December 22nd, 2010 by Lucy Hornstein, M.D. in Better Health Network, Health Tips, Opinion, True Stories
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The most moving speaker at the American Academy of Family Physicians (AAFP) convention I went to in Denver a few months ago was a doctor with Stage 4 cancer who had survived well past all expectations for his disease. While talking about achieving happiness through balance in life, he pulled out of his wallet a card made for him by his daughter, a preschool teacher.
“This is the C card,” he told us. “It says: ‘I have cancer. I can do whatever I want.’”
What a great idea, I thought. As much as it resonated with me, though, I couldn’t help but feel there was more to it than that.
Recently I was comforting a dear friend who had lost her mother. Remembering this handout from the AAFP, I held her close and said: “You’re a mourner now. You can do whatever you want.” I might as well said: “You have the M card.”
There’s this crotchety old guy in his eighties whom I’ve known for years. He does whatever he wants. I don’t think he actually carries a card in his wallet that says: “This is the O card. I am old. I can do whatever I want,” but he might as well. He is indeed old, and so he is entitled. Read more »
*This blog post was originally published at Musings of a Dinosaur*
December 13th, 2010 by Lucy Hornstein, M.D. in Better Health Network, Health Policy, Opinion
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There was a series of ads on the radio awhile back that went something like this:
When Mrs. Willis had a stroke, her husband never slept alone. Her daughter never had to go dress shopping for the prom by herself. And her son didn’t have to sit out the Mother-Son dance at his wedding. Why? Because she came to Hospital A…and she didn’t die!
There’s another ad for one of the big downtown hospital’s cancer center (sorry, “advanced cancer center”):
Every cancer, every stage. Your life depends on it!
Let’s see: No one ever dies at Hospital A. And the big downtown cancer center can cure any cancer. That’s certainly what those ads would have you believe. Even the little local suburban hospitals have taken to advertising: Billboards around the neighborhoods, kiosks at the outlet malls, mainly pushing the lucrative stuff like cardiac care and bariatric surgery.
Every time I see this stuff, I can’t help but wonder how much it all must cost. And how much medical care could have been provided to the uninsured instead of enriching the ad execs and billboard owners who are already rolling in dough. Clearly there is still plenty of money to be made in the hospital business, because these people aren’t stupid. They wouldn’t spend this kind of money on marketing unless there was plenty more to be made from it. I believe it’s a little business concept known as “return on investment.” Read more »
*This blog post was originally published at Musings of a Dinosaur*
November 17th, 2010 by Lucy Hornstein, M.D. in Better Health Network, Health Policy, News, Opinion
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There’s an article in the New England Journal of Medicine entitled the “Unintended Consequences of Four-Dollar Generic Drugs.“ Ever one to hone in on unintended consequences of all stripes, I quickly clicked through. Oh, dear! What bad could possibly come of making drugs significantly more affordable?
Were more people demanding prescriptions for drugs they didn’t really need now that they were so cheap? (Dream on. I’m still twisting arms to get my high-risk cardiac patients to take their generic statins.) Were pharmacies going out of business, no longer to make ends meet without massive markups on brand name drugs, contributing to skyrocketing unemployment and otherwise adding to the country’s general economic malaise? Were cardiologists’ incomes plummeting because of sagging rates of coronary disease now that everyone could easily afford their beta blockers, ACE inhibitors, and statins?
Or maybe it was something good. I guess, technically, “unintended” doesn’t automatically equal “bad.” What could it be? So I read. And what did I discover? Read more »
*This blog post was originally published at Musings of a Dinosaur*
November 15th, 2010 by Lucy Hornstein, M.D. in Better Health Network, Health Policy, Opinion, True Stories
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A friend who works with the unemployed called me up the other day huffing with indignation. The local charity clinic, apparently overwhelmed, had changed its policies so that her unemployed uninsured would no longer be able to seek care there.
“Someone has to do something!”
Um, what exactly would that be? I’d love to help, but I have bills to pay (as do charity clinics) so I can hardly provide medical care without seeking payment. I understand her desperation (and that of the people she so valiantly helps) but who, exactly, is supposed to do what, precisely?
Things are going to get worse before they get better, I fear. The unemployment issue goes way beyond a devastating economic downturn. It’s a reflection of the most basic economic principle of supply and demand. Wages are the “price” of labor — prices go down when supply goes up. In the case of labor, it’s when you have large numbers of people willing to accept lower wages. Can you say “outsourcing?” Watch as the jobs flow overseas while we’re still left with all these people, but not enough jobs to support themselves. In the meantime they all still need healthcare, but can’t pay for it.
Someone has to do something!
Guess what? It just so happens that we really do have a healthcare infrastructure in this country. Between the Veterans Administration (VA) and public healthcare clinics, we have rather a good start at building a truly national healthcare system. Perhaps now is the time to expand it. Read more »
*This blog post was originally published at Musings of a Dinosaur*
November 9th, 2010 by Lucy Hornstein, M.D. in Better Health Network, Health Policy, Opinion
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Forgive me for being a little late to the healthcare insurance reform discussion. I was busy, y’know, providing actual healthcare to sick people while that whole rigamarole was going on. But that one sentence, uttered over and over by everyone from the President on down, always stuck in my craw. At long last, I’m finally able to properly articulate my response.
Trying to pass sweeping health insurance reform legislation while telling people that, of course, they “can keep their current plans if they want” is like legislating tough new laws against wifebeating and assuring women that, of course, they can stay with their husbands if they like.
No one tries to force victims of domestic violence to leave their abusers, but they do try to help them understand that they have options, and that they don’t deserve to be treated so poorly. I firmly believe that people who like their current insurance plans probably have several things in common. Read more »
*This blog post was originally published at Musings of a Dinosaur*
