The Role of Nurse Practitioners in Health Care Reform

This article was originally published by Georgetown University’s family nurse practitioner programs.

The Affordable Care Act created new health care delivery and payment models that emphasize teamwork, care coordination, value, and prevention: models in which nurses can contribute a great deal of knowledge and skill. Indeed, the nursing profession is making a wide-reaching impact by providing quality, patient-centered, accessible, and affordable care.

- Institute of Medicine 1

An estimated 27 million Americans have gained health insurance coverage during the past five years thanks to the Affordable Care Act (ACA).2 But that, coupled with an aging population and an expansion of preventive care benefits, is putting significant strain on the country’s primary care provider workforce. (more…)

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U.S. Health Care vs The World

Julie-PotyrajThe United States spends 54 percent more on health care per person than most other developed nations spend. With this level of cost, you would expect that the United States would also lead the world in terms of health care quality. However, in many areas of health service availability and accessibility, the United States falls behind countries like Germany, Australia and France. For every 1,000 Americans, there are 2.5 practicing physicians compared to the Organisation for Economic Co-operation and Development (OECD) average of 3.2. This difference may seem small. But when we start considering 10,000, 100,000 or 300 million Americans, that difference adds up. With growing health care costs and a growing domestic population, will the health workforce be able to keep up?

While there are limited numbers of physicians in general, there is an even greater shortage of those specializing in women’s health. Only about 5 percent of the physicians in the United States focus on obstetrics and gynecology. (more…)

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Women, Children and Water

Pat Ford Roegner

Kaiser Health Tracking Poll: February 2016 reports that 64% of Americans have closely followed the news about the lead contamination of Flint, Michigan’s water supply, its likely effects on public health in that city, and the long road ahead as Flint struggles to restore a safe water supply. The same survey found nearly eight in 10 Americans are concerned about the safety of the water in low-income communities across the U.S.

But even the challenges facing one mid-sized American city pale when we see World Health Organization (WHO) estimates that 1.2 billion people worldwide lack access to clean drinking water, with an additional 2.6 billion lacking adequate sanitation services.

The United Nations estimates that by 2025, 2.8 billion people will face water scarcity in 48 countries worldwide. Closer to home, is Flint just the beginning of a water supply nightmare for low-income communities across North America?

As the news from Flint unfolded in recent weeks, I was reading a paper – of which my daughter Amber is a co-author – about the potential for natural grasses to filter the waters on Lake Victoria near Kisumu, Kenya. (more…)

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Symposium on Disability and the Sustainable Development Goals

DW-UKThe speech below was first posted here on Medium. It was given by Liz Ditchburn, Director of Policy Division for the Department for International Development (DFID) during the first day of the 2016 International Symposium Disability in the Sustainable Development Goals. The theme for this symposium was: Forming Alliances and Building Evidence for the 2030 Agenda.

Speech as delivered:

“Much of what Catalina said I would like to give my own take on. I was very privileged to be in the UN General Assembly when the gavel came down on the Global Goals. This is going to be something which I hold in my heart for the rest of my life.

There are a few things about this set of Global Goals that really set them apart from their predecessors. They genuinely integrate all of the issues that we think are important for development. We finally have this integrated set of Global Goals which include everyone. (more…)

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The Cost of Aging and the Burden on Female Caregivers

Julie-PotyrajGetting older comes with a price. As the U.S. population ages, more seniors are opting to remain in their homes and communities instead of relocating to long-term care facilities. This “aging in place” movement will increase the demand for caregivers and home health aides. The cost of each of these services can be burdensome on members of the aging population and their families.

Due to the rising costs of long-term care, family caregivers provide a large portion of unpaid care. In 2009, family caregivers provided more than $470 billion in unpaid care, which was more than four times what was spent by Medicaid on long-term services and almost seven times what individuals spent using private insurance. Many individuals older than 65 survive on an income that is 200 percent below the poverty line and, as a result, are dependent on Medicaid funds or on family members for unpaid care. (more…)

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The Deadly Disease You Don’t Hear Enough About

JudyOvarian cancer is always the bridesmaid, never the bride.

