Sobering Thoughts

Sobering Thoughts: Town Hall Meetings on Fetal Alcohol Spectrum Disorders: "Prenatal exposure to alcohol is one of the leading causes of preventable birth defects and developmental disabilities. During the past 30 years, fetal alcohol spectrum disorders (FASD), including fetal alcohol syndrome, have gradually begun to attract attention. However, awareness and understanding of the disorders remain low, and people who are affected are seriously underserved. The FASD Center for Excellence held a series of town hall meetings in 2002 and 2003 to gauge the issues surrounding FASD nationwide. On the basis of its findings, the center proposed a series of recommendations to begin to remedy some of the deficiencies that were identified."

Health insurance companies help block mental health parity bill

Wellstone Action - Wellstone Action Network: "Health insurance companies help block mental health parity bill' by Frederic J. Frommer, Associated Press
WASHINGTON - Aided by House Speaker Dennis Hastert, insurance companies successfully have blocked legislation to make them provide equal coverage for mental and physical illnesses if their policies include both. President Bush endorsed the concept two years ago. Today, supporters of the bill are willing to settle for a scaled-back version they hope Congress will pass in 2004. "

Health insurance companies help block mental health parity bill

Wellstone Action - Wellstone Action Network: "Health insurance companies help block mental health parity bill' by Frederic J. Frommer, Associated Press
WASHINGTON - Aided by House Speaker Dennis Hastert, insurance companies successfully have blocked legislation to make them provide equal coverage for mental and physical illnesses if their policies include both. President Bush endorsed the concept two years ago. Today, supporters of the bill are willing to settle for a scaled-back version they hope Congress will pass in 2004. "

Malnutrition Is Cheating Its Survivors, and Africa’s Future

Malnutrition Is Cheating Its Survivors, and Africa’s Future - New York Times: "Yet almost half of Ethiopia’s children are malnourished, and most do not die. Some suffer a different fate. Robbed of vital nutrients as children, they grow up stunted and sickly, weaklings in a land that still runs on manual labor. Some become intellectually stunted adults, shorn of as many as 15 I.Q. points, unable to learn or even to concentrate, inclined to drop out of school early."

Governor Blunt's Medicaid Transformation Report

Missouri Dept. Social Services - Programs & Services for Health Care: "The Medicaid Transformation Report describes Governor Blunts plans to replace Missouri Medicaid with a new program called Missouri Health Net in which every Missouri citizen would have a 'health care home.'"

Senator Gibbons (R-Kirkwood) on Mental Health in Missouri

STLtoday - News - Editorial / Commentary: "The Department of Mental Health recently received a $14 million, five-year transformation grant from the federal government. The funds will help support the strategic planning, workforce development and technological enhancements required to transform Missouri's public mental health delivery system into one that is more patient-oriented, efficient and cost-effective."

New Poll Finds Broad Support for Health Care Reform

New Poll Finds Broad Support Among Democrats, Independents, and Republicans for Drug Price Negotiation, Reimportation, and Prioritizing Children for Coverage of the Uninsured...Views on Stem Cells More Mixed - Kaiser Family Foundation: "While there is debate in Washington about whether and how to do it, substantial majorities of Democrats (92%), Independents (85%), and Republicans (74%) support allowing the government to negotiate drug prices under Medicare (85% overall, including 65% strongly and 20% somewhat favoring it). There is also widespread support for permitting Americans to buy lower-priced prescription drugs from Canada (79%, including 55% strongly and 24% somewhat). Eight in 10 people believe drug price negotiation will make medications more affordable, while 31% believe it will result in less research and development by U.S. drug companies."

Poor Scores for U.S. Health and Mental Health Care

Poor Scores for U.S. Health and Mental Health Care Systems on New National Scorecard: "A new report on U.S. health care shows that the system falls far short of what it could achieve. On a national scorecard of 37 indicators, the overall score was 66 out of 100, with wide gaps between the best and worst states. The findings indicate that improved performance in key areas would save an estimated 100,000 to 150,000 lives annually and $50 to $100 billion in health care spending. "

Sample Letter to the Editor

STLtoday - News - Editorial / Commentary: "The members of the Midwest Regional Fetal Alcohol Syndrome Training Center were shocked by 'Some say it's OK to drink when pregnant' (Nov. 29), which implied that it is safe for pregnant women to drink small amounts of alcohol. The article contained little credible research and tried to obfuscate the issue by claiming that the research was confusing and controversial. The article relied on the voices of women and obstetricians who are not in the vanguard of American medicine. In fact, numerous studies document the deleterious effects of alcohol during pregnancy. "

Doctors aren't chaplains

Doctors aren't chaplains - Los Angeles Times: "A concerted effort is underway to make religious practices part of clinical medicine. About two-thirds of U.S. medical schools now offer some form of training on the role of religion and spirituality in medicine, according to Dr. Harold Koenig of Duke University."

When Blind Faith in a Medical Fix Is Broken

When Blind Faith in a Medical Fix Is Broken - New York Times: "A blocked artery is not a good thing. Public health campaigns have drilled that message into the national psyche. Surely, then, whenever doctors find a closed artery, especially in the heart, they should open it. Maybe not. A major study, presented Tuesday at a medical conference in Chicago, challenged the widespread use of tiny balloons and metal stents in people who had suffered heart attacks days or weeks before. Although such treatment can be lifesaving in the early stages of a heart attack, the study found that opening the artery later did no good at all. It merely exposed patients to the discomfort, risk and $10,000 expense of an invasive procedure. "

Insurer Sued for Refusing to Pay Costs of Anorexia - New York Times

Insurer Sued for Refusing to Pay Costs of Anorexia - New York Times: "A New Jersey couple filed suit against Aetna Inc., the Hartford-based insurance company, on Wednesday, claiming that it refused to fully cover their daughter’s treatment for anorexia."

