The Health Care Blog – Page 968 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

Mixed reception for hospital ID bracelets

Sep 26, 2008• 2

By Sarah Arnquist

Color-coded hospital bracelets intending to identify categories of patients and prevent errors by ensuring they receive proper care have received a mixed reception, the New York Times reports.

Red bracelets indicate allergies, amber says the patient has a falling risk and purple tells hospital staff that the patient has a not resuscitate order. The DNR bracelets seem to be attracting the most criticism.

Apparently, the Joint Commission warns that the purple bracelets may "brand" patients by their end-of-life choice, and may upset family members unfamiliar with the patient’s wishes.

Are those really legitimate reasons for blocking greater uptake of this seemingly simple and pragmatic strategy to improve patient care and ultimately deliver the care the patient wants?

A Genius Shines…And, Where the Light Doesn’t, Hospitals Don’t

Sep 25, 2008

By Michael L. Millenson

It doesn’t take a genius to figure out that hospitals could dramatically reduce the hundreds of thousands of deaths and injuries they unintentionally cause patients ever year, but it may take a genius to coax change out of ossified organizations. As for getting hospitals to publicly disclose injuries and deaths the law says they must? That’s another story entirely.

On the good news front, The MacArthur Foundation has just honored Johns Hopkins’ Dr. Peter Pronovost with a “genius award,” the informal moniker for the go-and-do-smart-stuff prize given to MacArthur Fellows.

Pronovost, you may recall, is the critical care physician who came up with the idea of culling lengthy guidelines on error prevention in the ICU into a simple checklist of five precautionary steps. When tested in ICUs throughout Michigan, the result was to “change the culture of [the] institutions in the interest of reducing the risk of medical errors and hospital-acquired infections,” the foundation noted. “Pronovost’s checklist intervention yielded a significant and sizeable decrease in rates of infection and is currently being replicated by hospitals across the U.S. and Europe.”

Some good news in health care, really

Sep 25, 2008• 5

By Jocelyn Guyer

Even as the economy has fallen into an abyss and I find myself with distressing frequency discussing with people whether Levi Johnston really loves Bristol Palin, it turns out that there is actually some good news out there about health coverage. Over the past year, 19 states have taken significant strides toward covering more children despite challenging fiscal times. At a National Health Policy Forum last week, three states explained their progress. And, no, the featured states weren’t the usual suspects like Massachusetts with its impressive, but so-complicated-that-you-need-an-MIT-degree-to-untangle-it system or Vermont with its population of 62 people and 4 dairy farms. They were Louisiana, Iowa, and Pennsylvania.

Here are the details of what they’ve done:

If you can stay awake, the candidates’ health plans explained

Sep 25, 2008• 2

By Sarah Arnquist

The New England Journal of Medicine and Harvard University teamed up to bring you this compelling, hour-long nail-biter of Gail Wilensky and David Cutler discussing their respective candidates’ health plans.

I wonder if the NEJM has had to buy more bandwith to support the flood of viewers?

In all seriousness, I think it’s great the NEJM is sponsoring this type
of dialogue. It probably won’t reach many people, but it might reach
and influence those who have the potential to influence others — legislative staffers,
journalists, doctors and health care leaders.

There have been calls recently for more serious coverage of the candidates’ health care issues. We need a mix of coverage. This kind of wonky dialogue and the kind that ordinary folks read and watch — yes that 800-word explainer story with a few pithy quotes.

Speaking of ordinary folks …

Sep 25, 2008• 3

By Sarah Arnquist

PBS will air its film, "Critical Condition," at 9 p.m. Tuesday Sept. 30. Here’s what PBS says about the film:

What happens if you fall sick and are one of 47 million people in America without health insurance? "Critical Condition" by Roger Weisberg ("Waging a Living," P.O.V. 2006) puts a human face on the nation’s growing health care crisis by capturing the harrowing struggles of four critically ill Americans who discover that being uninsured can cost them their jobs, health, home, savings, even their lives. Filmed in vérité style, "Critical Condition" offers a moving and invaluable expose at a time when the nation is debating how to extend health insurance to all Americans.

