in. I will also help reduce carbon emissions.

Biking to work probably goes towards the top of a list of things good for you and the environment. It's not easy to bike. I had to deal with aggressive motorists, no bike lanes, exhaust. And I can't even take my bike on the T during rush hour.

A few years ago I was in the Netherlands, where tons of people bike to work in safe bike lanes, rain or shine. If we want to reduce carbon output and make healthier communities we need bike racks, bike lanes, and rules allowing bikes on public transportation.

Below is one organization trying to make a difference. I will try to make a difference by biking to work twice a month. Hopefully it will reduce my carbon footprint (You can calculate yours by clicking on the link at the top right of my blog) AND be good for my heart.

MassBike: The Massachusetts Bicycle Coalition

The Food Bill

A new article by Michael Pollan in the NY Times, talks about one of the most important bills in Congress. It is called the "Farm Bill", but affects the food system, the environment, and immigration.
Some select quotes:
On the Current Farm Law: "The result? A food system awash in added sugars (derived from corn) and added fats (derived mainly from soy), as well as dirt-cheap meat and milk (derived from both). By comparison, the farm bill does almost nothing to support farmers growing fresh produce."

"The public-health community has come to recognize it can’t hope to address obesity and diabetes without addressing the farm bill. The environmental community recognizes that as long as we have a farm bill that promotes chemical and feedlot agriculture, clean water will remain a pipe dream. The development community has woken up to the fact that global poverty can’t be fought without confronting the ways the farm bill depresses world crop prices."

"One of these years, the eaters of America are going to demand a place at the table, and we will have the political debate over food policy we need and deserve. This could prove to be that year: the year when the farm bill became a food bill, and the eaters at last had their say."

This is the year. To get BE ACTIVE on this issue check out the Oxfam Farm Bill Website.

Ronald McHummer

Combine Unhealthy Food and Gasoline Guzzling Hummers and destroy the world!
Make your own sign at The Ronald Mc Hummer Site

 

MoveOn.org Debate

Industry Sponsorship Biases Nutrition Research

I just published a study showing industry sponsorship of nutrition research biases the conclusions. Please read the complete article for our results and conclusions:
Relationship between Funding Source and Conclusion among Nutrition-Related Scientific Articles
Lesser LI, Ebbeling CB, Goozner M, Wypij D, Ludwig DS PLoS Medicine Vol. 4, No. 1, e5 doi:10.1371/journal.pmed.0040005

And the accompanying editorial:Does Industry Sponsorship Undermine the Integrity of Nutrition Research? Katan MB PLoS Medicine Vol. 4, No. 1, e6

Here are a bunch of news stories on it:
NPR : Researchers Find Bias in Nutrition Studies
WBUR (NPR Boston): Links Between Funding and Findings?
Boston Globe (front page): Beverage research tied to corporate dollars
http://www.msnbc.msn.com/id/16528571/
Google News Links

Kiva- A Nobel Idea to end Poverty

I just made a loan to someone in the developing world using a revolutionary new website called Kiva. Kiva is a system based on that developed by Muhammad Yunus, who just won the Nobel Peace Prize.

You can go to Kiva's website and lend to someone in the developing world who needs a loan for their business - like raising goats, selling vegetables at market or making bricks. Each loan has a picture of the entrepreneur, a description of their business and how they plan to use the loan so you know exactly how your money is being spent - and you get updates letting you know how the business is going.

The best part is, when the entrepreneur pays back their loan you get your money back - and Kiva's loans are managed by microfinance institutions on the ground who have a lot of experience doing this, so you can trust that your money is being handled responsibly.

I just made a loan to an entrepreneur named José Solórzano in Ecuador.

It's finally easy to actually do something about poverty - using Kiva I know exactly who my money is loaned to and what they're using it for. And most of all, I know that I'm helping them build a sustainable business that will provide income to feed, clothe, house and educate their family long after my loan is paid back.

Join me in changing the world - one loan at a time at www.kiva.org

Get Fast Food out of Hospitals

As a family doctor, one of my primary duties is to prevent my patients from suffering heart disease and cancer. I spend a lot of time counseling my patients to eat a healthy diet. I tell them to eat lots of fruits and vegetables, whole grains, and to limit sweets, soda, bad fats, and refined carbohydrates.

