PLANET saludygestion

I’m all of a sudden a nature photographer…somewhere up north of Edinburgh.

Read this. And then feel sorry for the poor person who had to spend their time preparing this. If you’d like to read the two paragraph summary of this “paper,” read this.

Damn…there are times at which I feel so, so sorry for government workers. And then reality hits and I realize they choose to do these jobs, like write 1128 pages of text nobody will ever read.

Some people believe Wal-mart supports universal healthcare because:

Megan McArdle believes that there is only one reason Wal-mart wants universal health care: profits.  If all employers are mandated to provide health insurance, Walmart will have a significant health insurance economies of scale compared to its smaller rivals.

The Health Care Blog: No Country for Old Men:

A good friend of mine, Jeff Goldsmith writes:

“It is possible that, for the second time in fifteen years, divisions inside the Democratic Party might doom health reform. President Obama will need all his skills and persuasive powers to save his Congressional party from itself. Rather than wasting scarce political capital on the public plan, health reformers need to focus on hospital and primary care physician payment reform, expanding Medicare coverage for the almost 11 million uninsured boomers and sensible design of a federal health insurance exchange. It isn’t going to take a miracle to get this important public task done, just focus and discipline…

By T. CHRISTIAN MILLER Congressional hearings generally follow a script. Lawmakers publicly vent their outrage, administration officials offer plausible defenses, and the outcome is inconclusive. But this month's airing of complaints about the government's system for taking care of civilian...

El momento de llenar nuestra vida de sonrisas y de momentos especiales... Una ayudita de la mano de Green Day.

I’m in Scotland traveling in between speaking at the Guardian and the British Medical Journal. Stopped in Appin today and took this scene with the 5D and new lens.

By JOSHUA SEIDMAN This week the Institute of Medicine (IOM) released its list of the top 100 topics that should be addressed in comparative effectiveness research (CER) now — thanks to $1.1 billion in the American Recovery & Reinvestment Act...

Tests play an important role in modern medical care.  Is my leg broken?  Check the X-ray.  Do I have HIV?  Look at the blood tests.

But when are tests appropriate?  In some cases, tests will not alter treatment.  For instance, let assume that a person is either healthy or has Disease X.  Disease X is untreatable or does not require treatment.  This illness could represent a life-threatening disease for which there is no treatment, or it could also represent a minor ailment which would heal on its own.  Since we know that if a patient has Disease X it won’t be treated, should insurance cover the cost of the test?

In our example, the value of information to providers is $0.  If the physician finds out the patient does not have Disease X, they will not treat them.  If they do have Disease X, they will still not treat them since because this particular type of disease.  From the clinical point of view, the test is worthless.

Los servicios de salud pagan a sus profesionales un salario, independientemente de la actividad que realicen. No hay pago por acto, y solo existe un leve e imperceptible incentivo por calidad del servicio prestado (productividad), todavía con importes muy bajos y por ello una herramienta poco potente por ahora.

By ROGER COLLIER Key members of the Senate Health, Education, Labor, and Pensions Committee announced on Thursday what they claimed were dramatically improved cost and coverage estimates for the latest version of their health care reform bill. Headed by Democratic...

I have less than 5,000 to go before my stream has been viewed by 1,000,000 unique visitors. Much of this had to do with my Aspiring series. If you want more information about the series, see this interview with Joerg…my interview was the first of many on Conscientious and I was truly honored to be included among many of my photography heroes.

For some reason, this is my favorite photograph I’ve ever taken:

There are many surveys that are looking at whether Americans are willing to pay for health reforms: in particular, to cover the uninsured. This is a conceptual question: we don't really know how people will really feel once they are mandated by tax law or other mechanism to reach into their pockets. Still, it's instructive to take a look at the range of possibilities.

Morgan Clendaniel makes a lot of sense.  Enough incremental garbage.  One way or the other, do something that is going to have an impact:

So, we need to forget free-market solutions, forget the public option. Enough marginal change. If someone is sick, they should get treated. Let’s accept that as our starting point and then figure out how to pay for it.

This is, of course, totally naive and politically nonviable. It also happens to be the right thing to do, and I’m confident that with enough smart people in the room, we could find a way to treat everyone. It’s really hard to argue that because something is too difficult to implement, we have to let people die, but that seems to be the point to which we’ve gotten ourselves.

Futurist Jeff Goldsmith's analysis of issues that could cause problems for any health reform effort that eventually emerges from the foodfight in Washington this summer provoked a wide range of reader replies. ("No Country For Old Men") Goldsmith wrote in...

Organizations (especially those in health care where high-priced, educated talent is required for existence and continued operation) who are able to leverage this reality by building internal, comprehensive education opportunities will win.  Talent = everything.  Education programs created by the organization to complement workers’ skills and abilities will help build and reinforce the culture necessary to create tomorrow’s (today’s? yesterday’s?) health care delivery system.

As I write this, Google is putting every book ever written online. Apple is offering video college lectures for free download through its iTunes software. Skype allows free videoconferencing anywhere in the world. The Massachusetts Institute of Technology and many other schools have made course materials available for free on their Web sites. Tutors cost as little as $15 an hour. Today’s student who decides to learn at 1 a.m. should be doing it by 1:30. A process that makes him wait 18 months is not an education system. It’s a barrier to education. (Jack Hough, MSN Money)

By RAHUL PARIKH Last Wednesday's headline in the Wall Street Journal may have surprised you. It read: "Wal-Mart Backs Drive to Make Companies Pay for Health Coverage." The article discussed Wal-Mart's open support for an employer mandate requiring all but...

In this blog, I have frequently discussed the merits of Canadian and American health care systems (see Health Care Grudge Match).  One thing most people can agree with is that mental health care is subpar in both countries.  

The Vancouver Sun reports of a man committing suicide by jumping off the Granville Street Bridge.  
[In British Columbia]…family members of persons with severe mental health problems complain about the difficulty of getting loved ones committed. They cite restrictive confidentiality rules that isolate the family member in need, or the difficulty of getting doctors to agree to a commital or the system’s unwillingness to commit a patient until it is too late.

“In the 20-month period from December, 2006 through to Mr. Kwapiszewski’s suicide in 2008, Ms. Haboosheh — either directly or through her husband, Mr. Kwapiszewski’s GP, a lawyer, and a North Shore mental health worker — contacted Vancouver mental health services 16 times, desperately trying to get them to intervene as her brother showed more and more troubling behavioural symptoms. Three letters were also filed as part of, or in conjunction with, those contacts, and some meetings were also involved. Ms. Haboosheh also called the Vancouver Police Department on three different occasions to report him missing. Of the 16 calls and other contacts, 10 were with Mental Health Emergency Services and six with the Midtown Mental Health Team. They consistently, however, declined to commit Mr. Kwapiszewski for treatment, insisting he was non-committable. There was no mistaking his deterioration, however.”

Medallitas... Y a veces nos pasamos con los trofeos y nos olvidamos que lo importante es participar, como dicen (y a veces piensan) en el mundo del deporte.

As I take a Fourth of July blogging break, I am pleased to note that Gretchen Reynolds in the New York Times reports on research showing that short, hard bursts of exercise may do as much for you as regular lengthy routines: "Can you get fit in six minutes per week?" Good news. I am canceling the morning bike rides and the soccer games. This will leave lots more time this summer for eating and naps. I'm sure to end up healthier.

See you on the beach, but only under the umbrella: No more swimming. I don't want to undo all the good effects of those very special six minutes. And the latest research shows the beneficial effects of sleeping. Probably more so when a light, warm breeze is blowing.

Gin and tonics are part of the new plan, too. My research shows that limes are an essential food group in the summer.