New claim: sugar is just as toxic as alcohol and tobacco and should be regulated the same way.
Man suffers heart attack while eating at Heart Attack Grill.
More than half of mothers under 30 are unmarried.
91% of small healthcare organizations suffered a data breach in the last year
The Kaiser Family Foundation (KFF) does some very good and objective work on health issues, but sometimes it just can’t help itself and turns into a bubble headed cheerleader for ObamaCare.
The latest example is an essay by KFF president Drew Altman on “Small Area Variations and the ACA’s Coverage expansion.” The point of the essay is that some areas of the country will be much more affected by ObamaCare than others. It’s a fairly obvious point. Even on a state-by-state basis, places like California and Texas with 20% or more uninsured will be more profoundly affected than Massachusetts with 5% or fewer uninsured. Altman takes it further and finds that the level of uninsured within a state varies considerably as well. This is drawn from a study KFF sponsored.
All of this is interesting and worthwhile information. The problem is that in Altman’s telling, the “effect” is an unmitigated “benefit.” He uses the term “benefit” as a verb fifteen times in this very short essay, including five times in a single paragraph:
Normally I don’t devote an entire Health Alert to someone else’s idea, but there was a fascinating post the other day at the Health Affairs blog by Abdulrahman El-Sayed, a social epidemiologist and physician-in-training at Columbia University.
His conclusion: health reform may actually make disparities in health outcomes (as well as in access to care) worse than what currently exists! Before you immediately dismiss this, let me say that there is evidence that this is exactly what the nationalization of health care produced in Britain. It may also have happened in Canada and in New Zealand. (See our summary of the issue in Lives at Risk.)
Let’s begin with a quick overview of some of the rather remarkable differences in health outcomes among various segments of our population:
The life expectancy gap between the 3.4 million high-risk urban black males and the 5.6 million Asian females was 20.7 years in 2001. Within the sexes, the life expectancy gap between the best-off and the worst-off groups was 15.4 years for males (Asians versus high-risk urban blacks) and 12.8 years for females (Asians versus low-income southern rural blacks)…. The disparities were caused primarily by a number of chronic diseases and injuries with well-established risk factors. Between 1982 and 2001, the … absolute difference between the advantaged and disadvantaged groups remained largely unchanged.
So what’s in the health reform bill that could make all of this worse? That’s where No Child Left Behind (NCLB) comes in.
Though I tried to resist
Being last on your list
At least check list medicine practiced in community health centers, ala Obama Care, doesn’t work. Here’s the back story:
The Affordable Care Act positions community health centers to be important intermediaries in the delivery of the beneficial effects of health care reform. In 2014 millions of low-income patients will acquire health insurance. To ensure that they will be able to obtain primary care, the act funded the expansion of community health centers to treat twenty million new patients (although recent federal budget cutbacks may curtail the scope of this growth).
Unfortunately, CHCs may be lousy places to deliver care. One study found that:
A nationally representative sample of community health centers had a 20 percent lower rate of foot exams and a 21 percent lower rate of hemoglobin A1c screening for their diabetes patients, compared to managed care organizations.
But what if the CHC does all the things it is supposed to do to qualify as a patient-centered medical home under a widely used assessment tool developed by the National Committee for Quality Assurance (NCQA) and endorsed by the federal government? That doesn’t seem to work either:
[O]ur analysis found no significant relationship between performance on the NCQA medical home tool and the quality of diabetes care, measured by either process or outcome… we observed a wide range of NCQA scores and substantive differences in the quality of diabetes care across the community health centers, but there was no statistically important association between NCQA score and quality of care.
Full article on medical homes in Health Affairs.
Last year, about 80,000 emergency-room patients at hospitals owned by HCA, the nation’s largest for-profit hospital chain, left without treatment after being told they would have to first pay $150 because they did not have a true emergency.
More from Phil Galewitz in the Kaiser Health News.
Tell me again why I should be glad that 16 million new people are going to be enrolled in Medicaid?
Medicaid patients had worse survival rates than the rest of the study sample, which included both those with private insurance and with no coverage at all. The disparities persisted even after the researchers controlled for where patients live, how much education they had received and the income level of their neighborhoods.
More on this study, and full article by Sarah Kliff in The Washington Post.
Survey: Nobody in the health insurance industry thinks that contraception coverage saves money.
If you are covered by a Medicare Advantage plan and you elect hospice, the payment for such care reverts back to fee for service Medicare (pointer from Austin Frakt).
NYT reviews the history of conservative support for a health insurance mandate. See our previous posts here, here, and here.
As a dawn chill broke over Chicago on Dec. 20, Mr. Terry received a plump pink kidney in a transplant at Loyola University Medical Center. He did not get it from Mr. Ruzzamenti, at least not directly, but the two men will forever share a connection: they were the first and last patients in the longest chain of kidney transplants ever constructed, linking 30 people who were willing to give up an organ with 30 who might have died without one.
More on this domino chain of 60 operations in The New York Times.
Pathophysiologic pathways leading to preterm labor and delivery are not the same in each and every subject and vary based on an individual’s risk exposure. This can include her race, type of infectious agent or bacterial pathogen, as researched in this study, or any other risk factor like BMI, nutritional deficiencies, behavioral issues, various stressors, genetic, and epigenetic factors.
More on tailored preterm birth interventions. Outline of study here.
