By Andrew Pollack
The New York Times
Originally published April 17, 2014
Saying they can no longer ignore the rising prices of health care, some of the most influential medical groups in the nation are recommending that doctors weigh the costs, not just the effectiveness of treatments, as they make decisions about patient care.
The shift, little noticed outside the medical establishment but already controversial inside it, suggests that doctors are starting to redefine their roles, from being concerned exclusively about individual patients to exerting influence on how health care dollars are spent.
The entire article is here.
Monday, May 5, 2014
In Medical Decisions, Dread Is Worse Than Fear
Procrastination, on the other hand, may not be so bad.
By Gabriella Rosen Kellerman
The Atlantic
Originally published April 15, 2014
Here is an excerpt:
One of the solutions Rosenberg proposed was “interventions aimed at improving risk communication.” Meaning that, perhaps if healthcare providers can help patients more rationally assess the risks for now versus later, they can help them avoid unnecessary suffering. To do so, providers will have to help patients address the assumptions that enable get-it-out-of-the-way decision-making.
What, for example, is the "it" in "get-it-out-of-the-way" thinking? The pain or consequence one wishes to avoid are often moving, even unknowable, targets. In pathological anxiety states, estimations of what “it” is are part of what goes awry. Patients with phobias consistently overestimate the degree of unpleasantness of a particular exposure.
The entire article is here.
By Gabriella Rosen Kellerman
The Atlantic
Originally published April 15, 2014
Here is an excerpt:
One of the solutions Rosenberg proposed was “interventions aimed at improving risk communication.” Meaning that, perhaps if healthcare providers can help patients more rationally assess the risks for now versus later, they can help them avoid unnecessary suffering. To do so, providers will have to help patients address the assumptions that enable get-it-out-of-the-way decision-making.
What, for example, is the "it" in "get-it-out-of-the-way" thinking? The pain or consequence one wishes to avoid are often moving, even unknowable, targets. In pathological anxiety states, estimations of what “it” is are part of what goes awry. Patients with phobias consistently overestimate the degree of unpleasantness of a particular exposure.
The entire article is here.
Sunday, May 4, 2014
Securing money for research is hard for everyone – but then there's the sexism
Anonymous Academic
The Guardian
Originally published April 15, 2014
Here is an excerpt:
As anyone who has ever applied for research funding will know, getting research money is hard. Only 30% of applicants to major research councils are successful, making it a highly competitive process.
But a growing body of literature suggests that getting research funding may be additionally difficult for women, as the peer review process is rife with sexism.
The entire article is here.
The Guardian
Originally published April 15, 2014
Here is an excerpt:
As anyone who has ever applied for research funding will know, getting research money is hard. Only 30% of applicants to major research councils are successful, making it a highly competitive process.
But a growing body of literature suggests that getting research funding may be additionally difficult for women, as the peer review process is rife with sexism.
The entire article is here.
Saturday, May 3, 2014
The States With the Worst Healthcare Systems
Nearly a quarter of West Virginians have lost six or more teeth, and other findings from a new Commonwealth Fund report.
By Olga Khazan
The Atlantic
Originally published May 1, 2014
Here is an excerpt:
Healthcare in Mississippi and in other Southern states is unlikely to become more equitable anytime soon, however. As the study authors note, 16 of the states in the bottom half of the ranking have opted not to expand Medicaid under the Affordable Care Act to adults making up to 138 percent of the federal poverty level.
The entire article is here.
By Olga Khazan
The Atlantic
Originally published May 1, 2014
Here is an excerpt:
Healthcare in Mississippi and in other Southern states is unlikely to become more equitable anytime soon, however. As the study authors note, 16 of the states in the bottom half of the ranking have opted not to expand Medicaid under the Affordable Care Act to adults making up to 138 percent of the federal poverty level.
The entire article is here.
Religiosity, Political Orientation, and Consequentialist Moral Thinking
By Jared Piazza and Paulo Sousa
Social Psychological and Personality Science April 2014 vol. 5 no. 3 334-342
Abstract
Three studies demonstrated that the moral judgments of religious individuals and political conservatives are highly insensitive to consequentialist (i.e., outcome-based) considerations. In Study 1, both religiosity and political conservatism predicted a resistance toward consequentialist thinking concerning a range of transgressive acts, independent of other relevant dispositional factors (e.g., disgust sensitivity). Study 2 ruled out differences in welfare sensitivity as an explanation for these findings. In Study 3, religiosity and political conservatism predicted a commitment to judging “harmless” taboo violations morally impermissible, rather than discretionary, despite the lack of negative consequences rising from the act. Furthermore, non-consequentialist thinking style was shown to mediate the relationship religiosity/conservatism had with impermissibility judgments, while intuitive thinking style did not. These data provide further evidence for the influence of religious and political commitments in motivating divergent moral judgments, while highlighting a new dispositional factor, non-consequentialist thinking style, as a mediator of these effects.
