Rock superstars Roger Daltrey and Pete Townshend of “The Who” have a new cause: sparking a franchise of teen-oriented cancer treatment centers across America. To kick off the launch of Teen Cancer America, Daltrey & Townshend were featured at a conference held at the National Press Club in Washington, D.C. I was fortunate to be invited to sit at the head table next to teen cancer survivor Sarah Sterner – a bright and confident young woman from Atlanta who was cured of brain cancer two years ago.
Sarah told the crowd what it was like to be a fifteen-year-old in a pediatric oncology unit populated by ukulele-playing clowns and screaming infants. The extreme age-related disconnect between her pscho-social needs and that of younger kids and babies served to make her feel even more isolated during her course of treatment. She longed for the companionship of others like her, but without any national cancer centers focused on the special needs of teens, she was on her own.
Roger Daltrey became interested in teen cancer when his personal physician took up the cause in the U.K. and turned to him for support. Daltrey’s decades of playing music to teen audiences made him keenly aware of their unique psycho-social needs. “When you’re a teenager, it’s horrifying if you have a spot on your nose. Imagine what it’s like if you have cancer!” said Daltrey.
Teen Cancer America began as a movement called the Teen Cancer Trust in the U.K. According to Daltrey, preliminary research (comparing teens treated in a typical NHS cancer ward versus a unit sponsored by the Teen Cancer Trust) suggests that there may be as much as a 15% survival advantage in being treated in the special units. Daltrey attributes this to increased morale that helps teens and families find the will to fight through life-threatening treatments.
When asked how American cancer centers compare to those in the U.K. Daltrey immediately responded that he believed the U.S. centers were far superior. He described the incredible resources available at UCLA and Duke, and how the facilities themselves were unbelievably beautiful, sporting plant-filled atria, massive skylights, and high tech imaging and radiation equipment. Nonetheless, he noted, “Teens don’t want to hang out in an atrium. There is just no place that appeals to teenagers at these centers.”
Whether specialized teen cancer treatment environments in the U.S. will dramatically improve survival rates remains to be seen, but there’s no doubt that recognizing the unique psycho-social needs of teenagers would be a boon for patients and families at pediatric cancer centers. Like post-traumatic stress disorder in military personnel, the psychological ravages of cancer may well be under recognized, especially in the teen and young adult populations.
Thank you Roger Daltry and Pete Townshend for bringing this to our attention.
Now that Mitt Romney has announced that Paul Ryan is his VP pick, I thought it would be helpful to repost some video and transcripts from a healthcare reform conference that I organized in 2009. Paul Ryan was our keynote speaker at the National Press Club, and I found him to be a bright, articulate, and humble person. I remember that he was eager to please, and that he came to the conference early so that he would have time to listen to the physicians and nurses who had traveled from across the country to speak out about healthcare reform.
I hope the video and transcript give you some insight into his take on (what is now) Obamacare. Enjoy!
*** Congressman Paul Ryan addressed the crowd at Better Health’s “Healthcare Reform: Putting Patients First” event. This is a transcript of his speech: ***
This event is a landmark in how we get discussion and debate going in the 21st century. We are communicating with the grass roots, with medical bloggers here in this room and across the country.
Let me tell you this: I don’t want government interfering in the relationship between doctors and patients…and I don’t want insurance companies interfering either! I want a vibrant health care market that lets patients choose the health care options that are right for them and their loved ones. I want a free market democracy that puts patients first. We can have this, and I’ll say something more about that in a minute.
Right now Congress is rushing through a health care overhaul that goes in the opposite direction. It’s important to analyze the relative financial costs and benefits of these proposals, but our greater challenge is not the dollars and cents. It goes to the issue of continuing the tradition of excellent health care that medical practitioners now provide. It’s about the equal dignity of each human person…and the future of America as a free society. The American character, and the principles of freedom & democracy which protect & preserve it, may be lost beyond recovery if Congress chooses the wrong path on health care reform—the path down which I believe the Obama Administration seems determined to lead our country.
