tag:blogger.com,1999:blog-6909222850906563288.post3987630754142729411..comments2024-03-10T11:29:12.088-07:00Comments on Advocacy for Patients with Chronic Illness: Fixing a HoleAdvocacy for Patientshttp://www.blogger.com/profile/05587406553911123626noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-6909222850906563288.post-26974160307027664922009-06-17T13:37:05.261-07:002009-06-17T13:37:05.261-07:00I understand your point. But that's not really...I understand your point. But that's not really what I'm referring to. <br /><br />I, and I believe the basic reforms I outlined, are all for delivering treatments to patients when there is expected recovery and a good quality of life after a certain procedure. <br /><br />A relative of mine has severe late stage Alzheimer's disease. She hasn't spoken a word in years, formed a complete sentence in nearly a decade, but every time she gets an infection, the nursing home gives her antibiotics. And she stays in the nursing home at a tune of $50,000+ a year. <br /><br />Somewhere along the line we have to say, "We wish things weren't this way, but this is inevitable," and cease life-prolonging treatments that keep people with no quality of life alive at great expense to everyone. It isn't just my Grandmother either. Basically the entire nursing home is filled by such patients. <br /><br />End of life care in American is ridiculous. We spend so much propping the old and barely alive patients up that we frequently, as you rightly point out, make the young and very sick wait at great risk to their continuing health. <br /><br />The European models are better than the US model (US is rated 37th in the world to 1st for France, 2nd for Italy, etc). They all provide universal access up front for preventative care, but limit life prolonging procedures in geriatric patients. If we're going to reduce health care costs, we have to reduce the 30% of all costs which are created in the last year of life. We need to favor hospices over nursing homes. <br /><br />That doesn't deny patients dignity, which is what the current system of unneeded treatments does in my view.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-6909222850906563288.post-86568586780516165332009-06-17T13:08:30.462-07:002009-06-17T13:08:30.462-07:00For real...number six?? How many people who read ...For real...number six?? How many people who read this blog have been that close to a number six to feel comfortable with that idea? On your "?" blood transfusion they say ummm, no we are low on blood and you've been here several times already and you'll be here again soooo...we'll just put you up somewhere and let you pass on? That's actually not so far from the truth already...<br /><br />RabbitAnonymoushttps://www.blogger.com/profile/12109708622058652160noreply@blogger.comtag:blogger.com,1999:blog-6909222850906563288.post-34053837935533717052009-06-17T07:40:23.273-07:002009-06-17T07:40:23.273-07:00Fair points. Though some doctors definitely do ord...Fair points. Though some doctors definitely do order more tests due to fears of malpractice suits. Others order more tests because state governments have fixed their budget problems with massive tuition increases over the past 10 years. So med school graduates are carrying $300,000 10 year mortgages of student loans upon graduation. i think this would be the best, most cost effective, and fairest health insurance reform we can hope for:<br /><br />1. Non-profit co-ops that operate on a PPO model. Additionally, a doctor who takes one co-op plan would have to take other co-op plans of patients who were from out of the area. <br /><br />2. A ban on for-profit insurance companies and hospitals compensating their employees with stock options. If employees get stock options, they have an incentive to increase the company's overall profit. For insurance companies, that means denials of needed procedures. For hospitals (see McAllen), it means ordering unnecessary procedures. <br /><br />3. Having the federal government negotiate drug prices and service fees. Medicare plus 10 percent isn't a bad idea. <br /><br />4. Sweeten what is inevitably a pay cut for good doctors by providing loan forgiveness to doctors who accept a co-op plan. <br /><br />5. An individual mandate, but the mandate lets you keep your insurance with no premiums when you're laid off. <br /><br />6. The elimination of unneeded life-prolonging, but medically dubious, procedures. I'm talking about feeding tubes in Alzheimer's patients and the practice of warehousing the ill, spending hundreds of thousands of dollars to keep them alive in their last year of life, and turning them into drugged vegetables. Instead of sending them to the hospice to enjoy, as much as possible, their last moments on this great planet with their family and friends. <br /><br />7. Pay for this by the elimination of the tax deduction companies get to insure their employees. And by a 2% Capital Gains tax increase and a 2% flat income tax. <br /><br />Such a reform would pay for itself, insure nearly every American, give good access to care. And allow doctors to do their jobs again. It's also the German system, basically. The German system is ranked 8th in the world for outcomes, even though they spend a fraction of what the US spends (in GDP terms) health care. The US, despite spending far more both in actual dollars and in percentage of GDP, is ranked 37th, right ahead of that economic powerhouse called Cuba.The Bag of Health and Politicshttp://thebagofhealthandpolitics.wordpress.comnoreply@blogger.com