Physician Talks Truth About End-of-Life Care
Time magazine interviewed Dr. Laurie Jacobs, vice chairman of the Department of Medicine at
Albert Einstein College of Medicine and
Montefiore Medical Center in New York City, about the
real issues concerning end-of-life care that has many people - stirred up by the un-truths fostered by the right-wing media - foaming at the mouth and screaming so loudly they can hear the truth.
Here is a sampling of her interview:
How important is Medicare reimbursement for doctors counseling patients about end-of-life care?
For some people one conversation is enough, and you get the whole picture and they tell you exactly what they want. For other people, 10 conversations in 10 weeks won't suffice. Coverage for this is expensive, but I think offering it is a wonderful first step in highlighting the importance of it by paying for it.
What kind of end-of-life-care counseling do you provide to your patients? How does it work?
Many patients have chronic illness and some disability or medical issue, and part of providing care is to speak with them about what to expect with their illness, what alternatives exist, and to have a conversation about what their preferences are. This shouldn't just happen at the end of life. You should get to know people and have these conversations throughout providing care. I like to talk individually with the patient if they are comfortable with that. If they are more comfortable with having family members there at the time, then I do it with the group. What I need to know from the patients is how they view their illness in the context of their life. Did they know somebody else with the same condition and therefore they have some [preconceived] idea about this? What are their values? How to they want to live their life? I also talk to them about whether there is someone who could make decisions for them if they are unable in the future.
Drug Companies Settle Vytorin Case for $41.5 Million
The Associated Press reports:
TRENTON, N.J. – Merck & Co. and Schering-Plough Corp. said Wednesday they will pay $41.5 million to settle lawsuits claiming the drugmakers, partners on two blockbuster cholesterol drugs, delayed unfavorable study results because they would hurt sales.
Shares of both companies initially rose after the news, then fell with the broader market.
In January 2008, the companies released long-awaited study data showing Vytorin and Zetia were no more effective than an older, less-expensive cholesterol treatment at reducing plaque buildup in arteries of people whose genes gave them stratospheric cholesterol.
Instead, the study showed $100-a-month Vytorin, which combines Zocor and Zetia, was perhaps a bit worse than Zocor alone, which is sold as a generic for a third as much. The study also cast doubt on whether Zetia, which works by a different mechanism, has much effect on cholesterol levels, and subsequent data have raised questions about their safety.
The companies finished the study, called ENHANCE, in 2006. Merck and Schering-Plough were criticized for not releasing the data earlier, and didn't do so until Congress began investigating the delay.
But don't start feeling too sorry for the pharmaceutical companies. They are still money ahead; billions, in fact.
In 2007, sales of the two drugs brought in $5.2 billion. The revenues dropped to $4.6 billion in 2008. That's nearly $10 billion
after the report was issued.
A tidy profit for a couple of drugs that are not as effective as the one they replaced and potentially dangerous.
The settlement is a joke.
Disability Claims Expected to Rise
The Social Security Administration is bracing for an
expected increase in the number of people filing disability claims.
The Associated Press reports:
Officials estimate they'll receive 3.3 million new disability claims over the next year, up from their previous estimate of 3 million projected just five months ago.
The unprecedented wave of new applications raises questions about the agency's ability to curb historic backlogs and cut processing delays, a problem that has plagued the agency for years. Officials had been making progress in reducing a massive backlog of disability appeals cases.
Also adding to the problem are recent moves in at least 10 states to furlough hundreds of employees who process initial benefit claims.
Agency officials say the extraordinary increase is driven by the recession and an aging baby boomer work force reaching their most injury-prone years. Long waits for the agency to process claims and resolve appeals can leave some claimants struggling to make ends meet.
U.S. Obesity Rates Continue Climb
A recent report by the Robert Wood Johnson Foundation shows an
increase in obesity rates in 23 states in the past year with no state reporting a decrease.
Other findings:
Mississippi had the highest rate of adult obesity, 32.5 percent, for the fifth year in a row.
Three additional states now have adult obesity rates above 30 percent, including Alabama, 31.2 percent; West Virginia, 31.1 percent; and Tennessee, 30.2 percent.
Colorado had the lowest rate of obese adults, at 18.9 percent, followed by Massachusetts, 21.2 percent; and Connecticut, 21.3 percent.
Mississippi also had the highest rate of overweight and obese children, at 44.4 percent. It's followed by Arkansas, 37.5 percent; and Georgia, 37.3 percent.
Senator Wants to Lower Health Costs by Taxing Benefits
Senate Finance Committee Chairman Max Baucus, D-Mont.,wants to control health care costs by taxing some benefits provided by employers. President Barack Obama has previously ruled this out.
"I know that's an issue we have to work out with the president, but I think it's an issue we will work out," said Baucus, who is among several Senate Democrats scheduled to meet with Obama Tuesday afternoon.
Baucus says the tax-free benefit packages Americans now enjoy are a big factor in the high costs of the country's health care system, because they provide workers free or low-cost access to too many health care services.
The senator's recommendation came at a White House event where Obama advisers released a new economic report that links fixing the economy with overhauling the costly U.S. health care system.
Obama is pushing Congress to enact sweeping health legislation this year to hold down costs and provide health coverage for 50 million uninsured Americans.
Perhaps Baucus will find some support for his plan from the general public if he includes taxing the benefits Congress enjoys at the public's expense.
Red Meat Will Kill You
Now there is proof that
red meat is the scourge of health that vegetarians have been calling it for years:
CHICAGO – The largest study of its kind finds that older Americans who eat large amounts of red meat and processed meats face a greater risk of death from heart disease and cancer. The federal study of more than half a million men and women bolsters prior evidence of the health risks of diets laden with red meat like hamburger and processed meats like hot dogs, bacon and cold cuts.
Calling the increased risk modest, lead author Rashmi Sinha of the National Cancer Institute said the findings support the advice of several health groups to limit red and processed meat intake to decrease cancer risk.
The findings appear in Monday's Archives of Internal Medicine.
Pain 'national health-care crisis'
From
McClatchy Newspapers:
WASHINGTON — Medical science has learned a great deal about the causes of pain and ways to relieve it, pain experts say, but for a host of reasons, the treatment of pain and suffering has improved hardly at all in recent years.
John Seffrin, the president of the American Cancer Society, calls this "a national health-care crisis of under-treated pain.''
"Nearly all cancer pain can be relieved, but fewer than half of our patients report adequate pain relief,'' Rebecca Kirch, the society's associate director of policy, told a pain seminar in Washington last week.
Hospitals do a little better than that in managing pain for patients with all kinds of illnesses, according to a survey to be published Thursday in the New England Journal of Medicine.
The survey of hospitals in 40 metropolitan areas by the Harvard School of Public Health found that one-third of patients felt that their pain wasn't well controlled. The percentage of those who were satisfied by their pain care ranged from 72 percent in Birmingham, Ala., to 57 percent in New York City hospitals.
