Skip to content

Posts from the ‘Diana Mason’ Category

Marijuana Policy

I recently wrote about the Institute of Medicine’s report on Dying in America for the JAMA News Forum. A colleague who read the post pointed me to a PSA that the Institute of Medicine (IOM) subsequently published on having the conversation with family and friends about our end-of-life wishes. At the time, the my computer was not cooperating, so I remembered yesterday that I still needed to view it. I went to the website and found the video. Here is the link: It’s Time to Have the ConversationIt’s quite good and should be shared widely.

But it was the video that automatically popped up after the PSA ended that I found especially intriguing. It was a half-hour IOM video on marijuana policy in the U.S. that provides historical and contemporary views. It’s a fascinating account of how we got to criminalizing marijuana–to the tune of billions of dollars in enforcement costs and untold human costs, particularly for those who were sent to prison for smoking a joint. In one image, the video shows the huge death toll from smoking tobacco and using alcohol, compared with zero deaths from marijuana. The “zero deaths” led me to want more detail on how the deaths for each were calculated, since I imagine that marijuana could be a factor in, for example, a deadly car accident when the driver is a first-time marijuana user. (Years ago, I read a study about the impact of marijuana on driving. It concluded that the danger was in first-time users and that experienced users actually were more cautious in their driving.) However, the video is important because of its straightforward, evidence based presentation and because it’s by the IOM.

The video should be used as a teaching tool for students of policymaking and those who want to understand how the U.S. developed a war on a drug that is probably safer than many of the medications that one can obtain with a prescription (and some that are available over the counter–too many aspirins or tylenol can kill you).

I applaud the IOM for moving beyond what the evidence says on topics and trying to improve how the major messages are disseminated and acted upon. That said, I’m waiting for a member of Congress to discover this video and call for defunding the IOM. Evidence doesn’t seem to matter much in the halls of Congress. Maybe they should smoke a joint.

Diana J. Mason, PhD, RN, FAAN, Rudin Professor of Nursing

Heatlhstyles: Security Breaches in Health Information and the Consumer Voices on Advisory Panels

PrivacyMany of us trust that our insurance companies or hospital or health care providers keep our information confidential. But that trust has repeatedly been broken. In February, ProPublica published a story by Pulitzer Prize-winning journalist Charles Ornstein about this situation, noting that since October 2009, health care providers and organizations (including third parties that do business with them) had reported more than 1,140 large breaches of data security, affecting close to 41 million people. On April 2nd, Healthstyles begins with producer and moderator Diana Mason interviewing Ornstein about the confidentiality of our health care information. Ornstein will be continuing his investigation of breaches of health care information and their impact on the organizations and on people’s lives. Those who would like to share their stories of experiences with breaches of their health care information with Ornstein can go to the Patient Privacy page of ProPublica.  (Disclosure: Charles Ornstein is a member of the National Advisory Council for the Center for HealthMedia& Policy at Hunter College that sponsors Healthstyles.) You can listen to the interview by clicking here:

A number of advisory panels, including some for the Food and Drug Administration and the Cochrane Collaboration that conducts systematic reviews of the evidence on various health care practices, include what are called consumer representatives. Most times, these are representatives of consumer advocacy organizations who are vastly outnumbered by health professionals and industry representatives on the panels. In fact, the consumer representatives may find that they are the lone dissenting voice on a recommendation put forth by a panel. Nonetheless, they are an important and essential voice that can serve as the conscience of a panel, demanding accountability for whose interests are being advanced in a particular discussion or recommendation. On the second part of Healthstyles, Diana Mason interviews  Maryann Napoli, deputy director of the Center for Medical Consumers, about her experiences as a consumer representative on federal and other advisory panels. You can listen to this interview here:

So tune in on Thursday, April 2nd, from 1:00 to 2:00 PM on WBAI, 99.5 FM in New York City (streaming online at http://www.wbai.org).

Healthstyles is sponsored by the Center for Health, Media & Policy at Hunter College, City University of New York.

Impact of the Affordable Care Act

Today’s New York Times provides some compelling evidence of the impact of the Affordable Care Act (ACA) on health. Quest Laboratories, a major company that analyzes blood and other body fluid and tissue samples, compared test results by state and found that new diagnoses of diabetes among Medicaid recipients increased by 23% in states that have expanded Medicaid coverage under the terms of the ACA in the first 6 months of 2014. By comparison, new cases rose only 0.4% in states that had not expanded Medicaid coverage. The study was published in Diabetes Care and is available online.

