The ACA and Pre-Existing Conditions

I have always wondered how some people diagnosed with AIDS in the 1980's were able to pay for treatments and medicine revolving around their pre-existing conditions.  Through research, I came to realize that before the the Affordable Care Act, many people with these conditions struggled with coverage.  It is a huge contributor to the allowance of healthcare to people suffering with AIDS, Asthma, and Cancer.  The ACA has allowed no American to be denied healthcare who has a pre-existing health condition.  "The Access, Care, & Engagement TA Center provides tools and resources to support the enrollment of people living with HIV in health care coverage" (The Affordable Care Act and HIV/AIDS). This is a great center to have in order to guide HIV patients to the right path to finally get the healthcare coverage they have been longing for.

In terms of Medicaid expansion and eligibility, the ACA has allowed for the expansion of Medicaid to those with low incomes and below the poverty line.  It is said in the HIV.gov website, that today, Medicaid is the largest payer for HIV in the U.S. This is a fact I was surprised about, because you do not hear to much, publicly at least, about HIV and those who are affected still.  "In states that opt for Medicaid expansion, people living with HIV who meet the income threshold will no longer have to wait for an AIDS diagnosis in order to become eligible for Medicaid.  That means they can get into life-extending care and treatment before the disease has significantly damaged their immune system" (The Affordable Care Act and HIV/AIDS).  This is a great expansion that the ACA is allowing because it can help so many suffering AIDS victims.  However, the population under the poverty line do not benefit from this.  There is only so much Medicaid can fund, and if people cannot pay for needs such as blood tests and other testing, it will be hard for them to receive the care they need to stay alive.

Overall, the ACA has definitely been a huge contributor to the HIV/AIDS community.  It has given ample opportunities for coverage that was not given to the sick in the 80's.  The ACA is able to give people of the proper income the treatment they need in order to become healthy and live a normal life as best they can. 



https://www.hiv.gov/federal-response/policies-issues/the-affordable-care-act-and-hiv-aids   

The Opioid Heroine

As we all know, the abuse of opioids now is extremely exponential.  Tracey Helton, also known as the "Heroin heroine", is taking a different approach to the abuse of opioid usage today.  She mails out dosages of the generic version of the drug, which revives people of an overdose, only if they want it.   Although she is aware that what she is doing is illegal, she is saving many lives.  "This epidemic kills tens of thousands of people in the US each year", says CNN.  She feels as if the law is wrong and being a "civil disobedience" by counting what she is doing as illegal.  There is a case in which Helton helped save a young mans life.  Ryan Coleman, 36, met Helton in 2013.  She mailed him the drug called Naloxone, to use in case of an overdose.  Coleman explained to his roommate how to use the drug if he ever overdosed, and needed to be revived.  A case happened where Coleman did overdose, and his roommate injected him with the Naloxone, and he turned pink again and was revived.  The same event happened another time, however, this time Coleman was with another friend, and he was the one who overdosed.  This time, the Naloxone did not work until the third time.  It did end up finally saving his friend on the third time.  However, I have some skeptic in this method of saving young people from opioid abuse. This method produced by Helton still allows the people to do the drugs just as much as they were before, but it gives them the reassurance that there is a backbone there that will save their life.  In this case, after these two events happened to Coleman, he decided to become sober, but he was lucky.  The reverse drug worked for him in both overdoses, but for some, they might not get that second chance.

I believe the overall motive Helton is trying to proclaim is a good start.  However, in my opinion, it could also rub people the wrong way in a certain sense.  Some might take this method as a lesson learned, that they cannot live off this reverse drug their whole life and that they should just quit using drugs in general.  Others might use it as just a simple crutch in their life.  Something that enables them to keep doing what they do in their every-day lives, but helps them stay alive along the way.  Helton's method could go two ways.  As readers, which route do you think drug abusers might be prone to lean towards more?

http://www.cnn.com/2017/10/02/health/heroin-heroine-naloxone-eprise-profile/index.html

How Does a Hospital Manage a Mass Shooting?

As many of you may know, on Sunday, October 1, the deadliest mass shooting massacre in the U.S. took place at a country concert in Las Vegas, Nevada.  59 people were killed, and 527 were injured.   After killing that many people, the gunman then killed himself.  As of right now there is no ulterior motive to the actions of the shooter.  This current event inspired me to think of the question 'How does a hospital manage a mass shooting?'.  On the CNBC website, I read about how the Las Vegas hospitals are dealing with this crisis.  "Nevada has just one Level-1 trauma center in the state, University Medical Center in Las Vegas" (How Las Vegas hospitals prepared for a massacre-CNBS). I can only imagine how packed this hospital must have been when the shooting first occurred, and even now.  It says that officials have asked many people to donate their blood to patients in need, probably because of how busy the hospitals are.  "As the numbers go by, the umbers continue to increase," said Clark Country Sheriff Joseph Lombardo.  Since 9/11, these hospitals in Nevada, as well as over the world probably, are increasing their "hospital preparedness" to allow them to be ready for situations as horrible as this one.   In July, this Level-1 trauma center hospital held a training session involving the first responders from around the area.  This seems extremely beneficial and almost strange timing in the sense of preparedness for the shooting.  It is definitely a good tactic for hospitals to have in order to be ready for any tragedy that could take place.