At weddings, there’s a reason we focus on the bride. It’s her big event. She’s the center of attention, and rightly so. But sometimes, the bridesmaid’s speech has more to tell us — and we should listen.

We hear a lot about breast cancer. It affects a quarter of a million women and is fatal 15 to 20 percent of the time. Breast cancer is a serious and important disease that merits the time, money, and resources we spend on funding and public awareness each year.

But what do you know about ovarian cancer, a disease with a fatality rate of 65 to 70 percent? Fortunately, far fewer women are diagnosed with ovarian cancer than with breast cancer each year. Yet the nearly 22,000 women diagnosed, combined with the high fatality rate, is what makes ovarian cancer so important. (more…)

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Latest Survey Findings from the Society for Participatory Medicine

A new national survey from the Society for Participatory Medicine found that patients overwhelmingly believe a partnership with their health care provider improves their overall health. The survey also found that people see benefits in monitoring and sharing their health information between visits. The results can be seen in the infographic below (also available for download here). (more…)

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Consumers Take Better Preventive Care of Pets Than Themselves, CIGNA Finds

Jane Sarasohn-Kahn

People Care Deeply About the Wellbeing of Their Pets Not So Much WellbeingThe post below first ran January 18 on Health Populi.

Nine in 10 pet owners know when their dog or cat is due for their shots. Eight in 10 women know the frequency with which they get manicures and pedicures. 80% of men know the mileage between old changes.

But only 50% of family health care decision makers know their blood pressure, and only 20% know their biometric numbers like cholesterol and BMI.

Americans are great at doing preventive care for their pets and automobiles; but not so much for their own bodies and health, finds the report CIGNA Preventive Care Research, a survey of 1,000 U.S. consumers between 25 and 75 years of age who have health insurance and are the health care decision makers for their families. The survey was conducted in September 2015. (more…)

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Disruptive Women and the White House Collaborate to Improve Men’s Health

mens 1During an afternoon’s worth of inspiring stories crystalizing the need to get men more engaged in their health, one speaker perhaps shared the day’s most powerful moment, speaking from a podium at the Eisenhower Executive Office Building, among an audience of esteemed guests, advocates and stakeholders.

John Kevin Hines recalled a day in San Francisco when he felt that he could no longer go on. Seeking just some simple positive interactions with other members of his community – an offer of encouragement or support – he instead got silence. Soon after, he found himself at the top of the Golden Gate Bridge, where, amidst his feelings of hopelessness, he hurled himself off the side. He said, upon his descent towards the water, he immediately regretted the decision; he had made a mistake.

He wanted to live. (more…)

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Meet Disruptive Woman to Watch: Judy Faulkner

just-faulkner2In telling the Judy Faulkner story, let’s get the essential facts out of the way first.  She is the CEO of one of the nation’s leading companies providing the technology for electronic health record keeping.  Epic Systems had 2014 revenues of $1.77 billion.  Its client base includes some of the leading names in the health provider world – Cleveland Clinic, Kaiser Permanente, Mayo Clinic, CVS Health, Johns Hopkins.

And Forbes has cited Faulkner’s personal net worth at $2.6 billion, placing her at number six on the magazine’s list of the nation’s most successful self-made women and calling her the most successful female founder of a technology company.

What makes all of this profoundly interesting is that, if there is such a thing as a rule book for contemporary companies on how to succeed, Judy Faulkner has completely ignored it. (more…)

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Disruptive Innovation in Childbirth Care

nanstrauss1 PhotoIn considering what to write for Disruptive Women in Health Care, I couldn’t stop thinking about the idea of disruption juxtaposed with the experience of birth and the US maternity care system.

In the context of maternity care, the concept of “disruption” hints at intriguingly different possible meanings: the consequences of a newborn entering a family, disruption during the childbirth process, or the urgent need for disruptive innovation in maternity care.

Birth itself is an absolute disruption of the status quo. Birth can be tumultuous, even when it is a joyous occasion. It is a turning point, beyond which things are never the same for those who give birth and those who incorporate a newborn into their lives, not to mention for the baby who is born.