But then my patients walk through one of my affiliated hospitals, Tufts-New England Medical Center. There they can purchase a Dunkaccino with 11 grams of bad fat at Dunkin Donuts. Then they can head over to Pizza Hut and get pizza with 1240 milligrams of sodium. They can finish off with a Carrot Nut Muffin with 38 grams of sugar from Au Bon Pain. They can eat all of these without ever stepping foot outside the hospital.

I recently conducted a study with the American Medical Student Association, which looked at the prevalence of brand named fast food at academic-affiliated hospitals. The research, published in this month’s Journal of the American Board of Family Medicine (www.jabfm.org) reported that of the 234 hospitals surveyed, 42 percent were selling brand-name fast food on their campuses. These included Krispy Crème, Subway, McDonald’s, and Burger Kings.

But, brand named fast food is not the only problem. If you visit the Harvard hospitals in the Longwood area you can pick up a cheeseburger, fries, and soda. A few years ago, I worked at Children’s Hospital (which has one of the healthiest cafeterias). I wondered how the obese children would fare after we told them sugary drinks are bad, and then saw our cafeteria serving soda.

Hospitals should be promoting a healthy safe eating environment for the communities they serve. The food served should be representative of national dietary recommendations. Hospitals should help educate patients as to what a healthy dietary menu looks like. The best way they can do this is by setting a good example.

The first thing hospitals could do to take the lead would be to provide nutrition information that is easily available. The menu boards that show the price should also show the number of calories and/or amount of bad fats. For instance: Chocolate Frosted Donut, 200 cal, 9g Bad Fat, $0.59. Second, hospitals should make sure that food has no deadly hydrogenated oils.

The hospitals should then look at the food offerings as a whole. If the whole menu was analyzed by food group, would it adhere to national guidelines? Is the majority of the menu whole grains, fruits, and vegetables? If not, hospitals should pressure the food vendors to adopt their menu to be healthy. There is no problem with Dunkin Donuts offering their coffee to fatigued doctors, but why can’t we tell them to sell their donuts somewhere else?

If these franchises or cafeterias cannot change, they should be asked to leave the facility and contracts should end. With the large problem of poor nutrition, someone has to push for change. Hospitals not only have the power to control what food is served, they have the responsibility. Their mission is to improve health. They receive millions of dollars from Medicare to treat people with high blood pressure, high cholesterol, diabetes, and heart disease. Yet they also help create these problems by serving some of the very food that causes these conditions.

The medical profession needs to start practicing what it is preaching. Let’s put words to action and create healthy hospitals which educate patients on a healthy diet inside and outside the examination room.

For more information see: www.amsa.org/cph/healthyhospitals.cfm.

Interns.... Don't be Ants

I can tell already that internship is going to be a bit tough. It's mainly the hours and the increase in responsibility I have for my patients. I was talking to my fellow interns and a lot of us are going through the same struggles in first weeks. Are we really helping our patients? Do we look stupid? Why can't I figure out how to prescribe GasX? The little things can really get you down and wondering.... what the hell am I doing?

I had a chance to see Dave Matthews Band at Fenway park on Friday night. It was a great show in a historic place. His closer was Ants Marching. As he sang, "Take these chances. Place them in a box until a quiter time. Lights down, you up and die," I thought of one of the babies I delivered this week. A first mom, with a new beautiful baby boy. As we put her new baby into her arms, she was crying out of happiness. It was such a great moment with so much joy going around the room.

It's times like these we have cherish during residency. Or else we will just be Ants Marching.... "always doing the same thing."

P.S. There is no reason to shout "Yankees Suck" at a Dave Concert. It's just dumb. I'm a huge Cornell Hockey Fan and love shouting Harvard Sucks, but I wouldn't do it if Dave came and played in historic Lynah Rink. I was trying to like the Red Sox, but it's so hard. Life is not a continuous baseball game.

Trust me I'm a Doctor

After 9 years of post-high school education, I've finally got my MD. It's exciting right now, but I will quickly become humbled when my first patient asks me a question I don't know. But questions are something I like and are ultimately only good. Every time a patient asks me something, I will be pushed to learn more to provide the best care for my patients.

As you can tell by my blog's title, I like to ask questions too. A lot of this came from my undergraduate education in nutrition at Cornell! where we were trained to analyze nutrition research carefully. We learned how to ask questions that develop research to figure out the "truth". To be in medicine, I think you have to be comfortable with questions, as research and policies are always changing with new information.

