Reply With Quote
I'm not defensive, I'm just pointing out you weren't being emphatic enough when you pretended to speak for me.
Why are you so defensive? I just mentioned that you have differentiated starving from very hungry..
I'm not defensive, I'm just pointing out you weren't being emphatic enough when you pretended to speak for me.
Nobody starves, hardly, but is Mac and Cheese or Top Ramon a good daily meal for a kid?....it's not like TX increases the amount they give the poor for food during summer months when kids are home more.....and a lot of people won't seek help unless things get really desperate....
Are you suggesting the people who can only afford Mac-n-Cheese or Top Ramen do not qualify for WIC or any other assistance program?
I have a relative, with children, who is the beneficiary our our tax dollars. She applies for every assistance program for which she qualifies. And, she is always "gifting" family members with the bounty of food that would otherwise spoil because she gets more money than she needs to feed her four children every month.
I also know that in Austin, the school district continues the free breakfast program through the summer -- even though the numbers of those who take advantage of it drops by over 75%. I know if my kid were "starving" or "very, very hungry" I'd get their asses in the school cafeteria every morning.
There is absolutely no reason, short of pure laziness, that a child should even go hungry in Texas. Aside from public, tax-dollar supported assistance, there are food pantries and free lunch programs sponsored by private charitable organizations.
My church will feed anyone that comes to the door hungry.
While we're on the subject of healthcare, here's another great moment in Socialized Medicine:
Englishwoman Olive Beal has a hearing problem. According to London's Guardian, she "finds it difficult to hear with her five-year-old analogue [hearing] aid and needs a digital version that cuts out background noise and makes conversation easier."
Mrs. Beal went to the Eastern and Coastal Kent Primary Care Trust, her local office of the National Health Service. No problem, they told her, she'll get a hearing aid. But it'll take her 18 months to get to the top of the waiting list:
Aw, c'mon, Mrs. Beal, look on the bright side. Just be grateful the thing is free!
Hearing aids, eye glasses, and dental aren't covered in France, I'm surprised hearing aids are covered in UK.
And, another one:
Woman In Britain Forced To Pay For Her Own Hip Replacement
Here’s yet another story proponents of socialized medicine will find a bit inconvenient. A woman in Great Britain needed hip surgery. She applied for the surgery to be done in the national health care system she’d been paying taxes to support. She was told by the bureaucrats in that system that she was too fat to have her hip replaced, so she was forced to raise money so she could travel to another country and pay for the procedure herself.
This would be money spent over and above the money she paid in taxes to fund the national health care system which was supposed to meet all her medical needs.
She then came back to her home country and sued her national health service plan to get the money she spent back. Her case is yet to be decided. But perhaps the most chilling part of this whole ordeal is this:
Basically, if some bureaucrat bean counter decides you’re too fat, you can’t get surgery in Great Britain. It doesn’t matter if you need the surgery or not, or that you paid for these services with your tax dollars. If you don’t conform to their standards you don’t get care.The PCT had refused her treatment because of its policy of not providing surgery to most people with a body mass index of more than 35 unless they go through a weight-loss plan.
What’s more, the tool they’re using to determine who is and is not fat is an archaic measure that is hardly accurate. Under body mass index measurements, people like professional football player Emmit Smith are “fat.” Along with people like Dwayne Johnson (a/k/a “The Rock), George W. Bush and Tom Cruise.
Could you imagine Tom Cruise not being able to get hip surgery in Great Britain...because he’s too fat? I’m not saying that being fat is a good thing. I’m just pointing out that socialized medicine is an awful, inefficient system that drives government bureaucrats to absurd lengths (like denying surgeries based on an outmoded obesity measure like BMI) in order to ration health services.
This is not something we, as Americans, should want to sign up for.
So, what happens if “universal healthcare” is decreed, and there’s no doctor in the house? What happens when the proponents of “universal healthcare” also castigate the best and brightest who choose to endure the rigors of medical training by reducing their financial incentive?
A report in the Wall Street Journal says that the Massachusetts experiment in “universal healthcare” may founder on the lack of enough primary care physicians:
An op-ed in USA Today, by an immigration lawyer, delves further, with attention to the British experience with terrorist doctors. Strict screening is the key.
Yeah, we need universal health care...
How about some horror stories from US health care, Yoni?
Can't find any? I didn't think so, you jingo mother er.
Yoni supports his unsupportabl case with rat .
The big picture, that nobody disputes, is that the US's healtcare bill per capita is by far the highest in the industrial world, for delivering less health care, and causing 10s of millions of people to live in fear of medical catastrophe and financial ruin, including the insured middle classes.
Last edited by boutons_; 07-31-2007 at 12:45 PM.
This article is 2 years old, assume that skyrocketing ripoff medical costs is now 2 years worse.
==================
For Americans, Getting Sick Has Its Price
Survey Says U.S. Patients Pay More, Get Less Than Those in Other Western Nations
By Rob Stein
Washington Post Staff Writer
Friday, November 4, 2005; A02
Americans pay more when they get sick than people in other Western nations and get more confused, error-prone treatment, according to the largest survey to compare U.S. health care with other nations.
The survey of nearly 7,000 sick adults in the United States, Australia, Canada, New Zealand, Britain and Germany found Americans were the most likely to pay at least $1,000 in out-of-pocket expenses. More than half went without needed care because of cost and more than one-third endured mistakes and disorganized care when they did get treated.
Although patients in every nation sometimes run into obstacles to getting care and deficiencies when they do get treated, the United States stood out for having the highest error rates, most disorganized care and highest costs, the survey found.
"What's striking is that we are clearly a world leader in how much we spend on health care," said Cathy Schoen, senior vice president for the Commonwealth Fund, a private, nonpartisan, nonprofit foundation that commissioned the survey. "We should be expecting to be the best. Clearly, we should be doing better."
Other experts agreed, saying the results offer the most recent evidence that the quality of care in the United States is seriously eroding even as health care costs skyrocket.
"This provides confirming evidence for what more and more health policy thinkers have been saying, which is, 'The American health care system is quietly imploding, and it's about time we did something about it,' " said Lucian L. Leape of the Harvard School of Public Health.
The new survey, the eighth in an annual series of cross-national surveys conducted by Harris Interactive for the fund, is the largest to examine health care quality across several nations during the same period. The survey was aimed at evaluating care across varying types of health care systems, including the market-driven U.S. system and those that have more government controls and subsidies.
The survey, published in the journal Health Affairs, questioned 6,957 adults who had recently been hospitalized, had surgery or reported health problems between March and June of this year.
"These patients are the canary in the coal mine of any health care system," Schoen said.
Nearly a third of U.S. patients reported spending more than $1,000 in out-of-pocket expenses for their care, far outpacing all other nations. Canadians and Australians came next, with 14 percent of patients spending that much. The proportion reporting similarly high costs was far lower in the other countries.
Americans had the easiest access to specialists, but they experienced the most problems getting care after hours, and Americans and Canadians were the most likely to report problems seeing a doctor the same day they sought one.
Americans were also much more likely to report forgoing needed treatment because of cost, with about half saying they had decided not to fill a prescription, to see a doctor when they were sick or opted against getting recommended follow-up tests. About 38 percent of patients in New Zealand reported going without care; the numbers were 34 percent in Australia, 28 percent in Germany, 26 percent in Canada and 13 percent in Britain.
"If that's not a reason for moral outrage, I don't know what is," Leape said.
About one-third of U.S. patients reported problems with the coordination of their care, such as test results not being available when they arrived at a doctor's appointment or doctors ordering duplicate tests. In the other countries, 19 to 26 percent of patients reported similar problems.
Americans also reported the greatest number of medical errors. Thirty-four percent reported getting the wrong medication or dose, incorrect test results, a mistake in their treatment or care, or being notified late about abnormal test results. Only 30 percent of Canadian patients, 27 percent of Australian patients, 25 percent of New Zealanders, 23 percent of Germans and 22 percent of Britons reported errors.
"The findings show that we have a lot to learn from our colleagues" in other countries, said Carolyn Clancy of the federal Agency for Healthcare Research and Quality during a briefing at which the results were released. She said the federal government has launched a number of initiatives to find ways to improve care, particularly for the increasing number of Americans with chronic illness.
"The findings here reinforce how difficult it is coordinating care. . . . That's the next frontier," Clancy said.
© 2005 The Washington Post Company
Put strict caps on malpractice liability so that doctors get to keep more of their earnings rather than paying exorbitant malpractice premiums (do you notice how deply the insurance companies have their tentacles wrapped around our system?), and watch the financial incentive to practice go up.
There are horror stories in all systems. But national
health isn't the answer in any way, shape or fashion.
