public health
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Mammogram Hysteria Meets the EARLY Act
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How NOT to Measure Healthcare Quality
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Canadian Healthcare Equality Meets H1N1
Your Doctor's Health Advice, Brought to You by Coke
Published November 06, 2009 @ 06:00AM PT
We are on the eve of a historic House vote for a healthcare reform bill that, while it addresses some healthcare issues, carefully avoids the profit elephant in the sector. Now would be timely for another exposé, yes? This time it has nothing to do with greedy insurers. No, the latest absurdity comes straight from those who generate the vast majority of healthcare charges. Lo and behold, a sugar-sweetened baby elephant just turned up in your doctor’s office.
The American Academy of Family Physicians recently announced a six-figure deal with Coca-Cola Corporation. The alliance deals with (of all things) consumer educational materials on soft drinks for the AAFP health and wellness website. AAFP CEO Douglas Henley of course assures us that the deal won’t affect family physicians’ public health messages. I’ll bet.
Harvard nutrition expert Dr. Walter Willett begs to differ. He says the AAFP has muzzled itself when it should be a vocal critic of products like Coke. Sodas “cause enormous suffering and premature death by increasing the risks of obesity, diabetes, heart attacks, gout, and cavities.” Well, cigarettes have similar negative public health effects, and that didn’t stop paid physicians advocating mild cigarettes as safe in 1960s advertisements.
Fortunately this time there has been more outcry. Twenty-one doctors near San Francisco resigned their AAFP memberships in protest. Another 22 health specialists sent a protest letter to Henley urging him to abandon the Coke deal, as they question the safety of artificial sweeteners and feel the AAFP should be strongly speaking out against sugary drinks.
Coke spokeswoman Diana Garza Ciarlante says all this criticism "misses the point of the partnership which is to provide education based on sound science." Yep, just like the Healthy Choices program was all about promoting healthy eating via Froot Loops. The AAFP’s president-elect Dr. Lori Heim confirms it: the idea is to “to develop educational materials to help consumers make informed decisions so they can include the products they love in a balanced diet and healthy lifestyle."
All of this is pretty ironic, given the latest Commonwealth Fund study released. The survey of over 10,000 primary care doctors in 11 developed countries (US, Australia, Canada, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden and the United Kingdom) again repeated that the US spends more than twice what other countries do, while lagging on quality measures. But more specifically, it found cost and access to care were the major primary care barriers in the US – 58% of doctors say their patients struggle to pay for medications and care.
So why doesn’t the AAFP suggest Coke sponsor medication subsidies, health fairs, or free health clinics? It could hand patients free samples of new Coke Zero on their way out the door. I guess that wouldn’t send the same subliminal “AAFP wants you to incorporate Coke products into your diet” message as educational pamphlets. I keep forgetting, it’s about profits, not health.
Photo http://farm4.static.flickr.com/3632/3559771258_5bac2c6891.jpg // CC BY 2.0
Army of Women Aims to Eradicate Breast Cancer
Published October 29, 2009 @ 06:00AM PT
Perhaps you haven’t heard of the Army of Women. The name may strike fear into the hearts of some men, and indeed these women are on the warpath. But their object of destruction isn’t the opposite gender; in fact this group actually includes men within its ranks too. Confused? Let me explain. The Army of Women aims to eradicate breast cancer by changing the face of breast cancer research. In fitting celebration of Breast Cancer Awareness Month (though football players wearing pink is nice too), this group dedicates itself to two revolutionary principles:
- Representing ALL women in studies so results apply to all women, and
- Studying prevention techniques in addition to treatments.
Yes, those are ambitious goals. To meet them, the Army of Women’s current target is to reach 1 million men and women. This joint partnership between the Dr. Susan Love Research Foundation and the Avon Foundation for Women encourages both healthy people and those already touched by the disease to join ranks and spread the word.
What are they looking for? Women of every age, ethnicity, and breast cancer risk, as well as male breast cancer survivors who want the life-changing opportunity to directly impact breast cancer research. This non-profit venture allows you to partner with scientists and participate in research studies, so you can help determine how breast cancer starts and how to stop it for good.
Better even than early detection, prevention is key. As our Change.org community is well aware, fighting a severe medical issue is just the beginning -- fighting the US "profits over care" system is the 10,000 pound gorilla in the room. The harsh dose of reality in the video below, courtsey of non-profit Talking Eyes Media, follows Sheila Wessenberg through her uniquely American breast cancer journey. It manages to expose just about every fallacy the enemies of reform like to spread, from supposed safety nets to the horrors of socialized medicine. Be sure to watch the whole thing, the punch line is near the end.
Join the Army of Women against breast cancer today, and spread the word. Your physical and financial health, as well as that of your sister, mother, daughter, or granddaughter may depend on it. Take action to prevent and effectively treat breast cancer.
Photo http://farm4.static.flickr.com/3223/2929895042_cc70ea63e1.jpg // CC BY 2.0
Pay For Performance: Why You Should Care (Part 3 of 3)
Published October 27, 2009 @ 06:00AM PT
Part 3: What IS That Noise?
