Ugly Questions for Ron Paul

I thought Dr.Paul might have been a little mis-understood, when some Tea drinkers at the Republican debate cheered the death of the hypothetical uninsured 30 year old man. But TPM quotes him confirming his philosophy that health care should be completely privatized, and regulations are just bad for business–herbs and charity will fill the need.

Ron Paul told TPM on Wednesday that even if there’s a “case or two” that makes Americans uncomfortable, the government should stay out of the health care business. Even if one of the cases in question is his former campaign manager, Kent Snyder, who died with $400,000 in unpaid medical bills after being unable to secure health insurance due to a pre-existing condition.

At a Christian Science Monitor breakfast, Paul took questions from reporters on Snyder, whose story surfaced in the press after Paul said in the last Republican debate that the government should not intervene even to save a comatose 30 year old who did not have insurance. As Gawker noted, Snyder died in June 2008 without health insurance, leaving behind $400,000 in bills. His friends and family set up a fund to raise money to pay off the debt. It’s not clear how much money they were able to raise: a site set up by Ron Paul aide Justine Lam to track the medical fund stopped updating in 2008 with only $34,870 in donations.

Later in the interview–

He also blamed the government for regulating medicine: “The federal government comes in and closes down shops that try to sell nutritional medicine and vitamins because the drug companies don’t want competition. That drives the prices up.”

And he’s aware that his stand can sound too cold-blooded for most Americans–

Paul added that “to twist it around and say that we have no compassion and we just throw people on the street, that to me is getting pretty ugly.”

I have some ugly questions for Dr.Paul, right here–

1. Who picked up the remaining bill for your campaign manager? Did it come anonymously from principled Libertarians, or from the government? Who do you think is already paying for uninsured people when they show up at the emergency room? How much free care could hospitals give to save lives if they didn’t get government money to provide it?

2. Did you know Kent Snyder was sick? Did you offer him any advice or help as he worked for you? Young people do die of pneumonia, but more often it’s treatable. Do you think lack of insurance might have kept him from seeing a doctor early. Do you blame him for that?

3.Do you agree that insurance companies should deny people with pre-existing conditions to maximize profits? Will that be one of your campaign platforms?

4. Can you give an example of an herb or alternative store that was closed down and why? I see them doing business all over the place. Does the government ever have the right to close down an alternative business for say, selling a cure for cancer that doesn’t work? Selling tainted or mis-labled medicine? I had a patient who was blinded by an eyedrop he got in his home country, where he had no conventional medicine to help him. Should we protect the public here from dangerous and quack remedies?

5.Does your belief that medicine should be ‘pay as you go’ extend to babies and children? If not, why not?

6. As a doctor, do you see a problem in the lack of continuity when people are forced to seek care from charity clinics and emergency rooms? Do you think we waste resources and lives by starting from scratch every time the patient seeks care, rather than having one medical home where their records are on file and they know their providers? Would you trade your own secure health care for this kind of ‘freedom’?

7. Do you see prayer as a substitute for medical treatment? If parents use prayer instead of medicine for a child’s treatable illness and the child is at risk of death, does the government have a right to take custody of the child? These cases come up regularly, and even worse, children die because parents refused to take their child to a doctor. Do you think that lack of access to conventional care will drive people to faith healers and ineffective but cheap herbal remedies?

I have to hit the road now, I have clients to see for home care. I’m grateful every day for Medicare. Seven adult children are very tired these days caring for our sick father, and Hospice has given us help and support that make it possible for him to stay at home in comfort and dignity. It’s interesting seeing this situation as both a provider and recipient of help.

Ron Paul says we won’t throw people out on the street to die, and he’s right. We are not that kind of society. But people will die– killed by neglect, by too little too late, quietly and un-noticed unless it’s someone you love. Some will kill you with a fountain pen, as Woody said.

So, how do you think Dr.Paul would answer these questions?

AND ANOTHER THING: There’s something funny about the way Rep.Dr.Paul keeps talking as if herbs and alternative medicine were in a fugitive underground somewhere. You can buy herbs and alternative medicines at the supermarket– though I’d put a word in for Providence local business Farmacy Herbs. When you go to Whole Foods or GNC, you are protected by laws that say the ingredients have to be listed on the label, so you know what you’re getting. And unlike the good old days, you can’t spike some herb tea with opium and sell it as a cure-all. We’ve been there, done that, don’t want a re-run.

