Category Archives: Health

Big Tobacco strikes back!

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An e-mail urges everyone to speak up for our right to decide, on the local level, whether we want smoke-free workplaces — and restaurants, for that matter:

Get on the phone, write a letter or get the email addresses at the link enclosed, or let me know & I will get them to you. Please forward this on to whomever you know who wants clean air & a safe workplace  for ALL South Carolinians. It is speak now or forever choke, stink & endure the cyanide, ammonia & other deadly chemicals that second-hand smoke carries with it.

Here’s the enclosed release that was mentioned. And here’s the State House link that the release mentions. And if you don’t know who your legislators are, click here.

OK, so maybe the message was a little over-the-top, but that doesn’t mean I don’t agree with the sentiment.

Ain’t the Free Market Great?

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As our libertarian friends always say, we don’t need the GOVERNMENT to ban smoking to breathe freely in restaurants.

Why here I am, sitting down to a nice meal at that same LongHorn steakhouse in Savannah where I first discovered that Georgia had banned smoking in such accommodations. (Forgive the lack of links — I’m on my Treo.*)

The nice waitress just brought me my food, only about 3 hours after I left home. Yum!
All I had to do is exercise my God-given right to have my lunch in the next state.
Ain’t the free market wonderful?

* Disregard parenthetical, now that I’ve stopped and fixed things up with my laptop. I leave the parenthetical because Randy refers to it in a comment.

Keeping us safe from common sense

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Vigilant S.C. lawmakers keep
us safe from common sense

By BRAD WARTHEN
EDITORIAL PAGE EDITOR
IF YOU THINK lawmakers are going to do the sensible thing and ban smoking in restaurants statewide, you must not have lived in South Carolina very long.
    OK, but surely they’ll at least get out of the way of local governments and let them respond to the great majority of voters who want to dine smoke-free, and deliver waitresses, cooks and bottle-washers from having poisonous gases crammed down their lungs in their workplaces?
    You think they’d at least do that much, right?
    Where are you from, boy? Russia? London? New York City? I never heard such innocent foolishness. Let me lay some facts of life and slow, lingering death on you. I should start by debunking a myth or two.
    First, this absolute refusal to use common sense and protect the public from a ubiquitous carcinogen is not a Southern thing. It’s a South Carolina thing.
    I discovered this detective-style, which is always the best way. I went into a Longhorn Steakhouse in Savannah last month and asked for a seat in the nonsmoking section. The hostess brushed off my request with a dismissive, “There’s no smoking in Georgia, silly.” All right, she didn’t actually say “silly,” but she was probably just too busy, or trying to be nice, or something.
    It seems that back in 2005, Georgia lawmakers decided that kids who get dragged to restaurants by their parents, which for kids is enough of a bummer, shouldn’t also have to die of lung disease. So the state banned smoking in public venues that serve children. (At least one joint responded by banning children, but you’ll always have a few like that.)
    The proposal was introduced by a state senator who also happened to be a family physician, and he told everybody breathing smoke was bad for kids’ health. That seemed to do the trick.
    That would never sway our lawmakers, who are made of sterner stuff. Secession was bad for kids’ health, too, but what was that compared to our iron determination that nobody was going to tell a South Carolina white man what he could do with his property. No sir, not ever.
    FYI, you can’t smoke in restaurants in Arkansas, Florida or Kentucky, either, or in 18 other states, according to the Web site of Smoke Free USA.
    Our lawmakers aren’t going to let that happen here, though — not even on the micro level. They made sure of that more than a decade ago, when Spartanburg had the temerity to ban smoking in its restaurants.
    They knew they would never give in to common sense, but with the Spartanburg example out there, those other weak-kneed local governments, being so close to the people and all, would start caving left and right, giving votgers what they wanted.
    So they passed a law that said henceforth cities would not be allowed to ban smoking. Stupid and evil as it may be, you’ve got to admit this move was forward-looking, given the rash of attempted bans recently.
    Why don’t they want people to be allowed to ban smoking in their own communities? Is it self-interest; is it greed for the tobacco lobby’s money or anything like that? No, that’s another myth.
    Rep. Ralph Davenport, R-Spartanburg, showed how selfless backers of the pre-emption were when he indicated at the time (1995) that even though his asthmatic daughter was “crippled” any time she so much as walked through smoke, he saw no reason to be “eroding the free enterprise system.”
    You see, in South Carolina, smokers and business owners have rights; employees and other nonsmokers don’t. Never mind that there are a lot more employees than business owners, and three times as many nonsmokers as smokers. Think about it: If South Carolina started handing out rights to just anybody — such as duly elected local governments trying to protect the public health — there’s no telling where it would stop.
    But prophetic vision isn’t quite enough if one is going to keep protecting the prerogatives of a privileged minority — and if the Legislature knows how to do anything, it knows how to do that. You also need eternal vigilance.
    A couple of weeks back, a really wild and crazy thing happened — wild and crazy by Palmetto State standards, I mean. Sen. Vincent Sheheen, an idealist who, despite his youth, has been around enough to know the futility of such gestures, nevertheless proposed to revoke pre-emption. He proposed, as an amendment to a bill banning smoking on school grounds, the following:

