Tag: California

California/General interest/Health/Lifestyle/Money/Politics & Causes/USA
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Anthem Blue Cross 'doing the right thing'?

by Fran Johns

In testimony before the California Assembly Health Committee yesterday, Anthem Blue Cross President Leslie Margolin said of her company, “I think we do the right thing, and we try to do the right thing every day.”

What that means is, turn a profit for the company every day. If you are in business to make money, that is the right thing to do.

On the other hand, when Margolin says the company’s goal is to provide “care, comfort and coverage to those in need,” that is simply not true. Physicians and health care professionals provide care and comfort. Anthem provides coverage which sometimes pays for these things and often does not, if they can help it.

Is there no way to connect those dots? Care and comfort for those who need and deserve it — i.e., every human being — are not going to happen until we get the coverage people out of the equation.

OK, not going to happen any time soon. It could happen in California, except for Governor Schwarzenegger‘s probable veto. It should happen in Washington, except for the money and muscle of the coverage people. In lieu of those realities, a health bill that takes a tiny step in the right direction would be welcome.

California/General interest/Health/Politics & Causes/seniors/USA
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Health care reform solution: eliminate insurance

by Fran Johns

“Insurance? My whole point is I want to kill it.”

Gil Ahrens knows health insurance. One terrible accident. Years of life turned upside down. Denials of payment. Claims argued. Liens placed on property. Throughout a long and arduous struggle to get life back on track, obstacles created by insurance issues stood in the way of what should have been everyone’s focus: care. It is a story familiar, in one variation or another, to millions of Americans.

Author of the recently released Shattered, Shaken and Stirred, Ahrens began his eye-opening journey through the catacombs of our health insurance system almost simultaneously with a devastating automobile accident. He escaped with a badly mangled foot and other injuries, his wife was left paralyzed. Their three-week-old daughter survived intact — but that was about the only good news the Ahrens family would have for a very long time. For the successful California businessman/entrepreneur and his family, life was forever changed; the book tells the years-long challenge of that change.

In recent appearances and radio talks, Ahrens has spoken out against what he describes as a health system “in shambles. In its current state, health care is a bigger threat than terrorism. And needless to say, we are paying through the nose.”

Shattered, Shaken and Stirred, written in the form of a letter to his now-school-age daughter, is part description of unbearable tragedy and misfortune, and part how-to guide for rebuilding one’s spirit. But underlying it all is an unvarnished message to America from one person who has been entrapped in the system: insurance is the #1 evil of American health care.

Elsewhere around the globe are examples of how to do health care right. The world’s top ten livable cities, Ahrens points out, share one characteristic: their citizens have health care. Not health insurance, health care.

“Americans do not want coverage,” Ahrens says; “they want care.”

Does that not make sense?

California/Lifestyle/seniors/teens/USA
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Roadkill: geezers, texters at the wheel

by Fran Johns

His father-in-law, aged 91, got a new 5-year driver’s license from the State of California, with zero proof of intact driving skills. The family was worried, but without much power. According to an op ed piece by Santa Cruz, CA writer John Moir, the community was saved from potential disaster at the hands of an age-challenged driver only when a mild heart attack prompted his physician to order him away from the wheel.

Meanwhile, a nationwide population of licensed drivers young enough to be his great-great-grandchildren are navigating our roadways with one eye on the intersection and full attention on a text message in progress. Another op ed piece not long ago, this one by the Atlanta Journal-Constitution‘s Cynthia Tucker, told of accidents caused by phoning/texting drivers that are estimated at close to a quarter of a million per year. There is a growing movement to address this truly scary problem. And it is scary: if you walk in cities much you know how often only your own wits (Can’t make eye contact? Don’t trust that driver) keep you alive. In Nebraska, for example, activist teens, largely motivated by the horrific BBC YouTube video now gone viral, are pushing for a state ban on phoning/texting while driving. A national organization, FocusDriven, was started by a group of individuals who had lost loved ones to drivers on phones; they offer support for victims and tips for advocacy. FocusDriven is patterned after MADD (Mother’s Against Drunk Driving.)

But the issue of geezer drivers gets sticky. My own father was fond of pointing out, well into his 80s, that he had never had an accident. We bit our tongues not to comment on the disasters that probably followed in his wake. But the Commonwealth of Virginia continued to renew his license and none of his four out-of-state daughters was able to convince him that his driving was not in others’ best interest. It took a family friend, who pointed out how much money could be saved on gas, upkeep and insurance coverage, to get my father to sell his car.