In Part 1, we introduced P4P and mentioned some loud screeching that now accompanies it (that’s Screech up above, by the way.) In Part 2 we showed you how to use its basis, quality measurements, to get better care regardless of where you live. But now back to the noise. As we know, the healthcare industry is notoriously resistant to change. The entrenched M.O. is to sit back, wait for it and reactively dig in heels -- with as much sensationalism as deemed necessary. Healthcare leaders know reform strategies have been studied and generally talked to death for the last 16 years. Still, most resist forcefully when innovation stops being voluntary and is instead mandated. Enter Massachusetts, stage right.
In 2005, it became the first state to require health insurance coverage for all residents, with hardship exceptions. Massachusetts is now drowning in healthcare costs. Its residents are covered and 70% of doctors support the program, but the great fee-for-service “quantity over quality” healthcare juggernaut rolls on. It’s time for step 2: rein in those costs with a combination of global payments and P4P – secret code for payment based on quality, coordinated care.
Pay for Performance: Why You Should Care (Part 2 of 3)
Published October 20, 2009 @ 06:00AM PT
Part 2: Empowered Patients
Last time we dug into what P4P actually is. Today we'll give you the P4P tools to become an empowered patient, and introduce you to their quality metrics basis. This will allow you to pay for quality versus average or sub-par care.
Ready? Quick! You’re having a heart attack. Your family called 911, and now the paramedics are asking which hospital you want to go to. How do you know? Your life may depend on it.
Limited Time Only: Own a Very Personal Part of Health Reform
Published October 16, 2009 @ 01:00PM PT
Today I come bearing an olive branch to those who don’t consider themselves pro-healthcare reform. It’s a chance to be a part of healthcare reform you CAN believe in, whatever side of the political aisle you call home. Don’t worry, I’m not abandoning the heart and soul of Change.org’s Healthcare forum – this one’s for all of us pro-reformers too.
Many of us celebrated the sea change of HIPAA privacy rules becoming law back in 2003. It meant that for the first time, our personal health information belonged to us (we owned it) while providers kept custody. But there was an important exception – the law still says your test results do not belong to you. It is still illegal for a laboratory to give test results directly to you, the patient, if you request them. The only way to get them is through your provider.
Pay For Performance: Why You Should Care (Part 1 of 3)
Published October 16, 2009 @ 07:00AM PT
Part 1: What Is It?
Earlier this year, amid all the yelling, name calling and finger-pointing, there was a small quiet force moving through US healthcare. It was the early adopter crowd of doctors, hospitals and health systems, girding up to become providers of coordinated, quality, and evidence-based care. I called this little-noticed movement the Silent Revolution. That loud screech I'm now hearing is the revolution reaching the mainstream.
We’ll get to the noise in Part 3 of this three-part series. First, today we’ll dig into what Pay For Performance (P4P) actually is, and in Part 2 we’ll look at how it can empower you as a patient.
School Nutrition Takes Two Steps Forward, One Flight Back
Published October 11, 2009 @ 09:00AM PT
Parents, rejoice. A news flash this week brought happy tidings on the school front of the childhood obesity battle. But if you blinked, you missed it. The other tidbit that came out, well, hopefully your kids missed it.
First, the CDC reported that significantly fewer high schools and middle schools are selling sugary and salty snacks to students. Comparing schools in 34 states between 2006-2008, the median proportion selling soda and other sugary drinks dropped by almost half, from 62% to 37%; candy and salty snacks dropped by a third, from 54% to 36%.
The best news is that the fattest states made the most progress. For example, Missippi soda-sellling schools dropped over two-thirds, from 78% to 25%. Of course, the study didn't tell us whether kids were just going down the street to the 7-11, Circle K or Qwik-e Mart.
Then comes the surprising news that military pilots fly better on fat. No, the Healthy Choices folks aren't at it again (besides, they claimed Froot Loops were better than donuts.) The military funded this study. They enlisted University of North Dakota researchers to track 45 student pilots and determine how the foods they ate affected their flying proficiency. In challenging maneouvers, turns out the high-fat buttered lobster trumped both high-carb pizza and high-protein chicken breast salad. Though all the students loved brownie day best (presumably the ones who got frosted ones performed better than those who got the small plain ones.)
Fortunately this was only a preliminary study, so schools shouldn't start stocking up on bakery items and downhome cooking staples. And the researchers were very clear that it wasn't aimed at weight control. They also didn't monitor the exact diet composition, and UCLA physiology professor Fernando Gomez-Pinilla reminds us that saturated fats have typically been found to reduce cognitive performance.
But the UND camp did theorize that perhaps because the pilots were young, they were able to absorb a lot of fatty acids for brain development. That's some instantaneous brain development! Meanwhile, if you're boarding a flight bound for rough weather, you might ask your pilot if s/he had biscuits and gravy before entering the cockpit.
Photo wwarby // CC BY 2.0
