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Go see.
The Final Parable for Health Care
Also see:
Clone Wars: The Impossible Reality of Moscow's Female Russian TennisPlayers
Maria Shapapova, Anna Kournikova, and the Russian Tennis Cloning Scandal
Because now that the Russians know the game, who knows where they will use the knowledge next; I assure you it will be something less benign than in professional tennis.
Also See:
Maria Shapapova, Anna Kournikova, and the Russian Tennis Cloning Scandal
Kournikova and the Moscow Tennis Clones
These are anal warts. Bumpy, cauliflower-like appearance. Probably due to the association between HPV and anal cancer, women with history of cervical cancer are at increased risk of developing anal cancer. This is what you want to look for and act on. People with these are at an increased risk for cancer.
Take Home Lessons: Wear condoms. Avoid people with warts in the genital area. Avoid sex with HIV+ individuals unless you are REALLY well informed and quite well protected. And a far as I am concerned, you should get the HPV vaccine if you are in an at risk group.
At Risk:
1. Unprotected Sex
2. Anal sex -- protected or not, male or female
3. Male-female vaginal sex if the male is uncircumcised
4. Many sex partners over the course of a lifetime, vaginal or anal or oral sex
5. History of genital warts--exposed to genital warts
Why worry about many partners? Because HPV is transmitted with increasing likelihood with an increasing number of partners; in addition, the virus will often cause no symptoms. It's frequently silent, and you'll never know you got it. As for women, given the frequency of cervical cancer and the implication of HPV in the origin of that disease, unless you intend to have very few partners --get the vaccine.
And let's not forget the legend as she was:
DATA IDENTIFICATION AND ANALYSIS: Literature search of English-language studies reported from January 1966 to October 31, 1993, using MEDLINE, manual literature review, and consultation with experts. A total of 13 studies were selected, and their results were combined using meta-analytic techniques based on the assumption of fixed effects
CONCLUSION: "Screening mammography significantly reduces breast cancer mortality in women aged 50 to 74 years after 7 to 9 years of follow-up"
--JAMA Vol. 273 No. 2, January 11, 1995
... is an epidemiological measure used in assessing the effectiveness of a health-care intervention... The NNT is the number of patients who need to be treated in order to prevent one additional bad outcome (i.e. to reduce the expected number of cases of a defined endpoint by one).
The importance of "the number of patients who need to be treated" translates to COST. This is what all you Obamaphiles should get through your heads. We intend to make the measure of health care what it costs to get it done, not how many fewer people die. What does it COST to save a life? It is not a measure that is used in our courts where the Tort system projects the value of life into millions; obviously. See my previous post here.
So, theoretically, even if screening mammography reduces deaths from breast cancer, if you have to do too many mammograms to prevent one death, then...it isn't worth it to the system
Who is the system? Whoever pays the bills.
Who make s the rules? Whoever pays the bills.
Who's paying the bills in the future of your heath care? The government.
So, if they want to question the value of mammography not in relation to death reduction but rather on how much it costs to actuate as compared to the eventual cost to the system...as Arnold Swartzeneger says in almost every movie he makes: "GET DOWN!"
Just the Facts, Ma'am
What is going on here? Has not anyone stopped to take note that an impossibly large number of young, blond Russian teenagers are now within the top 100 female tennis player? And they are, for the most part, tall, skinny and sport pulverizing forehands -- all manufactured with a severe Western forehand grip--and two-handed backhands that rip through the court like steam through a samovar...
Has anyone not said: "What are the chances?" No? Well let me ask you this: can you think of any 3 female tennis players in the history of United States tennis that were look alikes? Tracy Austin, Pam Shriver, Chris Everet, Mary Carillo, Lindsay Davenport, Mary Joe Fernandez...? No. Not even close. Even the Williams sisters -- who are indeed sisters -- look less alike than say, Maria Sharapova and Viktoria Azarenko; or Hantuchova and Cibulkova:Say It IS So
It really cannot be. It really is impossible. There is simply no way, statistically, that so many similar appearing women with nearly identical tennis games could all come from Russia, or very close to Russia--basically all from that part of THE FORMER USSR
Remember the USSR? Remember them? The original sports cheaters. The first country to use professional athletes disguised as amateurs. The first country to use performance-enhancing drugs on their athletes--the ones who must have put together the genetic material for this cloning experiment in the 1980's!