The primary problem with aging drivers is the ease with which they are (in California, at least) re-issued a five-year license. Not long ago, at the ripe age of 75, I renewed my own. My eyes tested just fine — although prescription distance glasses make me way safer behind the wheel, especially at night. I studied for the written test (same test as anyone gets at any age) because it is full of trick questions, often concerning factoids that have little to do with public safety.  Presumably, if one is not mentally acute one would fail the written test — but you can retake it the next day. There was no road test of any sort, so if I were becoming prone to miss road signs, clip corners or misjudge parallel parking distances nobody would know. (I hope I’m not.)

Mandatory age limits for driving, such as commercial pilots have, probably aren’t going to happen, and probably shouldn’t. Many seniors must drive their own cars for endless reasons. Time and manpower required for road tests may put them beyond what states can afford these days. But why aren’t other answers possible?

Why couldn’t AARP put its considerable muscle and money behind a volunteer training program that would set in motion volunteer-led senior driving sessions? Why couldn’t states then require completion of such sessions before licenses were renewed after a certain age? Why couldn’t some insurance agency — AAA comes to mind — get behind a state-mandated program of this sort, offering the lower rates for graduates that are commonly offered graduates of safe-driving programs? Why couldn’t safe-driving seniors be offered a small compensation for running such programs, in return for the savings in lives and ER costs?

My license expires on my 81st birthday. I’ll happily sign up for a seniors class. Meanwhile I will remain on the alert for texting juniors.

California/Health/Lifestyle/Medicine/Politics & Causes
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Is marijuana a medicine?

by Fran Johns

Of course it is, to answer this rhetorical question posed by a January 18 headline in the Wall Street Journal. New Jersey is the most recent to recognize that fact, becoming the 14th state to legalize use of marijuana for medicinal purposes. The New Jersey law, signed this week by outgoing Governor Jon Corzine, limits use to patients with specific illnesses such as cancer, HIV/AIDS, multiple sclerosis and ALS (Lou Gehrig’s disease) and specifically forbids grow-it-yourself projects.

What’s needed now are serious studies of how good a medicine it really is, and these aren’t happening very fast. As outlined in a New York Times article this week, getting permission to study the weed is no easy task.

Despite the Obama administration’s tacit support of more liberal state medical marijuana laws, the federal government still discourages research into the medicinal uses of smoked marijuana. That may be one reason that — even though some patients swear by it — there is no good scientific evidence that legalizing marijuana’s use provides any benefits over current therapies.

Lyle E. Craker, a professor of plant sciences at the University of Massachusetts, has been trying to get permission from federal authorities for nearly nine years to grow a supply of the plant that he could study and provide to researchers for clinical trials.

But the Drug Enforcement Administration — more concerned about abuse than potential benefits — has refused, even after the agency’s own administrative law judge ruled in 2007 that Dr. Craker’s application should be approved, and even after Attorney General Eric H. Holder Jr. in March ended the Bush administration’s policy of raiding dispensers of medical marijuana that comply with state laws.

“All I want to be able to do is grow it so that it can be tested,” Dr. Craker said in comments echoed by other researchers.

Marijuana is the only major drug for which the federal government controls the only legal research supply and for which the government requires a special scientific review.

“The more it becomes clear to people that the federal government is blocking these studies, the more people are willing to defect by using politics instead of science to legalize medicinal uses at the state level,” said Rick Doblin, executive director of a nonprofit group dedicated to researching psychedelics for medical uses.

In California, where a mish-mash of laws and enforcement policies can bewilder all but the expert — (and there are many experts) — the Supreme Court ruled yesterday that lawmakers acted improperly in amending the voter-approved legalization of medicinal marijuana to limit the amount critically ill patients might have:

The high court ruled lawmakers improperly “amended” the voter-approved law that decriminalized possession of marijuana for “seriously ill Californians” with a doctor’s prescription by limiting patients to eight ounces (227 grams) of dried marijuana and six mature or 12 immature plants.

The Compassionate Use Act, passed by California voters in 1996, set no limits on how much marijuana patients could possess or grow, stating only that it be for personal use.

In 1997, the state’s Supreme Court defined a lawful amount as enough to be “reasonably related to the patient’s current medical needs.”

The state’s quantity limits were passed in 2003 as part of a voluntary identification card program designed to protect against both drug trafficking and wrongful arrest by allowing police to quickly verify a patient’s prescription.

