Conferences: GLC Reaching Excellence in HMP Symposium and Net Impact Conference @ Ross

Saurabh Vyas

Farewell to Fall,

I am writing this sitting by a huge glass window at a cafe I usually frequent to get my daily fuel – coffee. The weather in the past few days in Ann Arbor has been lovely, and I must say this has been a great Fall with lots of sunshine, a weather to envy and go for a run… As much as I would love to just be outside and soak up the sun, I have been quite caught up with a number of events over the past couple of days. My finance exam was only a fraction of that. One of the biggest events that I am excited about is the upcoming GLC Reaching Excellence in HMP symposium. As I had mentioned in my last blog post (which has been a while ago), the event is all set to be the biggest event at the School of Public Health attracting alumni of the Health Management and Policy program from all over the country. On last count there were more than 600 delegates already registered, consisting of students, alumni and distinguished speakers like Dr. Donald Berwick (Administrator of CMS), John Griffith (distinguished Professor in HMP department), Beth McGlynn (Asso. director RAND corp.), Stephen Shortell (Dean of UC Berkeley School of Public Health) among others. More details regarding the speakers can be found at - http://www.sph.umich.edu/hmp/glc/reaching_excellence/speakers.html The symposium is on November 5th at the Mendelssohn theater in the Michigan League, followed by tailgate and a football game the next day.

So, what makes this symposium so special? For me, there are three major reasons which make it very exciting. First, with the current health reform debate ( I am still unsure if things will actually be ‘implemented’ – more on that in my next post), there are a lot of ideas regarding the implementation and integration with the current health system. This event will be a great platform to hear and even discuss the effects of reform from various healthcare angles – be it provider, insurance, or life-sciences. Second, the biggest alumni event for HMP Department, it is an amazing opportunity to meet and get inspired from alumni around the country, at a single location itself !! It is an unparalleled chance to expand your network. Third, for the students looking for internships, and job opportunities, it provides a platform to meet leaders of organizations and learn more about the organization, and may be they will find something that ‘clicks’ and ‘love’.

Another conference, which starts tomorrow is at the Ross Business School – Net Impact 2010; which will focus on issues ranging from microfinance to social entrepreneurship and corporate sustainability.

As the days pass, the weather will get colder. Though I had vowed to capture the Fall this year with my camera as much as possible, I have fallen behind on that front. But here is a photo that is a glimpse into the beauty of Fall. The photo was taken at the main Diag near the Graduate Library.

International Travel Doctor Visit

Carrie Rheingans

Since I’m going abroad for a social work internship this summer, I needed to make a travel health appointment to make sure I have all the vaccinations and immunizations I need to stay as healthy as possible while I’m traveling. I had my appointment last week (my third in five years…) and got my first-ever anti-malarial medication prescription.

As a current student, I have access to the services at the University Health Service (UHS). They have a travel & immunology clinic, and it can get pretty busy during certain times of the year (before spring break and summer break). They ask you to take an online basic travel health training in order to make an appointment. It doesn’t take long and is a good review of water and food safety, sun and bug issues, and what to do in a health emergency.

It’s best to go prepared to the appointment and know exactly where you’re going in your travels. Malarial areas can get pretty trick in some places, so it’s best to know what cities or villages you’re going to if possible. The appointment is pretty quick and includes a review of health issues in the locations where you’re traveling and some immunizations and prescriptions as necessary. My favorite part is getting ciprofloxacin to treat diarrheal illness. It’s helped me out in the past! UHS can also dispense many of the prescriptions right there in their pharmacy.

There’s a price list on the travel health page for planning for what immunizations you might need. If you don’t have insurance coverage for some of the requirements, it’s easy to go to the Washtenaw County health department as well.

Key Terms for Speaking #HC Reform

MB Lewis

A heavy bag strains my shoulder these days as I lug around reams of articles and notes, hoping to catch a few minutes here and there studying for my first  U.S. health care survey exam. My mind swirls with loaded phrases that succinctly describe why our country needs health care reform, unless we want to sink under $2.5 trillion-plus annual spending in a system that doesn’t work.

Know what I mean? Parlez-vous HC-speak? Let me unload a bit:

• Sick care system: That’s a more accurate term for America than the ubiquitous “health care system,” because bigger money is made treating illness than keeping our population well.
• Being uninsured is bad for your health: So is being poor or a racial minority in a system plagued by health disparities.
• We’re #37: That’s where the WHO ranks us on population health, even though we spend 16 percent of our GDP on health care, much more than any country. (Want to sing it?)
• Paradox of excess and deprivation: Inequalities, especially deep divisions between haves and have-nots, drive our miserable overall health status.
• Geography is destiny: Your health outcome could depend on the number and kinds of doctors where you live, as well as on your environmental stressors.
• The worried well: The economically privileged people who utilize health care services extensively, because they can.
• A built bed is a billed bed: Infrastructure-heavy investments in hospitals and equipment drive “supply-sensitive” spending more in some areas than others.
• Technological imperative: Expensive diagnostic equipment, once purchased, likely will be used–and Medicare will be billed.
• Bending the cost curve: This is what the Obama administration hopes to achieve with reform. Costs will continue to rise, but maybe not at such a steep rate.

