Can physicians really urge you, cajole you or nudge you to eat a healthier diet? That is the premise of a new study published in the journal, Circulation: Cardiovascular Quality and Outcomes. Eight weeks ago I blogged about whether doctors should counsel their patients on what they eat. My opinion is that nutrition counseling is a good idea,…
Author: Devon Herrick
Dialysis Should be Patient Centered and More Convenient
End State Renal Disease (ESRD) is the only disease condition that is covered by Medicare regardless of patients’ age. This benefit was passed in 1972. One result of Section 299I of Public Law 92-603 is that Medicare pays for two-third of dialysis patients, down from 87% in 2004. When your kidney function falls by 85% to 90% your kidneys can no longer keep you alive. According to the National Kidney Foundation, the average life expectancy on dialysis is 5 to 10 years, but many people live much longer when their dialysis is tailored to their needs. This often does not happen due to the United States’ mostly one-size-fits-all approach to dialysis, which is not ideal.
How Much Charity Care Should Nonprofit Hospitals Provide?
I began my career in health care working as an accountant for a nonprofit hospital. One of our senior finance executives did a case study of how much the heath care system saved compared to a for-profit system that had to pay taxes. I don’t recall all the details, but it was in the neighborhood of $100 million dollars in 1990. About that same time the accounting managers were told we could no longer write off bad debts to charity care. Charity care had to be granted to deserving patients; we weren’t allowed to decide after not getting paid that care must have been charity.
Universal Coverage Will Not Cure Health Inequity
The United States spends about twice as much per capita on health care as other high-income countries. Yet our health outcomes are not as good, on average. It’s not that all Americans are in poor health, it’s that some Americans are in poor health and pulling down the average. As I’ve said before, health is correlated with wealth and education. Wealthier is healthier.