vol_scouter

The article brings up concerns that it does not create true empathy. Nonetheless, there is suggestion that it may provide some benefit for some individuals with particular diagnoses. For it to gain that indication will require years of testing. It will need to go through Grade I, Grade II, and Grade III FDA clinical trials (the last of which is a prospective trial to prove efficacy). If the drug shows enough promise, then it will eventually be studied. Marinol has indications cachexia (anorexia) and nausea associated with malignancy and anti-neoplastic medications. Smoking marijuana has not undergone clinical trials for any purpose and is not recognized as a pharmaceutical. BS-87, I am glad that it appears to have helped you but that is far from a scientific study. Therefore, smoking marijuana has no medical role. For it to ever have a clinical role, the risk benefit ratio for lung malignancies, COPD, et cetera will have to be determined as well as the efficacy for treating the particular disease state. It is important to consider many possible medicinal agents for use to help us to relieve the suffering of mankind. They must be efficacious and be shown to possess more benefits than risks. Drugs for hyperactivity disorders are amphetamines which have serious addictive properties and were readily accepted by the medical profession despite the prior history of the drugs being abused. Due to the problems associated with smoking marijuana, I doubt that it will ever be an FDA approved medications. All medications that can be abused must be tightly controlled to prevent illicit use.

Gern, I think that folks are talking about two issues. One is the government spending our collective hard earned money for people who really are not poor. If they can afford a fancy cell phone with a data plan, cable television, large screen tv, designed tennis shoes, etc, they are not poor. The second issue has to do with giving. So if the parents have wasted the income of the family, we are still free to give to the family so that the children are not hungry. The real compassionate thing is still set up a security net that encourages people to work and gain pride in themselves than trapping them on welfare for the rest of there lives.

Beavah, That is a slippery slope. Who decides? I would then tax all of those runners who will need joint replacements. How about those folks doing high risk things like boy scouting? If you are too healthy minded, you will live longer and consume more total resources than the smokers who die earlier. I do not want the government determining which lifestyles are OK and which are not.

OGE, Your comment about a surgeon is correct. You certainly want whomever is going to cut open your chest with a scalpel, stop your heart, cut on the blood vessels on your heart, and then (you hope) restart your heart to be a little self assured. I was reading an online medical journal this past summer and discovered that the new medical care law requires all physicians to weigh patients on every visit and to report that to the federal government. The article pointed out that it is not just your primary care physician who is required to report your weight every time that you see them but your surgeon, pulmonologist, dermatologist, and even psychiatrist. The bill did not delineate the purpose of the reporting but your example is to close to the truth to be humorous.

BS-87, Were tried on marinol first?

Woapalanne, You are absolutely correct. Physicians and hospitals should be paid by the patients only. The patients should collect whatever is owed to them by third party payors and then pay the providers of their medical care. That way the patient employs the insurance company and the medical care providers. It could significantly decrease costs and improve choice. I read several years ago about a large internal medicine practice in the Pacific Northwest that decided to accept NO payments from third party payors. They got rid of their billing department and asked patients to pay upfront for the visit and as leaving for any lab or extra studies. The physicians saw their incomes increase, their costs plummet, they were able to decrease the charge to the patients, and they could give free care to those who could not pay (if you accept medicare, it is illegal to charge anyone less for the same service than you charge medicare). Their patient satisfaction improved. The federal government has since forbidden paying for medical services unless there is a contract with the physician. The federal government then tells the physician what they will be paid - the physician ha no input. Beavah, Physicians are effectively told what they must do. A few years ago, physicians were told that for a specific diagnosis that all patients must be discharged on a certain drug. Physicians knew that in the study that showed improved mortality rates that those patient had been and needed t be selected carefully due to a dangerous complication. Medicare keeps a 'report card' on all physicians and if you do not do what medicare wants, you can be removed from the program. Ultimately, physicians must earn a living to care for their families. As was to be expected, the mortality for the condition soared and medicare had to rescind the requirement. Physicians are required already to provide only certain options. Obamacare only increases the control as the physicians will work increasingly for the federal government.

BS-87, Someone who has tried to console families, care for, and watch die innocent people at the hands of people who were high and caused a serious automobile accident. Such as a early 20's male who was smoking marijuana and purposely tried to run over two ~10 year old boys riding their bikes. He hit one who died a few days later. People smoke marijuana to get high.

