Strollerderby : health care

When You and Your Ex Disagree Over Your Kids’ Health Care

Hannah Tennant-Moore — Wed, 15 Apr 2009 17:30:00 GMT

When I was a preteen, I was diagnosed with a serious kidney disease. My long divorced parents, who were normally quite cordial with one another, differed sharply in their opinions over my treatment, leading to screaming fights and subtle psychological tug-of-wars. They may have been able to compromise over who paid for violin lessons, but when it came to their daughter’s health, neither of my parents was willing to put their beliefs aside.

A Washington Post writer recently discussed this problem with family therapist Elayne Savage, whose commonsense recommendations echo the solutions that my parents eventually found.

Most importantly, Savage suggests enlisting the help of a counselor or mediator. The shift in my parents’ attitudes to each other changed palbably after they started seeing a mediator. Neither of my parents stopped telling me what they believed would be best, but it was no longer couched in terms of the “better” solution. Rather, they both simply explained to me what they would like me to do for my health (in my dad’s case, acupuncture and energy healers; in my mom’s, the most aggressive mainstream interventions), without pushing me or scaring me.

I learned to speak to my dad about certain health concerns and my mom about others, just as many children of married parents would do. I understood how my parents' approaches differed, but I ultimately felt this meant that I had more options, rather than less.

Savage also points out that doctors themselves can also be instrumental in helping parents reach agreements. When one parent feels strongly that medical intervention is not necessary or could even be harmful, a trustworthy doctor can step in and make recommendations that take nothing but the child’s health into account. I was lucky to have such a doctor, who sat down with both of my parents and me and thoroughly explained each of my options and the probable outcomes. In his presence, the three of us came to an agreement about my treatment, so there was no danger of emotions running too high.

Photo: lilsugar.com

Barack Obama Discusses Sasha’s Battle with Meningitis

SunnyChanel — Mon, 30 Mar 2009 20:00:00 GMT

Barack Obama has made the battle of reforming health care personal. Last week, during the While House’s ‘Open for Questions’ town hall, Obama not only discussed medical insurance in regards to his mother’s battle with ovarian cancer, but he openly discussed his youngest daughter being stricken with meningitis.

"When Sasha, our little precious pea, she got meningitis when she was three months old," said Obama. "The doctors did a terrific job, but frankly, it was the nurses that were there with us when she had to get a spinal tap and all sorts of things that were just bringing me to tears. And we've got a problem in this country, which is we have a shortage of nurses."

This is not the first time Obama has publically discussed Sasha’s health scare. In his book, “Audacity of Hope,” Obama used the example of Sasha’s illness and hospitalization to illustrate the “need for affordable and universal health care.”

In the book he wrote, "I still shudder when I think of those three days; how my world narrowed to a single point, and how I was not interested in anything or anybody outside the four walls of that hospital room -- not my work, not my schedule, not my future.”

Do you think having a president who has first hand experience dealing with medical industry will help reform America’s health care system?

The New State of Children's Health Care

Hannah Tennant-Moore — Fri, 30 Jan 2009 16:30:00 GMT

Soon after President Obama signed the Lilly Ledbetter Fair Pay Act into law, the newly empowered Democratic Congress has once again signaled their commitment to what they’re calling “women and children first.” The Senate voted 66-to-32 to expand the State Children's Health Insurance Program to cover four million currently uninsured children by 2013. A tobacco tax will be used to pay for the increase in the federal program.

This legislation, which former President Bush vetoed twice, couldn’t come at a more important time, as job losses mean that tens of thousands of children are losing their health insurance.

One of the most controversial aspects of the bill is that it allows states to decided whether or not recent legal immigrants can benefit from federal programs like Medicaid and the State Children’s Health Insurance Program. Currently, federal law bars legal immigrants from participating in these programs for five years after they move to the U.S.

According to The Times, “Many Republicans, including Senator John McCain of Arizona, said they worried that it was part of a long-term effort to replace private health insurance with government programs.” Since it's clear from President Obama's health care proposals that no one will be taking away McCain’s (or any rich, powerful man’s) private insurance, I think that the real concern is the possibility of having to pay an eensy bit more in taxes in order to help impoverished children and families get covered.

Some critics of the bill are also up in arms because the expanded program would offer federal assistance to families that do not qualify for Medicaid, but who can't afford private insurance--such as a family of four, living in New York, with a combined income of approximately $66,000. Although this is technically three times above the poverty level, it's easy to see how many families in this income range would find it impossible to spend upwards of $12,000 a year on health care.

Hmmm, let's see--would we rather help smokers keep their tobacco costs down or give four million children health insurance?

