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Showing posts sorted by date for query health care debate. Sort by relevance Show all posts
Showing posts sorted by date for query health care debate. Sort by relevance Show all posts

Monday, November 25, 2013

These Are The 36 Countries That Have Better Healthcare Systems Than The US

surgery doctors
12 years ago, the World Health Organization released the World Health Report 2000. Inside the report there was an ambitious task — to rank the world's best healthcare systems.
The results became notorious — the US healthcare system came in 15th in overall performance, and first in overall expenditure per capita. That result meant that its overall ranking was 37th.
The results have long been debated, with critics arguing that the data was out-of-date, incomplete, and that factors such as literacy and life expectancy were over-weighted.
So controversial were the results that the WHO declined to rank countries in their World Health Report 2010, but the debate has raged on. In that same year, a report from the Commonwealth Fund ranked seven developed countries on their health care performance — the US came dead last.
So, what can we learn from the report?
NOTE: The rankings are based on an index of five factors — health, health equality, responsiveness, responsiveness equality, and fair financial contribution. As noted above, all data is from 2000 or earlier and these findings have been questioned.
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Sunday, November 24, 2013

The ePrognosis App: How Calculating Life Expectancy Can Influence Healthcare Decision-Making

Today's post was shared by The Health Care Blog and comes from thehealthcareblog.com

By Leslie Kernisan, MD

Last month an intriguing new decision support app launched, created by experts in geriatrics and palliative care. It’s meant to help with an important primary care issue: cancer screening in older adults.
Have you ever asked yourself, when considering cancer screening for an older adult, whether the likely harms outweigh the likely benefits?
Maybe you have, maybe you haven’t. The sentence above, after all, is a bit of wonky formulation for the following underlying questions:
  • How long is this person likely to live, given age and health situation?
  • Given this person’s prognosis, does cancer screening make sense?
The first question seems like one that could easily occur to a person — whether that be a patient, a family member, or a clinician – although I suspect it doesn’t occur to people perhaps as often as it should.
As for the second question, I’m not sure how often it pops up in people’s minds, although it’s certainly very important to consider, given what we now know about the frequent harms of cancer screening in the elderly, and usually less frequent benefits.
Furthermore, there is abundant evidence that “inappropriate” cancer screening remains common. “Inappropriate” meaning the screening of people who are so unwell and/or old that they’re unlikely to live long enough to benefit from screening.
For instance, one astounding study found that 25% of physicians said...
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Social Security’s Job

The Social Security system is an "unfair" benefit distribution plan according to some authorities. Compounding this issue is the patchwork of workers' compensation system that all seem to apply different rules for setoff f benefits from lifetime benefits as well as COLA modifications. Choosing the "right" jurisdiction to file a workers' compensation total disability claim can make all the difference in the world for the amount of benefits an injured worker receives during his or her lifetime. Today's post was shared by Steven Greenhouse and comes from economix.blogs.nytimes.com

Ratio of Social Security benefits to Social Security taxes paid, by race or ethnicity and year.
Ratio of Social Security benefits to Social Security taxes paid, by race or ethnicity and year.
Source: The Urban InstituteRatio of Social Security benefits to Social Security taxes paid, by race or ethnicity and year.
Does Social Security need to be fixed?
As Democrats and Republicans grapple over how to reduce the government’s budget deficit in the face of rising costs for pensions and health care, whether Social Security should be touched remains one of the most controversial topics in American budgetary politics.
But something big is missing to the debate over the finances of what is still the largest component of the social safety net: an understanding of how well it does its job.
When you peek under the hood, it doesn’t always look so great. Indeed, this supposedly great redistributive program — which uses a broad tax on all workers to protect the elderly from poverty — exhibits some fairly stark regressive features.
One well-known regressive feature comes from the rule that benefits must be annuitized, paid out over time in monthly installments rather than as a lump sum. This means that richer people who tend to live longer will get a bigger benefit than poorer people with shorter life spans. Survivor benefits redistribute money from the singles — who don’t get the benefit — to the married, who do.
Eugene Steuerle, Karen Smith and Caleb Quakenbush of the Urban Institute in Washington just discovered another unsuspected regressive...
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Friday, November 22, 2013

California Doctors Prescribe More Name-Brand Drugs Than Any Other State

Today's post was shared by Huffington Post and comes from www.huffingtonpost.com


The only thing that perhaps matched the vastness of the spread or the depth of the traction of the "death panel" lie was the predictability that such a lie would come to be told in the first place.

