Weekend reading: Why a trip to the ER costs more than a college semester; Searching for the 'stomach share;' Lessons for the U.S. from Rwanda

Feb 21 2013

Every week Ankita Rao selects interesting reading from around the Web.

Time Magazine (special coverage): Bitter Pill: Why Medical Bills Are Killing Us
Routine Care, Unforgettable Bills .... Sean was allowed to see the doctor only after he advanced MD Anderson $7,500 from his credit card. ... The total cost, in advance, for Sean to get his treatment plan and initial doses of chemotherapy was $83,900. ... When we debate health care policy, we seem to jump right to the issue of who should pay the bills, blowing past what should be the first question: Why exactly are the bills so high? What are the reasons, good or bad, that cancer means a half-million- or million-dollar tab? ... What makes a single dose of even the most wonderful wonder drug cost thousands of dollars? Why does simple lab work done during a few days in a hospital cost more than a car? And what is so different about the medical ecosystem that causes technology advances to drive bills up instead of down? (Steven Brill, 2/20).

MedPage Today's KevinMD: The Transformation Of Health Care In The Information Age
Knowledge has been democratized: patients now commonly search for information from Dr. Google before they consult Dr. Welby. ... In the old days, the office visit (or the hospitalization) was the fleeting interlude during which the business of doctoring was conducted. Today, these face-to-face meetings are punctuation marks in a narrative arc that is no longer bound by physical proximity. Even with all these changes in the nature of the doctor-patient relationship, there may be none as transformative, and unsettling to physicians, as the fact that patients are increasingly learning about their doctors based on the doctors' online presence (Dr. Bob Wachter, 2/18).

The New York Times: The Extraordinary Science Of Addictive Junk Food
On the evening of April 8, 1999, a long line of Town Cars and taxis pulled up to the Minneapolis headquarters of Pillsbury and discharged 11 men who controlled America's largest food companies. Nestlé was in attendance, as were Kraft and Nabisco, General Mills and Procter & Gamble, Coca-Cola and Mars. Rivals any other day, the C.E.O.'s and company presidents had come together for a rare, private meeting. On the agenda was one item: the emerging obesity epidemic and how to deal with it. While the atmosphere was cordial, the men assembled were hardly friends. Their stature was defined by their skill in fighting one another for what they called "stomach share" -; the amount of digestive space that any one company's brand can grab from the competition (Michael Moss, 2/20).

Forbes: Employers Dropping Health Care Coverage Could Benefit Health Care Quality And Cost 
It is projected that a consequence of the coverage provisions implemented in 2014 will be for many companies to drop health care coverage for their employees. To date, the majority of research studies, modeling estimates and employer surveys have predicted some level of employer insurance drop. While this is usually framed as a negative consequence of the law, moving away from our employer system may actually have positive implications for the health care system and individuals. ... the transition is unlikely to be a smooth one in the coming years, but the benefits of changes in individual market insurance coverage could outweigh the unavoidable growing pains of the changing market (Nicole Fisher, 2/20).

The Atlantic: Rwanda's Historic Health Recovery: What The U.S. Might Learn
Since the genocide with which its name is still synonymous in the United States, Rwanda has doubled its life expectancy and now offers a replicable model for delivery of high quality health care with limited resources.  Dr. Paul Farmer, Chair of the Department of Global Health and Social Medicine at Harvard Medical School and co-founder of Partners In Health, says that, "Rwanda has shown on a national level that you can break the cycle of poverty and disease" (Neil Emery, 2/20).