Health Care 101: A consumer primer on Obama's bill

Recent health Articles, Events, Jobs, and Resources.

CONTENTS

1. Article: Health Care 101: A consumer primer on Obama's bill
2. Article: How would health care overhaul help young people?
3. Article: Nursing covering more health care
4. Article: Chief Rubin says EMS isn't broken -- despite total failures
5. Article: Project to get transplant organs from ER patients
6. Article: Despite probe, prescription drug abuse worsening
7. Article: Women on birth control pill may live longer
8. Article: New fitness center brings a SPIRIT of wellness to Southeast
9. Article: Allergy sufferers journey into the season of symptoms
10. Article: Dry cleaning uses toxic chemicals, but safety is unclear
11. Article: Professionals face taxing times
12. Commentary: Health reform passes the cost test

ARTICLE SUMMARIES

1. Article: Health Care 101: A consumer primer on Obama's bill
By Ricardo Alonso-Zaldivar, The Associated Press, The Washington Post, March 15, 2010

Summary: It took lawmakers a year to shape President Barack Obama's health care bill. If it finally passes Congress, it'll take the better part of a decade to write the user manual for consumers and doctors, employers, and insurance companies. Some health insurance consumer protections would go into place immediately, significant but limited in scope. The big expansion in coverage comes about four years from now, allowing more than 30 million people to sign up for insurance, with financial help from the government for most. Ripple effects continue well after Obama has to leave office in 2017, assuming he's re-elected. But even if the 2,700-plus-page bill passes, it's only the end of the beginning. The Obama blueprint will be carried out under less-than-ideal circumstances. Rising medical costs and an aging population will keep squeezing the federal budget. Lawmakers will have to revisit hard choices they sidestepped. The impact of the reform legislation will address how people get coverage, how health care is delivered, and how health care is paid for. The House could vote on the final legislation as early as this week, with the Senate to follow. Read the primer on some of the major effects regarding Immediate Changes, The Self-Employed, Seniors, Doctors, Employers, and Insurance Companies.  |  Read article

2. Article: How would health care overhaul help young people?
By Phil Galewitz, Kaiser Health News, USA TODAY, March 8, 2010

Summary: Most young Americans likely would be required to have health coverage under the legislation being debated in Congress. They could buy a low-cost plan under the Senate bill and the new White House proposal. Catastrophic illness plans would make insurance less of a financial burden, but they would require high deductibles -- at least $5,950 in out-of-pocket spending before most benefits kicked in. That's igniting a fierce debate over how much young adults -- sometimes known as the young invincibles because many don't believe they need insurance -- would benefit from such plans. Critics warn that the low-cost policies would leave young people financially vulnerable and reluctant to seek care. This would help the insurance companies, but it wouldn't do much to help the individuals insured. Supporters counter that the plans would help young people who otherwise might be uninsured. Any coverage is always better than no coverage. People in their 20s have the highest uninsured rate of any age group in the country and make up nearly a third of the 46 million uninsured. Under the health care overhaul bills, ~10 million lower-income young adults would qualify for Medicaid or for government subsidies to buy private insurance.  |  Read article

3. Article: Nursing covering more health care
By Deborah Yetter and Jessie Halladay, USA TODAY, March 11, 2010

Summary: Each year, Wendy Fletcher and two partners see 5,000+ patients at their practice in Kentucky. They're registered nurse practitioners who are able to increase access to health care and make it more affordable. The Kentucky Medical Association is fighting proposed legislation that would lift some limits on the ability of ~3,700 NPs in Kentucky to prescribe medication and perform mostly routine tasks such as signing a child's immunization certificate or certifying the need for employee sick leave. A former KMA president and family physician testified against the bill, and objects to this constant push by NPs to be physicians. His argument has been echoed nationally by the AMA, which issued a report last fall critical of the training that NPs receive. Advocates for nurse practitioners say it's primary care nurses who'll make up for the shortage of primary care physicians and keep costs down. According to the American Nurses Association, as of November, the median expected salary for a typical nurse practitioner in the U.S. was $83,293, while the median expected salary for a typical family practice physician was $160,586. Each year, state legislatures are seeing measures proposed that seek to increase the capabilities of NPs and eliminate a level of supervision from physicians. (Yetter and Halladay report for The Courier-Journal in Louisville, Kentucy.)  |  Read article

