Monday, April 13, 2009

Is nothing sacred?

According to an article in the Wall Street Journal, one in eight (twelve and a half percent of ) U.S. workers now work in health care. It says that 50 years ago this figure was 1 one percent (one out of a hundred workers).

This could just be one of those changes that take place in a dynamic economy (with the percentage of income spent on food and the numbers of people working in agriculture falling dramatically during the last century, for example). But the above average pay for health care workers becomes more and more of a problem as they become a higher percentage of all workers. Unlike in Lake Woebegon, it is impossible for everyone to have above average pay.

It is no wonder, then, that even health care workers are no longer immune from employment cutbacks.

Recession Now Hits Jobs in Health Care

Sunday, April 12, 2009

Reforming the medical system will not be easy

The following article, in the form of an open letter to editors of the New York Times, is not just interesting. It is an absolutely essential read for anyone who wants to understand just how difficult it is going to be to reform the current medical system (and I don't mean politically difficult).

Why Has the Press Failed Us In Reporting on Health Care Reform?

Friday, April 10, 2009

Upcoming changes in this blog

This blog is not working as I had hoped. None of the medical professionals to whom I gave notice about it have sent any comments in. No doubt they are very busy people!

I am thinking about how to change this blog to a more general focus, which will not exclude medical system reform ideas but will encompass much more. Stay tuned!

An interesting article from Common Dreams:

A System From Hell: My Personal Health Care Nightmare

Saturday, April 4, 2009

Socratic approach to medicine relevant today?

Here is a passage from Plato's Republic in which participants in the dialog discuss the proper place of medical treatment. Given modern advances in medical technology, the questions raised here take on even more significance.

Translated by Benjamin Jowett:

Well, I said, and to require the help of medicine, not when a wound has to be cured, or on occasion of an epidemic, but just because, by indolence and a habit of life such as we have been describing, men fill themselves with waters and winds, as if their bodies were a marsh, compelling the ingenious sons of Asclepius to find more names for diseases, such as flatulence and catarrh; is not this, too, a disgrace?

Yes, he said, they do certainly give very strange and newfangled names to diseases.

Yes, I said, and I do not believe that there were any such diseases in the days of Asclepius; and this I infer from the circumstance that the hero Eurypylus, after he has been wounded in Homer, drinks a posset of Pramnian wine well besprinkled with barley-meal and grated cheese, which are certainly inflammatory, and yet the sons of Asclepius who were at the Trojan war do not blame the damsel who gives him the drink, or rebuke Patroclus, who is treating his case.

Well, he said, that was surely an extraordinary drink to be given to a person in his condition.

Not so extraordinary, I replied, if you bear in mind that in former days, as is commonly said, before the time of Herodicus, the guild of Asclepius did not practise our present system of medicine, which may be said to educate diseases. But Herodicus, being a trainer, and himself of a sickly constitution, by a combination of training and doctoring found out a way of torturing first and chiefly himself, and secondly the rest of the world.

How was that? he said.

By the invention of lingering death; for he had a mortal disease which he perpetually tended, and as recovery was out of the question, he passed his entire life as a valetudinarian; he could do nothing but attend upon himself, and he was in constant torment whenever he departed in anything from his usual regimen, and so dying hard, by the help of science he struggled on to old age.

A rare reward of his skill!

Yes, I said; a reward which a man might fairly expect who never understood that, if Asclepius did not instruct his descendants in valetudinarian arts, the omission arose, not from ignorance or inexperience of such a branch of medicine, but because he knew that in all well-ordered states every individual has an occupation to which he must attend, and has therefore no leisure to spend in continually being ill. This we remark in the case of the artisan, but, ludicrously enough, do not apply the same rule to people of the richer sort.

How do you mean? he said.

I mean this: When a carpenter is ill he asks the physician for a rough and ready cure; an emetic or a purge or a cautery or the knife, -- these are his remedies. And if some one prescribes for him a course of dietetics, and tells him that he must swathe and swaddle his head, and all that sort of thing, he replies at once that he has no time to be ill, and that he sees no good in a life which is spent in nursing his disease to the neglect of his customary employment; and therefore bidding good-bye to this sort of physician, he resumes his ordinary habits, and either gets well and lives and does his business, or, if his constitution falls, he dies and has no more trouble.

Yes, he said, and a man in his condition of life ought to use the art of medicine thus far only.

Has he not, I said, an occupation; and what profit would there be in his life if he were deprived of his occupation?

Quite true, he said. . . . .

Friday, April 3, 2009

Timely articles raise interesting questions:

Doctors Are Opting Out of Medicare [Would this kind of problem occur under a single-payer system of insurance?]

G.E. and Intel Working on Remote Monitors to Provide Home Health Care
[Is this a step towards the "doctor in a box" that I wrote about recently?]

An Open Letter to Congress: Help Me or I Will Die [If there is a single-payer insurance system, it will either have to draw the line at some treatments that could extend lives, or it will bankrupt the country. Will Congress have the courage to draw the line?]

Wednesday, April 1, 2009

No fooling on April 1, 2009


An interesting article:
In Workplace Injury System, Ill Will on All Sides

The Archimedes Movement, a medical system reform organization led by former Oregon governor John Kitzhaber, has an interesting website .