Living on, with Heartbreak

This is an incredibly touching part of a great series by the Baltimore Sun on the effect of the death of a child. The series is inspired by an Institute of Medicine report on the failure of the U.S. healthcare system to respond to issues in terminal illness and death of children more generally:

Too many sick children endure aggressive procedures and treatments. Too many won't get the pain medicine they need. Many go months and years, cycling in and out of hospitals, without emotional and other support, concluded the Institute of Medicine in its report "When Children Die." In calling for more research and better training, the institute urged organized medicine and others to look at what has been a hidden issue.

"It is a painful thing to sit and dwell upon, that there is undue suffering happening to and with our babies and children," said Lizabeth Sumner, a member of the IOM committee who pioneered hospice programs for children in San Diego. "There will always be kids who die of something. As a society, how are we going to choose to respond to that situation?"

The Plan is Much too Complicated for Lobstermen

The Commonwealth Fund reports on the new health system proposal in Maine:

In June 2003, Maine Governor John Baldacci signed into law the Dirigo Health Reform Act to create a sustainable health care system for the state. Maine is seeking to contain costs and ensure health care access for all its residents, while improving quality at the same time.

[thanks Art Caplan]

Pro-Life? Show it with Child Health Policy

Mark Tushnet, a constitutional law scholar, argues carefully that the most important question about pro-life positions is their coherence. He demonstrates that the problem with pro-life arguments is that they are at best backed up by nominal support for "pregnancy crisis" centers, or for support of children in adoptions. Where is the committed right wing effort to decrease the amount of suffering among children of poor health? Then Governor Bush was much criticized in the 2000 election for the failure of his Texas administration to implement serious child health coverage reforms, for example.

And today? Though there is little federal information about abortion's prevalence during the first W. Bush administration, Christian ethicist Glen Stassen discusses the data that suggests that abortions have dramatically increased since President Bush took office. Perhaps the fear that women quite obviously (and rightly) have about the lack of sufficient child care might play more than a minor causal role in this pretty interesting correlation. (thanks to metafilter.

Votes & Values (Multiple Sources)

Just about enough time has passed for the Monday morning quarterback essays to come out in earnest about the election. Equally notable are the essays proclaiming victory. One of my favorite essays is Jeff Weiss' in the Dallas Morning News which analyzes the rhetoric of values in the election. The most read blog on the Internet, Daily Kos, summarizes his take on the most prevalent theories as to what the election means, and the discussion includes almost 400 responses many of which are from health policy analysts. Also around the blogs, Matthew Holt of Health Care Blog opines on winners and losers. The quite conservative San Francisco Chronicle discusses the role of celebrity endorsements, which really have reached an unprecedented pitch in this round of elections. Christian Science Monitor discusses the demonization of big pharma, which is interesting since the discussion of drug companies does not seem to have played a significant role in the election.

Health Care System is Broken

This is a great start to a 5 part series that the SF Chronicle is running on the problems with the U.S. health care system. While (unfortunately) they don't turn to any of the bioethics folks who work in this area, there are a lot of good economists and health services researchers who weigh in and the piece is quite substantial--and very scary for anyone who has been trying hard not to think about the cliff we seem to be heading towards. CORRECTED: link was broken! - David Magnus

Pay My Malpractice Insurance and Call Me in the Morning

Sandra Boodman, in a Washington Post story sent to us by the Northwest Herald, interviews two physicians who require extra fees of insure patients. One asks $10 each - again that's from the patient - to cover his $10,000 malpractice bill. Another writes of his $125 fee (to cover his $30,000 bill) that "he felt compelled to act ... after his income dipped below the national average for his specialty, about $140,000."