healthcare
lborkowski | August 17, 2012by Kim Krisberg
For years, Peter Rosenfeld was looking for an effective way to treat what doctors had diagnosed as severe and intractable migraines. He'd heard of medical marijuana, but thought it was a joke — that it was just a way for people to justify their marijuana use.
Then in 2000, the New Jersey resident enrolled in a California program studying the effects of medical marijuana. It was a blind study, so Rosenfeld didn't know whether he was one of the participants being given marijuana or not. It turns out he was. And it worked.
"Marijuana was the first effective treatment that I had…
lborkowski | August 16, 2012A new Health Wonk Review compiled by Jaan Sidorov is now up at Disease Management Care Blog. It's got links and descriptions for a bounty of blog posts on healthcare quality, the Affordable Care Act, Paul Ryan, and other healthcare topics (including a link to my recent post on where Medicaid beneficiaries can get care).
One of the featured posts I particularly like (and probably wouldn't have seen if not for the HWR link) is Justin Jones' "A farewell, a remembrance, and a request" at The New Health Dialogue. Jones, who has just started his second year of medical school, reflects on his great-…
lborkowski | August 13, 2012Presumptive Republican presidential nominee Mitt Romney’s selection of Congressman Paul Ryan (R-Wisconsin) as his running mate this past weekend has provided plenty of fodder for discussions about the role of the US government. Unlike Romney, who has often declined to provide specifics about policies he’d pursue as president, Ryan has been very clear about what he thinks the government should do. As chair of the House Budget Committee, Ryan authored the “Path to Prosperity” budget proposal that the House passed earlier this year.
The New Yorker's Ryan Lizza describe Ryan's evolution as a…
lborkowski | August 10, 2012In order to meet the healthcare needs of populations at the local, national, and global levels, we're going to need to think carefully about which providers can do which kinds of tasks. Pieces in Washington Post and New York Times blogs this week highlight projects that reconsider what kinds of providers patients need to see to get care for particular conditions.
In the Washington Post's Wonkblog, Sarah Kliff describes efforts by Albuquerque physician Sanjeev Arora to make Hepatitis C treatment available to patients across New Mexico. Arora is one of a small number of Hepatitis C specialists…
lborkowski | August 9, 2012Millions of people will gain insurance under the Affordable Care Act, but will they be able to get appointments with healthcare providers? Coverage doesn't automatically translate into access, and some newly insured individuals will struggle to find physician practices that will take them on as patients. In particular, states that adopt the (now optional) Affordable Care Act Medicaid expansion, which extends eligibility to adults up to 133% of the poverty level, may encounter a severe shortage of providers willing to accept new Medicaid patients. Although Medicaid reimbursement levels vary…
cmonforton | August 7, 2012I feel dense for not knowing this important public health fact: women with extremely dense breast tissue are at least four times more likely to develop breast cancer.
Over the years, I've had my routine screening mammograms with stellar results. No evidence of cancer in my two mammary glands. I've heard radiology technicians comment about my dense breasts, but I thought it was an interesting attribute like droopy breast, or perky breasts or double D breasts.
In December 2011, just before my 50th birthday, I was overdue for my routine screening mammogram. I felt a little guilty for putting…
lborkowski | August 3, 2012by Kim Krisberg
To the long list of hard-to-pronounce bacteria and viruses that threaten people's health can now be added one more threat: sequestration. Except sequestration isn't a disease — well, unless you'd call Congress' chronic inability to deal with the national debt in a fair and balanced way a disease.
Of course, if sequestration were a real disease, the public health system might actually be immune to such budget-slashing illnesses by now, considering its near-constant exposure rate. But come this January, if Congress doesn't act, the public health system will absorb another round…
cmonforton | July 31, 2012A few weeks ago, the editors of my local Austin American-Statesman admitted they were wrong. In "Tort reform's slight impact no shock," the editors recalled their support for a 2003 proposition on the Texas ballot to put a $750,000 cap on non-economic damages in medical malpractice cases. The measure passed by a 51 to 49 percent margin, with strong support by the Texas Medical Association.
"We tepidly supported the proposition. After all, voters were being asked to limit their legal rights should they fall victim to medical error. Still, reservations noted, we crossed our fingers in the…
lborkowski | July 20, 2012by Kim Krisberg
Legislative attacks on women's health care are so commonplace these days that they make proposals that don't include a state-mandated vaginal probe seem moderate.
In fact, so many legislators are introducing proposals under the guise of protecting women's health (2011 marked a record number of reproductive health restrictions), that it was pretty refreshing to read how the Affordable Care Act will actually protect women's health. Like, for real.
Last week, the Commonwealth Fund released a report finding that the health reform law is already making a difference in the lives of…
lborkowski | July 16, 2012If you haven't yet read Maryn McKenna's riveting Atlantic article "How Your Chicken Dinner is Creating a Drug-Resistant Superbug," you should. McKenna, working with the with the Food and Environment Reporting Network, has delved into research that's been accumulating about the association between the extensive use of antibiotics in poultry and the increase in drug-resistant urinary tract infections.
