healthcare
lborkowski | May 25, 2011I read a lot of stories about how our healthcare system fails people, but one of the ones that's stuck with me the most is the tragedy of 12-year-old Deamonte Driver, who died in 2007 after bacteria from an abscessed tooth spread to his brain. Deamonte and his brother were covered by Maryland's Medicaid program, but their mother, Alyce Driver, struggled to find a dentist that would accept Medicaid and had appointments available. Then, their coverage lapsed, mostly likely because their paperwork was sent to the homeless shelter where they'd been staying after they moved on to other housing…
mikethemadbiologist | May 20, 2011Let's just say that throwing up between 1am and 5am the week you have to prepare for a scientific conference (ASM) is, well, suboptimal. Anyway, I'm fine (thanks for asking), but Tuesday I had plenty of time to think about this NY Times article about the increase in healthcare deductibles (the amount of money you have to pay out of pocket before your healthcare kicks in):
But Dr. King said patients were also being more thoughtful about their needs. Fewer are asking for an MRI as soon as they have a bad headache. "People are realizing that this is my money, even if I'm not writing a check,"…
mikethemadbiologist | April 28, 2011I didn't think we would see assaults on unions happening in Massachusetts. I was wrong:
Last night, the Massachusetts House of Representatives overwhelmingly passed a bill (111-42) to strip public-sector workers of their ability to bargain collectively for healthcare. The rhetoric surrounding the bill, proposed by Democratic State House Speaker Robert A. DeLeo, is in many ways similar to what Wisconsinites recently heard as Gov. Walker pushed his infamous unionbusting bill....
The State of Massachusetts currently faces a budget deficit of $1.9 billion. House Democrats say that by limiting…
lborkowski | April 27, 2011Last week, Andrew Sullivan noted that a large proportion of healthcare costs are for the last days and hours of patients' lives and made the following proposal:
If everyone aged 40 or over simply made sure we appointed someone to be our power-of-attorney and instructed that person not to prolong our lives by extraordinary measures if we lost consciousness in a long, fatal illness or simply old age, then we'd immediately make a dent in some way on future healthcare costs.
He goes on to note that this would be entirely voluntary, and suggests "an easily reached website that makes such a legal…
lborkowski | April 14, 2011At her Washington Post blog 2chambers, Felicia Sonmez reports that the House has passed legislation repealing the section of the Affordable Care Act that created the Prevention and Public Health Fund, which gives the Department of Health and Human Services $15 billion over the next 10 years to fund prevention and public health.
The Republican complaint? Sonmez reports, "Republicans have criticized the account as a "slush fund" that gives Health and Human Services Secretary Kathleen Sebelius wide latitude in administering federal money without congressional oversight." This is an odd critique…
lborkowski | April 7, 2011Today is World Health Day, and the World Health Organization is using the occasion to draw attention to a serious global health problem: the rapid spread of bacteria resistant to antibiotics. The development and widespread use of antibiotics counts as a public health triumph, as infections that once routinely killed large numbers of people became much easier to treat. That triumph can be undone, though. WHO Director-General Margaret Chan warns, "In the absence of urgent corrective and protective actions, the world is heading towards a post-antibiotic era, in which many common infections will…
lborkowski | March 23, 2011Exactly one year ago, President Obama signed into law the Patient Protection and Affordable Care Act - the most sweeping change to US healthcare since the legislation that created Medicare and Medicaid in 1965. The law's most important achievement is its creation of a system that will slash our nation's shameful uninsurance rate by an estimated two-thirds once it's fully implemented.
Public opinion on the law is still mixed, and that's likely due to two things. First, many of the law's provisions won't kick in until 2014. Second, for those of us with a reliable source of affordable health…
lborkowski | March 17, 2011Earlier this week, the Geiger Gibson/ RCHN Community Health Foundation Research Collaborative released a policy research brief that estimates the impact of the House of Representatives' proposed reduction in funding to community health centers. (Full disclosure: the Geiger Gibson program is part of the George Washington University's School of Public Health & Health Services, where I work, and I've taken classes taught by Sara Rosenbaum, one of the authors of the brief.) I'm sure most readers won't be surprised to learn that cuts to community health center funding won't really save money…
lborkowski | March 14, 2011With nearly one-third of US healthcare spending going to hospital care, it's natural that people would be looking for ways to trim spending on hospital services. A new study just published in the journal Health Affairs reports that seriously ill hospital patients receiving consultations from palliative care teams can incur lower costs. For this study's population - Medicaid patients facing serious or life-threatening illnesses admitted to four New York State hospitals - the authors found that patients who received palliative care consultations incurred costs that averaged $6,900 less than…
lborkowski | March 7, 2011As part of a series on the "penny-and-pound foolish cuts the House Republicans want to impose," the New York Times editorial board lambastes a proposal to cut federal funding to Poison Control Centers from $29 million (Obama's request) to $2 million. This federal money only covers about 20% of the centers' costs, but slashing it will likely force many centers to close. This would be a shame, the editorial board explains, because poison control centers actually save money:
The nation's network of 57 poison control centers takes four million calls a year about people who may have been exposed…
mikethemadbiologist | February 14, 2011You might have heard of by now rightwing activist Lila Rose's attempted sting operation of Planned Parenthood, which resulted in the shocking finding that Planned Parenthood workers follow the law (and don't endanger themselves or their patients by physically confronting potentially dangerous people). Suffice it to say, it was a bullshit smear, but that's not stopping Planned Parenthood from catching flak. I have a personal reason for supporting Planned Parenthood (no, I'm not coming out of the closet or announcing that I am HIV-positive)--but, first, here's the breakdown of what Planned…
lborkowski | February 11, 2011A.G. Sulzberger reports in the New York Times about a new practice by some employers: refusing to hire smokers:
More hospitals and medical businesses in many states are adopting strict policies that make smoking a reason to turn away job applicants, saying they want to increase worker productivity, reduce health care costs and encourage healthier living.
