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...trillion renminbi (about $370 billion) on social programs by 2012. Lu Mai, the secretary-general of the foundation, notes that the government has started down this road with a new plan to drastically expand health coverage in rural China, where some 800 million of China's 1.3 billion people live. That's a step forward. But China will need to spend more to expand its safety net, as Lu says, and it needs to hurry. If only it could import Barack Obama's economic-recovery act. It might work better here than it does at home...
...most of us have found that CPOE is a lot harder than writing out orders on paper, takes far more time and in too many ways is just not as good. We're never quite sure that what we've typed is going to be seen by a real, live, analog nurse, that it isn't just going to disappear. (It does.) We can't order certain things with those buttons and pull-down menus that we could in writing - things like "patient may wear her own flannel nightgown and underwear" or "please, please get the x-ray I ordered...
...Doctors live with denials, some of them dangerous. I've ordered MRI's on hospitalized patients that somehow never got done, physical therapy and medication never delivered, because of "unmet requirements" picked up when codes are scanned. When the white blood count isn't high enough to "justify" the hospitalization for IV antibiotics, the physician whose judgment says "this patient is sick and belongs in the hospital" is told his services as well as the hospitalization will not be paid for. When a doctor is convinced a test or treatment is needed, (and his patient doesn't have the money...
Before we had them on every countertop, computers held such promise for us in medicine: doctors and patients live in a world of painful, pressing questions, the answers might be in there. Or so we thought. Twenty nine years from the night I first sat in a hospital in front of a computer screen the questions persist. And I still don't see the profit-maximizing, cost-controlling physician with his nationwide computer treating patients any better than the great physicians I've known have. With pen and paper, personal commitment to each patient and judgment born of practical experience...
Kluger maintains that "you live longer if you go to church." The reason for this might well be that church attenders on average come from more fortunate economic groups. One also needs to know the ethnicity of any grouping selected for research. Do the 82% of black people who say they are church members live longer than people in other ethnic groups who do not go to church? Richard Westall, WALTON-ON-THAMES, ENGLAND...