January 3, 2013
2012: the not-so-health(y) news
It's here again, time to take stock of the year just ended. Here's the big health news in the year that just was:
2012 started with the death of Google Health, the software company’s much ballyhooed online health record that would have allowed patients to store their medical information for easy access everywhere they went. Let's consider that a small victory. No longer will patient’s dietary history be subject to pop-ups from diet pill companies, along with the Google map location of the nearest weight control clinic.
Also in January, a study in the journal Nature revealed that fat doctors don’t give much advice about obesity to their fat patients. The study referred to a previous study of pots and kettles and their perception of color.
In February, a report revealed that more and more patients are visiting emergency rooms for dental emergencies. A spokesperson for the tooth fairy revealed that she is waiting for a government bailout, as the cost of operations has skyrocketed. “This is a sign of a health care system in crisis,” the spokesperson said, holding a golden tooth in its hand.
Also in February, the office of the national coordinator for health IT revealed stage 2 criteria for meaningful use of electronic health records. The criteria now contains a requirement for electronic health records to sing limericks while reading the end-user’s mind as he or she imagines examining the patient before billing for a comprehensive visit. Another requirement is to have a treadmill hooked up to a computer in each exam room, and make the physician jog while describing the benefits of a svelte waistline to their patients.
In March, the whole country was riveted by the Supreme Court’s hearings on the constitutionality of the Affordable Care Act. (The act, known as ObamaCare by the pundits on the right, is referred to as RomneyCare by the pundits on the left and WhyDoICare by a growing segment of the insured-to-the-gills public.) Little did we know then that Chief Justice John Roberts, in consultation with the tooth fairy, Dr. Evil and Houdini’s ghost, was concocting a twisted formula to preserve most of the act, while safeguarding the perceived impartiality of the Court and setting the legal basis to demolish pretty much every other legal precedent in existence.
From the department of my evidence-trumps-your-style, the U.S. Preventive Services Task Force in April recommended against all women in their 40s getting an annual mammogram. Watson, the supercomputer that in April joined forces with Wellpoint, the nation’s second largest health insurer, reportedly blew a fuse, as the recommendation was not compatible with its binary algorithm (“if boob=40, then mammogram”).
Upon hearing the news about Watson, doctors and nurses everywhere exhaled a collective sigh of relief. And the American Medical Association, as part of its national conference attended by two medical students and five drug reps, awarded the U.S. Preventive Services Task Force its “Humanitarian of the Year” award.
In May, the proposed revisions to the new version of the diagnostic and statistical manual of mental disorders was revealed. Apart from including “gambling” as an addiction disorder, the DMS now says that happiness and sadness are conditions easily treatable with pills or acupuncture, and that people who are emotionally balanced may need cocaine enemas to rebalance their normalcy.
June gave us the long-awaited decision by the Supreme Court on the Affordable Care Act. By a 5-to-4 majority, cemented by Chief Justice Roberts' convoluted logic, the court upheld AND struck down the law at the same time. As a result, no one knows who will have health insurance in the next decade.
In July, the Summer Olympics got under way, with an opening ceremony in London that celebrated England’s National Health Service. In response, Congress prepared to boycott the Olympics for celebrating a socialistic health system, until someone pointed out that “Social Security” starts with the same letters as “Socialist”.
Also in July, a depressed journalism student finishes reading the Supreme Court’s decision on the Affordable Care Act. Finding the word “cattle” in the text of the document, he deduces that cows will be eligible for health insurance in the year 2014.
In August, a study revealed that tax incentives being used to lure people into donating their organs for patients needing a transplant are not working. That's probably because the IRS has already taken our spleens, gallstones and pancreas.
Also in August, Kaiser Health News announced that the Johns Hopkins Armstrong Institute for Patient Safety and Quality received a grant to improve patient safety protocols in ICUs. Included in that project is developing software to allow machines such as ventilators and IV pumps to “talk to each other.” In his secure, undisclosed location, Watson looks at the map of the world, licks his cybernetic chops, and decides that soon, very soon, Australia will become “Siliconia." When that happens, human beings will indeed be reduced to batteries harvested for energy production.
From the department of really-obvious-research, a study published in the September/October issue of the Annals of Family Practice found that patients seen in primary care offices that offer extended office hours had lower total health care expenditures than patients seen in an emergency room. A follow-up study revealed that defensive medicine increases health care costs, ambulance-chasing lawyers are a bunch of schmucks and insurance companies really only care about their bottom line.
In October, the country was riveted by the presidential and vice-presidential debates. Lessons learned: One can lose a debate and win an election; he who smirks the most gets elected vice president; and always blame the moderator. The country also learned that one never learns anything new in these debates, and that DVRs are a blessing when trying to avoid election news coverage and commercials.
Also in October: Superstorm Sandy hit the East Coast. No joke there, just badness.
In October also, my father passed away. He was a great doctor. And surely, somewhere up above, he is rolling his eyes at this column.
In November, the election happened. The new president is the old president, which meant the Affordable Care Act would go forward. That college student who read the whole thing got hired as a lobbyist by the dairy industry to make sure cows indeed had health insurance for the next decade.
Also in November, the Journal of Happiness Studies (I swear I did not make this one up) published a study, revealing that happiness and health are not always linked and that people in poor health are often as happy as those with no medical problems. In an op-ed, the Journal of Pessimism and Doom downplayed the study as “insufficiently unscientific.”
December brought us the fiscal cliff, inactivity and procrastination that has served our country well. This includes the annual waterboarding of doctors, also known as the Medicare doc fix.
Every year, Congress waits until the final minute to patch this loophole that, unpatched, could result in a 27% pay cut for providers, starting in the New Year. Meanwhile, every year Congress is entitled to a “cost of living” pay increase unless they vote to freeze it for that year. Maybe they should fix that loophole too, and change it to a law that ties congressional pay to productivity. That should fix the country’s fiscal deficit.
Finally, the year ended on a terribly sad note with the massacre in Newtown. While we debate the merits of tougher gun control laws or improvements in the provision of mental health services, let’s not forget the families of all those affected. No law or intervention can bring those children and teachers back home.
So what am I looking forward to next year?
A recalculation of the Mayan calendar showing that the world will absolutely, positively, for sure end on Dec. 21, 3012;
Watson publishing an article in the Journal of Hyperbolic Quantum Kilobytes for Self-Aware Computers titled “Humans are people too, only stupider”; and
the student that read the whole Affordable Care Act getting fired over his assertion that cows may be covered for everything except for predisposing conditions … like mad cow disease.
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About Ruben J. Nazario, MD
Ruben J. Nazario, MD, is now medical director at Inovalon, a health care data analytics company, and is medical editor for Elsevier's First Consult. A pediatric hospitalist, Dr. Nazario is a veteran of both community and academic pediatric hospitalist programs. All material represents his own views and does not reflect the views of his employer.