Friday Five: Veterans, birth, ACA, Politifact, #HealthPolicyValentines

It's back by popular demand! (Okay, maybe only Carmen asked if I was ever going to write another Friday Five, but she's so awesome that she counts as at least ten people.) Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week. Obama signs vet suicide prevention act Yesterday, President Obama signed the Clay Hunt Suicide Prevention for American Veterans Act, legislation aimed at improving the VA’s mental health care and removing barriers that prevent veterans from seeking treatment for mental health conditions. Death by suicide is particularly high among veterans over age 50. While their wish to end their lives may not be directly related to their service, the VA has a responsibility to care for veterans who qualify for VA care and are in need of it. The VA is notoriously problematic, and I hope that the newly-required external audits built into this Act will keep it accountable. After asking them to do what nearly every other American refuses to do, we continually fail our veterans--this Act is just a fraction of what they deserve.

Birth: Home versus hospital A short literature review by Dr. Rikki Lewis reveals interesting findings about the complexities and controversies surrounding home birth.

  • In the US, home births increased by 29% between 2004 and 2009.
  • Among studies investigating the risks and outcomes of home birth, there is little consistency in patient selection and the necessity of reporting infant deaths after transport to the hospital means that those deaths are reported as hospital deaths rather than deaths at home.
  • Policies for deciding to take a woman laboring at home are much clearer in the United Kingdom than in the US.
  • Home births are far less expensive than hospital births, which average about $20,000.

As the hospital versus home birth debate continues, it will be important to use correctly interpreted research as the basis for argument.

ACA open enrollment ends on Sunday The last day to sign up for insurance through the Marketplace is Sunday, February 15. According to the awesome website ACAsignups.net 10.5 million people have already signed up. Originally, the Department of Health and Human Services estimated that 13 million people would receive coverage during the open enrollment period, but later readjusted the estimate to between nine and ten million. If you need insurance and haven’t signed up, do it now...don’t procrastinate! (Also, can we take a moment to wonder why the “marketplace.gov” doesn’t redirect to healthcare.gov? Missed opportunity!)

 

Politifact takes on measles and vaccines One of the best, most useful sites ever, Politifact, evaluated the truthfulness of public statements about measles and vaccines. While their website could use a redesign to make articles like this one easier to read, the information they’ve provided is really valuable. They’re successful in debunking the “vaccines have mercury” claim and Rush Limbaugh’s accusation that Obama’s immigration policy allowed measles to enter the United States through Mexico. Politifact also highlights some of the true statements made by Megyn Kelly and other cable news pundits. While you’re reading their website, take a look at their ratings of statements about health care in general.

Health policy nerds love bad jokes Valentine’s Day isn’t only about romantic love. It can also be a time for you to express your deep, abiding passion for one of the nerdiest arms of public health: policy. Back in 2011, Emma Sandoe started the hashtag #HealthPolicyValentines so we could enjoy gems such as:

and

Groan worthy? Maybe, but totally great anyway.

Have an awesome Friday. I'll be back here tomorrow with a Valentine's Day-themed post!

Friday Five: Lea-Ann Ellison, antibiotic resistance, apps, medical marijuana, adorableness

Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week.  

Surprise! Lifting weights while pregnant is controversial

Americans do a great job of finding reasons to criticize women, especially when it comes to reproduction and motherhood. This week, we were subjected to a wave of judgment about Lea-Ann Ellison, who has the audacity to lift weights while 33 weeks pregnant. She says her doctor is fine with her exercise. Pregnant women are told to continue being active, and that’s exactly what she’s doing. If her doctor—not the ones quoted by media outlets—deem her exercise intensity level safe, then we should butt out.

 

Antibiotic resistance is going to be a big problem

A first-of-its-kind report from the CDC on the status of antibiotic resistance classifies 18 microorganisms as “urgent,” “serious,” or “concerning” in their ability to fight antibiotics. The list includes everyone’s favorite infections: gonorrhea, typhoid, and tuberculosis. Antibiotics are one of the most important reasons our life expectancy has grown, and losing the ability to kill bacteria will certainly mean more severe illness. This is a great opportunity for primary prevention (preventing illness before it starts); strategies such as advocating for condom use, safe food handling practices, and vaccines will be necessary. Meanwhile, doctors should be discerning about prescribing antibiotics, and we must invest more money and effort into developing new drugs.

