Category Archives: Health policy

Racial/Ethnic Concordance and Doctor Communication

By | March 14, 2024

Patient-provider racial/ethnic concordance (i.e., physician and patient identify as the same race/ethnicity) has emerged as one key suggestion for mitigating healthcare disparities. Past research has underlined its benefits, including improved infant mortality and more appropriate prescription regimens. However, the sum of the evidence remains unclear and many facets of the patient-provider relationship have yet to… Read More »

Health Equity in the Time of Hospital Consolidation

By | March 7, 2024

Competition between hospitals in a given market should provide incentives to ensure quality while also lowering costs. Over the past two decades, hospital markets have increasingly consolidated. This consolidation reduces competition and increases the comparative leverage that hospitals and associated health systems have. While there are some theoretical advantages of increased consolidation such as potential… Read More »

Healthy Intersections Podcast: Healthcare’s Carbon Footprint

By | February 28, 2024

If the US healthcare industry were its own country, it would be in the top 10% of all countries in greenhouse gas emissions. Welcome to the February, 2024 edition of the Healthy Intersections Podcast! This month, we sit down with David Introcaso, PhD, to discuss the healthcare industry’s carbon footprint. Dr. Introcaso is the host… Read More »

History of Climate Policy and Advocacy by the American Public Health Association

By | February 23, 2024

In January, the Medical Care Blog’s editors published a consensus statement on climate policy and health. This statement was co-signed by many of our authors, editors, and editorial board members of the Medical Care journal. As we look ahead to our focus theme for 2024, we want to begin with a look backward as well.… Read More »

Trending Toward Medicare Advantage for All

By | January 18, 2024

Medicare for All is Not Happening… 10 years from now will we have Medicare Advantage for All? Grandmother and granddaughter in the same health plan? Others have written that the US should achieve universal health insurance coverage, better health outcomes, and lower costs via comprehensive programs such as “Medicare for All”, as proposed by Senator… Read More »

Climate Change and Public Health Consensus Statement

From The Medical Care Blog: A special consensus statement on climate change and public health In 2021, more than 250 of the world’s leading medical and public health journals released a joint statement about climate change and public health. Published simultaneously, editorial boards of the journals declared climate change to be the “greatest threat” to… Read More »

Yearning for Change: Youth Activism and Civic Engagement in Public Health

By | December 21, 2023

The need for youth activism and civic engagement in public health has never been greater. A mentor once said, “When public health is doing its thing, you will never hear a word about it.” But today, the profession doesn’t have that luxury. We must act if we want public health to remain a strong and… Read More »

Health Plans With Deductibles See Lower Lung Cancer Screening Rates

By | November 22, 2023

The United States Preventive Services Task Force has recommended lung cancer screening for at-risk groups since 2013, and updated again in 2021. This is a simple procedure involving a low dose of radiation used to take a CT image of the chest. If utilized by most eligible Americans, screening could reduce lung cancer mortality by… Read More »

A Significant Step Toward Single Payer Health Care in California

By | October 26, 2023

California just took a significant step toward single payer health care. On Oct 7, Governor Gavin Newsom signed Senate Bill 770 (Unified Health Care Financing) into law. Introduced by Senator Scott Wiener (D-San Francisco), the law directs the Secretary of the California Health and Human Services Agency to research, develop and pursue a waiver framework… Read More »

Beyond COVID and Opioids: Contextualizing Life Expectancy Decline in the United States

By | September 18, 2023

This entry was one of the winners of our Summer 2023 student blog contest! Trends in Life Expectancy The recent decline in life expectancy in the United States is largely attributed to the well-known COVID-19 pandemic and opioid epidemic. However, these recent crises are not the sole drivers of the stagnation and subsequent drop in… Read More »

Negative Health Outcomes of American Anti-LGBTQ Laws

By | September 8, 2023

This entry was one of the winners of our Summer 2023 student blog contest! Anti-LGBTQ laws are flooding the United States. As of June, a historic 491 anti-LGBTQ bills have been introduced in 2023 – a 203% increase from the entire 2022 year. More bills were introduced in the first three months of 2023 than… Read More »

Reducing the Harms of Substance Use: Lessons From Abroad

By | July 4, 2023

The way we’re addressing substance use and overdoses in the United States isn’t working. Let’s be perfectly clear: the “war on drugs” isn’t, and never was, really a war on drugs. It’s been a war waged on communities who are Black, Indigenous, and People of Color (BIPOC). The war on drugs started well before President… Read More »