Public health has always been a government priority. Our Constitution’s Framers saw every individual as having a “right of personal security” which includes being protected against acts that may harm personal health. This right is part of the natural right to life, and it is government’s very purpose to secure our natural rights to live, to be free, and to pursue happiness.
Now here is where believers in big government make their big mistake. The right of each person to protection of health does not imply that government must provide health care. The right to have food in order to live doesn’t require government to own the farms and raise the crops. Government’s obligation is normally met by establishing the conditions for free markets to thrive. Societies with economic freedom almost always have a growing abundance of goods and services at affordable costs for the largest number. When free markets seem to be failing to meet this test – and I’d argue today’s health care delivery is an example – government should not supply the need itself. It should correct its own interventions and liberate choice and competition.
We know from survey after survey that a vast majority of Americans are personally satisfied with the quality of their own health care. The problem is really with health care delivery, which is growing too costly and leaving many people without coverage. The proponents of government-run health care claim there are only two alternatives: either enact their plan or do nothing. This is false. Government bureaucracy is not the answer to insurance company bureaucracy.
An authentic solution to the problem of affordability should be guided by the principles of moral and political freedom… respect doctor and patient privacy…restrain spending…and channel the energy of our free market system, not dry it up. There is no lack of sensible alternative solutions proposed by Republicans to put patients first. Senators Coburn and Burr, and Congressman Nunes and I have offered one, called “The Patients’ Choice Act.” It’s an example of how to eliminate government-driven market distortions that exclude many from affordable health care delivery. More uninsured Americans can be covered by spending current dollars more wisely and efficiently than by throwing trillions more at the problem. Our health care delivery alternatives are based on timeless American moral and political truths.
In essence, we believe that the dollars and decisions should flow through the individual patient, not from the government. I want to see a market where providers truly compete against each other for our business as consumers and patients – not a bureaucratized system where health care providers vie for government favor as patients wait in line.
When federal bureaucracy replaces consumer choice and competition, services are distorted and costs escalate. Consider Medicare and Medicaid. Real cost control has become a national nightmare. Fraud has proliferated despite every effort to stop it. Program costs are always underestimated. In 1966, the cost of Medicare to the taxpayers was about $3 billion. Congress estimated that by 1990, Medicare would cost taxpayers only about 12 billion in real dollars. The actual cost? Nearly nine times as high — $107 billion. By 2006, Medicare reached $401 billion, while Medicaid added another $309 billion for a total of $710 billion. The failure to control Medicare’s costs shows us why we should look to free markets and decentralization for the answers.
The health care programs being pushed by the Democrats are outrageously expensive and fiscally irresponsible. Like Medicare and Medicaid, they will fail to control health care costs. They will exacerbate our growing debt. They will require crushing taxes. Their approach would spend trillions more dollars, mandate that all but the smallest of businesses provide health insurance, require every American to pay for health insurance or punish them for not buying it, impose a massive new tax burden on employers & heath care practitioners, and make our entitlement crisis worse by adding yet another open-ended entitlement.
The so-called “public option” is presented as a way of “keeping private insurance honest”. Well, if this is their idea of “honesty,” we’re in really big trouble. The “public option” isn’t honest. It is designed to make private insurers go away.
Government has four huge powers that force free market competitors out of business. First, the government does not pay taxes and the private competitors do. Second, it forces competitors to establish high capital reserves while the government has none. Third, the government does not have to account for employee wage and benefit costs – private competitors do. Fourth, the government gets to dictate the prices it pays, which are much lower than its competitors.
It isn’t “honest competition” when government serves as both referee and player in the same game. Before the game begins, you know who will win. Unfortunately, it’s the people who lose. According to one independent study from a reputable actuarial firm, two out of three Americans will lose the health coverage they now have in three years if the House bill becomes law.
Government-monopolized health service contradicts everything America stands for. It conflicts with our people’s character…it conflicts with moral principles…it conflicts with market freedom…it conflicts with democracy…and it conflicts with American health care excellence that still draws patients from socialist utopias for medical treatments in this country.
