A Very Sick Country
So.
It looks now like the regressive majority on the Supreme Court is poised to overturn Barack Obama’s signature legislative achievement, his health care bill.
That is so fitting.
More than that, it is also a reminder of just how sick this country truly is. Imagine that the lab returned the results from your battery of blood work tests, and all the indicators were screaming out “Danger!” and “Broken!”. That’s us, baby. Get this patient to the ER!
What a total disaster.
The first indicator of how unhealthy we are as a country – literally and figuratively – is the fact that we still don’t have universal health care here in the wealthiest place on Earth. It’s been more than century since the welfare state – a system in which the national government assumes responsibility, as an agent of the national will, for guaranteeing certain benefits and protections to its citizenry – was invented, and, unlike every other developed country in the world, the richest one still doesn’t come close to having universal care for our public, including millions of children. It’s a crime – there’s no other word for it – of astonishing proportions . But it gets worse. We pay more than half-again per capita above
Health, Politics and the Supreme Court
To the Editor:
Your April 1 editorial “The Roberts Court Defines Itself,” critical as it was of the willingness of the court’s conservative justices “to replace law made by Congress with law made by justices,” didn’t go far enough.
It was nothing less than astonishing for conservative justices to suggest that approval of the mandate to buy health insurance under the Commerce Clause would allow Congress to mandate that we eat broccoli. Indeed, why should the conservatives on the court insist that proponents define a bright line to distinguish which mandates might be allowable or not under the Commerce Clause?
Romney’s Health Care Plan
By ANDREW ROSENTHALMark Makela for The New York TimesMitt Romney visits his Pennsylvania campaign headquarters in Harrisburg. He spoke to supporters on the rooftop.
Mitt Romney was roundly mocked on Thursday for seeming to forget he went to Harvard. At a campaign rally in Harrisburg, Pennsylvania, Mr. Romney suggested that President Obama was out of touch, perhaps because he had “spent too much time at Harvard.” Mr. Obama attended Harvard for three years, obtaining a law degree; Mr. Romney was there for four years, obtaining a combined JD/MBA.
At the same rally, Mr. Romney pledged, as usual, to “repeal Obamacare,” and explained that he’d “return health care to the states.” I doubt that idea’s the product of his years in Cambridge, Mass., but wherever it came from, it’s lousy: The laboratories of democracy are ill-equipped to deliver universal health care.
The Autism Wars
By AMY HARMON
THE report by the Centers for Disease Control and Prevention that one in 88 American children have an autism spectrum disorder has stoked a debate about why the condition’s prevalence continues to rise. The C.D.C. said it was possible that the increase could be entirely attributed to better detection by teachers and doctors, while holding out the possibility of unknown environmental factors.
But the report, released last month, also appears to be serving as a lightning rod for those who question the legitimacy of a diagnosis whose estimated prevalence has nearly doubled since 2007.
As one person commenting on The New York Times’s online article about it put it, parents “want an ‘out’ for why little Johnny is a little hard to control.” Or, as another skeptic posted on a different Web site, “Just like how all of a sudden everyone had A.D.H.D. in the ’90s, now everyone has autism.”
The diagnosis criteria for autism spectrum disorders were broadened in the 1990s to encompass not just the most severely affected children, who might be intellectually disabled, nonverbal or prone to self-injury, but those with widely varying symptoms and intellectual abilities who shared a fundamental difficulty with social interaction. As a result, the makeup of the autism population has shifted: only about a third of those identified by the C.D.C. as autistic last month had an intellectual disability, compared with about half a decade ago.
Meager Participation Hobbles Drug Oversight
By SHOSHANA WALTER
Byung Sik Yuh, the owner of Nichols Hill pharmacy in Oakland, filled more than 5,000 online prescriptions for addictive painkillers before the California State Board of Pharmacy moved last year to revoke his license. The patients who picked up the prescriptions at Mr. Yuh’s pharmacy had never met their doctors, nor had physical examinations. They filled out a brief online survey and paid an anonymous doctor to write prescriptions over the Internet.