    Notwithstanding any other provision of state law, a county or municipality may enact ordinances prohibiting or restricting smoking in businesses or establishments open to the general public.

    It didn’t ban smoking, or tell anybody to ban smoking. It merely got state government out of the way so that Greenville, Columbia, Sullivan’s Island and all those other communities could do what they have been trying so hard to do in response to demand from their citizens.
    The wild and crazy thing was that the amendment actually passed. But that was a moment of weakness by the rank and file. Before final passage of the overall bill, Senate leaders — and we call them that without a shred of irony, because the rest of the state follows where they lead — let it be known that the overall bill would be doomed if the amendment stayed. So it went away.
    What do you do with people like this? They not only won’t act in the public interest; they take extraordinary steps to make sure nobody else does so.
    In South Carolina, what we do with them is keep electing them. But I can’t tell you why.

In limbo

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Sorry to have slackened the pace on posting. Pretty much unavoidable.Photo_030207_004

I’m in a hospital in Savannah. I had sinus surgery late yesterday. (You know that headache I’ve had for the past year? It’s about that.)

Anyway, I’m sitting here having been dismissed by my physician, but waiting for the hospital gears to finish grinding to the point that they’ll let me go. You know the drill.

I hope to be back in the normal swing of things in a day or two. Just not today.

Take care, folks. And as your mama might have said, Be sweet to each other.

Tell it, Paul

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Demarco_1For the sake of those of you who have not yet gotten to your op-ed page today, this is a heads-up to make sure you don’t miss the excellent piece from our own Paul DeMarco, M.D.

As usual, Dr. DeMarco sets out the issues fairly, intelligently and with impeccable intellectual honesty. Some who don’t know him would be surprised that he seems to find some fault within his own worthy profession. Not I, and not anyone who knows him.

Paul DeMarco will always tell it straight.

I experience a miracle

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I‘m having lunch at a LongHorn Steakhouse in Savannah. It smells better than our LongHorn in the Vista.
Here’s why:

When I walked in, I asked for a table in nonsmoking. The hostess dismissed my request with the finest words I’ve ever heard in a restaurant:
"There’s no smoking in Georgia."

AND SHE WASN’T KIDDING!
I am stunned. This is so fantastic. I’m just sitting here, breathing freely and deeply, as though it were the most natural thing in the world.
Which, if you actually THINK about it for a change, it actually IS, even though it is a departure from what I’ve experienced my whole life up to now.

Why, in the name of God and all that makes any kind of sense, did I have to wait 53 years for this? Why will I NOT be able to experience it when I go home?
I can think of no reason.

Out with the UnParty, in with ENERGY!

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Nobody’s proposing a comprehensive energy plan, so I guess we’ll have to do it ourselves.

I’ve had this idea percolating lately that I wanted to develop fully before tossing it out. Maybe do a column on it first, roll it out on a Sunday with lots of fanfare. But hey, the situation calls for action, not hoopla.

