CNN's Gupta approached for surgeon general

(Of course CNN is leaking this news )

(CNN) -- The Obama transition team approached Dr. Sanjay Gupta, CNN's chief medical correspondent, about becoming U.S. surgeon general, according to sources inside the transition and at CNN.

The Obama administration approached CNN's Dr. Sanjay Gupta about becoming U.S. surgeon general.

Gupta was in Chicago, Illinois, in November to meet with President-elect Barack Obama on the matter, sources said.

Gupta has declined comment.

The transition team is impressed with the combination of Gupta's past government experience, as a White House fellow in 1997 and a special adviser to then-first lady Hillary Clinton, along with his medical career as a neurosurgeon and his communication skills, the transition source said.

Gupta is a member of the staff and faculty of the Department of Neurosurgery at Emory University School of Medicine in Atlanta, Georgia. He regularly performs surgery at Emory University Hospital and at Grady Memorial Hospital, where he serves as associate chief of neurosurgery. Watch CNN's John King report on Sanjay Gupta as possible surgeon general »

Fact Box
The Surgeon General serves as America's chief health educator, informing Americans how to improve their health and reduce the risk of illness and injury.

The Office of the Surgeon General oversees the 6,000-member Commissioned Corps of the U.S. Public Health Service, one of America's seven uniformed branches of service. The service works to promote health, prevent disease and advance public health science. The office of the surgeon general is part of the Office of Public Health and Science in the Office of the Secretary, U.S. Department of Health and Human Services. CNN released a statement saying, "Since first learning that Dr. Gupta was under consideration for the surgeon general position, CNN has made sure that his on-air reporting has been on health and wellness matters and not on health-care policy or any matters involving the new administration."

Gupta joined CNN in 2001. As chief medical correspondent for the health and medical unit, he is a lead reporter on breaking medical news, provides regular health and medical updates for "American Morning," anchors the half-hour weekend medical affairs program "House Call with Dr. Sanjay Gupta" and reports for CNN documentaries.

Based in Atlanta, Gupta also contributes health stories to CNN.com, co-hosts "Accent Health" for Turner Private Networks, provides medical segments for the syndicated version of "ER" on TNT and writes a column for Time magazine. He also anchors the global health program "Vital Signs" for CNN International and is featured in a weekly podcast on health issues called "Paging Dr. Gupta."

Just after joining CNN, Gupta became part of the team covering the September 11, 2001, terrorist attacks on New York and Washington. Later that year, he led breaking news reporting on a series of anthrax attacks.

In addition, Gupta reported from Sri Lanka in the aftermath of the tsunami that swept the region in December 2004. He also helped cover the aftermath of Hurricane Katrina from New Orleans, Louisiana, in 2005.

He received his undergraduate degree from the University of Michigan and his medical degree from the University of Michigan Medical Center.

Washington Post Article
Reason Article

Gupta has also been offered the job of head of the NEW White House Office of Health Reform. Him being in two postions will allow him to have much more influence.
I have also seen people saying that he is a proponent of a single-payer healthcare system (an issue that at this time has not been debated on this site).
That coupled with Tom Daschle's assignment to the cabinet position of Sec of Health and Human Services could mean that the amount of money spent of health care could skyrocket. Tom Daschle has talked about a creating a Federal Health Board which would be similar the Federal Reserve Board. Daschle's inital plan for the board would to study the clinical and cost effectiveness of treatements and drugs. It might be a good idea to find out which treatments are most effective, but when you start studing the cost effectiveness you get into a rationing situations where the value of a year of life must be given a value. Idealogically, this seem to be opposite of most of the supporters of a single payer system. To do this study will cost money and the Congressional Budget Office studied the costs already and found that it was cost $1.1B more than it would save in 10 years.
When I consider single payer health systems, I always tend to look at UK's National Health Services which has the same problems comon to other single payers - Rationing and long wait times. The NHS decides which drugs can be offered to patients and if the condition is serious enough to require treatment. This boils down to determining when the good of society outweighs the benefits to individuals.

Gupta and Daschel have a new friend in the quest to obtain a single payer healthcare system. Dave Snow, the CEO of Medco, (the insurer that I have my plan through) says that he supports the Federal Health Board that Daschel wants to implement. He main support is behind designing a rule book on how to treat patients. This means that a doctor won't be able to make decision on how to treat you because every decision would be premade by a "rulebook" or "cookbook".

Snow's argument is that doctors can't keep up on all of the new advancements in medicine. I wonder how much it would cost for the development of the rule book to guide medical work. How much would it cost to keep it up to date with the new medical procedures coming out all the time?
READ THE ORIGINAL STORY

In the story, the blood thinner that Snow refers to is the very popular blood thinner that is the second leading drug to send people to the hospital behind insulin. A gentic test is on the market to tell if someone might have a gene that could cause uncontrollable bleeding. Snow says a reason that he supported a cookbook to tell docs about this test because his study showed that most of the docs didn't know about it. The story about the blood thinner and gentic test revel that most large insurers, which Medco is, do not cover this test. Maybe the reason that the test is not know if that you company does not cover it for your patient and the company that manufactures the test has not had a reason to advertise it.

