At this point, I’m not even sure Obama would get my next vote much less a peace prize. FAIL.

Judge Callahan says that it violates the constitution to do that and so now pull up your socks ’cause it’s time for Mr. Toad’s Wild Ride!

In a prepared statement, Abbott said he would appeal the ruling “to defend the traditional definition of marriage that was approved by Texas voters.”

His statement also said, “The laws and constitution of the State of Texas define marriage as an institution involving one man and one woman. Today’s ruling purports to strike down that constitutional definition – despite the fact that it was recently adopted by 75 percent of Texas voters.”

Gov. Rick Perry, who pushed for the constitutional prohibition on gay marriage in 2005, expressed confidence that the ban would stand up to this challenge.

“Texas voters and lawmakers have repeatedly affirmed the view that marriage is defined as between one man and one woman,” he said in a prepared statement. “I believe the ruling is flawed and should be appealed.”

So, basically, Perry and Abbot were so jealous of South Carolina’s politicians stealing the dumbass/ignorant spotlight they’ve jumped on the next best thing. Beat up on the gays. Nothing says election season like gay bashing!

We often hear the the health care system in America is the best in the world. But, what exactly do we use to back those numbers up? Our longevity is up, recent reports indicate we are living longer than ever. (More on that in my first post on this subject) Let’s start with infant mortality.  When the United States is compared to other countries, the picture is disappointing.  The U.S. Census Bureau indicates that 43 countries have life expectancies that exceed the United States, and 40 countries have a lower infant mortality rate than the United States. In the article “How American Health Care Killed My Father,” David Goldhill writes in the Atlantic that roughly 100,000 deaths every year in America are caused by or influenced by infections picked up in hospitals.

One hundred thousand deaths: more than double the number of people killed in car crashes, five times the number killed in homicides, 20 times the total number of our armed forces killed in Iraq and Afghanistan. Another victim in a building American tragedy.

It’s getting harder and harder to define the system as the best in the world. The talk of reform doesn’t even begin to address the issues of health care. It addresses the soaring costs and access, but the actual care and real reform is a long way off. In the same article, the costs of our broken health care system seem astronomical. Goldhill writes,

Already, the federal government spends eight times as much on health care as it does on education, 12 times what it spends on food aid to children and families, 30 times what it spends on law enforcement, 78 times what it spends on land management and conservation, 87 times the spending on water supply, and 830 times the spending on energy conservation. Education, public safety, environment, infrastructure—all other public priorities are being slowly devoured by the health-care beast.

For me, the numbers are staggering. As a businessman myself, it’s when we start talking money that I really start to pay attention. As a former health care executive, I have had the best health insurance available. I’ve rarely paid more than $5 for any prescription drug or $40 for an emergency room visit. I had surgery that only costs me a hundred dollars. Surely my health care actual costs were in the thousands (probably tens of thousands) of dollars, but I was completely unaware. My employer paid 100% of my premiums and my out-of-pocket expenses never caused me any financial pain. For me, there has been little incentive to reform anything in the employer funded health care system in America.

However, I started my own business a couple of years ago and had to source my own health insurance and my out-of-pocket expenses suddenly increased. My premiums went up dramatically and even though I have been fully insured with no gaps I was still subject to a pre-existing condition clause. My deductibles went up, my prescription costs skyrocketed. (You should have seen the shock on my face at the Walgreen’s when they said $200! I had no idea any drug could cost that much!).  Even though I am in good health, the insurance company accepts the risk that they will lose money on me. I get that, so let’s spread that risk for all of us self-employed folks. Spreading the risk reduces the cost. I’m beginning to see the benefits of a “public option” for health care.

I’m also paying for the sins of others. For all of those people that do not get preventive care and rush themselves to the emergency room, I’m talking to you. (And no, it’s not just the poor and uneducated that use the emergency room as a primary health clinic, but they make good villians in this debate) Every non-emergent visit to the emergency room that is covered by health insurance costs all of us. Those that are not covered by insurance that use the emergency room as a clinic are even more worrisome. They show up too late and require extensive services that cost many more times what they would if the person had been treated early. They also clog the emergency room with minor illnesses that increase the delay in services for other patients, tax staff and waste resources.

The more I think about the health care system in America, the more I know that it is a lot of things but the “best in the world” it surely is not.

