We’re not afraid of Google!

The cover story of the April 9th issue of BusinessWeek asks: "Who's Afraid of Google?"

We are NOT afraid of Google. We are NOT afraid of change. Point of fact, Google has changed our lives -- for the better, as consumers.

There are entrenched interests in healthcare and media, and change is never easy-- but it is the price we pay for progress. (We are not still riding in a horse and buggy--and thank goodness for it.)

CareTALK works with EVERYONE, and that has not been hindered by our relationship with Google at all. Hysteria aside by those who lunch at Michael's, CareTALK fully endorses Google's functioning as a change agent across deeply entrenched industries.

The one thing we, at CareTALK, can say is that we have been treated with the utmost RESPECT by Google, Inc. We have personally witnessed and experienced that it does not matter in the least whether you are a startup or a Madison Avenue/Hollywood titan.

So... how does that change agent, progressive stance apply to healthcare -- and where is it more needed than in healthcare?

78 Million American citizens are turning 60 at the rate of 10,000/day. Year in and year out, ad nauseum, we are told by politicians, employers, hospitals, and the pharma industrial complex, that consumers have to be responsible, proactive, pay more for less. Where is the RESPECT and service?

BIG QUESTION: Who has or will arm consumers with the information and management resources to take on these increasingly complex responsibilities?

For boomers worldwide, and those who depend upon this generation economically, the answer for nine years -- since it's birth--has been Google, Inc. Notwithstanding all of the brands, commercials, promotions and fads, this company has integrated education, service, and RESPECT of the consumer -- their primary goal. No wonder consumers trust and rely on Google, Inc.

Since the Ronald Regan Era, we have heard that something needs to be done about healthcare. Every four and six years, the issue is trod out as a safe and entertaining issue for campaign chit-chat. Then after the conventions are over, the die is cast, we wake up to 40 Million American citizens facing healthcare risks and possible bankruptcy -- the great uninsured. If you are lucky, you can be born uninsured and die uninsured without the basic human right every modern nation provides its citizens. What other recourse is there for consumers to manage and arm themselves with the information resources they need at the granular level-- than Google, Inc? Whether you won the lottery, are insured, or uninsured, Google's search prowess helps one navigate and source the information necessary to MANAGE our fractured healthcare system. Google, Inc. RESPECTS the consumer. They do not distinguish between haves and have-nots. Instead of balkanizing the universe of information and people, this company is seeking ways to level the playing field.

Now, we can either criticize and throw road blocks in their path or find ways to collaborate and partner with this company that is forcing progress in pivotal areas where it is desperately needed. LEADERSHIP is sorely needed and sorely lacking in the world today.

Think Katrina.
Think the war in Iraq.
Think healthcare -- CareTALK's domain.

They are not perfect, but who is? Google Inc's leadership and courage to take on the challenges that face consumers, voters, students, and people of every walk of life who can and can't afford an increasingly out of control university tuition--second only to runaway healthcare costs--should be rewarded and supported.

Google helps us manage and solve the problems of modern life. The world is coming at consumers very fast and the pace of innovation has accelerated to such a point that technology is creating more stress than decreasing it. Managing the information flow is paramount in modern life.

Progress is painful. However, information should be ubiquitous in the modern world.

We are with you Google, Inc!

We have confidence the economic issues for media companies/partners will be sorted out. However, we are also glad that lobbyists, investment bankers, men in suits at The Four Seasons, and other dictators will never have things as good as they did before Google, Inc.-- at the expense of the consumer.

Good.

Vaccine for Alzheimer’s?

It's incredible.

As we had written in a previous entry,

"one in eight people 65 and older have the mind-destroying illness, and
nearly one in two people over 85" --- currently an estimate of more than 5M
people in the US living with Alzheimer's. Unfortunately, these numbers are
expected to rise -- by 2030, 7.7M are expected to have Alzheimer's and by 2050,
16M.Imagine if this could be prevented.

According to Reuters, there has been an oral vaccine for Alzheimer's developed that has been proven effective in mice in Japan. According to the Japanese scientists who are preparing to conduct small-scale clinical trials in humans, the mice were "able to recover their functions after developing the symptoms" but they believe, in humans, the vaccine will only work "in the early stages of the disease, when symptoms are light."

