The End

Of the week, that is.  A very long week marked by much pain and a little fear over an infection gone wild -- life with chronic illness.  The swelling and pain are better -- not gone, but much better.  Now, I switch gears to getting ready for my annual cross-country pilgrimage to the West coast to visit with Pearl Jam's Mike McCready and his wife, Ashley O'Connor, for part of the Flight to Mars tour.  Good music, good causes, good friends -- what more can you hope for?

First, the news.

An FDA panel has backed the use of a preventive HIV drug.  What a wonder -- just great news.  But availability is always an issue.  For example, when Medicare reimbursement rules for anti-anemia drugs for dialysis patients changed, the drugs were prescribed less, but blood transfusions climbed.  Way too often, it comes down to money.  And that is where we go wrong in America.  Health shouldn't depend on whether you have enough money to afford it -- especially since illness is likely to change your financial status, as well as your health status.  But still, the House passed a budget slashing $310 billion, mostly cutting programs for the poor, many of which touch on health care.  Although Congress had agreed on automatic defense cuts if the super-committee was unable to trim the deficit -- part of the debt ceiling bargain -- the House GOP is changing its tune, preferring to cut food stamps, the children's health program, Medicaid, Meals on Wheels, child abuse prevention -- and on and on.  In a GOP world, the rich get richer and try to make the poor invisible.  Until the middle class becomes poor, and then what? 

And then you have Chris Christie, Governor of New Jersey, vetoing a bill to create a health insurance exchange. I get that he's against health reform.  And he talked a lot about the uncertainty created by the Supreme Court case.  But the exchanges should be built regardless of what happens to the federal law.  They are marketplaces where individuals and small businesses will be able to shop for, compare and buy insurance.  How is that a bad thing? 

In a good move, though, Medicaid payments to primary care providers will increase next year.  It is critical to find a way to entice new doctors into primary care, and increasing reimbursement rates will help.  This is yet another piece of health reform.  Although Medicaid is paid for jointly by the federal government and the states, this increase will be funded completely with government dollars. 

Should medical bills be itemized, so you know what your doctor did and what he/she charged?  It's interesting -- in any other industry, could a vendor get away with not telling you what they charge for their services?  Why should health care be different?

A new report shows that we have made little progress in eradicating racial disparities in health care.  There are some small improvements, but overall, there's been little change.  This problem is going to take more than just talk.

Finally, we end the week with another poignant post from the young woman undergoing a bone marrow transplant -- this one on posting your cancer on Facebook, being sick in the age of social media.

And there you go.  Have a great day and a great week-end!  Jennifer