Action Phase Podcast Episode 18

health insurance marketplaceOn this episode, I sit down with Nancy O’Connor, Regional Administrator for CMS Region 3. We talk about why people without health insurance really need to get some ASAP, why Medicaid expansion is really important, and that if you already have health insurance, you can sit back and relax. Remember: the health insurance Marketplace closes March 31! If you’re visiting for the first time via The Public’s Health, welcome! I hope you enjoy the show.

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As always, you can stream it here, too.

https://ia601202.us.archive.org/13/items/18-NancyOconnor-ActionPhasePodcast/18-NancyOconnor-ActionPhasePodcast.mp3

Friday Five: Marketplace, Olympians’ teeth, Wikipedia, sprinklers, McDonalds

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

The Health Insurance Marketplace is open for business

The day is finally here: the Health Insurance Marketplace is open! I’d hoped to poke around a little and report on what I saw, but the site is so busy I haven’t yet been able to get past this page:

alot_of_visitors

The fact that the site has been overloaded with visitors for the past four days shows us that we are ready to buy insurance and are on board with the Affordable Care Act. We’ll still have to work through some bugs, I’m sure, but I’m glad to see so many Americans are excited about this new option. Once I get past the waiting page, I’ll be sure to let you know how things work in the Marketplace.

Brush and floss twice a day…even you, Olympians!

According to a study just published in the British Journal of Sports Medicine, athletes competing at the 2012 London Olympics who visited the athlete’s village dental clinic had surprisingly bad teeth. Of those people examined, 55% had cavities, 45% had lost some tooth enamel, 76% had gingivitis, and 15% had periodontitis. A full 40% of athletes were “bothered” by their oral health, and 18% admitted their dental problems caused issues with training and athletic performance. While we hold up these Olympians as paragons of health and fitness, their teeth tell us another story. Oral health is an indicator of overall health, and perhaps focusing intently on training is leading them to disregard other important aspects of their health.

Earn credit for editing Wikipedia at UCSF medical school

The medical school at University of California, San Fransisco (UCSF) is offering a unique course to its fourth year students: editing medical Wikipedia articles. They are working with Wikiproject Medicine to add citations and increase the accuracy of the 100 most popular medical articles on Wikipedia. Health care providers use Wikipedia often, and medical students have an abundance of information—so it makes sense for the students to contribute their knowledge for the good of site they’ll use frequently in their practice. UCSF is the first medical school to link Wikipedia’s education goals with course credit. Hopefully, the combined knowledge of the nation’s medical students can be used to help all of us understand the details of razor burn (the #1 most-viewed medical page).

Nursing homes need sprinklers

Medicare and Medicaid require all new nursing homes or additions to a nursing homes to have automatic sprinkler systems. Older nursing homes did not have any regulation regarding fire suppression or sprinklers until August 2008, and they were given five years to comply with the rule. Now that those five years have passed, approximately 1000 facilities have “partial” systems, and about 125 have no sprinklers at all. Considering nursing home residents often have mobility issues, an uncontrolled fire in one of the facilities would be devastating. If you know of a nursing home that does not have a proper sprinkler system, I suggest calling CARIE (I did my summer internship at CARIE; they’re wonderful) and talk with the ombudsmen there to help ensure the safety of the residents.

Happy Meals just got a little happier

This week, McDonalds announced major changes to its menus—value meals can now be accompanied by salad, fruit, or vegetable in lieu of fries, Happy Meals will no longer be promoted with soda but instead with milk, juice, or water, and advertising and packaging for children will encourage wellness and good nutrition. The changes will be made in McDonalds’ 20 major markets across the world, which comprise 85% of global sales. The most important part of these changes is the addition of choice. Adults and children alike will be able to choose salad instead of fries, water rather than soda. Having these choices available—and encouraged—will help fulfill the public health goal of making the healthy choice the easy choice.

Friday Five: sterilization, pain robot, brains, surgeons, Sharknado

Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week. Rural women are more likely to be sterilized

Tubal ligation, also known as sterilization or “getting your tubes tied,” is far more common among rural women as compared to urban women. Of rural women, 23% said they had been sterilized; urban women, 13%. There is only speculation about why this difference exists. Some of the theories floating around are: less access to other forms of birth control; piggybacking tubal ligation onto post-partum Medicaid coverage; lower educational level. Importantly, 39% of those rural women regret their decision. We should be asking why they didn’t choose a long-term, reversible birth control such as an IUD or an implant (like Implanon) instead.

