Wednesday, July 31, 2013

Doctors Increasingly Ignore Evidence In Treating Back Pain

More From Shots - Health News HealthA Bit Of Thought Makes Finding Out Medical Risks Less ScaryHealth CareParents Grapple With Explaining Cancer To ChildrenHealth CareWill Obamacare Mean Fewer Jobs? Depends On Whom You AskHealthDoctors Increasingly Ignore Evidence In Treating Back Pain

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Tuesday, July 30, 2013

Canvassers For Health Coverage Find Few Takers In Boca Raton

More From Shots - Health News HealthDoctors Increasingly Ignore Evidence In Treating Back PainHealth CareCanvassers For Health Coverage Find Few Takers In Boca RatonHealthPanel Urges Lung Cancer Screening For Millions Of AmericansHealthBoys With Autism Or ADHD More Prone To Overuse Video Games

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Montana's State-Run Free Clinic Sees Early Success

fromMTPR

Listen to the Story 4 min 37 sec Playlist Download Transcript   Enlarge image i

Montana opened the first government-run medical clinic for state employees last fall. A year later, the state says the clinic is already saving money.

Dan Boyce for NPR

Montana opened the first government-run medical clinic for state employees last fall. A year later, the state says the clinic is already saving money.

Dan Boyce for NPR

A year ago, Montana opened the nation's first clinic for free primary healthcare services to its state government employees. The Helena, Mont., clinic was pitched as a way to improve overall employee health, but the idea has faced its fair share of political opposition.

A year later, the state says the clinic is already saving money.

Pamela Weitz, a 61-year-old state library technician, was skeptical about the place at first.

"I thought it was just the goofiest idea, but you know, it's really good," she says. In the last year, she's been there for checkups, blood tests and flu shots. She doesn't have to go; she still has her normal health insurance provided by the state. But at the clinic, she has no co-pays, no deductibles. It's free.

That's the case for the Helena area's 11,000 state workers and their dependents. With an appointment, patients wait just a couple minutes to see a doctor. Visitation is more than 75 percent higher than initial estimates.

"For goodness sakes, of course the employees and the retirees like it, it's free," says Republican State Sen. Dave Lewis.

He wonders what that free price tag is actually costing the state government as well as the wider Helena community.

"If they're taking money out of the hospital's pocket, the hospital's raising the price on other things to offset that," Lewis says.

He and others faulted then-Gov. Brian Schweitzer for moving ahead with the clinic last year without approval of the state legislature, although it was not needed.

Now, Lewis is a retired state employee himself. He says, personally, he does like going there, too.

"They're wonderful people, they do a great job, but as a legislator, I wonder how in the heck we can pay for it very long," Lewis says.

Lower Costs For Employees And Montana

The state contracts with a private company to run the facility and pays for everything � wages of the staff, total costs of all the visits. Those are all new expenses, and they all come from the budget for state employee healthcare.

Even so, division manager Russ Hill says it's actually costing the state $1,500,000 less for healthcare than before the clinic opened.

"Because there's no markup, our cost per visit is lower than in a private fee-for-service environment," Hill says.

Physicians are paid by the hour, not by the number of procedures they prescribe like many in the private sector. The state is able to buy supplies at lower prices.

