healthcare
lborkowski | May 3, 2012by Andrea Hricko, MPH
Rick Brown, PhD, a sociologist by training, was a world renowned champion of public health. Thousands of occupational health, children's health, and community health advocates who knew him are mourning his loss. Rick passed away two weeks ago of a stroke while lecturing in Kentucky.
His work on health care issues (especially the lack of health insurance for children) and his development of the California Health Interview Survey (CHIS) were just two of his major achievements. He was a longtime professor at UCLA School of Public Health, adviser to several U.S. Presidents,…
cmonforton | April 24, 2012Just as Republican lawmakers have been hyping the virtues of purchasing private health insurance----versus the evils of "Obamacare"----my husband Jim and I needed to do just that. I had been writing a check for $659 each month to maintain health insurance coverage under my former employer's plan, as provided by COBRA. After 18 months, it was due to expire. The time had come for us to venture into the Republicans' fantasy land of the free marketplace for health insurance. We took a deep breath and dove in.
The first thing we learned is that you don't really purchase health insurance. You…
lborkowski | April 16, 2012by Kim Krisberg
Broccoli. A nutritious green veggie of the cabbage family? Or a symbol of the federal government's over-reaching power grab? Like most things in life, it all depends on your perspective.
I've been thinking about that word -- broccoli -- since last month's Supreme Court hearings on the constitutionality of provisions within the Affordable Care Act (ACA). Specifically, I've been pondering this comment from Justice Antonin Scalia during arguments on the ACA's individual insurance mandate:
SCALIA: . . . could you define the market -- everybody has to buy food sooner or later, so…
denialism | April 13, 2012But you'd never know that reading AEI's highly dubious contribution to the literature in this week's Health Affairs (lay Reuters article here). Consistent with their free-market solves everything and can do no wrong (cover ears and yell "nananananananana") attitude towards the broken US healthcare system, they have managed to contaminate the literature with a paper that suggests our higher expenditures on cancer are generating significant returns in patient survival. Except that it doesn't show this, and to her great credit, Reuter's Sharon Begley nails it:
Cancer patients in the United…
lborkowski | March 30, 2012Unless they've deviated from their normal procedure, the Supreme Court justices have now decided on how they'll rule on the Affordable Care Act - but, as the Washington Post's Robert Barnes points out, we'll have to wait until late June to hear their verdict. In the meantime, this is a good opportunity to recap the key issues in the case and highlight some of the more insightful commentary about them.
The first issue on which the Court heard arguments was whether it could rule on this case to begin with, since it involves a tax on people who don't have health insurance coverage (or a hardship…
denialism | March 26, 2012With the Supreme Court hearing arguments for the next three days on the Affordable Care Act, many commentators, including Dahlia Lithwick appear to have so much contempt for the Roberts court that they believe the issue will likely be settled on politics rather than law.
The first proposition is that the health care law is constitutional. The second is that the court could strike it down anyway.
...
The law is a completely valid exercise of Congress' Commerce Clause power, and all the conservative longing for the good old days of the pre-New Deal courts won't put us back in those days as if…
denialism | March 23, 2012We've already extensively discussed why it costs twice as much for the US to provide healthcare for it's citizens all the while failing to cover health care for all. Most recently, we discussed the hidden tax of the uninsured and the perverse incentive structure of US healthcare which encourage costlier care, more utilization, and more procedures.
To summarize, the US spends more on healthcare compared to other industrialized nations because
We deliver it inefficiently
Without universality problems present when critical and in the ER
Fee-for-service incentives in the form of excessive…
denialism | March 22, 2012With the impending, and unprecedented, 3 days of arguments over the Affordable Care Act occurring early next week, it's interesting to see that the test case being used to challenge the law has now become a test case demonstrating the necessity of the law.
Mary Brown, the woman who asserts no one has the authority to make her buy health care is now bankrupt, at least in part due to medical bills. From theLA Times article:
Mary Brown, a 56-year-old Florida woman who owned a small auto repair shop but had no health insurance, became the lead plaintiff challenging President Obama's healthcare…
lborkowski | March 20, 2012Friday will be the two-year anniversary of the signing of the Affordable Care Act, and there's plenty of discussion about the law's impacts and the upcoming Supreme Court oral arguments. While many of the law's provisions won't take effect until 2014, it's already having an impact on some aspects of health insurance. I described several of these in a post on the law's one-year anniversary, so now I want to focus on two recent stories that underscore the difficulty and importance of changing how the US handles health insurance.
