Longer looks: The cost of dying; Insuring fertility

Jun 1 2012

Every week, KHN reporter Shefali S. Kulkarni selects interesting reading from around the Web.

Newsweek: Why Did Her Husband's End-Of-Life Care Cost So Much?
During those four days Terence had his blood drawn-;eight times. Urine collected at least twice. There was a CT scan of his chest and an MRI of his brain. A physical therapist dropped by several times. A nutritionist talked about cancer fatigue, decompensation, and calorie needs. Over the stay, at least 29 professionals-;nurses, physical therapists, a nutritionist, and nine M.D.s-;attended to his needs...But until years later, when I read Terence's medical records, I didn't realize that they had prodded and X-rayed and scanned and tested him even though they thought he was dying. Soon. The discharge record after his four-day stay expresses regret that they could offer no more than "comfort care." Thirty-three days and one more hospitalization later, on Dec. 14, 2007, Terence died...And why, if all they could offer was "comfort care," was the total bill for that penultimate four-day hospital stay $33,382. (Amanda Bennett, 5/28).

New York Times Magazine: Mommy Wars: The Prequel
[Ina May] Gaskin, who is 72, has the spry, almost Seussian presence of someone much younger. Her gray hair, trimmed since the days when she wore it in thigh-length braids, was loose and a bit wild, and she wore jeans, gardening shoes and a homemade jacket. Gaskin, a longtime critic of American maternity care, is perhaps the most prominent figure in the crusade to expand access to, and to legalize, midwife-assisted homebirth. Although she practices without a medical license, she is invited to speak at major teaching hospitals and conferences around the world and has been awarded an honorary doctorate from Thames Valley University in England. She is the only midwife to have an obstetric procedure named for her. The Gaskin Maneuver is used for shoulder dystocia, when a baby's head is born but her shoulders are stuck in the birth canal... In 2001 the American College of Obstetricians and Gynecologists (ACOG) recommended C-sections as the best route of delivery for breech babies. Although ACOG modified that view in 2006, more than 90 percent of breech babies are now born by Caesarean, and the Farm is one of a dwindling number of places in the United States where practitioners still know how to perform vaginal breech delivery (Samantha M. Shapiro, 5/23).

TIME Magazine: A New Website Encourages Egg-Freezing For Women
It's a dream on ice, one of 11 eggs that [Brigitte] Adams froze last year at the age of 38, with babies on the brain but Mr. Right nowhere in sight...But Adams was the only one to feel so alone and confused throughout the process that she started a website for wannabe moms like her. It's called Eggsurance, which is both appropriate and tongue-in-cheek because just as with insurance, women who freeze their eggs hope they'll never have to use them; they'd much prefer to meet a man and go about the business of procreating in the more traditional way. But if that never happens -; or if it does, and their natural egg supply is too old and finicky -; at least they've got a stash of frozen gametes at the ready (Bonnie Rochman, 5/30).

The Economist: UnObamacare
So the Utah Health Exchange is decidedly not Romneycare or Obamacare. But what is it? At first glimpse, it is a snazzy web portal where four of Utah's five largest health insurance companies offer about 140 plans to about 6,600 employees of 285 small businesses. Each employer determines in advance how much he will contribute to an employee's insurance, as in a defined-contribution pension plan. The employee then filters the plans and selects his favourite-;again, as he might choose mutual funds in his defined-contribution pension plan. As Patty Conner, the exchange's director, explains, this has advantages over traditional corporate health insurance. In the old system employers had no certainty about premiums, which often rise abruptly. And employees, offered little if any choice, often got stuck with inappropriate plans (5/26).

Salon.com: Listen Up, Doctors: Here's How To Talk To Your Patients
My doctor always walks into the exam room smiling. It's not necessarily the countenance you'd expect from a man who spends much of his time working with people with Stage 3 and Stage 4 cancers -; the kind that haven't responded to other forms of treatment...A natively cheerful demeanor isn't a requirement for being a competent healer. But what is far too often lost in our grueling, impersonal and cost-driven healthcare system is the basic fact that a human being in the chaotic and scary world of injury or illness deserves sensitivity and compassion. That a shivering person in a paper dress deserves dignity. So if you're a doctor, nurse or technician, here's your reminder. And if you've ever been a patient, we'd love to read your own additions to the list (Mary Elizabeth Williams, 5/23).