Bad prescription for health care

When it comes to financing the state’s health care reform law, the Patrick administration suddenly wants to change the rules of the game at halftime. Naturally employers are on the losing team.

Anticipating a shortfall in paying for health care reform, the administration has settled on a solution that presents a serious threat to the coalition that enabled the initiative to become law in the first place.

No, Deval Patrick wasn’t governor when the law finally passed - but somebody should have shown him the news clips. Reform was nearly strangled in the cradle when the House proposed a payroll tax on companies with more than 10 employees - what amounted to a backdoor employer mandate.

Instead, after months of negotiations, all parties agreed that businesses would pay a $295 penalty per worker only if they did not make a “fair and reasonable” contribution to their employees’ health insurance.

After another tough fight it was determined that “fair and reasonable” meant at least 25 percent of the work force is enrolled in the company’s plan - or at least a third of an employee’s premium is covered by the employer. Revenue from the penalties would subsidize care for those who remained without insurance.

But now the administration wants to require businesses to meet both standards - within 90 days of hire! - to avoid the per-worker penalty. Patrick estimates it would mean $33 million in new revenue this year.

Also contained in Patrick’s big Sunday surprise (he announced the proposal during his weekend budget-signing ceremony) is a plan to tax the reserves held by health care providers and insurers to the tune of $61 million. Again, someone might have thought to give the governor a packet of old news clips. Harvard Pilgrim Health Care, for example, was fighting for its life and ordered into receivership barely eight years ago and now, after a miraculous comeback, he wants to raid its reserves?

We chuckle remembering that those who fought for the per-worker “assessment” suggested it would actually go down over time, as fewer people drew from the free care pool. What were they thinking!

Yes, those footsteps you hear at the State House represent a retreat from the original deal - and a serious threat to its long-term success.

Medicare Override a Victory for America's Health Care

"Tonight's votes for the Medicare bill are a victory, not just for older Americans, but for the future of American health care. This legislation makes immediate improvements to Medicare, helping people afford their health care and better ensuring access to their doctors.

"This law also lays the groundwork, in statute and in spirit, for broader health care reform. By instituting a system of electronic prescribing, this bill will reduce errors and improve efficiency while setting the stage for greater use of health information technology.

"Looking ahead, today's demonstration of bipartisanship offers promise for our work in the coming years to broadly reform our health care system. By breaking down partisan divisions and gathering overwhelming support from Republicans and Democrats, this law proved that lawmakers can still set aside their differences and work toward meaningful policy.

"We thank Congress for listening to their constituents - including more than one million messages from AARP volunteers and activists - and keeping Medicare fair. We are optimistic that both parties can work together next year to make broad health care reform a reality."

AARP is a nonprofit, nonpartisan membership organization that helps people 50+ have independence, choice and control in ways that are beneficial and affordable to them and society as a whole. AARP does not endorse candidates for public office or make contributions to either political campaigns or candidates. We produce AARP The Magazine, the definitive voice for 50+ Americans and the world's largest-circulation magazine with over 33 million readers; AARP Bulletin, the go-to news source for AARP's 39 million members and Americans 50+; AARP Segunda Juventud, the only bilingual U.S. publication dedicated exclusively to the 50+ Hispanic community; and our website, AARP.org. AARP Foundation is an affiliated charity that provides security, protection, and empowerment to older persons in need with support from thousands of volunteers, donors, and sponsors. We have staffed offices in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands.

Better Health Care: Try a Little Empathy

In typical conversations about the U.S. health-care system, it is rare to hear "cost control" and "patient satisfaction" in the same sentence. Conventional wisdom suggests that health-care organizations often achieve cost savings at the expense of patient experience, and that "high touch" service occurs primarily in fancy facilities or in the doctors' offices that do not accept insurance. Let's face it: Many of the well-known examples of health-care cost cuts—like longer wait times, shorter interactions with clinicians, and increasingly automated customer service—leave patients feeling as if their personal interests are in direct opposition to the cost-conscious interests of the health-care organizations that serve them.

Fortunately for all us, there are health-care organizations defying the conventional wisdom. They've found ways to leverage the basic and irreplaceable power of the personal touch to improve both patient satisfaction and the bottom line. These organizations are innovating at the intersection of patient needs and organizational efficiency.

