Data curated by HealthGrove
Data curated by HealthGrove
Data curated by HealthGrove
Data curated by HealthGrove
Data curated by HealthGrove
Data curated by HealthGrove
Showing posts with label public health. Show all posts
Showing posts with label public health. Show all posts
Tuesday, January 12, 2016
Wednesday, October 22, 2014
A message from our partners. . .
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Tuesday, January 11, 2011
Community medicine. . .really!
Here at CitySquare we've been working off of a "community care," community-based model in our Community Health Services department for a long time.
Listen to the following NPR report describing new approaches to medical education and community health improvement. When in doubt, go to the community!
New Medical School Model: Adopt A Family to Treat
Listen to the following NPR report describing new approaches to medical education and community health improvement. When in doubt, go to the community!
New Medical School Model: Adopt A Family to Treat
Friday, October 02, 2009
Thursday, September 24, 2009
Cover everyone or worry about donations???
Here's a really great essay by E. J. Dionne, Jr., "Uncharitable Charities" from today's edition of The Washington Post.
Thoughts?
.
Sugar tax for improved national health outcomes?
Sidebar poll from The New England Journal of Medicine:
Do you favor taxing sugar-sweetened beverages as a way of helping to finance health care reform and improving public health?
No (26.0%, 493 Votes)
Yes (74.0%, 1,419 Votes)
Total Voters: 1,912 (as of 9/17/09)
Your vote???
Do you favor taxing sugar-sweetened beverages as a way of helping to finance health care reform and improving public health?
No (26.0%, 493 Votes)
Yes (74.0%, 1,419 Votes)
Total Voters: 1,912 (as of 9/17/09)
Your vote???
Monday, September 21, 2009
What doctors think. . .
The website for The New England Journal of Medicine (September 14, 2009) reported on a national survey of the attitudes and opinions of physicians when it comes to a plan to provide health coverage for all Americans.
The article, "Doctors on Coverage — Physicians’ Views on a New Public Insurance Option and Medicare Expansion" reports important findings, or so it seems to me.
Here's a taste of the content:
In the past few months, a key point of contention in the health care reform debate has been whether a public health insurance option should be included in the final legislation. Although polls have shown that 52 to 69% of Americans support such an option,1 the views of physicians are unclear. Physicians are critical stakeholders in health care reform and have been influential in shaping health policy throughout the history of organized medicine in the United States.2
The voices of physicians in the current debate have emanated almost exclusively from national physicians’ groups and societies. Like any special-interest group, these organizations claim to represent their members (and often nonmembers as well). The result is a well-established understanding of the interests of physicians’ societies but little, if any, understanding of views among physicians in general. Faced with this absence of empirical data, we conducted a national survey of physicians to inform federal policymakers about physicians’ views of proposed expansions of health care coverage. . . .
Overall, a majority of physicians (62.9%) supported public and private options. . . . Only 27.3% supported offering private options only. Respondents — across all demographic subgroups, specialties, practice locations, and practice types — showed majority support (>57.4%) for the inclusion of a public option. . . Primary care providers were the most likely to support a public option (65.2%); among the other specialty groups, the “other” physicians — those in fields that generally have less regular direct contact with patients, such as radiology, anesthesiology, and nuclear medicine — were the least likely to support a public option, though 57.4% did so. Physicians in every census region showed majority support for a public option, with percentages in favor ranging from 58.9% in the South to 69.7% in the Northeast. Practice owners were less likely than nonowners to support a public option (59.7% vs. 67.1%, P<0.001),>
To read the entire report, with charts and graphs, click here.
Interesting stuff, huh?
.
The article, "Doctors on Coverage — Physicians’ Views on a New Public Insurance Option and Medicare Expansion" reports important findings, or so it seems to me.
Here's a taste of the content:
In the past few months, a key point of contention in the health care reform debate has been whether a public health insurance option should be included in the final legislation. Although polls have shown that 52 to 69% of Americans support such an option,1 the views of physicians are unclear. Physicians are critical stakeholders in health care reform and have been influential in shaping health policy throughout the history of organized medicine in the United States.2
The voices of physicians in the current debate have emanated almost exclusively from national physicians’ groups and societies. Like any special-interest group, these organizations claim to represent their members (and often nonmembers as well). The result is a well-established understanding of the interests of physicians’ societies but little, if any, understanding of views among physicians in general. Faced with this absence of empirical data, we conducted a national survey of physicians to inform federal policymakers about physicians’ views of proposed expansions of health care coverage. . . .
