Health update: I had my most recent appointment with Dr. Flenner (Infectious Disease)a week ago Thursday, and he called two days ago with my latest lab results. My kidney function continues to be good (that's the most dangerous side effect of the anti-fungal drug I'm taking), and the level of histoplasmosis in my system has decreased over the past four months from 7.1 to 5.2. So, the good news is the continued progress in fighting this stuff. But it's amazing to me that the histoplasmosis is still in my system, after nine months of taking anti-fungal medication! The fungus had just taken over my lungs by the time they diagnosed what was going on. In fact, Dr. Flenner shook me up when he said, "You were so sick with this that there is no data I can use to determine how long you should continue taking the medication. I'm inclined to be very conservative and to keep you on it indefinitely." I agreed very quickly!

I still have periods of coughing -- which makes people around me very anxious! Most probably, there is scar tissue in my lungs. So, perhaps, I will never entirely lose the cough. On the other hand, today I rode my bicycle a metric century (100 kilometers; 62 miles). So I think I'm doing OK!!

Yesterday, in the mail, I received a bill for diagnostic testing that was done at the Williamsburg hospital on September 19, 2006! The bill lists the original charge, and what insurance paid -- on August 13, 2007, and so now they're billing me for the balance. Isn't that ridiculous: to think of this taking 11 months to make its way through the labyrinth of Sentara and Aetna bureaucracy??

The bureaucracy of health insurance is a pain in the neck. The only thing worse in not having health insurance. This past Tuesday, census numbers released showed that 47 million people lacked health insurance last year, up from 44.8 million in 2005! If that is true, it is a deepening national disgrace. (There is controversy over the accuracy of the figures.) But even if the number of Americans without health insurance is smaller than that, it impacts our society severely.

According to yesterday's newspaper, the American Cancer Society will "devote its entire $15 million advertising budget this year not to smoking cessation or colorectal screening but to the consequences of inadequate health coverage." The reason is that cancer deaths have not decreased in recent years as they had been. That's because the only effective prevention is early detection, and those without health insurance don't pay out of pocket to undergo colonoscopies or annual physicals with PSA blood tests or mammograms or any of the many tests that reveal cancer at its earliest stages. John R. Seffrin, the chief executive of the cancer society said, "I believe, if we don't fix the health care system, that lack of access will be a bigger cancer killer than tobacco."

I am glad that voters are insisting that both Republican and Democratic presidential candidates talk about how they will approach the crisis in health insurance.