Living With Love, Chaos and Haley

Living With Love, Chaos and Haley - New York Times: "PLYMOUTH, Mass. — When Haley Abaspour started seeing things that were not there — bugs and mice crawling on her parents’ bed, imaginary friends sitting next to her on the couch, dead people at a church that housed her preschool — her parents were unsure what to think. After all, she was a little girl."

Time to Go! Inside the Worst Congress Ever

Rolling Stone : COVER STORY: Time to Go! Inside the Worst Congress Ever: "There is very little that sums up the record of the U.S. Congress in the Bush years better than a half-mad boy-addict put in charge of a federal commission on child exploitation. After all, if a hairy-necked, raincoat-clad freak like Rep. Mark Foley can get himself named co-chairman of the House Caucus on Missing and Exploited Children, one can only wonder: What the hell else is going on in the corridors of Capitol Hill these days?"

Poverty

The Mismeasure of Poverty. America’s official quest to describe the circumstances of the disadvantaged in quantitative terms began in the 1870s and the 1880s, with the Massachusetts Bureau of Statistics of Labor and the U.S. Bureau of Labor Statistics, and the initial efforts to compile systematic information on cost-of-living, wages, and employment conditions for urban working households in the United States.1 U.S. statistical capabilities for describing the material well-being of the nation’s population through numbers have developed greatly since then.

Medicaid Hurdle for Immigrants May Hurt Others

"More than 50 million Medicaid recipients will soon have to produce birth certificates, passports or other documents to prove that they are United States citizens, and everyone who applies for coverage after June 30 will have to show similar documents under a new federal law. The requirement is meant to stop the 'theft of Medicaid benefits by illegal aliens,' in the words of Representative Charlie Norwood, Republican of Georgia, a principal author of the provision, which was signed into law by President Bush on Feb. 8."

A Physician Speaks Out on Health Care Reform

"[I]ncreasingly I've come to believe that if done right, health care in America could be dramatically better with true single-payer coverage; not just another layer -- a part D on top of a part B on top of a part A, but a simplified, single payer that would cover all Americans, including those who could afford the best right now. Representatives and senators in Washington should have to use the same system my patients and I do were they to vote it in."

Obstacles to Generic Drugs Criticized

"The brand-name drug industry is aggressively working to keep blockbuster drugs widely used by the elderly from being sold in cheaper generic versions when their patents expire, the organization that represents pharmacy benefit managers said yesterday. With an unprecedented number of top-selling drugs scheduled to go off patent within five years, the organization said, branded drug companies are constructing roadblocks to potential savings of $23 billion to seniors and the Medicare system."Free Registration Required for the Washington Post

China Has Too Many Men

"The gender imbalance grew out of communist China's draconian social engineering policies, where a woman, after having one child, was forced to make a choice: sterilization or insertion of an IUD (intrauterine device). To make sure the women kept their birth control devices in, the government � starting in 1982 � sent portable ultrasound machines all over the country. They are compact and lightweight and even some small villages got as many as two or three. But in a classic case of unintended consequences, pregnant women realized that the machines could also identify whether they were having a boy or a girl. And, as a result, by conservative estimates, more than 8 million girls were aborted in the first 20 years of the one-child policy."

Struggle Against Pricey Prescription Pills (Multimedia)

Why it's getting harder every day to find ways to save on prescription drugs.

Detox for the Botox Set?

"Brown, now 44, paid almost $15,000 for a controversial medical method known as 'rapid,' or 'anesthesia-assisted,' detoxification. Dubbed 'detox for the Botox set' by Elle Magazine, the procedure involves placing patients under anesthesia before giving them medicines that block opiate cravings."

The Economist on the Massachusetts Plan for Universal Access

"As was discovered by Hillary Clinton a decade ago, it is politically impossible to fix America's health-care system all at once. Congress is too angrily divided, and the federal government lacks the muscle to impose a grand vision on unwilling states. The riddle of how to provide health insurance for the 46m Americans who lack it will have to be solved by trial and error in the states. This week, Massachusetts offered an intriguing proposal. The state legislature passed a bill that would make health insurance compulsory. Just as everyone who drives a car must insure it, so everyone with a body must insure that, too. "

Universal Access in Massachusetts

"Governor Mitt Romney signed most of a sweeping new healthcare bill into law yesterday at a festive Faneuil Hall ceremony hailed as a hallmark of bipartisan achievement, even as healthcare specialists expressed concern that the plan could start losing money in three years. The bill will require all state residents to have health insurance by July 1, 2007, and require businesses with 11 or more workers to pay $295 per employee annually if the companies do not provide insurance. Romney vetoed the fee, but the Legislature is expected to override the veto."

Prophylactic Measures

"An informal survey found that almost half -- 22 of 50 -- of the District's CVS pharmacies lock up their condoms -- this in a city where one in 20 residents is HIV-positive. Most of those stores are in less affluent areas where the incidence of HIV/AIDS, other sexually transmitted diseases and unwanted pregnancy -- all preventable with condoms -- are highest."

