Here’s a rather prophetic story I wrote for the Fall 2004 issue of the Harvard Public Health Review. It outlines health reform principles discussed in Getting Health Reform Right: A Guide to Improving Performance and Equity, a book written by four Harvard professors, presumably for developing nations. But, maybe not.

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Four HSPH experts highlight the importance of social values, politics, organization, and economic considerations to health system reform in a new book, Getting Health Reform Right: A Guide to Improving Performance and Equity. Published by Oxford University Press, the uniquely multidisciplinary "repair manual" takes reformers step by step through the complexities of patching up and replacing broken systems.

"The world is littered with failed reform efforts," observes Marc J. Roberts, one of the quartet and a professor of political economy and health policy. But given the enormous needs, notes his colleague, Peter Berman, professor of population and international health economics, "We have no choice but to do better."

Despite what the United States spends to stay healthy--about $1.5 trillion a year, more than any other nation--this country ranked 37th among Western nations in one 2000 World Health Organization report that factored in quality and disparities in care among the insured and uninsured. When you consider that 2.8 billion people--more than half the population of all developing countries--live on less than $2 a day, you get an inkling of how little people in, say, Tanzania or Honduras have to spend on medical care, let alone prevention. If a wealthy, stable country like the U.S. can't provide good health services to all its citizens, what can resource-poor countries hope to accomplish?

See Getting Health Reform Right for the complete story. 

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I don't think we can ignore the 800-pound gorilla in the room any longer. 

It's time to weigh in on the topic of the moment, health care reform. Over the next few days, I will be posting my own thoughts, as well as yours and those of other bloggers. 

Be sure to click on Comments, to add your thoughts.

The above poster came from One Good Move, a very interesting site:
http://onegoodmove.org/movabletype/mt-search.cgi?blog_id=1&tag=healthcare&limit=20
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Got brain? 05/22/2009
 

Don't miss "At Card Table, Clues to a Lucid Old Age"in today's New York Times:  http://www.nytimes.com/2009/05/22/health/research/22brain.html?_r=1&hp


The story reveals new information from research on 90-somethings, especially those who have no signs of dementia. Of course, we'll all be in that pool, right?

Two factors keep showing up as important, if you want to keep those brain cells accessible. One is regular social interaction with friends or family, and the other is the use of grey matter. Wonder if today's young seniors, like us, will benefit from the use of the Internet, which provides both mental stimulation and a virtual social life? Would make an interesting doctoral dissertation, but the candidate might have to wait 20-30 years for the degree.   

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Here's an interesting story in today's Washington Post, about a long-term study of hundreds of people, and how they age. 

Excerpts from: Body of Evidence, by Lori Aratani, Washington Post Staff Writer, The Washington Post, Tuesday, May 19, 2009


Every year hundreds of people travel to Baltimore for an unusual purpose. They are not here to tour the city's aquarium or sample its fabled blue crabs. They are not in search of fame or money. Other than free lodging, they receive nothing in exchange for their visit, which entails a certain amount of discomfort.

No, these folks, some of whom have made this journey for decades, believe the trip is worth their time and expense because how they live -- calculated according to everything from the strength of their grip to how many apples they consume in a month -- may offer clues to how the rest of us might live better, longer, healthier lives.

These individuals -- homemakers, retirees, doctors and myriad others -- are participants in the Baltimore Longitudinal Study of Aging (BLSA), the country's longest-running study of aging.

Since 1958, a total of more than 1,400 volunteers have agreed to regularly undergo in-depth physicals and memory and other screenings conducted by the study's physicians. The resulting data span more than half a century and are a gold mine for researchers interested in the aging process.
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This is no vacation. During their stay, participants will have a physical that goes well beyond sticking their tongues out and saying "ahhhhh." They rarely will sit for more than 30 minutes before they are whisked away for another exam or stuck with another needle. Sprott, now in his 12th year in the study, confirms that the pace can be brutal.

Researchers take routine measures (temperature, blood pressure and weight), but participants also undergo more sophisticated tests. Echocardiograms help researchers examine hearts, and spirometry tests measure lung function. In addition to collecting blood and urine, researchers might also take samples of the participants' breath.

Even simple tests can provide valuable insight. Researchers will evaluate a participant's grip strength, which previous BLSA research has shown can predict whether someone might be at higher risk of complications after surgery or more likely to die prematurely.

Please go to this url for the complete story----http://www.washingtonpost.com/wp-dyn/content/article/2009/05/18/AR2009051802245.html?hpid=sec-health

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I've never trusted ophthalmologists who don't wear glasses, or dentists with perfect teeth. 

I mean, how can someone with perfect vision understand what it's like to be nearsighted? And, how do you describe a toothache to someone who’s never had a cavity? 

When Dartmouth Medicine Magazine offered me a chance to interview doctors who had been severely injured or sicker than many of their patients, I jumped at the chance. It’s no exaggeration to say that the resulting story changed my life. I met some of the most amazing people, and will never again assume a doctor doesn’t understand my pain, or fear, or embarrassment.

See what you think:

The nightmare runs like this: One minute you're schussing down a black-diamond ski trail, and the next you can't feel anything south of your neck. Or one minute you're stepping out of the shower to get ready for a big date, and the next, as you glance at yourself in the mirror, you gasp. What is that lump?

Every day, physicians see patients who have actually lived bad dreams like these. That's their job. But what happens when a physician experiences the nightmare?

For the full story, go to http://dartmed.dartmouth.edu/spring07/html/stethoscope.php
 



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