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	<title>Health &#38; FamilyCategory: Health Care &#124; Health &#38; Family &#124; TIME.com</title>
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	<description>A healthy balance of the mind, body and spirit</description>
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		<title>Health &#38; FamilyCategory: Health Care &#124; Health &#38; Family &#124; TIME.com</title>
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		<title>Diagnostic Errors Are the Most Common Type of Medical Mistake</title>
		<link>http://healthland.time.com/2013/04/24/diagnostic-errors-are-more-common-and-harmful-for-patients/</link>
		<comments>http://healthland.time.com/2013/04/24/diagnostic-errors-are-more-common-and-harmful-for-patients/#comments</comments>
		<pubDate>Wed, 24 Apr 2013 12:00:55 +0000</pubDate>
		<dc:creator>Alexandra Sifferlin</dc:creator>
				<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Health Reform]]></category>
		<category><![CDATA[Hospitals]]></category>
		<category><![CDATA[Policy & Industry]]></category>
		<category><![CDATA[Regulation]]></category>
		<category><![CDATA[Safety]]></category>
		<category><![CDATA[health care costs]]></category>
		<category><![CDATA[medical misdiagnosis]]></category>

		<guid isPermaLink="false">http://healthland.time.com/?p=85032</guid>
		<description><![CDATA[When Dr. David Newman-Toker was a medical resident at a Boston hospital, he witnessed what he calls tragic cases in which otherwise healthy people suffered serious consequences from misdiagnoses that could have been prevented. Newman-Toker, now an associate professor of neurology at the Johns Hopkins University School of Medicine, recalls an 18-year-old aspiring Olympic skater who fell on a ski slope and came to the hospital with weakness on one side of her body and a headache. She was told she had a migraine and was sent home. Six days later, she returned to the hospital after a stroke compromised the entire right side of her brain. He also remembers a hardworking janitorial immigrant in her 50s who came in with chest pain. She was seen multiple times at multiple hospitals and everyone missed that her chest pain was caused by compression from her spinal cord. By the time it was recognized, she was a paraplegic. Not every visit to the hospital has a happy ending, and neither does every misdiagnosis lead to severe harm, but Newman-Toker&#8217;s personal experiences motivated him to improve medical misdiagnoses, which he says are not only common, but preventable in most cases. To gain more knowledge about the scope of medical diagnostic errors in the U.S., Newman-Toker and his colleagues reviewed 25 years of medical malpractice claim payouts and reported their findings in the journal BMJ Quality and Safety. (MORE: In-Depth Video: The Exorbitant Prices of Health Care) To make their estimates, the investigators studied medical malpractice payment data from the National Practitioner Data Bank, an electronic collection of all malpractice settlement payments made by practitioners in the U.S. since 1986. They found that diagnostic errors were the most common source of the payments, the most costly and the most dangerous when it came to patients&#8217; health. Such errors, which included diagnoses that were incorrect, wrong or delayed &#8212; were most likely to result in death than other other sources of malpractice suits such as surgical mistakes or medication overdoses. &#8220;People who study diagnostic errors have known for many years that diagnostic<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=healthland.time.com&#038;blog=8684427&#038;post=85032&#038;subd=timewellness&#038;ref=&#038;feed=1" width="1" height="1" />]]></description>
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		<slash:comments>1</slash:comments>
	<primary_category>Health Care</primary_category><primary_category_link>http://healthland.time.com/category/policy-industry/health-care/</primary_category_link><featured_image>http://timewellness.files.wordpress.com/2013/04/bc8649-001.jpg?w=240</featured_image>
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			<media:title type="html">asifferlin</media:title>
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		<title>Doctors Go Shopping: Price Comparisons Lead MDs to Lower Testing Costs</title>
		<link>http://healthland.time.com/2013/04/16/study-hospital-cuts-costs-when-it-shows-doctors-test-fees/</link>
		<comments>http://healthland.time.com/2013/04/16/study-hospital-cuts-costs-when-it-shows-doctors-test-fees/#comments</comments>
		<pubDate>Tue, 16 Apr 2013 09:45:47 +0000</pubDate>
		<dc:creator>Alexandra Sifferlin</dc:creator>
				<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Policy & Industry]]></category>
		<category><![CDATA[health care costs]]></category>
		<category><![CDATA[medical bills]]></category>
		<category><![CDATA[medical tests]]></category>

		<guid isPermaLink="false">http://healthland.time.com/?p=84680</guid>
		<description><![CDATA[It&#8217;s a basic tenet of smart shopping &#8212; compare prices so you can find the best deal. Doctors, however, are often in the dark about what medical tests cost. In a commentary accompanying TIME&#8217;s recent report &#8220;Bitter Pill: Why Medical Bills Are Killing Us&#8221; detailing out-of-control health care costs, Cleveland Clinic CEO Dr. Toby Cosgrove described one of the sources of escalating costs &#8212; doctors who aren&#8217;t informed about how much tests and supplies and other medical services actually cost. Now, a new study by Johns Hopkins researchers published in the journal, JAMA Internal Medicine shows that alerting doctors to the costs of the tests they&#8217;re ordering can lead to cheaper choices and hefty savings. The scientists conducted a six-month experiment at Johns Hopkins Hospital to see if showing doctors test prices, and giving them the opportunity to comparison shop for tests they frequently ordered, would change decisions about services used at the hospital. The researchers identified 62 commonly ordered diagnostic blood tests and split the tests into two groups. Half of the tests came with their price, while the other half did not. The researchers compared the buying behavior of the physicians and found that showing the pricing information resulted in a 9% cut in use of the tests overall and a savings of over $400,000 over the six months. By comparison, there was a 6% increase in the use of the tests without pricing information over the same time period. (MORE: Bitter Pill: Why Medical Bills Are Killing Us) &#8220;We generally don&#8217;t make decisions based on what is cost-effective &#8230; for our patients, but knowing the cost of things appears to make us more thoughtful about what we think might be best for their health,&#8221; said study author Dr. Leonard S. Feldman, an assistant professor of medicine at the Johns Hopkins University School of Medicine in a statement. &#8220;There&#8217;s a lot of waste in medicine because we don&#8217;t have a sense of the costs of much of what we do.&#8221; The researchers say the savings can be largely<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=healthland.time.com&#038;blog=8684427&#038;post=84680&#038;subd=timewellness&#038;ref=&#038;feed=1" width="1" height="1" />]]></description>
		<wfw:commentRss>http://healthland.time.com/2013/04/16/study-hospital-cuts-costs-when-it-shows-doctors-test-fees/feed/</wfw:commentRss>
		<slash:comments>1</slash:comments>
	<primary_category>Health Care</primary_category><primary_category_link>http://healthland.time.com/category/policy-industry/health-care/</primary_category_link><featured_image>http://timewellness.files.wordpress.com/2013/04/136644834.jpg?w=240</featured_image>
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			<media:title type="html">136644834</media:title>
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			<media:title type="html">asifferlin</media:title>
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		<title>Letters to the Editor: Read Reactions to &#8216;Bitter Pill&#8217;</title>
		<link>http://healthland.time.com/2013/03/07/letters-to-the-editor-read-reactions-to-bitter-pill/</link>
		<comments>http://healthland.time.com/2013/03/07/letters-to-the-editor-read-reactions-to-bitter-pill/#comments</comments>
		<pubDate>Thu, 07 Mar 2013 12:47:53 +0000</pubDate>
		<dc:creator>TIME Staff</dc:creator>
				<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Health Insurance]]></category>
		<category><![CDATA[Policy & Industry]]></category>

