Tuesday, September 18, 2007

Goverment vs Market reform - “Killers” on Both Sides of the Aisle

“Killers” is becoming the operative word for describing the U\.S. health system. The health system, it seems, has “killers” on both sides of the aisle, the two sides being #1, the inefficient, costly health system itself; and #2 diseases that make up the leading causes of death.


In aisle #1, according to Regina Herzlinger (Who Killed Health Care? America’s $2 Trillion Problem – and the Consumer-Driven Solution (McGraw-Hill, 2007) – are five killers – the health insurers, the general hospitals, the employers, the U.S. Congress, and the elite Policy Makers.


In aisle #2, according to a 14 part NYT series, “Six Killers, ” are heart disease, cancer, stroke, chronic obstructive lung disease, diabetes, and Alzheimer’s disease.


As physicians, there may not be a lot we can do about the aisle #1 killers. But aisle #2 is our responsibility, and the responsibility of our patients, and you may want to read the advice and information NYT reporters are giving its readers. I’m not a fan of the NYT editorial page, but on the whole I find their medical reporting to be sound, albeit occasionally slanted against doctors.


See www.medinnovationblog.blogspot.com for list of 14 articles on six killer diseases.

Articles in the Six Killer Series

1) Looking Past Blood Sugar to Survive With Diabetes. August 20, 2007
By GINA KOLATA,. Largely because of a misunderstanding of the proper treatment, most diabetes patients are not doing what they should to protect themselves.

2) Tips to Help Patients Manage Their Care, August 20, 2007
By DR. JOHN BUSE, director of the Diabetes Care Center at the University of North Carolina, Chapel Hill, says everyone with diabetes should know.

3) ) An Increase in Diagnoses May Not Mean a Higher Rate of the Disease, a Survey Shows, August 20, 2007., By GINA KOLATAIt may just be that more people are learning they have diabetes, not that the number of those with it is increasing.

4) Obesity May Be Only One Piece of Diabetes Puzzle, August 20, 2007,
By GINA KOLATA. Researchers are struggling with a fundamental question. Why does high blood sugar lead to any of the diabetes’s complications — heart disease, stroke, nerve damage?


5) Cancer Patients, Lost in a Maze of Uneven Care, July 28, 2007,
By DENISE GRADY, Treating cancer can be very complicated, and it is difficult for even the most educated patients to be sure they have the best care.

6) Doing Battle With the Insurance Company in a Fight to Stay Alive, July 29, 2007,
By DENISE GRADY. A glorious blend of forces came together to save Gordon Hendrickson’s life; only his insurance company tried to stand in the way.

7) Push Hard for the Answers You Require
By DENISE GRADY, July 29, 2007, How can people with cancer make sure they are receiving the best treatment?

8) Lost Chances for Survival, Before and After Stroke, May 28, 2007,
By GINA KOLATA. From prevention to diagnosis to treatment to rehabilitation, a stroke is a litany of missed opportunities.

9) Cost Put a Stroke Treatment Out of Reach, Then Technology Made It Possible. May 28, 2007,
By GINA KOLATA, Doctors at Martha’s Vineyard Hospital knew the drug tPA had been shown to work for stroke, but they had not been giving it to their patients.

10) Steps Toward Reducing Risk , May 29, 2007,
The deputy director of the National Institute on Neurological Disorders and Stroke lists five things everyone should know about strokes.

11) Lessons of Heart Disease, Learned and Ignored, April 8, 2007,
By GINA KOLATA, The toll from the nation’s No. 1 killer could be reduced if the medical system delivered care that is known to make a difference.

12) How It Happens: It’s Not a ‘Plumbing Problem’, April 8, 2007
By GINA KOLATA, Doctors also fight the popular misconceptions about the causes of heart disease.


13) What I Wish I’d Known, April 8,2007
Naomi Atrubin, a survivor of two heart attacks, shares the lessons she has learned.

14) Answers to Questions About Heart Disease, April 17, 2008
By DR. ELIZABETH NABE, director of the National Heart, Lung and Blood Institute, answers readers’ questions about heart disease.