BHO just engineered an increase in the federal excise tax on cigarettes so that yesterday, the tax on every pack jumped from 39 cents to $1.01!
This represents the largest federal tobacco tax increase ever. In some cases, smokers will be coughing up $9-$10 for a pack...
For years health officials have claimed they hope that tax-price increases will motivate smokers to quit, and perhaps at one time that sentiment was real. But now the government--like the desperate smoker-- is also addicted, but addicted to cigarette tax money, which nowadays is viewed as a way to raise funds for federal programs.
Who What When...Teddy Kennedy
In 1997 Teddy Kennedy sponsored an expansion of Medicaid (SCHIP) in order to provide insurance for families that were not poor enough to qualify for Medicaid. An expensive proposition. This February, one of BHO's first acts as president was to expand this program (stimulus shmimulus) to include millions more people, even those who are not traditional families, including immigrants.
When pressed for a funding solution to support this new expansion of the government program, BHO and someone really clever (maybe Robert Reich?) came up with the idea that they could add another tax on cigarettes (who can argue against that?) and use that money to fund SCHIP. So now cigarette smokers are taking care of kids, at the cost of their lives.
The federal government has come to rely on cigarette taxes -- as states rely on lottery income-- to fund their social programs, so if people stop smoking...that would be bad. This approach is obviously contradictory. If the government discourages tobacco use with taxes then people will stop smoking. However, if the government uses the tax money to fund its pet projects then if people stop smoking, pet projects will suffer.
Looking for VolunteersOne could foresee a day when people quitting smoking may seriously jeopardize something important, like climate change research or digital TV converter coupons, and this administration in its inestimable cleverness would be looking for new solutions. For change.
One idea is to have young people, when they turn 21, to volunteer as smokers for 1-3 years. This would be seen as public service, a Marlboro AmeriCorps.
Or maybe the government could keep people alive, on smoking farms--which could be erected adjacent to windmill farms-- and let their breathless bodies shift from foot to foot in search of oxygen, but addicted to cigarettes while BHO funds his support of future smokers by maintaining their health as children.
Sounds good to me.
Since fresh fish--like the baracuda you see here-- gets flown all around the world nowadays, don't think for one minute that you are safe from ciguartera poisoning by living in Iowa or Uzbekistan. This illness strikes everywhere. And ciguatera poisoning is the most common nonbacterial, fish-borne poisoning in the United States.
So how will you know if you've been poisoned?
First, you will have eaten fish. Maybe a fish sandwich or the daily special which was grouper provencale...Well, after about 6 hours your mouth and lips will feel numb and you'll start to vomit and get a bad case of the runs. Then your hands and feet will start to tingle...makes you wonder how anyone actually got to the point where they might experienced painful sex, doesn't it?
The room starts to spin right before you begin panting to catch each breath. You feel exhausted, yet your heart is beating faster and has a jumpy feeling.
That's when you go to grab the ice-cold can of Coke...AND IT'S BURNING HOT!
That's the classic finding: temperature reversal. If this happens to you send yourself straight to the local ER and demand several hours of a Mannitol infusion -- an IV with heavy molecules in it which serves to "flush" out the toxin. This seems to reverse the neurological problems and from that point on have your doctor treat you symptomatically.
Don't Be a Hog (Snapper)
If you want to avoid ciguatera, make sure you identify any fish you eat anywhere. No mystery fish allowed. Next, if the fish is from a tropical or subtropical zone, ask how big it was. Really. Because the chances of a fish accumulating significant ciguatera poison are proportional to its size and if the fish was greater than 2 kg--have the lasagna.
Now can anyone remember why the hell we are rushing to throw away 700 thousand tons of pistachios? The only painful intercourse resulting from eating nuts is when you accidentally roll over the shells.
Is this what we want in health care reform today?
Reform the system, reform the process, address social grievances and perceived injustices while satisfying special interest groups and politicians? Because the system then faces the same fate as mammography.
You will reform insurance. You will reform distribution. You will address costs, but in the process, you will vitiate the services, chase away the best practitioners, and create a great a void where once the world's best health care resided.
You want the train to run on time but to be going nowhere?
...this is what the government will bring us.