Healthline Analysis: Election 2008 - McCain's Competition & Affordability Health Plan

John McCain, Republican Representative who subsequently became Senator from Arizona, first elected in 1982 has a distinguished record of service to the United States of America. He released his Health Plan in October 2007 and here are some of its features:

• control costs and spending to make health insurance affordable for all
• provide access to care for all
• provide veterans with more freedoms in choice of care
• promote competition between traditional and alternative medicine providers
• promote patient-centric care and emphasize personal responsibility
• require transparency from providers vis a vis outcomes of care, costs, quality and prices
• develop national standards for treatment and outcomes
• promote HIT
  
• give states leeway to experiment with alternative methods of access to care and licensing of providers
• promote reforms for access to cheaper medications
• provide individuals with $2500 tax credit for health insurance
• foster competition, access to and affordability of health insurance
• support public health initiatives to decrease incidence of chronic disease

John McCain advocates overturning Roe vs. Wade and protecting the status of marriage as a sacred bond between one man and one woman. He and his wife have four children, including a daughter they adopted from Mother Teresa's Bangladesh orphanage. (His son Jimmy, 18, is a Marine serving in Iraq.) Together they promote adoption over abortion. He opposes the intentional use of human embryos for research purposes and does not support any research for medical purposes that "sacrifices moral values".

John McCain is a leading advocate for benefits and rights of veterans. His wife, Cindy, has long been an advocate of children's health care needs. She founded and ran the American Voluntary Medical Team (AMVT), providing emergency medical and surgical care to children around the world, from 1988 - 1995. She has a history of prescription drug addiction. She is on the Board of Trustees for HALO (dedicated to removal of landmines and weapons destruction in war torn countries), the Board of Directors for Operation Smile, and the Board of Directors of CARE.

Thank you marcn for use of photo Question about global warming.

Labels: health care, mccain, veterans

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Thank you Dr. Emer for Grand Rounds 50! Remember September 9 10:30 PM HBO: ALIVE DAY MEMORIES: HOME FROM IRAQ

Thank you for including a link to my post Remember September 9 10:30 PM HBO: ALIVE DAY MEMORIES: HOME FROM IRAQ in Grand Rounds 50, a round up of medical writing in this week's blogosphere - on Parallel Universes...

You can preview the promo here: http://www.youtube.com/watch?v=gEZsuuOf3Ao

And a clip from the film as well: http://www.youtube.com/watch?v=1HFjnfMlRqM

Labels: Gandolfini, Grand Rounds, HBO, Iraq, veterans

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US Military Casualities: Amputations at Record Numbers

Last summer a report from the Congressional Research Service based on Department of Defense information was sent to Congress detailing the US military casualty statistics in Operation Iraqi Freedom and Operation Enduring Freedom. Twenty percent of soldiers injured have multiple injuries - and may have traumatic brain injury (TBI) as well as traumatic amputations. All most half of the amputations are caused by IED's. These could be prevented if the transportation vehicles our troops are using had undersides designed to bear the impact of this well known threat. The MRAP is one such vehicle that the Marine Corp is now contracted to produce. It has a V-shaped underbelly desgned to protect against underground devices.

Advances in battlefield medicine have saved many combatants who might have died - but is the rehabilitation they receive up to par? The Center for the Intrepid, a $50M rehabilitation center in opened its doors in San Antonio, Texas in January, 2007 to treat the record number of amputees and troops with severe burns. Amputee rehabilitation programs are run at Brooke Medical Center in Texas, Walter Reed Medical Center and Bethesda Naval Medical Center. Housing has been built at Center of the Intrepid for families of the soldiers in rehab. The Center was funded by private donations from 600,000 US citizens, which means the world to the beneficiaries of the services provided. State-of-the-art technology is provided to military amputees including advanced prosthetics, computerized and video monitoring, biomechanical studies and advanced physical therapy methods.

One of these programs is the art program at the Center, a collaboration between the General Services Administration (GSA) and the Fallen Heroes Fund. The art work was chosen to complement the architecture, to remind visitors of the heroes and the sacrifices they have made for the US, and to support the physical rehabilitation programs and motivate participation in extreme sports. The Intrepid Fallen Heroes Fund and the Wounded Warrior Project has also just made available a publication " A Handbook for Injured Service Members and Their Families". The handbook provides information about what to expect, resources available and issues that will crop up. The handbook is available at www.fallenheroesfund.org.

New generation prosthetic devices are being designed by researchers at Arizona State University's Polytechnic campus and the Military Amputee Research Program at Walter Reed Army Medical Center. The Otto Bock C-Leg has a microprocessor knee and was introduced in 1997. It allows the wearer to go up or down hills and slopes and provides greater freedom of movement. Otto Bock also makes a myoelectric hand that is lightweight, compact and responsive.

If you want to get up close and personal with some of the amputees returning from Iraq, watch HBO's Alive Day Memories: Home From Irag from Executive Producer James Gandolfini. The documentary film premieres on September 9, 2007 at 10:30 PM and continues through September 16, 2007. Don't miss it - I have had a chance to see it and it is very moving. These American heroes have sacrificed their health and well being - they don't want us to forget them.

Labels: amputees, HBO, injuries, Iraq, prostheses, veterans, warrior

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REMEMBER SEPTEMBER 9 10:30 HBO: ALIVE DAY MEMORIES:HOME FROM IRAQ

Beginning Sunday September 9 through September 16, 2007 HBO will be airing the very special documentary by Executive Producer James Gandolfini Alive Day Memories: Home From Iraq. I had the opportunity to see the film this weekend and was struck by how unsentimental it is. Filmed on a black, blank stage, Mr. Gandolfini quietly interviews some truly tough men and women about what lead them to enlist in the service (Army or Marines), what they remember about the day they almost died, and the aftermath. There are no cheap attempts to manipulate our emotions. There are no judgments about the right or wrong of war or this war in particular. There are just ten human beings, aged 21-41, unique, full of life, energy, love, ideas, desires, hopes and dreams sharing their stories with Mr. Gandolfini.