Bureaucratized health care is not compassionate health care. Let me say that again: bureaucratized health care is uncompassionate, impersonal, and inflexible. When government agents make decisions about how to treat the sick, they don’t decide according to need…they decide according to a budget-driven calculus. Bureaucratic indifference replaces compassionate caregiving by loved ones under free markets offering a range of health services. We need to restore personal, patient-centered health care, the very opposite of the plan now moving through Congress.
The question really before us is about power. Where does the power go? In other words, where do the money and decisions come from? Right now, the nucleus of power in health care lies with third parties – insurers, employers, administrators. Patients and doctors are at the fringe. Should this power be shifted to the government OR to patients and doctors?
It’s a truly critical question. The answer will determine how competition in health care works. Will doctors, hospitals, and patients contend for government favors? A better reimbursement? Coverage of a new cancer treatment? Approval of a new process? The currency in this power structure is political connections, interest group politics, and bureaucratic dictates. OR will providers compete with each other based on price, quality, and outcome for the patient’s business? The currency in this power structure is value, results, and achievement. These principles work in every other market when used – why not health care?
In this debate, direction is destiny. And the destination of the bill now before Congress is government-run health care.
The logic of this bill will require government rationing of health care resources. Last February, the Economic Stimulus package set up a new agency to do this, the Council for Comparative Effectiveness Research, or CCER, modeled on Britain’s National Institute for Health and Clinical Excellence—they call it “NICE”. CCER’s stated purpose is to identify medical practices that produce outcomes that work as opposed to those that don’t work. As long as there is a competitive private health care market, better information on price and quality could help bring much needed transparency to healthcare in America. But under the government-run plan, providers will not be paid for health care which CCER disapproves of. Once competing plans have been driven out, CCER’s approval or disapproval will dictate the care providers may offer, automatically denying treatments for certain categories of patients.
England’s NICE is now a rationing bureaucracy. Under NICE rationing, the government has capped the amount that may be spent on treatments to extend someone’s life by six months. The amount is $22,000, an arbitrary number arrived at not by medical professionals but by government accountants.
The idea that the government should make decisions about how long people should live is deeply offensive to everything America stands for. It is wrong to conclude that because health care resources are limited, therefore the federal government must ration care. This is what free markets are for: finite goods and services, including health care, are rationed by each person judging their unique needs as they allocate their own resources among competing producers. But should government do this with its “one-size-fits-all” template? I believe government rationing is morally and politically abhorrent. It denies basic personal rights. The sick, special needs patients, and seniors – those most at risk when the government involves itself in these tough decisions – deserve better. Like it or not, once government-run health care is a fait accompli, government rationing becomes the logical endpoint.
Now I want to speak from the heart to every provider of health-related services, including doctors and nurses, assistants, educators, hospitals and clinics. Many of you have traveled great lengths to join us today. You will be profoundly affected by the outcome of this debate. EITHER US health care will travel down a path directed by Washington, where you take your orders and instructions from the federal government – a path like that of our friends to the North and many in Europe – OR health care will be reformed to empower practitioners to pursue health care excellence. Countries that have chosen nationalized health services have wiped out individual competition and stunted innovation, by eliminating the incentives to outperform. By law or in effect, medical professionals become government wage earners without adequate reward for exceeding average standards.
Government-driven health care threatens providers in at least three ways:
First: Every aspect of government-monopolized medicine inevitably will be reduced to “cookie cutter” standards. As providers, you know patients’ conditions are not exactly the same. Treatments must be tailored to unique needs. Health care excellence like this is only possible under a vibrant free market.
Second: The cost and price structure of nationalized medical services are distorted by price controls dictated by political demands for low rates of reimbursement. The principal result is to shrink supplies of price controlled human and material resources – fewer doctors, medicines, & hospitals. Then government must manage the decline. The shortages must be spread around by deciding who shall receive and who shall be denied life-saving support. Patients with greater needs and groups deemed less worthy of treatment are the first victims.
Third: Government-run health services build barriers to talented young men and women considering a career in medicine. Today there is a growing need for more talented medical practitioners to care for aging boomers. America needs young people with ability and skill to take on the long years of education and incur substantial student loans to serve our growing need for health care. The best and brightest won’t do this just to become de facto government employees whose practice and reimbursement are dictated by Congress.
