Healthcare, health policy, cognitive science. , and the path to Universal Healthcare..
WWS 528c: Topics in Domestic Policy Analysis: Health Policy Reform:
Professor Paul Starr, Spring 2012
Requirements, Syllabus, and Reading List
Professor Starr wrote the seminal book, The Social Transformation of American Medicine, and is teaching this course this semester at Princeton. I put it here because of the excellent reading list and organization of the course. Thanks to Brad Delong’s blog for pointing me to this.
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Robert F. Kennedy Quotes (Author of Thirteen Days):
A nice collection of RFK quotes. I think this is my favorite.
“Too much and too long, we seem to have surrendered community excellence and community values in the mere accumulation of material things. Our gross national product…if we should judge the United States of America by that – counts air pollution and cigarette advertising, and ambulances to clear our highways of carnage. It counts special locks for our doors and the jails for those who break them. It counts the destruction of our redwoods and the loss of our natural wonder in chaotic sprawl. It counts napalm and the cost of a nuclear warhead, and armored cars for police who fight riots in our streets. It counts Whitman’s rifle and Speck’s knife, and the television programs which glorify violence in order to sell toys to our children.
Yet the gross national product does not allow for the health of our children, the quality of their education, or the joy of their play. It does not include the beauty of our poetry or the strength of our marriages; the intelligence of our public debate or the integrity of our public officials. It measures neither our wit nor our courage; neither our wisdom nor our learning; neither our compassion nor our devotion to our country; it measures everything, in short, except that which makes life worthwhile. And it tells us everything about America except why we are proud that we are Americans.”
― Robert F. Kennedy
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Why Public Employees Are The New Welfare Queens | The New Republic:
But ask yourself the same question you should have been asking then: To what extent is the problem that the retirement benefits for unionized public sector workers have become too generous? And to what extent is the problem that retirement benefits for everybody else have become too stingy?
I would suggest it’s more the latter than the former. The promise of stable retirement–one not overly dependent on the ups and downs of the stock market–used to be part of the social contract. If you got an education and worked a steady job, then you got to live out the rest of your life comfortably. You might not be rich, but you wouldn’t be poor, either.
Unions, whatever their flaws, have delivered on that for their members. (In theory, retirement was supposed to rest on a “three-legged stool” of Social Security, pensions, and private benefits.) But unions have not been able to secure similar benefits for everybody else. That’s why the gap exists, although perhaps not for long.
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Anti-Open Access Rises Again | The Scientist:
US Representatives Darrel Issa (R-CA) and Carolyn Maloney (D-NY) introduced a bill into the House of Representatives in mid-December that would roll back the National Institutes of Health Public Access Policy, which mandates that any published research that was funded by the federal science agency be submitted to the publically accessible digital archive PubMed Central upon acceptance for publication in journals. The bill, H.R. 3699, would also make it illegal for other federal agencies to adopt similar open-access policies.
Making your tax dollars go farther?
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No law as wide-ranging and complex as PPACA can satisfy all of the myriad concerns of psychiatrists, other physicians, health professionals, and patients. While PPACA is not perfect, APA’s Board of Trustees concluded that it warranted APA’s support. Among other provisions of importance to the practice of psychiatry, the law:
- Extends coverage to 32 million more Americans;
- Bars insurance companies from denying coverage based on pre-existing conditions;
- Bars insurance companies from dropping coverage due to illness;
- Requires insurance companies to permit enrollees to renew coverage;
- Permits dependent children up to age 26 to be covered by their parents’ health insurance;
- Includes mental health and substance use disorder treatment as part of the basic package of benefits in health insurance sold in state-based insurance “exchanges” created by the law;
- Ultimately requires full parity for mental health and substance use disorder treatment in such insurance;
- Establishes new Centers of Excellence for Depression and Bipolar Disorder;
- Provides new research funding for postpartum depression and postpartum psychosis;
- Ensures that patients with diagnoses of mental illness will be included in “health homes”;
- Boosts funding for community mental health treatment options; and
- Facilitates co-location of primary and mental health treatment centers
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Report: Breast Cancer Death Rates Decline, but More Slowly Among Poor:
A new report from the American Cancer Society finds that deaths from breast cancer in the United States continue to decline steadily. However, the decline has been faster for women who live in more affluent areas. Women from poor areas now have the highest rates of death from breast cancer.
