Highbrow Magazine - healthcare https://www.highbrowmagazine.com/healthcare en Healthcare in Crisis: Focusing on Primary Healthcare and Public Health in the U.S. https://www.highbrowmagazine.com/23000-healthcare-crisis-focusing-primary-healthcare-and-public-health-us <div class="field field-name-field-cat field-type-taxonomy-term-reference field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/news-features" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">News &amp; Features</a></div></div></div><span class="submitted-by">Submitted by tara on Wed, 11/30/2022 - 15:49</span><div class="field field-name-field-image field-type-image field-label-hidden"><div class="field-items"><div class="field-item even" rel="og:image rdfs:seeAlso" resource="https://www.highbrowmagazine.com/sites/default/files/styles/large/public/field/image/1health.jpg?itok=Mq-X1OMe"><img typeof="foaf:Image" src="https://www.highbrowmagazine.com/sites/default/files/styles/large/public/field/image/1health.jpg?itok=Mq-X1OMe" width="480" height="320" alt="" /></div></div></div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="content:encoded"><p><span style="font-size:18px"><span style="font-family:Times New Roman,Times,serif"> </span></span></p> <p><span style="font-size:18px"><span style="font-family:Times New Roman,Times,serif">Primary healthcare is the provision of integrated, accessible healthcare services by clinicians who are accountable for addressing a large majority of personal healthcare needs, developing a sustained partnership with patients and with families. </span></span></p> <p><span style="font-size:18px"><span style="font-family:Times New Roman,Times,serif">In the , most believe that better care is provided by specialists—nephrologists, cardiologists, cardiac surgeons, or endocrinologists— rather than a family doctor or generalist who practices primary healthcare. We have many more specialists than primary care doctors in this country. Most medical students say they want to pursue esoteric specialties. </span></span></p> <p><span style="font-size:18px"><span style="font-family:Times New Roman,Times,serif">Studies looking at primary care physicians among U.S. counties from 2005 to 2015 found that where the density of such doctors increased, life expectancy increased as well. But where their proportion to population decreased, <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2724393" style="color:#0563c1; text-decoration:underline">life expectancy declined</a>. This confirms the importance of primary healthcare to improve health in the United States. Since our health has been declining in the country overall, a part of the reason is that fewer doctors provide primary care services here. The countries with the healthiest <a href="https://www.oecd-ilibrary.org/social-issues-migration-health/health-at-a-glance-2017_health_glance-2017-en" style="color:#0563c1; text-decoration:underline">populations have three times the proportion of general practitioners</a> or primary care doctors as we do. Although the totality of medical care can’t adequately counter the corrosive health effects of social and economic hardships, access to quality primary care offers an important way of influencing mortality outcomes. </span></span></p> <p> </p> <p><img alt="" src="https://www.highbrowmagazine.com/sites/default/files/2health.jpg" style="height:366px; width:650px" typeof="foaf:Image" /></p> <p> </p> <p><span style="font-size:18px"><span style="font-family:Times New Roman,Times,serif">What is public health, and what is its role in producing health? In the United States, the phrase “public health” is generally considered to be something that benefits everybody. On their website, the American Public Health Association claims public health “promotes and protects the health of people and the communities where they live, learn, work, and play.” </span></span></p> <p><span style="font-size:18px"><span style="font-family:Times New Roman,Times,serif">The science of public health has evolved since the 18th century, when it focused on isolating the ill and quarantining those exposed to diseases to prevent transmission of infection. In the 19th century, the focus was on sanitation, especially separating fecal contamination from food and water. Living conditions improved tremendously as a result. With the understanding of infectious disease transmission in the early part of the 20th century, the focus shifted to immunizations and infection control. Later efforts centered on tobacco regulation and decreasing risk factors for chronic diseases such as heart disease and diabetes by promoting diet change and exercise. Efforts were also made to improve workplace conditions and motor vehicle safety. Such programs had definite health benefits that we take for granted today. </span></span></p> <p><span style="font-size:18px"><span style="font-family:Times New Roman,Times,serif">What directions should U.S. public health take today to continue health improvements? The IOM’s 1988 report, distilled its efforts into three pillars: assessment, policy development, and assurance. Translated, this means figuring out what the issues or problems are (assessment), doing something about them (policy development), and finally making sure the expected good outcomes occur (assurance). Has this approach been successful? </span></span></p> <p> </p> <p><img alt="" src="https://www.highbrowmagazine.com/sites/default/files/3health.jpg" style="height:600px; width:400px" typeof="foaf:Image" /></p> <p> </p> <p><span style="font-size:18px"><span style="font-family:Times New Roman,Times,serif">Assessment in the report asks for critical data collection at the local level: cities, counties, and states. These data include vital statistics such as births and deaths, a state responsibility. Other needed data are disease and health-related behavior surveys. While the Center for Disease Control and Prevention collects these data and makes them available to the public, they present almost no comparisons to assessments in other countries. </span></span></p> <p><span style="font-size:18px"><span style="font-family:Times New Roman,Times,serif">If we search the CDC website for life expectancy, we can see trends in the country and stratification by race/ethnicity subgroups. For maternal mortality, the CDC says that maternal mortality is increasing for 2019 over 2018 and Blacks are most impacted at almost four times the rate for Latinx. Infant mortality (IMR) is stated as being a good indicator of the overall health of a population and the website points out the IMR has dropped from 2017 to 2018, supposedly a good sign. </span></span></p> <p><span style="font-size:18px"><span style="font-family:Times New Roman,Times,serif">How does the CDC report American international rankings in recent years? The CDC’s <em>Health USA </em>report from 1960 to 2016 presented IMR rate and life expectancy data for OECD nations. The United States ranked 11th in 1960 but 24th in 2013! For subsequent reports, those rankings are no longer present although available on the CDC website for 2017 but not 2018. Why have they been omitted? The latest report for 2019 didn’t appear until the spring of 2021 when the CDC leadership had changed with the new federal administration. Yet still, there were no international comparisons. </span></span></p> <p><span style="font-size:18px"><span style="font-family:Times New Roman,Times,serif">In the IOM’s 2003 follow-up report, the first chapter launched into “Achievement and Disappointment. “For years, the life expectancies of both men and women in the United States have lagged behind those of their counterparts in most other industrialized nations.” Although they recognized the relative decline of the U.S. health compared to other nations, nowhere in their 34 policy recommendations for the future, did they suggest monitoring those trends. </span></span></p> <p> </p> <p><img alt="" src="https://www.highbrowmagazine.com/sites/default/files/4health.jpg" style="height:390px; width:650px" typeof="foaf:Image" /></p> <p> </p> <p><span style="font-size:18px"><span style="font-family:Times New Roman,Times,serif">There has been no comprehensive follow-up report along these lines looking at organized or institutionalized public health in the United States. Public health services have been drastically defunded throughout the United States. This reduction in services is in part responsible for our dismal COVID-19 mortality. </span></span></p> <p><span style="font-size:18px"><span style="font-family:Times New Roman,Times,serif">As our health status has continued to deteriorate in comparison to other countries, rarely do health or mainstream media publications acknowledge that astounding reality even in the COVIDian era. Public health has failed this nation, with its silence on our relatively low health status compared to what we know is possible. Public health is silent on what will be required to reduce this unprecedented, alarming trend. </span></span></p> <p><span style="font-size:18px"><span style="font-family:Times New Roman,Times,serif">When you ask people a general question of what can be done to improve health in this country responses tend to be, “focus on prevention.” But what is “prevention?” There are three common terms, primary, second, and tertiary prevention. Primary prevention halts the acquisition of a disease such as an immunization against polio. This makes us think in terms of diseases rather than of health. Secondary prevention refers to halting or slowing the progression of a disease once you have acquired it, such as catching breast cancer, or COVID-19 early. Then there is tertiary prevention to halt or reverse or delay disease progression, such as taking statins after a heart attack or dexamethasone for advanced COVID-19. Some have called for quaternary prevention, namely, limiting the harms of healthcare. Another concept is primordial prevention—preventing the emergence of predisposing social and environmental conditions that lead to disease or worse health. We have failed for all categories of prevention. </span></span></p> <p><span style="font-size:18px"><span style="font-family:Times New Roman,Times,serif">Spending on healthcare has not produced health. </span></span></p> <p> </p> <p><span style="font-size:18px"><span style="font-family:Times New Roman,Times,serif"><strong>Author Bio:                                 </strong></span></span></p> <p><span style="font-size:18px"><span style="font-family:Times New Roman,Times,serif"><strong>Stephen Bezruchka, MD, MPH, is Associate Teaching Professor Emeritus in the Departments of Health Systems &amp; Population Health and of Global Health at the School of Public Health, University of Washington, and author of </strong><a href="https://www.routledge.com/Inequality-Kills-Us-All-COVID-19s-Health-Lessons-for-the-World/Bezruchka/p/book/9781032278391" style="color:#0563c1; text-decoration:underline"><strong><em>Inequality Kills Us All: COVID-19’s Health Lessons for the World</em></strong><strong>.</strong></a><strong> </strong></span></span></p> <p><em><span style="font-size:18px"><span style="font-family:Times New Roman,Times,serif"><strong>This is adapted from Stephen Bezruchka’s new book, and is published here with permission.</strong></span></span></em></p> <p> </p> <p><span style="font-size:18px"><span style="font-family:Times New Roman,Times,serif"><strong>Highbrow Magazine</strong></span></span></p> <p> </p> <p><span style="font-size:18px"><span style="font-family:Times New Roman,Times,serif"><strong>Image Sources:</strong></span></span></p> <p><span style="font-size:18px"><span style="font-family:Times New Roman,Times,serif"><em>--Darko Stejanovic (<a href="https://pixabay.com/photos/doctor-medical-medicine-health-563429/" style="color:#0563c1; text-decoration:underline">Pixabay</a>, Creative Commons)</em></span></span></p> <p><span style="font-size:18px"><span style="font-family:Times New Roman,Times,serif"><em>--Tumisu (<a href="https://pixabay.com/photos/coronavirus-virus-mask-corona-4914026/" style="color:#0563c1; text-decoration:underline">Pixabay</a>, Creative Commons)</em></span></span></p> <p><span style="font-size:18px"><span style="font-family:Times New Roman,Times,serif"><em>--Routledge</em></span></span></p> <p><span style="font-size:18px"><span style="font-family:Times New Roman,Times,serif"><em>--Qimono (<a href="https://pixabay.com/illustrations/syringe-pill-capsule-morphine-1884784/" style="color:#0563c1; text-decoration:underline">Pixabay</a>, Creative Commons)</em></span></span></p> <p> </p> </div></div></div><div class="field field-name-field-tags field-type-taxonomy-term-reference field-label-above"><div class="field-label">Tags:&nbsp;</div><div class="field-items"><div class="field-item even" rel="dc:subject"><a href="/public-health" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">public health</a></div><div class="field-item odd" rel="dc:subject"><a href="/healthcare" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">healthcare</a></div><div class="field-item even" rel="dc:subject"><a href="/medicine" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">medicine</a></div><div class="field-item odd" rel="dc:subject"><a href="/covid" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">covid</a></div><div class="field-item even" rel="dc:subject"><a href="/immunization" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">immunization</a></div><div class="field-item odd" rel="dc:subject"><a href="/hospitals" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">hospitals</a></div><div class="field-item even" rel="dc:subject"><a href="/doctors" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">doctors</a></div><div class="field-item odd" rel="dc:subject"><a href="/us-health" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">U.S. health</a></div><div class="field-item even" rel="dc:subject"><a href="/patients" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">patients</a></div><div class="field-item odd" rel="dc:subject"><a href="/stephen-bezruchka" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">stephen bezruchka</a></div><div class="field-item even" rel="dc:subject"><a href="/illnesses" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">illnesses</a></div><div class="field-item odd" rel="dc:subject"><a href="/primacy-care-physician" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">primacy care physician</a></div><div class="field-item even" rel="dc:subject"><a href="/life-expectancy" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">life expectancy</a></div><div class="field-item odd" rel="dc:subject"><a href="/medical-advances" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">medical advances</a></div></div></div><div class="field field-name-field-author field-type-text field-label-hidden"><div class="field-items"><div class="field-item even">Stephen Bezruchka</div></div></div><div class="field field-name-field-pop field-type-list-boolean field-label-above"><div class="field-label">Popular:&nbsp;</div><div class="field-items"><div class="field-item even">not popular</div></div></div><div class="field field-name-field-bot field-type-list-boolean field-label-above"><div class="field-label">Bottom Slider:&nbsp;</div><div class="field-items"><div class="field-item even">In Slider</div></div></div> Wed, 30 Nov 2022 20:49:59 +0000 tara 11492 at https://www.highbrowmagazine.com https://www.highbrowmagazine.com/23000-healthcare-crisis-focusing-primary-healthcare-and-public-health-us#comments Welcome to Mongolia: A Great Place to Die https://www.highbrowmagazine.com/10723-welcome-mongolia-great-place-die <div class="field field-name-field-cat field-type-taxonomy-term-reference field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/news-features" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">News &amp; Features</a></div></div></div><span class="submitted-by">Submitted by tara on Tue, 07/07/2020 - 05:23</span><div class="field field-name-field-image field-type-image field-label-hidden"><div class="field-items"><div class="field-item even" rel="og:image rdfs:seeAlso" resource="https://www.highbrowmagazine.com/sites/default/files/styles/large/public/field/image/1mongolia.jpg?itok=e4b3AAVa"><img typeof="foaf:Image" src="https://www.highbrowmagazine.com/sites/default/files/styles/large/public/field/image/1mongolia.jpg?itok=e4b3AAVa" width="480" height="300" alt="" /></div></div></div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="content:encoded"><p> </p> <p>What comes to mind when you think of Mongolia? My answer, probably like many people’s, was vast empty space, those signature round white tents (which Mongolians call gers, not ‘yurts’ – a word brought in during the country’s period under Russian and Soviet influence) and Genghis Khan.