If that’s not possible, the academy would like to see hotdogs redesigned so their shape, size and texture make them less likely to get stuck in a child’s throat.  More than 10,000 children 14 and younger are treated in ERs every year after choking on food; as many as 77 die.  Approximately 17 percent of food-related asphyxiations are hotdog related.

“If you were to take the best engineers in the world and design the perfect plug for a child’s airway, it would be a hotdog,” said Gary Smith, director of the Center for Injury Research and Policy at Nationwide Children’s Hospital in Columbus, OH.  “I’m a pediatric emergency doctor, and to try to get them out once they’re wedged in, it’s almost impossible.”  Smith notes that the Consumer Product Safety Commission requires labels on toys with small parts, but takes no position on foods, even though more than 50 percent of non-fatal choking incidents involve food.

The National Hot Dog & Sausage Council supports the academy’s plan to better educate parents about choking prevention.  According to council president Janet Riley, “As a mother who has fed toddlers cylindrical foods like grapes, bananas, hotdogs and carrots, I ‘redesigned’ them in my kitchen by cutting them with a paring knife until my children were old enough to manage on their own.”

The real cost of failure to pass healthcare reform legislation could mean that 275,000 Americans

The states with the largest populations were found to be the ones where the majority of projected premature deaths would occur.  The top states are California (34,600 early deaths); Texas (31,700); Florida (25,400); and New York (13,900).  Families USA estimates that 68 adults under the age of 65 die every day because they lack healthcare insurance coverage.  Unless a significant change occurs, that figure will climb to 84 by 2019.

Research exploring the connection between a lack of health insurance and an increased risk of death has found that the uninsured are more likely to avoid screenings and preventive care.  As a result, their medical problems tend to be diagnosed later when they are advanced and difficult to treat.  “The bottom line is that if you don’t get a disease picked up early and you don’t get necessary treatment, you’re more likely to die,” said Stan Dorn, a senior fellow at the Urban Institute and author of an earlier study of premature deaths.

Healthcare experts warn that the Families USA’s study’s premature death estimate errs on the side of caution, although the report calculated that a lack of insurance increases mortality rates by 25 percent.  More recent research found that people who do not have healthcare research are 40 percent more likely to die early.

The vacant 1914 Beaux Art Cook County Hospital will get a second life now that the Cook County Board has voted to spend $108 million to renovate the structure and convert it into medical offices.

Although the hospital at 1835 West Harrison Street has become rundown since it was replaced by the John H. Stroger Jr. Hospital in 2002, it is listed on the National Register of Historic Places.  Portions of the structure are wrapped in metal straps to keep the deteriorating stone and brick façade from falling.  Historic preservationists have proposed establishing a tax-increment financing (TIF) district to fund the conversion to medical offices.  Engineers have determined that the hospital’s steel and concrete structure is sound.

Landmarks Illinois points out that historic hospitals have been converted to new uses in other cities.  An example is the Amazon.com headquarters in Seattle, which previously was an Art Deco hospital.  The green angle to the conversion is that renovating Cook County Hospital will prevent approximately 900 semi truckloads of demolition waste from ending up in a landfill.

Designed by Cook County architect Paul Gerhardt, the two-block long building “is at once powerful and graceful, its pairs of three-story, fluted Ionic columns anchoring a composition that features all the hallmarks of the Beaux-Art style, from mansard roofs and dormers to sculpted faces of lions and cherubs,” according to Chicago Tribune architectural critic Blair Kamin.  “Put a small museum in the building, conduct tours and you’d have an attraction for archi-tourists on their way to Oak Park to see the wonders of Frank Lloyd Wright.”

In a recent interview for the Alter Inspire Podcasts, Mattoon warned that most people probably don’t feel like the nation is coming out of a recession because there are few signs of job creation or easier access to credit.  One of the major concerns economists have is that this will be a double-dip “W-shaped” recession because once the bump from the $787 billion stimulus ends, there will be scant pent-up consumer demand for products and services to take the place of government spending.

