September 23rd, 2009 by David Kroll, Ph.D. in Better Health Network, News, True Stories
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From today’s article by the always-interesting Sarah Avery at the News & Observer:
After several failed attempts to extract the item, Manley was referred to another doctor, who suggested removing the entire left lung. “I said, no, I wouldn’t be doing that,” Manley says.
That’s when he decided to seek a second opinion at Duke University Medical Center.
We’ve heard of “hot tub lung” and “popcorn lung” but my chest hurts just thinking about “jagged, fast-food implement lung.”
If this case does not make it into the New England Journal of Medicine, I will be disappointed.
Photo credit: Duke Hospitals via the News & Observer
Title quote: courtesy of Dr Momen Wahidi, director of interventional pulmonology at Duke
*This blog post was originally published at Terra Sigillata*
September 23rd, 2009 by admin in Better Health Network, Health Tips, News, Opinion
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This week’s New England Journal of Medicine contained a very, very interesting proposal put forth by a few prominent physicians and researchers working on the obesity crisis in America.
They propose that beverages loaded with sugar should be considered a public health hazard (much like cigarettes) and should be taxes. The proposal calls for an excise tax of “a penny an ounce” for beverages like sugar sweetened soft drinks that have added sugars. They cite research that links obesity to heart disease, diabetes, cancers, and other health problems. They say sugar sweetened beverages should be taxed in order to curb consumption and help pay for the increasing health care costs of obesity.
They estimate that the tax would generate about $14.9 billion in the first year alone and would increase prices of soft drinks by about 15-20%. That is big money, but at what cost?
My personal opinion is that while the tax would generate a lot of money that could be put to good use on anti-obesity programs, it is singling out one industry when obesity has numerous contributing factors. Calories Americans are getting from beverages have actually gone down in the past decade, but obesity rates still climb. Soft drinks alone are not making us fatter.
Americans need to pay closer attention to portion sizes and overall calories coming into their bodies from all sources. We know that Americans also eat too much fried food, candy, ice cream, etc. Should we tax everything that is “bad” for us? Absolutely not! And these foods are not “bad” when consumed in reasonable quantities in reasonable frequency.
We also need to learn how to move our bodies more to burn off some of the sweet treats that we love to indulge in. Weight loss is a simple equation that I don’t get tired of explaining again and again: Move more and eat less.
Taxing soft drinks will not decrease heart disease risk…exercising more and losing body fat by consuming less calories definitely will!
This post, Will Taxing Soft Drinks Solve The Obesity Problem?, was originally published on
Healthine.com by Brian Westphal.
September 23rd, 2009 by DrRich in Better Health Network, Health Policy, Opinion
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In his last post, DrRich considered the differences between a system of healthcare rationing in which individual autonomy is honored, and one in which the good of the collective takes precedence. DrRich concluded that the former is more desirable than the latter, since the latter would amount to throwing aside the Great American Experiment. In response to this post, an astute reader calling him/herself Jupe wrote:
. . in the case of a limited supply of an effective vaccine during a deadly epidemic, it doesn’t weird me out to think of docs and nurses being prioritized over, say, me. Or a hypothetical situation of military leaders being prioritized in the event of bio warfare So it’s not that collectivism inherently offends me across the board.
In my mind there seems to be some sort of invisible line in there somewhere, but I can’t identify what it’s based on or exactly where it’s at, or why. I just know when it’s been crossed.
Jupe then continues, quoting Ezekiel Emanuel on setting rules for healthcare rationing. Emanuel says, “. . .Conversely, services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic and should not be guaranteed. An obvious example is not guaranteeing health services to patients with dementia.”
Jupe continues:
[That] just screams “line WAY WAY WAY CROSSED! HOLY CRAP!” to me. I know (well, deeply suspect) there actually is a fundamental difference between “doctors, nurses and military first to be immunized in the event of a bio-warfare attack” and “no antibiotics for the feeble minded” but I can’t pinpoint it outside of “it just intuitively seems right/wrong”.