Photo: faithfulamerica.org

Airing the Parental Dirty Laundry

Brett Singer — Fri, 02 Jan 2009 17:00:00 GMT

If you blog, you presumably want readers. And one way to do that is with a snappy headline. One could borrow from supermarket tabloids and go with something sensational and completely fake -- "Sarah Palin Gives Birth To Three Headed Alien" – that would do it. But if you blog about family matters, the truth can work just as well.

For example: this post on Yahoo! Shine.

My son is home!!! And I am really mad at his father.

The title got me to click and see what the heck was going on.

The first sentence was a grabber:

I recently wrote a blog about how I hate it when my son goes to his father's for Christmas.

Then it got better:

So many of you left very nice comments about my tough time while he is gone. There were a few that said I was being petty. Let me Go deeper into this........

I started to feel like a voyeur. This was pretty personal stuff. But it's not like I'm looking in the author's window. I'm reading something she posted on the Internet.

I'm not sure what the initial post was about, but this one tells the tale of a father who brought his son home after Christmas with an injured thumb. The mother was mad because the kid should have gone to the emergency room, and thinks that pop was too cheap to pay the seventy-five dollar co-pay. The injury is described in "ER"-level detail: "When I picked him up, it was black and purple and he could not bend it. We went immediately to the ER. After 2 shots of pain killer, they drilled 2 holes in the nail to relieve the pressure." Presumably the couple is divorced and the boy was spending the holidays with his father, although the post doesn't say that explicitly.

So here's my question. Is this fair to the kid, the father, and everyone else involved? Most of us who blog, whether for pay or play, reveal certain details. But it's one thing to talk about a goofy thing your three year old told you. It's another thing to reveal personal details like the ones on this particular Shine post.

It could be a generational thing. I'm selective about what I share with the world, and I think most folks are. Other people don't mind putting it all out there. (That's why Facebook is so successful.) In this case, I imagine that posting these personal details is therapeutic for the author. It is also interesting to other people; the post has over 100 comments. But if I'm the father, I'd be irritated.

Of course, if I'm the father and I really didn't take my son to the emergency room because I didn't want to spend seventy-five dollars, I'm also a major league jerk. Part of the problem, of course, is that we don't know what the father did or didn't do. It's possible that he weighed in with a comment; I haven't read them all. Still, judgments will be made – by me, the commenters on Shine, and commenters here. That's the nature of blogs. Once it's out there, it's out there. But is there a line that we shouldn't cross when kids and/or our significant others are involved? Can there be such a thing as too much sharing online?

Source: Yahoo Shine

Image (which is completely unrelated to this topic): sas.org.uk

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Tell Obama to Overturn the Global Gag Rule Sooner Rather Than Later

Shannon LC Cate — Fri, 19 Dec 2008 18:34:00 GMT

The Global Gag Rule, originally put in place by Ronald Reagan, makes U.S. aid dollars available only to health clinics that refuse to discuss abortion with their patients, regardless of the abortion law in their countries. As a result, helath clinics that provide basic services to poor people with little to no other options for health care have been closed due to lack of funding. Will Barack Obama overturn this rule (as Bill Clinton did during his years as president before GW Bush reinstated it)? Sure, he probably will. But let's be sure he knows that health care for poor women and children around the globe is a priority for us. This video from Engender Health tells you how to help:

Midwives to Daschle: We're Cheaper and Better

Miriam Axel-Lute — Thu, 18 Dec 2008 16:30:00 GMT

The folks at The Big Push for Midwives are organizing to try to get upcoming HHS Secretary Sen. Daschle to make one of the community meetings on healthcare he attends one that they are holding in Missouri to discuss reforming maternity care.

There's good reason for this: Maternity care is one of the areas where the U.S. healthcare system exemplifies the lose-lose proposition of spending tons of money for piss-poor results in terms of maternal and infant mortality rates. There are better ways. As the Big Push folks report, "A recent Washington State study, using conservative cost estimates, estimates that the state's licensed midwives program, over two years, resulted in recoveries from Medicaid Fee for Service (FFS) alone at more than $473,000. Cost savings to the health care system (public and private insurance) is estimated at $2.7 million." That should catch any budget-minded appointee's attention.

On the other hand, I do have to quibble a little with the activists when they write: "The first step in maternity care reform centers on recognizing that our problems go beyond the secondary issue of insurance coverage and access to care." Yes, access to a broken system is a mixed bag and our problems go beyond insurance. But lack of health insurance isn't secondary. As much as I adore the midwife model of care, I'm willing to bet that lack of any prenatal care at all, health complications in mothers that went untreated because they didn't have insurance pre-pregnancy, and the stress of working extra jobs/hours to pay for unaffordable insurance total to a bigger problem for babies' health than even intervention-happy OBs. Besides, people without insurance won't get to see midwives either.