Oh, I forgot. Universal Health Care. People like you
make others live in fear of catastrophe. How many people
do you actually know who have had a catastrophic
health problem that has not been taken care of in our
system?
"Put strict caps on malpractice liability so that doctors get to keep more of their earnings rather than paying exorbitant malpractice premiums"
show us that TX cap of $250K (extremely small compared to previous awards) has reduced TX malpractice insurance premiums.
US doctors are wildly overpaid, and corrupted by Big Pharma 100K detailers/drug pushers.
Emergency Medicine News:Volume 29(6)June 2007p 26
Drug Company Payments to Physicians
[In Brief]
Laws in two states requiring disclosure of pharmaceutical company payments to physicians do not provide the public with easy access to payment information and are of limited quality when accessed, according to a study in the March 21 issue of the Journal of the American Medical Association.
Interactions between the pharmaceutical industry and health care professionals often involve payments, including cash, gift certificates, meals, textbooks, or conference fees. In contrast to many other professions, medicine allows payments from a company to an individual who decides whether and how often to use products produced by the company. The American Medical Association recommends that gifts but not other payments to physicians should benefit patients and should not exceed $100 in value.
Recent legislation in five states and the District of Columbia mandated state disclosure of payments made to physicians by pharmaceutical companies.
In two of these states, Vermont and Minnesota, payment disclosures are publicly available.
The authors of the study found that the laws enacted by Vermont and Minnesota fail to provide the public with easy access to information about payments from pharmaceutical companies to physicians and other health care professionals. The study also found that pharmaceutical companies made substantial numbers of payments of $100 or more to physicians. In Vermont, among 12,227 payments totaling $2.18 million publicly disclosed, there were 2,416 payments of $100 or more to physicians. In Minnesota, among 6,946 payments totaling $30.96 million publicly disclosed, there were 6,238 payments of $100 or more to physicians.
Actually it really has helped.
---------------------------------------------
Doctors clamoring to come to Texas, creating backlog of applicants
More than 2,000 doctors awaiting Texas licenses, as patients wait to see certain specialists
By Mary Ann Roser
AMERICAN-STATESMAN STAFF
Monday, July 09, 2007
An influx of doctors into Texas has caused long waits for medical licenses, inconveniences for patients wanting to see certain specialists and anxiety for physicians awaiting new colleagues to help with high caseloads.
People in the medical field say the state's limits on malpractice lawsuits have generated a surge of doctors, including specialists, who want to practice in Texas, which is helping bring more doctors to areas of the state that don't have enough.
But the state's popularity has overwhelmed the Texas Medical Board, which screens doctors before issuing them a Texas medical license, a process that involves verifying doctors' medical education, doing a criminal background check and other steps.
Lawmakers have approved $1.2 million to hire six more staffers to process applications faster. Meanwhile, the board is using temporary workers and paying staffers overtime but still can't keep up, spokeswoman Jill Wiggins said.
"The pipeline is just clogged," Wiggins said.
The board received 4,000 applications for medical licenses in 2006, compared with 2,992 the previous year. Wiggins said the board expects to approve 2,750 new licenses this year, 235 more than the previous year.
There is a backlog of 2,398 license applications awaiting approval. The most complicated applications take an average of 6.3 months to process, and the simplest ones average 41 days, according to data provided by the board. The most complicated applications include ones that come from out-of-state doctors or from veteran doctors who have long histories to be checked.
In 2003, the most complex applications took an average of 45 days, and the simplest took 20 days, Wiggins said.
Dr. James E. Kreisle Jr., an Austin psychiatrist, said he and two colleagues have been been waiting since the fall for two psychiatrists from South Carolina and Georgia to get licensed in Texas so they can join the practice.
"There's a shortage of psychiatrists in this town," Kreisle said.
He said patients have to wait at least three weeks to get in to see him. Some Austin psychiatrists aren't taking any new patients, he said, which can pose serious problems for patients who are severely depressed or have some other condition that requires immediate treatment.
Many doctors are coming to Texas because of a 2003 law that has created a favorable legal environment for them, physicians and others said. The law limits damage awards in malpractice lawsuits and thus has discouraged lawyers from representing patients or their loved ones who want to sue a doctor.
