Micah Arsham
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micaharsham.bsky.social
Micah Arsham
@micaharsham.bsky.social
Interests: literature, ethics, medical history, public health | Pacific College of Health and Science (MS), Columbia University (BA) | She/her
Reposted by Micah Arsham
Telehealth update: I've been busy all day, but just looked for info on the CR bill the House passed today & Senate needs to pass by midnight. No one's reporting on the telehealth provision, but I looked at what I *think* is the final text, & it grants a THREE MONTH extension. So, we keep fighting.
December 20, 2024 at 11:29 PM
Reposted by Micah Arsham
2/ Caveat: a news outlet reported some hours ago that this was the final text, but that doesn't mean it really was. None of the coverage I've seen so far from *after* the House vote has mentioned a telehealth extension. Most say the new CR is *only* farm & disaster aid & keeping the gov. lights on.
December 20, 2024 at 11:29 PM
Reposted by Micah Arsham
The telehealth expansion is ending this month!

Thanks to @drjudystone.bsky.social for the interview on this & for sharing my words - and for linking to the letter campaign!

Sign onto it below. We have less than 3 weeks to save telehealth. You don't need to write an actual letter, b/c one...

1/2
Telehealth Will Die In 3 Weeks Without Congressional Action
Urgent action is needed to pass the Telehealth Modernization Act before it expires, ending telemedicine on Dec. 31. This would be devastating for disabled and rural patients.
www.forbes.com
December 8, 2024 at 6:58 PM
Reposted by Micah Arsham
The mere fact that we observe rapid reversal of negative decisions (denials) or expedited review of cases that had been languishing for while after the events of this week show one the randomness and arbitrary nature
of denials of coverage by insurance companies.
December 7, 2024 at 12:49 AM
Reposted by Micah Arsham
I spent twenty years in the US healthcare industry. The key insights I took away from those years are:

1. Hospital administrations have one focus and one focus only and that is maximizing revenue

2. Insurance companies are a major mechanism by which they do that

@kenklippenstein.bsky.social
December 6, 2024 at 1:48 PM
Reposted by Micah Arsham
3. Hospitals do not see patients as their customers. The customers are the insurance companies. To the insurance companies the hospitals are the customers

In no scenario are patients ever viewed by either hospitals or insurance companies as customers
December 6, 2024 at 1:48 PM
Reposted by Micah Arsham
The implications of this took me a while to understand

But the gist is that neither insurance companies nor hospitals make more money if patients are happy

Happy patients do nothing for a hospital or an insurers bottom line

There is NO monetary advantage to having patient satisfaction
December 6, 2024 at 1:48 PM
Reposted by Micah Arsham
4. A related issue is that fact that a large population of people who are chronically ill is an environment in which hospitals and insurance companies make money

While a healthy population makes it tough to make money
December 6, 2024 at 1:48 PM
Reposted by Micah Arsham
My final observation is that

5. Everyone in the system is miserable. Insurance companies, hospitals, doctors, nurses, patients

Why does it persist if it sucks so badly?

Money

For a very few people -- insurance company executives, hospital administrators, lobbyists and politicians
December 6, 2024 at 1:48 PM
Reposted by Micah Arsham
In other words, the very people with the power to define the status quo -- healthcare is enormously profitable

And they are not going to let go of that without a ferocious fight

The slides here are from a presentation I made a decade ago:

www.gregorytravis.com/resources/St...
www.gregorytravis.com
December 6, 2024 at 1:48 PM
Reposted by Micah Arsham
Latest estimates for excess deaths from disease for 2024

Excess deaths among school-aged (5-17yo) children: up 9% over pre-pandemic norm

Those 18-44 years old: up 5%

75 years or older: up 4%

More at: www.gregorytravis.com/SARS-CoV-2/C...
December 6, 2024 at 1:37 AM
Reposted by Micah Arsham
The root cause is that we continue to believe that healthcare is not fundamentally different from selling used cars or coffee beans

i.e. something where supply and demand are easily met, regulated and rationed by the invisible hand/free market

This is a toxic fiction
December 5, 2024 at 12:49 PM
Reposted by Micah Arsham
People either need healthcare or they do not

It's not a discretionary purchase where they are free to walk away from the transaction if they don't like the terms

If your son or daughter has a malignant tumor, you can't shop around to get the best price like shopping for a car
December 5, 2024 at 12:49 PM
Reposted by Micah Arsham
7:19 AM "Waiting For The Moon To Rise" by 𝐁𝐞𝐥𝐥𝐞 𝐚𝐧𝐝 𝐒𝐞𝐛𝐚𝐬𝐭𝐢𝐚𝐧
from 𝐹𝑜𝑙𝑑 𝑌𝑜𝑢𝑟 𝐻𝑎𝑛𝑑𝑠 𝐶ℎ𝑖𝑙𝑑 𝑌𝑜𝑢 𝑊𝑎𝑙𝑘 𝐿𝑖𝑘𝑒 𝑎 𝑃𝑒𝑎𝑠𝑎𝑛𝑡 (Jeepster Recordings Limited) #nowplaying
December 5, 2024 at 3:20 PM
Reposted by Micah Arsham
"Language is a virus," said William S. Burroughs