But nonetheless, Daschle should talk to the midwives at some point. Their message of better, cheaper, common-sense care is just the kind of thing the Obama administration might be able to see the value of.

More by this author:

Rural Hospitals Dropping Maternity Care

Amy Kuras — Mon, 24 Nov 2008 22:06:00 GMT

Living in a pretty good-size city and having good health insurance, I pretty much had my pick of hospitals to deliver my kids. The one we chose had opened a new wing with an incredibly nice mother-baby unit shortly before I delivered my daughter – and went all private rooms in the intervening three years before I gave birth to my son. Faaancy.

But in rural areas, some hospitals are dropping childbirth care altogether. While it’s usually a pretty big profit center for hospitals, according to this article from Northeast Georgia, some small hospitals are finding the expense of providing obstetrics exceeds what they could make from the small number of patients they see.

Kevin Bloye, spokesman for the Georgia Hospital Association, said, "It’s a tough time to be a rural hospital. The important factor is payer mix. In rural areas especially, the base of insured patients is shrinking. You need to have enough insured patients to offset the cost of treating Medicaid and uninsured patients."

That’s right, the healthcare crisis rears its ugly head again.

It’s not that pregnant women will have nowhere to go – two fairly nearby hospitals just opened new obstetrics units – but for people who maybe wanted a smaller, closer to home experience, that’s got to be a blow. And not only that, but they just announced this month that they’d stop delivering babies on Dec. 9. I was pretty amped up on hormones near the end, and if someone announced I would have to go elsewhere very close to the end of my pregnancy I would have lost it. Waiting out a due date is hard enough without wondering if your hospital will still be open.

N-Word Flies at Palin Rally

Brett Singer — Wed, 29 Oct 2008 21:00:00 GMT

This is really ugly.

I hope that whomever you happen to be voting for, this isn't something you can condone.

As the blog We Are Respectable Negroes (the name comes from the Forty Acres and a Mule document) puts it: "It seems that Barack Obama was finally called a 'nigger' at a recent Republican presidential rally."

Palin will get a lot of flack for not responding, and while I can't argue otherwise, I don't know what she should have said. (In a Palin voice: "Oh, come on now! That's a bad thing to say!") Then again, how do you stand in front of a crowd that screams out something like that?

Michelle Malkin is claiming that the person was actually shouting, "Redistributor!"

Yes, of course. I make that mistake all the time.

(Aside: in case anyone is planning to leave a comment along the lines of, "What about that Sarah Palin hanging effigy? Why aren't you railing against that?" It's terrible and should be taken down immediately.)

I'll ask you -- what do you think you heard? I actually closed my eyes so I couldn't see the captioning on the video. Send the kids out of the room and tell us what you think was said.

Source: We Are Respectable Negroes, MichelleMalkin.com

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Babble Talk: The Candidates Health Plans

Brett Singer — Mon, 27 Oct 2008 20:00:00 GMT

Kim Mance breaks down some of the key points in the Obama and McCain health care plans. I have a few thoughts to add.

I didn't realize this, but the debate about a national health care system goes back much further than when Bill Clinton attempted to implement one when he was first elected way back in 1992. "Both Roosevelt and Truman called for health care to be an 'economic right.' Truman then proposed a single-payer health program to cover all Americans. But it was called a 'Communist plot' by a House subcommittee after the American Medical Association denounced it." Funny (not ha-ha funny) how one of the current digs at Obama is that he's a "socialist". I guess socialist is the new communist.

A key difference between their proposals is, "how to ensure that all Americans have access to health insurance. Both want there to be no 'state lines' as there are now, so families can shop around for the best plan. However, Obama will regulate and require insurance companies to cover patients regardless of pre-existing conditions, and McCain will not. McCain will instead work with Governors on (fifty separate) plans to optimize access to health care within each individual state."

One thing that I find very interesting, and encouraging, is that at least both sides are talking about getting more people covered. Back in the 1990's, it was much more of an "us against them" situation, with the Democrats wanting a national health care system and the Republicans wanting everything to stay the same.

