Notes & Links: October 11, 2013

The court intervenes to save a child with cancer, and Make Adams lose his mind over it
Science Blogs Respectful Insolence examine the of an Ohio Court ruling that the hospital could not force a 10 year old Amish girl against the wishes of her parents to receive chemotherapy. This was later over turned by an Appellate Court. 

This is a longish article and an in-depth analysis of the case, the history, and the response of a one Mike Adams whose argument revolves around quotes like this…

The chemotherapy agents used today are, in fact, derived from the research of Nazi scientists and the chemical conglomerate known as IG Farben, which was later broken up into multiple companies, including Bayer, the modern-day pharma company. For example, the chemo drug thalidomide is actually an off-shoot of Nazi chemical weapons research.
Based on my research into all this, it is my opinion that the Akron Children’s Hospital is engaged in heinous crimes against children

WTF? If you need to get the blood pressure up read this. Or better yet if you want to see how the ignorant can use the internet to drive a message the kills jump to the link above. 

Getting estimated for insurance costs int he exchange, Indiana edition
Arron Carroll at The Incidental Economist looks at window shopping for health insurance in Indiana. I know I know yet another ACA ObamaCare post screaming from their individual position pulpit. Not so fast this is good stuff. Here is the money shot. 

Silver plans for an individual range from $278 to $301 a month (before subsidies). This is far less than what the state released a while ago. For a family like mine, silver plans range from $938 to $1018 a month (before subsidies). What’s more, even the gold plans range from only $1175 to $1329 a month.

Since we know that the average employer sponsored health insurance plan for a family in the US is $16,351, that means the most expensive gold plan on the exchange, at $15,948, is cheaper. Let me say that again: The most expensive plan I could find for a family line mine on the Indiana Health Insurance Exchange is less expensive than the average employer sponsored health insurance plan in the US.

How to cope with an aging population
The Lancet reviews data from Global AgeWatch Index 2013 with recommendations on what this means for the world. Some of their more interesting points are:

  • High-income countries did the best Sweden, Norway for all domains income security, health status, employment, education and an enabling environment. 
  • South Korea was 67th overall though ranked at 8th for health but crap income security
  • Interestingly life expectancy increased by 4.7 years for men and 5.2 years for women from 1991 to 2009. But healthy life expectancy stayed the same overall. So we may live longer but suffer more and cost more. 
  • Elderly patients are excluded from clinical trials
  • Consider the steep upward curve of older population in India, Indonesia, Mexico, and Russia. That population will double in the next 40 years. 

Better data are needed to gauge success (in terms of wellbeing) of interventions to address the long-term needs of an ageing population, and track progress on morbidity compression. Although a promising start, The Global AgeWatch Index was only able to provide rankings for 91 countries, including just seven from Africa. By 2050, more than 20% of the global population will be older than 60 years and 80% will live in low-income and middle-income countries. Success in other medical specialties means that the world’s population is getting old. To allow it to do so gracefully will require early investment and cooperation between health and social care.

CDC MMWR announcement in the face of the lapse in government funding.

Yet another victim of ass clown politicians. 

Academic Medical Centers and the The Coming Physician Shortage
David Kroll a contributor to Forbes is attending the Forbes Healthcare Summit: Empowering thePatient Revolution. The gist of Kroll’s article is large academic medical centers are in congestive areas, no parking, long drives, and dependent on Medicare. Great quote

I’d add that once they do find parking, patients are also frustrated by trying to navigate the complex array of buildings that have metastasized willy-nilly over the history of the institution. What academic medical centers must do, Rothman said, is go to the patient and pay more attention to customer convenience.

struggle with the idea of nice waiting area’s featuring WiFi and Miles van de Rohe designed furniture will not drive outcomes. Though I am in full support of the need to solve problems patients are seeking to solve as in convenience etc. So when Kroll says the following I would agree. It is about market expansion not market gloss

In my home, Durham, North Carolina, Duke University Medical Center has been aggressively opening primary care centers around the area. My walk-in urgent care clinic is barely a mile from my home, has plentiful, free parking, and I’ve never waited more than 30 minutes to see a healthcare provider. That’s the kind of thing that urban medical centers will need to do to remain sustainable.