Thursday, February 26, 2009

Medical Reform School

WASHINGTON (Reuters) - President Barack Obama would reform the healthcare system with a 10-year fund of $634 billion in a budget proposal he put forward on Thursday. He offered few details but the budget reflects new priorities:

* It stresses a shift from an unwieldy paper-based health system in which doctors and clinics share little information to health information technology, including electronic records.

_______ Ah, remember when computers first came on the scene a few decades ago and we were told by boasting giddy voices the machine would reduce paperwork. Well, anyone who has ever worked in most any field knows that never came true and never will - simply because so much still has a hard copy from which the information is entered into the computer; and a hard copy is excellent CYA if anyone tampers, screws up, or loses electronic records. And those never ending printouts that have to be filed.

* Obama is gambling that although costly in the beginning, the system will reduce errors caused by poor communication and scribbled prescriptions, save tens of thousands of lives every year and billions of dollars that go into the federal Medicare and Medicaid health insurance programs.

_______The majority of deadly errors made are human stupidity and carelessness - and that will continue whether done from a keyboard or handwritten. Currently, written medical information (rx, orders, tests, etc.) are seen by several sets of eyes (physicians, nurses, pharmacy, transcribers, techs), hence more chance of spotting errors. With higher tech methods and a single person directly entering the incorrect drug or dosage or a procedure, it will almost certainly go unnoticed. People tend to have faith that if a computer says so - it must be correct, never mind that computers are only as smart as the person entering the data; even if the computer says you cannot give that much heparin to a newborn how long will it take to chase the chain of command to set it right, and if it's an emergency? Have you seen the young doc whizzing through the hospital p.c. touch screening prescriptions, procedures, labs, etc.? Have you seen him proofread or double check anything? For the love of god, he has to tee off at 3.

* The budget includes a controversial $1.1 billion measure for the federal government to get into the business of comparing medical treatments. This is often left up to the private sector now, and drug companies have little interest in proving the benefits of cheap, generic treatments although studies have shown they often work better against disease such as heart failure and diabetes.

_______ Another government bureaucracy is born. Billions of dollars to compare the fact that Dollar Store aspirin works as well as Percocet on that stress headache - but you can't get high on aspirin, and since you eat narcotic pain killers like candy for those headaches you can't substitute an aspirin because it eats your stomach - better to be a prescription hophead.

* It allocates $6 billion for cancer research at the National Institutes of Health. Cancer is the No. 2 killer of Americans and costs billions of dollars. For instance, the U.S. Agency for Healthcare Research and Quality estimates the average hospital cost for a single lung cancer patient in 2006 was $14,200 or about $1,900 a day. The total cost for all lung cancer patients was about $2.1 billion in 2007.

_______ Over the last few decades trillions have been spent on cancer research, and some advances have been made for certain types of cancer, yet the 3 oldest ancient forms of treatment are still the norm - cut, burn, poison. Overall, this money would be better spent on preventive health maintenance rather than research on how to cut, burn, poison us more effectively. Besides, there is ample cancer research already, here and worldwide.

NIH will hand out the $6 billion in the form of grants; the same NIH which a couple of years ago "Following a string of high-profile scandals, the US government ... pushed for stricter oversight of grants given by the National Institutes of Health (NIH). The trend has many researchers worried that they might have to start accounting for their time and money or face being investigated."

What? Hold researchers and their institutes accountable? Have you lost your mind? These men are gods, gods, I tell you. Also, can someone tell me who the US government "pushes" when it wants stricter oversight? Does it push itself, reluctantly?

The typical "scandal" involves doctors/researchers, recipient of grants, who were also receiving payments from pharmaceutical companies. Or testing drugs on minority foster children.

But! There will be "government oversight." Yessirree, because someone in the government is going to push for it.

* The budget proposes cleaning up inefficiencies and reducing overpayments in Medicare, the federal health insurance plan for people over 65 and the disabled, which covers 45 million people and makes up 13 percent of federal spending.

_______Whut? No more medi-millionaires/billionaires? Like Bill Frist and HCA.

* The budget says that using more competitive bids for Medicare will save more than $175 billion over 10 years. Critics call this unrealistic.

_______ When the government claims it will save money anywhere at anytime on anything, I call it bullshit.

"Competitive bids" - that's politicalspeak for top companies who work out an arrangement and take their turn feeding at the trough. Sort of like mafia dons agreeing on how much and who gets a cut of the take.

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