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Who Will Pay For Healthcare?

A couple of recent news stories reminded me of the dirty little secret about healthcare that no one wants to talk about, the proverbial elephant in the room. All those pills, surgeries, x-rays, medical care? It costs money!

Yes, Virginia, quality medical is not a right, not guaranteed in the Constitution, not something good-hearted corporations and companies, whether for-profit or not, are obliged to hand out like candy corn at Halloween. It costs money. Billions of dollars a day.

This appears to be something we all forgot in the warm fuzzy moments of watching military transport planes fly critically ill people out of Haiti to Florida hospitals. Who was going to pay for all this medical care? For the months of hospitalizations and rehabilitation these people were going to require? When the state of Florida, rightly so, asked the same question, prompting the halting of those military convoys, it ended up on the receiving end of a world-wide outpouring of boos and hisses. Read more »

*This blog post was originally published at Debra Gordon's Musings on Medicine and Health Care*

Tough Love: When Should Physicians Use This Strategy?

Have you ever stopped bothering to care about a patient?  A doctor sent me his own personal account of the smoking Mr Jones:

Dear Happy.  I read your article on bounce backs with great interest, and was astonished by some of the vitriol it elicited.  I remember having one COPDer bounce back to me three times within a month at the VA when I was a medicine resident.  He would leave, smoke and drink, and then come back and be readmitted to my service with exactly the same course each time.  It was like Groundhog Day.

Finally I had a little talk with him and said: “Mr. Jones, each time you come in, you’re on death’s door.  So I come down to the ER, stay up with you all night and save your life.  But you know, I’m really getting tired of having you come in after drinking and smoking and then working like a dog to save your life.  So let me tell you, if you don’t quit smoking, the next time you do this there’s a good chance that I’m not going to bother.  Why should I?  It doesn’t seem to be doing either of us any good.”

To my complete astonishment, he actually quit smoking and stayed quit for about a year.  Then he fell off the wagon, deteriorated too far before getting to the hospital and died.  I was frankly proud of him for the effort, but somehow suspect that I’d be shot in a drive-by if I ever told that story in public. Read more »

*This blog post was originally published at The Happy Hospitalist Blog*

Government Spending On Healthcare Outpaces Other Sources

Much of the debate about the health reform has been on whether or not it will lead to government-run health care. But the fact is that the government’s share of health care spending already is growing at a faster rate than private spending, a trend accelerated by the recent economic recession.

A new report from Medicare’s actuaries, published in the journal Health Affairs, found that “Federal government spending for health services and supplies increased 10.4 percent in 2008 . . . and accounted for almost 36 percent of federal receipts, up considerably from 28 percent in 2007. By comparison, spending for health care by private businesses grew just 1.2 percent in 2008, in part because of a drop in the proportion of employer-sponsored insurance premiums paid for by employers” while “health care spending by households grew 4.3 percent in 2008, a deceleration from 5.9 percent growth in 2007” but still more than the adjusted personal income growth of 2.7%.

The current economic recession, the authors say, had two major impacts on health spending: Read more »

*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*

Our Senatorial Christmas Gift

As the Senators vote to pass their bill to extend insurance to thirty million more people while failing to address malpractice or physician payment reform, we can all only hope and pray that it’s worth it in the end.

On thing’s for sure, 2010 is shaping up to be one heck of a year.

Merry Christmas.

-Wes

Chart source.Musings of a cardiologist and cardiac electrophysiologist.

*This blog post was originally published at Dr. Wes*

Will Spending More Federal Money On Healthcare Improve Outcomes?

One need only look at the experience with education.

*This blog post was originally published at A Happy Hospitalist*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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