Showing posts with label healthcare. Show all posts
Showing posts with label healthcare. Show all posts

Friday, January 15, 2016

Hillary, Hypocrisy, and Healthcare

In a video from February 2008, presidential candidate Hillary Clinton passionately denounces candidate Barack Obama for criticizing her healthcare plan and daring to “discredit universal healthcare.”
“Since when do Democrats attack each other on universal healthcare?!” Clinton exclaims. Check out this video mashup of Clinton’08 and Clinton ’16.
She finds Obama’s comments to be “Republican talking points,” “the worst kind of politics,” and “very reminiscent of the health insurance industry’s attacks … the last time we went after universal healthcare.”
That “last time” was a reference to the effort Hillary led during Bill Clinton’s presidency. We learned later from the late Senator Paul Wellstone that her focus groups were presented with a single-payer plan and supported it above all others, but that Hillary Clinton rejected that approach.
A single-payer health plan is, of course, the solution long since arrived at by every other major country on earth. It eliminates private health insurance companies, their bureaucracy, their advertising, their CEO salaries, and other overhead. Under such a system, everyone is covered, and the cost is dramatically lowered. Under such a system, many might pay more in taxes, but not as much more as they would save by eliminating their insurance bills, deductibles, and co-pays.
Campaigning as a surrogate for her mom, Chelsea Clinton now claims in words very reminiscent of insurance industry talking points, that “Senator [Bernie] Sanders wants to dismantle Obamacare, … dismantle Medicare, and dismantle private insurance. … I worry if we give Republicans Democratic permission to do that, we’ll go back to an era — before we had the Affordable Care Act — that would strip millions and millions and millions of people off their health insurance.”

She also claimed, inaccurately, as has her mother, that Sanders’ single-payer plan would “empower” Republican governors to eliminate health insurance for low and middle-income Americans. While Sanders’ plan, unlike Congressman John Conyers’, does involve the states, it does not do what the Clintons are claiming.
Sanders responded, pointing out that the United States is “the only major country on Earth that doesn’t guarantee healthcare to all people as a right, and yet we end up spending far more per capita on healthcare as do the people of any other nation.”
ABC News asked Hillary Clinton on camera how she could justify her daughter’s claims that a truly universal system would strip people of health coverage. Clinton refused to concede the point, and changed topics to make a misleading claim that single-payer would cost more.
It would not.
Under Sanders’ proposal, unless you are among the top 5% of income earners, single-payer would reduce your total healthcare costs.
Hillary Clinton has been a leading opponent of single-payer healthcare for decades now. That doesn’t give her the right to lie about it. A system of enhanced Medicare for all, which is what single-payer amounts to, does not strip people of Medicare. It expands Medicare so that everyone is covered.
In doing that, single-payer of course replaces Obamacare, an approach originated by Republicans and the right-wing Heritage Foundation in collaboration with health profiteers who would be put out of work and out of the game of election funding if single-payer were established.
In that light, it’s worth noting that since 2013, Hillary Clinton has pocketed $2.8 million in exchange for giving 13 speeches to health-profiteering industry groups.
For that kind of money, some people will tell you anything you want to hear.
I’ve signed this petition and you can to: Hillary, Stop lying about single-payer.

Tuesday, July 7, 2015

Protecting Patients and Stopping Outbreaks

Antibiotic resistance in healthcare settings is a significant threat to public health.  Because almost all Americans will receive care in a medical setting at some point, antibiotic resistance can affect anyone.  By preventing antibiotic resistance in healthcare settings, patients’ lives are better protected and their health can be preserved.
Antibiotic-resistant infections can happen anywhere.  Data show that most happen in the general community; however, most deaths related to antibiotic resistance happen in inpatient healthcare settings, such as hospitals and nursing homes

Inpatient Healthcare Settings

Inpatient Healthcare Providers

  • Know what types of drug-resistant infections are present in your facility and patients.
  • Request immediate alerts when the lab identifies drug-resistant infections in your patients.
  • Alert receiving facility when you transfer a patient with a drug-resistant infection.
  • Protect patients from drug-resistant infections.
  • Follow relevant guidelines and precautions at every patient encounter.
  • Prescribe antibiotics wisely.
  • Remove temporary medical devices such as catheters and ventilators as soon as they are no longer needed.

