NEWS AND VIEWS
Health, Ethics, and Policy News and Views from the Staff
By TuftScope Staff
What Does Healthcare Really Cost?
The Kaiser Family Foundationís 2009 Employer Benefits survey that was recently conducted amongst employers provided a good look at the actual cost of healthcare for Americans. According to the Kaiser survey, the current average cost of healthcare coverage for Americans is $13,375, and this number is on a steady rise. By 2019, in fact, it is estimated that an average family coverage will cost $30,083. However, Employers pay a large portion of this cost that has resulted in a 300 percent rise in healthcare premiums over the past 30 years and has lowered hourly wage earnings for workers. The millions of Americans on public plans and who are uninsured receive their benefits from taxpayers, thereby increasing the cost of premiums even more. How will the government fix this issue? The public insurance option has been suggested as a way to provide healthcare for the underinsured and uninsured, as well as lower premiums for all Americans. For the average family, Comparative Effective Review is a current White House favorite, calling for the limit of new and expensive medical treatments that have not yet been proven effective. Another, more unpopular possibility is taxing healthcare benefits in hopes that Americans who have to pay more for healthcare won’t use as much of it. While the government is looking at the big picture, however, if small changes, such as replacing paper records with computerized files, were made to the system, millions of dollars could be saved.
Medical Students Learn About Geriatrics
Medical students at the University of New England in Biddeford, ME can chose to participate in a new program where they live as nursing home residents for two weeks. The philosophy behind the program is to expose medical students to the underserved field of geriatrics and to give them the tools to speak with institutionalized elders. The medical students are given a diagnosis and expected to live as a patient with that ailment for the duration of their stay, thereby gaining deeper understanding of life within a nursing home. Geriatrics is one of the lowest paid and most underrepresented fields in medicine. With only one geriatrician to every 5,000 geriatric patients, the field is in a crisis. The hope is that programs like the one mentioned will generate greater interest in this vital aspect of medicine.
Debate Over the Sugar Tax
The deliberation over tax on sugary soft drinks billed as a way to fight obesity is starting to ‘fizz over’. The chief executive of Coca-Cola calls the idea outrageous, while skeptics point to political obstacles and question how much of an impact it would really have on consumers. However, a team of prominent doctors, scientists and policy makers says it could be a powerful weapon in efforts to reduce obesity, in the same way that cigarette taxes have helped reduce smoking. The group’s review of research on the topic cited research on price elasticity for soft drinks that has shown that for every 10% rise in price, consumption declines 8 -10%. The scientific paper found that a beverage tax might not only raise revenue but have significant health effects, lowering consumption of soda and other sweet drinks enough to lead to a small weight loss and reduced health risks among many Americans. President Obama has said that a tax is justified in part because conditions like obesity and diabetes are often treated with public funds through programs like Medicaid and Medicare. He further emphasized that revenue from the tax could help pay for such care. Nevertheless, critics of the tax continue to voice their concerns about the potential consequences of implementing such a reform.
E. Coli and the Beef Inspection Process
We have all heard about E. Coli contamination of meat products, but who knew the cause for such contamination lies with poor sanitation and inspection practices of slaughterhouses and meat processing companies?
The New York Times reports a growing problem of severe illnesses caused by contaminated meat, particularly ground beef. Despite the fact that the United States Department of Agriculture, USDA, orders random inspections of all meat products, it appears that not all of the dangerous strains are being caught before being sent to market. Ground beef often contains a mixture of beef products from various slaughterhouses. By the time a contamination risk is discovered, distributors claim that the source is almost impossible to identify. Meat packing companies claim that the fault lies with the slaughterhouses, some of which refuse to sell to distributing companies that require screenings for E. Coli, in an attempt to hide their unsanitary factory conditions. On the other hand, meat product distributors object to the USDA required E. Coli testing, claiming it would put unfair strain on smaller distributors. It appears that despite attempts being made by the USDA, the problem with preventing and catching contamination early still remains, due to a lack of cooperation by both suppliers and distributors. More at: NY Times. 10/04/2009. E. Coli Shows Flaws in the Beef Inspection Process.
Healthcare Policy for Medical Students
Medical students do not receive much education on health care policy, which determines who receives how much care and for what cost. Students pack their schedules with requirements, so that even if they wanted to take a class on managed care or health disparities, they could not. In a movement to train doctors to treat individual patients while keeping the good of the health care system in mind, several medical schools have begun to take steps to encourage students to diversify their class load. These schools recognize that highly competitive students might not voluntarily steer away from the standard curriculum when selecting courses. The George Washington University School of Medicine offers the equivalent of a minor in health policy for students who want to learn about, and possibly write, legislation. Harvard Medical School now requires a class in health care policy, which teaches about insurance, managed care, Medicare and Medicaid, and reform. Both schools integrate policy-related topics into their regular classes. In a time when health care policy is so polarizing, medical schools recognize that health care providers must be engaged in the reform process. More at: Slate Magazine. 06/23/2009. Is Our Doctors Learning?
The End of the White Coat?
The white coat was adopted by the medical profession from laboratory scientists as a symbol of cleanliness and professional authority. Recent studies, however, have indicated that unclean white coats may harbor significant colonies of germs that are transferred to at risk patients. The American Medical Association has recommended that white coats be gradually phased out due to these risk factors. Strong opposition is certain to arise within the medical community and potentially even among patients themselves.
Massachusetts Health Commission Advocates Global Payments
A panel of experts has recommended that the Massachusetts legislature pass a reform to the current state healthcare system that would remove the fee-for-service payments that doctors and hospitals currently receive. Instead, global payments would be paid to healthcare providers for providing care for a patient. Providers would organize into coherent health networks and distribute care to patients with the incentive of offering necessary care, rather than ordering excessive testing and procedures. Some have argued that this model is similar to the much maligned capitation payments of the 1990s that both doctors and patients argued led physicians to provide fewer services in order to save money. The proposal is still in the early stages, with more developments likely to follow.
Subject: Global Health, Public Health
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