Tag: new york times

California/General interest/Health/Lifestyle/Politics & Causes/seniors/USA/Women
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Gay Rights, Abortion Lose – – Meanness Wins. Is this the 50s?

by Fran Johns

The New York State Senate‘s rejection of a bill that would have allowed marriage between two people who love each other — but happen to be gay — is just the most recent in a string of set-backs in the area of gay rights. Other set-backs have been occurring, or are currently looming, in women’s rights, specifically reproductive rights. One wonders about the mood of this country.

This particular one wonders if anyone else is harking back, with more than a little sadness, to the 1950s. If you weren’t around then, I can tell you it was a strange decade. Great optimism for the future — well, there’s not much of that today — while simultaneously there was terrible meanness behind the McCarthy witch hunts and the denial of women’s rights, plus a certain amount of smugness embedded into a bland, national complacency.

At ladies’ bridge parties there were small china ashtrays on each corner of the table and the conversation usually drifted toward those lovely wonder drugs emerging to give instant relief for any problem. The conversation never drifted toward back-alley abortions, unless someone had recently died and the others knew how it had happened. Those of us who had jobs — running a house, entertaining for the husband’s business, raising children; those were not considered jobs — usually had male counterparts doing the exact same thing for twice the salary. One did not complain. If one were middle class white, and involved in any sort of civil rights work, one never brought that up at the bridge table.  It was a strange decade.

Today’s New York Times story quotes senators who voted against the same-sex marriage bill as saying “the public is gripped by economic anxiety and remain(s) uneasy about changing the state’s definition of marriage.” The San Francisco Chronicle article includes a comment from sponsoring Senator Thomas Duane, “I wasn’t expecting betrayal.” I’m sure those are both accurate reports. Whatever its underlying economic, political or social fears, the public seems also to harbor a degree of meanness in discounting the rights of others.

If you substitute a measure of cynicism or hopelessness about the future for the complacency of a half-century ago, and throw in the self-righteousness of those who for religious or political reasons justify the denial of rights to their fellow citizens, it’s easy to draw parallels between this decade and that one long ago.

In the fifties the groundwork was being laid for civil rights, for women’s liberation, for Roe v Wade and the upheavals that eventually led to progress, by courageous and energetic people of all sorts. I wish I could list myself in that number; I was at the bridge table trying to pretend normalcy in a life gone amok.  Today there are others working just as hard for the rights of their fellow men and women.

I hope they can keep the faith.

General interest
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Health Bill Should not Pit Women against Seniors

by Fran Johns

The health care issue is, one would think, too important for partisan games pitting one group against another. Especially when huge portions of each group are one and the same. But as Robert Pear and David M. Herszenhorn report in today’s New York Times, that seems to be happening.

In a day of desultory debate on sweeping health care legislation, senators appealed to two potent political constituencies on Tuesday, with Democrats seeking additional medical benefits for women and Republicans vowing to preserve and protect Medicare for older Americans.

The Democrats’ first amendment, offered by Senator Barbara A. Mikulski of Maryland, would require insurers to cover more screenings and preventive care for women, with no co-payments.

‘Women often forgo those critical preventive screenings because they simply cannot afford it, or their insurance company won’t pay for it unless it is mandated by state law,’ Ms. Mikulski said.

I met with my oncologist two days ago and decided to have a mammogram. It’s been two years since the last one. She and I agree that, having had breast cancer in 2006 and breezed through a mastectomy, and being fit and healthy overall, my particular situation suggests the potential benefits — catch another cancer early, gain another good decade or so of life — outweigh the risks.  This is what the whole thing is about: every woman is different, every woman should be allowed to decide, with her doctor, on screening and preventive care. The Mikulski amendment will insure that can happen, whatever one’s age and circumstances.

The first Republican proposal, offered by Senator John McCain of Arizona, would strip the bill of more than $450 billion of proposed savings in Medicare. The savings would curb the growth of Medicare payments to hospitals, nursing homes, health maintenance organizations and other providers of care.

‘The cuts are not attainable,’ Mr. McCain said. ‘And if they were, it would mean a direct curtailment and reduction in the benefits we have promised to senior citizens.’

Senators said that debate on the bill, which embodies President Obama’s top domestic priority, would last for several weeks and perhaps continue into January. A vote on Ms. Mikulski’s amendment has not been scheduled but could come Wednesday.

The health care bill would require most Americans to carry insurance. It would subsidize coverage for people with moderate incomes, expand Medicaid and create a government insurance plan, which would compete with private insurers. The House passed a similar bill last month.