		<guid isPermaLink="false">http://healthland.time.com/?p=81748</guid>
		<description><![CDATA[As a surgeon, I want to commend Steven Brill on an outstanding article. A detailed discussion about the pricing and profits in health care is long overdue. You succeeded in putting a personal face on this crisis, and yes, it is a crisis. Most people are not aware of the outrageous costs  until they or a family member becomes ill. Indeed, we are but one major illness away from bankruptcy. To the Republicans: the health care market is not a free market. Competition raises costs, it does not lower them. Why? Fancy new buildings and technology of dubious benefit raise costs. Patients always demand what&#8217;s new, because it is perceived to be better, even when it is not.  Get over your dislike of President Obama; being against Obamacare is not enough. Our healthcare costs are bankrupting our nation and hurting our international competitiveness. You need to come up with realistic, constructive solutions. As on the issue of Social Security and Medicare, you risk being on the wrong side of history. To President Obama and the Democrats: Do not think that we practicing physicians love everything about Obamacare. The goal of universal coverage is laudable. But your failure to address the issue of cost, so eloquently illustrated in this article, will bring the entire health care system down very soon if it is not addressed. And I appreciate the article&#8217;s emphasis on the need for liability reform. The hidden cost is enormous. Roger R Perry, MD, FACS Virginia Beach, Va. (COMPLETE COVERAGE: Why Medical Bills Are Killing Us) I read Mr. Recchi’s story with interest on several levels. First, as a physician, I know how important it is for Americans that health care “get it right.” Second, as a person also diagnosed with non-Hodgkin’s Lymphoma, I understand the fear and uncertainty that comes with such a devastating diagnosis. And finally, on a third level, I serve as Chief Medical Officer for a company whose vision is to improve the quality and lower the cost of healthcare through better use of data and analytics.  I can understand the frustration of not being able to get answers to questions such “where can I get the best care”, “what should it cost” and “how can I<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=healthland.time.com&#038;blog=8684427&#038;post=81748&#038;subd=timewellness&#038;ref=&#038;feed=1" width="1" height="1" />]]></description>
		<wfw:commentRss>http://healthland.time.com/2013/03/07/letters-to-the-editor-read-reactions-to-bitter-pill/feed/</wfw:commentRss>
		<slash:comments>1</slash:comments>
	<primary_category>Health Insurance</primary_category><primary_category_link>http://healthland.time.com/category/policy-industry/health-insurance-policy-industry/</primary_category_link><letterbox>1</letterbox><featured_image>http://timewellness.files.wordpress.com/2013/03/bitterpill1.jpg?w=240</featured_image>
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			<media:title type="html">bitterpill</media:title>
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			<media:title type="html">timeadmin</media:title>
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		<title>Readers Respond: Your Hospital Bill Nightmares, via CNN iReport</title>
		<link>http://healthland.time.com/2013/02/28/readers-respond-your-hospital-bill-nightmares-via-cnn-ireport/</link>
		<comments>http://healthland.time.com/2013/02/28/readers-respond-your-hospital-bill-nightmares-via-cnn-ireport/#comments</comments>
		<pubDate>Thu, 28 Feb 2013 19:26:25 +0000</pubDate>
		<dc:creator>Kelly Conniff</dc:creator>
				<category><![CDATA[Health Care]]></category>

		<guid isPermaLink="false">http://healthland.time.com/?p=81242</guid>
		<description><![CDATA[How much does it cost to stay healthy? Steven Brill&#8217;s recent TIME cover story, &#8220;Bitter Pill: Why Medical Bills Are Killing Us,&#8221; took an in-depth look into America&#8217;s health care nightmare,  prompting a national discussion about Medicare, drug companies and insurance. We asked you to use CNN&#8217;s iReport to tell us how the high cost of health care has changed your life. The results were eye-opening: from a two-week hospital stay that cost nearly half a million dollars to a $23,000 bill for prescription medicine. Read more below and share your stories with us. ACL reconstruction surgery: $30,877 CNN iReport Eric Cooks, 33, of Tuscaloosa, Ala., was recently charged $30,877 for ACL reconstruction surgery. Thankfully, Cooks has insurance, but he was still shocked by the cost. “The healthcare system needs reform and I am not sure if the Affordable Care Act will be enough; these prices are crippling,” he said. “People are avoiding going to the doctor even with insurance leading to potentially more expensive chronic conditions. Overall, access to quality preventative care and specialists is still lacking for those without insurance.” Stitches &#38; scar repair: $22,000 CNN iReport After being bitten by a dog, 26-year-old Mallory Kerley was billed approximately $22,000 for stitches and scar repair. She later found out that the doctor was not part of her insurance plan and has been working with her insurance company for nearly a year now to try to adjust the costs. Double pneumonia hospital stay: $999,932 CNN iReport Alexandria Brooks, 46, of Hernando, Florida, was recently charged $999,932 for a month-and-a-half hospital stay for double pneumonia, which later developed into acute respiratory distress syndrome (ARDS). She wanted to share her story because that one bill was just $67 short of one million dollars. Another one of her notable bills: $36,806 to be airlifted to a different hospital. “People ask me about my bills. I am grateful that I had insurance; however, it is not preventing my credit and finances from being ruined. Such a large deductible despite HUGE premiums paid and<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=healthland.time.com&#038;blog=8684427&#038;post=81242&#038;subd=timewellness&#038;ref=&#038;feed=1" width="1" height="1" />]]></description>
		<wfw:commentRss>http://healthland.time.com/2013/02/28/readers-respond-your-hospital-bill-nightmares-via-cnn-ireport/feed/</wfw:commentRss>
		<slash:comments>0</slash:comments>
	<primary_category>Health Care</primary_category><primary_category_link>http://healthland.time.com/category/policy-industry/health-care/</primary_category_link><letterbox>1</letterbox><featured_image>http://timewellness.files.wordpress.com/2013/02/openheartsurgery.jpg?w=240</featured_image>
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			<media:title type="html">Open heart surgery: $428,903</media:title>
		</media:content>

		<media:content url="http://2.gravatar.com/avatar/e093348a57ed62aacb8a6205ceadb1d9?s=96&#38;d=http%3A%2F%2Fs0.wp.com%2Fi%2Fmu.gif&#38;r=G" medium="image">
			<media:title type="html">kconniff</media:title>
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		<media:content url="http://timewellness.files.wordpress.com/2013/02/knee-surgery.jpg" medium="image">
			<media:title type="html">Eric Cooks, 33, of Tuscaloosa, Alabama, was recently charged $30,877 for ACL reconstruction surgery</media:title>
		</media:content>

		<media:content url="http://timewellness.files.wordpress.com/2013/02/dog-bite.jpg" medium="image">
			<media:title type="html">26-year-old Mallory Kerley was billed approximately $22,000 for stitches and scar repair</media:title>
		</media:content>

		<media:content url="http://timewellness.files.wordpress.com/2013/02/pnemonia.jpg" medium="image">
			<media:title type="html">Alexandria Brooks, 46, of Hernando, Florida, was recently charged $999,932 for a month-and-a-half hospital stay for double pneumonia</media:title>
		</media:content>

		<media:content url="http://timewellness.files.wordpress.com/2013/02/openheartsurgery.jpg" medium="image">
			<media:title type="html">Open heart surgery: $428,903</media:title>
		</media:content>

		<media:content url="http://timewellness.files.wordpress.com/2013/02/hypertension.jpg" medium="image">
			<media:title type="html">Pulmonary arterial hypertension: $68,000 plus $23,000 in medication</media:title>
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		<title>The Profit Of Prestigious Cancer Care</title>
		<link>http://healthland.time.com/2013/02/21/the-profit-of-prestigious-cancer-care/</link>
		<comments>http://healthland.time.com/2013/02/21/the-profit-of-prestigious-cancer-care/#comments</comments>
		<pubDate>Fri, 22 Feb 2013 00:06:22 +0000</pubDate>
		<dc:creator>Steven Brill</dc:creator>
				<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Hospitals]]></category>