So here’s the idea (we’ll refine is as we go along):

Reinvent the Unparty as the Energy Party. Not the Green Party — it’s not just about the environment — but a serious energy party. Go all the way, get real, make like we actually know there’s a war going on. Do the stuff that neither the GOP nor the Dems would ever do:

  • Jack up CAFE standards.
  • Put about a $2 per gallon tax on gasoline.
  • Spend the tax proceeds on a Manhattan project on clean, alternative energy (hydrogen, bio, wind, whatever), and on public transportation (especially light rail).
  • Reduce speed limits everywhere to no more than 55 mph. (This must be credited to Samuel Tenenbaum, who bent my ear about it yet again this morning, and apparently does the same to every presidential wannabe who calls his house looking for him or Inez).
  • ENFORCE the damn’ speed limits. If states say they can’t, give them the resources out of the gas tax money.
  • Build nuclear power plants as fast as we can (safely, of course).
  • Either ban SUVs for everyone who can’t demonstrate a life-or-death need to drive one, or tax them at 100 percent of the sales price and throw THAT into the win-the-war kitty.
  • If we go the tax route on SUVs (rather than banning), launch a huge propaganda campaign along the lines of "Loose Lips Sink Ships" (for instance, "Hummers are Osama’s Panzer Corps"). Make wasting fuel the next smoking or DUI — absolutely socially unacceptable.
  • Because it will be a few years before we can be completely free of petrol, drill the ever-lovin’ slush out of the ANWR, explore for oil off Myrtle Beach, and build refinery capacity — all for a limited time of 20 years. Put the limit in the Constitution.

You get the idea. Respect no one’s sacred cows, left or right; go all-out to win the war and, in the long run, save the Earth. Pretty soon, tyrants from Tehran to Moscow to Caracas will be tumbling down without our saying so much as "boo" to them, and global warming will slow within our lifetimes.

THEN, once we’ve done all that, we can start insisting upon some common sense on entitlements, and health care. Change the name to the Pragmatic Party then. Whatever works, whatever is practical, whatever solves our problems — no matter whose ox gets gored. Leave the ideologues in the dust, while we solve the problems.

How’s that sound? Can any of y’all get behind that?

Low expectations column

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Living with low expectations
in the Palmetto State

By Brad Warthen
Editorial Page Editor
SHORTLY AFTER midnight, at the weary outset of Friday morning, a heavy-set woman stood outside the elaborate revolving doors of the Palmetto Health Richland emergency department, smoking a cigarette.
    She tilted her head at the sound of a distant siren, the volume and Doppler effect indicating its rapid approach.
    “Here they come again,” she said with resignation. “They bring in another one, we go to the back of the line.”
    I was standing nearby, preferring the mists of the night to the unwholesome miasma of the packed waiting room. A few moments earlier, I had used the last few drops of energy in my PDA to post this brief comment on my blog (hey, as a distraction it beats ragged old copies of People):
    I’m standing outside a hospital ER at 11:52 p.m., waiting for MY turn to go in and see my daughter, hoping they’ve started the IV that I’m pretty sure she needs (you know how it is in a state that refuses to adequately fund mental health or other essential services — if you have an emergency, you’ll be treated in a hallway if you’re lucky enough to get treated at all)….
    In the hallway, she could only have one visitor at a time. She eventually got into a room, receiving about four liters of fluid, and got stronger. I’ve got no complaints at this point about her treatment — certainly not against Palmetto Richland. The crowding at Lexington Medical had been worse. It was the worst I’d ever seen it, and with five mostly grown kids, I’ve seen it a few times. So we were at Richland.
    It’s not the fault of either hospital. It’s just a fact of life in South Carolina. Like the woman with the cigarette, we’ve come to accept it. Go to an emergency room on a typical evening, and if you’re not bleeding out your eyeballs, you’ll generally have a long wait. My experience tells me that if, for instance, you need some stitches and a tetanus shot but don’t have anything life-threatening, you should not be surprised to wait as long as four hours. It’s not always that long, but you’re no longer surprised if it is.
    (My daughter was “lucky” in that she obviously needed quick treatment for dehydration caused by a two-day stomach bug.)
    I don’t know, specifically, what caused the backlogs of Friday’s wee hours. I suppose if I had about a month and could get around the HIPAA privacy rules and track down every patient and interview them, I could give you a reliable answer.
    But I do know that there is a constant, underlying condition in this state that causes ER waiting rooms to overflow whenever other human variables — a rash of wrecks on a slippery night, a stomach virus going around — collide with it: Hospital beds are occupied by the mentally ill, who are often found on the streets, off their meds, and police have no other place to put them, their jail cells being full of actual criminals.
    The variables may be hard to pin down in a specific instance, but that one constant is not.
    “It’ll happen the same way tomorrow night and the night after that,” says Thornton Kirby, president and CEO of the S.C. Hospital Association. But there are two constants, not one, he reminded me. The second is the fact that so many uninsured people go to the emergency room for their basic medical care, not just when they’re in crisis. As the sign behind the desk at the Richland ER proclaims, in both English and Spanish, the hospital is forbidden by law to turn you away if you need medical care. Regardless of your ability to pay, the medicos have to do what they can for you.
    That second constant is a national problem, although the responsibility for it is shared by the states, via Medicaid funding and administration. The first one seems to be particularly acute in South Carolina. It’s related to the underfunding of the state Department of Mental Health over the last few years. People with brain problems who formerly would have received greater attention and care from the state now wander our cities, seriously strung out, a danger to themselves and others.
    So eventually they end up in an ER — quite likely at a comprehensive indigent care facility such as Richland — where they wait for someone to figure out something else to do with them. That can take a while.
    So the rest of us, when we have a situation that won’t wait until regular doctors open shop in the morning, find ourselves waiting much of the night, and accepting it, because that’s the way things are in South Carolina.
    We accept it the way we accept people whizzing past us at 90 miles an hour on the interstate (or faster, in the case of the lieutenant governor), secure in the knowledge that they will not be ticketed. There simply aren’t nearly enough troopers on the road to enforce the speed limits, and everybody who didn’t just fall out of the stupid tree knows it. This is because the folks who make up our state budget haven’t stepped up to pay for such enforcement.
    But hey, rest assured that when a loud minority of homeowners whose McMansions are appreciating too rapidly squeal about it, our state lawmakers take quick action to slash their taxes radically — by raising the sales tax on all of us, but refusing as usual to reform the overall tax system comprehensively, to make it fair and effective for a change.
    They can’t assess the state’s actual needs, set priorities and address them, but they can surely lubricate a squeaky wheel in one quick hurry — just in time for elections, in fact.
With our elected followers set to come back and do their thing for another half-year starting Tuesday, I stand out in the misty night, thinking about stuff like that.

