MetaFilter posts tagged with healthcare

The Oregon Health Insurance Experiment

Weebot — Fri, 03 May 2013 13:49:59 -0800

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. Opinions from around the web: Josh Barro for Bloomberg (and a follow-up), Aaron Carroll and Austin Frakt for the Incidental Economist, Jonathan Chait for New York Magazine, Jonathan Cohn for the New Republic, Tyler Cowen for Marginal Revolution, Kevin Drum for Mother Jones, Ezra Klein for the Washington Post, Philip Klein for the Washington Examiner, Paul Krugman for the New York Times, Annie Lowry for the New York Times, Megan McArdle for the Daily Beast, Avik Roy for Forbes, Peter Suderman for Reason, David Whelan for Forbes, and Matthew Yglesias for Slate (and a follow-up).

Texas Gets Its Report Card

jim in austin — Tue, 16 Apr 2013 09:00:52 -0800

While a bit parochial, this post reveals some things worth pondering if you are considering relocating to Texas...

The Texas Legislative Study Group released its 2013 “Texas on the Brink” report at the end of last week. The report is an annual study to determine Texas’ rankings among the 50 states and the District of Columbia on health care, education, and the environment. How’s Texas doing? Not so great: The state ranks 50th in high school graduation rate, first in amount of carbon emissions, first in hazardous waste produced, last in voter turnout, first in percentage of people without health insurance, and second in percentage of uninsured kids... - via The Texas Observer

How amazing is my thought!

seemoreglass — Mon, 08 Apr 2013 12:30:57 -0800

Lewis Thomas (1913-1993) was a physician and essayist, writing gracefully on topics as varied as language, nuclear war, and our excellent health and deplorable health-care system (PDF). He believed that the existence of Bach vindicates humanity, that "ants are so much like human beings as to be an embarrassment", and that the Earth is perhaps best thought of as a cell. A three-time winner of the National Book Award, Thomas authored Lives of a Cell, which was voted the 11th-best nonfiction work of the 20th century by the Modern Library.

Not So Evergreen

vidur — Mon, 01 Apr 2013 12:26:21 -0800

"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." "Glivec sells in developed nations for more than $3,000 for a month's worth of treatment, but a generic version is sold in India for less than $200." "The Indian Patent Office in 2006 denied a patent to Novartis, a decision upheld by the Indian Intellectual Property Appellate Board. The board cited a provision of Indian law that aims to prevent “evergreening,” in which companies make an incremental change to a drug’s chemical makeup, without any real medical benefit, to extend its patent life and prevent the introduction of low-cost generic copies." Novartis says it will stop investing in R&D in India.

We are powerless buyers in a sellers’ market

zarq — Thu, 21 Feb 2013 08:12:48 -0800

Bitter Pill: Why Medical Bills Are Killing Us. Summary: Inside the Cover Story. Related video: The Exorbitant Prices of Health Care Time is soliciting reader stories about their experience with the high cost of US healthcare. CNN has been investigating the story with the magazine. Comments on the article.

this is why that is important

fight or flight — Tue, 19 Feb 2013 07:11:46 -0800

NSFWCORP presents This Is How You Healthcare: American Death in London by Sarah Bee:

The main things that keep me sane are the airy beauty and peacefulness of the hospital building, messages from friends and family far away on earth, the mundane magnificence of the staff: and the knowledge that all of this is free and taken care of and I do not have to fill in a single fuckforsaken form or bust one precious braincell worrying about how I might have to find money to pay for the futile care of my dying deadbeat dad.

I return to this miraculous fact many times a day, in exactly the same way that I return often to the little visitors’ bedroom, lock the door and curl up on the bed. The knowledge soothes me like clean sheets and heat. Imagine, I think in the middle of the night. Imagine if I had to worry about that stuff. With what, exactly, would I worry about it?

Cat Bites Man. Hospital Charges $55k.

Kitty Stardust — Mon, 28 Jan 2013 14:59:40 -0800

Call it the $55,000 cat bite.