		<guid isPermaLink="false">http://healthland.time.com/?p=80855</guid>
		<description><![CDATA[Like MD Anderson’s aggressive pricing for Sean Recchi’s stay, Sloan-Kettering’s markup on drugs like the Flebogamma given to Alan A. is one reason cancer care is so profitable. In 2011, the hospital and research institution of Sloan-Kettering had an operating profit of $406 million even after everything it spent on research and the education of a small army of young cancer doctors. The cash flow comes from more than just drug markups. It also comes from the high pricing enabled by a great brand and an enterprise that has learned how to expand the reach of its brand. One of Sloan-Kettering’s major revenue sources is the outpatient clinics it has been opening around New York City in recent years so that patients don’t have to travel to the busy Upper East Side of Manhattan for the kind of treatments Alan A. gets every six weeks. There is a cancer-screening and treatment outpost (run in partnership with Ralph Lauren’s foundation) in Harlem and a chemotherapy clinic in Brooklyn, and clinical-care facilities can also be found in five of the New York City metropolitan area’s wealthier suburbs, such as Sleepy Hollow in Westchester County, New York, and Basking Ridge, N.J. A sixth is being constructed in Harrison, another wealthy Westchester town. Building on the deserved allure of the Sloan-Kettering brand, these outposts eat into the profits of area hospitals, which would otherwise be providing the same high-margin outpatient cancer care either on the basis of what their own doctors prescribed or according to instructions from Sloan-Kettering’s specialists. “Sloan-Kettering can open these clinics and treat people 9 to 5 at their [high] rates, and because they’ve got the brand name, they’ll be very successful because they don’t have to run a 24/7 operation,” complains the president of one hospital in a wealthy suburb north of New York City. “But if those patients need help at midnight on Saturday, they’ll end up in our emergency room.” That may be true, but Sloan-Kettering’s foray beyond the Upper East Side of Manhattan also represents a rare outbreak of competition in<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=healthland.time.com&#038;blog=8684427&#038;post=80855&#038;subd=timewellness&#038;ref=&#038;feed=1" width="1" height="1" />]]></description>
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		<slash:comments>0</slash:comments>
	<primary_category>Hospitals</primary_category><primary_category_link>http://healthland.time.com/category/policy-industry/hospitals-policy-industry/</primary_category_link>
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			<media:title type="html">jb1271</media:title>
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		<title>Social Reactions: Bitter Pill &#8212; Why Medical Bills Are Killing Us</title>
		<link>http://healthland.time.com/2013/02/21/social-reactions-bitter-pill-why-medical-bills-are-killing-us/</link>
		<comments>http://healthland.time.com/2013/02/21/social-reactions-bitter-pill-why-medical-bills-are-killing-us/#comments</comments>
		<pubDate>Thu, 21 Feb 2013 14:00:11 +0000</pubDate>
		<dc:creator>TIME Staff</dc:creator>
				<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Policy & Industry]]></category>

		<guid isPermaLink="false">http://healthland.time.com/?p=80476</guid>
		<description><![CDATA[<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=healthland.time.com&#038;blog=8684427&#038;post=80476&#038;subd=timewellness&#038;ref=&#038;feed=1" width="1" height="1" />]]></description>
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		<slash:comments>0</slash:comments>
	<primary_category>Health Care</primary_category><primary_category_link>http://healthland.time.com/category/policy-industry/health-care/</primary_category_link>
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		<title>Bitter Pill: Why Medical Bills Are Killing Us</title>
		<link>http://healthland.time.com/2013/02/20/bitter-pill-why-medical-bills-are-killing-us/</link>
		<comments>http://healthland.time.com/2013/02/20/bitter-pill-why-medical-bills-are-killing-us/#comments</comments>
		<pubDate>Thu, 21 Feb 2013 01:42:19 +0000</pubDate>
		<dc:creator>Steven Brill</dc:creator>
				<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Health Insurance]]></category>
		<category><![CDATA[Policy & Industry]]></category>

		<guid isPermaLink="false">http://healthland.time.com/?p=80659</guid>
		<description><![CDATA[Corrections Appended: February 26, 2013 1. Routine Care, Unforgettable Bills When Sean Recchi, a 42-year-old from Lancaster, Ohio, was told last March that he had non-Hodgkin’s lymphoma, his wife Stephanie knew she had to get him to MD Anderson Cancer Center in Houston. Stephanie’s father had been treated there 10 years earlier, and she and her family credited the doctors and nurses at MD Anderson with extending his life by at least eight years. Because Stephanie and her husband had recently started their own small technology business, they were unable to buy comprehensive health insurance. For $469 a month, or about 20% of their income, they had been able to get only a policy that covered just $2,000 per day of any hospital costs. “We don’t take that kind of discount insurance,” said the woman at MD Anderson when Stephanie called to make an appointment for Sean. Stephanie was then told by a billing clerk that the estimated cost of Sean’s visit — just to be examined for six days so a treatment plan could be devised — would be $48,900, due in advance. Stephanie got her mother to write her a check. “You do anything you can in a situation like that,” she says. The Recchis flew to Houston, leaving Stephanie’s mother to care for their two teenage children. About a week later, Stephanie had to ask her mother for $35,000 more so Sean could begin the treatment the doctors had decided was urgent. His condition had worsened rapidly since he had arrived in Houston. He was “sweating and shaking with chills and pains,” Stephanie recalls. “He had a large mass in his chest that was &#8230; growing. He was panicked.” Nonetheless, Sean was held for about 90 minutes in a reception area, she says, because the hospital could not confirm that the check had cleared. Sean was allowed to see the doctor only after he advanced MD Anderson $7,500 from his credit card. The hospital says there was nothing unusual about how Sean was kept waiting. According to<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=healthland.time.com&#038;blog=8684427&#038;post=80659&#038;subd=timewellness&#038;ref=&#038;feed=1" width="1" height="1" />]]></description>
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		<slash:comments>0</slash:comments>
	<primary_category>Health Insurance</primary_category><primary_category_link>http://healthland.time.com/category/policy-industry/health-insurance-policy-industry/</primary_category_link><letterbox>1</letterbox><featured_image>http://timewellness.files.wordpress.com/2013/02/1500_cover_03041.jpg?w=240</featured_image>
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			<media:title type="html">TIME Magazine Cover, Mar. 4, 2012</media:title>
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		<media:content url="http://0.gravatar.com/avatar/3b01e022cef5411570e897eb6a138f88?s=96&#38;d=http%3A%2F%2Fs0.wp.com%2Fi%2Fmu.gif&#38;r=G" medium="image">
			<media:title type="html">christinelim</media:title>
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		<media:content url="http://timewellness.files.wordpress.com/2013/02/seanrecchi.jpg?w=302" medium="image">
			<media:title type="html">Sean Recchi</media:title>
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			<media:title type="html">Gauze Pads</media:title>
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		<title>What Makes Health Care So Expensive?</title>
		<link>http://healthland.time.com/2013/02/20/what-makes-health-care-so-expensive/</link>
		<comments>http://healthland.time.com/2013/02/20/what-makes-health-care-so-expensive/#comments</comments>
		<pubDate>Thu, 21 Feb 2013 01:41:50 +0000</pubDate>
		<dc:creator>Andrea Ford, Heather Jones, Claire Manibog and Lon Tweeten</dc:creator>
				<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Health Insurance]]></category>

