HMS/HSDM Class Day: Science Applied to Problems of the Poor HSPH Class Day: Speakers Address People's Health and Social Disparities Alumni Day Symposium: HMS Alums Take on the Health Care Crisis Class Symposium Class of '79 Details Illness in the Body Politic Faculty Symposium: At the NRB, Faculty View Convergence of Biology and Medicine Class Day: HMS/HSDM Speakers Describe Their Personal Journeys International Health: Education and Research Center Launched in Dubai Medical Education: New Residency Created in Global Health Prizes and Awards: Honors Given to Students and Faculty for 2004 Letter to the Editor   Small Molecule Blocks Herpes Replication Test Ratio Predicts Breast Cancer Patients Who Respond to Tamoxifen   Proceedings of the HMS Faculty Council   Student-Faculty Collaboration Yields Pharmacology Text   Front Page

ALUMNI DAY SYMPOSIUM HMS Alums Take on the Health Care Crisis In the billing departments at Brigham and Women's, about 300 staff members are needed to cope with the daily deluge of paperwork. At the very similar Toronto General Hospital, just three people can get the job done. This partly explains why Americans spend three times as much as Canadians, more than $1,000 per capita, on health care administration, said Steffie Woolhandler at the June 11 Alumni Day Symposium, "Navigating the Healthcare Crisis." Is America ready for national health insurance? Sixty-two percent of Americans and 64 percent of primary care physicians in Massachusetts support some form of national insurance, said Steffie Woolhandler, cofounder of Physicians for a National Health Program. (Photo by Steve Gilbert) "There is no time at which we hear more from alumni than when they are asking us why we can't do more about the problems in health care," said symposium moderator Daniel Federman, the Carl W. Walter distinguished professor of medicine and senior dean for alumni relations and clinical teaching at HMS. Woolhandler, HMS associate professor of medicine at Cambridge Hospital, is no stranger to the health care cost debate. Having initially pursued a career in economics, she then had a "180 degree" change of heart and switched to medicine. Little did she know how hard it would be to get away from economics. "I wasn't in medicine very long before I realized something you all already know," she told the alumni audience, "which is that financing gets in the way of delivering care." "I wasn't in medicine very long before I realized something you all already know, which is that financing gets in the way of delivering care." --Steffie Woolhandler This revelation spurred Woolhandler to cofound Physicians for a National Health Program, a group that now advocates a single-payer "Canada deluxe" health care system for the U.S. Not only might this eliminate the growing problem of the uninsured--44 million and counting--but it would also prune the growing bureaucracy that siphons off billions of health care dollars each year. In the last few decades, for example, the number of health care administrators has grown by more than 2,500 percent in the U.S., while the large private health management organizations cream off nearly 12 percent of the money they collect in premiums, an overhead that amounted to just under $47 billion in 1999. In contrast, Medicare and Medicaid overheads were 3.6 and 6.8 percent, respectively. But speakers acknowledged that introducing a single-payer system will not solve all the problems. Vanessa Haygood, HMS '78, a partner at Piedmont Healthcare for Women, Greensboro, N.C., shared an obstetrician's perspective of what is wrong with health care. Seventy percent of obstetricians will be sued, she reported, and malpractice insurance premiums are at an all-time high. So are jury awards, said Haygood, citing the recent record payout of $25 million in North Carolina. It is no wonder, she explained, that residencies in obstetrics are at an all-time low. Tort reform was also addressed by Katherine Keeley, HMS '94, a maxillofacial surgeon and chair of the quality care committee at Sunrise Hospital and Medical Center in Las Vegas. Keeley explained how increases in jury awards, which averaged around $500,000 in 1996 and peaked at $21 million in 2001, precipitated a statewide crisis in Nevada. After the leading malpractice insurance company pulled out of the state in 2002, leaving 20 percent of doctors and almost all high-risk specialists without malpractice coverage, doctors went on strike to demand legislative reform. Regrettably, "being political neophytes," said Keeley, the doctors yielded too much to the trial lawyer lobby and the legislation that passed made a bad situation worse. Malpractice filings in the state rose from 31 per month in 2001 to 93 per month in 2003. --Tom Fagan