Posts Tagged ‘Healthcare’
A group of 18 doctors, researchers and public health experts have jointly urged the Food and Drug Administration…to take action on energy drinks to protect adolescents and children from the possible risks of consuming high amounts of caffeine.
“There is evidence in the published scientific literature that the caffeine levels in energy drinks pose serious potential health risks,” the doctors and researchers wrote.In their letter to Dr. Margaret A. Hamburg, the F.D.A. commissioner, the group argued that energy drink makers had failed to meet the regulatory burden placed on them to show that the ingredients used in their beverages were safe, specifically where children, adolescents and young adults are concerned. As a result, the group urged the F.D.A. to restrict caffeine content in the products and to require manufacturers to include caffeine content on product labels…
Less is known about the safe level of caffeine for a young teenager, experts say, apart from the fact that it is considered to be lower than for an adult. In their letter Tuesday to Dr. Hamburg, the group of researchers and scientists also pointed out that makers of energy drinks aggressively marketed their products to young teenagers and urged them to consume the drinks quickly. Including mixing them with booze!
In recent years, the number of reported emergency-room visits in which an energy drink was cited as the primary cause of a health problem, or a contributing factor, has grown sharply. In 2011, there were 20,783 such visits, compared with 10,068 in 2007. Problems typically linked to excessive caffeine consumption can include anxiety, headaches, irregular heartbeats and heart attacks.
Probably overdue. At least until and unless reasonable research indicates otherwise. Think we can count on the FDA to encourage that?
A common phrase in the current debate over the so-called fiscal cliff is “Medicare needs to be restructured.” The term serves as code for policies unlikely to be appealing to voters, a term that can mean everything and, thus, nothing.
The question is what problem restructuring is to solve in traditional Medicare, which remains one of the most popular health insurance programs in this country. People who use this vague term should always be challenged to explain exactly why and how Medicare should be changed.
Critics of traditional Medicare – even those who should know better – often accuse it of being “fee for service.” It is a strange accusation. After all, fee-for-service remains the dominant method of paying the providers of health care under private insurance, including Medicare Advantage, the option of private coverage open to all Medicare beneficiaries.
Describing Medicare as fee-for-service insurance is about as thoughtful as describing a horse as “an animal that has four legs,” a characteristic shared by many other animals. The practice is particularly odd, given that traditional Medicare as early as the 1970s was the first program to develop so-called “bundled payments” for hospital inpatient care – the diagnostically related groupings, known as D.R.G. – in place of fee-for-service payment of hospitals, an innovation that has since been copied around the globe.
A more descriptive term for traditional Medicare would be “free choice of providers” or “unmanaged care” insurance. These features, of course, would hardly be viewed as shortcomings among people covered by traditional Medicare or their families. Neither term would be a good marketing tool among voters for proposals to abandon traditional Medicare…
A case can be made, on theoretical and sometimes empirical grounds, that properly managed or coordinated care can on average yield superior medical treatments, at lower cost, than completely unmanaged care under classical indemnity insurance.
The problem has been and continues to be that this is not the folklore among patients or doctors. The latter, as noted, generally believe they can manage their patients’ care properly without outside interference into their clinical decisions. Among patients and doctors, the term managed care is still not quite respectable.
This can explain why critics of traditional Medicare delicately but nonsensically prefer to decry it as being fee for service rather than as free-choice-of-providers insurance or unmanaged-care insurance.
I hadn’t seen Uwe Reinhardt on television in a spell when he popped up on Tom Keene’s SURVEILLANCE yesterday morning on Bloomberg TV. I had forgotten his dry wit and political economist’s accurate simplicity of definitions. The folks I can understand the easiest also often make the most sense.
This blog post is one the earliest of his current series on Medicare.
Meanwhile, click the link and RTFA. Education, it’s wonderful.
Three years ago, at the height of the debate over health care reform, there was an uproar over a voluntary provision that encouraged doctors to discuss with Medicare patients the kinds of treatments they would want as they neared the end of life. That thoughtful provision was left out of the final bill after right-wing commentators and Republican politicians denounced it falsely as a step toward euthanasia and “death panels.”
Fortunately, advance planning for end-of-life decisions has been going on for years and is continuing to spread despite the demagogy on the issue in 2009. There is good evidence that, done properly, it can greatly increase the likelihood that patients will get the care they really want. And, as a secondary benefit, their choices may help reduce the cost of health care as well.