“ Because there's no markup, our cost per visit is lower than in a private fee-for-service environment.- Russ Hill of the Montana Health Center Bottom line: a patient's visit to the employee health clinic costs the state about half what it would cost if that patient went to a private doctor. And because it's free to patients, hundreds of people have come in who had not seen a doctor for at least two years. Hill says the facility is catching a lot, including 600 people who have diabetes, 1,300 people with high cholesterol, 1,600 people with high blood pressure and 2,600 patients diagnosed as obese. Treating these conditions early could avoid heart attacks, amputations, or other expensive hospital visits down the line, saving the state more money. Clinic operations director and physician's assistant Jimmie Barnwell says this model feels more rewarding to him. "Having those barriers of time and money taken out of the way are a big part [of what gets] people to come into the clinic. But then, when they come into the clinic, they get a lot of face time with the nurses and the doctors," Barnwell says. That personal attention has proved valuable for library technician Pamela Weitz. A mammogram late last year found a lump. "That doctor called me like three or four times, and I had like three letters from the clinic reminding me, 'You can't let this go, you've got to follow up on it,' " she says. Two more mammograms and an ultrasound later, doctors think it's just a calcium deposit, but they want her to keep watching it and come in for another mammogram in October. Weitz says they've had that same persistence with her other health issues like her high blood pressure. She feels the clinic really cares about her. "Yeah, they've been very good, very good," she says. Montana recently opened a second state employee health clinic in Billings, the state's largest city. Others are in the works. Share Facebook Twitter Google+ Email Comment More From Health Care Health CarePfizer Announces It's Splitting Up Its Drug BusinessHealth CareMontana's State-Run Free Clinic Sees Early SuccessHealth CareCanvassers For Health Coverage Find Few Takers In Boca RatonHealthPanel Urges Lung Cancer Screening For Millions Of Americans

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Sunday, July 28, 2013

Time To Get Out Of The High-Risk Health Insurance Pool?

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Friday, July 26, 2013

For Bioethicist With Ailing Spouse, End-Of-Life Issues Hit Home

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Margaret Battin's husband, Brooke Hopkins, was left quadriplegic after he collided with an oncoming bicycle while cycling down a hill in Salt Lake City.

Courtesy of The New York Times

Margaret Battin's husband, Brooke Hopkins, was left quadriplegic after he collided with an oncoming bicycle while cycling down a hill in Salt Lake City.

Courtesy of The New York Times

After writing books and essays about end-of-life issues, and advocating for the right to die, bioethicist Margaret Battin is wrestling with the issue in her own family. Her husband, Brooke Hopkins, an English professor at the University of Utah, where she also teaches, broke his neck in a bicycle accident in 2008, leaving him with quadriplegia and dependent on life support technology. In order to breathe, he requires a ventilator some of the time and a diaphragmatic pacer all the time. He receives his nutrition through a feeding tube.

Hopkins' living will gives him the right to decline this technology, and although he's chosen to keep living, there have been times he's told his wife he wants to die, and she's had to decide how literally to interpret his words.

In her academic life, Battin has also had to reflect on the positions she's taken in the past to see if she still believes in them. She and her husband are in their early 70s. She's a distinguished professor of philosophy and still teaches full time. When Hopkins is doing well, and not suffering from one of the many infections that have plagued him since the accident, he's able to do some teaching from his home, talk with friends who come to visit, go in his wheelchair on walks with his wife and even occasionally get taken to a concert or museum.

Battin and Hopkins were profiled in the cover story of last Sunday's New York Times Magazine. Battin tells Fresh Air's Terry Gross about what happened right after the accident, and the responsibility of deciding if someone is genuine in their wish to die.

Interview Highlights

On whether, post-accident, she and her husband discussed if he wanted to live or die

"It's odd ... that we didn't have that conversation. At least, I don't recall that conversation. I think it's because in those early days you are so intent on survival. He had had quite a respiratory infection at the time of the accident, which he had gotten campaigning during the 2008 election just prior to that. So the probability of him even surviving the accident, or the immediate period afterward, wasn't particularly good. Our efforts, his and mine, and everybody else's were focused on survival: Can he pull through these respiratory problems? Once those were a little more stabilized and he was able to communicate, there's a whole new phenomenon, and that's the ... enormous expression of love and affection and ... concern from family members, friends, people you haven't seen for ... five years, this overwhelming involving and concern by other people. ...

"So your sense of whether you want to continue or not ... your circumstances are so altered, and altered by this phenomenon that doesn't occur for most people in their ordinary lives; you don't have all of your entire family and your entire range of friends all showering you with love all at once. That's quite heady in a way. It's quite wonderful. ... You might even say it's sublime and it's extraordinary. That made a huge amount of difference at the beginning. ...