Overall, a majority of physicians (62.9%) supported public and private options. . . . Only 27.3% supported offering private options only. Respondents — across all demographic subgroups, specialties, practice locations, and practice types — showed majority support (>57.4%) for the inclusion of a public option. . . Primary care providers were the most likely to support a public option (65.2%); among the other specialty groups, the “other” physicians — those in fields that generally have less regular direct contact with patients, such as radiology, anesthesiology, and nuclear medicine — were the least likely to support a public option, though 57.4% did so. Physicians in every census region showed majority support for a public option, with percentages in favor ranging from 58.9% in the South to 69.7% in the Northeast. Practice owners were less likely than nonowners to support a public option (59.7% vs. 67.1%, P<0.001),>
To read the entire report, with charts and graphs, click here.
Interesting stuff, huh?
.
Tuesday, March 24, 2009
Oh, now I see! (or, you just can't make this stuff up!)
Texas routinely leads the nation in its record of draconian policy measures and miserly funding for health and human services. One of the reasons Texas enjoys such a surplus of funding these days is because we spend so little on our people, especially those who are very poor.
You know, things like most uninsured children, terrible enrollment rates for Medicaid and the Children's Health Insurance Program (CHIP), food stamps. . .the list goes on and on.
I've always thought that our problem resided in the state's current elected majority opinion when it came to public benefits. You know, like Governor Rick Perry's latest decision to turn down $555 million of federal funding that would benefit the unemployed in our state!
But, now I have reason to believe that I was wrong!
Our problem is much more basic than differences in philosophy.
The whole problem is grounded in simple ignorance!
Just go here to see what I mean!
You can't make this stuff up!
Unbelievable!
.
Friday, March 20, 2009
Health care as human right, not market commodity--an American physician speaks out
Dr. Marcia Angell has a message for Canadians: Don't be too quick to judge the U. S. system as superior to what is already in place in Canada.
I can already hear the "boo birds" bashing this post.
But, that's okay. We've been working for almost 20 years in the world of hands on medical service delivery and I've got to tell you the gaps and the people falling through them call for some fresh new thinking about how we do health and wellness here in the U. S.
Read her article in the Canadian Medical Association Journal.
The key points of the essay include:
• Health care costs per person are twice as high in the United States as in Canada.
• The US health care system has worse outcomes, is less efficient and provides fewer of many basic services than the Canadian system.
• The United States is the only industrialized country that treats health care as a market commodity, not a social service,and leaves uninsured those who cannot pay.
• In the United States, for-profit health care is more expensive and often of lower quality than not-for-profit or government care, with much higher overhead costs.
• The notion that partial privatization in Canada will shorten waiting times for elective procedures is misguided.
• Partial privatization would draw off resources from the public system, increase costs overall and introduce the inequities of the US system.
• The best way to improve the Canadian health care system is to put more resources into it.
Angell is clear: privatizing health care in Canada is not the answer.
In our arrogance, we seldom take a hard look at the facts of the system employed by our good friends to the north. Hear her out.
Almost 50 million of our fellow citizens would likely find her point of view very interesting indeed.
.
Friday, September 19, 2008
Vote For Parkland!
Between now and election day on November 4, I will post again about the local bond item that will appear on our ballots here in Dallas County in support of our community's need and desire to build a new public hospital.
Under the expert leadership of Dr. Ron Anderson, the Parkland Health and Hospital System is among the finest public health care systems in the United States. Over the years, Parkland's partnership with the University of Texas Southwestern Medical School has resulted in the training and education of thousands of physicians. Parkland provides the community the very best in trauma care, as well as excellent care for everyone from the poorest to the wealthiest of our neighbors.
Parkland Hospital's Board of Managers and the Dallas County Commissioner's Court unanimously approved a resolution to ask Dallas County voters to approve a $747 million bond program for Parkland.
If approved, the bond package monies will be used to:
--Construct an 862 adult-bed hospital that serves as a full service acute care hospital and houses a Level I Trauma Center and Burn Center.
--Construct an outpatient center adjacent to the hospital with associated diagnostic and therapeutic service, and integrated physician office space to enhance patient safety and physician access and productivity.
--Construct office buildings near the hospital for support personnel, designed to optimize productivity and minimize occupancy costs.
--Reconfigure parking to supply a cost effective mix of parking garages and surface parking lots to meet the parking needs of patients, visitor, physicians and employees.
For more information go here.
If you live in Dallas County, I hope you will support Parkland by voting "Yes" on November 4.
Between now and then, visit the website and determine to get involved in supporting the building of this new community asset.
.
Friday, April 11, 2008
Health Care Focus
The Hillary Clinton campaign created a media stir over the past couple of weeks when Ms. Clinton told a story about a woman who was denied health care because she couldn't pay. As the story unfolded, she was accused of distortion of the facts and of outright falsehood.
I recommend Paul Krugman's comments in today's edition of The New York Times. Krugman clears up the nature of the facts, demonstrating that the candidate did not tell a lie. She and her staff could have worked a bit harder to get the details of the case clearer before using the story.