4. Article: D.C. fire chief: EMS 'not broken' despite 'total failures'
By Michael Neibauer, The Washington Examiner, March 14, 2010

Summary: DC residents who require emergency medical assistance are in good hands despite a major breakdown in protocol when a paramedic declined to take a toddler to the hospital who was struggling to breathe, Fire Chief Dennis Rubin claims. According to Rubin, the District's EMS system isn't broken. DC police are investigating the death of a 2-year-old, to see whether there was criminal negligence by the paramedic crew that responded to her home, but didn't to take her to the hospital. Her mom called 911 a second time, 10 hours later, as the girl's breathing worsened. She died the next day. A similar case of not transporting a 911 patient, though not fatal, also is under review. Rubin sees them as total failures, but hopes that they're exceptions. Rubin is under fire from union leaders who allege the career firefighter is unqualified to run the EMS programs. The District is settling for mediocrity by maintaining a department that performs both fire and EMS functions, according to the president of the union that represents EMS providers. Roughly 85% of all calls to FEMS are medical, but the department's focus is squarely on fire. Only a separate agency would allow for growth necessary to create a medically driven world class EMS service. DC's All-Hazards model has firefighters and EMTs trained in both disciplines. They must learn to work cooperatively together as a single unit for the benefit of the public.  |  Read article

5. Article: Project to get transplant organs from ER patients raises ethics questions
By Rob Stein, The Washington Post, March 15, 2010

Summary: A federally funded project began trying to obtain kidneys, livers, and other body parts from car accident victims, heart attack fatalities, and other urgent care patients. Using a $321,000 HHS grant, the emergency departments at the University of Pittsburgh Medical Center-Presbyterian Hospital and Allegheny General Hospital in Pittsburgh started rapidly identifying donors among patients whom doctors are unable to save and taking steps to preserve their organs so a transplant team can rush to try to retrieve them. This pilot project aims to investigate whether it's feasible and, if so, to encourage other hospitals nationwide to follow. So far, neither hospital has yet gotten any usable organs. This is about helping people who declared themselves to be donors, but die in a place where donation is currently not possible. It's also about helping the large number of people awaiting transplants who could die waiting because of the shortage of organs. Critics say the program represents a troubling attempt to bring a questionable form of organ procurement into an even more ethically dicey situation: the tumultuous environment of an ER, where more than ever it raises the specter of doctors preying on dying patients for their organs. There's a fine line between pioneering and predatory methods. For decades, most hearts, lungs, kidneys, livers, and other organs obtained for transplants in the U.S. have come from patients who have been pronounced dead in a hospital after a complete cessation of brain activity, known as brain death, was carefully determined. The faster organs are retrieved, the better the chances they'll be useable.  |  Read article

6. Article: Despite probe, prescription drug abuse worsening, authorities say
By Jerry Markon, The Washington Post, March 14, 2010

Summary: Since 2002, the U.S. attorney's office in Alexandria convicted 170 people of selling, prescribing, or ingesting painkillers, with 10 more scheduled to plead guilty in coming weeks. These arrests were part of a federal crackdown that's the largest investigation of prescription drug abuse in U.S. history. The investigation, dubbed Operation Cotton Candy, snared seven doctors, 11 nurses, and a county prosecutor. One doctor pleaded guilty to demanding sex for drugs; a nurse shot up Dilaudid outside an emergency room. Another defendant burned down her flower shop to get insurance proceeds for pills. Yet for all the effort, prescription drug abuse continues to worsen in Northern Virginia and throughout the Washington region as demand for painkillers rises among teenagers and others. Local and federal investigators are seeing remarkable increases in Percocets sold on the street, a tremendous increase in Vicodin, and Oxy is off the charts. The investigation is criticized by patient advocates, who say Cotton Candy targets doctors prescribing legal drugs to people in chronic pain. Some question whether the eight-year probe -- which involved more than 50 prosecutors and employs 15-20 full-time FBI and DEA agents and Northern Virginia police officers -- is worth the time. For more info, read: "The Criminalization of Medicine: America's War on Doctors" by Ronald T. Libby.  |  Read article

