nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
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Wednesday, September 10, 2008

Fire Hazards. Medical Costs

Study suggests children may have high levels of chemical fire retardants in their blood.

USA Today (9/5, Szabo) reports that "a study of 20 families [conducted] by the Environmental Working Group (EWG)" reveals that "young children have high levels of chemical fire retardants in their blood." According to the EWG, "toddlers and preschoolers had levels of" polybrominated diphenyl ethers, or PBDEs, in their blood "that were, on average, three times higher than their mothers.'" In 2007, Danish scientists also "found that boys whose mothers had high levels of fire retardants in their breast milk were more likely to have" testicles that did not descend properly.

Doc D: This may not be all bad: maybe fire retardants in the blood stream increases toddlers’ resistance to getting burned in a fire, or scalded in their bath water.

That was kinda heartless, but it was a joke. Seriously, I’m hard pressed to know whether I want to take fire retardants out of toddlers’ clothes based on this. Neither option sounds too good; I’m not aware of any retardant substitutes yet, other than asbestos (which is carcinogenic)… or going naked (your clothes won’t catch on fire if you’re not wearing any). And while I’m really committed to every testicle’s journey into descent, I don’t think we’ve got the full story yet—only 20 children in the study.

Medical pricing system seen as "inscrutable."

In the Los Angeles Times's (9/7, Lazarus) Consumer Confidential column, David Lazarus wrote about "the inscrutable way that healthcare providers and insurers put a dollar value on medical services." According to Jim Lott, executive vice president of the Hospital Association of Southern California, "patients are wrong to think that the charge on their bill reflects the actual cost of treatment." Lott explained the "cost-plus system" allows hospitals to include "both the cost of a service and a portion of general overhead, including treatment of uninsured people," to calculate charges. Meanwhile, insurance companies and "state and federal authorities...negotiate lower rates, in return for delivering thousands of patients to a particular clinic or hospital." Lott described the system as one "that both condones and perpetuates inflation, while all but eliminating transparency in the marketplace.

Doc D: It’s not inscrutable. As a doctor, if I know that the insurance will pay $40 for a routine visit, I charge $80…because I know that if I charge $40 (what I should get) the insurance company will re-average the “customary” charge and give me $20. So I’m forced to charge high in order to keep the reimbursement rate up. Is this a stupid system or what?

Doc D

Opinions are entirely my own. Quotations from Kaiser Daily Health Policy Report ( © Kaiser Family Foundation), PND News Briefs – Texas Edition ( © 2008, Physician's News Digest, Inc.), and AMA Morning Rounds (© U S News Custom Briefings). As always, you may share this column, with appropriate attribution (above) included

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