Deportation While In Coma

Hey Folks ! Happy Thanksgiving!

Yes this is true, I am posting on Turkey Day. You might be asking yourselves, "why is he posting today? What gives?" Well, interesting story.

I just enjoyed a wonderful meal and was hanging out, enjoying the "food coma." Then I started to think, "where did the term 'food coma' come from. I googled the term and came across an interesting story that caught my eye. This article was in the NY Times regarding a patient, Antonio Torres, who was severely injured in a car crash which left him in coma.

A legal immigrant, Antonio was uninsured. So against the pleas of his parents, Antonio was deported to Mexico - WHILE STILL IN COMA. Here's the article link (http://www.nytimes.com/2008/11/09/us/09deport.html?_r=1)

This article floored me. I thought, how is that even possible? Is it legal? That's horrible!

A quote from the article: "There is only limited federal financing for these fragile patients, and no governmental oversight of what happens to them. Instead, it is left to individual hospitals, many of whom see themselves as stranded at the crossroads of a failed immigration policy and a failed health care system, to cut through a thicket of financial, legal and ethical concerns."

I don't usually come across situations where immigration policies are so intertwined with health care policies. I'm definitely not looking hard enough.

This makes me think - this is a huge problem, especially in areas of the United States where there are large populations of legal and illegal immigrants. I wonder, if there was a Universal Health Care system in place in the US, would something like this have still happened?

The Most Expensive Diet You'll Ever Undertake

An interesting paper notes that marriage is associated with a increase in BMI (4.6 pounds for men and 5.8 pounds for women) over two years, and correspondingly, a divorce is correlated with a similar loss in BMI (1.8 for men and 2.7 for women). The authors attribute the weight gain to increased intake of high caloric foods and decreased physical activity. Interestingly enough, spouse BMIs are related in terms of weight gain and not with weight loss. This does provide evidence to the theory about weight control being modified by a shared environment (as we learned for friends and family in 200C). But rest assured with the fact that the authors found that BMI gain or loss does not predict the prospect of divorce.

An interesting aside from one of my favorite health bloggers gives a good economic rationale for why Americans are unhappy with their body image, and that the best thing you can do is align your ideal body image more with your current body state.

Also, for your body image related knowledge, here's an interesting Q and A with the author of The Fattening of America, a book that's atop by Christmas break reading list all about how America incentivises people to be gain weight then lose it. Well worth a read.

Making the tough decisions

As all of you know, the President-elect has proposed a plan to reform this country's health care system. According to PricewaterhouseCoopers' Health Research Institute, Obama's plan could cost up to $1 trillion dollars over the next decade (http://www.bizjournals.com/nashville/stories/2008/11/10/daily34.html). While some might argue that this is a reasonable price to pay for such a plan, what about other priorities that this money could be spent on? Making decisions about the allocation of government resources is incredibly challenging; Sarah and I just got through a three-week long simulation exercise where we were assigned roles of members of the US House of Representatives and had to pass a budget resolution aimed at decreasing the national debt to $42B by the year 2012. Sarah was John Boehner, and I was Nancy Pelosi (yes, our friendship survived). We were given a copy of CBO's 2008/2009 "Budget Options" handbook that outlined the programs and revenue options we had to work with in designing our proposals. This was one of the hardest things I have ever done. The rest of the Democratic leadership and I solicited feedback from our party members (there were 36 Democrats and 24 Republicans), and went about designing our budget. Everyone was assigned a role, and had to make decisions based on how their member of Congress would make his or her decisions. Balancing these was, at times, painful. My friend Evan (James Clyburn in the simulation) and I had at least two twelve-hour days where we had to go through the options and weigh things like whether we wanted to cut Medicare funding for patients with ESRD or cancel the military's F-35 Joint Strike Fighters (these are actual options in CBO's handbook). It sounds absurd, but we had to make cuts and balance the interests of an extremely diverse group of Democrats (and, in the end, moderate Republicans). It was a fun, if somewhat exhausting, exercise, and it taught me a lot about negotiating and compromise, and the importance of understanding why you have made a decision, and being able to defend your stance. If any of you are interested, you should take John Ellwood's PP250 course next fall!

Health Care Reform on the Horizon?

It seems that everyone is beginning to prepare themselves for Obama's proposed health care reforms. The American Health Insurance Plans and the Blue Cross and Blue Shield Association have agreed to support Obama's plan as long as he imposes individual mandates for health insurance. The insurers claim that if mandates are not in place, people will wait until they are ill to purchase insurance, damaging the risk pool and driving up premium prices for everyone.

http://www.nytimes.com/2008/11/20/us/20health.html?ref=health

When we visited the Blue Shield headquarters a few weeks ago, Tom Epstein, their VP of Public Affairs, talked about Blue Shield's lobbying efforts in this arena. They have a PAC that contributes money to candidates and lobbies both on the federal and state level.

Not only are these new developments fascinating, but I think its fun that thing we learn in class actually happen in real life.

Bioentrepeneur/Haas Event and other things;-)

Hello Foundations class this is my inaugural post to "the blog" so please bear with me.

