Dealing With a Cancer Diagnosis; The Importance of Healthcare Coverage

I have debated whether or not to write about my latest challenge for a couple of weeks. I want no pity or sympathy.  When this blog first began, it was intensely personal as it described my often extremely turbulent coming out journey.  To my surprise, I had men from around the globe reach out and tell me that my hearing saga had helped them in their own journey.  Over time, the blog morphed into something much more political given the need for gay rights advocacy.  

Now, having learned that I have prostate cancer - thankfully, not an aggressive type and with an extremely positive prognosis - I opted to talk about this latest chapter in my life in the hope that others will get themselves checked out and, if necessary, get treatment. From my research, prostate cancer is among the most common forms of cancer in men - its causes are unknown and, in my case, I have no family history of prostate cancer. It is also one of the most survivable when discovered early and properly treated.  One of the big problems, however, is that it often has few discernible signs until well advanced at which point mortality goes up and the treatment options become more sever with more permanent impairment.  The bottom line: get tested regularly and ignore the thoughts of some in the medical community that an annual PSA test is of uncertain effectiveness or involve srisks (candidly, it is simply a matter of giving some blood). It's your body and you need to be your own advocate.

So how did I come to be diagnosed?  It began with a simple annual physical (the cost fully covered by my insurance) which included blood work, including a PSA - prostate-specific antigen - test that showed a somewhat elevated result (things from sex, to running, bicycle riding to strenuous workouts can cause results to be elevated - who knew?). As follow up, over a period of months I had additional PSA tests and the results remained consistently somewhat elevated.  As a result, an MRI was done which showed a small lesion.  This in turn lead to a biopsy - a truly unpleasant experience - that confirmed I had a problem.  I actually got the news while driving to court one morning with the doctor telling me "I have bad news and good news"after I stated I did not want to wait for an office visit to get the news: the bad news is you have cancer, the good news is that if you have to have it, you have the best type to have. An office consultation followed with the husband at my side where the list of options was discussed: (i) do nothing and monitor the situation through annual PSA tests and annual biopsies - I said "no thank you "to annual biopsies since one was more than enough, (ii) surgery, (iii) chemotherapy, (iv) traditional radiation, or (v) proton therapy.  I immediately rejected the surgery option - which can result in serious, lasting effects - and chemotherapy having seen my late sister go through that nightmare. I ultimately opted for proton therapy, the least invasive and most state of the art treatment option.  Thankful, a proton therapy facility is only ten minutes from our home. 

There are some preparation procedures one must undergo in order to receive proton therapy treatments, but none are as bad as the diagnostic biopsy procedure. The treatment sessions themselves take 30 minutes or less and while there are side effects, all in my case are manageable and far better than those that would come with the other treatment options.  One big issue for those considering this type of treatment is that the treatment regime lasts for up to or even over nine (9) weeks of daily treatments and proton therapy facilities are not located in many states.  The other big issue is the cost and whether or not one's insurance will cover the treatment regime.  Fortunately, between Medicare and my Anthem supplement, my treatments are fully covered, although one of the drugs I'm on to deal with side effects is ridiculously expensive - the pharmaceutical industry continues financially rape American patients - and the out of pocket cost is significant. 

One thing this experience has also taught me is the need for healthcare coverage for all - coverage that covers preventive measures and diagnostic testing.  Without healthcare coverage, many men will never get what could be life-saving testing and only when pronounced symptoms from advanced cancer will they seek treatment, probably via an emergency room visit.  By that point, the chance of surviving may have been be lost.  The same holds true for stripped down insurance coverage that either (i) does not cover diagnostic tests and/or (ii) leaves one with financially devastating co-payments.  Sadly, America's healthcare system - if one can even call it that - callously condemns some to death and/or financial ruin.  Not surprisingly, with prostate cancer, European nations with national, universal healthcare coverage have higher survival rates that in the USA. I have long been an advocate for national healthcare coverage - now, with this experience, I believe it is even more necessary.  We need to stop treating some lives as disposable. 

To men reading this post, I hope the take away is to get tested and do not procrastinate. One client I shared my story with admitted that he had not been tested in years - he plans to rectify the situation and will be getting tested. I hope others will do likewise.  I also hope that anyone diagnosed will study their options and not blindly follow doctor recommendations.  Unfortunately, too many medical practices are now owned by hospital systems that urge physicians to direct clients for treatment at their facilities, whether or not they can provide the optimum treatment regime.  In my case, the Hampton Proton Therapy Institute is not affiliated with either of the two dominant hospital systems and, but for my own research (and having a friend who had undergone proton therapy), I might have been pushed to seek a different treatment regime.  Currently, I have my treatment sessions early in the morning and have missed no days of work and have a very positive prognosis.   

Vulture Capitalism and Pharmaceutical Companies

In the 2012 election cycle Mitt Romney was his own symbol of vulture capitalism - the GOP's god after tax cuts for the wealthy - and it came back to haunt him.  Now, as we begin the 2016 election cycle, Martin Shkreli, the former hedge fund manager known as the “Pharma bro,” has singlehandedly underscored the evils of unfettered capitalism.  Shkreli accomplished this by buying the rights to Daraprim, a drug used to treat severe infections in AIDS patients and infants, and then increasing the price to consumers by 5000%.  Drug prices in America are out of control - one can get the identical drugs in Canada for far less - and perhaps Shkeli's greed will trigger some much needed oversight of the shockingly greedy pharmaceutical industry.  A piece in Think Progress looks at the phenomenon.  Here are highlights:

Is the “Pharma bro” coming to Congress? He will if Rep. Elijah Cummings (D-MD) gets his way.

Cummings, the Ranking Member of the House Committee On Oversight And Government Reform, has requested a hearing next week to question Martin Shkreli, the former hedge fund manager known as the “Pharma bro.”

Shkreli has attracted attention since he hiked the price of Daraprim, a drug used to treat severe infections in AIDS patients and infants, by 5000%. Shkreli is the CEO of Turing Pharmaceuticals.
In an interview, Cummings called Shkreli’s actions “criminal.”

As a member of the Democratic minority, Cummings cannot unilaterally call the hearing. But he wrote a letter to Chairman Jason Chaffetz on Tuesday, requesting a hearing be scheduled.

Cummings notes that the committee had previously “agreed unanimously to investigate the increasing price of certain prescription drugs” but “has held no hearings and has issued no document requests to drug companies this year.”

Tuesday night, Shkreli told ABC News he would reduce the price of Daraprim. He would not specify the new price.

We need a national health care system that would bar sleaze bags like Shkreli from engaging in such vile conduct.

The Idiocy of the GOP Base

Click image to enlarge

One last comment on yesterday's Supreme Court ruling.  Some of the untethered crazies of the far right who have been acting like the world is ending because of the health care ruling have said they emigrate to Canada.  As the image above underscores, these fools obviously know nothing about Canada - other than it has a majority Caucasian population - and must be Fox News viewers.  The further irony is that many of the same loons claim America's hard times are because of it's Godlessness.  If that's the case, then Canada ought to be suffering something akin to nuclear winter.  Of course, it's not and it's banks and economy are stronger than here in the USA. 

If "Obamacare" is Struck Down, Will It Lead to a Single Payer System?

There's an old saying "be careful what you wish for" that may come back to bit the GOP and conservatives in the ass big time if the conservative faction on the U. S. Supreme Court succeed it killing what the far right derisively calls "Obamacare." And what might that be? Demands for a single payer system so derided by the far right. When asked about individual parts of "Obamacare," a majority of Americans support these programs/policies. Now imagine that the Supreme Court strikes down Obamacare and these benefits disappear and millions find themselves uninsured or unable to afford sky rocketing health care insurance premiums. The resulting chaos and unhappiness might reignite a demand for a total overhaul of the health care delivery system and calls for a Canadian or European style health care system. Personally, I am all for it. As should be those who actually believe in the Gospel message of caring for the sick and the unfortunate. Here are highlights from a Washington Post column that looks at the possible fallout:

If Obamacare is struck down, the short-term implications are uncertain. Conservatives may be buoyed by an election-year victory; progressives may be energized by a ruling that looks more political than substantive. The long-term consequences, however, are obvious: Sooner or later, a much more far-reaching overhaul of the health-care system will be inevitable.

At the heart of the legislation is the requirement that individuals purchase health insurance or pay a fine. It became clear by their questioning that the court’s five conservatives — including Justice Anthony Kennedy, the swing vote who sometimes crosses the ideological divide and votes with the liberals — see this mandate as a significant expansion of the federal government’s reach and authority.

Verrilli gave him [Justice Kennedy] one. The market for health insurance is inseparable from the market for health care, he argued, and every citizen is a consumer of health care. Those who choose not to buy health insurance require health care anyway — often expensive care at hospital emergency rooms — and these costs are borne by the rest of us in the form of higher premiums.

I think Verrilli made his case. The court is supposed to begin with the assumption that laws passed by Congress are constitutional. Justices don’t have to like the Affordable Care Act in order to decide that it should remain in effect.

[I]t’s going to be a close call. What if they strike down the law? The immediate impact will be the human toll. More than 30 million uninsured Americans who would have obtained coverage under Obamacare will be bereft. Other provisions of the law, such as forbidding insurance companies to deny coverage based on preexisting conditions and allowing young adults to remain on their parents’ policies, presumably would also be invalidated; if not, they would have to be modified to keep insurance rates from climbing sharply. The United States would remain the only wealthy industrialized country where getting sick can mean going bankrupt.

