One thing Team Obama's gotten right

Ok, so the decision to send more troops to Afghanistan might not seem the most logical, but Obama's decision this past March to expand the number of cell lines approved for stem cell research definitely is. Proof: the NIH announced that they've approved 13 additional lines for researchers receiving federal funding. We all know how important this kind of research is to learning more about a plethora of diseases, and possibly finding cures that can't be developed with adult stem cells. Lucky for us Wolverines, UM researchers received a total of $6.8 million in federal funds through the Reinvestment act for different projects related to stem cell research. Check them out here- even if you don't understand the hard science of it all, realize that the studies here are very promising (and cool!).

Also, for those of you interested in 'food' issues, NY Times also published an interesting article about the comeback of food stamps. Interestingly enough, not much is said about those who abuse the program- something we've discussed at previous meetings.

Who Knows?

Health insurance companies spend enormous amounts on statisticians and experts to help them figure out just how sick you could get. If you're an elderly smoker than you'll probably cost the company a lot more money than a young healthy individual. Which is why smokers pay a lot higher premiums than everyone else. While smoking is an obvious indicator of potential expense, the insurance companies can't always predict how costly an individual will be. As a result, with every new customer comes extra risk.

Economists call this problem an "asymmetry of information," i.e. you know how likely you are to get sick but the insurance company doesn't. Insurance companies can get around this problem by including pricing schemes and co-pays that are designed to get people to reveal information about themselves. Nobel prize winning economist John Stiglitz called this process "screening" and said that it would lead to the inefficiencies in insurance markets if left unchecked.

New research at the National Bureau of Economic Research has shown that the now classic "Stiglitz Model" doesn't always hold for health insurance. Insurance companies can't rely on prices to differentiate types of customers, namely expensive vs. inexpensive. On a macro level this means that the market may not be able to reach what economists call a "competative equilibrium."

The NBER research as well as the "Stiglitz Modle" have a large impact on the health care debate. Both show that the free market which is essential to both the public option favored by Democrats and the counter-plan favored by Republicans can't guarantee an efficient outcome.

Because you have to start somewhere..

Since last year Taylor has been kindly reminding me to blog on the Healthcare site and although I had the best of intentions I was never quite able to turn that intent into action. I'm trying to remedy that this semester, even though I'm getting a bit of a late start. For those of you who don't know who I am (mainly because my meeting attendance has been sporadic at best).. I'm the lone grad student in the Healthcare Center who got involved with Roosevelt last fall due to the fact that Festifall was in between me and my destination of a Noodle and Co. lunch on State St. As I meandered my way through the tables and free candy I picked up a flyers for Roosevelt, and sailing, and ballroom dancing, and backpacking, and ended up sticking with RI... unlike the fates of the rest of that list. I am a 2nd year Masters of Public Health student in Health Behavior and Health Education here at the glorious U of M and I work at the Monto Influenza Laboratory (which conducted the infamous MFlu study here on campus) where we are currently in the recruiting phase of the new HIVE (Household Influenza Vaccine Effectiveness) Study.

While my future posts should (hopefully) provide more intellectually stimulating information I decided to start out with something a little less taxing on your cognitive load. Enjoy!

So goes San Francisco, so goes the Nation?

The healthcare debate of 2009 has become a topic of great importance with 45 million Americans uninsured (Kaiser 2009). The 6 percent annual increase in healthcare costs is unsustainable leading to costs doubling in the next decade (Callahan 2009). From single-payer healthcare to fully privatized insurance, we have heard the gamut of what is best for Americans. The cost of health insurance and service has increased dramatically over the past twenty years (National Governors Association 2008). Federal legislators are debating as we speak as to what is the most effective way to provide healthcare to uninsured citizens. One new policy that has been successful in providing insurance or access to care is the Healthy San Francisco Program (HSF), enacted in 1997 (the coverage then expanded in 2006). HSF was expanded when voters supported the initiative in 2006 (Kaiser 2009). HSF could be a model for the rest of the nation if it is sustainable financially and health outcomes are better with the program than without.