Somewhat cute robot helps reduce kids’ pain and suffering during injections

As a needle phobic myself, I was very excited to learn that there’s an innovation in helping kids’ distress during shots. The robot not only talks to the child in order to distract him or her from the scary needle, but encourages exhalation during the injection to help with muscle relaxation (video here). There are two reasons why reducing pain and anxiety for children receiving immunizations is important: excessive worry can make other parts of the exam difficult, and in the future, an adult who had a bad medical experience as a child may be more likely to avoid care. These both have significant health implications. If this robot can help, I say let’s get one in every pediatrician’s office—and maybe in internist’s offices too, for ‘fraidy cats like me.

Brain pathways involved with learning and changing behavior charted

This week the NIH published a study identifying neural pathways associated with learning and changing behavior in mice. The nerves associated with the switch from moderate to compulsive drinking were found to also have a role in learning and decision making. Researchers hope that their insights will be helpful in understanding alcoholism and addiction. Learning more about why some people can use substances in moderation while others become addicted is crucial to improving mental and physical health. Hopefully, these findings will also apply for humans.

Surgery residents operate less often under new rules

Medical residents (doctors who are done with medical school and are completing their practical training) work notoriously long shifts and even longer workweeks. Restrictions created in 2011 limited shifts to 16 hours for first-year residents and 28 hours for the more advanced doctors and everyone’s week is limited to 80 hours. Surgical residents have in turn participated in fewer hours of surgery because of the limits on working hours. Many doctors are concerned that this will put the budding surgeons at risk for not gaining enough experience. There has to be a balance between allowing doctors to get enough rest while also learning enough to practice on one’s own—the question is, how

Kathleen Sebelius may in fact have a sense of humor

Twitter blew up last night with references to Sharknado, a horribly wonderful movie about a tornado that blew sharks into a city. (I don’t know how that works, I didn’t watch it!) Buzzfeed immediately wrote an article claiming “There is no Obamacare coverage for pre-existing Sharknado injuries.” Kathleen Sebelius replied: https://twitter.com/Sebelius/status/355766513334108160 Hey, an ACA joke!

I leave you this weekend with an excellent infographic explaining pretty much everything you need to know about gender, sexual orientation, and the like…The Genderbread Person!

Genderbread-Person

Friday Five: Sarah Murnaghan, Plan B, Arizona, wildfires, mindfulness

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

Follow up from two weeks ago: Sarah Murnaghan got new lungs! After a judge ruled that she must be added to the top of the adult transplant list, Sarah was matched with organs within days. The Murnaghan family will now step out of the public eye and, as Sarah’s mother says, they will be “focusing all of [their] attention on Sarah” as she recovers from surgery. Sarah is not the only one to benefit from her family’s perseverance—11 year old Javier Acosta was also added to the list. This judicial intervention will certainly inspire ethical debate about who can get which organs, and hopefully children’s lives will be valued as much as adults’.

 

Judge Korman: New hero of reproductive rights?

After the Obama administration finally dropped its appeal of Judge Edward Korman’s ruling that all products containing levonorgestrel be made available over the counter, the administration decided to make available only Plan B One Step (containing just one pill rather than two). Korman is not happy about this. Plan B One Step is manufactured by Teva, and if it is the only emergency contraceptive authorized to be sold over the counter, Teva will be able to set its price and have no competition. Korman argues this unduly burdens low-income women and that “it is the plaintiffs, rather than Teva, who are responsible for the outcome of this case, and it is they, and the women who benefited from their efforts, who deserve to be rewarded.” Korman also makes it clear that if the FDA or Teva drag their feet on getting Plan B One Step to the drugstore shelves, they should expect to be sued again.

 

Arizona finally decides to expand Medicaid

Despite her deep opposition to the Affordable Care Act, Governor Jan Brewer now accepts that the ACA is here to stay and that Arizona should get in on the billions of dollars available to the state. Her website even touts the Medicaid expansion as “the conservative choice for Arizona.” Imagine that: after realizing that “uninsured Arizonans get sick just like the rest of us” (because uninsured people are markedly different from the insured, of course) providing them with Medicaid would help reduce the rates paid by the insured! Brewer even denies the state is participating in “ObamaCare” by crediting former (Republican) Governor Fife Symington with coming up with the idea of the expansion in the 1990s. I’m pleased that 57,000 additional Arizonans will have access to Medicaid, but Brewer can obviously see the advantages of the expansion and yet spent months rabidly fighting the ACA…what a hypocrite.

 

Wildfires? Denver Post has us covered

Multiple wildfires in Colorado are causing serious problems for the state, and the Denver Post is taking care of business when it comes to covering the fires. It’s providing maps of the perimeters of each fire, the properties damaged, and a map of all fires across the country. There are chilling before-and-after photos of neighborhoods turned to ashes. The Denver Post is doing an excellent job of keeping people informed, spotlighting the firefighters, and reminding residents of preparedness procedures without being alarmist. With two people killed and hundreds of homes burned down, the fires are a significant natural disaster, and the Denver Post will keep us all informed.

