Deconstructing Katrina

I've been catching up on some TV viewing missed while company visited for Thanksgiving thus this comes a bit 'after the fact.'

Last week on PBS they aired three programs focused on the Katrina disaster in New Orleans. The first was Nature's "Katrina Animal Rescue." Maybe I was already missing my relatives who had just taken off for the airport but this show really got to me. All those abandoned dogs, cats, fish, birds, reptiles, etc. Some estimates are 250,000+ animals were left to fend for themselves.

But these mostly aren't animals that can find food on their own. They rely on humans to open the can or scoop it out of the box. So many animals, so many beloved members of households, left behind because there is no room on the evacuation vehicle or in the shelters. But luckily the focus of the show was on the handful of people (some who had lost most they owned when their homes were flooded and others who dropped everything to drive cross country to help) who have been busting their asses to do something about the problem.

Granted, when you do the math in your own head you realize that many of those animals aren't going to make it because too few are working on the problem. But the show really points out that we need to make a provision in disaster planning to deal with this problem better than we have to date. After all, those animals left behind that do survive can contract and spread diseases; diseases which will be passed to humans who have contact with them when they return. [And while not mentioned, it was clear that many of the male dogs shown were not neutered so I'm predicting a surge in births of unwanted animals. It boggles the mind...]

Next, Nova tried to give the viewers a rundown of what happened during the storm in "Storm That Drowned a City." This was a fascinating look at the timeline before, during and after Katrina punished Greater New Orleans and paid special attention to just how and why the levies failed. The focus was on the science of the storm and the engineering of the city, much of which sits below the water surrounding it. Pretty much a must see education in what happened. (I didn't watch any of the Broken News coverage broadcast during the storm and almost none [less than 30 minutes] during the "scream for help" and now understand it better because of that fact.)

Finally it was time for some analysis of just why Katrina turned into the biggest natural disaster our country has faced with Frontline's "The Storm." More so now than ever, I believe the natural component of the storm as real, but the disaster was manmade. This program paid particular focus to Federal Emergency Management Agency (FEMA) and it's response to local requests for help from city, parish, and state officials as well as coordinating with the National Guard and Army Corps of Engineers.

Republicans are the Disaster

While it is clear that there is enough blame to share around with everyone in a position to do something about Katrina's aftermath, the bottom line for me is that since FEMA's creation during the term of Jimmy Carter way back in the late 70's, it has been viewed as an unimportant, but decent enough sounding, job for Republican appointees. You know, the kind of place that sounds like it carries enough clout, but has little enough power, so you can park someone you have to reward for hard work and support but who you don't want able to mess with your policies to reshape the country.

The only professional ever appointed to run FEMA, James Lee Witt, was appointed by President Bill Clinton and while some might argue he was just another crony from Arkansas, at least he had some experience and cared about helping out after a disaster. It was during his term that planning for disasters was a serious priority and he provided the leadership to turn the agency around. And to be honest, even during the second Bush's first appointment, the specter of 9/11 kept the agency focused on planning for disasters though the focus was largely shifted to responding to terrorist created ones. But while there was wide-spread agreement early in W's regime what should be done to make the country better prepared to respond to disasters of both kind, management was changed long before recommendations could by implemented.

So the Idiot in Chief promised to protect us against future disasters and respond appropriately after one happens, while his minions (or is it handlers?) basically gutted the only department with a mandate to respond and quietly shifted the responsibility from the Federal to State and local governments. Disasters are local, right? FEMA has twice been downgraded in status so that now it is a small subsection of the monstrosity now called the Department of Homeland Security.

Want to know why so many suffered after Katrina? Then just imagine fighting for funding to help people after a disaster that might happen when you a competing with halting illegal immigration on the country's borders, stopping every airline passenger from taking nail clippers aboard their flight, and protecting the American public from suicide bombers. Oh, and did I mention that you have to cut spending so you can give the rich a huge tax break while waging a losing war half a world away? Is it any wonder that we were not prepared to save people (let alone their animal companions) drowning and starving in New Orleans?

Then you've got Louisiana's Governor Kathleen Blanco saying "send help, send help, just send help. I mean, send help." The Feds, especially FEMA's deposed leader (Bush college roomie) Michael Brown complained that she didn't ask for anything specific or meaningful. Okay, this clearly points to kind of problems that happen with poor communication though it hardly accounts for why the Feds didn't respond to the 40-page official request from other Louisiana officials. Still, it makes one wonder about just who is getting elected to run these trillion-dollar corporations we call state government.

Blanco is a Democrat with a Democratically controlled legislature (close to 2:1 in each chamber) but from what I can tell, they spent the past session like many legislatures, trying to find new money and cut programs in an attempt to recover from the budget crisis that hit most states a couple years back. (However, I don't follow Louisiana state politics all that closely and suspect like throughout much of the South many Louisiana D's are really R's in disguise.) From what I saw, clearly Blanco is no Guiliani -- she might have great ideas for the local school system, but she seems to lack the leadership so critical in a time of crisis. Or maybe she just got bad press coverage, it's hard to tell for sure.

Now this will lead some to say, "see, it's not a Republican or Democrat problem since most of the political structure in Louisiana is controls by the Dems." However, this is misguided since the real problem is not Louisiana at all. The real problem is that on the national stage, the Republicans have targeted social programs for elimination or transfer to state and local governments -- the very same governments which are so underfunded that they are still trying to cut programs.

