ACP Online - ObserverWeekly - 14 August 2007: "Study: Expanding preventive services would save 100,000-plus lives Beefing up preventive care measures such as flu shots and cancer screenings would save more than 100,000 U.S. lives each year, a new study found. The Partnership for Prevention study found 45,000 fewer people would die each year if 90% of adults took aspirin daily to prevent heart disease, instead of the 50% taking it currently. Likewise, if 90% of smokers were given cessation advice, medicine and support by a health professional, 42,000 fewer people would die each year, the study found. Other measures that would save lives, if 90% of the target population received them, include: Colorectal cancer screenings for adults age 50 and over would save 14,000 lives. Fewer than 50% of these adults are screened now; Annual flu shots for adults age 50 and over would save 12,000 lives. Fewer than 37% get the shots now; Breast cancer screening every two years for women age 40 and over would save 3,700 lives. About 67% are screened now; and Chlamydia screenings for sexually active young women would prevent 30,000 cases of pelvic inflammatory disease annually. About 40% are screened now. The study also found African Americans, Hispanic Americans and Asian Americans were less likely to use preventive care than whites. That’s partly because many minorities lack continuity of health care or an ongoing relationship with a health professional who can help ensure preventive measures are taken, an expert said. The study was funded by the CDC, the Robert Wood Johnson Foundation and WellPoint Foundation. The Partnership for Prevention report is online here in pdf. "
Another data point for (inadequate) access to treatment and preventative services. In Sally Pipes piece, she comments about 10% of Canadians looking for a PCP. Ha!
Cheers,
Tuesday, August 14, 2007
ACP Online - ObserverWeekly - 14 August 2007
Court Rules Out Terminally Ill for Tests - washingtonpost.com
Court Rules Out Terminally Ill for Tests - washingtonpost.com:
"Terminally ill patients do not have a constitutional right to be treated with experimental drugs, even if they likely will be dead before the medicine is approved, a federal appeals court said Tuesday. The ruling by the U.S. Court of Appeals for the District of Columbia Circuit overturned last year's decision by a smaller panel of the same court, which held that terminally ill patients may not be denied access to potentially lifesaving drugs."
Just thought I'd start gathering data points about access to treatment, as that seems to be brought up quite a lot in these discussions. My position is that these access issues will need to be carefully thought out and thoughtfully debated as we move to a single payer system.
Monday, August 13, 2007
Most Canadians scoff at portrayal of their country as a health-care paradis
"When the government pays for healthcare, saving money is more important than saving lives. So bureaucrats have an incentive to delay - or deny - the introduction of new, costly drugs."
The people who write this stuff are a.) not involved in healthcare (at least, not seeing actual patients in any meaningful way) and b.)must have the best G-D insurance in the world. The idea that the US would come out on top in an "anecdote-off" is laughable to all of us actually in healthcare. Our US bureaucrats in our wonderful private insurance industry would make most Soviet era bureaucrats blush.
But the key is this: when the government pays for healthcare, if they don't cover what we demand, then that is a problem with the citizenry, not the bureaucrats, for not taking command of the situation. When we get to a single payer system, it will be up to us to be vigilant and oversee what is being done by our government. I know that is an odd concept to the Bushies, but that is how government needs to work. And, yet, I can guarantee that the Sally Pipes' of this world will howl the loudest when money is being spent on Rituxan for someone other than her family member because it would then be "wasteful government spending"!
Cheers,
read more digg story
Saturday, August 11, 2007
10 Questions: About Health Care - Couric & Co.
10 Questions: About Health Care - Couric & Co.
>>Expanding government control over the financing and delivery of medical services will guarantee even bigger bureaucracy,<< Not necessarily bigger, just different. Ask any healthcare provider or patient which bureaucracy they'd rather deal with, Medicare or a private insurer, and you'll have your answer as to why this a bad argument for conservatives to make. We, the people, have control over our governement bureaucrats, we have none over the privateeers.
>> higher taxes,<< I know this is supposed to scare us (like invoking Castro), but the trade off is no health care premiums and higher salaries (as no more healthcare expenditures out of our total compensation). So, certainly, if this is done in a progressive manner, the top 5% may lose a little, but everyone else will be far better off.
>> and increasingly detailed regulations governing the delivery of care.<< I refer you back to my first comment.
>> Conservative candidates generally emphasize the need to re-energize the market<<
I'd say that the performance of the healthcare sector, particularly insurers and Pharma, suggest no lack of "energy."
>> and make individuals and families the key decision-makers in the system.<< Amen to that, but the author must really live in an alternate universe if he thinks that will EVER happen with private insurers!
Wednesday, August 8, 2007
Postbulletin.com: If you want great care, don't put government in charge - Wed, Aug 8, 2007
Postbulletin.com: If you want great care, don't put government in charge - Wed, Aug 8, 2007
An op-ed from Grace-Marie Turner, president of the Galen Institute, which is funded in part by the pharmaceutical industry and medical industry, http://www.galen.org/.
Let's take this apart line-by-line:
ALEXANDRIA, Va. -- No one denies that America's health sector faces problems. Costs continue to rise, and 45 million people lack insurance. Even worse, many politicians think they've discovered the cure in a single-payer system.
But that remedy would be worse than the disease. The government-dominated health systems of Europe and Canada are struggling with serious cost pressures, inefficient bureaucracies and unmet demands for more advanced medical care.
