It's not always easy letting go of something with an emotional connection as strong as the one I have to Mike, but there comes a time when it becomes necessary.
That time has come for our name. Life o' Mike has honored the memory of my son, who died because he couldn't get access to health care. But people look at the name and wonder what it is we do.
Since what we do is to advocate for health care for all, and our programs are designed to advocate, educate and support people who need help in our system, we have decided to become WNC Health Advocates as of the first of the year.
The transition begins now and will continue with a new web site design and a new logo.
Our commitment to helping people in need will not change. We still will offer Start from Seed, our volunteer doula program to help first-time moms who are uninsured or receive Medicaid. We'll keep Patient Pals & Family Friends to offer one-on-one support to people with illness and injury who feel isolated and lost. And we'll keep telling the True Stories of people in our health care system.
None of this changes; we just want to make it easier for you to understand what we do.
Mike's spirit still lives on in the work we do, and you'll see references to him in our events (Eat at Mike's, Dance like there's Nobody Watching and our Michael T. Danforth Community Service Award).
Mike spent thousands of hours helping people get and stay sober. People tell me how he pulled them out of the gutter and helped them become whole again. We hope to honor him by working with his generous spirit in our own way.
I have railed against fast food and processed food rather frequently on this blog (and in person), and people usually claim that low-income people can't afford healthy food.
Well, the Environmental Work Group has issued a new publication to debunk that myth. The booklet, "Good Food on a Tight Budget," offers a wealth of information on how to eat a healthy diet on about $35 a week. You can download it at http://static.ewg.org/reports/2012/goodfood/pdf/goodfoodonatightbudget.pdf
The guide doesn't recommend any processed foods or fast foods and steers people away from the more processed foods, "instant" hot and sugary cereals and away from red meats. It contains recipes for chicken, fish and bean main dishes, most of which don't take a lot of time or effort to prepare.
Did you know you can throw beans and liquid into a slow-cooker before you go to work and they'll be done when you get home? And they'll contain a lot less salt (sodium) than canned beans. You can use them as a main dish, in soups or in other recipes like burritos and tacos. Freeze them in small portions and they're as convenient as canned.
You can make your own salad dressings in a matter of minutes and adjust them to your own taste. You can even make your own mustard and ketchup and you'll be amazed at the taste.
Throwing together a soup or stew is simple -- just toss vegetables, beans, lentils, meat, water or stock into a pan with whatever herbs and spices you like and simmer it in the slow cooker for a few hours. Make a big batch on the weekend and eat it during the week.
I cook from scratch because I want to know what's in my food. It doesn't take that much time, especially if you cook a big batch of something on the weekend and eat leftovers during the week.
Big Agribusiness would love you to believe that factory-farmed food is the same as locally grown produce and meats, but it isn't. Watch the movie, "Food Inc." if you want to know more about corporate-produced food.
I grew up on a farm and my mother baked fresh pies, cookies and cakes every week. She cooked local eggs and chicken and we drank local milk. We had apples, strawberries, blueberries and other fresh fruits in season. I'll admit, I did like the fatty, salty taste of fast food when I finally tasted it as a teenager. But when my kids were young, I stopped eating it for the most part. A decade or so ago I gave it up for good. I also gave up factory-farmed meats, and now about 80 percent of what my husband and I eat comes from within a 50-mile radius of where we live.
Thing is, our grocery bill hasn't increased much. We eat less meat -- usually twice a week -- and more fresh vegetables. The meat we do eat is humanely raised and slaughtered and it contains no antibiotic or growth hormone. Our pork has rolled in the mud, our beef has grazed contentedly in the meadow and our chicken has eaten what birds are supposed to eat. This low-stress life spent eating what nature intended leads to meat that is tastier and lower in cholesterol. The eggs from these chickens also are lower in cholesterol.
The more you cook fresh food from scratch, the worse the processed stuff will taste to you. Before you know it, you might even lose your taste for fast food.
I don't want to be political here, but I need to correct some falsehoods out there, especially the one about President Obama "stealing $716 billion from Medicare.
Here's the truth, as told by the New York Times (with my comments in italics):
"In reality, the $716 billion is not a 'cut' in benefits but rather the savings in costs that the Congressional Budget Office projects over the next decade from wholly reasonable provisions in the reform law.
"One big chunk of money will be saved by reducing unjustifiably high subsidies to private Medicare Advantage plans that enroll many beneficiaries at a higher average cost than traditional Medicare. (That's right, we'll lower profits to private insurance companies as we send them 30 million new customers) Another will come from reducing the annual increases in federal reimbursements to health care providers — like hospitals, nursing homes and home health agencies — to force the notoriously inefficient system to find ways to improve productivity.
"And a further chunk will come from fees or taxes imposed on drug makers, device makers and insurers — fees that they can surely afford since expanded coverage for the uninsured will increase their markets and their revenues (They don't want to give up any profits, nor do they want to be regulated in any way).
