Thursday, April 13, 2006

Doctors Rely on Spun Studies

A new study just out, published in the American Journal of Psychiatry shows that doctors prescribe less effective, more expensive medicines to treat common psychiatric illnesses.

Doctors base their decisions on studies paid for by the companies producing the drugs. When five drugs were tested against each other in various studies, the most effective drug was shown to be the one marketed by the company paying for the drug. Boy, am I ever surprised!

A more objective study, not funded by a drug company, found that two drugs that are least prescribed are actually the most effective for at elast one illness. These drugs, clozapine and perphenazine, are not under patent.

The five drugs studied are only worth around ten billion dollars, a tiny drop in the ocean of the nation's healthcare expense. What is not a drop in the bucket is that industry sponsored studies are used in many branches of medicine.

One can only hope the drive for evidence based treatment programs grows stronger. In the meantime, who can blame us for doubting we are actually getting the right medicine for our ailments?

Monday, April 10, 2006

Why the Massachusetts Plan is Doomed

Massachusetts, led by Republican governor Mitt Romney, recently adopted a form of universal healthcare. (If you haven't kept up on this story, read here, here and here.)

I applaud the impulse, but unfortunately the plan does not address the problems that are driving people out of the system. In fact, it appears likely the Massachusetts plan will quickly make matters worse for that state.

The plan requires every citizen to find and purchase health insurance for themselves and their familes. Residents who fail to comply will pay extra on thier income taxes, an amount estimated to be $1,000.00. Employers are required to provide health insurance or pay a fine of $295.00.

What the plan fails to recognize is that people respond to incentives. For most individuals and businesses, it will still be significantly cheaper to pay the added taxes than to enroll in health care plans.

So the effect is to pass a large tax increase under the guise of health insurance reform.

If the plan did work as intended, it could only drive up costs by increasing demand.

The real problems of the healthcare system, as both conservatives and liberals have noted, is that the current system is a misbegotton state supported olgiopoly with no cost controls. In a true free market, where people could become informed of the actual price of the goods and services they are shopping for, and actual competition was permitted, the plan might make sense.

Instead, I predict the state will see costs rising even faster than the current dizzying pace while state revenues lag far behind. I see large numbers of employers choosing to pay the fines that cost far less than insurance, thus driving more individuals into the market for indivual health insurance. Forced to pay 100% of the cost of their own insurance, these people will be looking to change the mess they've created.

I only hope this misbegotten plan does not yet again set back the cause of reform.

Sunday, April 09, 2006

Co-Pay Worries

I am very worried about someone & pray for her daily.

A very close friend of mine has been ill with cancer. She works as a secretary at a large federal agency. She has good health insurance; the government pays 60% of the premium costs.

She takes three treatments each week. The co-pay for each one is $40.00; weekly cost $120.00.

Her income as a secretary is modest. Until my family took her with us a few years ago, she and her son had never had a nice vacation. Money is a constant worry; she drives an old car and lives in a small house. $120.00 per week is a large sum to her, and much larger percentage of her income than it would be for most people.

I worry about her. I hope and pray she will keep up with her treatments. I hope she remains able to work.

We so need a national system to take care of people like her.