Monday, August 13, 2012

Monday Already?

Aw, c'mon.  Tell me it's really Sunday and I have another day off -- please?  Oh, well.  I guess I have to deal with the reality of Monday morning.  So here goes.

As you know, Mitt Romney chose Paul Ryan as his VP choice.  Kaiser Health News put out a special Saturday edition in their honor, so here are the health care basics of Paul Ryan's views.  The big deal is how he proposes to change Medicare to a voucher system.  More here.  And for me, here's the most important take-away.  Paul Ryan is a fan of Ayn Rand's -- as WaPo says, the virtue of selfishness.  In many ways, the coming election will be about selfishness vs. compassion.  Are we a country that cares for its most vulnerable, or is it every man (I use the masculine deliberately) for himself?  Here's an essay that looked at Romney's view of the poor even before the Ryan pick.  It's a stark contrast that will say a lot about our country.  For the sake of those who call me with nothing less than tragic circumstances, I hope this comes out right. 

This is a little complicated but since I try to keep you informed, let's see how it goes.  The health reform law says you can buy insurance -- with subsidies -- through the exchange unless you have "affordable" insurance through your employer.  The IRS interprets "affordable" to mean individual insurance, not family insurance.  So if your self-only coverage is "affordable," you have to buy it, even if your family coverage is not.  Members of Congress are appealing to the administration to fix this in regulation.  This could leave people without an affordable option. 

Laws permitting assisted suicide in Oregon and Washington were opposed on the ground that poor people would be forced to kill themselves, depressed people would kill themselves prematurely -- that all kinds of wrong decisions would be made.  It's turned out to be quite the opposite.  The assisted suicide laws have been used properly and sparingly, and mostly by white, educated, and financially comfortable

Is gun violence a social disease?  Yes, say doctors, and we need to approach it like a public health problem.  Host factors -- what makes someone more likely to shoot?  Product features -- what makes which guns the most dangerous?  Environmental risk factors -- what conditions allow for or give rise to shootings?  Disease patterns -- how does the problem spread?  Why not ask these questions about guns?

More than 2200 hospitals will be penalized by Medicare for unacceptably high rates of readmissions.  The point here is that hospitals have to do a better job of discharge planning to make sure patients have the care they need when they leave the hospital so they won't be readmitted.  Hospitals that serve the poor will be hardest hit.  Do the community-based resources exist for the poor? 

That's it for this morning.  Have a great day, even if it is Monday.  Jennifer

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