This finding comes as 11 million more people are covered under the ACA’s expansion of Medicaid and the Children’s Health Insurance Program (CHIP), another important safety net program. CHIP is to expire in September and, if it does, 5.8 million children currently enrolled in the program could lose coverage. And all of the ACA could unravel if the Supreme Court rules in King v. Burwell that federal subsidies for people who sign up for health insurance under the federal health insurance exchange are ineligible for this subsidy because the ACA specifies subsidies for insurance purchased on the state insurance exchanges, not the federal exchange.

And all of this comes as as Congress is poised to act on the “Doc Fix” that would end routine cuts in physician payments (and payments to nurse practitioners and physician assistants). Often simply referred to as the “SGR”, the formula for paying physicians under Medicare was developed in 1997 as a way of containing costs by basing physician payments on economic growth. Repeatedly, Congress has voted to delay scheduled cuts. It’s become an untenable situation, with wide coalitions and the Medicare Payment Advisory Commission even calling for its end. Too many physicians were refusing Medicare patients. We need more physicians, nurse practitioners and physician assistants to be available, particularly in primary care. Although the expansion of insurance coverage under the ACA may help the uninsured, it could take a toll on Medicare beneficiaries’ ability to find health care providers who may conclude that their practices are more sustainable if they take patients with private insurance rather than Medicare. One of the potential show-stoppers for an SGR solution is an amendment that would extend CHIP coverage through 2019.

All of this leaves me wondering what those who oppose the ACA think about the impact of its demise on the lives of people who can’t afford care to diagnose and manage their diabetes and so develop costly complications–whether amputations, blindness, kidney failure, or other life-threatening conditions. The ACA is saving lives–and money. Estimates of the costs of diabetes and its complications range f4rom $132 billion in 2002 (more than half of which is related to complications and associated medical conditions) to a more recent estimate of $218 billion in 2008.  Time to move on with transforming our health care system into one that truly focuses on promoting health through primary prevention and early diagnosis and management of chronic illnesses.

Diana J. Mason, PhD, RN, FAAN, Rudin Professor of Nursing and Co-Director, Center for Health, Media & Policy at Hunter College, City University of New York

Healthstyles: Continuing the Conversation about Racism and Health

racism stop

The repeated public examples of subtle and blatant racism demonstrate the importance of conversations about the role of racism in the health and well-being of individuals, families and communities. As part of Healthstyles’ ongoing series on health disparities, co-producers Kenya Beard, EdD, NP-C, and Diana Mason, PhD, RN, FAAN, talks about these issues with Willie Tolliver, PhD, MSW, professor in the School of Social Work at Hunter College and three of his social work students: Jason Cartwright, James Gilliam, and Kim Wolfe. Their authentic and candid discussions about the deaths of Eric Gardner and Michael Brown include their own experiences with racism and how it plays out in the lives of all of us.

So tune in on Thursday, March 19, 2015, to Healthstyles on WBAI, 99.5 FM in New York City (www.wbai.org) or click here to listen anytime:

HealthCetera is sponsored by the Center for Health, Media & Policy at Hunter College, City University of New York.

Healthstyles, January 29th: Reproductive Services and Breastfeeding

WBAI

The results of the national and state elections in 2014 suggest that we will continue to see efforts to restrict women’s right to abortions and access to contraception and abortion services. But even in states where the right to abortion is considered safeguarded, access to abortion services may be limited. Healthstyles producer Diana Mason, PhD, RN, interviews Diana Taylor, PhD, RN, Professor Emerita at the University of California at San Francisco School of Nursing and Research Faculty for the Advancing New Standards in Reproductive Health Program, about these issues and strategies to increase this access that are underway in California and could serve as a model for other states.

On the second half of Healthstyles, Diane Spatz, PhD, RN, Professor of Perinatal Nursing and the Helen M. Shearer Term Professor of Nutrition at the University of Pennsylvania School of Nursing, talks about some of the policy issues and latest scientific findings on breastfeeding, including some fascinating information about how breast milk can actually be used as a therapeutic intervention for sick infants who cannot eat.

So tune into Healthstyles on Thursday, January 29, 2015, at 1:00 on WBAI, 99.5 FM in New York City (www.wbai.org). Or click here to listen to the program anytime:

Healthstyles is sponsored by the Center for Health, Media & Policy at Hunter College, City University of New York.

Follow

Get every new post delivered to your Inbox.

Join 8,777 other followers

%d bloggers like this: