When Friends of Rock Creek Environment volunteers picked 7,000 plastic store bags out of the Rock Creek watershed in April, Del. Al Carr (D-Dist. 18) was among the collectors.

This year, Carr wants to turn that trash into treasure for the environment.

Following on the heels of a law in the District, Carr plans to introduce legislation in Maryland that would charge a nickel for each plastic or paper reusable grocery bag used by shoppers. At least 3 cents per bag would go to the Chesapeake and Atlantic Coastal Bays 2010 Trust Fund to pay for pollution mitigation.

Those 7,000 bags that were pulled out of Rock Creek, if purchased by shoppers under the proposed law, would have amounted to at least $210 for the fund.

“In these tough economic times, it’s been very hard to find money to put in the fund so this will help,” said Carr, who is on the Environmental Matters Committee.

Carr said plastic reusable shopping bags can tangle wildlife, be mistaken as food by fish and turtles and do long-term damage to the environment.

Carr’s bill and another that will be introduced in Virginia are modeled after a grocery bag bill that took effect in the District at the beginning of January. Carr introduced a five-cent fee for bags during last year’s session, but said he removed it from consideration at the committee level because he wanted it to be passed in D.C. first.

“Now we can come back in Maryland and point to the success in D.C. and have the momentum,” Carr said. Similar laws have been enacted in California and Washington. The bill introduced by Carr in the 2009 legislative session estimated as much as $3.9 million could be generated annually for the Chesapeake and Atlantic Coastal Bays Trust Fund if each store in the state sold 5,000 jute bags and retained 1 cent of the proceeds. The figure was for illustrative purposes only.

The Maryland law would rebate 1 cent of the fee to the retailer for administrative costs, or 2 cents for retailers that offer rebate incentives to customers who bring reusable shopping bags. The rest of the fee would go toward watershed preservation. There are exceptions to the bag fee in the legislation, including for hot carry-out food, meat, fresh produce and bulk items.

Beth Mullin, executive director of Friends of Rock Creek Environment, said her group was a “strong supporter of the D.C. bag bill,” and the group is “very encouraged” to see similar legislation in Maryland, which contains 79 percent of the Rock Creek Watershed.

But the custom bags all begin in a checkout line, and Scot Shuck, owner of the Grosvenor Market in North Bethesda, said even with the effort to pay retailers’ administrative costs, implementing the fee would be a headache.

“It sounds like it’s going to be a lot of work and at the end of the day as a retailer I want to give customers what they want without having to charge them,” said Shuck, of Garrett Park.

Safeway stores in the District have adapted, a process spokesman Greg Tenyck said required training checkers and reprogramming self-checkout machines and keeping records of the fees collected to send to the District.

“It certainly adds a layer of complication to what used to be an uncomplicated practice, but having said that it certainly does carry a strong environmental message and we are an environmentally conscious company so we aren’t going to oppose that,” said Tenyck, who said Safeway neither endorses nor opposes the bill.

Jamie Miller, a spokesman for Giant Food, said that retailer will take no position on the Maryland bill until it is officially introduced, but said the chain distributed 250,000 free reusable bags in the District in the first week of January to respond to the law there.

Loading nearly a dozen plastic jute bags into her minivan last week, Christine Spain of Chevy Chase embraced the idea of a nickel charge for each.

“I’m all over that, I’d completely agree with that,” she said. Spain, who recycles the plastic customized bags she gets at the store, has considered using the reusable bags, but said her twice-weekly grocery trips for a family of four would require a lot of them. Still, she said she might change her behavior and buy reusables if the fee was enacted.

Gary Leyland of Kensington, who uses the reusable totes, said he bought them two years ago because of a 10-cent-per-bag incentive at MOM’s Organic Market, not a disincentive from Uncle Sam.

“I’m kind of green but I don’t agree with this taxation stuff,” Leyland said. “It’s kind of a regressive tax if you think about it. I’m generally just frustrated with taxes. I don’t think it’s generally a good way to regulate behavior.”

End of Life Medication

Morphine an opiate is a main stay for pain therapy. It also eliminates the autonomic biological oxygen hunger response, therefore is commonly used in end of life Managed care jobs California. In other words, morphine relieves or suppresses a sense of air (oxygen) hunger—that leads to less breathing, oxygen deprivation, and to cardiac arrest and brain death. In the end, the involved patients lose their lives by drug induction.

Hospice-care organizations certainly provide end of life comfort-care in their lavish facilities, and no pain deaths with narcotics. Their approach is obviously much more comfortable than what death-row inmates’ experience. However, I question their right to decide when people take their last breath—absent an advance directive. Our 1st and last breathes are suppose to be God’s call not Hospices’ or Palliatives’ call. Managed Care jobs Los Angeles County pertinent statute in his 10 commandments states: “Thou shell not take innocent life.” It is similar to when people take their dogs and cats to a veterinary to be put down or to death when they become old, infirmed, and are too much work and no fun anymore. There are certainly arguments from those managed care jobs orange county people who want to be putdown or to death when they become terminally ill. This is where legal informed consent comes into play in the form of advance directives. Hospice and Palliative care businesses need to be held accountable to the law by providing informed consent—to their clients and their clients’ loved ones. The public needs to be better informed concerning end of life-care legal rights, legal remedies, and options.