Healthy San Francisco is not considered insurance, but a reorganization of the San Francisco health care safety net, that allows residents to access primary and preventive care through a private and public system partnership (Healthy San Francisco 2009). Participants of HSF choose a medical home where all services are coordinated (including laboratory, hospitalization, and prescriptions). This allows a greater focus on primary care, followed by secondary and tertiary care (Healthy San Francisco 2009).

Healthy San Francisco is only one option by which a covered employer can satisfy its obligation to make the required health care expenditure (HCE). In complying with the San Francisco Health Care Security Ordinance, employers have a variety of options to choose from, such as private health insurance, direct reimbursement to employees, health-spending accounts, the HSF City Option or a Medical Reimbursement Account (San Francisco Health Care Security Ordinance 2006). The Medical Reimbursement Account (MRA) account does not have to be used in the community to which they reside.

In order to see if this program can be implemented statewide in California, the political climate and leanings of the legislature needs to be evaluated. This is important because the passage of HSF statewide will depend or legislators preferences as well as the voter’s if this becomes a ballot initiative. An individual district analysis of the state house and senate would help to either support the passage of statewide legislation or reveal that HSF does not have the legislative support it needs. A survey of voter’s preferences and political leanings will also help to support or show a lack of support for the initiative.

Healthy San Francisco is a major progressive move toward universal access to health care. To research whether this is a sustainable policy it is necessary to evaluate the funding methods of HSF and whether or not this places an undue burden on County businesses. To understand if HSF is placing an undue burden on employers a review of the lawsuit and challenges to the legality of HSF is necessary. It is also imperative that HSF does not stagnate businesses because of the employer mandate.

Malcolm's Blog

Policy proposed to community organizers, advocacy groups and nonprofit organizations:

- National campaign between reform groups to restructure campaign system; candidates with adequate number of popular supports are given time to prepare stances on a series of issues deemed to relevant voters by electoral commissions, which are listed in print online and in newspapers prior to candidate elections so that appearance has little influence on voter selection; campaigning limited to periodic broadcasts of the candidates or publication of candidate stances together; public financing; ban on all private financing of candidates

- Publicly registered associations for the recognition of different interest groups before the Congress and the presentation of their viewpoints

- Reestablishment of mandatory public news regulations for broadcasting networks and the enhancement of public news outlets

- Recommendation for nationally coordinated effort to push

Policy proposed to legislators:

- Medical board for research and review of all known medical treatments and assessment of evidence; this function could be integrated into an effort to review the efficacy of treatments over a long-term, continuous basis; meant to evaluate efficacy in comparison to cost effectiveness in context of severity of diseases and disorders

- Establishment of a board under the jurisdiction of the Department of Health to send out representatives for newly tested therapies and treatments to doctors’ offices; bans on private parties sending out representatives to doctors’ offices; establishment of public records for tested treatments for different conditions, diseases ad disorders

- Establishment of enhancement of public libraries; creation of a Wikipedia-like database of information actively researched and revised by librarian and research staff; can be accessible online and via telephone and mail, especially for the elderly; publicly funded and free to the public as with the standard public libraries; public campaign to enhance awareness of new information source that is consolidation of many sources as well as reliable, accurate and concise; emphasize measures such as trust fund and reliance on philanthropy to stress autonomy from federal government

- Institution to assist legislators with insight into voter preferences; delegated the task of frequent administration of polls, creation of focus groups, facilitation of surveys, etc, to aid politicians in the most reasonably accurate assessments of voter preferences

Emily and Kathleen's Blog: Long-Term Care Coverage

As our country continues to discuss health care reform and how to best provide quality care to all Americans, we must remember to address our nation’s most vulnerable citizens. Unfortunately, however, health care for the elderly is often left out of health care debates, despite the fact that the elderly often have long-term needs and there are millions of seniors and persons with disabilities who cannot afford health care. Providing health care for the elderly is only going to become an increasingly growing problem as baby boomers age and are faced with expensive and persistent health crises. Today, there are nearly 10 million Americans who need long term care services, and this number will increase to 15 million by 2020 – evidence that our nation must address long-term care issues and its exorbitant costs.

