Monday, June 21, 2010

Pain management politics

Earlier this year, the Institute of Medicine (IOM) published a report calling for a culture change in the US healthcare services. There are major problems in the treatment of pain and, without urgent steps to reform the current practice standards, it's likely more people with be left suffering unnecessary pain. This is a serious indictment of the US in failing to even begin matching the clinical standards in other countries. So what's gone wrong and why? There are two quite different contributions to the present collapse of care. The first starts in the medical schools. We should be able to assume each new generation of doctors is being taught all they need to know about pain and how to manage it effectively. Across the country, we are lucky enough to have 117 university courses teaching medicine. But only five of them have mandatory course on pain management.

More generally, less than twenty have elective courses. It does not take a math genius to understand there's a chronic failure here. For decades, each new cohort of students has been passing through the academic courses and practical training without any insistence future doctors learn anything about how to manage pain. This is a victory for the pharmaceutical industry. Through a variety of different means, it has convinced the medical profession all it needs to know about pain management is which pills to prescribe.

Now let's get these doctors out into the real world. All the most ambitious and best qualified go where they will make the most money. This means they specialize in the forms of treatment with the highest profit margins. So long as their billing numbers are high, they will do very well. Now ask yourselves how for-profit hospitals and clinics make the most money. The answer, of course, is to treat as many people as possible in the shortest period of time. There's no time to think. Everyone is treated the same and given standard treatment. Now comes the second problem. The insurance industry has been pressuring doctors to join networks in which they have to meet performance targets. This maximizes the profit for the insurers and even further reduces the face-to-face time available for individual patients. That's why, if you are lucky enough to see one of the doctors treating you, it will be a five minute appointment with an emphasis on either referring you for more tests or giving you a prescription.

The IOM is calling for reform of the insurance framework for funding treatment, allowing for more consultation time and greater flexibility in the range of treatments that can be included. As it stands, hospitals and clinics are discouraged from offering one-to-one therapy because this is an inefficient use of labor. So in other countries you would see a physical therapist or go for cognitive behavioral therapy. We are told this is too expensive to be included in the health plan. You can pay for it yourself, of course, or there's the always reliable Tramadol. We take more painkillers than any other country in the world. The answer is always a pill like Tramadol instead of actual treatment designed to reduce the pain. And our healthcare services will stay this way until the politics are resolved.

Monday, June 14, 2010

Why Politics, From Me?

I'm 58 years old! I am a Veteran of the U.S. Navy who worked in Top Secret communications! I am a Recovering drug Addict with over 13 years of clean time, after having used drugs for nearly 30 years! I have been incarcerated many times and am a convicted felon! I am a Certified Drug and Alcohol Abuse Counselor! Does this mean anything? Not in itself, but if I may, let me try to qualify! My primary presence on the Internet has been as the WebMaster of my Addiction Recovery site! I have had over a dozen articles pertaining to Addiction and Recovery from this disease, published on the Internet. I have had one article published regarding my Political views. I thought to myself, recently, why should anyone care what I think about politics? Well, just what does qualify someone to make public commentary? Surely, some of the commentators regularly on television don't seem to know anything special! So, I'll take a shot at making my case...

My family migrated from Missouri to California in 1958, when I was 9 years old.

This move in itself most certainly changed my future and that of my entire family. Missouri is a conservative area. California is liberal and trendy. They are two very different places in our Society. Thus, ingrained midwestern values and beliefs were the root of our family, and over a lifetime, we have melted into the West Coast lifestyle and have become Californians. Thus said, on to my life as it pertains to my political views...

A teenager of the 1960's, I'm sure that I am a typical baby-boomer in many ways. But, in many ways I'm not a typical or average citizen, at all! Only about 1% of the U.S. population succumbs to drug addiction. I am one of them! I am also a Veteran of the Armed Forces, also a small percentage of the population, since the WWII Vets are passing in great numbers. I am also a convicted felon. Would it surprise you to know that 1 out of 99 Americans is incarcerated over the course of a month? I don't know the stats on those who have ever been incarcerated. Currently 2,300,000 Americans are incarcerated. That said, let's move on to my individual case...

When I was 13, John Kennedy was assassinated. That event had a prominent effect on me as a person, as it did many Americans. The mystery of that incident brought politics into the lives of people who had previously basked in the luxury of the robust American lifestyle that followed WWII. Before that most citizens of the U.S. took it for granted that we had the best, most honest government possible. It has never been the same since. The Vietnam War added to the questionability of our undaunted faith in Government and it's many agencies. When President Richard Nixon was branded as an outright liar, a little more confidence slipped away. Average American belief systems were challenged by the Civil Rights movement, the Women's Rights movement, and concerted efforts on the part of our citizenry, as a united front, to force an end to the Vietnam War.

As I approached the age of 18, it was a safe assumption that I would be drafted into the military. Every boy who was not wealthy and able to find an exemption of the privileged, got drafted. That part has not changed. The poor still fight the wars for the rich. The poor still do the dieing for the Capitalists. Having had many friends die in Vietnam, I reached the conclusion that the only way to avoid being drafted into the Army Infantry was to enlist, which I did. On November 17, 1967 I took the Oath to defend my country in the U.S. Navy. I was just a kid. I had no idea how prolific an effect this would have on my life. The worst thing that happened as a result of serving was that my recreational experience with drugs would turn into an Addiction lasting nearly 30 years.