First, it's important to remember that the law isn't an overhaul…
lborkowski | March 9, 2012by Elizabeth Grossman
Nurses face many hazards on the job, and one that clearly demands more detailed analysis than it's received to date is the effect of occupational chemical exposures on nurses' reproductive health. A recent study by researchers at the National Institute of Occupational Safety and Health (NIOSH), Harvard School of Public Health, and Brigham and Women's Hospital has found that female nurses exposed to sterilizing agents and chemotherapy drugs at work are at least twice as likely to have miscarriages than those who are not. The study, published in The American Journal of…
lborkowski | March 6, 2012Back in December, the Department of Labor's Wage & Hour Division published a proposed rule that would extend minimum-wage and overtime pay protections to the home care workers who assist elderly and disabled patients with their daily needs. The Fair Labor Standards Act requires that nonexempt workers be paid minimum wage (currently $7.25 per hour) and 1.5 times their pay for hours worked above 40 hours in a week. (It also prohibits most forms of child labor, but allows children to work in agriculture, as Celeste has discussed.) Many of us are exempt from these requirements because we're…
denialism | March 4, 2012We've discussed it before, why are costs so much higher in US healthcare compared to other countries? The Washington Post has a pointless article which seems to answer with the tautology costs are high because healthcare in America costs more. How much more? Well, we spend nearly twice as much per capita as the next nearest country while failing to provide universal coverage:
In the WaPo article they make a big deal of the costs of individual procedures like MRI being over a thousand in the US compared to $280 in France, but this is a simplistic analysis, and I think it misses the point…
denialism | February 19, 2012Hot Air and the daily caller are excited to pronounce socialized medicine dead as the British NHS plans to contract with private hospitals and providers on top of socialized care. From The Caller:
Joseph A. Morris, a former Reagan White House lawyer who now serves on the board of the American Conservative Union, told TheDC that socialized medicine has turned out to be a threat to Britons' health, and to their economy as well.
"Europe's message to the world is no longer that the socialist dream of the cradle-to-grave welfare state is an easy achievement," Morris said. "Rather, it is the…
lborkowski | February 15, 2012Everyone should read the personal story by Kevin Zelnio, a marine biologist and blogger at EvoEcoLab, about his son's recent medical emergency. Having a six-year-old child whose flulike symptoms turn into a struggle to breathe must be scary enough -- but this family's troubles are compounded by not having health insurance.
Zelnio is self-employed, and he and has wife have been unable to find affordable insurance for themselves and their two children. He cites uninsurance as one reason why they didn't bring their son to an urgent care facility as soon as his fever reached 103. They did get…
denialism | February 13, 2012We've written quite a bit about single payer health care systems as well as other models that are a mixture of public and private spending.
We've also analyzed some of the sources of excess cost of US healthcare to other countries. What is uniformly true about universal health care systems is that they all spend less on medical care per capita than the US. The next nearest country in spending to us, France, spends 50% of what we do per capita while providing top notch care, possibly the best in the world. And while the cause of our excess costs are multifactorial, one of the greatest…
lborkowski | February 7, 2012I wrote last month about the role of chronic diseases in healthcare-cost growth, so I was excited to see a new report from the Institute of Medicine called Living Well with Chronic Illness: A Call for Public Health Action.
When I think of chronic illness, diabetes and heart disease are what leap to my mind -- in part because they're so tied to the lifestyle factors of smoking, inadequate exercise, and poor nutrition, and in part because they cost our health system so much money. The IOM report notes that chronic illness represents 75% of the $2 trillion the US spends each year on healthcare…
lborkowski | January 31, 2012by Kim Krisberg
Joy Jay has the sweetest Southern accent you'll ever hear. It's the kind of accent that makes her news about the state of mental health services in South Carolina harder to hear than usual.
"Mental health has taken some of the biggest (funding) cuts of any agency in the state," said Jay, executive director of Mental Health America of South Carolina. "It's really affected the number of people who can be served -- the door is very narrow now for people with chronic, persistent (mental) illness. And for people with temporary problems, they can't even get into the system; there's…
lborkowski | January 27, 2012During his State of the Union address, President Obama spent more time talking about education than about healthcare, which he mentioned only passing. The two are connected, though, as a response from Dean Dad at Confessions of a Community College Dean reminds us:
In reference to yesterday's post about cost (among other things), a commenter asked how I could assert ever-rising costs for colleges in the face of flat salaries for faculty.
That's an easy one. Costs include much more than salaries.
The elephant in the room for any discussion of labor costs is health insurance. When the cost of…
lborkowski | January 24, 2012Last week, the Congressional Budget Office released some disappointing news: several demonstration projects aiming to contain growth in healthcare spending are not showing cost savings. Specifically, the Centers for Medicare and Medicaid Services have been focusing on programs involving either disease management and care coordination or value-based payment systems for the fee-for-service Medicare population. A CBO issue brief reviews programs in both these categories that have been conducted over the past two decades, and I'm particularly interested in what it says about the disease…
cmonforton | January 20, 2012Money talks, as the saying goes, and a recently published paper on the annual cost of work-related injuries and illnesses should get policymakers to listen up. The number is staggering: $250 Billion, and it's a figure on par with health conditions like cancer, coronary heart disease, and diabetes that attract much more attention and research funding.
The author, J. Paul Leigh, PhD, a professor of health economics at University of California Davis, assembled data from more than a dozen sources to estimate the annual economic burden of occupational injuries and illnesses. Using data from 2007…