"At the beginning we had been told that the paralysis, initial paralysis, would last five to six weeks anyway, and only after that would you have some sense of realistic prognosis. So, while you worry about it, you ... knew that there was no point in thinking about it until after this period. Would he be able to get up and walk away eventually? Well, maybe. That's the kind of thing you can't tell. ... So such a choice would've been premature. Also, walking isn't the only thing in the world. So one begins to recognize that one will begin thinking about how to adapt to a very changed situation."

On the responsibility of deciding if someone is genuine in their wish to die

"I think you have to take it seriously. That doesn't mean that because he says, 'I want to die right now,' that you have to marshal action about it. ...

Author Interviews Discworld's Terry Pratchett On Death And Deciding Remembrances Assisted Suicide Advocate Uses Law To End His Life Health When Prolonging Death Seems Worse Than Death

"It's not easy, I can tell you that. It doesn't diminish in any way my belief that people � my belief and firmly considered position that people ought to be able, ought to be legally protected, legally empowered to control the character of their own deaths. That is, I do favor legalization of Death with Dignity laws, but that doesn't mean that these decisions are always easy. There [are] some differences. Brooke is not terminally ill, in any standard sense, although his life in certain ways is precarious, his survival. I'm not a physician, I don't pretend to be, so under the Death with Dignity laws it would be the physician that made the determination of whether ceding to this request was appropriate or not. ... If a physician under these laws were to receive a request from a patient and had any doubts about competency, they would be expected to request a psychological or psychiatric consult."

On her husband's accident hitting so close to her academic expertise

"To have it become so real, that someone you love � and love a lot, deeply � would be enmeshed in the same ... very kind of choice you had been thinking about academically for so long is an extraordinary experience. In one way, it's a healthy experience as it forces me to rethink everything. And even doing that, and even given the acute agony of being so close to something that is so difficult, it doesn't change my basic position that people should be recognized to have the right to not only live their lives in ways of their own choosing, providing of course that they don't harm others ... be the architects of their own lives, but that includes the very ... ends of their lives. You shouldn't have to lose those rights just at the end, especially since the very end makes the greatest amount of difference to some people, and also to some of their loved ones around them."

Share Facebook Twitter Google+ Email Comment More From Health Care Health CareFor Bioethicist With Ailing Spouse, End-Of-Life Issues Hit HomeHealthPlan B To Hit Shelves, Protected From GenericsBusinessFull-Time Vs. Part-Time Workers: Restaurants Weigh ObamacareOn AgingMove Over Nursing Homes � There's Something Different

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Thursday, July 25, 2013

How A Family Copes With Schizophrenia And Suicide

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Plan B To Hit Shelves, Protected From Generics

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Tuesday, July 23, 2013

New York City Labor Council Endorses HR 676

The Executive Board of the New York City Central Labor Council, AFL-CIO, unanimously approved a resolution supporting HR 676, national single payer health care legislation, sponsored by Congressman John Conyers (D-MI).

NYC CLC President Vincent Alvarez calls this resolution �Labor�s way of standing up for the health and well-being of working men and women and their families,� noting �The national legislation is a true means of controlling ever-increasing healthcare costs, while ensuring that Americans get the medical care they so desperately need.�

In the resolution, the Council notes that almost every union is forced to battle and sacrifice to sustain healthcare benefits for members. The Council also notes that while the United States spends twice as much of our GDP on healthcare as other developed nations, we remain the only industrialized country without universal healthcare coverage.

Robert Score, Recording-Corresponding Secretary of IATSE (Theatrical & Stage Employees) Local One, said “As we all know, nobody in the United States should have to choose between healthcare and keeping a roof over their heads, food on their table or clothing on their children. HR 676 will prevent such calamities. I am thankful to President Alvarez for guiding the NYC CLC to endorse HR 676.” IATSE Local One submitted the resolution that was passed.

