A 100 year old woman is brought to the emergency room by a concerned friend because she can no longer get out of bed to get food or go to the bathroom. Other than being unwashed and a little confused, she is fine. Her electrolytes are pristine, her electrocardiogram the definition of normal, her blood count and chest x-ray perfectly mirror the expected physiology for her age. Even her urinalysis is normal. She takes no medications and hasn't been to the doctor for a decade. She has no living family and her friends have their own lives and problems. She can't go home because she has just gotten too old. What shall we do with her? When the law establishing Medicare was enacted in 1966 as title XIII of the Social Security Act during the presidency of Lyndon Johnson only half of seniors had health insurance and many had no access to healthcare because they couldn't afford it. Now nearly all seniors in the US have insurance coverage for both ambulatory and hospital care. M...
The cost of health care in the US is higher than anywhere else in the world, and yet we are not healthier than our peer nations. In fact, in terms of such measures as infant mortality and life span, we don't measure up. Why is this? Many people involved in providing or receiving care have some pretty good ideas about what costs so much, and what we can do to reduce costs and improve quality. Sharing these stories is an important step in creating affordable universal health care.