HealthyConcerns.com

Universal Health Care, examined

Joe Paduda from Managed Care Matters caught my eye with his Top 10 Reasons Universal Health Care is Bad. The thing is that he listed the ten reasons without commentary, although some were willing to go at it over whether these were valid or invalid reasons in his comments.

Friday he followed up with a post examinig Item #1 on his list: "Universal Healthcare Will Lead to Rationing".

I hope he follows up every single item from the Top 10 list in this fashion!

Here's some interesting data to get you hot and bothered to read the whole post:

Here's what a bit of specific data show (excerpted from the Commonwealth Fund report).

• The percentage of U.S. patients who waited six days or more for a doctor appointment when sick was not significantly different from the rate in Canada (23% v. 36%), the worst-performing country
• Only 47 percent of U.S. patients were able to see a doctor on the same or next day when sick, versus 61 percent to 81 percent of patients in the four better-performing nations
• U.S. patients were less likely than patients in Canada (12% v. 24%) but more likely than patients in Germany (4%) to wait four hours or more to be seen in the emergency department
• U.S. patients were less likely than patients in four countries (except Germany) to wait four weeks or longer to see a specialist (23% v. 40%–60%) or to wait four months or longer for elective surgery (8% v. 19%–41%) (Schoen et al. 2005)

Interview with Kevin MD

KevinMD is a long-time and extremely dedicated medblogger. He is one of the more reliable resources for quick links to news and current events in the medical space. I read him (and link to him) regularly.

The Pulse, a healthcare marketing blog, does a nice interview with Kevin here.

Of course Kevin points out what it takes to be a successful medbloggers:

D.J.: Why do you think that you have been so successful in attracting followers?
KevinMD: It’s persistence. When you start a blog you have to stick to a schedule and I post normally three times a day. When you have a readership that looks forward to that schedule, then it can certainly grow.  I have posted almost everyday. There are very few days that I don’t post unless I’m on vacation and what not.  So I think that posting regularly is very important.  I also have different mediums that people can access my blog through. I have the blog itself.  I have a link to my post served up on twitter, so that it exposes the blog to a different audience. People who don’t want to go to blog itself can read my posts through a RSS reader or they can subscribe by e-mail newsletter. Having a variety of means that people can access your writing is important, and the fact that they all go back to the blog - it kind of helps identify your brand within the Internet and that helps increase readership.

Wowsa. I guess we can see why I'm no Kevin MD. Posting 3x per day? Sigh. I'm lucky when I do 3x/month, and you all would probably fall over dead if I blogged 3x/week!

It's nice interview all the way around. he makes the point that there is no barrier to entry to blogging that anything to do with anything other than your time. It's easy, it's cheap, it's accessible. But it does take time. 

He closes with a plug for appreciating primary care more in the country, and I can buy that too.

Check it out.

The second-guessing continues on Richardson case

Terrible news this past week when actress Natasha Richardson died, subsequent to what seemed to be a minor fall while learning to ski.

Such cases always spur second-guessing, and as this post at Kevin MD illustrates, this case is no different. Some people are turning this into a political football, wondering if somehow the Canadian style of national health care system is what did Ms. Richardson in. When I read the actual timeline, it seems clear that this was a case of the accumulation of a bunch of questionable human decisions every step of the way. Throw in the lack of helicopter availability in the area where they were vacationing, and in a case where time is of the essence, they lost it over and over.

The single most questioned decision has got to be: Who turned away the ambulance that arrived 17 minutes after her fall, and why did those EMTs agree to leave without even seeing the patient? The two hours lost right from the beginning is likely be all the delay required to make her situation unsalvageable.

And yet, how many of us would do the same if we felt fine, could walk, talk, etc? Well, maybe not anymore. But just in the comments and links in this BlogHer post, plenty of women share their stories of being bonked on the head and not immediately jumping to get checked out. 

We can only hope that this tragic death convinces people that a head injury is nothing to ignore or "wait and see" about...hit on head? Get thee to an emergency room...stat!

Vote: Good idea/bad idea?

I gotta ask: Will this teddy bear-shaped blood bag designed for use in pediatric wards make kids feel all comforted and cozy?

Or scare the living daylights out of them, giving them nightmares about bloodthirsty teddy bears coming to life and wanting to swallow all their blood?

I'm just asking. Is that so wrong?

Hat tip: Kevin MD.

What do you think of Sanjay Gupta as Surgeon General?

Well, to answer that question, perhaps first you need to know what the Surgeon General actually does. So, for that, you might want to go read the interview Dr. Val does with the 17th Surgeon General of the US, Richard Carmona. 

Now, Dr. Val is clearly not too hep to the idea of Gupta as SG.

But not everyone is so automatically opposed. You can find people on both sides of the argument in the comment thread on this Kevin MD post.

And Robert Laszewski over at Health Care Policy and Marketplace Review actually claims Sanjay Gupta could be a great pick for Surgeon General.

But then there's recent Nobelist and current NY Times columnist Paul Krugman telling us the trouble with Sanjay Gupta.

Not to mention the Daily Green seeming to have strong feelings about it, as evidenced by the post The 6 Most Idiotic Positions of Dr. Sanjay Gupta. Gee, tell us how you really feel.

I really can't say I know what to think. I can't say I think much about the Surgeon General. The only two I can name are C. Everett Koop and Jocelyn Elders. And I can't understand exactly why Obama would expend a controversial selection on such a low-profile role?

All very odd. Your thoughts?

If you're a nurse, you are in demand...for now

One of my favorite jokes goes as follows:

A man dies and much to his surprise he is met by both the devil and God. They tell him he gets to visit both heaven and hell as a tourist and then choose where he belongs. Well, this was quite surprising to him, but pretty exciting. I mean who knew, right?

So he decides to go with a bad new first approach and visits Hell. Again, much to his surprise, Hell seems mostly to be about wine,women and song. Or maybe like Vegas, but whatever the analogy, it was actually a lot of fun.

Then he visits Heaven. Lots of people dressed in white robes sitting around, maybe playing a little harp, but otherwise...a bit of a snooze.

So, when the man returns to the waiting devil and God, it seems like a no-brainer and he chooses Hell.

The devil claps him on the back saying "I knew you were a smart man", and with a snap of his cloven hoof they are back in Hell. Only this time it was quite different...this time there was all the fire and brimstone you might expect...agony, abject fear, the works.

The guy recoils in horror and says, "Hey what is all this? This isn't at all what it was like yesterday!!"

And the devil said, "Yes, but yesterday you were a prospect. Today you are a customer."

This joke ran through my mind when reading this article about the nursing shortage and the desperate measures some organizations are taking to recruit nurses.

Of course at least one blogger thinks fancy recruiting strategies are pretty useless, if ongoing working conditions suck. Retention is the ultimate recruitment, in other words. Makes sense to me. 

I'm hiring for a key position at my company right now, and I've been struck by how all the second round candidates have told me about how impressed they've been to meet the other members of our team during that second round (they met only me for a first round) and see their passion and commitment. Meeting our team was, I believe, a big plus and will help me in my recruitment.

I wonder if these institutions are able to use their current staff as recruitment tools? If not, it's no wonder they're in trouble.

Hat tip: Kevin MD.

Healthy Concerns still somewhat unusual

Or at least, I think it must be, because how else can I explain being honored with inclusion in this 100 Best Health Care Policy Blogs list from the Radiology Technician Schools site?

It used to be unusual that I was a layperson blogging about health at all. But now there are lots of "PatientBloggers".  However, most of them blog about a particular condition from which they suffer...whether chronic or acute.

I blog randomly about my random thoughts about health care, coverage, politics etc.

And in that, I think, I am still unusual :)

Thanks RT folks!

Bucking the trend and praising the U.S. health care system?

Recently the Obama transition team asked Americans to get together, talk about health care in America and report back the thoughts, ideas and suggestions from such meetings. You can read more about the questions the Obama campaign suggested as discussion points here, but they range from defining the biggest current problem in our system to questions about how each group thinks public policy can actually help to questions delving into what kind of care people had gotten, and how they had health insurance to begin with.

Dr. Val Jones from Better Health held one such group, and her report on it is interesting, mostly because she seems to feel that most of us take a glass half empty approach to looking at our health care system, while she definitely sees the glass half full

She says: "Although we had been instructed to compile a list of compelling stories about system failures – instead we decided to be rebellious and discuss “what’s right with the healthcare system” and compile a list of best practices" 

But reading the suggestion question list (again, excerpted here) sounds like they weren't exactly the crazy rebels they wanted to paint themselves as. Yes, there were questions asking to illustrate a system gone wrong, but mostly the question guide seems to want to delve into finding out what people want and what they would consider best practices to be. As an employer I found it particularly interesting that the Obama team wanted to know if people in the room knew how much their employers paid for the health care benefits they, as employees, received. I'm betting most have no idea whatsoever. 

Anyway, Val goes on to list 10 good things. She mentions Kaiser Permanente a few times, which interested me, since they're my provider. I'm actually quite satisfied with the care and coverage I've received as a long-time Kaiser customer, but let's be clear that I (knock on wood) haven't taxed them too hard.

A couple of the items on the list have nothing to do with the American health care system per se. I wouldn't consider #4-Social Media, for example, an American health care system feature or innovation, those same apps (and people participating on them) are available worldwide. 

And one other big blind spot about the list is that some of the positives listed are only available if you already have insurance. Which is awesome, but I think it's a given that most of us consider the number of Americans who do not have insurance to be one of the biggest problems and burdens on the system. I find it unintentionally ironic (or maybe I mean oxymoronic) to refer to "democratic" accessibility, which just happens to be limited to those already with coverage.

I think most of us who are looking at our system as glass half empty are doing so because it seems un-American to be satisfied with being able to make a list such as Val's, knowing it doesn't even apply to so many people. 

Here's my analogy: Would you go to a Club Med resort in the middle of an impoverished region (as many of them are) and tout the availability of fresh, potable water within the resort's confines as one of the things that country's government was doing really well...while people died every day outside its walls from the lack of clean drinking water? I don't think so...the pride about providing for resort-goers might be mitigated just a bit by shame over being unable to take care of the rest of your countrymen and women.

So, what I would have liked to see close out Val's list was at least one idea, from what sounds like an esteemed group gathered at her house, about how to truly democratize those great things happening in our health care system. And how to improve accessibility for those uncovered and level of coverage to those under-covered.

Isn't THAT the biggest challenge the Obama administration faces?

Val: How about a sequel? :)

Pay your dental bills, or else...

Just a medical nightmare story to start you day, what could be better?

Apparently a dentist in germany got a little sick of waiting for a delinquent patient to pay up for some bridgework. So. He broke into her house, tied her up, pried open her mouth and removed the bridgework he had put in.

I kid you not.

Of course, let's al take note that this all really started because her health insurer refused the claim.

Wow, dentists gone wild, indeed. (Hat tip: Kevin MD)

Revolution Health over and out after <2 years?

Revolution Health was a big sponsor at BlogHer '07 in Chicago, less than 18 months ago. They had Steve Case, former chairman of AOL, at the helm, driven by personal passion stoked by personal experience in the world of health care. They had at least one really smart blogger/doctor in the person of Dr. Val Jones. They clearly had money. And they seemed to have a mission that went beyond just becoming WebMD lite. They did seem to want to be a truly Web 2.0-embracing agent of change in the health care world online.

Apparently, it's nice to want things, but it doesn't mean you'll last.

And John from e-patients.net shares his insights from working at Web 1.0 failed med-start-up drkoop.com to theorize about why. In a way it's simple: the vast majority of such start-ups fail...statistically, this was likely to happen. I think most of us expected a better outcome based on the pedigree behind the venture, but perhaps that pedigree contributed to a sense of hubris...over-reaching, over-commitment, over-promising? And a little less freedom to focus on organic, sustainable growth.

"Organic, sustainable"? Sounds like something I should be writing about on my green blog, but sometimes it applies to business too.