NY Times: Length vs. Quality of Life

Letters to the Editor

The New York Times

letters@newyorktimes.com

Dear Editor:

Yesterday, you reported that many older people undergo surgery late in their lives (nearly one-tenth within a week of passing!) and that this is largely due to doctors refusing to discuss the quality vs. length of life with their dying patients. With health care expenditure skyrocketing, these surgeries aren’t an efficient use of resources. Though every life is valuable, it is frustrating that so much is spent prolonging the inevitable and that patients’ freedoms are violated by physicians’ cowardice.

A public health student at UC Berkeley, I propose that doctors be mandated to disclose their patients’ health status to patients and these families. These individuals also need a support system and resources, as the article suggests, to help them understand their decisions’ implications. The amount spent on these surgeries, which seek to prolong life rather than cure disease, could significantly decrease if patients and their families were better informed.

Sincerely,

Elizabeth Hui

2220 Dwight Way

Berkeley, CA 94704

elizabethhui@berkeley.edu

(714) 336-0169

http://www.nytimes.com/2011/10/06/health/research/06medicare.html?_r=1&ref=policy

Karely Ordaz Section104

Letters to the Editor
San Francisco Chronicle
901 Mission Street
San Francisco, CA 94103

(415) 777-7100

Dear Editor:

It is extremely important that there is a well-defined federal Medicaid law that provides little room for interpretation. The law should clearly state the lowest reimbursement rates that states can adopt and must say whether third parties can object to those rates. This will limit confusion. Next, it is crucial to reflect upon the consequences that the reduction of reimbursement rates may have on patients. Considering that 43% of Medicaid expenditures go to the low income disabled means that they will be more susceptible to care exclusions. Being less attractive to providers, the low income disabled will face many challenges when seeking basic health services. Finally, it is essential to consider the reasons why California chose to reduce Medicaid reimbursement rates. It seems likely that this was done to reduce costs. In the long-run, this short term goal will fail to save costs because relatively the number of individuals joining Medicaid is increasing meaning that overall costs will inevitably go up. Rather than cutting reimbursement rates, California should look for other ways to reduce cost.

Sincerely,

Karely Ordaz

1231 40^th Avenue

Oakland, CA 94601

kordaz09@berkeley.edu

(510) 927-1292

http://www.sfgate.com/cgi-bin/article.cgi?f=/n/a/2011/10/03/state/n005719D03.DTL

Maternity care for the collective good

http://www.latimes.com/news/local/la-me-maternity-20111001,0,1594619.story

Re ”Individual insurance may have to cover maternity care,” Oct. 1

Pregnant women without access to prenatal care is not a problem we can afford to brush off. In 2008, 21% of pregnant women in California did not receive adequate prenatal care. Babies are three times more likely to have low birth weights and five times more likely to die if their mother did not receive prenatal care, reported the HHS Office on Women’s Health. Critics of bills SB 222 and SB 299 argue it’s unfair for people who don’t need maternity care to endure higher health insurance costs because people like Van cannot afford to pay out-of-pocket. Without prenatal care, a greater percentage of expecting mothers will experience health risks, which in turn will exacerbate health care costs. In short, we as taxpayers will pay for it when those women go to public hospitals for their births. We will pay at some point. Why not pick the most humane and ultimately cost effective way even if that means paying a little more on your insurance plan now. Those unborn children deserve the best start to life we can give them. The healthier the start the more they will contribute to society instead of burdening it.

“Patient Data Landed Online After a Series of Missteps”

The New York Times

letters@nytimes.com

October 5, 2011

To the editor:

Re “Patient Data Landed Online After a Series of Missteps” -

I was surprised to read “breaches of private medical data have become distressingly commonplace.”

As a pre-medical student, I worry that public malaise about the implementation of electronic medical records (EMR) could imperil my ability to provide the best health outcomes. Along with decreasing operating costs and material waste, EMRs show full patient history, facilitate physician collaboration, enhance precision, and allow for study among other benefits.