Of people turning 65 years old today, 69 percent will need some type of long-term care – a statistic that is daunting when considering the extreme costs of care, combined with the reality that many elderly are retired and are therefore on a fixed income. Currently, there is no single, coherent system to help the elderly pay for long-term care. Instead, various sources (such as family budgets, Medicaid, a small portion of Medicare, and private insurance) are relied upon to help fund long-term care. With the reality of a growing baby boom population, and thus a growing demand for long-term care, this fragmented system is not sustainable. Currently, only one in five people can afford to pay for long-term care, and to further compound issues of coverage, many health insurance companies refuse to serve people with pre-existing conditions. The majority of people who are in need of long-term care, therefore, have no means to pay for such services, and current policies require Medicaid recipients to be impoverished before they can receive assistance.

Financing long-term care will not only be beneficial for the growing population who cannot afford it, but also for sustaining current, pivotal programs – such as Medicaid – which are becoming burdened by this growing demand for long-term care. The extent to which the entire health care system is currently being crippled by the unbearable costs of long-term care is evidenced by the fact that one third of Medicaid’s budget is directed towards providing long-term coverage, even though only ten percent of its beneficiaries use these services. The need to create a program that provides long-term care coverage, therefore, is necessary to aid the elderly, as well as to relieve state budgets and to ensure that programs such as Medicaid do not collapse.

In acknowledging the dire need to address issues of long-term care coverage, we suggest implementing a program that will subsidize costs for patients through an additional program to Medicare and Medicaid. This plan would call for the creation of an employer-based, national long-term care insurance program that will be funded through an additional tax taken out of workers’ paychecks similar to Social Security. This tax would be deducted on an “opt-out” system, allowing for individuals to opt out if he or she does not wish to participate in funding this program. All people eighteen and older in the work force would be eligible to participate, and would need to contribute for at least twenty years before they could benefit from the program—with a grandfather clause that would not require those in the workforce now to contribute for this long. Additionally, the institutional bias that is in place now in the Medicaid system needs to be removed so that individuals in need of long-term assistance have the choice of receiving their care and services in their own communities. This system would allow not only for more funding for long-term care patients, but also a variety in the kind of care that would be available to them to ensure better and more effective care for more people.

Additionally, another aspect of our plan would include providing a tax credit for families who choose to take care of their loved ones in their own home. Currently, family spending is in the billions per year and it has created a strain on many family incomes as a result. This tax credit would provide incentive for more families to provide long-term care for their family members in their own homes, which could additionally help with the burden felt by insurance companies and private sector health care providers. We believe that this tax credit would greatly assist many families who are currently spending significant funds on their loved ones as well as help decrease the inevitable stress the baby boom generation will be placing on health institutions over the next few decades.

While our nation is currently focusing much attention to health care reform, little of this debate has been directed toward the issue of long-term care and the rising number of baby boomers that will be needing it in the very near future. It is our belief that this kind of policy is necessary to ensure there is sustainable coverage for those in need of long-term care. This plan not only provides funding for these kinds of services, but it also creates the possibility for various types of care for long-term care patients, which could open up a new market for private sector care providers in this area. A long-term health care coverage plan, therefore, can be regarded as a positive reform measure not only for those in need of services, but for the entire nation.

Phil's Blog: Addressing Prescription Drug Abuse

The idea of prescription drug abuse is prevalent in American popular society. From the health care debate to the vices of Dr. House, a strong pessimism exists about our culture’s addiction to medication.

