The Gold Standard for Current Cancer Treatment

Published Online 6/27/2016 in JAMA Internal Medicine.

EandBA couple of months before Elaine died from peritoneal cancer, we hired Anila, a cheerful, hearty Albanian house cleaner. On her first visit, Anila saw that Elaine was bedridden. “Kerosene can save her,” she said. “There is science. Look it up on the Internet.” Later, Elaine and I had a good laugh over it. She said, “Maybe that’s all they have available in Albania.” But in retrospect I’ve thought, “Could it be any worse than the treatment she got here?”

Elaine was a bright light to those who knew her, one of those rare people whose inherent grace put others at ease and made them feel special. A trained pianist, she was also a gifted and productive artist who in her last year painted and gave away more than a dozen original pieces to friends and family. Continue reading “The Gold Standard for Current Cancer Treatment”

When Employers Get Serious About Managing Health Care Risk

Brian Klepper

Posted 4/07/13 on Medscape Connect’s Care & Cost Blog

ALP_H_BK_0010RostLast week I visited with Gary Rost, an unassumingly knowledgeable man and the Executive Director of the Savannah Business Group (SBG), arguably one of the most effective health care coalitions in the country. Their offices are only a couple hours away from my home on the Northeast Florida coast, so it was a quick trip up.

SBG was founded in 1982 as a way of mobilizing employer buying power for better care at lower cost. Its reach now extends beyond Savannah about an hour south, north into South Carolina and west from the coast. The vision described on its site is straightforward and easy for purchasers to appreciate:

“SBG endorses and adheres to the principles of value-based purchasing: performance measurement, transparency, public reporting, pay for performance, informed consumer choice and collective employer leadership.”

Continue reading “When Employers Get Serious About Managing Health Care Risk”

The Reality of Health Care Cost

Brian Klepper

BK 711This beautifully written letter was forwarded after an interview with me on health care cost appeared in a Florida newspaper.

Many of us with coverage often think in abstract terms about working families that do not have access to employer-sponsored coverage, and that must shoulder the overwhelming burden of costs on their own. As Mrs. Doss describes, health care costs dominate her family’s economic life and drive many of their most important decisions.

Continue reading “The Reality of Health Care Cost”

Hospitals: Are We All Talking?

Elaine Waples

Elaine Headshot 11713Complications from my cancer sent me to the hospital again recently. The news that I was in trouble came unexpectedly from my oncologist’s office Thanksgiving eve, following a routine blood test. “Your liver numbers are out of whack.” My response was “Really?” as if I’d been notified that my driver’s license had expired.

I was diagnosed with a blocked bile duct and I missed the turkey and cranberry sauce. My oncologist called in a gastroenterologist, who scheduled a procedure to open the blocked duct. But my tissues were too distorted to complete the procedure, so the next day an interventional radiologist inserted a bile drain. I met him seconds before I drifted into sedation. When it was over and I was awakening, he offered me a cheery “good luck” as I rolled out the door. I never saw him again.

Continue reading “Hospitals: Are We All Talking?”

Walmart Moves Health Care Forward Again

Brian Klepper

Posted 10/12/12 on Medscape Connect’s Care & Cost Blog

Walmart. Save Money. Live Better.Walmart’s sheer size makes almost any of their initiatives newsworthy. That said, despite being a lightning rod for criticism on employee benefits and health care, they have introduced initiatives with far-reaching impacts. Their generic drug program began in September 2006 – more than 300 prescription drugs for $4/month or $10 for a 90-day supply – and was widely emulated, disrupting retail drug markets and generating immense social benefit. Imagine the difference it made to a lower middle class diabetic who had been paying more than $120 per month for medications, and suddenly could get them for about $24.

Yesterday Walmart announced that “enrolled associates” – covered workers and their family members – needing heart, spine or transplant surgeries could receive care with no out-of-pocket cost at 6 prominent health systems around the country: Mayo Clinics (Rochester, MN and Jacksonville, FL); Cleveland Clinic (Cleveland, OH); Geisinger Clinic (Danville, PA); Mercy Hospital Springfield (Springfield, MO); Scott & White Memorial Hospital (Temple, TX); and Virginia Mason Medical Center (Seattle, WA).

Continue reading “Walmart Moves Health Care Forward Again”

Cancer Survivor on N-of-One’s Direct-to-Patient Ombudsman Model

Kevin Davies

Posted 5/31/12 on Bio-IT World

The long-term success of N-of-One, a Waltham Mass.-based company offering personalized cancer information, will undoubtedly be shaped by the vision of its newly appointed CEO, Christine Cournoyer, and strategic partnerships with companies like Foundation Medicine, announced this week.

But ultimately it comes down to whether the company’s original direct-to-patient strategy works for cancer patients like Elaine Waples.

Continue reading “Cancer Survivor on N-of-One’s Direct-to-Patient Ombudsman Model”

DeathWise.org – DIY End of Life Planning

Pat Salber

Posted 5/10/12 on The Doctor Weighs In

For most of us, talking about death doesn’t come easily. Yet, it’s something we all experience — the loss of those we know and love, and ultimately, our own death quote from DeathWise.org

In this wonderful age of digital empowerment, we can now take charge of many things that we used to have to depend on others to do for us.  Examples include booking vacations and managing our investment portfolios. Now, there is a website, DeathWise, that can help you manage your death–well, not exactly your death, rather the planning for your death.  This can mean the difference between an orderly exit or one that leaves your family and friends combing through your papers and guessing your wishes.

In my family, no one ever talked about death, let alone planned for it. One example was the death of my maternal grandmother who, at the age of 78, died in her bed in the apartment she had rented for almost 40 years. Neither her daughters, their spouses, nor the rest of her extended family had any idea about the details of her life despite the fact that we all lived within 30 miles of her house and saw her frequently. We were pretty surprised to find out that all of “her” furniture actually belonged to the landlord.

And, that her frugal habits included saving every rubber band that ever made it into her hands – all rolled up into a gigantic rubber band ball. We didn’t know where her papers were, what type of service she would like or even if she preferred cremation or burial. We muddled through, spending days in her apartment opening cupboards, poking around in drawers, and rifling through papers, bankbooks (remember them?), and check stubs. We hoped we did what she would have wanted, but we weren’t really sure.

Continue reading “DeathWise.org – DIY End of Life Planning”