Friday, January 12, 2007

When the pathetic game of politics can still accomplish some good....(Mental Health Parity-Part I)

On his Exit, and clearly in preperation for his hope for a national stage, Governor Pataki signed into law, a Mental Health Parity bill. Not a great bill, with some costly compromises, but a good bill. I say that this is a result of a pathetic political game because, as you can see, Pataki was governor for several terms, and signed this law on his exit. Also, if he believed he could not work on this before, because it would be too costly for the state, it is telling that he did not mind saddling his predecessor with it. But it won't be too costly, of course. As the Federal Government has seen, while there may be a rise in the mental health care costs of the plan, there are cost savings to be had in lowered medical bills, less absenteeism and better employee productivity. Meaningful Helathcare Reform in this country will certainly entail Mental Health Parity, because of the benefits to the economy that a work force less challenged by mental illness will bring, as well as the needs to address the high cost opf mental health care for those chronically and pervasively challenged by mental illness. For them, an expansion of Residential programs, and a new effort to combat the secondary medical conditions we are seeing in the population due to side effects of the strongest medications and highest doses, need to be encouraged. On that front, I am involved in developing, with the guidance and resources of a dynamic, state of the art Residential system, a program to coordinate diet, exercise, psychiatric and case management to aid in medical and psychiatric adherence as well as use diet and exercise to combat these side effects. One area to explore, especially in light of recent studies questioning the benefits of some of the newer medications for some patients, is creating protocols to keep certain medications for use as a last resort, for those in the population who are clearly most susceptible to the potential damaging side effects, such as obesity and Type 2 Diabetes that are being observed. Any valuable protocols will clearly need to be useful for the many facets of a comprehensive Residential System (from group home and scatter site housing). Soon I will be posting updates on these projects as well as the development of an anti-stigma campaign that has been mentioned here before. However, I think it is time we once again work on some issues regarding medical healthcare reform, and look in on some of the things going on around the country.

Saturday, January 06, 2007

Satan to the Northeast this winter..."Hot enough for ya?"

