How to Charge $546 for Six Liters of Saltwater

It is one of the most common components of emergency medicine: an intravenous bag of sterile saltwater.
Luckily for anyone who has ever needed an IV bag to replenish lost fluids or to receive medication, it is also one of the least expensive. The average manufacturer’s price, according to government data, has fluctuated in recent years from 44 cents to $1.
Yet there is nothing either cheap or simple about its ultimate cost, as I learned when I tried to trace the commercial path of IV bags from the factory to the veins of more than 100 patients struck by a May 2012 outbreak of food poisoning in upstate New York.
Some of the patients’ bills would later include markups of 100 to 200 times the manufacturer’s price, not counting separate charges for “IV administration.” And on other bills, a bundled charge for “IV therapy” was almost 1,000 times the official cost of the solution.
It is no secret that medical care in the United States is overpriced. But as the tale of the humble IV bag shows all too clearly, it is secrecy that helps keep prices high: hidden in the underbrush of transactions among multiple buyers and sellers, and in the hieroglyphics of hospital bills…

If you didn’t think the system was broken before…

How to Charge $546 for Six Liters of Saltwater

It is one of the most common components of emergency medicine: an intravenous bag of sterile saltwater.

Luckily for anyone who has ever needed an IV bag to replenish lost fluids or to receive medication, it is also one of the least expensive. The average manufacturer’s price, according to government data, has fluctuated in recent years from 44 cents to $1.

Yet there is nothing either cheap or simple about its ultimate cost, as I learned when I tried to trace the commercial path of IV bags from the factory to the veins of more than 100 patients struck by a May 2012 outbreak of food poisoning in upstate New York.

Some of the patients’ bills would later include markups of 100 to 200 times the manufacturer’s price, not counting separate charges for “IV administration.” And on other bills, a bundled charge for “IV therapy” was almost 1,000 times the official cost of the solution.

It is no secret that medical care in the United States is overpriced. But as the tale of the humble IV bag shows all too clearly, it is secrecy that helps keep prices high: hidden in the underbrush of transactions among multiple buyers and sellers, and in the hieroglyphics of hospital bills…

If you didn’t think the system was broken before…

Vaccines are Public Health Superheroes
Likely Healthy turned 3 today!  Thanks Y’all!

Likely Healthy turned 3 today!  Thanks Y’all!

Good point.

Good point.

In Canada, the town of Dauphin, Man., was famously the subject of a government pilot project where residents were provided with a guaranteed minimum income from 1974-1978.

The goal of the program, which cost $17 million, was to find out whether providing extra money directly to residents below a certain household income level would make for effective social policy.

The community’s overall health improved and hospital rates declined during the period, according to a 2010 study by Evelyn Forget, a professor at the University of Manitoba.

Participants with mental illness, addictions thrive after being given apartments: five-year national study

The research project, which concluded a year ago, found those given homes, compared to a control group of 200 homeless people who were not given housing, had more stable living conditions, committed fewer crimes and relied less on social services.
The final results of the study — which was held in five Canadian cities — were released by MHCC in April, and found that paying for housing and support services for high-needs, homeless people cost nearly the same as leaving them on the street to rotate through shelters, emergency rooms and jails.
The price breakdown in Vancouver was similar: it cost, on average, $28,282 annually to provide housing and support to high-needs participants living in the scattered apartments; as a result, their lives stabilized and they used, on average, $24,190 less per year in social services, the MHCC report said.
That means that for every $10 invested in providing this “housing first” model of support, there was an average savings of $8.55 in avoided use of social services.
For the difference of $1.45, the participant went from living a chaotic life on the street, to living inside and starting to address challenges such as mental illness, addictions, terrible health, poverty and poor quality of life.
“It’s more possible than we thought to support rehousing and recovery for people who have been left out of housing and support for far too long,” said Somers.
“And their success stories can be remarkable, and surprising.”

We need to scale this up! 

Participants with mental illness, addictions thrive after being given apartments: five-year national study

The research project, which concluded a year ago, found those given homes, compared to a control group of 200 homeless people who were not given housing, had more stable living conditions, committed fewer crimes and relied less on social services.

The final results of the study — which was held in five Canadian cities — were released by MHCC in April, and found that paying for housing and support services for high-needs, homeless people cost nearly the same as leaving them on the street to rotate through shelters, emergency rooms and jails.

The price breakdown in Vancouver was similar: it cost, on average, $28,282 annually to provide housing and support to high-needs participants living in the scattered apartments; as a result, their lives stabilized and they used, on average, $24,190 less per year in social services, the MHCC report said.

That means that for every $10 invested in providing this “housing first” model of support, there was an average savings of $8.55 in avoided use of social services.

For the difference of $1.45, the participant went from living a chaotic life on the street, to living inside and starting to address challenges such as mental illness, addictions, terrible health, poverty and poor quality of life.

