Category: Health Care Access

Rights of the Mentally Ill: Have We Gone Too Far?

Suzanne Lankford for seven years has tried and failed to get long-term mental-health care for her son. When she hears news of a gun rampage or other violence, she gets chills…Ms. Lankford has watched her son, Joshua Rockwell, today 28 years old, barricade himself inside a room to ward off imaginary assassins. He once knocked her out with a blow to the head. She called the police on him after recognizing him in a mall security video of an armed robbery. Charges are pending.

…After Ms. Lankford’s punch to the head, she asked her son’s doctors about his treatment. She received a standard answer: Privacy laws prevent his doctors from talking to her without his permission, because he is an adult. (More)

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Jun 18, 2013 | 12 comments | by

Sperm for Profit is Against the Law in Canada

So they import semen from the U.S.:

Since its inception in 2004, the ban has been criticized by many in the fertility industry, who blame it for the fact that the supply of sperm has virtually disappeared in Canada now that donors cannot be paid fees. Patients here obtain more than 90% of semen from the United States, and the federal government appears to turn a blind eye to the fact they buy it from mostly for-profit sperm banks — a criminal offence in this country. (More)

HT: Alex Tabarrok, who posts additional information.

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Jun 18, 2013 | 11 comments | by

Your Medical Records Are an Open Book

Bloomberg is reporting that states hungry for revenue and flush with the power to requisition individual medical records are moving to capitalize on the value of that information by selling the information in them to all comers. Unlike private companies, states and their agents are exempt from HIPAA requirements and therefore do not have to take data privacy especially seriously.

In an experiment, researchers were able to match several dozen people with their supposedly de-identified medical records by combining public record searchers and the information in a sample group of records purchased for $50 from Washington State. Among other things, “an executive treated for assault was found to have a painkiller addiction,” and a “retiree who crashed his motorcycle was described as arthritic and morbidly obese.”

Bloomberg reports notes that states that exclude zip codes, and admission and discharge dates are less vulnerable to records identification. But even “de-identified” data sets contain significant personal information that could be used to identify individuals, especially in rural areas with small populations.

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Jun 07, 2013 | 11 comments | by

Why Don’t We Have Drug Approval Reciprocity?

If the United States and, say, Great Britain had drug-approval reciprocity, then drugs approved in Britain would gain immediate approval in the United States, and drugs approved in the United States would gain immediate approval in Great Britain. Some countries such as Australia and New Zealand already take into account U.S. approvals when making their own approval decisions. The U.S. government should establish reciprocity with countries that have a proven record of approving safe drugs — including most west European countries, Canada, Japan, and Australia. Such an arrangement would reduce delay and eliminate duplication and wasted resources. By relieving itself of having to review drugs already approved in partner countries, the FDA could review and investigate NDAs more quickly and thoroughly.

Dan Klein and Alex Tabarrok here and more here.

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Jun 05, 2013 | 15 comments | by

Robots as Therapists

The session begins:

The virtual therapist sits in a big armchair, shuffling slightly and blinking naturally, apparently waiting for me to get comfortable in front of the screen.

“Hi, I’m Ellie,” she says. “Thanks for coming in today.”

Right now there are two assistants guiding the avatar, but:

Real people come in to answer Ellie’s questions every day as part of the research, and the computer is gradually learning how to react in every situation.

It is being taught how to be human, and to respond as a doctor would to the patients’ cues.

Soon Ellie will be able to go it alone.

Tyler Cowen. Article here.

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May 28, 2013 | 12 comments | by

What Drug Companies Know About You and Your Doctor

The information allows drug makers to know which drugs a doctor is prescribing and how that compares to a colleague across town. They know whether patients are filling their prescriptions — and refilling them on time. They know details of patients’ medical conditions and lab tests, and sometimes even their age, income and ethnic backgrounds. (NYT)

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May 17, 2013 | 11 comments | by

You Probably Thought the Problem Was Too Much Alcohol

Pfizer Inc. (PFE), the drug’s producer, now has a site for you: its own Viagra.com, where you can get the blockbuster impotence fighter without wondering what shady source you’re dealing with. Using CVS Caremark Corp. (CVS) to verify prescriptions and fulfill orders, the site is Pfizer’s latest attempt to fight counterfeiting. In its announcement this week, the world’s largest drug maker cited a 2011 analysis it did of pills bought from 22 sites ranking high in search results for “buy Viagra.” About 80 percent were fake, containing only 30 percent to 50 percent of the drug’s active ingredient, sildenafil citrate. The new site is a reminder of the original value of consumer branding: as a guarantee of quality. It’s also evidence of the failure ― and the perverse effects ― of online drug regulation.

Virginia Postrel at Bloomberg.

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May 10, 2013 | 13 comments | by

A Million-Dollar Patient

This is what happens when the government ignores Dr. Jeffrey Brenner:

For more than two decades, Wanda Remo has battled one illness after another. Asthma, chronic lung disease, heart disease, high blood pressure, arthritis, depression, chronic pain, strokes. Specialists treat her lungs, her heart and her joints.

Her litany of ailments brought her to emergency rooms six times last year, between numerous additional visits to a federally subsidized health clinic in South Los Angeles.

“You are one of the million-dollar patients,” her doctor, Derrick Butler, tells the 57-year-old as she leans on her walker during one appointment. (LA Times)

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May 09, 2013 | 11 comments | by

Why Doctors Hate Electronic Medical Records

Unsent letter to the Tech Department:

So today I’m doing anesthesia for colonoscopies and upper GI scopes. Nowadays we have three board-certified anesthesiologists doing anesthesia for GI procedures every single day at my institution. I’ll probably do 8 cases today. I will sign into a computer or electronically sign something 32 times. I have to type my username and password into 3 different systems 24 times. I’m doing essentially the same thing with each case, but each case has to have the same information entered separately. I have to do these things, but my department also pays four full-time masters-level trained nurses to enter patient information and medical histories into the computer system, sometimes transcribed from a different computer system. Ironically, I will also generate about 50 pages of paper, since the computer record has to be printed out. Twice.

No wonder almost everyone I know hates electronic medical records! I don’t know anything about computers, and I don’t know what systems other hospitals have. I may be dreaming of a world that doesn’t exist or that world is here and I haven’t heard about it.

HT: Jason Shafrin.

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May 07, 2013 | 11 comments | by

A Market for Chronic Care?

It’s not just sore throats and flu shots anymore. Walgreens today became the first retail store chain to expand its health care services to include diagnosing and treating patients for chronic conditions such as asthma, diabetes and high cholesterol…

Retail clinics generally appeal to consumers looking for convenience and cost savings. Costs are roughly 30 percent to 40 percent less than similar care at doctor’s offices and 80 percent cheaper than at an emergency room, according to a 2011 study published in the American Journal of Managed Care.

This is from Kaiser Health News.

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Apr 04, 2013 | 10 comments | by
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