Longer Looks: Parting Wisdom; Organ Donors; Fixing Medicare
Each week, KHN's Shefali Luthra finds interesting reads from around the Web.
The Washington Post:
Before I Go: A Stanford Neurosurgeon’s Parting Wisdom About Life And Time
In residency, there’s a saying: The days are long, but the years are short. In neurosurgical training, the day usually began a little before 6 a.m., and lasted until the operating was done, which depended, in part, on how quick you were in the OR. ... But the years did, as promised, fly by. Six years passed in a flash, but then, heading into chief residency, I developed a classic constellation of symptoms — weight loss, fevers, night sweats, unremitting back pain, cough — indicating a diagnosis quickly confirmed: metastatic lung cancer. The gears of time ground down. While able to limp through the end of residency on treatment, I relapsed, underwent chemo and endured a prolonged hospitalization. (Paul Kalanithi, 3/12)
As They Lay Dying
As doctors, we have sworn to do no harm. And yet, every Wednesday and Thursday morning, we remove kidneys from living donors. These patients are not getting any medical benefit from donating one of their kidneys—to the contrary, they are accepting a small risk of complications, including hypertension and a slightly increased likelihood that their remaining kidney will fail. But they do experience a very real, if intangible, benefit: the experience of saving someone’s life. (Joshua Mezrich and Joseph Scalea, 3/16)
The Wall Street Journal:
Warning Prompts Shift In Surgeries On Women
Gynecologists in the U.S. have changed the way they perform hysterectomies now that they no longer can readily use a popular medical device that was found to spread hidden cancers in some women, according to doctors, hospitals and a new study. While some surgeons remain dismayed about new limits imposed on the tool, called a laparoscopic power morcellator, concerns that its loss would lead to major problems or a dramatic shift to open surgery don’t appear to have materialized. Instead, doctors say they have turned to alternatives for one of the most common operations performed on American women. (Jennifer Levitz, 3/16)
Pelosi, Boehner Have A Plan To Fix Medicare Doctor Payments. That’s A Big Deal.
Last week, House Speaker John Boehner (R-OH) and Minority Leader Nancy Pelosi (D-CA) started having serious discussions about getting rid of the Medicare funding formula everyone hates. What's new in the Pelosi-Boehner negotiations is that they're actually starting to talk about how they would pay for a solution — a discussion insiders think shows that, just maybe, the doc fix might be about to get fixed. (Sarah Kliff, 3/17)
Why Medicare Will Always Need Fixing
Over the last 14 years, Medicare’s Sustainable Growth Rate formula—the SGR, which was passed in 1997 as a way to keep Medicare spending growing in line with the economy—has scheduled deep cuts to physician reimbursements on 17 different occasions. On each of those occasions, Congress has avoided the cuts by passing a patch .... The wrinkle here is that although the SGR cuts never happened as required by law, the doc fixes were almost always paid for with offsets—meaning that something else in the budget was cut to pay for the patch. According to the Committee for a Responsible Budget, this has resulted in a savings of about $165 billion so far, although most supporters will concede that some of these offsets were gimmicks, not real savings. Still, not all of the offsets have been budget tricks .... So here’s the dilemma, and the debate: Accept a hit to the deficit up front in exchange for a small but real long-term reform to Medicare—or reject the deal unless it can be fully paid for within the 10-year budget window? Keep a frustrating but somewhat effective tool for restraining Medicare spending—or ditch it in favor of a small but real long-term structural reform? (Peter Suderman, 3/16)
Is It Fair To Ask The Internet To Pay Your Hospital Bill?
Sites like YouCaring, GoFundMe, and Indiegogo Life cumulatively host thousands of pages set up by people looking for help with medical expenses, from cancer treatment to in-vitro fertilization (IVF). These crowdfunding pages are a place for family and friends to help out and receive updates on the status of a loved one’s health—but they’re also a place where strangers can log on and make a donation to someone they’ve never met before. (Cari Romm, 3/12)