In doing some other research, I ran across this statistic:
In this country? With the information and resources we have?
How much of this is incest?
Why?
Source: National Vital Statistics Report, Vol. 65, No. 3, 2 June 2016.
The Senate proposal is out. The proposed law is 142 pages of (perhaps unnecessary) complexity, and, given the rushed nature, probable errors. But it’s out.
It’s not out in time to prevent damage for 2018.
The proposal represents a mixed signal for consumers.
Sticking points:
Collateral damage:
Sources:
The monologue on Mexico focuses on those crossing the border into the US. In fact, that’s
a very narrow view of the relationship between the two countries.
According to the State Department, there are one million US citizens living in Mexico. However,
CNN reports that there are four reasons that Americans give for moving to Mexico:
One American comments that doctors in Mexico are more helpful and enjoyable to visit than are doctors in the US.
It’s cheap. It’s very patient-oriented. It’s like my father practiced in Illinois about 50 years ago, without all the paperwork.
Many Americans, including some in Congress, view Mexico through the prism of an out-dated stereotype. Of course, if that changes, more Americans might move there.
Sources:
This is not a defense or excuse for the exorbitant pricing or profits in the health insurance industry in the US. As with most social issues, there is no single cause of a problem. The industry owns part of the issue, Congress owns a major part, but consumers also own a piece. It’s time to recognize that and do what you can do about it.
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I grew up in an advertising era touting “rugged individualism.” The icons of that era included John Wayne, the TV character Palladin, and the advertising “Marlboro Man,” all part of a mythology that people could cut their own path regardless of others.
Unfortunately, that’s not how life works. If your reading this, someone else probably had provided the electricity for you. If you also write, the court system protects your intellectual property. If you have a retirment account, you depend on financial regulators to protect your assets. If you eat (and you’d better be doing that), there’s the farmers and fishermen who provide what you consume. We are a connected network of people, whether on the grid or not. Whether you like it or not.
That’s blatantly the case in health insurance. There was a time when health insurance didn’t exist and didn’t matter. There were relatively few doctors in the 1850s, medical knowledge was relatively crude, and life expectancy was short.
Life expectancy has increased dramatically in the last two years, as you can see from the chart above, from an excellent article by Max Roser. (1)
In most geographies, the major gain in life expectancy came after World War II.
However, the increase in life expectancy comes at a substantial cost. One estimate says that each day of additional life expectancy adds $1.6 billion to medical costs just in the US. (2) However, living longer is just one component of the story of rising health costs.
Behavior matters. Certain things some of us do add substantially to medical costs for each and every one of us. How does that work? It’s in built into the concept of insurance as conceived by Benjamin Franklin.
That might seem unfair to healthy people, but we have to remember that no one stays healthy forever. Everyone dies. Everyone gets a turn with illness, sometimes more than one turn.
What might be considered unfair is when people do things or allow things to happen that cause illness. For example,
The medical expenses that result from these behaviors hit every consumer:
High spending doesn’t mean better medical results.
With development, health outcomes generally improve, but the U.S. is an anomaly. The U.S. and the U.K. are both high-income, highly developed countries. The U.K. spends less per person ($3,749) on health care than the U.S. ($9,237). Despite its high spending, the U.S. does not have the best health outcomes. [Life expectancy, for example, is 79.1 years in the U.S. and 80.9 years in the U.K. And while the U.S. spends more on health care than any country in the world, it ranks 12th in life expectancy among the 12 wealthiest industrialized countries, according to the Kaiser Family Foundation, a non-profit organization focusing on health issues.] (8)
Europeans and the Chinese government understand the impact of individual behavior on costs. Americans have been more reluctant to understand and accept personal responsibility for how their behavior affects themselves and everyone else. It’s time to grow up and put the myth of rugged individualism away.
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In the rush to repeal the Affordable Care Act, the Trump Administration has been repeating the mantra that the individual insurance marketplaces are “failing.” Like most statements made by politicians these days, the facts seem to be a little different.
Clearly, Iowa is in crisis. With the withdrawal of Aetna from the individual marketplace, there is a real risk they may have no insurers offering individual coverage through the marketplace in 2018.
My suspicion is that Aetna’s withdrawal has more to do with its stock price and financial liabilities after a failed merger attempt than with the ACA itself. Aetna has also stopped writing small group insurance in some states.
However, Pennsylvania has six carriers committed to the marketplace for 2018. The only concern is what the Trump administration might do the mess things up.
Further, another insurer, Centene, has announced that it is expanding individual marketplace coverage into three new states — Kansas, Missouri and Nevada.
So what’s the real story with Iowa? If the fault were with ACA, it would be impacting every state and every carrier, and that’s not the case. What have state officials done to mess things up?
If you know the story, please reply. I’d like to know, both about Iowa and about other states where local officials are whining about Obamacare. Let’s get the full story out into the open.
We already know that early detection of cancer
Cancer screening is invaluable.
Now a new study from the Cleveland Clinic shows that the time lapse between detection of cancer and the start of treatment also matters. Each week that passes between diagnosis and the start of treatment impacts the five-year survival rate.
Longer delays between diagnosis and initial treatment were associated with worsened overall survival for stages I and II breast, lung, renal and pancreas cancers, and stage II colorectal cancers, with increased risk of mortality of 1.2 percent to 3.2 percent per week of delay, adjusting for comorbidities and other variables. (1)
In the example of stage I non-small cell lung cancer, the five-year survival rate is
The problem is that the length of time between diagnosis and treatment has been increasing since 2004.
What you need to consider:
Sources:
There are two relatively new terms in medical jargon that are worth knowing:
Pharmaceutical companies obviously provide information about when a drug should be used and about side effects that might indicate that the drug should not be used.
What’s rare is information about when a drug ceases to be effective or of value to the patient. Thus as people age, they tend to add prescriptions, and continue them beyond the point of the drug having any real value to the patient.
Dr Farrell notes that at her hospital in Ottawa, it is not unusual to see a patient on 25-30 medications. “Frequently, a medication is started to see whether it will help with certain symptoms—almost like a diagnostic test—but then the medication is never stopped,” she explains. “Ten years go by, and the family doctor retires or dies, and the patient sees a new family doctor who doesn’t know why the drug was prescribed in the first place but is scared to stop it. I see patients in their 80s and 90s who have been on a medication for 30 years, and no one can remember why they are taking it.” (1)
The Canadians are ahead of the US in tackling this issue, even though drug costs are substantially lower in Canada than in the US.
Dr. Barbara Farrell is a clinical scientist at the Bruyère Research Institute and the C.T. Lamont Primary Health Care Research Centre, and assistant professor in the Department of Family Medicine, University of Ottawa, Canada. She is a cofounder of the Canadian Deprescribing Network and codeveloper of deprescribing.org, a website for the dissemination and exchange of information about deprescribing approaches and research. (1)
Her Canadian team is in the process of developing guidelines for reducing or eliminating the medications prescribed for a patient.
Why is this important?
What you should consider:
Ultimately, you’re the custodian of your body. Like a house or a car, your body needs maintenance and you need to be in control.
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