Saturday, February 24, 2007
I have not been posting much over the past months because my grandmother, age 92, fell and broke her hip shortly after Thanksgiving. She is doing much better but is still not back to her old self. She was living on her own and is back at home now with some daily visits from a nurse. We are now working on locating a new home for her. She is reluctant to move and lives in a small town that doesn't have very good nursing home or assisted living options - making things rather difficult. She is a wonderful woman that we love very much but also worry about living by herself. We are working through various options and hopefully all will work out for the best.
In the meantime, I wanted to link to this recent post at Firedoglake concerning Medicare and Walter Reed but also mentioning Medicare's nursing home compare website - a very help site if you need to find a nursing home.
Friday, February 23, 2007
As you know, early last year South Dakota enacted an extremely restrictive abortion ban (abortion permissible only to save a woman's life, no exceptions for rape or incest) that was later overturned by the South Dakota voters in November. In response to the voters, the state legislature attempted to pass another abortion ban. This new legislation, that contained exceptions for rape, incest and life-threatening conditions, has failed to pass the Senate Affairs committee on an 8 to 1 vote. For more information and some of the recent history of South Dakota's abortion bans, see TalkLeft.
My Health Law class just finished our segment on informed consent and now I find this article. Ezra Klein posts on American reading and the need to make medical information more accessible so that people can make necessary choices about their health care. He cites to a recent Washington Post article discussing the low health literacy in the United States and quotes it saying:
A 1999 report by the American Medical Association found that consent forms and other medical forms are typically written at the graduate school level, although the average American adult reads at the eighth-grade level.
Yikes! Eighth grade!! The Washington Post article continues:
Earlier this month a Chicago-based organization known as the Joint Commission, which accredits the nation's hospitals and clinics, unveiled a list of 35 recommendations to address the problem, which is estimated to cost taxpayers $58 billion annually. Among the recommendations developed by a panel of experts: adoption of communication techniques proven to be effective with patients, simplification of jargon-laden consent forms, and development of patient-friendly navigation signs, which may include the use of pictures or icons that are also recognizable to non-English speakers.
Low health literacy "is a silent epidemic that threatens the quality of health care," said Dennis O'Leary, commission president. Too many physicians and administrators, he said, fail to grasp the dimensions of a problem that affects every aspect of medical care and is a major impediment to patient safety. In some cases, cultural and language differences are a barrier, but experts emphasize that the majority of those with low health literacy are native-born and white.
Interest in health literacy comes at a time when Americans are expected to assume ever-greater responsibility for their care and are discharged from hospitals sicker and quicker, experts agree. Many patients are expected to comply with sophisticated drug regimens, to adjust or calculate medication doses or to manage complicated equipment with little training and less supervision. A comprehensive national assessment of adult literacy conducted in 2003 by the U.S. Department of Education found that 43 percent of adults have basic or below-basic reading skills -- they read at roughly a fifth-grade level or lower -- and 5 percent are not literate in English, in some cases because it is not their first language.
The Washington Post article is an interesting (and sad) read.
Thursday, February 22, 2007
The horrific treatment that many returning veterans received at Walter Reed Hospital was recently exposed by the Washington Post in a series of articles. They are an amazing tale of neglect and bureaucratic mess. Here is the PBS News Hour discussion of the Hospital conditions as well as some information on future fixes for the hospital.
As you are all well aware, law year, the FDA approved the cervical cancer vaccine HPV, manufactured by Merck. This was an important break through and public health experts began to focus on how to encourage the use of the vaccine, which is best provided at a young age. Last month, Texas Governor Rick Perry mandated the vaccine for all Sixth grade girls (11-12 year olds). His move has met some resistance from the state legislators. Now, other public health officials and state representatives across the country are re-considering how to handle the distribution of the vaccine. Unfortunately, there is the argument that this vaccine will encourage young women to have sex, but that is not all -- Merck, with a potentially large profit-motive, has been very aggressive about encouraging the mandate for the vaccine and that has made some public health officials uneasy (the drug is not cheap). National Public Radio's Morning Edition had a brief spot on the controversy this morning, featuring Professor Larry Gostin. I am not sure what the best answer is in terms of how to make the public most comfortable with this important and potentially life saving vaccine. Hopefully, Merck's behavior will not cause states to back away from considering the best way to ensure that as many young girls receive the vaccine as possible.