If this vaccine works, this will be phenomenal --- and will benefit millions, if not billions, of people worldwide. According to a special, Boomer Century 1946-2046, on the NYC PBS channel, if the onset of Alzheimer's can be delayed by just 5 years, half of all nursing homes would be empty. Can you imagine the cost savings, not only to the individual families, but to the nation?
This is something well worth thinking about.

What exactly is the "best" care possible?

Many of you may have read about Adam Bosworth's, VP of engineering at Google, latest posting regarding health on the Official Google Blog. In it he asks several questions that we all, as consumers, patients, and caregivers, have asked ourselves regarding our health care. Mainly... "How do you know you're getting the best care possible?"

Here is Adam's blog:

Official Google Blog: How do you know you're getting the best care possible?
Posted by Adam Bosworth, Vice President

When I talk to people using Google to search for information about their health questions and how well search answers these questions, I hear several common concerns. I want to list them and discuss our thoughts about them.

How do I know if the information is trustworthy and reliable?
There is a lot of material out there about drugs, diseases, procedures and treatments. How do you know what is trustworthy and what isn't? Search is great at finding us places with relevant information, but it is hard to know which links are reliable and which are less so.

Honestly, this is a hard problem. At Google, we have tried, as I said in an earlier post, to enlist the help of the health community to help us know which links contain medically reliable information, sift these reliable links so that they tend to show up relatively earlier in the search results, and then let you decide which groups in the health community you trust. If you go to Google and type in [Lipitor], for example, and then you click on the "For patients" link and look carefully, you'll see that the search results often include at the bottom the word "Labeled By," followed by words like NLM and HON. NLM stands for the National Library of Medicine, the world's largest medical library, and HON stands for Health on the Net Foundation, an organization which is in the business of certifying web sites with health content that is reliable. These are organizations that have marked the part of the web that this link in the search results points to as medically reliable. It seems that we at Google may not have done a great job of making this clear enough. Unfortunately, many of you either don't notice these words when you're searching about health questions at Google or have no idea what they mean. Clearly, we can do better at making this kind of labeling noticeable and your ideas on how we could make it clear to you that a site is medically reliable or trustworthy would be greatly appreciated as we think this through.

Am I getting the best standard of care?
There is, actually, a lot of information out there about generally accepted medical guidelines for care. For most diseases, the medical literature lists the medically agreed-upon standard of treatment, rules to follow, and guidelines for which tests to administer and the best course of treatment - although it is hard to pull together from the various medical organizations and texts as it is constantly evolving. Experts determine which drugs make sense based upon a patient's condition, other conditions and drugs, age, gender, weight, and so on. There are of course always cases where doctors need to make exceptions to these rules about which drug to administer due to side effects and/or prescribe an alternative drug due to the patient's specific medical history. The point is that there are guidelines to help doctors with these decisions. However, this information isn't really accessible to those of you who aren't health professionals.

Speaking, I think, both for those of us at Google and most of you, given our specific condition or conditions and medicines, just knowing what the guidelines and generally accepted standard of care is for us specifically would be hugely helpful in knowing what to discuss with our doctors and what to research further. Today, even if we can figure out which sites upon which to rely, it is hard to find this out. We don't know where to start. Our treatment scares us, or our drugs have worrying side effects, or we're just frightened that we're not getting the treatment we should be getting.

Honestly, this information can even help our doctors sometimes. They are over-worked and often pressed for time and it cannot ever hurt to double check. Sometimes they didn't get accurate or complete information from us. While most drug-to-drug and drug-to-condition interactions are known to our doctors, they do change and the doctor might miss a new one or not know about all your drugs because we forgot to tell your doctor about one. The statistics show that mistakes happen. In fact at some point in a patient's life, the odds of them being treated in a way which doesn't follow the guidelines and rules is about 45%. There are estimates that somewhere between 44,000 and 98,000 Americans die every year from a preventable medical error at a hospital — or about 150 to 300 preventable inpatient death a day. And approximately 770,000 people are injured or die each year in hospitals from an adverse drug event. There are roughly 5,000 preventable medical errors a day taking place at doctor's offices.

So it seems that it would really help to let people know. It is tricky, however. Everybody's condition is unique. It isn't possible to just play doctor and tell you exactly what your treatment should be and why. Even doctors have a hard time with this because of the incredible and ever changing complexity of modern medicine. What is the best way to help people searching for answers to their health questions to know the right standard of care they should be receiving, what treatments or classes of medicines they should be researching, and what procedures might be indicated?

