I recently produced a film, called "Money-Driven Medicine," based on the book of the same name by Maggie Mahar, which looks at the way that our business model for medicine has badly damaged the patient doctor relationship.
"What's that?" you may say. I thought that it was those damn government bureaucrats that were trying to get in between me and my doctor.
Well, the director of this film, Andy Fredericks, followed doctors all over the country who are deeply frustrated that the current system, whose goals favor profits over good, efficient and humane health care. In one scene, for example, a hospital refuses to share a possibly life-saving protocol with another hospital for fear it would lose its "competitive advantage." In many other sequences, doctors complain that, in the current system, they are forced to embrace wasteful and expensive (and extremely profitable) procedures while patients wonder why it is that they can quickly get expensive tests - like MRIs - but have to wait weeks to see primary care physicians (who are the most in demand) because so few doctors can afford to become general practitioners.
"Money-Driven Medicine" explores how a profit-driven health care system squanders billions of health care dollars, while exposing millions of patients to unnecessary or redundant tests, unproven, sometimes unwanted procedures, and over-priced drugs and devices that, too often are no better than the less expensive products that they have replaced.
More than two decades of research done by the Dartmouth Institute for Health Policy and Clinical Practice reveals that one out of three roughly one-third of our health care dollars - or nearly $600 900 billion of the $1.7 $2.6 trillion that we spend annually - is wasted on products and procedures that provide no benefit to the patient.
"But this isn't just a waste of money. This is hazardous waste - waste that is hazardous to our health," says Mahar, a healthcare fellow at the Century Foundation where she writes the healthbeat blog.
"When a patient is subjected to an ineffective treatment he is, by definition exposed to risk without benefit. We need to squeeze this waste out of the system. If we do, we have enough money to provide high quality, affordable and sustainable care for everyone."
Here's a clip from the film, in which Dr. Don Berwick, warns about the dangers of an unregulated competitive "war," in which, too often, the patient is "collateral damage."
In the days ahead, as insurance companies and pharmaceutical firms try to prevent any "government interference" in health care, it will be important to remember, that the goal of our health care system is not to reward providers; it is to deliver the best and most cost-effective health care to patients. Assuming that profit-oriented corporations always have patients' best interests at heart could be a fatal mistake.
Inside ABC’s tonally bizarro update of the seminal 1987 romantic drama Dirty Dancing are about four different projects trying to get out. There’s the most obvious one, a frame-by-frame remake of the original that’s as awkward and ill-conceived as Gus Van Sant’s 1997 carbon copy of Psycho. There’s the one Abigail Breslin’s starring in, an emotionally textured and realistic coming-of-age story about a clumsy but engaging wallflower. There’s a musical, in which Breslin and Nicole Scherzinger mime along to their own singing voices in a strange dance rehearsal while half-heartedly exploring the idea that power emanates from the vagina. And there’s the most compelling story, a Wide Sargasso Sea-inspired spinoff starring Debra Messing as a lonely housewife coming to terms with the turbulent depths of her own desire.
The condition has long been considered untreatable. Experts can spot it in a child as young as 3 or 4. But a new clinical approach offers hope.
This is a good day, Samantha tells me: 10 on a scale of 10. We’re sitting in a conference room at the San Marcos Treatment Center, just south of Austin, Texas, a space that has witnessed countless difficult conversations between troubled children, their worried parents, and clinical therapists. But today promises unalloyed joy. Samantha’s mother is visiting from Idaho, as she does every six weeks, which means lunch off campus and an excursion to Target. The girl needs supplies: new jeans, yoga pants, nail polish.
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At 11, Samantha is just over 5 feet tall and has wavy black hair and a steady gaze. She flashes a smile when I ask about her favorite subject (history), and grimaces when I ask about her least favorite (math). She seems poised and cheerful, a normal preteen. But when we steer into uncomfortable territory—the events that led her to this juvenile-treatment facility nearly 2,000 miles from her family—Samantha hesitates and looks down at her hands. “I wanted the whole world to myself,” she says. “So I made a whole entire book about how to hurt people.”
She lived with us for 56 years. She raised me and my siblings without pay. I was 11, a typical American kid, before I realized who she was.
The ashes filled a black plastic box about the size of a toaster. It weighed three and a half pounds. I put it in a canvas tote bag and packed it in my suitcase this past July for the transpacific flight to Manila. From there I would travel by car to a rural village. When I arrived, I would hand over all that was left of the woman who had spent 56 years as a slave in my family’s household.
The president’s business tells lawmakers it is too difficult to track all its foreign revenue in accordance with constitutional requirements, and it hasn’t asked Congress for a permission slip.
Days before taking office, Donald Trump said his company would donate all profits from foreign governments to the U.S. Treasury, part of an effort to avoid even the appearance of a conflict with the Constitution’s emoluments clause.
Now, however, the Trump Organization is telling Congress that determining exactly how much of its profits come from foreign governments is simply more trouble than it’s worth.
In response to a document request from the House Oversight Committee, Trump’s company sent a copy of an eight-page pamphlet detailing how it plans to track payments it receives from foreign governments at the firm’s many hotels, golf courses, and restaurants across the globe. But while the Trump Organization said it would set aside all money it collects from customers that identify themselves as representing a foreign government, it would not undertake a more intensive effort to determine if a payment would violate the Constitution’s prohibition on public office holders accepting an “emolument” from a foreign state.
A recent push for diversity has been blamed for weak print sales, but the company’s decades-old business practices are the true culprit.
Marvel Comics has been having a rough time lately. Readers and critics met last year’s Civil War 2—a blockbuster crossover event (and aspiritual tie-in to the year’s big Marvel movie)—with disinterest and scorn. Two years of plummeting print comics sales culminated in a February during which only one series managed to sell over 50,000 copies. Three crossover events designed to pump up excitement came and went with little fanfare, while the lead-up to 2017’s blockbuster crossover Secret Empire—where a fascist Captain America subverts and conquers the United States—sparked such a negative response that the company later put out a statement imploring readers to buy the whole thing before judging it. On March 30, a battered Marvel decided to try and get to the bottom of the problem with a retailer summit—and promptly stuck its foot in its mouth.
For a number of reasons, natural and human, people have abandoned many places around the world.
For a number of reasons, natural and human, people have evacuated or otherwise abandoned many places around the world—large and small, old and new. Gathering images of deserted areas into a single photo essay, one can get a sense of what the world might look like if humans were to suddenly vanish from the planet. Collected here are recent scenes from abandoned construction projects, industrial disaster zones, blighted urban neighborhoods, towns where residents left to escape violence or natural disasters, derelict Olympic venues, ghost towns, and more.
The Islamic State is no mere collection of psychopaths. It is a religious group with carefully considered beliefs, among them that it is a key agent of the coming apocalypse. Here’s what that means for its strategy—and for how to stop it.
What is the Islamic State?
Where did it come from, and what are its intentions? The simplicity of these questions can be deceiving, and few Western leaders seem to know the answers. In December, The New York Times published confidential comments by Major General Michael K. Nagata, the Special Operations commander for the United States in the Middle East, admitting that he had hardly begun figuring out the Islamic State’s appeal. “We have not defeated the idea,” he said. “We do not even understand the idea.” In the past year, President Obama has referred to the Islamic State, variously, as “not Islamic” and as al-Qaeda’s “jayvee team,” statements that reflected confusion about the group, and may have contributed to significant strategic errors.
The story of a decades-long lead-poisoning lawsuit in New Orleans illustrates how the toxin destroys black families and communities alike.
Casey Billieson was fighting against the world.
Hers was a charge carried by many mothers: moving mountains to make the best future for her two sons. But the mountains she faced were taller than most. To start, she had to raise her boys in the Lafitte housing projects in Treme, near the epicenter of a crime wave in New Orleans. In the spring of 1994, like mothers in violent cities the world over, Billieson anticipated the bloom in murders the thaw would bring. Fueled by the drug trade and a rising scourge of police corruption and brutality, violence rose to unseen levels that year, and the city’s murder rate surged to the highest in the country.
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People with preexisting conditions could face sharply higher costs in some states if the legislation was enacted, the Congressional Budget Office reported Wednesday.
The House-passed Republican health-care bill would leave 23 million more people uninsured over a decade and could dramatically increase costs for people with preexisting conditions in many states, the Congressional Budget Office projected in a highly-anticipated analysis released Wednesday afternoon.