To me, a sign that the McCampaign is out of touch on this particular issue is the notion that a family can purchase health coverage for $5,000, or even that they can purchase it at all. First, as Mance points out in her Babble article, $5,000 covers less than half of the typical family's yearly health insurance bill. Obama says that the cost is $12,000, Mance cites a study that puts the number at $12,680. Second, as someone who has run a small business and offered health insurance to employees, I can tell you that it is not that simple to just go buy a plan the way McCain says it is. For an individual, it is significantly more difficult. Health insurers simply don't want to talk to individuals about coverage, they prefer to deal with "groups", meaning employers. So while it sounds nice to say, "hey, here's five grand, you can buy whatever health plan works best for you", it's just not that simple.

There are more details discussed in Mance's article, which is very much worth a read. The bottom line? It's hard to tell what will happen no matter who gets elected, but they agree that the current system isn't good enough. "Neither presidential candidate's health care plan brings us anywhere near a true socialized medicine or single-payer system. But they do both point out the many ways our own health care structure can be improved." That's at least something.

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Palin Speaks Out On Special Needs Trusts

Brett Singer — Sun, 26 Oct 2008 14:00:00 GMT

Republican Vice Presidential candidate Sarah Palin gave a speech in Pittsburgh on Friday where she discussed the challenges facing children with special needs.

Here is a video clip with a few choice digs at the Obama-Biden tax plan:

If the clip does not appear, try clicking here to see it.

And a couple of pertinent lines from the speech:

As families across America know, the care of special-needs children requires long-term planning, and especially financial planning. A common practice among these families is to establish financial trusts. These are known as special needs trusts, covering years of medical and other costs, and for parents they bring invaluable comfort.
Understandably, then, many families with special-needs children or dependent adults are concerned that our opponent in this election plans to raise taxes on precisely those kinds of financial arrangements. They fear that Senator Obama's tax increase will have serious and harmful consequences -- and they are right. The burden that his plan would impose upon these families is just one more example of how many plans can be disrupted, how many futures can be placed at risk, and how many people can suffer when the power to tax is misused.

I’m unfamiliar with special needs trusts, but it sounds to me like something only someone with money can do. That is, if a family lives paycheck to paycheck, how much financial planning can they really do? Like most political rhetoric, what Palin says is short on specifics and long on fear mongering. (That's true of both sides; lack of details is non-partisan.) Also, "the power to tax"? Oy vey. You would think no Republican administration had ever raised taxes, or that the tax cuts in recent years actually worked. (That's another conversation, but really. Oy vey.)

She also makes this claim:

In a McCain-Palin administration, we will put the educational choices for special needs children in the right hands their parents'. Under reforms that I will lead as vice president, the parents and caretakers of children with physical or mental disabilities will be able to send that boy or girl to the school of their choice -- public or private.

Just like that? Come on. We're not electing a Supreme Ruler; we're electing a President. And anyone who thinks that a school voucher law like the one that Sarah Palin describes (I know that may be an oversimplification, but hey, I can do it too!) will get passed quickly and easily is at best naïve.

A commenter on the nationaljournal.com article says it pretty well:

I find all these promises far too vague and general to mean much of anything. … What about health insurance? … Sorry, I don't need a 'friend' -- I need someone with a plan that does more than 'hope' that 'market forces' will allow me to afford insurance for my child.

I will say that I think it's interesting to hear this much talk about autism/special needs children during an election year. It's possible that this issue was front and center in the past, but if so, I didn't notice.

Text of the full speech is here if you want to read it.

If anyone has more direct experience with special needs trusts, or any of the other issues Palin raised in her speech, I'd be curious to hear your take on what she had to say.

sources: MSNBC, National Journal

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Bipartisan Group Says McCain Would Be Bad for Kids' Health

Hannah Tennant-Moore — Wed, 22 Oct 2008 22:30:00 GMT

First Focus, a bipartisan children’s advocacy group, has released a statement warning voters that John McCain’s health care plan would result in millions of American children going without health insurance.

McCain’s proposal centers around a flat tax credit, which would be given to every family, regardless of size or income, to be used to buy health insurance. (The money for these credits would be raised, at least in part, by cutting Medicaid and Medicare.)

First Focus has warned that the tax credit is well below the amount of money required for the average family’s health care needs. Plus, since McCain wouldn't require insurance companies to cover children with pre-existing conditions, it's likely that many of these kids would be denied coverage.

Obama’s plan guarantees that every child will be covered, either privately or publicly, regardless of preexisting conditions.

For a comprehensive primer on Obama and McCain’s health care proposals, check out Kim Mance’s essay.

Photo: New York Times

They Say: no cold medicine for kids 4 and under

Brett Singer — Wed, 08 Oct 2008 15:30:00 GMT

Kid has a stuffy nose? Suck it up. Well, not literally. But don't give them over the counter cold medicine. That's the word from the FDA, who are now saying that you shouldn’t give cold meds to any child under 4 years old.

