health care
denialism | May 25, 2009
To start off some balanced discussions of what universal health care looks like around the world, I thought I would begin with Australia, a system that we could learn a great deal from.
In the US system, we do not have universal healthcare, we have mostly employer-subsidized healthcare, private insurance and medicare covering people's health expense. We also lack a universal electronic medical record, our main recourse for responding to poor care is lawsuits, and we have a high disparity in services available to those with money and those who do not. We still manage to spend more on…
denialism | May 22, 2009A dishonest campaign has started against healthcare reform in this country and the first shot has come from Conservatives for Patients Rights (CPR), a group purporting to show that patients in universal health systems suffer from government interference in health care. To bolster their argument, they have a pile of anecdotes from people around the world who have suffered at the hands of evil government-run systems. The problem, of course, is that anecdotes are not data, it is impossible to determine the veracity or reasonableness of these claims, and there is no way, ethically or…
denialism | May 12, 2009I was pleased to see president Obama deliver this address yesterday:
Click To Play
I was even more pleased because he has gathered the traditional opponents of healthcare reform around him and has convinced them to commit to reform in the US system. This is a positive sign. However, I'm concerned because, as with all political debates that challenge a dominant ideology - in this case free-market fundamentalism - we will soon see the denialists come out of the woodwork to disparage any attempt at achieving reforms that may result in universal health care coverage. This has, in fact,…
revere | May 9, 2009Maryn McKenna has a great piece at CIDRAP News today about something that should worry all of us as we wait to see if the other shoe drops with swine flu. Our acute care health services system is so brittle it won't take much to break it:.
With the global outbreak of novel H1N1 influenza (swine flu) entering its fourth week, physicians at emergency rooms, clinics, and hospitals around the United States say they are overwhelmed with "worried well" who have as much as doubled their patient loads.
All the clinicians work at medical centers that have planned and practiced for pandemics and…
terrasig | May 8, 2009Each summer, the fair City of New York plays host to a cosmic convergence of bloggers within the ScienceBlogs.com corral. It's a great time to meet all the folks we know very well online, but perhaps not IRL. Moreover, we had a really nice reader meetup last year where - thank you very much - all four of you came to see me, including Dr Val of Better Health and Peter Frishauf, Medscape founder.
The planning for this summer's gathering has led to the two following posts. One is a throwing-down-of-the-gaunlet by Isis the Scientist to Ed Brayton, challenging him to a duel over the 40 oz…
revere | May 6, 2009We get emails, all kinds of emails, from people thinking it would be great if we mentioned something near and dear to them on Effect Measure. We are flattered by this, of course, but we aren't journalists or a commercial site or a non-profit advocacy site (well, we are ultimately non-profit, but not intentionally). Occasionally, though, we get email that piques are interest and enthusiasm. This afternoon I got one from Jonathan Link, a writer for AboutKidsHealth, a project of the The Hospital for Sick Children at The University of Toronto.
Back in the days when Quebec was a referendum in the…
revere | April 13, 2009The idea that if the United States joins the rest of developed nations and finally adopts a universal health care system it will bankrupt itself is not based in reality. The reality is that the US spends a larger proportion of its Gross Domestic Product (GDP) than any other developed nation. By far. Not even close. CDC has just documented it from data collected by the Organisation for Economic Co-operation and Development (OECD) in its 2008 health data yearbook (statistics and indicators for 30 countries). It suggests we are being bankrupted by our lack of a universal health care system:
CDC…
terrasig | March 27, 2009Just a quick note of congratulations to friends of Terra Sig (FOTS, if you will) on earning 2008 Awards for Excellence in Health Care Journalism from the Association of Health Care Journalists (AHCJ).
Online
FIRST: M.B. Pell, Jim Morris and Jillian Olsen, Center for Public Integrity, "Perils of the New Pesticides"
SECOND (tie): Tara Parker-Pope, The New York Times, The "Well" blog
SECOND (tie): Scott Hensley, Jacob Goldstein and Sarah Rubenstein, The Wall Street Journal Online, The Wall Street Journal Health Blog
THIRD: Randy Dotinga, Voice of San Diego, "Suicide Magnet" [Part I, Part II]
You…
revere | March 20, 2009If the 1960s film, The Graduate, were to be made today (Graduate, II: The Stimulus), the iconic scene at the party where a friend of the family takes Dustin Hoffman aside and whispers in his ear, "I have only one word for you, Plastics") would be transmogrified into, "I have only three words for you, Health Information Technology." HIT, and its love child with the recently passed stimulus package, the Electronic Medical Record, have all the characteristics of a good idea destined to go bad. One of my vivid memories from my early career was being shown a new kind of quiet printer, called an…
terrasig | March 18, 2009I just had a chance to check in on a triad of posts by Prof Janet Stemwedel at Adventures in Ethics and Science (1, 2, 3) on the ethical issues of the conduct of studies, particularly clinical trials, supported by the US NIH's National Center for Complementary and Alternative Medicine (NCCAM).
