More than half the population of small, rural Madras, Oregon (population: ~6059) and its surrounding community is served by one clinic: Madras Medical
. At the beginning of 2006, the clinic's doctors and nurses decided to ban pharmaceutical reps from visiting their practice. No more free lunches. No more free drug samples. No more gifts. And yet.... "It's made us better doctors." (Via) [more inside]
posted by zarq
on Aug 27, 2013 -
The Oregon Health Insurance Experiment, an outgrowth of Oregon's 2008 lottery to allocate Medicaid slots to eligible residents, has released their second year of results
(Previous discussions on the lottery
and the experiment
). The gist of the results are that they found statisitically significant reductions in catastrophic health care expenditures, improvements in the incidences of depression, and increased use of health care services. They found minimal (and not statistically significant) improvements in the rates of physical health indicators (diabetes and hypertension) they tracked. Because of ethical concerns, there are no other randomized controlled tests on this scale that study the effects of Medicaid and few on the effects of health insurance in general (the only significant one being a RAND study released 30 years ago
). Because of the small amount of information available on the topic and the impending Medicaid expansion offered by Affordable Care Act, this study has drawn a lot of attention from political commentators. This will presumably be the last year these results will be published, as the state of Oregon was able to find extra money in 2010
in order cover the rest of its Medicaid-eligible population. [more inside]
posted by Weebot
on May 3, 2013 -
"India's supreme court has ruled against Swiss drug giant Novartis in a landmark case
that activists say will protect access to cheap generic drugs in developing nations." [more inside]
posted by vidur
on Apr 1, 2013 -
The Geography of Abortion Access
- Forty years ago Tuesday, the Supreme Court ushered in legal abortion for American women when it decided in Roe v. Wade. Today, states—particularly in the South and Midwest—are eroding that right by legislating hundreds of provisions intended to impede access with burdensome obstacles. To understand more fully the complex state of access to abortion services in America, The Daily Beast identified and confirmed the location of the country’s remaining 724 clinics and calculated the distance from every part of the country to its closest clinic.
posted by Artw
on Jan 24, 2013 -
A chronic public health disaster.
Complex trauma and toxic stress puts children into a state of reflexive fight, flight, or freeze responses to a perpetually threatening world. The traditional authoritative response only serves to reinforce those behaviours and, perhaps worse, has long-term health consequences:
With an ACE score of 4 or more, things start getting serious. The likelihood of chronic pulmonary lung disease increases 390 percent; hepatitis, 240 percent; depression 460 percent; suicide, 1,220 percent.
One doctor describes it as “a chronic public health disaster”. Remediating this problem is going to require listening, kindness, and parachutes.
posted by davidpriest.ca
on May 1, 2012 -
Since she is not truly an emergency patient, she is triaged to the back of the line, and other folks, those in immediate distress, get in for treatment ahead of her. She waits on a gurney in a cavernous green hallway.
The “chief complaint” on her chart at Grady Memorial Hospital, in Downtown Atlanta, might have set off a wave of nausea in a hospital at a white suburb or almost any place in the civilized world. It reads, “My breast has fallen off. Can you reattach it?
” (via Boing Boing
) [more inside]
posted by Joe in Australia
on Apr 24, 2012 -
In the summer of 2007 on the campaign trail Barack Obama took a clear stance
on the controversial subject of medical marijuana. “I would not have the Justice Department prosecuting and raiding medical marijuana users. It’s not a good use of our resources.”
As President in 2009 he took action to follow through on this promise by instructing federal prosecutors to “not focus federal resources in [their] States on individuals whose actions are in clear and unambiguous compliance with existing state laws providing for the medical use of marijuana.” The memo cited the “efficient and rational use” of the U.S. Department of Justice’s “limited investigative and prosecutorial resources,” as a motivating factor in the decision."
In the winter of 2012 Rolling Stone magazine takes a look back
on this subject and the record is surprising. "With more than 100 raids on pot dispensaries during his first three years, Obama is now on pace to exceed Bush's record for medical-marijuana busts. "There's no question that Obama's the worst president on medical marijuana," says Rob Kampia, executive director of the Marijuana Policy Project. "He's gone from first to worst." [more inside]
posted by furiousxgeorge
on Feb 19, 2012 -
The Oregon Health Insurance Experiment: Evidence from the First Year
(or, What Happens When You Give Poor People Health Insurance?) "We find that in this first year, the treatment group had substantively and statistically significantly higher health care utilization (including primary and preventive care as well as hospitalizations), lower out-of-pocket medical expenditures and medical debt (including fewer bills sent to collection), and better self-reported physical and mental health than the control group." [more inside]
posted by OmieWise
on Jul 11, 2011 -
What US Health Care Needs Medical doctor and writer Atul Gawande gave the commencement address recently at Stanford's School of Medicine. In it he lays out very precisely and in a nonpartisan way what is wrong with the institution of medical care in the US — why it is both so expensive and so ineffective at delivering quality care uniformly across the board.
posted by kliuless
on Jun 21, 2010 -
Do you have a life-changing medical condition? Patientslikeme (mentioned previously in a 2008 post on mood conditions)
is a way for you share information online with other people who have the same condition. Some of the conditions with groups established already are epilepsy, depression, and Multiple Sclerosis.
