healthcare
mikethemadbiologist | September 19, 2007Or maybe not? Should doctors be salaried workers? From Political Animal:
UNKIND CUTS?....Last month Blue Cross put physician reimbursement cuts into effect in California and doctors were predictably outraged. "I don't know how anybody can afford to stay in practice and accept Blue Cross rates," Dr. Charles Fishman, a San Luis Obispo dermatologist told the Los Angeles Times. "Boo hoo" was undoubtedly the response from many readers. It's hard for the average American to feel much sympathy for a profession where the median income is $215,000 a year. Soon, Medicare will be making its own cuts,…
mikethemadbiologist | September 5, 2007...then please take this survey (it's anonymous). The survey designers are trying to understand more about about the concerns of people affected by MRSA. The survey should take about 25 minutes to complete. You can take the survey here. If you know someone who has had a MRSA infection, please forward this link to him or her. Also, if your blog can handle it, please think about posting the link.
mikethemadbiologist | August 31, 2007A well-developed sense of irony can be a very useful thing to a politician. From Paul Krugman:
"I don't want the people who ran the Katrina cleanup to manage our health care system," says Mitt Romney...
Good reason not to vote for Republicans, I think. Particularly, if you're on Medicare...
mikethemadbiologist | August 24, 2007This post by ScienceBlogling revere about the horrendous human cost of influenza is getting some serious exposure. This gives me an excuse to mention something I haven't in a long time:
Stop worrying about avian influenza. Get serious about 'ordinary' influenza.
Why? Last year, 'ordinary' influenza killed roughly 36,000 U.S. residents. That's about equal to breast cancer which kills 40,000 annually. Before the polio vaccine, the polio virus killed 3,000 people annually, and, even if you adjust for population increases, that number would be roughly 9,000 in today's terms. HIV/AIDS kills…
mikethemadbiologist | August 23, 2007Maha does a great job of getting at the underlying issues in the Bush adminstration's opposition to expanding the S-CHIP children's health insurance program:
The most legitimate question that we have to ask, seems to me, is why is there government? In particular, what is representative, republican government good for? Do people really elect representatives to Congress so that their needs can be ignored in favor of special interests? Is the Constitution really all about limiting the power of people to establish justice, insure domestic tranquility, provide for the common defense, promote the…
mikethemadbiologist | August 20, 2007...to me. Or at least, to the residents of my congressional district. MoveOn.org has a district-by-district list of what your congressional district's contribution to the Iraqi War and Occupation could have bought instead. For me, a resident of Massachusetts' Eight District:
*The cost to Massachusetts taxpayers alone is $12.89 billion.
*Taxpayers in the 8th congressional district are paying $998 million for the Iraq war.
What Citizens of Massachusetts's 8th District Could Have Gotten Instead:
· Health care coverage for 290,837 people--or 363,877 kids, or
· Head Start for 118,751…
mikethemadbiologist | August 2, 2007The July 28 edition of the Lancet has a superb editorial about the need for legal and safe abortion in the developing world, particularly in Latin America (I've snipped parts; italics mine):
...Irrespective of an individual's viewpoint, the debate over abortion in Latin America cannot be ignored. In Brazil, which has the world's largest Roman Catholic population, abortion is only permitted after rape or to save a mother's life. Yet every year 1·4 million women undergo the procedure, terminating one in three pregnancies. Almost 250 000 Brazilian women seek treatment in public hospitals for…
purepedantry | July 17, 2007Ronald Bailey at Reason has an article about the costs of the FDA black box warning on antidepressants:
Excessive caution is risky, too. Back in 1992, Congress, worried about the slow rate of approvals, passed legislation imposing FDA user fees on pharmaceutical companies. Flush with these new funds the agency hired 1000 additional drug reviewers and slashed new drug review time from 30 months to 15 months. Now critics claim that the FDA is in the thrall of drug companies and is endangering the public's health by rushing dangerous new drugs onto the market. As evidence they cite the dangerous…
mikethemadbiologist | July 12, 2007Or actually visitors who cite Galt. Jane Galt responds to calls for adopting a French-like system:
In the United States, government at its various levels now accounts for roughly 45% of health care spending. (And by "now", I mean 2004, the latest year for which OECD data are available. In 2004, of course, the government provided little prescription drug coverage. Remember that fact; it will become important later.) The United States spends about 15.3% of total GDP on healthcare. That means, for those following along at home, that government spending on health care consumes about 7.7% of GDP…
mikethemadbiologist | July 8, 2007The title is self-explanatory. From digby:
When the TB guy story was blazing I wrote that one of the most annoying things about it was that the guy said he was willing to put god knows how many other people at risk because he believed that he would die in a European hospital and had to get back to America where the health care was good. Aside from it being a thoroughly selfish act, it was just wrong. He would have had fine care in that Italian hospital and he could have arranged for transportation back to the states without endangering the lives of of all those strangers many of whom might…
mikethemadbiologist | July 6, 2007...and the Mad Biologist attempts to give a serious answer. In response to this post about adopting a French-like healthcare system, a reader writes:
I know this may sound contradictory to many of you, but I am a staunch Republican who has always believed in the need for universal health care in our country. I am so glad that Michael Moore and all of the Democratic candidates for President in 2008 are raising the level of discussion once more about this need.