Particularly, narcotic analgesics have drawn increasing criticism for being overprescribed. These drugs, more commonly known as “pain-killers”, include names such as Vicodin and Morphine. While these drugs certainly help and should be used to help with short-term pain, analgesics are commonly prescribed to treat chronic long-term pain.

Two issues exist with this treatment, discounting side-effects. One, narcotic analgesics put the patient at risk of addiction, which causes them to seek out further medication beyond their immediate health needs. Two, this type of drug causes habituation: The medication becomes less effective as the patient continues the regimen, requiring higher doses to achieve the same end. The combination of these issues can lead to an increasing addiction that is expensive and hazardous to the health of the individual.

Due to these consequences, narcotic analgesics should not be used for long-term treatment. Health care providers need to develop an alternative approach to medication for helping patients cope: One possible solution is comprehensive pain clinics. Pain clinics use several different sciences and arts to help individuals negotiate pain, including physical therapy, chiropractic, massage therapy, psychiatry, psychology, and alcohol and drug counseling. While these programs do not exclude prescription drugs from their regimens, they try to decrease the dependence of the individual on medication. The encouragement of pain clinic programs can help avoid the vices of narcotic analgesics while allowing for their use in the short-term. The goal of every physician should be to help patients deal with their pain inside their health interests, and not to try to prescribe it out of existence.

Public Health's role in Food Deserts

Hi everyone! Just a little preview of what I'll be putting together for my portion of the "food policy" paper, in conjunction with Melanie and David (from the Urban Planning center).

I'm focusing more on the public health aspects of food deserts- namely, what sorts of effects food deserts place on the overall health/ quality of life of those who inhabit them, as well as the ways in which we can increase public awareness of the necessity for diet changes as a means of preventative health care. For many, it's not a clear line of thought that buying a bushel of apples today will help ward off debilitating chronic diseases like diabetes- as well as skyrocketing health care costs- twenty years down the road (especially when a bag of chips at the liquor store around the block costs a lot less).
I've started looking into methods of different outreach programs (like the Healthier Schools Challenge) that serve to educate children about the importance of healthy food and activity choices, as well as improve school lunches. Stemming from these ideas, I'd like to explore the options available for increasing the awareness of healthy diets in adults and the elderly. The USDA published some policy options about increasing access to fruits and vegetables this past June, which I am in the process of reviewing.
I haven't had hours upon hours yet to sink into my lit searches, but I hope I've given you all a good idea of what I'm looking into. If you have any questions, comments, ideas or suggestions, please send them my way!

Food Deserts

For my policy paper I am collaborating with Annie and a member of the Urban planning center, David. We are looking at food deserts and how they impact health in individuals. Our focus is going to be on Detroit specificially, while we will make connections to programs and cities in similar situations nationally and internationally as well.
My portion of the paper is going to focus on existing programs, mobile markets and food banks and looking at how we can make improvements in them to better individuals' health. Right now the programs that I have looked into focus on education and accessibility to fresh foods. There has been a recent program instituted called USHealthier schools, which focuses on training and tech assistance for healthy school meals, nutrition education, school and community support. In Michigan one school has met the standards so far and I think if we can increase the amount of schools involved-especially in areas with food deserts, it will better the understanding of people (especially children) of the importance of fresh foods. This is the link for the site: http://www.fns.usda.gov
Another program is Project FRESH, which allows women participating the WIC program and qualifying seniors to get booklets with coupons in them that can be used at farmer's markets. This is important because with more funding for the program and education about it, there will be increased availability of fresh foods for individuals most at risk. A big problem is that though many farmer's markets accept Project FRESH coupons, many people that would be eligible are not aware of the program. Project FRESH : http://www.projectfresh.msu.edu
I am also going to look into mobile markets and their success in the past and how food banks (Gleaner's in Detroit especially) have affected the accessibility to fresh produce.

