Friday, August 19, 2016

RAMBLINGS ON HEALTH CARE #1




Once again I will reiterate that Obama care is overall a bad health care solution for Americans.

Aetna is dropping out of 11 of the 15 Exchanges where it has been offering Insurance .Medications are being limited in many cases to “similar drugs” which may not have equal therapeutic effect, but are cheaper. Doctors are becoming employees of conglomerate hospitals.

I will expand on this later on.

I may be prejudiced by the fact that I practiced or was involved with patient care for 55 years. During that time there was the golden age of medicine with the evolvement of many new procedure and many new medications.

Yes, the quality of care would vary from locality to locality, and from doctors to doctors. It was not until after WWII that Board Certification evolved so that a quality level of individual physicians could be determined.

In the 40s there was little criteria for a standard for surgeons. In Plainfield for example the 4 senior surgeons on Muhlenberg’s staff were also general practioners who had gradually restricted their practice to some form of surgery. Most also still acted as a family physician. As Board Certification and Residency programs became the norm there was a standard of training not the doctor’s self-assessment that justified his privileges in the hospital.

By the seventies to be admitted to the Muhlenberg’s Staff a physician had to be certified in his field, including family (general) practice. That as something not yet being required at other area hospitals including JFK>

During my term as Staff President I know that Muhlenberg’s Staff was as good as any hospital’s in the country including some medical schools.

However for the first 30 years Federal government intervention was minimal. Now there are so many rules and regulations which not only does the doctor have to spend the greater portion of his time complying, but he/she has little time for one on one with a patient.

After the Thalidomide disaster of the 60s The FDA began strict testing of new medications before permitting their use for specific indications. Even older one for new indications had to undergo such study. Off the label use by Doctors was at his legal risk, even if the drug was effective. A new field day for the lawyers.

Now it may take years for approval although the drug or procedure has been in use in Europe for several years.

No longer were unsupervised clinical trials by physicians permitted or accepted. True, some unfortunately had had the results adjusted to fit the Drug Companies desired results. No longer could a doctor like myself do clinical trial on a drug as I did when my report to Cibia was instrumental in getting Serpasil a manufactured alkaloid from rauwolfia approved as the first drug treatment for high blood pressure. Upjohn used my letter to get their drugs approval.

Ciba was so grateful they made me a member of the National Academy of Science. They then sent me a drug called Ritalin which they wished to sell in completion to SKF’s appetite suppression best seller Benzedrine. When I reported after 10 cases it was not worth a damn, they dropped me as a clinical tester, the also shelved the drug for decades when it found a use for child ASHD. This has since been largely discredited.




.This is the first of a new series about health care today and the impact of ACA after 2 ½ year.
 


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