After all, this was a Democratic president trying to sell a new health care reform plan with the intention of opening access and reducing cost to millions of Americans who had gone without for so long. What's the best way to counter it?

Tell everyone that millions of Americans would have increased access ... to Death! The best account of how the "death panel" myth was born into this world and spread like garbage across the landscape has been penned by Brendan Nyhan, who in 2010 wrote "Why the "Death Panel" Myth Wouldn't Die: Misinformation in the Health Care Reform Debate."

Wednesday, November 20, 2013

New obesity treatment guideline released

Obesity is now been classified as disease. With such a designation of Worker's Compensation systems will be impacted by request for benefits in order to diminish obesity is a pre-existing and coexisting diagnosis. Treatment plans will need to be included for the reduction of weight in order to treat certain diseases by protocols including medication.Today's post was shared by RWJF PublicHealth and comes from www.bostonglobe.com

A new guideline for obesity treatment, released last week by the American Heart Association and American College of Cardiology, provides a solid road map for doctors challenged with helping overweight patients achieve a healthier weight.
Insurance coverage for weight-related counseling, such as helping patients plan new menus with fewer calories or outline a realistic fitness program, could improve under this new recommendation. More importantly, the panel of physicians and weight researchers outlined which interventions are the most effective based on clinical trials.
Doctors should treat patients who are obese — a BMI of 30 or above (180 pounds or more for a 5-foot-5 person — as well as those who are overweight with a BMI between 25 to 30 (150 to 180 pounds for a 5-foot-5 person) if they have certain heart disease risk factors such as type 2 diabetes, the guideline states. People at a healthy weight, or who are overweight without any health problems, should keep their weight steady.
“It’s not just about body weight, but whether excess body weight is associated with medical conditions,” said Dr. Timothy Church, director of preventive medicine research at Pennington Biomedical Research Center, who was not involved in writing the guideline.
Doctors can offer drugs or bariatric surgery to help reverse obesity, but they should first try providing patients with intensive counseling to help them exercise and eat right.
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Friday, November 15, 2013

More Obamacare Enrollees In California Than In 36 States Combined

Today's post was shared by Huffington Post and comes from www.huffingtonpost.com

Obamacare California
Obamacare California

The only thing that perhaps matched the vastness of the spread or the depth of the traction of the "death panel" lie was the predictability that such a lie would come to be told in the first place. After all, this was a Democratic president trying to sell a new health care reform plan with the intention of opening access and reducing cost to millions of Americans who had gone without for so long. What's the best way to counter it? Tell everyone that millions of Americans would have increased access ... to Death! The best account of how the "death panel" myth was born into this world and spread like garbage across the landscape has been penned by Brendan Nyhan, who in 2010 wrote "Why the "Death Panel" Myth Wouldn't Die: Misinformation in the Health Care Reform Debate." You should go read the whole thing.But to summarize, the lie began where many lies about health care reform begin -- with serial liar Betsy McCaughey, who in 1994 polluted the pages of the New Republic with a staggering pile of deception in an effort to scuttle President Bill Clinton's health care reform. As Nyhan documents, she re-emerged in 2009 when "she invented the false claim that the health care legislation in Congress would result in seniors being directed to 'end their life sooner.'"Nyhan: "McCaughey's statement was a reference to a provision in the Democratic health care bill that would have provided funding for an advanced care planning for Medicare recipients once every five...

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Wednesday, November 13, 2013

Professionalism and Caring for Medicaid Patients — The 5% Commitment?