On average, malpractice insurance premiums in Texas have gone down 21.3 percent since the tort law took effect in September 2003, said Jon Opelt, executive director of Texas Alliance for Patient Access. The alliance, which supported changing the medical liability law, describes itself as a coalition of doctors, hospitals, nursing homes, health care providers and medical liability insurers.
The law is "a big factor why Texas has become a popular state to practice in," said Dr. Punit Chadha, an oncologist who moved to Austin from Chicago last summer. "When medical recruitment firms send out information, . . . they will tout the friendliness" of the malpractice environment.
Chadha, who grew up in Houston, said he wanted to come back to Texas but would not have returned if not for the 2003 law. His malpractice insurance premium is now about one-fourth of what it would have been in Chicago, which has some of the highest rates in the nation, he said.
It took him five months to get his license approved in Texas, he said.
Dr. Kevin H. Brown, who started practicing obstetrics in Round Rock in May, applied for a Texas license the same day in September as his obstetrician wife and partner, Ingrid W. Brown. It took six months for his license to be approved; his wife is still waiting for hers because of a paperwork delay, he said.
Brown said that his wife was able to get a temporary license and that their practice is helping alleviate Round Rock's shortage of obstetricians.
The medical board can issue temporary licenses to doctors who have completed the licensing process and are only waiting for final approval from the board, which meets every other month, Wiggins said.
Brown said he and his wife paid $130,000 a year for both of them to have malpractice insurance in Georgia. Now, they pay a combined premium of $82,000 a year, he said.
"It was a $24,000 raise for each of us before we even got started," Brown said.
Many parts of the state that have had doctor shortages are seeing new physicians arrive, Opelt said. Beaumont once had to fly some trauma patients to other cities for treatment because the city didn't have enough trauma surgeons, Opelt said. Now, enough surgeons have moved to Beaumont to handle the caseload.
"Most every area of the state is seeing gains except for far East Texas," Opelt said.
Still, Kreisle, the Austin psychiatrist, said he fears that the backlog could cause physicians to go elsewhere.
Wiggins estimated that it will take "a little over a year" before the new staffers at the medical board can bring the backlog of license applications under control.
"You're turning a battleship around," she said.
http://www.memag.com/memag/content/p....jsp?id=443728
What drug rep visits cost you
By swearing off meetings with detailers, some doctors are seeing more patients—and watching their earnings rise.
In 2005, Brewer decided that the 15 or so drug reps—also known as detailers—who visited his office each week distracted him from patient care. So he went cold turkey, refusing to meet with them or accept their samples. Life without reps, as he recently wrote in his online column for The Wall Street Journal, has allowed him to treat a few more patients each week, and earn an extra $6,300 a year.
"I didn't think rep visits cut into my time with patients, but a few minutes here and a few minutes there added up," says Brewer.
It's not just the money or the productivity at issue; it's the overall value of detailing visits, which have faced increasing criticism in recent years. Doctors like Brewer, who find them expendable, view the samples they leave behind as an attempt to lock patients into new medications.
Not everyone sees it that way. Most of the doctors we informally surveyed welcome the attractive men and women who show up with pizzas and meds. But many have nevertheless tried to rein them in, only meeting with them during lunch hour, for example, or limiting how many can come to the office on a given day. Here's a closer look at how some doctors deal with detailer visits.
"Reps cost us far too much money"
Nationwide, there are an estimated 90,000 to 100,000 reps; each calls on eight to 10 physician offices a day. Some practices may get only two to four visits a week. However, in 2005 and 2006, primary care physicians deemed as "heavy prescribers" were called on by an average of 29 reps a week, according to Health Strategies Group, a research firm that tracks the pharmaceutical industry.
How those visits break down hints at the possible strain on physician practice: In 2005, 85 percent were drop-ins, 5 percent were appointments, and 10 percent were lunch dates.
Hearing a drug spiel over a fajita wrap may not disrupt the schedule, but drop-ins and appointments eat up roughly 60 minutes a week, Health Strategies Group reports. If you used that extra time to see four established Medicare patients, using CPT code 99213 for an intermediate visit, you'd collect roughly $60 per visit, $240 per week, and $12,000 over 50 weeks. Subtract 50 percent for overhead, and you'd net an extra $6,000 a year—just a hair under what Brewer cleared after dropping rep visits.
Some doctors eliminate face-to-face conversations but still accept samples, a practice FP Patti Roy in Muskegon, MI, started 10 years ago that freed up a whopping three hours a week. "The staff brings me the form to sign for samples," says Roy. "I don't even say good morning to the reps."