Ms. Mikulski’s proposal was prompted, in part, by the recent furor over new recommendations from a federal task force that breast cancer screenings begin later for many women.

The Senate majority leader, Harry Reid, Democrat of Nevada, hailed Ms. Mikulski’s proposal, saying: ‘The decision whether or when to get a mammogram should be left up to the patient and the doctor. That decision should not be made by some bureaucrat, a member of Congress or someone they’ve never met.’

As health costs and insurance premiums rise, Mr. Reid said, ‘more women are skipping screenings for cervical and breast cancer, and doctor visits that can catch problems like postpartum depression and domestic violence.’

Votes on the Mikulski amendment will show whether Republicans “truly want to improve this bill or just want to play games, stall,” Mr. Reid said.

Ms. Mikulski said her proposal would ‘shrink or eliminate the high cost of co-payments and deductibles’ for women who receive screenings for cancer, heart disease, diabetes and other conditions.

Senator Kay Bailey Hutchison, Republican of Texas, criticized the proposal, saying it would ‘allow yet another government agency to interfere in the relationship between a woman and her doctor.’

No, Senator Hutchison, the government isn’t interfering in my relationship with my doctor, nor will it do so by insuring other women’s choices and coverage.

Republicans argued that the bill would be paid for on the backs of older Americans.

‘We are receiving incredible and overwhelming response from seniors all over America,’ Mr. McCain said. ‘They paid all their working lives into the Medicare trust fund, and now they’re in danger of having $483 billion cut out of it.’

Mr. McCain’s proposal would effectively cripple the bill, because Democrats are relying on savings in Medicare to help offset the cost of providing coverage to more than 30 million people who are now uninsured.

This senior would like to add a word to that “overwhelming response” Mr. McCain reports. I paid all my working life into Medicare (which, by the way, was not exactly a gift to America from the Republican party) and I want a decent health bill more than I want every penny of my Medicare coverage protected.

A lot of us have come to terms with the fact that the health bill we may get is a long way from the health bill we so fervently wanted. We are still hoping that something survives the attempts to sink it at any cost.

Senators Pitch to Women and Elderly on Health Bill – NYTimes.com.

General interest/Health/seniors/USA/Women
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New Cancer Guidelines: One Good Message

by Fran Johns

News about changing guidelines for cervical and breast cancer screening have some women cheering, a lot of women fuming, and most women feeling confused. Or betrayed, or mistreated or worse.

There is one universal message in it all: every woman has to be her own advocate.

For most of us, that is no big deal. We’ve known for a long time that no two of us (and surely no four collections of breast tissue or no two histories of sexual activity) are alike, and most of us have gotten used to asking a lot of questions. It’s unfortunate that so many changes have been announced at almost the same time, and especially that the issue has become politicized.

New York Times health writer Denise Grady summed up the latest developments, and the issues that have caused confusion and anger in a November 20 article:

New guidelines for cervical cancer screening say women should delay their first Pap test until age 21, and be screened less often than recommended in the past.

The advice, from the American College of Obstetricians and Gynecologists, is meant to decrease unnecessary testing and potentially harmful treatment, particularly in teenagers and young women. The group’s previous guidelines had recommended yearly testing for young women, starting within three years of their first sexual intercourse, but no later than age 21.

Arriving on the heels of hotly disputed guidelines calling for less use of mammography, the new recommendations might seem like part of a larger plan to slash cancer screening for women. But the timing was coincidental, said Dr. Cheryl B. Iglesia, the chairwoman of a panel in the obstetricians’ group that developed the Pap smear guidelines. The group updates its advice regularly based on new medical information, and Dr. Iglesia said the latest recommendations had been in the works for several years, “long before the Obama health plan came into existence.”

She called the timing crazy, uncanny and “an unfortunate perfect storm,” adding, “There’s no political agenda with regard to these recommendations.”

Dr. Iglesia said the argument for changing Pap screening was more compelling than that for cutting back on mammography — which the obstetricians’ group has staunchly opposed — because there is more potential for harm from the overuse of Pap tests. The reason is that young women are especially prone to develop abnormalities in the cervix that appear to be precancerous, but that will go away if left alone. But when Pap tests find the growths, doctors often remove them, with procedures that can injure the cervix and lead to problems later when a woman becomes pregnant, including premature birth and an increased risk of needing a Caesarean.

Still, the new recommendations for Pap tests are likely to feed a political debate in Washington over health care overhaul proposals. The mammogram advice led some Republicans to predict that such recommendations would lead to rationing.

