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This is not strictly a medical topic but does reflect the incompetence of our congressional leadership and members, mainly republican.

The point of sequestration was to force congress and the executive into making difficult budget choices in a budget.  Republicans in congress decided it was easier and in a perverse way better for them to simply accept the 10% across the board cuts in the sequestration than negotiate with a Democratic president.  .  The  executive branch warned of the impact both before and after it’s passage. .  Republicans in Congress ignored the warnings and now are claiming ignorance…and they are right.

This is frankly embarrassing in the leader of the free world…..it’s more like what happens in those “socialist” countries in Europe.  Actually it’s worse because of the wilful stupidity.

He said that he and others at the Transportation Department had been warning since February, before the sequester took effect, that it would cause layoffs that would create air traffic delays, adding that the agency had done everything it could to limit the impact.

And:

But Mr. Rogers insisted, “You didn’t forewarn us that this was coming; you didn’t ask advice about how we should handle it.”

Medicynical note: I wouldn’t trust a repub congressman to drive a car, much less run the country.  Too bad they can’t be sued for malpractice.

This company has claimed better results from their treatment approach.  If it’s too good to be true, it probably isn’t.

It turns out their approach is to not accept patients unless their insurance is “preferable.”  They minimize Medicare and Medicaid patients in their population—unlike other facilities.  They arbitrarily don’t accept certain patients.  They don’t report on patients who do not receive all their treatment at their facility.  As a result when they report outcomes the results are skewed by small numbers and careful patient selection.  They are under pressure to change as noted in the article.

Hilborn had seen CTCA’s website touting survival rates better than national averages. His call secured Vicky an appointment at the for-profit, privately held company’s Philadelphia affiliate, Eastern Regional Medical Center. There, the oncologist who examined Vicky told the couple he had treated other cases of histiocytic sarcoma, the cancer of immune-system cells that she had.

“He said, ‘We’ll have you back on your feet in no time,'” Keith recalled.

Vicky’s cancer treatment was forestalled by an infection and other complications that kept her at Eastern Regional for three weeks. In July 2009, when she got back home, things changed. Despite Keith’s calls, he said, CTCA did not schedule another appointment. As his wife got sicker, Keith, a former deputy sheriff in western Pennsylvania, was reduced to begging.

Read the article to get the full flavor of this type for profit beast. 

Medicynical Note:  What’s missing is an accounting of cost of treatment at this facility that provides “free transport” and limos to their hospitals.  It’s little wonder that medical care is bankrupting us.  More on this in Brill’s recent Time essay. 

In fact there is no magic in cancer treatment.  The reality, bad cancers that have spread have bad outcomes, with few exceptions.

No this is not the “gospel of hope,” but it is the truth.

It’s remarkable that so called “ethical” pharmaceutical companies are anything but…..ethical.  Johnson and Johnson and it’s DePuy Orthopedics division appear to have suppressed and/or ignored early information that the devices were faulty and would fail prematurely.

Johnson & Johnson never released those projections for the device, the Articular Surface Replacement, or A.S.R., which the company recalled in mid-2010. But at the same time that the medical products giant was performing that analysis, it was publicly playing down similar findings from a British implant registry about the device’s early failure rate.

The company’s analysis also suggests that the implant is likely to fail prematurely over the next few years in thousands more patients in addition to those who have already had painful and costly procedures to replace it.

Medicynical Note:  As we’ve noted before these companies are not about patient care or good outcomes.  They are about the money.

Sad story of the immorality of our health care non-system.  Jevon Thomas apparently worked the Trade Center site for a year and subsequently developed a sarcoma.  His disease and required treatment was costly and disabling.   He died impoverished and destitute.

He didn’t hesitate to say yes when his boss asked him to set up toilets at ground zero for the emergency workers. He told CNN in an interview two years ago that he worked there without a mask for 10 hours a day, seven days a week, for about 14 months.

Around the time he stopped working at ground zero, he noticed a lump on his hand. It turned out to be a rare cancer called epithelioid sarcoma.

Thomas had several surgeries and rounds of chemotherapy and had to quit his $65,000-a-year job.

His physician, Dr. Iris Udasin at Rutgers University, found him as much charity care as possible, but his family suffered financially as Thomas’ wife is disabled and couldn’t work to support their two

Medicynical Note:  It’s irrelevant whether or not his cancer came from his exposure at the Trade Center.  What’s relevant is that in our country, the “wealthiest” in the world, we have problems providing health care. 

To repeat the litany:  60% of bankruptcies in the U.S. are related one way or another to health care expenses; we lead the world in health care costs (1.5-2X as much spent per capita); we have 50 million uninsured; care is compromised because of lack of coverage and fear of the expense. 

We are unique in the world and it’s shameful. 

A Tennessee doctor’s views on health reform–It’s a no-brainer:

He notes:

The ultimate expense of health care is tied to quality and access. The state with the worst health care costs a third more than the states with the best. The state with the best access costs half as much as the worst. The best combination of access and quality is found in Massachusetts, the state whose plan was the blueprint for ACA.

And:

The ultimate expense of health care is tied to quality and access. The state with the worst health care costs a third more than the states with the best. The state with the best access costs half as much as the worst. The best combination of access and quality is found in Massachusetts, the state whose plan was the blueprint for ACA.

And finally:

Germany, Switzerland and the Netherlands have more privatized health systems than the U.S. They have almost universal coverage with better health outcomes and spend a lot less. Their private insurers are prohibited by law from making profit on the basic coverage packages but can profit on additional coverage.

Every country rations health care. Other rich nations do this by multidisciplinary committees. The U.S. rations like a Third World nation, allowing 50,000 people to die each year from easily treatable and preventable conditions because they do not have access to the system.

 

Medicynical Note:  Read the article.

People in the U.S. were stunned that the Brits should honor it’s health system at the opening of the Olympics.  Of course they expend half or less than what we do on health care/capita, and get comparable outcomes……and the people are quite pleased.  Visualize a similar salute to American Health Care at the next Olympics in the U.S.  from the Columbus dispatch: 

The spotlight widens to show 94 primary-care doctors, in multi-colored scrub suits, forming a ring around David Cordani, the CEO of Cigna Health Care, bowing and scraping to honor the fact that at $19.1 million, Cordani made more in 2011 than all 94 of them combined.

Medicynical Note:  Read the article and weep.  The current tea party and it’s repub echo chamber is pressuring states to torpedo any progressive change in health care in an attempt to maintain the status quo—a money grubbing  dangerous non-system.   Good ole American exceptionalism, or is this a form of cultural self immolation, or are they the same thing?