new hhs head.

Obama appointed another health care "expert" (this time on lobbying) to his staff. tom daschle.

From wiki: he has signed on as a Senior Policy Advisor with the K Street law firm Alston & Bird.[9][10] Health care interests, including CVS Caremark, the National Association for Home Care and Hospice, Abbott Laboratories and HealthSouth, are among the firm's lobbying clients.[4] The firm was paid $5.8 million between January and September 2008 to represent companies and associations before Congress and the executive branch, with 60 percent of that money coming from the health industry.[5]

more later....

Is there a Medical Expert in the White House?

Valerie Jarrett, a Chicago insider and former deputy to Daley, has officially been named a senior advisor for Obama, and will head the Office of Public Liason. She met the Obamas when she got a job for Michelle in the Mayor's office.

NYT says she is an "expert" on health care. Can anyone tell me how?

All I've found is that she's served on the board at Chicago Hospital and her dad was a doctor.

Currently Reading: The Social Transformation of American Medince

Just started reading. looks promising.

"To most of us, this power seems legitimate: When professionals claim to be authoritative about the nature of reality, whether it is the structure of the atom, the ego, or the universe, we genrerally defer to their judgment."

Do Something

Contact Congresspeople. Email, call, snail-mail, whatever...

If things are really going to CHANGE, let's try to make it for the better.

Per Health Care NOW: Contact Sen. Kennedy, who is really pushing to get health care legislation to BO's desk when "he hits the ground running."

Seniors aren't paying enough for drugs

USA Today article about how Medicare drug prices are going up up up.

Elderly and disabled people in Medicare prescription drug plans with the largest enrollments will pay 43% more on average in monthly premiums next year than when the drug program began in 2006, and some enrollees will see increases of as much as 329%, two analyses show.

[Even though]....Overall, the Medicare drug program is costing taxpayers less than originally estimated. The government's drug spending on the program fell by 12% to $44 billion in the fiscal year that ended Sept. 30, largely from the widespread use of low-cost generic drugs.

Someone want to argue with me about why having insurance companies involved in health care is a good idea?

AARP tells us to cut back on health care to cut back on costs.

"Of our total $2.3 trillion health care bill last year, a whopping $500 billion to $700 billion was spent on treatments, tests, and hospitalizations that did nothing to improve our health."

So many ways to react to this claim.

1. Who is choosing this treatment?

a. The patient. The double edged sword of information in a capitalist system:Patients are more able to take initiative when it comes to health care, and at the same time can fall prey to influence that is more prevalent with more information. And given how overworked doctors are nowadays, especially those that would give referrals, who can blame a patient for insisting on a test? It's a technological second opinion. And if the patient can pay, no problem. Its when the patient can't pay that the issues begin.

b. The doctor. To avoid malpractice, or to avoid a lengthy conversation with the patient or patient's parent as to why the treatment is not necessary. It's easier to just do it, if it's wanted.

c. Managed Care/Insurance??? Just a thought, though counterintuitive. The way doctors get paid is the biggest mess in the health care industry. This is not a sweeping statement that doctors' judgement is categorically influenced by payment, but I would imagine it's impossible not to think about it. Do I spend 30 minutes with this patient explaining the pros/cons of this MRI or CT scan, etc, or do i just send them to get it if they want it. As the article points out, they may not like the doctor's decision to decline to test and therefore find another doctor. So there's double financial incentive to give a more expensive test and to keep a patient.

2. A large portion of health care costs come from emergency and catastrophic treatment. Because people use the ER as primary care, and because people cannot afford regular checkups (among other preventative care options) and as such end up needing more care when they finally are forced to seek it out. I would assume this statement does not apply to this group of people because that would be absurd.

3. One thing that was not discussed is the high cost of technology and scientific advances in America. This comes through in so many ways. Not only are there more tests and more fancy expensive machines out there that do wonderful things, there are also more drugs being developed and at a high cost to Americans. Other countries cap payments for drugs. We don't. Why? Because we want to keep incentive$ for pharma to develop those drugs. The world benefits, we benefit. We're footing the bill. Not saying we shouldn't. Just saying we should recognize what's going on and decide if that's the best way to go about things.

I think the AARP is on to something here. But I don't think they know it. Western medicine--the American "system" specifically, is reactionary, not preventative. Think about it this way: Allopathic medicine, what is traditionally known as "western," was originally a derogatory term for a new kind of "heroic"medicine that was not evidence based. (Including bloodletting.) Allo means different. Compare with homeo (same) pathy. The whole point is to work against, rather than with, what is happening in the body--to react rather than nurture and sustain. This is going on a different tangent now, so I'll come back to the article, which does point out that much of the medicine practiced now is not "evidence based." (political buzz word, anyone?). Maybe in addition to rethinking the way health care delivery is structured in this country we should also rethink the care that is being delivered. That's a horse of a different color, to be addressed in another post.

All that said, worth reading, including a nice table of proposed changes to our current system with pros and cons. Enjoy!