One of the specific methods the University Medical Center of Southern Nevada used during the events of the massacre were "to prioritize patients, first responders and hospital staff use triage, evaluating who needs emergency treatment immediately, who can wait a bit longer, and who can wait beyond that" (CNBC article listed above). The article also noted that the "triage at mass shooting incidents can be complicated by the ongoing threat and mechanism of injury". I can see how using the triage method could raise anger to patients and their families because everybody wants to be healthy fast.  I believe it is the most fair, and efficient method in a time like this one.  Overall, I have learned that these tragic events do happen, and it is good that this Nevada hospital was prepared at best they could be.  All hospitals should be ready for anything that comes their way because you never know what can happen.

https://www.cnbc.com/2017/10/02/las-vegas-hospitals-dealing-with-hundreds-of-mass-shooting-victims.html

Italian Healthcare

The inspiration that drove me to write this blog post on the Italian Healthcare system was my Mother and my Nonna.  They are currently in Italy together visiting my family and relatives.   My Nonna has been there for two months, and my Mom is spending two weeks there.   Since I have never been there before, I have so many questions and wonders about what life is like in Italy.   In thinking about what to write, I thought it would be cool to look into their healthcare system.  I want to get more of an insight on the type of healthcare my relatives have access to in their every day lives.  

Italy is ranked among the World Health Organizations's top 10 countries for quality health services.  Private medical insurance seems to be what most patients have.  In small towns, mostly in the South, it is more common to have private doctors and hospitals, all of which are covered by the private medical insurers.   For example, my Mother's cousin is a doctor in a small town of Italy called Naples.  He works in a very small hospital there as well. From what I have read in this 'International Living' article on Italian healthcare,  the best medical care is located in northern Italy in cities such as  Milan, central Italy, and Rome.  That makes the most sense because those seem to be the biggest cities in Italy, where the most tourist attend to.  It is also said, these have the best emergency hospitals, because they have the most English-speaking doctors. 

The national health plan Italians use is called Servizio Sanitario Nazionale.  Like many other countries, this system provides them medical benefits for the people and hospitals.  If you are a legal resident of Italy, you are provided this healthcare.  With this plan, everything is either universal or very low costs.  This includes everything from consults with a physician, to hospital visits, and prescribed medications.  This is something that the U.S. does not fully cover.  We have copays, and less access for certain citizens to have health care.  There must be requirements.  However, the main thing Italian's need to pay a small co-pay for is a non-urgent hospital visit.  Urgent visits are reported free. 

From my readings, I learned a whole lot of things about what access my ancestors have in living in the great country of Italy.  Overall, it seems as if they are treated fairly in the aspects of healthcare.  It is interesting to compare where I live, and what systems and rights I have access to, to my family in a different country.  I look forward to learning more about other countries healthcare systems, and look forward to hearing about my Mother and Grandmother's experience back in their homeland when they return!  I am sure I will have many questions! 

Harvey and Irma

The recent destruction that hurricane Harvey and Irma has left on many states in the South has left many people, places, and infrastructure completely ruined.  Almost everything in different parts of Florida, as well as parts of the Caribbean is underwater.  With Harvey hitting the U.S, it has affected many of the health care companies within those areas.  It has affected hospital chains to medical technology facilities, as well as pharmaceutical chains.  "We estimate that the two storms (Harvey and Irma) could result in a procedural growth drag of ~30 bps for each week that hospitals are out of commission and/or patients are displaced," Matson said.  "We believe this impact could last anywhere from 2-4 weeks, resulting in an estimated 60-120 bps drag on U.S. procedure growth in 3Q17" (Needham analyst Mike Matson).   With all of this decrease and damage, I cannot even imagine how the patients and employees dealt with incoming patients in the middle of the hurricane. 

Pharmacies also were affected by the hurricanes.  Each chain, such as CVS and Walgreens, number percentages decreased in their income.  These hurricanes are not only affecting the hospitals physically, but financially as well.  It is terrible to see the hospitals in such destruction, but the cost to rebuild and resupply is equally as devastating.  The article also compares this to hurricane Matthew that hit Florida last October at a ranking of Category 5.  "Hurricane Matthew affected companies in different ways.  It cost Tenet hospitals an estimated $5 to $10 million and Tenet surgery centers an estimated $1.5 to $2 million, and cost Surgery Partners about $1.5 to $2 million, Ransom noted" (Analyst John Ransom).  This is only a few of the payments the state of Florida had to pay in order to rebuild.  