If I were a woman, I wouldn’t be big enough

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Well, I went to give blood last night, and this time they allowed me to do so. My iron was good, and for once I wasn’t taking an antibiotic for a sinus infection.

Since it had been so long, and they didn’t know when they’d get me back in good shape, they took twice as much — or rather, twice as many red cells. It’s an interesting process. They pump out a lot of your blood, running it through a machine that removes the red cells, then pumps back your plasma along with a little salt water to make up for any volume lost in the process. It’s pretty weird.

But I recommend it. This way, it’s twice as long before they expect you to be back. Also, counterintuitively, the needle is smaller — even though it has two channels in it, one for taking and one for putting back.

That’s not all that’s surprising about it. I made the higher iron requirement, and I made the weight fairly easily. But if I had been a woman, I would not have. Here’s the rule:

To qualify as a donor on the ALYX System, males must be at least 5’ 1 and weigh at least 150 pounds, and women must be at least 5’ 5 and weigh at least 175 pounds.

Why is that? I don’t know. I asked, and was told it had something to do with body density.

Now that I think about it, it’s probably ungallant of me to point this out, since there were two ladies in front of me giving double red cells — both of whom we now know weigh more than I do. Hey, I didn’t make the rules.

Standards column

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Oj

Could standards, of all things,
be making a comeback?

