Monthly Archives: August 2010

Some health and healthcare facts…

Posted on August 26, 2010 | 3 Comments

Heart disease is the number one cause of death for both men and women in the United States. Cancer and stroke round out the top three.

Heart disease accounts for 40% of all U.S. deaths, more than all forms of cancer combined.

Negative emotions and depression are risk factors for heart attack and stroke. Conversely, happier people are less likely to develop heart disease.

Researchers found that a woman’s resting pulse rate was a good indicator of her risk of heart attack. Women with high heart rates, at or above 76 beats per minute, were more likely to suffer a heart attack than women with lower resting pulse rates (62 beats per minute or less).

People with diabetes, older adults, and women may not have the classic symptom of chest pain during a heart attack. They are more likely to suffer from shortness of breath, nausea, back pain, and/or jaw pain.

More than 79,400,000 Americans have one or more forms of heart disease.

Research suggests that 25% of heart attacks go unrecognized and are discovered only later when a routine ECG is performed.

One in 2.6 female deaths in the U.S. is from heart disease, compared to one in 30 from breast cancer.

Source:Chilnick, Lawrence. 2008. Heart Disease: An Essential Guide for the Newly Diagnosed. Philadelphia, PA: Perseus Books Group.

Approximately 90% of people with Type 2 diabetes are obese.

African-Americans and Hispanics have a much higher rate of Type 2 diabetes than whites. There are 74 cases per 1,000 for African-Americans, 61 cases for Hispanics, and 36 cases for whites.

Some studies have indicated that individuals with diabetes are at much greater risk for developing Alzheimer’s disease and other forms of dementia than are non-diabetics, though the reasons are unknown.

There are approximately 86,000 lower-limb amputations on diabetics in the United States each year. Rates of amputation were higher among men than women and higher among African-Americans than whites. Experts believe nearly half of all amputations could have been prevented with appropriate examinations and education.

Approximately 11% of all Americans aged 65-74 have diabetes. About 20% of those over 75 years old have diabetes, and nearly half of them are unaware they have the disease.

According to the Centers for Disease Control and Prevention (CDC), diabetes is the sixth leading cause of death in the United States.

Experts report that diabetes decreases life expectancy by five to 10 years.

Approximately 17 million U.S. residents have been diagnosed with diabetes, which is nearly 10% of the estimated 170 million people suffering from diabetes worldwide.

Source: Adamec, Christine. 2002. The Encyclopedia of Diabetes. New York, NY: Facts on File, Inc. Collazo-Clavell, Maria. 2001. Mayo Clinic on Managing Diabetes. New York, NY: Kensington Publishing Corp.

More than 20 million people in the United States suffer from depression in a given year.

Women are twice as likely to suffer from depression than men. Women may be at a higher risk for depression due in part to estrogen, which may alter the activity of neurotransmitters that contribute to depression.

At some point in their lives, about one in four Americans will experience depression.

Men typically experience depression differently from women and use different means to cope. For example, while women may feel hopeless, men may feel irritable. Women may crave a listening ear, while men may became socially withdrawn or become violent or abusive.

Approximately 80% sufferers of depression are not receiving treatment.

Fifty-eight percent of caregivers for an elderly relative experience symptoms of depression.

The total cost of depression in the Untied States are estimated to be $44 billion: $12 billion in direct costs of treatment, $8 billion in premature death, and $24 billion in absenteeism and reduced productivity at work. These do not include out-of-pocket family expenses, costs of minor and untreated depression, excessive hospitalization, general medical services, and diagnostic tests.

Source: Lam, Raymond W. and Hiram Wok. 2008. Depression. New York, NY: Oxford University Press.

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Posted in Health information

Tagged Health facts

A lesson for pharma: How the Web empowers people to get to the truth when companies don’t embrace transparency

Posted on August 10, 2010 | 5 Comments

The Wall Street Journal does not pretend to be on the center of anything. They are a conservative big business newspaper but I still enjoy reading their stories. Today there was a story titled “Why I’m Not Hiring When you add it all up, it costs $74,000 to put $44,000 in Sally’s pocket and to give her $12,000 in benefits.”

The story is about the added cost of health insurance for employers;

Employing Sally costs plenty too. My company has to write checks for $74,000 so Sally can receive her nominal $59,000 in base pay. Health insurance is a big, added cost: While Sally pays nearly $2,400 for coverage, my company pays the rest—$9,561 for employee/spouse medical and dental. We also provide company-paid life and other insurance premiums amounting to $153. Altogether, company-paid benefits add $9,714 to the cost of employing Sally.

Companies have also been pressed into serving as providers of health insurance. In a saner world, health insurance would be something that individuals buy for themselves and their families, just as they do with auto insurance. Now, adding to the insanity, there is ObamaCare.

Every year, we negotiate a renewal to our health coverage. This year, our provider demanded a 28% increase in premiums—for a lesser plan. This is in part a tax increase that the federal government has co-opted insurance providers to collect. We had never faced an increase anywhere near this large; in each of the last two years, the increase was under 10%.

Mr. Fleischer is president of Bogen Communications Inc. in Ramsey, N.J.. Now because of the power of the Internet we see this response from a Wall Street Journal reader;

Did anyone go on this guy’s web site? He has posted his financials. Take a look at them and tell me his problems are due to a couple thousand dollar per employee increase in employment cost.

His problems are elsewhere. For some inexplicable reason Mr. Fleisher allowed his expenses to increase by $15 million dollars in the face of a $ 10 million decrease in revenues. But he’s worried about what appears to be a$165 thousand increase in insurance costs and some administrative requirements that are easily handled at a clerical level and by very inexpensive automated payroll services. IIn short he’s got a problem that’s 150 times bigger than the insurance problem he is focused on.

