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Archive for the ‘Healthcare’ Category

More good news on Obamacare

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Kevin Drum asks a good question: Why are Republicans so opposed to Medicare, now that it has been proven to work? Look at his post at Mother Jones:

During Obamacare’s initial open enrollment period, the uninsured rate dropped dramatically. Then it leveled out a bit when enrollment closed. So how are things going in its second year?

The latest Gallup numbers tell the story. During the first month of open enrollment, the uninsured rate dropped moderately, and then dropped sharply again during the first quarter of 2015. It’s now down to 11.9 percent:

blog_gallup_uninsured_2015_q1

This is great news, and confirms previous reports. As before, according to Gallup, the biggest drops have been among the young and those with low incomes. This represents millions of people who can now get decent medical care without fear of bankruptcy, and it’s being done at asurprisingly moderate cost. It’s just inconceivable to me why Republicans are so hellbent on ruining a program that’s showing such great results and such great promise for so many people.

Written by LeisureGuy

13 April 2015 at 5:46 pm

Posted in GOP, Government, Healthcare

Australia: If you don’t vaccinate your children, you don’t get government childcare benefits

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Australia has some good policies. One is the reasonably substantial fine levied on those who fail to vote—that should be implemented in the US. Another is this new policy (yet to be approved by Parliament), reported in Salon by Joanna Rothkopf:

On Sunday, Australian Prime Minister Tony Abbott announced a harsh new policy targeting anti-vaxxers: as of January 1, 2016, parents who opt out of vaccinating their children will be denied childcare-related government benefits. The measure, which could deprive families of up to $11,500 in government funds, still needs to be approved by Parliament before it can take effect.

“Parents who vaccinate their children should have confidence that they can take their children to childcare without the fear that their children will be at risk of contracting a serious or potentially life-threatening illness because of the conscientious objections of others,” Abbott said.

NPR’s Stuart Cohen reports that around 90 percent of Australian children are properly immunized, but almost 40,000 parents have claimed objections, which can be religious, medical, or even philosophical in nature.

The Sydney Morning Herald’s Stephanie Peatling reports:

Families claiming the end of year supplement for family tax benefits will also have to have their children vaccinated at all ages from the start of next year before receiving the payment…

People who have medical grounds for not vaccinating will continue to receive government payments.

But people with religious reasons will have their eligibility for government payments tightened.

They will only continue to receive childcare and family tax payments if they are affiliated with a religious group whose governing body has a formally registered objection approved by the federal government.

“The government is extremely concerned at the risk this poses to other young children and the broader community,” Abbott continued. “The choice made by families not to immunize their children is not supported by public policy or medical research nor should such action be supported by taxpayers in the form of child care payments.”

Written by LeisureGuy

13 April 2015 at 2:00 pm

Therapy in another language via Skype

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Very interesting article in the NY Times by the therapist Anastasia Piatakhina Giré:

I have a psychotherapy practice in Madrid, but I often receive email requests for counseling from people in other parts of the world, since I also practice psychotherapy online, via Skype, in several languages: English, French, Italian and Russian. Alex’s email looked like spam, and I nearly deleted it. He wrote in an abrupt English, with neither a greeting nor a sign-off. When I read more closely, I saw that he was seeking therapy, though he didn’t say much else. In his brevity I sensed hesitation, a shade of doubt.

Some hide-and-seek is not unusual in the early phase of the therapy process. Asking for help involves a degree of exposure, which can trigger feelings of shame. For those who are wary about psychotherapy, the online format often appeals, as it avoids the physical, face-to-face confrontation of a classical consulting room and offers the option, or at least the illusion, of anonymity.

I wrote Alex back, asking if he might say a little more.

His second email was a bit longer, perhaps because he now trusted that behind my web page there was in fact a real person available to listen. He alluded to his “continuous work on overcoming my homosexuality.”

