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Volume 27, Issue 470 |
June 26, 2006 |
HEALTH CARE
EDs on Life Support
Emergency departments (EDs) around the country are overwhelmed and on the verge of collapse, according to three new reports released June 14 by the Institute of Medicine. Half a million times per year, ambulances carrying sick patients are turned away from an ED and sent to one further away. The report also states that EDs do not have the capability or readiness to respond to large disasters such a terrorist strike or epidemic. The IOM outlined some steps for improving the situation. The first step would be for states and hospitals to set up regionally coordinated emergency systems that manage the flow of patients in and out of EDs, similar to air traffic controllers. Also suggested was the establishment of performance measures to identify and improve low-quality EDs and ambulance services. Under a 1986 law, EDs are required to evaluate and stabilize anyone who shows up, straining a hospital’s resources. From 1993 to 2003, the U.S. population grew by 12 percent, but ED visits grew by 27 percent. In that same time, 425 EDs closed, along with 200,000 hospital beds.
OBESITY
In the school nutrition sweepstakes, Kentucky may be the winner. According to a report card issued by the nonprofit Center for Science in the Public Interest, Kentucky has the strongest school nutrition policy in the land. The state allows vending machines and school stores to sell food only in the afternoon and has strong standards for foods and drinks sold during the rest of the school day. Permitted drinks include one percent or fat-free milk, waters, 100 percent fruit or vegetable juice or other drinks with less than 10 grams of sugars per serving. The state also set “reasonable” standards for portion sizes, saturated fat, sugars and sodium. For more on improving school foods, go to http://www.cspinet.org/nutritionpolicy/policy_options.html#ImproveSchoolFoods
BEHAVIORAL HEALTH
“Road Rage” Called a Disease
That angry driver throwing things at your car may be suffering from “intermittent explosive disorder (IED),” a condition that causes uncontrollable outbursts of anger, according to a new study by the National Institute of Mental Health. Sufferers of IED often attack others and their possessions, causing damage to one or either. To be diagnosed with IED, an individual must have had at least three violent episodes within their lifetimes that are “grossly out of proportion to any precipitating psychosocial stressor,” and “all of a sudden lost control and broke or smashed something worth more than a few dollars…hit or tried to hurt someone…or threatened to hit or hurt someone.” The study examined 9,000 subjects, and found that 7 percent of them experienced some form of IED. This extrapolates to 16 million people nationwide. The average onset of the disease is 14, with many sufferers later developing symptoms of depression, anxiety and substance abuse. Given the youthful onset of IED, researchers suggest early anger-management interventions to treat the disease. Antidepressants were also identified as a potential treatment.
Supreme Court Rejects States’ Injunction
On June 19, the Supreme Court declined to block a part of the Medicare drug program that states contend sticks them with unfair payments. Kentucky, Maine, Missouri, New Jersey and Texas were contesting a section of Medicare’s Part D which requires that states pay the federal government for some of the programs expenses. Specifically, the suit challenged the “clawback” provision, which requires states to pay the feds a portion of the money they expect to save by not having to pay for drugs for those enrolled in both Medicare and Medicaid. Texas Solicitor General Ted Cruz had told justices that states are expected to have to pay billions of dollars over the next two years. He said so far, however, states have not been told exactly how much they must pay or when they must pay up, making it difficult for states to plan for spending on schools or natural disasters. Gary Karr, a spokesman for the Centers for Medicare and Medicaid Services, said states are eventually going to save billions of dollars under the new program. "That's why very few states decided to join this lawsuit, despite requests for them to do so," Karr told USA Today.
NOTABLE AND QUOTABLE
At a recent two-day conference on health policy, sponsored by NCSL and the Henry J. Kaiser Family Foundation, Len Nichols, director of health programs for the nonpartisan New America Foundation, drew enthusiastic bipartisan applause when he laid out the moral case for universal coverage. Below are excerpts from his talk.
“We need to take a deep breath and get past the extreme polarization that’s present in this town (Washington, D.C.) and begin a serious adult conversation. And for that I think we need a moral case. At the end of the day, there are roughly 10,000 technical questions about health reform. But there is only one fundamental moral question you should ask before you start the 10,000, and that is, who should be allowed to sit at our health-care table of plenty? The more gray I get in my beard and the less hair I have on top, the more I think the best descriptions of community are the oldest descriptions we have. I’m talking about the Hebrew prophets. You go back and read Leviticus.
“All the (religious) scriptures admonish the faith: feed the hungry. Why? Because food was the only commodity one human could guarantee life. Well, I submit to you that health care has become like food: indispensable. The Institute of Medicine after years of study concluded that 20,000 Americans die every year because they don’t have health insurance—and because of that, they don’t get timely access to the care that could have saved them. I submit to you, that health care has become like food, so to deny health insurance because of cost is tantamount to denying food, which Moses, Jesus and Mohammed taught us not to do. I submit to you that they would not approve.”
For more on the conference presentations, go to this Kaiser-sponsored site. |
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