 

Now some apps will come with an “FDA approved” message

The FDA has made its final decision about which mobile health apps it will regulate. It is focusing on apps that could cause significant risk to users if the app does not function correctly. Apps that allow the user to check blood glucose levels or turn the phone into an ultrasound machine could be game changers for providers and patients. However, when I looked for these apps on the iTunes store, I couldn’t find any. Is this because they won’t be released until after the FDA approves them?

 

Egg Harbor dispensary is set to open

The long-awaited South Jersey medical marijuana dispensary run by the Compassionate Care Foundation is set to open in just a few weeks in Egg Harbor. Sales will be by appointment only and the building cannot have any illuminated signs, ostensibly to reduce the inevitable interest of recreational users. Interestingly, the non-profit Compassionate Care Foundation will have to pay federal income taxes because the federal government does not recognize its non-profit, leading to a projected cost to consumers of $400 per ounce, with a limit of two ounces per month. Could the rules and restrictions placed on the Egg Harbor dispensary be a model for regulating dangerous yet legal painkillers? We have a lot to learn from the state-by-state legalization of marijuana, and I’m interested to see how this evolves.

 

Adorable Care Act. That’s right. Adorable.

The Adorable Care Act has stolen my heart. These animals are just too damn cute. And they’re advocating for the Affordable Care Act on Tumblr and Twitter? Oh man, sign me up for insurance right now. Observe these baby animals that I poached right from the Tumblr:

This kitten is so excited she can stay on her parents' insurance for a few more years.

adorable_care_piglet

Friday Five: Creepy Uncle Sam and Generation Opportunity

This week, the fantastic Phoebe Jones sent me a link to troubling new anti-ACA ads. I got so riled up that this week’s Friday Five is all about Generation Opportunity. Take a look.

http://www.youtube.com/watch?v=R7cRsfW0Jv8

http://www.youtube.com/watch?v=djCftQGTMC8

Of course, I jumped head first into the Generation Opportunity wormhole after seeing those two gems. And lovely readers, I saw some scary things down there. These are five of the more remarkable bits from their sites.

This is how insurance works! The healthy subsidize the sick—and the healthy tend to be young. Unless, of course, you’re insulated from the full cost of your premium because you’re one fortunate enough to be one of the less than 60% of Americans who get their insurance through their employer.

There is no Obamacare insurance. You cannot purchase something called “Obamacare.” We’re still going to dump money into the pockets of health insurance companies, only now they can’t screw us over quite so often. (Pardon my language—you should see my notes for this post.)

This has been debunked for a while now. I just don’t even know what to do with this other than say This Is Still Not True.

That’s all the page says. There’s honestly nothing else on it but the header and sidebar. I’m interested to know what Generation Opportunity means by this—will Obamacare judge quality, quantity, or some mix of both? Is there extra credit?

I would like more information about this important topic. But I sense that Generation Opportunity has a slight obsession with sex and yet can’t quite get their thoughts together about how to link what it loves (horizontal mambo) with what it hates (the Affordable Care Act) and that’s why this page is blank as well.

I’m highlighting the misinformation and combative headlines because we will be able to purchase insurance through the Marketplace (aka websites, phone calls, and paper applications) starting on October 1. This is a big day for the Affordable Care Act, and we will see all kinds of insane stories about how everything is going wrong. We have to remember that many of the reports will be blown out of proportion or just false…but some of the problems will be real. Things will be be rocky for a while. That’s what happens when you make big changes.

One final note: Just to be clear, you cannot purchase something called “Obamacare.” It simply doesn’t exist. If you have health insurance, it will be through Medicare, the VA or other federal programs, Medicaid, or private companies such as Aetna and Coventry. One more time: A plan called “Obamacare” does not exist.