"the best of times..the worst of times"

As 32 million more people are about to enter our healthcare reimbursement system, a range of articles in a single day's Wall Street Journal (3/28/11) shows growing Dickensian tension between amazing high tech, low tech human contact, economics and a looming crisis:

--Intelligent LifeHabits: Nashville, home of America's health-care industry, gets $403 million in Federal grants to "foster healthier lifestyles" with programs for walking groups and paths, smoking cessation, weight loss and education. (What's playing in Nashville- Its got a New, Healthier Beat)
OBSERVATION- The grant program funds policy changes, rather than specific activities--- I have to wonder if change for change sake is good, and if good programs will be cut)

-- Fall Prevention: ATT developing "smart slippers" with pressure sensores to detect any changes in whe wearer's gait, and signaling providers of increased fall risk or other issue. (Medicine on the move)
OBSERVATION: Someone can make alot of money selling expensive slippers---if they get covered by medicare/obamacare

--Chinese Medicine: Chinese herbal medicine being researched with bio-informatics, with focus on chronic conditions.
(Putting Traditional Chinese Medicine to Test)
OBSERVATION: Funding is hard to find for such research, as there is no Big Pharm incentive. On April 30, sales of unlicensed herbals will be banned in the EU-- A race is on to demonstrate results before

--Nosocomial Infections: 31,000 deaths a year from bloodstream infections, but only 20% of hospitals have signed up with HHS program to reduce them by half. (The secret to fighting infections)
OBSERVATION: Some hospitals have infection rates 10-15x the national average, and yet there is resistance to using a simple 5 point checklist.

And my favorite..
--Prescriptions Meds: 31% of people didn't fill a prescription, 29% stopped taking too soon, and 49% forget to take their meds. The expert opinion- getting people to change behavior is hard, but "multi-faceted programs" including education delivered by health care professionals show promise in getting people to take their meds...but that is expensive. (How can you help the medicine go down)
OBSERVATION: See Nashville item above-- the dramatic tension between educating people on intelligent LifeHabits OR educating them to take their medicine will be a long running theme.

Steven Weiniger