One positive sign is an uptick in hiring by temporary employment agencies, which usually is considered to be a good harbinger of what future demand will be.  Another interesting theory about this particular recession in terms of jobs is the idea that companies adjusted their employee levels much more aggressively at the beginning of this cycle.  As a result, they are operating at extremely lean levels and so may hire earlier rather than later.

One problem is that there is a skills mismatch in the economy.  Many people who have lost their jobs don’t possess the right skills to find employment in growth industries such as clean energy or healthcare.  The challenge is training these individuals to bring their skills up to par.

Prior to the study, researchers determined the participants’ degree of negative emotions such as depression, hostility and anxiety.  They also measured positive emotions, including joy, happiness and excitement.  Although naturally happy people do experience depression and other negative emotions at times, lead researcher Karina W. Davidson, PhD, recognizes that this is usually caused by a certain situation and is transient.  “We know from previous studies that negative emotion is predictive of heart disease,” Davidson said.  “We wanted to find out if positive affect is protective.”

Taking known risk factors into account, the researchers found that the happiest people were 22 percent less likely to develop heart disease over the study’s 10 years when compared with individuals who fell in the middle of the negative-positive emotion scale.  The most negative people had the highest risk of heart disease.  According to Davidson, “It is just speculation at this point, but there are several possible explanations for how happiness may protect the heart.”

Happy people tend to have a healthier lifestyle, eat better, sleep well, smoke less and exercise more.  Another finding is that happiness may produce positive chemical changes in the body, such as a reduction in stress hormones.  Genetic influences could mean that people who are predisposed to happiness also tend to have fewer heart attacks.

]]> http://www.altergroup.com/alter-care-blog/index.php/healthcare/dont-worry-be-happy/feed/ http://www.altergroup.com/alter-care-blog/index.php/healthcare/hhs-secretary-sebelius-takes-on-blue-cross-blue-shield-of-michigan/ http://www.altergroup.com/alter-care-blog/index.php/healthcare/hhs-secretary-sebelius-takes-on-blue-cross-blue-shield-of-michigan/#comments Thu, 04 Mar 2010 02:38:26 +0000 Donna Jarmusz http://www.altergroup.com/alter-care-blog/?p=723 Secretary of Health and Human Services Kathleen Sebelius says the health insurance system is broken and must be reformed, citing attempts by a large insurance company in Michigan to raise premiums by as much as 56 percent. Sebelius’ report, “Insurance Companies Prosper, Families Suffer:  Our Broken Health Insurance System”, cited Blue Cross Blue Shield of Michigan for trying to raise premiums on 200,000 people aged between 18 and 64 who have individual, Medicare Supplemental or group conversion policies.  Michigan Insurance Commissioner Ken Ross pared back Blue Cross Blue Shield of Michigan’s request to just 22 percent.

“Premium increases have left thousands of families that are already struggling during the economic downturn with an unpleasant choice between fewer benefits, higher premiums or having no insurance at all.  Hard-working families deserve better,” Sebelius said.

Andy Hetzel, Blue Cross Blue Shield of Michigan’s vice president of corporate communications, took issue with Sebelius’ statement - primarily via Twitter.  Hetzel said the report failed to take into account differing circumstances between states that led to the rate increase request.  “As the insurer of last resort in Michigan, Blue Cross Blue shield covers the costliest population to insure.  That’s because Blue Cross Blue Shield must accept everybody who applies for coverage, regardless of their health status, while commercial carriers can reject applicants deemed too risky.  We have a uniquely dysfunctional problem in the individual market.”

In terms of the HHS report, Hetzel said “They’re painting the industry with a broad brush.  It fails to recognize state-level business issues that the Health and Human Services Department should be aware of.”  Hetzel might be underestimating Secretary Sebelius, who served as Kansas’ insurance commissioner from 1995 until 2003, when she was elected governor.

