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Posts Tagged ‘Healthcare’

I’m still amazed that a government agency is asking for our opinions – and better yet, they’re actually listening.

Check out this post for a little background. The verdict is in. The USDA is backing off on a proposal that might have inadvertently encouraged heavy drinking. They had originally proposed to ditch the daily recommendations and set weekly recommended quantities of alcohol, but the public spoke out. Since most people do their drinking only one to three nights a week, those who took the time to comment online were mostly concerned that drinkers would look at weekly guidelines and try to cram one week’s worth of drinking into one night. And that was a real possibility – most of us know how bright alcoholics are when it comes to justifying “let’s have another one!”

The USDA’s new guidelines retained a daily recommendation for alcohol consumption, and they now define heavy drinking and binge drinking as well. They admit there is evidence of health benefits of moderate drinking – apparently they’re trying extra hard not to give anyone the idea that it’s okay to drink like a fish – but they now give the stern “this is bad for your health” statement like you’ll find on a cigarette pack, listing all the health conditions that might get in your way if you drink too much.

According to Join Together, it was the online response from private citizens (both healthcare professionals and concerned consumers) that made a difference in the final policy decision. That is seriously encouraging. All government agencies should have a limited public commenting period like this every time new policies are being considered. 

Get ready to click again – someone else needs our input now. The Centers for Medicare and Medicaid Services (part of the Department for Health and Human Services) is asking what we think about Medicare covering alcohol screening and counseling in primary medical care.

This debate is about whether Medicare and Medicaid should cover alcohol abuse prevention, screening, and counseling. They already cover screening for other medical issues, but this time they’re considering doing that for something that might cross over into services that are normally performed by mental health providers.

Providing the service could mean a significant extension of prevention and early intervention services for individuals struggling with alcohol. It could also be pretty expensive, but then again so is the current drain on state and federal budgets when it comes to incarceration of drunk drivers and other alcohol-fueled criminals, child protective services, healthcare services for abused family members, emergency services for indigent people with alcohol poisoning, and anything else that relates to the public costs of excessive drinking.

A report on reducing underage drinking from the National Academy of Sciences found that government agencies, businesses, and individuals in the United States end up spending – and remember, this is just about underage drinkers – around $53 billion per year (including $29 billion due to violent crime and $19 billion from traffic crashes) because we can’t keep the alcohol away from the kids. Now that’s expensive. And that study was presented back in 2003. What are those numbers like today? And how much greater could the costs be for adults with alcohol problems?

If you want to get in on the debate, their National Coverage Analysis Tracking Sheet is open for comments until March 20, 2011. Let them know – especially if you work in healthcare – what you think about how this might work, who might coordinate the services, how often the services might be offered, or under what conditions Medicare or Medicaid might play a greater role in preventing a lot more unnecessary problems.

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I’ve been reading a lot of pontifications from people who think that they’re personally having to pay for the new health care law. They see that greed exists on both ends of the economic spectrum, and they’re offended at the possibility that they’re paying more than their share. I can understand that.

But when they start talking like everyone who doesn’t work or pay their own way is lazy or not worth a hill of beans, I’m sorry – I can’t let that one roll.

I was recently remarried, and if it weren’t for my husband, I would be one of those without health insurance, so I know what it’s like to have to go without. Most of my friends are still in that situation. They don’t ask for handouts, and if they’re eligible for food stamps, they don’t abuse the system any more than sharing their extra food with hungry out-of-work friends who have even less to eat. Their pride gets in the way of trying to actively work the system.

We’re not redefining greed to borrow from Robin Hood’s “steal from the rich and give to the poor.” Not all rich people are greedy, but not all poor people are greedy. We’re all naturally motivated to get money so we can have edible food and a decent roof over our heads, and some people in every economic situation take it to extremes and find greed to be a wonderful survival tactic.

What has been redefined is how the media works. It is now easier to spread the word about decent people who honestly can’t provide for themselves and earn their keep. Many times it’s not about whether or not they want to work. Employers won’t keep sick people on the payroll if they can help it – and that goes for both physical and mental illnesses. People without insurance tend to stay sick. Others get fired because they either call off work too much or they come to work sick because they’re afraid they’ll get fired – but they’re not operating at 100% so some get fired anyway and they lose their ability to pay the doctor.

It’s a big vicious circle – and it’s a realistic explanation of why people flood the emergency room when they get sick instead of seeing a regular doctor. They know that they can just get the bill later and hope they’re working by the time they get it. A lot of my friends don’t do either one. They can’t pay a regular doctor, and they don’t want the bill collectors blowing up their phone. They’d rather stay sick than incur a bill they don’t have much hope of paying, which in turn screws their chances of staying gainfully employed and screws their kids out of being able to pay attention in school, and it just goes round and round.

Health care reform is really an economic issue as much as a social issue. Full employment means getting the right leg brace and PT for someone with a bad leg instead of letting them limp around everywhere and depend on others. It means early detection of everything from the flu to cancer. It means making sure people with certain types of mental illness get the meds they need to be functional, productive members of society. Just a little bit of the right type of health care can put a lot of people back into the workforce (job availability permitting). More payroll tax income, more sales tax income, and more property tax income could make a real difference in the country’s cash flow.