Today, a contrite Mr. Yuh, who agreed to pay $150,000 in fines to avoid having his license revoked, says he supports the state’s prescription drug monitoring program, a real-time online database that displays a patient’s prescription drug history. As attorney general, Gov. Jerry Brown promoted the online database in 2009 as a new solution to the prescription drug abuse epidemic.
Using the system, Mr. Yuh could have instantly looked up the prescription histories of his customers and refused to provide medication to a patient whose drug shopping habits seemed suspicious or out of control. More than 40 states are using similar systems to help curb prescription drug abuse.
Dental Insurance, but No Dentists
By LOUIS W. SULLIVAN
Atlanta
WE know that too many Americans can’t afford primary care and end up in the emergency room with asthma or heart failure. But in the debate over health care coverage, less attention has been paid to the fact that too many Americans also end up in the emergency room with severe tooth abscesses that keep them from eating or infections that can travel from decayed teeth to the brain and, if untreated, kill.
More than 830,000 visits to emergency rooms nationwide in 2009 were for preventable dental problems. In my state of Georgia, visits to the E.R. for oral health problems cost more than $23 million in 2007. According to more recent data from Florida, the bill exceeded $88 million. And dental disease is the No. 1 chronic childhood disease, sending more children in search of medical treatment than asthma. In a nation obsessed with high-tech medicine, people are not getting preventive care for something as simple as tooth decay.
Tightening the Lid on Pain Prescriptions
By BARRY MEIER
SEATTLE — It was the type of conversation that Dr. Claire Trescott dreads: telling physicians that they are not cutting it.
But the large health care system here that Dr. Trescott helps manage has placed controls on how painkillers are prescribed, like making sure doctors do not prescribe too much. Doctors on staff have been told to abide by the guidelines or face the consequences.
So far, two doctors have decided to leave, and two more have remained but are being closely monitored.
“It is excruciating,” said Dr. Trescott, who oversees primary care at Group Health. “These are often very good clinicians who just have this fatal flaw.”
High-strength painkillers known as opioids represent the most widely prescribed class of medications in the United States. And over the last decade, the number of prescriptions for the strongest opioids has increased nearly fourfold, with only limited evidence of their long-term effectiveness or risks, federal data shows.
“Doctors are prescribing like crazy,” said Dr. C. Richard Chapman, the director of the Pain Research Center at the University of Utah.
Weak Claims From Both Sides on Health Care
By ALBERT R. HUNT | BLOOMBERG NEWS
In the Supreme Court’s historic argument over President Barack Obama’s health care law, the Republicans claimed the high ground on principle, Democrats on the politics.
Both positions are tenuous.
The Republican-conservative case against the constitutionality of the individual mandate requiring health insurance belies the fact that it was long championed by those very elements. It was only when the mandate became part of Obamacare that it morphed into an unconstitutional government power grab.
As for the politics, rarely has a White House so failed to rally public support behind its signature achievement. Public opposition to the health bill is unchanged from several years ago when it was being enacted. One prominent supporter said, privately, that the White House committed political malpractice by not explaining to the public that popular provisions in the bill were linked to the mandate. No one knows this, he said.
For two decades, until the Obama plan took shape, the individual mandate was a central tenet of Republican health care policy. It was the alternative to the government-run single payer system proposed by the late Senator Edward M. Kennedy and to the employer mandate proposed by President Bill Clinton in 1993.
Do You Need That Test?
If health care costs are ever to be brought under control, the nation’s doctors will have to play a leading role in eliminating unnecessary treatments. By some estimates, hundreds of billions of dollars are wasted this way every year. So it is highly encouraging that nine major physicians’ groups have identified 45 tests and procedures (five for each specialty) that are commonly used but have no proven benefit for many patients and sometimes cause more harm than good.
Many patients will be surprised at the tests and treatments that these expert groups now question. They include, for example, annual electrocardiograms for low-risk patients and routine chest X-rays for ambulatory patients in advance of surgery.
The doctors were prodded into action by a conscience-provoking article by Dr. Howard Brody, director of an institute that explores ethical issues in health care, published in The New England Journal of Medicine in early 2010. Dr. Brody criticized the performance of medical groups during the health care debates, saying they were too concerned about protecting doctors’ incomes while refusing to contemplate measures (beyond malpractice reform) to reduce health care costs.
No comments:
Post a Comment