It boils down to this: every woman will need to pay close attention to her own health care. That is bad news for the less educated, the less aggressive, and those with less access to care, and not particularly good news for many older women who grew up with “The doctor knows best” excuse for not paying attention.But it’s good news for those of us, particularly older women, who have questioned what sometimes seemed too-frequent testing and screening.

Asking questions just got more respectable.

Guidelines Push Back Age for Cervical Cancer Tests – NYTimes.com.

General interest/Health/Money/seniors/USA
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Facing Up to Dental Terrors

by Fran Johns

The only thing worse than toothache/jaw pain, to be cruelly specific, is toothache/jaw pain without insurance. Most of us are without such insurance. It has not even been on the radar of health reform advocates, which is just as well — if you add dental terrorism to abortion and public options we won’t see reform for another few decades.

Nevertheless, tooth reform, euphemistically referred to as full mouth restoration in some circles, is ahead for increasing numbers of Americans sooner or later. It comes down roughly to a choice between fixing the mouth or buying a yacht, but if your jaw aches, you forgo the yacht.

New York Times health writer Jane Brody traced the new path of dental repair journeys in a thoughtful article yesterday, explaining her own costly route from tooth decay to bridges to implants, and throwing out an estimate of approximately $3,500 to $4,000 per tooth for the now-preferred latter. Multiply this by at least three or four times if you have other issues, which most of us do once things start going south in the mouth, needing attention. That would be gum problems, repair to surrounding teeth or necessary attention to bone.

I write with authority. Some years ago, facing all of the above, I visited an assortment of dentists with an assortment of solutions that frequently had me in tears when contemplating the time, details (one would have had screws in my jawbone which I would tighten every few days for months as it rebuilt itself) and costs. Like Brody, I grew up before the days of fluoridated water and have had more repair work since childhood than the Bay Bridge. It was a mess in there.

Finally my husband, whose best wives have been born in 1933 but with bad teeth, said, “Just do it all. Don’t be going patch-patch-patch; do it all.” I proceeded to choose the most sympathetic and understandable (most of them were, except for the screws-in-the-jaw guy) dental professionals, assembled a team and went to work. Or rather, I scrinched my eyes shut while they went to work. Some 18 months and $40,000 later we were free at last.

(Out of this experience, during which I was doing a great deal of entertaining just to keep us happy and sane, came one of my finer unpublished books, Cooking for the Dentally Impaired: Recipes and Menu Suggestions for the Impaired and Unimpaired in Difficult Times. I think it’s a book whose time has come; my agent disagrees.)

Brody’s article is a must-read for anyone stewing over this issue. The following are abbreviated tips for anyone with teeth and plans to keep them:

1 – Consider early-decision. The sooner things like gum surgery, crowns, implants-v-bridges or bone issues are dealt with, the likelier all can be made well and kept that way.

2 – Get second opinions. You may even choose the screw-in-the-jaw route, but there are many different procedures and it is good to find one suited to your temperament and bank account.

3 – Ask questions. I asked so many that I was fired by one team; a polite letter said they did not believe they should take my case. It’s just as well. Those I wound up with answered my questions and seemed happy to do so.

4 – Ask for references. Brody suggests this, and I agree. Because I already knew several people who had been patients of the dentists with whom I eventually invested all that time and money, talking with them about their experiences helped keep me from any surprises.

5 – Talk finances. Several friends of mine have had major dental expenses that were far outside their budget, but worked out payment schedules with their dentists so that necessary work could be done sooner rather than later.

Meanwhile: floss.

General interest
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Fear (and the high cost) of falling

by Fran Johns

My husband was face down on the floor of the breakfast room, stretched below the table with one hand resting beside a chair he had pushed into the corner. As I came up from the garage, returning from a long opera just before midnight, he called out, hoping to spare me from alarm or a heart attack of my own. This is the sort of scene that tends to cause alarm at any age. According to an article in last Sunday’s New York Times, a similar scene occurs with alarming frequency: more than one-third of people ages 65 or older fall each year, writes Steve Lohr in an “Unboxed” feature, “Watch the Walk and Prevent a Fall.”

In our recent case, all was soon well. My husband had lost his balance while setting dinner on our not-too-sturdy table, and more or less slid to the floor. Still recovering from spinal fusion surgery 8 months earlier, he had done everything possible not to break anything — old bones or new rods and bolts that is; he wasn’t worried about the china — as he went down. But once down, getting back up was not an easy assingment. You know those awful “I’ve fallen, and I can’t get up” ads? Believe them. He tried shoving a chair into the corner to gain traction, but soon realized there was not enough strength in his lower legs to do the job, and decided just to wait. (Some people do carry cell phones… but that’s another story.) At 6’3″ and over 200 pounds, Bud outweighs me approximately two to one, so my getting him up was, we already knew, not an option. Happily we have a neighbor who seldom goes to bed early. Once he came over and the three of us strategized a while we were able to set my husband upright again. More specifically, John and Bud accomplished the deed; I supervised. Bud was tired and hungry, but otherwise fine.