7. Article: Women on birth control pill may live longer
USA TODAY, March 12, 2010

Summary: Women who took the birth control pill beginning in the late 1960s lived longer than those never on the pill, a new study says. British researchers observed 46,000+ women for nearly four decades from 1968. They compared the number of deaths in women on the pill to those who never took it. In the study, women on the pill generally took it for almost four years. Experts concluded the pill cut women's risk of dying from bowel cancer by 38% and from any other diseases by about 12%. Slightly higher death rates were found among women under 30 on the pill, but that began to be reversed by age 50. Doctors aren't sure exactly why the pill may lower death rates. It contains synthetic hormones to suppress ovulation, which may have some role in preventing certain diseases. Previous studies found the pill doesn't raise the risk of dying. It also may protect against ovarian and endometrial cancer, but slightly increase the chances of breast and cervical cancer. It may also be that women on the pill are somehow healthier than those that aren't. Because the study only observed women on the pill compared with those who weren't, researchers weren't able to make any hypotheses about cause and effect.  |  Read article

8. Article: New Fitness Center Brings a SPIRIT of Wellness to Southeast
By Denise Rolark Barnes, The Washington Informer, March 11, 2010

Summary: East of the River now sits an oasis where residents can rejuvenate their minds, bodies, and souls. SPIRIT Fitness, the brainchild of the Rev. Willie Wilson, pastor of Union Temple Baptist Church, located on the fifth and penthouse floors of the new Salvation Army Building at 2300 Martin Luther King Jr. Avenue SE, provides an holistic haven to those who enter. The Anacostia Health and Wellness Center which opened in October 2009 contains state-of-the-art exercise equipment and a variety of classes that includes African dance, belly-dancing, and Tai Chi. There's a dire situation with the people in our community when it comes to diabetes, high blood pressure, and obesity, said SPIRIT manager Adama Zawadi, an associate minister at Union Temple. They knew there needed to be a response, so the thrust was to stay in the community and to have a facility that was accessible and reasonably priced. The fitness center is the first of its kind east of the Anacostia River. SPIRIT focuses on overall health, with a wellness center on-site that identifies symptoms related to specific illnesses and pre-existing conditions, provides nutritional counseling, weight maintenance, and tips for savvy shoppers who want to adopt a healthy and nutritional lifestyle.  |  Read article

9. Article: Allergy sufferers journey into the season of symptoms
By Mary Brophy Marcus, USA TODAY, March 15, 2010

Summary: Allergic rhinitis afflicts an estimated 60 million people in the U.S. Global warming could be notching up allergies and extending allergy season around the world. In one study, researchers tracked season duration and prevalence of sensitizations for five types of pollens in one region of Italy from 1981 to 2007. Over time, there was a progressive increase in the duration of some pollen seasons. But global warming probably isn't the only culprit of increased allergies and asthma. Oral allergy syndrome is a phenomenon in people who are allergic to pollens when they eat certain foods, especially fresh fruits. The syndrome is a result of a cross reactivity between the proteins in the pollens a person is allergic to and the proteins in certain foods that are structurally similar to those in the pollens. Figuring out what to take among the myriad drug options -- from over-the-counter sprays and tablets to prescription pills and nasal sprays -- and whether to self-medicate, see your family doctor, or visit an allergy expert can be confusing. Most people treat themselves with OTC medications first. But if your symptoms make you miserable, interfere with life, and you're not getting much relief, a visit to your primary care doctor or an allergy specialist is wise. Allergy shots -- called immunotherapy -- are also very effective and safe.  |  Read article

10. Article: Dry cleaning usually uses a toxic chemical, but the safety picture is unclear
By Nina Shen Rastogi, The Washington Post, March 9, 2010

Summary: Traditional dry cleaning isn't really dry; it just doesn't involve water. The problem with dry cleaning is the liquid solvent perchloroethylene. Perc dissolves the gunk off your clothes. It's highly effective without being labor-intensive and it's not likely to burst into flames. People have been concerned about the chemical's health risks since the 1970s. Perchloroethylene (also known as tetrachloroethylene) is considered a toxic air pollutant by the EPA, meaning that it's known or suspected to cause cancer or other serious health effects. Short, intense blasts of perc can cause dizziness, headaches, or loss of consciousness. Not all dry cleaners are created alike, but there's no easy way for you to figure out how clean your local cleaner is. Check whether any of the clothes you normally get dry cleaned can be laundered and pressed instead. And just because a company says its product is green, doesn't make it so. There are a number of new garment care processes on the market, and just about every one that uses a non-perc solvent is billing itself as eco-friendly. Wet cleaning is like a souped-up version of what you do at the laundromat. Garments are cleaned in computer-controlled washers and dryers using soap and water, and then reshaped using specialized equipment.  |  Read article

