Enabling Ordinary Moments for Ordinary People

Dear Editor,

At the U.C. Berkeley graduation in May, I saw a paraplegic student cross the stage in an exoskeleton designed by the engineering department, creating an extraordinary, though transitory, moment. I appreciate that the Walk Again researchers in Melissa Healy’s article mention, “drinking a cup of coffee” as a goal of their prosthetic “body suit,” illustrating their aim to enable not extraordinary moments, but commonplace tasks in the lives of ordinary people. However, the cost of this technology isn’t mentioned at all, and would surely be more than today’s prosthetics costing $6,000-$35,000. Instead of ignoring cost, I suggest that the Walk Again researchers, and all biomedical device researchers, consider their devices’ costs to consumers and try to make them more affordable, without sacrificing quality, so that their technology is not only available to the wealthy, but to an ordinary person who might just want to drink a cup of coffee.

Sincerely,

Amy Levier

Berkeley, CA

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In Response to: "Body Suit May Soon Enable Paralyzed to Walk"

http://www.latimes.com/health/la-he-brain-machine-20111006,0,7089239.story

Report on Medicare Cites Prescription Drug Abuse

Dear Editor:

In the article “Report on Medicare Cites Prescription Drug Abuse,” you reported that Medicare beneficiaries have been abusing their access to medications. Patients have received prescriptions from multiple prescribers and filled them up at various pharmacies. This is significant as federal funds intended to aid the sick and elderly are instead used for monetary or addictive reasons by patients. Furthermore, this drug abuse could lead to increased costs to taxpayers. Medicare officials have been slow to recognize the evidence of such abuse.

One thing that could make a difference is to implement a health policy in which pharmacies, physicians, and prescription drug plans better streamline information on medical history, in order to find warning signs of abuse. In addition, both patients and providers could try to better coordinate in the treatment of pain symptoms to remove the need to visit another physician for extra medication. However, through such policy, we must remember that our focus is maintaining patients’ access to care.

Sincerely,

Sarah Youn
Berkeley, CA

The future of electronic medical records

To the editor:

In Sarah Kliff’s article “The future of electronic medical records, in one doctor’s visit,” it shows the potential for electronic medical records to revolutionize record keeping and access to information. Although the idea has been around for several years, there has been no drive towards a complete revamp and it was only recently that the Recovery Act and Affordable Care Act has provided funds and incentives towards “meaningful use” of digital records. Digitization of records, however, has faced much opposition from many practitioners who prefer paper, which they claim is more reliable and efficient. What new studies have found, albeit dependent on more than a pen, digital records have not only improved operational efficiency, but have also resulted in significant system wide reductions in costs. In addition, digital record programs implemented in Emergency rooms have even been shown to aid in quicker diagnosis and treatment. A universal network must be established and incentivized in order for the digital records to be extremely effective. What would foster this transition are larger federal incentives, especially for small practices, ease of access into the universal network, and a deadline to phase out paper records.

Sincerely,

Nicholas Hu

Berkeley, CA

Yet Another Slippery Slope—Drug Shortages Lead to Rationing

Dear Editor:

In “Shortages Lead Doctors to Ration Critical Drugs” (NPR, October 3, 2011), Richard Knox reports that “a growing number of Americans are not getting the medications they need…(including) cancer chemotherapy agents, anesthetics, antibiotics, (and) electrolytes needed for nutrient solutions.”

While approximately half of all drug shortages are due to production quality issues, the other half is avoidable with the help of government intervention. Older generic brands, which are not produced by companies due to their low profit, can be made in larger quantities if the government will offer subsidies or incentives. This is an example of market failure—companies are not keeping up with the demand, so government mediation is necessary in order to protect these susceptible individuals. So far, there have been 15 deaths due to these shortages with no “end in sight.” Without these essential drugs, unnecessary rationing and life and death decisions will be made, raising ethical issues.

As a community member, my perspective is: if these drugs can be cheaply made and lives are depending on its availability, then why can’t people have access to them? For those opposed to government intervention, I leave with you this—if the U.S. government is willing to bail out corporations, why can’t it bail out the health system when it matters the most?

Sincerely,

Leslie Salas

Berkeley, CA

Things May Get Worse For "Worst" Hospitals, Study Warns

Dear Editor:

Yesterday you reported in “Things May Get Worse for the ‘Worst’ Hospitals, Study Warns” that researchers have identified 178 low-quality, high-cost hospitals. Taking into consideration that the Affordable Care Act dictated that money be taken away from these institutions and given to those that provide quality care in a cost-effective way, it begs the question: What type of people will be most impacted by this transition? As this study notes, the “worst” hospitals treat twice as many elderly, black patients as did the “best” hospitals. So it appears we have our answer: the under-privileged will be hurt the most, per usual.

As a student interested in the ethics of resource distribution, I believe extra attention needs to be given to what we call “social determinates of health.” While I too am concerned with national health expenditures nearing 18% of the GDP, I believe we must take a second to consider who will be impacted during the changing payment process. One way to decrease the pressure put on the under-privileged is to make policies in which increasing education, creating jobs, and combating racism is the end goal. If this were the primary focus of health care reform (guidelines of care and cost effectiveness secondary), we would likely see drastic improvements in health outcomes as well as other aspects of social life.

Sincerely,

Lindsay Forbes

Study: Worst hospitals treat larger share of poor

October 5, 2011

Dear Editor,

In the article on the government’s “reward and punishment” system under the Affordable Care Act, the writer expresses a strong concern on the “worst hospitals” being at risk of financial failure because of the policy in the reform law that punishes hospitals that do not improve their patients’ health overall. However, although there are fears that the policy will push out hospitals that usually serve a very sick and poor population and therefore “increase health disparities for minorities,” this is a pessimistic view of the impacts of this policy. Hospitals that serve low-income, minority communities face unhealthier patients, but at the same time they also probably have low quality of care because of poor management or regulations that are usually as a result of minimal incentives. The government is taking a tactful market approach that gives it some power that it lacked before to incentivize hospitals to try to improve their care. However, the policy should clarify “improvement.” But feeling pressured to improve, hospitals can become more active in implementing new management tools and care approaches that they otherwise did not adopt because of the absence of any financial incentive. The “worst hospitals,” actually have more room to improve.

Sincerely,

Karla Vasquez

"Fight for Social Programs Looms Anew in the House"

Dear Editor:

Monday’s article, “Fight for Social Programs Looms Anew in the House,” describes a bill that would eliminate federal grants for Planned Parenthood clinics. Proponents argue that this would save money, and that taxpayer dollars should not be used to perform abortions. In reality, government grants are not used for abortion procedures, since the Hyde Amendment demands federal funding not be allocated for this purpose. Furthermore, abortion comprises only three percent of services that the clinics provide. Ninety-seven percent is preventive care including breast exams, pap smears, health education, contraceptives, and STD testing. A decrease in this preventive care would likely mean an increase in expensive emergency care and treatments later, so it’s doubtful that the proposed cuts would actually save money overall. Instead of disinvesting in affordable, preventive care for low-income and uninsured patients, the government should financially support these programs.

Sincerely,

Alexis Captanian

Berkeley, CA