The cough and cold medicine industry, in the wake of intensifying criticism from consumer groups, lawmakers and pediatricians, agreed Tuesday to add "do not use" warnings to pediatric cough and cold medicines.

Taken literally, this would mean that they will sell you the product, but add a label that says not to use it. I know that's not exactly what they mean, but it's funny to think about anyway. It's sort of what cigarette companies have to do, right? They can sell you the cigs, but they have to include a label that says YOU WILL DIE IF YOU SMOKE THESE. Of course, it doesn't say, "do not use." Just that if you DO use them, you'll get emphysema.

The real problem, according to the FDA, is misuse of the meds. "[Parents] should follow very carefully the directions on the package," said Dr. Janet Woodcock, director of the FDA's Center for Drug Evaluation and Research. "The No. 1 cause of problems is children getting into medicine for accidental ingestion."

The American Academy of Pediatrics wanted the FDA to tell people that the meds didn't work for kids aged 6 and under, but the FDA was concerned "that parents would give adult doses if it instituted a ban of products for children under age 6." Well, duh. If I can't give them their own drugs, I'll just cut mine in half.

Now look. I'm being obnoxious here, and I apologize. But as I understand it, no one is saying that over the counter cold medicine is unsafe when the recommended dosages are used. They do seem to be saying that the medicines are ineffective, which I can believe. In my own experience, I have more success treating my old colds with Ginger Tea, Vitamin C and sleep. (Those three things even rhyme, sort of.) The best thing in the world, for me, is acupuncture. Two needles in the right spots on my nose and poof – no more snot. That's not going to work for everyone, and on the rare occasion when I have severe sinus pain, I'll take something stronger (an over the counter sinus pill usually does it for me). Again, this is only my own experience, your mileage may vary, and I'm not a doctor nor have I played one on TV. I don't even watch "Grey's Anatomy." So don't take this as advice.

Bottom line: the FDA says don't give your kids cold medicine if they are under 4 years of age. They would say under 6, but they're afraid that if they did, you'd give them your drugs. Thanks guys.

Source: Chicago Tribune

image: webmd

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Hillary Clinton on Repro Rights

Brett Singer — Tue, 23 Sep 2008 19:00:00 GMT

Hillary Clinton (actually, its Hillary Rodham Clinton again; not sure if she used the middle name while she was still a Presidential candidate) and Cecile Richards of Planned Parenthood had an Op-Ed piece in the Times a couple of days ago that I thought would be of interest.

The Op-Ed discusses, "a proposed rule from the Department of Health and Human Services that would…require that any health care entity that receives federal financing — whether it’s a physician in private practice, a hospital or a state government — certify in writing that none of its employees are required to assist in any way with medical services they find objectionable. Laws that have been on the books for some 30 years already allow doctors to refuse to perform abortions. The new rule would go further, ensuring that all employees and volunteers for health care entities can refuse to aid in providing any treatment they object to, which could include not only abortion and sterilization but also contraception."

A clear definition of abortion is left out, which means it is open to the interpretation of the health care provider. "The Bush administration argues that the rule is designed to protect a provider’s conscience. But where are the protections for patients?"

"The 30-day comment period on the proposed rule runs until Sept. 25," which is just a couple of days away. If you feel strongly about this issue, call your Senator or Congressperson.

Source: NYTimes

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Cribsheet: Health Care

editors — Wed, 07 May 2008 18:00:00 GMT

Estimated cost of a postpartum home visit: $265
Estimated cost of an individual visit with a pediatrician: $92
Estimated cost of an individual visit with a registered nurse: $52
Cost of an average visit to a pediatrician compared to one with a family practitioner (what most rural areas have): 41% greater

Median salary of a pediatrician with more than one year's experience: $161,331
Average debt of a medical student: $95,000

Family income level below which your child gets free health insurance in most states: $34,100
Percentage of all U.S. children living in poor or near-poor families: 43% or 33 million
Percentage of low-income children who lack health coverage: 20%
Percentage of low-income children who have Medicaid: 61%
Percentage of middle-class children who lack health coverage: 10%
Percentage of middle-class children who have Medicaid: 19%

Percentage of all U.S. children who are uninsured: 12%
Percentage of all U.S. children covered by Medicaid or other public programs: 28%
Percentage of insured children who are in "excellent or very good health": 81%
Percentage of uninsured children who are in "excellent or very good" health: 75%

Research by Sarah Sundberg. Cribsheet appears in Strollerderby every Wednesday.

