Wednesday, February 22, 2012
Health and Money Premium
One of my longtime patients came in and said, "I need all of the medicines I can get right now because I've been laid off and I am losing my insurance at the end of the month. I have no idea when I'll have insurance again."
The state continues to experience ripple effects from the closure of Hawaii Medical Center's two hospitals following its second bankruptcy in recent years. One casualty is its liver and kidney transplant center.
I was recently invited to serve on the panel of a new think-tank about health care comprised of physician leaders from the academic, government, hospital, insurance and private sectors in Hawaii.
On Martin Luther King Day, physicians and staff at Hawaii Permanente Medical Group, together with community volunteers, dedicated themselves to a day of service.
Years ago, as a medical student at UCLA, I had the opportunity to perform research on magnetic resonance imaging (MRI). We studied the feasibility of visualizing the cornea of the eye. As technology advances, MRIs become more powerful but remain relatively safe.
Medical facilities cannot rely solely on state-of-the-art technology. They must build relationships to establish a sustainable brand. Some years ago I was invited to interview for medical director of Holistica Hawaii. Housed at the Hilton Hawaiian Village, the facility featured a new ultrafast CT that offered heart scans and total body scans.
My older son lives in Portland, Ore. An aspiring artist, out of school, in between jobs and before health care reform, he was among the uninsured. As a result of the Patient Protection and Affordable Care Act (PPACA), known to detractors as Obamacare, I have been able to add him to our family insurance plan until he becomes 26.
The bankruptcy and closure of Hawaii Medical Centers' two hospitals is the biggest health care story of the year. Its impact is being felt in waves throughout the islands.
Wealth of Health recently covered a landmark change in how providers will be reimbursed. Beginning in October, the Centers for Medicare and Medicaid Services will link $850 million of payments to a new measure: patient survey results.
My son arrived home after a visit to the dentist a few weeks ago and announced that he had signed us up for the Honolulu Marathon. This summer we completed our first Tin Man Triathlon, but we had never run a full marathon.
It's official. Customer satisfaction scores have become serious business in health care. Beginning in October 2012, the Centers for Medicare & Medicaid Services will link $850 million of reimbursement payments to a new measure: patient survey results.
Squinting through ti leaf-infused steam wafting from the glowing imu, I could make out the silhouette of a young, muscular man lifting turkeys into the cooking pit. Since he was a toddler, my son and I have been a part of the local Thanksgiving ritual at the Key Project.
This week the National Council of Asian and Pacific Islander Physicians is in Hawaii to study health disparities and to advance initiatives that remove barriers to healthy communities. The council believes that quality, access and cost containment are critical to health and wellness of Asian Americans, Native Hawaiians and Pacific islanders.
By the time a person begins to feel ill from high blood pressure, blood sugar or cholesterol, often, the damage has already been done. Even if we feel great, to ensure good health, it is essential that we receive preventive screening.
The majority of seniors prefer to age in place. When asked, most people want to remain independent as long as possible in their own homes. The ability to do so depends, in part, on family caregivers.
It is hard to imagine anything more painful than the death of a child. What parent would not willingly exchange places with their dying child if only they could?
At Grandmaster Cho's tae kwon do studio, approximately 300 elementary school students from East Oahu just began taking classes. They have come for the six-week President's Fitness Challenge Program, an initiative strongly supported by Michelle Obama.
My auntie is dying from metastatic breast cancer. This week she underwent surgery to remove one more mass under her arm. She is also scheduled to receive another round of radiation in six weeks. My mother observed that her doctors never spoke about her prognosis or chances of surviving the surgery or the radiation. Auntie is almost 80.
Last week, Denmark became the first nation to levy a fat tax at the register. Danes will now pay an extra 12 cents for a bag of potato chips and 40 cents more for a hamburger. People are accustomed to “sin” taxes for alcohol and tobacco. Are we ready for taxes on fat, salt and sugar?
On Thursday, Sam's mother called in a panic. "He's punching holes in the wall, Doc. Please do something." When he arrived in the clinic, Sam — not his real name — explained that despite every effort on his part, his TDI (temporary disability insurance) check hadn't come, he couldn't pay his rent and his landlord evicted him with 24-hour notice. About to be homeless, he became frantic.
The World Health Organization recently announced that chronic diseases — including heart problems, stroke, cancer, persistent respiratory conditions and diabetes — have now become the world’s leading cause of mortality, representing 63 percent of all deaths. Fully a quarter of these people are less than 60 years old, and 90 percent of early deaths are in the low- to middle-income population.