Who is the best doctor or institution for you?
Isn't it strange that you can find out a lot about a restaurant on the web or about a movie, but not about a doctor? In fact you usually don't even know who to go to and just accept whoever your general practitioner recommends? You clearly don't just eat at restaurants other restaurants recommend, even though you might take it into account. Now admittedly there is a difference here. When it comes to food, you know what you like and the worst that can happen is you don't like it. But when it comes to your health you may not know what is best, and you can't necessarily tell if we're getting the best possible care. Still, here is a common situation: You've been diagnosed. Your primary care physician and you have discussed it and it is clear that you need a specialist and your doctor has referred you to one, but you're wondering how you know who is the best out there for you. How do you know whether they cover your insurance? How do you find them? Today, often you just take your doctor's referral.

Normally there are lots of doctors who could treat or diagnose you. And in point of fact there is a lot of information about doctors floating around in the ether. Where they went to school is known. Whether they are board certified is known. What is their specialty is known. CMS (Medicare) and insurance companies actually know how many procedures of various types most doctors regularly perform. And this turns out to matter. There is an excellent book out called Complications, by Atul Gawande, discussing a lot of these matters, but in particular the book notes that practice really does make perfect.

But how do you know who is well seasoned? Do you always judge who to take care of you by how long they've been in practice? What does "best" really mean? This is a hard question. Mortality rates, for example, may not be a good indicator. Some specialists only treat the patients that others can't handle, and so, naturally, even though they are the best in the world, their rates might not be the best. Sometimes your choice may be dictated by other considerations. If there are two possible specialists, one is a man and the other is a woman, then sometimes people care about that.

It isn't clear how we can best help. We don't want to inadvertently steer you away from a brilliant doctor just because his or her mortality rate appears too high. What do you think, and what would you like to see made available on the web when you are searching for doctors?

Summary
At the end of the day, all these questions are about how you find the information you need. They are deceptively simple. If they were about restaurants, they would be trivial. But they are actually matters of life and death in the extreme and quality of life in the common case. In short, they matter profoundly.

I'd like to say that we have all the answers. But we don't. Mostly, at the moment, what we have is questions and we’d love to hear from you (health@google.com).

---------------------------------

Source: http://googleblog.blogspot.com/2007/03/how-do-you-know-youre-getting-best-care.html

Caregiving has been given a national stage.

Because of the unfortunate situation of the Edwardses, caregiving has been front and center across the nation (and perhaps the world). EVERYONE is talking about it, one way or another. (Below are some links to just some of the articles).

Now with Katie Couric's "60 Minutes" Interview on Sunday, this discussion has gained even more momentum. Yes, many people have been criticizing Ms. Couric for the manner in which she asked the questions -- her harsh tone, her pessimistic "you do know you're dying, right?" attitude -- especially since she went through a similar situation caring for her husband who died of colon cancer, and her sister, who died of pancreatic cancer. Perhaps there is some truth to the criticisms in that there might be some resentment or personal opinion that Ms. Couric was expressing in her tone. However, the questions themselves, though harsh, are exactly what the nation has been debating -- was it the right decision to continue with the campaign despite fighting this recurrence of cancer? Was it Mr. Edwards' ambition that influenced the decision? What about their children-- has anyone thought of them? Will the stress and strain of a presidential campaign accelerate Ms. Edwards' ailment?

Each one of us can give an opinion --- we are all entitled to that. However, there is no one who has the answer as to whether this was the right decision --- other than the Edwardses. We can all ask these questions, but in reality, the ultimate decision on what is right for them, falls on the Edwardses.

New York Times: http://thecaucus.blogs.nytimes.com/2007/03/26/couric-criticized-for-interview-with-edwardses/

CBS News: http://www.cbsnews.com/stories/2007/03/24/60minutes/main2605038_page2.shtml

Huffington Post: http://www.huffingtonpost.com/linda-milazzo/katie-couric-you-were-un_b_44284.html

April 16 -- mark it in your calendars

That is the day, as the New York Times reports in "Justices to Hear Case on Wages of Home Aides," that the US Supreme Court has agreed to hear oral arguments in a case in which the Labor Department regulations that say home care attendant are not covered by the federal minimum wage and overtime laws are challenged. The plaintiff, a 73 year old former home care attendant, states she "often worked three or four 24-hour days a week, sleeping at a client's home, while hardly ever receiving time-and-a-half pay for overtime." Unfortunately, this is not uncommon.

