Monthly Archives: March 2007

We lack value in our medical establishment. This $11,000 fractured rib is one extreme.

An article about insurers denying claims of long term care beneficiaries. Should we be surprised given that insurers are in business and their first priority is their profit, not the well being of their clients?

It’s also instructive that this appears in the business section of the International Herald Tribune and the NYT, rather than the health section.

The equivalent of forty 747’s crashing each year is the reported death toll from our lack of a national health insurance scheme.

“Across the United States, the ranks of the uninsured have swollen from 40 million to 47 million since 2000 for an increase of nearly 18 percent, according to a report by the Commonwealth Fund, a New York-based foundation focused on health care. The same report indicated that the working population aged 18 to 64 makes up rising numbers of the uninsured as insurance premiums soar and companies cut back on coverage.”

“The consequences are increasingly well known: inequities in access to care, avoidable mortality and poor quality care, financial burdens on people who are uninsured or under insured, and lost economic productivity,” Commonwealth Fund President Karen Davis wrote in a report. “The U.S. spends twice as much on health care as the median industrialized nation but does not systematically achieve the best quality care.”

“Gaps in health-care coverage lead to an estimated 18,000 deaths and as much as $130 billion in lost economic productivity annually, according to Commonwealth.” (bold emphasis is Medicynic’s)

In India, we’re just back from a visit, cab and rickshaw wallahs receive commissions from emporiums and other shopping outlets for bringing customers. As a result, when you are with a cab driver they recommend only those places which gives them commissions.

Cab drivers are thus not reliable sources of information about shopping and may even resist your attempts to get to the places you really want to visit. The situation is complicated by the fact that in India shops’ names are often near duplicates of each other and every store will claim to be that government emporium your guide book recommended.

Sound familiar? While on a different monetary scale, the situation is similar to the corroding effect of drug company’s gifts, consultant fees, salaries, “fourth phase” research funds etc, on physicians in the U.S. We’re talking thousands to millions of dollars here. At the most basic level, these funds, commissions if you will, are designed to encourage physicians to bring their clients to the pharmaceutical company’s products. These payments at a minimum give the impression that physicians are not objective sources of information about treatment and may have an actual conflict of interest. In the U.S. we’ve more fully developed the system so that the agents of the pharmaceutical companies (detail people) can actually check with pharmacies and confirm that their physician wallahs are recommending their product and if necessary provide more effective incentives to influence them.

This timely article explains, in part, how it works.

What the hell has happened to my profession!