Health Care CEOs, Medical Officers, and Other Healthcare Facility Leaders

  • Require and strictly enforce CDC guidance for infection detection, prevention, tracking, and reporting.
  • Make sure your lab can accurately identify infections and alert clinical and infection prevention staff when these bacteria are present.
  • Know infection and resistance trends in your facility and in the facilities around you.
  • When transferring a patient, require staff to notify the other facility about all infections.
  • Join or start regional infection prevention efforts.
  • Promote wise antibiotic use.
 Top of Page

Resources for Healthcare

Outpatient Healthcare Settings

Antibiotic-resistant infections outside of the hospital setting were rare until recently.
  • Prescribing antibiotics when they are not needed or prescribing the wrong antibiotic in outpatient settings such as doctors’ offices is common.  
  • In some cases, doctors might not order laboratory tests to confirm that bacteria are causing the infection, and therefore the antibiotic might be unnecessarily prescribed.  
  • In other cases, patients demand treatment for conditions such as a cold when antibiotics are not needed and will not help.
Resources for Outpatient Healthcare Settings
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Steps to Combat Antimicrobial Resistance in Outpatient Settings

StepsSuggestions for implementation
Improve antibiotic prescribing
Use current clinical guidelines to support rational and
appropriate antibiotic prescribing
Share unremarkable finding during the examination (e.g., "no inflammation" or "normal breathing"), while acknowledging the patient is sick.
Determine the likelihood of a bacterial infection, especially for upper respiratory track infections.
Provide a specific diagnosis (e.g., "viral bronchitis" vs "virus")
Weigh benefits vs harms of antibiotics
Communicate with patients about when and why antibiotics may not be necessaryExplain that unnecessary antibiotic use can be harmful (e.g., adverse effects associated with antibiotic use, potential resistance development)
Explain that treating viral infections with antibiotics does not work
Explicitly plan treatment of symptoms by describing the expected normal course of the illness, and instruct patients to call or come back if symptoms persist or worsen; consider providing care packages with non antibiotic therapies
Educate patients if an antibiotic is neededEncourage adherence
Discuss potential adverse effects
Create an office environment that promotes a reduction in antibiotic useStart the process in the waiting room with videos, posters, and other materials
Hang posters in examination rooms to display a commitment to not prescribe antibiotics for viral infections
Involve office personnel in the reinforcement of the physician's messages
Prevent infections and the spread of resistant bacteria
Ensure that all patients get recommended vaccinations
Prevent cross-transmission
Provide pneumococcal and influenza vaccines (to help avoid secondary bacterial infections)., which are particularly important
Counsel patients onhow to avoid spreading or becoming infected with resistant pathogens in the community (e.g., methicillin-resistant Staphylococcus aureus)
Follow recommendations for infections control in outpatient settings (http://www.cdc.gov/hai/settings/outpatient/outpatient-care-guidelines.html)
Monitor antibiotic-resistant infections
Report notifiable diseasesReport to the health department any diseases caused by bacteria on the Centers of Disease Control and Prevention's list of urgent and serious pathogens (reporting requirements differ by U.S. state and Canadian province); antibiotic-resistant strains of some bacteria (e.g., methicillin-resistant Staphylococcus aureus) are reportable in some states
Be alert for treatment failuresConsider the possibility of antibiotic resistance in cases of treatment failure; obtain laboratory confirmation and notify local public health authorities in case of unusual or unexpected treatment failure
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Biggest Antibiotic Resistance Threats in Healthcare