More to the important point, Krugman illuminates the tragic stories of health care failure in the United States among the uninsured, working poor. Clinton's point as well.
Must read essay in my view:
http://www.nytimes.com/2008/04/11/opinion/11krugman.html?_r=1&hp&oref=slogin.
.
I recommend Paul Krugman's comments in today's edition of The New York Times. Krugman clears up the nature of the facts, demonstrating that the candidate did not tell a lie. She and her staff could have worked a bit harder to get the details of the case clearer before using the story.
More to the important point, Krugman illuminates the tragic stories of health care failure in the United States among the uninsured, working poor. Clinton's point as well.
Must read essay in my view:
http://www.nytimes.com/2008/04/11/opinion/11krugman.html?_r=1&hp&oref=slogin.
.
Tuesday, April 08, 2008
New partnership means better access to better meds for the working poor in Dallas
Last Wednesday, Central Dallas Ministries (CDM) and CommuniCare, a non-profit organization in South Carolina, unveiled an exciting new partnership that will bring new prescription medicine benefits to thousands of low-income patients.
All of the major pharmaceutical companies in the United States have "indigent patient" medication programs that offer free medicines to low-income patients who qualify. The challenge with these programs has been with the procurement process. Until now, the process involved a physician or other medical staff being required to complete a rather long and tedious application every time a medication was prescribed. The time and administrative paper work requirement made the programs difficult to use, especially for clinics like ours that serve thousands of patients with a limited staff and few volunteers.
CommuniCare, under the leadership of Ken Trogdon, has worked hard over the past several years to develop a relationship with all of the major pharm corporations and a new process of accessing the indigent drug program. Thanks to CommuniCare, now our patients will need to qualify for such programs by means of one annual application and a $20 registration fee. One form and one fee for any and all prescriptions from any of the companies with the programs--huge improvement!
The outcomes for CDM and our patients are exciting. State of the art medications will now be available to patients at no cost beyond the registration fee, a fee we pay when patients cannot. We will achieve significant cost savings that will allow us to purchase more medications that are affordable and treat more patients in our clinic.
Beyond the benefit to CDM, as the new process is perfected here, we hope to "roll it out" across the Dallas area among our indigent health clinic partners.
This new development promises to have major positive consequences for the uninsured working poor men, women and children who come to us for care, as well as for our other partners who face similar challenges.
We are grateful to our partners at CommuniCare who are moving outside the state of South Carolina for the first time in this new initiative. As Ken says, "If we can make this work in Texas, we can make it work anywhere in the nation."
Thanks also to Dr. Jim Walton, Vice-President of Health Equity for the Baylor Health Care System and CDM Board member, for his tireless efforts in seeing this new partnership become a reality.
To view a WFAA Channel 8 television news report on our press conference announcing the new partnership just click on this link:
http://www.wfaa.com/video/index.html?nvid=232336&shu=1
.
All of the major pharmaceutical companies in the United States have "indigent patient" medication programs that offer free medicines to low-income patients who qualify. The challenge with these programs has been with the procurement process. Until now, the process involved a physician or other medical staff being required to complete a rather long and tedious application every time a medication was prescribed. The time and administrative paper work requirement made the programs difficult to use, especially for clinics like ours that serve thousands of patients with a limited staff and few volunteers.
CommuniCare, under the leadership of Ken Trogdon, has worked hard over the past several years to develop a relationship with all of the major pharm corporations and a new process of accessing the indigent drug program. Thanks to CommuniCare, now our patients will need to qualify for such programs by means of one annual application and a $20 registration fee. One form and one fee for any and all prescriptions from any of the companies with the programs--huge improvement!
The outcomes for CDM and our patients are exciting. State of the art medications will now be available to patients at no cost beyond the registration fee, a fee we pay when patients cannot. We will achieve significant cost savings that will allow us to purchase more medications that are affordable and treat more patients in our clinic.
Beyond the benefit to CDM, as the new process is perfected here, we hope to "roll it out" across the Dallas area among our indigent health clinic partners.
This new development promises to have major positive consequences for the uninsured working poor men, women and children who come to us for care, as well as for our other partners who face similar challenges.
We are grateful to our partners at CommuniCare who are moving outside the state of South Carolina for the first time in this new initiative. As Ken says, "If we can make this work in Texas, we can make it work anywhere in the nation."
Thanks also to Dr. Jim Walton, Vice-President of Health Equity for the Baylor Health Care System and CDM Board member, for his tireless efforts in seeing this new partnership become a reality.
To view a WFAA Channel 8 television news report on our press conference announcing the new partnership just click on this link:
http://www.wfaa.com/video/index.html?nvid=232336&shu=1
.
