Health Care

Did Austerity Abet the Ebola Crisis?

A conversation with Terry O'Sullivan, an expert in the dynamics of catastrophic disease outbreaks, on the high human cost of cutbacks to public-health funding.

(AP Photo/Brynn Anderson)
(AP Photo/Brynn Anderson) Licensed clinician Hala Fawal practices drawing blood from a patient using a dummy on Monday, October 6, 2014, in Anniston, Alabama. The Centers for Disease Control and Prevention (CDC) has developed an introductory training course for licensed clinicians. According to the CDC, the course is to ensure that clinicians intending to provide medical care to patients with Ebola have sufficient knowledge of the disease. T erry O'Sullivan is a professor of political science at the University of Akron. His research focuses on "the risk and dynamics of catastrophic infectious diseases threats from naturally occurring infectious disease outbreaks such as influenza and SARS, and from biological terrorism." In this special podcast (transcript below) from Politics and Reality Radio , O'Sullivan makes two important points in his conversation with host Joshua Holland: First, Ebola poses a minimal threat to a country like the United States, with a functional health-care...

Fear of Lawsuits Is Not Why We Spend So Much On Health Care

Let's get you in there, shall we? (Flickr/Joe Shlabotnik)
You surely know that a good part of the reason our health care system is so expensive is the scourge of "defensive medicine," where doctors order test after test just so that if the patient doesn't get the outcome they want, it'll be harder for them to sue on the grounds that one more MRI or CAT scan would have made all the difference. Making it difficult for people to sue, then, should bring down the cost of health care, right? Actually, no : There's been a long-running theory that one reason medical costs are bloated is that doctors are scared of medical malpractice suits, so they order expensive and unnecessary tests to protect themselves from liability. But in three states over the past decade that enacted laws to put stricter limits on medical malpractice lawsuits, there hasn't been much of an impact in the volume or cost of emergency room care, a new Rand Corporation study shows. The finding suggests that doctors "are less motivated by legal risk than they themselves believe,"...

Some Things More Likely to Kill You Than Ebola

With the Ebola virus having now infected fully .0000006 percent of the American population, it's obviously time to panic, because you're probably going to die from it. But while you're panicking over Ebola, are there other things you should be fearing simultaneously, to really take your terror into the stratosphere? Why yes there are. And I've decided to make a chart, so you'll know just what to be afraid of. These data are drawn from statistics put out by the Centers for Disease Control ; 2011 is the most recent year for which the numbers are available. From the 113 different causes of death they list, I've chosen a few, then added one extra one down at the bottom: There are things that don't appear in this particular set of data; for instance, medical errors kill as many as 440,000 Americans every year. And some of those diseases are the result of other factors; for instance, the CDC says that smoking is responsible for 480,000 deaths in America each year. But you get the idea. Of...

Abortion Without Apology: A Prescription for Getting the Pro-Choice Groove Back

Only by reclaiming abortion as a fundamental right and normal part of health care can the pro-choice movement hope to win, writes Katha Pollitt in a lively new book.

(AP Photo/The Monitor, Joel Martinez)
(AP Photo/The Monitor, Joel Martinez) People protest in front of the Whole Women's Health clinic Saturday, Oct/ 4, 2014 in McAllen, Texas. Abortion-rights lawyers are predicting "a showdown" at the U.S. Supreme Court after federal appellate judges allowed full implementation of a law that has closed more than 80 percent of Texas' abortion clinics. This article is from the Fall 2014 issue of The American Prospect magazine. Pro: Reclaiming Abortion Rights By Katha Pollitt 258 pp. Picador. $25 I n August, a swarm of police officers was dispatched to the scene of a miscarriage at a Dallas high school, after a dead fetus was found in the girls' lavatory. Police officers combed the school in search of a female “suspect.” The investigation concluded only when the authorities satisfied themselves that the miscarriage had been spontaneous. We might have known it would come to this. Abortion access has decreased dramatically in Texas since the state’s restrictive anti-choice law went into...

Unpredictable Schedules Inflicted on Workers are Wrecking People's Lives

This nationwide trend goes virtually undetected when we take the economy’s temperature each month.

(iStockPhoto/4774344sean)
(iStockPhoto/4774344sean) Nurses are among the many workers who suffer from unpredictable schedules that often lead to working double shifts. T he unemployment drop in the September jobs report, to 5.9 percent, was welcome news. But as many have noted, wages remain flat and 7.1 million Americans worked part-time but wanted to work full-time. Furthermore, the monthly snapshot, which focuses on limited questions and simplified distinctions, altogether misses a key indicator of the job market’s health. Our recent book, Unequal Time , suggests that for the millions of Americans fortunate enough to be working, scheduling has become chronically unpredictable. Most discussions of employment fail to capture the widespread variability in work hours, or what some employers now like to call “flexibility.” While recent media reports have focused on the unwieldy lives of young people working at Starbucks and clothing stores—working with a day’s notice or splitting shifts—the issue is far more...