The entire article is here.
Social Psychological and Personality Science April 2014 vol. 5 no. 3 334-342
Abstract
Three studies demonstrated that the moral judgments of religious individuals and political conservatives are highly insensitive to consequentialist (i.e., outcome-based) considerations. In Study 1, both religiosity and political conservatism predicted a resistance toward consequentialist thinking concerning a range of transgressive acts, independent of other relevant dispositional factors (e.g., disgust sensitivity). Study 2 ruled out differences in welfare sensitivity as an explanation for these findings. In Study 3, religiosity and political conservatism predicted a commitment to judging “harmless” taboo violations morally impermissible, rather than discretionary, despite the lack of negative consequences rising from the act. Furthermore, non-consequentialist thinking style was shown to mediate the relationship religiosity/conservatism had with impermissibility judgments, while intuitive thinking style did not. These data provide further evidence for the influence of religious and political commitments in motivating divergent moral judgments, while highlighting a new dispositional factor, non-consequentialist thinking style, as a mediator of these effects.
The entire article is here.
Friday, May 2, 2014
Justice and Bad Luck
Stanford Encyclopedia of Philosophy
First published Mon Jun 20, 2005; substantive revision Fri Apr 11, 2014
Some people end up worse off than others partly because of their bad luck. For instance, some die young due to a genetic disease, whereas others live long lives. Are such differential luck induced inequalities unjust? Many are inclined to answer this question affirmatively. To understand this inclination, we need a clear account of what luck involves. On some accounts, luck nullifies responsibility. On others, it nullifies desert. It is often said that justice requires luck to be ‘neutralized’. However, it is contested whether a distributive pattern that eliminates the influence of luck can be described. Thus an agent's level of effort—something few would initially see as a matter of luck—might be inseparable from her level of talent—something most would initially see as a matter of luck— and this might challenge standard accounts of just deviation from equality (or, for that matter, other favored distributive patterns). Critically, relational egalitarians argue that so-called luck egalitarians' preoccupation with eliminating inequalities reflecting differential bad luck misconstrues justice, which, according to the former, is a matter of social relations having a suitably egalitarian character.
The entire entry is here.
First published Mon Jun 20, 2005; substantive revision Fri Apr 11, 2014
Some people end up worse off than others partly because of their bad luck. For instance, some die young due to a genetic disease, whereas others live long lives. Are such differential luck induced inequalities unjust? Many are inclined to answer this question affirmatively. To understand this inclination, we need a clear account of what luck involves. On some accounts, luck nullifies responsibility. On others, it nullifies desert. It is often said that justice requires luck to be ‘neutralized’. However, it is contested whether a distributive pattern that eliminates the influence of luck can be described. Thus an agent's level of effort—something few would initially see as a matter of luck—might be inseparable from her level of talent—something most would initially see as a matter of luck— and this might challenge standard accounts of just deviation from equality (or, for that matter, other favored distributive patterns). Critically, relational egalitarians argue that so-called luck egalitarians' preoccupation with eliminating inequalities reflecting differential bad luck misconstrues justice, which, according to the former, is a matter of social relations having a suitably egalitarian character.
The entire entry is here.
Q&A: Why 40% of us think we're in the top 5%
By Christie Nicholson
www.smartplanet.com
Originally published April 15, 2014
Here are two excerpt:
Since then Dunning has performed many studies on incompetence. And he has uncovered something particularly disturbing: We humans are terrible at self-assessment, often grading ourselves as far more intelligent and capable than we actually are. This widespread inability can lead to negative consequences for management and for recognizing genius.
(cut)
Giving feedback especially in the workplace is a very touchy situation, and companies make reviews more touchy by directly connecting it to things like pay raises. There are two reasons people may not be receptive to feedback: One is it’s going to come as a complete surprise to them, because they probably don’t know what their weaknesses are, second is that it’s just a natural human tendency to be defensive.
So, you have to work around that. There are three different things you can do as a manager. The first thing is if you are going to give feedback make sure that it’s about a person’s behavior or their actions. Do not make it about their character or their ability.
