We kept our baby. Here’s how Republicans can prove that they’re pro-life, too.

Ultrasound of a fetus at the fourth month. (bigstock)

By Emily Barbero January 27 at 6:15 PM

Emily Barbero lives in Minneapolis.

In 2012, while expecting our first (and only) child, my husband and I went in for a routine ultrasound. The technician saw something and alerted the resident perinatologist, who alerted the genetics team. We quickly wiped the gel from my belly, and they escorted us down the hall. In the rush, the black-and-white photos of our baby were left on the printer. Someone probably threw them away long ago.

After reviewing our file, the genetics counselor explained to us that they couldn’t quite know what was wrong for sure without further testing, but that our son’s brain showed clear anatomical issues. She said that some children with our son’s condition never walk or talk. They sometimes have cognitive, social and emotional delays. Their quality of life can suffer, and they can be a considerable drain on the emotional and financial health of families.

She hesitated, but then posed the question: Did we want to keep our baby?

My husband and I simply had to glance at each other. We each knew what the other was thinking. We weren’t going to terminate.

We didn’t say yes to our son because any political party said that it was the decision that differentiates those with good morals from those with bad ones. We made our decision holding hands, with a prayer on our lips, oceans of love in our hearts, a spark of hope and a lot of naivete. It was our personal decision to make, not any sort of political or religious agenda to be had.

Our son turns 4 this month.

He has developmental delays and a complex health history, but he is happy and thriving. He is also a true success story for early-intervention services. Without his weekly occupational, physical and language appointments, without his surgeons, gastroenterologists, developmental specialists and neurologists, he would not be where he is today.

But what about tomorrow? Currently, because of the Affordable Care Act, insurers cannot discriminate against people with preexisting conditions. They can’t deny coverage, they can’t limit coverage, and they can’t charge exorbitant premiums to those with significant health problems.

So right now, my son’s insurance coverage is secure. But in their drive to repeal the ACA, Republicans in Congress are conjuring up a different world — one where one little gap, like the job my husband lost several years ago, can result in bankruptcy and in the rapid decline of health in a loved one, even death.

The Republican Party prides itself on being a pro-life party and has delivered a pro-life president into office. During campaign season, we heard messaging about the value of life and our collective responsibility to protect it. The GOP wants everyone to know that no matter what the ultrasound says, they should choose life.

We did. And now, sleeping in our house tonight is a beautiful boy with dimples, a boy who loves Lego Ninjago and Batman, a boy who thinks tackling snowmen is hilarious. Just this month, he showed us he can hit a baseball off a tee.

He also happens to be a boy with a preexisting condition and six-inch-thick medical file.

Has our language become empty? Suddenly, Republican members of Congress no longer seem to view him as so precious and beautiful. Now he’s expensive, and a risk, and a liability. The argument that his life should be supported and protected at all costs has fallen eerily silent. The new argument is over which of the ACA’s protections should be preserved, if any, and to what extent, and whether the law should be done away with even before a replacement is worked out.

We gave my son life, despite the warnings, and now he needs care. There are millions like him. But the Republicans in Congress look the other way.

So who is the real pro-life supporter among us?

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Want to fix the health care system? Fix hospitals first

By Rich Lesser and Barry Rosenberg, CNN   |  Posted Jan 23rd, 2017 @ 6:18pm

WASHINGTON (CNN) — As Congress and the Trump administration debate the future of America's health care system, they should go beyond the issues of access and cost and recognize an equally important priority: that patients come first, so health reform should also focus on quality of care.

Seen statistically in hospitalized patients' complication and mortality rates, and in the percentages of individuals with chronic diseases who are kept out of the hospital with effective preventative care, these quality "outcomes" are the overlooked elephant in the room for health reform.

We recently analyzed 22 million hospital admissions across the country, examining two dozen common conditions, including such widespread illnesses as heart disease, diabetes and post-operative infections. What we found were surprisingly large variations between the best- and worst-performing hospitals.