What would be a better way to solve this problem of people dying from taking the drug? Maybe, if you are an insurer and want these deaths prevented (because it cost you less) you would cover the drug.
If you are a doctor and if you know about the genetics test, you could offer it to your paitents if they want to pay the extra fee for it. Or if you are the company manufacturing the drug, you could voluntarly put the warning on your label.

As a note, the FDA was ruling on whether the avaliablity of this gentic test should be stated on the label of the drug. The label was approved in Aug 2007 and contains no mention of genetic testing, but does talk about the genetic markers that show a disposition to bleed with the drug.
Lets review: a CEO of a health insurer wants the government to maindate a "cookbook" to practice medicine, because not a lot of doctors have heard of a genetic test that the majority of insurers don't pay for and the FDA finally decided not to included the words "genetic testing" in the new label. I looked up websites on the drug and genetic testing.
Clotcare.com states that the benefits associated with genetic testing are unproven with no clinical experiementation. They say it might save money but it is unproven and there is a bigger risk that it will increase healthcare costs since if the 2M patients are genetically tested it would cost about $1B and it is unclear if the test offers significant info on getting a correct dose since studies have shown that the genetic predisposition only provides half of the varriablity in sensitivity to the drug. Clotcare.com also warns that widespread use of the testing could have negative effects due to doctors relying on the testing and not monitoring the levels of the blood to reach a correct dose. Clotcare.com Story
Closing Statement: "The bottom line is that genetic testing for warfarin dosing may hold promise, but its time has not yet arrived. more research ...,solid clinical data demonstrating a clear benefit of such testing should be required before such testing is recommended on a routine basis. "

Another thing that is often forgot by the public about testing is that when the find a gene is does not mean that something will happen, it means that the person has a greater chance of developing a condition. It is not a hard prediction but rather showing of risks.

A government mandate often has an effect of increasing the price of a service/product because there is not any competition of the other choice: abstaining. The only way a government can control this is to instuite price controls which often has the effect of lowered supply because companies know they can make a better profit in some other activity rather than supplying the mandated product/service. The government must do something to fufil its mandate, so it can use funds from the taxpayers to subsidy the companies so enough companies will want to produce the product/service. Or the Government can take over the industry and supply those products and services using tax payer funds to make up the difference between what is costs to produce and what costs are imbedded in the effeciency of crappy Government work.

Do we want the government that is constant being influenced by players in any situation by people like Pharmacuical companies making the decision on how our doctors treat us from far away? Or do we want our doctor who is next to us with the extensive training and personal knowledge of us, take into account all the factors that contribute to our reaction to the drug and monitor us closely and if needed use genetic testing more and more as it become more refined and cheaper?

Yeah....I don't know about that "Health Handbook".....that seems silly if the doctors are trained for almost a decade to do this and then what do they do? Give you a fucking handbook? I mean I could see where it might be nice to have it on the side for those "when in doubt" moments (but aren't regular medical books for that?), but I think we need to have the doctor evaluate and use his judgement BASED on his years of education/experience....good point about the updates! With technology booming the way it is and the constant medical research being done, it seems like you should have something like that online....that'd be the easiest way to update.

So wait a sec, there's a CONGRESSIONAL BUDGET OFFICE? They're sucking right now!!!!!!

Original Article

The Cato's Insitute's blog had this recent breakdown of what they think will come in Obama's Healthcare Reform.
1) Mandates that require a business to supply health insurance to all employees. - I believe that unless tax credits or exemptions for small businesses is put in place, this could have a very negative effect of growth since employement law changes effect small business to the greatest extent, and small business provide most of the growth and invovation in this country. Mandates by definition raise the price because you don't have the choice to decide to go without because it is too expensive. Isn't healthcare costs one of the things that has been crippling the Automakers?

2) Minimum Benefits - Why can't I get a plan that has less coverage if I have good health, have exercised personal responsiblity, and have determined that I only need catasphrophic case health insurance. Providing a higher benefit must resulting in higher premiums if a system is to remain opperational.

3) Insurance Co unable to charge different prices for different risk. - All this does is to move the cost to help the couch potato smoker onto the well fit person.

4) Insurance Co would have to accept anyone, no more turning people away for conditons they already have. - I really feel bad about this especially when someone is taken off of a group plan and put out by themselves and they already have a condition, but this is not the definition of insurance. Insurance is something you buy to a future unrealized need. I feel as though we need something to pick up for those people. A new kinda of service which provides reasonably priced health CARE but does not motivate people to not get health insurance because they know that they are covered.

5) Subsidy of a large chunk of the population - Cato predicts that low and middle class americans will be subsidized. That comes from the recent change to SCHIPs where it now allows it to go to families that make 4 times as much as the poverty line which means a family of four could make $84,000 and still be on the program. This bring in part of the middle class to a government program to provide health care.

6) Cost Effeciency Studies - Mentioned above in post. This denys options to patients and stiffles inovation.

I would love to be able to walk into clinics, not wait in a line, see my favorite doctor, and get treated for no money. But how will we all pay for it in the long term. Obama has promised to reduce the healthcare costs but how will we do that unless we reduce the amount of care or made it more effecient and when does the government make something more effecient?