The invisible hand of the Free Market guides insurance payments to hospitals "Call it the best-kept secret in Massachusetts medicine: Health insurance companies pay a handful of hospitals far more for the same work even when there is no evidence that the higher-priced care produces healthier patients. In fact, sometimes the opposite is true: Massachusetts General Hospital, for example, earns 15 percent more than Beth Israel Deaconess Medical Center for treating heart-failure patients even though government figures show that Beth Israel has for years reported lower patient death rates."
What's wrong with primary care in the US? With a new survey suggesting that nearly half of all primary care physicians would leave medicine if they had a viable alternative, and with American medical schools not generating nearly enough new doctors going into primary care, in this, their first issue to hit doctors' desks since the election, the New England Journal of Medicine has devoted their entire editorial section to exploring yet another challenge that threatens the stability of the US health care system. Video of the roundtable discussion. Individual essays, at times touching, at times hopeful, from various primary care perspectives in the US and Britain. [more inside]
£35,000-a-year kidney cancer drugs too costly for NHS: Sutent offers to extend a kidney or GIST cancer patient's life by about 26 months, but the British NHS refuses to fund it, citing "marginal benefit at quite often an extreme cost."
RocketBoom's co-founder Andrew Baron found out last week that his father had Multiple Myeloma, and likely less than 48 hours to live. Then a miracle occured. A drug that could save his father's life existed. However the drug was not approved by the FDA to be used this way. They sought and quickly got approval from the FDA. But now, the drug's manufacturer Biogen won't approve usage despite pleas to Biogen's president from Lance Burton, President Clinton, and others. Read this open letter and request for help from Andrew to learn what you can do to save his father's life.
The Stakes, 2008. Eight of the Washington Monthly's contributing editors "consider the looming challenges that America is likely to face—in the economy, education, the courts, and other areas—during an Obama or McCain presidency, and how, based on what we know about the two men, they are likely to handle them." [more inside]
Not just for religious pharmacists anymore: the Department of Health and Human Services proposes a rule that protects anyone who refuses to provide medical services on moral or religious grounds. [more inside]
MexCare offers "An Alternative Choice for the Care of the Unfunded Latin American National." [more inside]
Sexual Healing. "Sad stories and otherwise freaky tales from Florida's last sexual surrogate." A longish article, and fascinating.
Two years since Massachusetts instituted major statewide healthcare reform, the statistics are coming in. 340,000 residents, roughly half the state's previously uninsured, are now insured. The state says that 95% of its population is now covered, based on Department of Revenue estimates. However, a large portion of them are enrolled through state-subsidized insurance programs, and those program's rate of enrollment have far outpaced estimates. This has led lawmakers to forsee a budget shortfall. Premiums and co-pays are going up, cigarette taxes have increased, and a cost control proposal is making its way through the legislature. Assessments have been all over the map.
Birth of the National Health Service - How the state of the nation's health became a political ideal
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."
We've talked about BMI as a metric for health, and possibly laws regulating health. What about waist measurment? [more inside]
An analysis of the medical care provided to the family of Homer J. Simpson from the Canadian Medical Association Journal.
Sick Around the World, the newest documentary piece produced by PBS's Frontline asks: "Can the U.S. learn anything from the rest of the world about how to run a health care system?" Having previously shared a Pulitzer Prize with The New York Times, and produced such quality programs as Bush's War, this should be well worth a mere hour of your time.
The antidote to LOLbushsuxx0rs. Over the course of the past week, Slate ran a ten (10!)-piece series, "Fixin' It", in which various writers postulated how the course of various aspects of the United States' military, culture, and policies could be redirected for the better. Although the articles are not entirely devoid of Bush criticism, there's mostly a fairly rare focus on the positive actions to be taken from here onward by the next President (whether it be McCain or Obama or Clinton).