Thursday, April 03, 2008
Is inequality making us sick?
Most of us take our advantages for granted.
I expect most reading here today have never experienced "oppression" and its side effects.
But, sadly, many have and do today.
Yesterday morning I saw the segment below on The Today Show. It describes new research and an upcoming 4-part television series based on this research documenting the fact that race, socioeconomic standing, education and other social factors determine length of life and health status. In short, inequality is making us sick. Injustice has very real, practical, life and death consequences.
You will be able to catch the entire report by checking your local listings for PBS programming or by visiting the website at www.pbs.org.
Watch the segment. Tell me what you think.
Below is a video from The Today Show called "Is inequality making us sick?"
I expect most reading here today have never experienced "oppression" and its side effects.
But, sadly, many have and do today.
Yesterday morning I saw the segment below on The Today Show. It describes new research and an upcoming 4-part television series based on this research documenting the fact that race, socioeconomic standing, education and other social factors determine length of life and health status. In short, inequality is making us sick. Injustice has very real, practical, life and death consequences.
You will be able to catch the entire report by checking your local listings for PBS programming or by visiting the website at www.pbs.org.
Watch the segment. Tell me what you think.
Below is a video from The Today Show called "Is inequality making us sick?"
Tuesday, February 26, 2008
Obesity and poverty. . .
Diet and nutrition continue to be incredible challenges for people who don't have much money.
On the one hand, access to affordable and healthy food products remains very limited in many inner city neighborhoods in Dallas simply because there are almost no full-service grocery markets.
On the other, the food products that prove to be affordable and available usually turn out to be very unhealthy.
Our Community Health Services clinic recently prepared a report on a segment of its patients battling dietary challenges that are resulting in dangerous health status outcomes.
Of the 1,291 patients screened. . .
. . .14 were underweight.
. . .187 were judged at a healthy weight.
. . .391 were overweight.
. . .571 were obese.
. . .128 were very obese.
Terrifying results from a public health standpoint.
Income levels dramatically affect health outcomes, as do neighborhood environments and resources.
So, how do we change things? What do you think?
.
On the one hand, access to affordable and healthy food products remains very limited in many inner city neighborhoods in Dallas simply because there are almost no full-service grocery markets.
On the other, the food products that prove to be affordable and available usually turn out to be very unhealthy.
Our Community Health Services clinic recently prepared a report on a segment of its patients battling dietary challenges that are resulting in dangerous health status outcomes.
Of the 1,291 patients screened. . .
. . .14 were underweight.
. . .187 were judged at a healthy weight.
. . .391 were overweight.
. . .571 were obese.
. . .128 were very obese.
Terrifying results from a public health standpoint.
Income levels dramatically affect health outcomes, as do neighborhood environments and resources.
So, how do we change things? What do you think?
.
Sunday, December 09, 2007
An old lady with a baby doll
I sat by my dad as he tried to eat his lunch.
He has great difficulty swallowing. He has little appetite for any kind of food, especially that served up at the skilled nursing center where he lives right now.
He tries, but it is so hard for him.
Strange, how it breaks my heart to watch him, but at the same time it is so good just to be with him. Sort of like those times when I was much younger and we would occupy ourselves out in the garage for hours doing. . .I can't remember what. . .we were just together. I loved those times. I think he did too.
Now we sit and visit, but with long periods of silence between us.
I'm having to come to grips with the fact that he is dying. But then, aren't we all? At times like this I realize again the importance of just "being with" a person you love.
But, back to the lunch room.
We sat at a table with his roommate, R. V. Thompson.
Dad and R. V. worked together over 50 years ago at the City of Richardson. R. V. was the Mayor. My dad served as City Secretary, a position like City Manager today. At the time, Richardson's population numbered about 1,500 or so. A few stories have been heard between them as they've shared the same room. We feel fortunate that R. V. is dad's roommate.
Also at the table was a lady who cradled a baby doll in her arms as she ate. Sad, but sweet and moving. She found comfort in some far away memory of her own children--the ones she loved the most, no doubt.
The other man who shared the table couldn't talk much, but he too was a long-time Richardson resident known by my dad and R. V. It was just good being with them all.
It was also sad. But, you know, sad is okay.
As I sat with my father, I remembered lots of visits years ago to nursing homes with youth groups. Many, if not most, of the residents we visited enjoyed our visits, but it was clear that after we left most of the residents probably didn't remember that we had been there. It hit me as I sat with my dad that it didn't matter. They knew we were there when we were there. Just like my dad.
So much of what counts most in life is all about just being there. You know?
Just being there. . .that's hard to beat.
He has great difficulty swallowing. He has little appetite for any kind of food, especially that served up at the skilled nursing center where he lives right now.
He tries, but it is so hard for him.
