Tag Archives: Health Policy

New Post at Pan American Zoonotic Research and Prevention (PAZ)



Click here if this isn’t patently idiotic to you→http://pazresearch.org/2013/09/13/stupid-funding-cutbacks/







Chagas’ Disease is NOT the new AIDS: Part I


It is a great picture of the bug, though. Why do biting arthropods always have their portraits taken while posing on human flesh?

Chagas’ Disease, while being a medical nightmare, is not the new AIDS.

  • The first, and perhaps biggest problem with this article is calling Chagas’ Disease the “new” anything. Chagas’ disease was discovered in 1909 by a brilliant Brazilian scientist, Carlos Chagas. Chagas’ discovery was justly recognized for this great discovery during his own lifetime.
  • Chagas’ disease is like AIDS, in that it targets certain populations, but that is where the similarity stops. Chagas’ disease is spread by a vector (bugs of the family Reduviidae) that is exquisitely evolved to infect the poor, as it is related to low-quality housing. AIDS does target the poor of the world more than the rich, but there are certain groups that AIDS targeted, or continues to target, that have nothing to do with economic standing. AIDS is not transmitted by arthropod vectors (though there was concern in the early years of the pandemic), but by sexual contact and contaminated transfusions and medical equipment. Chagas’ disease can be spread by transfusion, but this risk is decreasing. As of a few years ago,around two decades after the blood supply began being screened for HIV,  the blood supply in the US began being screened for Chagas’ disease.
  • Chagas’ disease is called a Neglected Tropical Disease. These are diseases that have high prevalence in the hotter regions of the globe, affect a large number of people but yet do not get a lot of attention from the press, their governments, NGOs, and even much of the local population. For example, many residents of Lima (where the power is) don’t even know what Chagas’ disease is, even though it afflicts a large number of Peruvians. Why?  It doesn’t occur in Lima, and public education about the disease does not extend to those who won’t get it, even though they may be the ones most able to help.
  • Stigma: Yes, it sucks to get AIDS or Chagas’ or both together. But tell me from your heart of hearts: Which would you rather tell your co-workers and parents–that you’ve contracted HIV or that you’ve contracted Chagas’. I’m betting on Chagas’. 30 years into the epidemic, and HIV/AIDS still carries a burden unmatched by any other disease.
  • Research funding: No comparison. HIV/AIDS has been a research juggernaut over much of the pandemic. As a result, we’ve made brilliant and amazing progress in treatment and prevention of the disease. Chagas’ disease is still treated by the same two lousy drugs that were used over a decade ago. Some research is being done on new treatments, but I you’d be embarrassed to see the shoestring some of those labs run on. Moreover, most of these studies involve using drugs that were already approved for other indications, such as anti-fungals and anti-malarials.(They ain’t much money to make sellin’ drugs to po’ folk in the developin’ world.)

    No mention of Chagas' disease here.

    No mention of Chagas’ disease here.

Your Mouth Is Not Part of Your Body



ONE would think, to judge by the way health care insurance is provided, that the mouth is some separate entity, rather than the part of your body you probably use the most. Dental insurance, then, becomes like the rider to your homeowner’s insurance that covers your grandmother’s jewelry or your collection of stamps–it  requires some sort of different coverage. I don’t know how the hell you’re supposed to eat, drink, kiss, or bite the fingers off of your predators without a mouth, but health insurance separates this one very important part of your body from everything else. It’s a historical anomaly, and one that should have been corrected when we let surgeons become doctors. If you haven’t noticed already, there’s a fair amount of pathology that can occur within the oral cavity, and much of it is related to illnesses elsewhere in the body.

Why doesn’t basic health care insurance cover problems to the teeth and gums? My primary care doctor’s exam of my mouth is brief and cursory. Would he be able to tell if I were unable to chew my food properly? Would he know where to look for the most common oral tumors?

I went to public health school at Boston University. They have a dental school. Were teeth or oral health even mentioned once during my time there?  (That was a rhetorical question. No, of course, they were not. You would think that with the fluoridation of water being cited as one of the ten greatest public health measures of the 20th century that a light bulb might have gone off over someone’s head, but you would be wrong.)

Why am I thinking about all of this? Well, for one reason, I am now in the situation of shopping for dental insurance. Want to know what I’ve learned? Dental insurance sucks raw eggs. It eats donkey dung. It takes your premiums and then sneers at your pain. Worse than that, it doesn’t do enough for children who are going to need lots of care in order to get the smile that is required for getting a good job in this society.

Dentistry, as sufferers from dental problems know, does not come cheaply. According to thewealthydentist.com, a 2009 survey found the average root canal fee is $740 for a front tooth and $1,000 for a molar. Considering that the average dental insurance only pays around 60-70% for these procedures, the bill will come with an out-of-pocket expense of  around $300. Benefits with most plans generally max out at around $1000-$1300 per year, and you can see that it’s going to take some serious jack if you’ve got more than an occasional problem.

Those of us who were lucky enough to grow up in financial security, along with parents who appreciated the fact that one is neither employable nor datable with a rotten mouth, can most likely survive with this insurance. It sensibly pays for two cleanings a year, helping the insurance company avoid having to pay out for more sever problems. But if you’re the person who grew up in where water wasn’t fluoridated, where you parents had rotten teeth, etc, you’re probably not in position to pay for all the work that needs to be done.

Chew on that for a while, if you can.