And of course, we have none of that here. I beleive her first sentence is about cost-pressures and unmet demands for care here in the US. She forgets by the time she got to the end of her thought, I guess. Perhaps she was trying to parse "advanced" medical care. If you want basic medical care and can't afford it, that's not our problem. And if she would like to get into a contest regarding inefficient bureaucracies and hold up private health insurance as the better system, she is truly clueless. The ignorance boggles the mind.
For the privilege of their supposedly "free" care, other countries pay much higher taxes. In 2005, taxes consumed 41 percent of GDP in Canada, 42 percent in Britain, and 51 percent in France, compared to 32 percent in the United States.
Yes, the $10-15K or so it costs to insure a family is sooo much better than
Single-payer systems invariably involve rationing. What good is free care if the government denies access to it?
Yes, clearly much better to have private insurers or economic circumstances ration it.
What good is the most advanced high tech medical care in the world if you can't get it?
About 1 million people in the U.K. are on waiting lists for hospital care, including surgeries. And 200,000 more are waiting just to get on the waiting list.
Cancer patients in Britain have resorted to waging public relations campaigns because their government won't pay for new medications for breast and kidney cancer.
Our waiting lists are nicely trimmed by leaving 1/6 of the population out of eligibility to even get into the queue. And if there were alarming statistics indicating a significant differnce in mortality in our favor in more than a few tiny niches, this might actually matter!! And if you can't afford any medication at all beyond the $4 Wal-mart list, tough break, loser!
In Canada, the situation is no better. Long waiting lines lead to restricted access to care. There were 45 inpatient surgical procedures per 1,000 Canadians in 2003, compared to 88 in the United States. Canadians received only one-third as many MRI exams and half as many CT scans.
Again, if we could point to better outcomes, and if we didn't ration so heavily by economics, this might be important. It is a minor concern, and if we were somehow limited in our choice of single-payer to either the Canadian system or nothing, it would only be slightly greater than a minor concern.
Meanwhile, patients in Sweden have been sent to veterinarians for diagnostic tests so the government could reduce waiting lists.
Same.
Proponents of a single-payer system argue that the United States would be different -- that we could get all the money we need to finance universal health insurance by eliminating profit in the private health sector.
But that's like trying to cure a disease with arsenic. Socializing our health-care system would mean that one-sixth of our economy would operate under different economic rules, with the government setting prices, allocating resources and deciding what medical care would be available to whom and when.
Seems to work everywhere else, apart from some issues that we should address as we move forward. But, as with all these pieces, invoking the socialism bogeyman is de rigeur. Because we all know how awful Medicare turned out. Those poor elderly bastards!
There is a better way.
We should embrace competition, not stifle it. We should reward innovators, risk-takers and entrepreneurs for providing faster, better, more affordable health care. And we should recognize that progress depends upon innovation and profit. The U.S. market already is pointing the way by responding to consumer demands for more convenient, more affordable health services.
Yes, this has worked out so well, hasn't it?
Health plans increasingly are offering programs to help patients better manage chronic diseases like diabetes and heart problems that account for roughly 75 percent to 80 percent of our medical payments. The result: dramatic gains in lowering costs and improving healthy outcomes.
Small clinics are springing up in retail stores around the country, providing customers with easy access to nurses who treat common ailments like ear infections and poison ivy. These clinics cost less than a visit to the doctor or emergency room.
And yet, we still lag behind those poor suckers in almost every other country in the western world. They just don't appreciate the sublime beauty of our system.
Competition is leading to more affordable prescription drugs.
And the new Medicare drug benefit shows how competition can lower costs and provide better benefits.
When the Part D program started in 2003, Congress estimated the drug benefit would cost beneficiaries an average of $37 a month. But because private drug plans compete to deliver the Medicare benefit, prices have been far lower than predicted. The average monthly cost of the standard benefit is just $22.
Hahahahahahahahahahahahahaha!
Coming in below cost is unprecedented for a government program -
and for non-government programs as well [DUH!]
- and it shows the government can lower prices by encouraging competition. It's virtually the opposite of a single-payer system, in which governments shut out the private sector.
Rather than regressing to the failing systems of Europe -
Uh, they're only "failing" directly depending upon the degree of underfunding. And, oh, yeah, they're not failing: they're doing bette than we are!!!
- with waiting lines and rationing -- we must develop our own unique solution. Ultimately, that means embracing the truly American qualities of innovation and competition.
How embarrassing for her. But I'm sure she's paid well for it.
Thursday, August 2, 2007
Physician/Adminstrator "Balance"
A great slide from PNHP's Sickocure.org web site that speaks for itself.
The full slide show is here.
Wednesday, August 1, 2007
From BibleGateway.com: The Sheep and The Goats
BibleGateway.com: From Matthew Chapter 25, The Parable of the Sheep and the Goats.:
"41'Then he will say to those on his left, 'Depart from me, you who are cursed, into the eternal fire prepared for the devil and his angels. 42For I was hungry and you gave me nothing to eat, I was thirsty and you gave me nothing to drink, 43I was a stranger and you did not invite me in, I needed clothes and you did not clothe me, I was sick and in prison and you did not look after me.'
44'They also will answer, 'Lord, when did we see you hungry or thirsty or a stranger or needing clothes or sick or in prison, and did not help you?'
45'He will reply, 'I tell you the truth, whatever you did not do for one of the least of these, you did not do for me.'
46'Then they will go away to eternal punishment, but the righteous to eternal life.'"
How bad can single payer be that Christians can walk away from this lesson so blithely? What evil in a government sponsored single payer system is so compelling to ignore these charges of Jesus? What principles have been teased and tortured out of Christianity to trump this parable so central to Christ's call for us to take care of each other?