Obesity On The Interstate

On Saturday and Sunday, Kish and I drove home from Maine.  It was a long trip, so we broke it up into two days.  The distance wasn’t a problem for me, though, because I just enjoy driving, listening to the radio, and seeing the countryside pass by.

northway-exit1We rolled along interstate highways in Massachusetts, upstate New York (where we got ridiculously gouged paying tolls on the New York Turnpike), and then Pennsylvania and Ohio.  Because we were on the NY Turnpike, we used the service plazas to fill up, and we visited rest areas on the non-toll roads.  As we stopped from time to time and I passed fellow travelers, I slowly realized something:

My God!  We are a country of porkers!

Look, I recognize that the crowd you see on the interstate highway system in the Eastern time zone isn’t a random statistical sample of the United States as a whole.  I know you can’t extrapolate from the people I happened to see, by chance, as I stopped to fill up or hit the men’s restroom.  But after a while the number of seriously obese people I was seeing at every stop became so obvious that it just couldn’t be ignored.  And I’m not talking about people who are a few pounds above their ideal, either.  I’m talking about people that move with the slow waddle characteristic of the grossly overweight, men with colossal beer guts, women who are huffing and puffing just walking from their cars to a roadside restroom, and people who look like they are ready to burst out of their clothes.

I’m not saying this to be funny, or provocative.  It really was disturbing, and depressing.  There obviously are a lot of morbidly obese people in this country, and if you want to see them just drive a while on the interstate highway system.  When you think about the back problems, and diabetes, and joint problems, and heart disease, and high blood pressure, and other health conditions associated with obesity, you realize that the weight problems of so many people have to be a large contributor to the exploding health care costs in the United States.  Is it any wonder that we can’t control health care costs, when so many people can’t control their own urges and their own weight?

The Value Of A Good Nurse

Today’s outpatient procedure at the East Side Surgical Center demonstrated the value of a good nurse — and how essential they are in the modern world of healthcare.

From the outset, after I completed the registration materials, I was in the realm of nurses. Pre-operation, a friendly nurse adjusted my crutches to the right height, got me changed into surgical garb, took my vitals, created my ID bracelets, gave me my initial medication, and set up the blood vessel portal for the anesthetic to be administered, among other tasks that I wasn’t even aware of thanks to our relaxed conversation. She was a real pro.

After the surgery, I awoke to the company of another nurse who checked the dressing on my foot, explained that the operation had gone well, took my blood pressure, gently engaged me in a slow-talking conversation as the anesthetic fog gradually lifted, steadied me on my crutches, then wheeled me out to where Kish was waiting for me with the car. She was great, too.

In our penny-pinching health care system, doctors have to focus on doing the high-level procedures for which they are so well trained, and nurses carry the load of performing the other medical, and administrative, and human interaction duties that need to be completed. We can only keep costs under control — and also create an experience where the patients truly feel like they are receiving care — if we have a corps of kind, pleasant, professional nurses who make the system run.

I’m happy to report that I received excellent nursing care from some wonderful people at the East Side Surgical Center on my visit this morning. Of course, the best care of all is at home, where Kish is saddled with keeping an eye on me while I’m flat on my back for a few days.

The “Health Care Reform” Law Hits The High Court

It is looking increasingly likely that Supreme Court will hear an appeal of the ever-controversial “health care reform” law, and soon.

Both sides to a lawsuit — the Department of Justice in favor of the law, and 26 states and the National Federation of Independent Businesses in opposition — have asked the Court to accept an appeal and decide whether the law should be upheld or struck down as unconstitutional.  The Supreme Court has the discretion to decline the appeal, but the fact that the appellate court declared the law unconstitutional, and the fact that both sides to the case are seeking review, should increase the chances the high court will hear the case.

Stripped of its partisan baggage, the appeal poses a fascinating legal issue:  how far does Congress’ power to regulate interstate commerce extend?  In prior cases, the Court has articulated an expansive view of that power.  However, opponents of the new law argue that this case is different because Congress — through the “individual mandate” provision that requires all citizens to buy health insurance — is for the first time assuming the power to compel unwilling citizens to engage in commerce.  Proponents of the law respond that, when it comes to health care, every living American is already affecting commerce, because those who don’t have insurance and then need health care are imposing economic burdens on the rest of us.  A Supreme Court decision on this issue would go a long way toward defining, once and for all, the full extent of Congress’ power to regulate the daily lives of Americans.

If the Supreme Court takes the appeal, it would be likely to rule in the summer of 2012 — just before a presidential election where the wisdom of the “health care reform” law is likely to be a very hot topic.  And the decision will come against the backdrop of a recent report that shows a sharp increase in health care costs, which undoubtedly will cause Republican candidates to blame the unpopular new law and redouble their attacks on it.