		<guid isPermaLink="false">http://healthland.time.com/?p=80670</guid>
		<description><![CDATA[<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=healthland.time.com&#038;blog=8684427&#038;post=80670&#038;subd=timewellness&#038;ref=&#038;feed=1" width="1" height="1" />]]></description>
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		<slash:comments>2</slash:comments>
	<primary_category>Health Care</primary_category><primary_category_link>http://healthland.time.com/category/policy-industry/health-care/</primary_category_link><featured_image>http://timewellness.files.wordpress.com/2013/02/graphic.jpeg?w=240</featured_image>
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			<media:title type="html">bitter pill graphic</media:title>
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			<media:title type="html">jb1271</media:title>
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		<title>Inside &#8216;Bitter Pill&#8217;: Steven Brill Discusses His TIME Cover Story</title>
		<link>http://healthland.time.com/2013/02/20/bitter-pill-inside-times-cover-story-on-medical-bills/</link>
		<comments>http://healthland.time.com/2013/02/20/bitter-pill-inside-times-cover-story-on-medical-bills/#comments</comments>
		<pubDate>Thu, 21 Feb 2013 01:41:20 +0000</pubDate>
		<dc:creator>TIME Staff</dc:creator>
				<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Policy & Industry]]></category>

		<guid isPermaLink="false">http://healthland.time.com/?p=80705</guid>
		<description><![CDATA[Simple lab work done during a few days in the hospital can cost more than a car. A trip to the emergency room for chest pains that turn out to be indigestion brings a bill that can exceed the price of a semester at college. When we debate health care policy in America, we seem to jump right to the issue of who should pay the bills, blowing past what should be the first question: Why exactly are the bills so high? Steven Brill spent seven months analyzing hundreds of bill from hospitals, doctors, and drug companies and medical equipment manufacturers to find out who is setting such high prices and pocketing the biggest profits. What he discovered, outlined in detail in the cover story of the new issue of TIME, will radically change the way you think about our medical institutions: · Hospitals arbitrarily set prices based on a mysterious internal list known as the “chargemaster.” These prices vary from hospital to hospital and are often ten times the actual cost of an item. Insurance companies and Medicare pay discounted prices, but don’t have enough leverage to bring fees down anywhere close to actual costs. While other countries restrain drug prices, in the United States federal law actually restricts the single biggest buyer—Medicare—from even trying to negotiate the price of drugs. · Tax-exempt “nonprofit” hospitals are the most profitable businesses and largest employers in their regions, often presided over by the most richly compensated executives. · Cancer treatment—at some of the most renowned centers such as Sloan-Kettering and M.D. Anderson—has some of the industry’s highest profit margins. Cancer drugs in particular are hugely profitable. For example, Sloan-Kettering charges $4615 for a immune-deficiency drug named Flebogamma. Medicare cuts Sloan-Kettering’s charge to $2123, still way above what the hospital paid for it, an estimated $1400. · Patients can hire medical billing advocates who help people read their bills and try to reduce them. “The hospitals all know the bills are fiction, or at least only a place to start the discussion,<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=healthland.time.com&#038;blog=8684427&#038;post=80705&#038;subd=timewellness&#038;ref=&#038;feed=1" width="1" height="1" />]]></description>
		<wfw:commentRss>http://healthland.time.com/2013/02/20/bitter-pill-inside-times-cover-story-on-medical-bills/feed/</wfw:commentRss>
		<slash:comments>0</slash:comments>
	<primary_category>Health Care</primary_category><primary_category_link>http://healthland.time.com/category/policy-industry/health-care/</primary_category_link><letterbox>1</letterbox><featured_image>http://timewellness.files.wordpress.com/2013/02/1500_cover_03041.jpg?w=240</featured_image>
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			<media:title type="html">TIME Magazine Cover, Mar. 4, 2012</media:title>
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		<media:content url="http://0.gravatar.com/avatar/3cb61b88047e46fa55ea7dd6bf87ec1c?s=96&#38;d=http%3A%2F%2Fs0.wp.com%2Fi%2Fmu.gif&#38;r=G" medium="image">
			<media:title type="html">timeadmin</media:title>
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		<title>Sound Off: Are Medical Bills Too High? Tell Us Why</title>
		<link>http://healthland.time.com/2013/02/20/sound-off-are-medical-bills-too-high-tell-us-why/</link>
		<comments>http://healthland.time.com/2013/02/20/sound-off-are-medical-bills-too-high-tell-us-why/#comments</comments>
		<pubDate>Thu, 21 Feb 2013 01:40:50 +0000</pubDate>
		<dc:creator>TIME Staff</dc:creator>
				<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Medicine]]></category>
		<category><![CDATA[Policy & Industry]]></category>

		<guid isPermaLink="false">http://healthland.time.com/?p=80472</guid>
		<description><![CDATA[$7 for a gauze pad, $995 for the ambulance ride, $13,225 for one day in the ICU—has the cost of medical care become untenably high?  In the new cover story of TIME magazine, journalist Steven Brill explores the problem of rising medical bills, examining who is setting such high prices and pocketing the biggest profits. Tell us what you think in the space below, sharing your experiences, insights and strategies for navigating the American healthcare system. (MORE: Why Medical Bills Are Killing Us) Editor&#8217;s Note: Anything that you post will be made public, and we reserve the right to take down any post. We cannot respond to comments or help resolve any particular billing disputes.  <img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=healthland.time.com&#038;blog=8684427&#038;post=80472&#038;subd=timewellness&#038;ref=&#038;feed=1" width="1" height="1" />]]></description>
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		<slash:comments>0</slash:comments>
	<primary_category>Health Care</primary_category><primary_category_link>http://healthland.time.com/category/policy-industry/health-care/</primary_category_link>
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			<media:title type="html">timeadmin</media:title>
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		<title>The Kindest Cut: How One Hospital Lowered Costs by Making Doctors More Budget Conscious</title>
		<link>http://healthland.time.com/2013/02/20/the-kindest-cut-how-one-hospital-lowered-costs-by-making-doctors-more-budget-conscious/</link>
		<comments>http://healthland.time.com/2013/02/20/the-kindest-cut-how-one-hospital-lowered-costs-by-making-doctors-more-budget-conscious/#comments</comments>
		<pubDate>Thu, 21 Feb 2013 01:38:41 +0000</pubDate>
		<dc:creator>Dr. Toby Cosgrove</dc:creator>
				<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Health Reform]]></category>
		<category><![CDATA[Policy & Industry]]></category>
		<category><![CDATA[Viewpoint]]></category>

