Achild
without health insurance is three times
as likely to have no regular doctor, more
likely to have sore throats and earaches,
more likely to be absent from school and
less likely to be up to date on vaccinations.
New census figures show that in the past
year 8.3 million children were not insured,
the highest rate number since 1998 and
a jump in one year from 10.8 percent to
11.3 percent.
H
I T S
An
HBNS story from the Annals of Behavioral
Medicine linking post-partum smoking with
concerns about weight gain won wide coverage,
with usage in the Los Angeles Times, Washington
Post, Pittsburgh Post-Gazette, Scripps-Howard
News Service, the Sydney Morning Herald
and the Web sites of CBS News and USA Today.
M
I S S E S
The
usually reliable USA Today had a big expose
about the danger of fatal fires on college
campuses, often involving student drinking.
While such stories are of legitimate interest,
and feed television's lust for flames, The
New Republic's Michelle Cottle points out
that the actual rate of campus fire fatalities
is far less than the rate in the general
population and about one-seventh the risk
of getting killed by lightning. The real
problem, she notes, is fire fatalities among
the elderly, which are two to three times
more likely than among the general populace. http://www.tnr.com/doc.mhtml?i
=w060828&s=cottle090106.
The United States
still ranks miserably low among industrialized countries
in the overall quality of health care despite spending at
more than twice the rate of the average of all peer nations.
Jessie
Gruman President
and Executive Director
Center for the
Advancement of Health
The
Commonwealth Fund recently issued a scorecard that
rates performance on 37 different measures. We are
nowhere near the top in any of them, except the cost
and inefficiency of the health system. Overall, we
rate 66 on a scale of 100, and on the measure of deaths
due to preventable causes, America is 15th out of 19,
with first place going to France. No industrialized
country is even close to the U.S. rate of uninsured
people.
Things
may get worse after Election Day when Medicare Part
D begins a new enrollment period, with penalties for
latecomers to the system and the possibility that more
insurance plans will bow out of the system, citing
government restraint on their ability to appropriately
reward stockholders or compensate their chief executives.
So with
less choice for Medicare recipients and with fewer
employers offering health insurance, a market exists
for those who need to buy insurance the old-fashioned
way -- shopping for an individual plan. But another
study by the Commonwealth Fund reports that nearly
90 percent of people in that market are going uninsured
either because of cost or because of a prior condition
that makes them virtually uninsurable at any price.
It isn't
just older Americans or hourly-wage workers who are
floundering. The Institute of Medicine says that one-third
of the nation's nearly 75 million kids are, or are
at risk of, becoming obese. Blame is everywhere, especially
on parents and the kids themselves. But many children
also are captive of the lunch choices schools provide,
they watch television advertising and they live where
street crime keeps them indoors and sedentary.
Those
factors are not flaws of individual character but of
a public policy influenced more by Wall Street and
K Street than by Sesame Street.
Those
with a more optimistic view believe the free market
can best provide health equity and quality. Look at
what it already did: After 12 months of drug prices
rising at twice the rate of inflation, they leveled
off this summer. Even Wal-Mart is looking to slash
prices for generic drugs to as low as $4 a prescription.
And you can see the free market at work at the gas
pump, where prices dropped about a third in the month
of September alone -- a coincidence of astounding politico-calendric
proportions.
I am not
pessimistic, because there are plenty of policy solutions
to the lousy rankings on mortality, the low priority
on disease-prevention, the high number of uninsured
and the even higher price of obesity. But unlike gasoline
and drug prices, those solutions will have to wait
until after Election Day.
FROM THE CENTER
Center
President Jessie Gruman appeared on the Webcast "Health
Talk" to discuss her new book: "AfterShock: What
to Do When the Doctor Gives You -- or Someone You Love -- a
Devastating Diagnosis," due in bookstores next February
and at http://tinyurl.com/lroa5. The Webcast can be heard at
http://www.healthtalk.com/live/programs/ under the Sept. 20
entry.
Dr. Gruman also
spoke at the Fifth Annual Information Therapy Conference
on "Catalysts for Innovation" in Park City, Utah,
and at the Vantage Point meeting in Madison, Wis., on "Learning
to Be a Patient: Who Knew You Needed a Degree?" She
will speak at the ECRI conference on dilemmas of risk in
health care practice and policy Nov. 15-16. (Details below)
A number of
Kellogg Scholars and Fellows -- David Chae, Emily
Ihara, Naima Wong, Rashid Njai, Alek Sripipatana, Rajni Banthia,
April Oh, and program director Barbara Krimgold --
attended a Kellogg-supported conference of the Asian Pacific
Islander American Health Forum in San Jose, presenting papers
and participating in workshops. Barbara also spoke and ran
two workshops on soon-to-launch Diversity Data Website for
the Health Institute of the Joint Center for Political and
Economic Studies.
HEALTH AND BEHAVIOR INFORMATION TRANSFER
NEW
DEPUTY AT OBSSR Deborah Olster, Ph.D., has been
named deputy director of the Office of Behavioral and Social
Sciences Research at NIH. She joined the office in 2002 as
an expert in neuroendocrine control of reproduction.
RISK
DILEMMAS ECRI, a nonprofit research agency,
is holding a conference Nov. 15-16 in suburban Philadelphia
on "Confronting Dilemmas of Risk in Healthcare:
Emerging Trends and Practical Approaches for Decision
Makers." Register at http://www.ta.ecri.org/taconf/2006/.
GENES
AND BEHAVIOR The Institute of Medicine has
a new report called "Genes, Behavior, and the
Social Environment: Moving Beyond the Nature/Nurture
Debate." http://www.iom.edu/CMS/3740/24591/36574.aspx.
WEBINAR
ON DISPARITIES The National Institute for
Health Care Management Foundation is conducting a webinar
Oct. 30 from 1 p.m.- 3 p.m. EST on "Strategies & Challenges
to Reduce Disparities and Ensure Culturally Competent
Maternal & Child Health Care." http://www.nihcm.org/finalweb/registration.pdf.