We have written in previous entries about the looming crisis we will be facing regarding the shortage of professional caregivers, as clearly outlined in Caregiving In America, a comprehensive report released by the ILC and the Schmieding Center for Senior Health & Education published Fall 2006. As we had mentioned before, one reason could be the low wages these caregivers receive. Home health aides barely make minimum wage--- in fact, since 1999, their " median hourly wage has fallen 4.4% after adjusting for inflation."

Tragically, the former home care attendant who spent most of her career caring for others until health conditions prevented her from continuing working, can't afford a professional caregiver herself. She doesn’t even have health insurance to pay for her thrice weekly dialysis treatment. She must rely on her son to care for her everyday.

Something must be done to change this plight of professional caregivers. We will soon be facing a shortage --- yet we are doing nothing to encourage people to become professional caregivers. Professional caregivers are currently in the position of knowing that despite spending a career caring for others, they will not be able to afford to be taken care of themselves. As it stands now, the system can't even provide them with health insurance.

Forget the pumps. Dress code for this political fundraiser: t-shirts, Lycra, and sneakers

This may be a first. A political fundraiser by former President Bill Clinton on behalf of Presidential hopeful, Senator Hillary Clinton, held during a spinning class at SoulCycle spinning studio on the Upper West side in Manhattan.

Yes, you read right -- a fundraiser during a spinning class.

40 men and women paid $2,300 each to hear Mr. Clinton speak about good health care and take questions on behalf of his wife's presidential campaign. Though Mr. Clinton did not spin, according to the New York Times article "Bill Clinton Raises $70,000 Without Breaking a Sweat," he seemed to have accomplished the goal of informality and getting to hear people's thoughts/ praises/criticisms regarding Senator Clinton's campaign.

All in all, this was a great (and very creative) way to raise money, hear people's concerns, and combine health/wellness/healthcare (a strong focus in Senator Clinton's campaign) with politics.

Courageous, strong, inspirational…

Those are words that have been attributed to Elizabeth Edwards from the other democratic presidential candidates after hearing about Mrs. Edwards’s renewed battle with cancer.

And they're right.

Mrs. Edwards has an uphill battle. Instead of cowering and letting the recurrence of cancer take her over, she is -- and will --fight it. In today's news conference she said she will continue on with her schedule -- she will do next week what she did last week. This recurrence will not stop her. That is the positive attitude we should all take when we have setbacks--- medical or otherwise. Bad things happen to good people. When you have setback, take a second for self pity, but then roll up your sleeves and continue on with your life. Don't let that setback stop you.

As everyone now knows, Mrs. Edwards is one of (if not the) strongest allies and assets that John Edwards, presidential hopeful, has. Now, many people may questions whether she should be on the hectic and grueling presidential campaign -- and many more may questions whether Mr. Edwards should continue on with his campaign. After all, not only is he a father of two young children, but now he is a caregiver for his wife. Will he be able to manage the hectic schedule of a presidential campaign? How will he manage his new caregiving responsibilities along with his other responsibilities? Should he even try to pursue his campaign?

These are the challenges CareTALK will explore--- because of a setback in which you are suddenly thrust into a caregiver role, what do you do? Do you give up your goals, plans, and ambitions? Or do you maintain those responsibilities and take on the additional responsibilities of a caregiver? Can it be done? If so, how?

The answer is yes, it can be done.

Will it be easy? No. Take the article "The Other Juggle: Taking Care of Mom and Dad" in the Wall Street Journal, for example.

Should it be done? There is no right or wrong answer for that. That is dependent on each person and their situation. However, CareTALK will try to weave our way through the pros and cons to make some sense of this. CareTALK will provide you with the tools to help you --- whichever decision you may make.

One must also remember that children can also be caregivers. Cate Edwards, John's and Elizabeth's oldest daughter,-- though not a child-- will also be thrust into a caregiver's role -- a caregiver for her mother and for her younger siblings. Therefore, Mr. Edwards is not alone… and neither are you.

CareTALK and its support community will be here for you.

It's a start...

