In a 15-year study of older Medicare patients, Yale School of Medicine researchers saw an estimated 20% drop in mortality, about 30% fewer hospitalizations, and 40% reduction in deaths after hospitalization…
Published in the July 28 JAMA theme issue on Medicare and Medicaid at 50, the study took a comprehensive look at national trends in mortality, hospitalizations, outcomes, and expenditures from all causes from 1999 to 2013. The team, from the Center for Outcomes Research and Evaluation at Yale-New Haven Hospital, analyzed data on 68,374,904 Medicare recipients 65 years of age or older from key demographic groups and geographic areas.
“We are in the midst of a remarkable era of improvements in health and health care in America,” said lead author Harlan M. Krumholz, M.D….co-director of the Clinical Scholars Program. “This decline represents millions of hospitalizations averted and hundreds of thousands of deaths delayed.”
“The news should give us reassurance about our current efforts, but not make us complacent. We should seek to continue our advances in technology, health behaviors and policies, and quality of care — and seek to continue this remarkable trend,” Krumholz added.
Krumholz and his team also found that the total number of hospitalizations for major surgery decreased over the course of the study. The average length of time spent in the hospital declined from 5 to 4 days, and the average inpatient costs per Medicare fee-for-service recipient declined from $3,290 to $2,801. The findings were consistent across geographic and demographic groups.
Now, imagine how much better this good news might be – if we kicked whiners and ideologues out of Congress and concentrated on solid science, best administrative practices and took as the single goal improving health and healthcare for all Americans.
That would really be good news.
Ain’t nothing wrong with conformity – defined by freedom and equal rights.
You’ll probably be hearing a lot about death panels these next few days.
That’s because Medicare, the federal insurance program for elderly Americans, wants to start reimbursing doctors for having conversations with their elderly patients about death. Those talks might cover things like how much medical treatment a person is willing to endure in exchange for the chance of a few more months on the planet, and the circumstances under which a person would prefer to let go.
Similar ideas were stripped out of the the Affordable Care Act after that great medical intellect Sarah Palin started using the provocative term “death panels” to describe them. It was picked up by Obama-haters everywhere and the end-of-life counseling notion was soon declared DOA. A lot of [opportunist] media outlets used the language to describe Medicare’s announcement…
You can pretty much count on the death-panel trolls crawling back—some of them might even be running for president. Times have changed, and we’ve probably gotten smarter on this, but you can count on some of the old death-panel trolls to come crawling back—and some of them might even be running for president. We’ll see. In any case, they will be profoundly and tragically wrong. The proposed conversations will not only save the healthcare system a bundle, they will improve the quality and duration of people’s final days. Even tea partiers will benefit from the policy, which, if it survives its critics, will almost certainly be adopted by private insurers. (Some are already doing it.)
Michael Mechanic supplements the article with an earlier interview of author, surgeon, and New Yorker staff writer Atul Gawande, whose best-seller “Being Mortal” covers this topic. A worthwhile read. Click the link up top to RTFA.
I visit this topic from time-to-time. As a cranky old geek, questions of mortality are closer to my own life than most. As I said in January, “We had our first Death Panel get-together with my wife’s doctor a few weeks back. I have nothing but contempt for the conservative idjits who coined that term – so, of course, I deliberately use it as a joke. My wife’s doctor didn’t smile.”
“A line this long that never ends and everybody is happy,” marveled Jim Leighton, a 30-year Oregon resident. “Isn’t that great?” He and some 1,300 others stood in a queue that snaked around the block in the sweltering Portland heat Friday afternoon, waiting for entry to an event where they could get up to seven grams of marijuana for nothing more than a smile and a handshake.
Oregon is the fourth state in the United States, in addition to the District of Columbia, to legalize marijuana for recreational use for adults 21 years and older. But even after parts of the law went into effect Wednesday that legalized possession and growing of small amounts, marijuana still cannot be sold to the general public.
So growers and medical dispensaries at Weed the People found their way around the law by giving away their weed for free, some hoping to use it as a marketing tool later…
On midnight Wednesday as the law went into effect, hundreds gathered on Burnside bridge in downtown Portland in celebration. The bridge was billowing with smoke as the clock struck midnight. But while the original plan was to hand out free samples of marijuana, the overwhelming turnout halted the giveaway.