REMEMBER STEVE MC QUEEN: Brilliant and handsome actor, died tragically of cancer. He tried an alternative medicine called Laetrile. Remember that? Naturally derived from apricot pits, miracle cure for cancer. The only problem was that every reputable drug trial showed it to be ineffective and poisonous in large doses. Laetrile never passed the first step for any new drug in development– a Phase 1 clinical trial that tests for safety, never mind the Phase 2 for effectiveness…

As Laetrile became newsworthy, several cancer victims treated with it drew widespread media scrutiny. One was Chad Green, who developed acute lymphocytic leukemia at age 2. Although he was rapidly brought into remission with chemotherapy, his parents started him on “metabolic therapy” administered by a Manner Metabolic Physician. When Chad developed signs of cyanide toxicity, Massachusetts authorities had him declared a ward of the court for treatment purposes only. His parents then brought suit to reinstitute “metabolic therapy.” When the court ruled against them, they fled with Chad to Mexico, where he was treated by Dr. Contreras. Several months later Chad died in a manner suggestive of cyanide poisoning. Dr. Contreras stated that the boy had died of leukemia, but was a good example of the effectiveness of Laetrile because he had died a pleasant death! Chad’s parents stated that he had become very depressed because he missed his grandparents, his friends and his dog.

Follow this link for an epic story of unfounded claims, conspiracy theories and shady practices around Laetrile.

I have the greatest sympathy for parents of a sick child, and for people facing a serious illness. They are in desperate circumstances and should be protected, not thrown into the mix of legit medicine and quacks with no advocate or defender. Medicine fails, people die, humans are not gods. All we can do is make the best choices we can with the knowledge we have. When people seek alternative remedies they deserve transparency and accountability from the providers, and protection from false claims and tainted ingredients, protection from exploitation and the consequences of delaying conventional treatments that offer a known chance of cure.  It’s possible to be pro- alternative medicine and anti-quack. I am.

I actually think some of Rep.Paul’s critiques of our over-technical, expensive, pill-pushing medical system are valid and deserve discussion. But using the flaws of the present system to justify triaging the poor and working class out of care so that the rich can enjoy top-shelf services is truly ugly, and there’s nothing Rep.Paul is saying that offers a real answer to the millions of Americans who do not have secure access to care.

MORE: Susan at Daily Kos cites examples of adults and children who died for lack of timely care, including her own brother. This is not the America we want to be.

Men–CNN Will Scare Your Pants Off

Today’s health headline– Five Questions to Ask Before Having Penis Surgery.

An unfortunate man in Kentucky not only lost a part of himself, but also a lawsuit against the surgeon who did the cut. It sounds like the doctor had evidence that the man did really have cancer and that he followed the standard of care.

The CNN article kind of drivels about how women have all kinds of pink ribbon support, and men are on their own. Not too long ago, it was routine for a woman with a breast lump to go under anesthesia not knowing whether she would wake up with her breast amputated, or just an incision. Better treatment is the good news, high incidence of breast cancer is the bad news. I guess, all things being equal, it’s better not to have a rare disease, but the downside is that breast cancer is common and there are few women of any age who never worry about it.

It may be time for a men’s advocacy organization for better treatment of male problems. I’ve done nursing care for guys whose ‘routine’ surgery became a debilitating, miserable, long-term ordeal. CNN’s article contains a lot of good advice and is a good place to start if you want to know more about men’s health.

Fighting Back

It’s hard to definitely connect a disease to an exposure to a toxin. There are various estimates of how many children got thyroid cancer after Chernobyl, the International Atomic Energy Agency, in a strangely upbeat post , says four thousand. The World Health Organization says five thousand, with a little more consideration of the implications. Other cancers also were increased after the disaster.

Yan Leyfman suffered painful, relentless and unexplained illnesses all during his early childhood. Now a student in the US, he is researching cancer as his mother survives cancer treatment. They believe they are victims of radiation exposure.

STONY BROOK, N.Y. — Yan Leyfman was born in Belarus in 1989, three years after the Chernobyl nuclear disaster. His family lived only about 75 miles from the nuclear plant, and as a toddler, Mr. Leyfman had a constellation of mysterious symptoms: cysts that covered his entire body, fingernails that fell out, limbs that were swollen and skin that itched torturously.
Though he recovered his health after moving to Brooklyn at age 5, Chernobyl still followed him.

