healthcare
denialism | January 13, 2012Via Zite I found the article How Doctors Die by Ken Murray and was surprised to find it one of the best I've read on the issue of end-of-life care. The context is that of how Doctors typically forgo extreme measures in the face of terminal diagnoses, and often reject the type of care we routinely provide to our patients as "not for us". While the article lacks hard data on the prevalence of these attitudes or behaviors, I have to say this viewpoint is consistent my experience of learning my colleague's beliefs and how I now personally feel about ICU care . And I'm someone who is interested…
cmonforton | January 11, 2012Washington State becomes the first in the nation to adopt specific workplace safety rules to protect healthcare workers who are potentially exposed to anti-neoplastic drugs and other hazardous medications. The new rule, issued earlier this month by the State's Department of Labor & Industries, stems from legislation passed in April 2011 and signed into law by Governor Chris Gregoire. The rule applies to healthcare facilities in which employees are "reasonably anticipated" to have "occupational exposure to one or more hazardous drugs." The CDC's National Institute for Occupational…
lborkowski | January 2, 2012While we're on vacation, we're re-posting content from earlier in the year. This post was originally published on January 27, 2011.
By Liz Borkowski
Atul Gawande's latest New Yorker article, "The Hot Spotters," is a must-read for anyone concerned about the out-of-control growth of US healthcare costs (and that description should apply to everyone in this country). It's about possible solutions to the problem of the highest-cost patients, who account for a disproportionate share of healthcare spending but often aren't getting the kind of care that could really improve their lives. Gawande…
lborkowski | December 27, 2011While we're on vacation, we're re-posting content from earlier in the year. This post was originally published on April 27, 2011.
By Liz Borkowski
Last week, Andrew Sullivan noted that a large proportion of healthcare costs are for the last days and hours of patients' lives and made the following proposal:
If everyone aged 40 or over simply made sure we appointed someone to be our power-of-attorney and instructed that person not to prolong our lives by extraordinary measures if we lost consciousness in a long, fatal illness or simply old age, then we'd immediately make a dent in some way on…
lborkowski | December 14, 2011Following up on last year's nine-minute animated video explaining the Patient Protection and Affordable Care Act, the Kaiser Family Foundation has produced a new interactive feature that gives examples of how different individuals' situations will change (or not) in 2014 when the law is fully implemented. Click on character - 23-year-old uninsured graphic designer Phil Butler, the Santos family who gets insurance through work, etc. - or an employer to get the details about how the individual or family's situation will change. In some cases, like when a person gets health insurance through an…
cmonforton | November 8, 2011An overwhelming majority of seniors want to remain in their own homes as long as possible. Residing with a family member or friends may not be an option, and assisted living facilities may take too big a chunk out of a senior's fixed income. Older Americans, and I'd argue most of us, feel more independent when surrounded by their own belongings and in their own community. But, living alone or with another frail senior, like a spouse, can create its own problems. Millions of U.S. seniors suffer from hunger and food insecurity, some because of resource constraints, but others because of…
New data shows nursing home workers suffer more injuries than construction, factory and mine workers
cmonforton | October 24, 2011We've seen reality shows featuring dirty jobs, cops and coal miners. I wonder if it's time for one showing a day-in-the-life of nursing home workers. Most of us don't give much thought to what goes on inside of nursing homes, that is until a friend or family member needs to reside in one. What might appear as a quiet, slow-paced, restful setting is usually a stress-filled, physically-demanding environment for the people who work in them. Lifting and moving patients from beds, toilets, recliners, showers, and wheelchairs can cause all sorts of injuries, but then throw on top of that, the…
lborkowski | October 3, 2011One thing that drove me nuts during the healthcare reform debate was the scare tactic of claiming that proposed legislation would result in rationing of healthcare. The problem with making such a claim is that healthcare is already rationed in the US. We ration healthcare based on insurance status and ability to pay. And, as a story from NPR's Richard Knox points out, we ration when there are supply shortages -- as there are now with several important drugs. Here's Knox's overview of the problem:
The shortages involve a wide range of medications: cancer chemotherapy agents, anesthetics,…
lborkowski | September 20, 2011If you hold a job right now, here's something to think about: If you became disabled and were no longer able to work, how would you pay your bills? If your disability were due to an on-the-job injury or an occupational illness, you might be able to get workers' compensation benefits. But what if you were paralyzed after falling down a flight of stairs at home or suffering a stroke? If you're lucky, you'll have disability insurance, which some employers offer as a benefit. But for most people whose ability to work becomes compromised before they're able to retire, disability payments from…
lborkowski | August 22, 2011By Kim Krisberg
Public health director Kerran Vigroux sounds almost matter-of-fact when she talks about having to shut down her department's screening services for sexually transmitted diseases. As she talks about the prevention and education opportunities that packed up and left along with the testing services, there's that familiar, barely audible public health tone to her voice -- the one that says "this makes no sense at all."
