Political interference with Health Care

It is unfortunate that this is unsurprising, but once again Bush's regime seems to be interfering with scientific reports in the name of politics. The recent accusations by the former Surgeon General are well detailed in this report: Bush Aide Blocked Report in the Washington Post.

Carmona told lawmakers that, as he fought to release the document, he was "called in and again admonished . . . via a senior official who said, 'You don't get it.' " He said a senior official told him that "this will be a political document, or it will not be released."

Steiger did not return a phone call seeking his comment. But he said in a written statement released by an HHS spokesman Friday that the report contained information that was "often inaccurate or out-of-date and it lacked analysis and focus."

Steiger confirmed that he sharply disagreed with Carmona on the issue of how much the report should promote Bush administration policies. "A document meant to educate the American public about health as a global challenge and urge them to action should at least let Americans know what their generosity is already doing in helping to solve those challenges," Steiger said in the statement.

Steiger said that "political considerations" did not delay the report; "sloppy work, poor analysis, and lack of scientific rigor did." Asked about the report's handling, an HHS spokeswoman said Friday that it is still "under development."

This seems amazing, if you read the actual draft of the report available here: draft report (Hat tip to Daily Kos) You will see that Carmona primarily relies on World Health Organisation figures and data, not renowned for their lack of scientific rigour. And the report seems sound, there is nothing radically wrong here. It sure looks like the regime trying to edit the science in the name of politics.

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How to fix health care? Start with med schools

Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention has argued that the way to fix health care is to start with the med schools today in MSNBC.

Gerberding focuses on the suggestion of more professionals being trained and more cross over between medical professions in training so that they can do this effectively in the field. I'd also suggest (as I have argued in a forthcoming paper in the Journal of Medical Ethics Am I my Brothers' Gatekeeper? Professional Ethics & the Prioritisation of Health Care) that what is needed is explicit training in the ethics and justice of health care prioritisation. If health care professionals believe it is ethically unacceptable to ever prioritise between patients then any prioritisation scheme is doomed to fail, regardless of whether it is actually consistent with their professional ethics. This requires a considerable program of education for present health care professionals and a revision of much of the training provided for new health care professionals, to get them to recognize both the scarcity of health care resources and the compatibility of prioritisation of these resources with the professional ethics of health care professionals.

Of course what is also needed is a fair background system of health care distribution, something America seems to be sadly lacking presently.

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Comparing US Presidential Candidates on Health

Susan J. Blumenthal, M.D., Jessica B. Rubin, Michelle E. Treseler, Jefferson Lin, and David Mattos have created a very useful site: U.S. Presidential Candidates' Prescriptions for a Healthier Future: A Side-By-Side Comparison.

As you might imagine from the name this provides both a discussion of, and charts of and links to the positions of presidential candidates on health care. If you want a one-stop shop summary of their views on health care, this is the place to go.
(Hat tip to Women's Bioethics Project)

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Massachusetts Begins Universal Health Care

Massachusetts has begun its universal health care program. This will in many ways function as a test case for the US, so let us hope it goes well.

Details can be found here: Massachusetts Begins Universal Health Care

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Intel's Andy Grove's Health Plan

Andy Grove co-founder of Intel has put forward his views on how to solve the health care problems brewing in the US.
He basically makes three suggestions:

First: Keep elderly people at home as long as possible (an idea he calls "shift left"). Use high-tech gadgets to help them remember to take their medicine and monitor their health. In one year, if a quarter of the people now living in nursing homes went home, it would save more than $12 billion, Grove says.

Second, Grove advocates addressing the uninsured by building more "retail clinics" -- basic health care centers in drugstores and other outlets that can take care of problems that are presently, and expensively, addressed in emergency rooms.

Lastly, unify medical records using the internet. In his vision, every patient carries a USB drive containing his or her medical records, which any doctor can download.

Each of these suggestions is at least sensibly focused on controlling health care costs and the provision of health care prior to it reaching the critical and costly hospital care stage. Having more of those people in managed care at home could be a good idea, but it does risk people falling through the cracks and would need to be monitored carefully.

However the last suggestion seems foolhardy, people are unlikely to all carry their own USB drive no matter how it seems that way in silicon valley or academia. A better idea would simply to have net accessible medical records stored on external servers which any health care professional could access and add to.

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