Our Health Policy Matters

On December 8, 2010, Jack Dalrymple, a Republican Governor in the safely Republican state of North Dakota, sent a budget to the state Legislative Assembly calling for an $8 million increase in funding for mental health services. His transmittal message accompanying his FY2011-2013 proposed budget was simple. “We… need to make investments that help take care of people.  We have all been alarmed recently about teen suicide rates, especially on our Native American reservations.  These highlight the need to make more resources available for critical mental health services for our citizens.” So, in a $3.3 billion general fund budget, he proposed over $6 million for new inpatient services, community crisis stabilization, and drug dependency treatment.  He also proposed $1 million for suicide prevention, another million dollars for mental health services on college and high school campuses, and a rate increase for mental health providers.  He summed up these requests by sayin

“I will keep them from harm and injustice.” “I will prevent disease whenever I can, for prevention is preferable to cure.” - Classic and modern versions of the Hippocratic Oath , from MedicineNet.Com Senator Tom Coburn of Oklahoma is a physician.  He’s familiar with the Hippocratic Oath, and has used it to explain his opposition to health care reform. Last November, Senator Coburn famously termed a $15 billion appropriation for public health and prevention a “slush fund.”  That’s because it was paying for community tobacco control programs, immunization activities, and addiction disorder prevention and treatment services around the country.  For information on sources, see note below “Prevention is about focusing on an individual patient,” he commented, apparently forgetting everything he learned about epidemiology at the University of Oklahoma’s College of Medicine and at least some of the words of the Hippocratic Oath. Public health is the basis of health

In arguing last week for the “contraception exception,” did Catholic Bishops – whose compassion for human beings is generally second to no one’s – really mean to open the door to those who would deny people access to other needed prevention services? To recap, the Obama Administration announced that birth control had to be a part of employer-based health insurance plans.  Contraception is considered preventive health, and the Affordable Care Act mandates this and many other prevention services be offered free of charge. The Catholic Bishops objected strongly.  They are morally opposed to birth control, and argued that, as an employer, the Church should not be compelled to pay for prevention services it deems immoral. The Obama Administration then announced a compromise.  No religious institution would be required to pay for contraception services in its health insurance plan, but insurers would still have to cover the services for women who wanted them. On Friday, i

We’re now just a little more than a month away from the day the Supreme Court will hear the arguments that determine the fate of the Affordable Care Act.   The fight will be narrow – about the constitutionality of the individual mandate and Medicaid expansions.   The consequences for health care financing, however, will be widespread. And, ironically, both states rights conservatives and pro-national health insurance progressives may end up rooting against their own positions. To understand why, consider the four ACA Supreme Court issues that will be argued.  The first is the constitutionality of the individual mandate under the Commerce Clause of the Constitution.   To be constitutional under the Commerce Clause, a law has to regulate economic activity that “has a substantial effect” on interstate commerce.  While it may seem that all the activity under ACA will have a substantial effect on interstate commerce, Judge Vinson in Florida disagreed.  In c

I first heard about James McGillivray, Lloyd “Jim” Middaugh, and Paulus “Dutch” Smit about a month ago, though not by name. A tiny news crawler reported that three men were victims of a serial killer in southern California. James McGillivray’s body was found near a Placentia, CA, shopping mall on December 21 st .  53 year-old McGillivray hung out almost every day at the mall.  Regulars there called him humble, unobtrusive, and a “nice guy.”  A 17 year-old commented “I don’t know why someone would kill him.”  McGillivray was sleeping when he was attacked and stabbed to death. Jim Middaugh’s body was found along a riverbed trail in Anaheim on December 28 th .  He was also stabbed to death as he slept.  After his death, his mother – to whom Middaugh was exceptionally close – described her six foot, four inch son as a “gentle giant.” Dutch Smit was 57 years old when his body was found outside a Yorba Linda public library on December 30 th .  He left three children and 1