Below, Amy Berman describes her recent journey through our health care system as “eye-opening.” In part 1 of this post, she explained why she decided on palliative treatment for breast cancer, rejecting aggressive procedures such as mastectomy and chemo.
When Amy Berman was diagnosed with Stage IV breast cancer a year ago, she made a courageous choice. Instead of fleeing death, she decided to pursue life. In the essay below, she describes why she rejected chemotherapy, radiation, and surgery, choosing palliative care instead.
Should the Preventive Services Task Force Depend on Congress for Funding?
Should Doctors Who Share Decision-Making Be Protected Against Lawsuits?
If Doctors Don’t Tell Patients What They Are Doing, Is This Malpractice?
Should Physicians Who Want Tort Reform Give Something in Return?
Should Nurses with PhD’s be Called “Doctor”?
These are some of the questions I thought about after reading the latest edition of Health Wonk Review, hosted by Health Affairs’ Chris Fleming. In this two-part post, I focus on just five of the best health care posts of the past two weeks. Inevitably, I have omitted some outstanding posts. I urge you to read the full round-up here.
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Over the past decade, state laws restricting abortion have mostly focused on trying to reduce demand for the service. Some states do this simply by making abortion financially out of reach: The average cost of a first-trimester surgical abortion is $451, and in all but fifteen states Medicaid will not pay for low-income women to have the procedure.
Today, the Obama administration released newly revised rules for “accountable care organizations” (ACOs) that are designed to persuade hospitals, doctors, and other health care workers to collaborate in providing better value for our health care dollars. In an ACO all providers involved in treating a particular patient or condition share a single flat fee. That fee will be higher if they succeed in achieving better outcomes for less, lower if they fail. In other words, providers are being asked to share in the risk that patients and payers now face when they agree to undergo treatment—or to pay for it. The lump sum payment creates an incentive for hospitals and doctors to work together to achieve the best possible results. They will win the wager only if they co-ordinate care.
The following post originally appeared on the TIME Moneyland blog.
Kaiser Permanente’s stand-out performance in Consumer Reports’ national rankings of some 830 insurance plans raises an obvious question: What makes Kaiser so different? In a word: collaboration.
The following post originally appeared on the TIME Moneyland blog.
Are health insurance plans with big brand names better than smaller insurers that most people have never heard of? “Not usually,” says Nancy Metcalf, senior program editor, at Consumer Reports. Unless, that is, the plan’s name is “Kaiser.”
Sen. Orin Hatch (R-UT) called it a “Ponzi scheme,” President Barack Obama held it up as a testament to the work of Ted Kennedy who wanted to ensure that the elderly and disabled would be able to afford help with simple activities of daily living; Rep. Phil Gingrey (R-Ga.) simply called the program “insolvent.”
Are health insurance plans with big brand names better than smaller insurers that most people have never heard of? “Not usually,” says Nancy Metcalf, senior program editor, at Consumer Reports. Unless of course, the plan’s name is “Kaiser.” As Metcalf points out, Kaiser Permanente, a non-profit that insures some 8.8 million Americans nationwide, stands “head and shoulders” above the other large insurers. In general, smaller plans outranked the well-known names, and surprisingly, when it comes to patient satisfaction, Health Maintenance Organizations (HMOs) received higher marks than Preferred Provider Organizations (PPOs) even though HMOs require that the patient remain “in network.”
Over the past decade or so, there have been at least 20 prescription drugs removed from the market, including several cases of high-profile blockbuster drugs that were found to be harmful only after millions of patients had taken them. Vioxx, the pain reliever sold by Merck is one example; taken by an estimated 20 million Americans, it increased the risk of heart attack and stroke in some patients. The company ended up paying out a $4.85 billion settlement after the drug was pulled from the market in 2004. The diet drug Meridia, also linked to a higher risk of heart attack and stroke, was on the market for over 12 years before it was withdrawn last year. According to the watchdog group Public Citizen, drugs taken off the market since 1993 were sold for an average 4.1 years before being pulled.