A quick bit of background: For decades, health officials and advocates have been concerned about the overuse of antibiotics. The more you use an antibiotic, the more quickly bacteria resistant to…
lborkowski | July 9, 2012by Kim Krisberg
Last month, more than 70 ironworkers walked off an ExxonMobil construction site near Houston, Texas. The workers, known as rodbusters in the industry, weren't members of a union or backed by powerful organizers; they decided amongst themselves to unite in protest of unsafe working conditions in a state that has the highest construction worker fatality rate in the country.
The workers reported multiple problems with the ExxonMobil subcontractor who hired them, including not being paid on time, not having enough water on site and no access to medical care in the event of an…
lborkowski | July 2, 2012Joe Paduda at Managed Care Matters has posted the second of two parts in the special edition of Health Wonk Review responding to the Supreme Court's decision on the Affordable Care Act: Part I is here, and Part II is here.
I'm delighted with the Court's decision to uphold the law as a whole, but concerned about its making the Medicaid expansion optional. One Slate article and two posts on the Health Affairs Blog (one of which was included in Part I of the special-edition HWR) are especially helpful in thinking about the Medicaid aspect of the decision:
Darshak Sanghavi explains in Slate that…
lborkowski | June 29, 2012There's been a lot of great analysis and commentary since the Supreme Court issued its decision on the Affordable Care Act yesterday. Joe Paduda at Managed Care Matters is graciously hosting a special edition of Health Wonk Review -- check it out a variety of takes on the legal, economic, and healthcare implications of the decision.
On the topic of states now getting to choose whether or not to participate in the Medicaid expansion, Sarah Kliff talks to Matt Salo, director of the National Association of Medicaid Directors, about how states will think through their options and runs some of the…
gregladen | June 29, 2012... the hazzards of sickness ... should be provided for through insurance. This should be [charged to] the industries the employer, the employee, and perhaps the people at large ... Wherever such standards are not met by given establishments, by given industries, are unprovided for by a legislature, or are balked by unenlightened courts, the workers are in jeopardy, the progressive employer is penalized, and the community pays a heavy cost in lessened efficiency and in misery. What [European country] has done in the way of old age pensions or insurance should be studied by us, and the system…
lborkowski | June 28, 2012As Kim has already reported, public health advocates are delighted that the Supreme Court has upheld the Affordable Care Act. The law takes important steps toward improving the way we pay for care and invest in prevention, but its most important achievement is in reforming the bizarre US health-insurance system, whose reliance on voluntary employer-sponsored coverage has resulted in millions of people lacking health insurance. By deciding that the law’s Medicaid expansion is optional for states, though, the Court is leaving the fate of 16 million low-income people up in the air.
The ACA…
lborkowski | June 28, 2012by Kim Krisberg
For me, there were few better places to hear about today's 5-4 Supreme Court ruling upholding the Affordable Care Act and its individual insurance mandate than at a meeting of the American Public Health Association (APHA). Here in Charlotte, N.C., for APHA's Midyear Meeting, I was surrounded by hundreds of public health practitioners, researchers and advocates as we all watched the magnified scroll of Scotusblog.com, anxiously waiting for the decision.
At 10:08 a.m., the blog declared: "The individual mandate survives as a tax."
That was when the cheers (and tears) began. You…
lborkowski | June 26, 2012by Kim Krisberg
Just a few years ago in Butte County, Calif., it wasn't unusual for public health workers to administer more than 1,000 free HIV tests every year. In true public health fashion, they'd bring screening services to the people, setting up in neighborhoods, parks and bars, at special community events and visiting the local drug treatment facility and jail. The goal was prevention and education, and no one got turned away.
That was before 2009, which is when California state legislators cut millions in HIV prevention and education funds from the state budget. The cut meant that…
lborkowski | June 20, 2012As we're waiting to learn whether the Affordable Care Act will survive the upcoming Supreme Court decision, it's a good time to remember what's at stake with the individual mandate -- the part of the law that's least popular with the public and that some Supreme Court Justices seem to find objectionable. I've written before about why the mandate, which requires everyone who can afford it to purchase health insurance or pay a penalty, is a necessary part of the healthcare law and is not the same as requiring everyone to buy broccoli. Now, the Washington Post's Sarah Kliff adds to the…
lborkowski | May 30, 2012Earlier this year, Kim Krisberg wrote about cuts to mental health funding in states across the country, and what that means for public health. Via Reporting on Health, here's a devastating portrait of the impact of mental health cuts to one California county, in a Modesto Bee series by Jocelyn Wiener:
Mental health care breaking down in Stanislaus County
Help eludes father until son ends up behind bars
A family's never-ending cycle
A shining light in Modesto
Wiener gives voice to people who suffer from mental illness and can't get help until they're in crisis, families who struggle to get…
lborkowski | May 25, 2012Earlier this month, NPR, the Robert Wood Johnson Foundation, and the Harvard School of Public Health released the results (PDF) of a poll they conducted to learn about the experiences of the 27% of US adults who reported having serious healthcare needs (specifically, those who’d been hospitalized overnight in the past year or who reported having an illness, medical condition, injury, or disability that requires lots of medical care). It’s no surprise that many of the poll respondents reported serious problems with healthcare costs, which sometimes resulted in them not getting needed care. But…