http://blogs.chron.com/cancerdiva/
If you are a doctor, or a person with cancer, this insider's view of cancer is a must read. Sometimes I forget to realize that people with illnesses are people, too
Thursday, December 27, 2007
A sad day in Pakistan
I don't know much about politics. But I do know that I am very sad that the former Prime Minister of Pakistan, Benazir Bhutto, has been assassinated. I'm glad I live in a country where opposition party leaders do not get killed.
http://www.cnn.com/2007/WORLD/asiapcf/12/27/bhutto.obit/index.html
by the way, I'm sure this does not bode well for our boys in Iraq and Afghanistan.
http://www.cnn.com/2007/WORLD/asiapcf/12/27/bhutto.obit/index.html
by the way, I'm sure this does not bode well for our boys in Iraq and Afghanistan.
Tuesday, December 25, 2007
17 year old with Leukemia denied payment for treatment
http://www.cnn.com/2007/HEALTH/conditions/12/21/teen.liver.transplant.ap/index.html?eref=rss_topstories
So many issues to bring up, where to start?
1. She had a 65% chance of living 6 months with the transplant. Does that make the transplant mandatory? What if there was another possible recipient with a greater chance of living longer and healthier? 2 out of 3 people live 6 months- I would not take those odds for me, I would for my kids.
2. Everyone is saying the insurance company should pay for every transplant. I think that these should be made on a case by case basis, with some basic criteria as a baseline. Those transplants ain't cheap, and the after care is not easy on the recipient. Remember, a bone marrow transplant from her brother caused the liver failure.
3. CIGNA did not kill the girl, leukemia and liver failure did. Cigna had nothing to do with the leukemia and liver failure.
4. One newspaper editorial said that if a doctor says a procedure is OK, then it should be covered by the insurance company. I appreciate the vote of confidence, but you don't want me to have absolute power to order treatments for you. There is too much new information with new treatments with new benefits and new side effect to just let me run amok. Most doctors, like most people in general, will chose the treatment that pays the doctor best. The pendulum has swung too far in the insurance companies' favor, but physicians still need that check to our authority.
5. The payment for the transplant was refused on December 11th. The family could have given an OK, then sought media attention to pay for it (it probably costs more than a million dollars, so it's not easy to pay for). To say the insurance company stopped the transplant is false- CIGNA decided not to pay for it. When your insurance refuses to pay for your MRI, you can still get one, you just have to pay for it.
6. What was the girl's condition at the time the transplant was denied? Was she in a coma at that time? Why isn't that part of the media story?
7. It's so sad when a kid dies. I hope the family an come to terms with the fact that she died amidst all of the legal battles.
So many issues to bring up, where to start?
1. She had a 65% chance of living 6 months with the transplant. Does that make the transplant mandatory? What if there was another possible recipient with a greater chance of living longer and healthier? 2 out of 3 people live 6 months- I would not take those odds for me, I would for my kids.
2. Everyone is saying the insurance company should pay for every transplant. I think that these should be made on a case by case basis, with some basic criteria as a baseline. Those transplants ain't cheap, and the after care is not easy on the recipient. Remember, a bone marrow transplant from her brother caused the liver failure.
3. CIGNA did not kill the girl, leukemia and liver failure did. Cigna had nothing to do with the leukemia and liver failure.
4. One newspaper editorial said that if a doctor says a procedure is OK, then it should be covered by the insurance company. I appreciate the vote of confidence, but you don't want me to have absolute power to order treatments for you. There is too much new information with new treatments with new benefits and new side effect to just let me run amok. Most doctors, like most people in general, will chose the treatment that pays the doctor best. The pendulum has swung too far in the insurance companies' favor, but physicians still need that check to our authority.
5. The payment for the transplant was refused on December 11th. The family could have given an OK, then sought media attention to pay for it (it probably costs more than a million dollars, so it's not easy to pay for). To say the insurance company stopped the transplant is false- CIGNA decided not to pay for it. When your insurance refuses to pay for your MRI, you can still get one, you just have to pay for it.
6. What was the girl's condition at the time the transplant was denied? Was she in a coma at that time? Why isn't that part of the media story?
7. It's so sad when a kid dies. I hope the family an come to terms with the fact that she died amidst all of the legal battles.
Merry Christmas!!!
May you have peace and joy during the Holiday Season. And for a couple more months, too.
Sunday, December 23, 2007
Immigration and business
http://www.chron.com/disp/story.mpl/business/5398754.html
This is the best article on immigration issues I've read. It points out all of the relevant issues concisely, and without emotion.
This is the best article on immigration issues I've read. It points out all of the relevant issues concisely, and without emotion.
"Meaningless" Bowl games
I am the last person in America who likes the bowls. All of them. I like the fact that Florida Atlantic, BYU, and New Mexico all finished their seasons with a post-season win. But this post is specifically about one of those games.