		<guid isPermaLink="false">http://healthland.time.com/?p=80461</guid>
		<description><![CDATA[Give a surgeon the choice between a $5 silk stitch and a $400 staple to close up an incision, and he’ll choose the $5 stitch, right? Not necessarily. The problem is, most surgeons never know that the stitch costs $5 and the staple costs $400. Traditionally, knowing the costs of a stitch or a catheter or a bone screw — or any of the thousands of other supplies used during surgeries — hasn’t been part of many doctors’ medical consciousness. Health care costs, however, have grown too massive — topping $2 trillion a year – to continue doing things the way we’ve always done them. Conscientious medical providers have no choice but to confront cost issues or become guilty bystanders to the slow deterioration of America’s health care system. (MORE: Why Medical Bills Are Killing Us) Meaningful change, however, can only come with knowledge. Believe it or not, most hospitals don’t know what it costs them to perform common procedures like removing a prostate. But at the Cleveland Clinic, we’ve made it a point to know, asking our physicians to deconstruct the costs of their top three procedures — to record the price of sutures, count how many instruments were on the table, tag the devices on the shelf and record how long patients spent in post-anesthesia care. Once the details are in, it’s easy to see where to cut costs. Three years ago, we challenged ourselves to save $100 million by focusing on how and what we buy to stock the hospital with needed equipment and supplies. The key was to meaningfully engage doctors. Now, as part of the purchasing process, dozens of doctors gather to discuss the merits of certain products: Which ones provide the best outcomes for patients? How many are needed? How much does it cost? (MORE: Least Healthy Employees? Hospital Workers) Take, for example, nitric oxide, a drug commonly used in heart, lung and chest surgeries to keep tissues well-supplied with oxygen during the operation. When it&#8217;s effective, it&#8217;s very effective, but it doesn&#8217;t help all<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=healthland.time.com&#038;blog=8684427&#038;post=80461&#038;subd=timewellness&#038;ref=&#038;feed=1" width="1" height="1" />]]></description>
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		<slash:comments>1</slash:comments>
	<primary_category>Health Reform</primary_category><primary_category_link>http://healthland.time.com/category/policy-industry/health-reform/</primary_category_link><featured_image>http://timewellness.files.wordpress.com/2013/02/31doctorbill1.jpg?w=240</featured_image>
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			<media:title type="html">Medical Cost</media:title>
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		<media:content url="http://0.gravatar.com/avatar/69fc92d1c4598c5b98d03fde16cdfa74?s=96&#38;d=http%3A%2F%2Fs0.wp.com%2Fi%2Fmu.gif&#38;r=G" medium="image">
			<media:title type="html">apark7</media:title>
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		<title>Is Your Doctor Burned Out? Nearly Half of U.S. Physicians Say They&#8217;re Exhausted</title>
		<link>http://healthland.time.com/2012/08/21/is-your-doctor-burned-out-nearly-half-of-u-s-physicians-say-theyre-exhausted/</link>
		<comments>http://healthland.time.com/2012/08/21/is-your-doctor-burned-out-nearly-half-of-u-s-physicians-say-theyre-exhausted/#comments</comments>
		<pubDate>Tue, 21 Aug 2012 13:15:14 +0000</pubDate>
		<dc:creator>Alexandra Sifferlin</dc:creator>
				<category><![CDATA[Doctors & Nurses]]></category>
		<category><![CDATA[Emergency Care]]></category>
		<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Medicine]]></category>
		<category><![CDATA[Policy & Industry]]></category>
		<category><![CDATA[Primary Care]]></category>
		<category><![CDATA[burnout]]></category>
		<category><![CDATA[doctor burnout]]></category>
		<category><![CDATA[physicians]]></category>
		<category><![CDATA[Stress]]></category>

		<guid isPermaLink="false">http://healthland.time.com/?p=66878</guid>
		<description><![CDATA[Job burnout can strike workers in nearly any field, but a new study finds that doctors are at special risk. Nearly 1 in 2 U.S. physicians report at least one symptom of burnout, with doctors at the front line of care particularly vulnerable, the study found — a significantly higher rate than among the general working population. Overtaxed doctors are not only at risk for personal problems, like relationship issues and alcohol misuse, but their job-related fatigue can also erode professionalism, compromise quality of care, increase medical errors and encourage early retirement — a potentially critical problem as an aging population demands more medical care. The new findings, published in the Archives of Internal Medicine, are based on a survey of 7,288 physicians conducted in June 2011. Led by researchers from the Mayo Clinic and the American Medical Association, the study asked participating physicians to fill out a questionnaire asking about their feelings of burnout — including &#8220;emotional exhaustion&#8221; or losing enthusiasm for their work; feelings of cynicism or &#8220;depersonalization&#8221;; and a low sense of personal accomplishment. The 22-item questionnaire, called the Maslach Burnout Inventory (MBI), is considered the gold standard for measuring burnout; the doctors also completed a shorter, modified version of the MBI, the answers to which researchers used to compare with the general population. Researchers also asked doctors how long they worked each week, how satisfied they were with their work-life balance, and whether they had any symptoms of depression or thoughts of suicide. (MORE: TIME’s Mobile Tech Issue: Better Care Delivered by iPad, M.D.) The data showed that rates of burnout were high: 45.8% of doctors experienced at least one symptom of work-related burnout; when each symptom was considered separately, 37.9% of the physicians had high emotional exhaustion, 29.4% had high depersonalization and 12.4% had a low sense of personal accomplishment. U.S. doctors are burning out &#8220;at an alarming level,&#8221; the authors write. &#8220;Our finding is concerning given the extensive literature linking burnout to medical errors and lower quality of care,&#8221; says study author Dr. Tait Shanafelt of<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=healthland.time.com&#038;blog=8684427&#038;post=66878&#038;subd=timewellness&#038;ref=&#038;feed=1" width="1" height="1" />]]></description>
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		<slash:comments>0</slash:comments>
	<primary_category>Doctors &amp; Nurses</primary_category><primary_category_link>http://healthland.time.com/category/policy-industry/doctors-nurses/</primary_category_link><featured_image>http://timewellness.files.wordpress.com/2012/08/sb10065285bb-001.jpg?w=240</featured_image>
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			<media:title type="html">sb10065285bb-001</media:title>
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		<media:content url="http://1.gravatar.com/avatar/dd9dc95ff828efb70c16a5a509a75150?s=96&#38;d=http%3A%2F%2Fs0.wp.com%2Fi%2Fmu.gif&#38;r=G" medium="image">
			<media:title type="html">asifferlin</media:title>
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		<title>TIME&#8217;s Mobile Tech Issue: Better Care Delivered by iPad, M.D.</title>
		<link>http://healthland.time.com/2012/08/16/doctors-using-ipads/</link>
		<comments>http://healthland.time.com/2012/08/16/doctors-using-ipads/#comments</comments>
		<pubDate>Thu, 16 Aug 2012 11:20:54 +0000</pubDate>
		<dc:creator>Kate Pickert</dc:creator>
				<category><![CDATA[Clinical Practice]]></category>
		<category><![CDATA[Doctors & Nurses]]></category>
		<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Medicine]]></category>
		<category><![CDATA[Policy & Industry]]></category>

		<guid isPermaLink="false">http://healthland.time.com/?p=66533</guid>
		<description><![CDATA[Signs barring cell-phone use are a familiar sight to anyone who has ever sat in a hospital waiting room. But the growing popularity of electronic medical records has forced hospital-based doctors to become dependent on computers throughout the day, and desktops — which keep doctors from bedsides — are fast giving way to wireless devices. As clerical loads increased, “something had to give, and that was always face time with patients,” says Dr. Bhakti Patel, a former chief resident in the University of Chicago’s internal-medicine program. In fall 2010, she helped launch a pilot project in Chicago to see if the iPad could improve working conditions and patient care. The experiment was so successful that all internal-medicine residents at the university now get iPads when they begin the program. Johns Hopkins’ internal-medicine program adopted the same policy in 2011. Medical schools at Yale and Stanford now have paperless, iPad-based curriculums. “You’ll want an iPad just so you can wear this” is the slogan for one of the new lab coats designed with large pockets to accommodate tablet computers. (MORE: Read about the TIME Mobility Poll) A study of the University of Chicago iPad project published in the Archives of Internal Medicine found that patients got tests and treatments faster if they were cared for by iPad-equipped residents. Many patients also gained a better understanding of the ailments that landed them in the hospital in the first place. With a tablet, “if you tell someone they have pulmonary edema, you can pull up an abnormal chest X-ray, which is theirs, and a normal X-ray and say, ‘Your lung is full of fluid, and that’s why you’re short of breath,’” says Dr. Micah Prochaska, a second-year resident at the University of Chicago. (MORE: Read TIME&#8217;s Special Report On How Your Phone Is Changing The World (and your life) Here) Smartphones, too, are changing medicine. Dr. John Halamka, a Harvard professor and the chief information officer for Beth Israel Deaconess Medical Center in Boston, is a toxicologist specializing in mushroom poisoning. About 300<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=healthland.time.com&#038;blog=8684427&#038;post=66533&#038;subd=timewellness&#038;ref=&#038;feed=1" width="1" height="1" />]]></description>
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		<slash:comments>1</slash:comments>
	<primary_category>Health Care</primary_category><primary_category_link>http://healthland.time.com/category/policy-industry/health-care/</primary_category_link><featured_image>http://timewellness.files.wordpress.com/2012/08/dripad.jpg?w=240</featured_image>
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			<media:title type="html">dripad</media:title>
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		<media:content url="http://1.gravatar.com/avatar/d40234a6843419b1a17b2c08b6848561?s=96&#38;d=http%3A%2F%2Fs0.wp.com%2Fi%2Fmu.gif&#38;r=G" medium="image">
			<media:title type="html">katepickert</media:title>
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		<title>TIME&#8217;s Mobile Tech Issue: Tracking Disease, One Text at a Time</title>
		<link>http://healthland.time.com/2012/08/15/disease-cant-hide/</link>
		<comments>http://healthland.time.com/2012/08/15/disease-cant-hide/#comments</comments>
		<pubDate>Wed, 15 Aug 2012 23:15:40 +0000</pubDate>
		<dc:creator>Belinda Luscombe</dc:creator>
				<category><![CDATA[Global Health]]></category>
		<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Medicine]]></category>
		<category><![CDATA[Policy & Industry]]></category>

