Saturday, December 28, 2013

How We Do Harm

It's one thing to read a statistical assessment of overtreatment, and how some "cures" are either ineffective or worse.  It's quite another to read the personal stories of people who underwent such treatment. 

A woman suffered brutal side effects getting HDC-ABMT, only to discover that studies show the treatment doesn't prolong survival.  A few years later she finds the cancer has come back, and at almost the same time she loses her insurance for having blown the life time benefit max.

A 70 year old man gets free prostate cancer screening at the mall, finds an abnormality and gets "treated."  He spends his remaining years incontinent and with a colostomy bag before dying of a UTI.

Even as we spend vast sums on overtreatment we have people suffering from undertreatment, such as an uninsured woman who walked into an ER with a body part in a bag after suffering auto-mastectomy from advanced, untreated breast cancer.

Health care reform is going to have its ups and downs.  But if you ever need a reminder about why the pre-ACA system was unacceptable, why it was a gross moral failure, check out How We Do Harm by Otis Webb Brawley and Paul Goldberg.  In their words, incidents of failure weren't aberrations from the system, failure was the system. 

Saturday, December 7, 2013

Hollywood Micro Apartments- what exactly is the problem?

Micro-apartments continue to draw opposition, particularly the Hollywood location. Why?

Street-parking near the Hollywood location is already at capacity, it's extremely rare to see open spots.  And because of the configuration of the highway and Sandy Blvd there are no nearby neighborhoods that would absorb parking by new residents.  Given that, what difference could new residents make?  There's no such thing as negative parking spaces, street parking can't be more full than it is now.  I get the distinct impression neighborhood concerns are not about parking, but about other things.

A recent letter from the Hollywood Neighborhood Association Board printed in the Hollywood Star reinforces that impression, emphasis mine:

Imagine the effects on your neighborhood if small, single-family homes on standard 50-by-100-foot lots were replaced by 64-foot tall apartment buildings that housed 70 or more people stuffed into 56 dormitory-like units with no parking.  Imagine further that the buildings' tenants were temporary with no connection to each other despite its so-called "group living" designation.  Imagine no dorm proctor to keep things from getting out of hand.  It is easy to anticipate noise problems, even worse parking problems than we've already experienced from no-parking apartments…

Never mind the false insinuation that the block in question is for single family homes when in reality it is surrounded by commercial property and highway, and zoned CX intended for intense development.  And never mind the hand-wringing over the plight of people "stuffed" into dormitory like units since no one will be there except by choice, meaning without that choice they'll be somewhere worse. 

 Look instead at the concerns:  The residents will be noisy and temporary, they won't have a proctor.  Those concerns have nothing to do with parking, and everything to do with fears and preconceptions about potential new residents.

If residents of the new buildings create noise problems or "get out of hand," whatever that means, then it should be addressed via law enforcement just as it would be if they lived in a single family home.  And yeah, people in single family homes do get out of hand and we find a way to cope and the world goes on.  But do we prohibit construction of new single family homes because their residents might be criminals?  How is that any more rational with apartments?

People should be judged on what they do, not on where they live.  It is shameful when we do otherwise.