According to the New York Times, the FDA has announced a new rule which would prohibit any expert advisor who receives over $50K from a drug or device maker from serving on a committee reviewing that company's (or a competitor's) product. According to the FDA acting deputy commissioner, "a 'significant number' of the agency's present advisers would be affected by the new policy."

It is shameful that an agency, established for the protection of the American people, allowed expert advisors with such clear conflicts of interest to serve on committees -- especially in light of the fact that "the announcement of waivers [issued for any financial conflicts other than owning more than $100K+ in the company's stock] was becoming so common at the start of advisory committee meetings that they took on the feel of fast-talking car commercials."

Now, don't be fooled. The main reason the FDA announced this new rule is because they wanted to pre-empt a bill from a NY democratic representative which would have prohibited an expert advisor with any financial conflict of interest from serving on a committee. (Now with the new Congress, the bill had a higher chance of passing). As a result, the FDA tried to "strike a balance here… and they would rather strike it themselves than have it struck for them."

Again, it is incredibly shameful, but this is what our government has been reduced to--- catering to the corporations, the pharmaceuticals, and the interests of the elite. As a democratic representative of Connecticut stated, the FDA has a "recent track record of putting political and corporate interests above science."

Hopefully, this new rule will be strictly enforced.

Exercise, exercise, exercise… your brain that is.

According to a report that was released today, "one in eight people 65 and older have the mind-destroying illness, and nearly one in two people over 85" --- currently an estimate of more than 5M people in the US living with Alzheimer's. Unfortunately, these numbers are expected to rise -- by 2030, 7.7M are expected to have Alzheimer's and by 2050, 16M.

Why is this occurring? The answer given by the Alzheimer’s Association medical director is tragic…"Ironically, in fighting heart disease, cancer and other diseases, we're keeping people alive so they can live long enough to get Alzheimer's disease."

We've found ways to deal with heart disease, cancer, and other deadly diseases. Now we must find ways to combat Alzheimer's. As indicated in the New York Times article, "Over 5 Million Living With Alzheimer's," there are drugs in clinical trials that will slow down the degeneration of someone with Alzheimer's. However, each person must do their part as well.

Pick up some Sudokus, or crossword puzzles…. Or try mind stimulating games such as Brain Age by Nintendo. Here are some more tips on exercising your brain: "As Minds Age, What's Next? Brain Calisthenics".

Love is a funny thing

When you think of love, what do you think of?

Many may say they think of hearts. Others may say they get a warm, fuzzy feeling. Yet most, if not all agree they also feel a sense of calm and happiness -- especially if they know that love is returned.

The article in the New York Times, "Modern Love: My Parents Couldn’t Outlive, or Outrun, Each Other," is a very poignant reminder that not all love is "warm and fuzzy." Yet the couple in the article were in love -- even after 30 years of being divorced and after remarriages to other people. As you read the article, it may not seem like your typical love affair -- but it is love. (The writer calls it "modern love.")

Yet, is it really modern love?

Every person has their own definition of love. But in its foundation is a deep sense of commitment to the person whom you love and a willingness to do everything in your power to make that other person happy -- without expecting something back in return.

Caregivers have this love for those they are caring for. If they didn't, they wouldn't be able to take on the responsibilities they must bear. Caregiving is not easy--- and it shouldn't be viewed as a duty. It is a commitment you make to make your loved one as happy as you can.

Throw away those "granny glasses"

Good news everybody.

If you need to wear those "granny glasses" or the glasses you buy at the pharmacy to help you read objects that are near, now you can get contact lenses. Although contact lenses that correct distant, intermediate and near vision have been around for years, technology (and more experience) has helped in refining and fine-tuning the manufacturing of these lenses.

Now before you start jumping for joy, be warned that these lenses need to be carefully fitted -- and the cost is slightly more than normal content lenses. According to the New York Times article, "Better Vision Without Looking Your Age," one year supply of between $200 to $500 depending on the degree of customization and the fitting can range "range from a modest insurance plan co-payment to about $1,000" depending on the number of visits it takes. Also, not everyone who wants the lenses is a candidate for these contacts. But if you're interested, you should definitely contact your optometrist. One optometrist said he saw a success rate of "75 to 80 percent for gas permeable lenses, and 60 to 70 percent for soft lenses."

Now, many may say this is just vanity--- why not just wear the glasses? As one optometrist said "it's a matter of utility. People are living longer, working longer and leading more active lives. They want to function as they age like they did when they were young."