</p> <p> </p> <p>One thing you might not think of is ‘a good place to die’. Yet Mongolia is punching above its weight in palliative care, the branch of medicine that supports people with terminal or complex illnesses. Palliative care takes a magpie approach, borrowing from other medical disciplines and addressing a whole range of issues at once, ranging from pain and other symptoms to spiritual, social and psychological support.</p> <p> </p> <p>In a 2015 survey of global palliative care, the UK comes top, Australia second and the USA ninth. And while the richest Western nations lead the pack, Mongolia appears notably high up, especially considering that it’s well down the economic rankings. (It comes 28th in the palliative care survey but ranks 141st for gross national income (GNI) per capita.)</p> <p> </p> <p>In fact, when it comes to palliative care, Mongolia is performing far better than any comparable economy, and is ahead of several European states with much more developed healthcare systems and greater spending power, including Greece, Hungary and Lithuania. It also eclipses several big economies, including its two giant neighbors, Russia and China.                                                         </p> <p> </p> <p>A ribbon of snow marks the dark hilltops from an overcast sky. The wind bites at the canvas folds of the Tumurbat family ger, their dome-tented dwelling. A few lambs – almost fully grown, too late to be sold – huddle together in a wooden pen nearby, the remnants of a once 100-strong flock. As his aunt and two doctors come into the yard, 18-year-old Dorj Tumurbat stands by the gate, foot up on a kennel. The dog jumps for the visitors, held back by its chain. But Dorj stays put, not even turning his head as they cross the yard and then duck inside the ger. Inside, his father is dying.</p> <p> </p> <p>Tumurbat Dashkhuu has late-stage liver cancer. Although his illness is incurable, there is something the physicians can do: grant him a death that’s as peaceful as possible.</p> <p> </p> <p>The materials for making a ger have evolved – canvas is increasingly being used for the outer walls rather than animal hides – but they are still constructed to the same basic design. A typical family ger is built around two central wooden pillars (larger ones have more), symbolizing the man and woman of the household in harmony. It is bad manners for any visitor to stand in this central, sacred space.</p> <p> </p> <p>But when Dr Odontuya Davaasuren and her colleague enter the ger, everything is off balance. Enkhjargal, Tumurbat’s wife, is holding back tears, clutching a sheaf of prescriptions and other medical papers. The stove is going out. A pool of water is collecting on the linoleum floor, spilling from a washing machine on one side of the tent.</p> <p> </p> <p><img alt="" src="https://www.highbrowmagazine.com/sites/default/files/2mongolia.jpg" style="height:450px; width:600px" /></p> <p> </p> <p>Next to the washing machine is a large fridge-freezer, and wires strung across the tent’s wooden frame lead to a television, DVD player and other electricals. The ger is situated in a capacious fenced compound, with a platform built for a second tent.</p> <p> </p> <p>The family had been doing well from its livestock business, shifting between the pastures in spring and summer and hunkering down during Mongolia’s harsh winter here on the outskirts of the capital, Ulaanbaatar. But with Tumurbat unable to work, they have had to sell almost all their sheep. Enkhjargal has had to take a part-time job in a local abattoir to make ends meet. Diagnosed late, barely a year ago, Tumurbat’s cancer has upended their lives. And he is in agony.</p> <p> </p> <p>The light from the doorway picks out his face, which is stiff with pain. He sits back across a bed, leaning on a stack of tightly folded blankets. He rests his hands delicately on the source of his torment, a bloated, fluid-filled abdomen, a typical symptom of late-stage liver cancer.</p> <p> </p> <p>The comforting evidence of family surrounds him. At one end of his bed there is a large wooden board propped up on a table and tied to one of the ger’s rafters. It’s covered with color photos of big groups of adults and children. To the side, there’s a small altar with a little figure of Buddha on top and several brass water bowls below, part of a Buddhist ritual to ward off negativity.</p> <p> </p> <p>I fail to find any immediate positives in this example of palliative care in action. Tumurbat struggles even to answer questions from Odontuya and her colleague Dr Solongo Surinaa. “All I want is to be without pain,” he whispers.</p> <p> </p> <p>Solongo is in charge of palliative care at the nearest district hospital, looking after both in- and outpatients. Odontuya asked her to make this home visit during my trip so I could see how palliative care works for those without medical services on their doorstep.</p> <p> </p> <p>Mongolia is the least densely populated country in the world, and distance is one of the biggest challenges to delivering any service there, including healthcare. It is just under an hour-and-a-half’s drive from the hospital to Tumurbat’s home, which is in a semi-rural hillside area – although it is still part of the Ulaanbaatar capital city region. (The Ulaanbaatar region – treated as a province in Mongolia – has a population of barely 1.4 million, but covers an area nearly three times that of Greater London and five times that of New York’s five boroughs.)</p> <p> </p> <p><img alt="" src="https://www.highbrowmagazine.com/sites/default/files/3mongolia.jpg" style="height:400px; width:600px" /></p> <p> </p> <p>Tumurbat is being hit by surges of what is called ‘breakthrough pain,’ which burst through the 60 mg/day of morphine he has been prescribed. Two weeks earlier, I am told, he had come home from hospital in a stable condition, his pain under control. The oncologists said the best place for him was here with his family. The local clinic would provide outpatient support, including his weekly prescription of morphine tablets – all covered by Mongolia’s national health insurance scheme.</p> <p> </p> <p>But Tumurbat’s condition has worsened in recent days and, as Odontuya and Solongo learn more, it is clear he and his family have not been sure how to react. Enkhjargal has not bought an additional drug, dexamethasone, that had been prescribed to reduce the inflammation around her husband’s liver and thereby temper the pain.</p> <p> </p> <p>And crucially, Tumurbat was not aware that he could take additional, so-called PRN doses (from the Latin pro re nata, meaning ‘as the circumstance arises’) of morphine beyond his daily prescription to deal with the surges of breakthrough pain. If he were to go beyond four PRN doses in 24 hours, then his prescription would be recalculated and updated.</p> <p> </p> <p>On this visit, Odontuya – the more senior doctor – acts as a trouble shooter, explaining how to respond to the pain surges, gently soothing both Enkhjargal and her husband, and providing an impromptu class in spiritual care, advising her how to prepare for his impending death. Enkhjargal is distraught as the two doctors make to leave. Outside she breaks into sobs and buries herself in Odontuya’s shoulder. It is a moment some doctors would struggle with, but Odontuya lets her cry before gently pulling back, and then, holding her arms, urges Enkhjargal to prepare for the end.</p> <p> </p> <p>The doctor’s most direct advice concerns Enkhjargal’s son Dorj, who was due to start his military service the following week. The family has to talk to the relevant authorities to delay his enlistment, Odontuya tells them. “It is so important that he is there when his father dies,” she tells me as we drive back, “to avoid complicating his grief.”</p> <p> </p> <p>Odontuya is more than just a conscientious doctor – she’s also largely responsible for Mongolia’s rapid progress in palliative care. Spurred by her own father’s traumatic death from cancer, she’s made it her life’s work to campaign for better treatment for people with incurable illnesses.</p> <p> </p> <p>The treatment Tumurbat and his family are receiving is a long way from what Odontuya was taught when she trained to be a doctor in the late 1970s. Growing up in Mongolia’s socialist years, when the country was a satellite state of the Soviet Union, she studied in what was then Leningrad. She speaks fluent Russian. It was excellent tuition, she says, “but we were told simply to treat patients, not to treat them as people. There was no compassion.”</p> <p> </p> <p><img alt="" src="https://www.highbrowmagazine.com/sites/default/files/4mongolia.jpg" style="height:338px; width:600px" /></p> <p> </p> <p>The way her father died changed her outlook forever. He was diagnosed with lung cancer the same year she began her studies in Russia, and in Mongolia’s health system at the time, he was effectively condemned to a painful death. Not only did palliative care not exist, but it was impossible to get hold of morphine or other opioid-based painkillers.</p> <p> </p> <p>Less than a decade later, her mother-in-law was struck down by liver cancer, and Odontuya says she too died in extreme distress. What she calls the “psychological pain” of witnessing a loved one in such a state affected everyone in her family, she says.</p> <p> </p> <p>It was a trauma that many more families have gone through since, because of a steady increase in cancers nationwide over the past two decades, especially liver cancer. The underlying cause was Mongolia’s already high incidence of hepatitis ­– dubbed a “silent” hepatitis epidemic by the World Health Organization – which was exacerbated by frequent needle sharing in the poorly resourced socialist healthcare system.</p> <p> </p> <p>Government policies made things worse, according to Odontuya and other doctors I speak to, by handing out free vodka. In the economic turmoil that followed Mongolia’s independence (after the collapse of the Soviet Union in 1991), the authorities were forced to introduce food rationing. But one thing they had plenty of was vodka, and they added it to every ration. “Each family got two bottles a week,” says Odontuya, shaking her head. “It was a very stupid policy.”</p> <p> </p> <p>Mongolia was already a country of heavy drinkers, and alcoholism became even more common in those early years of independence. Precisely how much impact this had is hard to determine, but with already high rates of hepatitis infection, Mongolian doctors believe the increase in drinking contributed to the rise in liver cancer.</p> <p> </p> <p>But it was this same cancer crisis that helped make the case for developing palliative care in Mongolia. Odontuya started lobbying for the introduction of palliative care in earnest from 2000 onwards. But first she had to come up with the right words. “[In Mongolia], we didn’t have any terminology for palliative care,” she tells me as she gives me a tour of the country’s first palliative care ward, established in the early 2000s at Mongolia’s National Cancer Center.</p> <p> </p> <p>The initial reaction from officials was scorn, she says, as they dismissed palliative care as an “activity for charities.” “They asked how they could justify spending money on ‘dying’ patients, when we don’t have enough money for ‘living’ patients.” She answered with her own question: “Would you say this to your own mother, if she gets cancer or some other incurable condition? And I told them, these are still ‘living’ patients.” Even at the end of life, she says, people have human rights.</p> <p> </p> <p><img alt="" src="https://www.highbrowmagazine.com/sites/default/files/5mongolia.jpg" style="height:398px; width:600px" /></p> <p> </p> <p>None of the former health officials I contacted responded. That Odontuya encountered resistance is hardly unique. Palliative care advocates elsewhere have also faced skepticism regarding its value – as much from medical professionals as from bureaucrats. For instance, one US study reported oncologists being reluctant to refer patients for palliative care because it “will mean the end of cancer treatment and a loss of patients’ hope”.</p> <p> </p> <p>And for many doctors, palliative care chafes against their default philosophy. As Simon Chapman, director of Policy and External Affairs for the National Council for Palliative Care, a UK-based umbrella charity for people involved in palliative and end-of-life care, puts it: “There is still a view among many clinicians that [a patient] dying is a professional failure.”</p> <p> </p> <p>Today, Mongolia still has the highest incidence of liver cancer in the world. Many people are diagnosed late, when the disease is advanced and doctors can do little to stop it spreading.</p> <p> </p> <p>The Songino Khairkhan district hospital on the west side of Ulaanbaatar has a solidly Soviet feel. Built in Mongolia’s socialist period, its walls are so thick they look like they would stop a tank. And the signs around the building add to the atmosphere, written in the Cyrillic script the Russians bequeathed the Mongolians.</p> <p> </p> <p>Behind the locked door of the hospital’s main dispensary for morphine and other opioid painkillers, I am firmly back in the present. There is an air of efficient calm as two staff members work at computers, updating the database on recent prescriptions, while their boss Dr Khandsuren Gongchigav gives me a short tour of their workspace. The security is necessary to meet local and international laws aimed at combating drug abuse, and here they distribute only opioids. There is another pharmacy in the hospital for everything else.