The Pioneer Las Vegas Bowl pitted a disappointing UCLA team that had just fired their coach ad was using their 4th string QB against BYU- who happened to be on a 9 game winning streak. Both teams played with the sort of intensity you see when my 2 year old wants THAT COOKIE. Guys were making diving catches, big time tackles, and occasional brain farts. BYU's captain got hurt in the first half, came back in, and got hurt again. He waved to the crowd to say thank you for their cheering in a classy move. Several UCLA players also played valiantly with injuries. It was a hard fought, well played drama. UCLA had a chance to win if they could kick a field goal at the end. They drove from their 2 yard line to the BYU 10. On the last play- UCLA's kicker- who had made 2 50 yard field goals, lined up for a 30 yard chip shot.
And it was blocked!
The BYU players that got to the kick put up the ind of Herculean effort you see in an action movie. The BYU players ran out on the field, jumping and hugging. UCLA's captain cried like he lost a national championship. For a meaningless bowl- it sure was great theater and meaningful.
Long live the Bowls!!!
The Pioneer Las Vegas Bowl pitted a disappointing UCLA team that had just fired their coach ad was using their 4th string QB against BYU- who happened to be on a 9 game winning streak. Both teams played with the sort of intensity you see when my 2 year old wants THAT COOKIE. Guys were making diving catches, big time tackles, and occasional brain farts. BYU's captain got hurt in the first half, came back in, and got hurt again. He waved to the crowd to say thank you for their cheering in a classy move. Several UCLA players also played valiantly with injuries. It was a hard fought, well played drama. UCLA had a chance to win if they could kick a field goal at the end. They drove from their 2 yard line to the BYU 10. On the last play- UCLA's kicker- who had made 2 50 yard field goals, lined up for a 30 yard chip shot.
And it was blocked!
The BYU players that got to the kick put up the ind of Herculean effort you see in an action movie. The BYU players ran out on the field, jumping and hugging. UCLA's captain cried like he lost a national championship. For a meaningless bowl- it sure was great theater and meaningful.
Long live the Bowls!!!
Primary care issues- can we survive
www.memag.com/memag/Medical+Practice+Management%3A+Business+Operations/Practice-Overhaul-Contest-Turnaround-help-for-inco/ArticleStandard/Article/detail/479380?contextCategoryId=43934
The article above is about a private practice that is trying to improve business practices without compromising patient care. What I find interesting is the idea that PCP's should see 30-35 patients a day. It's do-able, but not preferable. Patients want more time from their doctors. Doctors need to see more patients as reimbursement per patient is decreasing. The current practice models are not sustainable in the long-term unless all of us join large groups.
Meanwhile, concierge practices see 10-15 people per day and make more money- without having to deal with insurance hassles. More money per patient and fewer patients calling after hours. It sounds great for me, but I can't say the same thing for the general public (especially the general public in the lower 75% income group). As someone with a struggling new practice, I have to choose between the bird in the hand (low reimbursement insurance covered patients- of whom there are many) and the bird in the bush (a concierge practice- where I have to hope that there are at least 250 families willing to give me $2,500 per family to care for them). I definitely need to phrase it as $200 per month.
But with practices going out of business and large group practices being slow to move into some of the new suburbs, the general public is beginning to lose access to health care services due to a lack of PCP's. This is a problem for both the poor and the middle class. I don't have a solution that is workable, I'm just saying this is an unrecognized problem.
http://laissezfairehealthcare.com/2007/12/22/primary-care-physicians-an-endangered-species/
Another aticle addressing the practice of primary care medicine. I can't add anything to this except to say, "yep, he's right".
http://www.thehealthcareblog.com/the_health_care_blog/2007/12/bad-medicine-ho.html
And finally, the most comprehensive blog post I found on the subject.
The article above is about a private practice that is trying to improve business practices without compromising patient care. What I find interesting is the idea that PCP's should see 30-35 patients a day. It's do-able, but not preferable. Patients want more time from their doctors. Doctors need to see more patients as reimbursement per patient is decreasing. The current practice models are not sustainable in the long-term unless all of us join large groups.
Meanwhile, concierge practices see 10-15 people per day and make more money- without having to deal with insurance hassles. More money per patient and fewer patients calling after hours. It sounds great for me, but I can't say the same thing for the general public (especially the general public in the lower 75% income group). As someone with a struggling new practice, I have to choose between the bird in the hand (low reimbursement insurance covered patients- of whom there are many) and the bird in the bush (a concierge practice- where I have to hope that there are at least 250 families willing to give me $2,500 per family to care for them). I definitely need to phrase it as $200 per month.
But with practices going out of business and large group practices being slow to move into some of the new suburbs, the general public is beginning to lose access to health care services due to a lack of PCP's. This is a problem for both the poor and the middle class. I don't have a solution that is workable, I'm just saying this is an unrecognized problem.
http://laissezfairehealthcare.com/2007/12/22/primary-care-physicians-an-endangered-species/
Another aticle addressing the practice of primary care medicine. I can't add anything to this except to say, "yep, he's right".
http://www.thehealthcareblog.com/the_health_care_blog/2007/12/bad-medicine-ho.html
And finally, the most comprehensive blog post I found on the subject.
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