Recently in Medicine Category

William Olmsted, a Dallas Catholic priest convicted of molesting a 10-year-old girl, has been allowed by church authorities to continue in ministry, under certain restrictions.

Aren't you angry? When will the church learn? Etc.

Actually, that's not true. Olmsted is not a priest at all, but rather a child psychologist who was recently allowed by the state licensing board to keep his license to practice medicine, despite his conviction. It's an outrage -- but just think how infuriated people would be if this were a church tribunal going so easy on this skunk instead of a board of his medical peers! From today's Dallas Morning News story:

Olmsted, 46, was placed on probation for 10 years, with certain restrictions. He must submit to a psychiatric evaluation; limit his practice to a group or institutional setting, and to treatment of adult males only; complete "professional boundaries" courses; and pay a $5,000 fine.

He also must follow the terms of his plea bargain with Dallas County, where he agreed to six years of deferred adjudication and registration as a sex offender, including the requirements that he stay away from children other than his own and obtain counseling.

How does this happen?

UPDATE: As a reader points out in the comments below, I mistakenly assumed he was still allowed to treat children, even though the story clearly indicates otherwise. I've changed the text here to reflect that. That makes this story not quite as bad, but still, I don't understand how a psychologist convicted of sexually abusing a child is thought to be responsible enough to treat anybody.

Have you heard about the teapot-tempest surrounding Regina Benjamin, Obama's pick for surgeon general? No, it's not the fact that she's the latest in a string of pro-abortion Catholics Obama has appointed to a post in his administration (has the "common ground" president ever met a pro-life Catholic he liked, one wonders?). It's about her weight:

Dr. Regina M. Benjamin, Obama's pick for the next surgeon general, was hailed as a MacArthur Grant genius who had championed the poor at a medical clinic she set up in Katrina-ravaged Alabama.

But the full-figured African-American nominee is also under fire for being overweight in a nation where 34 percent of all Americans aged 20 and over are obese.

Critics and supporters across the blogsphere have commented on photos of Benjamin's round cheeks, saying she sends the wrong message as the public face of America's health initiatives.

But others support the 52-year-old founder and CEO of Bayou La Batre Rural Health Clinic, citing new research that shows you cannot always judge a book by its cover when it comes to obesity. [...]

Even some of the most reputable names in medicine chimed in.

"I think it is an issue, but then the president is said to still smoke cigarettes," said Dr. Marcia Angell, former editor of The New England Journal of Medicine who is now a senior lecturer at Harvard University Medical School. "It tends to undermine her credibility."

"We don't know how much she weighs and just looking at her I would not say she is grotesquely obese or even overweight enough to affect her health," Angell told ABCNews.com.

"But I do think at a time when a lot of public health concern is about the national epidemic of obesity, having a surgeon general who is noticeably overweight raises questions in people's minds," she added.

Frankly, this is ridiculous.

I'm not able to support Dr. Benjamin, due to her abortion views--though I think it could be argued that the issue of pro-abortion Catholics is a far greater scandal for the Church than for the State; we live in a State where it's legal to kill human beings before they're born, so believing in and supporting the legalized killing of unborn humans doesn't disqualify anyone from government positions in this nation, sad though that is to people like me.

But attacking her on the basis that she's overweight, and thus lacks credibility to be surgeon general, is so wrong-headed I almost don't know where to start. Weight issues are complex; people who struggle to maintain an ideal weight are usually dealing with issues beyond just the physical, that go deep into emotional/psychological territory. A gain of twenty or thirty pounds above the ideal may take years to erase, even if the person in question is eating moderately and exercising regularly; our bodies are, generally speaking, better at maintaining excess weight than losing it.

For all anybody knows, Dr. Benjamin could already be addressing her weight issues, and might be able to bring her personal experience to bear in focusing on our national obesity epidemic. As someone who struggles with weight myself, I know I'd rather hear what someone who has also been on that journey has to say about it; people who are naturally thin and who've never had to lose more than five pounds are sometimes awfully dismissive of the sheer level of time and effort and focus it takes to lose three or four of five times that amount.

There might be legitimate reasons to oppose Dr. Benjamin's appointment to be our nation's surgeon general. Her weight isn't one of them.

Good morning, all! Doing a bit of co-blogging today so Rod can concentrate on other things.

Is it just me, or does some of the language being employed in the health care debate sound a little odd? For example:

House Democrats on Tuesday rolled out a far-reaching $1.5 trillion plan that for the first time would make health care a right and a responsibility for all Americans, with medical providers, employers and the wealthiest picking up most of the tab.

The federal government would be responsible for ensuring that every person, regardless of income or the state of their health, has access to an affordable insurance plan. Individuals and employers would have new obligations to get coverage, or face hefty penalties. [...]

The legislation calls for a 5.4 percent tax increase on individuals making more than $1 million a year, with a gradual tax beginning at $280,000 for individuals. Employers who don't provide coverage would be hit with a penalty equal to 8 percent of workers' wages with an exemption for small businesses. Individuals who decline an offer of affordable coverage would pay 2.5 percent of their incomes as a penalty, up to the average cost of a health insurance plan. [All emphasis added--E.M.]

Now, there are plenty of other details in the House's plan that seem odd, such as the idea of expand Medicaid coverage for individuals and families up to 133 percent of the poverty line, but for the moment I'm more struck by the words being used. Health care is a right and a responsibility? Americans are obligated to purchase coverage, or they'll face penalties?

I think one of the frustrating things about talking about health care is that just about everyone agrees that people ought to be taken care of when they are ill or suffering. That's health care, and making sure people can get it is a good thing.

But what we're really talking about is mandating insurance coverage--and anyone who thinks that insurance coverage and health care are the same thing probably hasn't dealt with either one lately.