The invidious incidents of Stanford Hospital and the 330 similar cases could sway the masses from taking advantage of what EMR provides. It seems private lawsuit liability is statistically not costly enough for providers to invest in proper management and security of patient records.

In resolution, there should be severe pre-determined fines on those that have leaked private medical information. Further, under its powers to enforce HIPPA, the Department of Health and Human Services should review and ensure the security of these networks.

Chris Ackman

New Survey Projects Higher Employee Health Premiums: Letter to the Editor

The New York Times


620 Eighth Avenue New York, NY 10018

letters@nytimes.com

10/4/2011

Dear Editor,

On Sunday, you reported that a study done by Aon Hewitt revealed that companies will push more health care costs onto their workers by nearly 11% next year. This is ironic because this increase can be attributed to the tough state of the economy. The state of the economy causes more young adults to be unemployed, yet if we had more employed and healthy young adults companies’ medical expenditures wouldn’t be so costly. As a college student who will shortly be entering the workforce, my perspective is that large companies should be incentivized to hire young adults to balance out the medical expenditures for older employees. What people don’t realize is that our nation as a whole could decrease our health care expenditures in the long run if we’d adopt a defensive attitude towards our health. I think preventative care and health incentivizing could really make a difference; whether it is on a national level, or a more specific level, like the workplace, which this article addresses.

Sincerely,

Riley Sisk

2710 Channing Way, Berkeley CA 94704

rsisk@berkeley.edu

(831) 334-7693

To view the actual article:

http://prescriptions.nytimes.com/2011/10/02/new-survey-projects-higher-employee-health-premiums/

letter to the editor

To the Editor:

Re: “Contraceptive used in Africa May Double Risk of H.I.V.” by Pam Bullock, Oct. 3^rd, 2011. As a public health student, the future prevalence of H.I.V. is of importance to me. This article highlighted a recent study, which found injectable birth control might increase risk of contracting H.I.V. The study cited the popularity of injectable birth control due to its ease and the fact that it does not require administration from a doctor.            

Although there is merit to the idea that women should use the birth control option that is easiest, the study revealed a severe downfall to this method. One option that is not thoroughly explored by this article is the use of intrauterine devices (IUDs), which have extremely high efficacy and a lifespan of up to ten years. In other countries there has been great success in training nurses to administer IUDs, which would eliminate the need for a doctor in the process. IUDs are not linked to higher incidence of H.I.V. This is a contraceptive method that should be explored more widely in Sub-Saharan Africa.

Mattie Boehler-Tatman

Student, University of California, Berkeley

http://www.nytimes.com/2011/10/04/health/04hiv.html

NY Times: Surgery Rate Late in Life Surprises Researchers

Letters to the Editor
The New York Times
620 Eighth Avenue
New York, NY 10018

CC: letters@nytimes.com

Dear Editor:

The October 5^th article “Surgery Rate Late in Life Surprises Researchers” reported that of the surveyed Medicare patients, a third undergo surgery in their last year of life. Although this study over-generalizes individual situations and may be shallow in analysis, it does highlight an important issue: 5% of patients account for more than half of all healthcare spending.

A flaw in the U.S. healthcare system is our focus on disease treatment at the expense of preventative and palliative care. Many unnecessary procedures are done with the single-minded goal of treating a disease instead of looking into a patient’s overall health. One thing that could really make a difference is if doctors communicated better the costs and benefits of operating when a disease has progressed to advanced stages. Especially in elderly patients, avoiding surgery and/or focusing on palliative care may improve the quality of life late in life. By evaluating the benefits of invasive operations on elderly patients, medical care can stop being “overused and needlessly driving up medical costs.”

Sincerely,

Katerina U
katerinau@berkeley.edu

http://www.nytimes.com/2011/10/06/health/research/06medicare.html?_r=1&ref=health