Abortion in America

Artw — Thu, 24 Jan 2013 07:22:32 -0800

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. (more)

This is day-to-day, everyday life.

roomthreeseventeen — Sat, 19 Jan 2013 08:43:28 -0800

There are four states in this country where there is only one abortion clinic in the whole state , including Mississippi, which is facing the prospect of becoming the first state where abortion access is, effectively, gone. via

The Costs and Solutions to American Health Care

hopeless romantique — Mon, 07 Jan 2013 14:38:12 -0800

Three excerpts from David Goldhill's new book on American health care:

Part One: Focus on Health-Care Costs Causes More Spending

Part Two: Obamacare Math Doesn't Add Up to a Healthier U.S.

Part Three: To Fix Health Care, Turn Patients Into Customers Bonus reading! Goldhill's response to Atul Gawande's article on the future of medicine, posted here last year. [Gawande, previously]

Do Not Disturb: Grandma’s Having Sex

Pirate-Bartender-Zombie-Monkey — Fri, 21 Dec 2012 22:43:56 -0800

Adults over 50 are the fastest growing demographic for online dating sites, according to a recently [sic] study from UCLA’s department of psychology. Yet while older adults often value companionship over passion and marriage, experts say frisky behavior by seniors should never be underestimated. “I hesitate to generalize that they’re only having gentle, intimate moments,” says Melanie Davis, co-president of the national Sexuality and Aging Consortium. “Older adults can have really hot sex.” But not, typically, in long-term care facilities.

The Definitive Guide to the Medicare Debate

reenum — Thu, 23 Aug 2012 10:38:10 -0800

Jonathan Cohn compares the effects on Medicare from the Affordable Care Act with the proposals being promoted by Mitt Romney and Paul Ryan.

3D-Printed "Magic Arms"

Foci for Analysis — Fri, 03 Aug 2012 05:03:23 -0800

Two-year-old Emma wanted to play with blocks, but a condition called arthrogryposis meant she couldn't move her arms. So researchers at a Delaware hospital 3D printed a durable custom exoskeleton with the tiny, lightweight parts she needed.

Canadian medical professionals react in disbelief, shock and horror to how things work in the US

MartinWisse — Fri, 20 Jul 2012 01:11:47 -0800

"I believed based on my politics that government mandated health care was a violation of my freedom." When a "die-hard conservative Republican" woman moves to Canada and encounters the universal healthcare there, hilarity ensues as cultures clash.

Wait, wait...

youarenothere — Sun, 08 Jul 2012 11:44:12 -0800

But it is already too late. CNN has been carefully orchestrating its transformation into a shockingly efficient news distribution company. They have been planning to saturate every screen in reach with this story as fast as possible, and the producer’s initial go-ahead pulled the trigger. On the air, Wolf Blitzer is sending the coverage to the Courthouse steps. And as planned the reporter is putting her phone down to go on the air, which cuts herself off from the only CNN employee with access to the opinion. We’re getting wildly differing assessments: SCOTUSblog compiles first-hand accounts of the minutes between 10:06 and 10:15am on June 28, when CNN and FOX misreported and retracted that the mandate had been struck down.

Misconception #247: It's actually called Bidencare.

schmod — Mon, 02 Jul 2012 08:09:12 -0800

What's Obamacare? A studious Reddit user has read the mammoth 955-page Patient Protection and Affordable Care Act, and outlined the important points of what the new law actually does, with specific citations. While the recently-upheld law itself remains unpopular, most individual components of the bill enjoy widespread popularity among republican politicians and the public, despite the fact that both groups remain largely unaware of the bill's actual provisions. Another interpretation of the PPACA, straight from the horse's mouth.

The end of "With this policy, I thee wed."

Cash4Lead — Sat, 30 Jun 2012 11:01:12 -0800

Obamacare: One Less Reason to Get Married. Erin Gloria Ryan of Jezebel writes: Insurance Marriages had become to the 21st century what shotgun weddings were to jokes about hillbillies. Back in 2004, the LA Times wrote about couples that married for insurance, couples who for varying reasons had not wanted to marry, but who had been driven to marriage by financial necessity. ABC News posted its own roundup of With This Policy, I Thee Wed-style couples in 2008, as did the New York Times. In 2008, 7% of couples who married reported doing so primarily for the insurance benefits. With the Affordable Care Act now upheld by the Supreme Court, however, (assuming that it's not repealed in 2013), health insurance will cease to be an incentive to get married; and, conversely, may remove a potential impediment to divorce.

Tie game. Bottom of the 9th. Bases loaded. Two outs. Three balls. Two strikes. And the pitch...

