Fixing it will go beyond money:

Across Iraq, many hospitals have neither computers nor meaningful patient files. Working X-ray machines and MRI scanners are few and far between.

At one of the busiest hospitals in Baghdad, five people die on average every day because medics and nurses don't have the equipment to treat heart attacks and other commonplace ills and accidents, said Husam Abud, a doctor at al-Yarmouk Hospital. ...

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The Lancet starts a blog

Creatively titled, The Lancet Blog. Welcome to the party medical journalists. Can the NEJM be far behind? (via Clinical Cases and Images)

A "kidney bazaar"

Poor Pakistanis are donating their kidneys for money.

A paramedic observes that computers are increasingly tuned to an internet health pages during his EMS calls.

I haven't had anyone yet give me their list so they can switch to the $4 generics, but I agree Wal-Mart's marketing ploy has led to some beneficial ripples. And yes, their generics list is not too shabby.

Deja vu in the ER

A medical student sees for himself how broken our health care system is. He writes about a typical ER encounter, repeated several times throughout the day:

Hi Doc, I'm here because I have chest pain. It started this morning, and it feels like an elephant is on my chest. What's that? No, I don't have a regular doctor. I don't have insurance. What's that? No, well, I had ...

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OnThePharm thinks so. The GLP-1 based therapies are an exciting new class of diabetes medications. So far, Byetta has worked well for my patients - the jury is still out with Januvia. Merck certainly hopes that Januvia will rescue them.

The amount spent on overhead gets cut down drastically when you stop taking insurance:

He also calculated that he needed to see 25 patients a day just to cover his overhead. In order to make his salary, he often saw 35 or 40. And he never could spend as much time as he'd like with them. According to his wife, Gena, practice employees had developed a ruse to keep ...

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A man is being persecuted in China for questioning traditional Chinese medicine:

Mr. Zhang, a professor at Central South University in Hunan province who has been studying medical history for more than 30 years, is urging the government to stop promoting traditional medicine. He has launched an online petition to seek its removal from the constitution and the official medical system. And he wants China's traditional-medicine practitioners to get mainstream ...

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A year of study was spent coming to this obvious conclusion:

"The hospitals and the doctors are not making any money to speak of, but the person in the middle, who is the paper pusher, is making all the money."

The first time I've seen this. Makes some sense since end-of-life care consumes a disproportionate proportion of costs:

Applicants would have to sign directives describing the level of care they want at the end of life to reduce use of extraordinary efforts for those who do not want them.

Often, PCPs in major academic medical centers accept patients only as favors to other doctors, or through connections. Don't know anyone? You're out of luck:

Callers to Massachusetts General Hospital's physician referral line, for example, are told that all, or almost all, of the hospital's 178 primary care physicians are not accepting more patients. All 42 internists at Boston Medical Center have had full lists since four months ...

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With an average debt in excess of $100,000, I'm sure this is a dream for every medical student.

Like any business, no one can survive when costs rise above revenues:

Ms. Udall said no doctor has to accept Medicare patients, She explained Medicare payments are often less than the cost of performing services, but said insurance payments from other patients help cover the cost. "When the point comes that they are losing money, they will cut Medicare patients or refused to take additional Medicare patients. A doctor has ...

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This observation isn't new. But with the way that primary care is treated, I don't expect anything to change soon:

Reviewing a Dartmouth Medical School study that found higher mortality rates in areas that spent the most on Medicare, professor Elliott Fisher concluded that "perhaps a third of medical spending is now devoted to services that don't appear to improve health or the quality of care "” and ...

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Just another room taken - leading to further backup in an already clogged system:

The woman told the nurse she had a history of mental instability and was off her medication. She wanted to check herself into a mental health hospital - a request that would take hours to fulfill.

The closest mental health inpatient facility is two hours away. But the availability of a bed and an officer ...

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The hospital staff thought he had eloped - so they discharged him:

But when a nurse came to his bed at 7:30pm to give him his test results, his bed was empty and the patient had disappeared. Staff searched for the man in the immediate vicinity of the ward, but did not find him.

Nurses assumed that the man had left the hospital, so they discharged him. It was ...

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The NY Times presents a rare case of copper deficiency, diagnosed by a 2nd year resident. Nice job.

They are upset at paying a $75 fee to address the medical malpractice crisis:

"We believe the complex constitutional questions involving the separation of powers and equal protection clauses that this case presented were ripe for consideration. ... We firmly believe the factual and legislative record is devoid of any compelling evidence of a real health-care crisis, and certainly of any rational basis for imposing this tax burden on ...

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Partly due to tort reform. Another success story.

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