At this stage, I would usually invite a client to meet me via Skype to talk at greater length. But I was curious (I am only human): Where was Alex from? Something about his brisk, straightforward and slightly aggressive mode of address felt familiar to me, and I suspected he was Russian. But I am Russian, too. Why didn’t he avail himself of our common native language?

I wrote another email to Alex, listing the various languages in which I practiced therapy, and noting that Russian was my first language. It turned out that he was indeed Russian, and lived in a remote city many miles away from Moscow or St. Petersburg. At that point, we switched to speaking Russian. And we set up a time to talk via Skype.

At the beginning of our first Skype session, . . .

Continue reading.

Written by LeisureGuy

5 April 2015 at 9:20 am

Be careful what you ask for: GOP Rep asks on Facebook for Obamacare horror stories from constituents

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And doubtless the answers she received did indeed fill her with horror. Jen Hayden writes at Daily Kos:

mcm
Congresswoman Cathy McMorris Rodgers posted an image on her official Facebook page, slamming the Affordable Care Act on the fifth anniversary of President Obama signing it into law. She asked constituents to share their Obamacare nightmare stories and well, the response probably wasn’t what she expected. Below are a small sample of the comments constituents left on her page:

My story is that I once knew 7 people who couldn’t get health insurance. Now they all have it, thanks to the ACA and President Obama, and their plans are as good as the one my employer provides–and they pay less for them. Now, that’s not the kind of story you want to hear. You want to hear made-up horror stories. I don’t know anyone with one of those stories.

I work for cancer care northwest. We actually have more patients with insurance and fewer having to choose treatment over bankruptcy. Cathy, I’m a die hard conservative and I’m asking you to stop just slamming Obamacare. Fix it, change it or come up with a better idea! Thanks

With Obamacare, I saved 300 bucks a month premium.. I have more coverage.. I like ObamaCare and can’t wait til we go to the next step… Medicare for ALL.

And now my daughter, diagnosed with MS at age 22, can have insurance. What do you plan to do with her?

My daughter is fighting for her life with stage 3 breast cancer! We are about to enter a second go round of diagnostic procedures and possibly more treatment after two full years of treatment! So yah! The ACA is more than helping! I resent that our rep thinks the only problems involve her personal story!

My whole family now has coverage. The ACA is the cause for this, I work in health care, I have seen the increase in covered patients first hand. The next step is universal coverage, this will truly lower costs and provide the best care. Cathy, you barely work, spend most of your time catering to special interests so you can be re-elected.. All while receiving a large wage and the best health insurance and care. Stop telling us how it doesn’t work while enjoying your tax payer funded care and life.

Instead of trying to repeal it why don’t you improve it? Our local rural clinics are packed daily with people who have needed healthcare for years!! it is a godsend. It is pitiful this nation does not have healthcare for all and that doesn’t mean the EMERGENCY room!!

Thanks to the ACA, my cousin was able to get affordable insurance despite her preexisting condition. So grateful.

I think we should repeal Obamacare, and replace it … with universal socialized medicine – like the rest of the industrialized nations of the world.

Hello Congresswoman McMorris Rodgers! I work as the facilitator of a task force that is overseeing the implementation of the Affordable Care Act in Washington State. I have learned that the ACA is helping people who did not previously have health insurance get it. It is helping bring down medical costs. It is improving the quality of care. It is improving experiences of both patients and their families.

I work with doctors, nurses, hospital and clinic managers, non-profit service providers, citizens-at-large. Each of them can cite an improvement they would like to make to the Act. But whether they are Republican or Democrat, from urban or rural areas, powerful or not, they all say the ACA is working.

Can’t you and your Republican colleagues stop trying to repeal this Act and work to make it even more effective? Please?

Obama Care saved us when my husband was unemployed and we couldn’t afford coverage. We might have been ruined without it. My husband could not have had the eye surgery needed after an accident. So grateful.