By BRAD WARTHEN
Editorial Page Editor
STANDARDS are making a comeback. We may be able to get a civilization going here after all. You doubt me? I have several reasons for my optimism:
    We’ll begin with a trivial matter. The New York Times carried an essay last week from a senior physician wringing her hands about the inappropriate attire worn by young doctors today.
    “Every day, it seems, I see a bit of midriff here, a plunging neckline there,” she fretted. “Open-toed sandals, displaying brightly manicured toes, seem ubiquitous.”
    She thought it was because she worked in Miami, but colleagues elsewhere assure her it’s a nationwide epidemic, from unshaven male interns in T-shirts, to females with plunging necklines.
“One colleague commented that a particularly statuesque student ‘must have thought all her male patients were having strokes’ when she walked in their exam room wearing a low-cut top and a miniskirt.”
    I’ve never seen a doctor like that myself, although I’ve seen an actress play one on TV. But I agree that it’s far better for patients to have confidence in the seriousness of one into whose hands they place their lives.
    I recently saw a new specialist about a chronic sinus thing, and I recall being reassured by his attire. He took propriety to places it had not been since about 1955. He had on the white coat, of course (take note, Dr. House), which helped set off his bow tie. But what made the costume was the proverbial reflector on a headband. It was so wonderfully nerdy, it helped me forget his otherwise unforgivable youth. So good for him. I’m quite sure he would never wear open-toed shoes.
    It’s good that some doctors are worrying about the small things that provide us with little touchstones of order amid the chaos of life in 2006. The essayist’s employer, the University of Miami, has a dress code specifying “that students have hair ‘of a natural human color,’ among other things.” That’s got to be tough to enforce. But it’s worth trying.
    On a more sensational front, someone stood up for standards last week in a way that defied belief: That it was Rupert Murdoch elevates this particular miracle to biblical, Cecil B. DeMille proportions.
    A lot of people had shaken their heads and looked away, certain that the plan for a book and a TV special in which O.J. Simpson would tell us how he killed his wife — while pretending that he was speaking hypothetically — was just another incident in our society’s inevitable slide into utter shamelessness. First reality TV, now this. Nothing to be done.
    But fortunately, others hadn’t given up right and wrong, and they raised enough ruckus that Mr. Sleaze himself backed off — canceled the book, the TV show, the whole grotesque mess. My own mother had told me to call the local Fox affiliate and tell them they shouldn’t air the TV part of the spectacle.
    I didn’t do it, but plenty of others did, and good for them. It gives me hope I didn’t have. Next thing you know, shame will actually make a comeback in America. Not that O.J. will ever feel any, but it’s not too late for the rest of us.
    “Seinfeld” was about something: Shallowness. That was the running gag, and it worked wonderfully. Everything in life, big and little, was a joke. Comedic conflict centered around the failure of the four central characters to be sufficiently serious and respectful of the things that mattered in life: Yadda-yadda.
    So it’s little wonder that when Jerry Seinfeld arranged for his friend to apologize on the Letterman show for his outrageous behavior at the Laugh Factory in Los Angeles a few nights earlier, some in the studio audience took it at first as a gag. Mr. Seinfeld had to interject to say that Michael Richards’ words of abject regret were not meant to be funny.
    And nothing about it was funny. Mr. Richards, better known as “Cosmo Kramer,” had loosed an obscenity-laced barrage of racist insults at some black hecklers. You can see a cell-phone video of it on the Internet. Warning: It’s profoundly unpleasant. It’s as though “Kramer” had taken his Jedi-class frenetic eccentricity over to the Dark Side. A human being self-destructs with loathing on a stage, and perhaps the most disturbing aspect is that some people kept trying to laugh. They had paid good money to be amused, and were slow to adjust.
    Some of you out there will write or call to say the hecklers are just as much to blame. Well, hecklers are a pretty low life form, and while I can’t hear much of what they said, these don’t seem to be much of an exception. But Mr. Richards was the one with the microphone. Listen to how he responded to that routine hazard of his profession on this occasion, and ask yourself whether you could ever justify reacting as he did. If you can, seek counseling.
    That’s exactly what “Kramer” needs to do, because a public “sorry” doesn’t cure the things that lie behind that kind of rage.
    It would be easy to dismiss his mea culpa entirely: A has-been comic tries to salvage what’s left of his career by offering a big dose of schmaltz to the gods of political correctness. But forget the politics. This is a guy who lost it to the point of stepping outside all the bounds — and he knows it, Jerry Seinfeld knows it, and so does David Letterman.
    I appreciate comedy, and “Seinfeld” provided some of the best. But when the funnymen can sober up long enough to say, “This goes too far,” it helps us all be a little more civilized.

Kramerjesse

Blue Marlin shows the way

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"I want to be a leader in something that is extremely important," says Bill Dukes.

Well, he is — and God bless him for it.

The local business leader’s decision to ban smoking from his distinctive Vista restaurant, The Blue Marlin, will at the very least provide a healthy haven for workers and patrons. Beyond that, there’s good reason to believe that customers will flood his establishment in a grateful rush, in order to be able to breathe freely while they eat and drink.

And the food’s good, too.

Better yet, it seems inevitable that other bistros and bars will follow.

Given that I have my doubts that state law will let Columbia ban smoking in public accommodations by ordinance, this is particularly encouraging.

You go, Bill.

