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Inquirer Daily News

Archive: March, 2013

POSTED: Sunday, March 31, 2013, 4:00 PM
Filed Under: Robert I. Field

When it comes to Medicare, could Democrats and Republicans be any further apart?

President Obama and most Democrats in Congress want to keep the current structure with tweaks to save costs. Republicans have rallied around Rep. Paul Ryan’s (R-Wisc.) proposal to radically transform Medicare into a program of subsidies for purchasing private coverage (known either as a “voucher system” or “premium support” depending on your opinion of it.) 

The stakes are huge. Medicare will drive increases in federal spending more than any other expense in coming decades. And the lives and health of tens of millions of elderly and disabled Americans are on the line.

POSTED: Wednesday, March 27, 2013, 1:45 PM
Filed Under: Erica Cohen

Fans of the TV series Homeland may have wondered at the end of last season whether it is truly possible to hack into a pacemaker and cause someone’s death. That’s what the show’s terrorist organization did to the vice president. The answer is, scarily, yes.

For years, experts have warned about the vulnerability of medical devices to outside sabotage. The United States Department of Homeland Security (DHS) has even issued a warning that medical devices can be compromised by hackers. While it may seem far-fetched for a terrorist halfway around the world to tap into an individual’s pacemaker and cause a heart attack, it is perfectly plausible. And malicious attacks are not the only concern regarding this form of technology.

Many medical devices are controlled by software, just as your iPad, laptop, and smartphone are. As a result, security can be breached on a medical device just as it can be on other technology. Many people remember the time their iPhone software update temporarily turned their phones into dark-screened paperweights. Unfortunately, the same result is possible with wireless medical devices. Many are networked and can be monitored or controlled remotely, sometimes without adequate security engineering and protections.

POSTED: Sunday, March 24, 2013, 6:00 AM
Filed Under: Robert I. Field
Four-year-old Gabriella Diaz sits as registered nurse Charlene Luxcin, right, administers a flu shot at the Whittier Street Health Center in Boston, Mass., Wednesday, Jan. 9, 2013. Boston declared a public health emergency Wednesday as the city tried to deal with a harsh flu season and the state reported 18 flu-related deaths so far. (AP Photo/Charles Krupa)

Apparently, some people find bioethics as confusing as rocket science. And many of those who are most confused are in the media.

Last week, a presidential bioethics commission led by University of Pennsylvania President Amy Gutmann declared that the vaccine against anthrax should not be tested in children until its safety it better understood. Amazingly, several press reports had the Commission saying just the opposite. Bioethics seems to have left some in the media quite perplexed. 

The Commission, formally known as the Presidential Commission for the Study of Bioethical Issues, concluded that it is unethical for researchers to expose children to anything more than “minimal risk”, unless they can directly benefit from the research. As a result, until we better understand the anthrax vaccine’s potential for harm, testing in children should be off limits. (Click here to read the full report.)

POSTED: Thursday, March 21, 2013, 6:00 AM
Filed Under: Erica Cohen

We live in a society that values openness and acceptance of difference, yet many people face unfair stigma and discrimination. No group experiences it more that those who live with HIV, and it is especially evident in the health care setting.

Federal laws protect those with HIV by explicitly prohibiting discrimination based on disability. It is illegal for hospitals, health clinics, dental offices, social services agencies, drug treatment centers, and nursing homes to provide them with lesser levels of service. However, disparate treatment still seems to occur with alarming frequency.

A 2005 study published in the Journal of General Internal Medicine found that 26% of HIV-infected individuals believed they had been the victim of discrimination by physicians and other health care providers. Of nearly 2,500 patients studied, most reported that a provider had been uncomfortable with them (20%), treated them as an inferior (17%), or preferred to avoid them (18%). These behaviors were attributed to providers at all levels, including physicians (54%), nurses and other clinical staff (39%), dentists (32%), hospital staff (31%) and case managers and social workers (8%).

POSTED: Thursday, March 14, 2013, 5:55 AM
Filed Under: Erica Cohen
(iStockphoto)

While physicians are usually more concerned with monitoring patient heart rates and reading lab results than with their personal grooming, a recent study showed that a physician’s appearance can be quite important. It is part of making patients’ families feel comfortable in a high-stress hospital environment.

The study, published by the Journal of the American Medical Association (JAMA), found that about one-third of patient families members in an intensive care unit (ICU) considered a lack of tattoos and piercings important in their first impression of a physician. While this number is considerably less than those for other professional attributes that respondents deemed important – wearing an easy-to-read name tag (77%), neat grooming (65%) and professional dress (59%) – the number is still considerable.

Respondents also favored traditional medical attire, such as a white coat (52%) or scrubs (24%). They were less partial to a suit (13%) or casual attire (11%).