Sally Satel on SAMHSA and Mental-Health Politics

"Recently, the federal Substance Abuse and Mental Health Services Administration (SAMHSA), part of the Dept. of Health and Human Services, has released its Consensus Statement of Mental Health Recovery. It is a travesty of psychiatric care. In fact, if a psychiatrist treating patients with severe mental illness followed most of the ten "fundamental" principles of recovery elaborated in the statement, he would be at risk of committing malpractice."

Federal suit seeks RxP for psychologists

"A group of RxP-trained psychologists in California filed suit in the U.S. District Court in Los Angeles contending that a state law barring them from writing prescriptions denies treatment to thousands suffering from mental illness."

Lower Income Linked with Poorer Care Experiences

"There is a health care gap not only separating the U.S. from the other four countries, but also one standing between lower-income and higher-income Americans. Among the countries surveyed, the U.S. stands out for income-based disparities in patient experiences, with below-average-income U.S. adults reporting the worst experiences�compared with their counterparts in the other four countries�on most measures of primary care access, coordination, and doctor-patient relationships. Although a lack of health insurance intensified the disparities, with uninsured U.S. adults often forgoing needed care, insurance coverage does not level the playing field. Even when insured, below-average-income Americans under the age of 65 were more likely to report access problems and delays than insured, above-average-income adults."

U.S. Ranks Poorly on Many Measures in Cross-National Patient Surveys

"U.S. health care leaders often say that American health care is the best in the world. However, recent studies of medical outcomes and mortality and morbidity statistics suggest that, despite spending more per capita on health care and devoting to it a greater percentage of its national income than any other country, the United States is not getting commensurate value for its money. The Commonwealth Fund's cross-national surveys of patients' views and experiences of their health care systems offer opportunities to assess U.S. performance relative to other countries through the patients' perspective�a dimension often missing from international comparisons."

Appearance and Success

"Marie Curie may have discovered radium, but judging from her pictures, she never figured out how to control her frizzies. Eleanor Roosevelt, looking back on a singularly accomplished career, wished she'd been prettier. Madeleine Albright's memoir records her long losing battle to lose weight along with her triumphs as secretary of state. And so on ..."

Effects of Student Debt on Careers

"At a time when the government estimates that two million new teachers will be needed in the next decade, the large student-loan debt that college graduates face may deter students from entering public-service careers like teaching and social work, according to a report released on Wednesday by the State Public Interest Research Groups' Higher Education Project."

Gallup: Worries About Health Care Now Top Issue in U.S.

"A new Gallup Poll released Tuesday reveals that the issue cited by most Americans as the one they worry about the most is 'the availability and affordability of healthcare.' A total of 68% said they worried about this a 'great deal.' Coming in second is the social security system at 51%. Following close behind that were 'availability and affordability of energy,' drug use, crime and violence--and only then 'the possibility of terrorist attacks in the U.S.'(at 45%)."

Prescriptive Authority Bill for Hawaii Psychologists

"With the stroke of a pen, Hawaii lawmakers have the power to improve access to mental health care for tens of thousands of people -- an estimated 55,000 -- served by nonprofit community health centers in our state's poorest and most underserved rural areas."

Study Backs Equal Coverage for Mental Ills - New York Times

"Providing insurance coverage for mental illness equal to that for physical illness does not drive up the cost of mental health care as many insurers feared, a new study of health benefits for federal employees says. President Bill Clinton ordered such equal coverage for federal workers in 1999, and the changes took effect in 2001. Under the policy, known as parity, insurers were forbidden to charge higher co-payments or impose stricter limits on psychiatric care or treatment for alcohol and drug abuse. The new study of those changes, being published Thursday in The New England Journal of Medicine, concludes that if mental health care is properly managed, expanding the coverage of it 'can improve insurance protection without increasing total costs' beyond those paid by insurers that do not offer parity."

Woman With Perfect Memory Baffles Scientists

"James McGaugh is one of the world's leading experts on how the human memory system works. But these days, he admits he's stumped.
McGaugh's journey through an intellectual purgatory began six years ago when a woman now known only as AJ wrote him a letter detailing her astonishing ability to remember with remarkable clarity even trivial events that happened decades ago.
Give her any date, she said, and she could recall the day of the week, usually what the weather was like on that day, personal details of her life at that time, and major news events that occurred on that date."

Personality and Politics

"Remember the whiny, insecure kid in nursery school, the one who always thought everyone was out to get him, and was always running to the teacher with complaints? Chances are he grew up to be a conservative."

WHO | mental health Global Action Programme (mhGAP)

"Mental health has become a major international public health concern and WHO has placed high profile focus on the importance of mental health. During 2001 the World Health Day (7 April 2001) was devoted to mental health and 155 countries celebrated the event.":

Depression (Unipolar) - After SSRI Fails, Switching Antidepressants May Help

"A proportion of patients with major depression who are unresponsive to the selective serotonin-reuptake inhibitor citalopram may benefit from taking an alternate antidepressant, according to two studies reporting results from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial in the March 23 issue of the New England Journal of Medicine."

Shock therapy seen to improve quality of life

"Most severely depressed patients who are given electroconvulsive therapy (ECT) -- commonly known is electroshock therapy -- experience improved health-related quality of life that lasts for at least 6 months, a new study shows."

