Posted by on March 24, 2013 - 9:44am

As the three-year anniversary of the Affordable Care Act approaches, the Kaiser Family Foundation has updated its interactive quiz that allows users to test their knowledge about what’s in – and what's not in – the health reform law.

Quiz takers can compare their health reform knowledge to that of their friends by sharing their quiz results on Facebook and Twitter. The quiz also includes links to more information about specific provisions of the law.   There's a lot posturing and misunderstanding out there so take the quiz and see how informed you are.  I got 9 out of 10, not bad.   Let us know how you do.

Posted by on March 19, 2013 - 10:41am

March is National Women's History Month in the U.S.  and we didn't want to close the month without paying tribute to the women who have made significant contributions to the nation's health.   We've provide two links for you to view.  The first link will bring you to the March 19 Huffington Post Healthy Living site where they provide profiles of 50 female scientists and physicians who have made a difference.  The second link is to our own March e-newsletter where we discuss the role women have played in health care reform.    We hope you visit these links and celebrate the important accomplishments all these women have made.

Posted by on April 26, 2012 - 9:17am

With record numbers of Americans lacking health coverage, the substantial growth of the uninsured population in recent decades has been a vexing problem in the United States and served as a primary impetus for the enactment of the Affordable Care Act.  Unfortunately, there is a lot posturing on both sides of the issue and it's important for the public to have the real facts.

In order to foster greater understanding of the nature of the problem, the Kaiser Family Foundation has created an Uninsured Quiz to help people gauge how much they know about the uninsured population and the consequences of not having health coverage.  I just took it and scored 8 out of 10, not bad, but I could use a refresher, especially on the extent of the problem.

Take the quiz to test your knowledge about a range of subjects, from how many Americans are uninsured, to what happens to people who lose their employer-based health coverage when they lose their job, to what the health reform law will do to make coverage available to more people. The answers page provides links to Foundation resources for additional information on each topic covered in the 10 questions.

Posted by on April 7, 2012 - 1:39pm

While we continue to fight for  access to health care (pending the US Supreme Court decision on the Affordable Care Act) it's rewarding to see that work continues on economic and job issues.   U.S.  Senator Tom Harkin recently  introduced the Rebuild America Act, which would improve economic security for women and their families.

According to the National Women's Law Center, the Rebuild America Act recognizes the need for quantity and quality when it comes to job creation. The bill provides funding to help states and localities hire teachers and other public service workers — an especially crucial sector for women, who have lost nearly 70 percent of the public sector jobs cut since June of 2009. It also invests in infrastructure and manufacturing — and increases support for job training and education to expand access to these jobs among underrepresented populations.

Other feature of the bill  would increase the minimum wage and the tipped minimum wage, advancing fair pay for women who represent nearly two-thirds of minimum wage workers; provide significant new funding to make child care more affordable for families, help states improve the quality of child care, and increase the supply of high-quality programs in low-income communities; give workers access to paid sick days, which could also be used to care for a sick child or aged parent; and improve Social Security benefits. And these critical investments would be financed by ensuring that the wealthiest Americans pay their fair share of taxes and closing tax loopholes.

This is not a slam dunk deal and we need to continue monitoring this legislation along with actions related to the Affordable Care Act.


Posted by on August 29, 2011 - 2:17pm

Concierge or boutique medicine is growing as busy people of means look for a way to bypass the red tape, waiting times, and inconveniences that may accompany a visit to the doctor.  On the physicians' side, doctors, including primary care physicians have joined concierge groups to avoid the long hours, incessant forms and high overhead of an overworked, understaffed practice.

Basically, concierge medicine is generally a small practice of physicians who limit the number of patients they see for an additional fee or "membership" that the client pays. In return for this fee (usually $1000-2000 per year over actual treatment fees), the patient gets return phone calls and same day appointments, in most cases. The doctors get to see fewer patients but are able to provide more customized care and be able to navigate their patients more efficiently to any needed hospital care or specialists.

So what about the good, the bad and the ugly?

The good (on the patient side)  includes more personalized care and as a result, more timely preventive care, when most diseases are caught early and interventions can prevent more serious problems.    Most people work hard because it enables them to lead a better life.   People work to send their kids to better schools, take more vacations, and have a better house.   Why shouldn't an executive be able to see a doctor at his or her convenience!   This is the American dream, right?   We all want the best for our loved ones.

The good (on the doctor's side) includes a less stressful workplace, more time to really spend with a patient, and more time to have a personal life.   They may see this as a better way to get to know their patients and provide better care, without the time limits of an overbooked waiting room.  Because there are less patients, the paper work including insurance forms get processed quickly---no insurance delays here!

For the individual patient and doctor, it looks like a pretty good deal.   But what impact will this have on the middle and lower economic classes that can't afford these 'boutiques' let alone health insurance.  This is where the bad and the ugly come in.

As more primary care providers join concierge practices, less physicians are available to provide general medicine to the masses.  This causes a larger workload for the physicians who are left in the mainstream.    This could lead to lower quality care because visits will be shortened and patients will be referred to see more physician extenders like physician assistants, nurse practitioners, etc.   Not that there is anything wrong with these compassionate and dedicated caregivers who can handle the majority of stomach aches and ear infections (and sometimes are preferred to a busy doctor).  But what about the prediabetic, the child with funny looking blood cells.  Sure, the PA or NP can refer any unusual symptoms to the doctor on duty (if they can catch them between appointments!).  But this only adds to the time needed to get a problem diagnosed and treated. The result could be less healthy patients who often miss the advantage of preventive care.

At the end of the day, this really becomes a social justice and ethical issue.    We have a broken health care system that is forcing some to run away---if they have the money and opportunity.   The others who don't have the resources simply deal with it.   We need some kind of fair and equitable way to ensure that all people have access to basic health care that includes less costly preventive care.   If we keep filtering off resources (e.g. primary physicians) to help those with money, there is little left to ensure the others have basic care.  In the end, we all pay when we miss the opportunity to practice preventative medicine and a patient ends up in an expensive emergency room because their acid reflux wasn't treated and they now have a bleeding ulcer!


Posted by on April 14, 2010 - 9:31am

The Agency for Healthcare Research and Quality issued its 2009 National Healthcare Quality Report and National Healthcare Disparities Report on April 13.  The 2009 reports include a new section on lifestyle modifications because preventing or reducing obesity is a crucial national goal. The reports found:

  • One-third of obese adults have NEVER received advice from their doctor about exercise.
  • Obese adults who are black, Hispanic, poor or have less than a high school education are LESS likely to receive diet advice from their doctors.
  • Most overweight children and one-third of obese adults report that they have NOT been told by their doctor that they are overweight.
  • Most American children have NEVER received counseling from their health care provider about exercise, and almost half have NEVER received counseling about healthy eating.

The reports indicate that the lack of health insurance slows improvement in health care quality and reduction of disparities.  For many services, not having insurance is the single strongest predictor of poor quality care, exceeding the effects of race,  ethnicity, income or education.

So, the BIG question....will expanding health insurance to more people change some of these statistics????   Let's hope so.