BS-87, You misunderstood me, there is absolutely no medical reason to smoke marijuana - none. I care for cancer patients and can control nausea and emesis just fine without ever needing for my patient to smaoke marijuana. It is only an excuse to get high. Smoking marijuana is still a federal crime and there exists NO medical need. The legal oral medication, Marinol, does just fine. If the patient cannot keep oral anti-emetics down, IV meds can be given via their port for chemotherapy. If the emesis is so significant theat it cannot be easily controlled at home, the petient needs to be seen. Since some of the chemotherapy medications are nephrotoxic, dehydration is a serious problem and the patient should be seen.

Eagle92, I have seen those polls. Furthermore, a recent poll said that 74% of physicians would like to leave medicine now. The reason is consistent - government interference makes it difficult to provide the best care for their patients. The public has no idea how their care is already being adversely affected by government interference lose of time that in the past was devoted to patient care but is now devoted to filing out forms. In the mid 1980's, it would require ~20 minutes for me to discharge a patient and I would spend all but about the last 3 minutes of the time in the patient's room so that I could answer any other questions. Now, due to government imposed paperwork, the process takes about an hour and I spend only about 5 minutes in the patient's room. Part of that to be fair is due to lab and imaging reports being on computers whereas in the past, there were printed forms in the physical chart so that all information was literally in your hands. I think that the number is easily 50% figure is accurate. Even worse, almost every physician I know with college age or recent college age children encouraged them NOT to become physicians which is a reversal of the attitudes from 10 years ago or before.

CalicoPenn, Once again, the polls are the only way that folks like us can discuss issues and have some quantitative measure. I agree with you that the polling has shown that the reasons for opposing Obamacare were somewhat varied. The polls that I remember showed dislike for universal payor system and the exchange that was passed. The American people seem to want insurance reform but just in the sense of forcing the current system to eliminate pre-existing conditions and not to drop patients when they get a serious illness. In a republic, such consistent and strong dislike of a bill should have lead to its' demise. The anger seen at the town hall meetings came from people who have not been politically active in the past based upon numerous interviews. These people felt like congress was not listening to them which was true since the bill passed anyway. That was part of the rejection of the democrat party in November. Gern, Most legitimate news sources quote the same pollsters. There is no reason to seek out the opinion of a biased source as you request because it will not be fair. Despite the slurs that you make, Fox is a centrist station. The left is so far from the mainstream of American thought, that they seem to see centrist views as right wing. Calico and Gern, The American people do not like Obamacare for different reasons but dislike it nonetheless. Many of my liberal friends with whom I have lunch most days are just like the two of you. They like Obamacare so much and think they it is so good that they cannot comprehend that others do not share their views. The majority of Americans, based upon polling data that has issues, do not and have never supported Obamacare. That view cannot be proven to be supported by the recent elections but the elections certainly would be consistent with that view. From my view as a physician with 25 years experience and from conversations with colleagues across the country (not scientific poll but it is 9 out of 10 physicians with whom that I talk), Obamacare will eventually decrease the quality of care, decrease the options available to the patient, will result in fewer physicians available to treat the patients, and will result in less able students applying to medical school. There will be committees deciding what criteria will qualify a patient for a given treatment. Now insurance companies decide whether they will pay for a given treatment (which can effectively mean that the treatment is not available) but the physician is still free to recommend the best therapy for the patient. Under Obamacare, physicians will not be able to even offer anything other than the prescribed by the government treatments. The doctor patient relationship has been severely eroded by the insurance companies where the physician increasingly works for the insurance company because that is who is paying for the treatment. Under Obamacare, the erosion will lead to a severance as physicians will work for the government controlled (though not employed - sort of a fascist system for the doctor) by the threat of criminal prosecution. To date, there is not a measured desire by the public to have this system. You both may feel that it would be better than what we have now - I do not.

Gern, Several have posted recently that according to UCLA (not a bastion of conservatism by any means) that Fox News was centrist slightly to the right whereas ABC and NBC were about the same amount to the left. 18 of the 20 studied were to the left. So I am citing a centrist, not right wing, source of information. Here is the link: http://newsroom.ucla.edu/portal/ucla/Media-Bias-Is-Real-Finds-UCLA-6664.aspx

Marinol is a legal drug that has the active ingredients of marijuana. Smoking marijuana is not FDA approved, is not medically needed, smoking is harmful to the smokers and those nearby, smoking marijuana impairs drivers harming innocent people. There is no medical reason to smoke marijuana. It is smoked to get high. Harming more people is not ethical or moral.