Video Catches Hospital 'Dumping' Incident

"For many months, Los Angeles city officials have complained that regional hospitals are dropping off their indigent patients in the city's tough Skid Row area. On Wednesday, officials at a homeless shelter released a videotape that allegedly catches one hospital in the act."

Saint Louis State Hospital

The Commonspace > July 2002 >"High on a hill, looming over South St. Louis, the St. Louis Psychiatric Rehabilitation Center / St. Louis State Hospital sits silent. Located at 5400 Arsenal, the hospital first opened in 1869 as the St. Louis County Insane Asylum."

Should Psychologists Prescribe Medications?

"Like in many rural areas of Hawai'i, people on Moloka'i have limited access to psychiatric care and often rely on primary-care physicians or psychologists for help with stress, depression, anxiety or more severe mental disorders. But, unlike psychiatrists and other doctors, psychologists such as Oliveira are not allowed to prescribe medication for patients because they lack medical education and training. 'I've been working on Moloka'i for four years and the access to quality psychiatric care has not changed,' Oliveira said, 'so I'm dedicated to make something different.' In a close vote, the state House agreed this month to give psychologists the limited ability to prescribe antidepressants to patients at 13 federally qualified community health centers and at health clinics in areas where there is a shortage of mental health professionals. The bill now goes before the Senate, where similar legislation failed last session in an unusual deadlock after one supporter missed the vote because of illness."

Physician Charity Care Declines

"Continuing a decade-long trend, the proportion of U.S. physicians providing charity care dropped to 68 percent in 2004-05 from 76 percent in 1996-97, according to a national study from the Center for Studying Health System Change (HSC). The ongoing decline in physician charity care is alarming given the increase in the number of uninsured people, particularly during the first half of the decade. Declines in charity care were observed across most major specialties, practice types, practice income levels and geographic regions. Increasing financial pressures and changes in practice arrangements may account in part for the continuing decrease in physician charity care."

A Warning From South Dakota - New York Times

"When President Bush's Supreme Court nominees were asked about abortion and Roe v. Wade, their answers ranged from vague to opaque. But the state legislature in South Dakota felt it heard the underlying message loud and clear. Now, South Dakota has thrown down the gauntlet. It adopted a law last week that makes every abortion that is not necessary to save the life of the mother a crime. The law is clearly unconstitutional under existing Supreme Court rulings. But its backers are hoping that the addition of John Roberts and Samuel Alito to the court will be enough to change things."

Stem Cell Proposal Divides Missouri Republicans - Yahoo! News

"A ballot proposal promoting embryonic stem cell research is turning conservatives against each other and threatening to tear apart Missouri's Republican Party at the very height of its modern-day influence. The measure -- sponsored by a coalition of medical groups, researchers, businesses and patient advocates -- would make Missouri the only state besides California to enshrine the right to stem cell research in its state constitution."

Pharmacy refusals to fill prescriptions sets debate

"The Washington State Board of Pharmacy is considering a policy that would outline if and when pharmacists could refuse to fill prescriptions due to moral, religious or ethical objections.
The discussion is clearly aimed at clarifying whether pharmacists can turn away prescriptions for Plan B, the emergency contraceptive that has caused controversy nationwide, although such a conscience clause could pertain to other areas as well."

A Wrongful Birth? - New York Times

"As in many other realms, from marriage and its definition to end-of-life issues, those ethics and standards are being hashed out in the courts, in one lawsuit after another. And what those cases are exposing is the relatively new belief that we should have a right to choose which babies come into the world. This belief is built upon two assumptions, both of which have emerged in the past 40 years. The first is the assumption that if we choose to take advantage of contemporary technology, major flaws in our fetus's health will be detected before birth. The second assumption, more controversial, is that we will be able to do something � namely, end the pregnancy � if those flaws suggest a parenting project we would rather not undertake." [Free Registration Required]

Study: Drugs Better for Elderly Depression - Yahoo! News

"For elderly people who suffer bouts of depression, drugs work surprisingly better than psychotherapy at keeping these black spells from returning, suggests the longest study ever in patients so old. The findings from the two-year study may encourage some doctors to prescribe antidepressants for longer periods, perhaps even for life, in patients who have been depressed."

Use of Implanted Patient-Data Chips Stirs Debate on Medicine vs. Privacy

"When Daniel Hickey's doctor suggested he have a microchip implanted under his skin to provide instant access to his computerized medical record, the 77-year-old retired naval officer immediately agreed. 'If you're unconscious and end up in the emergency room, they won't know anything about you,' Hickey said. 'With this, they can find out everything they need to know right away and treat you better.'" [Free Registration Required]

Sex and Safety - Los Angeles Times

"Los Angeles County's 11 known sex clubs and bathhouses have long been popular places where gay men (and to a lesser extent heterosexual couples) go to have casual or public sex. Although perfectly legal as long as money doesn't change hands between partners, the steamy meeting points are also a major concern for public health officials because they can be breeding grounds for HIV and other sexually transmitted diseases."

Campaign for Mental Health Reform

"The Campaign for Mental Health Reform is a collaboration of 16 national health organizations, representing millions of Americans, to make health a national priority and early access, recovery and quality in mental health services the hallmarks of our nation�s mental health system."

Medicare Rights Center Part D Monitoring Project

"The frustration levels of my clients have been unimaginable! I have actually had clients burst into tears trying to understand the Part D program. As difficult as that process was, it was nothing compared to trying to explain to my clients after they had done everything they were supposed to do, they couldn't get their medications on January 1, 2006."