Politics came head on into my life as a Navy Radioman, working in Top Secret communications at the Commander-In-Chief of the Pacific Fleet Headquarters, Naval Communications Station, Message Center Makalapa, across the King Kamehameha Highway from Pearl Harbor, several stories underground. As a result of my security clearance, I became privy to all communications to the Pacific Fleet, including operational information between CINCPACFLT, the Pentagon, and the White House. I will not now and never have discussed any details of this information, as I took an oath not to. The only exception was in protected confidence with my Counselor in drug treatment at the VA Hospital program in Fresno, California. Even then, many details were omitted, and limited to a couple of sessions. The point being, that I found out many things that obliterated my trust in the Government. During this period, President Richard Nixon was forced out of office for basically deceiving the public and abusing his power, for political gain. I couldn't avoid politics even if I had wanted to.

I re-entered civilian life skeptical of government, spiritually bankrupt, and severely addicted to drugs. My dependency started in Navy schools, with Benzedrine, an amphetamine. I eventually used drugs as psychological self-medication, also. Once addicted you use drugs for any and every reason you can think of, avoiding confronting the problems that they actually mask. The first year I was out, I didn't work. I grew my hair out, and lived outside the norm, not desiring to be a part of anything, especially Society. I did get involved in the fight to stop the War in Vietnam, helping people beat the draft, and participating in demonstrations. In my mind, the government was responsible for everything that was wrong with the World and me. Though my thinking was very distorted, I became extremely politically aware, keeping up with the daily news, and being able to factually defend my positions as an anti-social personality developed in me. Marriages failed as a result of my Addiction. I lost and quit jobs as a result of my drug use and abuse. I went back and forth from a functional addict to a dysfunctional addict. I was in and out of jail. I became a pipeline welder with my own tools for the independence and high demand that made changing jobs easy.

This lasted until drug testing became a regular part of the job market. I had chosen selling drugs as my profession, which made using that much easier. But, in the end the law caught up with me. After many incarcerations and many ups and downs, I just could not stay out of jail. My arrest on January 21, 1995, and a radical spiritual experience while facing a prison sentence, allowed me to acknowledge that I had hit my bottom. I had lost the will to live and broke down mentally during my detoxification from Meth, in jail. I resorted to prayer and my prayer was answered. I used drugs for the last time at the beginning of that jail term. I took my last drink on March 24, 1995. As a result of a plea bargain, my prison sentence was suspended on the terms that I serve one year in jail and one year in a drug treatment program. I would actually only serve four months in jail and remained in the program for six months. I entered the VA Hospital, Fresno, California, Chemical Dependency Treatment Program on April 11, 1995. As it turned out the very government that I had blamed for my problems for nearly 30 years, became my saving grace. I had to seriously re-assess my political views after that. At 50 I began my quest for Certification as a drug counselor at a State University.

Little did I realize how politically dependent the profession I had chosen, was. After 7 years of Counseling I had a serious health crisis that took me off of work for 8 months. During this period of time the failing economy under the Republican administration, resulted in a major cancellation of Grants. Drug treatment depends hugely on Grants as treatment is a financial impossibility for most Addicts. Having lost my job and my health insurance, I found myself approaching 60, in a scant job market, competing with people half my age. I am now living on unemployment insurance compensation, with no real prospect for a job. Politics are again very crucial to my life. Republicans fund wars and big business. Democrats fund social programs and middle America. I fear it will take a robust economy and major funding for drug treatment before the market become great enough for the job competition in my field to accommodate my demographic. Meanwhile, I contribute meekly to the Democratic Party and depend on my Spirituality to get through, one day at a time. I sponsor a needy child through Children International, and have several family members, also in financial distress, living with me. I have developed a totally non-profit Addiction Recovery website, and use it to keep me sane and as my way of still being able to help other Addicts. I feel that my experiences with the military, the criminal justice system, and my Recovery from drug Addiction, have shaped a well-informed, highly aware political position and very well developed political opinions. Of course the key word is "opinion"! I feel very qualified to comment...

You be the judge! I will quote this article as a reference in all future political articles that I submit.

Thank you,

Sunday, June 6, 2010

Political Satire in Sculpture

Dick Cheney has taken a variety of shots at the Obama administration over the last two weeks. He seems to have concerns regarding the current administration's ability to protect the United States from a terrorist attack. The former vice-president has made his opinion clear that he feels the previous administration was able to protect the American people better than President Obama's team. This constant criticism has political satirists fired up. Cheney is depicted in many political cartoons throughout the country; he is the focus of a variety of comedians, and editors have happily made him their focus of writing. We can expect more from the political funny people in future because Mr. Cheney has made it clear he will continue to give his opinion.

Perhaps a future artist will make a sculpture of the former vice-president as a large dominant figure controlling a small President George W.

Bush puppet. This would take a lot of talent and careful use of many different gloss glazes. The two different figures would require a careful hand to create, and to properly show the separations of the two characters a variety of color patterns would be necessary.

The creation of two sculptures to properly point out a political point of view is not an easy task. Our neighbors to the south in Mexico have had plenty of corrupt, or just bad, politicians in the past. Even though this is true, we do not see a lot of mexican clay pottery being used by Mexican political satirists. The amount of work, time, and talent necessary to make humorous sculptures of real people is enormous, and politicians do not seem to be in office long enough to make the effort.

The artist looking to make a political statement may be able to save some time and effort by incorporating the use of a type of mold. Drape molds could easily help an artist make statement pieces within a sculpture. These "accessory" pieces could help the artist make a statement about a political figure quickly and easily. Thus, the actual sculpture of the politician would not be as important.