We now have patients that can see a doctor in the clinic on time rather than waiting till they are too ill. ACA is saving lives and you are too stupid to realize that. Get your political view out of the way and see what is happening in our community because you have shown again and again it is not your community. I see that your son has Downs but not everyone in our community has it so get done with this supporting Downs to the neglect of everything else.

My plans are intact, premiums have increased as always, but what seems to be a lesser rate, my plan was not cancelled, I did not lose my doctor, I have not experienced reduced work hours, and it’s actually freed me from the chains of employer based being the ONLY path to coverage. #FEARMONGER

Those are just a small sample of the hundreds or even thousands of comments left on her Facebook page. It is damn clear that her constituents are loving the Affordable Care Act. Will she take their comments to heart and abandon attempts to take insurance coverage away from her constituents?

Edit: Paul Krugman has an excellent blog post on why the GOP hates the law and why the “victims” penalized by the law (and there are some) are unsuitable for its purposes. And he includes an interesting graph:

032715krugman2-tmagArticle

Written by LeisureGuy

27 March 2015 at 10:38 am

Physicians should take into account their patients’ early-life traumas

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But that, of course, would require asking about them, something physicians seem loath to do. And one can understand their reluctance when you look at the questions that should be asked. They’re tough questions, but it’s important that the physician know the answers for effective treatment.

Written by LeisureGuy

11 March 2015 at 11:24 am

Another fight worth fighting: Making sure children get vaccinated on schedule

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Michael Specter writes in the New Yorker:

Even in an era defined by profound technological advances, the practice of medicine remains an art as well a science—a fact that often frustrates both physicians and their patients. For many conditions, solutions are not simple and there are rarely easy answers. There are exceptions, of course; perhaps the most notable among them has been the success of vaccines.

Until recently, in the United States and other wealthy countries, diseases such as measles, pertussis and rotavirus—which kill hundreds of thousands of infants in the developing world each year—had virtually disappeared. Both measles and pertussis are now back, largely because increasing numbers of children remain unvaccinated. Vaccines are the most powerful public-health tool that pediatricians possess. Unfortunately, there are people (a minority, but a dangerous one) who just don’t care.

Many of these people don’t approve of the vaccine schedule set out by the Centers for Disease Control and Prevention, and they seek to spread the shots over a longer time period than the one recommended. This has presented American pediatricians with a stark new challenge to their Hippocratic Oaths. Which does more harm: delaying scheduled vaccines and reducing their effectiveness, or refusing to delay and running the risk that parents will simply not vaccinate their children at all?

It’s a terrible choice, forced almost wholly by the notion (which is demonstrably untrue) that if a child receives “too many vaccines too soon” it could overwhelm his or her immune system. A study published this week in the journal Pediatrics provides the best proof yet that a large majority of doctors agree to the delays. Ninety-three per cent of those surveyed for the study reported that they had been asked, at least once, to delay vaccines. The physicians acquiesce in overwhelming numbers—two thirds said they do so at least occasionally—even though most of them don’t want to, and even though they are aware that data clearly show that such delays put their patients (and those around them) at increased risk.

Nobody can dispute that the number of vaccines has grown significantly. A hundred years ago, children received a single vaccine: smallpox. By 1962, that number had grown to five (diphtheria, pertussis, tetanus, polio, and the M.M.R.). Today, the C.D.C. advises that children be vaccinated for fourteen diseases before age six, on a recommended schedule that usually includes twenty-nine shots, sometimes several at once. Vaccines worry parents, in part because of of an old, unfounded, and ultimately discredited theory that children who receive measles vaccines develop autism at higher rates than other children. (They don’t, as has been demonstrated in dozens of studies carried out throughout the world.)

That baseless concern, publicized by activists such as Jenny McCarthy, morphed into a movement to spread out the timing of vaccines in order to protect children from a possible shock to their immune systems. But there simply is no such threat. Because progress in molecular biology has made it possible to create vaccines with fewer antigens, children’s systems are now exposed to far less of a burden than was the case in the past. The smallpox vaccine, for example, contained two hundred proteins—all separate molecules. All together, the vaccines that children routinely receive today contain fewer than a hundred and fifty.

