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

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. 33^rd 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

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