Florida law mandates insurance payments for autism

Brett Singer — Sat, 03 May 2008 19:00:00 GMT

Some good news from the south: Florida lawmakers have passed a bill that requires insurance companies to pay for treatment costs for autistic children – up to $36,000 per year, with a lifetime cap of $200,000. The bill was approved after another more complex piece of legislation that will offer inexpensive health insurance ($150 a month) to uninsured state residents.

Both programs are part of an initiative started by Florida governor Charlie Crist called "Cover Florida." Although the plan is being criticized by some for not being comprehensive enough, it certainly seems like a step in the right direction.

With health care making headlines this political season, maybe this news will inspire a debate about the specifics of how to get insurance to people who need it most, and also how to help families with autistic children get the treatment they need.

image: lacounty.gov

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Pregcellent: Ms. Infertile Goes to Washington

Amy Kuras — Wed, 09 Apr 2008 17:34:00 GMT

This actually falls less under "pregcellent" than "trying to get that way": Resolve, the National Infertility Association, is holding Federal Advocacy Day tomorrow, April 10.

They're offering training and appointments with members of Congress (or more likely, members of their staffs) in order to push for several issues important to people who've faced family building challenges. It's a little late to get to Washington for the event, unless you live close by, but you can call or write your member of Congress right from your very own cozy chair.

Advocates will ask their representatives to:
*Co-sponsor of The Family Building Act of 2007 (HR2892), federal legislation mandating insurance coverage for infertility diagnosis and treatment.
* Make permanent the adoption tax credit.
* Increase funding for medical research for the National Institutes of Health (NIH).
* Support the goals of RESOLVE's National Infertility Awareness Week, October 19-25, 2008.

With 1 in 8 couples facing infertility in some form, chances are good you know someone who went through it, maybe even your favorite celebrity -- although many won't cop to it. But when it comes to insurance coverage, it's treated about the same as a boob job – unless you live in one of the few mandated coverage states, you're on your own for the incredibly expensive treatment. Many couples have to face going into massive debt just to afford the treatment or adoption fees that would make them parents.

Infertility is real, and it's heartbreaking. I should know, I've been there. And people who are going through it deserve to have the same choices as anybody else facing a medical decision, no matter what their financial status.

Even if you conceived your kids on the first try, even if you can’t imagine what it might be like to be infertile, please think about participating. Because it's not about relaxing and it's not about patience, it’s about the very simple desire to be a parent. And if you're reading this, that's something you can understand.

Clean Hands: Purell Ain't Getting It Done

Madeline Holler — Wed, 30 Jan 2008 19:38:00 GMT

We had a nice but icky discussion last week about how healthcare professionals weren't exactly scrupulous when it comes to washing their hands between patients (and door touching, etc.) and that patients are being encouraged to ask them to wash up. And there was some talk of hidden hand santizer pumps that they might be using outside the patient's room, which made a few of us (and by "us" I mean "me") feel better and like they could go on living in denial about their doctor's dirty hands.

Well, a study out of Nebraska got down and dirty and concluded that Purell and the other alcohol-based hand santizers aren't getting it done. Even though a hospital in the study doubled its use of the sanitizing gels, the rate of infections did not decrease. These gels may clean the hands but they don't kill bacteria that cause infections. Ew.

See, the hand gunk doesn't get in all the areas on the hands where the bacteria reside.

The doctor who studied the problem pointed to many villains: Rings and fingernails that are too long and hard to clean, poor handling of catheters and treatment areas that aren't sanitized.

Is it really such a big deal? Yes.

The spread of infection-causing germs in U.S. hospitals is a huge health problem, accounting for an estimated 1.7 million infections and 99,000 deaths each year, according to the CDC. These include drug-resistant staph, urinary tract infections and ventilator-associated pneumonia, among others.

So we're back to where we were the other day in this discussion. It's up to us to bravely ask doctors and nurses and any other healthcare worker who are about to touch us to wash their hands with soap and warm water if we don't see them do it. And gloves are only sterile if they've been put on by hands that have been washed. And hand sanitizer doesn't count. Can't wait to run that one by my defensive pediatrician.

You Can Ask? Really?

Madeline Holler — Fri, 25 Jan 2008 23:31:00 GMT

Have I mentioned I'm not terribly assertive with medical professionals? Well, I'm not. I've got a milllllion opinions and demands and I'm more than willing to share them, just not with the actual nurse or doctor. I just hate the double-takes, exasperation and sometimes mild offense of a reaction I get those times I have womaned-up and asked a question and/or made a request.

