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Like a good, smart doctor, morally grounded and, perhaps, influenced by compassion (hard to tell), the Chief Justice figured out a legally acceptable way for his court to do the right thing. Bravo! See more Three Reasons to Celebrate the Supreme Court’s Decision on Obamacare 
Profit is not what medical care is about, or should be about. What we need is a simple, national health plan, Europe-style, available to everyone, with minimal paperwork and, yes, limits to care. See more Why I Support Health Care Reform 
The unreasonable price of the medical records, combined with the delay in receiving them, exemplifies unnecessary harms patients encounter in an outdated, disjointed health care system. See more 73 Cents: A Film on Regina Holliday’s Work, and Patient Advocacy Through Art 
The current debate about the individual mandate reminded me to post this - About a year ago, I had the opportunity to hear Wendell Potter, author of Deadly Spin — an insider’s sharp critique of the insurance industry, speak at a meeting of the New York Metropolitan Chapter of Physicians for a National Health Program. Despite the cold, dark winter night and midtown dreariness of the meeting location, the large lecture room was packed. I arrived well before Potter’s presentation but couldn’t get a copy of his book; they’d sold out. The meeting was instructive: I got a sense of Potter’s personal story (he’s from Tennessee, and lived for a while in Appalachia), his previous career (he worked as a journalist, turned to marketing, eventually led PR for Cigna) and his perspective on how people in the health care industry use language to frame the debate on health care reform. See more Notes on Wendell Potter, and Why Companies Support the Individual Mandate Something I learned at the MBCN conference is that the Patient Protection and Affordable Care Act of 2010 (PPACA, a.k.a. HCR), will require that private insurance companies cover the routine costs of medical care for patients participating in approved clinical trials. Medicare does so already, said Dr. Tatiana Prowell, an oncologist on the Johns Hopkins faculty who spoke at the meeting. Indeed, it says so on a CMS document. The Association of Community Cancer Centers provides a readable section on the relevant changes, including definitions of “routine costs” and what are “approved trials” according to the new law. All for now - Related Posts:Why I Support Health Care ReformNotes on Wendell Potter, and Why Companies Support the Individual Mandate Three Reasons to Celebrate the Supreme Court’s Decision on Obamacare73 Cents: A Film on Regina Holliday’s Work, and Patient Advocacy Through ArtQuote of the Day: On Death Panels and the Insurance Industry, From Dr. Donald Berwick Today’s New York Times features an op-ed by Dr. Ezekiel Emanuel, on the oncology drug shortage. It’s a serious problem that’s had too-little attention in the press: Of the 34 generic cancer drugs on the market, as of this month, 14 were in short supply. They include drugs that are the mainstay of treatment regimens used to cure leukemia, lymphoma and testicular cancer. Emanuel considers that these cancer drug shortages have led to what amounts to an accidental rationing of cancer meds. Some desperate and/or influential patients (or doctors or hospitals) get their planned chemo and the rest, well, don’t. Unfortunately, what’s behind this harmful mess is neither a dearth of ingredients nor unsolvable problems at most of the manufacturing plants. Rather, the missing chemotherapies are mainly old and inexpensive, beyond their patent protection, i.e. they’re not so profitable, and not high-priority. Emanuel proposes that the prices of old oncology Recently the NEJM ran a Sounding Board piece on Bending the Cost Curve in Cancer Care. The authors take on this problem: Annual direct costs for cancer care are projected to rise — from $104 billion in 20061 to over $173 billion in 2020 and beyond.2…Medical oncologists directly or indirectly control or influence the majority of cancer care costs, including the use and choice of drugs, the types of supportive care, the frequency of imaging, and the number and extent of hospitalizations… The article responds, in part, to Dr. Howard Brody’s 2010 proposal that each medical specialty society find five ways to reduce waste in health care. The authors, from the Divisions of Hematology-Oncology and Palliative Care at Virginia Commonwealth University in Richmond VA, offer two lists: Suggested Changes in Oncologists’ Behavior (from the paper, verbatim — Table 1): 1. Target surveillance testing or imaging to situations in which a See more Running 2 Lists That Might Lessen the Costs of Oncology Care Today a short article in the NY Times, New Kidney Transplant Policy Would Favor Younger Patients, draws my attention to a very basic problem in medical ethics: rationing. According to the Washington Post coverage, the proposal comes from the United Network for Organ Sharing, a Richmond-based private non-profit group the federal government contracts for allocation of donated organs. From the Times piece: Under the proposal, patients and kidneys would each be graded, and the healthiest and youngest 20 percent of patients and kidneys would be segregated into a separate pool so that the best kidneys would be given to patients with the longest life expectancies. This all follows last week’s front-page business story on the monetary value of life. I have to admit, I’m glad to see these stories in the media. Any reasoned discussion of policy and reform requires frank talk on health care resources which, even in the “This caught my interest because it doesn’t diminish physicians’ autonomy,” Blumenthal said. It just enables them to make decisions for their patients in the context of additional, current information. “The end goal is not to adopt technology, but to improve care.“ See more No More Clipboards …My point, which is really a question, is whether people who seek out or need health care should be referred to as consumers or customers. My gut feeling is that neither term is appropriate. But then again, I don’t believe that medicine can be or should be run as a business. Here’s why: The program promises to continue “its look deep inside the complicated heart and soul of a functioning addict, a loving wife, mother, and a first-class nurse.” I’m curious but must admit that last year I watched only part of one episode and didn’t return…The program promises to continue “its look deep inside the complicated heart and soul of a functioning addict, a loving wife, mother, and a first-class nurse.” I’m curious but must admit that last year I watched only part of one episode and didn’t return…Today she beckons half-smiling, an aura of pills and syringes above and syringes above her head. Maybe she’s happy about … See more A New Nurse Jackie in Preview “The insurance market as it works today basically slices and dices the population. It says, well you people with medical conditions, over here, and you people without them, over here… — Jonathan Cohn, Editor of The New Republic, speaking on The Brian Lehrer Show, February 16, 2010* —– There’s a popular, partly true, sometimes useful and very dangerous notion that we can control our health. Maybe even fend off cancer. I like the idea that we can make smart choices, eat sensible amounts of whole foods… |
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