My letter to a grant recipient at OSU

Today I noticed in OnCampusToday you’ve received a handsome grant of $2.27 million from NIH for “patient engagement.” Congratulations.  I’ve read through your publications, and you have had an impressive career. Although I don’t know what “concept map to define capacity for engagement” means, I would like to comment on patient portals as a means to engage patients in their own care.

I hate them.

My husband has 2 doctors, 3 if you count the cancer specialist whom he rarely sees, and I have 3, family, ophthalmologist and cardiologist. We share the family doctor. Each practice uses a different portal system for finding our lab results, asking questions, tracking meds, etc.  But the worst feature is their sending us advertisements! I don’t know until I’ve made the effort to get in—not easy—why I’m being contacted. What a mess! Fortunately, I don’t think my ophthalmologist uses one, because he’s the one I see most frequently. When I ask him to send a record to my family doctor, he uses a fax.

Recently we received a notice from our financial advisor suggesting we have our own “portal” for his financial services, and I fired back, Absolutely Not. Face to face is always better. I’ve not had eye-contact with a doctor since Obama imposed the horribly expensive EMR system, which had never been tested for improved care or cost reduction. One of the Emanuel brothers just thought the tech industry needed a pay off. My medical records could be transported faster by carrier pigeons from Riverside Hospital to Dr. Jennifer Bush, 2 miles away. And I hold no hope that patient portals will improve my care, at least not the ones in use by any of our doctors.

And by the way, how secure are these portals? Who designs them to be unworkable? Are they more secure than large medical practice records? Two years ago my husband’s urologist’s practice was hacked, and thousands of records exposed with all the personal data that goes along with that.

I have 9 blogs, I’m on at least 4 e-mail discussion lists, I’m on Facebook, I read a lot of medical, political, technology and religious information web sites, and I’m a retired librarian (veterinary medicine) who formerly taught classes in data base searching and information skills.  I used to teach “older learners,” which is anyone over 25.   You need a system that is easy for 80 year olds or admit this technology does not have the capacity to engage.

Norma J. Bruce

OSU Libraries faculty, retired

A little Thanksgiving humor

From my November 25, 2013 blog entry.

The U.S. government has just passed a new law called: "The Affordable Turkey Act..." declaring that every citizen MUST purchase a Turkey this Thanksgiving, no later than Thanksgiving itself, Thursday, November 28th, 2013. These "affordable" turkeys will cost an average of $430 -$545 each. This does not include stuffing, cooking pots, meat thermometers, hunting fees, feather plucking fees, a stove or other device used to cook it in, meat cutters, “removal of innards” fees, labor costs resulting from losses caused by passing out after eating yourself sick of turkey [i.e. 1lb dark meat = appx. 2 lbs white meat in estimated labor losses felt by your employer].

This law has been passed, because until now, typically only wealthy and financially responsible people have been able to purchase turkeys during Thanksgiving. This new law ensures that every American can now have an "affordable" turkey of his or her own, because everyone is "entitled" to a turkey during Thanksgiving. If you purchase your turkey before Thanksgiving, you will receive 4 "free" pilgrim vests; not including frequent dry-cleaning fees.

In order to make sure everyone purchases an affordable turkey, the costs of buying a Thanksgiving turkey will increase on average of 250-400% per year. This way, wealthy people will pay more for something that other people don't want, still can’t afford, or haven’t enough space in their stomachs or people in their home to eat it all. But to be fair, people who can't afford to buy a turkey for Thanksgiving will be regularly fined and children (under the age of 26) can just eat their parent’s turkey until they turn 27; then they must purchase their own turkey for Thanksgiving. If you already have a turkey, you can keep yours (just kidding; no you can't). If you don't want or don't need turkey this Thanksgiving, you are required to buy one anyhow. If you refuse to buy one or can't afford one, you will be regularly fined $800 until you purchase one, or face imprisonment. Failure to eat the turkey this Thanksgiving will also result in fines. People living on the beachfronts; ghettos; inner cities or areas with no access to grocery stores or hunting grounds are not exempt. Meat allergies, veganism/vegetarianism, PETA advocates, lack of knowledge nor desire to cook your turkey are unacceptable excuses for not eating your turkey this Thanksgiving.

A government review board (that doesn't know the difference between the turkey, duck, and bacon in a turducken will decide everything, including; when, where, how often and for what purposes you can eat your turkey, to include how many people you can share your Thanksgiving turkey with and determine if one is too old or healthy enough to be able to eat turkey. They will also decide if your turkey is acceptable to FDA or USDA standards or if you must purchase specific seasonings, condiments, recipes or other additions, (like a government issue can of cranberry sauce estimated at $25.00) or a newer and more fresh turkey. Those who can afford turduckens will be required to do so...it's only fair.