So I am at once in awe/totally tense reading about these people, who have the nerve to ask doctors and nurses to do something they should have had the professional sense to already have done: wash their hands.

According to this, repeated studies show that healthcare workers wash up adequately about half the time. (Half!) Some hospitals post a hygiene rate of 20 percent. (Twenty percent!).

I know! Washing hands! The No. 1 way to cut down on those infections and viruses that are spread around hospitals and medical facilities! But I think we all know they DON'T always wash their hands -- the pediatrician coming in to do a check-up, the nurse readying my kid for another round of shots. I HAVE noticed that the sink sits there dry and unused, but of course I haven't said anything (wouldn't want to cause ill will).

Here's what's supposed to happen: National guidelines say they’re supposed to use alcohol-based hand rubs or soap and warm water for at least 15 seconds before and after every direct contact with a patient, with excretions, or with contaminated surfaces or objects. And just putting on gloves isn't enough, the article says. They're supposed to wash their hands first and THEN put on the gloves, otherwise they contaminate the outside of the glove when putting it on.

In an effort to increase the hygiene rate, some hospitals across the country want you to ask. They've got posters, brochures, buttons, etc. saying "It's OK to ask," and hope to urge you to speak up when you don't see the nurses and doctors wash up before touching you.

That's exactly what Dalynn Morales did. The 33-year-old cancer patient at Providence St. Vincent Medical Center in Portland, Ore., noticed that a nurse failed to clean her hands before adjusting Morales’ antibiotic line.

“I said, ‘Could you please wash?’” Morales recalled, adding that the nurse quickly complied. “I’m not sure if she felt insulted or not.”

We'll just skip over why we even have to ask, how it's not already automatic to walk into a room and straight to the sink. But now that I know it's OK, I wonder if I will. I'm trying to think how I would ask. Do you say: "Hey, mind washing up?" or "I read that I should be asking you to wash your hands," or ... how do you phrase it without getting them all pissy with you? Come on, give me the script.

Have you ever asked your doctor or nurse to wash their hands? What was the reaction?

Hospital Kicks Out Terminally Ill Child: U.S. Healthcare Rules!

Rachael Brownell (Redsy) — Wed, 28 Mar 2007 17:28:00 GMT

Say what you will about the U.S. health care system, it has the perfect combination of profit-making and heartlessness to routinely make news headlines. But what alternative do we have? Nationalized health care has legions of detractors who claim it is far too expensive, inefficient, and restrictive to be any sort of solution to the U.S. health care crisis. Whichever health system you champion likely depends greatly on your wealth, insurance status, age, and race and ethnicity. If you are a child and prefer being uninsured and under-served, the U.S. system is for you.

A hospital in Cleveland is hopefully ruing the day it turned a 16-month old boy on life support away from care. Seton Hospital in Austin, Texas gave the boy's family 18 days to find another hospital, citing the usual combination of cost and liability.

It's stories like this that make me unutterably proud to be an American.

"Shot Down": Babble Investigates the Anti-Vaccination Movement

JasonAvant — Tue, 27 Mar 2007 12:36:00 GMT

Show of hands: how many of your kids have had polio? Measles? Mumps? I'd venture to guess that most of you have vaccinated your kids against those and other diseases. There are a surprising number of parents who are opting out of vaccinations, and to many parents (myself included), that decision is seen as irresponsible and fraught with peril - not only for the child in question, but other kids who may come into contact with those who have not been vaccinated.

Over at Babble, reporter Liza Featherstone contributes a thoughtful but tough look at the anti-vaccination movement. She explores the myriad of reasons why some parents choose not to give their kids shots; chief among these are fears of autism, side effects, and actually contracting the disease that the vaccine was supposed to prevent. According to Featherstone, such fears are based on misinformation, inference, and flawed logic. Indeed, she wonders how it that people are "more willing to believe a random article on the internet than scientists who have spent their lives studying vaccines."

The problem here, notes Featherstone, is that the choice to not vaccinate has repercussions beyond one's own child. Featherstone cites outbreaks of whopping cough in Colorado, a state with a considerable number of "vaccine resistors" (also of note but not mentioned in the piece: an outbreak of mumps in the Midwest last year and another outbreak of measles in Boston - in the measles case, the outbreak was traced back to a computer programmer from India, a country where only 56% of the population is thought to be vaccinated against the disease. Gee.) So - to vaccinate, or not? Tell us what you think.

Bad Post Partum Care in Britain Still Better than Care in the States

Rachael Brownell (Redsy) — Sun, 25 Mar 2007 22:12:00 GMT

The Brits have national health care, which for the uninsured masses of Americans must sound like pure bliss. And yet. In a recent Telegraph report, a new mom complains about her treatment by the medical establishment after giving birth. I'm inclined to take the issues raised in this article seriously.