The court on Thursday let stand the voluntary card program but found that the limits it imposes should not “burden” a person’s ability to argue under the Compassionate Use Act that the marijuana possessed or grown was for personal use.

California Attorney General Jerry Brown said in a statement the decision “confirms our position that the state’s possession limits are legal” as applied to medical marijuana cardholders.

While conceding that marijuana may have some just-for-fun attraction too, I can’t vouch for the recreational weed. Thankfully, since I am addicted to anything that comes down the pike and question the view that marijuana is non-addictive,  it hadn’t made its way to small-town Virginia when I was experimenting with other mood-altering substances. But I do know its medicinal value. My beloved now-deceased sister could have had much suffering relieved with legal pot. Countless friends I loved and worked with during the height of the AIDS pandemic would have suffered less with legal, easily-accessible marijuana.

We are past time to establish, through definitive studies, the medicinal benefits of this natural bounty, and make it legally available to those in desperate need.

California/General interest/Lifestyle/USA
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The face of homelessness

by Fran Johns

My friend Kevin told me this afternoon that he will be going to Bakersfield to stay. St. Vincent de Paul, he says, bought him a bus ticket for Sunday. I will be seriously sad to see him go.

Kevin lives somewhere, he’s never explained and I don’t press, in the rich-man/poor-man city of San Francisco. Wherever he spends his nights, he spends his days, mostly, on a bench in Mountain Lake Park near my home, watching the seagulls and ducks on the water, the pigeons on the grass, children on the swings. The par course which functions as my personal gym loops around the park, leading me past Kevin’s bench just after the hop-kicks and before the newly replaced (thanks, Park & Rec!) push-up bars. Kevin finds my exercises highly amusing.

Kevin has skin like polished coal, a bushy Afro usually tucked under a leather cap that would work well in Moscow, and a grin that displays a wide row of crooked, gap-filled bottom teeth. He has few. if any, top teeth. His wardrobe, which also includes an outsized leather jacket and very heavy boots, seldom changes, nor does his mood, which is sunny with occasional fog.

Many months ago I introduced myself, mid-workout. Kevin has never asked for a handout, but I took to offering him a dollar for a cup of coffee and it’s never been refused. Once recently, while he was dozing in the sunshine by the playground, I stuck a folded dollar bill into the same pocket occupied by his large, square hand, hoping it wouldn’t fall out and disappear. The next day he confirmed, with a huge guffaw, that it had been found. “And I knowed it was you come around!!” he said, pleasing me immensely.

Sometimes, when the weather has been cold and rainy or the fog too oppressive I do not see Kevin for a while. “I been going to the liberry,” he tells me later, a testament probably more to the warmth of the nearby building and its inhabitants than to our educational system — but with Kevin you never know.

When I am not constrained by time and the cares of the world I join Kevin on his bench. We talk about the water birds, the golfers far across the small lake, or the construction going on farther across and to the west, where the Presidio Trust is spending your tax money to convert the old Veteran’s Administration Hospital into apartments which will have drop dead gorgeous views. Kevin, on my recommendation, once walked up there to see what it is like. That was about the time when, on a beautiful, balmy San Francisco day I remarked to him that I thought I was the luckiest person in the world. He said, “I be lucky too.” That is a comment to take to the bank.

Because he is of indeterminate age and mental agility, I would worry about Kevin going off to the far country of Bakersfield. But he says he has family there, is looking forward to the bus ride and thinks it will be swell. I just hope they have a park with birds and children to entertain him, and perhaps an occasional jogger to join him on the bench.

Still, I will feel his absence. Never once has Kevin failed to say, as I pass on to the push-up bars, “Have a guht one!” Coming from behind an unfathomable grin, from a man presumably alone on the mean streets of urban America, who considers himself lucky, that is a blessing one doesn’t always get in the middle of a fitness course. And a blessing one can always use.

General interest/Politics & Causes
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Moving Mom & Dad — into a Village

by Fran Johns

What about moms and dads who really don’t want to move?

The problem of where to go and what to do about housing in the sometimes not-so-golden years has an assortment of solutions for those who prefer (and can afford) the retirement community or any of the multitude of assisted living communities around. But for those who are bound and determined to stay put in the old house or the long-familiar apartment? A collection of obstacles begins to accumulate.

Enter the village.

