healthcare
purepedantry | February 19, 2008Much is made by politicians about the benefits of preventive medicine. Politicians often treat preventive medicine like it can perform fiscal magic, causing health care expenditure to evaporate.
The reality is that some preventive medicine is cost-effective and some of it is not. How effective pushing preventive medicine will be at reducing costs depends very heavily on which preventive medicine you choose to emphasize.
Such is the thrust of Cohen et al., publishing in the New England Journal of Medicine. Cohen et al. surveyed the literature on preventive medicine using a database from…
mikethemadbiologist | February 17, 2008Sara Robinson continues her assault on the lies surrounding healthcare. One target--'rationed' healthcare.
We'll have rationed care
Don't look now: but America does ration care. And it does it in the most capricious, draconian, and often dishonest way possible.
Mostly, the US system rations care by simply eliminating large numbers of people from the system due to an inability to pay. Last year, one-quarter of all Americans didn't go to a doctor when they needed one because they couldn't afford it. Nearly that many skipped getting a test, treatment, prescription, or follow-up appointment…
mikethemadbiologist | February 12, 2008Revere busts another myth about the Canadian healthcare system--ER waiting times:
But 70% [in Canada] saw someone within 15 minutes. In the US, wait times for cases requiring immediate attention as determined by a triage nurse are almost that long -- 14 minutes according to a recent study. Average wait times for heart attack victims? An average of 20 minutes, with one quarter of them waiting 50 minutes or more in the US. Heart attack victims. One quarter wait almost an hour to be seen. One reason is that US emergency rooms are crowded with patients that otherwise would see their primary care…
mikethemadbiologist | February 9, 2008Apparently, I'm not the only one who thinks mandating the purchase of private health insurance is a political train wreck (not to mention overpriced and inefficient). Dave Johnson writes:
But Hillary says her plan will have a mandate to buy health insurance. FORCING people to give money to greedy, corrupt corporations? This is political suicide. Readers know how I feel about insurance companies. I will never vote for someone with the brilliant idea of forcing me to give my money to greedy corporations so their CEOs can buy bigger jets. This shows that Hillary now (correctly) feels it is…
mikethemadbiologist | February 8, 2008Sara Robinson, who has lived in both the U.S. and Canada, explodes the myths about the Canadian healthcare system. Here's my favorite (italics mine):
10. This all sounds great -- but the taxes to cover it are just unaffordable. And besides, isn't the system in bad financial shape?False. On one hand, our annual Canadian tax bite runs about 10% higher than our U.S. taxes did. On the other, we're not paying out the equivalent of two new car payments every month to keep the family insured here. When you balance out the difference, we're actually money ahead. When you factor in the greatly…
mikethemadbiologist | February 7, 2008While everyone is worried about who is more TEH SUCK, Obama or Clinton, there's a stimulus package working its way through Capitol Hill. One of the arguments revolves around what is the best way to stimulate the economy. But that's the wrong way to pose the problem.
There isn't a single economy; rather, different people experience different economies. For example, this editorial from The Back Bay Sun describes the economy of the Back Bay, Boston (a very wealthy neighborhood):
The nation is feeling an economic pinch and Goldman Sachs chief economists are all predicting a recession but so…
mikethemadbiologist | February 6, 2008A rant in Boston's Weekly Dig lays out why the healthcare problem is a wage problem:
Dearest Governor/ Presidential Candidate/ Botox Abuser,
Thanks for leaving us with the mandatory health insurance law. I really appreciate being told that I'm legally obligated to have health insurance by January 1st (which I don't), and pay $196/month (which I can't afford), or be subject to a $219 yearly penalty (which will soon be $912). To repeat: I can't afford to spend $196/month for health insurance, so somehow I can afford $912 for the year for nothing???
So basically, because of your landmark law,…
purepedantry | January 21, 2008Although typically Americans have greater and more rapid access to surgical procedures than people in other countries, we do not possess a uniform superiority in the speed of health care access. One excellent example of this is visiting the Emergency Room. ER wait times have been increasing steadily over the last decade as indicated by Wilper et al. publishing in the journal Health Affairs.
Wilper et al. performed the best and most comprehensive analysis to date of wait-time in ERs around the country. The looked at wait-times from 1997 to 2004 using the National Hospital Ambulatory Medical…
mikethemadbiologist | December 28, 2007Revere proposes a simple healthcare plan: "Medicare for all." He bases this on the finding that the healthcare outcomes of people aged 55 to 64 don't become worse once they turn 65, even though that would be expected with chronic conditions. Why? Access to healthcare through the Medicare system:
If you have heart disease or diabetes and you are uninsured you are worse off than those who are insured by several measures. Those are the kinds of health conditions that usually worsen with age, too, so you would expect this to be a bigger problem for the uninsured near elderly. But they don't…
purepedantry | November 14, 2007(I am going to try not to go on a big rant here; we'll see how well that goes.) Jonathan Cohn wrote an article in The New Republic looking at one of the critiques of universal health care: that it might stifle innovation. He presents his case as a balanced one where the relative trade off between costs and benefits need to be considered:
But one argument against universal health insurance isn't so easy to dismiss: the argument about innovation and the cutting edge of medical care. It goes more or less along the lines of my conversation with Mike Kinsley: In a universal coverage system, the…
mikethemadbiologist | November 13, 2007First of all, thank you to everyone who commented on my post about COBRA. One of the odd things about the situation was that I was screwed by the calendar: had I switched jobs during a calendar month, I wouldn't have to have picked up my own health insurance. This doesn't alleviate other inefficiencies, such as everyone wasting their time (and salary money) re-registering me for the exact same health insurance. Which brings me to a point that needs to be raised, even if it is obvious:
There is a difference between health insurance and healthcare.