Immediately after the film, Susan Dentzer, health correspondent for
"The NewsHour With Jim Lehrer," will moderate a discussion with
spokespersons for McCain and Obama and other health policy experts.

Study Shows Unpaid Medical Bills Put Families in Debt

Sep 25, 2008• 2

By Shuka Kalantari

While the federal government plans to bail out the financial sector with $700 billion of taxpayer dollars, a growing number of tax payers are grappling to get themselves out of debt from unpaid health care bills.

Yesterday’s New York Times discussed two studies released on Wednesday by the Kaiser Family Foundation and the Center for Studying Health System Change. The studies show that more and more American families have debt from health care.

"Premiums for employer-sponsored health insurance rose to $12,680 annually for family coverage this year – with employees on average paying $3,354 out of their paychecks to cover their share of the cost," said the Kaiser Family Foundation news release of the study.

Bill of Health — a Good move

Sep 24, 2008• 5

By Sarah Arnquist

Good Magazine has this interesting graphical representation of the problems facing health care in the U.S. Considering how complex health care is, I think it’s a great attempt to put lots of information visually on one page to provoke conversation. The visual aspect is key because few people have the patience or desire to read long diatribes.

Evidence of a Need for Change

Sep 24, 2008• 4

By THCB Staff

The Health Care Blog regular Michael Millenson wrote a great piece recently in Miller-McCune Magazine on the necessity of practicing more evidenced-based medicine, and why it’s not happening.

Here is a powerful snippet but it’s definitely worth checking out in its entirety.

Experts believe that a stunning 20 to 40 percent of the $2.4 trillion America spends on health care in 2008 will be wasted on misuse (including harmful and fatal errors), overuse (care that’s unnecessary) or underuse ( effective care that’s not provided). If you take a midrange figure — let’s say 30 percent — you end up with $720 billion in savings. That’s enough in health care savings to pay the cumulative costs of the Iraq war (about $560 billion by mid-September 2008) and still have enough cash left over to pay for universal health care and the entire federal education budget. If you simply sent out a rebate check, it would come to some $2,100 for every man, woman and child in the country.And that’s just one year of savings.The failure to follow best practice carries a price tag in human lives, too, and it is equally enormous. Providing appropriate, effective and safe care where we know how to do it — no “medical mysteries” included — could annually prevent the deaths of hundreds of thousands of Americans in and out of the hospital and millions of injuries.

Divying the pain

Sep 24, 2008

By Jim Jaffe

When campaigning politicians talk about reforming America’s health care system, they’re understandably quiet in identifying who will take the pain that will ultimately be allocated between the three basic groups involved –- patients, providers and payers.

If politicians ever get serious about reform, their big challenge will lie in finding a balance that at least two of these groups find tolerable. They’re not serious yet.

A new analysis this week by the Tax Policy Center confirms that, giving neither presidential campaign credit for doing anything to cap costs and sensibly concluding that the bottom line here is that insuring more people requires spending more money (Obama’s plan, it concludes spends more money more efficiently to insure many more people).

So the current spate of ads on the topic may seem a bit puzzling. Here’s how to decode them.

Health reform prospects in the wake of Black Sunday

Sep 23, 2008• 20

By Jane Sarasohn-Kahn

"Opening up the health insurance market to more vigorous nationwide competition, as we have done over the last decade in banking, would provide more choices of innovative products less burdened by the worst excesses of state-based regulation," said John McCain to a reporter in an interview in Contingencies magazine. The article is titled: "Better Care at Lower Cost for Every American."

This isn’t a Photo-shopped, made-up comment. See page 30 of the publication, the last paragraph in the left hand-column which continues into the right side.

Contingencies is the magazine of the American Academy of Actuaries. These are those sober professionals who, according to their mission statement, "put a price tag on risk." They do that through evaluating the likelihood of future events, and, in their words, "designing creative ways to reduce the likelihood of undesirable events."