Just in time for sounding extra-smart when discussing health care, Merrill Perlman dissects the finer points of how to correctly use insure, assure, and ensure for Columbia Journalism Review’s Language Corner. Allowing for the fluidity of English (and subtle, disputed uses), Perlman still manages to boil down general proper rules into one illustrative sentence: “In Washington, legislators are trying to ‘assure’ their constituents that they are working to ‘ensure’ that any new health-care bill will ‘insure’ them.”

Source: Columbia Journalism Review

Rep. Joe Wilson (R-SC) issued his now infamous outburst—“You lie!”—during a very specific part of President Obama’s health care speech: the dismissal of claims that a new health care plan would cover “illegal” immigrants.

“In an instant, Wilson was willing to breach protocol, embarrass himself, and undermine his party—because he was so infuriated by the idea that Obama’s plan might provide care to a certain group of people,” Channing Kennedy writes on ColorLines’ blog RaceWire.

To illuminate why “our conversation around immigration [is] so often driven to extremes, both of language and of policy,” Kennedy points to a fantastic short video about the loaded term illegal featuring ColorLines publisher (and 2008 Utne visionary) Rinku Sen.

Source: RaceWire, ColorLines

When assault rifle toting, anti-health care reform advocates stormed town hall meetings, many people thought it was big news. The bigger story, according to the Pew Research Center, was that Brett Favre was returning to professional football. A full 69 percent of people heard at least something about Favre returning to the NFL, while 66 percent heard about the gun-wielding protesters. Both of those stories trumped the news that former Homeland Security Secretary Tom Ridge announced that he was pressured into fiddling with the terrorist threat levels for political purposes. Almost half (48 percent) of the people surveyed said they had heard nothing of Ridge’s allegations.

Source: Pew Research Center 

With the public option clinging to life and the health care debate drowning in a sea of hyperbole and lies, efforts to insert truth and nuance into the debate are constant, if not entirely successful.

Morning Edition spent eight minutes debunking myths about Britain's National Health Service in, which Republican Congressman Charles Grassley says would kill Ted Kennedy if it could only get its hands on him.

The Daily Dish has collected all of its View from Your Sickbed posts in one place. This moving series of posts from Daily Dish readers is as damning an indictment of the current sytem as any I've seen.

Foreign Policy takes the side door into the debate, placing a summary of the decisions that have shaped the current U.S. health care system at the end of a list of the world's worst healthcare reforms.

Meanwhile, the battle to discredit the Obama "death panels" rages. A new poll finds that 57% of Republicans either believe or are "not sure" about the truth of claims that President Obama and supporters of health care would murder the terminally ill. Thank you (again) Sarah Palin.

Sources: Morning Edition, Daily Dish, Foreign Policy 

Image by  José Goulão , licensed under  Creative Commons .

Type-2 diabetes has reached epidemic levels in the United States and is particularly destructive in low-income and immigrant communities where, according to a New American Media report, language and education barriers affect “the patient’s ability to read food labels, track blood sugar levels, assess insulin amounts, record meal schedules and communicate with clinicians.”

A new program in San Francisco helps low-income and immigrant patients manage their diabetes over the telephone. Participants who enroll in the project—Improving Diabetes Efforts Across Language and Literacy (IDEALL)—aim to better control the disease and its associated health problems by receiving weekly phone calls from an automated telephone support system. Each call is delivered in the patient’s native language (English, Spanish, or Cantonese), and depending on his or her responses, the system generates information “regarding issues ranging from symptoms and taking prescribed medications to diet, physical activity, and self-monitoring of blood sugar.” If necessary, a nurse calls back for a “live” chat.

Dr. Dean Schillinger, director of San Francisco General Hospital’s Center for Vulnerable Populations, which runs the project, told New America Media: “We were really impressed that diabetes patients with limited literacy and limited English proficiency, who many health care workers consider to be ‘hard to reach,’ were the most likely to use this communication tool. . . . We found that better communication between a public health care system and the vulnerable populations they serve yielded concrete benefits.”

It looks like San Francisco wants to expand the program, and not a moment too soon: The University of California at San Francisco estimates that 3 million Californians—about 1 in 10 of the state’s residents—have the disease.

Source: New America Media

Healing lepers, giving sight to the blind, the Bible portrays Jesus as a one-man health care reform plan. A significant portion of the gospels are devoted to the idea of healing the sick, and much of the political debate in Washington currently centers around the same idea. Karin Granberg-Michaelson writes for Sojourner’s, “Faith and healing are integrally related, as demonstrated in all the healings recorded in Scripture.”