A lot of this work is counterintuitive and requires a willingness to experiment. Ask most doctors or hospital administrators if they believe increasing the frequency of contacts between patients and clinicians can save time and money, and they'll wonder what medication you're on.
More Visits, Fewer Interruptions

But at Montefiore Medical Center in New York, the staff found that frequent interruptions, usually in the form of pages to doctors' beepers, made rounds longer and made it more difficult to focus on patient care—for doctors and nurses alike. The hospital realized staff could be significantly more efficient if they increased the number of patient visits in order to reduce unexpected disruptions. Now a doctor or nurse checks in on every patient's needs every hour, and instead of a traditional numerical page, doctors now receive simple text messages.

As a result, patients felt better cared for and the doctors and nurses also saw real benefits. The program created financial value for the hospital as well. Average length of stay decreased, as did the incidence of falls and pressure ulcers, all of which saved costs while actually enhancing the patient's service experience.

How far should health-care providers go to improve customer service and efficiency? What about giving patients a bath when they are admitted to a hospital? In all hospitals, infections—especially from antibiotic-resistant bacteria such as MRSA—present significant health risks for patients and drive up costs.

Cleaner Patients, Lower Costs

HealthSouth's Tustin Rehabilitation Hospital in California changed its admission procedure to require that each patient be given a bath and treated with an anti-infective product upon admission. The original motivation was patient safety and infection prevention. But the hospital recognized that the procedure could feel intrusive or dehumanizing if executed poorly. Coaching for staff proved critical to success. Leaders presented the process to employees as an opportunity to connect with each patient and provide a caring, empathetic service.

The program has helped increase patient satisfaction, in great part due to the staff's thoughtful approach. The program's clinical results have been impressive. Rates of infection have decreased dramatically and consistently, which has led to a significant reduction in the costs associated with patient treatment and isolation.

It's not just about doctors and nurses. Changing the attitudes and behaviors of frontline health-care workers plays a key role for patient care and efficiency at every stage of the health-care experience—including patients' transportation by wheelchair or gurney within a hospital, a process in which individual patient needs sometimes get lost in the shuffle. Instead of looking at the transport of patients as a series of impersonal handoffs, the Ticket to Ride program at the Presbyterian Hospital of the University of Pittsburgh Medical Center (UPMC) makes a critical shift to highly personal "hand-overs" that position nonclinical transporter employees as important participants in patient safety and continuity of care.

Empathy Leads to Solutions

As they are transferred around the hospital, UPMC Presbyterian patients carry a piece of paper that contains information about their itinerary and any special instructions for care. When handing over these instructions, the transporters make a point of engaging with the technician or clinician who is receiving the patient to ensure all instructions are conveyed in a personal way.

This simple innovation has supported patient safety and reduced costly errors and inefficiency. It also has increased patients' confidence about their care and empowered and energized the transporters, who previously had not recognized or taken pride in their role as caregivers. As the program rolls out rapidly across UPMC's 13 acute-care hospitals, it serves as a powerful illustration of innovation that simultaneously creates value for the organization, for patients, and for employees.

These stories of health-care innovation share a common theme: leaders who look to their patients' and their employees' interests as a springboard for solutions. Their people harness the power of empathy to deliver superior results across multiple dimensions. At a time when most conversations about U.S. health care focus on challenges and frustrations, these leaders demonstrate that important health-care results often start with basic person-to-person empathy.

Dislocation

A dislocation is displacement of one or more bones at a joint. The joints most frequently dislocated are those of the shoulders, elbow, thumb, fingers and lower jaw, the last named resulting sometimes from yawning or a blow on the chin.

Signs and Symptoms
1. Pain of a severe and nauseating character at or near the affected joint.
2. The casualty cannot move the joint normally (Fixity of the joint).
3. Deformity. The limb assumes an unnatural position and appears misshapen at the joint.
4. Swelling of the joint may occur.
5. It is usually difficult for a First Aider to distinguish between a dislocation and a fracture. Both mav occur at the same time. In certain people, particularly epileptics, recurrent dislocations are common. These are practically painless and frequently unrecognized. Careful enquiry into previous history will help in reaching a diagnosis in doubtful cases.

First Aid Treatment
1. Do not attempt to reduce a dislocation. Obtain medical aid at once.
2. If dislocation is in a limb:
a.If accident occurs out of doors, steady and support the limb and secure it in the most comfortable position using padding in order to lessen the effects of jolting during transport to a hospital.
b.If accident occurs indoors, place the casualty on a couch or a bed in the most comfortable position. Support the limb with pillows, cushions etc.
3. If dislocation occurs in the lower jaw:
a.Remove any dentures.
b.Support the lower jaw by a bandage tied over the top of head.
4. It is absolutely necessary that the patient should be immobilised properly.

Avoid Cancer ..

