Can You Mix Inalienable Rights With the Business of Medicine?

Actually, we think our work is done, simply by asking the question. Thomas Jefferson tossed the wrench into the process by suggesting in the Declaration of Independence that Americans should have inalienable rights including life, liberty and the pursuit of happiness.

Setting liberty and the pursuit of happiness aside, for now, generally, we divide rights into those which are natural versus legal. Clearly, we have some rights simply because they are allowed and supported by our highly malleable laws and legal system. Other rights are considered essentially independent of law, current acceptable social manner, contemporary political correctness, and leanings of the present government. These rights are seen as expected or natural. And, that which is natural or universal comes to be seen as inalienable.

Rights define our senses of behavioral freedom and sense of entitlement. They circumscribe our expectations of our behavior, that of others, and that expected of corporate entities which are often referred to as if sentient. In our civilization, a body of people of shared civil manners and rights are the bricks and mortar forming the infrastructure of morality, law, and governance we share.

From this point, you work backward. Considering government to be the arbiter, the issues pertinent to unalienable rights are then based upon the society’s decisions defining our morality. Morality is an essential element because inalienable rights generally address the “good,” by necessity defining the bad, right, wrong, and so on. Of course, different religious/spiritual groups, Atheists, legalism and the undecided regarding a source of ultimate moral authority never all agree on the “good”. Even inalienable rights are always a socially dynamic issue, including the definitions and rights pertaining to “life”.

If in the U.S. there is such an entity as an inalienable right to life, then such encompasses the inalienable right to that which keeps you alive. That is, you cannot live without attending to the needs for food, water and all that which protects you from, or is applied in response to the adverse effects of living in our world (AAOL). We do not all have access to ideal food and water, but we shall also be put that aside for now. However, what is society’s responsibility to address the AAOL on people’s well-being? If the effects of AAOL are physical and mental illness, injury, disease, and disability, then it would appear that comprehensive medical care for our citizens is the appropriate response to addressing this inalienable right.

Presume that everyone both empowered and relevant to considering the above arguments drew comparable conclusions. In that case, they would agree that every citizen should have access to comparable medical care. The challenges then become 1) access as primarily defined by the distribution of care facilities, appropriate service providers, and products, and 2) management of quality and cost of products/services delivery.

The cost of all contemporary medical products, services, and related insurance rises much faster, year over year than personal incomes and net revenue growth of the average business. So, most Americans and their employers are not prepared to handle the costs of medical care purchase directly or via insurance. Issues of access and distribution aside, government intervention to address medical care as an inalienable right then means either 1) marked cost capping and controlling consumer fees, 2) subsidizing patient payments, or 3) a combination. Capping and controlling costs would cause an evolution in the business of medicine. All participants (pharmaceutical companies, medical instruments and soft goods manufacturers, sales/distribution organizations, clinicians, insurers, IT services and others) in the industry would need to reconsider their margins, as well as their ability and willingness to remain in the medical industry. However, our government needs to control the sometimes markedly excessive and inflationary medical billing practices. Capping and controlling costs should ideally be tackled first, addressing runaway fees associated with hospital services, pharmaceutical products, surgical procedures, medical hardware, other medical technologies and insurance coverage. All components of the medical system will resist capping and controlling fee schedules.

Providing patient fee subsidies will always be fraught with inflationary excesses, deductibles and patient portions of bills would need to be eliminated. Even nominal point of service charges could always be a challenge unless the net annual out of pocket personal expenditures do not exceed the price of a visit to a fast food venue eliminate them. Otherwise, the middle and lower economic strata and their [potential] employers would continue to be obliged to choose between eating, acquisition of other necessities, employment and offering benefits. Additionally, service providers should not be allowed to bill in excess of fee schedules, writing off the excesses as tax deductions.

There are many products and services people should not expect to purchase if they have not financially successful in life to the extent of their more affluent neighbors. As such, nobody would suggest that all have the inalienable right to own a brand new luxury automobile, yacht or personal jet. However, if as a society we state that life, including full, high-quality medical care is an inalienable right of American citizens, then we should deliver it, without burdening others. But, there is “no free lunch” even regarding medical care. So what does “full, high-quality medical care for all citizens, without burdening others” actually mean? It may need to be defined in two ways: 1) products and services price caps, and 2) society attitude adjustment.

Regarding society attitude adjustment, as an example, we already provide military services to protect the entire nation without attempting to provide some stratified, sliding scale, itemized bill to each citizen. Medical services could be addressed in a similar manner. If medical businesses were all conscripted, essentially indefinitely subcontracted, to deliver care in a uniform manner (e.g., blend of active military care and preferred provider organization models), with a central payer and QA provider, maybe we could do it.