And we agree. Why wouldn't we, as we age, want to function like we did when we were young? Why be dependent on glasses?

Update: Lost records found

The CD containing the unencrypted medical and personal information of approx 75,000 members of Wellpoint was found --- It had been delivered “by mistake to a resident in the Philadelphia area.”

This is utterly and completely ridiculous, especially considering the information was exchanged between two subcontractors without adequate security protection --- which is strictly prohibited by privacy laws.

As mentioned in yesterday's entry, a Magellan spokesperson stated the company would, in the future, transmit information electronically.

As you can see, sending information electronically is more secure than sending it the old-fashioned way --- via hard copies.

Lost records again…

For a second time in 5 months, Wellpoint has lost privileged and confidential personal information of some of its members. According to the New York Times article "Medical Data on Empire Blue Cross Members May Be Lost," Wellpoint begun notifying 75,000 of its members by mail on Saturday that a CD holding their medical and personal information (including names and social security numbers) has been lost. Unfortunately, all the information on the CD was unencrypted.

What is even more unfortunate and disturbing is that Wellpoint has begun notifying its members this past Saturday (March 10) yet, the company was notified of this breach in privacy on Feb. 9th. Why the delay? Ostensibly to perform a preliminary investigation to identify the members whose information may have been on the disc.

This also raises the questions -- who exactly has access to our information? How safe is it?

The CD was lost as it was being transported to Magellan Behavioral Services, a subcontractor of Wellpoint which "specializes in monitoring and coordinating mental health and substance abuse treatments for insurance companies." As a result, a Magellan spokesperson said the company has adopted "a procedure to transmit this information electronically through a secure network, eliminating the CD and using a delivery service."

Consider this… opponents of Google creating a "health URL" believe their records will not be secure and that it can be easily hacked. Yet, is it more secure to have the records stored on a physical computer hard drive or transported via CD because of the "danger" of sending files electronically? Apparently, Magellan now believes it is safer to transport the files electronically.

Also, opponents have concerns over Google having this information. Yet, do you know exactly who has seen your records? If fill out your information at a doctor's office, or at a bank, or when filling out an application for a credit card—do you really believe it is just the one or two people reviewing your application/form who sees your information? Unfortunately, no. As in the case of Wellpoint, many companies you give your information to may need to share that information to their subcontractors in order to provide you with the services you need. This is not bad in and of itself, but you must understand there are many more people than you think who have access to your information.

Therefore, why not have your information on Google Health's "Health URL"? At least you are the one who controls the information you put in and who has access to it. In addition, isn't Google the only portal who hasn't had a security breach or lost/accidentally released any member information?

Let there be light…

It's very difficult to see in the dark (unless, of course, you have cat eyes) ... but it gets increasingly difficult as you grow older. This may not seem like a big problem --- but what will happen when the single largest group ages ... and they all have worsening eyesight, especially at night. Now add on top of this, the fact that many boomers will be driving long into their senior years (unless they are able to have others drive them, or they take public transportation) and many times, they'll be driving at night. You will have to wrestle the car keys away from them (the car keys are a symbol of independence and freedom to move about. Boomers love their freedom).

This does not mean that once you hit a certain age, you should call it quits and hand over the car keys (actually, there's something to be said about the young teenage population being more dangerous on the road). However, aging boomers should try to take preventative measures, and also follow some simple tips as explained in the New York Times article, "Growing Older, and Adjusting to the Dark."

These suggestions are simple, easy, and make sense for everyone to follow--- whether you are 10 or whether you are 80.

Prescription drug sales increase

It's great to see not all are against the Medicare Prescription Drug benefit. According to the Wall Street Journal article, "Prescription-Drug Sales Increase, Fueled by Medicare-Drug Benefit," US prescription drug sales rose 8.3% in 2006. "Prescriptions dispensed through the Medicare drug benefit accounted for 17% of retail prescriptions," -- pretty significant, especially in light of the report by the Consumers Union (see yesterday's blog entry).

It seems the Prescription drug benefit is one of the best things to occur to the pharma companies.

"If there's one thing that can bankrupt America, it's health care"

That is the statement made by the US Comptroller General, David Walker.

