Massachusetts leads on health care while Maine regresses
By Philip Caper, M.D.
Bangor Daily News, Aug. 23, 2012
Massachusetts, the first state that attempted to offer health care to all its residents and provided the template for national health reform, recently took the inevitable and much more difficult next step.
It passed a law intended to restrain future growth in total statewide health care costs. Once government has adopted a policy of achieving universal health care, it must then take steps to maintain affordability.
http://www.pnhp.org/news/2012/august/massachusetts-leads-on-health-care-while-maine-regresses
Why ObamaCare is Not Enough: Turning off the Demand for Health Care
by Mark Hyman, MD
n the run up to the presidential election, the political debate is heating up around health care. Recently the Supreme Court upheld the Affordable Care Act and the individual mandate, but the single biggest question is hauntingly absent from the campaign discourse.
How do we stop and turn back the tsunami of chronic disease, in particular, diabesity – the continuum of obesity, pre-diabetes, and diabetes that is the major driver of 21st century suffering and costs?
Diabesity is the hidden cause of most heart disease, hypertension, high cholesterol, stroke, dementia, many cancers (breast, colon, prostate, pancreas, liver, and kidney) and even depression. Yet is it almost never treated directly because there is no good drug for it.
In short, health care reform addressed the supply side of health care, making it more accessible and improving processes and systems to reduce inefficiencies and medical errors.
http://www.bostonglobe.com/lifestyle/health-wellness/2012/08/26/for-physicians-and-patients-time-best-medicine/ABqZSk3BogpFmfmF31EwyM/story.html?camp=newsletter
James Dichter awoke from elbow surgery in May and went home with a simple navy-blue cloth sling. When the bill for that sling arrived a month later, Dichter’s jaw dropped.
He discovered that his insurer had paid Surgi-Care, a Waltham medical equipment supplier, $83 for providing the item, which consists of two panels of thin cloth sewn together and a shoulder strap. His share was $25. Dichter, 59, a consultant with an MBA from the University of California Berkeley, suspected something was wrong with that price. He searched online and found a similar basic sling for $7.
He wondered why any insurer would pay nearly 12 times that amount. “Somewhere in our health care system,’’ he said, “common sense has left the building.’’
The Last Bipartisan
WHEN I first encountered Ron Wyden in 1974, he was setting up the Oregon outpost of the
Gray Panthers, a lobby group founded by the liberal activist Maggie Kuhn with a broad agenda but an emphasis on empowering the elderly. Wyden, who was 25, seemed improbably boyish to be a champion of senior citizens. But he radiated a winning, wonky exuberance. He was clearly bound for a life in politics. He won an insurgent campaign for a House seat in 1980, graduated to the Senate in 1996 — and now, at age 63, has spent almost exactly half his life on Capitol Hill.
If the name rings a bell, it’s probably because Senator Wyden — without really deserving it — has become a bumper sticker in the Republican presidential campaign. Wyden, an Obama Democrat, co-authored a Medicare reform proposal with Paul Ryan last year, a precursor to the Ryan budget plan that Democrats have pilloried as a heartless effort to throw grandma and grandpa off the train. When Romney and Ryan refer to their Medicare thinking as “bipartisan,” as they do ceaselessly, they mean Ron Wyden. In truth, Wyden never subscribed to the most draconian aspects of the Ryan blueprint, but the fact that the Romney-Ryan ticket uses his name as cover has not endeared Wyden to his own party. Charles Pope, the Washington correspondent for Wyden’s hometown paper, The Oregonian, began a
thoughtful analysis of the senator’s predicament this way: “Trail blazer or traitor?”
We’ll get back to Medicare in a moment, but let’s linger a bit on what this episode tells us about the decline of the honorable craft of lawmaking.
AUGUST 27, 2012, 2:37 PM
Overtreatment Is Taking a Harmful Toll
By TARA PARKER-POPEWhen it comes to medical care, many patients and doctors believe more is better.
But an epidemic of overtreatment - too many scans, too many blood tests, too many procedures - is costing the nation's health care system at least $210 billion a year, according to the Institute of Medicine, and taking a human toll in pain, emotional suffering, severe complications and even death.
"Sometimes the test leads you down a path, a therapeutic cascade, where you start to tumble downstream to more and more testing, and more and more invasive testing, and possibly even treatment for things that should be left well enough alone."
Have you experienced too much medicine? As part of The New York Times's online series
The Agenda, I asked readers to share their stories. More than 1,000 responded, with examples big and small.
Some complained that when they switch doctors they are required to undergo duplicate blood work, scans or other tests that their previous doctor had only recently ordered. Others told of being caught in a unending maze of testing and specialists who seem to forget the patient's original complaint. I heard from doctors and nurses, too - health professionals frustrated by a system that encourages these excesses.
Many Bone Tests for Some, and Too Few for Others
By RONI CARYN RABINThough Riva Schwartz, who manages a law office in Garden City, N.Y., has never broken a bone, she began receiving bone-density scans almost 10 years ago, when she turned 50. Eventually she was given a diagnosis of
osteoporosis and started treatment. But every bone-building medication she took had side effects.
The bisphosphonate drugs often used to treat bone loss caused a severe flulike reaction that landed her in bed with
fever and chills. When Mrs. Schwartz switched to a different drug, which she had to inject herself, she developed painful
kidney stones.
Now she is taking a third medication. "I'm glad I'm getting treatment," said Mrs. Schwartz, 59, "but I'm the first one to say I'm a guinea pig."
Fractures in old age, and broken hips in particular, are a serious health problem. One in every two women will experience a
fracture after the age of 50, and for those who break a hip, the injury can be life-altering, making a woman up to four times as likely to die within a year of the injury as she would be otherwise.
About 7 percent of postmenopausal women will experience a hip fracture. A broken hip can lead to isolation and
depression in addition to increasing the risk of dying, and many elderly people who break a hip will require nursing home care.
But recent reports suggest that too many younger women are being evaluated and treated for bone loss when they should not be.
Aspirin May Aid Cancer Recovery
Men treated for
prostate cancer who took aspirin regularly for other medical conditions were less likely to die of their
cancer than patients who weren’t taking aspirin, according to a new study published on Tuesday in The Journal of Clinical Oncology.
The new report is not a randomized controlled clinical trial of the kind considered the gold standard in medicine, but it adds to an intriguing and growing body of evidence suggesting that aspirin may play a beneficial role in the treatment and possibly the prevention of a variety of cancers. Much of the earlier research on aspirin focused on
colon cancer.
“This is another piece of evidence suggesting aspirin does seem to have this effect against cancer across different body sites,” said Dr. Andrew T. Chan, an associate professor of medicine at Harvard Medical School, who studies the role of aspirin in preventing
colorectal cancer but was not involved the new research.
In the new study, researchers used the national database of a project known as CaPSURE, for Cancer of the Prostate Strategic Urologic Research Endeavor, to look at nearly 6,000 men who had localized prostate cancer and were treated with surgery or radiotherapy. Just over one-third of the men, or 2,175 of the 5,955, were taking anticoagulants, mostly aspirin.
Those taking aspirin were less than half as likely as those who were not to die of prostate cancer over a 10-year period, researchers calculated; the prostate cancer death rate for those taking aspirin was 3 percent, the researchers found, compared with 8 percent for those who did not.
Republicans steal Medicare from the Democrats
TAMPA
Who knew? In the hall-of-mirrors parallel universe where the Republican National Convention is taking place, the GOP stands tall and proud as the party of Medicare.
I’m still a little confused about the historical timeline in this alternate reality. Was it President Goldwater who signed into law the nation’s health-care guarantee for seniors? Was it President Dole who made sure the program remained solvent? Did John McCain win in 2008?
It must be that in RNC World, the past simply doesn’t exist. There is no other explanation for all the Great Society rhetoric coming from Republicans who once claimed to favor small government, limited entitlements and a balanced budget.
At a breakfast hosted by Bloomberg News on Monday morning, Mitt Romney’s campaign brain trust claimed to welcome a fight with President Obama over the future of Medicare. I say “claimed” because the Romney team surely recognizes that putting Rep. Paul Ryan (R-Wis.) on the ticket means not being able to run away from Ryan’s plan — endorsed by House Republicans — to
transform Medicare into a voucher program.
This radical change would, as Democrats claim, “end Medicare as we know it.” Instead of the current guarantee that the program pays for medical costs, Ryan’s plan would give seniors a set amount of money each year to buy private health insurance. If that sum isn’t enough to pay for the necessary coverage — or to pay for traditional Medicare — seniors would have to make up the difference.
“I think we’re winning the Medicare battle because the facts are on our side,” said Eric Fehrnstrom, Romney’s communications chief. “It’s not usual that Republicans have the upper hand in this argument.”
To say the least.
Answering readers’ questions about Medicare
Posted by Glenn Kessler at 06:02 AM ET, 08/28/2012
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