Microorganism Notable information
Urgent
Clostridium difficileA1,A2Deaths related to C. difficile increased 400% between 2000 and 2007, in part because of a stronger strain
Most infections are connected to receiving medical care
Hand sanitizer does not kill C. difficile, and hand washing may not be sufficient
Carbapenem-resistant EnterobacteriaceaeA3Difficult to treat and, in some cases, untreatable
Kills up to one-half of patients who get bloodstream infections
Easily spreads antibiotic resistance to other bacteria
Drug-resistant Neisseria gonorrhoeaeA4Cases in the United States are more prevalent in the West and among men who have sex with men
All patients treated for gonorrhea should routinely be offered condoms, referred for risk-reduction counseling, and retested for gonorrhea three months later
Serious
Multidrug-resistant AcinetobacterA5Increasingly common in U.S. health care facilities; hard to treat
Noted in U.S. service members wounded in Iraq and Afghanistan
Drug-resistant CampylobacterA6Most cases are sporadic and not part of outbreaks
Ciprofloxacin (Cipro) resistance to Campylobacter increased from 12% in 1997 to 24% in 2011
Fluconazole- (Diflucan-) resistant Candida (fungus)A7-A9Antifungal resistance in mucosal candidiasis varies by species
Extended spectrum β-lactamase producing EnterobacteriaceaeA10,A11Infections have become more common in recent years
Once confined largely to hospitals, these bacteria, especially Escherichia coli, are increasingly common in community-acquired infections, particularly urinary tract infections
Vancomycin-resistant EnterococcusA12-A14Enterococci are the fifth most common cause of health care–associated infections
Most likely to be found in urine and in wounds; may pose a risk for spreading in the outpatient setting
Multidrug-resistant Pseudomonas aeruginosaA15,A16About 8% of all health care–associated infections are caused by P. aeruginosa; about 13% of severe P. aeruginosa health care–associated infections are multidrug resistant
P. aeruginosa may be isolated from outpatients with otitis, skin rash, and urinary tract infections
Drug-resistant non-typhoidal SalmonellaA17,A18Estimated 1.2 million cases occur each year in the United States; most go unreported
About 100,000 of cases (8%) are caused by drug-resistant SalmonellaOutbreaks occur each year; some involve multiple states and/or national distribution
Drug-resistant Salmonella serotype TyphiA19Estimated 5,700 cases annually in the United States
Most (up to 75%) are acquired during international travel
Increasing resistance to antibiotics, especially fluoroquinolones
Drug-resistant ShigellaA20High-risk groups include children in day care centers (younger than five years) and their caregivers, men who have sex with men, international travelers, and persons in custodial institutions
Increasing resistance to ciprofloxacin and azithromycin (Zithromax) is of particular concern
MRSAA21-A23Although overall cases of invasive MRSA are declining, the proportion of community-associated infections has increased
MRSA should be considered in the differential diagnosis of skin and soft tissue infections
Drug-resistant Streptococcus pneumoniaeA24The increasing threat of antibiotic resistance makes vaccination according to the Advisory Committee for Immunization Practices’ recommendations for children and adults more important
Drug-resistant TBA25,A26The number of TB cases is declining in the United States
63% of TB cases in the United States occur among foreign-born persons
The proportion of primary multidrug-resistant TB cases occurring among foreign-born persons has been increasing
Concerning
Vancomycin-resistant Staphylococcus aureusA27Rare; 13 cases have been identified in the United States since 2002
The severity of the consequences of S. aureus resistance to vancomycin require continued vigilance for this pathogen
Erythromycin-resistant Group A StreptococcusA28Penicillin remains the drug of choice, but the resistance to other drugs needed for patients allergic to penicillin is worrisome
Of samples tested by the CDC, 10% were erythromycin-resistant and 3.4% were clindamycin-resistant
Clindamycin-resistant Group B StreptococcusA29Neonates, pregnant women, and persons older than 65 years with underlying conditions are at highest risk
Penicillin remains the drug of choice, but the resistance to other drugs needed for patients allergic to penicillin is worrisome
NOTE: Additional information on the microorganisms in this table can be found in the CDC’s antibiotic threats report at http://www.cdc.gov/drugresistance/threat-report-2013/index.html(http://www.cdc.gov/drugresistance/threat-report-2013/index.html) (accessed March 27, 2014).
CDC = Centers for Disease Control and Prevention; MRSA = methicillin-resistant Staphylococcus aureus; TB = tuberculosis.

Monday, December 30, 2013

ORIGINAL - U.S. Healthcare FACQS: By the incomparable John Green, who says the following about his sources: "For a much more thorough examination of health care expenses in America, I recommend this series at The Incidental Economist and The Commonwealth Fund's Study of Health Care Prices in the U.S. Some of the stats in this video also come from this New York Times story."


Saturday, November 23, 2013

21 Ways Canada's Single-Payer System Beats Obamacare

Canadian style single-payer healthcare is simple, affordable, comprehensive and universal—unlike the US's labyrinthine ACA.