A thoughtful reader might ask, so why push more on their plate when they have too much now? This is an excellent question. Well, once again, the Republican leadership knows better than the rest of us what we should be doing. Their desire is to reshape government -- all government -- and since they can't get control of the Louisiana legislature or Portland City Council or a host of other representative bodies that don't agree with their agenda, they figure they can force those bodies to do what they want. More or less.

See, if one shifts something like Emergency Preparedness and Disaster Recovery out of the Federal budget to the State and local governments then, the theory goes, they will have to do drop such programs as healthcare for the poor, public funding of reproductive choice, housing for the homeless, and sponsorship of public television and the arts. Now granted, that doesn't mean those governments have to take care of these things, but at least you can blame them when something goes wrong and then you say "it's not the responsibility of the Federal government to help people. We only fight wars and save them from terrorists and illegal aliens."

Will Americans remember this when they vote in November 2006? After all, that will be the perfect chance for a referendum on this issue. Instead of asking themselves, "who will lower my taxes" or "who will save marriage" or "who will protect those unborn babies" maybe they should ask "who will help me if my community is wiped out by a storm (or maybe even a terrorist, but that's much less likely)?"

It's all really about just what kind of country we want to live in and if we are prouder of the image of waging war in Baghdad or people dying in our own streets after a disaster.

Speaking of Weather

Recently I posted an entry with a number of links focused on what might be called my micro-climate - mostly centered on temperature variations between my apartment complex and the nearest reporting stations. Now for the other side of coin, here's some interesting news on the macro-climate.

It seems that NOAA weather scientists are forecasting a warmer winter with normal precipitation for most of the US. While I don't know that this really tells me about the coming winter, I guess I don't have to worry too much about snow. Or do I?

I really find it interesting though that the area at the southern and western corner of Lake Michigan has much stronger chances of having a warmer winter. What's up with that? It's almost like they have done some much in the last few years to pave over the prairie that there it's just getting warmer.

The one important thing is that we aren't heading into a nasty El Niño. On the contrary, it looks like a weak La Niña. NOAA provides monthly forecasts, or should we think of them more like updates, of the current conditions of the El Niño Southern Oscillation with weekly updates of readings taken across the globe.

There is something absolutely fascinating about this stuff. For one thing, it shows just how small this little planet can be in terms of how conditions in one area affect the weather of much or all of the Earth. But another part is that much of this is very new science. I guess we can even think about it as almost as cutting edge as the genome.

On a related front, it really looks like we've had many more tropical storms and hurricanes this year in the Atlantic than they would have predicted when they dreamed up the naming convention. We are up to 24 with TS Gamma. Of course we in the US only focus on the storms off our SE coast. I find myself wondering if other parts of the globe are experiencing as many storms this year too.

First TAPPY Awarded to Portland Parks!

Portland Parks Wins First TAPPY Award

Hillsboro - Portland Parks and Recreation was awarded the very first TAPPYon November 17, 2005.

Webguy and TAPPY creator Thomas announced that Portland Parks had received the award for having such an annoying website.

"All I wanted was some information about Washington Park," explained Thomas. "Relatives are coming to visit on Thanksgiving and they want to do some things up there."

It seems Thomas really just wanted a map showing what was near the Oregon Zoo since only one relative might want to participate in a fund raising activity to be held at the zoo on Thanksgiving Day.

"The online map is completely useless!" he declared indignantly. "I mean, it shows all the streets but that's it. Oh, yeah, and you can zoom -- but you can't recenter the map or move it around or anything!"

As the first TAPPY was awarded, it was clear that frustration was written all over Thomas' face and motivated him to give the award.

But the truth is it went further than that. Not only was the online map difficult to use, slow to load and pretty unhelpful, but when Thomas tried to use the "Contact Us" link he was required to log in to the Portland Online website. (The official website of the City of Portland, Ore.)

Thomas questioned, "Whoever heard of requiring users to log in to a website to simply offer feedback or ask a question? Seems like rather than reaching out to users, the parks department is really looking for an easy way to discourage users from communicating. What a joke!"

To use the "Contact Us" link, users are required to sign in or create a user account on Portland Online. While the only required information is first name, last name, email, and zipcode, the user is required to create a username and password. Additionally, the web form requests middle initial, phone number, fax number, and address information but such added information is voluntary.

"Like I don't already have enough logins and passwords as it is! Now Portland Parks requires it too! Gee, do we need it to use the park as well?" he quipped.

Given the difficulty in reaching out to the parks department, no effort was made to contact them for a comment on the receipt of their TAPPY. However, one and all assumed they couldn't even be bothered.

The TAPPY was created on November 17, 2005 to recognize those "that excel at doing a really crappy job at whatever they do." More information on the TAPPY is available here.

TAPPY's Announced & FAQs

Thomas' Award for Poor Performance or Product
the TAPPY

Hey, everyone else has their own awards, so why not me too? It doesn't look like anyone else has used the name for some other award, so it's about damn time that I claimed it and made it mine. All mine!

But unlike so many out there, I am not selfish. I live to give and this award is for anyone, any company, any group, any non-profit that excels at doing a really crappy job at whatever they do. It doesn't have to be all they do, but when it's really top-notch bottom-of-the-barrel, then it's time someone recognized that fact and pointed it out. There's no time like the present, they say!

F A Q s

What is a TAPPY?

Simply put, a TAPPY is recognition for a job poorly done! No more. No less.

Who can be awarded a TAPPY?

Currently anyone (real or incorporated) who produces a product or performs a service.

When is a TAPPY awarded?

Whenever I feel like I've spotted a truly inferior product or received really poor service.

What do you get when you get a TAPPY?

Besides recognition and mention is this blog, absolutely nothing! (At least until I get rich enough to make nifty little golden idols and host wildly exorbitant televised extravaganzas.

