Bring Health Care Home
By JACK RESNICK
ONE of my patients called me with a high fever, chills and dropping blood pressure. He was 48 and had been a quadriplegic since he was shot during a robbery in the hardware store he owned. I called an ambulance and admitted him to the hospital, where we soon brought his urinary tract infection under control. But he developed a bedsore, which became infected with an antibiotic-resistant bacterium that breeds in hospitals. He didn’t survive the hospitalization.
This was in 1998. Ever since, I have struggled to treat my patients in their homes and avoid hospitals except when absolutely necessary. I practice general internal medicine on Roosevelt Island in New York City’s East River, where many of my patients are elderly and homebound: survivors of the polio epidemic, people with multiple sclerosis, paraplegics, some on respirators.
Patients who are treated at home by a doctor and nursing staff who know them intimately and can be available 24/7 are happier and healthier. This kind of care decreases the infections, mistakes and delirium, which, especially among the elderly, are the attendants of hospital care. And it is far more efficient. According to a 2002 study, for the patients treated by the Veterans Affairs’ Home Based Primary Care program, the number of days spent in hospitals and nursing homes was cut by 62 percent and 88 percent, respectively, and total health care costs dropped 24 percent.
The welfare state’s reckoning
By Robert J. Samuelson,
We Americans fool ourselves if we ignore the parallels between Europe’s problems and our own. It’s reassuring to think them separate, and the fixation on the euro — Europe’s common currency — buttresses that mind-set. But Europe’s turmoil is more than a currency crisis and was inevitable, in some form, even if the euro had never been created. It’s ultimately a crisis of the welfare state, which has grown too large to be easily supported economically. People can’t live with it — and can’t live without it. The American predicament is little different.http://www.washingtonpost.com/opinions/the-welfare-states-reckoning/2011/12/02/gIQAI1xrTO_print.html
LePage: State can’t afford MaineCare for childless adults
Posted Dec. 05, 2011, at 11:30 a.m.
AUGUSTA, Maine — Gov. Paul LePage is expected to unveil a plan this week to close a $120 million deficit in the budget for the state Department of Health and Human Services.
While details of the plan have yet to be revealed, LePage said during his weekly radio address Saturday that the state can no longer afford a Medicaid program that provides health insurance to some 19,000 low-income adults who do not have children.
Health care and the high court
By Editorial,
EVEN BEFORE the Supreme Court agreed to hear a challenge to President Obama’s health-care program, outside interest groups were angling to elbow out the justices they fear would not rule their way.
Liberal groups argue that Justice Clarence Thomas should disqualify himself because of his wife’s work on behalf of conservative groups that opposed the legislation. Conservatives raise questions about Justice Elena Kagan’s impartiality because she was the president’s solicitor general while the legislation and its legal defense were being crafted.
- The “Kemble Health Reform Manifesto” in 4 short articles:
- 1. U.S. Health Care Spending: Where is the Waste? http://www.opednews.com/articles/U-S-Health-Care-Spending-by-Stephen-Kemble-111116-331.html
- 2. Why Competition Among Health Plans Can’t Help Us http://www.opednews.com/articles/Why-Competition-Among-Heal-by-Stephen-Kemble-111117-858.html
- 3. Universal Publicly Funded Health Care: Establishing Accountability Without Competition http://www.opednews.com/articles/Universal-Publicly-Funded-by-Stephen-Kemble-111123-777.html
- 4. Principles for Cost-Effective, Sustainable Health Care Reform http://www.opednews.com/articles/Principles-for-Cost-Effect-by-Stephen-Kemble-111203-878.html
Dr. Berwick’s Pink Slip
By JOE NOCERA
Dr. Donald Berwick was already in Massachusetts when I spoke to him Sunday afternoon. He was back in the Newton home where he’d lived for 30 years, being pleasantly interrupted during our conversation by his 2-year-old grandson. His last day in Washington as the administrator of the Centers for Medicare and Medicaid Services had been Thursday. Friday was packing day. Saturday was moving day. And, by Sunday, he was already talking about his too-short, 17-month tenure as the nation’s top Medicare official in the past tense. Which, alas, it was.
http://www.nytimes.com/2011/12/06/opinion/nocera-dr-berwicks-pink-slip.html?tntemail1=y&emc=tnt&pagewanted=print
Weighing Berwick's Top Five Accomplishments At CMS
My Health Insurance Rates Just Went Down Again
By PAUL DOWNSI got an e-mail last week with my health insurance renewal rates for 2012. (I have written extensively on this subject: on previous rate declines, on the subsequent feedback, on the health care overhaul, and on rates for older workers.) I opened the e-mail with some trepidation, given the general trend of substantial increases every year. Surprise! Another decrease: 6 percent less for single workers, married couples, and families.
No comments:
Post a Comment