Two days later, the free handouts proceeded as planned at Weed the People, thought to be the first formal event with free cannabis giveaways – after attendees paid a $40 admission fee to attend.
The alcohol-free event lasted for seven hours, as attendees mulled around to test out smoking devices; relaxed on comfy chairs and listened to records in a “chill out area”; and waited in a line that wound through the inside of a warehouse to enter the “Grow Garden”, the highly secured and roped off area where they could pick up their free goodies. One growing entity, Green Bodhi Gardens, said it brought more than 2,000 grams divided into one-gram jars in anticipation of the crowds…
Restrictions notwithstanding, “people want to celebrate,” said event organizer Josh Taylor. “Oregonians are big on sharing!”
The easiest thing to share still is Good News. As more and more folks are exposed to the reality of attitude-alteration with substances like cannabis versus craptastic amounts of alcohol, mellow stoners versus combative drunks, progress towards an understanding of reality outside the boundaries of conventional politics continues to grow – and grow.
Our culture, our government, our politicians may be characterized by ignorance, stupidity, superstition and bigotry. The fact remains that exposure to reality changes folks’ minds. It’s always too gradual for many; but, it’s inevitable. Even faster if you get on board the freedom train. :)
Last May the Girl Scouts took a historic stance for inclusivity and made their long-term policy on accepting transgender girls into their troops official, much to the chagrin of bigots everywhere. Unfortunately, some of those bigots have bank. Fortunately, there are good people in the world too.
An unnamed $100,000 donor sent the Queen Anne offices of the Girl Scouts of Western Washington a note last May asking the chapter to “guarantee that our gift will not be used to support transgender girls. If you can’t, please return the money.”
Council CEO Megan Ferland returned the donation, which would have sent 500 girls to camp and helped the troop meet nearly a quarter of their annual fundraising goal, with a note saying “Girl Scouts is for every girl. And every girl should have the opportunity to be a Girl Scout if she wants to.”
An Indiegogo has now been set up to help raise back the funds returned to the donor.
SeattleMet reports that the Gender Justice League, an organization designed to support Seattle’s transgender community, has offered to help promote the Indiegogo campaign.
$172,690 has so far been donated to the Indiegogo campaign in a single day. The campaign’s stretch goals will go towards helping the estimated 2,000-plus girls who will require financial assistance to participate in Girl Scouts over the next year.
Bravo! An example of real heart, principled courage, rewarding an old organization with the good sense to change with the times – in a progressive direction.
White House illuminated in celebration, tonight
A special Thank You to Supreme Court Justice Anthony Kennedy. He is the sole traditional American conservative within that court. The sole honest conservative in that court. Willing to look forward, willing to join in building progress and understanding in a nation still wracked by divisions grounded in hate and fear on the Right.
Including the syllabus of the original filing, here is the Supreme Court’s decision [.pdf] – which Anthony Kennedy wrote for the majority.
Workingclass men and women built this land. We deserve the fruits of our labor.
This week, the Alliance for Retired Americans released its annual report detailing the voting record of every U.S. Representative and Senator on issues important to current and future retirees. The voting record looks at ten key votes in both the Senate and the House and assigns a “Pro-Retiree” score for each member of Congress. Scores reflect a member’s level of support for retirees and older Americans.
This year, votes examined include whether to:
Privatize Medicare and create a voucher-like system in its place;
Turn Medicaid into a block grant system, which would undercut its ability to provide care for millions of older Americans;
Raise the minimum wage; and
Increase the debt ceiling and keep the government open…
In total, 49 members of the Senate and 135 members of the House received perfect scores of 100 percent. 34 Senators and 122 House members received zeros. Of those members of the Senate who have declared their candidacy for President, Ted Cruz (R-TX), Marco Rubio (R-FL), and Rand Paul (R-KY) scored zero while Bernie Sanders (I-VT) scored 100%.
I hope my peers break the mold of American ignorance and vote in their own general interest instead of believing what politicians say – versus what they actually do.
There’s an interactive map at the ARA site so you can check up on your own state.
“What do we do, now?”
