Dr. Blascke's lectures and readings

Hello all:

I trust you enjoyed Dr. Blascke's lecture on Qualitative Research. Just a reminder that he has assigned two articles to be read by next week's lecture: Pediatric Residents' and Continuity Clinic Preceptors' Perceptions of the effects of Restricted Work Hours and Their Learning Relationship and Why do Parents bring Children to the Emergency Department for Nonurgent Conditions: A Qualitative Study. Also, don't forget to complete the discussion questions for each article.

If you are missing any articles or did not receive an email with Dr. Blaschke's PowerPoint presentation slides attached, please email me at sdelmar@ucsd.edu, and I will email them out to you as soon as possible. Otherwise, enjoy the reading and we will see you all in class next week.

PRIME HEq class starts tomorrow

Hello everyone:

My name is Stacey and I am Dr. Broyles new assistant for both the CRCHD program and for the PRIME HEq class. Just wanted to send out a reminder that PRIME HEq will begin tomorrow, Thursday, April 2 and will run from 3:00 to 5:00 pm. Class will be held in building #301, room #136. Please remember to bring your add cards.

Dr. Broyles is looking forward to seeing you all tomorrow in class, and we are both looking forward to working with you this quarter.

Stacey Delmar
Program Assistant
Comprehensive Research Center in Health Disparities (CRCHD)

Socio-economic Background Affects Brain Function

Hey all.

Here's an interesting article from BBC, talking about a study performed at Berkeley that tested the brain function of kids from both low and high socio-economic backgrounds. Turns out that kids from low SE families did not process information in their brains as well as those from higher SE backgrounds.


"This is a wake-up call - it's not just that these kids are poor and more likely to have health problems, but they might actually not be getting full brain development from the stressful and relatively impoverished environment associated with low socioeconomic status."

http://news.bbc.co.uk/2/hi/health/7762492.stm

Researchers think this lower performance may be because these children were not spoken to as much by adults as they developed.

NY Time Article

Yes, this is a bit late....

I came across this article in the Times: Finding a Voice to Match the Pressing Medical Needs of Hispanics.

It is an interesting story about a Latino community that rallied together and compelled their governor to give fully fund a program which institutes interpreters in medical facilities.

Certainly a step in the right direction--Yay :)

Impoverished HIV Patients in California

Hey Everyone,

This just came out today in the LA Times about California's health care system for poor patients with HIV:

http://www.latimes.com/features/health/la-me-hiv5-2008dec05,0,6358115.story

In 2002, Governor Gray Davis signed a bill into law that would make Medi-cal more accessible to low-income HIV patients.

Unfortunately, California's Department of Health Care Services failed to take the mandated steps to put the law into action.

Now, a LA County Superior Judge has decreed that Governor Schwarzenegger's administration has not fulfilled it's obligation to enact the law.

The intent of the law was to cut the costs of AIDS care by switching patients from expensive fee-for-service systems into managed care. The savings would then be used to extend Medi-cal coverage to more poor HIV patients.

A spokesperson for the Department claims that the increased cost of care could not be resolved by the proposed changes. However, instead of looking at other strategies for making the changes successful, it seems that the program was just abandoned.

It is disappointing to see our Department of Health Care Services giving up so easily on a project that could pave the way for more universal coverage. It's hard to say how much analysis or effort they put into the situation from reading just one article, but it would be nice to see some inspiring dedication and creative efforts put into something that is this important. If anyone has any insight on what went on behind the scenes, I'd love to know!

Nicole

Quick update: Obama & changes to U.S. healthcare!

Quick summary of Obama's recently announced plan here: I can't get the URL to work, so just go to news.google.com and type in "FACTBOX: Obama's ambitious healthcare plan"

My favorite points of the plan are:

-- Stop insurers from denying coverage based on pre-existing conditions.

-- Obama says he can reduce healthcare spending by 8 percent and save each taxpayer $2,500.

-- The Lewin Group, a consulting firm, forecasts the Obama proposal would raise federal spending by $1.17 trillion from 2010 through 2019. (From wikipedia: "In 2007 the U.S. spent $2.26 trillion on health care")

(Quick side note: The Lewin Group conducted a study on the single payer CA Bill SB840 showing that a single payer system would SAVE (versus increasing spending) $8 billion in the first year. Savings are because you decrease the insurance companies' 25% administrative overhead to the 4% Medicare admin overhead. Check it out here: http://www.healthcareforall.org/studies.html)

-- A National Health Insurance Exchange to help people buy private insurance, act as a watchdog and create standards

-- Tax employers who do not provide coverage.

-- Small business tax credit to help pay for employee health insurance

-- Require healthcare for all children, expanding Medicaid & SCHIP to cover poor children

If the U.S. really can get insurance companies to take everyone, regardless of pre-existing conditions, that would make a big difference and would make us more like Germany, which you can watch a 10 minute Frontline video about here: http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/

Health Care Reform Reveals Doctor Shortage

Hi everyone,

It seems that every time time I read the news I encounter a new article about the need for universal health care. Just today, I was reading about former Senator Tom Daschle, Obama's nominee for Secretary of Health and Human Services, who has plans to hold holiday-season house parties to brainstorm over how best to overhaul the U.S. health-care system.

One subtle aspect that is not being openly discussed is the fact that health insurance does not necessarily guarantee health care access. To prove this point, I just saw an article in the New York Times that relates a new crisis facing Massachusetts universal health care reform: the lack of primary care physicians to provide care for all the newly insured. The article stresses that what has happened in Massachusetts has put " a spotlight on the workforce shortages that don't get meaningfully talked about in just about any other other state." The main point is that Massachusetts is the first to encounter a problem that will confront other states as more people are able to afford/receive health insurance. People will have insurance, but who will accept them as patients? Unfortunately, this is a problem that promises to particularly affect poor and underserved communities.

Why the decreased interest in primary care? Why are so many existing primary care physicians disenchanted? Among the issues highlighted in the articles are high student-loan debt and poor compensation/reimbursements by insurance companies, Medicaid and Medicare for primary care visits--no one pays for the time it takes to fill out enormous amounts of paperwork, take on the insurance companies on behalf of patients or to write sick notes to employers.

What to do to change this situation? As one article states, "the solution is ultimately political, since it requires making sure that our enormous public investment in medical care goes where it will do the most good."

You can take a look at the following articles I just referenced at:
http://www.nytimes.com/2008/04/05/us/05doctors.html?pagewanted=1&sq=primary%20care%20physician%20shortage

http://seattletimes.nwsource.com/html/opinion/2002895859_rosenblatt29.html

http://www.npr.org/templates/story/story.php?storyId=97620520

All the best,
Rosa