Archives for April 25, 2009

Pandemics and Politeness

I have learned the Western Way of politeness: when meeting a stranger look them in the eye and give a firm handshake.  I do this quite a lot in this ‘patient satisfaction’ world, shaking the hands of not just the patients but also their families.  (And sometimes you’d think I’d learn).

I’m wondering if we need some sort of socially acceptable way to say ‘I’d shake your hand but given that this is a hospital where illness concentrates, let’s not’.   Seems like a good tradeoff from a risk-benefit standpoint.

Yes, I use the alcohol-based foam gels between patients, and when I pass a dispenser, and when I think about it.  I’m pretty obsessive about it.  I’m not advocating not touching patients appropriately, just seems like something we should be able to change.

Merck made a US Doctor hit list

This came out in the Australian version of the Vioxx suits:

Article from:  The Australian

AN international drug company made a hit list of doctors who had to be "neutralised" or discredited because they criticised the anti-arthritis drug the pharmaceutical giant produced.

Staff at US company Merck &Co emailed each other about the list of doctors – mainly researchers and academics – who had been negative about the drug Vioxx or Merck and a recommended course of action.

The email, which came out in the Federal Court in Melbourne yesterday as part of a class action against the drug company, included the words "neutralise", "neutralised" or "discredit" against some of the doctors’ names.

Don’t be evil.  It’s not just a Google slogan.

via Slashdot

Incoherent Support for “The Public Plan”

Shadowfax is reveling in the first 100 days of a new administration with glee, and as such would usually be allowed the customary adult ‘just ignore it’ pass, but at a certain point … an intervention is in order.

After an okay lead in we find this bit of Hope:

The other possibility is that the public plan will have some advantages due to lower overhead, executive compensation, provider networking, lack of profit motive, etc, which will lead to the public plan being cheaper, and thus patients would prefer the public plan and shun the private insurers.

The premise of this opposition is, however, based on some self-contradictory logic, and on an assumption that the public plan will have Medicare reimbursement rates.   If the goverment-run [sic] plan turns out to be an NHS-style nightmare of byzantine rules, rationing care, and bureaucratic interference in the doctor-patient relationship, wy [sic] would patients choose it?   Seems to me that the marvels of competition would ensure that patients would shun such a system and flock to the consumer-oriented private insurance plans.

This assumes a premise of a level playing field, wherein one side doesn’t a) have the ability to impose its will on the other through legislation and b) the same side that can skew the playing field can put its hand into the public wallet and extract as much money as it takes from the citizenry to outspend or bankrupt the private system, then it’s all gravy, from the progressive side of the world.  No more fat-cats, no more private payment schemes (they are schemes: I dislike Insurance Companies only a little less than Socialists) and everyone in a nice Government Hospitalization Facility, where we’re All Equal.

Attention Progressives: FREE equals MORE. Medicaid is exactly the horrible system he describes, a low paying, byzantine disaster that providers shun in droves, and for good reason.  Has this bad system driven those patients to paid insurance?  No.  It has driven them to ED’s by the family, but has not been in any way a social or medical panacea.  (Why? Because it has to be paid for, and States understand very well how Free=More and they’ve been paying for it.  For years.  States Are Aware.  They’re also very willing to shift this burden onto the US Govt. to get this spending off their balance sheets).  Expect States to be all for Universal Care, it’s self interest in action.

I’d welcome universal coverage for every American.  I would.  I also would welcome Space Aliens (with some reservations) and World Peace (with conditions).  Okay, I’m kidding, Aliens would bug me.  Socialism of 14% of the total US Economy (not the budget, the Entire Economy) bugs me, too.

GruntDoc’s Perquisites for Universal Care:

  1. Make MediCare work transparently, with understandable rules and payments on billing (and on time).
  2. Make Medicaid a fully-funded non-joke.  (It’s not funny.  It’s a tragic fraud, promising care to patients they cannot get, because the program is so awfully administered and governed).  (By the government we’re going to trust our healthcare to under this plan).
  3. Start an education program, today, with the focus on making everyone aware that We’re All Going to Die.  Spending on astonishing end of life and futile care is dragging all of us under now; imagine a future where our kids are paying for Everything for Everyone (remember: Free=More).  I won’t be surprised when our kids decide enough is enough and decide we’ve had all they’ll pay for, or worse, they’re not going to work to support this insane spending.

When people are no longer craven and Government is Efficient and Works, we’ll talk.  Until then, beware those who promise you the world.  Free=More.