Following the news regarding legislative proposals for Health System Reform (HSR) can be stressful for all of us, with all of its complexities, and our concerns about the future availability of quality, affordable care.
In my search for sources of information that look at the facts of current legislative proposals, I believe that the American Medical Association (AMA) offers a perspective that is truly concerned about patients having access to quality, affordable care.
The AMA has studied health system issues and advocated for constructive reforms for over 20 years. As an organization that is driven by the time, energy, and experience offered by volunteer physicians, the AMA advocates for 7 guiding principles to achieve meaningful health system reform.
As we follow the debate and proposed legislation, the AMA continues to monitor proposed legislation as measured against these 7 guiding principles, commenting on how well legislative proposals live up to these principles.
-Provide health insurance coverage for all Americans.
-Enact insurance market reforms that expand the choice of affordable coverage and eliminate denials for pre-existing conditions or due to arbitrary caps.
-Assure that health care decisions are made by patients and their physicians, not by insurance companies or government bureaucrats. This sacred bond should include the right of patients to privately contract with physicians, so that their health care choices are respected.
-Provide investments and incentives for initiatives that improve quality and enhance prevention and wellness.
-Repeal the Medicare physician payment formula … a formula that will trigger steep cuts and threaten access to care for senior citizens.
-Implement medical liability reforms to reduce the cost of defensive medicine.
-Streamline and standardize insurance claims processing requirements to eliminate unnecessary costs and administrative burdens.
The AMA web site has lots of useful information for patients and their families, in addition to their perspective on the latest legislative proposals, and how they “measure up” to each of the 7 principles. You can find more information at http://www.ama-assn.org/ama/pub/patients/patients.shtml
Wednesday, October 28, 2009
H1N1 Vaccine: What to do?
H1N1 Vaccine: What to do?
“THE MEDICAL LETTER” is a publication that has provided credible information to healthcare providers about medications for over 20 years. It is funded by subscriptions and does NOT accept no funding from any other source, including pharmaceutical companies.
The October, 2009 issue reviews the H1N1 vaccine for prevention of flu. The article concludes that the H1N1 vaccine “is prepared in the same way by the same manufacturers as the usual seasonal vaccine. Those who are at increased risk of flu complications should receive the vaccine first…[they include] pregnant women, people who live with and provide care for infants <6 months old, all persons 6 months – 24 years old, persons 25-64 years old with illnesses that increase their risk of flu complications, and healthcare workers.”
I believe that credible sources such as the “THE MEDICAL LETTER” provide reliable information to healthcare providers and consumers, helping us to make the best possible decisions about risks vs. benefits of medical treatments. For further detail, consult your healthcare provider.
“THE MEDICAL LETTER” is a publication that has provided credible information to healthcare providers about medications for over 20 years. It is funded by subscriptions and does NOT accept no funding from any other source, including pharmaceutical companies.
The October, 2009 issue reviews the H1N1 vaccine for prevention of flu. The article concludes that the H1N1 vaccine “is prepared in the same way by the same manufacturers as the usual seasonal vaccine. Those who are at increased risk of flu complications should receive the vaccine first…[they include] pregnant women, people who live with and provide care for infants <6 months old, all persons 6 months – 24 years old, persons 25-64 years old with illnesses that increase their risk of flu complications, and healthcare workers.”
I believe that credible sources such as the “THE MEDICAL LETTER” provide reliable information to healthcare providers and consumers, helping us to make the best possible decisions about risks vs. benefits of medical treatments. For further detail, consult your healthcare provider.
Sunday, October 25, 2009
Is it OK to take medication for a long time for anxiety or mood disorders?
In my experience and according to scientific research, chronic anxiety and mood symptoms are extremely common. I think that, for many people, these symptoms can be due to being overloaded with all of the things that we expect ourselves to do (parent, spouse/relationship, work, friends, other family, etc, etc). When stressful life events happen, these are often “the straw that breaks the camel’s back.”
From my point of view, the important thing is for each individual to find out what works to feel better and function better, by that person’s own idea of "better." This means that the individual is better able to accomplish more of what they want & need to do, and to get more pleasure & fulfillment from those people & activities that are important to them.
It's always best to emphasize non-medication techniques as much as you can actually do, in the real world. These include exercise, spending time in green spaces, prayer/meditation, relaxation techniques, massage, stress management, and counseling/therapy.
No one that I ever known has been able actually do all of the non-medication techniques that they could/should do due limitations of time, energy, & money.
Even if you could, clinical research and our experience indicate that non-medication techniques are only of limited benefit for pain, anxiety, mood and/or sleep disorder symptoms that have been present for a long time, or are beyond a mild level of severity.
If medication works to do the good things (reduce suffering and improve ability to do things you want and need to do), and is not causing significant side effects, then I believe that it is actually having a positive healthy impact on the central nervous system and overall health, with benefits that often include reducing the impact of stress on things like chronic pain, IBS, PMS, headaches, asthma, blood pressure, as well as risk for heart disease and immune system disorders.
As a rule, I think it's good to learn about possible side effects that can occur from any medication that you're taking on a regular basis and for more than a few months, and to always call your prescribing physician if you feel worse in any way, especially after a dosage change.
If you've been taking a particular medication on a regular basis and for a long time, I think that it's always good to speak with your prescribing physician about trying a step down in the dose for a short period of time. If you feel worse and nothing gets better, then you can go back to the original dose. If your symptoms are not in complete remission, then speak to your prescribing physician about a trial of a step higher in the dose, with careful continued monitoring for benefits vs. side effects.
If you feel better on a lower dose, then you can talk to your prescribing physician about taking another step down in the dosage.
From my point of view, the important thing is for each individual to find out what works to feel better and function better, by that person’s own idea of "better." This means that the individual is better able to accomplish more of what they want & need to do, and to get more pleasure & fulfillment from those people & activities that are important to them.
It's always best to emphasize non-medication techniques as much as you can actually do, in the real world. These include exercise, spending time in green spaces, prayer/meditation, relaxation techniques, massage, stress management, and counseling/therapy.
No one that I ever known has been able actually do all of the non-medication techniques that they could/should do due limitations of time, energy, & money.
Even if you could, clinical research and our experience indicate that non-medication techniques are only of limited benefit for pain, anxiety, mood and/or sleep disorder symptoms that have been present for a long time, or are beyond a mild level of severity.
If medication works to do the good things (reduce suffering and improve ability to do things you want and need to do), and is not causing significant side effects, then I believe that it is actually having a positive healthy impact on the central nervous system and overall health, with benefits that often include reducing the impact of stress on things like chronic pain, IBS, PMS, headaches, asthma, blood pressure, as well as risk for heart disease and immune system disorders.
As a rule, I think it's good to learn about possible side effects that can occur from any medication that you're taking on a regular basis and for more than a few months, and to always call your prescribing physician if you feel worse in any way, especially after a dosage change.
If you've been taking a particular medication on a regular basis and for a long time, I think that it's always good to speak with your prescribing physician about trying a step down in the dose for a short period of time. If you feel worse and nothing gets better, then you can go back to the original dose. If your symptoms are not in complete remission, then speak to your prescribing physician about a trial of a step higher in the dose, with careful continued monitoring for benefits vs. side effects.
If you feel better on a lower dose, then you can talk to your prescribing physician about taking another step down in the dosage.
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