yarn diet

I am obsessed with knitted cotton miters.


I have made twelve.

I am avoiding figuring out how many more I need to make. And to sew up.

The yarn has been discontinued (that is why I got it for such a great price), as I found out today when I went to buy more. I could order more of a reasonable substitute (at the risk of boring you, I used Butterfly 3 Aran weight, which is exactly the same as Tahki Cotton Classic II, except that the Cotton Classic II is much more expensive) but instead bought more of the same colours at the closeout sale price.

I will be using nine colours in total (I had planned to use lots more).

But I am happy.

And I have decided to go on a yarn diet. No new purchases for six months (that would be until December 30, or for the rest of 2007). Any new projects need to use yarn from my stash.

Putting it in writing means you'll hold me to it, OK?

but does it have that special odour?

My older son S. gets the photo credit here. J-dog looks decidedly unimpressed with I-dog.

S. and I have been hanging out a fair bit these last couple of days, as school is out. It's been fun. Nine year old boy humour can be a bit contagious though.

CBO Issues a Major Report on Medicare Advantage Plans--Pours More Fuel on the Private Fee For Service Fire

Yesterday, the Congressional Budget Office (CBO) issued a very comprehensive report on Medicare Advantage plans.I found the following to be an especially important finding:"In 2007, CBO estimates the average payments to such plans [MA] is 12% above traditional FFS costs. The difference is larger for private fee-for-service plans: According to estimates by the Medicare Payment Advisory Commission

a father's love

We are in the middle of a brutal heat wave in Ottawa.

Our air conditioning unit has died. The earliest we can replace it is July 5th.

Last night, at 11:00pm, my spouse was in the kitchen, with the oven on, making granola bars. Our son had asked if he could bring them to his end of school party.

I think he could have been forgiven for insisting that a bag of Doritos would suffice.

He's a very good dad.

separated at birth?

We watched Curse of the Were-Rabbit this evening, as we hid in the basement from the heat. It struck me that our dog bears an uncanny resemblance to Gromit. They look a bit alike (Gromit is a beagle and J-dog is a mutt of uncertain parentage). In demeanour, intelligence and disposition, though, they are eerily similar.

"Mid-Atlantic Convergence"--The European Government-Run Health Care Systems Are Coming Our Way!

One of the themes I have often heard in international meetings on the topic of health insurance is the term, "Mid-Atlantic Convergence."That is, our system may be gravitating to look more like those in Europe and theirs maybe moving more toward ours.One of the people I often see at these meetings is Bill Boyles, publisher of Health Market Survey and Consumer-Driven Care.Today, I have asked Bill

i feel like celebrating

I was very, very tired this morning and went back to bed instead of going to yoga. We'd had a lovely but busy weekend and I woke up exhausted.

I was feeling a little guilty about hanging around in my pajamas until my friend D. asked me what I'd done this week end. Before I'd finished the list (S. had two friends over for a twenty-four hour play date, I walked with D. to the library, out to lunch and then to soccer. On Sunday, we went to the market. I had a physio appointment, we took the kids to the park and then S. and I went for a walk...), I realized exactly why it was that I was so tired.

I gave myself permission to stay in my pajamas until late in the afternoon.

I was in a very good mood this evening. My spouse took D. out to hear some jazz and my friend H. came over with her new dog. We walked S. over to his friend's house (yes, I know it's a school night, but it's almost the end of the year and the boys wanted to watch Doctor Who together) and then strolled a bit before heading back to my house.

It was then that I realized that I felt like celebrating.

We had local strawberries with whipped cream and a bottle of ice wine we had saved from our trip last fall to Niagara on the Lake. We drank the wine in champagne flutes, because that's what you do when you celebrate.

It is only now, as I sit at the computer that I stop to articulate my reasons for celebrating. And I realize that I have too many too count.

My lovely neighbourhood.

My dog's joy in going for a walk.

My son's pride as he held the leash, directed us to his friend's house and greeted the kids he knew along the way.

