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Why Health Care Costs So Much: Is The Public Partially To Blame?

It is my job at EverythingHealth to steer the reader to great information.  For this reason I am providing you with a Link to The New England Journal of Medicine article titled “The $650 Billion Dollar question – why does cost effective care diffuse so slowly?”  I have retitled it “Why Health Care Costs So Much”.

The United States spends much more on health care than other industrialized nations with no improvement in outcomes or health status of it’s citizens.  If we enacted some of the policies that other nations use, we would have $650 Billion to spend on education, infrastructure, social security and other societal needs.  Why can’t we get there?

Read here to understand the barriers.  It isn’t simple.  Resistance to change and instituting cost effective care has many stakeholders including legislators, doctors, hospitals, drug and equipment manufacturers, academic training centers, insurance companies and even the media.  We, the public, are also to blame for not understanding that reform which lowers costs would benefit all of us.  There is no free lunch.  When the cost of care goes up for employers, that keeps our wages stagnant.  When millions are uninsured, the cost of their care is born by everyone and it is inefficient care.

The article authors tell us: Read more »

*This blog post was originally published at EverythingHealth*

From The CDC: Top Ten Greatest Public Health Achievements

The Center for Disease Control published the top ten public health achievements from 2001-2010, the first decade of the 21st century.  In no order they are:

  • Vaccine-preventable Diseases – new vaccines for herpes zoster, pneumonia, HPV and rotavirus have saved thousands of lives  When you add in the older vaccines for diptheria, pertussus, tetanus and measles/mumps millions of lives have been saved around the world.  (I saw diptheria in Haiti and it is horrible)

  • Tobacco Control- We have been battling tobacco since 1964 but there is finally progress with more states enacting smoke-free laws and raising cigarette taxes.  By 2010, the FDA banned flavored cigarettes and established restrictions on youth access.  We have a long way to go.  Smoking costs us all about $193 billion a year on medical costs and loss of productivity.


  • Motor Vehicle Safety –Enforcing seat belt and child safety legislation has reduced deaths from crashes.  Teen drivers have new policies too.
  • Cardiovascular Disease Prevention-During the past decade, age-adjusted heart disease and stroke deaths declined.  What worked? Treating hypertension, elevated cholesterol and smoking…along with improved treatment and medication. Read more »

*This blog post was originally published at EverythingHealth*

Heart Attack Survivors Should Avoid Certain Pain Medicines (NSAIDs)

New information published in Circulation advises against using any nonsteroidal anti-inflammatory drugs (NSAIDs) in patients who have had a prior heart attack.  These over-the-counter drugs are commonly used  like Advil, Aleeve, Diclofenac, Ibuprofen.  Using NSAIDs for even as little as one week was associated with a 45% increase for death or recurrent myocardial infarction (MI).  The researchers could not identify a period that seemed to be safe, no matter how short.

The study used the Danish National Patient Registry and identified 83,675 patients who had a first MI between 1997 and 2006.  The average age was 68 years and 65% were men.   All the NSAIDs (except Naprosyn) used during the observation period were associated with an increased risk for death or new heart attack.  Diclofenac (brand name Voltaren) was the worst.

Readers should not go away thinking NSAIDs cause heart attacks.  This study looked at patients who had already had an MI.  But for those patients, the over-the-counter pain relievers should be avoided.  Many patients with heart disease also have arthritis or other pain syndromes.  We need to come up with safe treatments for pain or use “safer” NSAIDs like low dose Naprosyn or Ibuprofen only when the benefit is weighed with the risk.

Just because something is sold without a prescription does not mean it is without risk.  Tell your doctor every medication you take.

*This blog post was originally published at EverythingHealth*

What Are The Most Popular, And Most Expensive, Drugs In America?

The top 10 prescribed drugs in the U.S. for 2010 in order of prescriptions written are:

  • Hydrocodone (combined with acetaminophen) — 131.2 million prescriptions
  • Generic Zocor (simvastatin), a cholesterol-lowering statin drug — 94.1 million prescriptions
  • Lisinopril (brand names include Prinivil and Zestril), a blood pressure drug — 87.4 million prescriptions
  • Generic Synthroid (levothyroxine sodium), synthetic thyroid hormone — 70.5 million prescriptions
  • Generic Norvasc (amlodipine besylate), an angina/blood pressure drug — 57.2 million prescriptions
  • Generic Prilosec (omeprazole), an antacid drug — 53.4 million prescriptions (does not include over-the-counter sales)
  • Azithromycin (brand names include Z-Pak and Zithromax), an antibiotic — 52.6 million prescriptions
  • Amoxicillin (various brand names), an antibiotic — 52.3 million prescriptions
  • Generic Glucophage (metformin), a diabetes drug — 48.3 million prescriptions
  • Hydrochlorothiazide (various brand names), a water pill used to lower blood pressure — 47.8 million prescriptions.

Notice that most of these are generic so they aren’t the ones that make the most money for Big Pharma.  Those drugs are not offered in generic and they brought in  n $307 billion  in 2010.  What was number one?  Drumroll……..

Lipitor, a cholesterol lowering statin.

In case you wondered who is paying for these drugs…Commercial insurance helped pay for 63% of all prescriptions.  Medicare Part D (Federal government) paid for 22% of prescriptions.  The average co-payment for a prescription was $10.73.  The average co-payment for a branded drug was $22.73.

If you are paying for prescriptions, make sure you ask your physician if it is available in generic.  It can save you a lot of $$.

*This blog post was originally published at EverythingHealth*

Should The U.S. Limit The Number Of Embryos Transfered?

Everyone knows about “Octomom” and her octuplets born after in-vitro fertilization (IVF).  That was an extreme case, but multiple births resulting from unregulated artificial reproductive technologies have skyrocketed over the last decade.  The increased rate of twins, triplets and even higher multiples are due to in-vitro treatments and those women and infants are at much higher risk of pregnancy complications, premature birth and long term health problems.

New research,  published in theJournal of Pediatrics, looked at admissions at just one hospital in Montreal, Quebec and found multiple embryo transfers was responsible for a significant proportion of admissions to the neonatal intensive care unit (NICU).  These infants were born severely preterm.  Six babies died and 5 developed severe intraventricular hemorrhage or bronchopulmonary dysplasia.  The researchers extrapolated their data to the entire country of Canada and said that a universal single-embryo transfer policy would have prevented 840 NICU admissions, 40 deaths and 42,488 days in the NICU.  The cost was $40 million annually. Read more »

*This blog post was originally published at EverythingHealth*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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