Last night I was thinking that it's been quite a week with one thing and another and only Wednesday reached.

In fact, the stars must be out of alignment or something because there seems to be rather a lot of madness and insanity going on at the moment…  The barbaric repression of the Iranian people to the running out of budget in California, politicians going AWOL, politicians in Albany behaving like naughty infants and Senator Claire McCaskill of MO observing the obvious that passing a new Health Care bill will be difficult at best.  Granted some of these examples of the week that was seem to be going from the ridiculous to the inane rather than sublime, but it does make you wonder sometimes whether people have any common sense left.

I don't normally write about politics, but as an outsider, American politics has always struck me as being about vested interests and big business.  The little guy doesn't stand much of a chance, no more than ordinary Iranians on the streets against the butchers of the Basij.  The odds are heavily stacked against them from the beginning.  That doesn't make it right, of course not, but give me 10 caring people who want to make a difference to others than 100 ruthless Republicans bent on their own self interests.

For any major changes in the Health Bill to survive intact, Obama needs to lead and drive it through assertively with a majority in his favour, or it will flounder amid GOP and Lobby shenanigans.  It's a tough order, but we will see what this Administration is made of and what sort of tone it will set for the next 3.5 years.

The Constitution of the United States refers to "We the People" not "We the HMO's" or "We the industry Lobbyists", but somehow in the end, individual Senators ultimately vote for what will likely re-elect them again, not necessarily what is the right thing to do for the greater good.  Think about it, how many Senators in tobacco country will vote against more stringent tobacco or smoking bills, or those in Motown voting for less Union powers, for example?  It simply isn't going to happen and it would be naive to think otherwise.  Real change only happens when the People decide en masse to get up and DO something about it, rather than vote for change and then sit back and expect politicians to enact it. That way lies apathy and resumption of the status quo.

There are some good examples of business people doing good things in politics, though.  Look at Mayor Bloomberg in New York, for example.  The other day I was struck at how clean and pleasant it was to eat out in the Big Apple unhindered by pollution from second hand cigarette smoke.  As I walked along Bleecker to the Christopher Street Path station, I noticed a sign in a junk food restaurant displaying calorie content for all the items on the menu.  You don't see that sort of relevant consumer information in New Jersey, only half a mile across the river.  It was shocking enough to make me stop in my tracks on the street: 700 calories for a burger?  Without the cheese?  Yikes.

Imagine then, my interest in an article in The Lancet was more acute this morning on seeing a headline scream:

"Effects of bariatric surgery on cancer incidence in obese patients in Sweden (Swedish Obese Subjects Study): a prospective, controlled intervention trial."

Obesity Obesity is known to increase the risk of many types of cancer, but it has been unclear whether surgery to address the problem could also cut the risk of cancer.  The Swedish study showed that weight-loss surgery was associated with a 42% reduction in cancer levels in women.

What is interesting is when you juxtapose this sort of information with the news media such as the Washington Post reporting on:

"A majority of Americans see government action as critical to
controlling runaway health-care costs, but there is broad public
anxiety about the potential impact of reform legislation…

Most respondents are "very concerned" that health-care reform would
lead to higher costs, lower quality, fewer choices, a bigger deficit,
diminished insurance coverage and more government bureaucracy.

There is absolutely nothing in there about people accepting more personal responsibility for their health and well being, of connecting the dots between health, disease, lifestyle and ultimately costs.  Containing drug budgets won't solve the real root of the problem: we need to get more Americans healthier and fitter, not spend less and change nothing else. 

Meanwhile, the proposed Public Plan will probably derail and undermine the wider changes inherent in the health care bill by fracturing uneasy consensus and escalating the debate into shrill rhetoric as politicians scramble to defend their turf and their jobs rather than focusing on the broader issues of what's the right thing to do for the People.  But that's politics for you.

ResearchBlogging.orgSjöström, L., Gummesson, A., Sjöström, C., Narbro, K., Peltonen, M., Wedel, H., Bengtsson, C., Bouchard, C., Carlsson, B., & Dahlgren, S. (2009). Effects of bariatric surgery on cancer incidence in obese patients in Sweden (Swedish Obese Subjects Study): a prospective, controlled intervention trial The Lancet Oncology DOI: 10.1016/S1470-2045(09)70159-7

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