Healthcare. Is it worth going to prison for it?

Mansfield Frazier writes a piece about it for the Daily Beast.

“Imagine a place where you don’t have to pay anything or no more than $5 for a visit to the medical clinic,” Roberto Hugh Potter, an expert in the Department of Criminal Justice at the University of Central Florida wrote in an article about the future of universal health care, “Where your physician-prescribed medications cost you nothing, where there is no penalty for missing work or school to go to the clinic, and where every individual has an absolute right to access and receive “adequate, reactive” health care. Welcome to prison!”

That's right. Prisoners have the right to receive healthcare, and they do receive it regularly, with all their prescriptions paid for. There is a viral story about a man named James Verone who robbed a bank for one dollar, specifically so he could receive healthcare after he was put in prison. After being laid off as a truck driver, he could no longer work his part-time job nor afford healthcare after his back started to hurt him and he had a protruding growth on his chest. It looks like he is not the only person who takes advantage of the system.

Damien Calvert, who was recently released from an Ohio prison for a drug-related murder he committed when he was 18 (he’s now a straight-A student at Cleveland State University, studying nonprofit management), said that part of the reason recidivism rates are so high is due to the lack of access to health care on the streets for parolees. “Guys get out with a week’s supply of their medications,” said Calvert, “and when they’re unable to navigate the health-care delivery system out here in the world, they commit another crime so they can go back to their comfort zone, back to where they know they’ll be kept alive. But there’s something fundamentally wrong in this country when people have to resort to committing crimes to receive adequate health care.”

An experienced, old-school convict would not have robbed a bank for $1 as Verone did; they, instead, would have heaved a brick through the front window of their local Post Office, a crime that’s guaranteed to result in a federal judge giving out a buffalo. For those unfamiliar with the argot, a “buffalo” is a “nickel” uh, five years? Plenty of time to get healthy… and pick up a nice hobby to boot.

Instead of having to get arrested to receive healthcare, wouldn'y a universal system of healthcare be better than this? One in which we all pay into the system and get to reap the benefits of seeing healthcare providers early and often for preventative measures, decreasing the cost overall. Read the whole piece. It's worth it.

Car Free City Centers of Europe to the US?

Wow. Even though I really shouldn't be surprised, I always am when I read about transportation and/or environmental news out of Europe. It is so different than the United States. An article in the New York Times by the Elisabeth Rosenthal describes how the cities of Europe are discouraging city driving on purpose, while American cities are making it easier.

Cities including Vienna to Munich and Copenhagen have closed vast swaths of streets to car traffic. Barcelona and Paris have had car lanes eroded by popular bike-sharing programs. Drivers in London and Stockholm pay hefty congestion charges just for entering the heart of the city. And over the past two years, dozens of German cities have joined a national network of “environmental zones” where only cars with low carbon dioxide emissions may enter.

There are obviously environmental applications to these decisions. Less cars on the road means less carbon emissions from the exhaust, less oil required for gasoline. There are great health benefits as well as daily requirements for exercise are surpassed on the commute into work.

As noted in the article, most European cities were developed hundreds if not thousands of years before motorized transport appeared as a means of getting around, and therefore have narrow roads and are naturally pedestrian/cycling friendly. Living in Boston, I can see how much easier life would be if there were much more cycling and much less driving, considering our roads were developed along the same lines as cow paths.


(everyday traffic in Amsterdam, cycling capitol of Europe)

I have been impressed by the avid cyclists here in Boston who ride even in the winter, and one of the main reasons I wanted to move here in the first place was because it is such a walkable city. One of my biggest concerns for moving to South Florida is that it is not very pedestrian friendly. I know, kind of silly, but being connected to the heart of a city without needing a car is important to me. I've heard than some cities in the US have started encouraging more pedestrian traffic, like Portland, Oregon and San Francisco. I hope this is an idea that catches on.

LGBT Healthcare

It is important to know your patients. It is important that they feel comfortable enough to tell you everything relevant to their health history. This is a quote from Dan Savage, co-founder of the It Gets Better project.

The first adult authority figure that I came out to who wasn't a member of my family: my pediatrician. I'd been seeing him since I was a child and he was still my doctor. After my third or fourth visit about "a small skin blemish," he asked me what I was really worried about. I remember what I said to him: "I'm gay and I don't want to have AIDS." I don't remember what he said to me, but I'll never forget the look on his face. It was this combination of pity, panic, disappointment, and judgement. I never saw him again.

This is unacceptable. This encounter occurred in 1981, at the beginning of the AIDS epidemic, and attitudes have mostly changed since then. Nevertheless, queer people still feel uncomfortable going to the doctor. New York City Health Department has put together a video to help train physicians on the importance of understanding sexual orientation and gender identity, how these identities affect the health of those people who claim them, and how important it is to help these under-served populations feel comfortable to seek the healthcare they need.



This video helps to put a human face on LGBT people. I think everyone should watch it.

House Votes to Withhold Education from Medical Students

How far will the right-wing go? This makes me burn with rage. An amendment to a funding bill for the health care law signed last year was sponsored by arch-homophobe and now anti-medical Virginia Foxx (R-SC). The amendment states that no federal funding will go to any medical school that teaches abortion procedures to its students. It passed with bipartisan support, 234-182.

