Author Archive

Let’s take a moment to celebrate

March 24, 2010

There’s still a lot of work to be done, but let’s pause and be happy that our government finally passed real health reform. It’s not perfect, and there are many battles ahead, but for just a few moments, let us celebrate what we accomplished today.

Interstate health insurance shopping

February 24, 2010

John Goodman doesn’t seem like someone I’d normally agree with. I’m not talking about the former Roseanne star; I’m talking about the founder of the National Center for Policy Analysis. The site calls him the “Father of Health Savings Accounts” and  lists one of his major accomplishments as “playing the pivotal role in the defeat of the Clinton Administration’s plan to overhaul the U.S. health care system.”

That being said, I really enjoyed a posting he recently submitted to the HealthAffairs Blog on allowing consumers to purchase health insurance across state lines. He makes some great points about the benefits, including the ability to choose among 50 different insurance regulatory schemes. This means that if your state mandates in vitro fertilization coverage but not the chiropractic coverage you want, you could shop around for insurance from a state that does require chiropractic coverage to ensure you always have that coverage.

He notes that allowing interstate shopping could be bad for people with preexisting or chronic conditions. Healthy people from their state that might have normally subsidized their care through “guaranteed-issue and community rating in the individual market” might flock to states with cheaper insurance rates. This could leave people with preexisting or chronic conditions (which insurance companies do not like to insure) in ever smaller insurance pools and accordingly, higher premium costs. He mentions that the 6 states that currently require this could be exempt from interstate insurance shopping unless they want to opt in, but an even better solution would be “for states to find more rational ways of subsidizing the care of high-cost patients.” That’s the part that made me smile the most, because I fully agree that it’s important to help people with preexisting and chronic conditions receive affordable health insurance!!

Read the full posting here. If interstate health insurance shopping were allowed, what do you think states could do to subsidize the care of high-cost patients?

Dental health should be included in reform

February 21, 2010

Dental health has long been considered “optional” or an “extra” when it comes to health insurance. Just having insurance for dental procedures made you a lucky person; having good dental insurance that actually helped with the cost of expensive procedures (such as root canals and crowns) was like hitting the jackpot.

With the recent recession, dental health has fared even worse. People who lost their coverage along with their jobs are turning to safety net clinics, which were already overwhelmed with clients who never had dental insurance. Some states offer dental insurance to qualified applicants, but even that is dwindling.

States are feeling the sting of the recession when it comes to their budgets for dental insurance. According to NPR, California dropped 3 million people off of their dental plan 8 months ago due to budget cuts. The consequences of this? People are thronging to safety net clinics, which are struggling just to stay afloat in the economic downturn. Folks are turning up at these clinics swollen gums and infected teeth – problems that might have been avoided had they had access to regular cleanings. Instead of preventative care, people are forced to get teeth pulled because they can’t afford the expensive root canals and other treatments.

Public health has been pushing oral hygiene for several years now, since studies  have linked oral health to diabetes, stroke and heart disease. It is clear that dental health should not be considered optional, an extra or a luxury. I believe health is a human basic right – and this includes dental health.

Vaccines and obesity

February 21, 2010

The folks over at Effect Measure posted their take on a recent research article about vaccinating obese adolescents. The researchers were trying to see if needle length had an effect on the amount of antibody titer found in the subject’s blood after vaccination. The researchers found that those vaccinated with a 1.5″ needle  had higher antibody titers than subjects vaccinated with a 1.0″ needle.

I wish I could see the entire article, but unfortunately I don’t have access to Pediatrics and the abstract will have to suffice. The study itself was small, with only 22 young women and 2 young men receiving the Hepatitis B vaccine over 3 years. It raises an interesting point and possibly names another negative consequence of the obesity crisis in this country.

Of course, one study doesn’t tell us if using shorter needles constitutes under-vaccinating in obese individuals. In fact, it raises so many questions. Is it the needle size or the person that is the bigger factor in antibody levels? Will nurses have to start taking skin fold measurements before administering vaccines? Would vaccine needles have to start coming in many different sizes, to accommodate different levels of girth? And how will the anti-vaccine folks respond to this?

Think: Kill Your Speed

February 8, 2010

I’ve been living in England for about 6 months now, and one thing that still startles me is cinema advertising. Before the previews, there are several adverts, for everything from alcohol to cell phones to…social issues? Yes, sandwiched in with the vodka and Blackberry ads are ads that tug at your conscience. One ad was posted earlier on this blog: Pablo the drug dog. However, there is one that touched me more than Pablo. It is an advert for the Think! campaign, which seeks to get people to stay under the speed limit when it is posted as 30mph. It takes the perspective of a man who has killed a child because he was speeding, and now he has to live with that everyday:

http://www.youtube.com/watch?v=L7fhzDUOsxI

Could you see something like this airing on American television? Or before the latest blockbuster movie?