This is a blog for the Mental Health Policy Class at the George Warren Brown School of Social Work.

July 14, 2008

The coming burden of Alzheimer's disease

In 2005, Medicare paid out $91 billion for costs related to Alzheimer's and other forms of dementia. By 2015, those costs are expected to climb to $189 billion. Medicaid paid $21 billion in nursing home costs for Alzheimer's and dementia patients in 2005; by 2015, those costs will climb to $27 billion. It seems ironic that Alzheimer's-related costs are set to balloon as the billions of dollars pumped into treating and preventing other maladies are beginning to show results. In recent years, medical care has advanced to the point that deaths from cancers, heart disease and stroke, the leading causes of death in the U.S., have dropped dramatically. Very quietly though, deaths from Alzheimer's disease have climbed 44 percent, from 49,558 to 71,696. There is no cure for Alzheimer's. Its biggest risk factor is old age.

Some psych patients wait days in hospital ERs

Emergency rooms, they say, have become all-purpose dumping grounds for the mentally ill, with patients routinely marooned a day or more while health care workers try to find someone to care for them. A survey of hundreds of U.S. hospitals released last month by the American College of Emergency Physicians found that 79 percent reported that they routinely "boarded" psychiatric patients in their waiting rooms for at least some period of time because of the unavailability of immediate services. One-third reported that those stays averaged at least eight hours, and 6 percent said they had average waits of more than 24 hours for the next step in a patient's care.

Psychiatric Group Faces Scrutiny Over Drug Industry Ties

Commercial arrangements are rampant throughout medicine. In the past two decades, drug and device makers have paid tens of thousands of doctors and researchers of all specialties. Worried that this money could taint doctors’ research plans or clinical judgment, government agencies, medical journals and universities have been forced to look more closely at deal details.
In psychiatry, Mr. Grassley has found an orchard of low-hanging fruit. As a group, psychiatrists earn less in base salary than any other specialists, according to a nationwide survey by the Medical Group Management Association. In 2007, median compensation for psychiatrists was $198,653, less than half of the $464,420 earned by diagnostic radiologists and barely more than the $190,547 earned by doctors practicing internal medicine. But many psychiatrists supplement this income with consulting arrangements with drug makers, traveling the country to give dinner talks about drugs to other doctors for fees generally ranging from $750 to $3,500 per event, for instance.