I questioned a lot of things in medical school: from antibiotics to nutrition policy to evidence based care to changing our health insurance system. I often felt like Patch Adams in medical school, in a sense I was always questioning to make things better. I think my questions and drive for change were often met with encouragement. But, there were many times I got the response Patch got, with resistance from those who don't want change. I'm excited now that I'm further on the path to making my own ideas into reality on how to help to have healthy happy lives.

I want to thank all my friends and family for supporting me on my road to becoming a doctor. I could not have done it without all of you. I'm hoping you will keep me sane as I go through the next stage of my training.

Listen to Elie

Elie Wiesel on the Darfur, Sudan:
It was a direct or indirect consequence of a millennium lecture I had given in the White House on the subject, “The Perils of Indifference”. After I concluded, a woman in the audience rose and said: “I am from Rwanda.” She asked me how I could explain the international community’s indifference to the Rwandan massacres. I turned to the President who sat at my right and said: “Mr. President, you better answer this question. You know as well as we do that the Rwanda tragedy, which cost from 600,000 to 800,000 victims, innocent men, women and children, could have been averted. Why wasn’t it?” His answer was honest and sincere: “It is true, that tragedy could have been averted. That’s why I went there to apologize in my personal name and in the name of the American people. But I promise you: it will not happen again.”

That brutal tragedy is still continuing, now in Sudan’s Darfur region. Now its horrors are shown on television screens and on front pages of influential publications....A million human beings, young and old, have been uprooted, deported. Scores of women are being raped every day, children are dying of disease hunger and violence.

“Lo taamod al dam réakha” is a Biblical commandment. “Thou shall not stand idly by the shedding of the blood of thy fellow man.”

Should the Sudanese victims feel abandoned and neglected, it would be our fault – and perhaps our guilt.
That’s why we must intervene.

If we do, they and their children will be grateful for us. As will be, through them, our own.

Save Darfur.org

Munich and Terrorism

I've been meaning to write for awhile about my thoughts on the movie, "Munich". I thought it was an excellent film and very powerful.
Watching the film, I started to agree with its thesis: Killing terrorists for revenge or for deterrence does not really work. There are always more to fill their gap.
I definitely agree with the revenge issue, as I have been adamantly against the death penalty for many years. I just don't think civil human beings should kill another to prove they are more civilized.
But what about killing terrorists to prevent a terrorist attack? What if they are a direct threat? I think it is easier to argue to kill another individual if they are directly about to kill you. For instance, shooting a person who is about to blow up a bomb. But, in today's world a lot of the threats are more theoretical. Should we kill Osama? Will it really make a difference to KILL him? I definitely believe we should catch him and put him on trial, and if guilty (yes he will be) put him away for ever. And he won't allow us to capture him, I guess we have no choice. But should our goal be to kill all terrorist leaders? According to the premise of the film Munich, they will just be repopulated by new terrorists. We'd end up having to kill a lot of people.
I've always believed we have to fight the root causes of terrorism and hate, which I believe are poverty and lack of freedom.
But should we kill everyone? As I was thinking about this, I read a great quote from Sogyal Rinpoche: "...the natural karmic logic that taking the life of others or harming them will shorten your life, and giving life will lengthen it." As long as we follow the noble path, we will be rewarded, even if it is not in this lifetime.
The balance is just hard to find sometimes.

Becoming a Republican

Funny.
Sad.
Much of it true of the current Republican Leadership.
BECOME REPUBLICAN

"Most Wanted" Corporate Human Rights Violators of 2005

Check out this list of companies that have no respect for human rights. Most notable are some of my favorite food companies: Coca Cola and Nestle. I guess they can kill in many ways.

Global Exchange : "Most Wanted" Corporate Human Rights Violators of 2005

Exit Time from Iraq

We all know by now that the attack on Iraq was the wrong thing to do. But, for anti-war people like me it's hard to figure out a good way to get out of there. I don't want the country to go into further turmoil. Especially because we started all of this in the first place. I was searching the web for a plan to get us out that made sense. Senator Feingold's speech to the Senate was the best I can find. He clearly delineates why we have to get out and how best to do it.
It's best if you just read it:
Statement of U.S. Senator Russ Feingold On Why A Timeframe For The U.S. Military Mission In Iraq Will Improve Our National Security: "What we need is a public, flexible, realistic timetable that will tell people when and how we expect to finish the military mission in Iraq."

