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USA Today Series on Health Care Costs

USA Today began a three-part series today on US health care costs. Even the Insured can Buckle Under Health Care Costs, the first article in the series, details the findings of a survey conducted by the newspaper, the Kaiser Family Foundation and Harvard School of Public Health.

“Medical costs are a growing burden for middle-income families with children, as well as for the working class, people with chronic illnesses, the disabled and the uninsured. Many who cannot pay skimp on health care, go without prescription drugs or simply ignore their bills, the survey showed. . . .

“Overall, the hardest hit by medical costs are the uninsured.

“Next are adults under age 65 with insurance who have household incomes of less than $75,000, an analysis of the survey data found. Those in that vast swath of Middle America were far more likely than those richer or older to report not having enough money to pay for medical costs in the past year (33%), to have paid $1,000 or more in out-of-pocket costs for care (31%) or to have skipped medical treatment or a prescription because of the cost (34%).

“Wealthier households and those who report few health problems — two groups that represent nearly half of Americans — had little or no difficulty with medical costs.”

Other findings include:

  • 62% percent of those struggling to pay medical bills have health insurance
  • 28% of adults were unable to pay for some form of medical care in the past year
  • More than one in five Americans currently have an overdue medical bill
  • Nearly two out of 10 say health care costs are their biggest monthly expense after rent or mortgage payments
  • Almost three out of 10 estimate they paid $1,000 or more out-of-pocket for health care in the past year on top of premiums

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Olive Oil as NSAID

In an analysis of freshly pressed extra-virgin olive oil, a University of Pennsylvania biologist found a compound, called oleocanthal, that acts like the NSAID ibuprofen. The compounds have different chemistry, which means that oleocanthal may or may not cause the long-term kidney and digestive problems that ibuprofen can.

Four tablespoons of olive oil equal about 10% of the recommended dose of ibuprofen for pain relief, so it’s not a viable alternative to popping Advil. But since sauteing veggies in olive oil instead of butter isn’t much of a sacrifice, I’ll tell myself that every little bit counts.

Extra-Virgin Olive Oil Mimics Painkiller

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Hurricane Katrina Relief

Today WebMD published a short article on ways to help Katrina’s survivors. It addresses the benefits of donating cash over goods, how to volunteer, and organizations to consider if you’d like to donate money or time.

I’ll continue to blog about relevant health care news this week, but my problems are small in comparison. I hope you’ve all been able to contact your loved ones affected by the hurricane and its aftermath. Take care of yourselves.

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What’s Medical, What’s Private?

Since medical privacy rules (aka HIPAA) went into effect, patients have signed form after form saying that our health care providers and pharmacists have told us that they comply with the laws. With restrictions on who can see, know about or be sent our medical information, it seems as if our private medical information is well-protected from prying eyes. “But that depends very much on what you mean by medical, and what you mean by privacy,” maintains Abigail Zuger, MD, in her essay, The Water Cooler, a Font of Good Medicine, which appears in today’s New York Times.

For medicine to shift from treating symptoms or disease to treating whole people, Zuger argues that the social information about patients that was once considered gossip is now relevant to their health care. She writes,

“No longer is a well patient with a sick gallbladder of medical interest for her gallbladder alone…

“Is the gallbladder upset because its owner is eating too much fatty food? Are those deep fried onion ring binges caused by unhappiness in the home? Is there a possibility of domestic violence? Should a social worker and a lawyer be called as well as a surgeon? The scans show only the inflamed gallbladder, but medical caretakers are now encouraged to see beyond the scans.

“Sharing information from every perspective has become the way of the future. In medical school, students are now encouraged to link disparate medical and social details into a cohesive story, a veritable novel about each patient.”

If talking about the gory details of my life means that my health problems are better attended to, I’ll provide refreshments for that meeting. How do you all feel about your medical privacy after reading Zuger’s essay? Please leave a comment or e-mail me.

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Coexisting Conditions

“Comorbid” is a word I’m seeing more and more in discussions of migraine. I don’t know if it’s appearing in more patient-centered articles than it once did or if I see it more because I read so much more about migraine than I once did. In any case, it’s something everyone with headache should know about.

Here’s the definition: Comorbidities are disorders that have a greater-than-coincidental association with another disease. According to WebMD, disorders that are thought to be comorbid with migraine including stroke, epilepsy, lupus, Raynaud syndrome, multiple sclerosis, essential tremor, bipolar disease, depression, anxiety disorder, panic disorder and social phobia. Meniere’s disease and certain gastrointestinal disorders are also sometimes mentioned.

It’s like being in high school. Maggie, Ann and Peter are best friends and don’t go anywhere without each other. Ann starts dating Steve and he becomes the fourth member of the group. Does Ann cause Steve to be part of the group? Could he have joined them if he was Maggie’s lab partner and she knew her other friends would like him? What if they all sit next to each other in a class and Steve just naturally joins the group? Does it matter which came first or why?

There aren’t many web resources that catalog and describe comorbidities. The best I’ve found is Headache Disorders: Common Coexisting Conditions. If you want to know if a specific disease is comorbid with migraine, the best online option is to Google both terms together or use both terms and comorbid or coexist.