Placebo Gazette #152 (Keeping Our Finger On The Prostate Of Medicine)
5/19/10
The Cost of Care Going Up
PJTV Breaking News Report
Reward: Most Wanted
The Cost of Cancer
The Electronic Way by Ted Bacharach MD (retired)
Genetic Devices
Placebo Journal Update
1. Cost of Care Going Up
It seems even in a healthy part of the country like Provo, Utah there is a continuing trend to spend more money on healthcare. Provo has been used as a model by President Obama but spending on Medicare patients has accelerated rapidly. There are also many other reasons mentioned in this Washington Post article that could be the causing the increase:
Increase in the number of tests and procedures being performed
Doctors owning their own testing machines (GI docs owning CT scanners, oncologists own radiation machines, etc)
More diagnostic machines in the area
New surgical suites in the area
Increase in the number of patients being seen
More aggressive treatment earlier on in disease stages
Treatments being performed more frequently
No one seems to have an answer and everyone is puzzled by the fact that we are a country that is getting older, likes new technology and the combination of the two costs more and more.
The FDA is asking doctors to report misleading drug ads in a effort to police the pharmaceutical industry. The FDA now has only a few dozen people to comb through all the ads and find the ones that show misinformation. Now they are even offering training at medical conferences so that physicians can be the "minutemen of medicine". The reward for this action? Nothing. We are supposed to do it, in our free time, out of the goodness of our heart. There are so many other programs that the government has which uses bounty hunters (lawyers, auditors) but with doctors they are going to rely on our conscience. For me, I'd rather mock these ads in the Placebo Journal. The next issue has a parody on the new diabetes drug Onglyza. Ours is called Onguysa. My method is much more fun that playing footsie with the Feds.
Here is the moral dilemma of our healthcare era. How do we pay for the rising cost of cancer?The cost of treating cancer in the United States almost doubled between 1987 and 2005. This could be due to many reasons: we detect cancer earlier, we have more modalities to treat these cancers, people are living longer, etc. As more and more drugs are invented to keep us around longer, when will we hit the tipping point where we realize that we can't afford it anymore? Maybe this is not a moral dilemma but a fiscal survival dilemma. Your thoughts?
5. The Electronic Way by Ted Bacharach MD (retired)
Not too long ago while shopping during a storm I was amazed that all the stores in the area shut their doors and were unable to transact any business because of the power outage. The clerks could not run the cash registers and calculating sales without the electronic calculator is unthinkable. The electronic medical record would probably produce the same catastrophic result. No care could be rendered as it could not be recorded. A major catastrophe could stop all medical care if our dependence on the electronic record continues to grow. Maybe schools should continue to teach writing and calculating skills so that some records could be maintained at least until the power comes back on?
The FDA has stepped in and temporarily stopped Walgreens from selling a genetic test made by a company called Pathways. Their concern is that this item is a medical device and therefore under their jurisdiction. I just can't believe we are in an era where someone can basically spit into a cup and find answers to whether they have a "a propensity for developing medical conditions such as Alzheimer's disease, diabetes and obesity; the likelihood of parenting a baby with cystic fibrosis, Tay-Sachs and other genetic disorders; and the possible reaction to caffeine, cholesterol-lowering drugs, blood thinners and other medications". Wow. Of course, most of this information is overdoing it and will cost a lot. I don't know the price of the test but the cost of further testing, which may or may turn out to be false, will again overburden our bankrupt healthcare system. But by all means, let's open this genetic Pandora's Box. You know, as a doctor I could make the same kind of miraculous predictions. Since most Americans are overweight or obese and don't exercise, I can play the great Karnak and predict whether they are going to get diabetes, heart disease, back pain and/or depression. But alas, no one wants to hear what we say. Besides, genetic testing from a local pharmacy sounds so much more fun.