11. Article: Professionals face taxing times
By Bill Myers, The Washington Examiner, March 7, 2010

Summary: Tens of thousands of Washington-area families, already feeling squeezed by the recession, are facing skyrocketing taxes. President Obama and the Democrats want to help the nation's economic recovery by letting Bush-era tax cuts for those making $250,000 or more expire at the end of the year. Under President Clinton, the government took 39% of the top tax bracket's income. Bush reduced the tax rate to 36%. But his cuts expire at the end of the year. Democrats hope the reinstatement of old taxes on the wealthy will generate up to $850 billion over 10 years. The Cato Institute, a foe of tax increases, says those who focus on the rich to fund the government aren't paying attention to history. Nearly 181,000 DC-area families make $200,000 or more per year. A UDC sociologist says the U.S. is overdue for a rethink about wealth distribution. Contemporary political debate is mangled by two political parties that want to be populist in a time of genuine working- and middle-class anger at inequalities of the system. A tax and budget expert at the liberal-leaning Center for American Progress said the Bush tax cuts have to go -- not for class reasons, but for practical reasons. Nobody likes to see their taxes go up, but we're seeing a pretty substantial budget deficit -- caused mainly by the Bush tax cuts.  |  Read article

12. Commentary: Health Reform Passes the Cost Test
By David M. Cutler, The Wall Street Journal, March 9, 2010

Summary: Many people are worried that the health care reform proposed by President Obama and congressional Democrats will fail to bend the cost curve. A number of commentators are urging no votes because of this, and Republicans asked the president to start health reform over, focusing squarely on the issue of cost reduction. These calls overlook the actual legislation. Over the past year of debate, 10 broad ideas have been offered for bending the health care cost curve. The Democrats' proposed legislation incorporates virtually every one of them, including: Form insurance exchanges, Reduce excessive prices, Moving to value-based payment in Medicare, Tax generous insurance plans, Empower an independent Medicare advisory board, Combat Medicare fraud and abuse, Malpractice reform, Invest in information technology, Prevention, and Create a public option. Why is reform viewed so negatively? It may reflect the perfect being the enemy of the good. Reform is also viewed negatively because official scorekeepers don't believe anything on this list other than reducing prices will save much money. No one knows precisely how much medical spending increases will moderate, but one cannot doubt the commitment to try. What's on the table is the most significant action on medical spending ever proposed in the U.S. Should we really walk away from that? (Cutler is a professor of economics at Harvard University.)  |  Read commentary (subscription needed)

EVENTS

2010 Parent Advocacy Day
Monday, March 22nd, 10 am (parent briefing), 11:30 am (lunch), 12 noon (Council briefing), and 2 pm (Council visits)
The John A. Wilson Building, Room 104
1350 Pennsylvania Avenue NW
If you've ever wanted to speak up for yourself and your family and YOU DID! If you ever wanted to speak up for yourself and your family and YOU DIDN'T! This day is for you! RSVP by March 17th to This e-mail address is being protected from spam bots, you need JavaScript enabled to view it or (202) 299-0900.

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No matter what situation or chaos you're dealing with, it can go one of three ways: get worse, stay the same, or get better. Odds are that if you do nothing, your loved one's behavior will continue to get worse, or at best stay the same. Many conditions are progressive. They'll get worse. Most addictions are primary, chronic, progressive, and often fatal. Although we care deeply about a loved one who's hurting or in the midst of chaos brought on by some behavior, we think we can do little to help them change. An often-cited study of families who have an addicted loved one in their midst, tells us that, on average, it'll take nine years for a group of loved ones to build consensus to speak up and try to usher in change, which requires action and determination. Intervention Specialist Brad Lamm's The Change Institute is a virtual clubhouse where you can get what you need in the form of information and inspiration.

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JOBS

Health Quality Improvement Manager, DCPCA

Senior Policy Coordinator, DCPCA

Senior Grants Writer/Specialist, DCPCA

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RESOURCES

Health Wellness and Nutrition Supplement
The Washington Informer, March 11, 2010
Efforts in Washington, DC, to fix our broken health care system and provide affordable coverage for all Americans are only part of the battle. Companies and organizations teamed up in this edition to help make a difference in our community and become part of the solution. Outreach is a key part of the health care debate.

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