Showing posts with label Health Care Reform. Show all posts
Showing posts with label Health Care Reform. Show all posts

Saturday, March 1, 2014

The Emergency Room as a Place of Change



"If airports can become shopping malls and McDonalds can become a local playground, surely we can reinvent the clinic waiting room."


Above is a Ted Talk by Rebecca Onie, founder of Health Leads. The goal of Health Leads is to connect low-income hospital patients to basic needs and resources such as food, housing and health insurance. The idea behind Health Leeds is to put "health" back into the healthcare system by viewing it in a holistic. In her Ted Talk, Rebecca Onie discusses using a hospital waiting room as place of social change and cites a man named Dr. Jack Gieger as her primary influence. In 1965, Dr. Gieger founded one of the first two community health centers in the United States, located in some of the poorest areas of the country and he noticed that although many of his patients came in with a variety of symptoms and ailments, most were suffering from malnutrition. He began to notice that the root causes of most of their illnesses went back to being starving; he began prescribing food as a result. The patients would then take these prescriptions to the grocery store and the pharmacy budget would be charged to cover the cost. After his funders got upset and told him he was supposed to use the budget for medical purposes only, Gieger responded "Last time I checked my medical textbooks, I read that the cure for malnutrition was food." Dr. Gieger's powerful words laid the foundation for Health Leads: that good health health starts at basic needs and hospital visits should be about more than making basic clinical diagnoses.


Health Leads as it exists today trains doctors and other healthcare professionals to recognize the social determinants of health and incorporate them into traditional models of care. When physicians treat someone that has health needs that go beyond the parameters of biomedicine, they refer them to the Help Desk that situated in the hospital waiting room. This way the patients can work with a volunteer advocate at the Help Desk to get other aspects of their health situated while they’re waiting for their "traditional" prescriptions to be filled. The volunteers, typically undergraduates interested in a career in health care, connect the patients out to the existing landscape of community resources. For example, doctors might treat asthma by prescribing a medication for it but people at the Help Desk would try to instead identify a cause; perhaps the patient has mold in the walls of their apartment, so in response we would try to find them better housing and get them a lawyer to advocate for their tenant rights. These sorts of Help Desks exist as a two-fold: to make a positive impact on people's lives in the waiting room, and also to train the next generation of healthcare professionals to recognize health needs beyond a basic clinical diagnosis. Help Desks aim to treat the cause, not the illness. Health Leads is currently working on providing a business case as to why the healthcare system as at large should pay for this type of care in addition to what they already provide in addition to policy work.


Help Desks like Health Leads are gaining ground across the country and more and more every year are being incorporated into traditional models of care. My PE at Highland Hospital is modeled after Health Leads except it is run on a purely volunteer basis, whereas Health Leads has paid employees as overseers. Berkeley students reached out to Health Leads in 2012 to start help desks in the Bay Area, but at that time Health Leads was not ready to expand so the Berkeley students did it themselves through Big Ideas at Berkeley [http://bigideas.berkeley.edu/winners/highland-health-advocates/]  Highland Health Advocates is just a part of the Bay Area Regional Health Consortium, which is a team of doctors, lawyers nad undergrads devoted to helping those in poverty acheive good health. According to their Big Ideas at Berkeley page,"The goal of this interdisciplinary approach is to improve the health of low-income patients, enhance the patient experience, reduce emergency room utilization by high frequency patients and ultimately lower healthcare costs in outpatient clinics and the emergency department." The pilot Help Desk through the Consortium was founded at Highland Hospital in Fall 2012 with 8 undergraduate volunteers and has since grown to over 60 undergraduate volunteers in Highland Hospital, Oakland Children’s Hospital, and San Francisco General Hospital.

If anyone is interested in volunteering with us, let me know! We require a minimum of one semester. We’re also looking for summer research interns.


Thursday, February 27, 2014

Obamacare vs. Affordable Care Act - Jimmy Kimmel Live

Being a fan of the Jimmy Kimmel Live show, I saw this clip last year, where they sent out a camera crew to Hollywood Boulevard to conduct an experiment on the community's opinion on Obamacare and the Affordable Care Act. As Jimmy mentioned in the clip, Obamacare and the Affordable Care Act are the exact same thing. The purpose of the experiment was to determine how informed the public is on the subject of the Affordable Care Act. This video was my inspiration for the idea of our group project.

http://www.youtube.com/watch?v=sx2scvIFGjE

The video is very funny and entertaining. It also indicates that the general public is not very informed about the Affordable Care Act at all, despite their strong opinions. We can see in the video that a large majority of the people stated that they agree more with the Affordable Care Act and that it is the "better" option. One man even said that it is "more American."

It is very interesting to see what their responses are when asked about why they disagree with Obamacare.

-"there's a lot of holes in it"
-"to force people to pay something and doctors to make something, limiting their ability to do their job, that's kind of anti-American"
-"I just don't agree with the whole Obamacare policy thing that's going on"
-"I don't like anything that has to be forced for everybody to buy"
-One womyn was asked if she thinks Obamacare will lead to gun prohibition, she responded, "yes."

I think that when the general public is not informed about certain topics, they lean towards a certain side based on the names of the topics; whichever name that sounds "more" right and interesting. Even though this can possibly be an issue of naming of the health care program, it does not hide the fact that the general public does not know that they are the same. How can a program that is developed to serve Americans be "anti-American?" Or, is the name "Obamacare" what actually sounds "anti-American" to him? I actually found it quite funny that the womyn responded "yes" to the question about Obamacare leading to gun prohibition. What could be a potential relationship that she saw between the two? I cannot see the relationship yet and actually think that it was just a random question to test her. Another thing that stood out to me was the fact that this video was taken at the Hollywood Boulevard in Los Angeles. Generally speaking, I would assume that these members of the public are from a pretty well off background, since Hollywood Boulevard is an affluent part of LA. It is also a tourist attraction; in order to be a tourist and travel, one must also have the financial capabilities to do so. This brings up the question that, if the middle and upper middle income class do not know about the Affordable Care Act, how much does the lower middle class knows? Have they heard of the Affordable Care Act? Do they know what it offers and what their options are?