Patients in the worst-performing hospitals — those in the bottom 10% — were three times more likely to die and 13 times more likely to experience complications than those in the top-performing hospitals. The probability of dying in the hospital after a heart attack or stroke was more than twice as high in low-performing hospitals as in high-performing ones. And patients in low-performing hospitals were nearly 20 times more likely to experience IV line infections and more than three times more likely to contract post-operative sepsis infections than in high-performing hospitals.

It would not be overly dramatic to characterize some of the outcome differences as alarming, including significant differences among hospitals within the same metropolitan area.

For example, if you had called 911 for a heart attack in Phoenix, you could have been treated at a hospital with a 5% death rate or a facility with a 15% death rate, depending on which of 14 local hospitals cared for you. Among the 26 hospitals in New York City, you could have been taken to a hospital with a 4% death rate or one with a 21% death rate.

Most Americans know that hospitals vary in quality, but do they realize the wrong choice can increase their chance of death so significantly?

The standard answer from many medical professionals when confronted with such variations is that they're often caused by factors beyond their control, such as the patient's health or income. But that's only part of the story, or so we found.

After rigorously risk-adjusting for more than 80 distinct measures in patient health, demographics, socio-economics and health system factors — including whether the hospitals were in urban or rural areas, the prevalence of smoking in the area, and so forth — we saw that the variations persisted. Indeed, challenging conventional wisdom, the study found some poor-performing hospitals serving mainly high-income, largely white populations and some high-performing hospitals serving primarily low-income, minority populations. This was true across the country, between states, within states and within cities. In other words, where you live might determine if you live.

We can't say conclusively why such outcome differences exist and persist even after risk adjustment. But it's clear that what happens inside a hospital matters a lot.

Measuring, reporting and acting on outcomes provides a real opportunity to avert harm, save lives and lower health care costs. Small steps are being taken in this area, such as measuring IV line infection rates and reducing reimbursements to hospitals with high readmission rates. But more needs to be done.

The policy changes being contemplated for next year are rooted, advocates say, in the fundamental American ideals of choice and competition. But a consumer-based, patient-centered health system requires individuals, families and third-party payers, whether government or private insurers, to know what they're buying.

Similarly, doctors and health care professionals can't effectively set goals and make improvements if they don't know where they stand. Our experience indicates that doctors and hospital administrators want to provide the best possible care. They mean well. They are mission driven. But they need clear and objective data on their hospital's performance so they know where to focus their efforts.

Interestingly, to conduct our research we were forced to use 2011 hospital data because the Agency for Healthcare Research and Quality, in 2012 — ostensibly to "enhance confidentiality" — eliminated "state and hospital identifiers" from its National Inpatient Sample (NIS) database. That's like knowing there's been a big pileup on the Beltway, but not knowing where.

Outcomes data from every hospital in the United States, analyzed at both the disease level and procedure level, should be compiled and made available for legitimate research and quality improvement purposes.

We're not looking to generate tabloid headlines. Hospitals should be given ample time to react to the data and improve. After that, the same type of information should be made publicly available -- so that patients, in consultation with their doctors, can select hospitals where they're most likely to get the best care, rather than those that simply accept their insurance.

Our research should send a strong message to policy makers that good health insurance, no matter how affordable or accessible, is not synonymous with good care.

You don't go to an Italian restaurant and expect great sushi. Similarly, just because a hospital is good at knee replacements doesn't mean it's good at brain surgery. Collecting and analyzing data on outcomes, providing transparency, and driving performance improvements should be core elements of health-care reform. The American people deserve nothing less.

Copyright 2017 Cable News Network. Turner Broadcasting System, Inc. All Rights Reserved.

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How much does American health care cost compared to other developed countries?

How much does American health care cost compared to other developed countries? 