I would very much like to join a group of fellow Republicans who support the need for univeral[sic] health care, however, I have been…
mikethemadbiologist | June 17, 2007There's an excellent article in the NY Times magazine about the problem of opiate addiction. One of the problems when distinguishing between patients and doctors who are trying to manage pain versus those who are dealing opiates is that there is no easy way to regularly track opiate prescribing.
I've discussed before how national databases, when privacy issues are properly addressed, are important for drug safety. One of the serious impediments to national health databases is that our healthcare system is so fragmented that electronic surveillance becomes very difficult (e.g.,…
mikethemadbiologist | June 10, 2007I'm usually loathe to rip into a top-notch economist like Brad DeLong, especially when he titles his post "An Unrealistic, Impracticle, Utopian Plan for Dealing with the Health Care Opportunity." But several things bothered me about that post.
What I've never understood about the entire healthcare debate is the need to invent completely new plans. My take on this is ultimately pragmatic: find a system that provides universal coverage and good healthcare and institute it. Much of Europe--including the dreaded French--have very good healthcare. Translate the damn documentation, slap a big…
mikethemadbiologist | June 7, 2007I like much of Matt Yglesias' writing. But he still doesn't appreciate how science and evolution affect public policy issues. As many of you know, three out of ten Republican presidential candidates stated that they don't believe in evolution at one of the presidential debates. Yglesias comments on Huckabee's response:
I see that Jamie Kirchick didn't care for the reply at all: "Sorry, but if someone believes in fairy tales, I think that's pretty relevant to their qualifications as president." But why? The core of Huckabee's answer is here:
It's interesting that that question would even…
purepedantry | June 5, 2007Michael Blim wrote a column at 3 Quarks Daily about when his doctor decided to drop him in a move to a boutique medicine practice. For those of you who don't know what that is, it is a family medicine practice where the physician has a limited number of patients who pay an annual fee in addition to whatever treatment costs they might incur for that year. The rationale from the patients point of view is that you are getting more access to your doctor. The rationale for the doctor is that you get to limit your patient load -- and the insanity that comes with an unlimited patient load -- and…
mikethemadbiologist | May 25, 2007A couple of weeks ago, after I posted about a very serious emerging bacterial threat, KPC, I received an email from a reader with an elderly relative in the hospital with a very serious case of pneumonia caused by KPC. What he* told me is shocking.
The relative, who has had repeated hospital stays and a previous MRSA infection, was in the hospital for a week before any laboratory cultures were performed. That's right, a patient with practically every major risk factor for a multidrug resistant infection wasn't tested for a week. So this patient wasn't isolated, exposing other ICU patients and…
mikethemadbiologist | May 4, 2007No, KPC isn't a new fast food restaurant. It's short for Klebsiella pneumoniae carbapenemase. The bad news: it's very hard to treat. The good news: it's very rare...for now.
Actually, the correct term is KPC-possessing K. pneumoniae*, but we'll just use the slang 'KPC'--it's what all the cool microbiologists use (I'll refer to the carbapenemase gene as the 'KPC gene'). KPC causes pneumonia, urinary tract infections, and sepsis; the mortality rate from these infections is extremely high.
The KPC gene confers resistance to all cephalosporins and Ã-lactam antibiotics: basically,…
mikethemadbiologist | April 19, 2007One of the things that has been revealed by the VA Tech shooting is that the government keeps a database of prescription drug users. This has bothered some. Glenn Greenwald writes (italics mine):
Let me ask you this question: let's say I come into your office (I'm a mentally competent adult -- at least in our hypothetical) and tell you that I want to take a Schedule II drug (or Schedule III) for Medical Problem X (or even just garden-variety insomnia, depression, or anxiety). You tell me that I shouldn't, that there is a high risk of addiction, that the problem doesn't warrant that…
mikethemadbiologist | April 6, 2007A huge number of antibiotic prescriptions are filled due to the misdiagnosis of sore throats. Here's something from the archives about this problem while I'm away.
A long-standing complaint by many microbiologists has been the mistreatment of sore throats in children. Antibiotics are often prescribed even though they are usually ineffective (italics mine):
Most children with sore throats are given antibiotics when they see their doctors, even though a large majority of the ailments are caused by organisms that do not respond to the drugs, a new study has found.
The only common cause of…
mikethemadbiologist | March 13, 2007Last night, I was reading some of the comments you leave here, and, in response to a post about a surgeon who thinks evolution is irrelevant to medical practice (Got Antibiotic Resistance?), fellow ScienceBlogling Mark left a comment. I'll get to the comment in a minute, but tragically, I hear stories like his far too often. Mark writes (italics original):
Mike, you've nailed exactly what pisses me off so much about Egnor. Right now, we're talking about something that's become deeply personal to me.
Since January, my father has been paralyzed from the waist down. The cause of it is MRSA. He…