Americans In the Grip of Irrational Fears, Just Like Usual

Flickr/NIAID
Thomas Eric Duncan, the American who contracted Ebola in a visit to Liberia, died today in Texas. That tragedy will obviously be big news, and it will lead more people to freak out about the disease, something that will be heartily encouraged by the cable news channels (or at least by Fox News, which has apparently been going a little crazy on the "We're all going to get Ebola because Obama hates America Benghazibenghazibenghazi!" line). And freaked out we are. Let's look at some poll numbers: Gallup asked people "did you, personally, worry about getting the Ebola virus yesterday, or not?" Twenty-two percent of people said that they worried yesterday about getting Ebola. Then they asked people how likely it was that they or someone in their family would get Ebola. Four percent said "very likely," 10 percent said "somewhat likely," 34 percent said "not too likely," and 49 percent said "not at all likely." On one hand, almost six in seven Americans are still tethered to reality on this...

Contraception, News Coverage, and Identifying Fringe Groups

The story of the day comes from The New York Times , which reports on this study in the New England Journal of Medicine showing the results of a project that provided long-term contraception to teenagers. The results were both stunning and completely predictable (we'll get to that in a second), but I want to raise a small objection to something in the Times story. It concerns how groups should be identified, and when it's necessary to alert readers to the fact that you're quoting somebody on the fringe. But first, the news: it turns out that if you offer long-term contraception (mostly IUDs and implants) to teenagers, they don't get pregnant. Take a look at this graph, which compares teens in the program (called CHOICE) to national data on young women of the same age: As I said, these results are remarkable in that the reductions in pregnancy are so dramatic, but also predictable—birth control works well at controlling birth! If you have a teenage daughter, you should probably think...

Tragedy, Privation and Hope: Joy Boothe's Inspiring Journey to Moral Monday

Horrifically orphaned and raised with prejudice, she built a house and a new life with her own hands. Now hers are among many building a movement for justice.

©Jenny Warburg
©Jenny Warburg Joy Boothe (in black pants) at a sit-in outside the office North Carolina Senate President Pro Tempore Phil Berger in June 2014, protesting Republican education cuts. W hen Joy Boothe showed up at last week’s Moral Monday rally in her hometown of Burnsville, North Carolina, she was fighting both sleep- and sun-deprivation. Boothe had just driven in from Asheville, 35 miles away, where her husband was recovering from a double knee replacement. “Despite my fears of leaving my husband’s hospital room for the first time in four days,” she told the small crowd gathered in the town square, “I’ve come to stand with you today. It’s that important. It’s that important. ” Boothe, a vice president of the local NAACP branch, was referring to the ongoing political upheaval in Raleigh, the state capital, four hours east of this small mountain town. There, an emboldened Republican legislative majority had cut unemployment benefits, turned away federal Medicaid funds, slashed education...

The United Kingdom Nearly Died for Margaret Thatcher's Sins

(Press Association via AP Images)
W hy on earth did the Scots, largely quiescent as part of Great Britain for three centuries, suddenly become the mouse that roared? It wasn't because they became besotted watching re-runs of Braveheart or Rob Roy , or even because they coveted more of a share of North Sea oil revenues. No, the Scots got sick and tired of Thatcherite policies imposed from London. Thanks to the partial form of federalism known as "devolution" provided by the Labour government of Tony Blair in 1997, Scotland got to keep such progressive policies as free higher education and an intact national health service, while the rest of the U.K. partly privatized the health service and began compelling young people to go into debt to finance college like their American cousins. But as long as progressive Scotland, with just one Conservative M.P. sent to the national parliament at Westminster, remained part of Great Britain, its own policies were in jeopardy. So the near-miss referendum was one part revived Scottish...

Does America Have the Greediest Doctors?

Flickr/UCD School of Medicine
Yesterday, The New York Times published a mind-boggling investigation into a way some physicians have found to hit patients with absolutely mind-boggling bills for not just routine procedures, but the involvement of doctors in their care that they neither asked for nor knew about until they got the bill. However widespread a practice this is, I'm going to argue that what we have here is not a few bad apples but a problem of culture. But first, here's an excerpt: In operating rooms and on hospital wards across the country, physicians and other health providers typically help one another in patient care. But in an increasingly common practice that some medical experts call drive-by doctoring, assistants, consultants and other hospital employees are charging patients or their insurers hefty fees. They may be called in when the need for them is questionable. And patients usually do not realize they have been involved or are charging until the bill arrives. The practice increases revenue...