“In general, progress in reducing breast cancer death rates is being seen across races/ethnicities, socioeconomic status, and across the U.S.,” said Otis W. Brawley, M.D., chief medical officer of the American Cancer Society. “However, not all women have benefitted equally. Poor women are now at greater risk for breast cancer death because of less access to screening and better treatments. This continued disparity is impeding real progress against breast cancer, and will require renewed efforts to ensure that all women have access to high-quality prevention, detection, and treatment services.”
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Medical debts put patients at risk of financial collapse | Detroit Free Press | freep.com:
Frances Giordano found out she had lung cancer in June. After that, the bad news just kept coming.
First, she discovered that even with a good job and health insurance, her medical expenses were more than she could afford on disability.
Then she started slipping into debt, like millions of other Americans who don’t have the cash to cover their medical bills. Hospitals expect to be paid promptly and offer little leeway to insured patients. Unpaid bills go to collection agencies, damaging a person’s credit history for years.
Finally, she learned that fighting for her life was not her only battle or maybe even her toughest. When she finished her chemotherapy in December, she was fired. “Due to changes in business operations,” wrote her employer of more than six years, “we can no longer hold your position open.”
It arrived nine days before Christmas.
“I’m a good person,” the 58-year-old Giordano said. “I worked hard. Isn’t having cancer enough?”
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Soaking the Poor, State by State | Mother Jones:
The Corporation for Enterprise Development recently released a scorecard for all 50 states, and it has boatloads of useful information. That includes overall tax rates, where data from the Institute on Taxation and Economic Policy shows that in the median state (Mississippi, as it turns out) the poorest 20 percent pay twice the tax rate of the top 1 percent. In the worst states, the poorest 20 percent pay five to six times the rate of the richest 1 percent. Lucky duckies indeed. There’s not one single state with a tax system that’s progressive.
Follow the link to see the chart with all the states.
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The States Doing The Most (and Least) To Spread The Wealth – 24/7 Wall St.:
24/7 Wall St. examined government spending by state in a number of categories to identify those that give the most and least in money and benefits to their residents. Our analysis has found that states that provide the most services and benefits have high income inequality. In order to finance these programs, the states that offer the most to their residents also have among the highest tax burdens in the country. While all income levels benefit from government assistance, the poor and the dispossessed benefit the most, in the form of welfare, medicare, and unemployment insurance.
Tax burden refers to the average amount a person pays in taxes as a percentage of his or her income. The Tax Foundation calculates each state’s tax burden by taking the total amount paid by the state’s residents in taxes, and dividing it by the total income of the state’s residents. Eight of the ten states that are most generous are among the top fifteen states with the highest tax burdens. New York, New Jersey, and Connecticut are all included on the list and also fill the top three slots for largest tax burdens in the country.
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PERRspectives: Perry Calls Texas’ 46th-Ranked Health System Best in U.S.:
Everything, they say, is bigger in the Texas. So it is with the failure of the health care system. Leading the nation with a horrifying 25% of its residents uninsured, Texas ranked 46th in the Commonwealth Fund’s 2009 scorecard of state health care performance. Nevertheless, that dismal performance was no barrier to Governor Rick Perry proclaiming that the Lone Star state has the best health care in the country.
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The answer, of course, is quite poorly. While from 2007 to 2009 Texas nudged its way from a horrific 48th to a merely miserable 46th in the Commonwealth Fund rankings, the health care system there remains an ongoing calamity for its residents. Among the poster children for the failure of red state health care, Perry’s state brought up the rear across the five indicators measured. When it comes to health care access and equity, Texas is dead last.
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