Disruption of the process of birth is a different type of disruption. Few things are as important to a positive birth experience as feeling safe, private, and calm – in other words, being free from intrusion and interference. (more…)

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Pregnant in Prison: Maternity Care for Incarcerated Women

myheadshotWhen thinking about maternal health access, one group of women are often forgotten, even silenced – incarcerated women.  According to the two part TV series “Babies Behind Bars,” the number of women in US prisons has climbed 400% over the past 30 years. It is estimated that the majority of these women are in jail for non-violent crimes. Each year, 6-10% of all incarcerated women are pregnant.

Adequate maternal care for inmates has multiple components. Do they have access to prenatal care? Are they allowed more food? If they sleep on a top bunk can they be moved to a bottom bunk? Is access to mental health services provided to help with post-partum issues that may arise as the result of separation from their infant? Can the women breastfeed? Is shackling used?

Restraining women during labor and delivery and post-labor poses potential harms to the health of the mother as well as the baby.  The National Commission on Correctional Health Care, Federal Bureau of Prisons, and American College of Obstetricians and Gynecologists, along with numerous other notable organizations advise against shackling pregnant women. However, it is up to state and local jurisdictions to decide. While some states and local leaders have made great strides to prohibit shackling of pregnant women, many still have not enacted laws to protect pregnant inmates against this inhumane treatment. (more…)

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Food from Different Worlds—Finding Foods that Nourish and Heal Across Cultures

josephineWhen I was a college freshman starting life on campus, I found the food available in our college cafeteria very confusing. Though ranked among the most diverse and delicious offerings, many times, I would walk through and find myself still with an empty plate. I could not find anything to eat. I had grown up on non-typical food, lots of roots and tubers, legumes and pulses, kale before it became a dietary hit, and lots of plain old water. Now I was part of a place that had fun theme food nights, and I could not find something that resembled my normal diet. Where I should have been thrilled, I was feeling tense, and very hungry. Many times, the most familiar thing was pizza. It often made me feel full, long before I felt satisfied with the meal.

Saved by a last-ditch connection with a wonderful nutritionist named Mimi in those first few weeks, I quickly started looking at our college food theme nights, and their accompaniments with new eyes. I could not find the foods I knew well, but I could find their close cousins in the dining hall. Since then, I began a lifelong practice of looking for the familiar foods, among those that may appear radically different. Foods from cultures that are not our own hold secrets to our own health, and happiness, if only I could get into them. (more…)

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Recap – The Intersection of Health and Housing: Opportunities and Challenges Panel

Tim_HeadshotIt was an honest, eye-opening remark during the Alliance for Health Reform panel on Friday, when speaker Barbara DiPietro talked about a common obstacle for patients when they receive a prescription for an illness: many drugs have side effects, some of which may lead to a few more visits to the restroom. For most people with a permanent home or workspace, especially when it comes to making a recovery from an illness or condition, this is an inconvenient, but necessary, reality.

However, for homeless people who do not have access to bathroom facilities 24/7, they do not have the luxury of taking a treatment with such side effects; otherwise they risk a legal citation or worse, arrest, for public indecency. As a result, they choose to not use their medications to avoid going to jail, and thus, they do not get better and have a hard time improving their prospects of finding more permanent housing and employment. (more…)

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TBT: Happy 48th Birthday to Medicare!

OWL logoWith today being the 50th birthday of Medicare and Medicaid we thought it was appropriate to throwback to a post we ran two years ago. Do you think the sentiments and concerns around the programs are the same today?

It’s July 30, 2013. You are 48 years old, and if YOU TWO don’t have a Happy Birthday, who will? We will all suspect something is wrong. Maybe you haven’t been getting enough sleep, or maybe you are not eating right. The Congress isn’t treating you badly, is it? Maybe, too, you are both very proud of your lives, as you work your way through middle age; or maybe you are a little disappointed in your accomplishments.

Maybe you could have done more, and aren’t thinking right now about all of your millions of friends and supporters, let alone the nearly 1.5 million people who consider Medicaid and Medicare nothing less than lifelines to participation in the game of life, no matter how many years go by. (more…)

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