Many people sign living wills that specify the care they want as death nears and powers of attorney that authorize relatives or trusted surrogates to make decisions if they become incapacitated. Those standard devices have been greatly improved in recent years by adding medical orders signed by a doctor — known as Physician Orders for Life Sustaining Treatment, or POLST — to ensure that a patient’s wishes are followed, and not misplaced or too vague for family members to be sure what a comatose patient would want…
With these physician orders, the doctor, or in some states a nurse practitioner or physician assistant, leads conversations with patients, family members and surrogates to determine whether a patient with advanced illness wants aggressive life-sustaining treatment, a limited intervention or simply palliative or hospice care.
The health care professional then signs a single-page medical order telling emergency medical personnel and other health care providers what to do if the patient is incapacitated. In most states, the patient or surrogate must also sign the medical order to indicate informed consent. The orders are conspicuously highlighted in a patient’s electronic medical record and follow patients from one setting to another — such as a hospital emergency room or nursing home — so that any health professional handling the case will know what interventions the patient might want…
No matter what the death-panel fearmongers say, end-of-life conversations and medical orders detailing what care to provide increase the confidence of patients that they will get the care they really want. In some cases, that could well mean the request to be spared costly tests, procedures and heroic measures that provide no real medical benefit.
RTFA for a broad understanding of your rights. It’s easy to drag your feet and put off a living will. The prospect ain’t exactly thrilling. But, do it – pay attention to the suggestions in this article and push your physician to cooperate if they must be pressed. Most are already ahead of you on this question.
Meanwhile – back in the US, back in the US, back in the US of A
France is set to reimburse 100 percent of the cost for all abortions, and provide free contraception to girls aged between 15 and 18 under a bill passed by France’s Lower House on Friday.
At present French women can only claim back between 70 and 80% for the operation, which can cost up to 450 euros.
The move to full reimbursement is designed to improve women’s access to abortions, and was included in the 2013 social security budget and a specific campaign promise of President Francois Hollande.
By allowing free contraception, France hopes to reduce the number of unwanted pregnancies and abortions.
Everywhere free contraception has been introduced, this is exactly what has happened. A bit of education helps, as well.
The much publicised move was welcomed by Martine Hatchuel, president of ANCIC, the French Association which counsels women on contraception and abortion. “It’s about time,” she said previously. “Minors should have access to contraception and it should be free and anonymous. But unfortunately just because a girl reaches 18 doesn’t mean she is out of the woods, and we would like to see this extended to women aged 25.”
Keep on rocking in the Free World. We’ll catch up to France on healthcare, some day.
Republican panel on birth control – no one who could possibly get pregnant!
A new study by researchers at Johns Hopkins University shows that fulfilling unmet contraception demand by women in developing countries could reduce global maternal mortality by nearly a third, a potentially great improvement for one of the world’s most vulnerable populations.
The study…comes ahead of a major family planning conference in London organized by the British government and the Bill and Melinda Gates Foundation that is an attempt to refocus attention on the issue…
The issue of family planning is fraught in the United States, where government assistance often gets caught up in political battles. Contraception has again become controversial this political season, though the United States remains a major donor…
This is only controversial in the minds of the mindless, backwards religious and rightwing nutballs — and cowards afeared of confronting them..
Maternal deaths have declined dramatically since 1990, down by a third, according to the World Health Organization…But about 16 percent of the world’s population lives in countries where fertility is still more than four children per woman, Mr. May said. The numbers of people are expected to more than triple in these places during this century, an issue that is urgent not only for their economies and environment, but also for the women themselves, who women’s rights advocates argue would benefit from more power to decide about bearing children…
Birth control reduces health risks, the researchers said, by delaying first pregnancies, which carry higher risks in very young women; cutting down on unsafe abortions, which account for 13 percent of all maternal deaths in developing countries; and controlling dangers associated with pregnancies that are too closely spaced.
Reactionaries hate and fear independent women, women who govern and guide their own lives – almost as much as they fear the liberty they prattle about in the dim halls of phony debate.
Politicians who chair hearings on why women should obey priests and pundits – without inviting a single female voice – are the signal example of what this discussion is about. Foolish men trying to hold onto a past when they believe silent and obedient citizens were the happiest in history.
Average life expectancy is one of two statistics commonly used to compare the health-care systems of different nations. (The other is infant mortality.)
One of the puzzles about the U.S. system is that we spend far and away the most money per capita for health care, but we rank 50th in average life expectancy — after Macau, Malta, and Turks and Caicos, among others.
