Healthcare reform explained. The Kaiser Family Foundation video

Cokie Roberts explains all or at least a little

Sorry about the earlier video; this one should work on iDevices. -e

How many chickens for a 7-day linezolid course?

Like many, I’m intrigued by the health care reform proposal recently put forward by a Nevada Senate candidate. The proposal calls for a return to the barter system for health care delivery. There are only a few problems. One recent analysis concluded that basing such a system solely on chickens would be impossible, given the sheer number of chickens required.

Another shortcoming--what to do about adverse events and nosocomial infections? Shouldn’t a patient also receive goods or services if he or she is harmed during the delivery of health care? I can see it now…returning home after a hospital stay complicated by a nosocomial infection, you discover that the hospital has sent someone over to paint your house…

"Lessons of a $618,616 death"

I arrived at the gym tonight with nothing to read. Given that 30 minutes on the bike can seem like eternity, I went to check out whatever was left behind by those smart enough to bring along some reading material. I found only two recent but ragged magazines--BusinessWeek and Entertainment Weekly. My heart sunk--I was facing eternity on the bike. Then the BusinessWeek cover caught my eye: Lessons of a $618,616 death. The cover story was written by Amanda Bennett about her husband, who died after a 6-year struggle with kidney cancer. After his death, she read all 5,000 pages of his medical records, analyzed every medical bill, and tells the story of his illness in an incredibly honest way. She describes some of the fundamental flaws of the US healthcare system, the bizarre workings of the insurance industry, the moral hazard of having good insurance, and the desperation of the terminally ill that leads to a spare-no-expense mentality even when the odds of success are very, very small. In the end, she feels guilty about the fact that the resources spent on trying to save her husband could have vaccinated a quarter million children, yet she admits she would do it all over again. The entire article can be read online here. It's a must-read.   

Aneurin Bevan

"... no society can legitimately call itself civilized if a sick person is denied medical aid because of lack of means."

—Aneurin Bevan, In Place of Fear

I suspect many in the US will have never heard of Aneurin Bevan. I recently came across his name while reading the obituary of Michael Foot. In the wake of England's Labour Party landslide victory in 1945, Bevan was appointed Minister of Health, charged with starting the new National Health Service and asked to solve the nation's housing shortage. He was the youngest member of the cabinet. His "National Health Service Act of 1946" did not come into force until July 1948 after great fights with the conservative party and a showdown with the BMA.

It has been interesting to read the postmortem stories and talks of battles ahead. What I'm struck with are the similarities and differences between Britain's fight in 1945 and ours. Tough economic times, major housing issues (bombs vs foreclosures), landslide victory for one party and the long duration of the battle for universal coverage. At the same time, England's left nationalized healthcare and ours maintained a free-market system which will now be challenged by the "free-market" right. Oh, well. It hasn't even been a year...or has it been 65?