Realigning Health with Care
The misalignment between the expansive goal of “health” and a cramped definition of “care” has cost the United States untold lives and treasure. Yet realignment is in reach: Through expanding the scope of health care, the place where it is delivered, and the workforce that provides it, the US health care system could significantly improve health outcomes and reduce inefficiencies.By Rebecca Onie, Paul Farmer, & Heidi Behforouz
Mass. hospitals urged to apologize, settle
For hospitals, avoiding lawsuits may mean learning to say ‘I’m sorry’
HEALTHCARE’S HIGH COST
Many hospitals, doctors offer cash discount for medical bills
The lowest price is usually available only if patients don't use their health insurance. In one case, blood tests that cost an insured patient $415 would have been $95 in cash.
By Chad Terhune
5:00 AM PDT, May 27, 2012
http://www.latimes.com/business/la-fi-medical-prices-20120527,0,2699813,print.story
Medical supplies head from here to the world
The Partners for World Health drop-off day helps get supplies to developing countries.
SCARBOROUGH - Celia McGuckian showed up Saturday at the Partners for World Health community drop-off day with a car full of medical supplies that accumulated during the last month of her father's life.
McGuckian, of Auburn, said the 43 pounds of items, including crutches, an inflatable mattress and other supplies, would have gone unused without the community drop-off day. Still to come on the next trip, she said, is the "Cadillac of wheelchairs," which her father used twice.
In Medicine, Falling for Fake Innovation
By EZEKIEL J. EMANUELEzekiel J. Emanuel on health policy and other topics.
THE sleek, four-armed “da Vinci” robot has been called a breakthrough technology for procedures like prostate surgery. “Imagine,” the manufacturer says, “having the benefits of a definitive treatment but with the potential for significantly less pain, a shorter hospital stay, faster return to normal daily activities.”
That’s just the kind of impressive-sounding innovation that critics of the health care reform act say will be stifled by the new law, with its emphasis on cost control and the comparative effectiveness of new pills and devices. “Instead of encouraging innovation,” wrote Senator Ron Johnson, Republican of Wisconsin, in The Wall Street Journal, “it stifles creativity.”
The critics are right — if they’re talking about innovations like the da Vinci robot, which costs more than a million dollars and yet has never been shown by a randomized trial to improve the outcomes of prostate surgery. Indeed, a 2009 study showed that while patients had shorter hospital stays and fewer surgical complications like blood loss when they underwent this kind of robotic surgery, they later “experienced more … incontinence and erectile dysfunction.” Similar problems are occurring with robotic surgery for other cancers.
In other words, this is a pseudo-innovation — a technology that increases costs without improving patients’ health.
MAY 28, 2012, 8:37 AM
When Costly Medical Care Just Adds to the Pain
By JANE E. BRODYYvetta Fedorova
In talks about reducing the nation’s exploding health care costs, the “R” word — rationing — strikes fear into the hearts of both patients and doctors.
Why, many people ask, shouldn’t the richest country in the world spend whatever is necessary to protect and preserve its citizens’ health? This is the philosophy under which our health care system operates, and it promises to bankrupt us without necessarily improving our health.
In more instances than many people realize, doing more medically can be worse than doing less. Too often, costly, overly aggressive medical care causes more pain and suffering than if nothing had been done at all.
Our expectations and demands of health care must change, and we must reckon with the incentives for tremendous waste that are now built into the system.
Health care costs can bite
Riddle me this, health care consumers, watching from the sidelines as our politicians ponder the untenable rise in medical costs. How are we, the people, supposed to do our part to keep those costs from spiraling out of control? How are we supposed to make the right choices? How much choice do we really have?
Consider the case of a family of four, which will (cough) remain nameless. On a recent night, while the children slept in a nearby room with an open door, the parents roused from their slumber to hear something rattling against their bedroom window. It was a bat. In a brief frenzy at 1 a.m., it was captured and released.
The next morning, the father recalled that, a few days earlier, he’d seen something in the kitchen that looked like bat poop. And the mother, who is mildly paranoid by nature, thought about rabies.
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