Tuesday, September 1, 2009

Grab Bag 1

Here's just a bunch of topics I've pulled aside and not gotten around to posting.

Teen pregnancy and STD rates got worse under G.W.Bush's watch, especially in the South. No surprises, there. When you take money away from programs that work and give it to programs that don't work, the outcomes suffer. When you have a culture that uses evidence-based practices, you see returns on your investments.

Putting stents in arteries may be unnecessarily done 240,000 times per year. Dr. Teirstein is an obvious example of the big problem with many doctors. He is biased towards something he has experience with and makes a fortune from, which leads him to discount real research. He doesn't care what really works best for people. He doesn't want to be told what to do. He wants to do what he likes and effectively defraud insurers. Fee for service is a terrible way to pay doctors. We need fee for outcomes. They need to be accountable.

Stupid Americans will not vote for politicians who would actually make the best decisions for our country. Rationing is not bad. Every health system has rationing. In fact, every system that involves money or resources has rationing. It's a fact of life. Get over it. Right now, insurance companies ration the Hell out of people's health care, and the uninsured get nothing at all. The British system is brilliant. The British try to make sure they get the most pop for the pound. With finite resources, they try to do the most good that they can for everyone. Only complete idiots would take the American route and deprive children and workers from basic care while spending the bulk of resources on people who are going to die soon. Also in this article is the idea that we should find out what treatments work best in which situations, then NOT require doctors to use that information. I sure as Hell want my doctors to do what's been shown most effective instead of whatever else they feel like.

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