Swiftly catching on around the country, aging-in-place “villages” are designed to help  members overcome those obstacles by providing a variety of programs and services – while the members stay put. The prototype was Boston’s Beacon Hill Village, founded in 2001, which offers “groceries to Tai Chi to cultural and social activities to home care.” Others have popped up in states ranging from Colorado to New York, Florida to Nebraska, Massachussetts to Hawaii.

San Francisco Village was the second, after Avenidas in Palo Alto, to get off the drawing boards and into action in California. Although each Village differs from others, SFV illustrates many of the attractions that are drawing in the stay-put crowd. The organization began with some local grants and individual donations, and is sustained now by annual membership fees.

Sarah Goldman agreed, after a good bit of arm-twisting, to be a poster girl for SFV in upcoming stories for the neighborhood’s New Fillmore newspaper. Sarah was among the first to join the organization, and in many ways typifies the village member-enthusiast: fit, active and fiercely independent at 80, she plans to stay that way as long as humanly possible. Her first move, as a Village member, was in support of someone older still and desperately in need of help: her landlady. Goldman could see that the landlady, who also lived alone, was becoming forgetful and increasingly unkempt – the distress signals that often propel seniors into care facilities. So she began by talking the landlady into joining also. This paved the way for calling in, with the landlady’s approval, a wide-ranging group of service providers: house cleaners, organizers, financial assistance people, personal care helpers. All had been vetted by SFV. Their help has now enabled both landlady and tenant to keep right on aging in place.

Goldman also quickly started a program patterned after one she had organized when working with an assisted living community. SFV’s play-reading group was an immediate hit among those seeking socialization and intellectual stimulation. Three necessities of life — social, physical and mental fitness — added to issues such as those dealt with by the landlady, add up to the heart of the Village. Members hope that by accessing things like this while staying on familiar turf their golden years may indeed stay shiny.

This one hopes that SFV membership will help keep the contributions of this space emanating from this laptop on this Sacramento Street kitchen counter for a very long time to come.

California/General interest/Lifestyle/Politics & Causes/seniors/USA
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God, Thanksgiving & Mother Theresa

by Fran Johns

Former San Francisco Mayor Art Agnos spoke briefly, and with holiday hilarity, this morning to several hundred Christians, Muslims, Jews, Buddhists and assorted other believers at the annual San Francisco Interfaith Thanksgiving Breakfast — “the biggest crowd I ever addressed at seven in the morning.” The event highlighted some of the work the SFIC does in the city: an annual winter shelter for homeless men, a citywide disaster preparedness program, a variety of ongoing efforts to promote understanding, cooperation and general interfaith goodwill. Agnos told a tale of encountering Mother Theresa which is condensed and paraphrased below as a Thanksgiving present from this space.

Coming home one Sunday night during his tenure, the mayor got a message (this was in the late 1980s, pre-cellphones) from his wife saying Mother Theresa was at their door. (“What should I do?” “Let her in.”)  When he walked into the living room, sure enough, there was the diminutive nun in her blue and white habit, seated on the Agnos’ sofa with another nun on each side. She wanted the mayor, she explained, to secure a particular piece of property for her good works. It was after 9 PM.

“I’ll get right on it, first thing in the morning,” Mayor Agnos said.

“No,” said the tiny nun in her quiet voice. “God’s work does not wait until morning.”

The property in question was in an area of town into which few ventured after dark. When that factor was mentioned as cause for caution, however, Mother Theresa would have none of it. “God,” she said in her still-quiet voice, “will protect us.”

So the mayor, the three nuns, the mayor’s wife (who wasn’t about to miss this experience) and a police bodyguard Mayor Agnos invited along just in case God wasn’t paying attention, climbed into a police car and drove to the building in question. Working their way through a fence which had long before been erected around the property, they walked around the back to find a small group of homeless men gathered around a fire. It was not only getting later all the time, it was mid-winter.

“Oh,” the men said in unison, “it’s Mother Theresa.” She blessed them. Then the mayor asked if the building did indeed belong to the city. “Well, yes,” they said, “but we’ve been living here for several years and nobody’s bothered us.” So the mayor assured the nun that he would get to work on her request first thing in the morning.

She was not finished. Next, she wanted to see about another piece of property, this one necessitating a trip to San Francisco General, the City/County hospital of last resort for citizens in need. By now it was getting on towards midnight.

