Hilarious Tamiflu side-effect

Okay, it’s not hilarious, it’s funny that it’s included as a side effect of Tamiflu (treatment for influenza):

2013-11-26_16-53-35

I’m not a huge fan of Tamiflu (for the neuropsychiatric side effects), but I saw this last night on my pocket brain, and had to look today to see if it’s really listed.

It is, that’s off the Tamiflu full-download of the medication information (Link on the official Tamiflu page).

So you know, when patients are in studies, basically everything that happens while the subject is taking the medication has to be reported to the FDA, which is how all that oddness gets enshrined as less than 1% side effects. I do find it a little amusing that ‘pyrexia’ (fever) is listed as a side effect, since influenza classically has a fever, and the peritonsillar abscess diagnosis quite possibly indicates the patient didn’t have the flu, they had an undiagnosed condition subsequently diagnosed.

Tamiflu is a Genentech product, FYI.

Why the Zero Defect mentality will never work

At least, not in real life:

The idea that “failure is not an option” is a fantasy version of how non-engineers should motivate engineers. That sentiment was invented by a screenwriter, riffing on an after-the-fact observation about Apollo 13; no one said it at the time. If you ever say it, wash your mouth out with soap. If anyone ever says it to you, run. Even NASA’s vaunted moonshot, so often referred to as the best of government innovation, tested with dozens of unmanned missions first, several of which failed outright.

Failure is always an option. Engineers work as hard as they do because they understand the risk of failure. And for anything it might have meant in its screenplay version, here that sentiment means the opposite; the unnamed executives were saying “Addressing the possibility of failure is not an option.”

via » Healthcare.gov and the Gulf Between Planning and Reality Clay Shirky.

Healthcare has this idiocy. It’s a disconnect between the doers, who will tell you what’s possible, and the managers, who either don’t know or don’t remember.

Leaders, by the way, would know the difference.  Need more of those.

Happy Birthday USMC!

SemperFi

I post this every year, and I still enjoy it…
original poster from: stores.ebay.com/WONDERFULART

Grading a Physician’s Value — The Misapplication of Performance Measurement — NEJM

NEJM realized the PQRS Emperor has no clothes.

Perhaps the only health policy issue on which Republicans and Democrats agree is the need to move from volume-based to value-based payment for health care providers. Rather than paying for activity, the aspirational goal is to pay for outcomes that take into account quality and costs. In keeping with this notion of paying for value rather than volume, the Affordable Care Act ACA created the “value-based payment modifier,” or “value modifier,” a pay-for-performance approach for physicians who actively participate in Medicare. By 2017, physicians will be rewarded or penalized on the basis of the relative calculated value of the care they provide to Medicare beneficiaries.

Although we agree that value-based payment is appropriate as a concept, the practical reality is that the Centers for Medicare and Medicaid Services CMS, despite heroic efforts, cannot accurately measure any physician’s overall value, now or in the foreseeable future. Instead of helping to establish a central role for performance measurement in holding providers more accountable for the care they provide and in informing quality- and safety-improvement projects, this policy overreach could undermine the quest for higher-value health care. Yet the medical profession has been remarkably quiet as this flawed approach proceeds.

via Grading a Physician’s Value — The Misapplication of Performance Measurement — NEJM.

How many tens of thousands of hours are spent jumping through hoops like these that turn out to be more meaningless (or worse) ‘government work’?

Spin in the cancelled-policy articles

All the articles about cancelled Individual Insurance plans have some variation of this spin in them:

For some who have received the letters, the new plans being offered are more expensive, but for others — especially those who qualify for a federal subsidy to bring down the cost of the premium — their insurance bill will go down.

via Canceled health insurance plans add to angst of change | Local News | The Seattle Times.

Emphasis added.

Here’s the thing: people (like me) in the Individual market don’t have IBM or Exxon sitting across the table from an insurance company, dealing from a position of some strength. We’re individuals. We’re independent Contractors (me), self employed and scraping by, or doing well. We looked at our options, bought plans we could afford, and realized there are tradeoffs from a cost/benefits standpoint. Not a lot of people in that group bought a soup-to-nuts expensive plan (some did, most don’t).

The emphasized thing above is pure spin on the part of the writers. I have no doubt they’ve been told this over and over, but I have yet to see one article about someone in the Indy market that got a ‘better’ plan that dropped in price. There will be a few, but most if not all will see their costs go up.

Just so you see it for what it is.

AAPS Sues to Stop the Unlawful Revisions to ObamaCare

A constitutional argument. From docs:

The Association of American Physicians & Surgeons (AAPS) has filed a lawsuit today in federal court to halt the unlawful revisions to ObamaCare (the Patient Protection and Affordable Care Act).

The separation of powers required by the Constitution prohibits the executive branch—the Obama Administration—from rewriting laws passed by Congress. Yet that is what Obama has done by changing key parts of ObamaCare in order to implement it.

The AAPS lawsuit, which was filed today in the Eastern District of Wisconsin, asks the Court to enjoin the Obama Administration from imposing its “individual mandate” while delaying the “employer mandate.” The law that was passed by Congress in 2010 requires that the employer mandate go into effect at the same time as the individual mandate: Jan 1, 2014.

“The U.S. Constitution requires a strict separation of powers between the three branches of government, such that the executive branch cannot change laws passed by Congress,” AAPS’s lawsuit explains. By imposing the individual mandate in 2014 without the protection of the employer mandate, the Obama Administration has changed the legislation passed by Congress.

via AAPS Sues to Stop the Unlawful Revisions to ObamaCare.

Bizarre congress is super-cool with the executive branch picking and choosing the laws to bother enforcing.