 

Mindfulness classes in high school

Central Bucks High School East will add a new subject to its curriculum: mindfulness. Using techniques from Learning to BREATHE, the school hopes to teach students to regulate their emotions, manage stress, and strengthen their ability to focus. Central Bucks East hopes the mindfulness training will help high-achieving students feel less stressed about AP classes, applying for college, and taking the SAT while the training will also be taught in a program designed for students to learn how to live independently. Acknowledging that stress hurts students (whether they are in classes about healthy interpersonal relationships or European History) shows that Central Bucks East is trying to see its students as whole people. I’m eager to see this program evaluated—will mindfulness change test scores or graduation rates?

 

Start the weekend off right with the evolution of Daft Punk and Pharrell's new song Get Lucky as it would have sounded if it was made in the past.

http://www.youtube.com/watch?v=3r3BOZ6QQtU

 

Friday Five: Transplant ethics, Planned Parenthood, Hepatitis C, immigrants, Google

Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week. Child in dire need of lung transplants starts a debate on ethics

Ten year old Sarah Murnaghan has been waiting for lung transplants for 18 months due to her cystic fibrosis and related lung failure. Doctors say she is not likely to live past the weekend without a transplant, so the severity of her illness placed her at the top of the pediatric list. However, Sarah is on very bottom of the adult list, meaning that any adults in need of lungs will be offered the organs before her, regardless of whether or not their need is as pressing as hers. Since 2005, organs are supposed to be distributed based on need, but that rule applies only to patients over age 12. Sarah’s parents have petitioned Kathleen Sebelius to change the rules to allow pediatric transplants of adult organs based not on age but on medical necessity. Hopefully, Sarah’s dire situation will ignite a conversation on organ donation and the ethics of treating children as if they are adults. (Okay, so this is six sentences but I think it’s worth it.)

Planned Parenthood case will not be heard by the Supreme Court

Indiana tried—and failed—to refuse Medicaid funding to Planned Parenthood. The Supreme Court refused to consider an appeal on behalf of the state to allow Indiana to withhold money from Planned Parenthood because it offers abortion services, even though federal law prohibits Medicaid dollars from being spent on abortion. Hopefully, this development will stall other attacks on low-income women’s right to choose their health care providers. However, the wily anti-choice movement is probably cooking up other ways to deny services to women—Indiana already has a law in place requiring facilities that offer non-surgical abortions to meet the same standards as facilities that perform surgical abortions. The Supreme Court’s choice not to hear the appeal is important, but as usual, fighting against restrictions on this legal medical procedure is a constant battle.

Is the “war on drugs” to blame for millions of Hepatitis C cases?

The Global Commission on Drug Policy called for an end on “the war on drugs,” in part because criminalization of injection drugs has lead to a quiet epidemic of Hepatitis C. The Commission estimates that of the 16 million injecting drug users (IDUs), 10 million are living with Hepatitis C; China, the Russian Federation, and the USA have the highest rates of Hepatitis C among IDUs. Arguing that harsh drug laws dissuade IDUs away from public health efforts such as needle exchanges, the Commission recommends reforming existing drug laws and focusing on health rather than incarceration and forced treatment. While I doubt many countries will decriminalize heroin and other injectable drugs, I’m pleased the Commission is drawing attention to the broader health concerns of IDUs. Regardless of drug use or dependence, a person has a right to access public health initiatives without fearing arrest and imprisonment.

Immigrants subsidize Medicare

A study published in June’s Health Affairs showed that in 2009 naturalized and non-citizen immigrants contributed $33 billion to the Medicare trust fund and received $19 billion in expenditures, creating a surplus of $14 billion. American-born citizens, on the other hand, contributed $192 billion and used $223 billion, creating a deficit of $31 billion. There are a few reasons why immigrants’ contributions lead to surplus: there are 6.5 working immigrants for every one retired immigrant and the cost of care for immigrants is less than the cost of care for the American-born. In a time when immigration and a path to citizenship are pressing issues, focusing on the positive contributions of new residents and citizens can only help decision makers to make choices to encourage new immigration. This study reminds us that immigration is crucial to the success and longevity of the United States, and treating all immigrants with respect and dignity is non-negotiable.

Google nutrition facts and get a clear answer

This coming week, Google is launching a new search feature: type a question about nutrition facts, and it provide you with a precise answer. The screen shots look much like the results when Googling conversions from cups to liters or the definition of a word. The feature is rolling out in the United States over the next ten days, but it shown up yet in Philadelphia so I haven’t been able to give it a try myself. Having the ability to ask direct questions about the nutrient content of food helps demystify some of the complicated information about healthy eating. This is health communication done right!

If you're looking to change up your workout routine this weekend, may I suggest Prancercise?

http://www.youtube.com/watch?v=o-50GjySwew