Interspersed with the interviews are videos of the servicemen and women at home or at play or in Iraq before they were injured. There are videos of them in the hospitals and rehab centers or dancing after the injuries. Each has a story to tell.

Some of the facts Alive Day Memories: Home From Iraq educates us about:

• 90% of the wounded of this war survive their injuries
• the majority of the wounded cope with amputations, traumatic brain injury (TBI), post-traumatic stress disorder (PTSD)
• this war is seeing the highest percentage of amputees since the Civil War
• 50% of those wounded suffer from PTSD
• 33% of the injured suffer from TBI
  

Mr. Gandolfini calls them "True American heroes." And as HBO has observed, their fight has just begun. For the 30,000 wounded troops among us, and no doubt many more who will return to our shores, we need to rally round them, and help them with this fight. Watch this movie to gain a better understanding of their struggle.

See previous posts: War of Disabilities: HBO's Alive Day Memories: Home From Iraq Tells the Stories
Home From Iraq: HBO, James Gandolfini Focus on New Veterans

Labels: amputees, Gandolfini, HBO, Iraq, PTSD, TBI, veterans

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War of Disabilities: HBO's Alive Day Memories: Home From Iraq Tells the Stories

Penetrating wounds from improvised explosive devices (IED) create unique patterns of injuries that are challenges for clinicians and rehabilitation professionals. An upward oblique trajectory through the neck region, coupled with chest wall and lung contusions is often seen. Extremity injuries present with extensive comminuted fractures and traumatic brain injury (TBI) due to combat appears to be associated with increased cerebral edema as compared with civilian TBI.

IED's are easily assembled from agricultural and medical supplies. Activated by remote control, they combine blast, fragmentation and armor penetration. Often grouped as "daisy chains ", inflicting damage on the underside of multiple military patrol vehicles and, using time delay, the rescue teams as they rush to help the wounded. IED's then, are an illusive battlefield threat generating deadly blast effect injuries. A wavefront of high pressure spreads out at1600 feet per second from the point of explosions, propelling shrapnel at high velocity. Ballistic trauma injuries, or penetrating brain injuries, are treated conventionally. But blast waves cause invisible brain damage, smashing the soft brain tissues against the hard inner skull. Neither helmets nor body armor can protect against the forces of high pressure wave blasts which can result in loss of consciousness, severe concussion, blindness and other neurological deficits.
1800 US troops are suffering from TBI due to penetrating head injuries but there are concerns that there may be many more suffering TBI due to blast waves from TBI. TBI has become "the signature wound of troops returning from Iraq".

Military records indicate that 60% of military injuries are due to IED's or roadside bombs. According to Defense Update International, Online Defense Magazine, the Iraq war, now in its fifth year, is not a war of death but a war of disabilities. David Eschel states the symbol of the war is not the cemetery, but "...the orthopedic ward, the neurosurgical unit..." Executive Producer James Gandolfini looks at a new generation of war wounded in his upcoming HBO feature documentary, Alive Day Memories: Home From Iraq. The film premieres September 9, 2007 at 10:30 PM and can be streamed beginning Sunday 9/9/07 at 111:30 PM EST through 9/16/07 at 10:30 PM.

Thank you, Google images and mindhacks.com for use of image of Iraq IED.

Labels: blast injury, combat, defense, Gandolfini, HBO, IED, veterans

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Home From Iraq: HBO, James Gandolfini Focus on New Veterans

Depression is a serious problem for returning veterans of the Iraq war and their needs are going unmet. Returning veterans report feelings of alienation from their homes and families. The psychological problems, be they depression or post-traumatic stress disorder (PTSD) are creating havoc in family life, with almost half of veterans reporting family conflict or other relationship troubles upon returning from service.

The Veteran Resources Website has rich resources for family members concerned about loved ones with signs of mental illness or distress. That's just not enough though to prevent the alarming public health crisis that is the high suicide rate found in returning veterans. Mark Kaplan MD of Portland State University, has published a study finding that male veterans are twice as likely to commit suicide as civilian males. Oddly, being overweight seemed to confer protection against suicide by 50%. Dr. Kaplan states that being a veteran is a risk factor for suicide, especially for males.

Last week the Pentagon was forced to acknowledge that the suicide rate among returning veterans is the highest it has been in 26 years. Morale is extremely low, troops report little faith in their commanding officers. Problem relationships, legal and financial problems upon returning home are the reasons cited for suicide. "...there was a significant relationship between number of days deployed...and limited evidence to support the view that multiple deployments are a risk factor for suicide behaviors..."


The biggest threat to troops in Iraq and Afghanistan is improvised explosive devices (IED). Experts describe a mind set needed of constant vigilance - no place is safe. There is no safe haven. There is no down time. Devastating injuries from the war are the focus of a new HBO film by Executive Producer James Gandolfini, Alive Day Memories: Home From Iraq.
In this new documentary which first airs September 9, 10:30 PM exclusively on HBO, Gandolfini interviews 10 veterans about their "alive day" - the day they suffered devastating injuries and lived to tell about it. Healthline will be featuring more posts about this event as we approach the date. We are honored to help HBO promote the important message of the film.

Thank you Cpl. Joseph DiGirolamo for use of photo of Lance Corporal William A. Staley while stationed in Iraq, 5/2006.

Labels: depression, Gandolfini, HBO, IED, PTSD, suicide, veterans

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