I have several problems with this. First of all, what the hell?! Abortion is legal, and it should be. Regardless of how one may feel about the morality or ethics of abortion, there will always be women who have them performed, whether in a back alley, someone's home, a clinic or doctor's office. As someone who actually respects life, especially of someone who is already living, I would prefer that these women see someone who is competent in their skills, so there are as little complications as possible and they may receive the support they require/want without fear of being arrested or the stigma of having one performed. Second, some abortions aren't really a choice. Sometimes babies need to be aborted to save the life of the mother. Should a woman be required to carry a baby to term when said baby was conceived during a rape? What if the baby's father was a close-blood relative of the mother, like her father, uncle, or brother? I feel like the 'respect for life' movement has jumped the ship named Sane Discourse, and is swimming to shore, hoping to make it to Crazy Town, USA. Third, I thought that republicans were all about less regulation and control and more freedom. How does this amendment allow for more freedom? Will this attachment create a better, more competent, compassionate medical field? No. Third, if you want to decrease the amount of abortions performed in the country, and the world, research has shown that proper comprehensive sex education needs to be implemented. Counseling should be provided for those women who are considering an abortion, and rhetoric should be toned down. If you are really 'pro-life,' then you should practice being pro-life for everyone. Oh, and get ready to adopt a bunch of babies.

The abortion debate is so complex and nasty. It sickens me that I have even felt the need to put in my two cents. However, when the culture wars start meddling in my professional life, I won't take it sitting down.

P.S. A book was recommended to me, Killing Rage, by Bell Hooks. It is my understanding that it suggests constructive ways to deal with rage. It might be helpful for those who feel so strongly about this issue.

Practicing Better Medicine?

A part of preparing to begin the process of medical school involves paperwork - a mountain of paperwork. This mountain is not Everest, but it is still a mountain. Ok, maybe a hill, but it was still more than I was expecting. Most of it was just, 'sign this document stating you will consent to allow other students to learn manipulation on you. Do you promise all this background information is true, etc.' A majority of the annoying stuff to fill out was health information. I've been vaccinated, but getting the proof of vaccination ended up being ridiculously round-about.

Finally I decided to call my pediatrician to get the records, I think off of the advice Neil gave me. As someone who has moved around a few times in recent years and a future medical professional, I am a strong advocate for a centralized health records system.

This concept is not a new one. Since the internet came into being, many of our 'sensitive' documents and information about our lives have found themselves online: banking information, insurance information, credit cards, investments, shopping habits, likes/dislikes and friends. Why not have a secure system in place where we can store our health histories? Moving from one part of the country to another would be much easier (for those who don't already have their health information organized). Going from specialist to specialist would no longer require a stack of paperwork to fill out, and needed information, like familial health history, might not slip through the cracks (did Uncle So-and-so have high blood pressure or COPD?).

Even having a centralized electronic health record (EHR) for a hospital/primary care facility could help improve quality of care by catching medical errors immediately or before the treatment plan begins. When prescribing medication, walk through screens could increase patient safety as drug incompatibilities and adverse affects can be highlighted before the pen reaches the Rx pad.

On a wider level, health trends and treatments could be categorized and implemented much faster if the EHR were used in conjunction with evidence based medicine.
Privacy has been cited as a concern, but with proper password/id protection, it shouldn't be a problem. Actually, the Health Insurance Portability and Accountability Act (HIPAA), set up in 1996 not only helped to protect patients' right to privacy, but also set up guidelines for a paperless, centralized system of electronic health records. I have seen software systems used in academics and in medical practices that allow for information to be shared without compromising privacy standards.

More can be done to assuage privacy concerns, but I believe that the benefits of having a centralized EHR system outweigh any costs. What do you think?

Marriage Equality Update

Friends who fight the good fight! For a couple months now, a guy from California named Matt Baume has been updating the world via two youtube channels, first the Prop8-centric Stop8org, then the more inclusive Marriage News Watch. If you were ever curious as to how gay marriage rights are doing across the nation, Baume does an excellent job collecting the stories, presenting them, and then explaining what can be done to help move the country towards equality. Here is this week's video:

This issue is huge for me, for hopefully obvious reasons, if you know me. Right now I live in a state where I am allowed to get married to the person I love, but those protections and responsibilities will not follow me down Florida, where I am going to school. When you do not have marriage equality, simple things become ridiculously difficult. If we're married, Neil should be covered under my health insurance provided through the school. They are unwilling to do that, and we have to go down to Florida, crossing our fingers that he can find a job so we don't have to spend a fortune on insulin supplies (more on this issue later). That problem isn't as big as potentially losing a legal spouse due to deportation. Watch the video, follow along; this is one of the most important civil rights movements going on in the country. I hope that you care.

more to come

Friends. I've been extremely busy trying to get myself ready for school in the fall. This includes doctor's visits, figuring out health insurance, moving, timing, other prior commitments (like an amazing relay race to the Cape)etc. There are a couple topics. I want to write about, including centralized health care, mental health and marriage protection rights, but they are going to have to wait for a bit while I catch up on work (which I also want to blog about). I will try and fit them in as soon as I can. In the meantime, please enjoy this glee cover of one of my favorite songs by one of my favorite artists: Rolling in the Deep by Adele.



I LOVE THIS SONG!