Leyfman is a young cancer researcher, driven to find a cure for his mother and answers for himself.

At this time, the ruins of Chernobyl are still dangerous, Ukraine and the international community are trying to raise the 2 billion it will cost to entomb the reactor before the temporary structure fails.

Radioactive Marker

This article in today’s New York Times is not panic-inducing, but neither is it reassuring…

Tests of milk samples taken last week in Spokane, Wash., indicate the presence of radioactive iodine from the troubled Fukushima Daiichi nuclear plant in Japan, but at levels far below those at which action would have to be taken, the Environmental Protection Agency said on Wednesday.

The problem arises when materials that emit beta particles are ingested or inhaled. Iodine 131 is chemically identical to normal, nonradioactive iodine and thus is absorbed into the body just as normal iodine is, mainly in the thyroid gland, where it delivers a concentrated dose to that small organ and can cause cancer.

In the Chernobyl nuclear accident of 1986, the biggest health effect was cases of thyroid cancer, especially in children living near the nuclear plant in Ukraine.

Go to NYT for more on the short half-life of Iodine 131.

Radioactive Iodine 131 is used in medicine to diagnose and treat thyroid cancer. When a person has cancer, radiation therapy is lifesaving and a good risk, but note that there are precautions against exposing the general public…

Radioactive iodine can also be taken up by cells lining the stomach. Some patients may experience nausea, stomach upset and rarely vomiting, for which relief in the form of medications such as Gravol can be provided…

Female patients of reproductive age should have a pregnancy test done at the time of admission to make sure they are not pregnant. Patients may not have visitors during the initial period of their hospitalization. Close body contact, or hugging/kissing, or having subsequent visitors eat or drink in the room is strongly discouraged. The radiation levels will be checked to ensure your levels are sufficiently low prior to discharge.

Should we be worried about the milk in Spokane? If I were pregnant or the mother of a small child I would err on the side of caution. For this specific instance, I tend to believe that the risk to older adults is very low. I see it more as a diagnostic test of our planet.

Each incident of radiation from Fukushima appearing elsewhere in the world is a marker for the swiftness, ease and persistence of radioactive contamination far from the site of a nuclear disaster.

We have put a radioactive marker into the circulation of the air and water of our planet. Nuclear enthusiasts continue to claim ‘no immediate risk’ but the deeper message is clear. Nuclear pollution circles the globe, affecting people far from the benefits and far from the decision to build bombs and power plants. The benefit does not justify the risks.

SPREADING CONTAMINATION: This last October there were reports of hospitals and clinics administering radioactive iodine and sending the patients out to motel rooms and homes without proper screening and instruction. A man on a bus set off radiation alarms on the highway, motel maids and guests had measurable contamination just from being in the same rooms. Link to the story here.

Carly Fiorina– Get Well Soon

I want desperately for Barbara Boxer to win the race for the Senate, and I want Carly Fiorina to win her battle against cancer and its complications. She is in the hospital being treated for an infection related to surgery.

We’re all in the human race, and women, especially, understand.

“We wish Carly Fiorina a speedy recovery and hope she is able to return to her normal schedule soon,” Boxer campaign manager Rose Kapolczynski said.

First lady Michelle Obama, Jill Biden, wife of Vice President Joe Biden, and Boxer all used speeches at a Democratic National Committee fundraiser in Los Angeles Tuesday to wish Fiorina a speedy recovery.

UPDATE: Carly Fiorina should be back on the campaign trail as this goes to press. When it’s pathogens vs humans, I’ll vote for the humans every time. Congratulations, Carly. Now I hope Barbara Boxer wins the Senate race, because she is the better candidate.

Once Again–No Nukes

I’m discouraged that President Obama is not putting more emphasis on renewable energy and conservation, and worse yet, proposing to give a huge loan and protection from liability to the nuclear industry.

Too busy to cover all the aspects of this, but I’m going to post a link to some earlier posts referencing the Providence Journal’s fine article about United Nuclear in Charlestown, RI.

Whenever I hear claims that no American ever died in a nuclear accident I think of Robert Peabody. I think of all the people exposed to radiation, and the enormous cleanup costs.

So here’s a link to ‘Rhode Island’s Nuclear Fatality’.

And a reminder that nuclear power is such a bad investment that banks won’t touch it unless the government underwrites it and the public takes the risk.

More on this here, including the unsolved question of where to put the waste.