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Who Will Pay For Healthcare?

A couple of recent news stories reminded me of the dirty little secret about healthcare that no one wants to talk about, the proverbial elephant in the room. All those pills, surgeries, x-rays, medical care? It costs money!

Yes, Virginia, quality medical is not a right, not guaranteed in the Constitution, not something good-hearted corporations and companies, whether for-profit or not, are obliged to hand out like candy corn at Halloween. It costs money. Billions of dollars a day.

This appears to be something we all forgot in the warm fuzzy moments of watching military transport planes fly critically ill people out of Haiti to Florida hospitals. Who was going to pay for all this medical care? For the months of hospitalizations and rehabilitation these people were going to require? When the state of Florida, rightly so, asked the same question, prompting the halting of those military convoys, it ended up on the receiving end of a world-wide outpouring of boos and hisses. Read more »

*This blog post was originally published at Debra Gordon's Musings on Medicine and Health Care*

Tough Love: When Should Physicians Use This Strategy?

Have you ever stopped bothering to care about a patient?  A doctor sent me his own personal account of the smoking Mr Jones:

Dear Happy.  I read your article on bounce backs with great interest, and was astonished by some of the vitriol it elicited.  I remember having one COPDer bounce back to me three times within a month at the VA when I was a medicine resident.  He would leave, smoke and drink, and then come back and be readmitted to my service with exactly the same course each time.  It was like Groundhog Day.

Finally I had a little talk with him and said: “Mr. Jones, each time you come in, you’re on death’s door.  So I come down to the ER, stay up with you all night and save your life.  But you know, I’m really getting tired of having you come in after drinking and smoking and then working like a dog to save your life.  So let me tell you, if you don’t quit smoking, the next time you do this there’s a good chance that I’m not going to bother.  Why should I?  It doesn’t seem to be doing either of us any good.”

To my complete astonishment, he actually quit smoking and stayed quit for about a year.  Then he fell off the wagon, deteriorated too far before getting to the hospital and died.  I was frankly proud of him for the effort, but somehow suspect that I’d be shot in a drive-by if I ever told that story in public. Read more »

*This blog post was originally published at The Happy Hospitalist Blog*

Government Spending On Healthcare Outpaces Other Sources

Much of the debate about the health reform has been on whether or not it will lead to government-run health care. But the fact is that the government’s share of health care spending already is growing at a faster rate than private spending, a trend accelerated by the recent economic recession.

A new report from Medicare’s actuaries, published in the journal Health Affairs, found that “Federal government spending for health services and supplies increased 10.4 percent in 2008 . . . and accounted for almost 36 percent of federal receipts, up considerably from 28 percent in 2007. By comparison, spending for health care by private businesses grew just 1.2 percent in 2008, in part because of a drop in the proportion of employer-sponsored insurance premiums paid for by employers” while “health care spending by households grew 4.3 percent in 2008, a deceleration from 5.9 percent growth in 2007″ but still more than the adjusted personal income growth of 2.7%.

The current economic recession, the authors say, had two major impacts on health spending: Read more »

*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*

Our Senatorial Christmas Gift

As the Senators vote to pass their bill to extend insurance to thirty million more people while failing to address malpractice or physician payment reform, we can all only hope and pray that it’s worth it in the end.

On thing’s for sure, 2010 is shaping up to be one heck of a year.

Merry Christmas.

-Wes

Chart source.Musings of a cardiologist and cardiac electrophysiologist.

*This blog post was originally published at Dr. Wes*

Will Spending More Federal Money On Healthcare Improve Outcomes?

One need only look at the experience with education.

*This blog post was originally published at A Happy Hospitalist*

Latest Interviews

The Surprising Economic Burden Of ADHD (Attention-Deficit Hyperactivity Disorder)

If you can read this you need to download a more recent browser It is estimated that as many as million U.S. adults have ADHD Attention-Deficit Hyperactivity Disorder A recent research study publication-pending suggests that the economic burden of ADHD on America could be as high as billion annually. I…

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Is The Adderall Shortage A Harbinger Of Future Drug Supply Problems?

If you can read this you need to download a more recent browser Today most- if not all- Doctor’s offices are strained by the shortage of some prescription medication or vaccine. A month ago President Obama signed his executive order directing the FDA to take steps to reduce drug shortages…

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Latest Book Reviews

Book Review: The First Step To Improve Health Care Is A Close Examination Of How It’s Delivered

My friend and former Chair of the CFAH Board of Trustees Doug Kamerow has written a book that I think you will like. Besides being a mensch and witty as heck Doug is a family doctor and a preventive medicine specialist. In his new book Dissecting American Health Care Commentaries…

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“Your Medical Mind” Explores Factors That Influence A Patient’s Medical Decisions

Recently I had a conversation with Shannon Brownlee the widely respected science journalist and acting director of the Health Policy Program at the New America Foundation about whether men should continue to have access to the PSA test for prostate cancer screening despite the overwhelming evidence that it extends few…

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Book Review: Food Truths, Food Lies

Food Truths Food Lies written by family physician Eric Marcotte M.D. may be the most refreshingly evidence-based diet book of the decade. You will not find a single mention of super-foods magical berries or supplement must-haves in the entire book. What you will find is the cold hard truth about…

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