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Politics : A US National Health Care System? -- Ignore unavailable to you. Want to Upgrade?

To: Lane3 who wrote (6380)	3/14/2009 1:12:57 PM
From: Lane3	1 Recommendation Respond to of 42652

From today's WaPo. Apparently nationalizing health care doesn't stop heart disease... <g> Study: Some heart patients undoing drug benefits By MARIA CHENG The Associated Press Thursday, March 12, 2009; 4:06 PM LONDON -- European heart patients are taking more medication than ever before to lower their blood pressure and cholesterol, but bad habits such as overeating and smoking are undermining the drugs, a new study says. Despite big increases in heart patients on medication, most still have high blood pressure and nearly half have high cholesterol. Researchers interviewed more than 8,500 patients in eight countries. Patients were on average about 60 years old, and had a history of heart problems. The experts found that more young patients are smoking, and more patients are fatter and diabetic compared with similar groups from 12 years ago. The study was published Friday in the medical journal, Lancet. "In terms of the lifestyles of patients with coronary disease, everything is moving in the wrong direction," said Dr. David Wood, one of the paper's authors and a professor of cardiovascular medicine at Imperial College in London. The study was supported by the European Society of Cardiology and paid for by pharmaceutical companies that make heart drugs. Researchers also found that the numbers of patients taking drugs to lower their cholesterol was seven times higher in 2006-2007 than in 1995-1996. About 43 percent of patients still had high cholesterol. And while more people now take medications to lower their blood pressure, Wood said that hadn't made any difference. "The response of physicians is just to give more and more drugs, but what we need is a comprehensive lifestyle program." Experts said trends were similar in the United States. "Even if we advise patients to lose weight, they have to walk out the door and do that themselves," said Dr. Alfred Bove, incoming president of the American College of Cardiology. Bove, who was not linked to the study, said more patients were now being treated for high blood pressure, but millions were unaware they even had a problem. In the last decade, deaths due to heart disease have dropped by about 30 percent in the United States and 45 percent in Britain. But the rates are leveling off, and experts worry the surge in obesity and diabetes will reverse previous successes. Even with advances such as medications, heart stents and angioplasties, Dr. Daniel Jones, a past president of the American Heart Association, said that fighting heart disease "is like swimming upstream." Jones, who was not connected to the Lancet study, warned that the widespread use of heart drugs has masked the effects of the obesity epidemic and that it would be even worse without them. "We know that giving medications will reduce patients' risk, but we shouldn't put all our eggs in that one basket," he said. "We need to work harder on preventing problems at their root."

To: Lane3 who wrote (6380)	3/14/2009 1:32:13 PM
From: i-node	Respond to of 42652

Not if the hospital owns both the ER and the clinic. It's the same patients getting the same services, just two different doors and, in some cases, two different price tags. Well, if one is charging $500 for a visit and the other is charging $50 .. but I don't think most ERs are abused in that way. I think in cities where you have a lot of homelessness, etc., is the problem -- the visits aren't being paid for at all in many instances. In this regard, I think the health care initiative in Obama's stimulus plan that provides for "community health centers" could make a lot of sense. Although, I don't know the details of what they're doing. But I cannot imagine that better health care wouldn't be available if every city had one or more such health centers that provided 24/7 care staffed by physicians and PAs and that dispenses medication onsite, predominantly generics, etc. I would not find it problematic for the government to fund, for example, 250 such clinics across the country to care for the homeless/indigent -- as opposed to providing other free benefits. You could spend a couple billion a year and probably handle 10 million or more patient visits a year with drugs dispensed on the spot. That may well be a cost-effective model for government to provide care for those who cannot provide their own. For the severely ill, they at least get some care and can be diagnosed and perhaps placed into the county hospital system or whatever. I have no doubt it would provide a better outcome than a lot of these people now get and for a fraction of the cost.