Racial Disparities & Prescription Surveillance

"Health policies designed to curb inappropriate medication prescribing can have the unintended effect of increasing racial disparities in access to appropriate care, reports a study by the Department of Ambulatory Care and Prevention (of Harvard Medical School and Harvard Pilgrim Health Care). . . 'This is the first well-controlled study to show that health policies designed to reduce drug costs and abuse can increase racial disparities in access to effective care for those with chronic illnesses, like schizophrenia,' said Pearson."

Kweisi Mfume: We Must Do More to Address Crime at its Roots Before a Generation's Lost

"For years, criminal justice policies have reflected the conservative view of lock them up and throw away the key without reflecting on the fact that many reactionary policies have caused more harm than good. Such policies have helped to increase -- not decrease -- the number of felons and the number of victims. Some of the once hailed and triumphed criminal justice policies such as 'three strikes - you're out' have proven to be -- as we knew they would -- a nightmare for criminal justice administrators and policy makers across the nation."

GWU Suit Prompts Questions Of Liability

"About 2 a.m. one sleepless night, sophomore Jordan Nott checked himself into George Washington University Hospital. He was depressed, he said, and thinking about suicide."

Politics and Medicine

"For many of the doctors, involving themselves in the political process is a new experience but one they find themselves having to do as political decisions increasingly affect how they practice. Many of the nation's most pressing domestic policy issues deal with health and medicine -- prescription-drug costs, Medicaid's impact on state budgets, growing numbers of uninsured, etc. -- and doctors want to be part of the conversation."

The Mythology of Health Care Reform?

"Health care is once again moving to the top of the national political agenda. The early evidence is that this debate will be dominated by misinformation and misconceptions. Advocates of a government-run, national health-care system will do everything they can to frighten Americans and discredit consumer-directed health care. But we would be advised to look at the facts and not the scare tactics." (Note: I am providing this link to the CATO Institute website because I want you to be familiar with some of the arguments AGAINST many of the positions I take in class. It will behoove you to spend some time on the CATO site; for a more elaborate analysis of conservative concerns about health care reform, go to http://www.cato.org/pub_display.php?pub_id=1044.)

The Fix-It Myth

"Almost everyone agrees that we ought to 'fix the health care system' -- a completely meaningless phrase despite its popularity with politicians, pundits and 'experts.' Indeed, it is popular precisely because it is meaningless. The people who proclaim it rarely tell you the discomforting choices it might involve. Instead, they focus on a few specific shortcomings of our $1.9 trillion health-industrial complex and imply that, if we correct these often serious flaws, we'll have 'fixed' the system or at least made a good start. This is rarely true, and so most forays into 'health reform' end with disillusion."

Should Health Care be the Business of Business?

"It wouldn't be a major leap to put all Americans on an expanded version of Medicare. We'd pay higher taxes but no insurance charges. Employers would no longer be saddled with health care. Workers would no longer worry about health care for themselves or their children. And we could toss the disgraceful private health insurance industry, with its wasteful bureaucracy and inscrutable coverage rules, into the Dumpster."

New Research on "Plan B" Contraception

"Recent studies justify the conclusion that Plan B does not produce a 'hostile uterus.' Rather, it prevents conception by delaying ovulation."

The Health Care Crisis and What to Do About It

"{T]he evidence clearly shows that the key problem with the US health care system is its fragmentation. A history of failed attempts to introduce universal health insurance has left us with a system in which the government pays directly or indirectly for more than half of the nation's health care, but the actual delivery both of insurance and of care is undertaken by a crazy quilt of private insurers, for-profit hospitals, and other players who add cost without adding value. A Canadian-style single-payer system, in which the government directly provides insurance, would almost surely be both cheaper and more effective than what we now have. And we could do even better if we learned from 'integrated' systems, like the Veterans Administration, that directly provide some health care as well as medical insurance."

Supreme Court has unusual chance to step into prescription drug fight

"Fifteen states are urging the Supreme Court to take the unusual step of immediately intervening to resolve a dispute between states and the federal government over the costly new Medicare prescription drug program. Justices were told Friday that states should not be forced to help fund the program, which could cost them billions of dollars over the next two years."

Missouri Senate bill targets consulting contracts

"The consulting contract between House Speaker Rod Jetton and state Sen. Jason Crowell would be illegal under a bill introduced this week by a St. Louis Democrat. Jetton, R-Marble Hill, receives $1,000 a month to act as a political consultant for Crowell, R-Cape Girardeau. Crowell's campaign fund pays the money to Jetton's firm, Common Sense Conservative Consulting LLC. The contract has paid Jetton $33,000 since the consulting firm was created in June 2004. 'The perception is just terrible,' said state Sen. Rita Days, D-St. Louis. 'It doesn't pass the smell test.'":

Mental Health and Marriage

"Within a handful of years, marriage equality has catapulted from an obscure social concept to a polarizing political issue on par with abortion, stem cell research, and the death penalty. Yet while the political debate has raged about the meaning of marriage and who should have the right to marry, little is known about the effect denial of same-sex marriage has on the gay and lesbian population."

Bush, Chertoff Warned Before Katrina

"In dramatic and sometimes agonizing terms, federal disaster officials warned President Bush and his homeland security chief before Hurricane Katrina struck that the storm could breach levees, put lives at risk in New Orleans' Superdome and overwhelm rescuers, according to confidential video footage."