CalicoPenn, Before responding, I heard on Fox and Friends this morning while driving to work that Obamacare's peak in popularity was 48% in the fall of 2009. Assuming that Gretchen Carlson is correct, there has not been a majority of Americans who support the plan. To respond, you are correct that the methods and questions asked as well as the demographical statistics are seldom available.The accuracy cannot be determined. Certainly, the people who complained at town hall meetings were not the typical demographic for protestors at congressional events. They were passionate and anger at the health care bill was an over riding theme. Thus, observations would tend to support the poll conclusions. Perhaps, I should be careful to always say support according to polling data and I will endeavor to do so. Finally, polls and elections are the only ways to gauge the mood of the American public which is the only way that groups like this can discuss issues. Elections do not occur very often and they do not cover a single issue. So the polls are the only way to gauge the public support or lack thereof for a given issue. Thus, the polls have a consistent shown a lack of support for Obamacare which is only a crude view of the public opinion. However, when combined with the summer of 2009 town hall meetings and the recent election results, the polls seem to reflect the views of the voting public.

Gern, That is not a bad idea. The Amendment could solve the issue of initial commitment of troops that often comes up. The president says that he can commit troops and the congress says that he cannot without approval. Certainly, if Russia , China, or some other country launched an attack, we do not want to have to get congressional approval to respond. At the same time, we might wish to make sure that the president cannot act in a manner that would commit troops in an activity that will likely lead to a war. Also, I would add that we cannot commit troops to a major operation unless it is a declared war.

Recent shows the most opposition and lowest approval in the ABC poll: http://blogs.abcnews.com/thenumbers/2010/12/new-low-in-support-for-health-care-reform.html CNN http://i2.cdn.turner.com/cnn/2010/images/03/22/rel5a.pdf from Mar 19-21 2010 Favor 39% Oppose 59% No opinion 2% I can find many others. The medical care bill from the democrats has been unpopular nearly from the beginning.

I have not seen a recent poll (since the last election). Around the passage of the bill many polls were ~60% against and this has persisted through before the last election. I read these online from various independent pollsters and as reported on Fox news. The pollsters were independent of Fox. If you are unaware, it is not a surprise since many of my liberal friends never heard about the scandal in the justice department over the New Black Panthers case. Seems that a justice department that wanted to not enforce the law without consideration to race was not worthy to report. They seemed to think that it is alright for the justice department to enforce laws based on race.

CalicoPenn, States require people to have automobile insurance to drive a car but do not require people to drive a car. Obama and the democrats want to force you to purchase insurance just because you are a citizen. That is an enormous difference. Your argument to me seems to be that there is some way to force the people to do something that the majority does not want. That is what is objectionable. The American people do not want this plan and to be forced to purchase insurance. In a democracy, the majority rules. By the way if you want to be picky, it is medical care reform or medical insurance reform as Thomas Sowell pointed out a while back. Medical care is what is provided to patients whereas health care is also the participation of the patient in their care to achieve health (exercise, watch diets, etc.). No government or insurance company can provide health care. The bill sets up ways to determine what will be covered, what procedures that can be done, what screening tests will be done, etc. Then either all medical care bills are insurance reform or this is more than simple insurance reform.

Gern, Great question that should have been asked initially. It is my stance that to a greater extent that the executive branch and the congress should determine the political goals and then ask the military to determine what is required and carry out the plan. The more that the politicians meddle, the worse the situation. That said, I think that the initial plan should have been to go after Bin Laden et al. and leave the Taliban alone unless attacked. The attack should have been massive and then declare that we had our reckoning and leave. Now, I do not know how to get a tribal culture to become a modern democracy and so I do not know what constitutes victory. Iraq is a little better but I doubt that our idea of democracy will last long in Iraq. Is that a success or failure? Perhaps, the US should be more careful about committing troops and should have a clear cut goal determined in advance. So Gern, I am frustrated with our commitment of troops and the results. I think that at this point in time that Americans do not have the stomach to do what is necessary to win a war.