Rhaomi — Thu, 28 Jun 2012 06:02:59 -0800

In less than an hour, the Supreme Court will hand down its final judgment in what has become one of the most crucial legal battles of our time: the constitutionality of President Obama's landmark health care reform law. The product of a strict party line vote following a ~~year~~ century of debate, disinformation, and tense legislative wrangling, the Affordable Care Act would (among other popular reforms) require all Americans to buy insurance coverage by 2014, broadening the risk pool for the benefit of those with pre-existing conditions. The fate of this "individual mandate," bitterly opposed by Republicans despite its similarity to past plans touted by conservatives (including presidential contender Mitt Romney) is the central question facing the justices today. If the conservative majority takes the dramatic step of striking down the mandate, the law will be toothless, and in danger of wholesale reversal, rendering millions uninsured, dealing a crippling blow to the president's re-election hopes, and possibly endangering the federal regulatory state. But despite the pessimism of bettors, some believe the Court will demur, wary of damaging its already-fragile reputation with another partisan 5-4 decision. But those who know don't talk, and those who talk don't know. Watch the SCOTUSblog liveblog for updates, Q&A, and analysis as the truth finally comes out shortly after 10 a.m. EST.

'A childhood that began with a sort of cautious optimism quickly devolved into absolute horse shit.'

the man of twists and turns — Wed, 20 Jun 2012 07:15:05 -0800

My mother became my daughter when I was nine years old.

I sat in the waiting room with the kind of faceless authority figure who sits with your child when you are her only person, in my pajamas: milk spilled down the front, urine staining the crotch, reading Harriet the Spy and completely unaware of the major shift occurring beneath the tectonic plates of my life. There was a blood clot in her brain, at the site of impact, and the doctors had to shave her head and crack her skull open to get it out before it ruptured and killed her. And they did, which was a kind of a little miracle.

NYMag: "A Life Worth Ending"

ThePinkSuperhero — Mon, 21 May 2012 17:28:55 -0800

“Old age isn’t a battle, it’s a massacre.” A son’s plea to let his mother go.

We gone be up here all day. We have a long wait.

cashman — Mon, 21 May 2012 14:29:36 -0800

One Hospital | Hundreds of Stories. A YouTube Playlist. Experience a day in the life of a public hospital (Highland Hospital) in Oakland, CA at a moment of profound change to the nation's economy and its healthcare system. "How would the patients in the waiting room at Highland Hospital respond to President George W. Bush’s statement, echoed by many others, that we already have universal health care in this country because, by law, nobody can be turned away from an emergency room for lack of ability to pay? " The filming took place for 5 months in 2010.

"The dentist man got me"

evilmomlady — Thu, 17 May 2012 06:31:45 -0800

ReachOut Healthcare America, a dental management services company, “built its business model on the premise that low-income parents often don’t have time or transportation to take children to the dentist. So mobile teams pack equipment in large cases, load up a minivan, head to schools and set up in gyms, libraries or classrooms.” Services are billed to Medicaid. ReachOut and other dental management services companies are increasingly backed by private equity firms. What could possibly go wrong? A 4-year-old in Arizona received two "baby root canals," crowns and 10 X-rays -- all while he was at school. And without his mother's knowledge or consent, she says. State investigators are examining complaints that ReachOut-dispatched teams billed Medicaid for unnecessary work on children. ReachOut says what happened is not common practice.

it's a big cold world out there but warm & cozy in here

flex — Fri, 11 May 2012 08:30:45 -0800

Consumer Reports May 2012: What to reject when you're expecting (10 procedures to think twice about during your pregnancy; 10 things you should do during your pregnancy; 5 things you should do before you become pregnant). Mentioned in particular is the conclusion found in a federal study: Babies Take Longer To Come Out Than They Did In Grandma's Day."One big implication: Today's obstetricians may be rushing to do cesarean sections too soon because they're using an out-of-date yardstick for how long a 'normal; labor should take... The definition of a 'normal' labor — the range of times when a woman in labor reaches certain milestones — was laid down in the 1950s. Contemporary obstetricians still use that 'labor curve.'"

A hidden children's health crisis.

davidpriest.ca — Tue, 01 May 2012 11:39:07 -0800

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.

My breast has fallen off. Can you reattach it?

Joe in Australia — Tue, 24 Apr 2012 22:16:14 -0800

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) This is an extremely distressing story. Be cautious.