Category: Health

Tonight's Bill of Health segment is about the growth of "telemedicine networks" around the country. These networks basically allow people and clinics in rural or inner-city areas to connect with medical specialists in urban centers. Those specialists can run the gamut from dermatology to cardiology -- and even psychiatry.

Telemedicine is not new. Since the late 1960s, technologists have been working with various devices to link physicians and patients remotely. However, the medical community didn’t really begin to take telemedicine seriously until the 1990s. Once again, we can thank the advent of the Internet, as well as cheaper computer technology, for making that happen.

What's interesting about this week's Bill of Health is that "corporate medical clinics" are something that a great many large companies of another era - the 1950's and 1960's - used to have. Company infirmaries were a commonplace service offered to everyone, from executives to the guys driving the forklift at the warehouse. Full-service infirmaries fell victim to corporate cost-cutting efforts in the 1970s. By the 1980s, the idea of a company staffing its own medical clinic for the benefit of employees was considered a quaint throwback, and most companies were busy outsourcing any of their medical obligations to HMOs as another cost to get off the balance sheet.

Today's Bill of Health looks at the nation's latest shortage -- of pharmacists. Our nation's bulge bracket of aging baby-boomers and changes in the role pharmacists play in the healthcare system are driving this shortage.

I find it something of an irony that physicians spend less and less time with individual patients because of the demands and pressures of operating a practice and getting paid by HMOs, while, at the same time, pharmacists are spending more and more time helping to advise those same clients on the drugs they take. If you visit new chain-store pharmacies, you're likely to see small booths or "private areas" near the pharmacy counter. That's a location increasingly set aside as a place where pharmacists and patients can consult in private about their prescription, possible ways to lower drug costs, and the interactions of multiple drugs on their bodies.

I got lots of emails from people who were furious that my story last night did not lay the California health care crisis at the feet of the undocumented/illegal alien population. (No my head is not in a bucket.) I did a bit more digging on this and wanted to present a quick cut on the blog.

Check out this report by RAND: http://www.rand.org/news/press.06/11.14.html Here's the headline: "Researchers estimate that total medical spending on undocumented immigrants in Los Angeles County was $887 million in 2000 – 6 percent of total costs, although undocumented immigrants comprise 12 percent of the region's residents."

I don't know about you, but I don't like being told what to do. So, I am naturally skeptical of health care plans that require everyone to buy health insurance. (Hillary and Barack are going toe to toe on the issue in the Iowa snow.) Along with the laundry and trash and my taxes, I already face a long list of things I must do. Why ask for more?

That's my initial reaction. But then I think about my car. If someone hits me, I know there's a good chance they have insurance because the law requires it. So, I understand that my insurance is lower because almost everyone has coverage.

The same should go for health insurance. The emergency room is an expensive place to get care. Also, people without insurance wait too long to get help. That means 18,000 people without insurance die premature, preventable deaths every year, while at the same time raising my health care costs. So changing that should help my pocket book while also making me feel better. After all, how can you not be upset that 18,000 people a year die because they don't have health insurance? That's not right.

Remember the original “Star Trek” series and the ship's physician, Dr. McCoy? It seemed that every other episode, McCoy would wave his sensor-wand over a patient to fix an internal ailment. Then he’d offer a wry comment on the “barbarity of 20th century surgery,” in which surgeons actually cut people open with scalpels to perform an operation. After doing the reporting on today's “Bill of Health” story, I think we are yet another step closer to an era in which scalpels are just another of yesterday's surgical tools.

Stereotaxis is a St. Louis-based company that has developed an interesting medical technology to perform procedures on the heart. The Stereotaxis system consists of a pair of giant magnets mounted on either side of a surgery patient, a millimeters-thin wire catheter, a digital controller, and computers. The controller and computer allow a surgeon to use the powerful magnetic field to guide the catheter from an incision in the leg, all the way up into the heart. Once in the catheter reaches the heart, the surgeon can place its head with pinpoint accuracy.

I like Iowa.

The people are thoughtful, kind, and modest. The voters I ran across understand what a privilege it is to help select the next leader of the free world. (Or as one Iowan put it to me, quoting a political analyst, "We don't chose the next president of the United States, but we decide who won't be the next president of the United States.) Iowa winnows the field. Senators and Governors who are famous somebodies at home find they are just another candidate in Iowa. And behind the modesty, there is an earnest desire to do the job right. Iowans I spoke with take the caucuses seriously. They want answers and know this is their chance to get them from powerful people.

Most of the time, the real fight in Washington is not about the immediate topic of dispute. So it is with the President's veto of a bill to expand the State Children's Health Insurance Program.

On the surface, the two sides are battling over whether the program meets a pressing need in a cost-effective way (the Democratic argument.) Or whether SCHIP is really another unfunded government entitlement program that will not help the people it's designed to help (the President's main argument.) The real fight is over the President's reputation for fiscal responsibility and his influence in Washington. If the President can convince conservatives he is battling to control spending -- after years of expanding federal budgets -- then he will have more leverage in negotiating with Democrats in Congress. Also, his veto, if sustained, gives him the ability to shape future policies in a way that is more to his liking.

As the mother of three young children, it should come as no surprise that I’m worried about toy safety. But, you may be surprised to hear that lead-paint-tainted toys (made in China) do not top my list of safety concerns this holiday season. Instead, I am most fearful of the must-have toys my older boys covet…Lego Star Wars sets with their hundreds of tiny pieces. Or the minute weapons that are included with many action figures. I also fret about the small “player” pieces in any of my sons’ board games.

I am most concerned about these items because I also have toddler that picks up everything on the floor…and then puts it in his mouth. Nevertheless, I bring or will bring all of these toys into my home and take a chance or make a leap of faith. Call me crazy or call me naïve, but I truly believe that parents have a responsibility to “police” our own homes and keep our children safe from dangerous toys.

Shortly after I started working, Congress passed this new law that allowed you to keep your health care for a while after you were fired or switched employers. They called it COBRA -- Comprehensive Omnibus Reconciliation Act. The legislation was tucked into the massive bill that funded the entire government, and it changed health care in the United States. I remember COBRA because I was about to leave my old job and start a new one. The HR folks asked me if I wanted "COBRA" coverage. I was young and didn't know much, so I said no.

Big mistake. For a year and a half, I couldn't find health insurance.

Now comes another weird acronym that employees are likely to have to learn -- VEBA.