More of what we don't need

I came across this article earlier today, which has a lot to do with America's problem with nutritionism and healthy eating behaviors. According to the 'Cookie Diet', you simply consume 6 pre-packaged, delivered-to-your-door cookies (complete with mystery ingredients beknownst only to the doctor who makes them) every day! Add in one "regular" meal, and you're on your way to weight loss paradise! !

This to me is the epitome of eating behavior dysfunction in America. We're so consumed (no pun intended) with losing weight (but without any actual Effort) that the event of selecting, preparing and eating whole FOODS as our ancestors have done becomes an automated process that doesn't detract time from our so-called lives. Just press the 'Order' button and voilà! (near)Instant success!

Honestly, you'd be much better off investing your time walking/bike riding to the grocery store, picking produce and cooking something that you're actually excited to eat! Really, this can be more fun than downloading new Apps on your iPhone. I swear.

You'll have to hand it to the Doctor who's got these half-baked ideas, though. From a cognitive standpoint, these guys are tapping into the way we approach 'dieting' and healthy lifestyles, telling us that "Hey, cookies AREN'T taboo anymore! That's right, you CAN eat cookies! You'll be thin, we promise!" when in reality, we should just exert a little self-control and not beat ourselves up if we eat a few cookies every now and then along with a well-balanced diet. A little conscientiousness in our eating habits goes a long way to promoting good health.

Check out Dr. Siegal's "Cookie Diet" website and draw your own conclusions...Sure, cookies are good, but would you REALLY want to eat one with unidentified 'secret' ingredients?

Welcome Back to the Blog!

This is the blog's second semester in operation and it's an exciting time not only for health care but for our voices in the health care debate. Last year, we had a few regular contributors to the blog (myself being the main one) and I'd like to see the list of authors expand this year.

Today, in particular, is an exciting day for the health care chapter at UM. Hilary Doe, former leader of UM Roosevelt and current leader of the national Roosevelt Institute, had an article published on Huffington Post discussing the need for young voices in the health care debate. It's a great piece and I encourage everyone to check it out.

Also noteworthy today is the return of the NYTimes Home Fires Veteran Blog. This blog follows the lives of recently returned veterans and puts names and faces to a lot of those issues that we discussed last year.

On the topic of health care there are a few bloggers that I like to follow, Ezra Klein being one of my favorites. He posted an interesting blog today discussing how the concern and confusion about rationing health care has obscured the actual problem of overuse in our system. Klein makes some great points, but having seen how quickly discussing overuse of health care services turned into 'death panels,' I wonder if that part of the health care equation is a safe political argument.

And to end this post, I'm linking an awesome graphic representation of Obama's proposed 2010 federal budget. If you like 'infographics' check out the other stuff the author has created here

Someone who HAS had H1N1

Proof that the swine flu can happen to anyone...even famous UM alumni who work for CNN.
Lesson: Wash Your Hands!

Mental health care issues, revisited.

I hope you're all enjoying summer vacation.. that means plenty of extra time to search for articles to add on the blog! haha, just kidding. This piece is a sad one, but at least it's good to know that we've got Bob Herbert on our side.

Bezoars galore!

At the request of our dear co-director, Taylor, I am sharing this health issue with you all here on the blog. My sister, a med student, recently brought to my attention the existence of bezoars as she was studying the gastrointestinal system.
What's a bezoar, you might ask? Perhaps if you recall from the Harry Potter series, they are commonly referenced as a magical stone from the stomach of a goat that works as an antidote to poisons. However, on a more general level, bezoars are conglomerations of undigested material that form in the stomach (i.e., hairballs).

Now here comes the gross part. Being the inquisitive "life-learner" that the University of Michigan has trained me to be, I decided to google "bezoars." I came across this article from CNN about a girl who had a 10lb bezoar removed from her stomach. Since the picture isn't with that story, I found it here. (Beware, it's mildly disturbing).
Lessons learned: 1. Never eat your own hair; and 2. Hairballs (and curiosity, of course) can kill cats and humans.