The way both my sons light up when they see me.

Friends and family who love me.

The fact that I am alive, pain free and able to go for a walk with a dear friend on a hot summer evening.

And aren't fresh strawberries and whipped cream a good reason to celebrate, in their own right?

The Cost to Administer Medicare Versus the Cost to Administer Private Health Plans--The Difference Isn't Anything Close to 25%

Those that favor a single-payer government-run health care system have been reenergized by the Michael Moore movie, "Sicko."One of their contentions I keep hearing is that we could save 25% by getting rid of private health insurance plans and creating one big government-run plan. They point to Medicare's expense factor of 2.9% as evidence.The private health insurance plans have much higher

"AMA Takes on Retail Clinics"--Oh Come On!

That was the headline in today's Chicago Tribune.The American Medical Association (AMA) is having their annual meeting in Chicago and is considering opposing the opening of in-store health care clinics in places like Wal-Mart and Walgreen drug stores.The docs are arguing that this new phenomenon in health care, that would give consumers a low-cost and quick access to very basic medical care,

A Canadian-Style Health Care System--How Would We Get From Here to There?

The movie "Sicko" inevitably gets us talking about making over America's health care system into one that would resemble the single-payer government-run systems like those in Canada, Britain, France--or now even Cuba!I find the proposal a simplistic one.Having spent so much time in Europe and Canada working with health care policymakers and major stakeholders there, let me first tell you I have a

A Review of the Movie "Sicko"--Michael Moore Blew It!

Michael Moore's new movie, "Sicko," was supposed to be this great argument for a "single payer" government-run health care system.It turned out to be exactly the opposite because Moore overplayed his hand and did his argument more damage than good.The first half of the movie would have had anyone mad at the system--and for good reasons. It's real easy to find lots of examples of market stupidity

and the rain came down

Last Friday night, I had a meltdown.

I can count on one hand the number of times I have cried since being diagnosed with breast cancer, in late 2005.

I remember crying after my surgery.

And when my dog died.

And I probably cried when I found out about the metastasis but my memory of that time is clouded by shock, pain and the drugs used to numb it all.

Other than that, there have been a few teary moments but no honest-to-goodness meltdowns.

I was due.

It was a conversation with my spouse that set me off. It wasn't his fault. He merely expressed reservations about a proposed getaway.

Every insecurity I have ever felt about being loveable came to the surface, as well as the emotional toll of how cancer has changed my body.

I felt rejected.

And I dissolved into a sobbing, gasping puddle.

But really, I'd been primed for a meltdown for days.

I had had a very busy week, as I usually do on my weeks 'off' from chemo. By Thursday, when I went to see my physiotherapist, I was running on fumes. She made a casual comment about an aunt who had liver mets, and who'd had a wonderful active life, post-diagnosis. She added, "and she lived another eight or nine years."

I am not yet forty years old.

In eight years, my youngest son will only be twelve.

I will be lucky to live another eight years, and I will likely be in treatment right until the end.

She intended her words as a kindness but they hit me hard. I didn't respond or even dwell much on her comment but it stayed inside me. I was cranky with my naturopath and out of sorts for the next twenty-four hours.

Tension built, the clouds broke and then down came the rain.

Like all good summer storms, though, the air felt lighter after it ended. The sky was a little bluer this week and the sun shone brightly.

My step has been a little lighter, too, even with a chemo treatment.

And, can I say how lucky I am to live with a man who knows what to do in a meltdown, understands why they're necessary and never expects either apology or explanation?

He's even come around on the getaway plans.

content

That is how I feel today. And have for the last several days.

It's the calm after the storm. I'll tell you more about the storm itself later but I'm feeling pretty glad that it blew on through.

Now, I think I'll take a beer out of the fridge, grab my knitting and go watch Intelligence.

Life is good.

Will Medicare Advantage Payments Be Cut as Soon as 2008?

