How doctors contribute to the high cost of health care

At Better Medicine, Negoba points out how doctors contribute to the high cost of health care. Even though some doctors make high salaries (some specialists making extremely high salaries), the salaries are not the biggest part of the problem.

A doctor can be just as valuable as a controller of loss as a source of profit. In either case, the amount of money flow a doctor controls is easily 5-10 times the amount he or she makes in salary. Many larger systems with interests both at the office and hospital level will take losses on salary to retain a physician whose orders then net a profit in orders.

Continue ReadingHow doctors contribute to the high cost of health care

Luxuries of sickness

Ever since I heard the detailed story of holocaust survivor Ben Fainer, I've been haunted by Ben's story. His video interview is about an hour long and it is riveting. I was sick for most of the past four days, including two days on which I barely crawled out of bed. I had a fever, my muscles ached, I had chest congestion and migraine headaches and I couldn't think straight. I'm better now, but while I was at my sickest, I wondered how Ben survived Nazi concentration camps for six years, even through the sicknesses that people periodically experience, especially when they were in the process of being starved. Ben just happened to call me yesterday (on another matter), and I took the opportunity to ask him: What would happen at Buchenwald if a prisoner was so sick that he was unable to report for work duty on even one occasion. Ben answered: "The system was simple. If you didn't report for work, several people would go inside the barracks to pick you up, and they would walk you over to the crematorium oven, which was burning 24 hours a day. Even if you were still alive, they would throw you into the oven. I saw this happen and I heard the screams." I still can't conceive of how a young boy could have survived this horror, even as he aged into a teenager during his six years of captivity. And I'm so very lucky to live in a situation where sickness is usually not life-threatening, either biologically or socially.

Continue ReadingLuxuries of sickness

Health care and death

Progressive sites are howling at the insensitivity of the Tea Party based on a hypothetical. This is how the conversation went down at a recent Republican debate:

Wolf Blitzer: A healthy 30 year old young man has a good job, makes a good living, but decides—you know what? I’m not going to spend $200 or $300 a month for health insurance because I’m healthy—I don’t need it. But something terrible happens … all of a sudden he needs it. Who’s going to pay for it if he goes into a coma. Ron Paul – He should do whatever he wants to do and assume responsibility for himself . . . My advise to him is to have a major medical policy . . . Blitzer: But he doesn’t have that and he needs intensive care for six months. Who pays? Ron Paul: That’s what freedom is about . . . taking your own risks. This whole idea that you have to compare and take care of everybody . . . Blitzer: Are you saying society should just let him die?" [A couple voices in the large crowd shout “Yes!”] Ron Paul: . . . The churches . . . [will help him]
Several things come to mind. The hypothetical was designed to make us not want to take care of this man. After all, if I am working overtime to scrape together huge payments for my family’s health insurance and the man in the hypothetical decides he won’t bother to pay even though he “makes a good living,” my gut feeling is he is trying to cheat the system, which makes me highly ambivalent about him, and much less sympathetic about his terrible situation. How much do I care about this man? I once told a friend of mine that I “cared” about a sad situation, and he said, “No you don’t. If you cared, you would do something to fix the problem and all you’re doing is complaining.” I think he was dead-on with that comment. If we care, we get involved. If we’re merely complaining, we don’t really care, no matter what we say. How do Americans often show they really care? By reaching into their pockets and giving money to the cause. With this in mind, allow me to offer a few of my own hypotheticals. [More . . .]

Continue ReadingHealth care and death

Meat is on the defensive

Today I ate and much enjoyed a hamburger for lunch (it was grass-fed beef, the restaurant said).   I eat burgers about once every two weeks, and I eat chicken quite often. Once in a while someone will offer me a processed meat like hot dogs or bacon, and eat that sort of food about once a month.  I don't buy pork or order it at a restaurant, but if it is offered to me by a host, though, I will gladly eat it. Two years ago I decided that pork would be a meat that I didn't eat, after seeing and hearing a truck full of squealing pigs being taken to slaughter in the middle of Springfield, Illinois.  I eat fake meat about once per week: I typically use the popular brands of veggie burgers and fake sausage sold at the grocery story (such as Morningstar's "burger" patties and "sausage" links).  If you haven't seen these products cooked up, here are some photos. At bottom, I enjoy eating meat, but I'm an ambivalent meat eater, and that ambivalence has been made all the worse with two recent articles I've recently read. One of the articles is by Neal Barnard, M.D., who brings this bad news:

At least 58 scientific studies have looked at the issue, and the jury has rendered its verdict, which is now beyond reasonable doubt. The more hot dogs people eat, the higher their risk of colorectal cancer. And it's not just hot dogs. Any sort of processed meat -- bacon, sausage, ham, deli slices -- is in this group. And here are the numbers: Every 50 grams of processed meat you eat on a daily basis (that's about one hot dog) increases your risk of colorectal cancer by 21 percent. And just as there is no safe level of smoking, no amount of hot dogs, bacon, sausage, ham or other processed meats comes out clean in scientific studies.
I'd like to know more about this study, but if this is accurate, it gives me serious pause about eating hot dogs and other processed food. The other bad news comes from the Environmental Working Group, which warns of the harsh environmental impact of eating meat. Check out the damage caused by meat-eating in the at-a-glance brochure. There is a lot more information here. These brochures also mention studies indicating that high rates of meat eating are associated with high rates of cancer and heart disease. If you'd like to take the first step to cut back on meat eating for yourself and for the planet, here's an easy way to start: Meatless Mondays.

Continue ReadingMeat is on the defensive