Banning or Taxing Bad Health Habits

Sanjay Gupta (one of our favorite alums) asks some important questions about taxing/banning unhealthy products (i.e. cigarettes, sugary drinks) in his blog.  I know some of us have discussed this before, but the conversation needs to continue since solutions have not been widely adopted to address this issue.  Share your thoughts on the issue!

p.s. Check out our page on the Roosevelt website for a great picture capturing the Michael Moore/Sanjay Gupta showdown last year.

Improving Health Care for the Poorest- A TED Talk

Here's a link to a TED talk given by Dr. Ernest Madu who runs the Heart Institute of the Caribbean in Kingston, Jamaica.  He proposes that with careful design, smart technical choices, and a true desire to serve, it is possible to offer world-class health care in the developing world. 

It's definitely worth watching!

And with that, I'm done blogging for the day because I'm starting to feel like Perez Hilton 

A Public Plan for Health Insurance?

Check out this Editorial from the NYTimes today.

Yes, I'm going crazy blogging today!

Google Health Care

If you haven't seen it yet, check it out...Google Health

I'm definitely in favor of moving towards electronic medical records but it's somewhat scary that Google has already created a program to do so.  The goals of Google Health are to:

• Organize your health information all in one place.
• Gather your medical records from doctors, hospitals and pharmacies
• Share your information securely with a family member, doctors or caregivers

I really don't know what to make of Google Health.  Will it be necessary to have a third party, such as Google, maintain electronic records in the future?

Medicare-No Longer Accepted

We're used to Medicaid patients being turned away.  The Medicaid program pays out at a lower fee schedule than Medicare and private insurance companies.  Doctors tell us that it's not manageable for them to take on Medicaid patients, they just can't afford to.

Now a new problem has arisen.  Increasingly, Medicare patients are being turned away.  I came across this article in the New York Times just a few days ago about how more and more doctors are opting out of Medicare.  In particular, specialists (i.e. psychologists, gastroenterologists, etc...) have been turning Medicare patients away.  

The doctors' reasons: reimbursement rates are too low and paperwork too much of a hassle...Doctors who have opted out of Medicare can charge whatever they want, but they cannot bill Medicare for reimbursement, nor may their patients.

The article also highlights that there is a national shortage of internists (primary care doctors who deals with adults) and among practicing internists, many are unwilling to accept Medicare patients.  

Is this the beginning of the end for Medicare?  Will the government be forced to address health care reform now that one of the most important constituencies in this debate (those represented by AARP) is facing hardships?  I have long believed that a breakdown in Medicare would be the catalyst for major health care reform.  I think we have finally reached the point where funneling more money into Medicare is no longer an option, rising health care and drug costs must be curbed by a system wide reform.  First, however, we need to get a Health and Human Services Secretary in office.  

What is Medicaid?

This is shocking. That is all.

Daily Op-Ed on Stem Cell Research

This is coming a little late, but check out the op-ed on stem cell research we got published in the Michigan Daily last week!

Not-so Socialized Medicine

Hopefully some of you have already seen this article in today's New York Times about the corruption in Romania's health care system. Basically, it's impossible to receive [any] quality health care--albeit universal coverage is provided to citizens by the government--without excessive bribes to doctors (about $1 million USD's worth of "informal payments" per day, according to a survey by the World Bank, mentioned in this article). Otherwise, patients are simply refused care.

There have been some measures to reduce the bribe system, but it has been a problem for many years (i.e., rule under the Communist party). Many doctors believe they deserve to earn more than they actually do--according to the Southeast European Times , Romanian doctors earn about 10 times less than those in western EU nations. In order to prevent an exodus of doctors, Romania has proposed measures requiring new doctors to remain in the country, in an attempt to prevent their health care system from crumbling any further.