"The Republicans imply that the $716 billion in cuts will harm older Americans, but almost none of the savings come from reducing the benefits available for people already on Medicare. But if Mr. Romney and Mr. Ryan were able to repeal the reform law, as they have pledged to do, that would drive up costs for many seniors — namely those with high prescription drug costs, who are already receiving subsidies under the reform law, and those who are receiving preventive services, like colonoscopies, mammograms and immunizations, with no cost sharing."
That's where the $716 billion is coming from, not from cuts in services to seniors, and the cuts that Romney and Ryan are proposing will cut into services big time, turning Medicaid into a voucher program that will leave many people with no other option than to die.
Another misconception I came across over the weekend was when a friend of mine from New Jersey posted on Facebook that a hospital there is no longer offering mammograms because of the Affordable Care Act. At least that's what the hospital is saying. I asked whether he could connect the dots for me and someone else posted, saying that the real problems will come in 2014 when "Obamacare" takes effect.
"It's not like millions of women suddenly got access to mammograms," she said.
Um, yes it is, I told her. The provision that anyone with insurance can get a mammogram (or colonoscopy or a number of other tests and screenings) with no out-of-pocket costs took effect earlier this month. What this means is that people with $5,000 deductibles can get these tests and the insurance companies have to pay the costs.
So, it's not that the hospitals and clinics have to pay, but the insurance companies do.
Now, I don't know why this hospital has stopped offering mammograms. I suspect the real reason isn't Obamacare, unless insurance companies have lowered the rate they will pay to below what the procedures cost to provide.
In the last few years, physicians have begun to recognize various forms of violence as a public health issue.
Certainly, with the number of people who are shot simply because they are in the wrong place at the wrong time, gun violence now is seen as a danger to health. The National Rifle Association and gun manufacturers refuse to agree with that assessment, but an increasing number of the rest of us see it.
Bullying also has come under more scrutiny. Until recently, schoolyard bullying has been shrugged off as a reality that can't be changed.
But the realization has dawned on most of us that bullying needs to be addressed because children deserve to be in a safe place. Yet in a survey by Bullying Statistics, nearly three-quarters of school children consider bullying a problem in their school. One in 20 children surveyed reported seeing a student with a gun at school, and about 10 percent of children drop out or change schools because of being bullied.
Bullying is a leading cause of child and adolescent suicide, now called "bullycide" by some child advocates.
Children who are perceived as somehow different are most often the target of bullies, but it can happen to any child, especially when bullies band together and gang up on a child.
Child bullies grow up to be adult bullies, at home and at work. They prey on people who they perceive to be weaker than they are, and they will back off (or cut off contact) with people who stand up to them.
I recall an editor who was given to kicking trash cans and yelling at people. He threatened to fire anyone who disagreed with him and generally made people's lives miserable -- except for the few people willing to stand up to him. The editor was an average-sized man, and the man who stood up to him was rather scrawny. But when the writer stood up and challenged the editor to go ahead and fire him, the editor backed down and went on to bully other people.
Despite what you might think, bullies are not strong, confident people; they bully to prove to themselves that they aren't weak. They're angry for any number of reasons, such as the world isn't what that want it to be and people don't agree with them.
Bullies have a way of convincing their victims that the problem lies with them and not with the bully, which is why so many children in homes where there is domestic abuse become bullies ( one recent survey showed about half of bullies report seeing domestic violence at home), and why so many bullies become abusers.
Bullies can't seem to see their anger as their own fault -- their victims somehow deserve the abuse. Eventually, victims, especially of domestic abuse, believe they bring the violence on themselves.
MedPage Today reports that women who are given resource lists to escape domestic abuse aren't likely to follow up. There are a number of reasons for this, including fear -- the most dangerous thing a victim of domestic violence can do is leave. But women also believe they brought on the abuse themselves.
Bullying and domestic violence are expensive. An average school can spend more than $2 million annually to deal with bullies and vandals, according to the National Association of Secondary School Principals (http://www.nassp.org/Content.aspx?topic=The_Financial_Costs_of_Bullying_Violence_and_Vandalism_Web_only_).
As for domestic violence, according to the National Coalition Against Domestic Violence:
- The cost of intimate partner violence exceeds $5.8 billion each year, $4.1 billion of which is for direct medical and mental health services.
- Victims of intimate partner violence lost almost 8 million days of paid work because of the violence perpetrated against them by current or former husbands, boyfriends and dates. This loss is the equivalent of more than 32,000 full-time jobs and almost 5.6 million days of household productivity as a result of violence.
- There are 16,800 homicides and $2.2 million (medically treated) injuries due to intimate partner violence annually, which costs $37 billion.
So, violence is expensive. It also is, in many cases, preventable. But first we have to admit we have a problem.