Strange, how it breaks my heart to watch him, but at the same time it is so good just to be with him. Sort of like those times when I was much younger and we would occupy ourselves out in the garage for hours doing. . .I can't remember what. . .we were just together. I loved those times. I think he did too.
Now we sit and visit, but with long periods of silence between us.
I'm having to come to grips with the fact that he is dying. But then, aren't we all? At times like this I realize again the importance of just "being with" a person you love.
But, back to the lunch room.
We sat at a table with his roommate, R. V. Thompson.
Dad and R. V. worked together over 50 years ago at the City of Richardson. R. V. was the Mayor. My dad served as City Secretary, a position like City Manager today. At the time, Richardson's population numbered about 1,500 or so. A few stories have been heard between them as they've shared the same room. We feel fortunate that R. V. is dad's roommate.
Also at the table was a lady who cradled a baby doll in her arms as she ate. Sad, but sweet and moving. She found comfort in some far away memory of her own children--the ones she loved the most, no doubt.
The other man who shared the table couldn't talk much, but he too was a long-time Richardson resident known by my dad and R. V. It was just good being with them all.
It was also sad. But, you know, sad is okay.
As I sat with my father, I remembered lots of visits years ago to nursing homes with youth groups. Many, if not most, of the residents we visited enjoyed our visits, but it was clear that after we left most of the residents probably didn't remember that we had been there. It hit me as I sat with my dad that it didn't matter. They knew we were there when we were there. Just like my dad.
So much of what counts most in life is all about just being there. You know?
Just being there. . .that's hard to beat.
Thursday, October 18, 2007
The facts about children's health in the U. S.
My friend, Janie Metzinger of the Mental Health Association of Dallas sent this message around earlier this week. I believe it provides the factual reality facing us as we consider the cost of blocking health coverage benefits to all of our children. We need to improve the overall system of health care delivery to all of our children.
Somehow it seemed appropriate to add this post to what is below regarding the hymn heard in church on Sunday.
Please consider the facts.
Contrary to the rhetoric of some SCHIP opponents, the Children’s Health Insurance Program was specifically designed for children in families of middle class and moderate incomes. These families are not eligible for Medicaid, which was designed for children in very low-income families.
CHIP is a public-private partnership. A portion of the money for the program is put in by state governments. (Texas uses a portion of the Tobacco Settlement money for this purpose.) The state’s portion is matched by the federal appropriation, and parents pay a sliding scale premium for CHIP insurance for their children.
Texas consistently leads the nation in the number and rate of uninsured children within our borders.
ACTION: Please contact you Senators and Members of the House of Representatives to tell them that you support CHIP. A vote may come as early as today on the veto override.
Study: Medical care for children often falls short
Doctors score low on preventive steps, tests for seriously ill infantsThursday, October 11, 2007
"They got an F," said Dr. Joseph Hagan, a Burlington, VT pediatrician. Dr. Hagan co-edited the American Academy of Pediatrics' latest update to its children's health guidelines, due out later this month.
"It's sad, but I think it reflects some unpleasant realities about our current health care system or, I might say, non-system," Dr. Hagan said.
Somehow it seemed appropriate to add this post to what is below regarding the hymn heard in church on Sunday.
Please consider the facts.
_________________________________
BACKGROUND: A recent study published in the New England Journal of Medicine underscores concerns for children’s health raised by the President’s veto of the SCHIP legislation. (Please see The Dallas Morning News article below.)
Contrary to the rhetoric of some SCHIP opponents, the Children’s Health Insurance Program was specifically designed for children in families of middle class and moderate incomes. These families are not eligible for Medicaid, which was designed for children in very low-income families.
CHIP parents are hard-working. They often work in the construction, health care, hotel, restaurant and manufacturing industries. Many work for small businesses who simply cannot find affordable insurance to offer to their employees.
CHIP is a public-private partnership. A portion of the money for the program is put in by state governments. (Texas uses a portion of the Tobacco Settlement money for this purpose.) The state’s portion is matched by the federal appropriation, and parents pay a sliding scale premium for CHIP insurance for their children.
The state contracts the program out to private insurance carriers who vie for the business. Parents then choose which plan they want for their children. CHIP covers preventive care, lab tests, X-rays, hospital care, prescription drugs, physical therapy, rehabilitation, mental health and dental care.
Texas consistently leads the nation in the number and rate of uninsured children within our borders.
ACTION: Please contact you Senators and Members of the House of Representatives to tell them that you support CHIP. A vote may come as early as today on the veto override.
Here's the article from The Dallas Morning News from last week:
Study: Medical care for children often falls short
Doctors score low on preventive steps, tests for seriously ill infantsThursday, October 11, 2007
MELVILLE, N.Y. – Children are not faring well in the health care system, a team of researchers reports today in the largest analysis of its kind. The study, published in the New England Journal of Medicine, concludes that overall, doctors gave children the appropriate outpatient medical care only 47 percent of the time.