The Medicare Drug Benefit is under fire now, being called "probably the most fiscally irresponsible piece of legislation since the 1960s." The benefit was meant to help seniors with the cost of their prescriptions yet, a new report from Consumers Union found that 28% of private insurance plans offering the Medicare Part D increased the costs of their drugs in 2006 by 5% or more --- after seniors were already locked into their insurance plan for the year. Already, increases in some prescription drug costs have occurred in 2007-- and are expected to continue.

In order to get some accountability, the Chairman of the House Oversight and Government Reform Committee sent "letters to Medicare drug plans requesting data to determine the size of drug plans' profits and whether discounts negotiated by PBMs [Prescription Benefit Managers] with drug makers were passed on to beneficiaries." This sounds like a reasonable request; however, the CMS Administrator declined the request stating "several independent entities … have concluded that public disclosure of negotiated price concessions will reduce the ability of pharmacy benefit managers and plans to negotiate significant discounts." Even the lobbyists representing the PBMs responded to the chairman's request by stating "... we think it's critical that the committee safeguard the information."

If the savings are being passed down to the beneficiaries (which doesn't explain the increases to the Part D plans), why the secrecy?

How does your hospital rate in its quality of care?

"You can find out a lot more about buying a washing machine than buying health care."

This is a disturbing but true statement.

Think about it. When choosing a doctor, do you know how s/he rates compared to other doctors? When choosing a hospital, do you know how it rates compared to other hospitals? For instance, New York City has many hospitals to choose from. Do you know which one is the best?

The sad answer is no.

It has only been recently that Health and Human Services has begun ranking hospitals based upon some of the data they have collected (www.hospitalcompare.hhs.gov). This has helped improve the performances of some hospitals--- as described in the New York Times article, "The Data Tell a Different Story on Heart Patients." Nothing is more motivating than having your performance data made public—now, hospitals can't hide anymore. As one doctor in the article stated, "I think people underestimate the role of pride." (It's very unfortunate this is the main--if not only--reason hospitals are forcing themselves to improve).

CareTALK aims to change this. In collaboration with GoogleHealth and its strategic partners, CareTALK will provide rankings for caregiving products, goods, and services. For example, the gray market for professional caregivers carries some risk because the caregivers are not vetted by professionals. We, with our partners, aim to change this. We aim to take some of the unnecessary risk out.

The consumer has been kept in the dark too long. It's time for a change. Consumers need to be empowered and informed.

Why we need health insurance…

If you had any question as to whether you needed health insurance, you should read the Wall Street Journal article, "A Technology Writer Confronts Wizardry In Today's Hospitals," where the writer (a technology writer) describes his sudden 12 day hospital stay and the cost of such a stay -- $125, 000 -- that included up-to-date technology such as the latest CT scanning machines and a blood analyzer to for his daily white-blood cell count.

His procedures were all needed -- but who can afford $125,000 if you don't have health insurance? This is why it is important we all stay on top of the issues being addressed by the presidential candidates --- it is time we provide the 47million uninsured with some insurance.

Clinic reports via text message?

Ever think you could get clinic reports via text message, a voice-call system or on the Internet using a computer or Internet-enabled cellphone? Well, this technology is available and is being used on a daily basis -- in Rwanda.

According to the article, "Wireless Technology Speeds Health Services in Rwanda" in The New York Times, "Voxiva, a United States company ... has built a system that lets health workers send reports by cellphone directly from the field" which has connected 75% of the Rwanda's 340 clinics (approx 32,000 patients). Prior to this technology, doctors/officials had to send notes by hand to other clinics. Rwanda is a "country of one thousand hills, so it often takes one month to receive a message from the field about a disease outbreak or drug shortage."

Because most of the population has mobile phones, this technology can be used by individual patients to send text messages "to authenticate code numbers on individual [pharmaceutical] bottles." In addition, "each time a new patient enters the system, the information is sent in, while weekly reports cover data like a clinic's stocks of drugs, and monthly reports cover the number of patients under treatment. Clinics receive messages including the results of laboratory tests and drug recall alerts sent by the ministry of health."

If this technology is available, why not have it widely available in the United States? Why does each caregiver/patient have to go running around from office to office?

One main reason: HIPPA

This is the reason Personal Health Records (PHRs) are so important -- and why creating a "health URL" (as Adam Bosworth, VP of engineering at Google and head of GoogleHealth, stated in his speech) is so important.