</p> <p> </p> <p>Against one wall is a bulky metal security cabinet, its shelves filled with neat stacks of boxes of tablets. Some contain morphine, the strongest of the opioid family of drugs. It’s used for severe pain, including breakthrough cancer pain, because of its fast and powerful effects. There are other stacks – of tramadol, a less potent opioid for what specialists call moderate to severe pain.</p> <p> </p> <p>There is a lot more to palliative care than pain relief, but experts agree you can’t have a successful palliative care program without it. That means having an effective system for distributing opioids, which both meets patients’ needs and satisfies concerns about addiction and abuse. Reforming Mongolia’s approach to morphine was an early priority of Odontuya’s campaign.</p> <p> </p> <p> </p> <p><img alt="" src="https://www.highbrowmagazine.com/sites/default/files/6mongolia.jpg" style="height:411px; width:600px" /></p> <p> </p> <p>Before the government agreed to reforms in the early 2000s, the rules were highly restrictive and counterproductive. Only oncologists were allowed to prescribe opioids and at a maximum of 10 tablets per patient – enough for just two or three days in most cases. As a result, people with cancer often died of “pain shock” when their dose ran out, says Odontuya, leading to a widespread myth that the drugs were killing people. Making morphine more readily available has helped educate patients and doctors about its benefits and reduced what she calls “morphine-phobia”.</p> <p> </p> <p>Opioid medications still require a special form, as in most countries worldwide. But a much wider range of professionals can now prescribe them, including oncologists and family and palliative care doctors. This has led to a 14-fold increase in their use in the country from 2000 to 2014, according to Mongolian Health Ministry figures. Khandsuren is an oncologist by training, and now oversees opioid prescriptions for all the hospital’s outpatients. The majority are still people with cancer, but non-cancer patients have become more common.</p> <p> </p> <p>Every district hospital in the country now has a pharmacy like this one, allowing patients to visit weekly and get all the medication their doctor has prescribed. Nonetheless, in a country so large and so sparsely populated, that still means long journeys for patients in areas beyond Ulaanbaatar or other towns and cities.</p> <p> </p> <p>Beyond the store cupboard, Khandsuren shows me into a room where they keep garbage sacks filled with empty blister packs. Patients have to hand over the used strips before they can get their next dose. “We do everything here according to guidelines from the United Nations,” says Khandsuren, referring to rules drawn up by its specialist drugs control agency, the International Narcotics Control Board.</p> <p> </p> <p>Mongolia’s achievements have turned it into an example for many middle-income countries struggling with similar health problems but which, for a variety of reasons, maintain much stricter rules on opioid use. Doctors from former socialist states in particular have been coming to Mongolia to learn from its experience, their mutual past ties to Russia giving them a common language and training background.</p> <p> </p> <p>The National Cancer Center recently hosted some doctors from Kyrgyzstan, one of the former Soviet states of Central Asia. They remarked on how “peaceful” the palliative care department was, says Dr Munguntsetseg Lamjav, one of the centre’s senior staff. In Kyrgyzstan, she was told, it’s much harder to prescribe morphine and patients are always crying in pain.</p> <p> </p> <p>One of the most striking contrasts with Mongolia is its giant neighbor Russia. So tight are the rules there on prescribing morphine and other opioids, I learn, that consumption has actually declined in recent years, according to International Narcotics Control Board figures.</p> <p> </p> <p>There is also a tendency among Russian doctors, many still influenced by their Soviet-era training, to see pain as a problem to be endured rather than treated. It is hardly surprising then that palliative care there remains very limited. But one result is frequent horror stories of people with cancer or chronic pain dying by suicide because it is so hard to get effective medication.</p> <p> </p> <p>In fact, many governments around the world remain nervous about making morphine more available – and with good reason. Take a look at the USA, which has an endemic problem with abuse and addiction to legally prescribed opioid painkillers. But there are far more Americans suffering chronic pain (at least 30 per cent of the population according to one study) than there are drug addicts. It is all about balancing priorities, Odontuya argues.</p> <p> </p> <p><strong><em>This is an excerpt from an article originally published in </em></strong><a href="https://mosaicscience.com/story/surprisingly-good-place-die/" style="color:#0563c1; text-decoration:underline"><strong><em>Mosaic</em></strong></a><strong><em>. This article is republished with permission under a Creative Commons license. Read the rest </em></strong><a href="https://mosaicscience.com/story/surprisingly-good-place-die/" style="color:#0563c1; text-decoration:underline"><strong><em>here</em></strong></a><strong><em>.</em></strong></p> <p> </p> <p><strong>Author Bio:</strong></p> <p><strong><em>Andrew North is a journalist and writer based in Tbilisi, Georgia, who also packs a sketchpad on his reporting trips. He previously worked for BBC television and radio, reporting from Delhi, Kabul, Baghdad and Washington, before adding drawing to his storytelling kit. He now contributes to <em>Foreign Affairs</em>, the <em>Guardian </em>and <em>Village Voice,</em> among other publications. </em></strong></p> <p> </p> <p><strong>Highbrow Magazine                                                               </strong></p> <p> </p> <p><strong>Image Sources:</strong></p> <p><em>--Kanenori (</em><a href="https://www.needpix.com/photo/891636/nomad-mongolia-sunset-bogatto-modernization" style="color:#0563c1; text-decoration:underline"><em>Needpix</em></a><em>, Creative Commons)</em></p> <p><em>--Christopher Michel (</em><a href="https://www.flickr.com/photos/cmichel67/34708670143" style="color:#0563c1; text-decoration:underline"><em>Flickr</em></a><em>, Creative Commons)</em></p> <p><em>--Sgt. Ben Eberle (</em><a href="https://www.marforpac.marines.mil/Photos/igphoto/2000705222/" style="color:#0563c1; text-decoration:underline"><em>USMC</em></a><em>, Creative Commons)</em></p> <p><em>--Dan Nevill (</em><a href="https://www.flickr.com/photos/dnevill/48810814631" style="color:#0563c1; text-decoration:underline"><em>Flickr</em></a><em>, Creative Commons)</em></p> <p><em>--Prince Roy (</em><a href="https://www.flickr.com/photos/17352537@N00/30432301345" style="color:#0563c1; text-decoration:underline"><em>Flickr</em></a><em>, Creative Commons)</em></p> <p><em>--</em><a href="https://pxhere.com/en/photo/819894" style="color:#0563c1; text-decoration:underline"><em>Pxhere</em></a><em> (Creative Commons)</em></p> </div></div></div><div class="field field-name-field-tags field-type-taxonomy-term-reference field-label-above"><div class="field-label">Tags:&nbsp;</div><div class="field-items"><div class="field-item even" rel="dc:subject"><a href="/mongolia" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">mongolia</a></div><div class="field-item odd" rel="dc:subject"><a href="/ulaanbaatar" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">ulaanbaatar</a></div><div class="field-item even" rel="dc:subject"><a href="/mongolian-health-ministry" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Mongolian Health Ministry</a></div><div class="field-item odd" rel="dc:subject"><a href="/cancer-patients" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">cancer patients</a></div><div class="field-item even" rel="dc:subject"><a href="/death" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">death</a></div><div class="field-item odd" rel="dc:subject"><a href="/dying" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">dying</a></div><div class="field-item even" rel="dc:subject"><a href="/funerals" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">funerals</a></div><div class="field-item odd" rel="dc:subject"><a href="/hospice" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">hospice</a></div><div class="field-item even" rel="dc:subject"><a href="/death-mongolia" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">death in mongolia</a></div><div class="field-item odd" rel="dc:subject"><a href="/mongolians" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">mongolians</a></div><div class="field-item even" rel="dc:subject"><a href="/soviet-union" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">soviet union</a></div><div class="field-item odd" rel="dc:subject"><a href="/society" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">society</a></div><div class="field-item even" rel="dc:subject"><a href="/family-traditions" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">family traditions</a></div><div class="field-item odd" rel="dc:subject"><a href="/healthcare" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">healthcare</a></div><div class="field-item even" rel="dc:subject"><a href="/longevity" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">longevity</a></div></div></div><div class="field field-name-field-author field-type-text field-label-hidden"><div class="field-items"><div class="field-item even">Andrew North</div></div></div><div class="field field-name-field-pop field-type-list-boolean field-label-above"><div class="field-label">Popular:&nbsp;</div><div class="field-items"><div class="field-item even">not popular</div></div></div><div class="field field-name-field-bot field-type-list-boolean field-label-above"><div class="field-label">Bottom Slider:&nbsp;</div><div class="field-items"><div class="field-item even">Out Slider</div></div></div> Tue, 07 Jul 2020 09:23:14 +0000 tara 9666 at https://www.highbrowmagazine.com https://www.highbrowmagazine.com/10723-welcome-mongolia-great-place-die#comments Media Hype and the Myth of Ageless Baby Boomers https://www.highbrowmagazine.com/8410-media-hype-and-myth-ageless-baby-boomers <div class="field field-name-field-cat field-type-taxonomy-term-reference field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/news-features" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">News &amp; Features</a></div></div></div><span class="submitted-by">Submitted by tara on Sun, 08/20/2017 - 15:13</span><div class="field field-name-field-image field-type-image field-label-hidden"><div class="field-items"><div class="field-item even" rel="og:image rdfs:seeAlso" resource="https://www.highbrowmagazine.com/sites/default/files/styles/large/public/field/image/1boomers.jpg?itok=V8FxprSD"><img typeof="foaf:Image" src="https://www.highbrowmagazine.com/sites/default/files/styles/large/public/field/image/1boomers.jpg?itok=V8FxprSD" width="480" height="379" alt="" /></div></div></div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="content:encoded"><p> </p> <p><strong>From our content partner <a href="http://newamericamedia.org/2017/08/the-age-of-anti-aging-media-hype-and-the-myth-of-ageless-baby-boomers.php">New America Media</a>: </strong></p> <p> </p> <p>SAN FRANCISCO--As a journalist, my perspective on aging is somewhat unusual, in that in 1972, when I began writing my book, <em>Senior Power: Growing Old Rebelliously</em> (1974), I believed I’d somehow found my way to the cutting edge of a new frontier in the movement for social justice.</p> <p>       </p> <p>Opposing ageism was a cause I was sure everyone would see manifest in their morning mirrors. Until that period, few in the “Movement” had taken old age very seriously, especially as a looming issue of inequality.</p> <p> </p> <p>I’d arrived in San Francisco from Minneapolis in time to witness the aftermath of the media-vaunted Summer of Love, as well as the acceleration of the antiwar and social-change movements.</p> <p> </p> <p>However, after two years immersed in the subject (as both a first-time author and a new father at age 28) and while also working full-time, I found myself fascinated by the depths of issues in aging that remained largely unexplored. I also became increasingly baffled by the undercurrent of resistance to aging, even as a dynamic topic for American journalism.</p> <p> </p> <p>Now as a “grandpop” (what my 5-year-old grandson calls me), I remain just as confused about how my boomer generation continues to be largely unaware of the ageist undertow in America’s youth-consumed consumer culture.</p> <p> </p> <p>While one aging boomer after another – and the increasing ranks of 50-plus Gen Xers -- confronts the convoluted challenges of aging, often through care for their elderly parents, the long-term expectation of this aging nation would foment an era of change has dimmed as media attention, marketing forces and political campaigning have zeroed in on the 83.1 million Millennials.</p> <p> </p> <p><strong>Ageism—the Beat Goes On</strong></p> <p> </p> <p>America’s commercial and political chase after youth dollars and votes has placed a drag on the country’s ability to prepare for the challenges and opportunities of today’s much vaunted longevity revolution. Public understanding remains lacking in our nation’s need to address such disparate areas as family caregiving, older adult–friendly and safe environments, affordable (and universally designed) senior housing options, elder abuse prevention, and, especially, the widely predicted retirement-finance crisis.</p> <p> </p> <p><br /> <img alt="" src="/sites/default/files/2boomers.jpg" style="height:326px; width:585px" /></p> <p><em>Author Paul Kleyman at the Rolling Stones concert in Altamont in 1969.</em></p> <p> </p> <p>At the same time, the media’s appeal to older Americans too often translates into marketable nostalgia for the Sixties (cue PBS pledge break here!) and with fiftieth anniversaries, some of them truly historic (the Selma march, the moon landing, three shattering assassinations), and some of more questionable gravity (Woodstock, Altamont, and, yes, the Summer of Love). My view, from more than a half-century in the countercultural epicenter of San Francisco, is that the headlines have largely missed the essential stories of (cue The Who) “M-m-my Generation.”</p> <p> </p> <p>In paging again through my book <em>Senior Power</em> recently, I came across passage after passage that read as true today as they did when I typed them on my Remington manual. Certainly, there have been improvements, such as enactment of the Americans with Disabilities Act, with its requirements for wheelchair access to public buildings and transportation.</p> <p> </p> <p>As for the baby boomer trinity of sex, drugs, and rock ’n‘ roll, though, the sexual revolution has long since gone the way of cable TV, both in the crude stream of bleeps and with shows like <em>Frankie and Grace</em>, in which Lily Tomlin and Jane Fonda wrestle in their 70s with relationships of all kinds.</p> <p> </p> <p>Drugs? Marijuana is legal in 26 states, with more pending in 2017, according to <em>Governing Magazine</em>, and numerous articles reveal that aging boomers may benefit the most—not from getting high but in gaining relief from pain and nausea.