Stolen Election 2004

You won't see this on any of the major news outlets.
A new report by Congress' GAO shows that the 2004 election could have been easily stolen by Bush. I'll let the article speak for itself:Powerful Government Accountability Office report confirms key 2004 stolen election findings

Dean and Lakoff

Dean discusses Alito, abortion, Libby and Iraq - Hardball with Chris Matthews - MSNBC.com: "The position we support is a woman has the right to make -- and a family has the right to make up their own mind about their health care without government interference."

The other night on Hardball, Democratic Chairman Dean was using phrasing from George Lakoff to indicate the party's position on reproductive rights. For those of who don't know Lakoff, check out The Rockridge Institute. The idea is that we have to fram our language in new ways. I am a big fan of this. And I think the language Dean used is great. However, I'm a little scared that it will make the democrats look more politician-like. Eventually, this language will be good for the democrats. But in the short term it can make it look like they don't have a spine. What do you think?

US Senate closed for Iraq debate

BBC NEWS | Middle East | US Senate closed for Iraq debate

Kudos! The Democratic leadership showed some spine today. Bush tried to get off of the Iraq subject by talking about judges and bird flu. Senator Reid not only forced an investigation of the biggest scandal of history (the lying of the Bush Administration about the Iraq situation), but did so at a perfect time.
These are democrats that I would vote for.

Don't let terror stop our fight against poverty

The attacks in London today are horrible. The people who undertake these attacks are blood-seeking murders. I believe they planned this to coincide with the G8 meeting. It is clear that we will not stop terrorism by surveillance alone. We have to combat the root CAUSES of terrorism.

What brought millions of people to follow Hitler? What brought the start of WWI? What brings violence around the world? When people are poor and have no hope, they will listen to anyone who gives them hope. Al Queda takes advantage of this and recruits people who have no hope in life. Thus, Al Queda sees a G8 summit that is designed to fight poverty as a threat to its recruiting base.

Let's not let Al Queda win. Let's keep on track to devote 1% of our annual income to fighting poverty around the world. www.onecampaign.org While the deaths of 37 people today is horrible, let's not also forget the thousands of children that die each day from lack of food, water, and medicine.

News

While I was in Seattle, I had no radio. This meant no National Public Radio (NPR), my primary source of news. NPR gives an unbiased source of news and goes IN DEPTH into important issues.
In Seattle, I relied on TV, with the crappy, flashy, and SUPERFICIAL coverage of NBC, CNN, and MSNBC. (No, I don't watch fox.) Most of the newscasters fail to ask good questions. They simply read off screens that are owned by big media conglomerates, who own all of the media.

There are some good people who ask real questions and go into the issues. Tim Russert on Meet the Press, Chris Matthwes on Hardball, George Stephanopolis on ABC, and Wolf Blitzer on CNN all are decent newscasters.

But CNN, once a respected source of news has been following fox in becoming a flashy, superficial network. They recently have gotten rid of their last notable shows. Inside Politics, with the good news anchor, Judie Woodruff, is going off the air. They are getting rid of the long time politics show, "Capitol Gang" as well as the always fun, Crossfire.

I challenge you all to listen to NPR for a week and hear the difference. Go to NPR.com to find your local station and awaken your mind.
And finally, for all the best fake news check out the The Daily Show with John Stewart.
Keep informed and Be Active.

You pay for the Uninsured

For those of you who think that the uninsured are not your problem, this new study might make you think twice. If you don't think you should have to pay for "lazy people who can't afford health insurance", well it turns out you are. Most uninsured are working class people who's employers don't offer health insurance. The money comes from somewhere when they need care. Individuals and businesses end up paying for it with their private insurance. Wouldn't it be better if we worked out a different system????
Here's the report: Families USA Uninsured Report
Here's an excerpt:

"This study quantifies, for the first time, the dollar impact on private health insurance premiums when doctors and hospitals provide health care to uninsured people. In 2005, premium costs for family health insurance coverage provided by private employers will include an extra $922 in premiums due to the cost of care for the uninsured; premiums for individual coverage will cost an extra $341...