		<guid isPermaLink="false">http://healthland.time.com/?p=66528</guid>
		<description><![CDATA[Accurate bookkeeping is on nobody’s list of heroic acts. But without it, some revolutions are impossible, including the overhaul of a nation’s health care infrastructure. And Uganda’s health care system needs quite an overhaul. There aren’t enough doctors, just 131 hospitals serve nearly 36 million people, and children are dying of treatable diseases, especially malaria, which accounts for up to 40% of medical visits and almost a quarter of deaths among kids under 5. The Ugandan Ministry of Health and various NGOs have tried to address the issue with smaller clinics and volunteer village health team workers, some of whom dispense drugs. Malaria can be held at bay with artemisinin-based combination therapies (ACTs). But too often, Ugandans who turn up at local clinics cannot get them. There isn’t a shortage of medicine, but supply lines to the clinics have gotten snarled or the drugs have been diverted to private clinics. Without accounting, it’s impossible to untangle the knot. (MORE: TIME&#8217;s Mobility Poll) While Uganda may not have enough hospitals, it’s well served by cellular carriers. A third of Ugandans have mobile phones, which are widely shared. They’re not smart phones — the only app most of these $7 handsets offer is a flashlight — but they can send texts. For all the apps and gee-whiz features of phones, their ultimate transformative power is the ability of one person, no matter where he or she is, to communicate with another. In developing nations, the simple text message represents a quantum leap in connectivity. (MORE: Three Myths About Cell Phones) In a new initiative called mTrac, supported by UNICEF and the World Health Organization, health workers using these phones to text details of drug supplies and disease outbreaks that they had previously put on paper. This information is amassed and coded into a kind of online dashboard so that public-health officials can see in real time what’s going on. “It’s easy to track who has a lot of medicine and who has none and to move the stock from one clinic to the<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=healthland.time.com&#038;blog=8684427&#038;post=66528&#038;subd=timewellness&#038;ref=&#038;feed=1" width="1" height="1" />]]></description>
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	<primary_category>Health Care</primary_category><primary_category_link>http://healthland.time.com/category/policy-industry/health-care/</primary_category_link><featured_image>http://timewellness.files.wordpress.com/2012/08/wuganda.jpg?w=240</featured_image>
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			<media:title type="html">wuganda</media:title>
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			<media:title type="html">blandnotblond</media:title>
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		<title>Report: Why 40% of Donated Medical Equipment Goes Unused in Poor Countries</title>
		<link>http://healthland.time.com/2012/08/06/report-why-40-of-donated-medical-equipment-goes-unused-in-poor-countries/</link>
		<comments>http://healthland.time.com/2012/08/06/report-why-40-of-donated-medical-equipment-goes-unused-in-poor-countries/#comments</comments>
		<pubDate>Mon, 06 Aug 2012 12:00:10 +0000</pubDate>
		<dc:creator>Laura Blue</dc:creator>
				<category><![CDATA[Global Health]]></category>
		<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Hospitals]]></category>
		<category><![CDATA[Medicine]]></category>
		<category><![CDATA[Policy & Industry]]></category>
		<category><![CDATA[developing countries]]></category>
		<category><![CDATA[medical equipment]]></category>
		<category><![CDATA[technology]]></category>

		<guid isPermaLink="false">http://healthland.time.com/?p=65150</guid>
		<description><![CDATA[High-tech medical equipment is largely wasted in the developing world, a new report finds, because donated machines are not designed to run in the settings they&#8217;re sent to. As much as 40% of health-care equipment in poor countries is out of service, according to the new report on global health technology recently published by the medical journal The Lancet and by Imperial College London. That&#8217;s compared to less than 1% out of service in high-income countries. But technology does have the potential to do much, much more for global health and longevity, the report says. The problem is one of allocating resources. The report notes that almost all of the planet&#8217;s medical technology today is designed for rich-world markets, and for rich-world medical communities — characterized by reliable infrastructure and electricity, along with a well-trained health-care workforce and relatively high spending. The report states: By contrast, low-income and middle-income countries have little money, underdeveloped infrastructure, and few health-care workers. However, technologies from high income countries are often deployed in these settings without enough thought of the consequences, and such technologies might rapidly become useless. A major reason that so much equipment sits idle, the report says, is that donors from hospitals and charities in the rich world don&#8217;t properly think through health-care delivery elsewhere before they ship off their surplus gear. If they have secondhand or excess medical equipment, many donors assume that, as long as it&#8217;s in good condition, it can be useful in settings that lack the equipment — not realizing that lack of resources can extend to basic infrastructure needed for operation. According to the report: Some low-income countries receive as much as 80% of their medical devices as donations. Although well-intentioned, donations can place a burden on recipients; [for example,] oxygen concentrators donated to a Gambian tertiary hospital required a voltage incompatible with the electricity supply in that country. Time-consuming attempts were made to find a solution without success. The report recommends that, instead, donors and would-be donors work with low-income health facilities to figure out<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=healthland.time.com&#038;blog=8684427&#038;post=65150&#038;subd=timewellness&#038;ref=&#038;feed=1" width="1" height="1" />]]></description>
		<wfw:commentRss>http://healthland.time.com/2012/08/06/report-why-40-of-donated-medical-equipment-goes-unused-in-poor-countries/feed/</wfw:commentRss>
		<slash:comments>0</slash:comments>
	<primary_category>Global Health</primary_category><primary_category_link>http://healthland.time.com/category/medicine/global-health-medicine/</primary_category_link><featured_image>http://timewellness.files.wordpress.com/2012/08/2100_medicalequipment_0806.jpg?w=240</featured_image>
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			<media:title type="html">Wheelchair and stretcher</media:title>
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		<media:content url="http://1.gravatar.com/avatar/a069e8b4ff0dc386def0882f71bbfee6?s=96&#38;d=http%3A%2F%2Fs0.wp.com%2Fi%2Fmu.gif&#38;r=G" medium="image">
			<media:title type="html">Laura Blue</media:title>
		</media:content>
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		<title>The 8 Preventive Health Services that Women Start Getting Free Today</title>
		<link>http://healthland.time.com/2012/08/01/the-8-preventive-health-services-that-women-start-getting-free-today/</link>
		<comments>http://healthland.time.com/2012/08/01/the-8-preventive-health-services-that-women-start-getting-free-today/#comments</comments>
		<pubDate>Wed, 01 Aug 2012 18:15:58 +0000</pubDate>
		<dc:creator>Alexandra Sifferlin</dc:creator>
				<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Health Insurance]]></category>
		<category><![CDATA[Health Reform]]></category>
		<category><![CDATA[Medicine]]></category>
		<category><![CDATA[Policy & Industry]]></category>
		<category><![CDATA[Prevention]]></category>
		<category><![CDATA[Women's Health]]></category>
		<category><![CDATA[affordable care act]]></category>
		<category><![CDATA[preventive care]]></category>