The business model dilemma for managed care jobs hospitals and hospice is understood, in that, they have limited facility space, time, and staff; and terminally ill patients can linger on-and-on-and-on. The sooner a patient’s health-care transactions can be brought to a close; the better it is for business profits. So that room can be made for new patients. This is obviously connected with racking up charges for medications, nursing services, and general end of life care numbers and total dollars. I believe these end of life care business practices and model apply to palliative-care as well.

End-of-life-care (death-care, human-put-down-care, or euthanasia) has become more than a cottage industry, and came into being because it is bad for hospital business to have patients lingering in their inventory, and dieing on their property. Such patients are considered deadbeat inventory, and are transferred to euthanasia organizations who promise no pain death with dignity. The patients and their love ones never know what hit them until it’s forever too late. The Nursing jobs California business model gravity is to encourage old and terminally ill patients to die as soon as possible. American end-of-life-care is not straightforward as is the Netherlands’ euthanasia public policies. Obfuscation, covert activities, and looking the other way while crimes against humanity are being committed—have become the American way of life and governance. Honesty has become a foreign public and private virtue and concept.

‘As Dr. Martensen alluded, most lay people have no idea that this is the consequence to their loved one in allowing a doctor or nurse to put them under euphemized and euthanasia end of life care. And he says it is much, much easier to hand over a family-member to an end of life care organization, than it is to take unconditional care of him or her for an extended period. He recommends that doctors have a discussion with their patients and their families about what utilization review los angeles is important for their last days. Furthermore, when people have a conversation with their doctor about what they want for themselves when they get close to death, the costs become lower as well. Dr. Robert Martensen has held positions teaching bioethics and medical history at Harvard Medical School and Tulane University in New Orleans. Over the course of his career, author, doctor, and bioethicist, Robert Martensen has treated an estimated 75,000 patients in the emergency room and the ICU. He is the author of the newly published A Life Worth Living: a Doctor’s Reflections on Illness in a High-Tech Era.’

Read the rest of this entry »

At the beginning of 2009, I consulted with a cardiologist, and he scheduled me for 3 tests. After pricing these tests through their utilization review orange county department, I decided not to have them done. Their prices were ridiculously high. In the past month (near the end of 2009), I received 2 voice messages on my answering machine asking me to reschedule these tests. The female voice in this message stated that the prices for these tests have come down. Also, I received a notice through the US postal service requesting me to reschedule these tests. Their interest in me taking those tests has more to do with a recessionary slumping in their cardiac care business than with their concern for my healthcare. If I had had serious cardiac problems, I would have been long dead when they decided to pursue me about taking those tests. As a side note, some of these diagnostic tests use radioactive scanners that shot into body tissue, and in other tests, patients are asked to ingest radioactive chemicals that radiate out through body tissue. These tests can be hazardous to healthy body tissue in the short or long run.

Earlier this year I researched the associated costs for a colonoscopy, and depending on the doctor I spoke with, and whether it was going to be done at a RN jobs orange county hospital or outpatient surgery clinic – the price ranged from $707 to $7,000. Other examples of ridiculous medical service costs incurred in past few years:

1. Office Consultation with a Cardiologist for 15 to 20 minutes – $266 (priced arbitrarily at their highest Level 5),

2. Office Consultation with a Digestive System Specialist 40 minutes – $253,

3. Office Consultation with an Internal Medicine Specialist 30 minutes – $306,

4. Office EKG by Cardiac Technician 5 minutes – $66.

5. Blood Libratory Work – $786.34 (for 8 separate tests)

6. Blood Libratory Work – $629.90 (for 5 separate tests)

7. Blood Libratory Work – $541.75 (for 5 separate tests)

8. 2 Biopsies – $1,306

Of the 6 Digestive System doctors consulted concerning a colonoscopy and EGD procedure—only one of them was concerned about my blood serum calcium level being too low. This doctor informed me that I would need to get my blood serum calcium level up before she would perform a colonoscopy on me. Another of these doctors had scheduled me for this procedure and an exploratory EGD biopsy to take a biopsy to determine why calcium was not being absorbed. After I thought this over, I contacted this doctor’s nursing jobs orange county office, and informed his team nurse that I did not want an exploratory EGD biopsy. She then got an attitude, and stated, “There is no reason to go into doing the EGD”. She said she would inform the doctor of my decision and get back to me. She called back and left a voice message stating, “The doctor would discuss this decision with me the day of the procedures”. I ended doing business with this doctor.

I had my 1st colonoscopy and EGD October 13, 2009 with another doctor. These procedures took about an hour, and near the end of the colonoscopy, I was asked to look at a monitor. The colonoscope was still in my colon, and I could see the inside of it and blood being flushed out after a polyp had been clipped off. This was a strange twilight Disney fusion effect.

Since I had been significantly sedated, I had given permission for the doctor and nurses to share details of the procedures’ outcomes with the person who accompanied me. The only thing the doctor and nursing jobs Los Angeles County communicated to my mother was that everything went well, and I looked ok inside. They had put a post-op instruction sheet and prescription (for 1 Carafate 1 gm Tablet per day) in a folder I brought with me. It was disappointing that this prescription was not emphasized to my guardian angel. It would have been helpful to know about this prescription sooner, and to have been informed pertaining to its remedial use. This nursing jobs California hospital could have provided this medicine from their own pharmacy, or they could have recommended that I stop by their pharmacy before leaving the hospital to get it. Also, it would have been nice for this doctor to emphasize making an appointment for a free follow-up office visit.

Read the rest of this entry »