Group items matching

in title, tags, annotations or url

"Hop up on the table, Honey." mThat's how an x-ray technician addressed my 89-year-old mother-in-law in 2001, when we took her for knee x-rays. Mom, who had advanced osteoporosis and arthritis as well as confusion and heart problems, had long since given up hopping. When it became obvious that she needed assistance, the technician grabbed her arm -- as if pulling on another sore appendage would magically raise the rest of her onto the table. It didn't. This incident has become our personal mantra for expressing what is wrong with America's health care system. Having helped our four parents during their final years and having both had cancer ourselves as well as other medical problems, we have had experiences with five nursing homes, two personal care facilities and a half dozen hospitals. We've lost count of the doctors, drugstores and health insurance plans. All of us have had health insurance, though some policies were better than others. Nonetheless, we have experienced incident after incident demonstrating the waste, ignorance and apathy which is rampant in the system. Unable to list them all, I have been heretofore reluctant to write about a handful of them lest the reader be persuaded that the problem is with only that hospital, only that nursing home or only that doctor. There is, however, an increasing crisis of confusion, mismanagement and ill-preparedness which is at the core of our healthcare system. We are all familiar at least with the trend line if not the specifics for healthcare costs. According to WhiteHouse.gov, "The United States spends over $2.2 trillion on health care each year-almost $8,000 per person." That's sixteen percent of the economy. Healthcare costs are projected to increase to almost twenty percent ($4 trillion a year) by 2017. Meanwhile forty-six million Americans are without health insurance (14,000 more each day), premiums and co-pays are rising and more reasons are used to refuse coverage both to those willing to pay and thos

"Hop up on the table, Honey." mThat's how an x-ray technician addressed my 89-year-old mother-in-law in 2001, when we took her for knee x-rays. Mom, who had advanced osteoporosis and arthritis as well as confusion and heart problems, had long since given up hopping. When it became obvious that she needed assistance, the technician grabbed her arm -- as if pulling on another sore appendage would magically raise the rest of her onto the table. It didn't. This incident has become our personal mantra for expressing what is wrong with America's health care system. Having helped our four parents during their final years and having both had cancer ourselves as well as other medical problems, we have had experiences with five nursing homes, two personal care facilities and a half dozen hospitals. We've lost count of the doctors, drugstores and health insurance plans. All of us have had health insurance, though some policies were better than others. Nonetheless, we have experienced incident after incident demonstrating the waste, ignorance and apathy which is rampant in the system. Unable to list them all, I have been heretofore reluctant to write about a handful of them lest the reader be persuaded that the problem is with only that hospital, only that nursing home or only that doctor. There is, however, an increasing crisis of confusion, mismanagement and ill-preparedness which is at the core of our healthcare system. We are all familiar at least with the trend line if not the specifics for healthcare costs. According to WhiteHouse.gov, "The United States spends over $2.2 trillion on health care each year-almost $8,000 per person." That's sixteen percent of the economy. Healthcare costs are projected to increase to almost twenty percent ($4 trillion a year) by 2017. Meanwhile forty-six million Americans are without health insurance (14,000 more each day), premiums and co-pays are rising and more reasons are used to refuse coverage both to those willing to pay and thos

McAllen TX is one of the most expensive health-care markets in the country. Only Miami-which has much higher labor and living costs-spends more per person on health care. In 2006, Medicare spent fifteen thousand dollars per enrollee here, almost twice the national average. The income per capita is twelve thousand dollars. In other words, Medicare spends three thousand dollars more per person here than the average person earns.

Health Care Spending, Quality and Outcomes

Bending the Curve: Effective Steps to Address Long-Term Health Care Spending Growth

An Agenda for Change: Improving Quality and Curbing Health Care Spending

Analysis & report regarding health spending in the current (2008-09) economic crisis. Health Update No. 7, produced by the International Coordination Group for Health (ICGH)

As of mid-August 2009, there were six (6) lobbyists per single (1) member of House and Senate (Bloomberg News). That's 6:1, folks. Just for healthcare reform. For financial industry reform, there are 2,400 lobbyists in play. The Chamber of Commerce spent $26.2 million--in the first 2 quarters (6 months) of 2009. Clearly, private industries and their foot soldiers on K Street/Capitol Hill influence/dictate American policymaking. No matter who's 'voted in,' it's the influence machine that rules Washington. Worse, there's a good chance that the Supreme Court will grant corporations (as 'fictive persons') to spend unlimited dollars in funding electoral campaigns. Is there hope that this country will be a democracy one day? Or is it doomed to become increasingly, irrevocably plutocratic?

As of mid-August 2009, there were six (6) lobbyists per single (1) member of House and Senate (Bloomberg News). That's 6:1, folks. Just for healthcare reform. For financial industry reform, there are 2,400 lobbyists in play. The Chamber of Commerce spent $26.2 million--in the first 2 quarters (6 months) of 2009.

Key Issues in Health Reform: l The federal government's role in financing and delivering health care l Lowering the rate of growth of Medicare spending l Advance care planning for serious illness

Full-text PDF, policy white paper from Brookings Institute

The HHS Agency for Healthcare Research and Quality (AHRQ) has announced plans for spending its $300 million share of the $1.1 billion Congress appropriated for comparative effectiveness research (CER) under the American Recovery and Reinvestment Act of 2009 (ARRA or Recovery Act for short). AHRQ plans to solicit grant applications this fall and award grants and contracts by spring 2010. The $300 million must be encumbered by end of FFY 2010.

Patient Centered Learning: The solution is to permit alternatives to rigid institutions, utilize free internet programs, and have medical students assist practicing physicians by assisting practicing physicians in taking patient histories. These students would offer valuable, free services to doctors. At the same time, they would have a vivid learning experience by spending several hours each day interacting with actual patients. The Cost Of Medical Education Would Be Negligible. The expense of healthcare is directly proportional to the cost of the doctor's education. With the institutional bottleneck gone, there would be a greater number of doctors, and the cost of healthcare would plummet.

This is really unbelievable: The drug and medical-device industries are mobilizing to gut a provision in the stimulus bill that would spend $1.1 billion on research comparing medical treatments, portraying it as the first step to government rationing.

Why Paying for Health Care Reform Is Difficult and Essential - Numbers and Rules. In a short few paragraphs, Dr. Aaron elegantly simplifies and quantifies why finding the $1 trillion for universal coverage is so difficult. He concludes, realistically, soberly,

Accountable care organizations (ACOs) represent a critical step away from volume-driven health care payment and toward better health and better care at lower cost.

Understanding High Value Care and Reducing Unwarranted Variation in Health Care Delivery: A Collaborative Project of the Mayo Clinic, Intermountain Health Care and The Center for the Evaluative Clinical Sciences

Dr. Fisher is a professor of medicine and of community and family medicine, Dr. Bynum an assistant professor of medicine and of community and family medicine, and Dr. Skinner a professor of economics and of community and family medicine at Dartmouth Medical School, Lebanon, NH, where Dr. Fisher also directs the Center for Health Policy Research, Dartmouth Institute for Health Policy and Clinical Practice.