47 Million

That is the number of people without health insurance in this country – and it has INCREASED in the past ten years! According to the NY Times/CBS Poll, even those who DO have insurance do not get certain tests because of out-of-pocket expenses.

This lack of health insurance coverage MUST be a priority discussion of ALL CANDIDATES for the 2008 Presidential Elections. They need a clear, detailed plan that can be executed. Many candidates are saying the right things/the right words--- but where is the detailed plan of how to fix the problem?

We ALL need to keep a vigil that this election does not offer a pass for this critical issue -- this time around. Each candidate has a channel on YouTube:

Democratic Candidates

• Joe Biden: http://www.youtube.com/joebiden
• Hillary Clinton: http://www.youtube.com/hillaryclinton
• John Edwards: http://www.youtube.com/johnedwards
• Dennis Kucinich: http://www.youtube.com/denniskucinich
• Barack Obama: http://www.youtube.com/barackobama
• Bill Richardson: http://www.youtube.com/BillRichardson

Republican Candidates

• Rudy Giuliani: http://www.youtube.com/RudyGiuliani
• John McCain: http://www.youtube.com/johnmccain
• Mitt Romney: http://www.youtube.com/mittromney

Keep up to date on the issues each candidate addresses. Make sure these are the REAL issues. It is time for Americans to become THE priority of our governments – federal, state, and local.

Annie... get your gun

Everyone -- especially those in NY--should be keeping an eye out on the fight over Governor Spitzer's proposed budget cuts. It is getting ugly--and this is just the start!

The Greater New York Hospital Association (GNYHA) and 1199SEIU have joined forces "to become one of the most powerful lobbies in Albany" and they (along with others at the power breakfast on Friday that included "business executives, civic leaders and former mayors") were stunned when Governor Spitzer included a slide in his presentation titled "Guardians of the Status Quo" with the logos of the two health care groups.

Many of you may have seen the television commercials by GNYHA and 1199SEIU -- the newest ones featuring "a series of nurses, in their scrubs, saying things like, 'I don't understand why Governor Spitzer is attacking me and my hospital,' and, 'Let the governor walk in my shoes for a day, and then call me a crybaby.' " These were a rebuttal to the commercials Governor Spitzer had featuring "a group of newborns in the hospital, with the implication that budget critics were 'crybabies.' "

Get ready. This battle will get ugly.

Increase taxes to cover universal health insurance?

Everyone is talking about how to resolve the issue of providing health insurance to the 47 million who don't have any insurance. The major problem is this presidential administration squandered a surplus left behind by the last president by giving everyone tax cuts (and continuing to give them despite this country being in a war) instead of using it to lay a foundation to help those without health insurance.

According to a New York Times/CBS poll, 24% of those polled were satisfied with "President Bush's handling of the health insurance issue." (not a big surprise).

However, some interesting statistics were:

• 25% of those with insurance "said someone in their household had gone without a medical test or treatment because insurance would not cover it."
• 6 out of 10 "of those without insurance said someone in their household had gone without care because of the cost."
• 64% say the government should guarantee health insurance for all
• "Nearly 8 in 10 said they thought it was more important to provide universal access to health insurance than to extend the tax cuts of recent years."

Some respondents to the poll even went as far as saying they would be willing to pay additional taxes if it meant the government being able to provide health insurance to all—very interesting.

Would you be willing to pay additional taxes to have universal health insurance as an option?

Let us know. We'd be interested in your thoughts.

Pandemic Flu being compared to 1918 "Spanish Flu"?

According to an article in the Associated Press, scientists believe they can learn how to fight a possible pandemic from the H5N1 virus by studying the last major pandemic--- the 1918 Spanish Flu that killed over 40M people worldwide. Not only will they be studying documents and other literature --- they want to exhume the body of a British diplomat who died in the last pandemic -- in the hopes that the body (buried in a lead coffin) is intact enough to retrieve body tissue.

Why are scientists focusing on the 1918 pandemic? Because "victims of Spanish flu frequently experienced an overly aggressive immune response, which began to attack their own bodies. The same phenomenon has been seen in human H5N1 cases."

For more information regarding the 1918 Spanish flu, you can watch "Standing in the Safety Zone" on the CareTALK channel on YouTube. For information about H5N1 or concerns about a pandemic flu, you can visit the government's official site.