28 October 2022: Anti-abortion laws continue to endanger the lives of girls and women

Anti-abortion laws continue to endanger the lives of girls and women by diminishing the number of trainees and likely practicing OB-GYNs in these states, https://www.nytimes.com/2022/10/27/health/abortion-training-residency-programs.html

Of course, individual girls or women may decide that, based on their religious beliefs, they want their medical care guided by strict Catholic or other religious teachings, even at the risk of their lives. However, the United States does not have a national religion. This means we are free to practice our own religious beliefs or none at all and cannot be forced to adhere to the religious beliefs of others. In this spirit, and based on federal law, an Idaho federal judge recently ruled that physicians can do abortions if, in their judgment, it is necessary to save their patients' lives, regardless of state law, https://www.washingtonpost.com/opinions/2022/08/28/federal-judge-pushback-idaho-abortion-ban/ 

I believe that medical care of girls and women will get worse in anti-abortion states as "fertilized egg personhood" laws are passed and enforced, which will affect care for all girls and women ages 9 to 59, whether pregnant or not, https://natpernickhealth.blogspot.com/2022/10/24-october-2022-fertilized-egg.html 

As a pathologist, and in collaboration with 1500+ other Michigan health care professionals, I  urge voters to vote YES on Michigan's Proposal 3 on November 8, 2022 to guarantee the right to abortion to Michigan girls and women, https://mireproductivefreedom.org/open-letter/ . 

@NatPpolitics

24 October 2022: Fertilized egg personhood

Fertilized egg personhood

Any proposal to grant “personhood” to fertilized eggs will do much more than eliminating abortion. It may also severely restrict the permissible activities of all girls or women of reproductive age, as indicated below. This is important because many states are proposing to grant “personhood” (i.e. the rights of babies that are born alive) to fertilized eggs (https://www.nytimes.com/2022/08/31/opinion/abortion-fetal-personhood.html). Although called “fetal personhood”, this terminology is improper because a fetus is defined as 8 weeks gestation compared to 0 weeks for a fertilized egg - thus, fertilized egg personhood is a more accurate term for these laws.

Here are some possible consequences of fertilized egg personhood laws:

1. These laws may ultimately require all girls or women ages 9-59 (i.e. ages at which they could possibly become pregnant), to get regular pregnancy tests unless it is medically impossible for them to get pregnant (i.e. clearly post-menopausal or lacking a uterus or ovaries). This testing would be necessary because society would have an obligation to protect the health of the unborn baby (who has rights equal to that of any person), but this could not be done until its existence is known.

2. This testing would have to be done by the State to protect the unborn baby because the law presumes that the mother may have adverse interests to her unborn baby.

3. It might be necessary to have a separate physician for the unborn baby and possibly even to have a guardian appointed to protect its interests.

4. In some cases, there will be disputes between the best interests and treatment for the two "persons", which the treating physicians may not be able to resolve between themselves. Thus, there may need to be "maternity judges" to settle these disputes.

5. These factors will cause marked changes in the standard of care for pregnant girls or women. Already, in anti-abortion states, pregnant girls or women may suffer delayed or altered care due to miscarriages or medical emergencies (https://www.blogger.com/u/1/blog/post/edit/5625050818749205890/4203045862329327302)

6. Every positive pregnancy test that does not result in a live birth may give rise to an investigation and possible criminal charges against the pregnant girl or woman, her friends, family, employer or anyone else who may have contributed to the death of the unborn baby (https://www.washingtonpost.com/national-security/2022/09/01/prosecutions-drugs-miscarriages-meth-stillbirths/). This means that pregnancy will be considered a high risk condition and will limit the activities of pregnant girls or women.

7. Society may presume that any girl or woman aged 9-59 is pregnant to avoid any activities that may harm the fertilized egg person and lead to a murder charge. This also limits the medical care given to girls or women, who are presumed to be pregnant or possibly to become pregnant at any time. Specifically, it might affect treatment for cancer, arthritis (https://pubmed.ncbi.nlm.nih.gov/21120498/) or other inflammatory diseases because treatment (chemotherapy, radiation therapy, anti-inflammatory or other drugs) might damage an unborn baby. 

8. This presumption of pregnancy and the fear of being investigated for murder for any miscarriage will greatly impair the types of activities that people want to engage in with girls or women, including employment. The only activities that may be widely tolerated are those that are safe for pregnant girls or women.

To many of us, these consequences are extremely offensive. However, it is foreseeable that they will occur, at least in some states.

@NatPpolitics

23 October 2022: You probably should not have to pay anything for your colonoscopy

Earlier this year, I had a routine colonoscopy at Henry Ford Health. The cost was about $4,500 and my HAP insurance paid for all but $900. 

At about the same time, I read an article at NPR.org that indicated that under the Affordable Care Act ("Obamacare"), I should not have to pay anything if I had insurance, based on this law, see https://www.npr.org/sections/health-shots/2022/05/31/1101861735/colonoscopy-cost-cancer-screening .

I wrote to Henry Ford Health Systems, who denied my request, and ultimately threatened to send this claim to a collection agency. I then filed a complaint with the Michigan Insurance Commissioner, DIFSComplaints@michigan.gov, see https://www.michigan.gov/difs/about/contact-info (who only responded a week ago requesting more information). It then occurred to me that I should file an appeal with HAP. They took 60 days to respond, but they did agree with me and now the balance is zero (so everything has been resolved).

This was what I wrote to Henry Ford, HAP and the Michigan Insurance Commissioner:

I think this procedure was coded incorrectly.

My understanding is that under The Affordable Care Act, colonoscopies are provided free of charge to patients without cost sharing. This procedure should be coded as Screening, not Diagnostic, and if done properly, there would be no charge to me.

My understanding is that The Centers for Medicare & Medicaid Services has clarified repeatedly over the years that under the preventive services provisions of the ACA, removal of a polyp during a screening colonoscopy is considered an integral part of the procedure and should not change patients' cost-sharing obligations.

Please review and advise.

I hope this information is helpful to you!

18 October 2022: Every eligible citizen should vote in this election

Every eligible citizen should vote in this election. Please forward this article to your friends and family and promote on social media. These short articles give some reasons why:

http://natpernick.blogspot.com/2022/10/16-october-2022-dont-kvetch-vote.html

http://natpernick.blogspot.com/2022/10/14-october-2022-why-vote.html

http://natpernick.blogspot.com/2022/09/27-september-2022-importance-of-voting.html

http://natpernick.blogspot.com/2022/09/12-september-2022-voting-to-achieve.html

In Michigan, voting by absentee ballot already started on September 29. So it's time to get started.

I believe that EVERY community should have a turnout of 80% or more in this election. Towards that end, I have established a Voter turnout challenge for our 8 Next Door communities (Berkley, Ferndale, Huntington Woods, Lathrup Village, Oak Park, Pleasant Ridge, Royal Oak, Southfield), see http://natpernick.blogspot.com/2022/08/22-august-2022-this-years-southeast.html, but every community should try to get as high a voter turnout as possible.

To register to vote in Michigan, you must be:

* A U.S. citizen
* 18 years old when you vote
* A Michigan resident for at least 30 days
* Not currently serving a sentence in jail or prison

See https://www.michigan.gov/sos/elections/upcoming-election-information

All Michigan voters have the right to choose to vote in person at their polling place on Election Day or by absentee ballot by mail or in person at their clerk's office. Voters are not required to provide a reason to vote absentee.

Deadlines: 

October 24, 2022: Last day to request an absentee ballot online or by mail. This is also the suggested last day to return absentee ballot by mail to avoid potential for mailing delays. Or you can drop off your ballot at the clerk's office.

October 25 through 8:00 p.m. November 8, 2022: In-person registration with local clerk with proof of residency.

