This is a blog for the Mental Health Policy Class at the George Warren Brown School of Social Work.

August 28, 2007

Middle-Class Americans Join Ranks of Uninsured in 2006 as Private Coverage Shrinks

The U.S. Census Bureau released data today showing that the number of uninsured Americans jumped by 2.2 million in 2006 to 47.0 million people, with nearly all the increase (2.03 million) concentrated among middle-class Americans earning over $50,000 per year, according to an analysis by Physicians for a National Health Program (PNHP). Strikingly, 1.4 million of the newly uninsured were in families making over $75,000 per year. An additional 600,000 were in families earning $50,000 to $75,000 per year. (The median household income in 2006 was $48,200).
"Middle income Americans are now experiencing the human suffering that comes with being uninsured. It makes any illness a potential economic and social catastrophe," said Dr. Steffie Woolhandler, co-founder of Physicians for a National Health Program and Associate Professor of Medicine at Harvard Medical School.

August 24, 2007

Medical Homes Promote Equity in Health Care

The Commonwealth Fund 2006 Health Care Quality Survey finds that when adults have health insurance coverage and a medical home—defined as a health care setting that provides patients with timely, well-organized care, and enhanced access to providers—racial and ethnic disparities in access and quality are reduced or even eliminated. When adults have a medical home, their access to needed care, receipt of routine preventive screenings, and management of chronic conditions improve substantially.

August 23, 2007

Why can't Americans give up their guns?

According to the U.S. government's Center for Disease Control and Prevention, in 2004 — the latest year for which such figures are available — a total of 11,624 people were shot dead or murdered. That averages out to 32 a day. In the same year an additional total of 16,750 people shot themselves to death with firearms, 649 people died in gun accidents, and 311 in "legal intervention," that is, shot dead by police. Also, 235 people died for unknown reasons though it was clear that they did so of gun wounds. A grand total of 29,569, or an average of 81 people a day, were killed or died by use of guns.

Romney's rhetoric glosses Massachusetts years

On the presidential campaign trail, Mitt Romney points to healthcare reform as his major achievement as Massachusetts governor, presenting the plan as an example of how he used conservative principles to provide affordable health insurance for all state residents without a government takeover. But he does not mention aspects of the plan that may hold less appeal for his Republican audiences. For example, he decries "socialized medicine" and says the Massachusetts plan is "all a private initiative, a private-based, market-based healthcare" -- omitting the fact that the state and federal governments subsidize much of the overall cost and that a public board negotiated the benefits and prices that private insurers now offer. . . .

August 6, 2007

Science vs. politics gets down and dirty

Malicious, vindictive and mean-spirited. These are words that might surface in divorce court.
But they have been lobbed in the course of a different estrangement: the standoff between the Bush administration and the nation's scientific community.
The relationship, which has been troubled since the dawn of the Bush presidency, hit a new low last month when Richard Carmona, surgeon general from 2002 to 2006, lashed out at his former colleagues in testimony before a House committee.

Lawmaker Calls for Registry of Drug Firms Paying Doctors

WASHINGTON, Aug. 3 — An influential Republican senator says he will propose legislation requiring drug makers to disclose the payments they make to doctors for services like consulting, lectures and attendance at seminars.
The lawmaker, Charles E. Grassley of Iowa, the senior Republican on the Senate Finance Committee, cited as an example the case of a prominent child psychiatrist, who he said made $180,000 over just two years from the maker of an antipsychotic drug now widely prescribed for children.

Under the influence

For many Americans, a doctor's decision to prescribe medication is something of a sacred transaction. A physician considers the patient and symptoms and chooses the best drug for the job, drawing upon years of training and clinical experience. It is an exchange conducted in a hushed sanctuary, far from the heat and noise of the marketplace -- a place where cool judgment reigns. That sanctuary has been breached. Today, drug manufacturers do everything in their considerable power to ensure that their brand-name prescription medications are on the lips of patients and in the minds of physicians every time the two meet across an exam table. A growing chorus of critics says their efforts have begun to rewrite the dialogue between patient and doctor, influence physicians' judgments and open the act of prescribing to forces more profit-minded than sacred.

August 3, 2007

Children’s Health Plan Focus of New Struggle

The Children’s Health Insurance Program has suddenly become a vehicle for an ideological struggle between President Bush and Congress over the future of the health care system.
But in the short term, members of both parties say, the broader outline of that struggle is likely to be reduced to a simple question: “Are you for or against children?” . . . . Representative John Shadegg, an influential conservative from Arizona, said, “This debate is the opening salvo in a battle over the future of health care in America.” . . . . Republicans say Mr. Bush’s opposition to the House and Senate bills stems from conviction and principle, not a political calculus. But, they say, he is not running for re-election and appears oblivious to the political risks for Republicans.

August 2, 2007

Child abuse claims raise queries about Maori culture

The case of a three-year-old girl who was allegedly hung from a washing line and spun in a tumble-dryer has reignited debate in New Zealand about the touchy subject of child abuse within Maori communities. . . . In many such cases, it has emerged that the victim's extended family knew the child was being mistreated. But it is Maori custom that people sort out their problems themselves, rather than report them to the police.

Bill Would Let States Force Drug Discounts

U.S. Rep. Chris Van Hollen is preparing legislation that would allow states to make prescription drugs more affordable for low- and moderate-income Americans, a challenge to Bush administration policies that have thwarted such efforts in Maryland and elsewhere.
Van Hollen (D-Md.) said he will introduce a bill early this week allowing states to use their purchasing power to require drug companies to provide discounts on medications for low-wage workers. Under the proposal, states could negotiate the same breaks they get for people on Medicaid, the state-federal health-care program for the poor.

Skipping doses could be deadly

Consider it the other drug problem: Millions of people don't take their medicine correctly — or quit taking it altogether — and the consequences can be deadly. On average, half of patients with chronic illnesses like heart disease or asthma skip doses or otherwise mess up their medication, says a report being issued later this week that calls the problem a national crisis costing billions of dollars.

The Right Rx for Sadness

. . . [T]here's a growing concern that medicine often goes to people who shouldn't be taking it. And a consensus has formed that the estimate of how many people will develop depression at some point—1 in 6—might be greatly inflated. "There's no question that the availability of these drugs has increased the diagnosis of depression," says Jerome Wakefield, a professor of social work at New York University. Wakefield is coauthor of the new book The Loss of Sadness, which argues that selective serotonin reuptake inhibitors—Prozac, Paxil, Zoloft—are commonly overused to treat sadness, a normal and healthy response to divorce, sudden unemployment, the end of a friendship, a house foreclosure.

Bush Aide Blocked Report

A surgeon general's report in 2006 that called on Americans to help tackle global health problems has been kept from the public by a Bush political appointee without any background or expertise in medicine or public health, chiefly because the report did not promote the administration's policy accomplishments, according to current and former public health officials.

Carmona told lawmakers that, as he fought to release the document, he was "called in and again admonished . . . via a senior official who said, 'You don't get it.' " He said a senior official told him that "this will be a political document, or it will not be released."