POSTED: Monday, March 11, 2013, 6:00 AM
Filed Under: Robert I. Field

If you get health benefits through an employer, you have probably seen your costs rise every year. That’s in part because premiums keep going up. But it’s also because many employers are picking up a smaller share of the tab. 

A recent survey by the consulting firm of Towers Watson and the nonprofit National Business Group on Health found that workers are contributing 42% more for health care than they did five years ago. During the same time, the amount paid by employers rose by only 32%. In the last two years, the average employee share of health care costs has grown from 34% to 37%.

You may feel the larger financial burden in several ways. The most noticeable for most is that their employer is covering a smaller portion of the premiums. The average employee share of total premiums was $2,658 in 2012 and is expected to rise to $2,888 in 2013. That’s an increase from 23% to 25%.

POSTED: Friday, March 8, 2013, 6:00 AM
Filed Under: Erica Cohen
(iStockphoto)

As the Internet becomes ever more ingrained in our lives, it increasingly affects the way patients interact with each other and with their doctors. They can more easily learn about conditions, treatments, and providers and can find the solace and support of others in similar circumstances. 

Web-based services serve a range of important needs. For example, two social media sites, CaringBridge and CarePages, allow supporters near and far to read journals in which patients post updates of their condition. Outlets like these allow patients and their families to post information on a real-time basis concerning sometimes-critical conditions. Among the posts are pleas for group prayer, requests for advice or support from others who have been down the same path, and descriptions of the frustrations of dealing with illness. This avenue for communication can be an invaluable help. 

Websites such as WebMD and sites maintained by many hospitals provide detailed information about medical conditions and potential treatments. The ability to research a diagnosis with ease increases patients’ independence and autonomy because it frees them from the need to call their doctor with every question.

POSTED: Sunday, March 3, 2013, 5:05 AM
Filed Under: Robert I. Field
Following a closed-door party caucus, House Speaker John Boehner of Ohio, accompanied by fellow GOP leaders, meet with reporters, on Capitol Hill in Washington, Tuesday, Feb. 26, 2013, to challenge President Obama and the Senate to avoid the automatic spending cuts set to take effect in four days. Speaking at the Republican National Committee headquarters, Boehner complained that the House, with Republicans in the majority, has twice passed bills that would replace the across-the-board cuts known as the "sequester" with more targeted reductions, while the Senate, controlled by the Democrats, has not acted. From left are, Rep. Lynn Jenkins, R-Kansas, Rep. Cathy McMorris Rodgers, R-Wash., Boehner, and House Majority Leader Eric Cantor of Va. (AP Photo/J. Scott Applewhite)

With no deal in Washington to stop it, the sequestration of federal funds is about to begin. It could be enough to make you sick - literally.

Some of the automatic budget cuts won’t be felt for months, if sequestration lasts that long. But several cuts involving health care will hit us much sooner. And they could hit us hard.

Here are five to be especially concerned about. (Figures for their impacts this year in Pennsylvania are available here.)

About this blog

The Field Clinic reports and analyzes health care laws, government policies, and political trends that are transforming the care we receive and the way we pay for it. Read more about our panel of bloggers here.

This blog is produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health-policy research and communication organization not affiliated with Kaiser Permanente. Portions of this blog may also be found on Inquirer.com and in the Inquirer's Sunday Health Section.

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Robert I. Field, Ph.D., J.D., M.P.H. Professor, School of Law & Drexel School of Public Health
Jeffrey Brenner, MD Founder of the Camden Coalition of Healthcare Providers, Medical Director of the Urban Health Institute at Cooper University Healthcare
Andy Carter President & CEO, The Hospital & Healthsystem Assoc. of Pa.
Robert B. Doherty Senior Vice President of Governmental Affairs & Public Policy American College of Physicians
Neil I. Goldfarb President & CEO of the Greater Philadelphia Business Coalition on Health
David Grande, MD, MPA Assistant Professor of Medicine at the University of Pennsylvania
Tine Hansen-Turton Chief Strategy Officer of Public Health Management Corporation
Drew A. Harris, DPM, MPH Director of Health Policy Program at the Jefferson School of Population Health
Antoinette Kraus Director of the Pennsylvania Health Access Network
Laval Miller-Wilson Executive Director of the Pennsylvania Health Law Project
David B. Nash, MD, MBA Founding Dean of the Jefferson School of Population Health
Howard J. Peterson, MHA Managing Partner of TRG Healthcare, a national healthcare consulting firm
Donald Schwarz, MD, MPH Deputy Mayor for Health & Opportunity and Health Commissioner for the City of Philadelphia
Paula L. Stillman, MD, MBA Healthcare consultant with special expertise in population health and disease management
Elizabeth A. W. Williams Senior Vice President & Chief Communications Officer for Independence Blue Cross
Krystyna Dereszowska A third-year law student concentrating in health at Drexel
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