Except honestly I could not get through the first paragraph without laughing in disbelief. After leaving the hospital "six days after giving birth" she became upset when the home visiting midwife failed to show up. Six days?? Home visiting midwife? As if.

Can you imagine? Complaints in the States look more like "I left the hospital 24 hours after my c-section and didn't see my doctor again for 6 weeks." or "I was given an epidural without my consent and then discharged 10 hours later."

I'm willing to believe that nationalized health care is at times frighteningly substandard. But even "only" six days in the hospital after the birth of a child, seems grand in comparison to the less than 24 most women get Stateside. So buck up, British women, you could have it worse. You could live here.

Uganda Reports 20,000 Children Tested HIV Positive in 2006

JasonAvant — Sun, 04 Feb 2007 20:20:00 GMT

Some sobering news from Uganda: the Elizabeth Glaser Pediatric AIDS Foundation reports that over 20,000 Ugandan children tested positive for HIV last year. According to Uganda's Ministry of Health, the majority of those children were infected by their mothers during pregnancy, childbirth, or breastfeeding.

The article's focus is on the AIDS epidemic in Uganda; it seems almost beyond comprehension that in 2001, there were over 110,000 Ugandan kids living with HIV. Equally hard to grasp is the fact that obtaining something as basic as reliable transportation is a challenge - the story points out that the man heading up the Glaser Foundation's work in Uganda was donating motorcycles to local health officials to assist in communication and shipment of blood samples from clinics.

The spread of AIDS through Africa is one of the great tragedies of our time. There are no easy answers, only mind-numbing numbers. Around the world, 2,000 kids a day test positive for HIV.

5 Best Cities to Have a Baby

Karen Murphy — Thu, 25 Jan 2007 20:09:00 GMT

Say you're pregnant (or want to become pregnant), have unlimited funds and flexibility, and want to move to the U.S. city best suited for your and your baby's new lifestyle. What city would you pick? Fit Pregnancy spoke to The Today Show about their findings of a review of the 50 most populous cities in the country, and how they stacked up in terms of health care, safety, child care, affordability, birthing options, and fertility laws. Who made the list?

1. Boston. Awesome healthcare, and definitely the place to be if you need specialized prenatal care (and I hope you don't). Plus Boston has the best chowdah anywheah.

2. San Francisco. Well, duh. A healthy lifestyle makes for a healthy baby, plus it has high breastfeeding rates and is chock-full of fertility specialists. And the fried calamari? Yum.

3. Minneapolis. Three times the national average for the number of child-care providers? Wow! Plus it has lot of fertility clinics, specialty birthing options, and midwives and doulas. Something for everyone! And don't mind the cold in winter: there's a cool network of above-street Habitrail-style walkways that can get you all over downtown without setting foot in icy slush.

4. Portland. It's all about the nunnies, as we say in my house. Yeah, that. Breastfeeding. Portland's got the highest rate in the nation. Woot! And is jam-packed with midwives and doulas-a-plenty. If you have alternative leanings? Sounds like this is the place to be.

5. Omaha. Er, Omaha? That's in Nebraska, right? Well, I hear they have great steaks. Also? Affordable housing, access to daycare, and a Baby Friendly Hospital. Who knew? Hey, Omaha! You've been outed! (Get ready for the influx)

Although my personal favorite city, Boulder, wasn't mentioned (it's not one of the 50 largest cities), nearby Denver made #6. So there. Family-friendly bike trails, a wide variety of fresh and organic produce, lots of alternative birthing options, over 200 days of sunshine per year, and a gorgeous daily eye-feed known as the Rocky Mountains make this MY place to be. (Philadelphia, the city near where I'm presently ~~interred stuck~~ uh, living, is at almost the bottom of the list. Yeah, I knew that.)

[photo credit: UrbanInfant.com]

Finding Childcare as Challenging in Canada as in U.S.

Rachael Brownell (Redsy) — Sat, 20 Jan 2007 15:22:00 GMT

One you've experienced the challenge of finding affordable and high quality child care, you begin to understand why so many families opt to have one parent stay home and care for their children. And you also appreciate the popularity of grassroots movements such as MomsRising, that champion high quality child care as one of the cornerstones of their legislative agenda.

Since I favor universal health care and higher taxation in order to create a stronger social safety net for lower and middle class families, I have often assumed that Canada would be a better place to raise children than the U.S. Apparently, when it comes to childcare, this isn't the case.

...(read more)