Public Health Saved Your Life Today: Insight From Dr. Leana Wen

Public health saved your life today, but you probably didn’t know it. That was one of the valuable take-home messages from Dr. Leana Wen, when she spoke to public health students and early career professionals at California State University Los Angeles. Dr. Wen was the culminating speaker in our semester-long series on public health leadership.… Read More »

Don’t Wait to Lead: A Conversation with Dr. Chris Chanyasulkit

Don’t wait to lead. That is a key message from Dr. Chris Chanyasulkit, the president of the American Public Health Association (APHA). And it resonates with many students and early career professionals anxious to make a change. Our conversation with Dr. Chanyasulkit was the first in a series on public health leadership. The Department of… Read More »

Designing From the Margins to Advance Equity

By | May 2, 2023

“Access for the sake of access or inclusion is not necessarily liberatory, but access done in the service of love, justice, connection, and community is liberatory and has the power to transform.” – Mia Mingus, community organizer, disability and transformative justice advocate  Are you designing with equity and inclusion in mind? For public health and… Read More »

Medicare Advantage Should Be Making News

By | March 3, 2023

Medicare Advantage should be making news. It’s not because the Medicare trust fund continues to run on fumes, which it does. Nor is it because Medicare was taken “off the table” in recent debates about cutting the federal budget, which it was. Rather, it should be getting a lot of attention for new data about its… Read More »

Is It Time for Medicaid-For-All?

By | February 1, 2023

It isn’t what supporters of single-payer health care might prefer. But a Medicaid-for-all program, based on the already expansive safety-net program, might open new doors to universal coverage. And rising familiarity with the program is creating a window of opportunity. My realization began with several conversations First, it was a friend going through a divorce… Read More »

Reporting detention-related harms

Community-based clinicians sometimes see patients who have been recently released from immigration detention. Those encounters can be challenging, especially when patients reveal health harms experienced while in detention. It is obviously critical that clinicians provide high-quality medical care and address any health issues potentially brought about or exacerbated by their detention history. But do they… Read More »

December 2022 Healthy Intersections Podcast

By | December 8, 2022

In this month’s podcast, co-editor Jess Williams recaps blog posts from November and talks about some December journal articles. Listen here or wherever you get your podcasts. Transcription Welcome back to Healthy Intersections, the podcast of themedicalcareblog.com. In this month’s episode, I’ll review some of our blog entries from November and give you a preview… Read More »

November 2022 Healthy Intersections Podcast

In this month’s podcast, Dr. Samy Anand gives an overview of The Medical Care Blog posts published in October and a preview of the journal articles in the November issue of Medical Care. Then, co-editor of the blog, Dr. Gregory Stevens, discusses the results of the midterm election and the results of ballot measures relevant to… Read More »

APHA Annual Meeting 2022 Preview

By | November 4, 2022

It’s that time of year again–APHA’s Annual Meeting! This year we’ll be meeting in Boston Nov. 6-9 with a digital event Nov. 14-16. I’m looking forward to seeing colleagues this year and getting to catch up with so many interesting people. Of course, I’m also excited about the excellent Medical Care Section Program. Here’s a… Read More »

Public health is (once again) on the ballot

By | November 29, 2022

The 2022 midterm elections are upon us. And public health is once again prominent on the ballot. Think back to the 2020 presidential election and just how stark a contrast Joe Biden and Donald Trump presented on COVID-19, climate change, and the Affordable Care Act. This year is no different. Voters across the country are choosing… Read More »

Early Access vs. Proven Efficacy: FDA’s Accelerated Approval Process

By | October 24, 2022

A recent JAMA article noted that only one-third of new drug approvals through the accelerated approval process by the FDA in the US or the conditional marketing authorization in the EU have shown therapeutic value.  Many of these drugs are high cost, and this begs the question if we are spending our health care dollars appropriately. … Read More »

The Medicaid Outcomes Distributed Research Network MODRN [Podcast]

By | October 10, 2022

The Medicaid Outcomes Distributed Research Network (MODRN) was started by AcademyHealth and is a collaborative research network of state Medicaid agencies and university partners. The goal of the network is to allow analysis and learning about Medicaid by facilitating comparison across states and aggregate data with a shorter lag time than other available sources.  This… Read More »

