April 21st, 2011 by AndrewSchorr in Opinion, True Stories
Tags: Medical Advice, Patient Advocates, symptoms, The Web Savvy Patient, Worry
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It is happening several times a day now. The phone rings. I get stopped at Starbucks, or at the dog park, or at the supermarket. “My friend may have a brain tumor,” “I have been short of breath,” “I am tired all the time.” Then come the questions: “What do you think I should do? Who should I see?” I am not a doctor, but people are increasingly looking to me as if I were one. It’s a little daunting.
As you may know, I’ve been producing and/or hosting programs on medical topics for patients since the mid 1980’s. First it was erectile dysfunction, then breast surgery, then multiple sclerosis, cancer, diabetes – you name it, I’ve interviewed someone about it. Town meetings, live audio webcasts, radio shows, and videos. I feel like I’ve gone to med school two or three times. And like a med student I’ve worried common symptoms could mean the worst diagnosis. That headache could be too much coffee OR it could be a brain tumor. Feeling tired could be you are snoring and have sleep apnea OR you have leukemia.
A number of years ago, having just moved from Los Angeles to Seattle, Hollywood called. A friend sold a 5 day a week medical show to MGM and he needed wife/partner Esther and me to be producers. We were the ones who wrote what flashed on the screen when a patient described their symptoms to one of the real docs who were stars of the show “Group One Medical.” “I have had some blood in my stool, the patient would say. Flash on the screen: could be hemorrhoids. Could be advanced colon cancer. We walked around the home/office worrying about every ache and pain. I am told that’s just what med students do. The most mundane could be life-threatening. Read more »
*This blog post was originally published at Andrew's Blog*
April 21st, 2011 by Richard Cooper, M.D. in Health Policy, Opinion
Tags: Childhood Education, Education, Healthcare Costs, Pediatrics, Poverty, Reducing Costs, San Francisco
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In a recent op-ed in the San Francisco Examiner, William Dow, a professor of health economics at UC Berkeley, commented on the importance of education as a means of enabling more people to afford health care insurance. In my view, education is important not simply because an educated population can more easily pay for health care. The main importance is that educating children will allow those children and their children to have healthier childhoods, less burden of disease as adults, access to more personal and communal resources to deal with whatever disease they have and less need for health care, and that translates into less health care spending. Let me frame this in terms of the San Francisco Bay Area.
In a series of articles in the Contra Costa Times last year, Susanne Bohan and Sandy Kleffman described the striking differences in life expectancy in poor vs. wealthy ZIP codes in East Bay. Life-expectancy in Walnut Creek (94597) was 87.4 years, but it was only 71.2 years in Sobrante Park (94603), where household incomes are about half and poverty >20%. That’s a gap of 16.2 years. We find that, in addition to a shorter life-expectancy in Sobrante, the inpatient hospital utilization rate is double the rate in Walnut Creek. Poverty is not only tragic. It’s expensive. Read more »
*This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*
April 20th, 2011 by Stanley Feld, M.D. in Health Policy, Opinion
Tags: Accountable Care Organizations, ACO, ACOs, CMS, Cooperation, Costs, healthcare, HHS, Hospitals, Medicare, Payments, Physicians, Reimbursal
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In 2009 President Obama stated that Accountable Care Organizations (ACOs) were going to be pilot programs in real world settings. The goal was to see if they effective in reducing costs and increasing “quality of care.” The results of the pilot programs have not been published.
Last week despite the lack of proof of concept HHS and CMS announced new proposed regulations for ACOs.
The new delivery and payment model the agency estimates could serve up to 5 million Medicare beneficiaries through participating providers, and also potentially save the Medicare program as much as $960 million over three years.
How were these estimates derived? It could be another accounting trick by President Obama’s administration.
The idea of coordinating care and developing systems of care is a great idea theoretically. From a practical standpoint, execution is very difficult.
I tried to execute something similar in 1996 with the American Association of Clinical Endocrinologists; a national Independent Practice Association. AACECare received little cooperation or interest from Clinical Endocrinologists.
The problem is coordinated medical care is dependent on physicians cooperating and not competing with each other. It also depends on hospital systems developing an equitable partnership with physicians.
The equitable partnerships between hospital systems and physicians are difficult to achieve if past results are any indication of future results. Read more »
*This blog post was originally published at Repairing the Healthcare System*
April 20th, 2011 by DrRich in Health Policy, Opinion
Tags: Costs, Elderly, Harm, Healthcare reform, Medicare Cuts, Obamacare, Paul Ryan
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For some time now, numerous loved ones and dear friends have been advising and occasionally urging DrRich that, perhaps, it has become a bit inappropriate, and even unseemly, for him to continue in his longtime position as President and sole member of Future Old Farts of America (FOFA). For a not unsubstantial interval DrRich ignored this advice, feigning incipient deafness. But finally, after some focused study of that which these days returns his gaze in the mirror, and reluctantly concluding that maybe his loved ones have a point (and not wishing to seem Cranky), DrRich has reluctantly decided to resign from (and therefore disband) FOFA.
DrRich is pleased to announce that he has accepted a new position as President and sole member of Glorious Old Farts of America (GOFA).
And it is in this new capacity that DrRich has become alarmed at some of the dire warnings now being sounded by respected leaders of the Democratic Party, to the effect that the Republicans’ proposed federal budget for fiscal year 2012, released last week by Congressman Paul Ryan (who serves, DrRich believes, as Deputy Whippersnapper of the House Republican caucus), proves that Republicans are trying to kill old people. Read more »
*This blog post was originally published at The Covert Rationing Blog*
April 20th, 2011 by BobDoherty in Health Policy, Opinion
Tags: Access, Criminal, healthcare, Illegal, Illegal Immigrants
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According to some state legislators, the answer is yes. Lawmakers in South Carolina are pushing legislation that would “make it illegal to transport immigrants anywhere, including a hospital” reports the New York Times. Fox News Phoenix reports that in Arizona, a bill has been introduced to “require hospitals, when admitting nonemergency cases, to confirm that a person seeking care is a U.S. citizen or in the country legally. In emergency cases where the patient isn’t here legally, the hospital would be required to call immigration authorities after the treatment is done. Hospitals in non-emergency situations would also be required to contact federal immigration authorities, but they would have more apparent discretion about whether to treat illegal immigrants.”
Such ill-advised efforts by states to criminalize health care for undocumented persons has led the American College of Physicians, the nation’s second largest physician organization, to speak out against “Any law that might require physicians to share confidential information, such as citizenship status to the authorities, that was gained through the patient–physician relationship conflicts with the ethical and professional duties of physicians.” ACP made this statement in a new position paper on immigrants’ access to health care released yesterday at its annual scientific meeting in San Diego, California. Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