Even as the Senate remains at an impasse over the future of US domestic surveillance powers, the National Security Agency will be legally unable to collect US phone records in bulk by the time Congress returns from its Memorial Day vacation…
The administration, as suggested in a memo it sent Congress on Wednesday, declined to ask a secret surveillance court for another 90-day extension of the order necessary to collect US phone metadata in bulk. The filing deadline was Friday, hours before the Senate failed to come to terms on a bill that would have formally repealed the NSA domestic surveillance program…
It represents a quiet, unceremonious end to the most domestically acrimonious NSA program revealed by whistleblower Edward Snowden, in a June 2013 exposé in the Guardian – effectively preempting a bid by GOP leader Mitch McConnell to retain it. But McConnell and other Senate Republicans intend to continue their fight to preserve both that program and other broad surveillance powers under the Patriot Act…
I hope no one expected leading Republicans to support unfettered privacy for Americans other than themselves.
“The Senate is in gridlock, but the tides are shifting,” Michael Macleod-Ball of the American Civil Liberties Union’s Washington office said Saturday. “For the first time, a majority of senators took a stand against simply rubber-stamping provisions of the Patriot Act that have been used to spy on Americans…
It is unclear how the House will vote if its choices are pushed to the extremes that the Senate impasse has set up: all the post-9/11 domestic surveillance powers under the Patriot Act or none of them.
The NSA and the Obama administration have conceded that the bulk domestic phone records collection has never stopped a terrorist attack. Even though the administration has taken as a fallback position the line that the FBI surveillance powers under Section 215 are crucial for domestic counterterrorism, a Justice Department inspector general’s report issued on Thursday “did not identify any major case developments that resulted from use of the records obtained in response to Section 215 orders.”
I was heartened by the actions of a New Mexico Senator I haven’t followed as well or as long as I have Tom Udall. That is Martin Heinrich. I wasn’t surprised by Rand Paul’s grandstand opposition. After all, he’s running for president. Heinrich has nothing to run for other than re-election and that is with a base that is highly dependent on government funding for every military-industrial gewgaw since the invention of the Cold War.
Apprehensive as I am of Democrats who talk like they’re prepared to stand up for working class families and constitutional rights, civil rights and civil liberties – Martin Heinrich appears ready to walk the walk, as well.
SolarCity Corp. Chief Executive Officer Lyndon Rive doesn’t want his customers defecting from the power grid — unless they live in Hawaii.
The biggest U.S. residential solar installer expects to offer by next year a package that combines solar panels, batteries and a back-up generator, and will supply all the power needed by residential customers.
In Hawaii, home to the highest U.S. electricity rates, using the setup to disconnect from the power grid may save people as much as 15 percent compared to their local utility bills, Rive said in an interview on Bloomberg Television.
In other states, utilities would benefit from millions of homes with batteries and solar panels, by tapping the stored electricity during periods of peak demand when the local grid needs extra capacity. Having people disconnect from power grids is a symptom of poorly designed regulations.
“It’s bad policy that got us there,” Rive, 38, said in the interview in San Francisco.
Utilities in states from Arizona to Wisconsin are seeking changes to rates and adding fees for residential customers with solar power, to offset lost revenue from the growth of companies like SolarCity.
Most public utilities are as incompetent as elected officials from the two weasel parties we’re allowed. Instead of working to combine alternative power sources and systems, they’re like craft unions or guilds in the 19th Century trying to protect their fiefdom instead of moving to the collective benefits of modern tech.
Our family is convinced of the benefits of solar technology for all the good reasons – from health and sane energy production to long-range reduced cost. Our public utility here in New Mexico is as backwards as any. Perfectly willing to lie and cheat to maintain their guaranteed profits regardless of environmental and cost negatives. They misstated their cost of maintaining coal-burning plants by a billion dollar$, they’re already trying to push pandering state politicians into a regressive tax on homeowners who convert to solar power – even grid-tied systems.
Useless enemies of progress. It will be their policies that determine whether we go grid-tied or off the grid when we convert our little compound to solar.
Oh yeah. Before going to bed, last night, I caught the end of Rive’s interview with Emily Chang on BLOOMBERG WEST. He obviously has little confidence in either public utilities corporations or state regulators doing anything sensible. He figures Solar City will end up bringing the Hawaiian model as an option to all the mainland states.