The three-doctor Acacia Family Medical Group in Salinas, CA, takes the same signature-only approach. "We're convinced reps cost us far too much money," says FP and group president Sumana Reddy. "I have always wondered how doctors can spend that precious time listening to a solicitation."
Yet many physicians insist there's little time lost, since they book the maximum number of patients and see drop-in detailers in between.
That time management strategy sounds good in theory; in practice, it can derail a doctor's schedule—and annoy patients.
"Every rep visit makes the patient wait an extra five to 10 minutes," says pediatrician Tammi Schlichtemeier in Coppell, TX. "I often hear their frustration when they open the exam room door, only to find me talking to a rep. The question is always, 'How much longer?' " To stay on track, Schlichtemeier limits detailers to 9 to 11 a.m. and 2 to 4 p.m., with no more than two per session.
Why some doctors love their reps
Time constraints aside, most of the doctors we interviewed say the benefits of rep visits outweigh any disadvantages.
They're particularly thankful for the free drugs. "Samples help a lot, especially for the significant percentage of our patients who can't afford high-priced medicines," says urologist Sivaprasad Madduri in Poplar Bluff, MO. In all, 78 percent of doctors accept samples, according to a recent study published in The New England Journal of Medicine.
( tell the pushers to drop the free drugs through the mail slot)
There's also appreciation for the product information detailers provide. "A drug I'm prescribing has been reformulated, and if I hadn't heard this from the rep, I'm not sure there would have been an easy way to find it out," says pediatrician Katrina Hood in Lexington, KY. New York City psychiatrist Sharon Packer credits a rep with helping to convince another specialist that a prescription he wrote for her patient had an adverse interaction with another medication.
( tell the drug pushers to drop the printed drug info thru the mail slot)
Doctors reap other benefits. Eighty-three percent eat catered meals, according to the NEJM study. At the practice of FP Scott Jordan in White House, TN, a different rep treats the 25-member staff to lunch each day. Some doctors we interviewed see the food as an employee benefit and a productivity stimulant—nobody has to leave the office to grab a meal.
With a physician marketing budget that topped $7 billion in 2006, member firms of the Pharmaceutical Research and Manufacturers of America (known as PhRMA) shower practices with supplies—pens, notepads, staplers, exam room paper—that help keep overhead down. Patient-education materials are also a hit—ditto for golf putters and tickets to sporting events.
Then there are the intangibles. "Detailers are a wonderful community resource," says FP Steven Kamajian in Montrose, CA. They've used their contacts to help him find new employees, for example. Socializing counts, too. "The few reps I see offer a break from patients—they listen to me talk," says psychiatrist Sharon Packer.
"I got turned off being a sales target"
Despite the goodwill, the doctor-rep relationship appears to be eroding. Detailers spent 20 percent less time with doctors in 2004 than in 1999, according to Health Strategies Group. Some medical schools and academic medical centers ban samples and free lunches and admit reps only by appointment. The rationale: Freebies shouldn't influence doctors to prescribe costly brand-name drugs when low-cost generics may be just as effective.
( the US govt should buy up all the major drug patents and license the formulations to generic mfr's world-wide. Consider the savings through the years just in Medicare/Medicaid. Take the $1T wasted in Iraq and buy out drug patents)
The pharmaceutical industry contends that modest meals don't hinder a doctor's ability to render independent professional judgments. And drugmakers defend samples, saying they not only help the uninsured, but also make it easier for doctors to test the efficacy of a new treatment.
Patti Roy takes the middle ground. She dispenses samples for chronic conditions only after establishing that a generic can't do the job and sees no harm in using a sample antibiotic for an acute illness, because it doesn't lead to a long-term prescription. But she avoids reps because she feels she is getting sales pitches, Roy says.
Benjamin Brewer agrees. "I got turned off being a sales target," he says. He couldn't stand drug reps tracking his every prescription with their computer software, which was more sophisticated than his EHR.
He's doing fine, by the way, without samples. "If a patient is uninsured, I'll prescribe a proven generic." He also falls back on old-fashioned charity. Brewer recently saw an unemployed patient who had run out of his antidepressants and charged zero for the visit so the man could spend his scarce dollars on meds.
With extra money in his pocket as a result of his no-rep policy, Brewer finds it easier these days to be generous.
