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The sorry state of health of US medicine
Date:3/7/2011

tical companies.

The authors lay out the "rules of the game" as played by these interconnected entities. Insurance companies have set the rule "restrict choice and coverage" by using an elaborate system of co-payments and deductibles, exclusion clauses, and loopholes. HMOs have set the rule "manage care" to limit the number of treatments patients receive, the days spent in hospital, and their choice of provider. The pharmaceutical industry has set the rule "charge as much as we want, because insurance will pay." This rule has resulted in prescription drug prices that are nearly 60% higher than in Canada, and nearly 100% higher than in Europe, and has led to patients being prescribed sometimes unnecessary, often useless, and even potentially dangerous drugs. Finally, corporate hospital chains have set the rule "test as much as we want, because insurance will pay." Under this rule, they extend the patient's range of tests and procedures, even when excessive or unnecessary.

According to the authors, "The sum of the 'rules of the game' devised by these organizations has resulted in a fragmented, haphazard, and broken system of healthcare. Reform is long overdue, andthis requires us to understand these rules, who is setting them, and how these rules are being used to exploit the system of medicine. Only then can we begin to heal our ailing healthcare system."

"The Affordable Care Act: Facing Up to the Power of the Pen and the Purse" looks at the political side of the healthcare debate. Eli Y. Adashi, MD, MS, CPE, FACOG, Professor of Medical Science, Brown University, Providence, RI, scrutinizes the various challenges to the Affordable Care Act (ACA). He reviews the statutory challenges of repeal measures being introduced in Congress and in 40 state legislatures. While Congressional action will likely be stopped by an Obama veto, and the state efforts will likely fail due to the Supremacy Clause of the US Constitution, broad state opposition co
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Contact: Pamela Poppalardo
ajmmedia@elsevier.com
732-238-3628
Elsevier Health Sciences
Source:Eurekalert

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