Tuesday, June 19, 2012

It's All About the Supremes - Almost

Supreme Court fever has hit hard.  You can't read a paper anywhere without seeing an article about what may happen depending on what the Court does.  WaPo's health care page is now a full page of links about the Supreme Court case.  Politico has a series of videos -- Congressman Gerry Connolly thinks the Court will strike down the law due to partisan politics rather than principleMother Jones appears to agreeHuffPo warns there will lots more litigation ahead if the law survives the Supreme Court's ruling. 

Of course, there already is a mandate -- the requirement that emergency rooms care for anybody who shows up in need of care, regardless of ability to pay.  We, the taxpayers, pay for that when people are unable to pay their bills.  So really, would you rather keep paying this bill rather than making people pay their own way by carrying health insurance?  It's trading one mandate for another -- and I'd just as soon the people who currently aren't contributing be required to contribute by buying health insurance -- with subsidies if they can't afford it.  I'm telling you -- if the American public ever figures all of this out, they're going to be mighty unhappy with the conservatives who only told them part of the story about the mandate.  Polls show Americans are going to be unhappy with the Court's ruling.  If think they'd be even less happy if they really understood what was at stake.   As HuffPo explains, many Americans, including the uninsured, don't really understand what they would be losing if the Court struck down the law.

What happens when you require coverage of pre-existing conditions without also requiring that everybody buy insurance?  Washington state's story suggests one such outcome.  If the Supreme Court strikes down the individual mandate but leaves the rest of the law, the task will be coming up with alternatives to a mandate.  With all the creativity and smarts we have working on this issue, I'm sure we'll find something -- if the Court gives us the chance.

What will the GOP do if the law is struck down?  Allow people to buy insurance across state lines (so you lose the legal protections that exist in your home state).  Tort reform -- because medical malpractice cases are the true evil that's driving up health care costs (please read sarcasm here).  Block granting Medicaid -- let the states do what they want with federal dollars, which kills the poor in some states. 

A bill that would have tightened controls over narcotic pain meds has failed -- and in my eyes, that's a good thing.  What lawmakers don't get is that these controls -- already in place in some states -- are making legitimate chronic pain patients feel like criminals.  I have one client who tried to kill herself after being made to feel guilty and ashamed when she went to the pharmacy to refill her prescriptions.  Before legislators act, they need to figure out a way to protect legitimate pain patients in the process.

Patients with HIV are more likely to have heart attacks and other cardiac issues, and they have them earlier in life than the rest of the population.  HIV causes inflammation, which causes clots and heart attacks.  Message: Get screened for heart disease early and often.

Do you assume the doctor is a "he" rather than a "she?"  Fifty percent of medical school students are women, so it's time to break through this stereotype and leave it behind.

We know bacteria are not all bad.  So how to we get rid of the bad without also killing the good?  Medicine is starting to ask this question -- and that's a good thing.  We know that people don't get Crohn's disease in the East anywhere near as much as we get it here in the West.  The theory has been that part of the problem is the super-cleanliness obsession we have here in the West.  We've killed off a lot of good bacteria.  I hope we can figure out a way to undo that damage.

Those of us who exercise regularly do it not to lose weight or stay heart healthy -- we do it because it feels good.  True -- I loved my morning swims.  So what happened?  Long story.  Like everybody else's long story.  Somehow, I have to find a way to exercise despite working 15 hour days.

Seniors who are lonely suffer more health problems.  This is one of the issues I just don't get.  I crave my alone time.  I can't imagine getting lonely.  After all, there's always Emily (my cat).  But for some, loneliness can be a killer.  I suppose it's more difficult as you age and can't get out and about as easily.

Electronic medical records help Health Departments track epidemics.  This is a great benefit of EMRs that I hadn't thought about.

More hospitals have policies to protect gay patients.  We've all heard the heart-breaking stories, partners kept from their dying spouse's bedside, not being allowed to make medical decisions, not even being allowed to visit.  So it's great that hospitals are coming around.

You go to the hospital and the doctor realizes you need food or a place to live and writes a prescription, which you take to a volunteer, who finds you the prescribed services in the community.  How cool is this?  It's called Health Leads and it's staffed by college students.  What a wonderful program!

Large employers are increasingly creating on-site health clinics.  It keeps workers productive and healthy.  But does it mean your employer knows more about your health than it is entitled to know?

And that, my friends, is a very long blog post for today.  Have a great day!  Jennifer

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