Sunday, October 9, 2011

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

Friday, October 7, 2011

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 40th 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


Thursday, October 6, 2011

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. 3rd, 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

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 5th 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

Re: In Practice: A system's slowness can be a breast cancer patient's enemy

Dear Editor:

Despite revolutionary medical advances and remarkable efforts to expand health insurance coverage via Medi-Cal, the health outcomes of our communities are inconsistent with these improvements; the women who have suffered from breast cancer treatment delays demonstrate this truth best.

With health care expenditures consuming 18% of the nation’s GDP, policymakers should critically evaluate where these dollars are going and whether these expenditures are most transformative of health outcomes. Even with increased funding toward research and insurance coverage, women still were unable to access adequate care because of an overwhelmed and ineffective health system.

More focus (and funding) should be directed towards breast cancer prevention, not only in the arena of screening. As important as it is, screening only catches cancers that already have developed. Resources must be dedicated to addressing both the genetic and environmental factors that contribute to breast cancer. Starting at the true source, social determinants of health, will have the greatest effects overall.

Sincerely,

Sydney Fang

http://www.latimes.com/health/la-he-practice-breast-cancer-20111003,0,7889693.story

Study: Worst hospitals treat larger share of poor

Associated Press

450 W. 33rd St.

New York, NY 10001

October 6, 2011

Dear Editor:

Yesterday, you reported that the nation’s worst hospitals treat twice the amount of elderly black and poor patients than the best hospitals. These patients receiving care from the worst hospitals are more likely to suffer and die from heart attacks and pneumonia. This is quite alarming because we’re seeing the scope of health care inequality and inaccessibility in its worst way. This is a time when our nation’s poorest are in great need of proper health care yet they’re not receiving it. As a student, I’m completely baffled and appalled at the blatant lack of consideration for our fellow Americans. What people don’t realize is that 5% of our population accounts for about 50% of health care spending. If we allocate money and resources to these “worse” hospitals and pay better attention to delivering adequate primary and preventive care, we could avoid such egregious spending. In addition to that, the notion that western medicine maintains about focusing on treatment needs to be changed and instead focus on prevention. Many patients could avoid having to seek out medical services for otherwise avoidable health problems. Until then, we’re only going to continue accruing mass debts among health care costs with no end in sight.

Sincerely,

Gryska Gonzalez

gryska_17@yahoo.com

http://news.yahoo.com/study-worst-hospitals-treat-larger-share-poor-200222522.html

Wednesday, October 5, 2011

Re: Report on Medicare Cites Prescription Drug Abuse

Letter to the Editor
New York Times
letters@nytimes.com

October 5, 2011

Dear Editor:

On October 3rd, you reported that Medicare beneficiaries are using government subsidies to buy large quantities of frequently-abused drugs through multiple prescribers. This is alarming because a government program established to help the medically underserved is being mistreated and threatening not only the health of the beneficiaries, but also increasing costs to taxpayers. The fact that this abuse was able to play out—that patients were able to gain prescriptions drugs from several different sources—shows the system is lacking in organization. As a taxpayer, I believe that there needs to be a better system of keeping track of and limiting the number of prescription drugs paid for by Medicare. I think it is important to make prescription data and patient history available to all physicians that a patient sees. It is important to keep in mind that patients’ access to care should not be limited and thus limiting patients to one pharmacy would not be a feasible option. Implementing the use of electronic health records would reduce abuse and allow better coordination of care for patients.

Sincerely,
Sarah Azam
sarahfazam@berkeley.edu

http://www.nytimes.com/2011/10/04/health/policy/04medicare.html?_r=2&ref=health

Study: Worst hospitals treat larger share of poor

Letter to the Editor

Mercury News

letter@mercurynews.com

October 5, 2011

Dear Editor,

According to your article, “Study: Worst Hospitals Treat Larger Share of Poor”, the hospitals that are considered the worst, with low quality care and high costs, are treating a higher proportion of elderly black patients and poor patients. This is leading to higher rates of deaths due to heart attacks and pneumonia. Instead of providing funding to help improve the conditions of these hospitals, the Affordable Care Act is penalizing them by cutting Medicare payments. This would cause a downward spiral trend of failing hospitals in the areas where their care is needed. I believe that this approach would have backfiring results because the hospitals that need the most funding to make improvements will be penalized for their low performance. I think the best way to approach this dilemma would be to gather best practice methods from high performing hospitals and invest in cardiac intensive care units. Since these are the two leading causes for the poor performance, it would be the most effective in improving hospital performance and saving more people’s lives.

