Preperation H Or Anusol

has come to my hands the last statement of the Medical College (WTO) on the sustainability of our health system, an issue that certainly concerns us all.

We maintain the idea that our system is efficient, equitable and having an impact on health comparable to the best in the world. Efficiency means that we get good results according to the means employed. Equity is synonymous with equality and respect that any citizen can access public health resources in the same conditions. And with regard to health outcomes they encompass the clinical outcome, patient-centered (humanistic) and economic performance and welfare activity.

The other day I heard from D. José María Fidalgo, former Secretary General of Workers' Commissions (CCOO) that our public health system is cheap, in other words, we get results similar or better health than those obtained by other countries that spend a higher percentage of its gross domestic product ( GDP) to finance his health.

In this line, then it would not raise more, but to manage better. In health economics, some measures such as tax collection or penny copay health, scientific evidence has shown more than doubtful.

Would it be logical rationalize the use of certain high-tech, sophisticated and costly? We understand that if this type of containment measures are imposed on pharmaceutical, could be applied to other fields of management. Criticize the lack of cohesion in a country where health cards coexist 17, 17 medical records in electronic or computerized classic, 17 portfolios of services, and where hospitals have been built without measure that distance, sometimes less than 50 miles between them, depending on the Autonomous Community in question.

into the limelight are administrative measures undertaken to control pharmaceutical spending, undoubtedly, a portion of the overall budget succulent health in Spain. There is a pharmacy co-pay long-established, users are pensioners in this country (except MUFACE and the like) do not pay a penny in pharmacies for the medications prescribed by doctors in public health, while the assets pay a variable rate, in most cases by 40%. Many voices claim on the gap and the obsolescence of this practice, believing it would be fairer to apply the copayment amount as income level and not according to the state job training. Because ultimately, it comes down to knowledge of the health problem we address, how we approach it and how much it costs this task.

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PAST AND FUTURE MISS

Ourense it falls far short of Madrid. The train leaves on time, at 00.15 hours and arrives at the Chamartin station at 8.00. From 9.30, I spend all day meeting at WTO headquarters in the Plaza de Las Cortes, fellow of the provincial delegationships urban primary care. I listen carefully to the intervention of José María Fidalgo, former secretary general of the CCOO, medical, orthopedic surgeon. The future outlook of our profession continues to be dark for a change. Visit to the headquarters of the College of Physicians of Madrid. A delight to contemplate many gems and historical figures together: Gimbernat, Cajal, Marañón ... Dr. Miguel Angel Sanchez is a generous host. In one of the windows of the library, I look at a copy of "The Women" by Don Santiago Ramón y Cajal. It appears our Nobel was "a little" macho. These are the words of Dr. Inés Picornell Darder, head of the Clinical Neurophysiology Service Hospital de Móstoles. Later, she would reveal to us the secrets of sleep and its disorders, with its emphasis Balearic nice, velvety, like a child who tells a wonderful story. It shows their devotion to childhood epilepsy. At 22.30 hours back home. Unable to sleep, however much they strive to coin the rattle of the train. Neither REM nor milk. I try to browse "An Alabama student and other biographical essays," by Sir William Osler, but continued my concentration keeps swinging in his reading. At 5.00 pm start to glimpse the lights of my home. Definitely, it falls far short Ourense, anywhere.

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Eventually

where

after my death,

get placate your cries.

Just then,

begin to live

forever.

Oragan Doaner Braslet

NO PATENT MEDICINES

A historical document. The daguerreotype by Albert Sands Southworth and Josiah Johnson Hawes, which shows William Morton and John Warren operating on a patient anesthetized with sulfuric ether at Massachusetts General Hospital (1847).

just surprised
Aloysius generous with his latest gift, a DVD copy of "big time", directed by Preston Sturges in 1944, in which Joel McCrea gave life to the American dentist William Morton . It was the September 30, 1846 when the dentist getting a tooth removed without pain to the patient Eben Frost, inaugurating the era of dental anesthesia. In key comedy, the film's plot revolves around the discovery of sulfuric ether as an anesthetic and the conflict generated between Morton and society of the time the patent as finding capital.

Seeing this film again has made a film about a curious coincidence of fashionable issues in public health, the use of generic drugs marketed after the patent has expired original brand.

force in Spain is Law 29/2006 of 26 July, on guarantees and rational use of medicines and medical devices which clearly states that the generic may not be marketed until they have passed 10 years from the date of the initial authorization of the reference product. In other words, the product patent for a novel chemical entity, a drug in this case represents the time during which the laboratory can exclusively exploit discovered the patented product, in practice the absence of market competition.

The issue is its complexity, since the pharmaceutical industry needs patent protection for profits are able to cover the increased expenditure incurred during the research, development and promotion of each drug. Otherwise, there would be no business, and it is clear that the engine is undoubtedly associated medical research to private. However, critics insist that only research laboratories las líneas patológicas rentables, como el cáncer o la obesidad, por ejemplo, abandonando a su suerte a enfermedades minoritarias por su baja incidencia o por afectar a colectivos desfavorecidos que no pueden sufragarse la medicación, como la enfermedad de Chagas o la tripanosomiasis africana, más conocida como enfermedad del sueño.

El vencimiento de las patentes farmacológicas pudiera representar un sistema de protección antimonopolio. La porfía de William Morton consistía en evitar que otros médicos pudieran utilizar también el éter sulfúrico para anestesiar a los pacientes. Afortunadamente cambió de opinión, al compadecerse de una indefensa muchacha on the verge of an operating room, when he would be subjected without anesthesia to a painful operation. On another occasion, speak of the compassionate use of drugs. Because in this fascinating world of medicine is not all business and greed. Fortunately.

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THE "clothed themselves"

remember with particular affection that interpretation was Manquiña Manuel Pazos, Galicia a drug dealer in "Airbag" (Juanma Bajo Ulloa, 1997). Must see the game that gave a simple falling point of a word, like a ripe fruit in summer, how it changes the meaning of a word when someone confuses their meaning.

I had the opportunity to read these anthologies of nonsense that occasionally show themselves in real and virtual worlds, usually compiled anthologies of nonsense in the classroom homelands or in doctors' offices. A deceased elderly patient, witty where they exist, I had to take some pills to control your blood called Bernardine. " I really wanted to refer to the drug Brinerdina ®, a cocktail of diuretic and Rauwolfia alkaloid that was used in the heroic days for the treatment of hypertension. Another gentleman soothed the pain of osteoarthritis with "lily ," a nickname floral water and more euphonious to defining the popular Neobrufen ®, perhaps the most famous anti-inflammatory in the world. Finally, one patient managed to allay their anxiety at bedtime taking one tablet every night " tranquilizin ", lo and behold a more convenient to define the well-known anxiolytic Trankimazin ®.

Now that electronic recipes and generally reports are written on the computer, it is more difficult to go wrong with the name of the medication. Much blame for the miscommunication between doctors and patients have the doctors, intent on using a complex jargon ridden hermetisms.

But tit for tat, the acerbic Aloysius just flood my email with some malicious phrases culled from some medical reports.

Here we leave some, as evidence to posterity: "slipped on the ice and his legs were in opposite directions in early December, "the second day after surgery, his knee was better, and the third was completely gone," the patient is depressed since she began visiting, in 1983 "," 69 year old male subject, decrepit but apparently healthy, active mental state, but forgetful, "the patient has occasional headaches, constant, infrequent," said he had been constipated for most of his life until 1989, when she divorced, "the patient left the hospital feeling much better, except for her original complaints, "and finally, the icing on the cake:" The patient expired on the floor, quietly. "

should be reviewed carefully all these clothed themselves because of all it is well known that has a mouth, think again.

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A TURN TO THE HEALTH EXPENDITURE NARRATIVE

These

Aloysius days foresight has certainly been engaged in various economic issues related to public health. His last email is full of thoughts that surely has been surmised calculator in hand.

In Spain, general statistics put our public health spending by about 1300 euros a year per citizen, $ 500 amount would vary up or down depending on the CCAA. Yet globally, we remain among the nations with the lowest health expenditure of the European Community.

Experience stubbornly persists in showing how every year this expenditure is continually increasing. This upward trend has been documented from the 70's of last century, and although it is more evident in developed countries has also been detected in the developing countries and those other so-called emerging. We could say without a doubt, public health spending has tripled in the last 50 years.

But in this aspect significantly affects the penetration of private health care. In our country, the regions with highest presence of private health insurance companies (Catalonia, Madrid and the Balearic Islands) have a health spending smaller groups. The opposite example is given in Asturias and Extremadura. In Galicia, for what the topic, we were in the middle of the table and climb or descend.

The private health insurance specialists estimate that if the government adopted tax relief applicable to such products, the public health system may be drained of about 1500 euros per person per year, mainly due to all those For many years users do not need or do not use public health resources. It is clear that the healthy or take drugs or admitted to hospitals. But the greatness of our national health system, universal and equitable, is its funding through taxes we all pay.

Various studies have shown that individual differences in health spending has more to do with proximity to the actual moment of death of the patient's age itself, but from Galicia Ourense we have been complaining population aging as one of the reasons that justify our more health spending.

Still, better management in the diagnosis, treatment and monitoring of chronic diseases shows remedial effects on overall health spending. Other factors that trigger health expenditure, since the application of modern technologies and costly to the medicalization of our society that increasingly demands more health care as a result of increased living standards and welfare. So where will place the top of this expenditure? Of all depends ...