Beyond political reform, Granberg-Michaelson writes that churches should work toward a “whole person health care [the treatment of a person as a unity of body, mind, and spirit].” This can work in tandem with modern medicine, and neither spiritual nor medical care should be neglected. She writes:

Problems occur when we isolate and compartmentalize either source of healing. A wholly scientific approach lacks the resource of God's power, and a wholly spiritual approach overlooks God's confidence in human beings.

This spiritual approach can point the way toward a more progressive health care system, according to Rose Marie Berger on Sojourner’s God’s Politics blog. She writes: 

We want to craft a health-care system that honors a fair exchange of money for services, that redistributes our social capital toward the health and healing of all over the long-term, and that allows for philanthropy and generosity of heart by those who can give freely for the betterment of all.

(Thanks, The Immanent Frame.)

Source:  Sojourner’s  

Opponents of health care reform say that the Democrats are trying to impose “Canadian-style health care” on the United States. They warn of long lines, delayed or denied care, and restrictive bureaucracy. A recent attack ad features a Canadian woman claiming, “If I had relied on my government for health care, I’d be dead.” 

The hyperbolic ad is proving effective at eroding support for health care reform among people of all parties, according to Media Curves. The research firm showed pro- and anti- reform ads to 611 people and found that the attack ad was far more convincing.

The anti-reform message is compelling—and entirely misleading. Maureen Taylor reported to On the Media that the star of the attack ad did not, in fact, have brain cancer. And the woman’s life was not threatened by her condition.  Taylor, a health care reporter for the Canadian Broadcasting Corporation, questions why the idea of Canada is so threatening. She pleads, “People, I'm not walking over a lot of dead bodies here on my way into the studio.”

Source: Media Curves, On the Media 

After 10 years as a doctor, Pamela Wible was burned out, “tired of being a factory physician, pushing pills and tests I didn’t always believe in,” she writes in a candid piece for Spirituality & Health (article not available online). “My soul was more than irrelevant; it slowed down the production line and got me into trouble with administrators.”

So she quit her job and held a big community meeting, asking attendees to describe what their ideal medical clinic would look like. And then she built it! (Warning: If you spend a lot of time in your doctor’s bland, hot tub–less waiting room, prepare to get very jealous.)

Clients can enjoy yoga; massage; a wheelchair-accessible, solar-heated saltwater pool; and a soak in the hot tub before their appointments. They relax on plush overstuffed chairs in a cozy office and look forward to warm exams as they’re wrapped in fun, flannel gowns. Antioxidant-rich chocolates and smiley-face balloons surprise the unsuspecting on random patient-appreciation days.

Most of would love to see health care look more like this, obviously, but what I really appreciate about Wible’s analysis is her emphasis on the comfort and well-being of both patients and physicians. Clearly, the health care system doesn’t work for either group, and seeing what’s wrong with the relationship from a self-aware physician’s perspective is incredibly illuminating:

Given that we all pledge to “first, do no harm,” why do we make physicians the first victims? While patients are encouraged to tell all, doctors must remain detached, sterile, untainted by emotions. No “irrelevant” personal anecdotes. No off-the-cuff commentary. Physician self-disclosure is a no-no. Decades of practicing professional distance—emotional and spiritual disconnect—destroys from the inside out. Who really wants to be treated by someone whose heart has died?

Source: Spirituality & Health 

Image by thomaswanhoff, licensed under Creative Commons.

Before Barack Obama won the 2008 election, pundits and politicos were already planning his first 100 days in office. Since then, the situation in the United States has gotten worse and the urgent calls for reform have gotten louder. 

“No president in recent memory has come into office with so many and such varied crises to deal with,” John D. Donahue and Max Stier wrote for the Washington Monthly. Obama’s agenda includes, but is not limited to, averting a global recession, ending the war in Iraq, stabilizing Afghanistan, closing Guantanamo Bay, and “passing and (the hard part) implementing universal health care,” Donahue and Stier report. 

After a campaign based on such amorphous themes as “hope” and “change,” some expect the myriad problems to evaporate as soon as the new president takes office. “I think that we've replaced the housing bubble in the United States with an Obama bubble,” Steve Clemons, a senior fellow and director of the American Strategy Program at the New America Foundation told Salon.com. Clemons and others are calling for quick, decisive action on foreign policy and other initiatives. According to Clemons, “He's got a very short window to make the Obama bubble mean something before it explodes.”

A huge challenge for the incoming administration is deciding which issues should be dealt with first. Shirley Ann Jackson, writing for the Scientific American, has joined a multitude of scientists and environmentalists calling energy security, “the greatest challenge and the greatest opportunity of our time.” In his first 100 days in office, Jackson wants Obama to update the national power grid, create a $200-billion “clean energy” bank for investment in sustainable energies, and “triple the currently paltry federal investment in basic and applied energy research and development.”

Though energy reform and foreign policy may garner big headlines, the most important tasks of the new administration may be the most mundane. Donahue and Stier report for the Washington Monthly that Obama should focus on fixing the federal bureaucracy, before moving on to bigger ticket items. “To put it bluntly” Donahue and Stier write, “even with brilliant policy ideas and flawless political instincts, Barack Obama’s administration is likely to fail if it doesn’t reverse the erosion in federal capacity.”

The disastrous example of the Federal Emergency Management Agency (FEMA) during Hurricane Katrina has shown what can go wrong when a federal agency is dysfunctional, and Donahue and Stier report that many important federal offices have fallen into disrepair. Donahue and Stier provide an urgent call to reform Medicare and Medicaid, the Office of Thrift Supervision, the Federal Aviation Administration, the Defense Contract Management Agency, the Defense Nuclear Detection Office, the Bureau of Immigration and Customs Enforcement, and especially FEMA, now under the Department of Homeland Security.

Most people realize that Obama’s promised “change” won’t come overnight, and that’s not a bad thing, according to Mark Schmitt writing for the American Prospect. Many politicos and pundits urged Obama to hit the panic button at various points throughout the 2008 election, but the candidate won with “a long, patient strategy of assembling a majority of delegates, one at a time, in friendly and unfriendly states alike.” Schmitt writes that the President-elect will need to use that same patient style to truly turn the country around in 2009.

 Image by  Ragesoss , licensed under Creative Commons.

Just about every episode of the hit medical drama House MD follows a pattern, as the humor magazine Cracked points out: A patient presents weird symptoms that escalate into a life-or-death situation, House and his team take ridiculous risks to save the patient, and then the patient is saved.

What many viewers don’t know is that the National Institutes of Health has its very own House-like team called the Undiagnosed Diseases Program (UDP). The main idea of the TV show echoes the UDP’s work, but the two don’t have much else in common. The New Scientist interviewed program head William Gahl, who, unlike the TV show's protagonist, seems to be a humble, caring man with a sincere interest in his patients. Plus, real patients usually show up with slow-developing conditions, not the dramatic collapses seen on the show.

The UDP began in May of 2008 and in those seven short months has received over 1000 doctors’ inquiries. The program, according to Gahl, serves two purposes: Not only do the physicians work to diagnose and help patients, they also try to identify new medical conditions in the hopes of making future diagnoses easier for everyone.

It’s not often that someone is awarded for resigning, but that's precisely why Glen Mabie received this year's Ethics in Journalism Award from the Society of Professional Journalists (SPJ). Mabie, the former news director of a TV station in Eau Claire, Wisconsin, stepped down in January after the station made a deal with Sacred Heart Hospital to run specific stories about the facility’s employees and services.

The Association of Health Care Journalists and the SPJ warn that these stories violate media ethics and unfairly influence the public, writes Trudy Lieberman for the Columbia Journalism Review. People are “unaware that the five o’clock news story on the latest imaging device used on patients at a local hospital—perhaps reported by the TV anchor—is really an ad in disguise.” There is no objectivity: when a facility is paying for the coverage, no alternative viewpoints are allowed.

Lieberman’s rundown of similar incidents in the media shows that they are more common than one would think or hope. She also points out that biased health reporting perpetuates the health care industry’s obsession with obtaining expensive equipment instead of focusing on patient education and care.

Mountains of contradictory statistics, insurance plans, tax brackets, and general wonkery confront anyone who tries to wrap their head around the morass of American health care. The American Prospect’s Ezra Klein makes the nut a little easier to crack by boiling down the data into ten bite-sized reasons why the U.S. healthcare system is floundering. 

Here are some choice findings: Even though Americans spend more on healthcare than any other country, our doctors fall behind other nations’ doctors in adopting new electronic filing technologies that can save everybody money. Americans have the second-highest rate of chronic disease in the world, but we can’t get the consistent care to fix the interconnected problems that go along with a diagnosis of diabetes or heart disease. And even though we spend the most on healthcare per capita, 16 percent of the population doesn’t even have healthcare. But at least the US healthcare system can help Rudy Giuliani with his prostate. —Brendan Mackie