October 7th, 2009 by DrRob in Better Health Network, Health Policy, Opinion
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Dear Mr. Obama and all of you congress folks:
I know you have been arguing about how to fix our system (and it really does need fixing). I know there is not much you can all agree on. I know it wasn’t all that much fun to face those yelling people at the town hall meetings. The press hasn’t been nice, and the polls aren’t good either. You guys are having a rough go of it.
So I am going to do you a big favor.
What you need right now are some quick wins – some things you can do that will make people happy quickly, and things that can be done without much cost. This is low-hanging fruit that can be picked without a high ladder; it is fruit that will sweeten things and make swallowing the more bitter pills a little easier. Here is what you need to do first:
1. Allow Medicare Patients to Use Drug Discounts
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*This blog post was originally published at Musings of a Distractible Mind*
October 7th, 2009 by Happy Hospitalist in Better Health Network, Health Policy, Opinion
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Some put the figure for defensive medicine at 10% of medical expenses a year. That’s $250 billion dollars. Others claim it to be 2-3% per year or about $60 billion dollars a year.
Now ask any physician what it is. I’d say it’s closer to 30% a year. That’s $750 billion dollars a year. Why? Because I know what is going through the minds of physicians when they put the pen to the paper. In America, we strive to exclude the long tail diagnosis. Why? Because getting sued for 67 million dollars because you treated a torn aorta when all the evidence pointed to an emergent MI has a way of making doctors evaluate the possible, instead of focusing on the probable.
Defensive medicine is not about losing a lawsuit. It’s about getting sued and the lack of boundaries that protect a physician from having bad outcomes with competent medicine, even if that competent medicine was the wrong medicine for the wrong patient at the wrong time, a fact known only after the fact when a bad outcome occurs. Read more »
*This blog post was originally published at A Happy Hospitalist*
October 7th, 2009 by SteveSimmonsMD in Primary Care Wednesdays
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“To see what is in front of one’s nose needs a constant struggle…” George Orwell
Do you know what the “P” in HIPAA stands for?
If you said “privacy” you are quite wrong. HIPAA stands for Health Insurance Portability and Accountability Act and was originally intended to guarantee health insurance when someone changed jobs. But the word “portability” is a far cry from “privacy.”
Since April 14, 2003, patients have been required to sign these forms, creating the durable illusion that our medical records are private. We sign HIPAA forms when we see our dentists, doctors, and upon receipt of a host of other health-related services. Yet your personal health information is anything but private — and the more legislation Congress passes the more public this information becomes. Read more »
October 6th, 2009 by DrRich in Better Health Network, Health Policy, Opinion
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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
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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*