Britain's National Health Service has unveiled a plan that would allow citizens to choose where they are treated. I found that I had to refer to the NHS wiki page to refresh my understanding of the British system. The Telegraph has also published an interview with the Health Secretary and is inviting reader response. [more inside]
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)
(Previously in dystopic health care developments)
"AngryJournalist.com, an increasingly popular site that consists of nothing but rants from pissed-off reporters, is now the most accurate summation extant of journalism as an industry," (via Gawker). It's spawned a marvelously less popular HappyJournalist.com, and what appears to be an unrelated copycat called AngryResident.com, for "for every doctor-in-training tired of suffering in silence."
The universal coverage debate comes down to one, simple question: why does health insurance pay for checkups when car insurance doesn't pay for oil changes? [more inside]
A new medical bill payment reporting system called MedFICO is said to be going live this summer. This system is being developed by the health care industry in an effort to judge a patient's ability to pay. Healthcare Analytics, a healthcare actuarial company, is developing the score in conjunction with Tenet Healthcare, credit scoring company Fair Issac, and venture capitalists. [more inside]
The Prepaid Healthcare Visa® Gift Card, for that special someone without insurance on your holiday list. Rejoice! Terry Gilliam's dystopian future is now! [via]
What do you call it when your insurance company takes your accident settlement to repay the medical costs you have incurred? If you said subrogation, you were close.
The Economic Consequences of Mr. Bush. "The next president will have to deal with yet another crippling legacy of George W. Bush: the economy. A Nobel laureate, Joseph E. Stiglitz, sees a generation-long struggle to recoup." [Via Firedoglake.]
You know what will help young people in Pennsylvania embrace a career in health care? A video featuring a rapping groundhog that cost $4157 in taxpayer money.
Salvador and Mabel Mangano, the owners of St. Rita’s nursing home in St. Bernard Parish, where 35 patients drowned in Hurricane Katrina’s flood waters, were found not guilty of negligent homicide and cruelty to the infirm charges tonight by a six-member jury. Read their story and decide for yourself if they're guilty.
"In 2003, Americans spent an estimated US$5,635 per capita on health care, while Canadians spent US$3,003... Canada’s single-payer system, which relies on not-for-profit delivery, achieves health outcomes that are at least equal to those in the United States at two-thirds the cost." What do wealthy, educated Americans living in Canada think?
Self-Diagnosis: Five anonymous doctors frankly discuss their patients, other doctors, American healthcare, and the inevitable mistakes doctors make, including mistakes they've personally made that jeopardized their patients' lives.
An Atlanta man caused the U.S. government to issue its first quarantine order since 1963 this weekend, knowingly exposing as many as 107 passengers on two transatlantic flights to a rare, "extensively drug-resistant" form of tuberculosis. "It's regretful that we weren't able to stop that," the CDC's Dr. Martin Cetron said of how the man fled when U.S. health officials tracked him down in Rome and told him not to get on an airplane.
Millions of uninsured children in this country. Even with public assistance, they teeter on the brink of a catastrophic illness. What's the answer? Elect Susie!
25 y.o. whistle-blower. Last Fall, a 24 y.o. by the name of Justen Deal, blew the whistle on what he perceived to be profligate waste by his employers. As an IT guy at Kaiser-Permanente, he'd seen a $442 million database project scrapped by the new CEO and replaced by a sweetheart deal for one of the CEO's former contractors. Internal estimates placed Kaiser's losses on this new contract at $1.2 billion dollars per quarter [more inside]
Sickday. (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...
A Google Map mash-up shows how hospital closures in NYC disproportionately effect the poor and people of colour. It's a pretty slick presentation of the data.
Soldiers Face Neglect, Frustration At Army's Top Medical Facility. The Iraq war has transformed Walter Reed into "a holding ground for physically and psychologically damaged outpatients." Meanwhile, despite predictions that the cost of medical care for veterans will skyrocket, the Bush administration apparently plans to cut funding for veterans' health care. Tired of waiting for the government, more people are taking the initiative in developing alternative facilities to help veterans.
The Challenge of Global Health is an article written in the most recent Foreign Affairs, describing how "stovepiping" health care funding towards only HIV/AIDS, the shortage of health care workers in the West, and a vacuum of international health-care experts are all causing great damage to developing countries. The article was written by Laurie Garrett, author of The Coming Plague, Betrayal of Trust, as well as a Pulitzer Prize winner for her writing on Ebola. Previously on mefi: garrett resigns, comments on world leaders.