Healthy Intersections Podcast: September 2022

By | October 10, 2022

On this month’s episode of the Health Intersections Podcast, Samy Anand from the Medical Care Section recaps last month’s blog posts and previews September’s issue of the Medical Care journal. Check out these great reads. Next, Jess Williams, co-editor of the blog and podcast, interviews Dr. Cheryl Conner who is a Clinical Associate Professor at… Read More »

Becoming Adept at Policy in Health Advocacy

The pursuit of health equity requires public health and medical professionals to become adept at policy in their health advocacy work. The American Public Health Association (APHA), in fact, defines policy work as one of its 10 essential public health services. APHA says professionals should be capable of “creating, championing and implementing policies, plans and laws”.… Read More »

Medicare Will Negotiate Prescription Drug Prices…In Four Years

By | August 25, 2022

In 2026, Medicare will negotiate prescription drug prices with manufacturers. It is a dramatic reversal of a stranglehold placed on Medicare back in 2003. And it may be one of the most impactful policy changes to the government program since its creation. But there is a catch…we have to wait. President Biden signed the Inflation Reduction… Read More »

Retrospective: On Prescription Drugs

By | August 22, 2022

The Medical Care Blog is preparing for its full return later this month. Until then, we are continuing to highlight articles published by our contributors on timely topics. A federal bill is pending that would allow Medicare to begin negotiating drug prices for the very first time. Even though it would begin with only 10… Read More »

Retrospective: On Reproductive Health Care

By | August 4, 2022

The Medical Care Blog is returning from its summer break this month. We hope you are feeling recharged and ready to dig deep again into health care and public health. We’re beginning with a series of retrospective posts to highlight the work of our contributors on prominent topics. This week, we focus on a collection… Read More »

APHA Calls for Single-Payer Health Reform

By | July 6, 2022

It is not too late to fix the US healthcare system. But every day spent in this folly, the problem gets worse. It is time to move this conversation forward. We are excited to share that in November 2021, the American Public Health Association (APHA) formally adopted a policy statement titled “Adopting a Single-Payer Health… Read More »

Ethical research using government administrative data

By | June 16, 2022

As a public health researcher, I love data, the more the better. I held this belief until I found that I myself had become the “subject” of research without my consent. This experience made me rethink ethical research. The more data, the better? In 2017, I encountered a state-level bill that required all the government… Read More »

Fixing Health Care: A Health Care Revolt Begs Five Big Questions

In a previous post, we shared highlights from an event about fixing health care featuring Dr. Michael Fine, a family medicine physician, former public health official, and the author of Health Care Revolt. The faculty of the Department of Public Health at California State University Los Angeles led the event as part of a department-wide book read.… Read More »

Whole Person Health: A Path to Health Equity (Part 2)

In our first blog post of this series, we discussed how the current medical approach misses so much of what influences health, and how it perpetuates health inequities in our society. In this post, we go in-depth on the elements of Whole Person Health (WPH) that are necessary components of a just and equitable approach… Read More »

Whole Person Health: A Path to Health Equity (Part 1)

Our current U.S. medical system doesn’t work. It is not able to adequately care for the sickest, most vulnerable, and least resourced people. It often excludes those seen as “other” in our society. To become a just system, we need a new focus on Whole Person Health (WPH). Very briefly, WPH cares for the whole person and… Read More »

Vaccination Choice: The Strongest Link in the Weakest Case

By | February 24, 2022

Almost 30 years ago I was working in the White House as part of a team working to win approval of President Bill Clinton’s proposal for universal health insurance. The effort was winding down. It was obvious it would fail. I was tired and depressed. One of my last appearances in support of the plan… Read More »

Is Something Going Wrong With the Patient Centered Medical Home?

By | January 27, 2022

Like others working at the intersection of public health and medicine, my faith in primary care has long been unshakeable. Increasingly actualized as the Patient-Centered Medical Home (PCMH), primary care has experienced a decade plus of attention thanks to efforts at retooling and rebranding the field. But in the last week, a tiny crack formed… Read More »

Lessons From Conducting the Path-4CNC Virtual Convenings

Last week, we detailed the findings of virtual convenings we held in North Carolina to improve care for children with complex health needs (CCHN). Here, we share our takeaways about the process of planning, holding and following-up on the convenings. We also outline the specific steps other leaders, innovators, and advocates can take to engage… Read More »

Engaging Communities to Improve Systems of Care for Children with Complex Health Needs

Children with complex health needs (CCHN) are a unique pediatric patient population. They have chronic medical and/or behavioral conditions that need ongoing health care. They use a disproportionate share of hospital resources. And they face greater social challenges when compared to other children. In North Carolina (where we work) and across the country, CCHN fail… Read More »