The government will also change the name of the “wishbone” to the “hopebone” as they will be determining the full extent of your fortune in the event that you snap off the larger half of said bone. Failure to comply with these rules – such as continuing to call it a “wishbone” – will also result in fines and possible imprisonment.

Government officials are exempt from this new law. If they want a Thanksgiving turkey, they and their families can obtain turkeys for free, at the expense of taxpayers. Unions, bankers and mega companies with large political affiliations ($$$) are also exempt. If the government can force you to buy health insurance, they can force you to buy a Thanksgiving turkey....or ANYTHING else.. It really is that simple.

By: Constitutional Watchmen

Trump invites people to tell their insurance stories

I find these stories breath taking, although I've heard it from others, like losing a doctor or network, or not being able to find a doctor who would take it.  Think what a family could do with $8,000, what that money could have done for the economy. How many small businesses couldn't expand due to unaffordable health insurance.  No wonder it was such a slow recovery and only the top 1% gained.  Many conservatives like myself have always believed it would implode by design so that they could put single payer in place. If Mrs. Clinton were president, that's where we'd be. Then instead of controlling 1/5 of the economy, the federal government would probably be controlling 1/4.

"One of the participants in the listening session was Brittany Ivey of Georgia, who said her insurance premiums started at $650 per month in 2009 for her family of four, "but from 2009 to 2015, [it] went up 102%. "Finally, [my husband's] employer told us in 2015 when it went up the final time and additional 34%, that they couldn't carry our family any more, so I had to enter back into the workforce but couldn't find a job that offered health insurance," she said.

As a result, the family had to get insurance on the ACA exchange, she continued, adding that she believed it when former president Obama had said that under the ACA, if you liked your doctors, you could keep them. "So even though we were going to have to pay $1,300 a month for Obamacare, we thought we'd still be OK for our doctors. We were on it for 5 months, our pediatrician wouldn't take it, my doctor wouldn't take it, so we paid $8,000 for 5 months and were never able to use it."

Another participant was Kim Sertich of Arizona, who said she lost her plan three times during the ACA era. After seeing her premiums rise from $365 per month last year to $809 per month this year, and her deductible was slated at $6,800. "It just didn't seem like a good use of my money," she said, adding that she has dropped out of her ACA plan and instead is now on a faith-based share program in which, typically, members send in checks to cover the cost whenever a fellow member gets sick. "My husband also runs his own business and can't afford to offer insurance to his employees."  Medpage Today

12 reasons Obamacare will raise your health care costs

All of us will see higher health insurance premiums with the Patient Protection and Affordable Care Act (aka Obamacare). It imposes several costly new mandates and restrictions on health insurers and providers that will raise health cares costs and therefore premiums. This paper lists a dozen factors that will contribute to higher premium costs. Read it carefully, so that when you're accused of being a homophobic racist right wing idiot because you think it should be repealed, you'll have some ammunition.

On reading the new health care bill

There are 2074 pages in the Senate version of health care “reform.“ Fox News is suggesting that we not just accept the talking points of the Democrats, but that the ordinary citizen take a piece of the Senate Health Care bill, study it and send in comments. There is a template in which you can enter information you either like or don’t like. So I took the challenge. (HT Bob C.) I randomly selected a page--1896. That’s a huge mistake, I learned--you're probably better off to begin with a section that interests you. Oh well. I ended up in something called “Follow-on Biologics User Fees.” Call me crazy, but a “user fee” is a tax. Here’s a little poem to keep in mind while browsing this health care bill.

No matter who gets the fee,
it is passed on to me.
So don't be so lax,
Remember it’s a tax.
He said that he wouldn't,
We know that he shouldn't.
But we just can't win,
We've been lied to again.
Unfortunately, I couldn’t make heads nor tails out of this tax. I think a special college level course is needed in how to read a Senate or House bill. They first had to define a biological product, and to do that I had to see section 351 of the Public Health Service Act (42 U.S.C. 262) (as amended by
this Act) and I had to familiarize myself with section 505 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355) and section 3511 of title 31, U.S.C. for standards, and requirements prescribed by the Comptroller General, etc.

But I did see some very disturbing things in this unintelligible section, like dates (5 years after fiscal year 2012, for instance)--for review and audit that seemed to involve a population the size of a small city. Although the wording is “shall consult with“ not “will consult with“ so that might actually make a difference in who figures this one out and how much it will cost me in 2017. Assuming this reform hasn't seriously shortened my life expectancy, which today is somewhere in the 90s.