"So basically,when it comes to saving lives, docs are three times more likely to recommend a screening test based on irrelevant data than they are to recommend it based on relevant data. I’m bracing myself for the hate mail, but this is part of the reason why I’m skeptical that just providing docs with more evidence will change the way they practice. Most docs just aren’t trained to understand this stuff."

"In short, arguments favouring private over public provision are not just theoretically flawed, but typically favour the few at the expense of the many. The pendulum has swung too far to the right: it's time to stand up for public provision."

"The other key thing to pay attention to is who this marketing campaign was targeted at: key decisionmakers at providers and insurance companies. Those are the people who decide whether medical procedures get ordered. It’s not patients. Patients aren’t going to experience a loss of freedom or satisfaction because an expert reviewer at the Independant Payment Advisory Board makes the call as to whether a procedure is medically beneficial, rather than the corresponding bureaucrat at their insurance provider or at the for-profit clinic they’re attending."

"These results are encouraging and suggest that random, short duration physical activity, which may be more feasible and enjoyable for inactive individuals attempting to engage in physical activity for health benefit, is indeed beneficial."

"I think there's at least one more possibility:

3. Sodium's isn't a causal agent of disease but instead given that processed foods are phenomenally high in sodium, is a useful biomarker for the degree of processed foods a person's consuming, and that it's the huge volumes of sugar and pulverized flour (that's more often than not packaged with gobs of sodium) that's actually causal for cardiovascular disease and death."

"…But this is America. If you want to have the procedure, so be it. You get to choose. That’s the way we roll.

My question is, did your doctor recommend it? Did your doctor tell you about this study? Do you think that those who recommend and perform this procedure don’t know about this study, and that if only they had this evidence they’d stop?

Or, do you think physicians are influenced by biases and their personal beliefs? Me? I think they’re human."

"In our final video from the last Bay Area Quantifed Self Show&Tell meetup, here is Dan Brown explaining the microphone he embedded into an air mattress under his bed to track motion, snoring, and heartrate during sleep. He describes how he assembled his invention, the tools he used for analyzing his data, and why he had to stop the tracking experiment."

"Hospital-based chaplains and pastoral counselors come up against a fairly brutal form of scientism all the time. In many health care institutions, these people are barely tolerated. They are pointedly not invited to participate in rounds or in patient evaluation sessions. I recall how, as a first-year seminary student doing what is called “supervised ministry” at a New Haven mental health hospital, I was somewhat shocked to see how patients’ behavior was interpreted purely in terms of reactions to their medications, whereas I could see plainly that many of these same patients were responding to the presence or absence of human connection—visits and phone calls from loved ones either made or not made, friendships with other patients either formed or broken."

"More than 90 percent of insurance markets in more than 300 metropolitan areas are “highly concentrated,” as defined by the Federal Trade Commission, according to the American Medical Association. A 2008 survey by the Government Accountability Office found the five largest providers of small group insurance controlled 75 percent or more of the market in 34 states, and 90 percent or more in 23 of those states, a significant increase in concentration since the G.A.O.’s 2002 survey."

"Looking at these, you would hope to achieve a low lefthand starting point (low cost), a high righthand point (high longevity), and a thick line (lots of doctor visits.)

The USA line looks like it was drawn by someone who got the instructions backwards -- a very high lefthand starting point (huge cost), a mediocre righthand point (middlin' longevity), and a hairlike line thickness (scanty doctor visits, less than 4 per year.)"

"More than that, it represents a rejection of the view that the solution for all problems is to cut some taxes and remove some regulations. In that sense, what’s happening now, for all the disappointment it represents for progressives, is a historic moment.

And let’s also not fail to take note of those who had a chance to join in this historic moment, and punted."

"But health care is not zero-sum villainy. This post is not arguing that insurers are better than you think and providers worse. This post is arguing that nature of both groups is beside the point. They work within the market the government constructs. And both the market for insurance and the market for health care need reform. But we're comfortable reforming only the market for insurance, and so we are leaving half -- or maybe more than half -- the job undone."

"Pot does not kill anyone, and he would have been content to make that his substitute for the mood-altering he seemed to have to have. But he was compelled to give it up, and now he is dead.

This fine man was 49 years old and leaves behind a young widow, mother and hundreds of grieving friends. He was loved by many for his gentleness and many charitable endeavors."

"I suspect Frank is right on the pay issue, but for the wrong reasons. I am always staggered when I hear of law school and business school graduates being in debt to the tune of $100,000, even $200,000. I have no idea what the level for MDs is, but I imagine it is even worse.

And you cannot discharge student debt in a bankruptcy. You have no choice but to pay it (or I suppose flee the US or go underground, there are always extreme options). So the fee for service model may remain intact despite the fact that it produces poor outcomes for society as a whole because the current generation of doctors needs high incomes to so they can service their debts."

"In case you wondered about what we in the US pay for health care compared with those unfree unfortunates who suffer under various forms of socialized medicine, here are some graphs showing the advantages of what Republicans here tell us is “the best health care system in the world.”"

"By AHIP's own admission, they have to be stopped or they'll kill again. The report is a taunt, a thug-level threat, terrorism, if you will. With no government alternative to corporate health insurance, it's like asking captured bank robbers if they'd mind not robbing banks anymore. When they say, "Yes, we mind," you ask if they'd stop shooting hostages. And when they say, "We'll think about it," you thank them for accepting their punishment so gracefully and release them."

"Often patients will prefer to deal with acute and chronic issues but have me bill under a preventative code because their high-deductible HSA will pay for prevention, but not for acute and chronic problem maintenance. This puts providers in an uncomfortable position. Should you make it a slam dunk that you get paid and bill under a prevention code and scribble a little health maintenance in the chart? Or should you stick the bill to the patient, discount for cash, or just take what you can get?"

"I'm working a serious publication now and so I'm going to try to avoid words like "barbaric" to describe policy decisions I don't like. But this is certainly unnecessary. CEPR ends with the economic argument: "Each year millions of American workers go to work sick, lowering their own productivity and that of their coworkers and potentially spreading illness to their coworkers and customers." I'm willing to cut employers some slack: Many don't offer paid sick days because they don't think doing so will make them money."

"The National Association for the Self-Employed (NASE) strongly supports proposals such as health care tax credits, a self-employment tax deduction on health insurance premiums, expansion of both Health Reimbursement Arrangements (HRAs) and Health Savings Accounts (HSAs), and pooling arrangements for small business as important steps to creating an equitable environment for micro-businesses and the self-employed to purchase affordable, quality health coverage. "

"To bolster weakening finances, Blue Cross filed a rate increase in January for its individual insurance plans asking for average increases on three types of policies: 56 percent on individual plans; 42 percent on group conversion coverage; and 31 percent for Medicare supplemental plans."

"Open source healthcare is forging forward quickly on the Internet. But, fast developments often produce many failures. But, many medicinal open source projects that have gained success development. This success shows that open source alone is not the solitary factor in development. Instead, look to great management, public relations, marketing and a sound program that stands up under the scrutiny of a growing number of peer users and, often, patients."

""We've decided to close your office. We think we might be able to find you another job. Hmmmm....maybe. Not sure about your staff and patients, but maybe. We'll see. Gotta go HIRE SOME CARDIOLOGISTS!" (I'm soooooooooooo not kidding.) "Thanks for taking it on the chin and not crying like a girl! I'll be in touch soon, I promise. Bye. Can't keep the heart guys waiting.""

"I’m single. I’m childless. I cared for my mother at the end of her life and for a friend, years before, through 10 months of brain cancer. If, as the saying goes, everything that goes around comes around, someone will do the same for me.

But that’s magical thinking, not a sensible plan for the future. I’ll still have to ask a friend to take me home, or hire a car service, after my next colonoscopy. After almost a decade, I still shudder at the memory of my reconstructive wrist surgery, alone in a hospital where they mixed up my chart with someone else’s. Before the operation and after, I couldn’t even open a bottle."

""These findings suggest that the hospice eligibility criteria of Medicare and other insurers requiring patients to give up cancer treatment contribute to racial disparities in hospice use," the authors wrote. "Moreover, these criteria do not select those patients with the greatest needs for hospice services," they added.

The basis for these disparities is likely related to both cultural differences and economic characteristics. The results from this study indicate that hospice access could be made fairer by using eligibility criteria that are more directly need-based. For example, the investigators suggested that eligibility might be determined by assessing needs for specific hospice services such as pain or symptom management."

Expected risk? One heart attack every 300 years you live.

"If you express the exact same risks from the same trial as an “Absolute Risk Reduction“, suddenly they look a bit less exciting. On placebo, your risk of a heart attack in the trial was 0.37 events per 100 person years, and if you were taking rosuvastatin, it fell to 0.17 events per 100 person years. 0.37 to 0.17. Woohoo. And you have to take a pill every day. And it might have side effects."

"John McCain’s health care plan is rubbish. So says everyone. Most of the summaries I’ve seen have focused on the fact that twenty million will likely lose their employer-cushioned coverage, and that the individual market is horrible to those who have been ill, or for those who are obese.

The plan is rubbish, for all the reasons cited. But it’s rubbish for more reasons. It’s rubbish because it’s made of rubbish."

"That study was denounced by many orthopedic surgeons, but Medicare decided in 2003 to stop paying for the operation. Still, because doctors can be reimbursed for the procedure by modifying what they say is the patient’s problem, it is not clear whether most doctors stopped doing the operation, or how many such operations are being done. There is no national system for keeping track."

"OSAHS is an important risk factor for the development of insulin resistance. It shows that OSAHS may develop IR of the patients and the treatment of MUPPP and CPAP can improve insulin sensitivity."

"See the sun rise or set if possible each day. Let that be your pill."

"Health and happiness are then held out as a promotional package to which all good citizens are expected to aspire, but the paradox is that it can lead to an addictive disorder that acts like a distorting mirror, affecting every aspect of our lives."