</p> <p> </p> <p>As for rock music, all you need to know is that Keith Richards is still at it at age 73. But the fundamental issues of aging—and ageism—haven’t much changed.</p> <p> </p> <p>Today, age continues as one of the last areas of openly uttered bias across the American cultural spectrum. In early 2017, not only did U.S. Department of Housing and Urban Development Secretary Ben Carson, MD, laugh while stating that brain surgery is a wasted “investment” on “old geezers,” but also the otherwise progressive <em>Daily Show</em> host Trevor Noah ridiculed President Trump as “America’s Xenophobic Old Grandpa” and as a “King Over the Hill.”</p> <p> </p> <p>Following the 2016 election, pundits from the left and right, such as MSNBC’s Chris Matthews and the <em>New York Times</em> columnist and PBS commentator David Brooks, bemoaned the unlikelihood that Donald Trump could change because “he’s 70.”</p> <p> </p> <p>I posted a New America Media commentary, headlined “Let Trump Be Held Accountable, Not Just ‘Too Old to Change.’” And Doonesbury cartoonist Garry Trudeau’s book <em>Yuge!: 30 Years of Doonesbury</em> on Trump shows the 45th U.S. President’s behavior hasn’t changed in at least 30 years (Trudeau, 2016).</p> <p> </p> <p>As the still dynamic Tina Turner (at age 77) might sing today, “What’s age got to do with it?”</p> <p> </p> <p><br /> <img alt="" src="/sites/default/files/3boomers.jpg" style="height:371px; width:625px" /></p> <p> </p> <p><strong>When Ageism and Racism Intersect </strong></p> <p> </p> <p>Regarding only one example of ageism then and now, I opened <em>Senior Power</em> and found, “Ageism is particularly virulent against those who are already vulnerable to other kinds of discrimination. A political observer of the problems of the aged, Professor Robert Binstock, has written, ‘In almost every measurable respect black older people are about twice as badly off as the rest of the aged population’”</p> <p> </p> <p>What about the double jeopardy of age and race? A 2015 Kaiser Family Foundation report states, “The official poverty rate in 2013 was nearly three times larger among Hispanic adults than among white adults ages 65 and older (20 percent versus 7 percent) and two and a half times larger among black adults ages 65 and older (18 percent).”</p> <p> </p> <p>And in 2010, former U.S. Assistant Secretary for Aging Fernando Torres-Gil, also a past president of the American Society on Aging, criticized the false image of largely white affluence presented in a CNBC special called <em>Tom Brokaw Reports: Boomer$.</em></p> <p> </p> <p>Disappointing to many who work in aging, Brokaw, the very same journalist who had rehabilitated the “Greedy Geezer” image of World War II-era older adults as “The Greatest Generation,” defaulted to a stereotypical depiction of aging baby boomers as “history’s wealthiest and most influential generation,” who pursue a “unique and unyielding quest to preserve their youth.”</p> <p> </p> <p>Criticizing the program’s lack of diversity, Torres-Gil asserted, “Latino baby boomers are an important bellwether of the [coming] demographic changes. Yet, Latino baby boomers remain a largely hidden population, and little is understood about their socio-demographic and economic characteristics.”</p> <p> </p> <p><strong>The Business of Age Discrimination </strong></p> <p> </p> <p>One doesn’t have to be impoverished to feel the effects of age discrimination in the 21st century. In his 2014 book, Unretirement: <em>How Baby Boomers Are Changing the Way We Think About Work, Community, and the Good Life</em>, Chris Farrell noted about older workers, “Far too many employers are hostile to the idea of hiring someone with gray hair. Negative stereotypes are rampant, cutting older workers out of new projects and corporate initiatives,” despite ample evidence that more mature workers are highly reliable and do not cost more in insurance and other expenses.</p> <p> </p> <p><strong>From our content partner New America Media. Read the rest of the article <a href="http://newamericamedia.org/2017/08/the-age-of-anti-aging-media-hype-and-the-myth-of-ageless-baby-boomers.php">here</a>.</strong></p> <p> </p> <p><strong>Author Bio:</strong></p> <p> </p> <p><strong><em>Paul Kleyman is director of the Ethnic Elders Newsbeat at New America Media in San Francisco and, as the national coordinator of the Journalists Network on Generations, he is the editor of the Network’s e-mail newsletter, Generations Beat Online. This article is adapted from his essay in the 2017 “Summer of Love” issue of Generations, journal of the American Society on Aging.</em></strong></p> </div></div></div><div class="field field-name-field-tags field-type-taxonomy-term-reference field-label-above"><div class="field-label">Tags:&nbsp;</div><div class="field-items"><div class="field-item even" rel="dc:subject"><a href="/baby-boomers" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">baby boomers</a></div><div class="field-item odd" rel="dc:subject"><a href="/aging-baby-boomers" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">aging baby boomers</a></div><div class="field-item even" rel="dc:subject"><a href="/summer-love" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">summer of love</a></div><div class="field-item odd" rel="dc:subject"><a href="/hippies" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">hippies</a></div><div class="field-item even" rel="dc:subject"><a href="/1960s-0" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">the 1960s</a></div><div class="field-item odd" rel="dc:subject"><a href="/counterculture" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">counterculture</a></div><div class="field-item even" rel="dc:subject"><a href="/healthcare" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">healthcare</a></div></div></div><div class="field field-name-field-author field-type-text field-label-hidden"><div class="field-items"><div class="field-item even">Paul Kleyman</div></div></div><div class="field field-name-field-pop field-type-list-boolean field-label-above"><div class="field-label">Popular:&nbsp;</div><div class="field-items"><div class="field-item even">not popular</div></div></div><div class="field field-name-field-photographer field-type-text field-label-above"><div class="field-label">Photographer:&nbsp;</div><div class="field-items"><div class="field-item even">New America Media; Wikipedia Commons</div></div></div><div class="field field-name-field-bot field-type-list-boolean field-label-above"><div class="field-label">Bottom Slider:&nbsp;</div><div class="field-items"><div class="field-item even">Out Slider</div></div></div> Sun, 20 Aug 2017 19:13:07 +0000 tara 7671 at https://www.highbrowmagazine.com https://www.highbrowmagazine.com/8410-media-hype-and-myth-ageless-baby-boomers#comments McCain’s Health Battle Casts Ugly Glare on GOP Healthcare Assault https://www.highbrowmagazine.com/7745-mccain-s-health-battle-casts-ugly-glare-gop-healthcare-assault <div class="field field-name-field-cat field-type-taxonomy-term-reference field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/news-features" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">News &amp; Features</a></div></div></div><span class="submitted-by">Submitted by tara on Sun, 07/23/2017 - 12:57</span><div class="field field-name-field-image field-type-image field-label-hidden"><div class="field-items"><div class="field-item even" rel="og:image rdfs:seeAlso" resource="https://www.highbrowmagazine.com/sites/default/files/styles/large/public/field/image/1johnmccain.jpg?itok=S7fTHUJm"><img typeof="foaf:Image" src="https://www.highbrowmagazine.com/sites/default/files/styles/large/public/field/image/1johnmccain.jpg?itok=S7fTHUJm" width="480" height="277" alt="" /></div></div></div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="content:encoded"><p> </p> <p><strong>From our content partner <a href="http://newamericamedia.org/2017/07/mccains-health-battle-casts-ugly-glare-on-gop-health-care-assault.php">New America Media</a></strong>:</p> <p> </p> <p>Arizona Senator John McCain will get and deserves the best medical care he can get in his battle against brain cancer. Millions rightly will be pulling for his healthful recovery. But McCain’s health battle also casts an ugly glare on the hypocrisy and contradiction in the GOP’s relentless war against Obamacare. It starts with McCain. In August 2016, he was in a mildly tough fight for re-election to his sixth Senate term. The issue that McCain went after was healthcare, specifically, Obamacare. He bluntly told a Fox Business interviewer that Obamacare was “collapsing like a house of cards.”</p> <p>       </p> <p>This was not simply another case of a GOP senator taking a straight, hard-line stance against the Affordable Care Act. McCain made it plain before he lashed out at Obamacare on Fox that healthcare should be mostly left to the free market. He ticked off a checklist of ways healthcare should function. It included such things as: risk pools, greater interstate insurance availability, and letting people opt out of healthcare completely. Said McCain, we must go back to “square one” with healthcare and take a “capitalistic approach to it.”</p> <p> </p> <p>McCain has been as good as his word and belief about what healthcare should be about and the limited role government should play in it. Between 1996 and 2007, he voted against every federal measure to either expand or strengthen healthcare coverage. This includes: funding for the State Children Health Insurance Program by increasing the tobacco tax, increases for AIDS prevention drug assistance, tax credits for long term and chronic healthcare needs, credits to small business owners for employee health insurance coverage, and the extension of healthcare coverage to mental illness.</p> <p>                                       </p> <p>In every case when a proposal was made to increase funding or expand a vital healthcare program, McCain could be counted on to oppose it. In contrast, the government will pay the bulk of the costs of McCain’s care. He is also eligible to receive limited medical services from the Office of the Attending Physician of the U.S. Capitol. And, since he is a military veteran, he can be treated free of charge at Washington, D.C. area hospitals, Walter Reed Army Medical Center and National Naval Medical Center. Again, all costs for his care will be paid by the government.</p> <p> </p> <p>McCain’s proposals to replace Obamacare is simply another variation of what the GOP has plopped on the table. They are just as dreadful.</p> <p> </p> <p><img alt="" src="/sites/default/files/2mediumhealthcare_1.jpg" style="height:335px; width:600px" /></p> <p> </p> <p>They include scaled-down subsidies, tax credits, the expansion of high-risk pools, health savings accounts, give insurers the right to peddle insurance in any state they choose, and create Association Health Plans to small businesses and risk pools. The subsidies would scrap the income-based measure that Obamacare imposes and substitute instead age as the basis for the subsidy. The subsidy to the poorest and neediest was the linchpin of Obamacare. This made it possible for millions who couldn’t afford insurance at any price to purchase it for the first time. To get the tax credits a low-wage worker would still have to come up with the cash to purchase insurance. For many that would be problematic.</p> <p> </p> <p>The high-risk pools that McCain touts supposedly would move thousands of medically indigent persons in pools to ensure low cost access to coverage. In fact it would do just the opposite. The bulk of those in the pool would be the sickest and most in need of continuous medical treatment. They would pay more, not less for that coverage. To cover the high cost of maintaining these pools, states would have to pony up more tax dollars or impose premium assessments on insurers who in turn would simply hike their prices to cover the assessments. It would be a never-ending cost increase cycle with absolutely no guarantee that the sickest and neediest in the pool would get the coverage they need.</p> <p> </p> <p>Under the plan that McCain and other GOP senators had proposed, a staggering 30 million Americans would have been plucked from the healthcare rolls in the next decade. This according to a report from the Congressional Budget Office on the impact that ending Obamacare would have on the nation. Millions, of course, either had no insurance or went without coverage for a period during the course of a year or years before Obamacare kicked in. Many others who got coverage also lost that coverage, almost always because they couldn’t pay for it, or the insurer dropped them because of a medical condition that the insurer considered too costly to pay for. The state of American healthcare was worse than abysmal for millions.</p> <p> </p> <p>McCain’s claim that Obamacare is collapsing, and that the private market will take care of all health needs has no basis in fact. The high quality of care he’ll get in his fight against cancer almost entirely at government expense proves that. McCain is the best argument that all should receive the same quality of care.</p> <p> </p> <p><strong>Author Bio:</strong></p> <p> </p> <p><strong><em>Earl Ofari Hutchinson is an author and political analyst. His forthcoming book, The Trump Challenge to Black America (Middle Passage Press) will be released in August. He is a weekly co-host of the Al Sharpton Show on Radio One. He is the host of the weekly Hutchinson Report on KPFK 90.7 FM Los Angeles and the Pacifica Network.