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  • U.S. Health Care (Obamacare) – “Correct and Enhance” , A Subject Not For Our Politicians to Deal

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    Ted Cruz is not the only guilty party. The likes of Ron Paul and Cruz are misrepresenting labor union leaders and declaring Obamacare a plot similar to Nazism. Though the democrats have some proof of early success regarding the latest reports on patient access and a leveling off of health care costs, they are as unethical and misleading as their republican colleagues whom they compare to bomb-strapped terrorists.

    It appears that our politicians are not only making it more difficult to understand the need for broader and deeper health care coverage and a path to a healthier society, they now appear to be in a position to close down the government. Once again, the lives of thousands of Americans will be negatively affected. Closing the government will affect Wall Street, thus our pensions. Once again, their actions make us look weak, mean-spirited and indecisive to the rest of the world. And, in the rest of the world, especially in the more advanced industrialized countries, people are mostly happy with their health care systems. Or, at the very least, they are paying less with better results. For many countries, healthcare is a right, not an entitlement. Keep in mind, however, that it took generations; decades, to evolve and improve these international health care systems.

    Therefore, to start this conversation, let us start with the comment by Senator Ted Cruz. He offered, in his 21-hour marathon monologue, the question of why should, we, Americans be in a position to lose our physicians. He is assuming that we now have control over what physician we can choose and maintain; the furthest thing from the truth. We do not have such control now, nor will we in the foreseeable future. For the vast majority of physicians, they, themselves, are controlled by the very expensive managed-care or health care systems that provide them a pay check every two weeks. And, for a growing number of physicians, their salary is ultimately adjusted no longer by being good and ethical and showing up for work every day, but by how many patients they see in a day, or how many tests they order or not order. Senator Cruz’s assumption is that said physicians will magically be available to us for decades. The system is the deciding factor, not the patient nor the physician. Thus, he is wrong. Senator Cruz is also assuming that a U.S. physician is maximally trained and in a position to assist us along the path to better health. By better health I do not mean what is the best drug for one’s high blood pressure or best technology to further diagnosis a chronic or mental illness. I mean, who is the best physician who has garnered an incredible education, not only in acute and chronic care medicine, but also in health promotion, wellness, disease prevention, and alternative medicine, which in many cases should no longer be “alternative”, but a mainstay of how we care for our children, adult and elderly populations. Such well-rounded care is not happening in our U.S. health care system. Yes, some changes have been made regarding how we train our clinicians, however, it is occurring at an incredibly slow pace, with no national mandate, until recently, with this version of a progressive health care policy we define as Obamacare or the Affordable Care Act.

    We not only have a shortage of physicians, overall, but also disproportion. There are too many physicians in some locations and not nearly enough in other communities and regions of the country. Furthermore, a physician in the U.S can either be trained in allopathic medicine or osteopathic medicine. The thought, decades ago, when these two lines of training developed, was that one would be demonstrated to be more effective then the other or provide a better, more holistic level of care–this has not happened. Only in America… We now have nurses, nurse clinicians, and physician assistants doing the work of the physician, which may be fine, but as a nation we have not moved in declaring any major change in how we deliver health based on these new levels of heath care personnel. In fact, when you show up in a physician’s office thinking you are going to get “your physician,” there is a growing likelihood you will not, unless, of course, you are a prominent physician or wealthy or both.not happening in our U.S. health care system. Yes, some changes have been made regarding how we train our clinicians, however, it is occurring at an incredibly slow pace, with no national mandate, until recently, with this version of a progressive health care policy we define as Obamacare or the Affordable Care Act.

    So, Senator Cruz and politicians on both sides of the fence really do not get “how to get to better health” and appear not to be making an honest and ethical effort to do so. We have much to do, requiring a significant amount of courage, honesty, integrity and intelligence. Redefining the role of the U.S. physician and providing better training to our medical students and residents to enhancing the mission of our hospitals will demand these characteristics.