Among the greatest drivers behind the explosion of national resources directed to health care is the cost of technology used for powerful diagnostics, medical equipment and surgical interventions. Reimbursements for doctors who work with this technology in their hands is greater than that for internists who provide primarily cognitive services or psychiatrists who focus on human interaction. This is not because work with one’s hands requires more skill or training than working principally with one’s mind. Instead, it is the result of powerful interest groups comprising manufacturers of medical technology. The right surgery for the appropriate patient at the correct time is of incomparable benefit. Still, technology should serve and not drive the nature of the health care we receive.
It is certain that each of us will die, but the time of our death is unknowable. Both providers and consumers of health care fear and resist these truths to no end. Medical training still teaches that the death of a patient is a failure and malpractice carriers remind us that a patient’s passing could result in a lawsuit.
Struggling to regain consciousness, I reached back and felt the large bloody gash in my scalp. My son and I had just gotten into Ripstiks.
Screaming down the hill on Hawaii Kai Drive from Kalama Valley, the back wheel of the bicycle I was riding suddenly came loose. My right hip and leg crashed to the ground and slid along the wet asphalt for what seemed like an eternity.
The Arab Spring has given way to a sweltering summer. Much of the optimism in Egypt has gone stale; Libyan leader Moammar Gadhafi, now virtually surrounded, won't go down until he is taken down; and the European Union has just joined the U.S. in an unbridled call for Syrian President Bashar al-Assad to stop attacking civilians with tanks.
Last week, as my son and I tackled Glenn Pass, one of the highest points of the John Muir Trail in the Sierra Nevada Mountains, the food we brought was nutritious and tasty but above all lightweight.
Veterans who were exposed to highly traumatic events during deployment to Iraq or Afghanistan and discharged because of post-traumatic stress disorder recently won a class-action law suit entitling them to lifetime disability benefits, including military health insurance. The ruling affects more than 1,000 veterans with PTSD who were denied these benefits upon discharge. The National Veterans Legal Service Program argued that the military services violated the law by failing to assign a 50 percent disability rating to those discharged for PTSD. A 50 percent disability rating entitles the veteran to disability retirement benefits.
Not many years ago, patients could expect their primary care doctor to care for them at the doctor's office and, when necessary, admit them to the hospital.
The state continues to experience ripple effects from the closure of Hawaii Medical Center's two hospitals following its second bankruptcy in recent years. One casualty is its liver and kidney transplant center.
I was recently invited to serve on the panel of a new think-tank about health care comprised of physician leaders from the academic, government, hospital, insurance and private sectors in Hawaii.
On Martin Luther King Day, physicians and staff at Hawaii Permanente Medical Group, together with community volunteers, dedicated themselves to a day of service.
Years ago, as a medical student at UCLA, I had the opportunity to perform research on magnetic resonance imaging (MRI). We studied the feasibility of visualizing the cornea of the eye. As technology advances, MRIs become more powerful but remain relatively safe.
Medical facilities cannot rely solely on state-of-the-art technology. They must build relationships to establish a sustainable brand. Some years ago I was invited to interview for medical director of Holistica Hawaii. Housed at the Hilton Hawaiian Village, the facility featured a new ultrafast CT that offered heart scans and total body scans.
My older son lives in Portland, Ore. An aspiring artist, out of school, in between jobs and before health care reform, he was among the uninsured. As a result of the Patient Protection and Affordable Care Act (PPACA), known to detractors as Obamacare, I have been able to add him to our family insurance plan until he becomes 26.
The bankruptcy and closure of Hawaii Medical Centers' two hospitals is the biggest health care story of the year. Its impact is being felt in waves throughout the islands.
Wealth of Health recently covered a landmark change in how providers will be reimbursed. Beginning in October, the Centers for Medicare and Medicaid Services will link $850 million of payments to a new measure: patient survey results.
My son arrived home after a visit to the dentist a few weeks ago and announced that he had signed us up for the Honolulu Marathon. This summer we completed our first Tin Man Triathlon, but we had never run a full marathon.
It's official. Customer satisfaction scores have become serious business in health care. Beginning in October 2012, the Centers for Medicare & Medicaid Services will link $850 million of reimbursement payments to a new measure: patient survey results.
Squinting through ti leaf-infused steam wafting from the glowing imu, I could make out the silhouette of a young, muscular man lifting turkeys into the cooking pit. Since he was a toddler, my son and I have been a part of the local Thanksgiving ritual at the Key Project.
