Archive for the ‘prevention’ Tag

Universal Health Care Series: The National Security Argument

This post is Part III in a series exploring reasons to support universal health care. You can find the other parts of the series here.

Fences and security checkpoints versus pathogens. David versus Goliath. While it seems that one side has the brute strength and power to counter the other, we all know how the second conflict ends.

The flu epidemic of 1918 killed one-fifth of the world’s population in about two years, resulting in more deaths from the epidemic than World War I. Our interconnected society makes epidemics more likely to occur with the ease of mobility within countries and in between them.

photo courtest of Daquella manera

photo courtesy of Daquella manera

A recent epidemic scare happened in 2007 when Andrew Speaker, after receiving a diagnosis of drug-resistant tuberculosis, proceeded to travel overseas and back on commercial flights for his wedding and honeymoon. Speaker was already out of the country when before authorities realized that he was infected with multi-drug resistant tuberculosis, which is the most difficult strain to treat.

Fortunately, no one was infected; also fortunately, Speaker was diagnosed and authorities were informed that he was infected. Imagine what could have happened if Speaker could not have seen a doctor.

MRSA and other “superbugs” are becoming increasingly frequent. Avian flu and pandemic flu are also looming biological dangers.

Imagine a situation where a patient has a bacterial infection but never goes to see a doctor because they can not afford the visit. The patient would continue to pass through the general population, infecting others. Public health officials would have greater difficulty finding the source of the infection because there would be so many more cases.

Imagine a situation where a patient actually sees a doctor, but in a crowded emergency room. The doctor, overwhelmed with cases, quickly diagnoses the bacterial infection and prescribes penicillin. The patient takes the medication, but the bacteria becomes resistant to penicillin.  His condition worsens and he can spread a drug-resistant strain to others.

Imagine a situation caused that as a byproduct of his socioeconomic status, the patient lives in conditions that are ripe for the spread of infections: close quarters and poor ventilation. Poverty also compromises the strength of one’s immune system, leaving the body open to infections and once infected, the body can not fight infections well.

1) Universal health care provides a greater likelihood of early detection to curb infections before they grow too quickly. Early detection is a key advantage in controlling epidemics and preventing deaths. Earlier detection also helps to reduce the likelihood that drug-resistant strains develop in the general population.

2) Increasing access to health care allows health care professionals to identify patients at risk and intervene to offer ways to reduce the risk of infection.

3) Universal health care enables consistent access to proper treatment. Treating infections with the wrong medication or with an insufficient dosage can cause the pathogen to mutate, creating drug-resistant strains.

Preventing epidemics should be a priority of paramount concern if the government actually wants to ensure national security. Implementing universal health care is an important step in the right direction.

Universal Health Care Series: The Economic Argument

This post is Part II in a series exploring reasons to support universal health care. You can find the other parts of the series here.

Number crunchers consider this:

  • The United States spends more than any other country in the world on health care (16 percent of the national GDP).
  • For doctors that would like to volunteer, bureaucratic obstacles such as burdensome paperwork and high license fees up to $1000 from state medical boards prevent many doctors from alleviating the overcrowding in free clinics and government community health centers.
  • Each dollar spent on ensuring people are healthier and more productive would generate $20 in benefits.
  • In 2006, U.S. health care spending was about $7,026 per resident and accounted for 16% of the nation’s Gross Domestic Product (GDP). Total health care expenditures grew at an annual rate of 6.7 percent in 2006, a slower rate than recent years, yet still outpacing inflation and the growth in national income.
  • Analyses of data from the 2005 Medical Expenditure Panel Survey indicate that total medical spending is much lower when coverage is provided by public health coverage such as Medicaid when compared to private health insurance coverage.
  • Over the last 25 years, health systems’ average total profit margins have remained reasonably stable at around 5 percent. About one-quarter of all US hospitals, many of them safety nets, have reported negative margins, and continually teeter toward failure.
  • Health care costs are expected to rise by 10 percent in 2009.
  • California HMOs earned over $4 billion in profits in 2007 and spent $6 billion in administrative costs such as CEO salaries rather than using the revenue to reduce insurance premiums for the consumer.

