The conundrums caused by doublespeak

The Pentagon has ruled that Purple Hearts won't be given to those suffering from PTSD because it's not an injury intentionally caused by the enemy. What are we supposedly doing again? Fighting a war on terror? A tactic used to intentionally produce... psychological harms? Decide whether the people we're fighting against are intentionally trying to cause harms or not and get back to me.

Follow-up to yesterday

I wrote a more thoughtful response on facebook:

"I get the rationale that it's mostly a spokesperson job, and Gupta has had his face on TV talking about health stuff a lot, but nothing in his training gives him any expertise in public health. His training isn't even in general or preventive medicine. Frankly I'm sick of MDs getting a pass into the public health world without the requisite training, and this is just such an egregious example."

I'm bothered by two things here, both of which converge in Sanjay Gupta. One is the tendency for cable news to rely on familiar faces to be experts in everything, instead of actually seeking out and talking to experts. While not every expert is super articulate and it may be useful in a TV format to have recognizable journalists distill expert opinion, that's not generally what I see happening. On health, education, foreign relations and almost any complicated where there do exist people who have devoted their lives to figuring out what works and what doesn't, you see talking heads yammering inexpertly like it's all just a matter of opinion. And that is so annoying. I don't want to see this tendency entrenched in government.

The second strand I refer to in my facebook comment, which is that all too often, people who are trained in the medical world are able to just dance over to the public health world, without additional training. Many docs have the sense to at least get an MPH (like my fine students), but there are a lot of folks out there who really don't have the cred. Maybe I'm extra biased because the social and behavioral sciences are a lot more essential to public health than to most areas of medicine (although medicine could use a little more understanding of people and society), but I don't think training in medicine (particularly in specialty areas) gives you any cred to talk public health.

That's all I have to say on that.

WTF

Sanjay Gupta? Are we kidding? I mean, I guess the guy's job the last few years has been to stretch beyond his narrow expertise (CNN: sure, a neuroscientist can comment on any topic in medicine or health! Who needs to call in the real experts!). But really. There has to be someone in the ranks of legitimate health-related institutions who could take this job!

I'm so disgusted.

R.I.P. H.M.

Henry Gustav Molaison, thanks for the memories!

And I usually like red

Starbucks is doing this Red campaign thing where they donate $.05 for every eligible drink you buy to combat HIV/AIDS. But they're pitching it as some reason to get more coffee than you usually would. How about you just donate your $2-4 to a decent HIV foundation or NGO instead of buying extra coffee?

I think the train is going to be nuts this evening. But I got my lecture done and mailed out for tomorrow, so I can just relax and read magazines.

Hip replacements

Paul Krugman has been another kick of writing about universal health care, and he write something today (Times Select) that is totally obvious but which I've never heard mentioned. Every time opponents or skeptics talk about universal health care systems in other countries they bring up the long wait times for specialty services. Krugman makes the oft-made observation that even insured people don't exactly have short wait times for specialty services (or really any kind of service... I had to reschedule a primary care appointment I had tomorrow, and the earliest I could book was August 13, and that's after major improvements in the student health center's personnel). But then he goes one to note:

"It’s true that Americans get hip replacements faster than Canadians. But there’s a funny thing about that example, which is used constantly as an argument for the superiority of private health insurance over a government-run system: the large majority of hip replacements in the United States are paid for by, um, Medicare.

"That’s right: the hip-replacement gap is actually a comparison of two government health insurance systems. American Medicare has shorter waits than Canadian Medicare (yes, that’s what they call their system) because it has more lavish funding — end of story. The alleged virtues of private insurance have nothing to do with it."

I mean, yeah! Duh! I've never once thought to make this argument, and I did research on joint replacements. But Krugman is right! Is there a reason to believe the wait would increase if Medicare were extended to the entire population? That wouldn't necessarily be the case.

Plan B duh of the day

"Plan B Use Surges, And So Does Controversy" says the Washington Post today, noting that there has been a doubling in sales of the completely non-aborciafacent extra-strong hormone pill since the FDA allowed over the counter sales for women 18 years of age and over. Even though anyone with half a brain would think that making a pill, any pill, easier to get would probably lead to a big-ass rise in sales, conservatives are shocked, *shocked!* at the increase. That was the whole friggin point of making it over the counter, you idiots! There was this huge unmet demand that is now being met, what do you expect?

Some stupid ass from the FRC was saying the decision puts women's health at risk. Yeah, because we all know pregnancy is so health-neutral. *eye tendons limit desired extent of rolling*

Microcredit

I commented on this on Am's blog, but Nicholas Kristof wrote a column today about microfinance (Times Select only, which is free these days if you have a .edu email addy). Through the website www.kiva.org you can loan people in the developing world money to expand their money-making operations. The article talks about how loans were used by a baker to open a second bakery and benefit from economies of scale in ordering flour and oven fuel and by a TV repairman who is able to keep spare parts on hand due to the extra capital from his loan. Many of the loans are used to help women create and expand small businesses. A really high percentage of loans are repaid, which means that you can re-use your money again and again to help others. Commercial lenders in these countries often charge insane interest, so these kinds of loans are waaay better.

Kiva also allows you to give gift certificates, which people can use to make a loan, and then once the loan is re-paid they can re-loan the money or withdraw it. It's a great way to make the $25 you send to your nephew for his birthday mean a lot more -- it's still $25, but it helps someone eat before it becomes a video game.