Hey, I know of a sensationally poor product (or have received horribly dismal service), can I nominate someone for a TAPPY?

Sure, knock yourself out. Give me all the details -- the more sordid, the better! Reply to this message or contact me via this form. However, remember all decisions of the judges are final and as of now, I'm the only judge.

When will the first TAPPY be awarded?

Probably long before you finish reading this.

Why don't you have one of those nifty little graphics people can put on the their websites to proudly announce to the Whole Wide World they have received a TAPPY?

Good question! Maybe because I'm not designing cool graphics at the present time. However, if you'd like to design something, contact me via this form.

Why bother making such an obscure award as the TAPPY?

Because I need the satisfaction of calling an undue amount of attention to things which really deserve to be branded as not only inferior, but TAPPY!

Remember, most of all, TAPPY rhymes with crappy.

Health Economics 101

I received this on an email list with the statement "PLEASE CIRCULATE WIDELY" though The New York Times owns the Copyright. This is my effort to help with circulation...

November 14, 2005
Op-Ed Columnist
Health Economics 101

By PAUL KRUGMAN

Several readers have asked me a good question: we rely on free markets to deliver most goods and services, so why shouldn't we do the same thing for health care? Some correspondents were belligerent, others honestly curious. Either way, they deserve an answer.

It comes down to three things: risk, selection and social justice.

First, about risk: in any given year, a small fraction of the population accounts for the bulk of medical expenses. In 2002 a mere 5 percent of Americans incurred almost half of U.S. medical costs. If you find yourself one of the unlucky 5 percent, your medical expenses will be crushing, unless you're very wealthy - or you have good insurance.

But good insurance is hard to come by, because private markets for health insurance suffer from a severe case of the economic problem known as "adverse selection," in which bad risks drive out good.

To understand adverse selection, imagine what would happen if there were only one health insurance company, and everyone was required to buy the same insurance policy. In that case, the insurance company could charge a price reflecting the medical costs of the average American, plus a small extra charge for administrative expenses.

But in the real insurance market, a company that offered such a policy to anyone who wanted it would lose money hand over fist. Healthy people, who don't expect to face high medical bills, would go elsewhere, or go without insurance. Meanwhile, those who bought the policy would be a self-selected group of people likely to have high medical costs. And if the company responded to this selection bias by charging a higher price for insurance, it would drive away even more healthy people.

That's why insurance companies don't offer a standard health insurance policy, available to anyone willing to buy it. Instead, they devote a lot of effort and money to screening applicants, selling insurance only to those considered unlikely to have high costs, while rejecting those with pre-existing conditions or other indicators of high future expenses.

This screening process is the main reason private health insurers spend a much higher share of their revenue on administrative costs than do government insurance programs like Medicare, which doesn't try to screen anyone out. That is, private insurance companies spend large sums not on providing medical care, but on denying insurance to those who need it most.

What happens to those denied coverage? Citizens of advanced countries - the United States included - don't believe that their fellow citizens should be denied essential health care because they can't afford it. And this belief in social justice gets translated into action, however imperfectly. Some of those unable to get private health insurance are covered by Medicaid. Others receive "uncompensated" treatment, which ends up being paid for either by the government or by higher medical bills for the insured. So we have a huge private health care bureaucracy whose main purpose is, in effect, to pass the buck to taxpayers.

At this point some readers may object that I'm painting too dark a picture. After all, most Americans too young to receive Medicare do have private health insurance. So does the free market work better than I've suggested? No: to the extent that we do have a working system of private health insurance, it's the result of huge though hidden subsidies.

Private health insurance in America comes almost entirely in the form of employment-based coverage: insurance provided by corporations as part of their pay packages. The key to this coverage is the fact that compensation in the form of health benefits, as opposed to wages, isn't taxed. One recent study suggests that this tax subsidy may be as large as $190 billion per year. And even with this subsidy, employment-based coverage is in rapid decline.

I'm not an opponent of markets. On the contrary, I've spent a lot of my career defending their virtues. But the fact is that the free market doesn't work for health insurance, and never did. All we ever had was a patchwork, semiprivate system supported by large government subsidies.

That system is now failing. And a rigid belief that markets are always superior to government programs - a belief that ignores basic economics as well as experience - stands in the way of rational thinking about what should replace it.

Copyright ©2005 The New York Times

Doin' Better So Far

Well, I continue to take the new medication and while each night I feel an initial strange, almost hyper, feeling, I do seem to be sleeping better. I believe I am also sleeping for longer periods of time though this is somewhat more difficult to prove. However, I don't sense that I'm waking constantly and thus have to assume this means longer, better sleep.

But the more convincing evidence is that I'm starting to feel a bit better. I spent most of yesterday working around the apartment: got the dishes done, picked up the main room, and did some work on my collected seeds. Probably got some other things taken care of but can't quite remember.

My legs are still bothering me quite a bit though. The short stool helps a lot in the kitchen and that gets my by -- it's not perfectly comfortable, but I can get it under the kitchen sink to do the dishes and it works very well next to the cutting board I can pull out of the counter. This makes a great place for chopping and slicing so I can put together something for dinner. I've also noticed that I can set it next to the range and stir on the front two burners without needing to stand. All this helps.

It's going to take a long time still, but I'm glad my earlier hopes weren't totally misplaced. I was a bit concerned there for a bit after the first night but I think I'm adapting well enough. It's interesting though that my body seems to be telling me that it still needs lots and lots of rest. I can feel it when it should be about time to get up, but it's like it's saying 'no, not yet. Let's try a bit more rest.'

