Where was the medical profession? Doctors are supposed to feel an acute responsibility to deliver the best health service to the whole population. It is on this basis that they ask the public and government to support generous pay increases and terms and conditions of service. These attitudes and behaviours are what we commonly mean by professionalism. It seems that doctors failed completely to live up to the rhetoric of their commitment to professional values. Read more
Tag Archives: health care
The Affordable Care Act and the Civil Rights Act
The Civil Rights Act barred private businesses such as hotels, bus companies, and restaurants from refusing to sell their products or services to customers on the basis of race. The ACA bars state-licensed health insurers from refusing to sell products to individuals on the basis of health status. … This basic reconceptualization of health insurance as a good whose availability is a matter of national public interest essentially frames health insurance the way the Civil Rights Act framed other business interests. Read more
The tyranny of health then and now
When we hear the words “tyranny of health” these days, it’s usually a reference to the tyranny of health care. It brings to mind images of protesters carrying signs that denounce the “socialism” of Obamacare. As recently as 1994, however, the tyranny of health had a different meaning … the idea that patients should be coerced into being healthy. Read more
“Tyranny of health” on KevinMD
That we’re not routinely made seriously ill by this shortfall … is due largely to the fact that most medical interventions and advice don’t address life-and-death situations, but rather aim to leave us marginally healthier or less unhealthy, so we usually neither gain nor risk all that much. Read more
Once in a lifetime: Marcus Welby and David Bryne
Marcus Welby was not necessarily the inspiration here, of course. Alienation – and the dissatisfaction that comes with a midlife crisis — pervaded the zeitgeist in the seventies.
Whatever happened to alienation, anyway? Perhaps it fell along with the Berlin Wall. Or succumbed to Prozac. Read more
Health care reform and the 2010 elections
Bottom line: If you want to avoid a government shutdown, or the “dysfunctional and failed republic” scenario, vote on November 2 for candidates who support health care reform. Read more
The tyranny of health
A recent commentary in the Journal of the American Medical Association asks: If individuals don’t use preventive services, “what kind of penalty … would be ethically and morally acceptable?” The question wasn’t “How do we account for unhealthy behavior,” but what punishment would be sufficient either to change that behavior or at least to save money by denying these people health care. Read more
Obama appoints Berwick to head CMS
The obstetrician–gynecologist opposes one of the fundamental assumptions of the new health care law – that physicians should be paid according to the quality of their work, not the quantity. How can you argue against the quality of health care? Burgess spoke on the subject at a recent Health Affairs Media Breakfast:
Burgess came to the defense of the current fee-for-service [FFS] system where the provider is paid for each individual service rendered to a patient. The congressman argued that doctors are “so goal directed that we need that impetus” of FFS as motivation to provide the best possible care. Read more
The indignity of the waiting room
I gathered from conversations among those of us waiting that one man had been sitting in reception since 7 am. Well into his 70s, he was clearly nervous, biting his lower lip and muttering silently to himself. Occasionally, he pulled his appointment letter from his bag to double-check the instructions. He walked to the reception desk to ask what had happened. The same careless shrug, with another, “Just take a seat and they’ll call you”. Unable to see a way through this wall of unhelpfulness, he did as he was told. Eventually, he asked a passing nurse for help. She listened and looked him in the eye. But she said that sorry, she could not assist him. He must wait. Read more
Understanding the Tea Party
National politics may well determine the future of health care. How to make sense of the angry rhetoric coming from the political right. While MSNCB runs antagonizing documentary footage of Joe McCarthy and Pat Buchanan, the New York Times publishes a thought-provoking essay by philosopher J.M. Bernstein. It’s called “The Very Angry Tea Party” (emphasis… Read more
Suicide in Japan (part 2): The Internet and media coverage
There have always been people who wish they were dead, or who have thoughts about voluntary death. But nobody used to be directly encouraged to die. In conventional media, if somebody wrote or said: “I want to die”, the most probable answer was: “Hold on, don’t die!” On the contrary, in the Internet, everybody feels free to write whatever they please under a false name. The moment somebody mentions the intention of committing suicide, original words appear immediately and make their way to the suicide candidate. Horrible words and expressions such as “you are worthless”, “you are dead”, “you don’t deserve to live”, “the world is better off without you” start to appear. … In the Internet’s post modern world, words loose their link with the person responsible for them. … One of the most popular pages for the prevention of suicides had to lower the rule that users only could participate for a maximum 30 minutes, in order to prevent negative emotions from expanding.
Suicide in Japan (part 1): The recession
Some cultural factors exacerbate the problem: lack of religious prohibition against suicide, reluctance to discuss mental health and stress-related problems, a literary tradition that romanticizes suicide, a view of suicide as an honorable act, a way of taking responsibility for failure, among other issues. The breakdown of family and social networks and the increasing isolation of individuals contribute to the problem.