We are all familiar with statistics about how much of health-care spending takes place in the last year of life, and with stories about old people who are tortured with costly treatments they don’t want and which prolong dying but don’t extend life in any meaningful sense.
Certainly, ailing old people should be allowed to die in peace, if that’s what they want, and not be subject to excruciatingly painful surgeries and drugs that will do nothing for them. These are more the fault of lawyers than doctors. In our experience, doctors can be all too cool and rational in their thinking about the end of life. It’s fear of lawsuits (or, in a few cases, trolling for customers) that prevents doctors from behaving rationally when prescribing treatment for the old and terminally ill…
So what do we do about old people who, on balance, would rather get even older — whatever that means in terms of “quality of life” — than give up? This is one of the indelicate, unmentionable questions in the health-care debate…
In short, all the Republican talk during the health-care- reform debate about “death panels” was melodramatic and unfair, but not ridiculous. One way or another, holding down health-care costs will require policies that deny treatment to people who want it. And want it because it will extend their lives.
This goes on already, all the time. Health insurance companies have been known to deny payment for treatments deemed unnecessary. Age limits for organ transplants are another example. All policies that involve denying care because of “quality of life” considerations are, in effect, “death panels.” But no society can afford to give every citizen every possible therapy…
How do you persuade fellow citizens to accept limits on their right to consume health-care resources? The trick, we think, is to ask them when they’re healthy, not when they’re sick. If you think a $200,000 operation is going to give you a few more years to live, it’s going to be hard to convince you that it’s not worth the cost. But before then, when your odds of needing that expensive operation are the same as everybody else’s, you might well choose a system that offers a higher life expectancy, even though it costs less. In fact, why wouldn’t you?
Bloomberg View articles don’t always try to answer the questions they ask. This is one that sort of suggests alternatives; but, the final resolution isn’t settled yet. We’re stuck with politicians, insurance companies, healthcare corporations and their own versions of “death panels” in charge of negotiating with us.
You already know who has the most power in that dialectic – and it ain’t us.
Flora Goldberg filed her tax return last year – but someone had beaten her to it
Besieged by identity theft, Florida now faces a fast-spreading form of fraud so simple and lucrative that some violent criminals have traded their guns for laptops. And the target is the United States Treasury.
With nothing more than ledgers of stolen identity information — Social Security numbers and their corresponding names and birth dates — criminals have electronically filed thousands of false tax returns with made-up incomes and withholding information and have received hundreds of millions of dollars in wrongful refunds, law enforcement officials say.
The criminals, some of them former drug dealers, outwit the Internal Revenue Service by filing a return before the legitimate taxpayer files. Then the criminals receive the refund, sometimes by check but more often though a convenient but hard-to-trace prepaid debit card.
The government-approved cards, intended to help people who have no bank accounts, are widely available in many places, including tax preparation companies. Some of them are mailed, and the swindlers often provide addresses for vacant houses, even buying mailboxes for them, and then collect the refunds there…
The fraud, which has spread around the country, is costing taxpayers hundreds of millions of dollars annually, federal and state officials say. The I.R.S. sometimes, in effect, pays two refunds instead of one: first to the criminal who gets a claim approved, and then a second to the legitimate taxpayer, who might have to wait as long as a year while the agency verifies the second claim…
Florida, with its large population of elderly residents and health care facilities, provides a wealth of opportunities for swindlers. South Florida, which had the highest rate of identity theft in the nation, and Tampa have been hit hardest…
“The I.R.S. is doing what they can to prevent this, but this is like a tsunami of fraud,” Mr. Ferrer said. “Everywhere I go, every dinner, every function I attend, someone will come up to me and tell me they are a victim — people in this office, police officers, firefighters…”
The agency, prodded by lawmakers and the public, is moving more aggressively to stop the avalanche. It has increased the number of investigators, put in place better technology that flags more returns, distributed personal identification numbers to victims for the next filing season and hired more workers to help taxpayers get their refunds. The agency, which had $300 million cut from its budget this year, has invested the same amount in combating the problem…
Fraudulent filers first used names and Social Security numbers of the deceased to file claims. The numbers become public by law and, until recently, were easily available on popular genealogy Web sites. Swindlers also used the Social Security numbers of prisoners.
When officials cracked down on those two avenues, the theft migrated to anywhere Social Security numbers are collected. Most vulnerable are records from health care facilities, assisted-living centers, schools, insurance companies, pension funds and large stores that issue credit cards. The police say employees steal the information and sell it, an increasingly common practice here.