		<guid isPermaLink="false">http://healthland.time.com/?p=65318</guid>
		<description><![CDATA[Starting today, about 47 million American women will have access to free preventive health services as part of a new provision in President Obama&#8217;s Affordable Care Act. Comprehensive preventive care coverage will now be provided for insured women enrolling in new health care plans or renewing their existing policies on or after Aug. 1, 2012. Here&#8217;s the breakdown, courtesy of the Dept. of Health and Human Services, of the eight services women are now eligible to receive under the new provision without a copay or any cost sharing: Well-woman visits: This includes an annual well-woman preventive care visit for adult women to obtain the recommended preventive services, plus additional visits if women and their doctors determine they&#8217;re necessary. Gestational diabetes screening: This screening is for women 24 to 28 weeks pregnant, and those at high risk of developing gestational diabetes. Women who have gestational diabetes have an increased risk of developing Type 2 diabetes in the future, and their children are at a significantly increased risk of being overweight and insulin-resistant throughout childhood. HPV DNA testing: Women who are 30 or older will now have access to high-risk human papillomavirus (HPV) DNA testing every three years, regardless of Pap smear results. Early screening, detection and treatment have been shown to help reduce the prevalence of cervical cancer. STI counseling: Sexually active women may receive annual counseling on sexually transmitted infections (STIs). The sessions have been shown to reduce risky behavior in patients, but only 28% of women aged 18 to 44 discuss STIs with a doctor or nurse. HIV screening and counseling: Sexually active women can receive annual counseling on HIV. Women are at increased risk of becoming infected with HIV: from 1999 to 2003, the Centers for Disease Control and Prevention reported a 15% increase in AIDS cases among women, and a 1% increase among men. Contraception and contraceptive counseling: Women will have free access to all government-approved contraceptive methods, sterilization procedures and patient education and counseling. This does not include abortion drugs. Most workers in employer-sponsored plans are currently covered for contraceptives; however, employers<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=healthland.time.com&#038;blog=8684427&#038;post=65318&#038;subd=timewellness&#038;ref=&#038;feed=1" width="1" height="1" />]]></description>
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		<slash:comments>1</slash:comments>
	<primary_category>Health Care</primary_category><primary_category_link>http://healthland.time.com/category/policy-industry/health-care/</primary_category_link><featured_image>http://timewellness.files.wordpress.com/2012/08/200146015-001.jpg?w=240</featured_image>
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			<media:title type="html">birth control pills</media:title>
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			<media:title type="html">asifferlin</media:title>
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		<title>Prostate Cancer Screening: Why Can&#8217;t Doctors Agree?</title>
		<link>http://healthland.time.com/2012/07/30/prostate-cancer-screening-why-cant-doctors-agree/</link>
		<comments>http://healthland.time.com/2012/07/30/prostate-cancer-screening-why-cant-doctors-agree/#comments</comments>
		<pubDate>Mon, 30 Jul 2012 14:02:02 +0000</pubDate>
		<dc:creator>Laura Blue</dc:creator>
				<category><![CDATA[Cancer]]></category>
		<category><![CDATA[Clinical Practice]]></category>
		<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Medicine]]></category>
		<category><![CDATA[Men's Health]]></category>
		<category><![CDATA[Policy & Industry]]></category>
		<category><![CDATA[Prevention]]></category>
		<category><![CDATA[Public Health]]></category>
		<category><![CDATA[Reproductive Health]]></category>
		<category><![CDATA[cancer screening]]></category>
		<category><![CDATA[prostate cancer]]></category>
		<category><![CDATA[prostate cancer screening]]></category>
		<category><![CDATA[psa test]]></category>

		<guid isPermaLink="false">http://healthland.time.com/?p=64993</guid>
		<description><![CDATA[If you&#8217;re wondering why experts still can&#8217;t agree on prostate-cancer screening, you&#8217;re not alone. Just two months ago, a major U.S. government panel said that basically no one should get screened for prostate cancer, claiming the simple blood test for prostate-specific antigen, or PSA, does more harm than good. Now, a new study looks at government data and finds that, without PSA testing, the U.S. would have three times as many patients each year diagnosed with advanced-stage prostate cancer — and the vast majority of those cases would be fatal. &#8220;Almost all men with clinically apparent metastases at initial diagnosis will die from prostate cancer,&#8221; urologist and study author Edward Messing told reporters, as he explained the importance of his study. The new study reflects a broader divide in the medical community, between public health experts who have largely turned away from PSA screening, and many practicing clinicians who feel the test has helped their patients immensely. (MORE: Men Should Forgo PSA Testing, U.S. Panel Advises) No one denies that PSA tests can help to catch prostate cancer early. But two issues are still unresolved. One is how well screening can actually work to prevent cancer deaths; the other is what kind of negative effects screening brings along with its benefits. On the first issue, there is still some uncertainty. In the U.S., a large randomized trial found no mortality benefit of screening. But an even larger randomized clinical trial in Europe has found a benefit. In its latest results published this spring, the European study team said that men who undergo routine testing have significantly lower risk of prostate-cancer death after 11 years. Still, the real crux of the debate on PSA testing is the second issue: the possible negative effects of screening. No diagnostic test is 100% accurate, and if a PSA test comes back positive for prostate cancer, the patient will usually be referred for a biopsy to confirm the diagnosis. That test can have side effects. Then, if the patient does have cancer,  the available treatments<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=healthland.time.com&#038;blog=8684427&#038;post=64993&#038;subd=timewellness&#038;ref=&#038;feed=1" width="1" height="1" />]]></description>
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		<slash:comments>0</slash:comments>
	<primary_category>Cancer</primary_category><primary_category_link>http://healthland.time.com/category/medicine/cancer/</primary_category_link><featured_image>http://timewellness.files.wordpress.com/2012/01/psa.jpg?w=240</featured_image>
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			<media:title type="html">psa</media:title>
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		<media:content url="http://1.gravatar.com/avatar/a069e8b4ff0dc386def0882f71bbfee6?s=96&#38;d=http%3A%2F%2Fs0.wp.com%2Fi%2Fmu.gif&#38;r=G" medium="image">
			<media:title type="html">Laura Blue</media:title>
		</media:content>
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		<title>Colorado Shooting Victims to Get Free Health Care. Why Not Everyone?</title>
		<link>http://healthland.time.com/2012/07/26/colorado-shooting-victims-to-get-free-health-care-why-not-all/</link>
		<comments>http://healthland.time.com/2012/07/26/colorado-shooting-victims-to-get-free-health-care-why-not-all/#comments</comments>
		<pubDate>Thu, 26 Jul 2012 19:38:13 +0000</pubDate>
		<dc:creator>Maia Szalavitz</dc:creator>
				<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Policy & Industry]]></category>
		<category><![CDATA[aurora shooting]]></category>
		<category><![CDATA[batman shooting]]></category>
		<category><![CDATA[Colorado shooting]]></category>
		<category><![CDATA[Colorado shooting victims]]></category>
		<category><![CDATA[dark knight rises shooting]]></category>
		<category><![CDATA[health insurance]]></category>
		<category><![CDATA[hospitals]]></category>
		<category><![CDATA[medical bankrupcty]]></category>