Granted, even Yogi Berra probably wouldn't…
mikethemadbiologist | November 9, 2007...and you still get hosed by the U.S. healthcare system. I recently switched jobs (this is a good thing), and the joys of our wonderful healthcare system become so apparent.
Basically, I have to pay far more than I otherwise would to not allow a gap in my coverage (i.e., fork over the bucks to pick up a month of COBRA)*, even though:
My new job pays more than the old one; this isn't financial desperation--I'm actually doing what one is supposed to do in a capitalist society.
I was 'unemployed'** for only five business days.
I will actually keep the same healthcare plan.
What's even more…
purepedantry | November 5, 2007Last week, the Washington Post took Rudy Giuliani to task for an ad where he claims that his chances of surviving prostate cancer -- which he had about 6 years ago -- were much higher in the US than in the UK. The ad is meant to indict those who wish to modify the health care system.
He says:
"I had prostate cancer, five, six years ago. My chances of surviving prostate cancer and thank God I was cured of it, in the United States, 82 percent. My chances of surviving prostate cancer in England, only 44 percent under socialized medicine."
Here is the ad itself:
Since the ad, a flurry of…
mikethemadbiologist | October 26, 2007By way of Shakes, this display made its way into the House debate on S-CHIP:
What does abortion have to do with healthcare for children? It's as if conservatives believe in the totemic power of the Fetish of the Fetus. As bad as the Democrats can be, when they usually try to make some semblance of an argument. This is just waving the Bloody Fetus around, and hoping it causes enough people's brains to shut down their ability to think ('cuz fetuses are icky).
This is completely insane. How does one have a national conversation about anything when one half is utterly incapable of a…
mikethemadbiologist | October 23, 2007Because this week is really hectic, I just want to follow up on this post I wrote about MRSA.
One of the hidden stories in the rise in the frequency of antibiotic resistant bacterial strains is that this has also been accompanied by an absolute increase in the number of infections. In other words, it's not the case that you used to have 90 sensitive infections and 10 resistant infections per year in your hospital, and now, you have 50 sensitive and 50 resistant infections (which would be bad enough). Instead, you have the same 90 sensitive infections and 90 resistant infections (for a…
mikethemadbiologist | October 17, 2007I like this ad about S-CHIP:
Now, why can't Democrats communicate like this more often?
Help Public School Kids by Funding my Challenge at DonorsChoose
purepedantry | October 17, 2007From the Economist, medicine is not going well in rural China:
Since 2004 the government, for the first time, has been giving direct subsidies to grain farmers in an effort to keep them growing grain and to curb grain-price rises. This year the subsidies are due to rise 63%, to 42.7 billion yuan ($5.7 billion). Grain output has risen for three consecutive years, the best stint of growth since 1985. But high grain prices may have encouraged this more than the subsidies, which have been largely offset by the rising cost of fuel, fertiliser and other materials.
The changes are a temporary salve…
mikethemadbiologist | October 17, 2007According to the Boston Globe, a new study indicates that deaths from the bacterium Staphylococcus aureus ('staph infections') have exceeded AIDS/HIV deaths in the U.S (italics mine):
Deaths tied to these infections may exceed those caused by AIDS, said one public health expert commenting on the new study. The report shows just how far one form of the staph germ has spread beyond its traditional hospital setting.
The overall incidence rate was about 32 invasive infections per 100,000 people. That's an "astounding" figure, said an editorial in Wednesday's Journal of the American Medical…
mikethemadbiologist | October 12, 2007These are much cuter than Congressman Marshall
(from here)
I received an email from Jane Hamsher and Matt Stoller about S-CHIP:
Dear Mike,
Despite overwhelming bipartisan support and a near veto-proof majority in the House, eight Democrats voted against the State Children's Health Insurance Program (SCHIP).
That list includes Bush Dog Democrat Jim Marshall of Georgia's Eighth Congressional District.
Today, we can pressure Marshall to switch his vote and move the party an absolutely critical step forward towards overriding the President's veto.
We've created an ad to run next Tuesday, right…
mikethemadbiologist | October 8, 2007
At least Bush didn't tell the whole city to go screw itself, just the kids (from here)
ScienceBlogling Mike Dunford describes why a family making $83,000 per year needs S-CHIP despite Little Lord Pontchartrain's claims to the contrary:
After all of that [basic living expenses], the family of four has $17,550 left for insurance - assuming no unforeseen expenses, no savings, no college fund, etc.
The absolute, rock-bottom, cheapest HMO rate that NY State lists for Queens comes in at a bit over $17,640 per year. The average comes in at over $28,000 per year. Even the cheapest plan puts our…