"Don't ask, don't tell" won't help teens

"No responsible person wants to encourage teenagers to have sex; no one has to. That's what makes a bill moving through the Missouri Legislature so dangerous."

Support for Civil Commitment Ceremonies

"'We suggest you decline an invitation to a civil commitment ceremony,' Melissa Fryrear told a group of parents. Some busily took notes; a few others wiped away tears. 'So many Christians are yielding on this part,' she said."

How Did Your State Do?

NAMI's Grading the States 2006 Report

Bad News for FAS Prevention

"Both British and American women between the legal drinking age and 24 drank 33 percent more alcoholic drinks by volume in 2004 than they did five years earlier, Datamonitor said in a report last April."

Health cost to double in decade

"National health-care spending will double to $4 trillion a year over the next decade, outpacing the growth of wages, inflation and the U.S. economy as a whole, according to new government projections released yesterday.By 2015, one in every five dollars spent in the United States will go toward medical costs.The sobering cost data reflect the effect of aging baby boomers, the cost of the Medicare prescription-drug benefit, declining rates of insurance coverage, and rising hospital costs.The projections estimate that collective public and private spending for health care will average about $12,320 a person in 2015, compared with $6,683 a person in 2005."

AOL and Yahoo put price on e-mail

"Companies will soon have to buy the electronic equivalent of a postage stamp if they want to be certain that their e-mail will be delivered to many of their customers. America Online and Yahoo, two of the world's largest providers of e-mail accounts, are about to start using a system that gives preferential treatment to messages from companies that pay from 1/4 of a cent to a penny each to have them delivered. The senders must promise to contact only people who have agreed to receive their messages, or risk being blocked entirely."

Donuts for doctors

"He found out which anti-depressant the doctors in the clinic seem to be favouring lately - Prozac - and why they aren't using his antibiotic - too expensive and hard to dose. Not a bad return for the price of a box of donuts. Now, is that why they call us detailers? he muses, as he records these items in his electronic scheduler, which contains a database of extraordinarily detail. In it are the likes, dislikes, and habits of specific physicians in his sales area, even down to such minutiae as the birthdays of the doctors' kids, and the kind of wine their spouses prefer - and, of course, what drugs they tend to prescribe."

The New York Review of Books: Are We Safer?

"President Bush is fond of repeating, 'We are fighting them over there so that we won't have to fight them here at home.' As a slogan, this may be good politics. But as a counterterrorism strategy, it appears to be a disaster. Fighting them 'over there' has since 2003 meant committing over one hundred thousand troops, hundreds of billions of dollars, and thousands of lives to a conflict in Iraq whose only clear connection to the 'war on terror' has been its encouragement of terrorism."

Everyone Should Have a Blog

"Everyone should have a blog. It�s the most democratic thing ever. And, indeed, having a blog seemed to be the quickest way to fame in a country obsessed with fortune."

Medicaid Cuts

"The particularly vicious nature of the Medicaid cuts comes in three particular sentences in the CBO's report. On prescription drugs, it said, ''About one-third of those affected would be children and almost half would be individuals with income below the poverty level.' On cost-sharing for nonprescription services, it said, ''half of those enrollees would be children.'"

Where to Go to Check on the Size of the U.S. National Debt

U.S. National Debt Clock

In New Zealand, I could be a star

Drink ads ordered to use ugly men

Mental Health Parity

"Parity legislation attempts to make insurance companies treat mental health care needs with the same standards as general health care needs. Currently, Busch said, some insurance plans allot different amounts of coverage for general and mental health care, including the number of times a patient may visit a doctor. Some insurance companies, she said, also require higher cost-sharing for mental health care expenses."

Neurodegenerative Diseases

"By the year 2040 neurodegenerative diseases, such as Alzheimer's disease, Parkinson's disease, ALS and similar disorders, will overtake cancer as the second most common cause of death (1). What this means, from a practical standpoint, is that one in three of us will get a neurodegenerative disease."

PNHP Decries "State of the Union" Health Care Proposals

"President Bush's proposals for health reform would simultaneously: (1) worsen access to care for people who are already covered; (2) offer billions for new tax subsidies that will not expand coverage; (3) drive up bureaucratic costs and do nothing to control overall health spending; and (4) offer tax breaks targeted to the wealthiest Americans."

Molly Ivins on Why She Will Not Support Hillary Clinton for President

"Enough. Enough triangulation, calculation and equivocation. Enough clever straddling, enough not offending anyone This is not a Dick Morris election. Sen. Clinton is apparently incapable of taking a clear stand on the war in Iraq, and that alone is enough to disqualify her. Her failure to speak out on Terri Schiavo, not to mention that gross pandering on flag-burning, are just contemptible little dodges."

Using the Web for Advocacy Purposes

This is an example of the ways in which the internet can be used to advocate for a particular policy position. Click on the "Toolkit" tab to see examples of effective talking points, letters to the editor, and op-ed pieces. For my Tuesday class, feel free to post opposing viewpoints on your own blog; your particular position on these issues isn't as important as some demonstration of your ability to use the web as an advocacy tool.

Comparison shopping moves to medicine

"Last summer, the state of Oregon started to post hospital quality comparisons on a Web site. Under pressure from lawmakers, a hospital industry group recently opened a publicly searchable database to compare Oregon hospital charges."