At that hour at San Francisco General, Mayor Agnos explained, most of the people on site are the cleaning crews and base-level helpers — all of whom immediately recognized Mother Theresa. “When we got ready to leave,” said Agnos, “it was like a football huddle. Everybody in the area gathered around this tiny nun you couldn’t even see in the middle of the crowd.”

“When you die and go to heaven,” said Mother Theresa to her fellow laborers, “you will meet God. And God will bless you for your good work.”

“So,” concluded the Mayor as he opened his arms to indicate those around the room, “when you die and go to heaven, you will meet God. And he or she, whomever, will bless you for your good work.”

Makes you thankful to be in the presence of so many people doing good work.

California/General interest/Health/Lifestyle/Money/Politics & Causes/USA
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The aches & pains of medical marijuana

by Fran Johns

An article in Sunday’s New York Times details the struggle in Los Angeles to regulate the cannabis dispensaries which have proliferated around the  city over the past six or eight years, raising the old medical marijuana questions about how to control, whether to tax and how useful it is in the first place. Reporter Solomon Moore cites Oakland, California’s Harborside Health Center as the place to which many are looking for a model.

‘Our No. 1 task is to show that we are worthy of the public’s trust in asking to distribute medical cannabis in a safe and secure manner,’ said Steve DeAngelo, the pig-tailed proprietor of Harborside, which has been in business for three years.

Harborside is one of four licensed dispensaries in Oakland run as nonprofit organizations. It is the largest, with 74 employees and revenues of about $20 million. Last summer, the Oakland City Council passed an ordinance to collect taxes from the sale of marijuana, a measure that Mr. DeAngelo supported.

Mr. DeAngelo designed Harborside to exude legitimacy, security and comfort. Visitors to the low-slung building are greeted by security guards who check the required physicians’ recommendations. Inside, the dispensary looks like a bank, except that the floor is covered with hemp carpeting and the eight tellers stand behind identical displays of marijuana and hashish.

There is a laboratory where technicians determine the potency of the marijuana and label it accordingly. (Harborside says it rejects 80 percent of the marijuana that arrives at its door for insufficient quality.) There is even a bank vault where the day’s cash is stored along with reserves of premium cannabis. An armored truck picks up deposits every evening.

City officials routinely audit the dispensary’s books. Surplus cash is rolled back into the center to pay for free counseling sessions and yoga for patients. “Oakland issued licenses and regulations, and Los Angeles did nothing and they are still unregulated,” Mr. DeAngelo said. “Cannabis is being distributed by inappropriate people.”

I don’t know where Los Angeles will go with all this, or how well Harborside will continue to operate for how long. What I do know is that marijuana serves a real medical purpose. Probably serves a real recreational purpose too, and there’s the rub; but since I missed the pot party — thank heavens, as I am addicted to anything that comes down the pike, and please don’t try to tell me one cannot get addicted to marijuana — I can’t address that issue. Everything I know is anecdotal, but convincing.

Decades ago my beloved sister was suffering acute gastro intestinal distress, much later identified as a symptom of celiac disease but this was before anybody really knew anything about celiac sprue. One day she said, “You know, everybody at X High School either smokes pot or knows where to get it. Could you get me some so I could at least try it?” Well, even though the statute of limitations would probably protect the surviving players I think I won’t go into details of this adventure. But what I learned was: buying and selling illegal pot is a little scary for the novice, but the deal was easy and nobody went to jail. It did indeed give relief to my suffering sister. Though both of us wished she could have that relief on an ongoing basis, we reached a mutual conclusion that the risk was not worth the reward, and that was the end of that.

Fast forward to the 1990s, when everyone I knew with AIDS knew how marijuana could relieve some symptoms of the disease, and most had a supply. I was in San Francisco by then, and celiac disease pales in comparison to AIDS. I don’t even recall how legal it was for this relief; too many other issues were more important. But again, I saw its usefulness.

The Times article quotes Christine Gasparac, a spokeswoman for California Attorney General Jerry Brown, as saying his office is getting calls from law officials and advocates around the state asking for clarity on medical marijuana laws. I know that’s tough, and that the answer will in many cases be left to the courts. I also know that legalizing marijuana, whether here in woo-hoo California or elsewhere, raises a multiplicity of sticky issues.

But still. It’s a useful drug. If Big Pharma were producing and marketing it, it would probably come in a little pill that costs a fortune and would be covered by expensive insurance policies. Every governmental body in the U.S. needs money. Taxes raise money. Are there not some dots that could be connected here?

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