First, I just wanted to remind everyone of the Haas Event "Bioentrepeneurship roundtable" tomorrow evening at 6pm. I registered yesterday and it sounds as if it should be pretty informative. The other bonus is that its in Redwood City, that's right on the peninsula about ten minutes from Palo Alto. I recognize that the Big Game is this weekend, but I promise that it's safe. The attendance fee is $35 which includes dinner, and its advertised as being pretty interactive, so I think it'll be interesting. Looking for company though. Here's the link:

http://www.acteva.com/booking.cfm?bevaid=168599

Second, the NIH Health Disparities Summit is on Dec. 16-18. It will be held in New Harbor, MD which is right outside of Washington DC in a beautiful new complex that overlooks the Potomac River. I'm going to attend and I was blessed to have an abstract accepted for presentation. I've heard that its truly a great meeting and the registration is actually free. So once again it would be nice to have some company. I can even promise a personal tour of DC considering its 15 miles from where I grew up. Here's the link:

http://www.blsmeetings.net/2008healthdisparitiessummit/reg.cfm

Lastly, the data that I will be presenting at the summit was published in the Annals of Surgery this month. It has to do with diversity in the academic surgical workforce. Annals of Surgery is one of our most well respected surgical journals and it truly is an honor to get it published. They even wrote a little editorial about it. I went to Kim and Dr. Bloom with my idea to pursue this last July when Hari, Lyonel, and I started summer school (remediation) ;-). They were very supportive of the idea and then in September Jeff looked at one of the original drafts and was also supportive. So basically what I'm getting at is that if there is a research idea that you want to look into and are passionate about, the support is here at UC Berkely SPH/HPM and this article is proof of that. I would love to get your opinion on it if you find the time to read it. Its been well received by the other surgeons with whom I've spoken, which also serves as proof that many physicians care about health care disparities and public health initiatives more then might be expected/advertised ;-) Here are the links:

Article: http://www.annalsofsurgery.com/pt/re/annos/abstract.00000658-200811000-00003.htm;jsessionid=JjpWX8vQ0SRHkLDd1b2TYPm7pXnQMWCs01hXZrJrzQJtDXFb5rhy!620075815!181195628!8091!-1

Editorial: http://www.annalsofsurgery.com/pt/re/annos/abstract.00000658-200811000-00004.htm;jsessionid=JjpHPZgLyRV31Yp2kHLQkTl5CNQByy846Q57GSpv5k10fnPQ09TG!-409308177!181195629!8091!-1

Let me know if you can't get to it and I can send you the PDF. Well that's it. I hope to see some of you Thursday evening in Redwood City.

Health Econ in the NYT

New York Times has an article all about high-deductible health plans, one of our favorite topics from health economics!

http://www.nytimes.com/2008/11/15/business/15insure.html?pagewanted=1&ref=health

The gist is that in a time of rising health care costs and the general economic downturn, employers are more often offering these consumer directed health plans as the only health benefits choice for their workers.

The article interviews David Lee, and executive from the Pacific Business Group for Health, an employer coalition that provides consultation on health care. They are based in San Francisco and I was able to do an informational interview there.

http://www.pbgh.org/

Googling the flu

Hey all,

This is a super interesting article from today's NY Times about how google is using keyword tracking to anticipate flu outbreaks.

http://www.nytimes.com/2008/11/12/technology/internet/12flu.html?_r=1&em&oref=slogin

Vaccinations: Good or Bad?

The movement of parents avoiding vaccinations for their children has become quite a popular phenomenon. Some studies have linked vaccinations to signs of autism; however, many studies have failed to find conclusive evidence of this. What do you believe?

Additionally, what sort of implications does this have on child attendance in the public school system, where certain vaccinations are generally required?

Read CNNs Vaccines: Separating fact from fiction and decide what you think is the right thing to do.

Personally, I think this is quite intriguing, and especially important for anyone having children to be well informed about. Let me know what you think!!!

UK Royal Commission on Environmental Pollution issues report on health impacts of nanomaterials

The United Kingdom's Royal Commission on Environmental Pollution issued its latest report, entitled "Novel Materials in the Environment: The case of nanotechnology" this morning (it is available here: http://www.rcep.org.uk/novelmaterials.htm). Commission members are concerned that nanotechnology is being used more and more in everyday life, but that regulations lag behind its use. This is partly due to the fact that knowledge about the health and environmental impacts of nanotechnology applications lag behind nanomaterial innovation. The report calls on the British government to recognize the divide between innovation and knowledge in this area, to which the government must (by law) respond. This is extremely interesting for anyone interested in that other link between innovation and health - not the one that makes health care provision all the more expensive, but the one that has the potential to make it all the more necessary in the future.

http://www.nlm.nih.gov/medlineplus/africanamericanhealth.html
http://ndep.nih.gov/campaigns/SmallSteps/SmallSteps_index.htm
http://ndep.nih.gov/campaigns/SmallSteps/50ways/index.htm
http://www.womenshealth.gov/minority/africanamerican/diabetes.cfm
http://www.nhlbi.nih.gov/health/public/heart/other/chdblack/cooking.pdf
http://www.blackhealthcare.com/BHC/Diabetes/Description.asp
http://www.netwellness.org/healthtopics/aahealth/
http://www.diabetes.org/communityprograms-and-localevents/africanamericans.jsp

African American Diabetic Websites

We were asked to post the websites we used in our survey of elderly African American diabetics. We look forward to sharing our findings!