It's tricky finding any current health sector reform projects from outside groups (WHO, World Bank) that directly mention dealing with bribery, although one specifies investigation of patient deaths "within 48 hours and discharge for patients with major trauma or cardiac emergencies arriving alive at the hospital emergency department." Hm. The NYTimes mentions that patients are regularly ignored if they don't appear to be 'emergency-cases' or if they fail to offer a substantial enough bribe.

Additionally, many Romanians are afraid to report making bribes for fear that they will not be accepted by other doctors! Interesting to see how 'socialized medicine' works in the EU's No. 2 Most Corrupt Country...after Bulgaria (surprise!).

10 Secrets Successful Bloggers Know

Laura McClure, Multimedia Editor of motherjones.com, created this awesome list for blogging best practices. Check it out...take from it what you will.  

10 Secrets Successful Bloggers Know

1) Everyone loves a list

2)Most people also love embedded video, polls, charts, photos, or primary source documents.  If you need a blog post idea and are coming up blank, try picking one of these options, adding "of the day," and matching topic to fit.

3)Longer than 600 words is too long.  When in doubt, make it two posts.

4)  Start with the assumption that all your blog readers have already devoured the NY Times that morning, and probably at least skimmed the Washington Post as well.  Use different sources than these.  BBC, the Guardian, Foreign Policy, Politico Der Spiegel, Grist, the LA Times, HuffPo, Mental Floss, The New Scientist, BoingBoing, MetaFilter, Neatorama, AndrewSullivan.com, Wonkette, Kevin Drum's MotherJones.com blog, the from page of Digg- these are good starting points; branch out from there.

5) Being timely matters.  Want to know what's timely right now? Try searching Twitter (sidenote: I just got a Twitter account so (if you have one too) find me and let's share tweets!)

6) Aim to include at least five links per post.  To maximize search engine optimization make your anchor tags proper nouns, catchphrases, and other keywords people might search for in Google.

7) Headlines really matter.  Start with a keyword when possible, and make it catchy.

8) Consistently link to the blogs you wish would link to you; also join their comment threads.  And don't be afraid to email posts you've written to blogs you like- a little chutzpah goes a long way.

9) If you're funny, be funny.  If you're not, be cocktail party conversational.  The best bloggers are both.

10) You can write about anything you want, as long as you make it interesting and leave people a small but useful factoid as a party favor.

Kristof - Franklin Delano Obama

To add to the health care debate, New York Times' columnist Nicholas Kristof (my personal favorite columnist in the country) wrote his last column discussing at first Obama's health care proposal, but more generally the state of the American health system in the rest of the world. [You can read the column itself here].

Kristof attacks the notion that the United States has the best health care system in the world by using a different methodology than is commonly seen when comparing health car systems. For example, he uses the fact that, "Even the people of Cyprus live longer than Americans, according to United Nations figures."

I have an immeadiate qualm with this argument: to narrow the level of the health care debate to life expectancy alone is inherently flawed, and does not account for other necessary considerations. Kristof is smarter than this, and is probably just using this for a punchline, but I was still disappointed to see him do so.

Anyway - Kristof continues his piece while analyzing how the bottom (in GDP per capita) of the population receive health care. And this leads me to my question for this post - what subset of the population should be looking at in order to rank health care (or more generally other institutions) across countries? I find it necessary, though extremely unfair, to single out the bottom to make a political point. For example, Japan's GINI Index is much lower than the US's, and therefore corresponds to less income disparrity across the population. Were we to manipulate statistics in such a fashion for Japan, one could make the argument that the top 25% of Japan receive substantially worse health care services than the corrseponding percentile in the United States.

Regardless of any of this, when did we start using the bottom of the population to measure a country's success? (I'm not necessarliy saying this isn't what we should be using - just raising a question) Were we to only look at the bottom of the American public school system, it would severely distort the fact that some of the greatest universities in the world are also in the public schools (including Berkeley, UVA, and of course Michigan).