Missouri stem cell scientists wary

"One of the next big battles over stem cell research is shaping up in the nation's heartland, where research supporters want to make a conservative state a haven for controversial cloning experiments."

Democratic Leaders Call Medicare Drug Legislation the Product of a "Corrupt Legislative Process"

Democratic Leaders Call Medicare Drug Legislation the Product of a "Corrupt Legislative Process," Seek Investigation into Role of Scandal-Tainted Lobbying Group

Jails as Dumping Grounds for the Mentally Ill

The nation’s local jails are increasingly becoming the dumping grounds for the mentally ill. Of the 10 million people entering county jails each year, it is estimated that 16 percent are suffering from mental illness. Most of these individuals have committed only minor infractions, more often the manifestation of their illness than the result of criminal intent.

Getting a Letter to the Editor Published in the NY Times

" [R]eaders, new and old, send in questions (and even complaints!) about the letters page almost every day, and so a refresher course may help. This is an attempt to answer some frequently asked questions."

Advice from the Op-Ed Editor for the NY Times

"Here at the Op-Ed page, there are certain questions that are as constant as the seasons. How does one get published? Who chooses the articles? Does The Times have an agenda? And, of course, why was my submission rejected?"

United States: Mentally Ill Mistreated in Prison

"One in six U.S. prisoners is mentally ill. Many of them suffer from serious illnesses such as schizophrenia, bipolar disorder, and major depression. There are three times as many men and women with mental illness in U.S. prisons as in mental health hospitals."

Medicare Woes Take High Toll on Mentally Ill

"Mix-ups in the first weeks of the Medicare drug benefit have vexed many beneficiaries and pharmacists. Dr. Steven S. Sharfstein, president of the American Psychiatric Association, said the transition from Medicaid to Medicare had had a particularly severe impact on low-income patients with serious, persistent mental illnesses."

The Missouri Coalition for Lifesaving Cures

During the semester, I hope you will follow this debate and make a decision about how you feel about these contentious issues.

PAHO: Mental disorders in Latin America and the Caribbean Forecast to Increase

"Health authorities recognize that mental disorders and substance abuse are important public health problems. Nevertheless, research carried out in recent years on those problems' prevalence, impact, and associated costs demonstrate that their magnitude has been underestimated."

Illinois Program for Victims of Domestic Violence

"While that may seem like common sense, there is now a growing body of evidence indicating that experiencing abuse plays a significant role in the development and exacerbation of mental disorders and substance abuse problems, increases the risk for victimization, and influences the course of recovery from a range of psychiatric illnesses."

Balding, Wrinkled, and Stoned

"There are an estimated 1.7 million Americans over age 50 addicted to drugs, according to the Substance Abuse and Mental Health Services Administration (SAMHSA), a division of the Department of Health and Human Services."

Was 2005 the year of natural disasters?

"Why do natural disasters seem to be increasingly frequent and increasingly deadly? Poor and vulnerable people are usually the worst hit."

Hospitals Say Meth Cases Are Rising, and Hurt Care

"A sharp increase in the number of people arriving in emergency rooms with methamphetamine-related problems is straining local hospital budgets and treatment facilities across the country, particularly in the Midwest, according to two surveys to be released in Washington today. (Free, but Registration Required. Recommended)"

A Free Course in Psychiatric Epidemiology

"Psychiatric Epidemiology reviews descriptive and analytic epidemiology for major mental disorders of childhood, adulthood, and late adult life. The course will also examine issues of classification and the nosology of psychiatric disorders as well as operational case definitions and the measurement techniques to enhance field surveys and risk factor research."

President Tells Insurers to Aid Ailing Medicare Drug Plan

"With tens of thousands of people unable to get medicines promised by Medicare, the Bush administration has told insurers that they must provide a 30-day supply of any drug that a beneficiary was previously taking, and it said that poor people must not be charged more than $5 for a covered drug."

Assault on the Elderly

"It is hard to reconcile the Bush administration's ''compassionate conservatism' with its very uncompassionate assault on the safety net for our nation's most needy and vulnerable citizens, low-income Americans and the elderly.":

Harm Avoidance in the Treatment of Alcoholism

"The new concept, called harm avoidance, is gaining acceptance because of newer drugs such as acamprosate and naltrexone. Both acamprosate and naltrexone reduce craving for alcohol, and studies show that patients who relapse and fail to be totally abstinent while on these drugs still drink a lot less, which presumably means fewer adverse consequences."

Report Casts Fresh Doubts on Prostate Cancer Testing - New York Times

"Men who have been screened for prostate cancer by the most commonly used tests have no greater chance of surviving the disease than those who have not been screened at all, new research has found. A report on the research, published yesterday in the Archives of Internal Medicine, found that neither a prostate specific antigen test, known as a P.S.A., nor a rectal examination worked to reduce deaths from prostate cancer."

Abstinence-only sex ed is ethically indefensible

"The report reads like an indictment. Abstinence-only is bad science, bad policy and a blatant violation of medical ethics and basic human rights. Enough is enough. The time has come for Congress to declare an immediate moratorium on federal funding for these programs. It is a national scandal that we have already spent over $1.1 billion of taxpayers' dollars on programs that don't work and that censor vital public health information for young people."

Increased Nurse Staffing Can Save Lives, Reduce Costs

"In the face of preventable deaths, costly inefficiency, and a rapidly aging population, U.S. hospitals are eager to establish a viable business case to improve quality of care and patient safety. New research published in Health Affairs finds that increasing the use of registered nurses (RNs)without increasing total nursing hours could reduce costs and improve patient care by avoiding unnecessary deaths and reducing days of hospital care."