However, unlike changes in health measures, per capita, government spending on healthcare is a poor indicator of the effectiveness of U.S. medical care. Neither is ACA enrollment a measure of care delivery or effective care (e.g., see if holding a season ticket is a measure of NFL game attendance this year). Throwing taxpayer money at a series of poorly cobbled strategies is not an effective national medical care solution. Inalienable right or not, we cannot deliver broad-based high-quality medical care to all citizens via current medical business models.

American Health Care Industry – Why Innovation is So Difficult

Healthcare industry presently in United States is in miserable condition, the delivery of treatment to consumers is often inefficient, ineffective and consumer unfriendly. The problems in the sector had been well documented and they range from medical errors, which by some estimates contribute around 8 percent of all deaths in United States, soaring cost of health care administration, the amount of time one get an appointment with the physician and inadequate facilities.

Why there are no innovations in the industry to improve it

Despite enormous investments in innovation and magnitude of the opportunity for the innovators, not many people are willing to invest in the industry. The reasons are numerous but one of the primary reasons is failing of too many efforts. Not many companies have able to translate their paper plan in the real world. One example of a massive failure is, managed care revolution that ended up losing $40 billion of investors’ money into biotech venture and into endeavors of achieving economies of scale to fragmented physician practices.

How we can improve present state of American health care industry

The idea of universal coverage is in rounds in public domain for years now, and there are no signs that Bush administration will take such restructuring of the system. The second solution to the problem is to focus on particular areas rather than solving the problem at once. These areas can be chosen carefully by the company according to its expertise and core competency. Some of the areas to focus which companies can zero down on are –

Innovations in the delivery of health care can result in more convenient, effective and less expensive treatments for today’s time stressed and increasingly empowered health care consumers.

New Drugs, diagnostic methods and drug delivery system can offer the hope of better treatment and care at lesser cost.

Healthcare is still astonishingly fragmented industry and integrated health care activities can increase efficiency, improve care and save consumer time.

Getting Our Priorities in Order

He had bought one of those high-priced, high-performance European models – it was sleek and sexy – he loved it.

And boy did he take care of it.

– he washed the outside.

– he vacuumed the insides.

– he serviced it regularly;

– changed the air filter to assist in breathing.

– changed the oil filter.

– used nothing but top grade oil.

– filled it up at the pumps with high octane fuel.

He checked all the little things;

– air pressure to reduce rolling friction

– lubrication of all moving parts

– levels of all fluids – including the windshield washer fluid – he
really wanted to see where he was going at all times.

He was very proud of this, his most prized possession.

He knew he had a winner – especially when he received all those
envious glances while driving through the check-out lane at the
fast-food outlet.

She, had bought a cute, cuddly little designer dog – one that
would fit into the ultra modern apartment complex she had purchased.

Nothing was too good for it –

– it had it’s own bed, it’s own blankets – but it still slept in her bed.

– she groomed, clipped and pampered her pet.

– it ate only the best and choicest of dog foods.

It was;

– vaccinated,

– de-wormed,

– de-fleaed,

– de-ticked

– and if there wasn’t enough for weekly groceries, it wasn’t the dog
that went short.

And all her friends commented on how smart the pet was.

Yes, it’s sad but true – we take better care of ‘things’ than we do
ourselves.

Uses of Medical Masks

It is known to everyone that medical masks are an important part in maintaining hygiene in the area of health care. This equipment belongs to the category of medical tools known by the name personal protective equipment or PPE. The medical masks are present everywhere in a health care establishment, right from the operation room to the general outpatient unit. Their main function is to prevent the spread of contagious diseases and thus control any sort of infections. They are critical for the promotion of health and hygiene.

There are different kinds of medical masks available in the market. Disposable medical masks have become very popular, thanks to the spread of pandemics such as swine flu, H1N1 related infections and so on and so forth. The disposable masks are very effective in flu season when there is a greater threat of the epidemic being spread. They also come very useful in all sorts of emergency situations where there is a risk of infection.

The reusable masks come off as highly useful to people who suffer from severe allergies and asthma situations. These masks which are washable are helpful for those who are highly prone to infections caused by virus or bacteria. These masks are to be chosen properly. They should be able to effectively filter out the allergens in the form of pollen grains, dust particles, fungi or bacteria that are airborne. The masks can also be used by air travelers especially in those long distance flights involving a lot of time where the passengers have to deal with many people.

The sizes of medical masks may vary from person to person depending on the age group he or she belongs to. Thus a mask meant for the adult will not properly fit a small kid. Hence you need to purchase small sized masks for children. The medical professionals especially doctors will be able to help you choose the proper kind of masks for you.

