Dream Land is an engaging read–well written and well researched. Sam Quinones, author and journalist, traces the Opiod epidemic from the first distillation of Morphine from opium in 1804 to the present. He even includes the Opium Wars between the British and China in 1859 and 1957 to showcase what nations and people will do for opium.
The book’s vitality stems from its personal stories whether they are about the early marketing tactics of marketing and pharmaceutical companies or the stories of researchers, dealers and addicts. He gives the names, the history and motivations of key players. Seattle and Portland are featured as is Los Angeles, Utah, Arizona and Nayarit, Mexico as the story unfolds. His short personal stories focus on people, place and motivations that weave seamlessly together to showcase how the epidemic grew and thrived.
Dream Land is a compelling all too human tale of the players, the economic forces and the very personal drivers that rolled this epidemic. You won’t be disappointed.
Posted in opiod epidemic, pharmaceutical companies, prescription drugs
Tagged academic research, addiction, drug addicts, drug trafficking, drugs, marketing, opioids, pharmaceutical companies, physicians, research
This is a quick blog about some disturbing issues pending in Congress. First is the new call to eliminate pre-existing condition protection. The intent is to repeal the protection and leave the matter to the states. In the past there were High Risk Pools but they came with high risk costs for patients.
We are one of the few countries where you can be bankrupt with medical bills when you face cancer or heart surgery or other life saving, but expensive diseases. I know one family facing cancer with annual pharmaceutical costs of $65,000. Changes in pre-existing conditions could potentially cost individuals and families with health problems considerably more.
New healthcare technology is developed every day. But, with all the hope of these innovations comes important questions about safety: Patients want to know if this technology will work for them? Does it add value or will it just increase cost? The answers to these questions only come when the patient is a real research partner. Engaging the patient in research not only makes sure the patient gets the right care, but also that they are involved in planning and directing the research from the very beginning.
An effective healthcare system depends on asking the right questions and learning from those questions. A learning health care system makes sure the right people get the right care at the right time by the right caregivers. That’s where CERTAIN comes in.
Housed at the University of Washington, the CERTAIN Patient Advisory Networkwww.becertain.org/partner/patient_advisory_network seeks to improve medical research by having patients actively participate in the research process–from identifying research questions to communicating the final research results.
There’s no sense talking to you. It’s just like talking to me, is a line from a Bob Dylan song in the 1960’s. It was a time of great division over the Vietnam War. There were large marches and demonstrations. Some students were even killed for protesting. Our health care debate has been every bit as vitriolic since at least Teddy Roosevelt in the 1920’s and the threat of ‘socialized’ medicine. Dylan’s line remains true today.
Health care reform has been demonized as “socialized” or “government run” in one form or another since then. FDR kept it out of the New Deal for fear his whole program would fail. Campaigns were even waged against Nixon’s call for health reform—a modest reform through employers where most people had health insurance.
We attack taxes to pay for health care. We make rules and set financial limits such as degrees of poverty. We even take partial truths for examples, latch on to them and hold them up as yet another reason that disasters await if everyone gets health care.
Medicaid, Poverty, Children, the Disabled, and Seniors March 7, 2017
Before examining the proposed changes to Medicaid, here are quick facts about Medicaid as it now exists under the ACA (Affordable Care Act aka Obamacare). And, a cautionary tale.
In 2003 I read a small “Around the States” in a national newspaper, whose name I have now forgotten. What I have not forgotten was the story. Mississippi was going to cut 13,000 Medicaid nursing home beds to balance the state budget.