American health care costs are much, much higher than in other developed countries.  As a percentage of GDP (gross domestic product) American health care is almost 20%, which is twice the proportion of GDP spent on average in other first world countries.  Put into per person spending, on average Americans spend $10,000 each year per person on health care, which is about twice as much as is spent in other developed nations.  As a comparison, the per person total gross domestic product in Russia is $9000, which is less than what Americans spend on health care.  American health care spending is way more than similar spending in other countries, meaning health care is way more expensive here than anywhere else in the world.  This begs the question:  Why is American health care so expensive?

The U.S. spends more on health care than any other country. Here’s what we’re buying.

The U.S. spends more on health care than any other country. Here’s what we’re buying.

By Carolyn Y. Johnson December 27, 2016 

(Washington Post illustration; iStock)

American health-care spending, measured in trillions of dollars, boggles the mind. Last year, we spent $3.2 trillion on health care -- a number so large that it can be difficult to grasp its scale.

A new study published in the Journal of the American Medical Association reveals what patients and their insurers are spending that money on, breaking it down by 155 diseases, patient age and category -- such as pharmaceuticals or hospitalizations. Among its findings:

• Chronic -- and often preventable -- diseases are a huge driver of personal health spending. The three most expensive diseases in 2013: diabetes ($101 billion), the most common form of heart disease ($88 billion) and back and neck pain ($88 billion).

• Yearly spending increases aren't uniform: Over a nearly two-decade period, diabetes and low back and neck pain grew at more than 6 percent per year -- much faster than overall spending. Meanwhile, heart disease spending grew at 0.2 percent.

• Medical spending increases with age -- with the exception of newborns. About 38 percent of personal health spending in 2013 was for people over age 65. Annual spending for girls between 1 and 4 years old averaged $2,000 per person; older women 70 to 74 years old averaged $16,000.

The analysis provides some insight into what's driving one particularly large statistic: Within a decade, close to a fifth of the American economy will consist of health care.

"It’s important we have a complete landscape when thinking about ways to make the health care system more efficient," said Joseph Dieleman, an assistant professor at the Institute for Health Metrics and Evaluation at the University of Washington who led the work.

[The alluring idea that we can cure cancer has become a trap]

The data show that the primary drivers of health-care spending vary considerably. For example, more than half of diabetes care is spending on drugs, while only about 4 percent of spending on low back and neck pain was on pharmaceuticals. Generally, more spending is done on elderly people, but about 70 percent of the spending on low back and neck pain was on working-age adults. Such insights provide a way to find the drivers of growth in health-care spending and to launch strategies to control it.

"Data like this continues to draw attention to the fact a lot of these proposals being discussed about controlling health-care costs really don’t address the underlying issue, which is rising disease prevalence," said Ken Thorpe, a professor of health policy at Emory University who was not involved in the study but has done similar research. "You see this rise in chronic disease spending -- much of it is potentially preventable."

Most of the discussion of health care in America has focused on access to insurance, but the spending breakdown shows that the biggest opportunities may come in preventing disease.

[Americans are shouldering more and more of their health-care costs]

The researchers also analyzed spending on public health and prevention. In a separate editorial, Ezekiel Emanuel, a former health-care adviser to President Obama, pointed out that the largest public health spending was on HIV. But fewer than 7,000 Americans died because of HIV/AIDS in 2014 and it ranked 75th on the list of diseases by personal health expenditures.

"Few public health dollars focus on lifestyle conditions that ultimately contribute to the majority of chronic illnesses seen today," Emanuel wrote. Low back and neck pain, for example, ranked low on the list of public health expenditures with $140 million in public health funding, but high on the list of health-care spending. Tobacco control received $340 million in public health spending, but smoking contributes to several diseases that drive health-care spending.

What the data also show is that conditions that drive health-care spending aren't necessarily the ones that come to mind when people think about health care. Falls were the fifth-highest cause of health spending, followed closely by depression. Pregnancy and dental care were in the top 15.

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