Today's post was shared by NEJM and comes from www.nejm.org

Interview with Prof. Sara Rosenbaum on the health care safety net, Medicaid expansion, and access to care.
Interview with Prof. Sara Rosenbaum on the health care safety net, Medicaid expansion, and access to care.
Medicaid is an important federal–state partnership that provides health insurance for more than one fifth of the U.S. population — 73 million low-income people in 2012. The Affordable Care Act will expand Medicaid coverage to millions more. But 30% of office-based physicians do not accept new Medicaid patients, and in some specialties, the rate of nonacceptance is much higher — for example, 40% in orthopedics, 44% in general internal medicine, 45% in dermatology, and 56% in psychiatry.1 Physicians practicing in higher-income areas are less likely to accept new Medicaid patients.2 Physicians who do accept new Medicaid patients may use various techniques to severely limit their number — for example, one study of 289 pediatric specialty clinics showed that in the 34% of these clinics that accepted new Medicaid patients, the average waiting time for an appointment was 22 days longer for children on Medicaid than for privately insured children.3
Physicians have good reasons for not accepting Medicaid patients, as I learned from direct experience as a member of a nine-physician primary care practice in California. We accepted Medicaid patients, but it was difficult. Medicaid's payment rate was very low — we lost money on each Medicaid visit. When referrals were necessary, we often had to personally ask specialists to accept our patient....
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Tuesday, October 29, 2013

Spinal fusions serve as case study for debate over when certain surgeries are necessary

The necessity of medical treatment is coming under increased questioning as payers want to rein in costs. This article is shared from the washingtonpost.com.

By some measures, Federico C. Vinas was a star surgeon. He performed three or four surgeries on a typical weekday at the Daytona Beach, Fla., hospital that employed him, and a review showed him to be nearly five times as busy as other neurosurgeons. The hospital paid him hundreds of thousands in incentive pay. In all, he earned as much as $1.9 million a year.

Yet given his productivity, some hospital auditors wondered: Was all of the surgery really necessary?

To answer that question, the hospital in early 2010 paid for an independent review of cases in which Vinas and two other neurosurgeons had performed a common procedure known as a spinal fusion. The review was conducted by board-certified neurosurgeons working for AllMed, a company accredited to audit health-care businesses.

Of 10 spinal fusions by Vinas that were selected, nine were deemed not medically necessary, according to a summary of the report.

Vinas is still working at Halifax Health, and a hospital spokesman said that, after the AllMed report, the hospital conducted an internal review that validated his surgeries. Another review conducted this year in response to litigation also validated them, the spokesman said. The hospital would not answer further questions or release details of those reviews.

Vinas “has never and will never perform an unnecessary surgical procedure on any patient,” his attorney, Robert H. Pritchard, said in a statement.

More than 465,000...
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Wednesday, October 23, 2013

Questioning Statins for Older Patients

Limiting medication can reduce overall patient care costs. The efficacy of controlling cholesterol in the "very old" population is now being discussed. Today's post was shared from the NYTimes.com.

Should older adults take statins if they have elevated cholesterol but no evidence of heart disease? It’s a surprisingly controversial question, given the number of seniors taking statins.

Recently AMDA, a professional group representing physicians working in nursing homes, highlighted the issue in a list of five questionable medical tests and treatments. The list was drawn up as part of the national “Choosing Wisely” campaign, which alerts consumers to inappropriate or overused medical interventions, an effort that caregivers would do well to follow.

The standout item on the AMDA list: “Don’t routinely prescribe lipid-lowering medications in individuals with a limited life expectancy.” That means anyone older than 70, according to the medical society.

Dr. Hosam Kamel, an Arkansas geriatrician who is vice chair of AMDA’s clinical practice committee, said that there is scarce scientific evidence supporting the use of statins by 70- or 80-year-olds without pre-existing cardiovascular disease. Only a handful of studies have focused on outcomes (heart attacks, strokes, premature death) in this older population.

Most of the data on the benefits of statin use come from larger studies that looked at adults of varying ages. The results...
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Tuesday, October 22, 2013

The Great Coronary Angioplasty Debate: Giving Patients the Right to Speak | The Health Care Blog

Today's post was shared by The Health Care Blog and comes from thehealthcareblog.com