The policies reflect a frustration that softer efforts -- like banning smoking on company grounds, offering cessation programs and increasing health care premiums for smokers -- have not been powerful-enough incentives to quit.
The new rules…
lborkowski | January 28, 2011Atul Gawande's latest New Yorker article, "The Hot Spotters," is a must-read for anyone concerned about the out-of-control growth of US healthcare costs (and that description should apply to everyone in this country). It's about possible solutions to the problem of the highest-cost patients, who account for a disproportionate share of healthcare spending but often aren't getting the kind of care that could really improve their lives. Gawande visits several organizations that are testing out ways to deliver better, more cost-effective care to patients with multiple chronic conditions and high…
mikethemadbiologist | January 28, 2011Washington Post columnist E.J. Dionne recently wrote this about Obama which puzzled me:
An Obama who roared straight ahead hit a political wall. This next Obama is using finesse and subtlety to get to the same place.
Roared straight ahead? Obama? Yes, he appointed two not-batshit-lunatic Supreme Court Justices. But economically, how different would he have been than a Republican? Maybe there would have been more tax cuts and less spending in the ARRA, but even Republicans would have done something. Consider:
What do the American economy and economic policy look like right now on that…
mikethemadbiologist | January 26, 2011...they supported socialized medicine. Last week, Forbes writer Rick Ungar made the following historical observation:
In July of 1798, Congress passed - and President John Adams signed - "An Act for the Relief of Sick and Disabled Seamen." The law authorized the creation of a government operated marine hospital service and mandated that privately employed sailors be required to purchase health care insurance.
Keep in mind that the 5th Congress did not really need to struggle over the intentions of the drafters of the Constitutions in creating this Act as many of its members were the drafters…
mikethemadbiologist | January 23, 2011But not for the reason you're probably thinking. Loughner's ideas are a ludicrous hodge-podge of conspiracy theory, libertarianism, and anti-government sentiment, but what's striking about them is how incoherent they are. This incoherency isn't limited to Loughner either:
...the strange thing is that so much of this furious opposition to activist government appears to be make-believe. The American Enterprise Institute did a poll of self-identified conservatives and found that "only 3 percent of respondents favored reforming Social Security and Medicare." The 2010 elections put a lot of new…
lborkowski | January 18, 2011This week, House Republicans are voting on whether to repeal the Patient Protection and Affordable Care Act. Their bill, misleadingly titled "The Repealing the Job-Killing Health Care Law Act," has a good chance of passing the House but virtually none of passing the Senate or being signed by the President. It's a chance for House Republicans to show the public where they stand on healthcare - but they seem reluctant to engage with the actual projected impacts of the law.
First, the jobs claim. The ACA does not kill jobs. Ezra Klein explains that what House Republicans are referring to is a…
cmonforton | January 10, 2011Lena works in a turkey processing plant in Iowa. She's up by 5:30 am, eats sensibly, is not overweight and has never smoked tobacco. Lena should be the picture of health, but her job makes her feel much older than her 32 years. Over her 10-hour work shift, she makes about 20,000 cuts on the turkey carcasses that move in front of her at a rate of 30 per minute. Lena has chronic pain in her wrist, arms and shoulders. Her physical pain is exacerbated by other work-related stress. Lena earns several dollars per hour over minimum wage, but she has to work another job part-time to help pay…
cmonforton | January 4, 2011After being sworn-in on Wednesday (1/5/11), the new Republican-controlled House of Representatives are promising to do at least two things this week:
(1) read on the House floor the U.S. Constitution, and
(2) repeal the Patient Protection and Affordable Care Act (PPACA), the healthcare overhaul bill that was signed into law by President Obama in March 2010.
Those aligned with the Tea Party movement are pumped up about these actions, but they seem like contradictions to me.
The U.S. Constitution, adopted in 1787, begins with the idealist proclamation:
"We the people of the United…
lborkowski | December 24, 2010A few of the recent pieces I've liked:
Patricia Callahan and Trine Tsouderos in the Chicago Tribune: Chronic Lyme disease: A dubious diagnosis (via Orac, who critiques the backlash against the article)
The Economist: Migrant farm workers: Fields of tears
Christina Larson in Yale Environment 360: In China, a New Transparency on Government Pollution Data
Tracy Weber and Charles Ornstein at ProPublica: Med Schools Flunk at Keeping Faculty off Pharma Speaking Circuit
Adam Serwer in The American Prospect: Necessary and Proper ("Liberals can't make an effective constitutional case for the…