It is a terrible thing that there is nothing you can do about preventing the destruction of a hurricane.  It is hard to find a solution on how to keep everyone healthy and safe, when a lot of the destruction is in the hospitals and pharmacies themselves.  As long as the communities work together to the best of their abilities, that will keep everyone as safe as possible.  

http://www.marketwatch.com/story/how-hurricanes-harvey-and-irma-are-affecting-health-care-companies-2017-09-07

Lost in Cancer

Cancer is an ongoing battle that countless amounts of people all over the world are fighting every single day.  From all ages, whether you are 5 or 75, cancer is effecting the lives of people we all care about.  In the song, ‘I’m Gonna Love You Through It’ by Martina McBride, it says, “Cancer don’t discriminate, or care if your just 38”.  And it is sad, but true.  I decided I wanted to work with cancer as a future career because of the people it has struck, and tortured in my life already.  Cancer is becoming so common in our nation, that it seems as if it should just be a part of people’s everyday life now.  Not to say researchers and doctors aren’t sufficiently searching for a cure, but sometimes they could lose sight of the actual pain, unconmfort, and distress their patients are feeling in the process.   That should not be the case.  As I read in a New York Times article, ‘Cancer Patients, Lost in a Maze of Uneven Care’, this article talks a lot about how specific patients, as well as patient feel there is not one person throughout their battle who they can fully count on or call their “champion”.  Karen Pasqualetto is a 35-year-old woman who had just discovered she had colon cancer.  She is so young, and has already realized that the cancer is not just in her colon now, but her liver too.  Her life is slowly slipping away right before her, and her newborn babies, eyes.  “I don’t feel I have a doctor who is looking out for my care. My oncologist is terrific, but he’s an oncologist. The surgeon seems terrific, but I found him through my own diligence. I have no confidence in the system”, says Pasqualetto.  She knows each doctor is doing their job, but it seems as if she wants more of a fight or an effort in her situation. Yes, I do believe the doctors are all doing their jobs, very well I might add, however, Pasqualetto’s frustration makes sense to me.  As a cancer patient, you are seeing more than one doctor, more than one time a week.  It is a lot of tireless work, stress, and a lot of new levels of patient-doctor trust you need to learn to build.  Your main goal as a person living with cancer is to get better, and all these patients want is some answers. 

From my readings, I have come to understand that “death rates from cancer have been dropping for about 15 years in the United States, but experts say far too many patients receive inferior care. Mistakes in care can be fatal with this disease, and yet some people do not receive enough treatment, while others receive too much or the wrong kind” (Cancer Patients, Lost in a Maze of Uneven Care).  This makes the patient’s battle that much more difficult.  In reading articles as upsetting as these, it only makes my aspirations to help people with cancer grow stronger.  I hope that one day I can connect with these patients to make them feel as if I am their “champion”, and their hope to becoming healthy again.  Cancer is a terrible disease that is hurting so many people. With the help of countless doctors trying to find a cure, and support of family and friends, we can all help fight cancer together, one step at a time.  

http://www.nytimes.com/2007/07/29/health/29Cancer.html

The Start of It All

Hello, and welcome to my first blog post!  Throughout my blog, I will be trying to compare what is going in the Health Care world, to my personal life, as well as my goals and aspirations for my future career. A little bit of background about myself: my ultimate career goal is to become a Radiation Therapist.  In the fall of my Freshman year of college, I attended Suffolk University in Boston. I had explored many majors upon attending, however, nothing really stuck out to me.  I was very nervous and confused, because I was going into a brand new chapter of my life with no idea on what I wanted to pursue.  Until one day, with the help of my extremely productive mother, I found the program for me.  Suffolk has a very unique program strictly for radiation therapy. Since my mother is in the health care field, she always has pushed me in that direction. I soon realized, one of the best fields to be in is the health care field.  I have always been interested in the cancer aspect of health.  Since I was younger, I always said I wanted to “help people” when I get older.  That is a very broad statement, I know, but knowing multiple people close to me suffering from cancer, this major just seemed fitting.  Although I enjoyed being in the major and taking the core classes, after first semester, I decided Suffolk was not the all-around right fit for me.  That is when I decided to transfer to UNH in the Spring.  Since there was no program here specified for radiation therapy, I chose a new major that would keep me involved in health care still, Health Management and Policy.  And now, I am here. 

I have learned so much about health care since I transferred into the HMP major.  Even though I am looking to do more of a clinical career, all the information that I am learning in these classes will help me benefit and excel in any program.  I will need to know this information about health care for any future jobs, as well for my own knowledge about how the world stays healthy.  I am mainly focused on how health care and cancer intertwine with each other.      

In this specific blog post, I briefly focused on a few facts about the relationship between the health care system and radiation therapy. More specifically, the health care or insurance background to what all cancer patients deal with on day-to-day basis; on top of feeling extremely sick.  On the mdicare.gov website, I found the first facts I have read about the coverage for patients receiving radiation therapy specifically. I read that “Medicare Part A (Hospital Insurance) covers radiation therapy for hospital inpatients. Medicare Part B (Medical Insurance) covers this therapy for outpatients or patients in freestanding clinics” “All people with Medicare Part A and/or Part B are covered”. (The Official U.S. Government Site for Medicare-Radiation Therapy).   This information is what I assumed would be the insurance coverage plan for patients receiving this type of therapy.  In certain cases, doctors may require the patient to get more services than Medicare covers, and that is when the patient will pay some or most of the costs. These are just small facts about other things cancer patients have to worry about, other than the main goal; them becoming cancer free! 

https://www.medicare.gov/coverage/radiation-therapy.html