That's the question a poster asked today and it has been an issue on my mind. So I will address it here.First, CMS has already started the rate setting process for 2008 and will have it finalized by early September. While the Congress makes the rules and can do anything it wants, it would be very difficult to change the 2008 deal with the private sector after early September.The only way we would

no deconstruction needed

I have just started another knitting project. It's another giant undertaking, even bigger than the log-cabin, because I will have to sew pieces together. It's the mitered blanket (although my plans are less ambitious than this example, from the really inspiring Cara, at January One) from Mason-Dixon Knitting.

I don't think I need a psychologist to tell me why I am drawn to projects that will take me a really long time to finish.

I am, after all, an optimist at heart.

Commercial Health Care Cost Trend—Finally Hitting Bottom?

Commercia health insurance cost trend peaked in 2003 when costs hit 13.9%. On the same basis, health care cost trend fell to 7.7% in 2006 (Source: Kaiser Family Foundation Survey).Will medical cost trend keep falling in 2007 or are we near the bottom?The health insurance business tends to benefit from falling trend rates. Employers and benefit consultants tend to look backward when health care

of neutrophils and liver functions

I had chemo and Herceptin yesterday. I always drag my ass to the first treatment after my week off. It's especially hard to go into treatment, when I've had a few days to feel like myself.

My head is still fuzzy from the Demerol I take to mitigate the side effects from the Herceptin but, all in all, I could be feeling worse.

I had bloodwork done yesterday, as I always do before chemo. I have become obsessed with the results.

Yesterday's results were interesting.

My neutrophils (the white blood cells that fight in fection) were very low. They were so low, in fact, that if they had been any lower, chemo would have been cancelled (this also helps explain why I have been feeling so tired). The trick over the next week will be to remember my Neupogen injections (all five of them), to wash my hands (and my kids' hands) a lot and to stay away from sick people.

Additionally (and more importantly), all my liver functions were well within the range of normal, for the first time in many months.

I am very pleased about this. I choose to believe that this is a sign that my upcoming CT scan (scheduled for next week) will bring good news as well.

Perhaps, even news of shrinking tumours?

Of course, another report that all is 'stable' would be good. But I'm in the mood to indulge in a little wild optimism.

Leading Democratic Presidential Candidates Comment on Health Care This Week

Joe Paduda, over at Managed Care Matters, is attending the "Take Back America" conference in DC this week. Joe has been posting a review on his site of each of the Democratic candidates comments on health care.Comments include a review of Clinton, Edwards, Obama, and Richardson.

Cavalcade of Risk #28 is Up

Julie Ferguson, of Workers Comp Insider, hosts this week's "Cavalcade of Risk."This edition includes a couple of dozen of the best recent blog posts on the issue of managing risk.

Senator Max Baucus Is Crucial to the Health Insurance Industry's Continued Medicare Advantage Funding--But How Sympathetic Is He?

Everyone knows that House Ways and Means Subcommittee Chair Pete Stark is the Medicare Advantage program's biggest high-powered Congressional critic.The view of Medicare Advantage health plan payments, particularly for the controversial Private Fee For Service (PFFS) program, is more moderate in the Senate. Undoubtedly, the House Democrats will be more aggressive in the cuts they want than will

"Sicko"--Hate it All You Like But Don't Ignore It! The Best Response is to Satisfy the Customer!

Michael Moore's harsh critique, make that condemnation, of the health insurance industry is going to be hard to watch for those who have spent their careers in the business.The worst thing we can do is to rationalize it away as just another "single payer's" prescription for socialized health care.Thirty years ago, I was taught by the insurance company I worked for that the way to be profitable

Biggest Employers Propose Their Own Health Care Reform Plan––Moving Toward Individual-Based Benefits

The ERISA Industry Committee (ERIC) has proposed a far-reaching reform of not only the health insurance system but the employer-provided retirement system as well.They call for the movement of these important benefit plans from the workplace to individual ownership and responsibility.The group represents many of America's largest employers and covers 30 million people in their benefit plans.They

nine year old boys

I am alone in the house with two very excited pre-pubescent boys right now. They are both lovely people, brilliant, quirky and provide excellent blog fodder.

I was privy to the following conversation on our walk home:

N. (my son's friend): "I'm trying to grow a goatee (strokes his chin and thrusts it forward). How am I doing?"

S.: "I am growing a ponytail. It's been a really long time since I had a hair cut. My hair is so long I need to brush it almost every day and wash it once a week."

Honestly, I have to remind this child (several times) to use soap when he bathes, and he still doesn't always remember.

I can't wait to see what these kids are like as teenagers.

MedPAC Recommends a Reasonable Road Map For Reducing Private Medicare Advantage Payments--Plan Would Equalize Payments Over a Five-Year Period

The Medicare Payment Advisory Commission (MedPAC), the Congressional advisory group on Medicare payment issues, has sent a report to Congress recommending that the Congress structure future private Medicare plan payments in a way that eventually equalizes private plan and public plan costs.MedPAC said in its report that current Medicare Advantage reimbursement does not promote increased

Wall Street Comes to Washington--A Fascinating Discussion Between Wall Street Analysts and the Washington Health Policy Community

Paul Ginsburg, of the Center for Studying Health System Change, has been hosting a conference for 12 years where he brings some of the leading Wall Street analysts following the health care sector to Washington and puts them in a room with 400 Washington health policy people.The interchange, and the different perspectives, between the Wall Streeters and the Washington policy people is

D.

When we left for our walk, you carefully buckled your Horsie into the stroller seat beside you.

You made me stop four times to tell me that Horsie was falling asleep.

You fell asleep.

You awoke suddenly, and called out my name. I stopped and gently asked what you wanted. You said, "I'm ready to go now," and fell back asleep.

When you were really awake, we went for dog food, cat food and chocolate milk at the 'dog cafe'.

The young women who work there fell for your charms. There were lots of marshmallows in your chocolate milk.

You told me that Horsie was thirsty.

I said he could have some water.

You said that Horsie prefers chocolate milk.

I told you that chocolate milk would give Horsie a stomach ache.

You said it would be OK, because Horsie would only have a couple of sips.

I asked you if you planned to drink the rest.

Horsie had to settle for water.

Did I mention that the young women who worked at the store fell for your charms?

You walked all the way home, proudly walking the dog all by yourself.

It took us forty minutes to cover the fifteen minute walk home.

We had a big fight at the busiest intersection because I made you give me the leash and hold onto my hand.

Now, it is after 10:00 and you are still awake.

You just came downstairs. I opened my mouth to scold you but you said, "Mama, I can see the moon out my window. Come see."

We looked at the moon, I kissed you goodnight (yet again) and I tucked you in bed.

You look like me.

You drive me to distraction.

And I love you to distraction.

beats me

How could someone do a google search for "exotic dancers" and end up at my blog?

listening to my body

I hit the wall today.

Had a little bit of insomnia last night and that, on the heels of a hectic week, did me in.

I barely woke when my family did this morning and went back to sleep until 11:30. I spent the day in my pajamas, dressing only in time to walk the dog and pick up my son from school.

I used to push myself way past exhaustion. I can't do that any more.

Industry Trade Association Pledges to Halt Medicare Fee For Service Marketing Until Sales Abuses Are Cleaned Up--But Forgot to Mention One Thing

This from the June 15 AHP health insurance trade association news release:"Taking a major step to give Medicare beneficiaries peace of mind, today seven of our member companies are making a pledge to voluntarily stop marketing non-group Medicare Advantage Private Fee For Service plans and to strengthen consumer protections by implementing now the Centers for Medicare and Medicaid Services (CMS)

You Can't Have the Medicare Advantage Private Fee-For-Service Training Wheels Forever

Actually, my point was that the industry's arguments to preserve private fee-for-service payments amounted to an appeal to preserve corporate welfare, not that the original PFFS program is corporate welfare, but I'll accept the gist of this story:APConsultant Favors Cuts to Medicare PlansThursday June 14, 3:06 pm ETBy Matthew Perrone, AP Business WriterConsultant Says Congress Should Limit

Wall Street Journal Sends Shockwaves Through the Health Insurance Markets With the Headline "Health Savings Plans Start to Falter"

It's the kind of headline I would have expected to see in the New York Times instead of the Wall Street Journal but there it was in Tuesday's edition.Vanessa Fuhrmans' article seems to have unleashed some pent-up frustration in the health benefits market on the subject of health savings accounts (HSAs) specifically and consumer-driven care generally. It is as if it represents a turning point for

spent

I had back to back appointments with my physiotherapist (lymphedema has spread to my abdomen. Blech) and my naturopath today.

Then I went for a long walk with my young son via the library:

"Mama? Can I watch Chicken Little when I get home ?" (we got it from the library)

"It will be time for dinner when we get home. You can watch part of it after dinner."

Repeat 764 times. It took forever to get home because I had to keep stopping so I could hear what he was asking (see above).

He does have this new thing he does, that cracks me up.

If he wants to get a person's attention but he doesn't know their name, he addresses them as follows:

"Kid, why are you walking in the street?"

"Man, can I have some apple juice?"

"Guys, can I join your hockey game?"

OK. Maybe I'm just easily amused.

At any rate, I let D. watch the whole damn movie, even though it kept him up way past his bed time.

I was just too tired to move.

Can We Control Health Care Costs Without Universal Coverage?

My good friend, Joe Paduda, over at his blog, "Managed Care Matters" has responded to my recent post: The Mandate Myth--Health Reform Plans Don't Have to Mandate Coverage to Work But They Do Have Be Affordable.Joe has made the point that it might be important to mandate coverage in order to prevent cost shifting. He is pointing out that unless we mandate that everyone is in the health care

Latest "Health Wonk Review" is Up

David Williams is hosting the latest edition of Health Wonk Review over at his site, "Health Business Blog."It is the bi-weekly compendium of some of the best posts in the health blog world!

what a relief

So it turns out that the "five second rule" has a real basis in science.

I've lost count of the number of times I've picked up a candy off the floor, wiped it on my pants rinsed it off and let one of the boys pop it back into his mouth.

It's not often that rationalization, expedience and reality dovetail so nicely.

Why Does Health Insurance Cost So Much in New England?

I guess the easy answer is because health care itself costs so much in New England.As I travel around the country, I continue to hear that plan sponsors and insurers are all frustrated by the comparatively high health care (and insurance) costs in New England. For example, according to CMS, health care spending for Massachusetts residents exceed the national average by more than $1,500, or 33% in

blondes get more done?

Sorry for the long silence.

I'm fine. The heat has been slowing me down, though, and, as usual, I have over-committed myself, during this, my week "off" from chemo.

This week includes visits to the dentist (got a mouth guard to stop me from grinding my teeth. It is as attractive as you'd expect, with the added advantage of triggering my gag reflex), passport office (only two hours to be processed and two weeks for it to arrive. I'd been steeling myself for much, much worse), optometrist (my eyes are getting older, and weaker and my astigmatism is worse. New glasses, or at least new lenses, are on the horizon), medical oncologist (routine appointment), vet, physiotherapist, naturopath and my younger son's new day care (he starts school in the fall and is moving to a day care in his new school).

We are also getting estimates for a new air conditioning unit (which has died) and furnace (which will soon).

Oh, and the washing machine broke last week and tomorrow is the earliest we could get a service person in to take a look (and hopefully fix it).

Some of my 'commitments' have been very pleasurable.

We had a long-awaited visit from some lovely friends on the week end. I love them so much and wish their visit had been longer.

Sunday, I had the inaugural meeting of a new book club.

