TGIF: How To Write A Scientific Paper

The purpose of science is to get paid for doing fun stuff (Schulman et al. 1991). Nominally, science involves discovering something new about the Universe, but this isn't really necessary. What is really necessary is a grant. In order to obtain a grant, your application must state that the research will discover something incredibly fundamental. The grant agency must also believe that you are the best person to do this particular research, so you should cite yourself both early (Schulman 1994) and often (Schulman et al. 1993c). Feel free to cite other papers as well (e.g., Blakeslee et al. 1993; Levine et al. 1993), so long as you are on the author list.
Once you get the grant, your university, company, or government agency will immediately take 30 to 70% of it so that they can heat the building, pay for Internet connections, and purchase large yachts.

While I wouldn't follow these directions to the letter, among the tongue in cheek, there is some truth here.

More.

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Mumps Outbreak

From Chicago Tribune:

The mumps outbreak that has spread from Iowa to infect 72 people in Illinois amounts to a rare encore appearance of a disease that once was an ever-present fixture of childhood.

The latest outbreak is tiny compared with other illnesses that still cause widespread problems, such as influenza or strep infections. Yet experts say the local bump in mumps cases is a reminder of the risks that remain even from a virus that has been largely eliminated from this country.

One downside to the near-universal vaccination against childhood afflictions such as mumps and chickenpox is that the diseases can strike with more force when people contract them as adults. Most of the recent patients in Iowa and Illinois have been college age or older. Though mumps rarely causes serious medical problems, young men who contract the disease can have fertility problems later.

I heard about the mumps outbreak last week, and couldn't believe it. When was the last time anyone saw this disease? This was something we learned about in medical along with smallpox, but never treated anyone with it.

Head on over to here for a brush up on this reemerging disease.

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Overpriced Medical Bills

From the Med Bill Advisor Blog:

American hospitals are fleecing patients out of billions of dollars annually, and experts say that while some of the overcharges are honest errors, many are deliberate.

That’s because hospital bills are next to impossible for consumers to understand, which means hospitals can hide improper charges behind mysterious medical terminology and baffling codes.

That’s what Nora Johnson found when her 56-year-old husband, Bill, underwent hip-replacement surgery in 1999. The cost of the operation was $25,000.

Knowing that her family would have to pay a percentage of the costs, she requested an itemized bill.

$129 for a box of tissues
“What I got was five feet of single-spaced names and codes,” recalls Johnson. Written in “hospital-speak,” some of it made sense, she says, while some of it was absurd. “Like the charge for newborn blood tests and a crib mobile. That stopped me in my tracks,” recalls Johnson. “As far as I know, my husband never had a baby.”

Johnson, from Caldwell, W.Va., was so shocked by the overcharges she became a trained medical billing advocate. Today, she audits hospital bills for consumers and for state employees in West Virginia.

“More than 90% of the hospital bills I’ve audited have gross overcharges,” says Johnson.

Estimates on hospital overcharges run up to $10 billion a year, with an average of $1,300 per hospital stay. Other experts say overcharges make up approximately 5% of hospital bills.

It's articles like this that make the public think that the doctors are getting rich off of this. We doctors know that this benefits the hospitals financially. However, this is a rip off to the public, and while the hospital is collecting over $100 for a box of tissues, we can't even get the $500 for an appendectomy that we got out of bed a 2AM to do! Where will this all end?

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TGIF

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Taxachusetts

From the Kansas City Star:

Amid rising health-care costs and growing legions of uninsured, Kansans and Missourians are looking to Massachusetts.

The Bay State’s Legislature on Tuesday passed a groundbreaking bill to provide nearly universal health-care coverage. The bill, which Republican Gov. Mitt Romney says he will sign, requires all Massachusetts residents to obtain health insurance.

People who can afford private insurance will incur financial penalties if they do not buy coverage. Government subsidies to private insurers will enable more of the working poor to buy insurance and will make more children eligible for free coverage. Businesses with more than 10 employees that don’t provide coverage will get hit with fees of up to $295 per employee per year.

The program will cost more than $1 billion a year, though much of that money will come from shifting existing funds. Massachusetts will provide $125 million in new money, mostly to help pay for health insurance for lower-income residents. The rest could come from existing programs and the penalties paid by businesses and individuals who don’t follow the law’s mandates.

The bill, the first of its kind in the nation, is poised to take effect as America grapples with the problems of 45 million uninsured individuals. Health experts say that the lack of health insurance frequently leads to illness and premature death, and that the health-care costs of the uninsured get shifted to those who have insurance.

As a physician, and an individual who had no employer provided health insurance for several years, I am divided on this issue. While I don't think that "bigger government" is ever the solution, clearly the current system is broken, and needs improvement.

As a nation, we probably can't afford a true universal health care system. However, we have the money as a society for indigent care, often provided in our Emergency Departments. Just the other night, the ED physician was complaining to me at 2 AM as to why he was seeing a child with an ear infection. That child would clearly be better served in a pediatrician's office during the daylight hours. After all, that one visit to the ED probably could pay for a years worth of visits to the ED.

I give credit to Massachsetts for grappling with the problem, and trying to urge all to get health insurance. They are continuing with an employer based model, that has served the needs of many, but clearly not all.

However, if an employer chooses not to provide insurance, they pay a $295 fine...annually per employee. In the current marketplace, one month's insurance will cost more than that, so this is not much of a fine at all. There is also talk of eliminating the fine altogether.

Also, if an individual chooses not to get health insurance, they pay extra state taxes. Isn't this going to place an unfair burden on the already cash strapped poorest of the state?

In my opinion, this is too radical a step for the nation's uninsured. Some might see it as a way for a state to collect more taxes under the guise of providing universal healthcare. I would like to see as a first step, a way that families, that are not otherwise eligible, be able to "buy in" to Medicare. Also, employers that have someone working for them need to provide insurance for them, and not redefine them as per diem, or consultants for the sake of not providing benefits.

If Massachsetts real goal was to bring the issue of affordable health care for the uninsured to the national table for debate, they clearly have succeeded. In the meantime, we'll all have to see how this plays out, and it's not clear how many folks will be helped. Don't think for a minute that now everyone in the state will be automatically covered.

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