As tuitions soar, many attending medical school borrow significant dollars to pay for their education.  Unfortunately, student loans are one of the most toxic debts in existence and require extreme consumer caution and - as Dr. Bisutti learned the hard way - responsibility.  Additionally, the idea of not paying back student loans is virtually impossible because collection agencies typically are tapped to recover the money.  While lenders may trim payments, it is virtually impossible to have fees or principals waived.

Martha Holler, a spokesperson for SLM Corporation (also known as Sallie Mae), the nation’s largest private student lender, notes that loan terms, including interest rates, are disclosed “multiple times and in multiples ways”.  Sallie Mae’s website http://www.salliemae.com/ provides easy access to repayment tools and account information.

Dr. Bisutti is unhappy about the number of student loans she took, the missed payments deferring payments and the fact she didn’t completely fill out required paperwork.  Still, she didn’t like that the variable interest rates soared from three to 11 percent while she was in medical school.  She borrowed the maximum $152,000 from the federal government, took private loans from Sallie Mae, as well as two $20,000 loans from Wells Fargo & Company.  Ultimately, Dr. Bisutti’s father - who had co-signed the loans - agreed to pay $550 a month for one year.  Dr. Bisutti entered into a rehabilitation agreement on her defaulted federal loans, which now have a $31,942 collection cost.  She pays every month on those loans - now totaling $202,399 - at a rate of $990 a month.  Only $100 of that pays the original balance; the remainder pays the interest rates.  Dr. Bisutti’s federal loans will be paid off in 351 months.  At that time, the 41-year-old physician will be 70 years old.

The American College of Physicians (ACP) is urging Congress and the Obama administration to move ahead

“Let’s take the bills passed by the House and Senate and make them even better,” urges Bob Doherty, the ACP’s senior vice president of government affairs and public policy.  “We shouldn’t toss them out and start from scratch.”  An ACP report warns of the costs of failure to pass healthcare reform, quoting Congressional Budget Office projections that healthcare spending will climb to 25 percent of GDP by 2025.  Similarly, the Census Bureau has warned that the number of the uninsured will soar to 60 million Americans by 2020 if reform does not occur.

ACP President Joseph Stubbs notes that “A highly partisan and polarized debate over healthcare reform legislation has regrettably taken the country’s ‘eye off the ball’ from the urgency of implementing reforms.”  The ACP advocates building on existing legislation to reach ultimate agreement on a bill and create bipartisan proposals to cut the costs of the medical liability tort system with the goal of increasing the number of primary-care physicians.

The Obama administration has released approximately $1 billion from the American Recovery and Reinvestment Act stimulus bill.

Department of Health and Human Services Secretary Kathleen Sebelius announced that $750 million of the initial $1 billion will be used to help hospitals and physicians convert to electronic health records.  “We are at a point in the United States where only 20 percent of doctors and 10 percent of hospitals have even basic electronic health records,” Sebelius said in a teleconference.  “These grant awards, the first of their kind, will help develop our electronic infrastructure and give doctors and other healthcare providers the support they need as they adopt this powerful technology.”

Atul Gawande,

The book grew out of work Gawande did for the World Health Organization, which asked him to help them find a way to reduce surgical deaths.  According to Gawande, “We knew we had technology and incredible levels of training, people working unbelievably hard.  But we have more than 100,000 deaths just in the United States following surgery.  Half are avoidable, from our studies.  What could we do?  We have found this idea, this extra tool that others were using in aviation, in skyscraper construction, and thought, well, let’s give it a try.”

Surgeons, according to Gawande, are human.  “We miss stuff.  We are inconsistent and unreliable because of the complexity of care.”  To achieve better results, Gawande brings a simple checklist into the operating room to make certain that everything is in place to assure a successful procedure.  For example, when the operating team is introduced to each other by name, the average number of complications and deaths fell by 35 percent.

Commenting on the success of checklist use in the operating room, Gawande says “I have not gotten through a week of surgery where the checklist has not caught a problem.”