“Carve In” Mental Health and Substance Use Treatment

By | December 21, 2021

More than 150,000 avoidable deaths occur each year due to mental, emotional, and behavioral health problems. This includes nearly 50,000 suicide deaths and 100,000 overdose deaths. People with chronic persistent mental illness suffer a 20-year shorter life expectancy. This country urgently needs to address how we pay for mental health services. Medicaid is a major… Read More »

Downstream Efforts to Address Social Determinants in the CMS Financial Alignment Initiative

In our last blog post, we discussed the Biden Administration’s infrastructure package as an example of an upstream policy effort that could promote equity and help address disparities. However, as we pointed out in the first in this series of blogs, stakeholders who interact with community members are best suited to identify social risk factors… Read More »

Parent Perspectives on Birth Equity – Birth Equity Series Part 3

In the United States, 700 women die every year from often preventable pregnancy or childbirth complications. An additional 60,000 more experience highly preventable birth injuries. Black women are three times more likely to die from those complications than white women. According to the CDC, the maternal mortality rate in the U.S. is roughly 17.4 maternal… Read More »

Words Matter in Creating Birth Equity – Birth Equity Series Part 2

While some health outcomes improve in the United States, racial and ethnic disparities in pregnancy-related outcomes persist. In the United States, Black women are three times more likely to die from a pregnancy-related complication than white women. In Kansas, Black women are more than three times as likely to die of pregnancy-related complications compared to… Read More »

Defining Birth Equity in Kansas – Birth Equity Series Part 1

The pace of progress is never fast enough for those who stand to suffer the biggest losses. Nowhere is this more apparent than in the glaring health inequities impacting Black mothers and babies in Kansas. Among the multitude of injustices Black Kansans face today, the disproportionate rates of death and devastating health complications for Black… Read More »

The Future of Telemedicine Depends on Applying Lessons From The Pandemic

By | October 28, 2021

During the pandemic, telemedicine demonstrated it’s power. As we begin to make the shift back to in-person clinical care in a post-pandemic world, it’s important to look at the lessons learned during the pandemic. This will help guide us in how to move forward and improve telemedicine delivery. The History The use of telemedicine is… Read More »

Authentic Leadership in Healthcare And Public Health: What Is It And Why Should We Care?

The COVID-19 pandemic has strained healthcare and public health. Many workers in these industries have felt growing frustration with leadership. They face a barrage of medical misinformation, ethical strains, and burnout. Now more than ever, authentic leadership is critical in supporting healthcare workers and advancing public health. This post will describe authentic leadership and examine… Read More »

COVID-19 and Health Workforce Equity

COVID-19 has uncovered and multiplied health workforce equity challenges across the US. In the early days of the pandemic, healthcare workers faced incredible personal risk from an unknown, highly contagious, deadly disease. Insufficient personal protective equipment (PPE) and reprimand and dismissal by employers for speaking out worsened this risk. As waves of COVID-19 swept across… Read More »

Multimorbidity and Psychosocial Aspects of Homelessness

By | September 13, 2021

Homelessness persists in the US, and across the world, despite decades of recognition and longstanding efforts to end the condition. There have been major successes in our understanding of what policies and programs work to prevent and end homelessness. However, the work must and will find new ways to adapt and improve if we are… Read More »

Tracking Community Benefit Spending

By | August 31, 2021

Nonprofit hospitals make up the majority of hospitals in the US. In exchange for their tax-exempt status, the federal government requires these hospitals to provide support in the form of community benefits.  Tracking community benefit spending and its impact is important to ensure that such spending aligns with community needs. Community benefit activities can include… Read More »

Patient-Centered Transitional Care

By | August 12, 2021

How is research on patient-centered transitional care going? A supplement on this topic funded by the Patient-Centered Outcomes Research Institute (PCORI) was recently published in Medical Care. Care transitions are “ripe with hazard,” as discussed in an editorial from Amy Berman. As pointed out by Berman, figuring out what works and what doesn’t is critical to… Read More »

Veterans Affairs Community Care

By | July 24, 2021

Until a few years ago Veterans generally had to visit a Veterans Affairs (VA) facility to receive care. Long wait times and long travel times caused problems for Veterans who needed healthcare. In response, the VA MISSION Act (2018) expanded access to community providers and increased benefits for caregivers. A recent supplement in Medical Care explores some… Read More »