Reclaiming Our Rights: Going Proactive to End Discriminatory Abortion Restriction

Women are sick of politicians meddling in their health care decisions for cheap political points. Young people are hitting the road to let them know.

(All* Above All)
All* Above All I turned thirty-eight this year. This month the Hyde Amendment will also be thirty-eight, and since its passage, we have seen a growing number of abortion restrictions proposed and enacted across the country. The Hyde Amendment, passed by Congress in 1976, restricts abortion coverage for the young people, women and families most in need. It prevents federal dollars from being used to cover abortion. And while there is an exception in cases of rape, incest, or to save the life of the pregnant woman, it is enforced irregularly. There is no health exception to this policy for women covered by federal insurance plans. We have watched Congress pass this amendment year after year, for thirty-eight years. For nearly four decades we have watched this restrictive policy beget new anti-abortion, anti-women and anti-sex ballot measures, amendments, and legislation. We take on these fights one by one, state by state, defending the right to control our bodies. We win some, and we...

How District Lines Just Kept 400,000 Poor and Middle Class Virginians From Getting Health Coverage

Flickr/Taber Andrew Baln
Yesterday, the Virginia legislature passed a budget that once again rejected Governor Terry McAuliffe's call to expand Medicaid under the Affordable Care Act, which would have given health insurance to 400,000 Virginians who are currently uninsured. We don't have to go over all the specious arguments made by expansion's opponents, or delve into the details of the billions of federal dollars and economic benefits that the state is giving up. The question I want to address at the moment is, in a state that everyone acknowledges is trending blue, how does this happen? Particularly when even many strongly conservative states are coming around to expanding Medicaid? At one level, the answer is that Virginia's elected Republicans are a particularly cruel bunch, who like Republicans elsewhere would happily see a poor family go without coverage if it means they can give the finger to Barack Obama. But the more structural answer lies in the way district lines have been drawn there. First, let'...

Want to Fix the Jobs Crisis? Build a Federally Funded Worker Education Infrastructure

Critics are wrong when they say that, as one solution to underemployment, job training is a failure. Successful programs are plentiful, but they are small and scattered.

Photo: Paraprofessional Healthcare Institute (PHI)
Photo: Paraprofessional Healthcare Institute (PHI) Job training in cooperation with the NewCourtland Network in Pennsylvania. W ith unemployment still high, and millions discouraged from even looking for work, there is considerable interest in ways to connect people to jobs. Certainly stimulating the economy is essential to creating more opportunity. But what can we do to help people make the connections to employers who are looking for workers? Job training programs would seem to be a logical answer, a key step in moving someone from unemployment, or underemployment due to obsolete skills, into well-paying work. But there is much skepticism that training programs perform well. Reports of scandals surrounding proprietary schools with low placement and high debt feed this doubt. But focusing on these failures misses the larger point. Best-practice models exist, and are slowly diffusing. The challenge lies not in ignorance about what works, but how to reach scale in delivering quality...

Can Republicans Be Convinced to Help Improve the Affordable Care Act?

Eventually, they may find their way to ignoring this guy. (Flicir/Fibonacci Blue)
When the Affordable Care Act was passed in early 2010, people made lots of predictions about how its implementation would proceed, in both practical and political terms. While the law's opponents all agreed that it would be a disaster from start to finish, the law's supporters were slightly less unanimous, if nevertheless optimistic. Most figured that though there would probably be problems here and there, by and large the law would work as it was intended, enabling millions of uninsured Americans to get coverage and providing all of us a level of health security we hadn't known before. And that's what has happened. But there was one other assumption among the supporters that's worth examining anew, now that most of us agree the law isn't going to be repealed. Like every large and complex piece of social legislation, it was said, the ACA would have to be tweaked and adjusted over time. For instance, when it was passed in 1935, Social Security excluded agricultural and domestic workers...

What Happens When the Person Taking Care of Your Mom Can’t Earn a Living Wage?

When the Supreme Court ruled that unions could not collect dues from the home-care workers they represent, the justices set workers and their clients on a course that could harm them both.

(AP Photo/Seth Perlman)
(AP Photo/Seth Perlman) Tanya Melin of Chicago, right, Service Employees International Union members, home care consumers, workers, and allies rally in support of home care funding at the Illinois State Capitol Tuesday, Feb. 28, 2012 in Springfield, Illinois. O n June 30, the Supreme Court ruled that a key strategy used by unions to raise the earnings and professionalism of home-care workers was illegal. Since the 1990s, the labor movement has worked with states and countries to get laws or executive orders to allow home-care workers to be treated as employees of public authorities rather than as individual contractors. The result has been to allow these workers to form unions and to bargain collectively with government for better wages and working standards. In the Harris v. Quinn case, however, the Court held that workers could still unionize, but that they were not true public employees. Unions thus could not collect dues from workers who choose to remain outside the bargaining...

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