Category Archives: General Cynicism

No death panels for us. Just more uninsured who can’t afford health insurance……and care.

This is happening in Washington State but is not unique:

The Basic Health Plan, which provides subsidized insurance for the 66,000 working poor, gone.

Medicynical Note: It should be noted that Washington State voted down an income tax on high earners and passed an initiative requiring a two thirds majority to increase taxes. So rather than ask those who can afford it to pay more we’ll simply tax those who can’t and remove their safety net.

And if they get sick? Tough love and tough luck.

Our local hospital, a part of the Peacehealth system in Washington State, has been purchasing medical practices and incorporating them under their brand. It is the only hospital in town, the next one is about 25 miles south.

In addition to general physicians specialists are being added. All the the oncologists in town were added last fall and the cardiologists (except one) this year.

The medical oncologists had a new well-equipped infusion center at their practice which is located a few miles from the hospital. Last month with minimal discussion, the infusion center was moved to the hospital. No explanation was given but one can assume this “non-profit” made the decision because they can bill more for services at the hospital than in an office setting.

I’ve discussed this previously. In addition to a facility charge the reimbursement for services is significantly more for most billing codes in hospital outpatient settings

Medicynical note: At some point cost and value will need to be addressed and gaming of payments stopped. It doesn’t appear however, that this will happen soon as businesses have a fiduciary responsibility to maximize profit and consumers are insensitive to pricing when someone else pays and health issues are involved.

Addendum 12/16 PM — It’s hard not to be offended by organizations manipulating health care procedures to increase billings and ultimately patient cost.  Value, patient convenience,  efficiency does not seem to be in their vocabulary.

A number of necessary drugs are in short supply. While the full list is unavailable, one can assume that the drugs needed are off patent and lower priced.

From cancer treatments to surgical sedatives to standard emergency-room remedies, the pharmaceutical supply cabinet is increasingly bare of the drugs of choice, according to doctors, advocacy groups, and the FDA

Those include intravenous Lasix, a diuretic commonly used to treat congestive heart failure, and Cisatracurium, a muscle relaxant used in surgery, he said. Medicynic: lasix off patent for years, cisatracurium off patent this year.

As of Dec. 1, there had been shortages of 199 drugs, she said, two more than all of last year, the previous high. Anecdotally, others say, the situation is the most acute it has been in more than a generation.

Medicynical note: In a “market driven” money oriented non-system of health care drugs that are not money makers and I mean big time profit makers will not be manufactured.

If our system were truly market driven we would not be providing generation long patent protection to drug companies. Rather the drugs would compete based on merit, efficacy and cost. Given that this is not likely to change perhaps there should be a quid pro quo required of drug companies that requires manufacturing of less expensive needed medications in order to qualify and maintain patents on their expensive drugs.

Joseph Stiglitz reviews Gordon Brown’s book on the financial crisis which Brown calls the first crisis of globalization (tell that to the chronically unemployed)

As soon as Northern Rock began to teeter, he realized there were deep structural problems with the financial sector and he tried to act on what he saw. He grasped immediately that the problem was not just one of liquidity but of a weakness in the financial sector built on years of mismanagement, lax regulation and reckless speculation.

Read the article.

Medicynical note: There is a message here about the greed of unregulated markets that applies to our medical non-system. How else to explain our out of proportion, unaffordable costs–50-100% more/capita than in other industrialized nations; the mediocre outcomes; the 50 million or so people who are uninsured.

The problems in health care also were built on years of mismanagement, lax regulation and endless speculation (that people will pay more for anything related to health) and a cost plus mentality.  Value?  Cost efficiency?  Not anyone’s department.