Mayor Bob on smoking bans

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Columbia Mayor Bob Coble had sent me four e-mails (all of which I just read, since I just got back from vacation) responding to our lead editorial of July 30, which essentially said we’d love to see smoking eliminated from local bars and restaurants, but we didn’t think state law would allow a municipality to take such action.

FYI I am attaching the Attorney General’s Opinion
that holds that the State
has preempted cities from banning smoking in public buildings. The opinion
says that because the State Clean Indoor Act is statewide, it preempts
local governments from a smoking ban by "implication." I think the legal
issue is unclear enough that it should be decided by the Court in
a declaratory judgment action. The Clean Indoor Air Act does not
address smoking bans by cities but regulates where smoking is prohibited. If
the  State Legislature had specifically addressed smoking in restaurants
I would feel differently. Thanks

So the mayor is apparently forging ahead. Here’s a followup message:

FYI The Smoke Free
Columbia folks have sent me two ordinances. The first is a model ordinance (with
Columbia filled in) and the second is the ordinance that Sullivan’s Island
adopted (or is in the process). They are very similar. Thanks,
Bob

Well, I wish him luck, but it’s still our position that the Legislature intended to prevent localities from taking this common-sense step. Either way, state law needs to be changed. On this and other matters that naturally fit within the realm of local ordinance, the state should leave communities alone to decide their own rules, as expressed by the governments closest to the people.

Mayor Bob on smoking

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Still catching up on that e-mail. I got this one from Mayor Bob Sunday, regarding my column of that date. I guess Tony Blair showed it to him or something:

To: <Bwarthen@thestate.com>
Subject: No Smoking
Date: Sunday, July 16, 2006 11:46 AM

    Brad, I am in the UK on an economic development mission but read your editorial (or column). I believe that Columbia City Council could address the issue of a no smoking ordinance as early as August. I believe the Surgeon Generals report will be critical. While I have not talked with all of City Council I am very pleased with the level of support at this point. I addition to the health issue, I think it is also an economic development issue. People are going to want to invest and live in cities that have no smoking (I believe).
    Thanks
Sent Wirelessly while away from the City of Columbia with my International Blackberry.

Bad Blood, Part II

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Well, it happened again. I went to give blood at the Red Cross — as promised in a previous post — and they wouldn’t take it.

I walked in, signed the register, and the lady at the desk gave me a cool hat. Then she said they’d been waiting for me, and handed me the binder full of stuff you have to read before you give.

And there, on the first page, I saw that if you’re taking antibiotics, you can’t give.

I said well, I’m taking an antibiotic, but it’s no big deal. I’ve just had this sinus headache for years, and it got worse in recent months, and they took a CT scan a couple of weeks ago, and decided it was a sinus infection. So they told me to take these expensive (my co-pay was $148) pills for a month.

I haven’t had fever; I haven’t been sick. I don’t think I’m contagious. But I couldn’t give anyway.

They let me keep the hat, though. They said it didn’t matter, because "your editorials" caused hundreds of extra people to give blood over the last couple of days. Well, I’m pretty sure that it would have been the news story
that ran the same day, because that was much more prominent. But in any case, the effect seems to have been dramatic. In a period in which 40 people would normally give at the Columbia Red Cross facility on Bull Street, they had had 200.

I hesitated to mention that, because I don’t want people thinking, "Well, then, I don’t have to give then." No, they need people to keep giving at that rate. This rate was just enough that in another day or so, they expected to no longer have to ration certain types. And blood only lasts 40 days or so; they have to keep getting more.

To schedule your appointment, call 1-800-GIVELIFE, or do it online.

Anyway, they said I could give as soon as I quit taking the antibiotic. I will.

Go give blood. NOW!

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Iraq_blood
The South Carolina region of the American Red Cross is experiencing a severe blood shortage. That means we are all experiencing such a shortage.

Not giving enough blood to keep safe amounts on hand is par for the course around here. If anybody can explain why South Carolinians in the Midlands and Lowcountry (Greenville’s in a separate region) won’t chip in and give on a regular basis, I’d like to hear it. To me, it remains a mystery.

I know why I used to not give — I was scared. But I got over it, because I came to understand how bad the need was. And if I can get over it, you can. I’ve never been as afraid of anything as I was of giving blood. Just typing this paragraph mentioning giving blood would have made me feel faint. I’m still afraid every time I give, but I do it anyway. It’s good to face your fears.