</em></strong></p> <p> </p> <p><strong>From our content partner <a href="http://newamericamedia.org/2017/07/mccains-health-battle-casts-ugly-glare-on-gop-health-care-assault.php">New America Media</a></strong></p> </div></div></div><div class="field field-name-field-tags field-type-taxonomy-term-reference field-label-above"><div class="field-label">Tags:&nbsp;</div><div class="field-items"><div class="field-item even" rel="dc:subject"><a href="/john-mccain" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">john mccain</a></div><div class="field-item odd" rel="dc:subject"><a href="/healthcare" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">healthcare</a></div><div class="field-item even" rel="dc:subject"><a href="/better-care-act" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">better care act</a></div><div class="field-item odd" rel="dc:subject"><a href="/obamacare" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Obamacare</a></div><div class="field-item even" rel="dc:subject"><a href="/health-insurance" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">health insurance</a></div><div class="field-item odd" rel="dc:subject"><a href="/healtcare-reform" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">healtcare reform</a></div><div class="field-item even" rel="dc:subject"><a href="/republicans" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Republicans</a></div></div></div><div class="field field-name-field-author field-type-text field-label-hidden"><div class="field-items"><div class="field-item even">Earl Ofari Hutchinson </div></div></div><div class="field field-name-field-pop field-type-list-boolean field-label-above"><div class="field-label">Popular:&nbsp;</div><div class="field-items"><div class="field-item even">not popular</div></div></div><div class="field field-name-field-photographer field-type-text field-label-above"><div class="field-label">Photographer:&nbsp;</div><div class="field-items"><div class="field-item even">New America Media</div></div></div><div class="field field-name-field-bot field-type-list-boolean field-label-above"><div class="field-label">Bottom Slider:&nbsp;</div><div class="field-items"><div class="field-item even">Out Slider</div></div></div> Sun, 23 Jul 2017 16:57:35 +0000 tara 7628 at https://www.highbrowmagazine.com https://www.highbrowmagazine.com/7745-mccain-s-health-battle-casts-ugly-glare-gop-healthcare-assault#comments The Problem With the Republican Healthcare Plan https://www.highbrowmagazine.com/7582-problem-republican-healthcare-plan <div class="field field-name-field-cat field-type-taxonomy-term-reference field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/news-features" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">News &amp; Features</a></div></div></div><span class="submitted-by">Submitted by tara on Sun, 05/28/2017 - 14:12</span><div class="field field-name-field-image field-type-image field-label-hidden"><div class="field-items"><div class="field-item even" rel="og:image rdfs:seeAlso" resource="https://www.highbrowmagazine.com/sites/default/files/styles/large/public/field/image/1trumpryan.jpg?itok=tRYjwl87"><img typeof="foaf:Image" src="https://www.highbrowmagazine.com/sites/default/files/styles/large/public/field/image/1trumpryan.jpg?itok=tRYjwl87" width="480" height="270" alt="" /></div></div></div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="content:encoded"><p> </p> <p>There was something sublimely degrading about the beer bash President Donald Trump threw May 4 for House Republicans who passed his health care bill by the narrowest of partisan margins.</p> <p> </p> <p>Start with the host, who will say or do anything. By now it’s apparent that the president is untethered to reality. If he were to be impeached, a compassionate chief justice might declare him incompetent to stand trial because he lacks the mental capacity to be responsible for his words or acts.</p> <p> </p> <p>But the Republicans who sniffed his musk last week aren’t blissed by the clueless stupor his narcissism affords him. They’re fearful of their constituents. No wonder that, of the 217 congress members who voted his way, only two — one in Idaho, one in upstate New York — held district town halls this past weekend. They did not go at all well. When the rest of the cowering Republican conference is forced to face their voters, it will be similarly ugly.</p> <p> </p> <p>They must be baffled by how devoid of mojo their old battle cries have become. “Jobs-killing Obamacare” packs no punch in an economy that’s added more than 10 million jobs since the Affordable Care Act passed. “Disaster” and “death spiral” sound demented to someone who’s gone from no insurance to comprehensive coverage. “Higher premiums, higher deductibles, higher co-pays” may in some cases be accurate, but for Americans long suffering from rising prices, the real news is the slowing of the rate of increase.</p> <p> </p> <p>Republican capitulation to the Freedom Caucus’ demand to torpedo Obamacare’s coverage of pre-existing conditions has prompted hundreds of heartbreaking — and televised — stories of congenital defects, deadly tumors, chronic ailments, addictions and mental illnesses, whose long-term treatment was until recently made affordable by irrevocable insurance, but which now is slated for sacrifice in exchange for a trillion-dollar cut to Medicaid and a humongous tax cut for the wealthiest.</p> <p> </p> <p>Not only will those stories, juxtaposed with Rose Garden revelry, make for mercilessly effective ads in the coming midterm campaign; they also sound the death knell for the most toxic trope in the Republican rhetorical armory: the stigma of the unworthy unhealthy.</p> <p> </p> <p>The label descends from the widespread distinction, as recent as a century ago, between the worthy and the unworthy poor. The worthy poor — widows, orphans, the blind — were indigent through no fault of their own, victims of random misfortune, life’s vicissitudes, circumstances beyond their control. But the unworthy poor were the cause of their own impoverishment. Lazy, morally weak, addled by drink, gamblers: They had only themselves to blame. The worthy poor deserved charity; the unworthy, a kick in the pants.</p> <p> </p> <p>The Depression altered the presumption that bootstrapping is the royal road to success. If there aren’t any jobs, it doesn’t matter how much moxie you have. From our common catastrophe came a new compact. Every person is worthy of basic human decency, a safety net to catch us, a freedom from want we pledge to one another. To secure it? Not the market, not inheritance, not the luck of our genes — the government. And so from Social Security to Medicare, unemployment insurance to food stamps, we committed public resources to promote the public good.</p> <p> </p> <p><br /> <img alt="" src="/sites/default/files/mediumcongress_11.jpg" style="height:382px; width:600px" /></p> <p> </p> <p>Universal health care was always the outlier in America — not just the notion that government should provide it, but the idea that it’s an inalienable right. You could see that wariness, stoked by decades of propaganda, in a Wall Street Journal-Harris poll two years before Obama was elected. Asked whether unhealthy people should pay more for insurance, a majority of Americans – 53 percent – said yes. You can hear that same animus today in Alabama Republican Rep. Mo Brooks’ defense of Trumpcare: “It will allow insurance companies to require people who have higher health costs to contribute more to the insurance pool that helps offset all these costs, thereby reducing the cost to those people who lead good lives. They’re healthy, they’ve done the things to keep their bodies healthy, and right now, those are the people who have done the things the right way that are seeing their costs skyrocketing.”</p> <p> </p> <p>“Moral hazard” is how economists describe the ability to evade the bad consequences of risky decisions. The Wall Street bailout, which prevented a global meltdown, absolved the banks of having hell to pay. I get why House Republicans almost sank it; it maddened me, too. To them, the ACA’s passage two years later reprised that escape from accountability. It didn’t penalize people enough for being addicted to nicotine, for consuming the sugar and fat marketed to them, for escaping a stressful day with a sedentary night.</p> <p> </p> <p>The ACA has helped millions of Americans with illnesses unrelated to personal decisions get access to healthcare. At the same time, it established a no-fault policy for having made choices that are bad for you. Under current law, your right to treatment doesn’t depend on how or why you became dependent on opioids or alcohol, or whether your high blood pressure or cholesterol might have been prevented by behavior change. All that counts is that you’re seeking a path to health. We don’t punish the sick for being unhealthy; life has done that enough. There are not the worthy unhealthy and the unworthy unhealthy. All there is is us.</p> <p> </p> <p><strong>This column was first published in the <a href="http://jewishjournal.com/opinion/marty_kaplan/218790/stigma-unworthy-unhealthy/">Jewish Journal</a>.</strong></p> <p> </p> <p><strong>Author Bio: </strong></p> <p> </p> <p><strong><em>Marty Kaplan is the Norman Lear Professor of Entertainment, Media and Society and directs the Norman Lear Center at the University of Southern California’s Annenberg School for Communication and Journalism.  In the Carter Administration he served as chief speechwriter to Vice President Walter F. Mondale.</em></strong></p> <p> </p> </div></div></div><div class="field field-name-field-tags field-type-taxonomy-term-reference field-label-above"><div class="field-label">Tags:&nbsp;</div><div class="field-items"><div class="field-item even" rel="dc:subject"><a href="/affordable-care-act" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Affordable Care Act</a></div><div class="field-item odd" rel="dc:subject"><a href="/aca" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">ACA</a></div><div class="field-item even" rel="dc:subject"><a href="/ahca" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">ahca</a></div><div class="field-item odd" rel="dc:subject"><a href="/republicans" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Republicans</a></div><div class="field-item even" rel="dc:subject"><a href="/paul-ryan" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Paul Ryan</a></div><div class="field-item odd" rel="dc:subject"><a href="/donald-trump" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Donald Trump</a></div><div class="field-item even" rel="dc:subject"><a href="/healthcare" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">healthcare</a></div><div class="field-item odd" rel="dc:subject"><a href="/congress" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">congress</a></div></div></div><div class="field field-name-field-author field-type-text field-label-hidden"><div class="field-items"><div class="field-item even">Marty Kaplan</div></div></div><div class="field field-name-field-pop field-type-list-boolean field-label-above"><div class="field-label">Popular:&nbsp;</div><div class="field-items"><div class="field-item even">not popular</div></div></div><div class="field field-name-field-photographer field-type-text field-label-above"><div class="field-label">Photographer:&nbsp;</div><div class="field-items"><div class="field-item even">Google Images</div></div></div><div class="field field-name-field-bot field-type-list-boolean field-label-above"><div class="field-label">Bottom Slider:&nbsp;</div><div class="field-items"><div class="field-item even">Out Slider</div></div></div> Sun, 28 May 2017 18:12:15 +0000 tara 7534 at https://www.highbrowmagazine.com https://www.highbrowmagazine.com/7582-problem-republican-healthcare-plan#comments How Obamacare Improved Americans’ Health https://www.highbrowmagazine.com/7296-how-obamacare-improved-americans-health <div class="field field-name-field-cat field-type-taxonomy-term-reference field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/news-features" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">News &amp; Features</a></div></div></div><span class="submitted-by">Submitted by tara on Sat, 01/21/2017 - 14:49</span><div class="field field-name-field-image field-type-image field-label-hidden"><div class="field-items"><div class="field-item even" rel="og:image rdfs:seeAlso" resource="https://www.highbrowmagazine.com/sites/default/files/styles/large/public/field/image/1obamaclapping.jpg?itok=YpvEbE2u"><img typeof="foaf:Image" src="https://www.highbrowmagazine.com/sites/default/files/styles/large/public/field/image/1obamaclapping.jpg?itok=YpvEbE2u" width="480" height="268" alt="" /></div></div></div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="content:encoded"><p> </p> <p><strong>From <a href="http://newamericamedia.org/2017/01/how-obamacare-improved-the-nations-health.php">AFRO/New America Media</a> (our content partner)</strong>:</p> <p> </p> <p>WASHINGTON, D.C.--Ashley Turner has experienced ups and downs with the Affordable Care Act, but says she and other Americans have benefited overall. She doesn’t believe that Republicans should try to dismantle the ACA, also known as Obamacare.</p> <p> </p> <p>“That would be a mistake on their end,” said Turner, who lives in Hyattsville, Md. “People who are currently insured with the different plans that fall under the Obamacare law, they will no longer be insured and there will be a ripple effect with debt with hospitals not being paid, the doctors not being paid, and with more and more people not being covered.”</p> <p> </p> <p><strong>32 Million Would Lose Care</strong></p> <p> </p> <p>If the Affordable Care Act (ACA) is even partially dismantled, 18 million people could become uninsured within a year, according to a new report from the Congressional Budget Office (CBO).</p> <p> </p> <p>That number could nearly double to 32 million by 2026, the CBO estimated, if the Medicaid expansion is rolled back and subsidies cut to those who paid for insurance through the marketplaces set up under the ACA.</p> <p> </p> <p>“I’m healthy, but I have glaucoma in one of my eyes,” Turner said. She was able to use Obamacare from 2015 to 2016 to cover treatments and visits to specialists.</p> <p> </p> <p>Economist Julianne Malveaux and journalist Michael Days agreed that the ACA was President Obama’s signature achievement, during a recent signing and discussion of their books in Washington, D.C., assessing his legacy.</p> <p> </p> <p>“With the Affordable Care Act, he expanded the social contract for the first time in several decades,” said Malveaux, author of <em>Are We Better Off? Race, Obama and Public Policy (M Malveaux Enterprises, 2016)</em>, in her mixed assessment of the president’s overall track record during his eight years in the Oval Office.</p> <p> </p> <p>The lives saved under ACA are “incalculable,” said Days, author of <em>Obama’s Legacy: What He Accomplished as President (Hachette Books, 2016)</em> and Pulitzer Prize-winning editor of the Philadelphia News.</p> <p> </p> <p>Here are a few ways that Americans have benefited under the Patient Protection and Affordable Care Act, which President Obama signed in 2010 and was rolled out in late 2013:</p> <p> </p> <p>•           The number of uninsured people declined. When open enrollment began for Obamacare in 2013, census figures indicated that 50 million people were uninsured in the United States, an increase of 5 million from 2007 to 2009, the height of the Great Recession. Since the rollout, about 20 million people ended up with health insurance, according to the White House. This includes 3 million African-American adults, whose uninsured rate dropped 53 percent since 2013.</p> <p> </p> <p>•           Young people were able to stay on their parents’ insurance plans until age 26. This was one of the earlier provisions of ACA with 6.1 million young adults covered dating back before 2013. Since then, the uninsured rate for young people has dropped by 47 percent.</p> <p> </p> <p>•           Women gained more comprehensive services for reproductive healthcare. This included well-woman visits, mammograms, contraceptive coverage, breast cancer tests for women at high risk, prenatal services and breastfeeding support.</p> <p> </p> <p>•           People with pre-existing conditions were able to obtain coverage. Under ACA, coverage can’t be denied nor benefits reduced if someone has a history of heart disease, for example.</p> <p> </p> <p>•           A wider pool of people saved on out-of-pocket costs for healthcare. This ranged from savings on immunizations to annual physicals for Medicare recipients.</p> <p> </p> <p>•           Medicaid was expanded to reach more low-income adults under the age of 65. Even though at least two dozen states opted out the Medicaid expansion, more than 4 million people with average individual incomes of roughly $16,000 gained coverage.