Fight Cancer with America's Favorite Summertime Drink. The American Institute for Cancer Research (AICR) conducted a research study that turned up some surprising results. Tea contains antioxidants which neutralize "free radicals" that are thought to cause cancer. Next time you order refreshing iced tea, enjoy and know you may be fighting cancer.

Avoiding and Treating Blisters:

Cause and Effect

Blisters form when the skin rubs against another surface, causing friction. First, a tear occurs within the upper layers of the skin, forming a space between the layers while leaving the surface intact. Then fluid seeps into the space.

Soles and palms are most commonly affected for several reasons. The hands and feet often rub against shoes, skates, rackets, or other equipment. Blister formation usually requires thick and rather immobile epidermis, as is found in these areas. In addition, blisters form more easily on moist skin than on dry or soaked skin, and warm conditions assist blister formation.
Blister Care If you get a blister, you’ll want to relieve your pain, keep the blister from enlarging, and stave off infection. Specific steps depend on the size of the blister and whether or not it is intact. You can treat the vast majority of blisters yourself and need to call a doctor only if blisters become infected, recur frequently, form in unusual locations, or are very severe. Signs of infection include pus draining from the blister, very red or warm skin around the blister, and red streaks leading away from the blister.

Small, intact blisters that don’t cause discomfort usually need no treatment. Nature’s best protection against infection is a blister’s own skin, or roof. To protect the roof, this type of blister can be covered with a small adhesive bandage if practical.
Larger or painful blisters that are intact should be drained without removing the roof. First clean the blister with rubbing alcohol or antibiotic soap and water. Then heat a straight pin or safety pin over a flame until the pin glows red, and allow it to cool before puncturing a small hole at the edge of the blister.

Drain the fluid with gentle pressure, then apply an antibiotic ointment such as bacitracin with polymyxin B (double antibiotic ointment) or bacitracin alone. Avoid ointments that contain neomycin because they are more likely to cause an allergic reaction.
Finally, cover the blister with a bandage. Change the dressing daily--more frequently if it becomes wet, soiled, or loose.

Blisters with small tears are treated the same as those that you have punctured. Blisters with larger tears should be "unroofed" carefully with fine scissors, and the base should be cleansed thoroughly with soap and water or an antibacterial cleanser. Apply antibiotic ointment and bandages as described above.

Additional padding may be necessary for exercise or sports. Ring-shaped pads made of felt will protect small blisters. Larger blisters may require dressings. Some of the many available dressing materials are DuoDerm (ConvaTec, Princeton, New Jersey), Spenco 2nd Skin (Spenco Medical Corporation, Waco, Texas), Vigilon (CR Bard Inc, Murray Hill, New Jersey), and Opsite (Smith & Nephew United, Largo, Florida). Additional, doughnutshaped padding made of felt or lamb’s wool may be applied over the area surrounding the blister. Then the entire dressing can be applied to help keep the dressing in place on sweaty skin.

Cardamom - Health Benefits

Cardamom, commonly known as Elaichi is a spice variety native to India. However, countries like Nepal , Srilanka, Guatemala, Mexico also cultivate Cardamom to a greater extent. It is a perennial plant with a thick rootstock. It grows to a height of 6-12 feet. It is the dried unripened fruit of the plant. The pod contains tiny brown aromatic seeds which are slightly pungent to taste. The Indian cardamom is said to be of superior quality than the others. Cardamom is best stored in pod form, because once the seeds are exposed or ground, they quickly lose their flavor. It is often referred as the ‘Grains of Paradise’.

Cardamom is usually used to flavor a variety of dishes. The spice is also very popular in the Scandinavian countries. cardamom is broadly used to treat infections in teeth and gums, to prevent and treat throat troubles, congestion of the lungs and pulmonary tuberclosis, inflammation of eyelids and also digestive disorders. It is also reportedly used as an antidote for both snake and scorpion venom.

Exercise and Fitness

Simple fitness exercises can help to have a fitter and healthy life. Stretching exercises can help in many ways in mainting a fitter body. Weight loss can be achieved by following simple effortless regular exercises. Medical breakthroughs can happen by regular meditation and exercising. Yoga and other workouts which can be performed easily are available in this website to keep you fit and healthy.

Health and Fitness can make all that difference in one's life. Healthy living is all that one needs and to achieve that we picked up the best of the articles from reliable sources and have presented here in an organized manner. You might not be able to spend your valuable time on complicated medications and diet controls, but. you can find articles to help you have a better living using simple and easy technics.