On another subject, I have to admit that I'm not all that thrilled with the weather right now. I like to keep the front curtains open when I'm up but the sun shines in much too bright. Also without the cloud cover, it's freezing over night. I don't know if I'm getting frost on the plants but sort of doubt it since things are doing okay. But it's clearly getting too cool for some of the tropical transplants like the impatients. I guess it's supposed to stay like this for some time, but I've got a nagging suspicion that the rain will be back for my visitors. Now that's when sunshine would have been useful.

Model Trains a Bit Too Small?

The check out Train Mountain Railroad Museum!

Yes, that's right, the world's largest model railroad is in beautiful southwestern Oregon near the town of Chiloquin, in the shadow of Crater Lake National Park. Recently Oregon Public Broadcasting did a story on the very interesting complex as part of Oregon Field Guide. From the TMRM website:

Train Mountain Railroad Museum is a non-profit organization dedicated to the preservation of our railroad heritage. It is located in Southern Oregon on over 2000 acres of Ponderosa Pine forest in Klamath County, the home of Crater Lake National Park. Train Mountain currently has 69,900 feet (131/4 miles) of 71/2" gauge mainline track and 133,250 feet (251/4 miles) of total trackage, which includes yards, sidings, and connector tracks. In the 2004 Guinness World RecordsTM Train Mountain is recognized as the "Longest Miniature Hobby Railroad".

I have to admit that I find this fascinating. Not only the concept of developing a community built on and around a 'Garden Scale' rail system. I would love to be able to go down for one of the Sunday rides, not only to see the trains, but to see the scenery surrounding it. I've always thought Garden Trains were kind of cool -- I remember riding past one on the I-205 Bike Trail just south of the Springwater Corridorr. It was in someone's backyard, behind a hurricane fence, and thus not terribly inviting. I guess if I had been moremotivatedd, I would have tried to make contact.

But such model railroads, while interesting, are small. I'm sure they still require a great deal of work and effort, but it's still just a backyard. On the other hand, I think a bigger, cooperative effort like TMRM holds much greater prospects. Miles and miles through the forest, around the trees, and over the streams. Maybe even have a chance for some wildlife sightings.

Still, pretty interesting, and yet another place I'll never make it too...

That's Incredible!

In the period 20041201 - 20051113, my website had 128,447 hits!

pottymania

Now that I've reviewed the latest installment of Harry Potter series, I have to admit I've been quite curious as to the differences between the US and UK editions. See, if you look at the American copies closely you will see things that tell you that we don't get to read the exact same book they get on the other side of the pond. Well thanks to The Harry Potter Lexicon, I was actually able to find out more.

My favourite is that in England kids read about "many flourishing pot plants in brass containers" while the rest of us see that the plants are potted. Oh, then there are the Weasley boys and their "hooter-type objects." (UK) No, breasts they are not, but exactly what kind of horn is referred to in "horn-type objects." (US) All the differences are listed here.

Then check out these four different cover images posted on The Hogwarts Galleries:

US Cover	UK Child Cover
UK Adult Cover	"hbp schol deluxe" (whatever that means)

See the rest of the artwork in Year 6 Cover Art gallery.

And if you are looking for interesting Potter links, here are some more:

• The Leaky Cauldron


• The Floo Network


• A Wizard's Atlas


• JK Rowling Official Site
  

So what is it exactly that interests or maybe even fascinates me about Harry Potter? That's hard to say. I'm partially interested in it simply as a creative enterprise and especially how the work of one individual so captures the attention of millions worldwide. The mixture of her usage of mythic creatures like elves, wizards, dragons, and gnomes with the many that she invents (which I won't detail for fear of giving improper credit).

Then there simply is the humour in the books. I find myself smiling and laughing during the story. This lightness adds a certain something to the mix which obviously increases the level of enjoyment for the reader.

I also find myself thinking about the story logically. While I know that will sound crazy to some, let me give you an example. In the current installment, Harry Potter and the Half-Blood Prince Rowling spends more time discussing how the characters celebrate Christmas. Since there is absolutely no overt reference to the Christian traditions commonly associated with the holiday, it almost seems strange to me that these "ancient" people who have many of their own hallowed traditions would follow the rest of society. While I don't expect them to NOT celebrate at this time of year, I guess I would have expected them to have a different holiday be it Winter Solstice or whatever.

I don't think this qualifies as a condemnation of the author's work but it's just something that interested me and then move these thoughts to the world inside my own imagination (and yes, there actually is one though until this post, few knew of it). I'm especially keen to accept inspiration but the desire for originality is strong with me so I'm always worried about the derivative nature of my own creations. (To only be able to have that purely original thought.)

So, am I a pottymaniac and exactly what does that word mean?To be honest, no, I'm not a Pottymaniac. I don't live, eat, sleep, breath, think, read, do all things Harry Potter. It is a creative endeavor I enjoy much like The Lord of the Rings, Aubrey-Maturin Series, or Star Wars. [BTW, Revenge of the Sith would be an excellent choice for a birthday present.] It's been clear for much of my adult life that I have a certain penchant for the epic story and each of these could probably be considered epic in nature.

Well alas, Googling "pottymania" reveals two other hits so I can't completely claim to have invented the word. I define pottymania as: Noun, a persistent neurotic impulse to follow Harry Potter, slightly derogatory [from potty, a derogatory nickname for Harry Potter used throughout the novels + -MANIA] Now in the other two uses found in Google it is used as a pseudonym, so while not completely original, maybe this usage might be. Of course the more obvious, and I insist much less connotative "pottermania" generates over 100,000 hits.