My cellphone started vibrating and when I consulted the Caller ID it said "HELL".
I answered as respectfully as I could muster, "This is an honor Mr. President," but was interrupted,
"No, he's still alive. You know that. This is Satan."
"Yeah, I know." I said. "Our President's been practicing staying out of harm's way since Vietnam, so I am sure he has a few years left."
"How's the weather?" Satan asked with a chuckle.
"Nice. Warm. Why?" I asked.
"Know why it's so warm?" Satan asked.
"Well," I said, "the global warming community says it is increased green house gases from the world's growing industry and overindulgence of oil consuming cars and trucks. The neo- conservative movement would have us believe that global warming is utter nonsense, it's only the resurgent el nino current, and we should sit back, relax, and enjoy springtime in January." I said.
"And what do you think?" Satan asked.
"Well, now that I have the Devil on the line asking me, I think you have something to do with this."
"You know, this is one of those rare confluence of events where the answer is, actually, all of the above!"
"You mean like 'Murder on the Orient Express'?" I asked.
Well, sort of. It is global warming, and el nino, and Hell's doing, if that's what you mean."
"Satan, can I call you Satan?", I began.
"That's Mr. Devil, to you!" He barked.
"Sorry...You're kidding, though, right?"
"Yeah. I guess Satan's all right. Although my friends call me Stan, or Lou, or Santa."
"Oh, come on!! You are kidding now, right?"
"Yeah, I am,", he said, "mostly..."
'What's the deal with Santa anyway? Same letters in his name, the red suit?" I asked.
"Well, look at it this way, you take the birth of the Christian lord, and turn it into a commercial endeavor where parent's everywhere have to buy a bagload of presents, and then have to say it came, not from them, but from an imaginary character, and you didn't think there was anything devilish about that? My hands are all over that! I remember it like it was yesterday, I said to God, 'God, if you get to bring down a force for good in the world, and start a new religion, you gotta let me get something out of this too. Hence the conversion of the religious to the commercial, and the pious and poor lord to the mother of all shopping events! Then I got the Jews into the act. Eight days burning on one day of oil...not your most amazing of miracles, not the parting of the Red Sea, or anything, but certainly adequate enough for the making of eight nights of gift giving, to compete with the one monumental morning of the year!"
"All right. Enough!" I said. "You are taking the fun out of all of this." I said.
"That's part of my job. It comes with the territory." He said.
"And what were you calling me about?" I asked.
"To let you know why it is so hot up there." He said. "Remember how cold it has been in Hell lately?" He asked.
"You mean when Hell froze over because I was right about the American electorate coming through and booting the Republican majority, and you were wrong?" I said.
"Yes," he said. "Well, the heat has to go somewhere, and there you go. A few degrees of global warming, an el nino, and a little extra heat courtesy of Hell." It all spells a warm start to winter for you surface dwellers. Mostly, in the northeast, for a variety of interdimensional, geographical reasons. Much too complicated to go into now." He said.
"You don't understand why it's mostly in certain areas either, huh?" I asked.
"Don't taunt the Devil." He laughed. My nephew works for the IRS and I have other nieces looking for dates."
"I see. All good points." I said, chastened.
"And I can think of over 111 things I can do to your car that will not be covered by the warranty."
"My car's been giving me trouble. I'm thinking of trading it in!" I said smugly.
"See." He responded. "Don't taunt the Devil."
"Leave my cars alone, thank you." I said. "Don't you have better things to do?"
"No. It's been kind of slow. I promised to leave the new Congress alone for a few weeks. I used my cellphone to videotape Saddam Hussein's hanging, but that only took a few minutes. You can see it on YouTube. It's getting more play than the video I took up Britney Spears skirt when she was out with Paris and Lindsay that night. When she was a little girl, surely Brittney's mother told her to always go out wearing clean underwear, but I guess she should have stressed the underwear part more than the clean, huh?" He laughed.
"So what is your point here?" I asked.
"Don't stress global warming," he said. "Listen to your President, and to Dick Cheney."
"Really," I asked. "There's nothing to worry about?"
"Oh, of course there is. It will destroy the world. But hey, we all gotta go sometime, and your generation won't even have to worry, not before, say, your grandkids generation, at least!"
"That's not to worry about?" I asked, incredulously.
"Not if your Satan," he replied, "If the world ends through humankind's avarice, evil, or stupidity...I win."
"Win what?"
"The game. You know...." He said.
"No, I don't know. What game?"
"All of this." He said. "Everything. LIfe, the earth, you know.... Maybe not just a game, so much as a bet, a wager, between God and myself."
What do you mean?" I asked.
"God bet that he could create a physical dimension populated with independent biological processes, that would evolve with free thought and choice into an advanced race that would someday become fully self aware, and understand their true nature, and that of their creator, and a harmonious symmetry would be created that would transcend our dimension and yours to create a utopian pandimensional multiverse that would herald a golden age of plenty throughout the entire cosmic spheres. And I bet you'd be mostly a nasty lot of greedy, self annihilating poseurs."
"And have you collected on this bet?" I asked glumly.
"No, sadly, we are not even close to the finish, unless of course you 'accidentally' self annihilate before you can prove yourselves. God thinks you are moving, with major fits and starts, of course, in the right direction. I do not. Even God admits the last 6 years in America, one of his favorite places, has started to push the momentum in my direction. But he feels the previous 200 years or so, went his way. So, who can really say?"
"That's why you are pushing us now to ignore global warming! Now I understand." I said, "You are likely to lose unless the human race should exterminate itself."
"You mean when it does." He laughed. "I'm not worried about losing." He said, but clearly he was.
"The Devil you say!" I laughed. "I think you are concerned!" I said.
"Do I smell another wager?" He asked. "A chance for me to score some, after my poor insight into your election day?" He inquired.
"The result could potentially take thousands of years to decide." I said.
"So, what's our rush. If you lose, I can come collect you, that is, if I don't already have you!" He laughed, more Satanically than usual.
"I'll think about it." I said, as I also thought about maybe, making my next car a hybrid, or at least something more environmentally friendly than the cars I usually go for.
"Economical cars are soooo boring!" Satan whispered on the other end of the cellphone."
"Are you reading my mind?" I asked, aghast at the possibilities.
"You were talking about buying a new car before, and now about global warming and then you were silent. It doesn't take the King of the Underworld to figure that out. By the way, it is better to rule in a gas guzzling SUV or Sports Car, than to serve in a Hybrid." He laughed. "You can quote me on that." Then he laughed some more.
"Go to Hell." I muttered, annoyed.
"Already there. That's the beauty of the phone. Not as impersonal as email, more convenient than leaving your own dimension."
"Lucky you called after 9pm. I have unlimited night and weekend minutes and this is a long call!" I said.
"Sorry, any call from Hell is peak anytime minutes. It's Hell, after all."
"Are you kidding me?!! Next time leave your own dimension! You owe me more than a drink for all the minutes you're using!" I said.
"Fair enough. Next time...in person." He said.
"And when will that be?" I asked, but my phone already said --Call Ended--.