		<guid isPermaLink="false">http://healthland.time.com/?p=64783</guid>
		<description><![CDATA[The U.S. is the only rich country in the world where the fears of financial ruin due to medical bills haunt patients' efforts to heal<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=healthland.time.com&#038;blog=8684427&#038;post=64783&#038;subd=timewellness&#038;ref=&#038;feed=1" width="1" height="1" />]]></description>
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		<slash:comments>0</slash:comments>
	<primary_category>Health Care</primary_category><primary_category_link>http://healthland.time.com/category/policy-industry/health-care/</primary_category_link><featured_image>http://timewellness.files.wordpress.com/2012/07/108273558.jpg?w=240</featured_image>
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			<media:title type="html">108273558</media:title>
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		<media:content url="http://0.gravatar.com/avatar/0a5ac57e99124922fa628492ad3db6b2?s=96&#38;d=http%3A%2F%2Fs0.wp.com%2Fi%2Fmu.gif&#38;r=G" medium="image">
			<media:title type="html">MaiaSzalavitz</media:title>
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		<title>Should Medicaid Be Expanded? Study Finds It May Lower Death Rates</title>
		<link>http://healthland.time.com/2012/07/26/should-medicaid-be-expanded-study-finds-it-may-lower-death-rates/</link>
		<comments>http://healthland.time.com/2012/07/26/should-medicaid-be-expanded-study-finds-it-may-lower-death-rates/#comments</comments>
		<pubDate>Thu, 26 Jul 2012 18:30:19 +0000</pubDate>
		<dc:creator>Alexandra Sifferlin</dc:creator>
				<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Health Insurance]]></category>
		<category><![CDATA[Health Reform]]></category>
		<category><![CDATA[Medicare & Medicaid]]></category>
		<category><![CDATA[Policy & Industry]]></category>
		<category><![CDATA[affordable care act]]></category>
		<category><![CDATA[medicaid]]></category>

		<guid isPermaLink="false">http://healthland.time.com/?p=64781</guid>
		<description><![CDATA[As states debate whether to expand their Medicaid coverage under President Obama&#8217;s Affordable Care Act, a new study by Harvard School of Public Health researchers finds that doing so may save thousands of lives. The study compared health statistics in three states that recently expanded their Medicaid programs — Arizona, Maine and New York — with neighboring states that did not and found that when health insurance was extended to more low-income residents, death rates dropped by about 6%. Currently, Medicaid, a federal-state program for poor or severely disabled people, covers about 60 million Americans. Under the Affordable Care Act, Medicaid eligibility will extend to millions more Americans — perhaps half of the 30 million who are now uninsured — starting in 2014. Last month, the Supreme Court ruling on the health care law gave states the option to accept or reject the law&#8217;s Medicaid expansion, intended to grant coverage to uninsured adults without children and with annual incomes of about $15,400. Most states are expected to extend their coverage to some degree. (MORE: Brief History: Secret Medical Testing) The debate over Medicaid expansion has largely centered around cost and states&#8217; rights. For the first three years of expansion under the new health care law, the federal government will pick up the tab, then scale back to give states more of the financial responsibility. Some critics argue that the costs aren&#8217;t justified because coverage under the program doesn&#8217;t lead to better health; they contend that because Medicaid pays doctors less than Medicare or private insurance, patients may not get the care they need. Enter the new study, published in the New England Journal of Medicine, which seeks to answer that very question. The study looked at three states that had expanded their Medicaid programs between 2000 and 2005 to cover low-income adults without kids or disabilities, a population that was previously ineligible for Medicaid. The researchers compared mortality rates in these three states five years before and after the expansions. They then compared the rates to four neighboring states that did not<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=healthland.time.com&#038;blog=8684427&#038;post=64781&#038;subd=timewellness&#038;ref=&#038;feed=1" width="1" height="1" />]]></description>
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		<slash:comments>0</slash:comments>
	<primary_category>Medicare &amp; Medicaid</primary_category><primary_category_link>http://healthland.time.com/category/policy-industry/medicare-medicaid/</primary_category_link><featured_image>http://timewellness.files.wordpress.com/2012/07/1141469951.jpg?w=240</featured_image>
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			<media:title type="html">114146995</media:title>
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		<media:content url="http://1.gravatar.com/avatar/dd9dc95ff828efb70c16a5a509a75150?s=96&#38;d=http%3A%2F%2Fs0.wp.com%2Fi%2Fmu.gif&#38;r=G" medium="image">
			<media:title type="html">asifferlin</media:title>
		</media:content>
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		<title>Diagnosing Heart Disease, Faster</title>
		<link>http://healthland.time.com/2012/07/26/diagnosing-heart-disease-faster/</link>
		<comments>http://healthland.time.com/2012/07/26/diagnosing-heart-disease-faster/#comments</comments>
		<pubDate>Thu, 26 Jul 2012 15:55:43 +0000</pubDate>
		<dc:creator>Laura Blue</dc:creator>
				<category><![CDATA[Clinical Practice]]></category>
		<category><![CDATA[Emergency Care]]></category>
		<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Heart Disease]]></category>
		<category><![CDATA[Hospitals]]></category>
		<category><![CDATA[Medicine]]></category>
		<category><![CDATA[Policy & Industry]]></category>
		<category><![CDATA[CCTA]]></category>
		<category><![CDATA[chest pain]]></category>
		<category><![CDATA[coronary computed tomographic angiography]]></category>
		<category><![CDATA[CT scan]]></category>
		<category><![CDATA[emergency room]]></category>

		<guid isPermaLink="false">http://healthland.time.com/?p=64700</guid>
		<description><![CDATA[When a patient comes to the emergency room with chest pains, doctors need to figure out quickly if there&#8217;s a cardiac problem or if, instead, the cause of the pain is something more benign, like heartburn. That&#8217;s not always easy, and it&#8217;s not always cheap. But adding one extra test, a new study shows, may help doctors determine sooner whether seemingly low-risk patients in fact have heart disease — cutting the average time patients spend in the hospital by several hours. That&#8217;s the good news. The bad news is that adding the test gives patients an extra dose of radiation, and it doesn&#8217;t necessarily improve other outcomes: patients&#8217; overall risk of a cardiovascular event or death, or the total cost of the hospital visit. The study has prompted a debate among doctors about how many tests is too many, and what the threshold should be for adding a new test to already-expensive emergency care. (MORE: Long Commute? Your Heart and Waistline May Suffer for It) The new study comes from researchers at nine U.S. hospitals, who collaborated to test whether care is improved among chest-pain sufferers by adding CCTA (coronary computed tomographic angiography) to a battery of existing diagnostic tests. The researchers&#8217; evaluation of CCTA is published this week in the prestigious New England Journal of Medicine (NEJM). The study tracked 1,000 emergency patients with no known history of heart disease, and whose first round of hospital tests — an electrocardiogram and a blood test for the biomarker troponin — didn&#8217;t seem to show an obvious heart attack. Half of the study participants were randomized to standard care, and the other half to standard care plus CCTA diagnostic testing. CCTA combines CT scanning with the use of an intravenous contrast material, and allows hospital imaging staff to create detailed images of the blood vessels that supply the heart. Armed with those test results, emergency doctors have additional information to distinguish which of the patients who report chest pains have heart disease, and which ones do not. That information can then guide<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=healthland.time.com&#038;blog=8684427&#038;post=64700&#038;subd=timewellness&#038;ref=&#038;feed=1" width="1" height="1" />]]></description>
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		<slash:comments>0</slash:comments>
	<primary_category>Emergency Care</primary_category><primary_category_link>http://healthland.time.com/category/medicine/emergency-care/</primary_category_link><featured_image>http://timewellness.files.wordpress.com/2012/07/chest_pain1.jpg?w=240</featured_image>
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