“It’s more possible than we thought to support rehousing and recovery for people who have been left out of housing and support for far too long,” said Somers.

“And their success stories can be remarkable, and surprising.”

We need to scale this up! 

TW: Rape, sexual assault, gender-based violence.

Get the Facts.  Resist Rape Culture.

These posters were created by Courtenay Ruth McKay for the Gender-Based Violence Prevention Project. Download printables here.

Shape-Up And Check-Up: LA Barbers To Start Testing Blood Pressure

"I’m always the one asking about, ‘How’s your wife, how’s your children, how’s your mom?’ So it was easy for me to do that and say, ‘Well, look, brother, how’s your blood pressure? How’s your health?"

- James Smith, Barber

Screening and early detection for the masses!  Let’s hope this program is linked up with solid referrals to follow-up care and affordable treatment (or, hey ‘Merica, what about universal health care?).

Fake Bus Stop Prevents Seniors with Dementia from Wandering Off

As patients age, nursing homes risk that they will become disoriented and “escape” the nursing home.  Often, they are trying to return to homes in which they lived previously, desperate that their children, partners, or even parents are worried and waiting for them.
When they catch the escapee in time, the patient is often extremely upset and an altercation ensues.  If they don’t catch them in time, the patient often hops onto public transportation and is eventually discovered by police.  The first outcome is, of course, traumatizing for everyone involved and the second outcome is very dangerous for the patient.  Most nursing homes fix this problem by confining patients who’ve began to wander off to a locked ward and resigning themselves to physically or chemically restraining a desperate and emotionally-wrought patient.
An employee at the Benrath Senior Center came up with an alternative solution: a fake bus stop placed right outside of the front doors of the nursing home.  The fake bus stop does two wonderful things:
(1)  The first thing a potential escapee does when they decide to “go home” is find a bus stop.  So, patients who take off usually get no further than the first bus stop that they see.  ”Where did Mrs. Schmidt go?”  “Oh, she’s at the bus stop.”  In practice, it worked tremendously.  This meant that many disoriented patients no longer needed to be kept in locked wards.
(2)  The bus stop diffuses the sense of panic.  If a delusional patient decided that she needed to go home immediately because her children were all alone and waiting for her, the attendant didn’t need to restrain her or talk her out of it, she simply said, “Oh, well… there’s the bus stop.”  The patient would go sit and wait.  Knowing that she was on her way home, she would relax and, given her diminished cognition, she would eventually forget why she was there.  A little while later the attendant could go out and ask her if she wanted to come in for tea.  And she would say, “Ok.”

A more humane solution that respects the dignity and autonomy of those living with dementia - hope this idea spreads!

Fake Bus Stop Prevents Seniors with Dementia from Wandering Off

As patients age, nursing homes risk that they will become disoriented and “escape” the nursing home.  Often, they are trying to return to homes in which they lived previously, desperate that their children, partners, or even parents are worried and waiting for them.

When they catch the escapee in time, the patient is often extremely upset and an altercation ensues.  If they don’t catch them in time, the patient often hops onto public transportation and is eventually discovered by police.  The first outcome is, of course, traumatizing for everyone involved and the second outcome is very dangerous for the patient.  Most nursing homes fix this problem by confining patients who’ve began to wander off to a locked ward and resigning themselves to physically or chemically restraining a desperate and emotionally-wrought patient.

An employee at the Benrath Senior Center came up with an alternative solution: a fake bus stop placed right outside of the front doors of the nursing home.  The fake bus stop does two wonderful things:

(1)  The first thing a potential escapee does when they decide to “go home” is find a bus stop.  So, patients who take off usually get no further than the first bus stop that they see.  ”Where did Mrs. Schmidt go?”  “Oh, she’s at the bus stop.”  In practice, it worked tremendously.  This meant that many disoriented patients no longer needed to be kept in locked wards.

(2)  The bus stop diffuses the sense of panic.  If a delusional patient decided that she needed to go home immediately because her children were all alone and waiting for her, the attendant didn’t need to restrain her or talk her out of it, she simply said, “Oh, well… there’s the bus stop.”  The patient would go sit and wait.  Knowing that she was on her way home, she would relax and, given her diminished cognition, she would eventually forget why she was there.  A little while later the attendant could go out and ask her if she wanted to come in for tea.  And she would say, “Ok.”

A more humane solution that respects the dignity and autonomy of those living with dementia - hope this idea spreads!

All About That Bass by Meghan Trainor

Yeah it’s pretty clear, I ain’t no size 2
But I can shake it, shake it like I’m supposed to do
‘Cause I got that boom boom that all the boys chase
All the right junk in all the right places
I see the magazines working that Photoshop
We know that shit ain’t real
Come on now, make it stop
If you got beauty beauty just raise ‘em up
‘Cause every inch of you is perfect
From the bottom to the top

Some body positivity for y’all today!