    What we need to do now is at least get those citizens who do not have insurance into a health care system, even though that health care system is broken. We cannot let the poor and other uninsured citizens wonder out there with nothing. We cannot allow our newborns to suffer a higher mortality rate than newborns in most other industrialized countries, simply because their mothers do not have access to some national health care system. We cannot keep abusing our emergency rooms with illnesses and health issues that can be dealt with in some national health system even though it is broken. This is what Senator Cruz and the great majority of our politicians, who very much have the best health care in the world available to them, simply do not get. So, let’s “correct and enhance”, as many other countries have done from generation to generation, rather than tear down and allow others to fall victim, once again, to our politicians uncaring, dishonest, unethical and indecisive behavior.

  • Food Stamps, Poverty, and the Terribly Ignorant and Uncaring U.S. Politician

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    Poverty is increasing in America, with 17% of our citizens living in poverty, including 16 million of our children-our future. In several of our southern states, nearly 25% of the population lives in poverty. These states come close to Romania, considered an industrialized country, where their poverty rate is 25%. According to UNICEF, one American child in four is poor. When an educational minister from Finland, the country with the best educational system in the world, was asked what he could offer the United States as advice to enhance the educational status of the United States, his response was sobering – “nothing, there is too much poverty.”

    One shining light is the slow gains we have made in health care. For the first time in 37 years there are more Americans enrolled in a health care system. College students who will be buried in college loans now have affordable health care available to them. Our most vulnerable population now can enroll in a health care system with a pre-condition such as chronic illness; health promotion, wellness and disease prevention now are gaining some traction over the costly business of the latest and best technology, new and questionably safe medication; the unnecessary growth of some medical subspecialties and hospital surgical units, emergency rooms, and hospital executive office suites.

    So, what is our political response to this? Let’s randomly cut food stamps without offering a positive and sustainable alternative. The poor will work it out as the politicians go home to their comfortable homes and excellent health insurance, the best in the world in fact. And, this is their alternative; keep your food stamps, but let’s stop funding health care, even changes that have helped and will continue to help millions of our most needy.

    So, what should our response be as these politicians go home to their comfortable well- kept family and homes? Our educators and physicians, especially pediatricians, need to speak up. This, however, is a challenge and I will offer my opinion why in my next blog message on our ignorant and uncaring politicians.

  • Book Release- “A Public Health Approach to Bullying Prevention”

    The American Public Health Association is scheduled to release, “A Public Health Approach to Bullying Prevention”, co-edited by myself, Matt Masiello, MD, MPH, and Diana Schroeder, MSN, RN. This book highlights our evidence-based approach to bullying prevention and was written with educators, pediatricians, legislators, and community members in mind.

    Given the increasing burden of bullying in our United States schools, we assembled a team of 16 co-authors who are experts in the areas of bullying prevention and school-based health promotion. Together, we have created a comprehensive book that includes information about the consequences of school-based bullying from the perspectives of physical, mental, and public health, how best to implement, evaluate, and sustain an evidence-based bullying prevention program, school legislation, school climate, the cost benefit of bullying prevention, capacity building, and practical implications for school administrators.

    To read the full article about the release of “A Public Health Approach to Bullying Prevention”, please visit, http://thenationshealth.aphapublications.org/content/43/5/5.1.full

     

  • Keeping Children Safe From Guns A Priority For New Pediatrician At Health Center

    Mashpee Enterprise Newspaper
    December 28, 2012

    By ELSA H. PARTAN
    The new pediatrician hired by the Community Health Center of Cape Cod in Mashpee arrives on the job with dramatic, life-changing experiences behind him, both professional and personal.

    At an interview Wednesday in his home office in Harwich, 59-year-old Matthew G. Masiello described a career marked by a desire to improve the communities in which he has lived, including organizing a gun-buyback program in Pittsburgh and an antibullying campaign elsewhere in the state.

    The Bronx native became the staff pediatrician at the health center in Mashpee on December 3, moving to Harwich with his wife, Kathleen, a nurse, and his 12-year-old son, Jason. Another son, 18-year-old Matthew, attends American University, while an adopted daughter, Kim, lives with his first wife in Connecticut.

    In a startling twist, the man who came to be known in Pittsburgh as “Dr. Gun” in the 1990s for his ceaseless campaign to get unwanted firearms out of homes, watched as his 7-year-old son was shot in the shoulder on a soccer field in rural Johnstown, Pennsylvania, a decade later.

