Our Still-Ailing Health Care System

For many years now, those of us working in the US health care system have been aware of its failings, from the shortened inpatient stays, which leave some health care needs unmet, to the inexorable rise of health care costs, to the increasing numbers of uninsured individuals.

Two issues have arisen lately, pointing to the fact that the system is even more broken. I remember a few years ago when there was a lack of influenza vaccines and a troubling lack of tetanus immunization serum. Well, that is not all that is in shortage. Over the past few years, I have personally seen a shortage of certain brands of stimulant medications and the cipro shortage while the anthrax poisonings were prominent after 9/11. A few years ago, when I worked at a local RTC, there was also a shortage of haldol tablets. While I did not see any negative effect in any one patient's treatment, I do remember that we scrambled to make the supply stretch to accommodate those in need.

Lately, as I have been picking up shifts at UMMC, I have noticed rather frequent notices from the pharmacy that supplies of certain medications were in shortage, particularly such medications as cytarabine and norepinephrine. While none of my patients were affected, since I work in child psych, these two medications are vital, the former for cancer treatment and the latter for shock. People could die from the lack of these medications. Whatever the cause, this time, of the shortages of medications, this is a dire situation within health care.

The other that continues to haunt the US health care system is the issue of the uninsured, the numbers of which continue to climb.  This has arisen at a time that Republican legislators are grandstanding over whether to continue the Medicare program and Social Security.



The issue came home to a middle-aged man from Gastonia, NC, who lacked health insurance because he lost his job, but was at a loss to resume working to be able to get health insurance because he was in too much pain to work. So, this man wrote out a note that he presented to a teller at a local bank that he was robbing the bank of one dollar. The man had no weapon. Now, he sits in prison, getting food, clothing, shelter, and that vital health care that he couldn't get as a law-abiding citizen.

So, that comes around to this ill-advised plan to get rid of Medicare, which has been in effect for more than forty years. Very few companies provide any type of health insurance coverage for their retirees and very few could afford to pay for costly private health insurance out of pocket. Even a $6400 subsidy for the poorest would fail to provide any usable insurance. Are we all to become like that middle-aged man in NC? Is that the only way the Republicans would be able to let those of us who have worked for 30 to 50 years be dumped out of our workplaces, with no Social Security and no health insurance of any sort? Would they leave their own parents in that condition?

Personally, I see no other solution except to continue the safety net of Social Security and Medicare. Everyone in our society has come to rely on these programs and companies operate to cut people off from retirement plans and health insurance, except for what is provided by the federal government.

Keep in mind, folks, that the showdown is coming in August. That is when there is no more money to cover the refusal of the Party of No to increase the debt limit. My mother will be one of those opening her mailbox, only to find a note from the Social Security Administration that checks can't be paid, starting this month, due to government default. Looking at it, I think we all know who to blame. And if it takes all of this nation's seniors going to the local bank to get arrested, as above, or to have a massive sit-in at the National Mall, so be it. Whatever happens will be bigger than anything the Tea Partyers could devise.

A Tornado Warning? Here? In Maryland?

There was an era, not so long ago, when I had never heard of a tornado warning here in Maryland. In fact, a tornado touching down anywhere near here was extremely rare.

I guess my illusions were shattered last year in September, while I was traveling to an assignment as school nurse at Shiloh Middle School. As I was driving out of Baltimore County, I heard one of those emergency warning signals on the car radio - you know the kind, the warning blast that causes you to change the station for a few minutes.

Anyway, because I was driving in a new location (and also without GPS), I was trying to note when I needed to make a turn, so did not flip stations and found myself listening to a tornado warning. And guess what? I was driving to the county that was under the warning.



Obviously, it all turned out well, since I never encountered a tornado, but I was looking closely, since there were some pretty dark clouds overhead. Anyway, the experience sort of led to my noting more tornado warnings since then, breaking into my TV viewing. There have been so many, in fact, that I lost count of how many there have been since September.

Two things brought this circumstance to my awareness of late. The other day I was really into this program about invasion of nonindigenous animals into the US, mainly proliferating in Florida, which has provided ideal conditions for their increase in numbers. Anyway, the program kept getting interrupted by tornado warnings for Harford County because of the clash of hot and cold fronts. You remember the triple digit temperatures in Baltimore-DC area? Well, the storm ushered in a drop of about 30 degrees in temperature. Apparently, the US weather services are trying to determine whether a tornado actually did touch down near Belair.

Secondly, I was reading a bit about the Gaia hypothesis, developed by James Lovelock, in which he postulates the earth's surface as being one system. As those of us familiar with Systems Theory know, a change in one part of the system affects the rest of the system. So, it is Mr. Lovelock's conjecture that pollution is overwhelming the earth's system of self-regulation and will tip the balance from the more stable system into a more unstable, hotter one.

Whether one is playing ostrich, like the Republicans, or buys into the fact that pollution is adversely affecting earth's climate, one certainly must take note of such things as unstable weather patterns. I cannot say for certain that hearing tornado warnings more frequently is an indication of climate change or just the scientific knowledge and equipment enabling better warnings of adverse weather, but it certainly prompted me to think about the influence of human activities on our ecosystems.

If You're Looking For A New Furry Friend

This is the time of year when animal shelters become crowded with cats. With the abundance of litters of baby kittens, there is an abundance of homeless cats.

As they have done in past years, a consortium of Baltimore area animal shelters, known as the Baltimore Animal Welfare Alliance, have gotten together to waive their adoption fees for cats and kittens. The campaign is known as The Baltimore 500 and the goal is to adopt out 500 cats to new homes. So, for the entire month of June, cats and kittens can be adopted for free. The Towson Animal Hospital is donating the first vet exam, also for free.



Of course, all of the qualification requirements at each shelter for prospective pet parents still apply. I also add the further caveat that prospective pet parents be aware of the responsibilities involved with adding a furry friend to your household. Adoption is meant to be for the life of the pet and you need to have the necessary funds and live in a place that allows pets. You should also be willing to learn about what is involved in the care of your chosen pet. So, even though you can adopt a cat for free, think it over carefully before taking the plunge.

You can visit the animal shelters online at www.bmorehumane.org, www.baltimoreanimalshelter.org, and www.mdspca.org. Feel free to ask the staff for any information to help make your decision. Many thanks to Jill Rosen of the Baltimore Sun for the facts, noted above.