Tuesday, September 30, 2008

NEJM -- Campaign Contributions, Lobbying, and the U.S. Health Sector -- An Update

NEJM -- Campaign Contributions, Lobbying, and the U.S. Health Sector -- An Update:

"As of July, people affiliated with the health sector and political action committees (PACs) associated with the sector had contributed about $29 million to presidential candidates, including $8.8 million to Obama, $6.6 million to Senator Hillary Clinton of New York, the former Democratic contender, and $4.7 million to McCain, according to the Center for Responsive Politics (www.opensecrets.org), a nonpartisan organization that researches money in politics. Although these contributions represent less than 3% of the funds raised by presidential candidates, it is remarkable that the health sector has reversed a long-standing pattern of favoring Republican candidates, by contributing substantially more money to Democrats ($17.7 million) than to Republicans ($11.2 million). This trend also holds when the presidential and congressional elections are considered together (see Figure 1): as of July, the health sector had contributed $54.5 million to Democrats and $46.1 million to Republicans. Democrats lead Republicans in contributions from health professionals and from individuals associated with hospitals, nursing homes, or health services or health maintenance organizations. Contributions linked to manufacturers of pharmaceutical and health care products are split about evenly between the parties. The last time Democrats raised more money from health care interests than Republicans was 1992, when Bill Clinton was elected president."

Yaaaayyy! I am certainly getting this vibe from my colleagues more and more lately. You can only have insurers rub your nose in poo for so long before you understand that some (any!) sytem of universal coverage has to be better than this.

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Monday, September 22, 2008

TH - Pirmary Care Shortage

TH - Top News Article:
"The Georgia study suggests changes to insurance reimbursements hurt primary care by rewarding the delivery of diagnostic tests and medical treatments, instead of rewarding time spent communicating with patients.

'What has happened with the physician payment system historically is that it has given a higher value to procedures over cognitive care,' Hubbard said.

Family medicine physicians have the lowest average salary ($185,740) of the doctors studied, compared to radiologists and orthopedic surgeons, who had an average salary of more than $400,000.

'When a medical student chooses a specialty, potential income is becoming more and more of a factor in that decision,' Hubbard said.

Knox fears access to care could become restricted if a primary care shortage continues.

Physician assistants and nurse practitioners can fill some of the gaps left by a dearth of primary care physicians -- to a point.

'There is a higher level of qualification required to provide some of the services that physicians provide,' Tracy said.

Pechous said the economics of training and retaining new physicians is complex.

The debt load facing medical school graduates is one of the impediments to enlarging the pool of primary care doctors. For M.D.s, that debt is pushing $130,000, Tracy said.

'It is like a second mortgage.'"

Another interesting statistic:

"At the University of Iowa's Roy J. and Lucille A. Carver College of Medicine, 37 percent of the incoming class entered the family medicine field in 1996. By 2006, that number had dropped to 10 percent. In the early 1990s, Iowa graduated nearly 45 family doctors per year. By 2006, that dropped to 12."

Thanks to Dr. Pechous for writing this. The solution, really, is obvious. Pay more for the behavior you want and less for the behavior you don't want. Higher reimbursement for primary care services, lower for procedures. This is not "class warfare" for physicians, it is simply facing simple economics and the consequences of reimbursement rates.

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Wednesday, September 17, 2008

Sunday Forum: Which party best manages the economy?

Sunday Forum: Which party best manages the economy?

"I call the first fact the Great Partisan Growth Divide. Simply put, the United States economy has grown faster, on average, under Democratic presidents than under Republicans.

"The stark contrast between the whiz-bang Clinton years and the dreary Bush years is familiar because it is so recent. But while it is extreme, it is not atypical. Data for the whole period from 1948 to 2007, during which Republicans occupied the White House for 34 years and Democrats for 26, show average annual growth of real gross national product of 1.64 percent per capita under Republican presidents versus 2.78 percent under Democrats.

"That 1.14-point difference, if maintained for eight years, would yield 9.33 percent more income per person, which is a lot more than almost anyone can expect from a tax cut."

I don't think this surprises Democrats, but Republicans will just snort in disregard, because, reality has a well known liberal bias...

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Friday, September 5, 2008

Letter - Health Care Fiction - Letter - NYTimes.com

Letter - Health Care Fiction - Letter - NYTimes.com:

Too well said not to cite in its entirety...

"Re “Feeling No Pain,” by Paul Krugman (column, Aug. 29):

Mr. Krugman rightly notes that emergency room care cannot substitute for health insurance since the cost will be billed directly to the patient.

There is another reason emergency rooms cannot provide adequate health care. Emergency rooms are for emergencies. They can treat a patient in a diabetic coma, but they cannot provide continuing help in managing diabetes. They can treat a full-blown asthma attack, but they cannot provide the medications needed to manage asthma daily.

They can treat a woman who has gone into early labor, but they cannot provide prenatal care.
Emergency rooms cannot offer any help for managing Parkinson’s, Alzheimer’s or cancer. On a more basic level, they cannot provide eyeglasses, hearing aids or dentures.

Republican claims that no American is without access to health care because “you can just go to an emergency room” are openly false as well as appallingly callous.

Elizabeth Vandiver
Walla Walla, Wash., Aug. 29, 2008"

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Wednesday, September 3, 2008

WARREN BUFFET: SHIFT THE TAX BURDEN TO THE WEALTHY by Duane B. — economics, personal finance, money | Gather

WARREN BUFFET: SHIFT THE TAX BURDEN TO THE WEALTHY by Duane B. — economics, personal finance, money Gather

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Economic View - Is History Siding With Obama’s Economic Plan? - NYTimes.com

Economic View - Is History Siding With Obama’s Economic Plan? - NYTimes.com

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Angry Bear: Comparing Presidents: Rankings of Economic Growth

Angry Bear: Comparing Presidents: Rankings of Economic Growth

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Hi, all!

For any of you who followed the link from MyBarackObama, welcome!

I originally set up this blog to keep track of all the information that I came across about health care in the US and other health care systems around the world, as well as some postings on "contrarian" economics (economics that contradict standard, and often wrong, commonly accepted memes).

Go over to the right and click on a topic to get started. You can find out about individual countries, our system and information about access and waiting times and so on.

I hope you learn, and, in turn, post to teach me!



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