The health care crisis-formerly Kitzhaber/Archimedes

[Guest guest]

OR DCs,

I find the discussions

in regard to the health care system interesting, especially the range of

perspective offered by those on the list who have weighed in on the topic.

The problem is

systemic. Solutions are likely to require more than tinkering around the

edges. But real change is also sure to stir up all of the interest groups

around the table (patients, various advocates, powerful commercial interests,

health care providers, to name a few). I don’t have any magic to

offer (and many of you probably think I’m part of the problem

<grin>). As near as I can tell, the bottom line is that the current

system is not sustainable. At a certain point, the need for health care

resources will far outstrip the ability to pay for it. What then?

But I have run across

today in my email any number of items that play into what I see as a very deep

and complex problem.

End of life care…

Dr. DeBakey was

97-years-old and had decided that he didn't want to endure the surgery

necessary to repair the defect… The surgery, performed in early February

2006, bought Dr. DeBakey at least one more year, but at the cost of a long,

painful, and difficult recovery marked by kidney failure and dialysis, a

tracheostomy, six weeks of mechanical ventilation, parenteral feedings, and the

possibility -- although not the eventuality -- of brain damage.

The bill -- no one is

quite sure of the amount, and Methodist

Hospital here won't

comment -- is estimated to be well more than $1 million. http://www.medpagetoday.com/Surgery/GeneralSurgery/dh/4808

The impact of US health care costs on global

competitiveness…

Health spending is

rising faster than incomes in most developed countries, which raises questions

about how these countries will pay for future health care needs. The

issue may be particularly acute in the United States, which not only spends

much more per capita on health care than any other country, but which also has

had one of the fastest growth rates in health spending among developed

countries. Despite this higher level of spending, the United States

does not achieve better outcomes on many important health measures.

http://www.kff.org/insurance/snapshot/chcm010307oth.cfm

The power of “big pharma”…

The pharmaceutical industry claims the advertisements educate patients

about health, inform them about new treatments, and encourage them to talk to

their doctors about important health concerns. Opponents, however, argue the advertisements

are simply that: advertisements, most of which push expensive new drugs even

when less expensive and often safer treatments, or even no treatment at all,

would suffice.

A new US

government report suggests such concerns are warranted. The report was

published by the US Government Accountability Office (GAO), a

non-partisan investigative and research agency of the US Congress. The report

reviews direct-to-consumer advertising in the USA

and examines how well the US

Food and Drug Administration (FDA) oversees these advertisements. The

investigators found the oversight was lax.

http://www.thelancet.com/journals/lancet/article/PIIS0140673607600014/fulltext

The uneven and unpredictable influence of evidence-based

health care…

When a sophisticated

electrocardiogram test appears to rule out the need for an implanted

cardioverter-defibrillator (ICD) in ischemic cardiomyopathy, the results are

frequently ignored, according to researchers here and Cincinnati… As a result, perhaps 30% of

ischemic cardiomyopathy patients who prove negative by microvolt T-wave

alternans (MTWA) are given an ICD device anyway, even though the test reveals

no increased risk of sudden death, the researchers reported in the January

issue of the Journal

of the American College of Cardiology.

http://www.medpagetoday.com/Cardiology/AcuteCoronarySyndrome/dh/4807

And finally, the insurance industry…

Insurers

Overcharge Consumers, Advocates Say

by Arnold

Morning Edition, January 8, 2007 · Consumer advocates release data

showing auto and home insurers charge a lot more in premiums than they pay out

in claims. The insurance industry disputes the findings.

A. Simpson, DC

Vice President, Medical Director

Complementary Healthcare Plans

6600 SW 105th

Avenue, Suite 115

Beaverton, OR 97008

503-619-2041

csimpson@...