People who have insurance coverage can still lack access to health care. You might live in a rural area and need to see a specialist, for instance--but the nearest one is a considerable distance away, and you'll pay an "out of network" fee for going to see him, provided your primary care physician will give you the required recommendation in the first place. Having the option to buy a government insurance plan isn't going to change that situation for you in the least, and there's a chance that the government plan--should you switch to it--won't cover your visit to a specialist at all, especially if your condition is not life-threatening or doesn't meet other guidelines for care beyond a visit to your primary physician.

On the other side of the equation, people who lack insurance coverage aren't necessarily cut off from health care. The House plan estimates that 17 million people will remain without health insurance, half of them illegal immigrants. For this group of people, the availability of a government insurance plan doesn't change their ability to receive care at emergency rooms or similar facilities--and no, that's not adequate access to health care, but the point is that nothing about the new health care plan will change that. If you are an illegal immigrant in America, your ability to receive health care will be the same after a government plan option is initiated as it is beforehand.

Granted, for some people increasing their opportunities to purchase health insurance, subsidizing that insurance, and offering a government plan to compete with private insurance may help increase their overall access to health care--but for others of us, having more options to purchase health insurance, along with specific mandates to do so or be penalized, won't "fix" the aspects of health care our experiences of the industry find most broken at the present time.

Besides, when we employ the language of rights to talk about health care, I think we're in danger of losing sight of the pragmatic realities. It's true that people have certain basic human rights--food, clothing, shelter, and the like--and that the sick and suffering also have the right to receive care, even if we need to help them pay for it. But mandating that people be obligated to purchase health insurance, private or government-provided, or face penalties for the failure to do so may not change the landscape of health care as much as we'd like to think it will.

The debate over President Obama's health care plan continues to grow, and it looks like the government plan provision will be the point of greatest contention:

The impasse is rooted in ideological divisions that doomed former President Bill Clinton's health care plan in the 1990s. "The public option discussion is a mirror of the debate we've been having for 60 years about the government's role in health care," said Sen. Ron Wyden, D-Ore.

Part of the problem seems to be that Obama hasn't spelled out what he wants in a public plan, even as he expresses strong support for the idea. His health secretary, Kathleen Sebelius, said Friday that Americans need a new government-sponsored insurance plan to guarantee choice and competition -- especially in rural areas. "What the president feels is important is to have some competition and to have a choice," Sebelius said at a round-table discussion in Omaha, Neb.

The government already has a public plan for the elderly -- Medicare. And there's Medicaid for the poor.

But a government plan for middle-class workers and their families would be new.

Under some scenarios, a government plan could undermine one of Obama's central health care promises: that people can keep the coverage they have if they like it.

A recent analysis by the Lewin Group consulting firm found that if the new government plan was modeled on Medicare and open to all employers and individuals, it would swamp the private insurance industry. Employers and individuals would flock to the public plan because of its lower premiums. Private insurance enrollment would plummet by about two-thirds.

It seems that the divide among Americans about the government's role in health care is as wide as ever. Democrats want a public plan, and they appear to want to go farther than President Obama's campaign idea to limit a public plan to individuals and small businesses. Republicans want Americans to continue to have the private insurance option--but a public plan that all employers could use would effectively end that for the vast majority of American workers, as corporations ended their relationships with insurance companies in favor of the government plan option for their employees.

Doing nothing, the president said recently, is not an option; but as both sides of the debate dig themselves back into their longstanding ideological trenches, it's hard to see what, if anything, will actually be done.

President Obama's health care plans may have hit a little snag: turns out that doctors don't like a key provision:

WASHINGTON -- As the health care debate heats up, the American Medical Association is letting Congress know that it will oppose creation of a government-sponsored insurance plan, which President Obama and many other Democrats see as an essential element of legislation to remake the health care system.

The opposition, which comes as Mr. Obama prepares to address the powerful doctors' group on Monday in Chicago, could be a major hurdle for advocates of a public insurance plan. The A.M.A., with about 250,000 members, is America's largest physician organization.

While committed to the goal of affordable health insurance for all, the association had said in a general statement of principles that health services should be "provided through private markets, as they are currently." It is now reacting, for the first time, to specific legislative proposals being drafted by Congress. [...]

But in comments submitted to the Senate Finance Committee, the American Medical Association said: "The A.M.A. does not believe that creating a public health insurance option for non-disabled individuals under age 65 is the best way to expand health insurance coverage and lower costs. The introduction of a new public plan threatens to restrict patient choice by driving out private insurers, which currently provide coverage for nearly 70 percent of Americans."

If private insurers are pushed out of the market, the group said, "the corresponding surge in public plan participation would likely lead to an explosion of costs that would need to be absorbed by taxpayers."

This is interesting. Plenty of people on the right have been saying this sort of thing, of course, but the A.M.A. is coming at this from a different perspective than the usual partisan one. I've heard doctors express frustration before at the tangled rules and complex pay schedules they have to deal with every time a patient uses a government insurance program like Medicare or Medicaid; perhaps they are worried about the effects that a "...surge in public plan participation..." would have on their ability to maintain today's standards of care.

President Obama is to give a speech to A.M.A. members on Monday in Chicago. It will be worth paying attention, to see if he addresses this concern expressed by the A.M.A. about public health insurance.

Now that President Obama is back from his latest foreign travels, we can be pretty sure that health care is fairly high up on his agenda. The latest White House meme on the health care situation seems to be this...

I know, I know, Deepak Chopra's a co-author of this Wall Street Journal op-ed piece, but what he and his co-workers report -- that alternative medicine (used by 38 percent of the US population, according to a recent poll) is...