For background, NCCAM was originally established for political, not scientific reasons, as the NIH Office of Alternative Medicine in October 1991. It received a token budget of $2 million at the time. They still only get $120-ish million; modest by NIH standards as compared, say, with the 2007 NCI…
palmd | February 16, 2009The New York Times is reporting that the economic stimulus bill will include over a billion dollars to fund research into medical evidence. This is a good thing, but it's bound to be controversial. I've mentioned before that we need to spend money to improve our medical infrastructure, and this could be a step in the right direction.
Much of what we do in medicine is science-based, and much of it has evidence to support it, but some does not. There are plenty of open questions about how we practice medicine, and in order to deliver safe, quality care, we need answers. For example, a…
palmd | February 10, 2009There's a lot of talk about there about "economic stimulus" and "infrastructure", but what is "infrastructure"? Traditionally, it's the basic physical and social structure needed for a society to operate. Roads, sewers, utilities, schools---these are the "guts" of our nation. Without these things, and the pooling of resources they require, we are nothing more than an anarchic collective coexisting on a shared continent. Much of what is defined as infrastructure is about the basics of life---food and its distribution, public health, safety. How is health care not a part of that?
When we…
terrasig | January 6, 2009PharmGirl just sent me this tip after I got out of a meeting but I see that some bloggers have already weighed in about Obama's apparent selection of Dr Sanjay Gupta for Surgeon General.
PalMD was briefly positive but PZ is concerned that Gupta is merely a talking head or placeholder and an apologist for the US health care system. However, I see two main advantages.
1. He knows firsthand the limitations of the US health care system, especially in poor rural and urban areas where access to care is a challenge even under normal circumstances. Gupta has also been on-site for several of the…
revere | November 9, 2008Unemployment is up, state and local tax revenues are down. Along with their jobs people are losing their health insurance. Their sole remedy will be Medicaid, jointly financed by the states and the federal government. What a great time to cut the federal share of support:
In the first of an expected avalanche of post-election regulations, the Bush administration on Friday narrowed the scope of services that can be provided to poor people under Medicaid's outpatient hospital benefit.
Public hospitals and state officials immediately protested the action, saying it would reduce Medicaid payments…
terrasig | October 11, 2008Nobel Prize month also means that Denver's 5280 magazine has announced the annual results of their top 270 medical professionals in 79 specialties. While the picture here is the cover of last year's issue featuring my dear colleague, Dr John J (Jay) Reusch, the good doctor was again named among the top six physicians in Cardiovascular Medicine. Our other compatriot, Dr Daniel (Dan) Bessesen was named for the sixth year among the top specialists in Endocrinology, Diabetes, & Metabolism.
Even my former pulmonologist, Dr James (Jim) Good, made the list - for his 14th year! The Pulmonary…
revere | September 22, 2008Mrs. R. made the very same comment that Echidne of the Snakes did regarding John McCain's prescription of how to fix the US health care system:
Opening up the health insurance market to more vigorous nationwide competition, as we have done over the last decade in banking, would provide more choices of innovative products less burdened by the worst excesses of state-based regulation. (Quoted by Paul Krugman, New York Times, from McCain's article Better Health Care at Lower Cost for Every American, just published. Bad timing?)
Oh good, Mrs. R. said. Now we'll finally get socialized medicine.
I…
revere | August 31, 2008The folks at ScienceDebate2008 pushed hard during the primaries to have the candidates address science policy. Chris Mooney and Sheril Kirshenbaum from Scienceblogs The Intersection were among the leaders in this movement. They didn't succeed in getting a debate then, but now with the field down to the finalists, they have received a response from Barack Obama to 14 questions culled from over 3400 submitted by the 38,000 signers of the ScienceDebate initiative (we were proud to be among them; they include nearly every major American science organization, the presidents of nearly every major…
revere | August 14, 2008The headline was kind of strange: Doctor pays for 'letting polio out of hospital'. It sounded like a hospital doctor had negligently let an infectious polio case out into the community. But in fact the doctor was the hero of the story:
A Samundri Tehsil Headquarters Hospital child specialist, who spilled the beans of polio cases before the media, has been awarded suspension from service, Dawn learnt on Tuesday.
The district administration hastened to take the decision after the doctor informed journalists about the suspected cases of polio at Samundri's villages. (Dawn [Pakistan])
This sorry…
revere | July 18, 2008If you make a ranked list among developed nations on how well the US is doing in health care, we are towards the top of the list. If you hold the list upside down:
Americans live shorter lives than citizens of almost every other developed nation, according to a report from several US charities.
The report found that the US ranked 42nd in the world for life expectancy despite spending more on health care per person than any other country.
Overall, the American Human Development Report ranked the world's richest country 12th for human development.
The study looked at US government data on…
revere | June 2, 2008In a typically well informed and thoughtful commentary over at the mega-blog, DailyKos, DemFromCT reminds everyone that just because the media aren't talking about bird flu and pandemics and just because the candidates are arguing about the economy, the war and whose pastor is worse doesn't mean that anything has changed. All the elements that alarmed the public health community as far back as 1997 when the first human cases of H5N1 appeared are still there. In some respects we should be more alarmed because so much of what we thought about flu then we now know isn't the case at all. Learning…