Let's explain three phrases given prominence in our pandemic era in that context:

Chronic Fatigue Symptom
Long Covid
The Vulnerable

When I am done here I hope that you come away with the understanding why you should never use any of the above
December 4, 2024 at 2:34 PM
Reposted by Micah Arsham
Here's your periodic reminder that 2020 telehealth expansions authorized by Congress will expire on Dec. 31, unless we can get Congress to act. Please call your Senators & Rep, or use this form to send them a letter (it takes <1 min).

Detailed info below:

1/12

actionnetwork.org/letters/pres...
Preserving Telehealth
Preserving Telehealth Many U.S. telehealth benefits are set to expire shortly at the end of this year (December 31, 2024). With this email campaign, you can simply fill out your information and it wi...
actionnetwork.org
December 3, 2024 at 6:00 PM
Reposted by Micah Arsham
12/ Telehealth Modernization Act of 2024 (HR 7623) which passed out of the House Committee on Energy and Commerce subcommittee on health last fall (but went nowhere since).

🔺️So: tell your Members of Congress to get this done NOW. If telehealth expansions expire on Dec. 31, they are NOT coming back.
December 3, 2024 at 6:00 PM
Reposted by Micah Arsham
For folks here who don't know Argyropolous, I'm just going to give you this hot tip: that bro is even more sarcastic than I am.
If you appreciate original thinkers, follow him. First time I met him in person I thought we were going to talk abt Covid, but then he brought Lenin into the discussion.
Cognitive Behavioral Therapy, exercise therapy, pacing, Vitamin D, sunlight, and anti-depressants are guaranteed to help with that 😎👊
The SARS-CoV-2 spike protein can persist in the brain—in the skull bone marrow and meninges—to induce neurologic damage
www.cell.com/cell-host-mi... open-access
November 30, 2024 at 6:50 PM
Reposted by Micah Arsham
Read this and weep
"he traveled throughout Iraq...& saw firsthand how this so-called clean war w/ fewer civilian casualties was made more lethal by other means: infrastructure collapse — the decimation of electricity plants, generators, sewage & water-treatment plants."

War/violence scholars are largely missing this.
Modern Warfare Is Breeding Deadly Superbugs. Why? (Gift Article)
Researchers are trying to understand why resistant pathogens are so prevalent in the war-torn nations of the Middle East.
www.nytimes.com
November 28, 2024 at 8:03 AM
Reposted by Micah Arsham
The study from Vanderbilt showing that blood volume is ⬇️ in pts with #longcovid & POTS is an exercise in basic cardiovascular physiology. It was entirely anticipated by the biomarker data (VEGF/caveolin)

https://buff.ly/4fRk16I

Drinking water will not fix this
Blood volume deficit in postural orthostatic tachycardia syndrome assessed by semiautomated carbon monoxide rebreathing - Clinical Autonomic Research
Purpose The semiautomated carbon monoxide (CO) rebreathing method has been introduced as a noninvasive and radiation-free blood volume estimation method. We tested whether the semiautomated CO…
buff.ly
December 1, 2024 at 8:48 PM
Reposted by Micah Arsham
Puzzling and mysterious
realization that #longcovid = prolonged, nonclearing infection with all the baggage that comes with such a scenario.
Why long COVID may simply be 'long infection' - ABC listen
A parliamentary inquiry found between two and twenty per cent of Australians who get the virus will develop symptoms of long COVID including brain fog and fatigue, but its exact causes remain a mystery. 
buff.ly
November 26, 2024 at 3:57 PM
Reposted by Micah Arsham
I love the "simply" here. "Elementary" would fit nicely too.
November 26, 2024 at 4:54 PM
Reposted by Micah Arsham
You may think that neurological symptoms in #LongCovid are for old people, but it is the opposite. Young adults (18–44 years) and middle-aged (45–64 years) with mild acute #COVID cases (non-hospitalized), represent 90% of the cases of #NeuroCovid. Read here: onlinelibrary.wiley.com/doi/10.1002/...
November 23, 2024 at 6:53 PM
Reposted by Micah Arsham
The majority of excess deaths from COVID in the United States are concentrated in the young so this is not a surpprise at all

www.gregorytravis.com/SARS-CoV-2/C...
November 23, 2024 at 9:33 PM
Reposted by Micah Arsham
"many experts who wrongly stated that hybrid immunity isn't a thing and isn't protective."

Despite virtually everyone in the USA being either vaccinated, previously-infected, or both

Last month there were over three-thousand deaths from COVID

In people with "hybrid immunity"
November 23, 2024 at 9:20 PM