Medical Care Industry

The genius of modern marketing is pouring old material into new packaging. Over the years this has given us yogurt in tubes, prechopped salad greens in cellophane bags and, most recently, the health insurance industry's new image as a friend of reform.

It started out as just another Thanksgiving Day stomachache, a nagging pain that sharpened until it reverberated from California halfway around the world. When the ache in her lower right abdomen became excruciating, the twentysomething woman was rushed to a surgery center, where the doctor diagnosed a ruptured appendix. The woman needed an operation -- fast. But before the surgeon could wheel her into the operating theater, he had to find out whether the patient's insurance company would pay.

With soothing walls of turquoise tile and a vase of orchids on the front desk, the Colon Health Center of Delaware has been selling an alternative to one of medicine's most unloved procedures -- the colonoscopy. Rather than insert several feet of tubing into patients' lower intestines, clinicians slide patients into a computed tomography, or CT, imaging machine that can quickly scan the abdomen for signs of cancer.

Gainesville's first community hospital has been on life support ever since Shands HealthCare system in northern Florida bought it a dozen years ago. Now, because of the recession, the plug is being pulled on money-losing Shands AGH. This fall, its nonprofit parent company will shut the 80-year-old, 220-bed hospital and shift staff and patients to a newer, bigger hospital nearby in an effort to save $65 million over three years across the eight-hospital system.

Web search company Google Inc. is collaborating with Cleveland Clinic, one of the premier U.S. health institutions, to pilot an exchange of data that puts patients in charge of their own medical records. The healthcare industry has been trying to usher in a paperless era for more than a decade, holding out the promise that electronic medical records would bring significant cost savings. Currently, only a tiny minority of hospitals and primary care physicians use electronic medical records.

Even with sleep increasingly recognized as an important determinant of health, some doctors may resist the evidence. From working round-the-clock shifts during residency to on-call nights to early-morning rounds, they're sleep-deprived -- and proud of it. "Organized medicine and the professional medical societies are sanctioning 100,000 people a year to working 30-hour shifts twice a week during their medical education," says Dr.

The American medical system is woefully unprepared for the flood of aging baby boomers, according to a sweeping federal study released Monday, which predicted crisis-level shortages in healthcare workers and serious gaps in training.

Medicare proposed new rules Thursday to curb marketing abuses that have cropped up as the role of private insurance plans has grown in the giant healthcare program for the elderly and disabled. Critics called the rules an improvement, but questioned whether the federal government could adequately enforce them.

The Bush administration announced its "conscience protection" rule for the healthcare industry Thursday, giving doctors, hospitals, and even receptionists and volunteers in medical experiments the right to refuse to participate in medical care they find morally objectionable. "This rule protects the right of medical providers to care for their patients in accord with their conscience," said outgoing Health and Human Services Secretary Mike Leavitt.

Blockbuster or bust. Those are the stark outcomes facing Pfizer Inc.'s Exubera, the first inhalable insulin that will arrive on most pharmacy shelves as early as next month. Pfizer and some industry analysts have said they believe inhaled insulin -- delivered through a small pump about the size of a flashlight and filled with dry powdered insulin packages -- will be quickly adopted by some of the nation's 14.6 million diagnosed diabetes and could account for up to $2 billion a year in sales.