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Posts from the ‘Diana Mason’ Category

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.

Healthstyles: Single Payer Down the Tubes in Vermont? And What’s Race Got to Do with Stress?

WBAI

All eyes have been on Vermont when it became the first state to commit to adopting a single payer approach to health care. But the re-elected Vermont governor recently announced that he was backing out of the plan to do so. Betty Rambur, PhD, RN, Professor of Nursing and Health Policy at the University of Vermont and one of five members of Vermont’s Green Mountain Care Board, talks with Healthstyles producer and moderator Diana Mason, PhD, RN, on Thursday, January 15, 2015, about how the state is responding to the governor’s decision.

Healthstyles Producer Kenya Beard, EdD, ANP, GNP, joins Diana Mason for the second part of Healthstyles to talk with Willie Tolliver, PhD, MSW, professor of social work at Hunter College, about the connection between discrimination and stress as an important factor in health disparities. The discussion includes responses to the recent events surrounding the deaths of Michael Brown, Eric Garner, and other African Americans, and the implications for health disparities among African Americans.

So tune in on Thursday, January 15th, at 1:00 on WBAI, 99.5 FM, NYC (www.wbai.org); or click here to listen to the program:

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

Healthstyles on January8, 2015: One Nurse’s Ebola Story

WBAIOne of the major stories in 2014 was the Ebola crisis. Actually, the story’s beginnings in West Africa received relatively little media attention, despite the rapid increase in new cases in Liberia, Sierra Leone, and Guinea throughout the spring and summer, with initial death rates ranging from 50% to 90%.

Then a nurse and a physician who had become sick with Ebola in West Africa were flown to the U.S. for treatment. They survived, but Donald Trump got media attention with his call to ban other American health care workers with Ebola from returning to the U.S. for treatment.

On September 30th, the CDC reported that the first case of Ebola had been diagnosed in the U.S. Thomas Eric Duncan was a Liberian man who arrived by plane in Dallas, Texas, at the end of September to visit his finance. Prior to leaving Liberia, he had been with people who had Ebola. Duncan became ill, and was initially sent home after being seen at Dallas Presbyterian Hospital. But he got sicker and subsequently tested positive for Ebola. He was hospitalized at Dallas Presbyterian and died on October 8th. He was the first person to die of Ebola in the US.

The media frenzy began.

The diagnosis of two people coming into the U.S. with Ebola and two nurses becoming ill after exposure in a U.S. hospital led to an escalation of media coverage of Ebola that bordered on fear-mongering. It led to calls for banning flights from West Africa and quarantining all Americans who have contact with people with Ebola. But the initial media coverage brought hope to those who knew that bringing public attention to the health, humanitarian, and economic impact of Ebola in West Africa was essential to get the West’s attention and resources to bear on the crisis. Unfortunately, American media’s attention was on Ebola in America, with only limited attention to what was going on in West Africa.

The media is fickle. One minute media coverage of one issue is unrelenting and terribly redundant. The next minute, there’s no attention to the issue. It’s been six weeks since Craig Spencer was discharged from New York’s Bellevue Hospital and over two months since a case of Ebola was diagnosed in this country. What media coverage of what is happening in Liberia, Sierra Leone and Guinea have you seen?

The silence is deafening, as we approach 20,000 cases of Ebola in West Africa, almost 8000 of whom have died, compared with 4 cases in the U.S. and one death of a man who was diagnosed late in the illness.

On Thursday, January 8, 2015, at 1:00 PM, Healthstyles once again focuses on the story of Ebola. Host Diana Mason, RN, PhD, interviews nurse Deborah Wilson, RN, a nurse who spent six weeks in Foya, Liberia, caring for patients at an Ebola Treatment Center run by Doctors Without Borders. Her return to the U.S. coincided with the two Dallas nurses being diagnosed with Ebola, so she experienced the paranoia of friends, family, and colleagues whose fear of becoming infected was out of proportion to the realities of the disease. Mason and Wilson reflect on what happened in 2014 and what the implications are for 2015.

So tune into Healthstyles on January 8th, from 1:00 to 1:55 PM on WBAI, 99.5 FM, New York City, or at http://www.wbai.org. To listen to the interview any time, click here:

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