Everyone is susceptible. Two dozen Tampa police officers, including one whose job it is to investigate identity-theft fraud, had their identities stolen and their tax refunds diverted this year.
There are many ways to fight this kind of crime. It ain’t going to be solved by people suddenly learning about identity theft and countering it online. Not while there isn’t any shortage of petty crooks hired to work in healthcare facilities and corporations – because they work for cheap. Cheap, that is, until the thefts start to roll through the ID’s they’ve stolen from the records they process.
A solid national ID system might work. Between Ron Paulistas and the earned distrust of government – don’t hold your breath waiting for that one. The IRS policy of issuing a special private ID is helpful up to a point. If everyone wants one – Congressional Republicans will be certain to put a stop to that “unneeded” expense. Just as they cut $300 million from this year’s budget because, after all, who wants the IRS to do a more efficient job?
I check on my ID a couple times a month. And the first couple of days the info for my income tax return is available – it gets filed. I just hope I can stay ahead of the crooks.
A healthcare think tank founded by Newt Gingrich has filed for bankruptcy, piling further humiliation on the Republican presidential hopeful following the virtual collapse of his campaign.
In the interim between resigning as Speaker of the House in 1998 and announcing his bid for the presidency last year, Mr Gingrich set up a number of businesses, including the Gingrich Group, a healthcare advisory company.
Records show that that the business, which was at the heart of a collection of Gingrich-run firms referred to as ‘Newt, Inc.’, filed for bankruptcy in Atlanta on Wednesday. The company, also known as the Centre for Health Transformation, owed debts of between $1 million and $10 million to a group of fewer than 100 creditors…
Stefan Passantino, a lawyer for Mr Gingrich’s campaign, said the financial collapse did not happen while the candidate was in charge and would not harm his presidential ambitions.
“If anything, it shows the importance of his leadership while he was there,” he told the Atlanta Business Chronicle. Give me a break!
In reality, Mr Gingrich’s campaign has all but surrendered with the former Speaker rarely venturing far beyond the television studios and the Washington DC area.
His phony fronts for lobbying are as worthless as the lies he told of advising Congress and corporations about history. Gingrich’s understanding of history, his “dedication” to providing improvements in American healthcare are constructs designed to look programmatic – and serve only one purpose: to enrich the corporations that profit from providing healthcare. Regardless of the quality and true value of that product.
You might like your boss or you might hate your boss, but either way there’s probably one place you don’t want your boss hanging around: in your bedroom. But that’s exactly where Republicans want to put your boss — in your bedroom and in between you and your doctor when it comes to making your own personal health care decisions.
Here’s the rundown of this week’s battle in the conservative war on birth control and women’s health care.
WHO: Sen. Roy Blunt (R-MO) and allies including Sens. Scott Brown (R-MA), Marco Rubio (R-FL) and Kelly Ayotte (R-NH).
WHAT: Legislation that would allow ANY employer or insurance company to deny ANY essential or preventative health care benefit for essentially ANY reason. Benefits that could be denied include:
mental health coverage
This bill is so extreme that if your boss believed in healing exclusively through the power of prayer, he would have sufficient legal grounds to deny you coverage for various medical conditions. If your boss had a moral objection to single mothers, he could deny unmarried pregnant women prenatal coverage. Or if your boss had a “moral” objection to overweight people, diabetes screenings would not have to be covered.
Republican hostage-taking sophistry demands they attach this rider to a highway and transportation bill that supports at a minimum 1.8 million jobs. They couldn’t care less about the jobs – but, letting you have insurance governed by medical and scientific standards is counter to their commandment that says our lives must be governed by their religion-of-the-month.
The worst kind of hypocrisy still infects Congress. Their acceptable-rating among American voters is now down to 10% and the self-righteous pimps for theocracy continue as if nothing is still as important as chaining papier mache morality to every aspect of our recovering economy. We can only hope that the diminishing number of voters willing to admit to being Republicans join the rest of the United States, Democrat and Independent alike, in shoving these clowns out the door in November. Getting an honest job would be the best thing that ever happened to their morality.
If there’s one thing Republicans and other pretend-Libertarians hate is letting people make their own choice. They want to limit the possibility that we might not go along with whatever archaic ignorance about biology is popular this year with bigots.
Put all the choices into play via our insurance. If we don’t want them – we don’t have to use them; but, the choice should be ours – not our employers, not Congress.