DrRich interprets Jupe’s question as follows: Why does it intuitively seem OK to ration healthcare in the manner described in the first instance, but not in manner described in the second?
The most obvious answer would be that in the former case there’s an emergency, and extraordinary times call for extraordinary measures. For instance, in times of a war that threatens our survival, most of us would agree that a military draft – perhaps the ultimate sacrifice of individual rights for the good of the collective – is appropriate. And Lincoln, who was fighting a war whose explicit purpose he defined as upholding the Great American Experiment (i.e., to see whether a nation “conceived in liberty and dedicated to the proposition that all men are created equal could long endure”) was himself quite willing to violate individual freedoms to achieve that goal. For instance, he was willing to suspend habeus corpus and jail newspaper editors for sedition. Read more »
*This blog post was originally published at The Covert Rationing Blog*
September 23rd, 2009 by ValerieTinleyNP in Primary Care Wednesdays
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As a primary care practitioner, I often am baffled by why Americans need insurance for primary, or day-to-day, care issues. When I’m talking about primary care, I mean those health problems that are considered routine, or day-to-day, problems including ear infections to poison ivy as well as many urgent care issues like sutures and draining infections. These account for a large portion of all health problems that occur in the U.S – and 80% of the things that typically up in the ER or urgent care.
My understanding is that the purpose of insurance is to protect our financial well-being and thus our financial nest egg. Investorpedia, which is part of Forbes Digital Media, offers the following definition: “Insurance allows individuals, businesses and other entities to protect themselves against significant potential losses and financial hardship at a reasonably affordable rate.”
This definition explains why we invest in insurance of all types: car insurance, home insurance and health insurance.
Then I wonder why our expectations and utilization of health insurance differs so significantly from home or car insurance. I pay a monthly premium for my car insurance, and it protects me against having to pay out large sums of money if I would be in a bad car accident. I don’t expect, however, my car insurance provider to pay for an oil change or new battery. Likewise, I pay a yearly premium for my home owner’s insurance, yet I do not expect the insurance company to foot the bill if I need a new screen door – but I certainly will turn to them if a tree crashes through my garage during a bad storm.
Then why should I expect my health insurance to pick up every small, day-to-day health issue that I have, particularly those that can cost less then $150, like a well-woman physical, help with pink eye, a tick bite or extricating a fish hook?
Don’t get me wrong; I feel that health insurance is a must to protecting anyone’s financial assets against a potentially catastrophic health event, like a tragic accident or illness. We all need to be ensured that we will not go broke if we are faced with such health issues.
I currently work for a primary care practice, DocTalker, is built to deliver affordable access to our medical team, round the clock, to ensure that our patients save cost and time. Our patients pay for a doctor’s fees when service is rendered. We base the fee structure on time and materials; our patients pay us for the amount of time they spend with the medical team. An office visit typically lasts for 15 minutes and costs $75. Believe it or not, roughly 75% of our patients pay less than $300 per year for their primary and urgent care health issues. I know of a lot of people who pay that in one office visit to the vet!
Our philosophy is that the faster we can talk to and treat our patients, the faster they will get better, thus saving them time and money from lost work, not to mention saving them in expenses from waiting to treat a condition that can worsen with time (like bronchitis). Once we’ve met with a patient face-to-face, we offer phone and email consultations, which typically cost $50.
The other thought is that if people pay, out-of-pocket, for their day-to-day care problems, then they will be more like to be aware of the cost and quality of the care they receive – much like they are with that vast majority of other purchases that they make, from a car to cell phone service to food. This will cause the consumer to demand a higher quality of care for a better price, and will lead to consumer choice and thus to consumer’s driving the market.
I don’t think that a price tag of $300 for the care of majority of primary and urgent care problems is really that much to ask; after all, many of us pay this much when we have a plumber come to the house to unplug a sink.
I think that my health is worth as much as an unplugged sink. I believe we do can it at a less expensive price. Don’t you?
Until next week, I remain yours in primary care,
Valerie Tinley, FNP-BC
From today’s article by the always-interesting Sarah Avery at the News & Observer:
