HOW WE DO HARM
A Doctor Breaks Ranks About Being Sick in America
Otis Webb Brawley, M.D., with Paul Goldberg
St. Martin's Press
Obamacare: How the Supreme Court Could Rule Unanimously
Many pundits predict the Supreme Court will decide the Obamacare case 5-4 along partisan lines. Justices Scalia, Alito, and Thomas and Chief Justice Roberts, they assume, will vote to strike the legislation down, and justices Breyer, Ginsburg, Sotomayor and Kagan will vote to uphold it. If these predictions are correct, the outcome will depend on Justice Kennedy, often considered the “swing” vote between Court conservatives and liberals.
The guessing is that Justice Kennedy will tip the case to the conservative side.
This is all most unfortunate. An extremely important decision about public policy is at stake, and policy decisions are supposed to be made by elected politicians, not by judicial ideologues.
Still, policy decisions by elected officials must not exceed the limits posed by the Constitution. And there are weighty reasons why mandated purchase of insurance could be considered unconstitutional.
In Hopeful Sign, Health Spending Is Flattening Out
By ANNIE LOWREY
WASHINGTON — The growth of health spending has slowed substantially in the last few years, surprising experts and offering some fuel for optimism about the federal government’s long-term fiscal performance.
Much of the slowdown is because of the recession, and thus not unexpected, health experts say. But some of it seems to be attributable to changing behavior by consumers and providers of health care — meaning that the lower rates of growth might persist even as the economy picks up.
Because Medicare and Medicaid are two of the largest contributors to the country’s long-term debts, slower growth in health costs could reduce the pressure for enormous spending cuts or tax increases.
In 2009 and 2010, total nationwide health care spending grew less than 4 percent per year, the slowest annual pace in more than five decades, according to the latest numbers from the Centers for Medicaid and Medicare Services. After years of taking up a growing share of economic activity, health spending held steady in 2010, at 17.9 percent of the gross domestic product.
The growth rate mostly slowed as millions of Americans lost insurance coverage along with their jobs. Worried about job security, others may have feared taking time off work for doctor’s visits or surgical procedures, or skipped nonurgent care when money was tight.
Use of antipsychotic drugs raises alarm
Federal data obtained by the Globe show many nursing homes make heavy use of antipsychotic drugs to pacify residents
Paramedicine holds promise
Posted April 27, 2012, at 2:46 p.m.
A law passed with little fanfare could end up making a big difference to people who need routine medical care, especially those in rural areas. It could also save money.
A bill, introduced by Gov. Paul LePage and sponsored by Rep. Mike Willette, R-Presque Isle, calls for the creation of up to 12 pilot projects that would allow paramedics to provide medical treatmentto patients in their homes.
For example, a patient with a chronic lung or breathing disorder who needs regular medication and breathing treatments would be referred to the program by a doctor or health care organization.
The paramedic would go to the patient’s home to check vital signs and make sure she is taking her medications and following through on other treatment. This would be done during down time between emergency calls.
Such care will lessen the chances of the individuals in the program needing to access the emergency room or be hospitalized once again. This is better for patients and could save money because hospital care is much more expensive.
It is important that review of the pilot projects include a close look at costs. Using paramedics during down time in their shifts is likely to save money. Paying paramedics to do the work of certified nurse assistants won’t.
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