Just How Am I?

I have been posting important stuff from the news, but not much else. No real reason for this except that I don't have much to add about how I'm doing or feeling. However, this may be about to change.

After many stupid months were I was able to get no where in relation to a new medication to treat my sleep problems, I fired the prior provider and went back to my primary care provider. In about 26 hours he had the prescription the other doctor hadn't been able to get through the insurance company in the prior 5 ~ 6 months. So I got when I picked up my refills last weekend and started it last night.

As much as I'd like to be able to report the first night of this new treatment made all the difference and I can tell it's all going to get better, no such luck. However, after only a night - 1 dose - I can't tell much more than what it was like for me overnight.

I didn't fall immediately to sleep nor did I feel like I slept well or even better than I normally do. On the contrary, I felt like my sleep was much more disturbed -- it was almost like I was too hyper during sleep. My dreams were very vivid and for the first time in months I have a very strong reason to believe the hallucinations returned. Luckily it was nothing more than hearing sounds that were most likely no there (some I am 99% were not there and others were much harder for me to know one way or the other).

It's been clear that it's been months since I have any hallucinations (are that I've been aware of them - I can't really guarantee that I've NOT been having them). Mostly I hear things that don't exist -- a ringing phone, an animal sound, a knock on the door, a word spoken. Usually these sounds are most noticeable when going between sleeping and waking.

So what does this mean? While hallucinations are always a concern to me, it's just been a single night. They may not happen again, but I'm somewhat inclined to believe that it's a side affect of using this class of drugs (which I'm choosing not to record here at this time for personal reasons). It may not be the drug itself, but it may be related to that class of drug's interactions with my HAART (fka "the cocktail," a term many PWAs find offensive) and my own biologic system. It's hard to say and since we can't stop the HAART, it will be impossible to say though I might have a better guess when we next change my treatment. Who knows, it might mean I just can't take this class of drugs or will have to consider if their benefits outweigh the cost in terms of side effects.

So, with much more disturbed sleep and the return of hallucinations, I can't same I'm feeling terribly hopeful. I will continue to take the drugs for the next month or so before making any decisions unless I noticed nothing seeming like an improvement. I can't say I was as hopeful as I was two days ago, but let's say I'm guardedly hopeful.

Other than that, I continue to feel very tired and worn down. There is no improvement nor even change there yet. Mostly I just hang in there, waiting to see what comes next.

As for other information about my health, recent lab tests were mixed. I have very little active virus in my system and this has remained roughly the same throughout the year. However, my immune system seemed a bit weaker during the last test. This doesn't really mean anything by itself and won't until the numbers continue to decline over a series of test (done quarterly or so) or stay consistently below a given number. However, I would say that this number falls close to my average since I've been on treatment.

So that's a way that someone can say an awful lot about something that really hasn't changed much since the last time it was written about.

The one thing I can say is I seem to be reading more these days. I'm actually surprising myself at how quickly I'm going through large print novels. That's a good thing and I do enjoy it for the most part. I find myself wondering if I would watch at much TV if I could get more in large type.

Rob's fine. His overall skin health is much better. I think substituting canned food for some dry has made the difference. I do need to do something about the back though because he gets stuff between his toes and this seems to cause irritation and sores now. But we are moving in the correct direction.

That's about all I've got. I'm not working in the garden much though it isn't dying off as quickly as I'd imagined. Actually, the mums are gorgeous and I don't think anything died off because of the near freezing temperatures earlier in the week. I think between the building and the asphalt, my little garden stayed above freezing. So that's good but I do kind of wish I had the energy to spend a bit more time outside.

I'm also looking forward to a visit from family over the Thanksgiving holidays. I'm trying to get the house in order for that without stressing my body too much. I think it will be okay, and the hardest thing will be to NOT do things the couple of days before they arrive. However, I think that will be critical so that I am not too tired during their visit. It's going to be hard to not do all the things I will want to do while they are here, but that's just the way it is.

And so that's about the state of me at present.

Forget the Immune System, Worry about the Brain

From LATimes.com

Scans show loss of brain tissue with HIV
Scans show loss of brain tissue with HIV Drug cocktails help people live longer, but cognitive functions remain vulnerable.

By Susan Brink, Times Staff Writer

Neurologists who study AIDS have watched, waited and worried for nearly a decade about the long-term effect of HIV on the brain. They've known that the drug cocktails that so effectively extend lives don't protect the brain very well from the virus.

Now they've gotten their first actual look at the destruction HIV causes in living brains. A study published by the National Academy of Sciences last month used 3-D brain scans to see how much tissue was damaged. In vivid, color-coded images, researchers found up to 15% tissue loss in the centers that regulate movement and coordination, as well as a thinning of the language and reasoning centers.

"As people are living longer, the major risk of HIV is not the immune system anymore, but the brain," said Dr. Paul Thompson, professor of neurology at the UCLA School of Medicine and author of the brain scan study. "People who are doing well with HIV, living with it for over 10 years, have this progressive damage going on in the brain, well before symptoms are obvious."

For the more than 1 million Americans living with HIV, the virus that causes AIDS, it could mean minor problems with forgetfulness -- or it could mean early-onset dementia is on the horizon.

The study compared 26 infected people on treatment -- none of whom showed symptoms of dementia -- with 14 HIV-negative people. The brain deterioration seen among those with AIDS could cause slowed reflexes, mild vocabulary loss or poor judgment.

There just isn't enough experience with the multi-drug treatment, available only since 1996, to predict whether symptoms will stabilize or worsen.

