Health junction

Wow! Eighty percent of registered voters in Washington State showed up at the polls yesterday. The 2008 elections were a Republican�s nightmare, since high voter turn out typically means higher Democratic voters. America saw record numbers of voters across the country. Especially heart warming was the increase in new voter registration. As someone who has never missed a presidential election, I applaud this improvement in public participation in our democracy. There were a number of issues that I blogged on in the past year, which were impacted by yesterday�s election(s). Here are the highlights: Death with Dignity Approved Former Governor Booth Gardner�s Death with Dignity Initiative in Washington State was approved with a 58% majority. This means that terminally ill patients, who obtain at least two medical opinions, can elect to end their suffering with the administration of lethal drugs. McCain defeated Senator McCain�s health care platform to eliminate the tax-free nature of emplo...

Presidential Candidate John McCain presented his healthcare reform ideas on April 30th, to a Tampa, Florida audience. True to his style, Senator McCain has taken a polarizing approach to health care reforms, by seeking to eliminate private employers from the provision of health care in America. Here are the highlights of his reform ideas: 1. McCain would eliminate the tax preference for employer provided health insurance. Instead of a tax deduction for private employers to provide health insurance, he would offer a tax credit to taxpayer households, $2,500 for individuals and $5,000 for a family. 2. Individuals would purchase health insurance plans on the open market(s). 3. A guaranteed access plan would be available to all, even the unhealthy, whom private insurers would seek to exclude from coverage. 4. He is not in favor of a national health care plan. 5. He would encourage support of health savings accounts. 6. McCain seeks to reform Medicare reimbursements by bundling payments to ...

Assessing the Real Cost of Health Care in America We can�t measure the real cost of any public program, unless we consider the economic factors, such as opportunity cost, which is the cost of spending excessive resources on health care that could otherwise go to something else. In order to do this, lets look at what other industrialized countries have in per capita income and what they are spending for health care. Based on 2006 income data the United States is no longer the wealthiest country per capita. Norway is the wealthiest country with $53,100 dollars of gross national income per person, compared to the USA�s $44,200 per person. Ireland is third with an income of $41,300 per person. What is interesting is both of these countries have national health care plans and higher taxes than in the United States. When you compare spending on health care, citing the Journal of Health Affairs article published in June of 2004, Norway spent $2,920 per person compared to the United States $4,...

Leading Presidential Candidates-Clinton, McCain, Obama Proposals for Health Care Reform This week�s column analyzes the leading presidential candidates Senators Hillary Clinton, Barak Obama, and John McCain proposals on health care reforms and how their ideas would address these five questions: 1. Access to Care 2. Optimization of Government Purchasing for Medicare and other Programs 3. Reimbursement Alignment for Desired Clinical Outcomes 4. Streamlining the Health Care System Administratively 5. Financing Health Care for all Access to Care The three questions that must be addressed in order to answer the access question are: Do the proposed changes provide health care coverage for all residents, or at least a close approximation of that? Secondly, do their proposals address adequacy of reimbursements for health care clinicians and facilities? Thirdly, are there enough clinicians to meet the increased demand for primary care and other services from changes in health care access and if...

Leading Presidential Candidates-Clinton, McCain, Obama Proposals for Health Care Reform Two weeks ago I wrote an article about the five fundamental questions that need to be asked in order to design optimum health care reforms in the United States. This week�s column analyzes the leading presidential candidates Senators Hillary Clinton, Barak Obama, and John McCain proposals on health care reforms and how their ideas would address these five concerns: Access to Care Optimization of Government Purchasing for Medicare and other Programs Reimbursement Alignment for Desired Clinical Outcomes Streamlining the Health Care System Administratively Financing Health Care for all Access to Care The three questions that must be addressed in order to answer the access question are: Do the proposed changes provide health care coverage for all residents, or at least a close approximation of that? Secondly, do their proposals address adequacy of reimbursements for health care clinicians and facilities...

For the 50 million people without insurance in the United States, this blog is for you. How do you obtain health care if you have no insurance? There are four basic methods for accessing care sans health insurance financing and they are; pay with cash or credit per clinical visit, frequent public health centers in urban areas, access community health centers in rural and metropolitan areas, and use the old standby, hospital emergency departments. The average person who is without insurance may feel there are no options other than paying out of pocket for treatment and worse yet, frequenting the emergency room for care. The lack of health insurance does limit the number of clinicians who will serve the patient, but there are two institutional remedies in America, the public health system and federally qualified health clinics. Both of these organizations are designed to provide primary health care on an as-needed basis for under-served populations, including the uninsured. CHC-Community...

Since 2008 is an election year, there will be much attention on domestic issues and the elephant in the room is health care reform. This healthpolicymaven blog reviews five fundamental questions and their importance in creating a more effective health care system for Americans. Does everyone have access to some type of primary care? Is the United States government optimizing its purchasing power for public programs? Are provider reimbursements in line with health care goals? Is there a mechanism for eliminating unnecessary and costly redundancies in a fragmented delivery system? Is the financing of health care for the country adequate and equitable? Access to Care First of all, access to care is not the same as access to health insurance. Health insurance is one of the financing mechanisms for health care, it does not provide care. Secondly, access means adequacy of supply in relation to the demand for services, especially primary care services. Presently there are significant shortage...

Booth Gardner, former Washington State Governor is campaigning to have physician-assisted suicide legalized in Washington State. Since the New York Times published an article on his initiative the same week the healthpolicymaven posted an article about palliative care and medical directives, a closer look at the ramifications of the proposed legislation follows. Gardner is traveling throughout the state soliciting support for an Oregon style assisted suicide law, which would allow physicians to provide patients with suicide medication dosing under very specific circumstances. A similar measure was put before Washington voters in 1991 and defeated by 54% of the voters. Though suicide is legal in Washington, physician aided death is not. Here are the provisions for the proposed Death with Dignity referendum if it copies Oregon State Law: -Permits legally competent patients who are at least eighteen years of age, state residents, and who suffer from a terminal disease, to obtain lethal pr...

February 2, 2008, is the one-year anniversary of my brother�s death, due to the collapse of his pulmonary function following complications from a kidney transplant. Because he couldn�t breathe on his own, following a failed final course of treatment for the pneumonia, the decision was made to remove his breathing tube. It took approximately three weeks from the time of his initial plea until he was at peace. Though Russell entered the Hospital with a Do Not Recessitate (DNR) and had instructions on what he would agree to for treatment, the process of allowing a patient to die on his own terms is not a simple one. My sister, an experienced hospice nurse, held his medical power of attorney. Once the family had gathered we discussed his wishes and everyone was in agreement. A meeting with a member of the ethics committee of the hospital was required, followed by explicit instructions for the transplant unit. With each shift change we needed to make sure the directives for no additional in...