This week the National Council of Asian and Pacific Islander Physicians is in Hawaii to study health disparities and to advance initiatives that remove barriers to healthy communities. The council believes that quality, access and cost containment are critical to health and wellness of Asian Americans, Native Hawaiians and Pacific islanders.
By the time a person begins to feel ill from high blood pressure, blood sugar or cholesterol, often, the damage has already been done. Even if we feel great, to ensure good health, it is essential that we receive preventive screening.
The majority of seniors prefer to age in place. When asked, most people want to remain independent as long as possible in their own homes. The ability to do so depends, in part, on family caregivers.
It is hard to imagine anything more painful than the death of a child. What parent would not willingly exchange places with their dying child if only they could?
At Grandmaster Cho's tae kwon do studio, approximately 300 elementary school students from East Oahu just began taking classes. They have come for the six-week President's Fitness Challenge Program, an initiative strongly supported by Michelle Obama.
My auntie is dying from metastatic breast cancer. This week she underwent surgery to remove one more mass under her arm. She is also scheduled to receive another round of radiation in six weeks. My mother observed that her doctors never spoke about her prognosis or chances of surviving the surgery or the radiation. Auntie is almost 80.
Last week, Denmark became the first nation to levy a fat tax at the register. Danes will now pay an extra 12 cents for a bag of potato chips and 40 cents more for a hamburger. People are accustomed to “sin” taxes for alcohol and tobacco. Are we ready for taxes on fat, salt and sugar?
On Thursday, Sam's mother called in a panic. "He's punching holes in the wall, Doc. Please do something." When he arrived in the clinic, Sam — not his real name — explained that despite every effort on his part, his TDI (temporary disability insurance) check hadn't come, he couldn't pay his rent and his landlord evicted him with 24-hour notice. About to be homeless, he became frantic.
The World Health Organization recently announced that chronic diseases — including heart problems, stroke, cancer, persistent respiratory conditions and diabetes — have now become the world’s leading cause of mortality, representing 63 percent of all deaths. Fully a quarter of these people are less than 60 years old, and 90 percent of early deaths are in the low- to middle-income population.
Among the greatest drivers behind the explosion of national resources directed to health care is the cost of technology used for powerful diagnostics, medical equipment and surgical interventions. Reimbursements for doctors who work with this technology in their hands is greater than that for internists who provide primarily cognitive services or psychiatrists who focus on human interaction. This is not because work with one’s hands requires more skill or training than working principally with one’s mind. Instead, it is the result of powerful interest groups comprising manufacturers of medical technology. The right surgery for the appropriate patient at the correct time is of incomparable benefit. Still, technology should serve and not drive the nature of the health care we receive.
It is certain that each of us will die, but the time of our death is unknowable. Both providers and consumers of health care fear and resist these truths to no end. Medical training still teaches that the death of a patient is a failure and malpractice carriers remind us that a patient’s passing could result in a lawsuit.
Struggling to regain consciousness, I reached back and felt the large bloody gash in my scalp. My son and I had just gotten into Ripstiks.
Screaming down the hill on Hawaii Kai Drive from Kalama Valley, the back wheel of the bicycle I was riding suddenly came loose. My right hip and leg crashed to the ground and slid along the wet asphalt for what seemed like an eternity.
The Arab Spring has given way to a sweltering summer. Much of the optimism in Egypt has gone stale; Libyan leader Moammar Gadhafi, now virtually surrounded, won't go down until he is taken down; and the European Union has just joined the U.S. in an unbridled call for Syrian President Bashar al-Assad to stop attacking civilians with tanks.
Last week, as my son and I tackled Glenn Pass, one of the highest points of the John Muir Trail in the Sierra Nevada Mountains, the food we brought was nutritious and tasty but above all lightweight.
Veterans who were exposed to highly traumatic events during deployment to Iraq or Afghanistan and discharged because of post-traumatic stress disorder recently won a class-action law suit entitling them to lifetime disability benefits, including military health insurance. The ruling affects more than 1,000 veterans with PTSD who were denied these benefits upon discharge. The National Veterans Legal Service Program argued that the military services violated the law by failing to assign a 50 percent disability rating to those discharged for PTSD. A 50 percent disability rating entitles the veteran to disability retirement benefits.
Not many years ago, patients could expect their primary care doctor to care for them at the doctor's office and, when necessary, admit them to the hospital.
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