Analysis to Next Generation Sequencing Technology

With the development of science, traditional Sanger sequencing has failed to meet new requirements of low cost, high throughput and fast in speed.

Recent years, with the discovery and promotion of second-generation sequencing technology, the gene sequencing speed has increased greatly while achieving a substantial decline in costs, making large-scale application of genome sequencing possible. Now, the cost of personal whole genome sequencing is about 5,000$, and is expected to decreased to less than $ 1,000 in the next few years.

The rapid development of sequencing technology will promote the massive accumulation of DNA sequencing data, accompanied by the accumulation of the corresponding individual diseases, signs and other data at the same time. When we accumulate enough data, how to understand these data will be critical. On the micro level, generations of molecular biologists’ studying the effects of apparent biological traits genes exert on utilizing technologies like gene knockout have made breakthroughs in many crucial aspects. On the macro level, statistics and other data analysis techniques are introduced to study the relationship between gene sequences and biological phenotype. The accumulation of basic scientific research gradually brings breakthroughs in clinical applications.

There are now two types of clinical applications mainly, one aims at disease screening of ordinary people. It infers people’s future risks of getting cancer by measuring the known genes associated with a disease loci. The other aims at the diagnosis cancer and other deadly diseases. It finds in a series of drugs or plans the most effective one for certain patients by testing the loci of certain genes.

Data from BBC research shows that total global gene sequencing market increased from $ 7.941million in 2007 to $ 4.5 billion in 2013, and will reach $ 11.7 billion in the year of 2018 with the CAGR up to 21.2%.

Currently, the market of de novo sequence platform is mainly taken by several major manufacturers, including the Illumina, Ion Torrent / Life Technologies (was the acquisition of Thermo Fisher in 2014), 454 Life Sciences / Roche, etc.

Under such a circumstance, the next generation sequencing technology (second-generation sequencing) appears. As an emerging industry, the next-generation sequencing technology can be applied in clinical testing like antibody discovery, health industry, industrial and agricultural use of gene-oriented study as well as scientific research and development.

To stimulate the next generation sequencing market, we need to start by investing more small and medium size industry focusing on this field.

TENS Increase Your Profit Margin?

Advertisements are being sent to doctors via facsimile in various parts of the United States from a California company asking them if TENS/EMS units are presently being prescribed to patients for home use? If not, this company reports that they can show how to give patients drug-less pain relief and add a new profit center to the doctors office with TENS/EMS.

The company says their program is simple – they sell TENS to doctors for $29.00 (when 2 or more are purchased) EMS for $38 (when 2 or more purchased) and instruct the doctor on billing procedures for the TENS and fitting fee where the profits range from $200.00 to $600.00 per unit depending on the type of insurance coverage and amount charged for the unit/fitting fee. Next, the company indicates that they provide the patient with necessary supplies (batteries, pads & wires) and will bill the insurance company direct.

Good deal? Maybe.

Many state regulatory boards have prohibitions against excessive charges for health care services rendered – could the billing insurers $200 to $600 for providing a patient with a TENS the doctor purchased for $29 be considered excessive? What would the involved payer think of this activity – are they going to knowingly pay $200 to $600 for your providing the patient with a $29 TENS unit? And, what happens when insurance doesn’t pay – is the patient going to be billed the higher rates for the $29 unit?

I would recommend that doctors ensure that this practice activity is consistent with their administrative laws, third-party payer rules and to check it out first with their attorney prior to use.

3 Steps to a Successful Health Care Program

We all have friends who have been sick or diagnosed with severe health problems. You may be fairly health still (congratulations!) or you might already have some issues. No matter what your particular health is right now, there are three things you can start with immediately to take better care of yourself.

1. Good Nutrition. You have probably heard this dozens of times but do you really adhere to a good diet? How often do you eat fast food? How many sodas do you drink every week? Every day? Do you eat a lot of packaged processed food, even though it is labeled “Healthy Choice” or something similar. This is not good for you! You need to eat natural, unprocessed food. Fruits, vegetables, fish, nuts, soy products and the like. Your body will gradually break down if continually fed unhealthy products.

2. Exercise. This does not mean you have to run marathons or spend hours at the gym every day. Do things that you enjoy or you will not be able to sustain a exercise regime. Walking is one of the best forms of exercise. Light weights give you some body strength and muscles are what burn the most fat so you will be able to maintain a healthy weight. Keep moving as much as possible. Gardening, walking the dog, stretching, yoga, these are all wonderful ways to keep yourself fit.