Started by 3 MIT engineers who had personal experiences with ALS (Lou Gherig's disease), the site is funded by partnerships with healthcare providers
who have access to anonymised data about the member base. The stated goal in their Openness Policy
has a plain-English description of what happens to information that members share.
posted by harriet vane
on Mar 16, 2010 -
Atul Gawande offers a way
for health care to be improved through experimentation and pilot programs, much as agriculture was in 20th century
posted by reenum
on Feb 27, 2010 -
"Melissa" (name changed for privacy) is a transwoman who was badly injured in a car accident and is in hospital in critical condition. While in treatment, some of the medical staff and her family decided that since she still had a "male" body, to make things "less confusing", they will erase 4 years of her female identity by referring to her as a man and taking her off her hormone therapy
. (Warning: possible triggers) As little light puts it:
And if she woke up as from a deep sleep, she’d wake up into a world where her best friend was dead, where her body had been forcibly edited back to its pre-transition state and given a few more years of the influence of testosterone to boot, where her memory and self were hazy and confusing and nobody was calling her by the right name and pronouns, they were in fact pretending four years of her life, the four years she finally got to be honest and true to herself, those had never happened, and shh, she’s just confused, shhhh, calm down, let’s work on fixing your memory some more. [more inside]
posted by divabat
on Jan 13, 2010 -
How American Health Care Killed My Father After the needless death of his father, the author, a business executive, began a personal exploration of a health-care industry that for years has delivered poor service and irregular quality at astonishingly high cost. It is a system, he argues, that is not worth preserving in anything like its current form. And the health-care reform now being contemplated will not fix it. Here’s a radical solution to an agonizing problem.
) [more inside]
posted by kliuless
on Aug 18, 2009 -
The NHS at 60.
The National Health Service is 60 on July 5th. Take a look at documents, audio and video related to the birth and growth of this "radical plan."
posted by fire&wings
on Jun 28, 2008 -
The state of Oregon is holding a health insurance lottery
where 91,000 hopeful enrollees will be competing for a couple thousand spots under the Oregon Health Plan, the state's Medicaid program. OHP was created to cover those who made too much to enroll in traditional Medicaid but too little to afford market healthcare, and this development comes as a result of budget cuts and a subsequent enrollment closure in July of 2004. It's a far cry from the universal health care coverage that the plan was suppose to lead to, and marks a dramatic turn
for the state's once-ambitious health care reforms.(Previously in dystopic health care developments)
posted by Weebot
on Mar 30, 2008 -
(for my NYC mefites) As I sit here in Chicago with a fresh case of bronchitis and unable to leave the office, I'm wishing I was back in NYC. Apparently they have plans to expand soon...
posted by allkindsoftime
on Mar 5, 2007 -
How to think about prescription drugs.
Malcolm Gladwell's latest piece in The New Yorker
The emphasis of the prescription-drug debate is all wrong. We've been focussed on the drug manufacturers. But decisions about prevalence, therapeutic mix, and intensity aren't made by the producers of drugs. They’re made by the consumers of drugs.
posted by trharlan
on Oct 31, 2004 -
Conscience Clauses and Health Care
--"Yes, we need to respect individual freedom of religion. But at what point does it cross the line of not providing essential medical care? At what point is it malpractice?" she asked. "If someone's beliefs interfere with practicing their profession, perhaps they should do something else." The Protection of Conscience Project
feels differently: Protection of Conscience Laws are needed because powerful interests are inclined to force health care workers and others to participate, directly or indirectly, in morally controversial procedures
, while NARAL says: ... Many of these clauses go far beyond respecting individuals' beliefs to the point of harming women by not providing them with full information or access to medical treatment. Medicine, not ideology, should determine medical decisions.
posted by amberglow
on Sep 17, 2004 -
The Freeloader Registry.
When an employer pays low wages and doesn't provide health care benefits, its employees often end up getting free care through state and federal programs. How much does this cost you, and which companies benefit from the practice? A new Massachusetts state law will provide detailed information about top corporate welchers. (This follows recent discussion of the topic in the context of Wal-Mart
Via Good Jobs First
posted by alms
on Aug 6, 2004 -
Mysterious Fax Adds to Intrigue Over the Medicare Bill's Cost
"Late one Friday afternoon in January, after the House of Representatives had adjourned for the week, Cybele Bjorklund, a House Democratic health policy aide, heard the buzz of the fax machine at her desk. Coming over the transom, with no hint of the sender, was a document she had been seeking for months: an estimate by Medicare's chief actuary showing the cost of prescription drug benefits for the elderly....
"Ms. Bjorklund had been pressing Mr. Foster for his numbers since June. When he refused, telling her he could be fired, she said, she confronted his boss, Thomas A. Scully, then the Medicare administrator. 'If Rick Foster gives that to you," Ms. Bjorklund remembered Mr. Scully telling her, "I'll fire him so fast his head will spin.'"
(NYTimes.com, reg req)
posted by jpoulos
on Mar 19, 2004 -