The entire article is here.
www.smartplanet.com
Originally published April 15, 2014
Here are two excerpt:
Since then Dunning has performed many studies on incompetence. And he has uncovered something particularly disturbing: We humans are terrible at self-assessment, often grading ourselves as far more intelligent and capable than we actually are. This widespread inability can lead to negative consequences for management and for recognizing genius.
(cut)
Giving feedback especially in the workplace is a very touchy situation, and companies make reviews more touchy by directly connecting it to things like pay raises. There are two reasons people may not be receptive to feedback: One is it’s going to come as a complete surprise to them, because they probably don’t know what their weaknesses are, second is that it’s just a natural human tendency to be defensive.
So, you have to work around that. There are three different things you can do as a manager. The first thing is if you are going to give feedback make sure that it’s about a person’s behavior or their actions. Do not make it about their character or their ability.
The entire article is here.
Thursday, May 1, 2014
Hospice and Access to Medications - New CMS Guidance
Center for Medicare Advocacy
Originally posted April 10, 2014
Here are some excerpts:
Summary
Medications that should be covered by the Medicare Hospice Benefit are sometimes paid for by the insurance companies that administer Medicare Part D plans. To prevent this from happening, effective May 1, 2014, all prescribed medications for hospice patients billed to Medicare Part D will initially be denied coverage. To get their medications, hospice patients will have to initiate and ultimately succeed at a Medicare appeal. In other words, to protect insurance companies, dying patients will have to jump through hoops to get medically necessary, potentially life-sustaining medications.
(cut)
Conclusion
This burden-shifting to the dying patient is illogical and immoral.
CMS has erred in assuming that most hospice patients will not continue to have Part D covered medications. Most older Americans are on medications for chronic conditions, and some of these medications...
The entire article is here.
Thanks to Deborah Derrickson Kossmann for this information.
Originally posted April 10, 2014
Here are some excerpts:
Summary
Medications that should be covered by the Medicare Hospice Benefit are sometimes paid for by the insurance companies that administer Medicare Part D plans. To prevent this from happening, effective May 1, 2014, all prescribed medications for hospice patients billed to Medicare Part D will initially be denied coverage. To get their medications, hospice patients will have to initiate and ultimately succeed at a Medicare appeal. In other words, to protect insurance companies, dying patients will have to jump through hoops to get medically necessary, potentially life-sustaining medications.
(cut)
Conclusion
This burden-shifting to the dying patient is illogical and immoral.
CMS has erred in assuming that most hospice patients will not continue to have Part D covered medications. Most older Americans are on medications for chronic conditions, and some of these medications...
The entire article is here.
Thanks to Deborah Derrickson Kossmann for this information.
Belgium: accelerating down the slippery slope
By Michael Cook
Careful! A blog about end-of-life issues
Originally published April 13, 2014
Here is an excerpt:
The Society spells out its policy very carefully. It is not about grey areas like withdrawing burdensome or futile treatment or balancing pain relief against shortening a patient’s life. It clearly states that “shortening the dying process by administering sedatives beyond what is needed for patient comfort can be not only acceptable but in many cases desirable”.
“Shortening the dying process” is a euphemism for administering a lethal injection.
Most dying patients in intensive care have not made advance directives and “are usually not in a position to request euthanasia”. Therefore, “difficulty can arise when the purpose of the drugs used for comfort and pain relief in end-of-life management is misconstrued as deliberate use to speed the dying process.” The Society’s solution to this difficulty is to allow its members to kill the patients.
The entire story is here.
Thanks to Eric Affsprung for this information.
Careful! A blog about end-of-life issues
Originally published April 13, 2014
Here is an excerpt:
The Society spells out its policy very carefully. It is not about grey areas like withdrawing burdensome or futile treatment or balancing pain relief against shortening a patient’s life. It clearly states that “shortening the dying process by administering sedatives beyond what is needed for patient comfort can be not only acceptable but in many cases desirable”.
“Shortening the dying process” is a euphemism for administering a lethal injection.
Most dying patients in intensive care have not made advance directives and “are usually not in a position to request euthanasia”. Therefore, “difficulty can arise when the purpose of the drugs used for comfort and pain relief in end-of-life management is misconstrued as deliberate use to speed the dying process.” The Society’s solution to this difficulty is to allow its members to kill the patients.
The entire story is here.
Thanks to Eric Affsprung for this information.
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