btw2.net

ScienceRoll has a post titled Web Directories of Medicine and Web 2.0 which links to several other medical 2.0 blogs. And they note:

What is the difference between medicine 2.0 and health 2.0? Walter Jessen has the perfect answer:

Medicine 2.0 is science of maintaining and/or restoring human health through the study, diagnosis and treatment of patients utilizing web 2.0 internet-based services, including web-based community sites, blogs, wikis, social bookmarking, folksonomies (tagging) and rss, to collaborate, exchange information and share knowledge.

Health 2.0, a new concept of healthcare, also utilizes web 2.0 internet-based services but is focused on healthcare value (meaning outcome/price). Patients, physicians, providers and payers use competition at the medical condition level over the full cycle of care as a catalyst for improving safety, efficiency and quality of healthcare delivery.

The part worth noodling on:

…The U.S. health-care system has two distinct parts — financing and delivery. The financing system is how we pay for health-care services. It is composed of employer-based insurance, the individual insurance market, Medicare, Medicaid, SCHIP, the veterans health system and other programs. Today, the private part — employer-based coverage and individual insurance — accounts for just under 55 percent of all payments for health care, while government contributes about 45 percent.

The delivery system consists of about 850,000 doctors, 5,000 acute-care hospitals, 39,000 pharmacies and 8,100 home health agencies, as well as hospices, surgical centers, radiological centers, laboratories and other outlets that provide the actual health-care services Americans need.

To the extent that any health insurance scheme involves spreading among members of society the financial risk of getting sick, all insurance “socializes” the risk. This is, of course, not what people mean when they level charges of “socialized medicine.” This term is never used in reference to police protection, fire departments or highways — all of which are provided by government.

Properly speaking, socialism is when the state owns or controls the means of production. Thus “socialized medicine” is when the doctors are state employees; when the hospitals, drugstores, home health agencies and other facilities are owned and controlled by the government.

Only one part of the U.S. system really is socialized medicine: the veterans’ health-care system, which is wholly owned and operated by the federal government. Veterans love the system and vigorously oppose any suggestions of dismantling it and integrating them into civilian health care. By many measures, this bastion of socialized medicine may constitute the highest-quality and most efficient part of American health care….

It is absurd to call an expansion of government payments for health care in the existing private delivery system socialized medicine. Politics may be full of hype, exaggeration or partisan bickering, but there should be no place for overt deception. A serious debate about whether and how to reform the American health-care system requires that we eliminate comments whose only purpose is to mischaracterize and misinform….

‘Socialized Medicine’ Quackery
By Ezekiel J. Emanuel, The Washington Post, October 8, 2007
Ezekiel J. Emanuel, an oncologist and
the author of “No Margin, No Mission: Health Care Organizations and the Quest for Ethical Excellence,”
chairs the Department of Bioethics at the National Institutes of Health.
The views expressed here are his own.

The Arizona Republic has an article this morning about world weather records and who investigates them and arbitrates what are real records.
It’s not a weather record until he says it is
U.N. taps professor at Arizona State to create global archive

The purpose is to establish an authoritative tracking and record of weather extremes, which will help scientists understand weather patterns and climate shifts over time. A sharp increase in record-setting extremes could provide clues to the Earth’s climate shift.

How’d he get into this? “Cerveny got interested in weather as a child in Nebraska. His family’s hilltop farm was on the edge of town, and the sheriff would drive to their house in bad weather to watch for tornadoes. If the sheriff saw one, he would radio in so the town could sound warning sirens.”
His thoughts on On global warming:

“I don’t think it’s going to be catastrophic. We’re going to have to change and develop sustainability ideas to handle the change. But I was once asked by students, ‘Are we going to be around in 20 or 30 years?’ Well, yes, we’re going to be around. It’s going to be a different place, but we’re going to be around.

The World Meteorological Organization recently launched a Web site that archives world weather/climate extremes. Here are some examples from the site, wmo.asu.edu/….

Indicators of change

…As Cerveny considers such data, he ponders whether extreme events are an indicator of global climate change. No one can point to a new record rainfall or heat spell and declare it’s a sign of global warming, he says. But if more records occur, they could indicate a climate change. Any determination depends on their accuracy….

Today The Health Care Blog has a post - The Perpetual Health Care Crisis By Jeff Goldsmith.
It begins:

I began teaching health policy almost thirty years ago with Odin Anderson at the University of Chicago Graduate School of Business. Like me, Odin was a sociologist, and one of his hobbies was tracking the sociology of our nation’s “healthcare crisis”. He found that the health care “crisis” waxed and waned (as measured by press mentions and journal articles), but never disappeared. It had been going on for twenty years by then, so I guess we’ve now been in “crisis” for fifty years. The American health care “crisis” is not acute illness - rather it is like a chronic disease which flares up periodically, accompanied by fresh prophecies of impending doom and calls for someone on a white horse to fix the problem.

From 1970 to 1993, health costs roughly doubled as a percentage of GDP. All the way along, prophets of doom forecast that the country would simply fall apart when health costs exceeded 8%, then 10%, etc. . Our economy somehow continued growing and innovating, and the health system got steadily more capable at managing our illnesses the entire time. No-one I know would trade our present, very expensive health system for the cheaper one we had in 1965 or 1980….

There are several things to keep in mind as we delve into our “crisis”:

1. Medical care is not the same as health care. Health care involves illness avoidance as well as the treatments of medical care.
2. Many leaps have been made in both medical care and health care.  And, like Jeff Goldsmith, I wouldn’t got back to 1965 or 1980 for cheaper health care.
3. Some folks rely on their doctor to keep them healthy. The doctor can help but the “patient” does much of the health benefit effort by managing their lifestyle. (yes, heredity can short circuit all of that. but try anyway.)
4. While the cost of health care has gone up, the practice of medicine has changed dramatically. Some doctors are still trying to manage their practice like its 1980. The doctor and their patients are ill served by that lact of a progressive effort.

And I’ve found value in the ideas in this book.

ScienceRoll has a post - Personalized Medicine: The Future is Now
which links to several news and announcement links.