    Dr. Masiello’s experiences in Pittsburgh and in Johnstown led him to speak in Mashpee last week at a meeting dedicated to answering parents’ questions about security in schools in the wake of the Newtown, Connecticut, shooting. He urged audience members to speak to their representatives in government to make changes that will keep children safe, although he was not specific about what those changes should be.

    Surrounded by artifacts he collected during work trips to Mexico, Nicaragua and Indonesia, Dr. Masiello said he does not have a one-size-fits-all strategy. In the mid-1990s, Pittsburgh had the unfortunate distinction of being one of the few American cities in which more young African-Americans were killed by gunshot wounds than in car accidents, he said. Dr. Masiello saw the impact of accidental and intentional shootings of children as the director of pediatric critical care services at Allegheny General Hospital.

    “We were seeing a very different, terrible trend,” he said. “We developed a coalition and created the largest gun-buyback program in the country.”
    The community was ready to do something about it, he said. A previous gun-buyback had only yielded a few dozen guns. This time, people turned in thousands of weapons.

    When he moved to Johnstown in 1996 to become the chairman of the pediatrics department at Memorial Medical Center, he learned quickly that asking people to turn over their guns was not going to work.

    “They didn’t want to hear about it,” he said. “A well-known judge said to me, ‘I’ll help with whatever you want to do, but don’t do guns.’ He was an avid hunter.”
    Instead, he learned from a group of school nurses that their top three concerns were bullying, childhood obesity, and lack of mental health services. It was 1997, and the three issues that seem almost ubiquitous today were only beginning to emerge in the public eye.

    Thus began a decade-long effort by Dr. Masiello and a coalition of community leaders to bring in the Olweus Bullying Prevention Program, an 18-month system designed by a Norwegian professor to create a lasting change in a school’s culture.

    “In 2006 our public health group became the recipient of the first $1.7 million grant to do bullying prevention,” he said. “It is the largest bullying prevention program in the world. It has been an incredible experience.”

    Dr. Masiello has had a connection to Cape Cod ever since he and his wife purchased a cottage in Dennisport in the 1990s. They sold that house and purchased a summer home in Harwich in 2008, which is now their permanent home.

    In the three short weeks that Dr. Masiello has been working on Cape Cod, he has already turned his attention to the needs of his new community. As he talked about his work, Dr. Masiello was interrupted by a phone call from a Harwich police officer who was returning his call. Dr. Masiello set up an appointment to talk with the officer about gun violence and children.

    The pediatrician says his focus on preventing children from being injured by guns intensified after his son was shot in 2007 by a drunken man who was aiming at chipmunks near a children’s soccer match.

    “It was a beautiful summer day around the Fourth of July,” he said. “All of a sudden the referee is shouting, ‘Clear the field.’ He said, ‘Matt, Jason’s been shot.’ I can’t tell you how terrible an experience that was.”

    The worst part was seeing the expression of fear on the face of his 13-year-old son, Matt, Dr. Masiello said.

    “He didn’t know whether his younger brother was going to live or die,” he said.

    A dozen parents surrounded the oblivious shooter, who turned out not to possess any firearms’ licenses. The man was prosecuted for hunting violations and spent a few months in jail, Dr. Masiello said.

    Jason recovered from the blast, which was a “clean through-and-through shoulder injury,” Dr. Masiello said in the manner of someone practiced in describing gunshot wounds.

    As Dr. Masiello gauges Cape Cod’s willingness to address access to guns, he will also be taking on a quieter, even more far-reaching topic. He is continuing in his position as the director of the center for health promotion and disease prevention at the Windber Research Institute, a private, nonprofit organization in Windber, Pennsylvania. In this capacity, he is exploring a system of health care called the expanded chronic care model. An example of this is the “medical home” model already being pursued by the Community Health Center of Cape Cod. All of the innovations fall under the basic concept that the patient no longer has to be sick to receive health care.

    As he pursues his professional interests, the question that drives him is simple, he said.

    “How do we keep the kids healthy?” he said. “There is much more to do.”


    Elsa H. Partan, reporter

    capenews.net