November 8, 2022: Election day is Tuesday, November 8: Polls are open from 7 a.m. - 8 p.m.

Return absentee ballot to your designated drop box or local clerk’s office by hand
by 8 p.m. on Tuesday, November 8.

See https://www.michigan.gov/sos/elections/upcoming-election-information

@NatPpolitics

17 October 2022: COVID-19 related gratitude

This post is intended for those who believe in science and vaccines and that COVID-19 is a threat to human health. It is not intended to start arguments!

I tested positive for COVID-19 this past Friday, most likely from going to a pathology conference and walking the exhibit floor talking to ~100 people, almost all of us maskless. 

Positive COVID-19 at home antigen test. The presence of the T line means positivity. It appeared within seconds of dropping fluid from a nasal swap onto the test. The C line is the control, which should be positive or the test process was likely faulty.

Walking in a large group without a mask may have been foolish, but it is hard to talk to people with a mask and the purpose of the trip was to make business connections. My symptoms were mild (I thought it was only hay fever) and I am now taking Paxlovid, which has reduced the runny nose, cough, fatigue and sore throat (there were no other symptoms). I felt the worst about exposing others to COVID before I was diagnosed. The next time I have potential exposure like this, I will quarantine and take a home COVID-19 test before "going out".

Overall, I am grateful. I am grateful that I was able to receive 5 vaccines against COVID-19, without much hassle or bureaucracy and for no charge. I believe these vaccines may have saved my life. As a pathologist / scientist, I know that COVID-19 has killed over one million Americans and that the unvaccinated have a much higher death rate than the vaccinated (https://ourworldindata.org/grapher/united-states-rates-of-covid-19-deaths-by-vaccination-status?country=~All+ages). To me, it was a "no brainer" to get vaccinated and markedly reduce my risk of death, even with the possibility of vaccine side effects. Being vaccinated also reduces the chance I will spread the disease to my friends and family with frail health who might die if they got infected.

I am grateful that I was able to receive an effective treatment for COVID-19 that was easy to obtain and easy to take (5 days of pills in a logical package) for no charge. 

Paxlovid "blister pack". There are 5 packs, each containing 3 pills to take in the AM and 3 pills in the PM. I received the medication in the afternoon and so started with the evening pills.

I am grateful that we have fast, at home test kits for COVID-19, also easy to obtain (I got them in the mail, now at pharmacies), also for no charge. Elsewhere in the world, people are "hoping and praying" that they will soon be able to get vaccines, treatments or test kits in this manner.

Although COVID-19 was the #3 cause of death in the US in 2020 and 2021 (https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm, https://www.cdc.gov/mmwr/volumes/71/wr/mm7117e1.htm#F2_down), I am grateful that my disease was mild and seems to be going away without any "long COVID" side effects (https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html), although only time will tell.

Thanks to all those in health care, science and government who made the vaccines, treatments and test kits possible and easily accessible.

P.S. I am intentionally keeping the "long links" because I want people to know the sources.

@NatPpolitics

12 October 2022 - Get vaccinated against COVID-19 now

 White House Urges People To Get Updated COVID-19 Boosters By Halloween For Maximum Protection For The Holidays

The AP (10/11, Miller) reports that on Tuesday, the White House “said eligible Americans should get the updated COVID-19 boosters by Halloween to have maximum protection against the coronavirus by Thanksgiving and the holidays, as it warned of a ‘challenging’ virus season ahead.” White House COVID-19 Response Coordinator Dr. Ashish Jha “said the U.S. has the tools, both from vaccines and treatments, to largely eliminate serious illness and death from the virus, but stressed that’s only the case if people do their part.”

We are so fortunate to be able to get this lifesaving vaccine. Elsewhere in the world, people are begging to get it. If you value your life and those you meet with, please get vaccinated! 

Photo source: https://www.cdc.gov/museum/timeline/covid19.html