</p> <p> </p> <p>Republicans have vowed to kill Obamacare. With control of the three branches of government, including Donald Trump in the White House, they have the potential to do serious damage, ACA supporters claim.</p> <p> </p> <p>Newly elected U.S. Senator Kamala Harris, D-Calif., warned of hidden consequences during a recent rally in California.</p> <p> </p> <p>“If you’re a victim of domestic violence,” Harris said, “you can be denied access to healthcare because being a victim of domestic violence is considered a pre-existing condition. That ain’t right.”</p> <p> </p> <p><img alt="" src="/sites/default/files/4healthcareobama.jpg" /></p> <p> </p> <p>Linda Goler Blount, president and CEO of the National Black Women’s Health Imperative in Washington, D.C., has offered to work with the Trump administration to find ways to preserve healthcare gains.</p> <p> </p> <p>“We are extremely concerned that a Trump presidency and its resulting policies will mean increased mortality from avoidable chronic diseases, rising rates of poverty and, frankly, the weakening of black communities across the U.S.,” Blount said.</p> <p> </p> <p>Steven P. Wallace, Ph.D., director of the Coordinating Center for the National Institutes of Health/National Institute on Aging Resource Centers on Minority Aging Research, has similar concerns.</p> <p> </p> <p>“Any social program that’s being looked at for modernization or change is going to have a disproportionate impact on communities of color,” Wallace warned during the Gerontological Society of America’s Annual Scientific Meeting.</p> <p> </p> <p>“Anything that reduces Medicaid is going to have a huge impact,” he added. Looking at out-of-pocket spending for healthcare as a percentage of personal income, Wallace said it would be 2.9 percent for poor people with Medicaid, but 20.7 percent without it.</p> <p> </p> <p>With the graying of America, the impact would be even greater, Wallace noted, if Republicans are successful in their promises to cut back on Medicaid as well as Medicare.</p> <p> </p> <p>“The number of older adults will double in 30 years,” he said. “The fastest growth in the aging population is communities of color.” The African-American elderly population is projected to grow from 3.8 million in 2012 to 10.3 million by 2050, according to Wallace.</p> <p> </p> <p><strong>The Individual Mandate</strong></p> <p> </p> <p>A key and controversial component of the health plan is the “individual mandate,” requiring citizens who can afford insurance to maintain basic coverage or pay a penalty through the Internal Revenue Service. People could keep or obtain insurance through their employers or go through state exchanges being set up to provide subsidized coverage.</p> <p> </p> <p>The mandate is also intended to reduce overall healthcare costs to taxpayers across the board. It provides an incentive for insurance companies to cover the sickest and poorest patients by gaining a wider pool of healthy people to offset the cost of chronic illness. In addition, the ACA offers tax credits to help small businesses provide health insurance for their employees.</p> <p> </p> <p>The downside of ACA for Ashley Turner is that she’s unexpectedly on the receiving end of the penalty after attempting to adjust her premiums and deductibles through a health exchange in Maryland.</p> <p> </p> <p>“Somebody messed up the policies,” Turner said. “I wasn’t insured between January and May, because of their miscommunications.”</p> <p> </p> <p>“My issue, for reasons that are not my fault, is that I’m going to be charged this tax fee, because I had a period of being uninsured,” said Turner, who now has coverage on her own</p> <p> </p> <p>Nevertheless, Turner remains an Obamacare optimist.</p> <p> </p> <p>“From my experience, I think Obamacare is a good policy,” she said, “but it works better for people who are sick or people who are poor and can’t afford individual insurance outside an employer.”</p> <p> </p> <p>With the last day for open enrollment approaching on Jan. 31, for coverage under the hallmark of President Obama’s legacy, he too remains optimistic and throws down a challenge.</p> <p> </p> <p>“If anyone can put together a plan that is demonstrably better than the improvements we’ve made to our healthcare system and that covers as many people at less cost,” President Obama said last week in his farewell address, “I will publicly support it.”</p> <p> </p> <p><strong>Author Bio:</strong></p> <p> </p> <p><strong><em>Yanick Rice Lamb, co-founder of the health website FierceforBlackWomen.com, is chair of the Department of Media, Journalism and Film at Howard University. She wrote this article with support from the Journalists in Aging Fellows Program, a project of the Gerontological Society of America and New America Media, with funding from the Commonwealth Fund.</em></strong></p> <p> </p> <p><strong>From <a href="http://newamericamedia.org/2017/01/how-obamacare-improved-the-nations-health.php">AFRO/New America Media</a> (our content partner)</strong></p> </div></div></div><div class="field field-name-field-tags field-type-taxonomy-term-reference field-label-above"><div class="field-label">Tags:&nbsp;</div><div class="field-items"><div class="field-item even" rel="dc:subject"><a href="/obamacare" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Obamacare</a></div><div class="field-item odd" rel="dc:subject"><a href="/affordable-care-act" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Affordable Care Act</a></div><div class="field-item even" rel="dc:subject"><a href="/trump-1" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">trump</a></div><div class="field-item odd" rel="dc:subject"><a href="/healthcare" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">healthcare</a></div><div class="field-item even" rel="dc:subject"><a href="/repealing-obamacare" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">repealing obamacare</a></div><div class="field-item odd" rel="dc:subject"><a href="/health-insurance" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">health insurance</a></div></div></div><div class="field field-name-field-author field-type-text field-label-hidden"><div class="field-items"><div class="field-item even">Yanick Rice Lamb</div></div></div><div class="field field-name-field-pop field-type-list-boolean field-label-above"><div class="field-label">Popular:&nbsp;</div><div class="field-items"><div class="field-item even">not popular</div></div></div><div class="field field-name-field-photographer field-type-text field-label-above"><div class="field-label">Photographer:&nbsp;</div><div class="field-items"><div class="field-item even">New America Media</div></div></div><div class="field field-name-field-bot field-type-list-boolean field-label-above"><div class="field-label">Bottom Slider:&nbsp;</div><div class="field-items"><div class="field-item even">Out Slider</div></div></div> Sat, 21 Jan 2017 19:49:03 +0000 tara 7341 at https://www.highbrowmagazine.com https://www.highbrowmagazine.com/7296-how-obamacare-improved-americans-health#comments The Dangers of Repealing Obamacare https://www.highbrowmagazine.com/7278-dangers-repealing-obamacare <div class="field field-name-field-cat field-type-taxonomy-term-reference field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/news-features" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">News &amp; Features</a></div></div></div><span class="submitted-by">Submitted by tara on Sun, 01/01/2017 - 13:17</span><div class="field field-name-field-image field-type-image field-label-hidden"><div class="field-items"><div class="field-item even" rel="og:image rdfs:seeAlso" resource="https://www.highbrowmagazine.com/sites/default/files/styles/large/public/field/image/4healthcareobama.jpg?itok=OzxSH02X"><img typeof="foaf:Image" src="https://www.highbrowmagazine.com/sites/default/files/styles/large/public/field/image/4healthcareobama.jpg?itok=OzxSH02X" width="480" height="268" alt="" /></div></div></div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="content:encoded"><p> </p> <p><strong>From our content partner <a href="http://newamericamedia.org/2016/12/people-of-color-and-the-poor-will-be-hardest-hit-by-aca-repeal.php">New America Media</a></strong>:</p> <p> </p> <p>President-elect Donald Trump’s threat to repeal and replace Obamacare is bad news for millions of Americans, but the poor and people of color are going to be hit hardest, say healthcare advocates.</p> <p> </p> <p>“The winners and losers from repealing Obamacare will depend crucially on the details of whatever replacement plan materializes,” said Larry Levitt, senior vice president for special initiatives at the Kaiser Family Foundation during a webinar Dec. 19. “Based on what those replacement plans look like so far, it seems that the poor and people with pre-existing medical conditions could end up worse off.”</p> <p> </p> <p>Approximately 20 million people have gotten coverage since the launch of Obamacare.</p> <p> </p> <p>Trump has yet to reveal details of what he plans to do to the 2010 Affordable Care Act, aka Obamacare, other than to say that he intends to dismantle it soon after he takes office. It’s likely that some parts of it will be left untouched – like the pre-existing condition provision – and replacement could be delayed by a couple of years.</p> <p> </p> <p>The webinar was organized by the nonprofit California Health Care Foundation (CHCF), to give journalists an overview of what California, the state that took the lead in implementing some of the key provisions of Obamacare, could face if Trump makes good on his threat.</p> <p> </p> <p>Among those provisions were expanding Medi-Cal (California’s name for Medicaid) and setting up a health insurance marketplace for people to purchase federally subsidized coverage best suited to their budget, said Amy Adams, CHCF’s senior program officer. Additionally, even before the ACA became law, the state banned the prevalent practice of gender-based premium cost variations – younger women were paying more than men.</p> <p> </p> <p>As a result of its robust implementation, the state’s uninsured rate for residents under 65 fell by nearly half, from 22 percent in 2009 to 9.5 percent in 2015, according to a California Health Interview Survey (CHIS). More low-income people who historically were shut out of health insurance were able to gain coverage, as were people in minority communities.</p> <p> </p> <p>The survey showed that uninsured rates fell by nearly 7 percent among Asian Americans and African Americans, and 6.5 percent among Latinos.</p> <p> </p> <p><img alt="" src="/sites/default/files/2mediumhealthcare_0.jpg" style="height:335px; width:600px" /></p> <p> </p> <p>More than 10 percent of the populations in the counties of Fresno, Kern, Los Angeles, San Bernardino, San Joaquin and Tulare got coverage, according to a just-released UC Berkeley Labor Center study.</p> <p> </p> <p>A repeal would mean that California would lose around $20 billion in annual federal funding for Medi-Cal expansion and Covered California subsidies, making it virtually impossible for it to continue offering those programs.</p> <p> </p> <p>“It is a very large amount of money and would be difficult for the state to generate a comparable amount of revenue,” to go it alone, pointed out Adams.</p> <p> </p> <p>“It would be difficult for any individual state to try to raise the money required and provide benefits comparable to the ACA,” Levitt said. “That would put the state significantly at odds with other states in terms of tax rates and public benefits.”</p> <p> </p> <p>But critics of the ACA say that one of the least popular provisions of the law – forcing individuals to have health insurance and companies to cover their employees or face a penalty – would be eliminated with a repeal. An estimated $1.3 billion would be lost in eliminated penalties.</p> <p> </p> <p>One idea Trump’s advisory team has been floating is to allow insurance carriers to sell insurance across state borders, something some insurers already do. That could come with its own set of problems, Levitt said, because it could drive people to states where the insurance industry is less regulated. He said California has been able to rein in its providers to some degree because of “its stringent regulations.”</p> <p> </p> <p>Levitt pointed out that the safety net provided by Federally Qualified Health Centers (FQHC), clinics that provide healthcare to underserved communities, would weaken if the ACA were repealed. Those unable to retain their insurance coverage would likely flock to FQHCs, putting an extra burden on them.</p> <p> </p> <p>“There are a lot of moving pieces,” at this time, Levitt said. “No doubt that people are split on the ACA,” he said. “But ACA is status quo.”</p> <p> </p> <p><strong>From our content partner <a href="http://newamericamedia.org/2016/12/people-of-color-and-the-poor-will-be-hardest-hit-by-aca-repeal.php">New America Media</a></strong></p> </div></div></div><div class="field field-name-field-tags field-type-taxonomy-term-reference field-label-above"><div class="field-label">Tags:&nbsp;</div><div class="field-items"><div class="field-item even" rel="dc:subject"><a href="/obamacare" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Obamacare</a></div><div class="field-item odd" rel="dc:subject"><a href="/aca" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">ACA</a></div><div class="field-item even" rel="dc:subject"><a href="/donald-trump" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Donald Trump</a></div><div class="field-item odd" rel="dc:subject"><a href="/obama" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Obama</a></div><div class="field-item even" rel="dc:subject"><a href="/health-insurance" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">health insurance</a></div><div class="field-item odd" rel="dc:subject"><a href="/healthcare" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">healthcare</a></div></div></div><div class="field field-name-field-author field-type-text field-label-hidden"><div class="field-items"><div class="field-item even">Viji Sundaram</div></div></div><div class="field field-name-field-pop field-type-list-boolean field-label-above"><div class="field-label">Popular:&nbsp;</div><div class="field-items"><div class="field-item even">not popular</div></div></div><div class="field field-name-field-photographer field-type-text field-label-above"><div class="field-label">Photographer:&nbsp;</div><div class="field-items"><div class="field-item even">New America Media</div></div></div><div class="field field-name-field-bot field-type-list-boolean field-label-above"><div class="field-label">Bottom Slider:&nbsp;</div><div class="field-items"><div class="field-item even">Out Slider</div></div></div> Sun, 01 Jan 2017 18:17:35 +0000 tara 7314 at https://www.highbrowmagazine.com https://www.highbrowmagazine.com/7278-dangers-repealing-obamacare#comments Treating the Cause (not the Symptom) of Mental Illness https://www.highbrowmagazine.com/5993-treating-cause-not-symptom-mental-illness <div class="field field-name-field-cat field-type-taxonomy-term-reference field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/news-features" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">News &amp; Features</a></div></div></div><span class="submitted-by">Submitted by tara on Sun, 09/18/2016 - 15:13</span><div class="field field-name-field-image field-type-image field-label-hidden"><div class="field-items"><div class="field-item even" rel="og:image rdfs:seeAlso" resource="https://www.highbrowmagazine.com/sites/default/files/styles/large/public/field/image/4mentalillness.jpg?itok=4Lk3DsOP"><img typeof="foaf:Image" src="https://www.highbrowmagazine.com/sites/default/files/styles/large/public/field/image/4mentalillness.jpg?itok=4Lk3DsOP" width="480" height="268" alt="" /></div></div></div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="content:encoded"><p> </p> <p><strong>From our content partner New America Media: </strong></p> <p> </p> <p>Mental health underlies many of the issues at the forefront of our national consciousness. Police brutality, gun violence, mass incarceration – the conversation always comes back to mental health. And accordingly, the mental health care system has undergone significant improvements in recent years, most notably with the Affordable Care Act, which has expanded access to coverage for mental health services.