Without insurance to pay the tab, the uninsured struggle to pay as much as they can: More than one-third (35 percent) of the total cost of health care services provided to people without health insurance is paid out-of-pocket by the uninsured themselves...Through this study, we found that the remaining $43 billion is primarily paid by two sources: Roughly one-third is reimbursed by a number of government programs, and two-thirds is paid through higher premiums for people with health insurance."

Crazy Comments

ubject: Tell your friends: Frist and DeLay Should Reject Pat Robertson

Dear friend:

On Sunday morning, Christian Coalition founder Rev. Pat Robertson told TV viewers nation-wide that the threat posed by liberal federal judges "probably more serious than a few bearded terrorists who fly into buildings."

Robertson's statement is only the most outrageous example of a growing effort from the extreme right to whip up an intense fear and hatred of American judges. The strategy is designed to build support for the Republican "nuclear" scheme to break the rules and stack the courts –- and it is poisonous to our democracy. Republican leaders must reject these comments and end the intimidation now.

Please sign the MoveOn PAC petition today demanding that Sen Bill Frist and Rep. Tom Delay publicly condemn Robertson's comments and stop intimidating judges.

http://www.moveonpac.org/robertson/

Thanks.

Family Values?

NPR has been doing stories about soldier's and their families. (Check out one here http://www.npr.org/templates/story/story.php?storyId=4618906)
The above story is about a soldier who missed the birth of his twin girls while in Iraq. He luckily got back to see them, but was sent back to Iraq a few weeks later. I've heard many other stories of soldiers being killed, leaving a wives and young children fatherless.

These stories sadden me deeply. For a party (George W's) that talks about family values so much, they sure are ripping a lot of families apart. And why? Again, no weapons of mass destruction and no terrorist links to Iraq. This is a shame... And George W won't even allow video of soldier's coffins nor will he attend their funerals.

Who's got family values now?

US stands alone against Health Care as a Right

The United Nations
Commission on Human Rights
April 15, 2005

In a resolution (E/CN.4/2005/L.28) on the right of everyone to the enjoyment

of the highest attainable standard of physical and mental health, adopted as

orally revised and by a roll-call vote of 52 in favour to one against, with
no abstentions, the Commission urged States to take steps, individually and
through international assistance and cooperation, especially economic and
technical, to the maximum of their available resources, with a view to
achieving progressively the full realization of the right of everyone to the

enjoyment of the highest attainable standard of physical and mental health;
and called upon the international community to continue to assist the
developing countries in promoting the full realization of the right of
everyone to the enjoyment of the highest attainable standard of physical and

mental health, including through financial and technical support as well as
training of personnel, while recognizing that the primary responsibility for

promoting and protecting all human rights rests with States.

The Commission encouraged States to recognize the particular needs of
persons with disabilities related to mental disorders, as well as their
families, including by reflecting their needs in national health and social
policies, such as national poverty reduction strategies; and called upon
them to place a gender perspective at the centre of all policies and
programmes affecting women's health. They also called upon States to protect

and promote sexual and reproductive health as integral elements of the right

of everyone to the enjoyment of the highest attainable standard of physical
and mental health and decided to extend, for a period of three years, the
mandate of the Special Rapporteur on the right to everyone to the enjoyment
of the highest attainable standard of physical and mental health.

The result of the vote was as follows:

In favour (52): Argentina, Armenia, Australia, Bhutan, Brazil, Burkina Faso,

Canada, China, Congo, Costa Rica, Cuba, Dominican Republic, Ecuador, Egypt,
Eritrea, Ethiopia, Finland, France, Gabon, Germany, Guatemala, Guinea,
Honduras, Hungary, India, Indonesia, Ireland, Italy, Japan, Kenya, Malaysia,

Mauritania, Mexico, Nepal, Netherlands, Nigeria, Pakistan, Paraguay, Peru,
Qatar, Republic of Korea, Romania, Russian Federation, Saudi Arabia, South
Africa, Sri Lanka, Sudan, Swaziland, Togo, Ukraine, United Kingdom and
Zimbabwe.

Against (1): United States.