Happy New Year! Barely anyone died of Avian Influenza last year,

Making it a good yeargoodyear



Date: Fri 28 Dec 2012

Source: The Poultry Site [edited]



According to the World Health Organisation (WHO), there have been 32

cases of avian A(H5N1) influenza virus infection in humans so far this

year [2012], 20 of whom have died.

According to the latest figures, published by WHO on 17 Dec 2012, most

of the victims were in Egypt (11 cases; 5 deaths) but there were also

9 cases in Indonesia, 4 in Viet Nam, 3 in Bangladesh and Cambodia, and

2 in China.


Last year, 2011, there were 62 cases, of whom 34 died.


Since the emergence of H5N1 influenza in 2003, 610 people are reported

to have become infected, 360 of whom have died.


Still virulent after all these years

Still virulent after all these years

Go Get Your Flu Shot

My kids’ pediatrician doesn’t “believe” in the flu shot. That’s the word he uses, but since I know him to a person who thinks carefully about things, I know he means that for him the evidence just doesn’t add up. I look at the same evidence and I come to a different result. I am getting the flu shot, and my children will also. I don’t have a choice–the United States Army Reserve requires that I get vaccinated. They figure that a soldier with the flu isn’t worth much, and is a danger to other soldiers. Right on both counts.

As for my kids’ doctor, he’ll give patients the injection if their parents ask for it, or if they are in a one of the groups designated as high risk. The concern with healthcare workers, of course, is that they will be super-spreaders of the disease to vulnerable populations.  People infected with influenza begin to shed virus before they begin to show signs.

Don’t be a wimp


Is Infertility a Public Health Problem? The Responses


I received two comments on the post on infertility and public health, one pro, one con, both from women with degrees in the health professions.


Richard – Sorry, sweetie, but yours is a much too simplistic way of viewing the biological imperative to bear a child. Approximately 7 million Americans are currently experiencing infertility (1 in 8 couples). The causes of infertility are many (not just ‘advanced maternal age’): structural, Endometriosis, DES, low sperm count, tubal disease, DES exposure, STD’s, stress and who knows what else.
You say that “loving a child is the easiest thing to do – THINKING that you need to create something in your genetic imprint is egotism in the highest degree…” I would say that I love my child beyond all measure, and, at times, it isn’t easy to love her. Read Winnicott, or, how about “The Monster Within: The Hidden Side of Motherhood” by Barbara Almond. Nevertheless, regardless of the ambivalence many parents feel about their children as they raise them, women AND men dream of being parents from the time they themselves are children. It’s one of the “high dreams”, if you will. We are, as a species, inherently both selfish and compassionate, fearful and capable of tremendous love (was just listening to a great program on Wisconsin NPR about this!). Is it sheer egotism to want a child who has your husband’s nose and musical abilities and generosity, or to hope that your child has your hair color and artistic eye or love of mathematics? Why judge this so very harshly? Carrying and bearing a child is also the high dream of most little girls and one of the supreme joys, as far as I’m concerned, that anyone can possibly experience. It carries with it, great risks (although, thankfully, not like it used to a mere 100 years ago), as does parenting ones own biological child.
When my husband and I found out that I was “infertile”, I wasn’t particularly surprised. But I was devastated, as was my husband. I read everything I could, I joined a support group, saw a therapist a couple of times who specialized in infertility. I had to dig as deep as I could about what was important to me. I had actually always been open to the idea of adoption whether or not I had “my own” children, but I was also very aware of the stories of friends of my parents who had adopted children; not one of them had escaped unscathed – meaning, there had been serious and heart-breaking issues with each of these families. I knew if we were to adopt we could be inviting any number of “extra” risks that we might not have encountered had we had biological children. It’s my experience that most couples are very, very thoughtful about the issues and options that arise when they are faced with infertility disease.
Should insurance companies be forced to cover fertility treatment? Should insurance companies be forced to cover impotency? or diabetes? or bipolar disorder? Should they pay for birth control? or substance abuse treatment? Is infertility a public health issue? See http://www.healthandenvironment.org/initiatives/fertility; http://www.healthandenvironment.org/initiatives/fertility; “Carolina Papers International Health: A Global Perspective on Infertility: An Underecognized Public Health Issue.
In closing, let’s ponder the idea of whether unmitigated sarcasm (“sarcolepsy”) should be considered a public health liability. I love you, my friend, but I think you are being a poop-head and rather mean-spirited to boot.


From Lynn Williams, RN-P

My feeling has always been that undergoing fertility treatments instead of adopting a child is like buying a dog or cat from a breeder instead of adopting one from a shelter. Shelling out big bucks for a “purebed” animal or for a mini-me, when there are so many homeless creatures, human and non-human, languishing in shelters and hellish third world orphanages, is, as you put it so well, egotism in the highest degree. The fact that the earth’s resources are already stretched to the limit makes this practice indefensible, and asking taxpayers to foot the bill is outrageous. I would like to see a 5-year global moratorium on human reproduction. Just about every social problem I can think of would be, if not resolved, at least palliated by such a measure.

His love for us was so great,

that even from Beyond the Grave, this wonderful, kind, and always smiling Man is still trying to save you from liberals . No wonder we love him so much.

St. Ronald speaks out against Medicare

Things to be thankful for this holiday season

American life expectancy is shorter than countries like Finland, Sweden and Denmark. One of the legacies of American Conservatism is the gift of having to put up with fewer years of the creeping socialized medicine ruining this country, thereby reducing  just yet another indignity of old age.

We love you, Ronny!