Vigroux directs public health services in the New Hampshire city of Nashua, and she isn't alone in having to shutter her department's STD services. New Hampshire…
lborkowski | August 12, 2011The US spends far more per capita on healthcare than any other developed country -- $7,538 per person, compared to $3,129 in the UK, $4,079 in Canada, and $5,003 in Norway (the second-biggest spender), according to 2008 totals compiled by the Kaiser Family Foundation. One contributor to our high healthcare costs is high administrative costs, which is the natural consequence of having hundreds of different insurance plans with different policies, networks, and rates. A new study in the journal Health Affairs focuses on one aspect of administrative costs: the time physician practices spend…
lborkowski | August 2, 2011I wrote last month about the Institute of Medicine recommendations regarding preventive health services for women that should be covered by all new health plans without requiring co-payments or other cost sharing. Like many other supporters of women's health, I was especially interested in the proposal that contraceptives be covered at no charge to women. So, I was happy to hear that the Department of Health and Human Services has released a rule that accepts all of the IOM's recommendations.
Here's the list of preventive services that private health plans will have to start covering without…
lborkowski | July 25, 2011By Kim Krisberg
We're talking about it all wrong. Health reform, that is. We (reformers) think we're answering the questions that will change opponents' minds, when there's no answer that will ever satisfy. My head hurts just thinking about it (though a giant, energy-efficient light bulb flickered on over my head after I thought about it a bit.)
In essence, how do we talk about public health values? That was one of the main -- and I think most interesting -- topics at the American Public Health Association's Midyear Meeting in Chicago in late June, which focused exclusively on "Implementing…
lborkowski | July 21, 2011This post is part of the Birth Control Blog Carnival put on by the National Women's Law Center.
Yesterday I wrote about new Institute of Medicine recommendations regarding preventive health services for women that should be covered by all new health plans without requiring cost-sharing. One of the IOM's recommendations was that all FDA-approved contraceptive methods be available free of charge to women with reproductive capacity, and this was the one that attracted the most opposition. According to the Guttmacher Institute, 99% of women who've had sexual intercourse have used contraception.…
lborkowski | July 20, 2011One of the provisions of the Affordable Care Act is a requirement that new health plans cover preventive services for women without deductibles or co-payments. The Department of Health and Human Services asked the Institute of Medicine to review what preventive services are important to women's health and well-being and make recommendations about which of these should be required to be covered without cost-sharing.
The IOM issued its report, Clinical Preventive Services for Women: Closing the Gaps, yesterday, and it focuses on the preventive services not already spelled out for coverage in…
mikethemadbiologist | July 20, 2011While I've disagreed strongly with Megan McArdle, she recently wrote one of the more humane pieces I've read in the mainstream media about unemployment and underemployment (italics mine):
I was unemployed for basically two years between the time I graduated from business school in 2001, and the time I accepted a job with The Economist in 2003. I was much luckier than most people in that situation, both because my parents let me stay in their spare bedroom, and because I was working during much of that time--freelancing, flirting with a start up, doing some tech consulting, and of course,…
mikethemadbiologist | June 17, 2011The projections used by the Social Security Administration to determine when it will become 'insolvent' are notoriously pessimistic, in that they have been estimating that Social Security will be DOOOMED! in 28-38 years going on nearly twenty years. Like Zeno's spear, we never seem to hit that wall. Well, it's spread to Medicare (like E. coli O104:H4! ZOMG!!). Jared Bernstein lays out the past twenty one years of Medicare* estimates for us:
Just to make this clearer--because I like helping!--I've made a couple of changes:
If we take this year's prediction seriously--or at least…
lborkowski | June 16, 2011It's wonderful to hear what substantial progress US Representative Gabrielle Giffords has made in recovering from the traumatic brain injury she sustained from being shot in the head in January. As the Associated Press reported this morning, Giffords has spent the past five months in a rehabilitation facility and has regained some of her speaking ability. Now she'll move to the suburban Houston home of her husband, astronaut Mark Kelly, and continue daily intensive therapy on an outpatient basis. While at home, she'll have round-the-clock help from a home care assistant.
On hearing about the…
cmonforton | June 14, 2011When I decided yesterday to watch the Republican candidates debate, I created a scorecard to use while I observed the two-hour event. I was interested particularly in exchanges related to public health topics, such as access to health care, and clean air and safe drinking water. Within minutes of first tuning in, I remembered how these multi-candidate debates are heavy on rhetoric, but light on policy details. I heard the participants harp on "ObamaCare," and "burdensome regulations," as well as make promises to "de-fund," and "repeal," but there were too few substantive points on public…
cmonforton | June 13, 2011Seven Republicans will meet tonight at St. Anselms college in Manchester, New Hampshire for a Presidential debate. The participants include both the declared candidates (Herman Cain, Newt Gingrich, Ron Paul, Tim Pawlenty, Mitt Romney, and Rick Santoroum) and likely candidate, Michele Bachman. Given that the event will take place in the St. Anselm Hawk's hockey venue, I'm going to keep a scorecard on the candidates' responses to issues affecting public health.
Since the breath of topics relevant to public health is wide, during tonight's debate I'll focus my attention on domestic policy…