October 27th, 2011 by Richard Cooper, M.D. in Opinion
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(Note: After a five month absence from posting comments, I offer this observation, with more to come. There’s much to do.)
The message resonating from the Wall Street protesters is that income inequality doesn’t work. And among the developed nations, theUS is the most unequal. This distinction does not come without cost. The greatest, of course, is the social cost borne by those who are poor. But what the protesters may not fully realize is that another is the high costs of health care. This is because the costs of caring for the poor are much greater. And together with the rising numbers of poor patients, they are crushing the health care system.
This notion may seem shocking, since it is generally believed that low-income patients receive less health care. After all, many have little or no health insurance, and most have poor access to primary care. Isn’t it the wealthy whose access is best and who use the most? The answer is Read more »
*This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*
October 13th, 2011 by RyanDuBosar in Research
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Hospitals that provide the lowest quality care at the highest cost care for more than twice the proportion of elderly minority and poor patients as the nation’s best performers, researchers found. And patients at the “worst” institutions are more likely than patients elsewhere to die of certain conditions, such as heart attacks and pneumonia.
These hospitals and their patients may be the ones most at risk under new Medicare payment arrangements that could cut payments to hospitals that fail to meet quality metrics, reported researchers from the Harvard School of Public Health.
The researchers examined how quality, costs and patients served correlated among 3,200 hospitals nationwide. They then identified 122 “best” hospitals, those that were in the highest quartile of quality and lowest quartile of risk-adjusted costs, and 178 “worst” hospitals, those in the lowest quartile of quality and the highest quartile of costs.
Hospital quality and performance data were Read more »
*This blog post was originally published at ACP Hospitalist*
September 8th, 2011 by Edwin Leap, M.D. in Opinion
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I think a lot about the slow, certain dissolution of medicine as we know it. Mental health issues crowd emergency departments, as few mental health clinics are available. Psychiatrists are in short supply. Drug abuse overwhelms the medical system, with either patients seeking pills or patients families hoping to get them off of pills.
Persons with little interest in their own health continue to smoke and drink, use Meth and eat poorly. Disability claims are skyrocketing as younger and younger individuals confabulate their misery in hopes of attaining a check, paid for by someone else.
The poor, with genuine medical problems, have increasing difficulty finding care as jobs, and insurance, fade away. Politicians, eager to be re-elected, eager to be loved, promise Read more »
*This blog post was originally published at edwinleap.com*
April 5th, 2010 by Happy Hospitalist in Better Health Network, Health Policy, Opinion, True Stories
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We learn from the healthcare reform bill that the federal government will help subsidize Medicaid funding for all the new patients who qualify, but they will only do it for two years. After that, the states are on their own. Medicaid unfunded liabilities will crush state governments everywhere.
Why is Medicaid so expensive and going bankrupt? I’ll give you one example why. This is played out day after day, night after night in communities all across our country. And the only ones paying for it are you and me. The ones spending all the money have no incentive to stop.
I’m in the ER the other day when I see a chief complaint fly by on the radar. What is that chief complaint, you ask? Let me tell you a story.
Refused By Detox
The patient was so drunk even the community detox center refused him. So how did this play out? The patient was taken by ambulance from his home to a small-town community ER for altered mental status. There he was checked into the ER and seen by a small-town community ER physician, family practice resident, or PA or NP.
Diagnosis: Acute alcohol intoxication. Plan: Discharge to community detox center. Read more »
*This blog post was originally published at The Happy Hospitalist*
April 1st, 2010 by Richard Cooper, M.D. in Better Health Network, Health Policy, News, Opinion, Research
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Readers interested in the relationships between poverty and healthcare will want to read several new postings on the Web.
One is an article about my Rhoades Lecture at the Wayne County Medical Society in Detroit, “Poverty and Healthcare in America.” It is posted on the World Socialist Web Site.
Second is by James Marks, MD, MPH, Vice President of the Robert Wood Johnson Foundation, entitled “The Poor Feel Poorly.” It is posted on the Huffington Post site.
Third is “Health and Healthcare in America’s Poorest City,” a tragic and dramatic portrayal of America’s failures to its own in Detroit, also on the World Socialist Web Site.
Finally, here is a link to a collection of papers on social inequalities in health by the McArthur Network on SES and Health, published by the New York Academy of Medicine under the title, “Biology of Disadvantage.”
*This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*
(Note: After a five month absence from posting comments, I offer this observation, with more to come. There’s much to do.)
