With the story: "Democrats consider dropping insurance ban on pre-existing conditions," we learned that kids under 19 years of age wouldn't be denied coverage for preexisting conditions. Why? Because everyone over 19 will be denied coverage! The following is a particularly poignant blog extract: January 25, 20102:04:30 PM EST, Fredrick H (a triple doctor) comments:
Observation: children with mild to moderate acute asthma had been stabilized in the ER; upon discharge they received montelukast (Singulair] or oral prednisolone; those receiving the latter, the oral corticosteroids after discharge did better. Study Abstract Objective To examine whether outpatient post-stabilization therapy with montelukast produces more treatment failures than prednisolone.
The common retort when confronted with the escalating cost of care and unexplained variation is: "But, my patients are sicker! Southerland, Fisher and Skinner in "Getting Past Denial — The High Cost of Health Care in the United States," are again observing their mentor, Jack Wennberg's dictum, written about extensively at the end of the last century and earlier, that the cost differences between regions and practices may be unwarranted.
Multivitamins Don't Reduce the Risk of Cancer or Cardiovascular Disease in Women Background Millions of postmenopausal women use multivitamins, often believing that supplements prevent chronic diseases such as cancer and cardiovascular disease (CVD). Therefore, we decided to examine associations between multivitamin use and risk of cancer, CVD, and mortality in postmenopausal women.
It's schadenfreude: enjoyment obtained from the troubles of others. That's where I find myself as I observe the surfeit of specialists juxtaposed to a dearth of primary care docs. As Dr. Pauline W. Chen said in "Where Have All the Doctors Gone?"—"I [don’t] envy Mr. Obama.... Any attempt to make health care more accessible will be doomed to failure without an adequate number of primary care physicians and a strong primary care system."
The issues of appropriateness, compliance, cost-effectiveness, patient selection and symbiosis (ACCESS) are vital to both health care and pharmaceutical industries and define their possible relationship. "At this moment, Medicare’s rules – yes, the same Medicare that’s slated to go broke in a decade or so – forbid it to consider cost in its coverage decisions.
An interesting analysis of how medical spending increased (2004 to 2007) Average medical spending increased 34%, from $545 to $729 for all adults. Medical spending increased 42%, or $8,703, for the highest-cost 1% of adults Medical spending increased 39%, or $3,364, for the highest-cost 10% of adults Out-of-pocket spending grew 23%, or $85, for the lowest 50% of spenders
"Providers Believe Healthcare Reform will Increase Their Costs." Here follow a few of its responses: 61% believe "electronic health records (EHRs) could have a positive impact on their businesses" 82% cited their biggest challenge in implementing HlT is cost. 17% of providers are or are planning to participate in a Health Information Exchange (HIE) over the next 12 months.
Percentage of the U.S. Population That Is Obese or Overweight Overweight - 19.2% (Body Mass Index of 25.0 to 29.9) Obese - 7.4% (Body Mass Index of 30.0 to 39.9) Extremely Obese - 4.2% (Body Mass Index of 40.0 +) Source: Society of Actuaries, "Obesity and its Relation to Mortality and Morbidity Costs." December 2010. (pdf)
Adolescent obesity is a growing problem that causes consternation for all and for which there are few if any durable treatments available. Non-treatment, however, is no option. Obese children, like their adult counterparts can develop metabolic syndrome with all of its attendant complications-- cardiovascular problems resulting from years of high blood sugar and lipid levels and consequent, diabetes and/or hypertension . Pediatric Metabolic Syndrome May Not Be a Stable Diagnosis