==============
US's for-profit health care is a scandalous, ridiculous, corruption racket.
Many pundits predict health care will will be a primary 2008 election issue. I don't hear Romney talking about it seriously, although I think he has the career management experience to go after it if he chose to.
Last edited by boutons_; 08-14-2007 at 04:41 PM.
If you only knew how many filet mignon dinner's I've had courtesy of drug reps.
Yeah boutons, we want the US Government to run our
health care. Wasn't it you that was really, really ing
about FEMA and New Orleans. Guess you would like to
put health care under their jurisdiction. Or how about
the FDA. Or should be just create a whole brand new
group of government workers to handle it. All political appointee's. You know like Billary.
Or as you said in another post earlier:
"I'm from the (US) govt, and I'm here to help you" (St Ronnie, sowing hate and ridicule for the govt he presided over)
I was sitting in a doc's waiting room, and stunning 6-foot lady walked in, slim (0.5% of SA ladies DONT qualify). I asked the receptionist girl (behind the security window?) was that a doctor? "no, a detailer". Sex sells drugs.
August 14, 2007
Google and Microsoft Look to Change Health Care
By STEVE LOHR
In politics, every serious candidate for the White House has a health care plan. So too in business, where the two leading candidates for Web supremacy, Google and Microsoft, are working up their plans to improve the nation’s health care.
By combining better Internet search tools, the vast resources of the Web and online personal health records, both companies are betting they can enable people to make smarter choices about their health habits and medical care.
“What’s behind this is the mass consumerization of health information,” said Dr. David J. Brailer, the former health information technology coordinator in the Bush administration, who now heads a firm that invests in health ventures.
It is too soon to know whether either Google or Microsoft will make real headway. Health care, experts note, is a field where policy, regulation and entrenched interests tend to slow the pace of change, and technology companies have a history of losing patience.
And for most people, typing an ailment into a Web search engine is very different from entrusting a corporate an with personal information about their health.
Google and Microsoft recognize the obstacles, and they concede that changing health care will take time. But the companies see the potential in attracting a large audience for health-related advertising and services. And both companies bring formidable advantages to the consumer market for such technology.
Microsoft’s software animates more than 90 percent of all personal computers, while Google is the default starting point for most health searches. And people are increasingly turning to their computers and the Web for health information and advice. A Harris poll, published last month, found that 52 percent of adults sometimes or frequently go to the Web for health information, up from 29 percent in 2001.
If the efforts of the two big companies gain momentum over time, that promises to accelerate a shift in power to consumers in health care, just as Internet technology has done in other industries.
Today, about 20 percent of the nation’s patient population have computerized records — rather than paper ones — and the Bush administration has pushed the health care industry to speed up the switch to electronic formats. But these records still tend to be controlled by doctors, hospitals or insurers. A patient moves to another state, for example, but the record usually stays.
The Google and Microsoft initiatives would give much more control to individuals, a trend many health experts see as inevitable. “Patients will ultimately be the stewards of their own information,” said John D. Halamka, a doctor and the chief information officer of the Harvard Medical School.
Already the Web is allowing people to take a more activist approach to health. According to the Harris survey, 58 percent of people who look online for health information discussed what they found with their doctors in the last year.
It is common these days, Dr. Halamka said, for a patient to come in carrying a pile of Web page printouts. “The doctor is becoming a knowledge navigator,” he said. “In the future, health care will be a much more collaborative process between patients and doctors.”
Microsoft and Google are hoping this will lead people to seek more control over their own health records, using tools the companies will provide. Neither company will discuss their plans in detail. But Microsoft’s consumer-oriented effort is scheduled to be announced this fall, while Google’s has been delayed and will probably not be introduced until next year, according to people who have been briefed on the companies’ plans.
A prototype of Google Health, which the company has shown to health professionals and advisers, makes the consumer focus clear. The welcome page reads, “At Google, we feel patients should be in charge of their health information, and they should be able to grant their health care providers, family members, or whomever they choose, access to this information. Google Health was developed to meet this need.”
A presentation of screen images from the prototype — which two people who received it showed to a reporter — then has 17 other Web pages including a “health profile” for medications, conditions and allergies; a personalized “health guide” for suggested treatments, drug interactions and diet and exercise regimens; pages for receiving reminder messages to get prescription refills or visit a doctor; and directories of nearby doctors.