All that being said, I generally agree with Kristof and Obama on the necessary policies we must enact for an improved health care system, but more for reasons like this: "Repairing the system is thus not only a moral imperative but also an economic one. American businesses are at a competitive disadvantage when they have to pay for health care and foreign companies don’t. Among General Motors’ burdens is that it has to pay health costs equivalent to $1,500 for each car it sells."

Those are the kind of statistics that are needed in this debate, not political manipulations of stats for a cheap point. (I'm sorry Nicholas, I really am a HUGE fan).

Jack Lessenberry on Health Care Reform in America

In honor of our Op-Ed writing event with Jack Lessenberry next week (March 11th, 5pm, Koessler Room at the League), I decided to post today on one of his recent essays about health care reform.  Here's Lessenberry's assessment of America's health care system today:

We have a health care system that for years has been held together by the equivalent of twine and paper clips, coupled with what used to be called "benign neglect." That's also known as the ability to overlook the millions without any health care coverage at all.

He also explains that hospitals are in crisis, laying off workers and facing problems due to the increasing number of uninsured.  

Michigan has more than 140 hospitals, and they are now losing money on patient care, according to the Michigan Health and Hospital Association.  Accordingly, a survey by Crain's Detroit Business found, they are laying off workers, cutting services, and delaying projects.

The hospitals will tell you that none of this affects the quality of patient care, but common sense will tell you that of course it must. 

This is a major problem since health care is supposed to be one of the next booming industries along with green technology.  

Lessenberry concludes his article by suggesting that eventually socialized medicine will not be looked upon so unfavorably in the U.S.  Do you agree with his conclusion?  Will circumstances lead Americans towards a socialized health care system or is the natural predisposition against socialized medicine too strong in America?  

Check out the full essay, here

BONUS:  Lessenberry interviewed Dr. Davis (our favorite doctor!) as a part of this essay/radio show.  Check out his interview!

Kathleen Sibelius...ready to serve?

Kathleen Sibelius, the newest nominee for Secretary of Health and Human Services, will be coming into the spotlight this week.  As Governor of Kansas since 2003, Sibelius has steadily risen in prominence within the Democratic Party.  She's well known for crossing the aisle to get legislation passed and is respected by both her Democratic and Republican colleagues.  

But the real question here is whether or not she is qualified to take charge on the proposed Obama health care reforms.  A former state insurance commissioner, Sibelius has been well received by the insurance industry, making me wonder whether her 'insider' status will be a benefit or hindrance to the reform process.  Also, her track record of moving forward health care reform legislation in Kansas is not extensive.  There has been some movement in the past few years to expand coverage for children and the underinsured, but nothing revolutionary to recommend her for this position.  

Tom Daschle had written a book about health care reform, served as a U.S. Senator for 18 years, and had an extensive rolodex.  Basically, he was a political operative with the knowledge, skills, and contacts to jettison health care reform into the mainstream consciousness. Unfortunately, he hadn't paid his taxes.

It's still unclear what exactly Sibelius will bring to this position.  If her nomination is passed, she'll have a long, hard road ahead of her.  Obama will most likely appoint someone different to head health care reform in the White House (he had originally planned to have Daschle serve in this role), making it unclear as to what role Sibelius will be playing in the reforms.  

While I have some doubts, for now I'm willing to give her the benefit of the doubt.  Hopefully, she has studied the health care reform efforts of the Clinton era and learned from their mistakes.  And even more importantly, I hope she's paid all of her taxes.

Welcome!

If you're reading this then that means you've jumped on board the health care blogging train.  I'm hoping that we can make this a forum for discussion about health care related topics.  Also, I thought it would be a good way for those of you studying abroad to keep in touch with those of us still stuck in A2.  Feel free to post pictures of whatever exotic places you visit or just let us know what life is like on a different continent.

I'm planning to start posting interesting articles I come across on here instead of sending them out in emails.  I encourage you to post articles or opinions on here as well.  So I'll stop there and end by saying...Welcome the Roosevelt Health Care Blog!