It's long been understood that the drugs that keep HIV in check, like many other medicines, don't get to the brain in the same way they get to other organs. That's because blood vessels in the brain are less permeable than those elsewhere in the body and have an additional coating to prevent blood leakage into brain cells.

"It's as though you have a tight pipe, and then insulate it more," said Dr. David Clifford, head of the Neurologic AIDS Research Consortium at Washington University School of Medicine in St. Louis. The biological design, called the blood-brain barrier, is nature's way of protecting the brain. But it also acts to make it more difficult, though not impossible, for helpful drugs to get in. The brain ends up being a sort of sanctuary for HIV.

"The biggest concern is that this is the tip of the iceberg," said Clifford, who has been involved in AIDS research since the epidemic emerged in 1981.

The ability to treat AIDS at all was a tremendous breakthrough, perhaps pushing some of the drugs' limitations to the back burner of research. "The issue of cognitive problems in AIDS has kind of been overlooked," says Dr. Elyse Singer, a neurology professor at UCLA. "It has become a passe issue in the past couple of years. The drugs make people better, and you don't have horribly demented people doing crazy things any more."

But that doesn't mean that no damage is being done. "We should not be complacent about the brain in HIV," Clifford said.

Since 1996, many in the developed world have grown complacent about AIDS in general. That's when everything about the epidemic changed. Treatment known as highly active antiretroviral therapy was approved, and today, AIDS drugs are taken in combinations, often dozens of pills each day. They're expensive, costing $1,000 to $2,000 a month. They have troubling side effects including annoyances such as nail fungus and chapped lips, and real concerns such as increased risk of heart disease, stroke, diabetes and osteoporosis. And the drug regimen demands perfect compliance to keep working.

But for most people, the therapy worked. So seemingly overnight, the relentless death march of AIDS slowed down.

Before drug cocktails were available, two-thirds of AIDS patients suffered severe dementia at the end of their lives, Clifford said. Within six months, they'd go from losing focus to increased forgetfulness to a loss of interest in reading or even watching TV. As brain damage quickly worsened, by the end of their lives, they were incontinent, immobile and vegetative.

Right now, AIDS dementia is rare, said Dr. Mark Katz, regional HIV physician coordinator for Kaiser Permanente of Southern California. Only about 5% of the patients currently on combination drug therapy have developed dementia.

"I take care of 250 patients," Katz said. "I have many patients with some mood alterations. But I can't remember the last case of true dementia that I've seen."

And yet the brain remains vulnerable to this virulent and unpredictable virus.

In addition to the brain scan report, the National Institute of Mental Health has funded a long-term study of brain function in people with HIV that will eventually enroll about 1,600 people and watch them over time. "Our initial findings are suggesting that, indeed, the population isn't performing normally," says Clifford. "About 50% have subnormal performance."

They might be slower on computer keyboards, working crossword puzzles or have difficulty keeping track of what's been said in a conversation. They may even begin to move more slowly.

That could well describe Michael Sausser, 44, of Van Nuys. He believes he's been infected with HIV since 1988. As a city planner, he was used to keeping phone numbers, schedules, names and deadlines in his head. Then in 1994, he found that he couldn't remember which numbers to dial. He forgot appointments. He missed deadlines.

At the worst of it, he lost his job and his judgment became so bad he got into legal trouble. "I was arrested for keying cars," he says. "Anybody with half a brain wouldn't have done it. It was totally out of character. I didn't have a brain for consequences."

In the nick of time, combination therapy was approved and Sausser began treatment. His symptoms eased, a likely indication that drugs had an effect on his brain. But he's still left with some permanent brain cell loss.

He has problems with short-term memory, forgets if he's added both the flour and sugar when he's baking, and has trouble stringing words together for anything longer than a simple sentence.

"They're not necessarily the kinds of things that people notice, but they create big problems in my life," he says.

No one yet knows how great a problem looms. It could be that lowering the amount of virus in the rest of the body, as combination therapy does, will go a long way in protecting the brain, despite the blood-brain barrier.

But even mild to moderate problems among a significant proportion of those infected with HIV can be a public health issue. "Because people are living longer, we're seeing a slow growth in the number of people who have [cognitive problems]," says Dr. Igor Grant, director of the neurobehavioral research center at UC San Diego.

It's been only 24 years since the puzzling occurrence of unusual cancers and infections were identified as AIDS, and just less than 10 years since effective treatment became available. What will happen to the brains of people on treatment is one of the mysteries of this unfolding epidemic.

Activist Courts?

from PlanetOut via Yahoo!News

Judge upholds Oregon gay marriage ban

Gay couples in Oregon were dealt a blow on Friday, when a Marion County judge upheld the legality of the voter-enacted constitutional ban on same-sex marriage, otherwise known as Measure 36.

Measure 36, a single-sentence amendment limiting marriage to the union of one man and one woman, was passed by 57 percent of the Oregon electorate one year ago. In January, civil rights advocates at Basic Rights Oregon challenged the measure in court on several technical grounds.

Read the rest of the article.

GODDAMN LIBERAL ACTIVIST JUDGES!!!

Speaking of Paying More

I'm posting this from the Albany Democrat-Herald since I couldn't even find it in the horrible, useless online version of the Oregonian.

Hospital settles class-action claim by uninsured

By WILLIAM McCALL
AP Business Writer

PORTLAND -- A settlement considered the first of its kind nationally was reached Tuesday in a class-action lawsuit against a major nonprofit hospital by uninsured patients who say they were overcharged.

The agreement with Providence Hospital System will affect tens of thousands of low-income Oregonians, attorneys say.