He is oblivious to the fact the $3 million in dividends he paid last year might have been better used to finance future growth, or for improvements that might improve efficiency. He is oblivious to the fact that the $9 million he borrowed to finance his miscalculations in expense management will impede his ability o grow in the future. No, for Mr. Fleisher it’s all about government interference. His politics may make him feel better but they’re not going to help him dig himself out of the hole he’s n, and similar thoughts are not going to help you did your way out of yours.

This means that someone took the time to read the story, research the company and reply to the article which, at the time of writing this post, had over 700 responses. This is the power of the Internet. The way for consumers to get at the truth and not believe media stories. This is also the reason that pharma is having so many problems.

According to a story in Newsweek “Results from fully one third of the clinical trials of five classes of drugs never see the light of day, finds an analysis published in Annals of Internal Medicine. The drugs were anticholesteremics, antidepressants, antipsychotics, proton-pump inhibitors (which reduce gastric acid), and vasodilators (which relax blood-vessel walls in order to reduce blood pressure).

This story and the story in the WSJ are excellent examples of why transparency is NOT an option anymore. Like Mark Twain said “It ain’t what you don’t know that gets you into trouble. It’s what you know for sure that just ain’t so”

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Tagged #hcsm #socpharm, Transparency

The cost of dying

Posted on August 9, 2010 | 6 Comments

Last year, Medicare paid $55 billion just for doctor and hospital bills during the last two months of patients’ lives. And it has been estimated that 20 to 30 percent of these medical expenses may have had no meaningful impact. Most of the bills are paid for by the federal government with few or no questions asked.This statistic is from a 60 Minutes story on “The Cost of Dying” and is one reason our healthcare system is in trouble.

Modern medicine has become so good at keeping the terminally ill alive by treating the complications of underlying disease that the inevitable process of dying has become much harder and is often prolonged unnecessarily. ”The way we set up the system right now, primary care physicians don’t have time to spend an hour with you, see how you respond, if they wanted to adjust your medication”. “So, the easiest thing for everybody up the stream is to admit you to the hospital.

I think 30 percent of hospital stays in the United States are probably unnecessary given what our research looks like.

And once someone is admitted to the hospital, Fisher says, they’re likely to be seen by a dozen or more specialists who will conduct all kinds of tests, whether they’re absolutely essential or not.

“In medicine we have turned the laws of supply and demand upside down,

” Dr Elliot Fisher said. “Supply drives its own demand. If you’re running a hospital, you have to keep that hospital full of paying patients. In order to, you know, to meet your payroll. In order to pay off your bonds.

When it comes to expensive, hi-tech treatments with some potential to extend life, there are few restrictions. By law, Medicare cannot reject any treatment based upon cost.

It will pay $55,000 for patients with advanced breast cancer to receive the chemotherapy drug Avastin, even though it extends life only an average of a month and a half;

it will pay $40,000 for a 93-year-old man with terminal cancer to get a surgically implanted defibrillator if he happens to have heart problems too.

“The real problem is that many of the patients that are being treated aggressively, if you ask them, they would prefer less aggressive care. They would prefer to be cared for at home. They’d prefer to go to hospice. If they were given a choice. But we don’t adequately give them a choice,” Fisher said.

Should the FDA approve drugs that extend life a few months at a really high cost to the government ? That is an explosive issue to tackle. Most of us want to die with dignity and peacefully and research that I conducted with cancer patients last year indicated that a lot of them do not want to go through extensive treatments that have horrible side effects if there is no hope of a better quality of life. Eventually we are going to have to decide if it’s better to keep people alive, connected to machines at a huge cost, with no hope of recovery or to let move onto as nature had intended. Sometimes I wonder, do we keep people alive and in misery for ourselves or them ?

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Posted in Cost of healthcare in the U.S.

Tagged Cost of dying

The report estimates the medical costs of obesity to be as high as $147 billion a year

Posted on August 4, 2010 | 7 Comments

Is there any doubt that our healthcare system is in trouble ? Is there any doubt that the reason our healthcare system is in trouble is in large part because Americans eat too much bad food and are not doing enough to maintain a healthy lifestyle ?

The hard reality is that we can’t afford to pay for the cost of obesity without making deep cuts across the board, deep cuts that are going to hurt a lot of towns, villages, cites and their citizens. It’s time to take the war on obesity to the mainstream and fight it as hard as we fought smoking. It’s going to require an alliance of the FDA, big pharma, AMA, food marketers as well as restaurant chains but we have run out of options.

The FDA needs to do more to address basic consumer education when it comes to disease state awareness. They need to focus more on prevention and enlist the help of health care professionals and insurers to set up a reward system for people who proactively manage their health by choosing better lifestyle options. An insurer, for example, could offer lower premiums to someone who lost weight, lowered their blood pressure or cholesterol. Companies need to find enticements to get employees to join health clubs or they can work with the company that manages their cafeteria to offer a wider choice or healthy food.

What about big pharma ? I believe they need to do more to work with physicians to help people better manager their health. Chances are, for example, that if you have high cholesterol you will be prescribed a statin when possibly the first course of treatment should be an attempt to modify the patients diet and lifestyle through education and awareness of the dangers of high cholesterol.

It’s not going to be easy. Today people are becoming obese both because we are an aging population and because they tend to use food as a reward for dealing with the daily stresses of life. I believe that we can assemble some of the best and brightest advertising and marketing people to meet and form a coalition to get funding to fight this enormous problem and to hit it head on with reality of what obesity does to people and this country. We just can’t stand by and do nothing while we eat another cheeseburger.