</p> <p> </p> <p>But when it comes to young people, service providers who work with some of the youth most vulnerable to mental health issues are finding that their clients’ most significant social and emotional issues are ones that aren’t necessarily treated with traditional mental health care like therapy and medication. These youth include young people involved in the child welfare and juvenile justice systems, as well as ones who deal with housing instability.</p> <p> </p> <p>The work of these service providers raises a question: In all our focus on improving the mental health care system, are we missing something?</p> <p> </p> <p>Rob Gitin, the co-founder and executive director of At The Crossroads, an outreach organization that works with unstably housed youth in San Francisco, says “Perhaps the biggest deficit in our clients’ lives is a lack of two things – it’s a lack of community and it’s a lack of self-esteem.”</p> <p> </p> <p>While policymakers and government officials acknowledge the importance of mental health – the Surgeon General has named it one of his top six priorities – less attention has been paid to the root causes of poor mental health and to creating safe, supportive, and well-resourced neighborhoods and communities for people to live in. Mental health problems often start with difficulties in childhood, and if the work of youth service providers shows anything, it’s that addressing this will require expanding the current notion of what young people need in order to have good mental health.</p> <p> </p> <p>According to Margot Gibney, the founding executive director of Youth Treatment and Education Center in San Francisco (a center for juvenile drug offenders), effectively treating kids who are marginalized is not rocket science, because all kids essentially need the same things – the support of a family, the opportunities that come with education, and the safety of a stable place to live.</p> <p> </p> <p>“When people refer to ‘these kids’ – there are no ‘these kids.’ There are young people. And young people all have fundamentally the same needs,” she says. “Whatever any middle-class parent would want and provide for their children is exactly what young people that are facing all these challenges need, plus to have their trauma addressed.”</p> <p> </p> <p> </p> <p><strong>Former foster youth: Stability comes with social ties</strong></p> <p> </p> <p>Liberty Dycus, 24, was born in Ethiopia and adopted when she was very young by a family in Contra Costa County in the San Francisco Bay Area. She was later removed from her adoptive home because of abuse, after which she entered foster care.</p> <p> </p> <p>She says her foster mother “did the best she could,” but that she had other foster kids as well as kids of her own. Dycus did receive therapy, but says, “The thing about therapy in foster care is when you go home you’re still in the same situation. I still have to go home and I still have to live everything that’s happening.”</p> <p> </p> <p>After she emancipated, she felt lost. She moved through different living situations and struggled with depression. She ended up at a youth shelter in Richmond, Calif., and then got into transitional housing. She had to leave transitional housing after two years, and until recently, she dealt with homelessness and was moving between friends’ houses. It was difficult to find an apartment in the Bay Area she could afford while still being able to keep her car and buy food. “To not know where you’re going to sleep at night, it’s not a good feeling,” she says.</p> <p> </p> <p>She’s working and is doing her best to make ends meet. “When I left transitional housing, I thought I might have some support,” she says. “But everybody saw that I had a job, so it seemed like they thought, ‘Oh, she won’t need help.’ Sometimes I wish I weren’t working full time, but I’m trying to do the right thing.”</p> <p> </p> <p>“When you’re strong, people don’t notice you. When you appear to be okay, people don’t ask; they just expect you to have it together,” she says. “You don’t want your struggle to define you, but sometimes you need to express what’s happening in your life.”</p> <p> </p> <p> </p> <p>In recent years, foster care in California has undergone policy shifts meant to help kids in the system lead healthy lives. The <em>Katie A. v. Bonta</em> class action lawsuit, which was settled in 2011, led California’s Department of Social Services and the Department of Health Care Services to make significant changes in the way mental health care is made available to foster youth. Since 2012, Assembly Bill 12 has allowed kids to remain in the foster system until age 21. Implementation of Assembly Bill 403, Continuum of Care Reform, began this year; it will prioritize keeping kids in family settings as opposed to group homes, and provide for those families to get specialized mental health training.</p> <p> </p> <p>Change happens slowly, though, and the system works better for some youth than others. Eric Wagoner, who like Dycus grew up in Contra Costa County, entered the foster system after being removed from his mother’s care. Now 21, he says that AB 12 was instrumental in helping him become self-sufficient as he was transitioning to adulthood.</p> <p> </p> <p>But he says that he and a lot of other youth run into a common problem – if you want to see a therapist, it’s tough to find one who accepts Medi-Cal (which, under the Affordable Care Act, covers former foster youth until age 26). “We need to find a way to streamline the way that youth are accessing mental health services,” he says.</p> <p> </p> <p>For Wagoner, what ended up being a key factor in his personal growth and recovery were his social ties. Many of those ties have been the result of coming into contact with California Youth Connection, a nonprofit foster youth-led development organization that advocates for kids in the system.</p> <p> </p> <p>“Former foster youth are a small demographic and we can be isolated,” says Wagoner. “We don’t have a ton of other youth to connect with. CYC helps to bridge that issue by bringing people together.”</p> <p> </p> <p><br /> <img alt="" src="/sites/default/files/3mediummentalhealth.jpg" style="height:363px; width:650px" /></p> <p> </p> <p>He says he felt supported by the other current and former foster youth, and that he learned how to speak up. “You can receive support through therapy, but the foster youth population is a specific population, and [people I met through CYC] truly understand what you may have faced,” he says.</p> <p> </p> <p>A three-year study conducted in Washington State by Mathematica Policy Research and Community Science sought to quantify to what extent investing in community-based initiatives and networks (organizations similar to CYC) can prevent and mitigate the effects of difficult childhood experiences among individuals in those communities. The study, which began in 2013, released results in August 2016 finding that the statewide initiative (known as the Adverse Childhood Experiences Public-Private Initiative) had been able to make statistically significant improvements in a set of health and development outcomes for people who had experienced things like child abuse and neglect, domestic violence, and the mental illness of a parent.</p> <p> </p> <p>For example, one of the projects that was funded, the Positive Social Norms Campaign in Okanogan, was able to show a 10-point decrease in youth alcohol use among the high school students it worked with over the course of the study.</p> <p> </p> <p>The initiative’s goal, broadly, was to strengthen connections between people on the ground as a way of preventing and healing the effects of difficult childhood experiences in their communities. The study’s evaluators found that organizations that intervene at the community level can be measurably effective when given adequate resources.</p> <p> </p> <p>For Wagoner’s part, he’s now doing the kind of community work that contributed to his own healing, working as a youth partner with Contra Costa County.</p> <p> </p> <p> </p> <p><strong>Youth in the juvenile justice system: Combating stigma with education</strong></p> <p> </p> <p>Attorney Nisha Ajmani, who manages the sentencing service program with the San Francisco-based Center on Juvenile and Criminal Justice and works with young people in the juvenile justice system, says that a history of difficult childhood experiences is the norm for young people in detention.</p> <p> </p> <p>“Even if a kid doesn’t have a mental health disorder or a diagnosis, most of these kids have experienced a traumatic event in their lives, whether it’s exposure to community violence or domestic violence, or being abused or neglected, or living in poverty,” she says.</p> <p> </p> <p>Being in detention can re-traumatize young people, says Ajmani, and people familiar with the juvenile justice system tend to agree that it’s difficult to deliver effective mental health treatment in a detention environment.</p> <p> </p> <p>Andrea Appleton, 24, is one young person who ended up in juvenile detention following traumatic experiences. She grew up in subsidized housing in the Western Addition, a historically low-income African American neighborhood in San Francisco, and lost a brother to gun violence when she was 11. She and her brother had been very close, and his death was a turning point in her life. Heading into her teens, it became more and more difficult for her to get along with her mother. She struggled with homelessness and ended up spending time in juvenile hall in San Francisco and in Solano County, her stays ranging from a few weeks to several months at a time.</p> <p> </p> <p>Though she says that being incarcerated was difficult, she also says that juvenile hall was one of the few stable places she’d lived. “It was good for me to stay there,” she says. “I was in a safe environment.”</p> <p> </p> <p>Today, she’s living with a friend and still needs to finish high school. While she didn’t like the schools she attended while she was in juvenile hall – known as “court schools” in California – she says her existing high school credits are mostly the ones she earned in detention. She has two children of her own now and is struggling, but is determined to do what she has to do to move forward, including finishing high school.</p> <p> </p> <p>Detention may not be the optimal place to address a young person’s mental health needs, but it can be a place to provide them with the opportunities they need in order to lead healthy lives later on – namely, by getting their education on track.</p> <p> </p> <p>For youth who have been incarcerated, “There is no clearer passport to rehabilitation than being a college student and having a college degree,” says attorney Jennifer Rodriguez, the executive director of the San Francisco-based Youth Law Center. Rodriguez herself spent time in detention when she was a kid. But, she says, “The moment that I had my law degree, nobody cared about my juvenile arrest record.” A college degree was the clean slate that she needed – it provided her with the opportunity to do what she wanted to do with her life.</p> <p> </p> <p><strong>Read the rest <a href="http://newamericamedia.org/2016/09/in-mental-health-care-are-we-treating-the-symptom-but-not-the-cause.php">here</a></strong>.</p> <p> </p> <p><strong>Author Bio: </strong></p> <p> </p> <p><strong><em>Anna Challet’s reporting on mental health and youth in the system was undertaken as a California Health Journalism Fellow at the Center for Health Journalism at the University of Southern California's Annenberg School of Journalism.</em></strong></p> </div></div></div><div class="field field-name-field-tags field-type-taxonomy-term-reference field-label-above"><div class="field-label">Tags:&nbsp;</div><div class="field-items"><div class="field-item even" rel="dc:subject"><a href="/mental-health" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">mental health</a></div><div class="field-item odd" rel="dc:subject"><a href="/affordable-care-act" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Affordable Care Act</a></div><div class="field-item even" rel="dc:subject"><a href="/mental-illness" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">mental illness</a></div><div class="field-item odd" rel="dc:subject"><a href="/healthcare" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">healthcare</a></div><div class="field-item even" rel="dc:subject"><a href="/health" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">health</a></div></div></div><div class="field field-name-field-author field-type-text field-label-hidden"><div class="field-items"><div class="field-item even">Anna Challet</div></div></div><div class="field field-name-field-pop field-type-list-boolean field-label-above"><div class="field-label">Popular:&nbsp;</div><div class="field-items"><div class="field-item even">not popular</div></div></div><div class="field field-name-field-photographer field-type-text field-label-above"><div class="field-label">Photographer:&nbsp;</div><div class="field-items"><div class="field-item even">New America Media</div></div></div><div class="field field-name-field-bot field-type-list-boolean field-label-above"><div class="field-label">Bottom Slider:&nbsp;</div><div class="field-items"><div class="field-item even">Out Slider</div></div></div> Sun, 18 Sep 2016 19:13:33 +0000 tara 7152 at https://www.highbrowmagazine.com https://www.highbrowmagazine.com/5993-treating-cause-not-symptom-mental-illness#comments Playing Politics, Governors Jindal, Perry Ditch State Citizens on Healthcare https://www.highbrowmagazine.com/2410-playing-politics-governors-jindal-perry-ditch-state-citizens-healthcare <div class="field field-name-field-cat field-type-taxonomy-term-reference field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/news-features" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">News &amp; Features</a></div></div></div><span class="submitted-by">Submitted by tara on Tue, 05/07/2013 - 09:50</span><div class="field field-name-field-image field-type-image field-label-hidden"><div class="field-items"><div class="field-item even" rel="og:image rdfs:seeAlso" resource="https://www.highbrowmagazine.com/sites/default/files/styles/large/public/field/image/2mediumjindal.jpg?itok=Js7t5dq7"><img typeof="foaf:Image" src="https://www.highbrowmagazine.com/sites/default/files/styles/large/public/field/image/2mediumjindal.jpg?itok=Js7t5dq7" width="480" height="268" alt="" /></div></div></div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="content:encoded"><p>  </p> <p> From <a href="http://newamericamedia.org/2013/05/eyeing-white-house-govs-jindal-and-perry-ditch-citizens-on-health-care.php">New America Media</a> and <a href="http://www.blackstarnews.com/">Black Star News</a>:</p> <p>  </p> <p> <strong>Commentary</strong></p> <p>  </p> <p> Last week, 400,000 poor and underserved Louisianans, many them people of color, were shut out of potentially life-saving health insurance under the Affordable Care Act (ACA).