By Nortin Hadler, MD
Earlier this month, the editors of THCB saw fit to post my essay, “The End of the Era of Coronary Angioplasty.”
The comments posted on THCB in response to the essay, and those the editors and I have directly received, have been most gratifying. The essay is an exercise in informing medical decisions, which is my creed as a clinician and perspective as a clinical investigator.
I use the recent British federal guideline document as my object lesson. This Guideline examines the science that speaks to the efficacy of the last consensus indication for angioplasty, the setting of an acute ST-elevation myocardial infarction (STEMI). Clinical science has rendered all other indications, by consensus, relative at best. But in the case of STEMI, the British guideline panel supports the consensus and concludes that angioplasty should be “offered” in a timely fashion.
I will not repeat my original essay here since it is only a click away. The exercise I display is how I would take this last consensus statement into a trusting, empathic patient-physician discourse. This is a hypothetical exercise to the extent that little in the way of clear thinking can be expected of a patient in the throes of a STEMI, and not much more of the patient’s caring community.
So all of us, we the people regardless of our credentials, need to consider and value the putative efficacy of angioplasty (with or without stenting) a priori. For me, personally, there is...
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Saturday, October 5, 2013

Now the Government Shutdown Is Stopping Blood Drives

Today's post was shared by Mother Jones and comes from www.motherjones.com

blood donation

Here's how the government shutdown may literally be killing people: by causing blood shortages.

For all the scorn heaped on government employees, some people forget that the faceless bureaucrats who populate Washington are often, in fact, a bunch of do-gooders—people who genuinely believe in the notion of public service. As such, they contribute to the public good in a lot of ways that are taken for granted, like their immense contribution to local blood banks. Thirty-eight percent of the population is eligible to give blood, but only 5 percent actually does so. A lot of that 5 percent apparently works for the federal government. Thanks to the shutdown, in just two days, four federal agency blood drives scheduled by one DC-area health care system have been canceled. The regional Red Cross has had to cancel six others in the Washington region.

Inova Blood Donor Services projects that the cancelations will result in its projected loss of 300 donations that would have helped 900 patients in DC, Maryland, and Virginia. Inova's donated blood collections supply 24 hospitals, which bank much of the blood for inevitable disasters or, say, terrorist attacks. The Red Cross is suffering from similar disruptions, projecting the loss of 229 donations, each of which could potentially save up to three lives. A single major trauma event can easily deplete a hospital's entire blood store. The longer the shutdown goes on, the...
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Friday, September 20, 2013

Medical Transparency: Resistance is Futile

Today's post was shared by WorkCompCentral and comes from daviddepaolo.blogspot.com


John Green, one of the vlogbrothers, posted a video blog on YouTube that so far has racked up over 2 million views, entitled "Why Are American Health Care Costs So High?"

The bottom line take-away from this manic, though entertaining (and I assume accurate) review of the United States health care system is the reason why costs are so much higher in the US compared to the rest of the world is ...

Because they can...

John argues that there is no central pricing control like other countries, that consumers will pay whatever they are charged because, basically, they don't know any better, and there is no transparency in health care pricing.

Maybe that's true. I don't know, I'm no expert on health care costs, or health care for that matter - hell, I'm no expert on anything.

But it does make sense that health care pricing should be a factor in most medical care decision situations where there is time to make an informed judgment about a procedure - which is most of the time.

Some medical businesses are starting to advertise their prices and it's causing some debate in medical circles.

The Surgery Center of Oklahoma, owned by its roughly 40 surgeons and anesthesiologists, drew national interest and sparked a bidding war as several other medical facilities in Oklahoma posted their prices according to media reports.

Pricing transparency is gaining momentum.

North Carolina passed a law requiring hospitals to provide prices on 140 common medical procedures and services.
In May, the federal...
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Sunday, September 8, 2013

Bill to protect texters who send messages to drivers is promised

Today's post was shared by WCBlog and comes from www.nj.com



A Republican assemblywoman from Monmouth County plans to introduce legislation to protect texters from being sued if they send a distracting message to a driver who gets into an accident.
The bill, authored by Assemblywoman Caroline Casagrande, comes in response to last week’s groundbreaking decision by two state appeals court judges who said texters who send messages to someone they know is driving have a responsibility to other drivers.

“It is a sad state of affairs when a court believes that someone sending a text message can be held accountable if they have a special reason to know the recipient will be driving a vehicle and then read the message,” Casagrande said. “This legislation puts the responsibility where it belongs – in the front seat with the driver – not with the sender who can be held culpable for something beyond their control.”

Last week’s ruling was the result of an appeal by a couple who were riding a motorcycle through Morris County in September 2009 when they collided with a pickup truck that had just crossed over a double center line. The couple, David and Linda Kubert, each lost a part of a leg in the crash.
They sued driver Kyle Best of Wharton and Shannon Colonna, who sent Best a text message moments before the accident.

