Massachusetts Healthcare Reform – Out of the Frying pan, into the Fire
Posted by admin in Medical News on March 17th, 2009
For those who didn’t know, if you live in MA, you get universal healthcare. That is you are obligated to purchase health insurance, under threat of a fine. Those who are deemed unable to afford healthcare (earning under approx $66000) will get support from the state.
While this plan might sound like just what America was looking for, the perfect mix between a private healthcare system and a universal healthcare system, healthcare costs are ballooning. To the extent that MA is no longer able to foot the bill.
The answer? two solutions:
- Kill of a few MA residents by pushing forward eligibility requirements reducing the number of people gaining healthcare support from the state.
- Reform the way hospitals and doctors are paid
The latter was chosen. The idea is that instead of paying doctors and hospitals for every service they provide, e.g. a CT scan, a consultation etc. They will be paid based on performance and prevention.
At first look this might sound brilliant. Doctors lose the motivation to send you through thousands of tests and around various hospitals in an attempt to cash in on the HMO’s backs. There are drawbacks. We add a new motivation to treat curable patients. How is that bad? What about the cancer patient guaranteed to die within a few months yet perhaps prolonged to a few years with surgery and an aggressive course of chemo. Very expensive treatment for the hospital, and if they could get the same income from treating someone with less aggressive “curable” cancer, with much cheaper meds presumably they would put them first.
Do we really want a situation where patients needing the most medical attention are going to be put aside in preference of those needing the least. The is the situation the would inevitably occur if each patient was only paying a set amount, as opposed to per service. Something that HMO’s such as blue shield in MA are already carrying out.
Unfortunately for now, this reform seems inevitable. In the midst of a recession there is nowhere else to turn. The problem with healthcare is that it doesn’t behave like a normal market. Drugs that prolong lives immediately have a monopoly as through patent laws, no other drug will ever do what it can do. Also the drugs value is priceless, people will pay any amount of money to stay alive.
We cannot treat Healthcare like any normal free market because it just isn’t normal. The answer? We need to maintain a pay-for-services system, not pay per patient, yet through government regulation we need to work to lower ballooning healthcare costs.
As for MA all we can do is watch. At least it will provide a good test market for the rest of the country.
Experiment on dying patients for cash… $1560 to be precise
Posted by admin in In the Journals, Medical News on March 8th, 2009
A recent article in the BMJ showed that canadian doctors had admitted being paid excessive amounts to submit the patients in to experimental cancer trials.
One doctor reported being paid as much as $1560 per patient he/she submitted. While the cancer patient desperately looking for a new treatment may be overjoyed to get into a clinical trial, we must ask whether the doctor can be trusted to have chosen the experimental trial most likely to benefit the patient. Especially when putting the patient to different trials will affect the amount of money the doctor is paid.
This news comes under a wake of growing concerns about the financial relationships between drug companies, doctors and medical schools.
Just recently Harvard medical students vowed to expose the true relationships in the faculty and put an end to underhand dealing.
So far Ive been rather negative towards the drug industry, however as I’m sure you know, they produce drugs which often turn out to be very useful. Also a lot of the cash flowing into manipulating med students and doctors minds ends up improving their medical teaching. Surely a good doctor should be able to see the wood from the tree’s and act ethically regard less of the financial incentives.
Interns Hours
Posted by admin in Medical Student News on March 7th, 2009
We know from studies that interns make considerably less mistakes when allowed to sleep from time to time (surprised? go back to med school and find out about sleep) Theres even a couple of studies in the NEJM which will show you a 35% reduction in medical errors with well rested interns. Still however hours seem to be as high as ever with just a greater proportion of unreported hours. Nothing like work of the clock eh? It begs the question, what is the point? the intern gets a bad reputation, works hours they wont be paid for and the hospital lands its self with an increase in lawsuits. Bad for everyone involved. I propose a new attitude of being nice to the interns!
Happened this week…
Posted by admin in Uncategorized on March 4th, 2009
Here’s a brief summary of what happened this week in the journalasphere:
- NEJM found that composition of diet ie proportions protein, carbs, fats in diet has little effect on the amount of weight loss when dieting.
- Archives of Internal medicine released a study showing that taking up to 1300mg of calcium a day decreased risk of all types of cancer in women and colorectal cancer in men. see here.
