Remember that nasty little word - rationing - that keeps rearing its ugly head? Well, here is a bit more food for thought. The decision to use expensive cancer therapies that typically produce only a relatively short extension of survival is a serious ethical dilemma in the US being debated by the oncology community published, June 29 in the Journal of the National Cancer Institute.
The authors show cost-benefit relationships for several cancer drugs. They ask, "Is an additional 1.7 months a benefit regardless of costs and side effects?" (They don't answer a benefit to whom.)
According to the article, one drug was found to extend life by 1.2 months and cost an average of $80,000, which translates into an expenditure of $800,000 to prolong the life of one patient by 1 year. They describe how much it might cost to extend the lives of 550,000 Americans who die of cancer annually, by 1 year.
They recommend that studies to detect a survival advantage of two months or less should test only interventions that can be marketed at a cost of less than $20,000 for a course of treatment.
Every life is of infinite value, the authors say, but spiraling costs of cancer care makes this dilemma inescapable. I thought this was against the Hippocratic oath, so went to find out exactly what the oath says. Seems there are multiple versions and all physicians do not even take the oath. They believe it is outdated and less than relevant these days.
Jul 13, 2009
Weighing Atoms
Did you know we can now weigh a single atom? European researchers have built a device that can do just that. It may ultimately allow scientists to study the progress of chemical reactions, molecule by molecule. They believe they can push the technology to detect the mass of a single nucleon - a proton or neutron.
Carbon nanotubes are ultra-thin fibres of carbon made from thin sheets of carbon only one atom thick, known as graphene, and rolled into a tube only a few nanometres across. Even the thickest is more than a thousand times thinner than a human hair and are 1000 times stronger than steel. And I thought only Superman was stronger than steel.
Jul 9, 2009
Profound Thoughts
Here is a copy of Chapter one from one of my new books. This the first in a series of compiled great thoughts from great minds. Hope you enjoy.
You can click on the arrows above the book to turn pages or place the hand cursor to the right side of the page and click to turn. Also, there is a little box above the book at the top right that you can click to see the book in full page mode.
Profound Thoughts 1x
You can click on the arrows above the book to turn pages or place the hand cursor to the right side of the page and click to turn. Also, there is a little box above the book at the top right that you can click to see the book in full page mode.
Profound Thoughts 1x
Jul 3, 2009
Self Serving
I just had another book published on Amazon, 'Number One Book of Wacky Lists' - Should have the search inside feature available within about ten days. It's a hilarious compendium of lists from the sublime to the absurd. Interesting facts and bits of wisdom, humor, and just plain common sense.
Something for everyone to enjoy. . . and it is only $9.99. Check it out, you might like it.
PS - There is a link on the left for all my books.
Something for everyone to enjoy. . . and it is only $9.99. Check it out, you might like it.
PS - There is a link on the left for all my books.
July 4th
Happy 4th of July tomorrow. Let's remember what Independence Day is really all about, even if they call it just another paid day off in Washington, where they have traded in Free Speech for Cheap Talk.
Salute
Armored knights raised their visors to identify themselves when they rode past their king. This custom has become the modern military salute and soldiers from every country salute with their right hand.
July 4th Revisited
Imagine how you would feel if someone, maybe a sister or brother, or someone else kept telling you what to do all of the time and kept taking more and more of your allowance.
That is how the colonists felt in the years leading up to 1776. Great Britain kept trying to make the colonists follow more rules and pay higher taxes. People started getting angry and began making plans to be able to make their own rules.
They no longer wanted Great Britain to be able to tell them what to do, so they decided to tell Great Britain that they wanted to be independent. To be independent means to take care of yourself, make your own rules, and provide for your own needs. . . How soon we forget what our ancestors gave their lives for.
That is how the colonists felt in the years leading up to 1776. Great Britain kept trying to make the colonists follow more rules and pay higher taxes. People started getting angry and began making plans to be able to make their own rules.
They no longer wanted Great Britain to be able to tell them what to do, so they decided to tell Great Britain that they wanted to be independent. To be independent means to take care of yourself, make your own rules, and provide for your own needs. . . How soon we forget what our ancestors gave their lives for.
Date and Time
At 5 minutes and 6 seconds after 4 AM on the 8th of July this year, the time and date will be 04:05:06 07/08/09
Medical Imaging
Data shows that imaging equipment in rural regions of the country operates 48 percent of the time an office is open, while equipment in non-rural areas operates 56 percent of the time a center is open for business.
President Obama recently recommended CMS base its reimbursement formula on a 95 percent utilization rate for advanced imaging equipment. MedPAC has recommended 90 percent for equipment that costs more than $1 million.
The utilization assumption is a key component of the Medicare formula. Dramatically increasing the utilization assumption results in a severe cut for imaging reimbursements.
Spending on advanced imaging has already decreased significantly since 2005 and imaging use has essentially flattened due to low reimbursement rates. More imaging reimbursement cuts will severely disrupt access to diagnostic services, including long waits for appointments, and patients driving long distances to find an office that has equipment. Medicare reduces costs without appearing to reduce rates. Hmmm! This is just the beginning of rationing, without using the word 'rationing'.
President Obama recently recommended CMS base its reimbursement formula on a 95 percent utilization rate for advanced imaging equipment. MedPAC has recommended 90 percent for equipment that costs more than $1 million.
The utilization assumption is a key component of the Medicare formula. Dramatically increasing the utilization assumption results in a severe cut for imaging reimbursements.
Spending on advanced imaging has already decreased significantly since 2005 and imaging use has essentially flattened due to low reimbursement rates. More imaging reimbursement cuts will severely disrupt access to diagnostic services, including long waits for appointments, and patients driving long distances to find an office that has equipment. Medicare reduces costs without appearing to reduce rates. Hmmm! This is just the beginning of rationing, without using the word 'rationing'.
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