I was asked by a friend to look at this article in the New York Times today. The article is based in the study that was published in the journal Science. The full article is not available for review (you need to pony up some money in order to read the whole article). The following is the abstract to the article:
In 2008, Oregon initiated a limited expansion of a Medicaid program for uninsured, low-income adults, drawing names from a waiting list by lottery. This lottery created a rare opportunity to study the effects of Medicaid coverage using a randomized controlled design. Using the randomization provided by the lottery and emergency-department records from Portland-area hospitals, we study the emergency-department use of about 25,000 lottery participants over approximately 18 months after the lottery. We find that Medicaid coverage significantly increases overall emergency use by 0.41 visits per person, or 40 percent relative to an average of 1.02 visits per person in the control group. We find increases in emergency-department visits across a broad range of types of visits, conditions, and subgroups, including increases in visits for conditions that may be most readily treatable in primary care settings.
I’m not sure what to make of this. First, it is odd that you have a medical article that is NOT published in a medical journal. This makes you wonder. Was this article rejected from a medical journal? Did the authors believe that their information needed to get out to a wider audience and therefore they bypassed the regular medical or epidemiological journals? According to the abstract it’s hard to make any hard conclusions. There are no hard numbers in the abstract. I would like to see if the increased emergency room visits were statistically significant. Let’s go with the authors conclusions. Continue reading
I would like to wish you and yours a very healthy, prosperous, blessed Happy New Year!!
Jahi McMath. Sigh. It has been eight years since we have had an opportunity, as a nation, to discuss death and dying. Terri Schiavo provided us the last opportunity. We fumbled the ball and never got into the discussion. Now, we have Jahi McMath. First, let’s understand that this is a tragedy of epic proportions. A 14-year-old, previously healthy teenager should not go into the hospital for a routine operation and end up brain-dead. This should never happen. Secondly, in the United States since the late 1950s brain death has equaled death. Brain death is an irreversible condition. In the condition of brain death, the patient has lost all measurable brain function. This means that not only is there no evidence of higher brain function like thought and following commands, but neither is there evidence of lower brain function, which would include pupillary response, spontaneous breathing and other brain reflexes. There is no hope, with current medical technology, to reverse this syndrome. Because Jahi McMath was previously healthy and also extremely young, her heart is able to pump blood through her body without the assistance of her brain. The heart is on autopilot. Unfortunately, this is the state that in which she has been since December 12. Currently, the family is looking for facilities that will “take care of” their daughter. To what end? The harsh reality is that their daughter is gone. Unless we, the medical community, can come up with some way to regenerate dead brain cells or to transplant a brain, their daughter is not coming back. This is an extremely sad case. I hope and pray that the family and parents of Jahi McMath find peace and understanding. I’ll have more to say on this later. Continue reading
Over the last several years, more and more evidence suggests that vitamin supplements are a waste of money. Today another study has come out saying the same thing. Vitamins don’t appear to be harmful. They just don’t seem to be helpful. This shouldn’t be a surprise. We eat plenty well in our society. Many of our foods are enriched with vitamins. My recommendation? Unless there is something special going on in your life, like training for the Olympics, or you have had gastric bypass surgery, you probably don’t need supplemental vitamins.
I’m still kind of shocked that we got a budget deal done in a normal way. The House and Senate sat down and figured out what they could agree on and passed that. Compromise. Who would have thought? The budget deal just passed the Senate. It should go to the president, who thanked Congress, later on this week. I think that the GOP was weakened by the government shutdown. This is why they decided not to go down Crazy Avenue yet again.
Speaking of crazy, let’s talk about John McCain. In 2000, I was really looking at John McCain seriously. I thought that he made a ton of sense. I thought that he was on the right track. That was a long time ago. He took an unknown governor and threw her onto the national stage. She wasn’t ready. He stopped his campaign in order to come to Washington and do, really, nothing. So, now, three years after ObamaCare became law, Senator John McCain has an idea of how to fix Healthcare. Now, remember that John McCain had an idea of how to fix immigration. When he was running for president he ran away from his own bill.
Because I’m on the topic of crazy, you really can’t say “crazy” without mentioning Rick Santorum. He is all sorts of crazy - “If we have a system where the government is going to be the principal provider of health care for the country, we’re done. Because then, you are dependent on the government for your life and your health… When Thatcher ran for prime minister she said—remember this, this is the Iron Lady—she said, ‘The British national health care system is safe in my hands.’ She wasn’t going to take on health care, because she knew once you have people getting free health care from the government, you can’t take it away from them. And the reason is because most people don’t get sick, and so free health care is just that, free health care, until you get sick. Then, if you get sick and you don’t get health care, you die and you don’t vote. It’s actually a pretty clever system. Take care of the people who can vote and people who can’t vote, get rid of them as quickly as possible by not giving them care so they can’t vote against you. That’s how it works.”