Cheap, safe drug kills most cancers. That's the good news. The bad news is that because there's no patent and it's so cheap to make, researchers may not be able to get funding from the private sector for further research since the treatment wouldn't make a profit. [Via Hullabaloo.]
California's Governor Seeks Universal Care: Under a plan by Gov. Arnold Schwarzenegger, California would become the largest state to attempt to provide near universal health coverage.
Cancer Cure Patented A group of researchers claim that they are patenting a possible cure for cancer involving nothing more than sugar and short-chain fatty acid combination.
Coverage with Evidence Development. Never heard of it? Me neither, until today. It's what they call this idea: if you want to be covered by Medicare, you're forced to participate in medical research. The AMA approves (article abstract only). So much for informed consent.
Only 2,029 out of 9,145 veterans with post traumatic stress disorder resulting from combat have been referred to mental health for evaluation/treatment. I say give them the same treatment the IDF gets.
The Health Insurance Marketplace Modernization and Affordability Act (S. 1955) has passed out of committee and is now slated for a floor vote. The bill is ostensibly designed to save small employers money and extend health insurance options to employees who hadn’t had them. What it is actually likely to do is end basic health insurance coverage for women (and diabetics); birth control, regularly taken prescriptions, cancer screenings, maternity care, and more. Women in every state will lose benefits. S. 1955 would allow insurance plans to ignore important state laws that protect patients, directly affecting more than 90 million Americans. [more inside]
Few things are more sacred to Canadians than the nation's medicare system. After years of health spending cutbacks by conservative politicians, debate rages over whether private providers should now be allowed to compete with the public system. In British Columbia, where the government is shovelling tax dollars into the 2010 Olympics, patients are being left to die in emergency rooms and long-term care facilities due to overcrowding and understaffing. Is it too late to save public health care? Should it be saved?
"You drowned 1,200 people! I rebuke you." Politics as usual? Yes, if you're from Louisiana. Is it hot where you are? Well, at least your federal government didn't trick you into living in your car in 100 degree weather because they won't give you the keys to your trailer. Oh, but try not to get sick, because even though New Orleans is almost back to its Pre-Katrina size (1 million out of 1.3 million), half of the hospital space is gone. Only six weeks until hurricane season! Woot!
Today, about 17,000 American medical students and almost as many foreign trained doctors learn what types of doctors they will be. Yes, it’s Match Day. Ok, while most people probably could care less about this post, it presents an intriguing look into the forces (i.e. how the ratio between specialists and generalists arises and to note: more specialists equals more procedures and costlier health care) that shape American health care today. And, it represents the strange culmination of years of study (at least 8+ years after high school) that many students take just to leave it up to a strange algorithm that is under a anti-trust lawsuit as they wake up one day in March and learn where they will be spending the next (at least) three years of their life. Also, if you see a recent graduate of an "ADORE+P" residency -- Anesthesiology, Dermatology, Orthopedics/Optho, Radiology, ENT/Emergency Room medicine (plus, of course, Plastic surgery) -- (the professions that work great hours and make the most money) -- congratulate her or him on being the best (statistically) of the crop.
Springfield, Missouri the place mobsters go to die. John Gotti, Anthony Corrado, "Fat" Tony Salerno, Vito Genovese, Tony "Ducks" Corallo and now Vincent "The Chin"Gigante.
Lifestyle on the line. UK to allow hospital's opinions on personal lifestyle to define state healthcare decisions.
The New England Journal of Medicine published several articles this week on remaining, statistically significant gender and racial disparities in the quantity and quality of various medical procedures and care management resources made available to black and white Americans. These disparities may possibly help our understanding of the cause of some of the unexplained differences in mortality rates between populations. "Although the reasons for these differences are unknown, their persistence emphasizes the need for a continued search for explanations so that inequities in clinical care may be eliminated..." (registration req'd)