Posted in Affordable Care Act, budget cuts, Health Care Reform, Medicaid, policy and politics, seniors
Tagged affordable care act, Congress, Democrats, health care reform, Medicaid, poverty, Republicans, seniors
My last long article was about the first privatization of Medicare. Current proposals to privatize focus on Premium support and Vouchers. This will change Medicare’s structure, what it covers, and how services are paid. The following is a quick look at the proposal. Even Fox News has qualms about this new direction. Read on:
Medicare, Specific Services and Vouchers
Medicare currently pays for specific services (defined benefit). Briefly, Medicare Part A covers hospitals, limited skilled nursing care, hospice, lab tests and home health care. Part B covers doctors and some other providers, outpatient care, home health care, durable medical equipment (such as wheelchairs) and many preventive services, such as flu shots. Medicare did not cover prescription drugs until Medicare Part D became law in 2006. Medicare Part C created Medicare Advantage (managed care) programs that combine both A and B, and often D. Medicare Advantage programs receive federal subsidies which ‘traditional’ Medicare does not. Seniors must use the plan’s doctors and hospitals or pay for services themselves. Most seniors buy a Medicare Part B supplement that covers what Medicare Parts A and B do not, such as co-payments and other services.
I was the Medicare Marketing Director at a private for profit health insurance company in the late 1980’s and early 1990’s and the first attempt to privatize Medicare during the Reagan Administration. That job made me the ardent consumer advocate I have been ever since. What I learned then is happening again now in a slightly different way. It is not good news for seniors. Here’s why:
Congress and Medicare
Congress oversees Medicare coverage as well as mandated commercial insurance coverage. It required an act of Congress for Medicare to cover preventive services, such as mammograms or prostate screenings. Kidney dialysis coverage for End Stage Renal Disease required an act of Congress. Mental health was added as an insurance benefit in 2008 with the Mental Health Parity act. Expanded mental health and addiction coverage was added as part of the Affordable Care Act. All required Congressional action. Medicare covers what Congress allows in statutory language or specific legislation. For example, adding prevention coverage or prohibiting Medicare from negotiating prices with pharmaceutical companies. Physician fees for doctors who accept Medicare patients are set by a committee that was authorized by Congress.
Privatizing Medicare: I was the Medicare Marketing Director for a for-profit HMO in the late 1980’s, early 1990’s. Coming up will be my inside story of lessons learned and how the first attempt to privatize Medicare played out and left seniors in the lurch.
10 Things You Need to Know About Your Electronic Medical Record, by Alden Roberts, MD, MMM, FACs, retired Chief Medical Officer. He holds a certificate in Medical Ethics from the University of Washington. He has been involved in implementing two inpatient electronic medical records systems and has over twenty years experience as a physician, and surgeon and nine as a hospital administrator.
My son was killed in a car accident 25 years ago this month. He was proud of my work for health reform so I cannot remain silent now as major changes loom. We live with a system that can be soul crushing wrong. We ignore it at our peril. Here’s why.
43 million people are driven into debt, bankruptcy or lose their home from medical costs. 43 million people is roughly the combined populations of Ohio, Illinois and Florida.
Only we don’t see their faces or combined numbers. Their stories are one at a time. News media too often turn away or feature just one heart rending story: “Medical bankruptcy? We did a story on Medical Bankruptcy last week.” I know. A reporter told me. All stories aren’t told, just trickles. There are no collective faces. We don’t see them as the massive group they are.
Posted in Affordable Care Act, Health Care Reform, medical bankruptcy, patient care, policy and politics
Tagged affordable care act, Congress, conscience, health care costs, health care quality, health care reform, medical bankruptcies, politics, public interest
Today, November 11 is Veterans’ Day a day to remember and honor those who served our country.
Yet now nearly 25% of our veterans are homeless. Over 20 commit suicide every day. They fought grizzly wars for us in Korea and Vietnam and now in Afghanistan, Iraq, the Middle East, Africa and elsewhere. We no longer have the draft. These brave men and women volunteered to serve our country, many with multiple deployments.
My father was a career Naval Officer who served as a fighter pilot in the Pacific during World War II and in Korea. We had health care benefits for life as a career officer. This included me until I turned 21 as it should. I was not on active duty.
Our Veterans Administration began in the 1930’s to care for wounded soldiers from World War I. Our World War II soldiers and sailors returned to ticker tape parades and the GI Bill. There has been no such recognition or reward since.