And if you don’t like Obamacare, I suggest you get execs from the insurance, provider, pharmaceutical, and technology industries together and figure something else out, because what we have in the existing free market doesn’t really work for anyone but the top brass raking in the dough. Lock everyone in a room and don’t let them out – not even to go to the doctor – until they craft a system that everyone can live with.

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The diagnostic bible of the American Psychiatric Association is getting a makeover. A rough draft of version 5 (which is still being debated by the powers that be) is posted at http://www.DSM5.org. And this debate is going to be a dilly.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the manual that doctors, insurers, and scientists use in deciding what is officially considered a mental disorder and how to tell if someone has it. Every now and then they decide to re-evaluate this based on the latest research findings. In a new twist, they were seeking feedback via the Internet from both psychiatrists and the general public about whether the changes will be helpful before finalizing them. That ended in April. Now they have a committee (called the DSM-5 work group on their website) reviewing the comments; and between public input, APA member input, and private research, they will have the new version ready for publication by May of 2013.

Why so long? Take a look at their website, especially the timeline. Then check out the list of diagnostic categories on the home page. These are only the general categories. Specific disorders in each category can be seen by clicking on the name of the general category. All things considered, that final list is going to be huge – when they decide what will be on it and why.

Here’s one issue that they have to decide before 2013. Is Gender Identity Disorder a physical problem, a mental problem, or just another way for humans to behave? The LGBT community is already on the edge of their seats waiting for the APA to have an official opinion, and one way or another, that decision will make headlines for weeks.

My personal source of amusement comes from the fact that, at the moment, PMS is lumped in with bipolar disorder in the Mood Disorders category. I have both, I can tell the difference between the two, and I think that putting them in the same diagnostic category is hilarious. PMS is a physical problem with emotional side effects, and doesn’t belong in the DSM at all (although I think several men around the world would loudly disagree with me).

In other categories, the APA is officially considering hoarding, skin-picking, tics, and olfactory reference syndrome (delusional beliefs about one’s own body odor) as formally classified Anxiety Disorders. Binge eating is also being considered for placement with anorexia and bulimia in the Eating Disorders category. There’s an idea. I could get insurance to pay for a doctor to help me stop pigging out.

Seriously, if you are concerned about the diagnostic process when it comes to mental disorders, keep checking back for updates to their website. I hope that they’re carefully considering the comments of the people who have to personally deal with these issues every day, and not just letting the insurance companies tell the APA how to interpret the research.

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Check this out. The US Patent Office has officially declared that we don’t own our own genetic material, and apparently they’ve been doing it for years.

Now, normally I don’t jump every time the ACLU has a problem with something, but this one I like. On behalf of 20 plaintiffs, including other researchers and individual cancer patients who can’t get the testing they need, the ACLU has filed a lawsuit in a New York federal court to release the patent which says that Myriad Genetics is the only company that can study, test, and report on the BRCA genes related to breast and ovarian cancer.

This isn’t exactly a new story, but twelve years and eight patents ago, someone at the US Patent Office began setting a seriously questionable precedent.

If they’re really preventing anyone else from even looking at these genes, Myriad’s patents have succeeded in holding up cancer research – for now. Fortunately, someone has already recognized the futility of patenting nature. Myriad’s motion to dismiss was denied by the judge. Stay tuned.

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You have to see this, if you haven’t already. Anyone who is interested in topics like mental health, pediatric health, teaching children, pharmaceutical research, or what to do about children with unusual behaviour should watch and pay attention. This is a 56-minute video called The Medicated Child, and it was aired on PBS recently. It really struck a nerve with me, both as a mother and as an adult with bipolar disorder.

http://video.pbs.org/video/1316921025#

What do you think?

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I can’t decide which I like best – the database itself or the information-sharing. The National Institute of Mental Health (NIMH) is gathering information on what a normal kid’s brain looks like so they can share the information with people who are researching developmental disorders like autism.

NIMH described the latest release of data on their website today. They studied over 500 kids, from infants to young adults, using MRI brain scans, physical exams, psychological exams, and measurements of hormonal activity. The point was to catch each kid at different points in their life, get all of this information for that age, and wait a couple of years before doing it again to see what changed. The younger ones got tested more frequently because development occurs faster in the younger years.

The project, called The NIH Magnetic Resonance Imaging (MRI) Study of Normal Brain Development, is looking at things like brain size, memory function, motor skills, language development, and general social skills.

Their focus in this study is only on kids with no health problems. This way, they can pass on the information to people who are trying to figure out why some kids don’t develop normally, who can then compare the “normal” scans and physiological data to that of those kids and study what’s different. Hopefully, we’ll all learn something soon about why the brain can sometimes go haywire in childhood, and whether there is anything we can do to keep it from happening.

If you’re wondering how they got the kids to lie still for the MRI, I read somewhere else that the younger ones are usually scanned while they are sleeping. Trust me – telling most two-year olds to lie down and be still while they’re awake is like asking most puppies to calm down when you come home. That research environment must have been a real trip.

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Just when you think nothing can surprise you anymore…

http://www.jointogether.org/news/research/summaries/2009/cocaine-vaccine-cuts-drug.html

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