Last night I attended a knitting workshop (very cool. For those who care, I learned how to replace double pointed needles with a circular one, using a 'magic loop.' I was embarrassingly excited).

Tomorrow I am having lunch with a dear friend who I don't think I have seen since the recurrence, due to some ridiculous scheduling conflicts (when my spouse told me that the washing machine service person was coming tomorrow, he unhesitatingly offered to cover me off if this visit conflicts with my lunch with G. T. knows how many times the unexpected has caused us to cancel).

I am also having dinner tomorrow with a group of women with whom have much in common. We are all smart, strong trade unionists. We have all had breast cancer. And we all used to work in the same building (this is the subject of a long-postponed post that I really should crank out soon). We are planning a joint writing project.

Friday, I am taking my older son to the opening day of Fantastic Four.

Finally, I became a blonde today (before you email me about this, I know all about the risks involved in putting chemicals on my head. I chose to get highlights. They used a cap. My naturopath said it was OK. And I needed the lift). No pics, because I broke our camera (the lens is irrevocably damaged from getting wedged between the couch cushions). (And do you think any of the boys I live with even noticed the change? Ha! I really need to see my girlfriends).

I have exhausted myself just typing this.

Much of this was or will be fun. What isn't/wasn't fun is necessary (or needed to happen sooner or later).

And there is still so much more that needs to be done.

And so much more I want to do.

I am feeling a little overwhelmed.

And did I mention that it's really stinking hot here? And humid?

McCain to Propose a Health Care Reform Plan--Both Democrats and Republicans Becoming Predictable on Health Care

Republican presidential candidate Senator John McCain said this weekend that he is working on a health care reform proposal. He gave no time for its release but did mention a number of components:His plan will not include tax increases.It will not include any coverage mandates--presumably individual or employer mandates.He would make greater use of health care information technology.It will

The Mandate Myth--Health Reform Plans Don't Have to Mandate Coverage to Work But They Do Have Be Affordable

As the presidential candidates, Republican and Democratic, begin to come forward with their health reform plans, a side debate is heating up about whether any meaningful health care reform plan has to have a mandate, individual or employer.The reasoning goes that for health care reform to work we need to get about everyone in the pool--both in order to solve the uninsured problem and to be able

what if?

The story on last night's news about vitamin D really threw me for a loop. I felt quite sick, actually.

Of course, I know that prevention isn't that simple but I can't help asking, "What if?"

Giuliani Set to Announce a Health Care Proposal--But He Has to Make it Affordable for Everyone

Republican presidential candidate Rudy Giuliani is set to announce a new health plan this summer that would provide incentives to shift private health insurance from the employer group model to the individual health insurance model, according to an article in Thursday's Wall Street Journal.Details are sketchy. We understand that it would still allow the traditional employer plans to continue, it

New Ideas in Medical Liability Reform: Health Courts

Today, our guest contributor is Brynna Pietz of Common Good. Common Good has been a leader in arguing that it isn't enough to simply cap medical malpractice damages and call it reform. Instead, they believe we need to fundamentally change the health care tort system to one that does a better job of more quickly compensating the injured patient--and perhaps more importantly--improving the quality

Barack Obama on Health Care Reform and the Insurance and Drug Industries--a Healthy Cynicism

Earlier this week I wondered why Hillary Clinton continues to try to isolate and demonize the insurance and pharmaceutical industry in her comments about health care reform: Hillary Clinton on Health Care--Trying the Divide and Conquer Strategy Once AgainI pointed out that you would think she would have learned from her failed divide and conquer tactics in 1994.It is interesting to contrast

Hillary Clinton on Health Care--Trying the Divide and Conquer Strategy Once Again

In Sunday's Democratic presidential debate, Hillary Clinton once again tried to isolate the insurance industry (as well as the pharmaceutical business) as a means to advance her health plan.On health care Senator Clinton said, "What's important, and what I learned in the previous effort is you've got to have the political will--a broad coalition of business and labor, doctors, nurses, hospitals..