Medical Grand Rounds 5.47

Dr. Rich hosts this week’s issue of Medical Grand Rounds. The topic is cost containment in healthcare reform.

The commentary was true to his reputation for sharp, stinging humor. Good sarcasm is hard to do because if the audience doesn’t understand the issue, it can be taken all wrong.

In the introduction, Dr. Rich (retired cardiologist Dr. Richard N. Fogoros, M.D.) reminded readers that critics of healthcare reform legislation have been formally serviced notice that they are under surveillance should they be caught making errors in describing the proposed plan and risk being reported to Linda. He welcomed visitors on such important surveillance work, though, and assured them that they would find no malefactors here and that they could safely move on…

For readers who weren’t sure what he was talking about, it was a commentary about last week’s citizen informant news when the White House asked people to report to the government anyone saying or writing anything “fishy” about the Administrations’ healthcare reform legislation — whether rumors, casual conversations or emails. Of course, it’s raised privacy concerns and parallels to past governments that have used citizen informer techniques. Since then, bloggers have responded in droves, turning themselves in.

Medical news JFS readers may find especially interesting is that Dr. Nicholas Christakis has taken his social networking model (which he'd used to support a theory that fat is catching) to matchmaking.

A medical blog post Dr. Rich missed including in Grand Rounds was his own. Last week he talked to patients who believe greedy doctors using expensive technology and insurance companies are finally going to have it stuck to them in healthcare reform. They tell you that “once they take care of the evildoers, you, the patient… will be left with full, efficient, timely, and effective healthcare.” But this is where you are wrong, he wrote.

“If you believe that you patients are not, in fact, the primary target of the healthcare reformers, you have not been paying attention,” he wrote. “If you would like to get a preview of how you are going to be treated under the new healthcare regime, consider the growing plight of one relatively small subset of your number - the obese.” He went on to talk about “obesity as a health risk factor now marked for particular excoriation” under the plan. If patients and doctors don’t get this stuff, he wrote, then we are all “truly screwed.”