The NYC CLC, the 146th CLC to endorse HR 676, represents 300 local unions with a total membership of 1.3 million.

In other news also, on July 19th Congresswoman Loretta Sanchez of California�s 46th district became the 44th co-sponsor of HR 676.

New York City Labor Council Endorses HR 676

The Executive Board of the New York City Central Labor Council, AFL-CIO, unanimously approved a resolution supporting HR 676, national single payer health care legislation, sponsored by Congressman John Conyers (D-MI).

NYC CLC President Vincent Alvarez calls this resolution �Labor�s way of standing up for the health and well-being of working men and women and their families,� noting �The national legislation is a true means of controlling ever-increasing healthcare costs, while ensuring that Americans get the medical care they so desperately need.�

In the resolution, the Council notes that almost every union is forced to battle and sacrifice to sustain healthcare benefits for members. The Council also notes that while the United States spends twice as much of our GDP on healthcare as other developed nations, we remain the only industrialized country without universal healthcare coverage.

Robert Score, Recording-Corresponding Secretary of IATSE (Theatrical & Stage Employees) Local One, said “As we all know, nobody in the United States should have to choose between healthcare and keeping a roof over their heads, food on their table or clothing on their children. HR 676 will prevent such calamities. I am thankful to President Alvarez for guiding the NYC CLC to endorse HR 676.” IATSE Local One submitted the resolution that was passed.

The NYC CLC, the 146th CLC to endorse HR 676, represents 300 local unions with a total membership of 1.3 million.

In other news also, on July 19th Congresswoman Loretta Sanchez of California�s 46th district became the 44th co-sponsor of HR 676.

Friday, July 19, 2013

For A Long And Healthy Life, It Matters Where You Live

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Tuesday, July 16, 2013

Doctors Heed Prescription For Computerized Records

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Saturday, July 6, 2013

Abortion Providers Sue As Wisconsin Governor Signs Bill

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Friday, July 5, 2013

How To Make Disease Prevention An Easier Sell

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A Busy ER Doctor Slows Down To Help Patients Cope With Adversity

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A Busy ER Doctor Slows Down To Help Patients Cope With Adversity

More From Shots - Health News Health CareA Busy ER Doctor Slows Down To Help Patients Cope With AdversityHealthGut Bacteria We Pick Up As Kids Stick With Us For DecadesHealthScientists Grow A Simple, Human Liver In A Petri DishHealthA Surge In Painkiller Overdoses Among Women

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Thursday, July 4, 2013

Idaho AFL-CIO endorses HR 676, National Single Payer Health Care

From UnionsForSinglePayer.org –

Rian Van Leuven, President of the Idaho State AFL-CIO, announced that on June 12, 2013, the delegates to the 55th Annual Idaho State AFL-CIO Convention passed a resolution to publicly endorse and support H.R. 676, Single Payer Healthcare.

Further the resolution states “That the Idaho State AFL-CIO will develop working relationships with community organizations in Idaho which advocate for single-payer healthcare and Medicaid expansion.”

Louis Schlickman, MD, an Idaho physician who practices in Meridian and is Co Chair of the Physicians for a National Health Program state chapter, showed the movie Escape Fire and made a single payer presentation to the convention prior to the passage of the resolution.

After the resolution for HR 676 was passed by the Idaho State AFL-CIO Convention, Dr. Schlickman stated that, �Collectively we are all realizing that unions in general can play a huge role in helping others, not just union workers, see the merit in a single payer financing system of care.�

Dr. Schlickman observed that union members �have seen how one unexpected illness or injury leads to significant catastrophes of health and income status. And most important, they understand the issue of solidarity.�

Idaho is the 43rd State AFL-CIO Federation to endorse HR 676, which was introduced into the 113th Congress by Representative John Conyers (D MI). The bill is subtitled Expanded and Improved Medicare for All.