3. Take Some Good Supplements. No matter how well we eat, we are not able to take in the daily amount of vitamins, nutrients, etc. that doctors and nutritionists recommend. Make sure you get on a well recommended program that you can trust. There are some excellent natural vitamin companies out there, you just need to do the research and choose one. Look for a company with longevity and ask around to some of your healthier friends what they use.

Start today as you have no time to lose. Remember, if you have any questions about what you should do or take, check with your doctor.

Misuse of Medical Equipment

When doctors order tests like x-rays and CAT scans they usually only need a simple reason for doing so. Unfortunately, in many cases these types of health care equipment is misused or ordered when it is not really necessary. When this happens a patient ends up paying for a service they should not have had to. The costs alone from misuse of health care equipment is staggering. Not only is it putting a dent in the pockets of patients, but it is also part of the reason for rising health care costs.

Besides the financial side of misuse of health care equipment, there is the health concerns to consider. X-rays, for example, are known to be dangerous. A person is being subjected to radiation which can be profoundly damaging to the body. There is a limit on the recommended number of X-rays a person should receive, but many times when a doctor orders a x-ray, they are unaware of the person s history with getting x-rays. Additionally, x-rays are harmful for pregnant women and for reproductive organs, in general. Too many x-rays can lead to many health problems.

The misuse of health care equipment is something that is likely to go unnoticed. More and more insurance companies, though, are requiring further validation for such uses which may help to end misuse. However, most of the time as long as a doctor deems it necessary, the procedure will continue.

When it comes to medical equipment, x-rays are probably the most used type of health care equipment. In emergency rooms around the country, doctors usually are quick to order an x-ray if the diagnosis is not immediately recognizable. The misuse of health care equipment can lead to many problems for the patient.

Weight Gain Myths

Gaining weight is a gradual process that requires constant training and high intensity workouts. However, people do have certain myths regarding weight gaining program.

High repetitions burn fat while low repetitions build muscle: This statement is far from being true. In order to lose weight, one needs to decrease average calorie intake. However, for gaining muscle strength, one needs to have a progressive workload with a variable frequency of repetitions.

Vegetarians cannot build muscle: Research has shown that vegetarians can indeed gain muscle with regular training and daily supplementation of soy protein isolates.

Strength training will make you look masculine: This is the most common myth among women. However, building muscle is a steady process that needs proper strength-training regime ably supported by proper diet. Testosterone, which is the male sex hormone, is primarily responsible for muscle gaining in men. The secretion of this hormone is quite low in women, resulting in lesser muscular growth.

Many people believe that they can eat anything if they are doing a regular exercise. However, diet has a major role to play in defining a person’s general health and physique. It is always important to balance the ratio of calorie intake and calories burnt.

Occasional break from a rigorous training schedule is useful as it helps in refreshing the muscles and helps them to recover.

Eating more protein doesn’t necessarily help in gaining weight. Muscle building is primarily dependent on two factors which include a progressive workload and eating good calorie food. Diet derived from carbohydrates would be more useful.

One should always avoid taking steroids for building muscle as they are more harmful than being good.

Electronic Medical Record (EMR) Pros and Cons

Within the last few years there as been an aggressive push on the part of government, professional organizations, and other authorities to institute a uniform EMR system. This includes generous subsidies allocated by recent legislation and mandatory legal requirements to occur in the next few years. As a practicing and academic physician with a masters degree in public health, I would like to briefly note some observations.

Intuitively, a uniform, easily accessible EMR seems like a very good idea. In fact, one of my major difficulties in practice occurs when a new patient arrives without copies of previous diagnostic studies or lists of medications. This is compounded in an incapacitated or elderly individual with many medical conditions and medications, and when there is a language barrier. Such patients may have great difficulty, or be incapable of, relaying this information to the new physician. To go online and immediately retrieve it would be very helpful indeed.

However, in these days of lower reimbursement and higher practice volumes, time spent imputing information may be time spent away from patient care. You may have experienced a visit where your doctor, using an EMR, has his eyes and hands on the computer much more than on you. I personally have accompanied relatives to physicians and emergency rooms where the doctor spent almost no time talking to, or examining the patient but instead sat in front of the computer, recording or retrieving information.

Also, these electronic records include templates where “check off” of existing information, rather than recording of original information is involved. This helps improve physician reimbursement by conforming with insurance company guidelines for level of service. It does little, however, to record the doctor’s thought processes or enhance the necessary medical information provided by this specific physician.

Don’t get me wrong. Good information is a good thing. But, it must be good for the patient and not just there to satisfy an insurance company. Also, it must contribute to, not detract from, the overall quality of care.