People give in Iraq, and under considerably less comfortable conditions than we have at the local Red Cross (see above, in the Shiite slum of Sadr City in Baghdad). Why do they do that? Because they understand the need. Well, we have a need, too. We should respond to it. You can make an appointment online, or call 1-800-GIVELIFE or, in Columbia, 251-6138.

The Red Cross has extended its hours today, tomorrow and Friday in light of this emergency. Make an appointment and go. Or just go. I’m about to call them myself.

OK, I’m smoking now…

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I suppose Kathleen would call me a Nazi or something for even bringing this up, but …

What do you regard as an appropriately cruel and unusual punishment for somebody who saturates a non-smoking hotel room with cigarette residue?

I checked into this room with the standard international nicht rauchen sign on the door, and when I opened the door, the room hit me with a reek that made me think I might be better off going down to sleep in the bar.

Mind you, this is not an esthetic thing to me. I’m very allergic to the stuff, and in fact am at this moment in the middle of a second course of prednisone to treat sinus inflammation that’s been killing me for the past couple of months.

The lady at the desk was very nice, but there wasn’t another room available tonight that met our needs. They promise to switch us ASAP tomorrow. Meanwhile, I went down to the car to get my breathing machine so I wouldn’t have to fetch it at 3 a.m., just in case. Meanwhile, I’m thinking positive thoughts.

Never mind about me, though. I’ll be fine, I think. But don’t you think whoever last occupied this room should at least have his credit card billed double or something?

Thoughts?

Governor makes right call

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All hail Governor Sanford for doing the right thing for the right reasons, even though it’s likely to cost him in GOP-vote-rich Lexington County (my home, I always add). His veto message on the subject isn’t posted yet, but when it is, I’ll change this to link to it.

This was a bit of a nail-biter, as the governor could have interpreted "the right thing" two ways. Given his extreme libertarianism (you can tell an extreme libertarian by the fact that they even believe the market works with regard to health care), he doesn’t really believe in the state Certificate of Need process. But as long as it’s the law, he will not allow narrow interests to overturn it.

Now, to the override attempt. I was talking with Rep. James Smith this morning, and he says he expects a vote tomorrow. He’d rather have it today, but he said Speaker Bobby Harrell wants to give it a day.

"There should be no reason that this should not be sustained," he said. After all, the wrong side never had a 2/3 vote in their favor.

But he’s worried because some lawmakers who voted the right way the first time are — scuttlebutt has it — trying to hold up the state Hospital Association (which opposed Lexington Medical’s attempt to subvert the process through legislative fiat) for a little something in return for continuing to vote their "principles."

There will be a lot of phone-calling and button-holing today.

‘Invisible hand’ nowhere to be seen

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Here’s another one for you absolute believers in the wonders of the marketplace to ponder. In a very peeved mood, I sent this e-mail tonight to the makers of Tofutti non-dairy "ice cream" and related products:

    This is extremely frustrating.
    I live in West Columbia, SC — zip code 29169. I have been deathly allergic to milk my whole life. The last time I was skin-tested for it, the allergist called his staff in to see the reaction — it was that extreme.
    I love your product.
    I find it almost impossible to get it.
    Over the last few years, local supermarkets — most notably Food Lion and Publix — have stocked it off and on. Each will have it a few months, it will go away, and then come back maybe a month later.
    The nearest Publix ran out several months ago. I keep asking about it, and am told it must be a problem getting it from the distributor.
    Fine. My local Food Lion was at least stocking your vanilla (that, and the Vanilla Almond Bark, are my favorites). I make a point of buying out what they have so they will be motivated to keep it stocked; because of me, they never keep a pint of it more than a week. If market forces work as they should, I should never run out, right?
    I dropped by there tonight. I saw they had it on sale. Only one pint was left. As I picked it up, I noticed that the sign said "close-out price."
    So it’s going out of stock there, too.
    What is the problem? Why can’t your company keep the product in these stores?
    One place is left within 10 miles of me that I know of, and I’m worried now it will run out there. A distributor problem is a distributor problem, right? The store in question is 14 Carrot, between here and Lexington. It’s really out of my way, but I intend to go there tomorrow and buy whatever they have.
    By the way, the other 14 Carrot that your store locator cites (it was the one closer to me) closed several months ago.
    And the Rosewood Market you refer to only carries your "cheesecake" products, which I find to be a little too heavy and rich.
    I want to buy what you have to sell. Can you help me out here?