I wouldn’t favor the compassionate release of a mass murderer in the first place, but to see the flag-waving heroes welcome just makes me want to drop bombs on the whole country. What kind of fucked up mental state are people in that they celebrate the murder of 270 people? Is it fair for me to condemn the whole country? No, but if there are some right minded people there why aren’t they rising up against this kind of insanity?

Ugh, it makes my head hurt.

There are many reasons people die painful and slow deaths in this country. The advances in medical care that prolong life, the egotistical doctors that want to pump frail bodies ravaged by cancer full of chemotherapy to the very end, families that refuse to let go even when the patient begs to die. I know, I’ve seen all of these and more. I’ve helped families that received the bad news pick up the pieces and decide the right course of treatment for mom or grandpa. It’s never easy, and no one relishes accepting that death is imminent. I do take pride in the fact that I helped people in pain have a “good death” and to go from this earth without pain and with some bit of dignity and ability get their affairs in order.

Hospice care is provided and paid for in full by Medicare for six months (in some cases longer, if the patient survives and re-qualifies). [see benefit] Hospice benefits provide social worker services to navigate living wills, family arrangements and counsel with the patient and the family on the diagnosis, nursing care, medications, home health aide visits, spiritual counseling, volunteers and even provide for grief counseling for the survivors for up to a year. Yet still, nationally, nearly 32 percent of dying patients had hospice care during the same period, for an average of 11.6 days. (NYtimes)

When a patient is terminal and in pain, what is more sadistic…to provide comfort and emotional care at end of life or to continue aggressive treatment and false hopes while not treating the pain?

I’ve seen too many families that came to us at the last minute desperate for some help only to have their loved one die before we even got a nurse out to their home.

We will all die. Me, I’d prefer it to be pain free and in my home surrounded by my family rather than stuck in a nursing home reeking of urine.

I’ve held the hands of patients as they breathed their last breath and known that I’ve helped them and their family with the greatest gift, a good death. I have cried along with sons and daughters as they acknowledge a parent is terminal and seen their relief as I explained how hospice is going to help them during the most dramatic time of their life. I’ve learned great wisdom at the bedside of terminally ill patients and their bravery helped me confront my own mortality.

It is up to you to decide when enough treatment is enough, but the medical professionals treating you should tell you the truth about your condition and your options with care.

For example, if you are 90 years old with terminal cancer and fall and break your hip you probably shouldn’t have hip replacement surgery. I’m not a clinician, but I can tell you that a lot of patients don’t survive that surgery at that age and medical condition and if they do they usually only last a few days afterwards. Why put patients through that additional pain and families through the false hopes of recovery?

I’m no longer in hospice. It takes its toll on the living that live their lives dealing with death. I take many things from my time with patients and the deaths that were part of my job. None of what I take from my experience could ever be called “rationing” or a “death panel” and I’m deeply offended at the implication in the remarks from some of the most irresponsible people I’ve ever seen handed a microphone. Shame on them.

This is the first in a series of my personal opinions on the great health care debate. More to come.

When people show up with photos of the president to look like Hitler, you know from the outset that you are dealing with idiots. The irony I find delicious is how the Republican Party is so masterful at manipulation. They can stir up the dumbest and poorest people to oppose sweeping legislation that would mostly benefit them.

At these town hall meetings, I’ve not seen one person stand up and say “I make over $500,000 a year and I’m worried about how this legislation would impact my taxes.” Now that, is an objection that warrants a discussion.

So Tom DeLay will appear on Dancing with the “Stars” this season. Oh thank God, I was wondering if just slinking off to obscurity was going well…now we’ll know for sure! I would have paid at least $4,000 to be in the room when this got pitched to Tom. Whomever could sell him on this being a good idea totally gets a job offer for me. I need some good con artists sales people.

Reality: As of March 31, Texas Health had $1 billion in cash, down 6 percent from year-end 2008 and 22 percent from year-end 2007.

Let’s keep it in perspective folks. Yes, there are millions of uninsured and under-insured and millions subjected to pre-existing condition clauses. There are millions of us that resent the amount of premiums we have to pay and our high copays and deductibles that used to be awesomely low because we are smart and have better jobs than poor and dumb people that have high deductibles and coinsurances, etc so on and so forth.

An don’t get me started on the “yellers” at town hall meetings. Dear God I hate yelling. If we could implement a national health plan that would cut vocal chords of the stupid at an early age, I would be all for it! I’ll go lobby congress tomorrow for that one.