Medical Care Industry

Despite a 24.5% drop in deaths from all heart disease between 1982 and 1992, the incidence of congestive heart failure more than doubled during the same period, according to the American Heart Assn. The congestive disease, in which the heart muscle is overworked or damaged and unable to pump out all the blood that returns to it, accounted for 822,000 hospitalizations in the United States in 1992 and 39,000 deaths, the association disclosed at a science writers' seminar here.

Somewhere in Michigan is a middle-class, middle-age woman whose married daughter was pregnant last year. It was a high-risk pregnancy, and the obstetrician asked the mother to be ready to donate blood, since both mother and daughter had the same rare type. The mother, of course, said she would. Then she went to the family doctor for a checkup and mentioned that she might give blood to her daughter. The doctor said, "You can't do that." The mother asked why not.

For all the partisan acrimony and special-interest\o7 Angst \f7 over the GOP's Medicare reform plans, even the most far-reaching proposal--set for House passage today--would only postpone a financial crisis likely to make the current stakes seem like child's play.

The health care industry is computerizing patient records as fast as it can, but it is encountering a problem--patient privacy. Computer systems are making volumes of often sensitive medical records available more quickly and easily than before. That's a benefit to patients when the information ends up in the right hands--among doctors and at hospitals where it can be used it to make medical decisions.

For years, surgeons Jerald Waldman and Thomas Shaver worked side by side as directors of Mission Hospital Regional Medical Center's doctors' association. But the relationship soured and they haven't spoken in more than a year. They blame the falling-out on Monarch HealthCare, one of the fastest-growing medical enterprises in Southern California. Two years ago, it seems, Waldman championed his association's decision to join with two other local doctors groups to form Monarch.

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.