— Brad Warthen

You may say, "Hey, they can’t keep stocking it for one customer." Well, I wasn’t the only customer. I monitored the stock at Food Lion closely enough to be sure of that. And besides, how can a product — particularly a specialty product such as this — do better than to sell out within a few days each time it is restocked (I made sure of that, too)?

This is a case in which I keep counting on the market to work. And it keeps letting me down.

Markets and health care

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Well, regulars knew that at least one person would have something to say about my last post. It was Lee, of course. Lee comments on everything, usually multiple times. This would make for a lively forum if not for the fact that all of us know what Lee is going to say before he says it. He’s going to give you the standard radical libertarian line, regardless of the subject.

You see, the Lexington Medical Center folks are counting on reactions such as Lee‘s. That’s what they were counting on from the Legislature — ""Aw, gee, who are we to say no to somebody who wants to set up an open-heart center?"

Libertarians think the market works the same way with health care as with selling soda pop.
There are a lot of folks in America who think like Lee. That’s why we pay more in this country for health care than folks in other developed countries do, and we get worse health outcomes.

The fact that a surgical team has to do hundreds of such procedures to be good at it is meaningless to Lee. He’d rather see every hospital in the state take on open-heart if they want to (and since it is a big money-maker, they’ll want to), so that NOBODY can get a bypass from a facility that knows what it’s doing, and we’ll all have to pay for all that duplicative investment.

He actually thinks that the average person is a hard-nosed, discriminating consumer of health care. He thinks that if the average person is told by his physician that a bypass might keep him alive, he’s going to ask how much it costs, and then comparison-shop.

Har-de-har.

Folks, do you realize that one of the arguments LMC has been making in favor of opening this cash cow is that patients are NOT informed? It’s actually one of their better points.

In discussion with some docs who support the proposal, I’ve pointed out that I live almost right behind LMC, and have to pass it to go to any other hospital. So if I cut myself and need some stitches, I go to LMC. Or if I need major abdominal surgery, as I did in 1993, I go to LMC. But if I think I’m having a heart attack, I’m going to Providence (and would even when LMC gets its way on the heart center). And if I have cancer, I’m going to consult the folks who practice at Richland.

I said those things to a Lexington doc just a few days ago, and his response was, "Well, yeah, that’s because you’re an informed patient." His point was that most people aren’t. They’ll just stop at the first emergency room they get to. Good point — except that if you follow that logic to its natural conclusion, every hospital with an ER should be allowed to do open-heart, whether they ever get the chance to get good at it or not.

So much for the invisible hand.

Did I tell ya, or did I tell ya?

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Over the last month or two, I’ve broken the rules I’ve made against answering e-mails at length to respond to a Lexington County physician who has been extremely upset about our stance against Lexington Medical Center getting permission to start an open-heart-surgery facility.

What got to him the most was the fact that we got exponentially more down on it when the Lexington advocates — not satisfied to let their appeal of DHEC’s decision run its course — got their delegation to push to change the law under which they had been refused, so as to specifically allow LMC to have its way. He couldn’t see what a rank maneuver this was, or how many principles of sound government (and sound health regulation) this violated.

Anyway, the first thing I thought of when I read our lead story this morning was, "Well, somebody‘s going to be happy today."

As soon as I got to the office, I sent him this e-mail:

Dr. Black:

Didn’t I try to tell you that you had nothing to worry, much less get upset, about? From the moment this issue stepped out of the realm of merit and into the realm of raw politics, you were destined to get your way.

The reason we have regulation by people who are relatively insulated from politics is that they can look at things objectively. Politicians, particularly South Carolina legislators, can’t say "no" to anybody — particularly not to angry people from the most Republican county in the state.

So you can relax now. We won’t give up on this, even though the result is pretty much assured now. It’s not our job to write about what WILL happen, but to write about what SHOULD happen, no matter how unpopular the stand may be among our friends and neighbors. It’s not that much fun sometimes, but it’s what we do.

Have a good day,
Brad Warthen

If y’all show ANY interest in this issue, I’ll post some or all of my correspondence with him. It might be interesting; I don’t know. That’s up to y’all.