The Economist reviews Kaiser Permanente health care
The “newspaper” The Economist originates in London, but it has a wide circulation, with almost half of its subscribers in the US. A recent issue contained a lengthy opinion of the health care provider Kaiser Permanente (KP). Europeans tend to regard American health care with distain. French President Nicolas Sarkozy commented, after the passage of… Read more
Jack Abramoff and healthcare lobbying
Alex Gibney is probably best known as the director of Enron: The Smartest Guys in the Room. He also produced the documentary Money-Driven Medicine, based on Maggie Mahar’s book of the same name. Gibney’s latest work is Casino Jack and the United States of Money, a documentary about the lobbyist Jack Abramoff. The video excerpt… Read more
The financial crisis: Blame it on the collapse of Communism
Why did the global economy collapse so suddenly, seemingly without warning? Economic experts and political analysts continue to offer explanations, but sometimes an outsider’s viewpoint can be especially illuminating. John Lanchester is a British novelist (The Debt to Pleasure) who stumbled on his insights into the financial collapse while researching a novel. The result is… Read more
Can one communicate in a world of truthiness?
Anonymous Liberal captures the frustration of the current political scene in a post called “An Army of Trumans.” In this Bubble World, it is an accepted truth that our President is a bumbling ignoramus who can only string together a coherent sentence if he uses a teleprompter (which, apparently, other politicians don’t use). I can… Read more
Why we passed health care: WellPoint and breast cancer
Source: People’s World Reuters has a terrific investigative piece on WellPoint’s practice of canceling health insurance, a practice known as rescission. When a woman develops breast cancer, WellPoint immediately flags her for investigation to see if there’s some reason her policy can be canceled. Grounds for cancellation can be anything on the original insurance application… Read more
The health care battle isn't over
Source: About.com Now that health care legislation has passed, special interest groups — insurance and pharmaceutical companies, seniors, businesses, abortion rights opponents – are gearing up to influence the way specific provisions are implemented. Agencies such as the Department of Health and Human Services need to draft regulations that govern implementation. This is where lobbyists… Read more
Andrew Sullivan on the Tea Party
Nice summation of what makes sense and what doesn’t about the Tea Party from Andrew Sullivan at The Daily Dish. His conclusion: In my view, this confluence of feelings can work in shifting the public mood, as seems to have happened. When there is no internal pushback against crafted FNC [Fox News] propaganda, and when… Read more
Civil disobedience and the individual mandate
Source: SFGate “Individual mandate” refers to a provision in the new health care reform act that requires all citizens to purchase health insurance. There are exceptions for those who cannot afford to pay and for those who have religious objections, such as Christian Scientists. Without this provision, health care reform falls apart. If we’re going… Read more
Obama and health care: Deal making with lobbyists
Frontline has put together a documentary on the passage of health care reform. It argues that Obama caved in to special interests at every step of the way and that this is bad news for Democrats. Barack Obama promised change. Then he took on one of Washington’s toughest issues: health care. During his first year… Read more
Our only language is English
Source: Teabonics When President Obama filled out his census form last week, he had to decide how to answer the race question. Even though his selection was only half true, he settled on the “Black, African American, or Negro” option. I noticed Facebook friends struggling with the same issue: If my father’s parents were born… Read more
Reaction to health care: A step backwards
Source: University of Virginia There have been nasty and violent responses to the passage of health care: Spitting on members of congress; chanting the “N” word at black congressmen on their way to vote; images of Nancy Pelosi surrounded by flames; death threats to members of Congress; Republican congressmen on the House floor cheering protesters… Read more
Joe Biden on health care reform
Someone sent this to me, and I can’t find it on the web to give credit to the artist. Read more
"Dad, the 'unfinished business' is done."
Source: The Washington Post Ted Kennedy’s youngest son, Rep. Patrick J. Kennedy, visited his father’s grave on the day after health care reform was passed. He left a hand-written note, written on one of his congressional note cards: “Dad, the ‘unfinished business’ is done.” Senator Kennedy, in a letter delivered to President Obama by Vicki… Read more
The Supreme Court and health care repeal politics
Source: The Economist Attorneys general from 14 states (so far) are filing lawsuits to challenge the constitutionality of health care reform. Some have the support of their Republican governors. Others have incensed their Democratic governors. Orin Kerr, on the conservative/libertarian law professors’ blog The Volokh Conspiracy, gives the odds of repealing the individual mandate as… Read more
Health care: A history of last minute arm twisting
Source: The Truth or the Fight The media love to play the upcoming health care vote as a sporting event, with daily play-by-play analyses of whether Nancy Pelosi will get the 216 votes she needs to pass the reform legislation. Speculations on the vote count are meaningless, however, until the very last minute. Those members… Read more
Olbermann on the damage done by "death panels"
Last October, in a one-hour special commentary on health care reform, Keith Olbermann discussed his father’s illness in personal and graphic detail. Last night he provided an update that began: “Last Friday night my father asked me to kill him.” Visit msnbc.com for breaking news, world news, and news about the economy Olbermann and his… Read more
Health inequities, politics, and the public option
Source: Torontoist Constance A. Nathanson is an American historian of public health. She recently wrote an essay for The Lancet that explains why the public option is such a hot button – one that threatens to confront us with the underlying issue of health inequality. Early in the twentieth century, industrialized nations – with the… Read more
Health care inequality: The US vs. Europe
During last year’s immersion in matters of health care, the US system was frequently compared to those of Canada, the UK, Japan, Australia, and Western European countries. Whether the comparison involved infant mortality, lifespan, or comprehensive coverage, the US fell far behind these other developed countries. The lack of universal coverage is perhaps the most… Read more