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...

Here is one of the more intriguing headlines of Super Bowl week:  “Is the National Football League dying”? Probably not, but too many of its former players are dying young, and for reasons that may be preventable.  Many people are concerned about growing evidence of brain injury from the violence of the game. But that’s just part of the story. Linemen are too heavy. Their excessive weight is a danger to running backs now and to their own health after they hang up the cleats. Baltimore Ravens safety Bernard Pollard raised the issue when he was quoted as predicting the demise of pro football, in part because of its violence, but mostly because of the way the rule makers are responding to that violence.  “I hope I’m wrong,” he added, “but I just believe one day there’s going to be a death that takes place on the field because of the direction we’re going.”  President Obama weighed in on football safety, too, but in a less dire way.  “ I think th...

Here is one of the more intriguing headlines of Super Bowl week:  “Is the National Football League dying”? Probably not, but too many of its former players are dying young, and for reasons that may be preventable.  Many people are concerned about growing evidence of brain injury from the violence of the game. But that’s just part of the story. Linemen are too heavy. Their excessive weight is a danger to running backs now and to their own health after they hang up the cleats. Baltimore Ravens safety Bernard Pollard raised the issue when he was quoted as predicting the demise of pro football, in part because of its violence, but mostly because of the way the rule makers are responding to that violence.  “I hope I’m wrong,” he added, “but I just believe one day there’s going to be a death that takes place on the field because of the direction we’re going.”  President Obama weighed in on football safety, too, but in a less dire way.  “ I think th...

President Reagan gave his first speech on the AIDS epidemic almost twenty-five years ago on May 31, 1987.  This was after 36,058 Americans had been diagnosed with AIDS, 20,849 had died, and over a quarter of a million had been infected with HIV. For years, he had been criticized for ignoring and underfunding the worst public health crisis of the late 20 th century.   So he began his speech with a joke: “A charity committee approaches the wealthiest man in town for a contribution.  ‘Our book shows that you haven’t contributed any money this year,’ they tell him.  ‘Does your book also show that I have an infirm mother and a disabled brother?’ he replies.  ‘Why no,’ they say, ‘we didn’t know that.’ ‘Well, I don’t give them any money.  Why should I give any to you?’” The bad joke was an inadvertent punctuation mark on a presidency too fondly remembered by both republicans and democrats today. On matters of health, Reagan took us ...

President Reagan gave his first speech on the AIDS epidemic almost twenty-five years ago on May 31, 1987.  This was after 36,058 Americans had been diagnosed with AIDS, 20,849 had died, and over a quarter of a million had been infected with HIV. For years, he had been criticized for ignoring and underfunding the worst public health crisis of the late 20 th century.   So he began his speech with a joke: “A charity committee approaches the wealthiest man in town for a contribution.  ‘Our book shows that you haven’t contributed any money this year,’ they tell him.  ‘Does your book also show that I have an infirm mother and a disabled brother?’ he replies.  ‘Why no,’ they say, ‘we didn’t know that.’ ‘Well, I don’t give them any money.  Why should I give any to you?’” The bad joke was an inadvertent punctuation mark on a presidency too fondly remembered by both republicans and democrats today. On matters of health, Reagan took us ...

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.   ...

Obesity is a disease, just like cancer, heart disease, mental illness, and addiction.  That’s the message of experts at a recent  Future of Medicine summit on the subject. And there are missing pieces in the way states with some of the largest concentrations of obese residents, like Florida, Connecticut, Texas, California, New York, and New Jersey, approach the epidemic. As recently as 25 years ago, obesity was uncommon in America .  Most states didn’t even collect data on it, and not a single state reported obesity in more than 15% of its population.  Connecticut and Florida both reported rates under 10%. The CDC map at that link shows what has happened since.  Every state in the country quickly grew bigger.  By 2010, in 12 states, including Connecticut, between 20% and 25% of the population was obese.  In 24 states, including Florida, between 25% and 30% of the population was obese.  In the remaining 12 states, including T...

Obesity is a disease, just like cancer, heart disease, mental illness, and addiction.  That’s the message of experts at a recent  Future of Medicine summit on the subject. And there are missing pieces in the way states with some of the largest concentrations of obese residents, like Florida, Connecticut, Texas, California, New York, and New Jersey, approach the epidemic. As recently as 25 years ago, obesity was uncommon in America .  Most states didn’t even collect data on it, and not a single state reported obesity in more than 15% of its population.  Connecticut and Florida both reported rates under 10%. The CDC map at that link shows what has happened since.  Every state in the country quickly grew bigger.  By 2010, in 12 states, including Connecticut, between 20% and 25% of the population was obese.  In 24 states, including Florida, between 25% and 30% of the population was obese.  In the remaining 12 states, including T...