Google executives would not comment on the prototype, other than to say the company plans to experiment and see what people want. “We’ll make mistakes and it will be a long-range march,” said Adam Bosworth, a vice president of engineering and leader of the health team. “But it’s also true that some of what we’re doing is expensive, and for Google it’s not.”
At Microsoft, the long-term goal is similarly ambitious. “It will take grand scale to solve these problems like the data storage, software and networking needed to handle vast amounts of personal health and medical information,” said Steve Shihadeh, general manager of Microsoft’s health solutions group. “So there are not many companies that can do this.”
This year, Microsoft bought a start-up, Medstory, whose search software is tailored for health information, and last year bought a company that makes software for retrieving and displaying patient information in hospitals. Microsoft software is already used in hospitals, clinical laboratories and doctors’ offices, and, Mr. Shihadeh noted, the three most popular health record systems in doctors’ offices are built with Microsoft software and programming tools.
Microsoft will not disclose its product plans, but according to people working with the company the consumer effort will include online offerings as well as software to find, retrieve and store personal health information on personal computers, cellphones and other kinds of digital devices — perhaps even a wris ch with wireless Internet links some day.
Mr. Shihadeh declined to discuss specifics, but said, “We’re building a broad consumer health platform, and we view this challenge as far bigger than a personal health record, which is just scratching the surface.”
Yet personal health records promise to be a thorny challenge for practical and privacy reasons. To be most useful, a consumer-controlled record would include medical and treatment records from doctors, hospitals, insurers and laboratories. Under federal law, people can request and receive their personal health data within 90 days. But the process is complicated, and the replies typically come on paper, as photocopies or faxes.
The efficient way would be for that data to be sent over the Internet into a person’s digital health record. But that would require partnerships and trust between health care providers and insurers and the digital record-keepers.
Privacy concerns are another big obstacle, as both companies acknowledge. Most likely, they say, trust will build slowly, and the online records will include as much or as little personal information as users are comfortable divulging.
A person might start, for example, by typing in age, gender and a condition, like diabetes, as a way to find more personalized health information. If a person creates a personal health record and later has second thoughts, a simple mouse click should erase it. The promise, the companies say, will be complete consumer control.
There are plenty of compe ors these days in online health records and information from start-ups like Revolution Health, headed by AOL’s founder, Stephen M. Case, and thriving profit-makers led by WebMD.
Potential rivals are not underestimating the two technology giants. But the smaller companies have the advantage of being focused entirely on health, and some have been around for years. WebMD, for example, traces its lineage to Healtheon, a fallen star of the dot-com era, founded by the Netscape billionaire Jim Clark.
Google and Microsoft are great companies, said Wayne T. Gattinella, WebMD’s chief executive, but “that doesn’t mean they will be expert in a specific area like health.”
Specialized health search engines — notably Healthline — are gaining ground and adding partners. AOL recently began using Healthline for searches on its health pages, even though Google is a close partner.
Still, 58 percent of people seeking health information online begin with a general search engine, according to a recent Jupiter Research report, and Google dominates the field. “Google is the entry point for most health search, and that is a huge advantage,” said Monique Levy, a Jupiter analyst.
Indeed, it is the market reach and deep pockets that Google and Microsoft can bring to consumer health information that intrigues medical experts, and has lured recruits. Dr. Roni Zeiger, a graduate of Stanford’s School of Medicine, a medical informatics researcher and a former primary care doctor, joined Google last year. The 36-year-old, who still sees patients some evenings and weekends at a nearby clinic, said, “At Google, I can use my expertise and knowledge to potentially help millions of people each day.”
Source: University of California - San Francisco
Date: August 16, 2007
Health Care Disparities Start At The Local Pharmacy, Study Shows
Science Daily — Despite years of effort in reaching out to their local communities, the role pharmacists play as health care providers still remains unclear to the people who need them the most -- elderly Americans with multiple medications for chronic diseases.
As a result, many patients with the most complex prescription needs may be hesitant to ask the questions they need to take their medications safely and consistently, according to a new study from the UCSF School of Pharmacy.
In one of the first studies to interview only elderly African-Americans regarding their perceptions of their community pharmacist, UCSF researchers also report that most would like to relate to their pharmacist the way they do with their personal doctors, but very few actually achieve that. Findings were published last month in the spring issue of the journal "Ethnicity and Disease."