If there’s any single image that stays with me most from the hundreds of graphs in Professor Rich Lichtenstein’s lectures this month, it’s this one on what’s killing us now, instead of the infectious diseases of yore:

See that big yellow piece of the pie? Behavior patterns (the food we eat, the exercise we skip, the risks we take) exacerbate chronic conditions and bring us down. Years of lost life are a result, along with many unproductive disability-affected years.  I believe wider insurance coverage and Medicare reform are urgent national priorities, but so is living healthier any way we can.

Latinos and the Healthcare Debate

 

Valentina Stackl

One in three Latinos have no health insurance. Facing serious linguistic and cultural barriers, Latinos also have much lower rates of preventative care, like cancer screenings and regular checkups, and higher rates of many chronic diseases such as diabetes. The new Obama healthcare plan would cover all Americans, including Latinos citizens, in a comprehensive health insurance plan. It would still, however, exclude about 11.9 million undocumented immigrants in this country.

“This has always been in the elephant in the room — all of our families are mixed, some documented, some undocumented,” said Elena Rios, president of the National Hispanic Medical Association, a nonprofit group that represents Hispanic doctors. “But we’re so close to having health care reform. We’d be working against ourselves to let immigration issues stall the process.” Others, like Jennifer Ng’andu, deputy director of the National Council of La Raza’s Health Policy Project, disagree, believing that any plan that doesn’t include undocumented immigrants is not worth supporting since they make up about 15% of the nation’s approximately 47 million uninsured individuals.

Many studies show that inadequate access to regular, quality health care that is culturally and linguistically sensitive has serious consequences. Regardless of what side of the debate you’re on, one thing is clear: Latinos make up 15% of the total US population, and Latino children represent 25% of preschoolers and kindergartners. Not taking care of the Latino population now, will have serious consequences in the future.

Dental Experience In Peru

Carrie Rheingans

I got a root canal in Peru. Yes, it’s a story for my grandchildren… not really. It is the simple fact that I can’t actually afford dental care in the US, even when I had insurance! You can learn more about the root canal(‘endodontic therapy’) process on Wikipedia (I trust Wikipedia for non-partisan things of this nature).

Two years ago, I had a full-time job at a local non-profit, which included dental insurance. I’m very good at my dental care at home, and I take my 6-month visits very seriously. I think I might have missed only one in the last ten years, even when I didn’t have insurance. When I had insurance, they told me I grind my teeth at night and need to get an occlusal guard for when I sleep… for $600! And my insurance covered… 0%. Great.

Well, after the insurance ran out and I was a student again (in, ahem, public health), I was back in the no-dental-insurance club. Naturally, that’s when it was discovered that I needed to replace some old fillings… for something like $250. Too much for a poor student! When I got here to Peru, I ended up getting X-rays to see how close the fillings had decayed to the tooth nerves and it was not good. Time for a root canal!

I ended up getting the following: one crown, two fillings, one occlusal guard, and one root canal. At my dentist in Ann Arbor, this would have come to $2,388 out-of-pocket. Here in Lima, it was s./1795 (currency is nuevo soles, about s./3 = $1) which is about $600. This is a 75% discount! What makes it so expensive in the US? The dentist who specialized in root canals was trained in Canada! I’m sure he has tons of debt from it, which he must pay off. Yet it still costs 75% less. Why?

In the middle of my root canal (endodontic therapy) with Dr. Carlos

Going to the Doctor in Peru

Carrie Rheingans

It was bound to happen – I got sick in Peru. After four days in which I couldn’t be far from a bathroom, I went to the clinic down the street to see what the heck I had. They sent me to the emergency room because there was a long line for the general doctor, which freaked me out at first because I wasn’t really listening and all I heard was ‘emergency’. I went with the mother of the family I’m staying with, so I asked her to clarify as we were walking down the stairs to the ER. The health insurance that was mandatory for me to purchase for the FELA trip will end up covering all the expenses, but I have to pay for everything first and get reimbursed. Fortunately it wasn’t very expensive – I don’t know what I would have done if I needed an appendectomy or something!

The health clinic was pretty new-looking and was way bigger than I was expecting. One thing I noticed was that there doesn’t seem to be such a focus on confidentiality here as my experiences in the US. For example, the mother of the family went into the examining room with me and heard me answer all the questions. I didn’t mind in this specific case, but there are some cases I could imagine a young person would NOT want their mother in the examining room with them! Also, I heard some doctors talking about other patients, just to get advice. It really creeped me out. When I was in the examining room, I was looking out the windows and noticed that one didn’t close all the way and had a gap. This was at about ground-level, which means that all the lovely exhaust that coats Lima was getting in. I wondered to myself how many people leave feeling sicker, and realized that this wasn’t as bad as many healthcare locations around the globe.

The verdict was just that I had traveler’s diarrhea (was bound to happen, especially since I attempt to be a vegetarian) and the doctor perscribed a familiar, bright pink, viscous liquid to settle my stomach and told me to take ciprofloxocin for four days. I had been prescribed this by the UM university health service during my travel appointment before I left the States, so I had it on hand already and had actually started my first day’s worth of doses.

What stories do you have of getting sick while traveling? Any advice for other travelers? Leave it in the comments please!