If government-run health care becomes law, it will prove lethal to America’s health care providers. We will be on the path to socialized medicine. The Congressional majority ridicules the claim that this is their objective, but the government-run plan which they propose as “an important tool to discipline insurance companies,” in the President’s own words, must lead step-by-step down that road. Mocking a fact does not make it untrue.
Some of the biggest health care organizations are trying to cut a “deal” with the Administration and Congressional leaders. With all due respect, they should know better. This is a fool’s errand. All they can salvage is a temporary stay of execution…because a government takeover of health care in the United States will either squeeze out or take over all private sector providers, large and small.
What is at stake in this battle goes far beyond health care. This debate encapsulates the defining issue of our generation: do we reform and strengthen American free market democracy, or abandon it for European-style social welfare?
If the majority party wanted more competition, why propose government insurance instead of enabling more non-profit insurance?
If they had no intention of transforming the system into Medicare for all, why do they tie all payments to Medicare?
If they were so worried about our skyrocketing national debt and the burden on the next generation, why do they want to create an entirely new entitlement that would deal a staggering blow to our economy – an entitlement that rivals the size and liabilities of Medicare and Medicaid? Just yesterday the Director of the nonpartisan Congressional Budget Office told the Senate that their health care plan would worsen the overall fiscal outlook, and his review so far of the House proposal draws the same conclusion. It makes the fiscal situation even worse.
The fact is, this is ultimately not about health care but about promoting an ideological objective. This nation, founded on the self-evident truth that unalienable rights were granted to all not by government but by “nature and nature’s God,” is to be remade into a “benevolent” social welfare state. Federal health care is but the first step. Until now, people in other countries that have chosen that path might at least come to the United States. But where will Americans go when the US also has government-run health care? There will be no place of freedom left to us.
Every day America’s health care professionals meet the critical medical needs of our people with selfless dedication and passion. They would jump in front of a bus to save their patients. They deserve not just thanks but our recognition that their excellent care cannot continue under a government monopoly.
This is not the time to stand to one side. Providers themselves must engage in the struggle for the future of their high profession and commitment to the wellness of our people.
August is the time for action. This is the time when Americans either engage this debate and tell Congress they reject government-run health care…or sit silently by while Congress forces it on them. The President and Congressional leaders are saying this has to be done immediately – it has to be done right now – and leave the details to them – they know best. Well, whether your pet peeve is Iraq or bailouts or the so-called stimulus, we’ve all heard that line before. You know what they say: fool me once, shame on you. Fool me twice – or in the current political environment – 3 or 4 times – shame on me. Will we heed this lesson?
I am initiating this call to every person and group involved in health care: you must act now! Doctors, your patients trust you, they will listen to your “prescription.” Ask them. They’ll jam the Congressional switchboards. They have done it before and need to do this from now through August. They will defeat this threat to everything America has stood for.
Let’s get government health care off the table. Then we can address real reforms to bring patient-based health care back to America.
Until recently, I hadn’t given much thought to what it actually means to have 20/20 vision. Like most people, I assumed that 20/20 vision was just a synonym for “perfect” eyesight. But when I recently spoke with optometrist Graham Erickson, a sports vision specialist, I realized that there is an entire medical field devoted to optimizing vision for athletes – so that they can see better than 20/20, perhaps even 20/8! In fact, 20/20 vision just means that you can see an object 20 feet away as well as the “average” person.
In my interview with Dr. Erickson, I learned that some professional baseball players have vision that is two times better than average, allowing them to judge pitches further away by seeing how the baseball’s stitches and seams turn in mid-air. This kind of vision is not necessarily something that you’re born with – it can come with training and good vision-correcting lenses. There are exercises that professional do to improve their contrast sensitivity, peripheral visual acuity, and reaction times. And we regular folks (weekend warriors, kids, and aspiring athletes) can also “pump up our peepers” with exercises that we can do at home. Please listen in to the full Healthy Vision segment to find out how to do these exercises:
I also learned that different athletes (such as basketball players, archers, and offensive linemen) have unique visual demands, and they train for those demands quite differently. While a basketball player may focus on improving his “court vision” (dividing his attention between guarding “his man” and being aware of what’s going on in the periphery), an archer may rely almost exclusively on her central vision,
while an offensive lineman may need to split his attention between central near vision (controlling his man) and peripheral vision to pick up shifts by the defense. Since it’s estimated that 80% of the information we take in (while playing sports) comes from our eyes, even slightly blurry vision can dramatically affect performance.
Even though there is a lot that athletes can do to improve their visual skills, very few competitive athletes get annual comprehensive eye exams. In my latest Healthy Vision episode, NBA star Tyreke Evans* offered a call-to-action to his peers regarding regular check ups, and World-Champion female sprinter Allyson Felix spoke to me about the role that good vision has had in her success.
Sacramento Kings' Tyreke Evans
In summary, I learned from Dr. Erickson and Allyson Felix, that eye fitness is a critical part of competitive sports, but unfortunately something we often don’t think about. There are new training programs that help to develop peripheral vision skills that may reduce the risk of being blind sided in football or hockey games, and can therefore reduce concussion risk. Athletes should seek out an eye care professional who specializes in sports vision in order to optimize their visual potential. The American Optometric Association’s Sports Vision Section offers a doctor locator to help patients find sports vision experts in their area. Please check out the website here (or their Facebook page) for more information.
When I asked Meaghan Martin (star of Mean Girls 2, 10 Things I Hate About You and Camp Rock among others) what was the most difficult thing about being a teen these days, she didn’t hesitate: “Being a teen has always been difficult, but today there are so many ways to be rejected. Between Facebook, Twitter, and other online sites, it seems as if every day there’s a new way to be un-friended, excluded, or picked on.”
I interviewed Meaghan about her perspectives on teen self-esteem issues and the impact that physical appearance can have on young men and women. You can listen to the edited interview here (starts at minute 12:02):
The most striking thing about Meaghan is that she is a genuinely nice person. Down-to-earth, confident, empathic – she exudes an inner peace that is downright wholesome. How did she escape her teen years relatively unscathed by hormonal angst, I wondered? The secret, she said, was loving parents.
“I was a typical nerd as a kid. I had glasses, braces, and an asthma inhaler. But I didn’t care what others thought of me, because my parents told me that I was a good person who could do anything I wanted in life. They taught me self-confidence, and supported me 100% in anything I wanted to do. I was so blessed to have parents like that.”
I chuckled as I remembered my pre-teen and teen years, sharing with Meaghan that I was a lot like her – except that I had traded the asthma inhaler for acne. For me, Read more »
Attention-deficit/hyperactivity disorder (ADHD) is probably overdiagnosed by physicians. In the lay public, the term is often used jokingly to describe the common feeling of distraction we experience in a world filled with interruptions. With a constant stream of text messages, Facebook updates, TV commercials, and fast-paced Twittering, there’s little wonder that we all feel frazzled at times.
But the occasional experience of jangled nerves is not a proper basis for a diagnosis of ADHD. Unfortunately, there has been great confusion between the actual disorder, and its misuse as a label for simply feeling distracted.
So to help set the record straight and to tease out fact from fiction, I’ll be attending a forum on Capitol Hill with my co-bloggers Dr. Kevin Pho and Dr. Rob Lamberts.
It s no secret that most physicians are unhappy with the way things are going in healthcare. Surveys report high levels of job dissatisfaction burn out and even suicide. In fact some believe that up to a third of the US physician work force is planning to leave the profession…
I am a huge fan of the winter Olympics partly because I grew up in Canada where most kids can ski and skate before they can run and partly because I used to participate in Downhill ski racing. Now that I m a rehab physician with a reconstructed knee I…
When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…
I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…
I met Dr. Marty Makary over lunch at Founding Farmers restaurant in DC about three years ago. We had an animated conversation about hospital safety the potential contribution of checklists to reducing medical errors and his upcoming book about the need for more transparency in the healthcare system. Marty was…