"They got an F," said Dr. Joseph Hagan, a Burlington, VT pediatrician. Dr. Hagan co-edited the American Academy of Pediatrics' latest update to its children's health guidelines, due out later this month.
"It's sad, but I think it reflects some unpleasant realities about our current health care system or, I might say, non-system," Dr. Hagan said.
The report, by the Seattle Children's Hospital Research Institute and the nonprofit Rand Corp. research group, is the first comprehensive look at children's health care quality. The findings are particularly troubling because nearly all the 1,536 children in the nationwide study had insurance.
Eighty-two percent were covered by private insurance. Three-quarters were white, and all lived in or near large or midsize cities.
Experts said minority children, those with more restrictive government insurance, and the millions with no insurance at all certainly fare even worse.
The compliance rate was even worse than that found in a study of adults: They got only 55 percent of recommended care.
The study was based on a review of two years of medical records of children in 12 metropolitan areas.
The new research found children's doctors did best in providing the recommended care for acute medical problems – 68 percent. They scored just 53 percent for treating chronic conditions and 41 percent for preventive care.
"I was really taken aback by the results for preventive care," said Dr. Rita Mangione-Smith, lead investigator at the Seattle institute and an associate professor at the University of Washington. "It was really kind of distressing to me that there was some really basic stuff that we should be doing that's just not happening."
The researchers found, for example, that only 19 percent of seriously ill infants with fevers taken to doctors had the correct laboratory tests to determine the underlying ailment. Only 44 percent of children with asthma, the study found, were on the right medication.
"How can we appropriately treat an infant if we don't test?" Dr. Mangione-Smith asked Wednesday.
The research also discovered babies aren't receiving routine checks of their height and weight to ensure proper growth. Some youngsters aren't receiving all of their recommended vaccinations. And children are not being appropriately screened for anemia, a marker for learning disorders.
"There can be dire consequences for the children, for their families and for society as a whole," including death, when these easily managed conditions are not controlled, said Julia Paradise of the Kaiser Family Foundation.
Some experts said the results highlight the importance of the debate over the proposed expansion of the Children's Health Insurance Program, which Congress approved and President Bush vetoed.
A vote to override the veto is set for next week. [Which, in fact, is likely today! LJ]
Ms. Paradise noted that the proposed expansion of the CHIP program was to include the first major initiative to measure and find ways to improve quality of care for children covered by that program and by Medicaid – low-income groups that generally have more health needs than others.
The study was funded by the Centers for Medicare & Medicaid Services, the Robert Wood Johnson Foundation of Plainsboro, N.J., and the California HealthCare Foundation.
The researchers noted they had incomplete medical records for some children, no children from rural areas were included, and more than half the families asked to participate didn't respond.
Dr. Mangione-Smith and the other experts said they hope the new findings will lead to action to address the shortcomings. Dr. Hagan said doctors can do more to keep up with the latest care guidelines. But he said they can't solve all the problems, such as insurance plans that don't cover crucial screenings and the inadequate time pediatricians have to spend with each child.
Basing payments to doctors on measurements of performance, as Medicare has done in some cases, should be considered, said Dr. James Perrin, a pediatrician at MassGeneral Hospital for Children.
"It's not so much training doctors as rearranging incentives to encourage people to provide high-quality care," said Dr. Perrin, co-author of an editorial in the journal on the need to improve the quality of care for children.
Another big challenge, Dr. Mangione-Smith said, is to change pediatrician training, which now focuses on treating acute illnesses in a hospital.Dr. Mangione-Smith advises parents to go to the pediatrician armed with as much information as possible.
"Come in with your own checklist," she said. "Ask your doctor, 'Is their weight OK today? Should she be checked for anemia?' "
(McClatchy Newspapers, The Seattle Times and The Associated Press contributed to this report.)
Tuesday, October 16, 2007
Some important facts on SCHIP
Recently, Congress passed and the President vetoed a new version of the State Children's Health Insurance Program (SCHIP).
As Congress prepares for another vote in an attempt to override Mr. Bush's veto, several important facts should be kept in mind.
1) The bill under discussion will provide health insurance coverage for almost 4 million more children.
2) The bill targets only low-income children. The bill’s new cap is set at a maximum of 300% of the Federal Poverty Level or just under $62,000 gross pre-tax income (not net income) for a family of 4. The states have the option of setting their own cap levels. Only 600,000 of the 3.8 million new children gaining coverage under the bill are not currently eligible and would become eligible due to the proposed funding expansions if states so chose. Anyone who tries to pay for private or employer sponsored health plans understands that income at 300% of poverty does not guarantee a family will be able to afford coverage.
