The C2S blog draws on the arts, the social and biological sciences to explore the many meanings of health and "dis-ease." Designed to be a locus where patients, their families and professionals can meet on a level playing field, it is the natural off-shoot of the Cell 2 Soul Online Journal. We encourage the submission of ideas, essays, poems, stories, humor, and timely reviews relating to the humanities and health care.
"The trouble with a free-market approach is that health care is an immensely complicated and expensive industry, in which the individual rarely has much actual market power.
The point of universal coverage is to pool risk, for the maximum benefit of the individual when he or she needs care. And the point of having the government manage this complicated service is not to take freedom away from the individual. The point is the opposite: to give people more freedom.
I wish we were free to assume that our doctors get paid a salary to look after our best interests, not to profit by generating billable tests and procedures."
Excerpts from an amazing op-ed in the NY Times. It pretty well says it all in a pleasant "nordic" way.
When is it ethical to design a health care system that caters to those who can pay?
An old Yiddish proverb runs: "If the rich could pay the poor to die for them, the poor would make a very good living."
Khawar Mann, OBE, a venture capitalist with the Abraaj investment group, travels around Africa scoping out hospitals to buy that seem likely to provide good returns on investments.
Private health care has been an interesting model in the U.S. which lags behind all other developed nations in outcomes. So why is the American system now envisioned as a viable model for Africa? Will this not just serve to widen the "health" gap between the rich and poor?
Mr. Mann says: "“Nairobi is a sweet spot for us. There is a big population that is growing. You have emerging middle incomes. And there is a massive need for health care.” (for those who can afford to pay in cash).
(The following is taken from the book's introduction)
The central problem with healthcare is that too much medical care has too little value, too many people are being made to worry about diseases they don't have an are only at a low risk to get. Too many people are being tested and exposed to all the harmful effects of the testing process: the anxiety of false alarms and the vulnerability caused by ambiguous findings, not to mention the complications of diagnostic procedures.
Too many people are being given treatments they don't need or can't benefit from. Treatment interventions can have substantial physical harms such as medication reactions, surgical complications, even death
It's not lawyers who are the problem; it's economics. Physicians are paid more to do more and insurance, not the patient, foots the bill. Paying physicians a fee every time they provide a service encourages them to order more tests and procedures. Because patients are shielded from the costs by a third-party, they have little incentive to scrutinize the value of the services.
To complicate this more, the general public harbors assumptions about medical care that encourages overuse. Assumptions like the following are extant: it's always better to fix the problem, sooner is always better or it never hurts to get more information. These assumptions flow directly from information provided to the public from many sources (doctors, drug and device makers, the media, the Internet). The public winds up with assumptions that lead to an excessively optimistic view of medical care. That leads them to seek too much care.
This book is about challenging these assumptions – and helping all of us to avoid too much medical care. As a society, we have overstated the benefits of medical care and underplayed its harms. It is possible that in many cases less medicine would be better for our health.
Less Medicine, More Health gives a few simple strategies to avoid too much medical care.
What Walsh wants from medical care is a system that excels in the care and treatment of acutely ill and injured persons. This, in his opinion, is the most important activity of medical care, but is not what most medical care is about. Much of medical care doesn't reliably lead to better health.
This is a long, but invaluable, introduction to the topics of over-diagnosis and over-treatment. The Lown Institute has impressively addressed this topic for the past three years or so and a cadre of physician scientist and clinicians around the world have been interested in subject as well. In his polished way, Gawande covers the issue for the lay and professional reader. He asks: What can we do about the avalanche of unnecessary medical care that is harming patients physically and financially.
I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug. Modern version of Hippocratic Oath
In this inspiring 90-minute documentary, filmmaker David Grubin takes his camera across America to focus on the challenges and triumphs in our country’s health care delivery system. The four segments that comprise Rx: The Quiet Revolution introduce us to a diverse group of doctors, nurses, and health care professionals who are transforming the way we receive our medical care: lowering costs by placing the patient at the center of their practice.
Rx: The Quiet Revolution shows us what’s happening from Maine to Mississippi, California to Alaska. You will see physicians, nurses and other healthcare professionals placing the patient at the center of their practice — transforming the way medical care is delivered while lowering costs and improving outcomes.
Filmmaker David Grubin brings you these compelling stories:
In Maine, we meet Dr. David Loxterkamp, who practices family medicine with a team of doctors working to treat patients with chronic illnesses.
In Mississippi, a state with more diabetes cases than any other, Grubin finds a rural health clinic fighting diabetes with the aid of an electronic communications device that provides greater access to medical care, helping patients take responsibility for managing this devastating chronic disease.
In San Francisco, Grubin visits a health care facility for seniors called On Lok, dedicated to making it possible for frail, elderly Americans in need of nursing home care to live with dignity in their own homes.
In Alaska, the documentary follows Native Alaskans who own and operate their own health system, caring for 65,000 people across 107,000 square miles. In spite of the number of patients and the vast distances between them, they are determined to foster an empathetic relationship between patients and their health care providers.
At 90 minutes, this may seem a daunting investment in time, but Rx: The Quiet Revolution will speak to you in powerful and compelling ways.