Millions to die without donors' aid

A story based on an interview with Jeffrey Sachs, a senior United Nations adviser

'You've got to find what you love,' Jobs says

I think you'll enjoy reading the text to a speech Steve Jobs gave at Stanford.

U.S. Health Care Spending In An International Context -- Reinhardt et al. 23 (3): 10 -- Health Affairs

U.S. Health Care Spending In An International Context -- Reinhardt et al. 23 (3): 10 -- Health Affairs: "Using the most recent data on health spending published by the Organization for Economic Cooperation and Development (OECD), we explore reasons why U.S. health spending towers over that of other countries with much older populations. Prominent among the reasons are higher U.S. per capita gross domestic product (GDP) as well as a highly complex and fragmented payment system that weakens the demand side of the health sector and entails high administrative costs. We examine the economic burden that health spending places on the U.S. economy. We comment on attempts by U.S. policy-makers to increase the prices foreign health systems pay for U.S. prescription drugs. "

Health Spending In The United States And The Rest Of The Industrialized World

Health Spending In The United States And The Rest Of The Industrialized World -- Anderson et al. 24 (4): 903 -- Health Affairs: "U.S. citizens spent $5,267 per capita for health care in 2002�53 percent more than any other country. Two possible reasons for the differential are supply constraints that create waiting lists in other countries and the level of malpractice litigation and defensive medicine in the United States. Services that typically have queues in other countries account for only 3 percent of U.S. health spending. The cost of defending U.S. malpractice claims is estimated at $6.5 billion in 2001, only 0.46 percent of total health spending. The two most important reasons for higher U.S. spending appear to be higher incomes and higher medical care prices."

Prescriptions of mind-altering drugs for teens rise

"Drug prescriptions meant to counter depression, anxiety and mood or attention disorders in teens increased by 250 percent between 1994 and 2001 . . . ."

Anatomy and Structure of a TypePad, WordPress, Blogger and Movable Type Blog

This posting may help you decide which program to use when you set up your blog.

McGill Charities

Interesting website with striking photos of poverty. Be sure and visit the "Golden Rule" page. .

Early years study: Reversing the real brain drain

Early years study: reversing the real brain drain: "New evidence from neuroscience shows that the early years of development from conception to age six, particularly for the first three years, set the foundations for competence and coping skills that will affect learning, behaviour and health throughout life."

Women, violence and health - Amnesty International

Women, violence and health - Amnesty International: "The epidemic of violence directed at women and girls constitutes a major human rights scandal and a public health crisis. Around the world women are regularly beaten and sexually abused by intimate partners, family members, neighbours, and by people not known to them. They also suffer gender-based violence during and after conflicts and wars. The impact on women�s health goes far beyond bruises, broken bones or even death. As well as causing physical suffering to women, such violence has a profound impact on women�s psychological well-being, on their sexual and reproductive health and on the well-being and security of their families and communities. "

HIV/AIDS and Mental Health

Why Mental Health Matters in HIV and AIDS Interventions: "This World Bank discussion paper examines the relationship between HIV and AIDS and mental health."

Achieving the millennium development goals: Does mental health play a role?

Can we meet the UN's Millennium Developmental Goals if we ignore mental health?: "Achieving the millennium development goals: does mental health play a role?"

Trafficking of women and children for sexual exploitation in the Americas

Trafficking of women and children for sexual exploitation in the Americas: "The trafficking of women and children for sexual exploitation is a high-profit, low-risk trade that has been identified as a contemporary form of slavery. Although usually associated with Eastern Europe or Asia, there is mounting evidence that these crimes represent a significant problem in the Americas. "

Mental Health in Complex Emergencies

A Mental Health Action Plan for Complex Emergencies: "A review carried out by researchers at the Harvard Programme in Refugee Trauma suggests that psychological needs constitute a very large part of the human damage inflicted by complex emergencies. For example, 33 percent of all casualties in World War II were attributable to psychiatric causes and 15 percent of Vietnam veterans still suffered from post-traumatic stress disorder 10 years after the war."

World Health Organization (Mental Health)

Mental health"450 million people worldwide are affected by mental, neurological or behavioural problems at any one time."

NCVC

National Crime Victims Research and Treatment Center"The National Crime Victims Research and Treatment Center (NCVC) is a division of the Department of Psychiatry and Behavioral Sciences at the Medical University of South Carolina in Charleston, South Carolina. Since 1974 the Faculty and staff of the NCVC have been devoted to achieving a better understanding of the impact of criminal victimization on adults, children, and their families."

Welcome | Harvard Initiative for Global Health

Harvard Initiative for Global Health: "The Harvard Initiative for Global Health unites education, research, and global engagement, fueling the inspiration and innovation required to generate dramatic intellectual progress and practical approaches to global health challenges."

World Federation for Mental Health

World Federation for Mental Health: "The World Federation for Mental Health is the only international, multidisciplinary, grassroots advocacy and education organization concerned with all aspects of mental health!"

Corporate Human Rights Violators in 2005

"Most Wanted" Corporate Human Rights Violators of 2005: "This list of 'MOST WANTED' corporate criminals gives you information about the abusive behavior of this year's top fourteen worst corporations, tells you who is responsible, and how to connect with and support people who are doing something about it. "