If you believe the Congressional Budget Office, 84% of the children gaining coverage under the bill are either on the program now (but without the new money would have to be cut from the program for lack of funding) or are eligible now but not enrolled.
3) Contrary to some opposition propaganda, the bill reforms previous versions of SCHIP and cuts out adults. There will be no waivers under the new SCHIP legislation allowing for the provision of coverage for parents. Those states that have received such waivers in the past will have to transition parents to a separate program with a lower federal match. Further, the bill prohibits coverage for childless adults. States providing coverage in the past for childless adults under SCHIP will no longer be able to do so.
According to our friends at the Center for Public Policy Priorities (http://www.cppp.org/) "if the number of uninsured children grows this year at the same rate as last year, nearly 2,000 additional children will become uninsured every day."
Contact your U. S. Representative and each of your U. S. Senators to urge a vote for SCHIP when it comes up for a vote in the near future.
A vote for SCHIP is a vote for the health of America's children.
[Material for this post drawn largely from information provided by the Center for Public Policy Priorities, Austin, Texas]
.
As Congress prepares for another vote in an attempt to override Mr. Bush's veto, several important facts should be kept in mind.
1) The bill under discussion will provide health insurance coverage for almost 4 million more children.
2) The bill targets only low-income children. The bill’s new cap is set at a maximum of 300% of the Federal Poverty Level or just under $62,000 gross pre-tax income (not net income) for a family of 4. The states have the option of setting their own cap levels. Only 600,000 of the 3.8 million new children gaining coverage under the bill are not currently eligible and would become eligible due to the proposed funding expansions if states so chose. Anyone who tries to pay for private or employer sponsored health plans understands that income at 300% of poverty does not guarantee a family will be able to afford coverage.
If you believe the Congressional Budget Office, 84% of the children gaining coverage under the bill are either on the program now (but without the new money would have to be cut from the program for lack of funding) or are eligible now but not enrolled.
3) Contrary to some opposition propaganda, the bill reforms previous versions of SCHIP and cuts out adults. There will be no waivers under the new SCHIP legislation allowing for the provision of coverage for parents. Those states that have received such waivers in the past will have to transition parents to a separate program with a lower federal match. Further, the bill prohibits coverage for childless adults. States providing coverage in the past for childless adults under SCHIP will no longer be able to do so.
According to our friends at the Center for Public Policy Priorities (http://www.cppp.org/) "if the number of uninsured children grows this year at the same rate as last year, nearly 2,000 additional children will become uninsured every day."
Contact your U. S. Representative and each of your U. S. Senators to urge a vote for SCHIP when it comes up for a vote in the near future.
A vote for SCHIP is a vote for the health of America's children.
[Material for this post drawn largely from information provided by the Center for Public Policy Priorities, Austin, Texas]
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Monday, October 08, 2007
SCHIP support needed
Julia Easley, our good friend and partner at Children's Medical Center Dallas, sent the following our way last week after President Bush vetoed the SCHIP legilation. This message comes to us from one of our best hospitals in Dallas. Read on!
______________________________
Last week, President Bush vetoed the SCHIP Reauthorization Act.
Your help is needed again to ask the House of Representatives to override the President's veto.
Background
Congress must reauthorize the State Children's Health Insurance Program (SCHIP) this fall. Called CHIP in Texas, the program insures more than 300,000 low-income children including 43,000 Dallas area children.
The SCHIP Reauthorization Act will provide $35 billion over five years to fund an expansion of SCHIP. An additional four million children are expected to be covered under this bill.
Both the U.S. House of Representatives and the U.S. Senate passed the bill by wide, bipartisan majorities last week and sent it to the President. He vetoed the bill.
The next step is for the U.S. House of Representatives to attempt to override the president’s veto, which will require a two-thirds majority vote. Our representatives need to hear loud and clear that we want them to pass the bill and override the veto.
You can help!
Please take just three minutes to write your member of the U.S. House of Representatives and urge them to override the president’s veto and support this vital program for children’s health.
Here's a simple way to write your members of Congress: Go to http://capwiz.com/nach/issues/alert/?alertid=10377536&type=CO.
This link is provided by the National Association of Children's Hospitals.
Follow these steps:
1. Click on the link
2. Enter your zipcode and click Go
3. You will see a prepared message that you can edit if you'd like.
4. Add your name at the bottom and enter your contact information
5. Under hospital affiliation, choose TX-Children's Medical Center Dallas
6. Send your message
7. Share this with others if you'd like
The choice to participate is yours alone.
If you do participate, thank you for volunteering to speak up for the hospital and the children we serve.
For additional information about SCHIP go to: http://www.childrenshospitals.net/nach/schip .
