Our Health Policy Matters

I was asked recently why I didn’t actively seek out a specialized school setting many years ago in which to educate my son. My son has a serious mental illness, one which first manifested when he was a child.  I’ve written about this before in Health Affairs and will write about it again in a book scheduled for publication later this year. The argument is this.  If you put children with a special condition – such as serious mental illness – into a classroom with other children with the same condition, then you can adjust your educational services to meet the needs of those children all at the same time – and you will get better outcomes. That’s essentially how our health care delivery system has often been built, too.  Through most of the twentieth century, people with mental illnesses were treated in one set of hospitals (usually state hospitals). And people with most physical conditions were treated in a different set of hospitals. I wrote “mos...

I was asked recently why I didn’t actively seek out a specialized school setting many years ago in which to educate my son. My son has a serious mental illness, one which first manifested when he was a child.  I’ve written about this before in Health Affairs and will write about it again in a book scheduled for publication later this year. The argument is this.  If you put children with a special condition – such as serious mental illness – into a classroom with other children with the same condition, then you can adjust your educational services to meet the needs of those children all at the same time – and you will get better outcomes. That’s essentially how our health care delivery system has often been built, too.  Through most of the twentieth century, people with mental illnesses were treated in one set of hospitals (usually state hospitals). And people with most physical conditions were treated in a different set of hospitals. I wrote “mos...

There’s a new disease this year along with the winter flu.  It is called Secession Fever.  Secession Fever has reached epidemic stage across the south.  As of Monday, there were more than 25,000 cases in each of eight southern states – North Carolina, South Carolina, Georgia, Florida, Alabama, Tennessee, Louisiana, and Texas.  A ninth, Arkansas, had over 23,500.  Collectively, these states had almost 402,000 cases, and the number was still growing. Secession Fever is a self-reportable disease.  People who have it signed a petition on the White House website .  Secession Fever is characterized by the irrational belief that the federal government does more harm than good, and that states would be better off if they seceded from the Union. So what if these nine states did secede and form a new Southern Confederacy?  Would their citizens be better off?  Some data from the Kaiser Family Foundation and the Central Intelligence Agen...

There’s a new disease this year along with the winter flu.  It is called Secession Fever.  Secession Fever has reached epidemic stage across the south.  As of Monday, there were more than 25,000 cases in each of eight southern states – North Carolina, South Carolina, Georgia, Florida, Alabama, Tennessee, Louisiana, and Texas.  A ninth, Arkansas, had over 23,500.  Collectively, these states had almost 402,000 cases, and the number was still growing. Secession Fever is a self-reportable disease.  People who have it signed a petition on the White House website .  Secession Fever is characterized by the irrational belief that the federal government does more harm than good, and that states would be better off if they seceded from the Union. So what if these nine states did secede and form a new Southern Confederacy?  Would their citizens be better off?  Some data from the Kaiser Family Foundation and the Central Intelligence Agen...

Are the 1994 AFC Champion San Diego Chargers a cursed team, or just a reflection of a growing trend toward chronic disease and early death in America? Led by running back Natrone Means and linebacker Junior Seau, the 1994 Chargers won the AFC West with a record of 11 wins and 5 losses, and beat the Miami Dolphins and Pittsburgh Steelers to reach the Super Bowl.  The 53 players on the active roster averaged 26 years of age. According to 1995 life expectancy tables , a 26 year old male could expect to live to the age 75. But when 42 year old Lew Bush – a linebacker on that Super Bowl team – died on December 9, 2011, he was the 7 th member of the team to die more than 30 years prematurely. Source:  ESPN Official 2011 Roster Information There is talk that these 1994 Chargers are cursed.  The first player to die, linebacker David Griggs, was 28 when his car slid off an expressway ramp in Ft. Lauderdale and crashed into a pole in June, 1995.   ...

Are the 1994 AFC Champion San Diego Chargers a cursed team, or just a reflection of a growing trend toward chronic disease and early death in America? Led by running back Natrone Means and linebacker Junior Seau, the 1994 Chargers won the AFC West with a record of 11 wins and 5 losses, and beat the Miami Dolphins and Pittsburgh Steelers to reach the Super Bowl.  The 53 players on the active roster averaged 26 years of age. According to 1995 life expectancy tables , a 26 year old male could expect to live to the age 75. But when 42 year old Lew Bush – a linebacker on that Super Bowl team – died on December 9, 2011, he was the 7 th member of the team to die more than 30 years prematurely. Source:  ESPN Official 2011 Roster Information There is talk that these 1994 Chargers are cursed.  The first player to die, linebacker David Griggs, was 28 when his car slid off an expressway ramp in Ft. Lauderdale and crashed into a pole in June, 1995.   ...

If you are as grateful as I am that the nonstop coverage of debt ceilings and deficits is behind us for a while, and want to talk about something even Congress should be able to agree is worthwhile, then just repeat after me these two magic words. (No, not those two!) The words are "public" and "health."  There is a new article out entitled Evidence Links Increases in Public Health Spending to Declines in Preventable Deaths .   Source:  Mays and Smith, Health Affairs, 7/11 The article has been published online by Health Affairs , and is in the August 2011 edition of the print journal.   It was written by Glen Mays and Sharla Smith. Spending on public health has long been one of our government’s great success stories.   It keeps our water clean, our air free of pollution, our food pure, our children immunized, and our homes and neighborhoods free of lead, rats, and violence.   It also promotes our health.   I wrote in ...

If you are as grateful as I am that the nonstop coverage of debt ceilings and deficits is behind us for a while, and want to talk about something even Congress should be able to agree is worthwhile, then just repeat after me these two magic words. (No, not those two!) The words are "public" and "health."  There is a new article out entitled Evidence Links Increases in Public Health Spending to Declines in Preventable Deaths .   Source:  Mays and Smith, Health Affairs, 7/11 The article has been published online by Health Affairs , and is in the August 2011 edition of the print journal.   It was written by Glen Mays and Sharla Smith. Spending on public health has long been one of our government’s great success stories.   It keeps our water clean, our air free of pollution, our food pure, our children immunized, and our homes and neighborhoods free of lead, rats, and violence.   It also promotes our health.   I wrote in ...

Implementing health reform in the states is a governmental responsibility.   But Kaiser Health News reported this week that states are turning to foundations to help them with the costs of implementing these reforms.   Financing governmental duties has not traditionally been the role of a foundation.   Governmental programs should be implemented efficiently, but asking foundations to pay for this implementation is drawing dollars away from the most important work of foundations. This important work involves investing resources in promising initiatives that aren’t yet “government ready.”   Foundations are uniquely equipped to provide seed funding to experimental and innovative programs before they are ready for governmental action. On the other hand, funding governmental obligations leads to two unintended consequences.   First, it relieves governments of their obligation to justify to the public the expenditures they need to make to implement their prog...

Implementing health reform in the states is a governmental responsibility.   But Kaiser Health News reported this week that states are turning to foundations to help them with the costs of implementing these reforms.   Financing governmental duties has not traditionally been the role of a foundation.   Governmental programs should be implemented efficiently, but asking foundations to pay for this implementation is drawing dollars away from the most important work of foundations. This important work involves investing resources in promising initiatives that aren’t yet “government ready.”   Foundations are uniquely equipped to provide seed funding to experimental and innovative programs before they are ready for governmental action. On the other hand, funding governmental obligations leads to two unintended consequences.   First, it relieves governments of their obligation to justify to the public the expenditures they need to make to implement their prog...