A three-judge panel tossed out claims against Colonna, saying there was no evidence to suggest she knew Best was driving. However, two members of the appellate panel said...
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Thursday, September 5, 2013

Confirmed: Fracking practices to blame for Ohio earthquakes

Today's post was shared by Mother Jones and comes from www.nbcnews.com


Wastewater from the controversial practice of fracking appears to be linked to all the earthquakes in a town in Ohio that had no known past quakes, research now reveals.

The practice of hydraulic fracturing, or fracking, involves injecting water, sand and other materials under high pressures into a well to fracture rock. This opens up fissures that help oil and natural gas flow out more freely. This process generates wastewater that is often pumped underground as well, in order to get rid of it.

A furious debate has erupted over the safety of the practice. Advocates claim fracking is a safe, economical source of clean energy, while critics argue that it can taint drinking water supplies, among other problems.

One of the most profitable areas for fracking lies over the geological formation known as the Marcellus Shale, which reaches deep underground from Ohio and West Virginia northeast into Pennsylvania and southern New York. The Marcellus Shale is rich in natural gas; geologists estimate it may contain up to 489 trillion cubic feet (13.8 trillion cubic meters) of natural gas, more than 440 times the amount New York State uses annually. Many of the rural communities living over the formation face economic challenges and want to attract money from the energy industry.

Youngstown quakesBefore January 2011, Youngstown, Ohio, which is located on the Marcellus Shale, had never experienced an earthquake, at least not since researchers began observations in 1776....
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Jon L. Gelman of Wayne NJ is the author NJ Workers’ Compensation Law (West-Thompson) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson). For over 4 decades the Law Offices of Jon L Gelman  1.973.696.7900  jon@gelmans.com  have been representing injured workers and their families who have suffered occupational accidents and illnesses.

Sunday, September 1, 2013

In California, Renewed Debate Over Home Care

Today's post was shared by The New Old Age and comes from newoldage.blogs.nytimes.com


An important struggle over home health care is playing out in California, the nation’s most populous state, including nearly five million residents age 65 and older.

Unions and organizations representing the elderly have joined together to push for legislation that would license agencies, certify workers and create a publicly accessible caregiver registry. Home care agencies are pushing back, saying they favor regulation but oppose the measures under consideration. The legislation, Assembly Bill 1217, has already passed the State Assembly and was passed out of the State Senate’s appropriations committee on Friday. It will be up for a vote on the Senate floor next week.

An estimated 1,400 home care agencies and 120,000 paid caregivers would be affected by the proposed legislation, which is essentially an effort to bring consumer protections to an industry that has been likened to the Wild West. “It’s just not right that I can check the license status of an air-conditioning repairman but I can’t do so for someone coming into my home to care for a loved one,” said Assemblywoman Bonnie Lowenthal, a Democrat and the bill’s sponsor.

Friday, August 23, 2013

UPS Won’t Insure Spouses Of Some Employees

Today's post was shared by WCBlog and comes from www.kaiserhealthnews.org

Partly blaming the health law, United Parcel Service is set to remove thousands of spouses from its medical plan because they are eligible for coverage elsewhere.

Many analysts downplay the Affordable Care Act’s effect on companies such as UPS, noting that the move is part of a long-term trend of shrinking corporate medical benefits. But the shipping giant repeatedly cites the act to explain the decision, adding fuel to the debate over whether the law erodes traditional employer coverage.

Rising medical costs, “combined with the costs associated with the Affordable Care Act, have made it increasingly difficult to continue providing the same level of health care benefits to our employees at an affordable cost,” UPS said in a memo to employees.

The company told white-collar workers two months ago that 15,000 working spouses eligible for coverage at their own employers would be excluded from the UPS plan in 2014. The Fortune 100 firm expects the move, which applies to non-union U.S. workers only, to save about $60 million a year, said company spokesman Andy McGowan.

UPS becomes one of the highest-profile employers yet to bar working spouses from the company plan. Many firms already require employees to pay a surcharge for working-spouse medical coverage, but some are taking the next step by declining to include them at all, consultants say.

“They are simply saying to the spouse outright, ‘If you have coverage somewhere else you are not eligible...

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