Most of the falling elderly are not so lucky. About one fall in 10 results in serious injury such as a hip fracture, according to the Times story. Some 20 percent of older adult victims of hip fractures die within a year. If that weren’t enough to get one’s attention, reporter Lohr writes that “the estimated economic cost of falls ranges widely, up to $75 billion a year in the United States, if fall-related home care and assisted living costs are added to medical expenses.”

The last time I fractured my ankle, which I tend to do with dismaying frequency, I grumbled to a friend about “that dumb accident.” There are no smart accidents, she replied. (I was running late, and carrying a very large empty computer box down the stairs.) And this is a good thing to keep in mind. Somewhere not far past the age of 50 (I throw that in for all those weekend soccer-playing dads) bone breakage gets easier and healing begins to take longer. Somewhere a little farther along in the aging process, falling takes over from dumb accidents as #1 cause.

“Watch the Walk and Prevent a Fall” focuses on early research, backed by the National Institute on Aging, into the relationship between activity patterns and falls. “Fall prevention also promises to be part of an emerging — and potentially large — worldwide industry  of helping older people live independently in their homes longer,” Lohr writes. New technologies such as sensors that track behavioral and activity patterns will play growing roles in fall prevention, along with customized exercise programs and close attention to the role of medications.

Considering the risks and the cost, fall prevention may fast claim serious attention. But for now, especially if you’re over 65: get up slowly, watch your balance, and be careful setting your dinner plate down on a wobbly table.

California/General interest/Lifestyle/Money/Politics & Causes/Sports/USA
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Housing, homelessness & other inequities

by Fran Johns

Today’s Sonoma County (CA) Press Democrat features a front page story about Joe Montana’s digs near Calistoga, available for $49 er–million. It is right above a photo of homeless vet Jack Saltzman reading in his hatchback, the juxtaposition of photos hard not to notice.

Others vets don’t have hatchbacks. Press Democrat feature writer Jeremy Hay reports that according to the Department of Veterans Affairs, approximately 400, or 12%, of Sonoma’s 35,000 vets are homeless, which fellow homeless vet Don Bridges says is “just the tip of it.” Some 131,000 of the nation’s 24 million veterans are homeless on any given day.

Hay details some of the measures being undertaken to alleviate the problem, including $3.2 billion recently pledged by the V.A. to be spent over the next five years toward getting veterans off the street and keeping them from falling into homelessness. But returning vets have been part of another world most of us only see in the extreme abstract and can’t possibly comprehend; fitting right back into mainstream America can be harder than anywhere they have served, where at least, another vet explains, “you’ve been part of your tribe.” More vets will return, and more will wind up on the streets.

None of this is the Montanas fault.

Another Press Democrat front page story, a New York Times article by Andrew Martin and Lowell Bergman, mentions a 91-year-old Florida woman who got a letter from Citibank last month advising her that her new credit card interest rate was 29.99 percent, up 10 points from the previous rate. Haven’t we been reading about Citibank lately?

These bits of information are being digested by those of us who elected Mr. Obama and now feel sad and frustrated because our expectations were, perhaps, too high. Some of us are wondering why he ever wanted the job in the first place.

We don’t have an answer to homelessness. We may not make an offer on the Montana estate — even though, with a Tuscan-style mansion, equestrian center, full-sized basketball court, gym, pool, etc, etc it is probably worth that matching 49er price — because with 20% down and a 30-year 6% fixed rate mortgage the monthly payments of $235,023 would be a stretch. And we are not planning any credit revolt, despite the fact that it is the responsible credit users who are being penalized by the likes of Citibank. What we are doing is just trying to comprehend the surreal nature of today’s news as covered on one front page.

And keep the faith.

California/General interest/Health/Lifestyle/Politics & Causes/USA/Women
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Abortion, health reform and me: who is making our choices?

by Fran Johns

Am I the only person around who is squirming — make that fuming a little — over the concessions made to the anti-choice guys before the House passed its health reform bill? Does no one else find it offensive to turn from reading on page one of today’s New York Times about this sad state of events to page 14 for a large photo of President Obama shaking hands with Cardinal Sean O’Malley? They were meeting at the funeral for Senator Ted Kennedy in August, where reportedly the good clergyman told the president that the Congress of Catholic Bishops really wanted to support health reform ——– oh, but only if everybody caved to their wishes that abortion remain unavailable.