Sincerely,

Elizabeth Kim

Link: http://www.mercurynews.com/latest-health-news/ci_19047299

“Report on Medicare Cites Prescription Drug Abuse”

Letters to the Editor

The New York Times

letters@nytimes.com

October 5, 2011

Dear Editor:

On October 3, 2011, you published an article revealing that many elders are receiving prescriptions for painkillers from multiple providers with asymmetric patient information. Although this is not the first time that Medicare has had trouble with fraud, this mode of abuse is uniquely corrupt. It allows public funds, aimed at improving health, to promote pernicious habits. As a tax-paying citizen, I do not want my money being used to foster drug addiction or to support a fraudulent system.

Despite the systemic flaws of the Medicare demanding reformation, small steps can be taken quickly to resolve this over-prescription conundrum. If Medicare mandated that patients' primary care physicians are responsible for managing complete records with due treatment this issue could be avoided. With this policy, Medicare Part D abusers would be caught and citizens would be less upset to fund a corrupt program.

Sincerely,

Lindsay Allen

2467 Warring Street

Berkeley, CA, 94704

ljallen4@gmail.com

(925) 876-7914


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

Report on Medicare Cites Prescription Drug Abuse

Link to article: http://www.nytimes.com/2011/10/04/health/policy/04medicare.html?_r=1

Letter to the Editor

The New York Times

letters@nytimes.com

October 5, 2011

Dear Editor:

On October 3, 2011, you reported that Medicare beneficiaries have been able to obtain a dangerous amount of painkillers and other narcotics through multiple prescription drug plans offered by different insurance companies.

As a student, I consider these findings alarming where American tax dollars are being spent to satisfy the addictive needs of beneficiaries and possibly promote illegal drug distributing activities.

What people don't realize is that the funds used to fill these prescriptions will significantly impact the availability of finances for adequate healthcare for many other Medicare receivers.

One suggestion I have would be to implement an electronic health record system similar to the one in utilized in Taiwan. If Medicare officials were able to create some form of electronic "smart-card" for American citizens, providers could have access to detailed medical records for every patient. This way, we can prevent this abuse and allocate funds to more essential services for other Medicare recipients.

Sincerely,

Jon Holmberg


“Study Cites Increase in Cancers from HPV”

“Study Cites Increase in Cancers from HPV”

New York Times

Letter to the Editor

San Francisco Chronicle

901 Mission St.

San Francisco, CA 94103

October 5, 2011

Dear Editor,

The findings reported in the article “Study Cites Increase in Cancers from HPV” raises concerns for the public health community. It shed light on the connection between the Human Papillomavirus (HPV) and throat cancer. The increase in throat cancers caused by HPV should be taken into consideration when developing sexual health education curriculum. The Centers for Disease Control and Prevention (CDC) reports that 60% of orpharyngeal cancers are attributable to HPV. 1

While coverage for HPV is mandated under President Obama’s Health Care Plan, this finding should also shape health education policy. Young people should be made aware of the importance of getting vaccinated while also understand the risks of oral sex. The article stated there is an increase in oral sex, especially among young people. Therefore sexual health education should respond to this trend and place greater emphasis on demystifying oral sex to prevent an increase in the incidence of throat cancer cases.

Sincerely,

Udani Kadurugamuwa

2540 Regent Street. Berkeley, CA

925.216.5715

udanikaduru@berkeley.edu

1. Human Pappilomavirus.” Centers for Disease Control and Prevention. Sept. 2011. Web. 5 Oct. 2011

Link to Article: http://www.nytimes.com/2011/10/04/health/research/04hpv.html?ref=health