Tag Archives: health care

What is Obama’s Legacy?

New York Magazine asked 53 historians what Barack Obama’s legacy will be

Almost every respondent wrote that the fact of his being the first black president will loom large in the historical narrative — though they disagreed in interesting ways. Many predict that what will last is the symbolism of a nonwhite First Family; others, the antagonism Obama’s blackness provoked; still others, the way his racial self-consciousness constrained him. A few suggested that we will care a great deal less about his race generations from now — just as John F. Kennedy’s Catholicism hardly matters to current students of history. Across the board, Obamacare was recognized as a historic triumph (though one historian predicted that, with its market exchanges, it may in retrospect be seen as illiberal and mark the beginning of the privatization of public health care). A surprising number of respondents argued that his rescue of the economy will be judged more significant than is presently acknowledged, however lackluster the recovery has felt. There was more attention paid to China than isis (Obama’s foreign policy received the most divergent assessments), and considerable credit was given to the absence of a major war or terrorist attack, along with a more negative assessment of its price — the expansion of the security state, drones and all. 

The health divide between the rich and the poor

From the new head of the CMA

In her emergency room on Sunday Dr. Anna Reid treated patients in the throes of delirium tremens — severe alcohol withdrawal after a weeklong binge. One arrived with life-threatening seizures.

The incoming president of the most influential doctors’ group in the country also saw homeless patients with cellulitis — deep, severe and fast-spreading infections in their feet and lower legs from wearing the same pair of ripped, worn and wet shoes for more than a year.

"Those are the kinds of things I see on a daily basis," Reid says — homeless, addicted and mentally ill patients stranded in her Yellowknife emergency room, some of them residential school survivors who can’t function in society, she says, "because they don’t have any sense of who they are anymore."

The health divide between rich and poor perhaps gets no more blatant than in the North. "It’s in your face everywhere you turn," she says.

She doesn’t paint a rosy picture

Earlier this year outgoing CMA president Dr. John Haggie accused the Harper government of gnawing away at the country’s social safety net, warning that plans to raise the pension eligibility age to 67 would force low-income seniors to choose between buying groceries or buying medicine.

Reid says the profession has become "deeply demoralized" through the years because of a "top-down, this-is-what’s-going-to-happen" approach to local health planning and a federal government that seems to be distancing itself from health care.

"I think there’s this sense that the government has withdrawn from some of its responsibility to take true leadership on the health care portfolio," she said.

Haggie is attending the Global Health Policy Summit in London. "I got, from out of nowhere, an invitation from the United Kingdom prime minister to come and meet him," Haggie said on Tuesday. "I have not got past the receptionist and staffers at the PMO (Prime Minister Stephen Harper’s office).

"Because they don’t want to talk about health care, because they think that by doing it, somehow, I might pin them as being responsible for it. The Constitution and the British North America Act and the Charter, they pin them, not me. You can’t hide and hope it will all go away."

Reid says she is "proud" to live in a country "where I know that if there’s something wrong with you, you can go to a hospital and get health care and that’s fantastic."

But she said Canadians should expect to get equal health care no matter where they live or travel in the country. Instead, she said, "It’s a different set of rules everywhere you go in the country."

and this

"We see mental health issues — problems with addiction, suicide. Our suicide risk in Northwest Territories and Nunavut are many times the national average," she said.

"A lot of these issues are really worsened by a lot of the social determinants of health — poor economic status, poor education, poor housing. I see in my emergency room, my practice every day, huge outcomes from these health inequities."

But the problems aren’t restricted to the North. Reid has said that "cracks and chasms" exist across the country, from poor access to specialists, to medically unacceptable wait lists.

She said the federal government needs to take a larger role in setting standards and conditions for how money given to the provinces and territories is spent.

"We’re a country here, we’re all Canadians and this is federal money going out to the provinces," said Reid.

She believes in a strong publicly funded system but says Canadians must confront how to fill the gaps not covered by the Canada Health Act — "no pharmaceutical strategy, no long-term care strategy.

"How are we going to provide pharmaceuticals? Is it going to be a social insurance scheme? Is it going to be a private insurance plus public partnership? Society is going to have to decide how they’re going to have these services delivered."

The mess that is hospital insurance in the United States

I read this over at Meg Hourihan’s blog and am still shocked that people disagree with health care reform.

I haven’t had employer-provided health care in over ten years, which means I’ve been paying for individual or small group insurance for myself and now my family every month. Every year my premiums increase by 30%, so I’ve changed providers going from crappier to crappier policies until now we’ve got the cheapest I can find. This "cheap" policy is costing over $1300 a month and is an HMO, so it only covers in-network providers. Because it’s not a very good insurance company, very few providers take it. For my OB/GYN I just pay out-of-pocket for my appointments.

Two things now: my pediatrician referred my son to an ear-nose-throat specialist to check his hearing. None of his referrals take our insurance, so I called the company, used their website to pick a random doctor, called the doctor and was told they didn’t take it, was transferred to another doctor, was transferred again and finally ended up with a fax line picking up my call after fifteen minutes on the phone. After two hours calling various people, I gave up and am now going to pay out-of-pocket for the referred doctor for Ollie tomorrow.

Some time last week I think I stepped on a piece of glass. There’s something in my heel and I’ve soaked it and squeezed and tweezed but whatever it is, I can’t get it. It’s been throbbing for a week. My primary care physician can’t see me for two weeks. Their urgent care center takes my insurance but I have to make them my PCP to have the visit covered. Another local urgent care facility doesn’t take my insurance. So basically if I want to address this before May 24 and not pay out-of-pocket, I need to go to the ER and it’s a $50 copay.

This is after paying $1300/month.  I have written about Canadian medicare before and while it’s not perfect, it’s a lot better than what Meg describes.

Depression haunts homeless children

From Minnesota Public Radio

A new report by the Wilder Foundation estimates 4,500 children in Minnesota spend time in shelters on any given night — the highest number since the surveys began 20 years ago.

Those children are often haunted by depression, the study shows. Whether homeless children and teens get help and support has a big impact on whether they end up homeless as adults.

The Wilder research shows about half of all homeless children in Minnesota are younger than the age of 6. The organization found that children who grow up under this kind of stress have lasting physical and emotional problems that are hard to overcome.

The Wilder report found that one-third of homeless parents were homeless themselves as children, and 35 percent of homeless parents report struggling with depression.

Nothing in the report surprised me but from what we see in Saskatchewan, it’s a much higher percentage of children under six and from the amount of anti-depressants I see, it’s a higher percentage of people struggling with mental health issues although I wonder if that is because of Medicare and the supplemental health insurance that families on social assistance receive.