We have to admit that children who are exposed to violence, either in real life or in movies and video games, become desensitized to it.
We have to admit that the playground bully is committing violence and treat it as such.
We have to acknowledge that children who are bullied are victims of violence and assure them that they are not the ones at fault, lest they become adult victims of abusers.
When you see bullying, call it out, and call it what it is. This is not kids being kids; this is violence and we can stop it.
A new study by the Commonwealth Fund suggests that gaps in health coverage likely will be reduced once the Affordable Care Act kicks in fully in 2014.
The study showed that more than one-third of Americans were uninsured for one month or longer between 2004 and 2007, and 23 million of them lost insurance more than once.
What happens frequently is that people who lose their jobs also lose their health insurance. Since most people can't afford to continue to pay for their coverage after they lose their jobs, their coverage ends immediately. Even if they find new jobs right away, most employers make new hires wait three months before they're eligible for health insurance.
Among those with family incomes below 200 percent of the federal poverty level, 64.2 percent of adults and 59.5 percent of children were uninsured for at least one month.
Once the Affordable Care Act kicks in, people who don't get coverage at work can buy insurance at affordable rates in the health insurance exchanges, and if they're below 400 percent of the federal poverty level, they will get federal assistance to afford coverage.
Some 20 million people still won't have coverage, though, and most of those will be the poorest Americans, homeless people, people with psychiatric illnesses -- people who need help the most. And if states opt out of the Medicaid expansion, even more of the neediest people will fall through the cracks.
But people who are self-employed or who can't get insurance from an employer will be able to get coverage more affordably. And their insurance will pay for screening tests such as mammograms, colonoscopies, prostate cancer screenings and more with no out-of-pocket costs to the consumer, even if the person has a policy with a $10,000 deductible.
Insurance will be a lot less expensive for women, who won't be forced to pay up to 50 percent more for coverage just for being female.
People with pre-existing conditions like childhood asthma or a birth defect will be able to buy insurance -- my son died because a birth defect is a pre-existing condition.
Many of the gaps in coverage will close in 2014 -- a number of them have closed already. But until everyone has access to quality care, we still have work to do.
Two years ago, a nurse working for HCA, the largest for-profit hospital chain in the United States, sent a letter to the company's ethics office claiming that physicians at one of the company's hospitals in Fort Pierce, Fla., were performing unnecessary heart procedures in the catheritization lab, putting patients' lives at risk.
The nurse, C.T. Tomlinson, did not get his contract renewed, most likely in retaliation for his whistle-blowing.
Tomlinson's charges proved true, not just at the small Fort Pierce hospital, but at several of the company's hospitals in Florida and a few in other states. According to an article in the New York Times ( http://www.nytimes.com/2012/08/07/business/hospital-chain-internal-reports-found-dubious-cardiac-work.html?_r=1&pagewanted=all), the civil division of the United States attorney’s office in Miami asked information in July concerning reviews of the medical necessity of interventional cardiology services provided at 10 of its hospitals.
Doing interventional cardiology procedures (most often the placing of stents in narrowed arteries) on people who don't need it increases profits, and although it is less invasive than bypass surgery, it poses risks to patients. Arteries can be nicked or burst and patients can bleed out or go into cardiac arrest. The Times article recounts the misadventures of several such patients in HCA hospitals who very nearly died.
The motivator, of course, is greed: for each stent procedure, Medicare reimburses hospitals about $10,000; diagnostic catheterizations bring about $3,000.
The Times reviewed thousands of pages of memos, e-mails and other communications surrounding the investigation and found that the company's concern was more about how this might affect the bottom line than on whether regulators needed to be notified or how patients' health was affected.
HCA, by the way, is the company once headed by now-Gov. Rick Scott in Florida. Under his leadership in 2000, HCA reached one of a series of settlements involving a huge Medicare fraud case with the US Justice Department that would eventually come to $1.7 billion in fines and repayments. The accusations primarily involved over-billing, and Rick Scott wasdismissed by the board of HCA.
As part of the settlement with the federal regulators, HCA signed a 97-page agreement that extended through late 2008. It detailed what had to be reported to the government and provided for stiffer penalties if the company failed to report properly, which they appear to have done as early as 2002, according to the Times.
In 2003, the HCA hospital in Bayonet Point, Fla., was performing far more stent procedures than its population demographics would suggest. An investigation by an outside agency, completed in late 2004, found that nearly half -- 43 percent -- of stent procedures were "outside reasonable and expected medical practice," according to the Times article.
Even worse, doctors were found to have falsified records to say patients' conditions were far more serious than they actually were.
The Obama Administration is cracking down on Medicare and Medicaid fraud, and raking in millions of dollars in fines. It's about time we all stopped turning our backs on this kind of fraud because, in the end, we all pay the price.