HealthyConcerns.com

Some links/stories to keep you occupied

I may be otherwise engaged with BlogHer today and tomorrow, but I want to make sure you're engaged as well, so here are some stories I've been meaning to link to:

Would you be surprised to learn that immigrants use less health care than those born here? Per capita the expense is a lot less, although more heavily weighted toward Emergency Room usage than non-immigrants. I don't find these figures too surprising, but I'm sure there are some politicians out there who would like them not to see the light of day. Such an inconvenience, facts and figures.

Key excerpt: Results. Immigrants accounted for $39.5 billion (SE=$4 billion) in health care expenditures. After multivariate adjustment, per capita total health care expenditures of immigrants were 55% lower than those of US-born persons ($1139 vs $2546). Similarly, expenditures for uninsured and publicly insured immigrants were approximately half those of their US-born counterparts. Immigrant children had 74% lower per capita health care expenditures than US-born children. However, ED expenditures were more than 3 times higher for immigrant children than for US-born children.

For those of you who continue to wonder how the "uninsurable" get insured, InsureBlog has a 2-part series on high-risk pool solutions. We know the "uninsurable" on this blog, from my friend with the twisted intestine, to the blogger who has diabetes. They both found solutions, the former through a short-term plan, the latter through his girlfriend. But what's the long-term solution? InsureBlog's series doesn't prove the case that high-risk pools are the solution, but doesn't think of anything better either.

You know I have an interest in theatre, and an ActorMan friend who has no health coverage right now. Perhaps this lengthy post from Butts in the Seats (yes, great name, huh?) will help him. Some innovative programs are out there to tend to artists and their general, and specific, health needs. What kind of specific health needs? How about tinnitus, performance anxiety and hand care of musicians? Anyway, it's a cool story, and one that highlights that there are opportunities out there to get health care that people don't hear or know about.

Lastly, Forbes did a review of the MedBlogosphere, and named the "best." Of course they only reviewed MedBlogs from "doctors, professors and scientists" (because we laypeople, we consumers, we customers, we patients, we sufferers...we are the least important part of practicing medicine I guess?) so HealthyConcerns wasn't eligible. Because otherwise I'm sure they would have come knocking on my virtual door. Just like Brad Pitt, if he hadn't happened to have met Angelina Jolie first.

Can I just have a BlogHer moment and say I can't believe a doctor out there named his blog, Medicine and Man??? I've notice some vets focus on cats or reptiles or whatever. I guess this guy focuses on men?

On the other hand, Straight from the Doc looks pretty good. I'm going to subscribe to it for a while and see if it's MedBlogRoll-worthy.

See, I'm looking out for you!

In case you're wondering...

I usually mock people who post messages about their light blogging, as thought people were waiting breathlessly by their feed readers for the next post and sobbing with abandon when one didn't arrive.

So feel free to mock me right back, but I felt I should mention that I'm one of the co-organizers of BlogHer a conference happening this Friday and Saturday, and ti has truly sucked up more time than I possibly could have imagined. It's time well-spent, but it's a lot of time.

And just to throw in a little health-related note to this post: let's take bets on whether I fall sick the moment the conference is over, OK?

Anyone else ever noticed that? That when you have something you must absolutely power through, you can do it...despite abusing your body with lack of sleep, poor diet, high stress.

Then the minute things calm down, BAM, you get a cold or something. What's that about?

(And will it happen to me?)

Check back with me on Monday and I'll let you know.

Grand Rounds 44 is up at Pharyngula

Grand Rounds host Pharyngula, like me, doesn't feel like quite the inside medblogger, so the approach taken is kind of fun. Pharyngula tries to statistically represent what medbloggers take the time to blog about all week. Apparently 24% blog about training, while an equal number seem to blog about thinking/considering/ruminating about what they're actually doing.

Pharyngula points to two posts here, about my nephew with jaundice and my trouble asking the right questions when my cat was sick.

Pharyngula pulls out one of my quotes as an indicator of some concern, and I'd like to clarify:

The quote is: "…shouldn't the rates for doctors start to go down, since the Internet has alleviated the need for them to actually explain as much?"

Pharyngula's comment is: "I wonder if Google has encouraged more people to assume they know better than their M.D.s?"

My point is that patients have always had trouble extracting info from their doctors, sometimes cultural, sometimes understandable ignorance, sometimes doctors without time or intuition. Now patients have somewhere to turn to for info...but they still have to sift through lots of info and decide what's credible and applicable. If doctors were more forthcoming and more welcoming to questions perhaps we wouldn't need to be Googling or Wikipedia-ing "jaundice", but since they're not and we are...it seems like patients are taking on part of the job, and definitely expending more time doing their own research. And that will lower the perceived value of what doctors do, right?

Comparing the US to other countries

Read two interesting blog posts about comparing our medical costs here in the U.S. to other countries around the world.

First we have Managed Care Matters by Joe Paduda.

Bottom line: while we might want to claim malpractice costs drive our higher per capita health costs, or we might want to assume that we have many more available beds and diagnostic machines than those countries with the mythic waiting lists, those aren't borne out by the study Paduda cites. No, we pay more for drugs, for hospital stays and for doctor visits. As Paduda points out, the real problem is that the study may indicated what isn't causing our higher prices, but doesn't really reveal what is causing it.

Second we have guest blogger Nick Beaudrot over at Ezra Klein, also looking at malpractice costs.

Key excerpt:

"most of the higher spending comes from administrative overhead in the insurance industry, higher salaries for doctors, taking more medicine, and patients visiting the doctor a bit more often, not from the practice of defensive medicine. Capping malpractice premiums would not magically reduce health care spending, nor would it make much of a dent in its growth rate. There are exceptions for particular specialties, mostly ob-gyns and anesthesiologists, who seem to bear a great deal of liability and have very high payouts;"

My thoughts on all of the above, not surprisingly, run a little radical in that I wonder why insurance companies and pharma companies and the like have to make so much damn money (meaning profit, not just revenues of course)!

Read on...

Lance Armstrong: Miracle man wins race, stumbles with ad

Associated Press Photo

What can you say about Lance Armstrong. He is clearly an unbelievable athlete. Frankly to win any competition as grueling as the Tour de France for seven years in a row...well the accomplishment boggles the mind. And he's no young 'un anymore either.

To make the Tour de France a sporting even that Americans actually follow is also amazing. There are plenty of sports where Americans do well, but the vast majority of Americans couldn't care less. But each year we pull for Lance.

Coloring all of this is, of course, Armstrong's battle and victory over cancer. That is the integral part of why Lance Armstrong's story captivates the nation. It's not just that he has a winning streak, and we like winners. It's because despite his consistent winning, he can still be considered the underdog, having battled something with an even more consistent winning streak than he has: death.

But I really wish Lance and everyone else had rethought the Nike ad they've been showing during the Tour. It's footage of Lance at the press conference where he announced he had cancer, and that it had spread. But that he vowed to not only beat it, but to come back and race competitively again.

And, of course, being a Nike ad...the footage fades to a black screen with the words Just do it.

That's right folks. Just do it. Got cancer? Just beat it. What's wrong with you if you don't? The people who die obviously weren't committed enough to recovery. I'm all for positive attitude and all that helping the recovery process, but there's an undercurrent of "blame the victim" here.

Lance is inspirational. This commercial turns his inspirational story into something a little more scolding and depressing. I don't like it, as you can tell.

What do you think? Am I being too harsh on Lance and Nike?

An example of how not knowing what to look for literally kills

So, in my last post I talked about my sister and her husband wishing they were clearer about what the negative ramifications of jaundice were, and what to look for to know things weren't going well.

I know firsthand what can happen when you don't know what to look for with someone who can't articulate to you how they feel. No, not a baby, but a pet.

Read on for the story (Be warned: there are some unpleasant details.)

BlogNephew born. Yay! With jaundice. Bummer! And confusion...

On Tuesday morning the latest BlogNephew was born:

Picture of cuteness, no? He was born via Caesarean, so he came out looking pretty pink and cuddly...rather than pinheaded and scrunched up. (Yes, that's a medical term I'm sure.)

By Thursday afternoon BlogSister and her husband were ready to go home, as they never got into a private room, and my sister was feeling pretty good. She felt this time around the surgery and post-surgery effects were easier to deal with...and not just because she knew what to expect.

My mom, of course, thinks it's unconscionable that they send women home that soon after what is, after all, major surgery.

Before they left they were hit with the news that BlogNephew has jaundice.

There are several points to be made about medical personnel-to-patient communications that come out of this story...

I knew I liked that Depression Blogger

I've already pointed to the 'Beat the Blues' blog on the new Yahoo! Health Experts Blog a couple of times. He writes employing simple, clear descriptions and drawing equally clear distinctions.

Today he talks about Obsessions vs. Compulsions vs. Something You Just Like A Lot!

And I'm now calling myself a fan because of his opening paragraph on today's post:

"My family teases me, saying that I’m obsessed with the musicals of Stephen Sondheim. I confess I’m a little fanatical about them, maybe even “obsessed” as that word is used in its popular sense. But from a mental health viewpoint, an obsession is a problem, not something you enjoy a lot."

See everyone...my devotion to Sondheim is perfectly normal!

Healthy Story Update: The Expat hits a snag

My Expat friend was so pleased about his surprisingly smooth re-entry into getting health coverage in the U.S. that when he hit a snag, he was more disappointed than he might have otherwise been.

Expat got a letter from BlueShield that they had a problem because his last 5 years of medical records were from Budapest.

Expat called his friendly eHeathInsurance.com rep, and that person told him that he could resolve it by getting a routine physical here and sending the results to BlueShield. BlueShield just wants to know he's "OK." Of course the letter from BlueShield didn't actually say that anywhere, so Expat remains skeptical, feeling like he's getting two different stories.

I gave him my previous primary doctor's number, and he plans to do the physical (on his own dime I assume.)

But I'm left wondering: don't they have fax machines, scanners, email etc. that work between Budapest and California? Seems kinda lame to me.

Healthy Story Update: All's clear...for another 6 months

As luck/coincidence would have it, not 12 hours after writing last night's post about expecting the worst upon seeing Kaiser in my caller ID, today I got my little results postcard on my mammogram.

Last year the whole mammogram/ultrasound experience was a huge frustration of non-communication and misplaced priorities that led to this rant on my personal blog.

What a difference 9 months and a different doctor makes. As opposed to last year's doctor, who clearly couldn't have cared less, I got the little postcard today, plus my doctor called in the afternoon to make sure I got it and understood it.

Oh, and the results: it looked the same as 9 months ago, so I have to go back in 6 months since there's still that little "shadow."

So, I guess that's good. Right?