Few individuals and organizations benefit under the current health care system except certain CEOs. I am not going to touch the issue of executive compensation; however, per capita costs have risen faster than the rate of inflation, leaving more families behind. While there is a moral imperative to care for the wellbeing of others, increasing access to health care can not be considered without a consideration for the economic impact of a change.

The major objection is that universal health care will simultaneously decrease efficiency and choice while increasing costs. Universal coverage does not mean writing a blank check to every American. Rather, creating an umbrella of health coverage rather than a patchwork quilt takes advantage of economies of scale for purchasing and well as facilitating the development and implementation of best practices from a central authority.

The economic savings emerge in other areas of society as well. A healthier population is economically more productive because they are fewer days missed due to illness. Small business is likely to flourish because business owners do not have to fear covering employee health care costs. Increasing efficiency through technology, making prevention and health promotion a central focus of health care, and encouraging behavior change will also help to cut costs.

As private industry has had a horrible track record of policing itself, universal health care is the most viable alternative for addressing the dual problems of gaps in coverage and escalating costs.

Water, water nowhere: Social marketing and the quest for access to clean water

It’s one of the most essential things to a healthy life and taken for granted by those who have it. Lack of access to clean water plagues affected people with completely preventable diseases.

Argentina is the first developing country that I have lived in that has had water that you can drink from the tap without a filter but I still meet patients who do not have steady access to water. 1.1 billion people do not have access to clean water to drink, cook, bathe, and cultivate crops. Safe water helps to prevent diarrhea and other waterbourne diseases common to high rates of childhood mortality. Americans have seen some of the possible effects of unclean water on the food supply with outbreaks of salmonella and E. coli in the food supply. Fortunately, Americans also have access to antibiotics to treat these diseases. Millions are not so fortunate where outbreaks of water bourne illnesses are the norm rather than the exception.

A cost-effective intervention, both in regard to prevention and sustained wellbeing, access to safe water continues continues to lag in most development programs. Here is what the Millennium Development Goals have to access to clean water:

“Goal 7, target 10 of the Millennium Development Goals aims at halving by 2015 the proportion of people without sustainable access to safe drinking water and basic sanitation.”

Population Services International (PSI), a leader in social marketing campaigns, together with Proctor & Gamble has implemented a large social marketing effort to get safe water systems into homes. The systems allow the users to purify the water they do have access to with a powder that clears the water of pathogens and dangerous impurities leaving the water as clear as water from the tap. The powder is inexpensive to produce and can be produced locally. PSI leads educational campaigns to promote proper usage and hygiene.

World Vision UK has released a new viral video that targets the importance of clean water.

Hat tip: Osocio

Some innovative social entrepreneurship efforts are taking on the challenge as well. The LifeStraw filters water at the source, lasting for 700 liters of water purification. The newest campaign called the Coca Cola campaign that I have learned about comes from Simon Berry. Here’s is the idea of the campaign from the Facebook group:

Our idea is:
That Coca Cola use their distribution channels (which are amazing in developing countries) to distribute rehydration salts. Maybe by dedicating one compartment in every 10 crates as ‘the life saving’ compartment?

Check out the Coca Cola campaign or any of the other organizations listed below to learn how you can help.

Other organizations concerned with access to safe, clean water:

Water Aid
World Vision

National HIV Testing Day

Tomorrow is National HIV Testing Day. The object of creating this day was just to encourage people to know their HIV status. I have taken an HIV test; it is easy, quick and painless. One mouth swab and 20 minutes later, you know your HIV status. No needles and a short 20 minute wait…what is stopping you?

In the United States, HIV has a disproportionate impact on African Americans; although African Americans form 12 percent of the country’s population, they comprise 49 percent of diagnosed HIV cases. The epidemic is spreading fastest among young African American and Hispanic women. The Centers for Disease Control estimates that as many as 180,000 to 280,000 people could be infected with HIV and NOT KNOW. I personally don’t want to become another statistic. I know that it is easy to feel invincible with regard to your health when you are in your 20s. In this case, knowledge really is power. Knowing your HIV status allows to make plans to maintain your health.

If you are interested, you can learn about local campaign events for National HIV Testing Day.


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