November 22, 2013  |
This article originally appeared on The Nader Page, and is reposted here with their permission.
Dear America: Costly complexity is baked into Obamacare. No health insurance system is without problems but Canadian style single-payer full Medicare for all is simple, affordable, comprehensive and universal. In the early 1960s, President Lyndon Johnson enrolled 20 million elderly Americans into Medicare in six months. There were no websites. They did it with index cards! Below please find 21 Ways the Canadian Health Care System is Better than Obamacare. Repeal Obamacare and replace it with the much more efficient single-payer, everybody in, nobody out, free choice of doctor and hospital. Love, Canada
Number 21: In Canada, everyone is covered automatically at birth – everybody in, nobody out. In the United States, under Obamacare, 31 million Americans will still be uninsured by 2023 and millions more will remain underinsured.
Number 20: In Canada, the health system is designed to put people, not profits, first. In the United States, Obamacare will do little to curb insurance industry profits and will actually enhance insurance industry profits.
Number 19: In Canada, coverage is not tied to a job or dependent on your income – rich and poor are in the same system, the best guaranty of quality. In the United States, under Obamacare, much still depends on your job or income. Lose your job or lose your income, and you might lose your existing health insurance or have to settle for lesser coverage.
Number 18: In Canada, health care coverage stays with you for your entire life. In the United States, under Obamacare, for tens of millions of Americans, health care coverage stays with you for as long as you can afford your share.
Number 17: In Canada, you can freely choose your doctors and hospitals and keep them. There are no lists of “in-network” vendors and no extra hidden charges for going “out of network.” In the United States, under Obamacare, the in-network list of places where you can get treated is shrinking – thus restricting freedom of choice – and if you want to go out of network, you pay for it.
Number 16: In Canada, the health care system is funded by income, sales and corporate taxes that, combined, are much lower than what Americans pay in premiums. In the United States, under Obamacare, for thousands of Americans, it’s pay or die – if you can’t pay, you die. That’s why many thousands will still die every year under Obamacare from lack of health insurance to get diagnosed and treated in time.
Number 15: In Canada, there are no complex hospital or doctor bills. In fact, usually you don’t even see a bill. In the United States, under Obamacare, hospital and doctor bills will still be terribly complex, making it impossible to discover the many costly overcharges.
Number 14: In Canada, costs are controlled. Canada pays 10 percent of its GDP for its health care system, covering everyone. In the United States, under Obamacare, costs continue to skyrocket. The U.S. currently pays 18 percent of its GDP and still doesn’t cover tens of millions of people.
Number 13: In Canada, it is unheard of for anyone to go bankrupt due to health care costs. In the United States, under Obamacare, health care driven bankruptcy will continue to plague Americans.
Number 12: In Canada, simplicity leads to major savings in administrative costs and overhead. In the United States, under Obamacare, complexity will lead to ratcheting up administrative costs and overhead.
Number 11: In Canada, when you go to a doctor or hospital the first thing they ask you is: “What’s wrong?” 
Number 10:  In the United States, the first thing they ask you is: “What kind of insurance do you have?” In Canada, the government negotiates drug prices so they are more affordable. In the United States, under Obamacare, Congress made it specifically illegal for the government to negotiate drug prices for volume purchases, so they remain unaffordable.
Number 9: In Canada, the government health care funds are not profitably diverted to the top one percent. In the United States, under Obamacare, health care funds will continue to flow to the top. In 2012, CEOs at six of the largest insurance companies in the U.S. received a total of $83.3 million in pay, plus benefits.
Number 8: In Canada, there are no necessary co-pays or deductibles. In the United States, under Obamacare, the deductibles and co-pays will continue to be unaffordable for many millions of Americans.
Number 7: In Canada, the health care system contributes to social solidarity and national pride. In the United States, Obamacare is divisive, with rich and poor in different systems and tens of millions left out or with sorely limited benefits.
Number 6: In Canada, delays in health care are not due to the cost of insurance. In the United States, under Obamacare, patients without health insurance or who are underinsured will continue to delay or forgo care and put their lives at risk.
Number 5: In Canada, nobody dies due to lack of health insurance. In the United States, under Obamacare, many thousands will continue to die every year due to lack of health insurance.
Number 4: In Canada, an increasing majority supports their health care system, which costs half as much, per person, as in the United States. And in Canada, everyone is covered. In the United States, a majority – many for different reasons – oppose Obamacare.
Number 3: In Canada, the tax payments to fund the health care system are progressive – the lowest 20 percent pays 6 percent of income into the system while the highest 20 percent pays 8 percent. In the United States, under Obamacare, the poor pay a larger share of their income for health care than the affluent.
Number 2: In Canada, the administration of the system is simple. You get a health care card when you are born. And you swipe it when you go to a doctor or hospital. End of story. In the United States, Obamacare’s 2,500 pages plus regulations (the Canadian Medicare Bill was 13 pages) is so complex that then Speaker of the House Nancy Pelosi said before passage “we have to pass the bill so that you can find out what is in it.”
Number 1: In Canada, the majority of citizens love their health care system. In the United States, the majority of citizens, physicians, and nurses prefer the Canadian type system – single-payer, free choice of doctor and hospital , everybody in, nobody out.
For more information see Single Payer Action.