"This is a historic agreement and it will stick," said Brian Campf, an attorney representing uninsured patients.

Greg Van Pelt, senior vice president for Providence Health System, said the hospital disagrees with many of the allegations while sharing the concerns of low-income patients.

But it was cheaper to settle for all concerned, he said.

"Quite frankly the cost of litigation is so great it was in the patients' best interest and the hospital's to get this resolved, and this seemed the best way to do that," Van Pelt said.

The lawsuit is part of a national campaign headed by Richard Scruggs, a Mississippi attorney who helped win multibillion-dollar settlements with the tobacco industry in the 1990s to pay states for smoking-related health care costs.

Similar lawsuits have been filed against hundreds of hospitals in at least 27 states, alleging that tax-exempt nonprofit hospitals charge higher prices to uninsured patients than the discounts given to insured patients.

"Other hospitals around the country should take a hard look at this" settlement, said Sid Backstrom, spokesman for the Scruggs law firm.

Van Pelt said it would help Providence patients but the larger national problem of caring for the poor still must be addressed.

"This is more than we can solve as a single hospital or a single hospital system," he said.

The complaint filed in Oregon alleges that Providence contradicted its stated mission of providing universal access to health care, especially the poor, by charging uninsured patients much higher rates for the same services than other patients.

One of them was Gerry Hugo of Medford, a retired construction worker who walked to his mailbox one day and found a bill for about $13,000 for a routine hernia operation at a Providence hospital in Medford.

Hugo, 64, became one of the lead plaintiffs in the case after he took out a home equity loan to pay the bill when a collection agency hired by the hospital threatened to place a lien on his property.

He said the class-action settlement levels the playing field for poor people struggling to cope with corporate health care providers.

"So many Americans have a feeling of impotence, that the decks are stacked against them, the dice are rigged," Hugo said. "You can't go up against big corporations as an individual."

He said that he and many other patients simply wanted to be treated fairly.

"I never missed paying a bill in my whole life," Hugo said. "I was raised that way, and so were most people. But the bill has got to be fair."

The settlement covers medical charges to uninsured patients over a six-year period, going back four years and the next two years.

All charges will be recalculated in two steps. The first reduction will reflect the average 30 percent discount granted insured patients, and the second reduction will be based on patient income.

As an example, Hugo will receive a $7,300 refund on his hospital bill, attorneys said.

The class-action lawsuit named another Oregon hospital, Legacy Health System, but that case still is pending.

While I'm sure that hospitals will hide behind something like, "we have to charge more bereceivee are less likely to recieve payment on such bills" and "we charge them more because we have to cover other costs (providing care for the uninsured, marketing, exorbinate executive salaries) which other insurance providers won't allow us to pass along to them," the truth is much more like "we charge them more simply because we can!"

This is yet another, and quite perfect example, with what is wrong with the way we deliver health care in this country. And who really suffers? The honest person who was raised to pay his bills.

But what about the promises of a free market? Certainly competition lowers the cost of delivering such care -- but it isn't. Certainly the patient can shop around for the least expCertainlyre -- yeah, right. Certianly corporations can't get away with doing this kind of thing -- get a clue.

And here is the kicker, notice who is taking the robber-barons to task? The lawyers! That's why corporations like this are eager to work to convince consumers that lawyers are actually the one's responsible for driving up the costs of health care. This is why many in Congress are eager to render such lawsuits unfilable. But the silly American voter doesn't get it -- "just lower my taxes" they whine while giving away the store.

Spend More, Get Less - The American Way

Excerpts from the Washington Post with bolding added to call attention to key points

For Americans, Getting Sick Has Its Price
Survey Says U.S. Patients Pay More, Get Less Than Those in Other Western Nations

By Rob Stein
Washington Post Staff Writer
Friday, November 4, 2005

Americans pay more when they get sick than people in other Western nations and get more confused, error-prone treatment, according to the largest survey to compare U.S. health care with other nations.

The survey of nearly 7,000 sick adults in the United States, Australia, Canada, New Zealand, Britain and Germany found Americans were the most likely to pay at least $1,000 in out-of-pocket expenses. More than half went without needed care because of cost and more than one-third endured mistakes and disorganized care when they did get treated.

Although patients in every nation sometimes run into obstacles to getting care and deficiencies when they do get treated, the United States stood out for having the highest error rates, most disorganized care and highest costs, the survey found.

"What's striking is that we are clearly a world leader in how much we spend on health care," said Cathy Schoen, senior vice president for the Commonwealth Fund, a private, nonpartisan, nonprofit foundation that commissioned the survey. "We should be expecting to be the best. Clearly, we should be doing better."

Other experts agreed, saying the results offer the most recent evidence that the quality of care in the United States is seriously eroding even as health care costs skyrocket.

[clip]

Americans were also much more likely to report forgoing needed treatment because of cost, with about half saying they had decided not to fill a prescription, to see a doctor when they were sick or opted against getting recommended follow-up tests. About 38 percent of patients in New Zealand reported going without care; the numbers were 34 percent in Australia, 28 percent in Germany, 26 percent in Canada and 13 percent in Britain.

[clip]

Americans also reported the greatest number of medical errors. Thirty-four percent reported getting the wrong medication or dose, incorrect test results, a mistake in their treatment or care, or being notified late about abnormal test results. Only 30 percent of Canadian patients, 27 percent of Australian patients, 25 percent of New Zealanders, 23 percent of Germans and 22 percent of Britons reported errors.

© 2005 The Washington Post Company
The full article is available here. Additionally, the text of the report the article draws upon is available from the journal Health Affairs.