The number of bacteria that live on the nose of a newborn child or on the surface of his or her throat is in the trillions. “Those bacteria have between 2,000 and 6,000 immunological components and consequently our body makes grams of antibody to combat these bacteria,” Paul Offit, the chief of the infectious-diseases division at the Children’s Hospital of Philadelphia, has written. “The number of immunological challenges contained in vaccines is not figuratively, it is literally a drop in the ocean of what you encounter every day.” Offit has long been one of the nation’s most prominent proponents of vaccines—and he has long been vilified for his stance.

Pediatricians spend, on average, less than twenty minutes with each patient—often far less—and they usually have to cover a lot of ground. . .

Continue reading.

Ignorance persists because the ignorant really prefer the certainty of their convictions to gaining actual knowledge.

Written by LeisureGuy

8 March 2015 at 2:46 pm

The Demolition of Worker’s Comp: The continuing assault on labor

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Michael Grabell and Howard Berkes have an important story in ProPublica:

DENNIS WHEDBEE’S CREW WAS RUSHING to prepare an oil well for pumping on the Sweet Grass Woman lease site, a speck of dusty plains rich with crude in Mandaree, North Dakota.

It was getting late that September afternoon in 2012. Whedbee, a 50-year-old derrickhand, was helping another worker remove a pipe fitting on top of the well when it suddenly blew.

Oil and sludge pressurized at more than 700 pounds per square inch tore into Whedbee’s body, ripping his left arm off just below the elbow. Coworkers jerry-rigged a tourniquet from a sweatshirt and a ratchet strap to stanch his bleeding and got his wife on the phone.“Babe,’’ he said, “tell everyone I love them.”

It was exactly the sort of accident that workers’ compensation was designed for. Until recently, America’s workers could rely on a compact struck at the dawn of the Industrial Age: They would give up their right to sue. In exchange, if they were injured on the job, their employers would pay their medical bills and enough of their wages to help them get by while they recovered.

No longer.

Over the past decade, state after state has been dismantling America’s workers’ comp system with disastrous consequences for many of the hundreds of thousands of people who suffer serious injuries at work each year, a ProPublica and NPR investigation has found.

The cutbacks have been so drastic in some places that they virtually guarantee injured workers will plummet into poverty. Workers often battle insurance companies for years to get the surgeries, prescriptions and basic help their doctors recommend.

Two-and-a-half years after he lost his arm, Whedbee is still fighting with North Dakota’s insurance agency for the prosthesis that his doctor says would give him a semblance of his former life.

The changes, often passed under the banner of “reform,” have been pushed by big businesses and insurance companies on the false premise that costs are out of control.

In fact, employers are paying the lowest rates for workers’ comp insurance since the 1970s. And in 2013, insurers had their most profitable year in over a decade, bringing in a hefty 18 percent return.

All the while, employers have found someone else to foot the bill for workplace accidents: American taxpayers, who shell out tens of billions of dollars a year through Social Security Disability Insurance, Medicare and Medicaid for lost wages and medical costs not covered by workers’ comp.

ProPublica analyzed reams of insurance industry data, studied arcane state laws and obtained often confidential medical and court records to provide an unprecedented look at the unwinding of workers’ comp laws across the country.

Among the findings: . . .

Continue reading.

What they found is sobering indeed. I have to think that ultimately this sort of government action is due to citizen indifference: the low voting turnouts (in the current race in LA, the turnout is about 8% of voters) means that legislators no longer respond to the public at large and are free to ignore the public welfare. If all vote, then the issues of most concern to the public will get the attention they deserve.

Perhaps the US could adopt the Australian practice of levying a fine (in the $100 range) on those who fail to vote. Since early voting and absentee ballots are readily available, I don’t see a reason that would stop eligible voters from casting a ballot—other than indifference, of course.

Written by LeisureGuy

4 March 2015 at 10:59 am

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