[Reblog] My talk to Knight Science Journalism Fellowships at MIT Medical Evidence Boot Camp 2013

From the 8 December 2013 post at HealthNewsReview.org

Last week in Cambridge, I spoke again (5th time?) at this event.  Always an honor.   Always a smart audience.

Thanks to Phil Hilts for the invitation and the opportunity to share our work with a new group of journalists.

Here are my slides.

Some excerpts

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[Reblogged Infographic] What Physicians Say About Patient’s Internet Research

From the 8 December 2013 Medvizor article

 

 

Read the accompanying post here

 

 

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[Reblog] The Really Bad Math Behind the Social Security Cuts

As a volunteer Area Office on Aging counselor, I  help folks apply for Extra Help with their prescription drugs and a state program for Medicare Part B financial assistance.  In the past year I have been astounded at the prescription drug costs for quite a  few clients, as well as saddened by those who are falling through the cracks. Have heard folks tell me how they are choosing between eating well and buying prescribed drugs.

This blog item covers what I have heard first hand, and more

From the 8 December 2013 item at The Health Care Blog

Among the sacrifices Congressional representatives placed on the altar of deficit negotiations is an “inflation adjustment” that will shave “only” a few hundred dollars from an average, newly retired Social Security beneficiary’s income each year. But the cruel hoax is that the reduction will amount to as much as $1600 when the beneficiary is older, poorer, and sicker.  Many seniors already have a tough time paying for food, rent, and medical care.

Even worse,  reductions in beneficiaries’ incomes may well cost government more for potentially preventable hospital and long-term care.  Senator Elizabeth Warren and other New England lawmakers should be lauded for splitting from Democratic representatives and the Administration regarding this ill-conceived proposal.

Many senior citizens are already vulnerable to economic hardship.  A recent US Census analysis that counts rising medical expenses found that over 1 in 6 elderly people live in poverty, unable to meet basic living expenses, and almost 20% more are living just above the poverty line. Social Security is the only or largest source of income for about 70% of seniors; the average monthly check is only about $1200.

The typical retirement savings of seniors is a paltry $50,000 — barely enough to get through several years’ living expenses, let alone 20-30 years of retirement.  This is not the result of cavalier actions by the older generation; these are the Americans whose home values have plummeted, whose defined-benefit pension plans have been decimated or disappeared, and whose retirement accounts were eviscerated by the Wall Street meltdown of the last decade. Yet the current proposal punishes these Americans as if they were at fault for their poverty.

…

What are the consequences of having to rely on Social Security alone?  High out-of-pocket health care costs can be “catastrophic” because they cause people to go without essential medical care. Our studies published in the New England Journal of Medicine show that a 50% reduction in drug benefits in New Hampshire for low income, chronically ill seniors backfired.

The NH policy reduced the use of essential medicines (e.g., for diabetes and heart disease), worsened chronic illness, increased acute care, and doubled the rate of permanent institutionalization in expensive nursing homes. These increased admissions raised government costs several times more than the drug “savings,” not even counting increased pain and suffering of patients and their families.

Dr. Nicole Lurie, the current US Assistant Secretary for Preparedness and Response, showed that about 15% of people (many seniors) who are admitted to hospital emergency departments experience significant hunger before admission.  Frequently, seniors skimp on medicines to pay for food, and this leads to illness and further hospital care.

Similarly, our studies show that almost 30% of disabled Medicare recipients in poor health skip or split pills to make them last longer because they can’t afford their prescription drugs, even in the era of the Part D drug benefit. One study indicates that splitting pills increases hospitalization of heart disease patients by 21%.

The current debate in Washington encapsulates the growing political and ideological divide as to how the costs of deficit reduction should be allocated across various parts of the population.  No single proposal more starkly embodies that issue than efforts to trim and chip away from recipients of an earned, contributory entitlement at precisely that time in their lives when they can least afford reduced incomes, and have the least capacity to compensate for them.

Read the entire blog item here

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