Tuesday, June 5, 2012


Yesterday was completely INSANE!  I can't remember the last time our phones were that busy -- so busy that we had multiple calls coming in at the same time, and all three of us answering them!  It took me until way into the evening to return them all -- and there are still a few for whom I had to leave messages.  Starting the week like that makes me long for the week-end already.  But that's not going to happen.  Too much to do.  But first, the news:

Since it's now June, the fevered anticipation of a Supreme Court ruling on health reform is beginning to build.  Although the individual mandate has become a target of the right, it's worth remembering that it was, initially, a conservative idea.   This piece by Ezra Klein of WaPo is worth reading for its historical focus.  What will happen if the Supreme Court strikes down the individual mandate?  There are reports that the White House is already hatching a planPundits are engaging in what ifs.  I just keep hoping it doesn't come to that, because if we lose the individual mandate, we lose coverage of people with pre-existing conditions -- the most important civil rights victory for people with chronic illnesses ever.  And I don't believe I'm overstating it one bit. 

Once near universal coverage is achieved, the next step is to try to control health care costs -- starting with cleaning hospitals adequately to avoid hospital acquired infections.

Will recent studies showing that certain testing -- for example, prostate screening -- is unnecessary, will doctors do less of it?  Here's one doctor who thinks doctors will stick with business as usual, despite studies that show that doctors often order tests and recommend treatments that are not medically necessary.  I'm convinced that, if we are going to control health care costs in America, everybody in the system -- doctors, patients, pharmaceuticals, insurance companies, employers -- will all have to change.  So let's hope this pessimism is unwarranted.

If you're on Medicare, watch out for this one.  Hospitals keep you on observation status rather than admitting you -- and Medicare pays less for observation status, so patients are left footing the bill.  Even worse, Medicare only pays for nursing home care following a hospital admission, so no admission means no coverage of nursing homes. 

Are we really moving to virtual colonoscopies that don't require the horrible prep?   I've already decided I'm never doing that prep again, so I'd love an alternative, but I'm guessing my doctor would not be satisfied with this half-measure. 

Medical marijuana becomes law in Connecticut.  The law takes effect in October.  Presumably, there will be details about what you have to do to comply with the law.  So far, all I know is that patients will need a certification from a doctor and they will have to register with the Department of Consumer Protection.  They will be allowed a one-month supply, and the drug will be dispensed only by pharmacies (pot at your local CVS?  Really?).  The law limits the use of MM to specific diseases:  cancer, glaucoma, HIV or AIDS, Parkinson's disease, multiple sclerosis, epilepsy, cachexia, wasting syndrome, Crohn's disease, post-traumatic stress disorder and intractable spasticity arising from spinal damage. 

You know, I talk to patients all day every day.  I hear some incredible stories -- some sad, some tragic, some uplifting.  Here's some inspiration for you.  A woman who lost her sight to a rare neurologic disease called neuromyelitis optica (NMO) is on the TV show Master Chef, cooking blind.  Awesome.

And that's it for this Tuesday morning.  Have a great day!  Jennifer

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