If you would like more information about this campaign, please contact Julia Easley, director of Advocacy at Julia.Easley@Childrens.com.
______________________________
Last week, President Bush vetoed the SCHIP Reauthorization Act.
Your help is needed again to ask the House of Representatives to override the President's veto.
Background
Congress must reauthorize the State Children's Health Insurance Program (SCHIP) this fall. Called CHIP in Texas, the program insures more than 300,000 low-income children including 43,000 Dallas area children.
The SCHIP Reauthorization Act will provide $35 billion over five years to fund an expansion of SCHIP. An additional four million children are expected to be covered under this bill.
Both the U.S. House of Representatives and the U.S. Senate passed the bill by wide, bipartisan majorities last week and sent it to the President. He vetoed the bill.
The next step is for the U.S. House of Representatives to attempt to override the president’s veto, which will require a two-thirds majority vote. Our representatives need to hear loud and clear that we want them to pass the bill and override the veto.
You can help!
Please take just three minutes to write your member of the U.S. House of Representatives and urge them to override the president’s veto and support this vital program for children’s health.
Here's a simple way to write your members of Congress: Go to http://capwiz.com/nach/issues/alert/?alertid=10377536&type=CO.
This link is provided by the National Association of Children's Hospitals.
Follow these steps:
1. Click on the link
2. Enter your zipcode and click Go
3. You will see a prepared message that you can edit if you'd like.
4. Add your name at the bottom and enter your contact information
5. Under hospital affiliation, choose TX-Children's Medical Center Dallas
6. Send your message
7. Share this with others if you'd like
The choice to participate is yours alone.
If you do participate, thank you for volunteering to speak up for the hospital and the children we serve.
For additional information about SCHIP go to: http://www.childrenshospitals.net/nach/schip .
If you would like more information about this campaign, please contact Julia Easley, director of Advocacy at Julia.Easley@Childrens.com.
Wednesday, October 03, 2007
Banned at last!
Best news I've heard in years!
Talk about medical and public health research and analysis that calls for three cheers!
British hospitals are banning neckties! Never mind that they also have prohibited long sleeves, jewelry, and white lab coats for physicians.
The ban is an attempt to reign in the spread of sometimes deadly hospital-borne infections.
The ties, along with the other banned items of apparel, almost never make it to the laundry and are worn again and again.
Makes sense to me. Where better for a despicable viral varmint to lodge than in and on a cursed necktie?!
I've always loved the British.
But this is more than I could have hoped for.
Gentlemen, burn your ties!
Talk about medical and public health research and analysis that calls for three cheers!
British hospitals are banning neckties! Never mind that they also have prohibited long sleeves, jewelry, and white lab coats for physicians.
The ban is an attempt to reign in the spread of sometimes deadly hospital-borne infections.
The ties, along with the other banned items of apparel, almost never make it to the laundry and are worn again and again.
Makes sense to me. Where better for a despicable viral varmint to lodge than in and on a cursed necktie?!
I've always loved the British.
But this is more than I could have hoped for.
Gentlemen, burn your ties!
Tuesday, September 18, 2007
One American city leads the way
"San Francisco to Offer Care For Every Uninsured Adult"
That was the eye-catching headline of Kevin Sack's report printed in the upper left corner on the front page of last Friday's edition of The New York Times (A1, 17).
The City of San Francisco now offers "Healthy San Francisco" to all 82,000 adults who have no insurance. After a two-month pilot period focusing on two community clinics in the Chinatown area, the initiative rolled out to every part of the city yesterday.
The program to provide health care coverage to all uninsured adults in San Francisco is paid for mostly by the city itself.
The rationale back of this bold move on the part of city leaders? Officials believe that the city can provide "universal and sensibly managed care to the uninsured for about the amount being spent on their treatment now, often in emergency rooms."
Sack's report documents the unique nature of San Francisco as a community, including its political atmosphere, compact geography, unified city-county government structure, and a network of public and community clinics, as factors contributing to the innovative and aggressive public policy benefiting the city's uninsured. Until November, enrollment of patients in the plan will be limited to those with incomes below the federal poverty level. After this initial period of enrollment, the program will be open to any uninsured adult living in the city. The goal is to sign up 45,000 during the first year. The city will test the capacity of its medical infrastructure as it expands the enrollment.
By forging stronger connections between public and community-based, non-profit clinics, the city hopes to create a strong system of managed care for the uninsured. The goal is to turn the readily accessible clinics into medical homes for the uninsured.
What a bold move by a great city!
Possibly San Francisco will discover the secrets to making available universal health care coverage to all Americans. One thing seems clear at this point: this city cares about all of its people and it is taking a reasonable approach to solving pressing "bottom line" problems at the same time.
Sounds like a win-win to me.
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