Learning by Surfing: Issue 6

All health care. Links.

The Chicago Tribune reports on concerns of Chicago area hospital mergers:

Although the recent spike of hospital consolidations has yet to draw the attention of federal antitrust regulators, critics say the mergers could translate into rising prices as these bigger institutions gain more negotiating clout with health plans and self-insured employers.

“Time and time again, consolidation is bad for consumers,” said David Dranove, professor of health industry management for Northwestern University‘s Kellogg School of Management.

And any price increase could pique the interest of federal regulators.

I’ve written on this before.  It’s done better here by Half MD (h/t Kevin MD):

So there we have it. Evidence shows that white coats, neckties, stethoscopes, and artificial nails are a source of infectious disease transmission. My hospital requires medical students to wear white coats, wear neckties, carry stethoscopes with them at all times, and has no policy regarding artificial nails. And the result is that we do a pretty good job of infecting people with C. diff, MRSA, and Klebsiella. Maybe what we should be doing is telling everyone that all of our patients have HIV. That way, they’ll be sure to carefully protect themselves from any communicable diseases.

I heard recently that a hospital is being built in Iraq where patient beds take patient vitals, no provider necessary.  The logical question: is anyone doing that in the US? PSFK via Inhabitat reports on a building in Mumbai that will monitor the health of its residents:

A new futuristic building in India will spend as much time monitoring the health of its inhabitants as it will setting the temperature. Designed by James Law the 32,000 sq m egg-shaped building will both monitor occupants blood pressure and use vegetation for cooling when its built in 2010.

The Health Blog posts on interprofessional conflict (hint: read the comments):

A couple of months back, the group that advises Congress on Medicare funding suggested raising payments for primary care in a “budget neutral” way. Translation: Somebody else’s payments would be reduced. Surgeons aren’t too happy about that. Go figure.

The American College of Surgeons recently fired off a letter to MedPac, the advisory group, and copied several senators and congressmen who control Medicare’s purse strings.

Dr Joseph Martin, in The Boston Globe, is the latest to comment on the primary care shortage:

The question of whether there are enough doctors to care for patients, particularly if the nation moves toward a new scheme for universal health coverage, is the elephant in the room of the presidential campaign debate on health reform.

Fifteen to 20 years ago there were worries about too many doctors, particularly in some specialties. Now, the Association of American Medical Colleges is requesting medical schools to increase enrollments by 30 percent over the next seven to 15 years.

Bottom line: the new requirements in medical care require new thinking in how to deliver that care.

The Happy Hospitalist has the most emotionally-charged indictment (and true) of our health care system that I have ever read (via Kevin MD):

As many of you know, I am a strong believer in allowing capitalistic market forces to create the correct balance of supply and demand.  To create the correct type of value and service available to a population.  Whether that be the correct number of primary care doctors.  The correct number of orthopaedic surgeons.  The correct number of pharmacies.  The correct number of nursing homes.  The correct number of hospitals.  Some folks argue that supply drives demand.  To some degree that’s correct.  But I also believe, more importantly,  that demand, as defined by the never ending flow from the Medicare National Bank,  drives the supply.  And it drives it in a big way.

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