David Hohman (United States), speaking in explanation of the vote... said
the United States believed that while the progressive realization of
economic, social and cultural rights required government action, those
rights were not an immediate entitlement to a citizen.

http://www.unog.ch/unog/website/news_media.nsf/(httpNewsByYear_en)/0DC62B805
E191CF7C1256FE40050A75D?OpenDocument

My Movie of the Year

My Movie of the Year: The Motorcycle Diaries
The Motorcycle Diaries

This movie struck me deep. I went into it not really knowing who Che was in history. To me the movie resonated with me, being about a medical student who wanted to get out, travel the world and help people. It was a process of self discovery that almost inspired me to take a break from medical school and travel around the world. So much can be learned from traveling and seeing how other people live. This trip clearly influenced Che.

But, beyond my personal interest in the movie, it was fabulous. Of course the cinematography and acting was great. But the screenplay and story really showed the reasons behind Che's later political attitudes. The movie did a marvelous job of showing how the experiences on this trip influence Che deeply. But, it did it so subtly, without even directly relating to later politics.

It was also a movie that should inspire all of us to help the less fortunate.

"Let the world change you... and you can change the world."

2 Democratic Victories

Victory #1: The Iraqi People having a Democratic Election
Yes this is good. However, it probably should not have happened with American military force. The Bush administration led America into this war based on WMDs. Suddenly there is a flip-flop. He realized his reason for going to war was totally false, so he is trying to put a positive spin on things by saying the intention of the war was to spread democracy.
I found out this morning that I have some agreement with Pat Buchanan. He states that the US cannot forcefully spread democracy to every country in the world. This is true. If Bush and his dummies believe this, our country will be at never ending war. Invading other countries is the best advirtisement for creating new terrorists.

Victory #2: Howard Dean, MD elected to chair of democratic party.
I believe this is a big victory for the democrats. Everyone is fearful that he is too much of a liberal to win over the country. First, he doesn't have to take over the country. He just has to be an organizer, which he does very effectively. Second, he's not that liberal. Look at his views and you'll see he's a fiscal conservative (unlike the current president). Thirdly, he won by getting votes from Southern Democrats, an area where the Dems need to expand.
Dr. Dean will put a spine back in the Democratic Party.

Lenny

Top Wines

My Top 3 Wines of 2004:

#3.Terrazas 2003 Alto Malbec
Colour: deep red with blue shades.
Aroma: aromas of red, black and dried fruits, especially plums and figs combine to give the wine a great intensity. Further hints of vanilla and caramel can also be detected.

Taste: the wine is rich and juicy with soft, well-ripened tannin. Notes of black fruit, jam and vanilla blend to give the wine a mouth-watering finish.

Consumption suggestions: enjoy this tasty Malbec with red and white meats, fish and pasta dishes. Serve between 16° and 18°C.

#2 Citra Montepulciano D'Abruzzo
Color: Lush ruby with hints of purple.
Taste: Dry, well-balanced and delightfully tannic, with concentrated berry flavors.
Serving Suggestions: A perfect accompaniment to grilled meats, rich pasta dishes and vegetarian entrees. Enjoy at room temperature.

#1: Fess Parker Frontier Red Lot 22
Intended to evoke the spirit of rugged individualism upon which our country was founded, this is a complex blend of Rhone and Bourdeaux varietals. You will find blackberry and dark cherry fruit flavors along with spice, coffee, green olive, black currant, hints of licorice, menthol and herbs, plus subtle earth nuances.
“Frontier Red” is designed to be the perfect complement to the foods found
at most backyard cookouts and barbeques, that most common of American meals.

Have fun tasting!
Lenny

Bush and Chanukah 

Bush and Chanukah 

Happy Thanksgiving

Sorry I've been distant for awhile. First I had to recover from the man we call president somehow winning an election again.

Then I've been busy with AMSA stuff. We had some successful events, including NO SODA DAY. To see some of the news on NO Soda Day click here: http://news.google.com/news?sourceid=navclient&ie=UTF-8&q=%22no+soda+day%22

Happy Thanksgiving everyone. I'll be setting up a notify list soon, so you can keep up to date with my blogs.

Get Out the Vote

Be ACTIVE!
Do something to get rid of Bush and elect Kerry!
Click below and don't forget to vote on Tuesday.
Our lives depend on it.

MoveOn PAC
America Coming Together

My friend's Editorial

My Friend Sherri wrote this editorial in the Madison Capital Times. It's a good read and she makes a great point:
The Capital Times

Michael Moore.com : Mike's Message : Messages

Micheal Moore's new Letter. A good wake up call to us. Let's get Kerry elected.
Lenny

Michael Moore.com : Mike's Message : Messages

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