It is not as if we weren’t forewarned. I posted a brief note in this space a few days ago (see Abortion Foes Winning Health Concessions, 11/4, below) and tried to resume a position of calm.

It is hard to remain calm. Somewhere the lines about separation of church and state have to fuzz themselves back into reality. I believe in the right of the U.S. Congress of Catholic Bishops to tell Catholics how to behave (despite the fact that of my many Catholic friends I know almost none who pay any attention in matters of personal choice.) I even believe in the right of the Pope to tell the Bishops to tell their parishioners how to behave. I even believe in the responsibility of all individuals, including my Presbyterian self, to behave according to their conscience and their faith. I just hate being governed by someone else’s faith.

This is not a small distinction. My own church, admittedly starting with a small group here in woo-woo San Francisco, passed a fairly strong national resolution denouncing our country’s torturing folks and seeking justice. As far as I know, no one threatened the president about withholding support for these occasionally immoral wars we keep fighting unless the instigators of torture-in-our-name were sent to jail. However strongly I would like to see the latter happen, I believe there are limits to what faith communities should do.

I had personal experience with back-alley abortion, in the dark days pre-Roe v Wade. It was not pleasant. Is there any way a celibate Catholic bishop could even remotely understand the horrors to which he is condemning poor, desperate pregnant women with the relentless push to make abortion totally unavailable? No. I wish there were.

We still have got to have health reform. But what prices we are paying.

General interest/USA
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Jail time for texting driver

by Fran Johns

At the risk of invoking the wrath of some readers who disagreed with my proposal to jail texting truck drivers a few weeks ago, I hereby applaud the British Crown Court for sending a texting young driver off to jail where, presumably, cell phones are unavailable. I am sad for her and her family, far sadder for the victim and her family and still angry that such stupidity is tolerated in the U.S.  Here’s the story from Oxford via the New York Times November 2:

Inside the imposing British Crown Court here, Phillipa Curtis, 22, and her parents cried as she was remanded for 21 months to a high-security women’s prison, for killing someone much like herself. The victim was Victoria McBryde, an up-and-coming university-trained fashion designer.

Ms. McBryde was killed when her car was struck while stopped beside the road.

Ms. Curtis had plowed her Peugeot into the rear end of Ms. McBryde’s neon yellow Fiat, which had broken down on the A40 Motorway, killing Ms. McBryde, 24, instantly. The crash might once have been written off as a tragic accident. Ms. Curtis’s alcohol level was zero. But her phone, which had flown onto the road and was handed to the police by a witness, told a story that — under new British sentencing guidelines — would send its owner to jail.

In the hour before the crash, she had exchanged nearly two dozen messages with at least five friends, most concerning her encounter with a celebrity singer she had served at the restaurant where she worked.

They are filled with the mangled spellings and abbreviations that typify the new lingua franca of the young. “LOL did you sing to her?” a friend asks. Ms. Curtis replies by typing in an expletive and adding, “I sang the wrong song.” A last incoming message, never opened, came in seconds before the accident.

With that as evidence, Ms. Curtis was sentenced in February under 2008 British government directives that regard prolonged texting as a serious aggravating factor in “death by dangerous driving” — just like drinking — and generally recommend four to seven years in prison.

There are no winners in this story, only losers and sadder losers. But there could be a small win if it served as a wake-up call anywhere about the fact that driving a car requires two hands and an engaged brain. It is not possible to engage the brain in watchful, decent driving when pieces of it are off somewhere in cyberspace. The only reason why there are not literally thousands of additional casualties every day from the callous stupidity of texting/cellphoning drivers is that other, saner drivers — and cautious pedestrians, who know they are at constant risk — have noticed and managed to avoid them. But texting/cellphoning drivers are outnumbering other, saner drivers at an increasingly alarming rate. They should face jail time.

Victoria McBryde had, herself, been texting her friends before her car broke down. From the side of the road she called her mother, Jennifer Ford, to say she was frightened and worried because the car service company had not appeared.

Ms. Ford told her daughter to make sure the flashers were on and that she was pulled off the road. “She was like, ‘Mom, of course I did these things,’ ” Ms. Ford recalled in an interview.

When she called her daughter back 20 minutes later, no one answered. By that time Victoria McBryde was dead.

Driven to Distraction – Britain Sets Tough New Laws for Texting While Driving – Series – NYTimes.com.

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