Schwitzer health news blog

Big jump in the uninsured

The Health Affairs blog reports:

This morning the U.S. Census Bureau announced that the number of uninsured Americans jumped to 47 million in 2006, up from 44.8 million in 2005. In percentage terms, there were 15.8 percent of Americans without insurance in 2006, up from 15.3 percent in 2005. This also represents the sixth year in a row that the number of uninsured has risen.

The number and percentage of uninsured children also grew. In 2006, 11.7 percent (8.7 million) kids under age 18 were uninsured—up from 10.9 percent (8 million) in 2005. These new numbers are already sparking comment as the State Children’s Health Insurance Program (SCHIP) comes up for reauthorization at the end of September.

HealthNewsReview.org a finalist for a FREDDIE award

We've been notified that HealthNewsReview.org has been judged to be a finalist in the category of Web Sites in the 2007 International Health & Medical Media Awards.

All category winners will be named by September 17.

HealthNewsReview.org is now 15 months old, has reviewed more than 400 stories, and has already won a Knight-Batten Award for Innovations in Journalism, an e-Healthcare Leadership Award, and a Mirror Award for media industry reporting.

Is depression over-diagnosed?

An interesting online debate in the BMJ this week.

The discussion is framed as follows.

Rates of diagnosis of depression have risen steeply in recent years. One view holds that this is because current criteria are medicalizing sadness. Another argues that many people are still missing out on lifesaving treatment.

Tough questions missing on robot story

The Star Tribune offered a business section feature yesterday on local doctors finding new uses for the $1.2 million Da Vinci robotic surgery devices.

At $1.2 million, you bet they want to and need to find new uses.

The story explained that the robotic device came on the market just 8 years ago, that Minnesota hospitals started using it just three years ago., and that there are already nine da Vincis in the state.

But the story failed to address the obvious followup questions: how many does a state or a community need? Who's asking these questions?

The story was also completely devoid of any performance data on risks and benefits.

Finally, the story included a quote from a urologist using the device, who said

that getting the da Vinci was "physician driven," as doctors saw its benefits. Then its use became "patient driven," as people went to the Internet and discovered there was another way to have their surgeries done.

Such a comment can't go unchallenged. If physicians and hospital marketing folks weren't pushing the expensive devices, there would be no "patient driven" move.

Medical technology assessment in the U.S. is a huge question. This story didn't deliver many answers.

Under the influence of drug marketing

The Los Angeles Times last week published a series of articles on drug marketing.

Excerpts:

"In a nation that consumed $279-billion worth of prescription medications in 2006 - spending 80% of that on brand name drugs - their efforts appear to be paying off. Americans filling a prescription choose brand-name products 37% of the time, even though three quarters of all prescription drugs in the U.S. are available in cheaper generics."

"Each day in the United States, an army of roughly 100,000 pharmaceutical company sales reps storms the waiting rooms and offices of the nation's 311,000 office-based physicians."

"The drug industry, according to estimates by the Center for Public Integrity, has spent $758 million on lobbying - more than any other industry - since 1998."

New Pew Report: Public Press Criticism

A new report from the Pew Research Center for the People and the Press is good - but troubling - reading. It summarizes:

"The American public continues to fault news organizations for a number of perceived failures, with solid majorities criticizing them for political bias, inaccuracy and failing to acknowledge mistakes. But some of the harshest indictments of the press now come from the growing segment that relies on the internet as its main source for national and international news.

The internet news audience – roughly a quarter of all Americans – tends to be younger and better educated than the public as a whole. People who rely on the internet as their main news source express relatively unfavorable opinions of mainstream news sources and are among the most critical of press performance. As many as 38% of those who rely mostly on the internet for news say they have an unfavorable opinion of cable news networks such as CNN, Fox News Channel and MSNBC, compared with 25% of the public overall, and just 17% of television news viewers."

The survey shows some clear partisan divides.

Far more than twice as many Republicans as Democrats say news organizations are too critical of America (63% vs. 23%), and there is virtually no measure of press values or performance on which there is not a substantial gap in the views of partisans.

"Those who cite the Fox News Channel as their primary source of news stand out among the TV news audience for their negative evaluations of news organizations' practices. Fully 63% of Americans who count Fox as their main news source say news stories are often inaccurate – a view held by fewer than half of those who cite CNN (46%) or network news (41%) as their main source.

Similarly, Fox viewers are far more likely to say the press is too critical of America (52% vs. 36% of CNN viewers and 29% of network news viewers). And the Fox News Channel audience gives starkly lower ratings to network news programs and national newspapers such as the New York Times and Washington Post."

Dislike of both major cable news networks runs notably high among Americans who count newspapers and the internet as their main sources of national and international news. One-third of people who count on the internet for most of their news express an unfavorable view of Fox, and roughly the same number (31%) feel negatively toward CNN.

A purchaser and consumer complaint

Sometimes letters to the editor capture under-the-surface citizen unrest in ways that news stories often fail to do. One such example was a letter in today's Star Tribune. It's a reader reacting to an earlier op-ed piece by a health care exec. It reads:

"As the director of a nonprofit whose employee benefits expenses for HMO medical insurance through Allina/Medica have doubled since 2000, I find it highly disturbing that part of my business costs are not allocated for health but instead are used to pay for an executive vice president of law and public policy at Allina, Mary Foarde, so she can write articles (Opinion Exchange, July 29) dismissing single-payer.

In contrast, fees I must pay per employee for Medicare do not lead to any such waste of executive expense, which is one reason Medicare -- with its single-payer structure -- is enormously popular and faces no "huge political opposition" -- in absolute contradiction to Foarde's column and other empty propaganda put forward by the self-serving, profit-driven, health care industry."