Day: December 27, 2012

Categories
Contraception Reproductive Health Women's Issues

Promote Health

Quick, how many children does each of the presidential and vice presidential candidates have?

I knew that Michelle and Barack Obama have two daughters, but I had to search to find out about the other candidates. Joe and Jill Biden had four; two sons and two daughters, but tragically one daughter was killed in an accident. Ann and Mitt Romney have five sons, and Paul and Janna Ryan have two sons and one daughter.

Demographers have found that normal, healthy couples who don’t use any birth control will have an average at least eight children during their fertile years. In the past many of those children would have died, causing human populations to be stable. With modern health care (like all the candidates’ families have) fortunately almost all children will live to adulthood. Because of the small family size of all candidates, we can assume that they all have used contraception.

Yet some of these candidates wish to limit access to contraception. Vice presidential candidate Paul Ryan cosponsored H.R. 212, the “Sanctity of Human Life Act”, which is at variance with the medical definition of conception. This bill defines a human being’s life as starting at the unknowable instant sperm and egg unite. Courts could use this rule, if it were to become law, to prevent not only all abortions but also to outlaw the most effective methods of contraception. If it were to become law, H.R. 212 would be a public health disaster!

For centuries well-to-do people have had smaller families than the poor. Indeed, limiting family size has been a way that the rich have gained their wealth. Poor people currently have less access to birth control, unfortunately, and are less reliable in its use.

The United States of America was created on the premise of equal opportunity (“…all men are created equal….”) One way of increasing equality is to provide the means for all people to regulate their fertility. The Affordable Care Act is certainly one of the largest steps our country has ever taken toward equality.

We live in an outstanding nation. We have the richest economy in the world, but we are far from having the best health care in spite of spending more money per capita on health than any other nation.

Here are some health facts. Almost half (49 %) of pregnancies conceived in the USA are unplanned. This helps to explain why our abortion rate is so much higher than the rate in any other rich country. International statistics show that where abortion is illegal it is actually more common. Outlawing abortion, as some candidates promise, might increase its frequency, and women would suffer from illegal procedures.

The numbers are a bit out of date, but (according to the World Health Association) the USA is inferior to many poorer countries in the quality of its health care. We ranked number 37, behind Greece, Costa Rica and Dominica. Why is this? All of the world’s 25 richest countries have universal health coverage—except for the USA. Even our neighbor to the south, Mexico, recently instituted universal health coverage.

The rich can afford insurance and access to excellent health care in the USA. Unfortunately, our lack of universal health coverage leaves more than 48 million people in our great country without health insurance. Many of these poor people wait until too late to access care, and others inappropriately seek routine treatment through emergency rooms. It is no wonder that our health statistics are so bad.

Throwing more money at health cannot solve this public health tragedy. This point is proven by the fact that many countries with poorer economies have better health statistics. We need a new system of health care insurance with universal coverage.

One of our two presidential candidates has designed a health insurance system that will provide coverage to most people in our country. It will provide coverage for people with preexisting conditions, for young people before they have insurance through work and it will protect people with terrible illnesses from bankruptcy. The other candidate has promised to tear down universal coverage. If Mitt Romney is elected I expect that our health statistics will get even worse.

Please vote in this election. Please think about what will happen if women lose the reproductive rights that we have fought for. And please consider the state of our health care system when you are considering which candidates to choose for president and vice president. Our present lack of universal healthcare coverage is a national (and international) disgrace.

© Richard Grossman MD, 2012

Categories
biodiversity Global Climate Change Population

Pity the Poor Pika

Earlier this month I went where I had been told that there were pikas, the cold-loving relatives of rabbits, near the Wolf Creek Ski Area. I saw one little critter harvesting grasses for the winter. How much longer would this animal be able to live there before he gets roasted-out by climate change?

Even before climate change makes his rock pile too hot, my little friend will probably be rousted out by human incursion. His home is close to the proposed and hotly contested “Village” at Wolf Creek.

Wolf Creek is already suffering from climate change; bark beetles are destroying the spruces. In places, all the mature trees look dead. The only green trees are small; it will be decades before the forest is healthy again, if ever.

Billionaire “Red” McCombs’ money bought 288 acres of land just north of the ski area. For 25 years his people have been trying to make that land into a lucrative venture. They want to build a city there that would dwarf Pagosa Springs on one side of the pass and South Fork on the other. In fact, if McCombs got his way, with the “maximum density development concept” the “Village” would be almost four times the population of both those communities combined!

Let’s look at the practicalities of building a recreational city just below the most dangerous pass in Colorado. The first problem is access. There is only a single lane forest road leading from highway 160 to the parcel. The Forest Service is considering a proposal by McCombs’ people to trade some of his land for land along the highway. His stingy offer is to trade 178 acres of his land for 204 acres of public property.

The closest commercial airports are Durango and Alamosa, each about an hour and a half away with good road conditions. Stevens Field in Pagosa is closer, but doesn’t have commercial flights because it is beset by mountains and bad weather.

The infrastructure for a posh resort is also problematic. The current electric grid is not sufficient to supply the proposed resort. There are no natural gas lines up there, but apparently the plan is to truck in natural gas. Gas might be used for generating electricity as well as for heat during the subzero winter nights. It might be practical to get big trucks up there in the summer, but unreliable in the winter when most needed. Although there is adequate water, the “Village” would require a completely reliable wastewater treatment plant that can function in arctic conditions. A malfunction would pollute the headwaters of the Rio Grande River and a beautiful trout lake, Alberta Park Reservoir, below this pipedream.

Health is the most important reason I hope that the “Village” doesn’t get built. This beautiful parcel of land at 10,400 feet would be a magnet for rich people from sea level. Most of these tourists would fly in and drive rental cars directly to the “Village”. We locals are accustomed to high altitude, but many of these visitors, especially the obese and elderly, will encounter problems. Some will have to drive to lower altitudes, but a few will become acutely and critically ill. They will have to be evacuated by ambulance or helicopter, but there are times when access by either will be impossible. The closest hospital is in Pagosa Springs, over half an hour drive with good road conditions, but it doesn’t have an ICU.

Mr. McCombs must be a clever person to have gotten so rich. I am sure that he has hired a first-rate staff to look at the problems of building the “Village”. I can only surmise that they are familiar with all the problems mentioned above. Perhaps Mr. McCombs just doesn’t want to admit that it is impractical to make a resort out of his 288 acres in Mineral County.

In order to get direct access to the highway, McCombs has offered the above unequal trade. Not only does this deal seem unfair, it would also bring the “Village” a step closer to reality. The Forest Service is accepting comments on this proposal. I suggest that you learn about the possible land exchange and send your comments about the Village at Wolf Creek Access Project to: comments-rocky-mountain-rio-grande@fs.fed.us. The deadline is October first. I hope that you will agree with me that the Forest Service would be wisest to choose “NO ACTION” as the best possibility for us, for the health of possible visitors—and for my pika friend.

© Richard Grossman MD, 2012