Wednesday, February 27, 2008

Hold On To Your Wallet

Health-care spending in the U.S. is projected to hit $4.3 trillion by 2017, nearly double the current $2.3 trillion. Medicare spending will reach more than $2 trillion consuming nearly 20% of America's total Gross Domestic Product (GDP).

Much of this change is driven by the aging Baby Boomer population but the failures of the current medical system must also be faced. The current system of private insurance means that every doctor is faced with multiple forms with different rules and criteria in a system of denial management by insurance companies. It's estimated that this factor alone amounts to 1/3 of the total health care cost today.

Unnecessary medical tests and procedures driven in part by liability lawsuits and partly by our top-heavy ratio of specialists to general practitioners means that perhaps as much as another 1/3 of total costs could be reduced by adopting a different medical approach. The majority of other industrialized countries employ a majority of general practitioners to prevent health problems, an approach that produces lower costs and higher world rankings. (America ranks #40 in longevity today.)

Developing a new, affordable health care system is past urgent, it's now critical. Health-care spending is projected to grow on average 6.7% each year in the next decade, far greater than the 1.9% growth in the general economy.

Adding complementary and alternative medicine into the mix is one ingredient in the new recipe for better health and lower costs, as it is in other countries.

Tuesday, February 26, 2008

Congress Investigating Misleading Lipitor Ads

Pfizer said it is pulling all of the ads for its cholesterol drug Lipitor since Congress is investigating whether the ads are misleading to the public. Pfizer is the world's largest pharmaceutical company and through last October they'd spent $139 million advertising Lipitor making it the 5th most advertised drug. The drug is the world's best-selling medicine with nearly $13 billion in sales last year.

The United States is one of only two nations on earth that permits direct-to-consumer advertising and it is the leading cause of our nation's prescription drug obesity.

Monday, February 25, 2008

FDA: Americans Need More Drugs

The Food & Drug Administration (FDA) apparently believes that Americans are taking enough prescription drugs. After all, our country has only 4.3% of the world's population but consumes 48% of the world's prescription drugs ... but that's not enough. Now the FDA wants to allow drug companies to promote off-label uses of their drugs to doctors so more prescriptions can be written.

It's not like this is a new subject because off-label uses are already an estimated 21% of drug sales. Drug manufacturers want even more because it can mean additional sales ... lots of additional sales. For example, Risperdal was used off-label 66% of the time according to the Archives of Internal Medicine study from 2006. Anybody think this isn't about the money?

It's a complicated issue because drug manufacturers sued the agency in the 1990's for violating their freedom of speech. The Justice Department has been involved with a number of high-profile whistleblower lawsuits for off-label promotion so there's strong desire by the drug companies to get the situation nailed down ... to their advantage.

Tuesday, February 19, 2008

Money Talks in Medicine

Too many people think doctors and hospitals know everything and can walk on water. Fact of the matter is, they don't and can't. Did you know that 25% of all hospital patients suffer the indignity of a urinary catheter even though many don't even need them? Installing them is simply automatic in a hospital. Did you know that half of all hospitals don't even bother keeping track of who gets them? Less than 10% of hospitals bother to check and see if they're still needed on a daily basis. That research comes from a recent study by the University of Michigan.

Urinary tract infections are at the top of the Will Not Pay list from Medicare beginning on October 1st of this year since it's one of the most common hospital errors. The others are:
Bloodstream infections.
Bed sores/pressure ulcers
Objects left in patients during surgery
Blood incompatibility (giving wrong type of blood)
Mediastinitis, a type of infection after heart surgery
Air embolism - an air bubble in a blood vessel

Since Medicare insures 44 million elderly and disabled Americans it has the clout to get the attention of hospitals. They've also sparked a movement to eliminate preventable hospital errors and insurance companies like Aetna are joining the parade.

It's about time.

Sunday, February 17, 2008

Impersonal Medicine

Can mainstream medicine get any more impersonal than it is today with 8-minute appointments? The answer is: Yes! Now doctors don't have to even come in contact with you to diagnose your ills and prescribe a drug. Soon you'll have a virtual visit with the doctor via the Internet. Aetna and Cigna have both agreed to reimburse doctors for online visits.

Considered best for follow-up consultations or for minor ailments like a cold the visits can be simply e-mail answers to your questions or actual virtual visits. Some doctors are experimenting with webcambs to add a more "personal" touch.

Friday, February 15, 2008

Health Insurance Games

The attorney general of New York plans to sue UnitedHealth Group as part of his investigation into the games the health insurance industry plays with the payment schedule for out-of-network doctors. The common practice results in high bills for consumers.

By controlling the database that the "average cost" information is based on, the industry appears to manipulate the costs lower than they actually are leaving patients to fill in the gap by paying more.

"We believe there was an industrywide scheme perpetrated by some of the nation's largest health insurance companies to defraud customers," Mr. Andrew Cuomo said recently. "Real people get stuck with excessive bills and are less likely to seek the care they need," Mr. Cuomo added.

One of the major reasons America ranks so poorly in world health ratings is that other industrialized nations have health care systems based on prevention and early care instead of the acute care model in our country. It's also why we spend more on health care than any other nation on earth.

Thursday, February 7, 2008

Deaths Stop Drug Trials

Another week, another drug problem in the headlines. Today on the frontpage of the Dallas Morning News the story is about a trial for a new diabetes drug being cancelled because it was killing people. The intensive treatment to lower blood sugar raised the risk of heart attack and stroke.

My favorite quote in the article is from Dr. Steven Nissen, a Cleveland Clinic cardiologist, who said "This suggests that there are things drugs do that we don't understand." As Homer Simpson would say, "Duh!"

Almost as good was the quote from Dr. Elizabeth Nabel, director of the National Heart, Lung and Blood Institute, who said "We were obviously surprised, we were hoping for a positive outcome."

Sometimes the drug-dominated world of mainstream medicine is really scary.

Wednesday, February 6, 2008

Sick Is Cheaper

Society and governments may not want you to be healthy after all because it costs more money. Living longer is more expensive in the long run according to a Dutch study in the news recently. On the average healthy, skinny people lived 84 years at a medical cost of $417,000.

Smokers lived to an average of 77 years at a cost of $326,000 while obese people lived to about 80 years old at a medical cost of $371,000.

What a great advertisement for the tobacco companies! "Smoke now, you'll save your government money which is your family's tax dollars."

Sorry, but I prefer to be very healthy!

Friday, February 1, 2008

Treating the Whole Person

One of the many benefits of complementary and alternative therapies is that they tend to look at you as a whole being, not just bits and pieces. These therapies look for the source of your health problem, not just the symptoms. New studies are showing the wisdom of this common sense approach to health care.

Researchers studying brain injuries think they may have found a common factor in many social problems: an old blow to the head. Underlying brain injury can lead to a variety of cognitive and behavioral problems from alcoholism on up the list.

In one case Mount Sinai researchers looked at a group of 100 homeless men and discovered 82% had suffered brain injury in childhood, often from parental abuse. Many learning disabled are, in fact, suffering from the effects of a brain injury.

By looking at the whole person and not just a specific problem we may be able to find the true source of problems and then be able to offer better treatments. It's good to see mainstream medicine opening the blinders a little to see more.