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

To: Lane3 who wrote (13032)	1/13/2010 8:02:15 AM
From: Lane3	Read Replies (1) \| Respond to of 42652

The death squads are after us again. Now they want to reduce CT's and MRI's <g> December 15, 2009, 6:18 pm CT Scans and Health Care Reform By DAVID LEONHARDT This week’s news about CT scans offered the latest evidence of the problem with fee-for-service medicine. Radiation from the CT scans done just in the year 2007 will eventually cause 15,000 extra deaths, researchers reported in The Archives of Internal Medicine. And scan use continues to rise, so the death toll will probably grow. An editorial accompanying the research paper suggested that there appeared to be “significant overuse” of such scans. Many of those scans, of course, bring in extra revenue for doctors, hospitals, medical-device companies and the like. The scans are also also one small reason health costs are rising so rapidly and insurance has become unaffordable for so many people. CT scans are, in a nutshell, precisely what’s wrong with fee-for-service medicine: It causes wonderfully useful treatments and tests to become overused. Here is more from the Internal Medicine editorial: A popular current paradigm for health care presumes that more information, more testing, and more technology inevitably leads to better care. The studies by Berrington de González et al and Smith-Bindman et al counsel a reexamination of that paradigm for nuclear imaging. In addition, it is certain that a significant number of CT scans are not appropriate. A recent Government Accountability Office report on medical imaging, for example, found an 8-fold variation between states on expenditures for in-office medical imaging; given the lack of data indicating that patients do better in states with more imaging and given the highly profitable nature of diagnostic imaging, the wide variation suggests that there may be significant overuse in parts of the country. For example, a pilot study found that only 66% of nuclear scans were appropriate using American College of Cardiology criteria—the remainder were inappropriate or uncertain. ------------------ economix.blogs.nytimes.com Using, and Overusing, Medical Technologies By CATHERINE RAMPELL My colleague David Leonhardt wrote Thursday about the mortal consequences of overuse of CT scans in the United States, which is encouraged by the country’s fee-for-service health care system. To give you a sense of how much we use CT scans, here is a chart from the Organization for Economic Cooperation and Development’s most recent health statistics release, showing the number of CT exams administered per 1,000 people in 11 developed countries: Health Data 2009 Number of CT exams per 1,000 population, 2007 (or latest year available). Numbers for Australia and France include exams for out-patients and private in-patients (excluding exams in public hospitals). Notice which country tops the list, at 227.8 exams administered per 1,000 people. Not coincidentally, the United States also dominates in a ranking of MRI usage: Health Data 2009 Number of MRI exams per 1,000 population, 2007 (or latest year available). Numbers for Australia and France include exams for out-patients and private in-patients (excluding exams in public hospitals).

To: Lane3 who wrote (13032)	1/13/2010 8:45:56 AM
From: Road Walker	1 Recommendation Read Replies (1) \| Respond to of 42652

If we could look at what is accomplished in this legislation with the understanding that nothing more can be wheedled out of the system, then set that as the objective for a redo. If both sides could agree to do exactly that much, no more or no less. If we could then come up with the most constructive, or least destructive, way of accomplishing those slim objectives, we would be so much better off. We could get a bill under a hundred pages that hits directly on the target and wouldn't burn us going forward in myriad ways. If. There is much debate about how our legislative process got in such a sorry state but general agreement that it is dysfunctional. Health care is a perfect example of an issue where you cold have picked and chosen ideas from the left and right and put together a really good bill... but it's not in the cards. Both sides are responsible. I sure remember better days when the interests of the country came before the interests of the political parties.