I believe that cell phones distract drivers rather than impair their cognitive function. Texting is extremely distracting. If talking on a cell phone (not including dialing) is compared to talking to friends in the car, I would argue that friends in the car are more distracting because most people look at those to whom they are talking whereas on a cell phone, one has no reason to not look at the road. So perhaps we should make all cars single seaters, get rid of texting, and have only voice dialing. The answer to issues with the problems of abuse of alcohol is not to add more cognitive function altering drugs.

Beavah, The other suit in Virginia was from Liberty University and had little chance. I believe that it was dismissed because of a lack of standing but I might be wrong. The Michigan case was likewise thought to be unlikely to be successful. The case today was considered a key case as is the one where 20 states have filed suit in Florida. If the Florida case is ruled in a similar manner, then I think that makes it likely that the insurance requirement will likely be found unconstitutional by the SCOTUS. The difference between the current case and medicare is that you have the option of not accepting medicare. Even if people qualify for medicaid, they have the right to refuse the coverage. With this logic, a single payor is not viable because it would have to provide a way to opt out. The idea in Obamacare is to force young healthy people to pay premiums to cover older folks who have most of the long term diseases. I see the ruling as merely upholding the constitution. An activist judge would have granted the non-severablitiy requested by the Virginia AG but the judge did not do so. I concerned that those cold temps in your home are affecting your conservative logic circuits.

Beavah, The request was for 45,000 troops in Afghanistan and Obama approved only 30,000. By my math that is 2/3 not 95%. He should have sent 50 to 60 thousand troops or totally withdrawn. His response was not a conservative response. President Bush was not a conservative and the republicans who over spent are not conservative either. Bush was a moderate. Obama has spent far more in one year than any other president from what I have read. That is liberal and not moderate. Being a good steward to the environment is a conservative value. Cap and trade is not to care for the environment from what I have read. As you say, it is a mess. It will make a lot of people insanely wealthy on unsettled science. The current models and data did not and could not predict the harsh cold winter for the entire northern hemisphere seen last year. I have not heard about Asia but Europe and the US are having a harsh cold start to the winter season. If the issue were settled then the models would predict the winters that are being seen. Thus, cap and trade is politically driven to redistribute American wealth to the third world. Bush was not a conservative but Obama is certainly not a moderate.

I agree on the war issue. I would have preferred that Obama either just pull out of Afghanistan or have given more troops than requested to bring the operations to a swift and decisive end. Having read about prior wars and lived through Vietnam on, it seems to me that wars should either be total warfare or we should stay out of the conflict all together. That would likely save the most US lives in the long run. Extremely liberal is easy, Obamacare which was just found to be unconstitutional (I know that there will be appeals). Obamacare as enacted will eventually totally control a major portion of the economy. It will tell people where, who, and how their medical care will be given. It will gradually remove most of our choice in our care. That is extremely liberal to most Americans.

A study by a major trauma center found that in 86% of motor vehicle accidents in which there was a fatality that one or more of the drivers were drunk or drugged. Legalizing more drugs will result in the serious injury and death of more innocent men, women, and children. As a physician who frequently cares for patients with cancer, marinol along with other anti-emetics is satisfactory. There is no medical reason to allow the smoking of marijuana.

Obama has also made statements about redistributing the wealth, enacted socialized medicine that was just found unconstitutional, wants cap and trade, wants to make reparations, apologizes to other countries, etc. Those are certainly not centrist policies. Since Obama has extensive military training and knows more about the needs of the military than his generals, he over rode them on troop strength requirements in Afghanistan. I just saw this morning that of the 1433 US casualties in Afghanistan since the beginning of the war, 803 have occurred in the two years that Obama has had the reins (source icasualities.org). Iraq was essentially over since President Bush's surge worked though fought tooth and nail by liberals such as Biden and Obama. Though President Bush spent far too much, Obama is an order of magnitude worse. Political realities have prevented him from enacting more extremist policies. He is not a centrist, he is a liberal.

CalicoPenn, I agree with what you say. At the same time, there was no opportunity for the scientists to refute the irresponsible, grandstanding Proxmire. He garnered the air time but I doubt that even if organized science attempted to get air time (my guess is that they did not), that the time would most likely not be granted or the setting would be less than desirable. As someone just said in another thread, the press is letting the country down in its' role.