It's really hard to read something like this and now wonder how on earth people can believe something like "America's the greatest country in the history of the planet." This report isn't even talking about how the poor are so often shut out of the health care system but instead about how the average, middle class American pays more and gets less for what they spend. And this is something to be proud about?

Unfortunately though, it seems that the system will continue to crumble a long time before the fat and lazy drop their greaseburgers and remotes from their chubby little fingers and put together some sort of communication for the wonderful legislators they continue to return to office and demand that something be done to give us our money's worth. Will it take their own children dying of simple diseases because they are no longer able to pay for the doctor's visit, diagnostic tests, or simple prescription?

Clearly the average, middle class American, while willing to complain about health care still has it too good. In other words, they need so little health care and while annoyed at the cost, they are able to fit it in with their other credit card payments. But the time will soon come when very few will have employer subsidized healthcare because they will either not be willing to pay the costs that are currently covered by their employers or they will simply be working in jobs that don't offer such luxuries. (Those jobs will have gone overseas by then.)

Will it really take the deaths of spouses and children before people wake up and get angry about what they have allowed to happen? Or will they still just be content to believe that it is someone else's fault? Blame it on unions, management, lawyers, insurance companies, drug manufacturers -- it really doesn't matter because the truth is Americans allowed it to happen.

Maybe the best thing that could happen to this generation is to make everyone pay the cost of his own way through the world. Maybe then they would understand how much is hidden. Maybe if they knew how much their employer was subsidizing the cost of their healthcare they would demand change. But we are a nation obsessed with the concept, the deception, of getting something for nothing. We want our healthcare, but only as long as we don't have to know that we are paying for it.

And so, we get exactly what we pay for...again and again. And is that what makes this such a great country?

On to Bush's Next Nominee

From Advocate.com

Alito advocated discrimination against HIV-positive Americans

Samuel Alito, nominated by President Bush Monday to succeed Sandra Day O'Connor on the U.S. Supreme Court, helped write a U.S. Justice Department opinion in 1986 that said employers should be able to legally fire HIV-positive employees because of their infection, The Washington Post reports. Alito was working in the U.S. Office of Legal Counsel when he helped write the opinion, which stated that "fear of contagion, whether reasonable or not," was reason enough for an employer to legally fire an HIV-positive worker. The opinion went on to state that discrimination based on insufficient medical knowledge was not prohibited by federal laws that protect the disabled.

"We certainly did not want to encourage irrational discrimination, but we had to interpret the law as it stands," Alito later said of the opinion, according to the Post.

The rest of the article is here.

Two things strike me. First, that this ruling was written only 5 years or so into the epidemic and it was almost 20 years ago. However, some people continue to hold on to and practice similar sorts of prejudices even today. Second, while the article reports what happened, upon thinking what it indicates about the future, it provides little upon which to judge the candidate's suitability for office.

While the right will say "see, they are using scare techniquesbesmircherch the reputation of yet another Bush appointee," the fact is give then inability to predict the future, what else do we have to go on besides past performance. (And isn't this what employers do when they make hiring decisions every day?)

If we trusted our President, maybe we would be more willing to trust his nominees. However, as each scandal erupts, it becomes clearer that the current administration will use any means at its disposal, even outright lies, to push its agenda down the throats of the nation and the world. One only has to wonder what this portends for the Court.

It's impossible to say if Alito will help Roberts and the other conservatives on the Court to roll back protections gained in the recent past. But given something as cold, callous, and calculating as a written declaration rationalizing irrational discrimination against someone because of fear and declaring that a legal actinstillstils little hope.

Last, interpretation is just that. Some act as if it is all magically written somewhere in very simple black and white so that everyone can understand it as one understands the story of "Jack and Jill." Over how mmillenniaenia have Christians and their Jewpredecessorssors have argued over the meaning, the interpretation, of the scriptures?

Are we prepared to let those who believe that the earth was actually created in only 6 days of 24 hours each and that the planet is really less than 5000 years old go to work on our laws as well? I don't mean to imply that Alito is or isn't a Biblical literalist, but the point is that everything is subject to interpretation and the beliefs one brings to the job will always affect those interpretations.

One must wonder if he would have reached the same decision if he had known, loved, and worked with people with HIV/AIDS or if he had been asked to rule on the firing of a cancer patient because of irrational fears.

Senate Republicans Spending Priorities

from Advocate.com

Senate rejects ADAP measure

The Senate on Wednesday voted 85-14 to defeat an amendment to a spending bill that would have shifted $60 million earmarked for renovations and building construction at the Centers for Disease Control and Prevention to the nation’s AIDS Drug Assistance Programs, Congressional Quarterly Today reports. The amendment, sponsored by Republican senator Tom Coburn of Oklahoma, was defeated after senators from Georgia, which is home to the CDC, fought against it. The CDC funds that would have been redirected to buy lifesaving medications for low-income HIV-positive Americans will instead be used for such projects as building a scenic spot for employees at the agency’s Atlanta grounds that includes a Japanese garden and stream. At least nine ADAPs around the country are facing such severe budget shortfalls that they’ve had to restrict admission to the programs and implement waiting lists. Several others have reduced the number of drugs they provide, tightened financial eligibility requirements, or implemented other cost-saving measures. (Advocate.com)

Can the Republicans be any clearer about their priorities? After all, it is much more important to have a pretty building than get poor people life-sustaining medications. Aren't these the same people who are always crying about how their rivals use taxpayer's money frivously? More importantly though we need to ask, "what are the opposition Democrats doing about this?"