October 6th, 2009 by DrRich in Better Health Network, Health Policy, Opinion
Tags: Civil Right, CMS, Health Insurance, healthcare, Healthcare reform, Is healthcare a right, Justice
No Comments »
In his previous post, DrRich used a combination of history, logic, and sleight of hand to convince even his most conservative readers that healthcare is indeed a right.
To summarize that erudite posting: The BOSS rule says it’s a right, so it’s a right – as long as we’re talking about a civil (or legal) right, and not about a natural (or inalienable) right.
A civil right is granted, more or less arbitrarily, by a government or a society, to some group of individuals, usually to redress a past grievance, or to attempt to achieve equality in outcomes, or for some other form of social justice. Civil rights almost invariably require a second group of individuals to sacrifice something of their own in order to satisfy the civil rights granted to the first group. So the granting of civil rights (as opposed to natural rights) will often be seen by at least some as being inherently oppressive, but if used appropriately civil rights can be very good for the furtherance of a stable and civil society. (As DrRich has pointed out, even our Founders – the great purveyors of natural rights – explicitly understood the importance of well-designed civil rights.) Civil rights, at least ideally, advance the virtue of justice, just as their creators claim. Read more »
*This blog post was originally published at The Covert Rationing Blog*
October 6th, 2009 by GruntDoc in Better Health Network, True Stories
Tags: Cardiology, Cath Lab, EKG, Emergency Medicine, Heart Attack, LAD, MI, Myocardial Infarction, Normal EKG, Occlusion
No Comments »
I sent a guy with a normal EKG to the cath lab. Let me tell you my side of the story.
Dude was minding his own business when he started having crushing, substernal chest pain. I see dude by EMS about 45 minutes into his chest pain. He’s had the usual: aspirin, 3 SL NTG’s an IV, a touch of MS (I can abbreviate here, as it’s not a medical record) and is continuing to have pain.
He describes it like you’d expect (elephants have a bad rep in the ED), and looks ill. Frankly, he looks like a guy having an MI. Sweaty, pale, uncomfortable, restless but not that ‘I’ve torn my aorta’ look. The having an MI look.
Every EM doc knows the look. I didn’t ask about risk factors.
On to the proof: the EKG. EMS EKG: normal. ?What? Yeah, maybe there’s some anterior J-point elevation, but not much else. Our EKG: Normal. Read more »
*This blog post was originally published at GruntDoc*
October 6th, 2009 by EvanFalchukJD in Better Health Network, Health Policy, Opinion
Tags: Constitutional Amendments, Federal, Health Insurance, Healthcare reform, Legislation, Mandates, State
No Comments »
For months, Congress has been debating health care reform proposals that would have the effect of dealing a heavy blow to the system of state-by-state insurance regulation. State governments have stood by, silently. I’ve been wondering (
here,
here and
here) when the states would start to raise objections.
Slowly, it’s starting to happen. What has been a mostly overlooked factor in the health care reform debate may end up being one of the most important.
In fourteen states, legislators are trying to pass constitutional amendments that would ban health insurance mandates. Meanwhile, a bi-partisan group of governors are objecting to provisions of the Baucus plan that would leave the cost of expanding Medicaid to the states (by contrast, the House bill provides federal money for this). It’s an emerging trend that may reflect growing unease in state governments. Read more »
*This blog post was originally published at See First Blog*
October 6th, 2009 by Jonathan Foulds, Ph.D. in Better Health Network, Health Tips
Tags: MS, Multiple Sclerosis, Neurology, Primary Care, Psychiatry, Psychology, smoking, smoking cessation, Worsens
No Comments »
When thinking of the health risks of smoking, almost everyone is aware that smoking causes lung cancer and respiratory diseases. The connection between inhaling smoke into the lungs and developing diseases of the lung is immediately plausible. But every year medical researchers discover more and more diseases that are worsened by smoking.
One example that recently caught my attention is multiple sclerosis (MS). MS is a very serious neurological condition caused partly by damage to the myelin sheath covering cells and their connections in the central nervous system. The precise neurological symptoms the person experiences depends largely on which part of their central nervous system is affected. Read more »
This post, Smoking May Worsen Multiple Sclerosis, was originally published on
Healthine.com by Jonathan Foulds, Ph.D..
October 6th, 2009 by DrWes in Better Health Network, Health Policy, News
Tags: Atrial Fibrillation, CABANA, Cardiac Electrophysiology, Cardiology, CER, Comparative Effectiveness, Costs, Expensive, trial
No Comments »
I just finished our first day at the Principle Investigator Meeting for the launch of the Catheter Ablation Versus Anti-arrhythmic Drug Therapy for Atrial Fibrillation (CABANA) trial in Philadelphia today. The trial is a 3000-patient patient trial performed at 140 centers around the world and jointly sponsored by the National Heart, Lung, and Blood Institute (NHLBI), a component of the National Institutes of Health (NIH), and industry (St. Jude Medical and Biosense Webster).
The trial will randomize 3000 previously untreated or incompletely treated patients at high risk of cardiovascular complications in the trial to two arms: 1500 patients to catheter ablation as primary therapy of atrial fibrillation and the other 1500 patients to conventional medical therapy with rate control or rhythm control strategies to determine if catheter ablation is superior to medical therapy at reducing total mortality (the primary endpoint). Secondary endpoints of a composite endpoint of mortality, disabling stroke, serious bleeding, or cardiac arrest will also be studied.
If done properly, this study stands to be a landmark trial for the field of cardiac electrophysiology and has huge ramifications for the treatment of patients with atrial fibrillation. Also, it doesn’t take a lot of rocket science to know that the government will be looking closely at the results of this trial to determine which treatment strategy will receive government funding. Read more »
*This blog post was originally published at Dr. Wes*