- Study published in the journal Thorax showed that watching TV for more than two hours a day increases the risk of asthma in children under 12, it made the link that this is due to a sedentary lifestyle.
- Study in Nature suggested that Alzheimer’s could be due to reinitiating of an apoptosis cycle usually only see in the fetus after the human brain has produced more neurons then are necessary.
We’ve been twitterfied!
Posted by admin in MedicHack News on February 27th, 2009
follow us on twitter
http://www.twitter.com/medichack
Medpedia for profit or not for profit?
Posted by admin in Medical News, Medical Student News on February 26th, 2009
James currier’s medpedia (check him out here and medpedia here!) is now in public beta. Medpedia is a high-class wiki replica revolving solely around the medical world and firmly keeping the “riff-raff” out by limiting contribution to MD’s and PhD’s. Formed through a collaberation of some of the country’s top medical schools and a considerable contribution from the UK’s NHS the medpedia promises to be accurate and useful. Gone are the days where med students need to worry about the accuracy of their essays after pulling a large amount of the content from wiki.
After looking through the “about us” section of the site I was still left rather confused as to whether or not the site was designed as a non-profit. I understand that the site will NOT be ad-free and on the basis that the site is founded and chaired by an individual that has no interest in medicine yet instead has an entrepreneurial background suggests that this is a profit making vehicle.
Not quite so better-than-wiki after all. Im sure the pharmaceutical industry will find benefit in being able to advertise their drugs alongside educational articles. Considering that the reader would only be reading if they were lacking knowledge in the topic area, we must ask whether or not we want big pharma influencing this particular educational process?
Lastly how come the site gets to make money, yet the authors are expected to just volunteer.
eye candy: the life of a medical student
Posted by admin in Medical News, Medical Student News on February 22nd, 2009
In our eye candy posts we like to show you something it little bit different that we’ve found on the internet. We hope you enjoy this weeks find:
Is the governments protection of the FDA a sign of a larger problem in the United States
Posted by admin in Medical News, Uncategorized on February 22nd, 2009
“The FDA has shown itself incapable of keeping dangerous products off the market, and now the Supreme Court has said patients can’t sue companies for redress.” a georgetown professor told the NYT.
Quite right he was as well
Medical device makers cannot be sued as long as they conform to the FDA, as is imposed by the United States Supreme court. Consumers suing medical device makers already approved by the FDA would’nt look good on the FDA’s record. So the supreme court ruling made sense? no, if the FDA had done their job, the consumer would’nt need to sue. And if the FDA didn’t do their job? well at least the consumer would have to protection of the law on their side. Without the law, we cannot maintain our rights. This is a situation in which respect for the government and its related agencies has come before the basic rights of its citizens and the law which protects their rights.
The FDA should be given the same treatment that any private organization would. If they cannot do the job, they receive no respect from the public. If they can, they receive respect. This is the way in which we maintain our freedom. We should not have to believe in something just because our government tells us too, especially when it endangers our lives, that is most certainly not freedom.
Just Added: Online wiki resource for USMLE step 1
Posted by admin in Study Resources on February 16th, 2009
On our internet travels we came across a step 1 USMLE wiki produced by medical students.
Packed with mnemonics and quick facts it reads like the first aid series of books.
The site is a must see for last minute revision, check it out here.
Podcast Revision
Posted by admin in MedicHack News, Medical News, Medical Student News, Study Resources on December 23rd, 2008
I’ve spent some time recently listening to a medical podcast termed “medpod 101″. I liked the idea of using a podcast for revision as it seemed like an incredibly efficient way of going to the gym and revising at the same time!
If you had asked me what I thought of medpod101, available here, i would have said that they were crass and incredibly politically incorrect. It seemed that every case study mentioned involved either a borat type individual or a person of hispanic origin that struggles to speak english, demonstrates a distinct lack of intelligence and spends all day eating churros.
Unfortunately, despite my dislike for the examples used, this is an extremely good podcast, it gives you good reliable info, from the basics to exam standard knowledge. The creators have made sure that each episode is humorous, interesting and concise. And yes I did manage to learn a lot while in the gym listening to medpod101.
So if your now adverse to blatant stereotyping and prejudice, then medpod101 provides a great way to learn medicine on the go 