"There are many articles describing physician-patient relationships, but there is a paucity of information on patients and their pharmacists," explained Sharon Youmans, PharmD, MPH, a UCSF associate professor of clinical pharmacy who led the study. "When we look at the issues of adherence to prescription regimens and safety in combining medications, that relationship plays a critical role."
The study involved interviews with 30 women and 12 men, all of whom were African Americans over age 60 and living in San Francisco. A majority of these participants took four to six prescription medications regularly and reported an average of two chronic illnesses.
Researchers found that most participants sought a close relationship with a knowledgeable and respectful community pharmacist and most also reported an interest in engaging in informed decision-making, including discussions regarding medication options, side effects and concerns about rising medication costs. Yet few participants reported feeling comfortable initiating such discussions, due to either not being able to identify the pharmacist or a sense that the pharmacist was too busy to talk with them. None said they perceived this as an issue of discrimination.
Youmans said the study highlights the importance of patient-pharmacist communication and identifies the need for far more training of pharmacists and pharmacy staff in cultural competence and communication.
The study also showed that the individual pharmacists, and the profession as a whole, need to make increased efforts to become integral partners of local, state and national initiatives aimed at decreasing health disparities, she said.
( that doesn't seem like an expensive objective, could be handled in the training of new pharmacists and their assisants, and for current pharmacists/assistants, through the pharmacists' associations.
It's only common courtesy and humanity to handle these elderly, repeat customers, for whom life is getting more difficult by the year, with better than the cold, robotic "service" they now get, even in a big city. )
"This is an issue of coming out from behind the counter and making a connection with our patients, no matter who they are," Youmans said. "If we, as pharmacists, are going to help reduce the health disparities in underserved populations, this study shows the first step we all need to make."
Note: This story has been adapted from a news release issued by University of California - San Francisco.
Brought to you by for-profit health care:
Patient safety takes a back-seat to financial needs
Aug 1, 2007
Contemporary OB/GYN
So says a recent survey conducted by the American College of Physician Executives. Although it's been 7 years since the release of the Ins ute of Medicine's To Err is Human: Building a Safer Health System, "an absence of any dramatic progress has created a sense of frustration and anxiety" among physician-executives, reported Modern Healthcare (5/7/2007).
The survey found that physician executives face a number of hurdles to implementing patient quality or safety initiatives:
* About 60% said they struggle to find an appropriate balance between what they think is best for patients and what's best for their health-care organization.
* Nearly 55% believe employees of their organization fear reporting errors or safety hazards because of the potential repercussions, including job loss.
* Some 88% said that physician resistance to evidence-based care is "sometimes an obstacle" or "a major obstacle."
* Almost 90% said communication and cultural problems among physicians, nurses, and other providers are "sometimes an obstacle" or "a major obstacle."
* Approximately 39% said that their organization tolerated poor quality care by physicians or departments that generate strong revenue.
Doctors: Prescription Drug Ads Could Mislead Patients
Last Edited: Wednesday, 15 Aug 2007, 8:16 PM CDT
Created: Wednesday, 15 Aug 2007, 8:16 PM CDT
Ads for prescription drugs: you see them on TV, online and in magazines and newspapers.
Drug companies are spending a huge and growing amount of money on those ads in spite of criticism.
"The impact of it is to create anxiety, to create people thinking they might have a condition they don't have," Dr. Joshua Freeman said.
Drug companies spent more than $4 billion on prescription drug ads in 2005. That was the last year covered in a new report in the New England Journal of Medicine. Since 1996, the spending by drug companies on these ads has increased more than three-fold.
The report says most of the ads are for newer drugs, more expensive drugs, to treat long-term conditions.
The report found the more than $4 billion spent on ads was still far less than the $18 billion spent on drug samples and the $7 billion on marketing to health professionals. That includes the gifts drug companies offer doctors.
Those gifts and talks by drug reps have largely been banned in the family medicine clinic at the University of Kansas Hospital.
"We believe the best way for physicians to learn about drugs is through legitimate scientific channels," Dr. Freeman said.
The report says FDA oversight of the ads is weak.
The drug manufacturers group says the report overlooks the key role the ads play in "improving patient understanding of disease and available treatments."
Meryl Lin McKean, FOX 4 News
http://www.myfoxkc.com/myfox/pages/N...ogoDisplayed=1
==============
and STILL Big Pharma rakes in obscene profits.
There are currently 1 users browsing this thread. (0 members and 1 guests)
Posting Permissions