Eventually, however, our health-care system will be restructured. It has to be. The current fee-for-service paradigm, with doctors and hospitals being paid through for-profit insurance companies, is needlessly inefficient and ruinously expensive. When people talk about out-of-control government spending, they’re really talking about rising medical costs that far outpace any conceivable rate of economic growth.

Our only choice is to try to hold the costs down. President Obama tried to make a start with a modest approach that works through the current system. If this doesn’t pass constitutional muster, the obvious alternative is to emulate other industrialized nations that deliver equal or better health-care outcomes for half the cost.

I’m talking about a single-payer health-care system. If the Supreme Court strikes down Obamacare, a single-payer system will go from being politically impossible to being, in the long run, fiscally inevitable.

America's refusal to learn from the successes of other nations drives me crazy. Yes, a single payer system would mean that doctors would cease to make near obscene salaries in some cases. But the availability of preventive care and no need to pass the costs of the uninsured to everyone with insurance would lower costs in the long run. Moreover, families would no longer see their finances wiped out by a serious illness - something I experienced some years back when first my oldest daughter was stricken with bacterial meningitis and then my former wife was stricken with cancer. Medical emergencies should not mean bankruptcy or something close to it - even for those with supposedly quality insurance coverage.

The Supreme Court’s Health-Care Stock Problem

I've noted before the problems with Supreme Court justices who view themselves as exempt from the ethics and conflict of interest rules applied to the federal judiciary. Typically, among the most blatant offenders are Clarence Thomas and Antonin Scalia who consort with far right conservatives and, in the case of Thomas, receives significant family income from his wife's far right activities. But it's not always the conservatives who raise eyebrows. Now, with the health care law before the Court, a piece in The Daily Beast looks at the lack of clear rules applicable to the Court's justices. Here are some highlights:

Federal judges who own more than $25 of company stock are required to recuse themselves if a case comes before them that involves the company in question. If they fail to do so, they can be charged with a felony. But what about the Supreme Court? And more specifically, what about the current case involving health care? Should Supreme Court justices who own stock in health-care and pharmaceutical companies recuse themselves?

In the past, Supreme Court justices have removed themselves from certain cases. . . .

But they are not required to do so. It is left to the discretion of the individual Supreme Court justice to decide whether a financial conflict exists.

No member of the Supreme Court has stepped aside in the health-care reform case currently before them, even though two of the justices apparently own far more than $25 in health-care-company stock. By far the biggest owner of health-care stock is Justice Stephen Breyer.

Justice Samuel Alito also owns shares in health-care stock, holding up to $45,000 in Bristol-Myers Squibb.

Did Breyer and his family sell their shares in health-care companies before oral arguments on the Obamacare case began this week?Last year, Breyer sold his stock in Nestle so he could participate in a case involving that company. The Supreme Court Public Information Office is not saying whether a similar move was made in this case.

Does any of this matter? . . . . The reason the restriction [on other federal judges] requiring recusal was instituted in the first place was to remove any doubt that financial factors were at play.

But the larger question is, shouldn’t Supreme Court Justices put their assets in a blind trust? They are not required to. . . . . They make their own judgments about whether a conflict of interest exists.

This is a tradition in the Supreme Court. But it’s time to change it. Just as the growth of scope in government made congressional insider trading a real problem that warranted legislative reform, so too the growing scope of the court, and its ability to shape the stock valuations of companies warrants greater reform. Why not require Supreme Court justices to put their assets in a blind trust? Or at the very least to put their assets in mutual funds, not individual stocks?

The GOP's Fairy Tale Version of Proposed Healthcare Changes

I will admit at the outset that I believe that an advanced industrialized nation - especially one that claims to be Christian as per the Christianists - should provide some level of health care coverage to every citizen. In fact, pretty much every other advanced industrialize nation does so - as do many that xenophobic Americans like to look down upon. The USA stands largely alone in treating its citizens as disposable items. Now, the Congressional Republicans want to take steps backwards from the health care reforms of the last two years - which in my view went nowhere near far enough. In peddling their snake oil, the members of the GOP have even gone so far as to claim that their version of health care reform "It will be similar to a system “just like” what members of Congress have." Sounds good, but of course it's a lie. Like so much of what comes out of today's GOP. A story in the Washington Post fact checks the GOP claim and what it finds is not pretty. Here are some highlights:

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During the congressional recess, Ryan and other Republican lawmakers have been selling their proposal to restructure Medicare with what appears to be a poll-tested phrase: It will be similar to a system “just like” what members of Congress have. The phrase pops up in all sorts of news releases and interviews with members of Congress, as well as no less than five times in the budget plan crafted by Ryan.
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Republicans say they would preserve the current Medicare system for people who are currently 55 and older; the changes would only affect people who are younger. The current system, in place since the mid-1960s, is essentially a government-run health care program, with hospital and doctor fees paid by the government, though beneficiaries also pay premiums for some services as well as deductibles and coinsurance.
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The new system envisioned by Ryan would transform Medicare into a competitive market. Retirees would get from the government what Ryan calls “premium support” — a set payment adjusted to inflation — and then use that money to pick from a range of plans offered by insurance companies through what is termed a Medicare exchange.
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How does this system compare with what Congress gets? The federal plan provides lots of health-care options, with a range of about five to 15 plans for each enrollee, according to the Congressional Research Service. All of the health plans offer a standard package, but there are variations in what those plans pay for. In many ways, the federal plan works a lot like the run-of-the-mill employee-sponsored health insurance plan. The bulk of the costs are picked up by the employer — in this case, the government — with the employee contributing his or her share according to a set or negotiated rate.
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But the comparison begins to break down once you consider the premium support payments. Ryan would peg the premium support to the consumer price index, a broad gauge that has been rising more slowly than have health-care costs.
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The Congressional Budget Office, the nonpartisan arm of Congress, analyzed Ryan’s plan and estimated that, by 2030, the government would pay just 32 percent of the health-care costs, less than half of what it currently pays. The other 68 percent of the plan would have to be shouldered by the retiree.
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The CBO analysis also assumed that adding private insurance plans into the mix would raise administrative costs and would not keep medical inflation as low as traditional Medicare has done.
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The focus on “a system just like members of Congress and federal employees have” suggests that this would be something better than the typical employee plan. But it will not have a key feature of the current plan — a promise that the government will pick up 75 percent of the health-care tab. The reference to the health plan for members of Congress gives a false and misleading impression to ordinary people.
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Clearly, the Congressional Republicans are lying to the public - one thing they share with their Christianist masters is the belief that the Commandment against lying doesn't apply to them.

Ted Kennedy Adrresses the DNC

I am watching the opening night of the Democrat National Convention and Caroline and Ted Kennedy just spoke. I found it very moving, perhaps all the more so since I had the opportunity to meet Ted Kennedy many years ago when he spoke at UVA when I was in college. The ravages of time were obvious as Kennedy spoke and the knowledge that he's battling brain cancer made his address all the more poignant. At one point he spoke of Obama's goal of ending the old politics of division based on race, gender and other factors, including pitting gays versus straights. I truly believe that unless the politics of hate and division which have become the hallmark of the Republican Party, this country will never achieve justice and equality under the law for all citizens. I find it obscene that the USA does not have universal health care while citizens of other industrialized countries have better health care services for ALL citizens. Here are a few highlights from Kennedy's remarks via MSNBC:

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“This is the cause of my life,” Kennedy declared: “New hope that we will break the old gridlock and guarantee that every American — North, South, East and West, young, old — will have decent health care as a fundamental right and not a privilege.

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“Barack Obama will close the book on the old politics of race, gender and group against group and straight against gay,” Kennedy said, bringing the convention to its feet.

59% of US Doctors Support Universal Healthcare

In my opinion, one of the biggest scandals in the USA is the number of American citizens who lack basic healthcare insurance coverage and/or access to preventative medical treatment and diagnostic testing. As an employer, the amounts paid by both employers and employees for health insurance is an ever increasing burden. In the past, one of the lobby groups who opposed some form of universal or national healthcare system was the nation's doctors who believed that it would reduce their incomes. Now that tide appears to be turning, leaving I suspect insurance companies and pharmaceutical manufacturers as the leading opponents. Why the opposition? Because it could mean a reduction in the obscene denials by insurance companies of treatment coverage and almost unbelieveably expensive drug costs. Here are highlights from a Raw Story article (http://rawstory.com/news/2008/Doctors_support_universal_health_care_survey_0401.html):

WASHINGTON (Reuters) - More than half of U.S. doctors now favor switching to a national health care plan and fewer than a third oppose the idea, according to a survey published on Monday.

The survey suggests that opinions have changed substantially since the last survey in 2002 and as the country debates serious changes to the health care system. Of more than 2,000 doctors surveyed, 59 percent said they support legislation to establish a national health insurance program, while 32 percent said they opposed it, researchers reported in the journal Annals of Internal Medicine.

"As doctors, we find that our patients suffer because of increasing deductibles, co-payments, and restrictions on patient care," said Dr. Ronald Ackermann, who worked on the study with Carroll. "More and more, physicians are turning to national health insurance as a solution to this problem."

"Across the board, more physicians feel that our fragmented and for-profit insurance system is obstructing good patient care, and a majority now support national insurance as the remedy," Ackermann said in a statement.

The Indiana survey found that 83 percent of psychiatrists, 69 percent of emergency medicine specialists, 65 percent of pediatricians, 64 percent of internists, 60 percent of family physicians and 55 percent of general surgeons favor a national health insurance plan. The researchers said they believe the survey was representative of the 800,000 U.S. medical doctors.