</p> <p>  </p> <p> A Louisiana House health committee voted down a measure that would have forced Governor Bobby Jindal to opt into the Medicaid expansion provision of ACA that is being subsidized by the federal government to cover vulnerable communities.</p> <p>  </p> <p> Even more discouraging was the unfortunate reality that the vote was right along party lines. Is it too much to ask to keep partisanship out of our health care? I certainly hope not.Gov. Bobby Jindal made it perfectly clear that he won’t accept federal funding to expand Medicaid.</p> <p>  </p> <p> As he appears to be more focused on positioning for his own political future, this is coming at a huge cost to Louisianans. Louisiana has the second-highest rate of uninsured adults in the country. Many people — especially women and African Americans — in the state lack access to basic health care.</p> <p>  </p> <p> In fact, the American Congress of Obstetricians and Gynecologists estimates that of Louisiana’s 64 parishes, 33 do not have a single OB/GYN. Accepting federal dollars would mean that an estimated 398,000 more hardworking Louisianans would get basic health care when they need it, without facing devastating medical bills.</p> <p>  </p> <p> Medicaid expansion would also have the most positive impact on African Americans in the state; nearly half of those in our community who don’t have health insurance would likely gain coverage. Across the board, the percentage of uninsured in the state could actually drop by as much as 60 percent. It would also be a huge benefit to the state’s economy.</p> <p>  </p> <p> If the state doesn’t accept federal funding, it could actually cost Louisiana’s economy $15.7 billion over the next decade – money that could go to job creation and supporting small businesses, the backbone of our nation’s economy. There is no doubt that this would be life-changing for many Louisianans. More people would be able to afford preventive health care. They would be able to avoid chronic health problems, costly long-term medical care, and personal bankruptcy -- especially among African Americans, who often shoulder the increased cost of health care.</p> <p> <img alt="" src="/sites/default/files/mediumrickperry%20%28talkradionewsservice%29.jpg" style="width: 600px; height: 450px;" /></p> <p>  </p> <p> 
Of course, Louisiana is just one example. Some politicians in other parts of the country continue to put their own self-interests before the hardworking families in their state. In Texas, for example, Governor Rick Perry has vowed to block Medicaid expansion. That’s especially disturbing as Texas is the only state in the country that ranks higher than Louisiana in terms of uninsured people.</p> <p>  </p> <p> I write this as someone who understands via experience – not just hypotheses and projections – the fiscal burden many local governments are facing. As the former mayor of New Orleans, a former Louisiana State Senator and current head of the National Urban League, I’ve seen how basic health care can help empower people in underserved communities.</p> <p>  </p> <p> State lawmakers have a unique opportunity to care for more people than ever before, to make their states healthier than ever before and, in the process, save their states millions of dollars. It’s a pity that Louisiana lawmakers seem determined to reject what could be a boon for the state and for its residents who have suffered enough in recent years.</p> <p>  </p> <p> Folks like Bobby Jindal and Rick Perry must act on behalf of the millions of hardworking families across the country that will benefit from this funding, rather than play politics with their health and well-being. It’s up to lawmakers to lead on these issues, to accept federal aid to expand Medicaid and provide basic health care to millions of women and families.</p> <p>  </p> <p> By doing so, they have the potential to transform their states, improve – and save – lives, and reduce taxpayer costs.</p> <p>  </p> <p> <strong>Author Bio:</strong></p> <p> <em>Marc Morial is President and CEO of the National Urban League</em></p> <p>  </p> <p> <a href="http://www.blackstarnews.com/">Black Star News</a></p> <p>  </p> <p> <em><strong>Photos: New America Media; Talk Radio News Service (Creative Commons).</strong></em></p> </div></div></div><div class="field field-name-field-tags field-type-taxonomy-term-reference field-label-above"><div class="field-label">Tags:&nbsp;</div><div class="field-items"><div class="field-item even" rel="dc:subject"><a href="/marc-morial" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">marc morial</a></div><div class="field-item odd" rel="dc:subject"><a href="/rick-perry" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">rick perry</a></div><div class="field-item even" rel="dc:subject"><a href="/bobby-jindal" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">bobby jindal</a></div><div class="field-item odd" rel="dc:subject"><a href="/texas-governor" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">texas governor</a></div><div class="field-item even" rel="dc:subject"><a href="/louisiana-governor" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">louisiana governor</a></div><div class="field-item odd" rel="dc:subject"><a href="/healthcare" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">healthcare</a></div><div class="field-item even" rel="dc:subject"><a href="/health-insurance" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">health insurance</a></div><div class="field-item odd" rel="dc:subject"><a href="/obama-care" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">obama care</a></div><div class="field-item even" rel="dc:subject"><a href="/affordable-care-act" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Affordable Care Act</a></div></div></div><div class="field field-name-field-author field-type-text field-label-hidden"><div class="field-items"><div class="field-item even">Marc Morial</div></div></div><div class="field field-name-field-pop field-type-list-boolean field-label-above"><div class="field-label">Popular:&nbsp;</div><div class="field-items"><div class="field-item even">not popular</div></div></div><div class="field field-name-field-photographer field-type-text field-label-above"><div class="field-label">Photographer:&nbsp;</div><div class="field-items"><div class="field-item even">New America Media</div></div></div><div class="field field-name-field-bot field-type-list-boolean field-label-above"><div class="field-label">Bottom Slider:&nbsp;</div><div class="field-items"><div class="field-item even">Out Slider</div></div></div> Tue, 07 May 2013 13:50:29 +0000 tara 2817 at https://www.highbrowmagazine.com https://www.highbrowmagazine.com/2410-playing-politics-governors-jindal-perry-ditch-state-citizens-healthcare#comments 10 Questions That Should Have Been Asked During the Obama - Romney Debate https://www.highbrowmagazine.com/1691-10-questions-should-have-been-asked-during-obama-romney-debate <div class="field field-name-field-cat field-type-taxonomy-term-reference field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/news-features" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">News &amp; Features</a></div></div></div><span class="submitted-by">Submitted by tara on Wed, 10/17/2012 - 16:44</span><div class="field field-name-field-image field-type-image field-label-hidden"><div class="field-items"><div class="field-item even" rel="og:image rdfs:seeAlso" resource="https://www.highbrowmagazine.com/sites/default/files/styles/large/public/field/image/2mediumobamaromney%20%28wikipedia%29.jpg?itok=Yt8RqsZx"><img typeof="foaf:Image" src="https://www.highbrowmagazine.com/sites/default/files/styles/large/public/field/image/2mediumobamaromney%20%28wikipedia%29.jpg?itok=Yt8RqsZx" width="480" height="308" alt="" /></div></div></div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="content:encoded"><p>  </p> <p> From <a href="http://newamericamedia.org/2012/10/presidential-debate-top-10-questions-that-werent-asked.php">New America Media</a>:</p> <p>  </p> <p> <em>As Barack Obama and Mitt Romney squared off in the second presidential debate last night, New America Media editors posed 10 questions that have largely gone unasked -- and unanswered – in their campaigns.</em></p> <p>  </p> <p> <strong>1. U.S.-Mexico Border</strong></p> <p> Mitt Romney has pledged to finish the wall on the border with Mexico. What will that mean for U.S. relations with the country that gave his grandfather sanctuary as a polygamist?</p> <p>  </p> <p> <strong>2. Drugs</strong></p> <p> Our prisons are overcrowded with people who were arrested on nonviolent drug offenses. Street violence in American inner cities is largely a result of an illegal drug economy. Meanwhile, abuse of prescription drugs is a growing crisis. What would you change about current drug policy to alleviate these problems?</p> <p>  </p> <p> <strong>3. Federal Poverty Line</strong></p> <p> The Federal Poverty Line (FPL) masks U.S. poverty at a time when more Americans are struggling to make ends meet. What will you do to see that government figures are more honest--such as the new measure by the National Academy of Science? And what would you say to the growing numbers of people who aren't considered poor enough to qualify for assistance, but who are struggling just to get by?</p> <p>  </p> <p> <strong>4. South China Sea</strong></p> <p> The Asia-Pacific region is now in turmoil with many countries fighting over territorial rights over the South China Sea as well as the Eastern Sea, chief among them China. With so much at stake -- vast oil and natural pockets and potential rare earth and important shipping lanes -- how will the U.S. deal with this highly contentious situation and can it afford stay out of the skirmish?</p> <p>  </p> <p> <strong>5. Guantanamo</strong></p> <p> There are still 166 prisoners remaining at Guantanamo Bay, and many of them have been there for over a decade. Though it’s off the radar for many Americans, it is a sore point for many others who view it as a symbol of American imperialism and injustice. As president, what would you do about it? Will it be a permanent prison for those who are deemed ineligible for due process?</p> <p>  </p> <p> <strong>6. Teacher Shortage</strong></p> <p> The U.S. is lagging behind other countries in education. Meanwhile, we are facing a shortage of teachers and the profession is becoming less diverse. What are you going to do to stem this decline in recruitment of qualified teachers and keep the teaching profession diverse?</p> <p>  </p> <p> <strong>7. Energy Independence</strong></p> <p> Both campaigns have pushed for energy independence. Yet experts say the costs of this would be high and the solution would only be temporary. Energy independence sounds good but is it really achievable or is it a myth?</p> <p>  </p> <p> <strong>8. The Longevity Gap</strong></p> <p> A new study by the MacArthur Foundation shows a widening gap in life expectancy in the past 20 years, with those at low education levels living up to 10 years less than people with higher education levels. How would you reverse this trend?</p> <p>  </p> <p> <strong>9. Military Intervention</strong></p> <p> When is military intervention justified to prevent massive human rights violations, for example in North Korea or Syria?</p> <p>  </p> <p> <strong>10. Vision for America</strong></p> <p> We’ve put a man on the moon. We launched the Peace Corps. Periodically the president has inspired America to think about new frontiers. What’s the new frontier for America?</p> <p>  </p> <p> <a href="http://newamericamedia.org/2012/10/presidential-debate-top-10-questions-that-werent-asked.php">New America Media</a></p> </div></div></div><div class="field field-name-field-tags field-type-taxonomy-term-reference field-label-above"><div class="field-label">Tags:&nbsp;</div><div class="field-items"><div class="field-item even" rel="dc:subject"><a href="/presidential-debates" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">presidential debates</a></div><div class="field-item odd" rel="dc:subject"><a href="/president-obama" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">President Obama</a></div><div class="field-item even" rel="dc:subject"><a href="/mitt-romney" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Mitt Romney</a></div><div class="field-item odd" rel="dc:subject"><a href="/education" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">education</a></div><div class="field-item even" rel="dc:subject"><a href="/healthcare" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">healthcare</a></div><div class="field-item odd" rel="dc:subject"><a href="/mexico" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Mexico</a></div><div class="field-item even" rel="dc:subject"><a href="/2012-elections" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">2012 elections</a></div><div class="field-item odd" rel="dc:subject"><a href="/poverty-levels" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">poverty levels</a></div><div class="field-item even" rel="dc:subject"><a href="/drugs" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">drugs</a></div><div class="field-item odd" rel="dc:subject"><a href="/us-military" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">U.S. military</a></div></div></div><div class="field field-name-field-author field-type-text field-label-hidden"><div class="field-items"><div class="field-item even">NAM Staff</div></div></div><div class="field field-name-field-pop field-type-list-boolean field-label-above"><div class="field-label">Popular:&nbsp;</div><div class="field-items"><div class="field-item even">not popular</div></div></div><div class="field field-name-field-photographer field-type-text field-label-above"><div class="field-label">Photographer:&nbsp;</div><div class="field-items"><div class="field-item even">Wikipedia Commons</div></div></div><div class="field field-name-field-bot field-type-list-boolean field-label-above"><div class="field-label">Bottom Slider:&nbsp;</div><div class="field-items"><div class="field-item even">Out Slider</div></div></div> Wed, 17 Oct 2012 20:44:59 +0000 tara 1748 at https://www.highbrowmagazine.com https://www.highbrowmagazine.com/1691-10-questions-should-have-been-asked-during-obama-romney-debate#comments