Ayurveda, a science in vogue practiced since centuries, uses a wide variety of plants, animal origin substances, mineral and metallic substances to rebalance the diseased condition in the sick. A few tips on simple treatment of life style diseases have been carefully picked for the visitors of this website. These tips can help reduce or control diseases like diabetes, cholesterol, blood pressure, etc.

Sudden Sensorineural Hearing Loss is a Medical Emergency

What is sudden sensorineural hearing loss (SSNHL)?

A typical patient loses his or her hearing in one ear over a period of one to several days, associated with a feeling of fullness in the ear, and often tinnitus, or ringing of the involved ear.

There may be dizziness or vertigo. Occasionally, the patient may report an upper respiratory infection (cold symptoms) prior to the onset of the hearing loss.

Why do patients with SSNHL often wait before seeing a specialist?

Unfortunately, many patients delay seeking care by a specialist. The symptoms of decreased hearing and fullness of the ear are often diagnosed as a middle ear infection (otitis media) and so the referral to an audiologist or otolaryngologist (ENT specialist) is made too late. Or insurance issues may prevent referral in a timely fashion to an ear specialist.

A delay in treating this condition (2 weeks or more after the symptoms first began) will decrease the chance that medications might help improve the hearing loss.

How is sudden sensorineural hearing loss diagnosed?

The diagnosis can only be made by specialized hearing testing in a sound-proof chamber by an audiologist. Pure-tone thresholds, speech discrimination scores, acoustic reflex testing, and distortion product otoacoustic emission testing, the parts of a complete audiometric evaluation, are performed to confirm the diagnosis of a sudden sensorineural hearing loss.

A comprehensive evaluation by an otolaryngologist (ENT) and an audiologist will ensure that the loss is nerve-related, and not due to fluid, infection, or a perforation, or hole in the ear drum.

An MRI scan of the brain, with gadolinium contrast, is also performed to exclude the presence of a cerebellopontine angle tumor, such as a vestibular schwannoma (acoustic neuroma).

How is sudden sensorineural hearing loss treated?

If you do have sudden sensorineural hearing loss, treatment with steroids within the first 2 weeks of the symptoms provides the best chance that some of the hearing may return. The gold standard therapy is steroids by mouth but several small studies have suggested that steroids injected into the ear may be beneficial.

UC plans for 2 new medical schools

The University of California, which hasn't opened a medical school in more than 40 years, is preparing to open two new medical schools to help train more physicians for underserved rural and minority communities.

While the schools at UC Merced and UC Riverside won't be open for four or five years, they are intended to help fill a growing shortage of physicians in the state, officials say.

In addition to planning the new schools, UC is working to add slots at its existing medical schools in San Francisco, Los Angeles, San Diego, Davis and Irvine, which now enroll about 2,540 students.

"It is a little unusual for a university system to open two medical schools at once," said Edward Salsberg, director of the Center for Workforce Studies of the Association of American Medical Colleges. "But UC's decision-making has been good, looking at what areas of the state have needs."

California, with a rapidly growing and aging population, has less than half the national average of students enrolled in such programs, according to the Association of American Medical Colleges. Meanwhile, California sends more students out of state for medical school than any other state.

The state is expected to have a shortfall of 17,000 physicians by 2015, and the San Joaquin Valley and Inland Empire, among the fastest-growing parts of the state, have dire shortages of primary physicians and specialists.

Responding to a national need, nine new medical schools have recently been approved or are in the accreditation-review process across the country, while five more, including UC Merced and UC Riverside, are in development or under discussion, Salsberg said.

By 2011, enrollment of first-year medical students across the country is expected to be up 21 percent from the 2002 level, he said.

Maria Pallavicini, dean of natural sciences at UC Merced, said building and sustaining teaching hospitals is "unrealistic" during lean budget years, so both institutions plan to train students at clinics and hospitals in their regions. Both would also use faculty and resources from other UC medical schools to round out their curriculum and student experiences.

That model will allow the schools to develop a more innovative curriculum than traditional medical schools and will also help to reach many of the residents who now are not getting the medical services they need, she said.

"In the UC system, most of the curriculum is based on a campus teaching hospital," Pallavicini said. "We are in different times than when the existing medical schools started over 40 years ago. We are looking to leverage the clinical opportunities we have in the valley."

Plans for the UC Riverside medical school will go before the UC Board of Regents next week for final approval - although the approval is contingent on a provision that the school will not admit or enroll students until the UC president determines that sufficient funding and resources are available, according to UC spokesman Brad Hayward.

In May, UC Merced got the nod from the regents to proceed with planning its school.

UC Merced began planning for its medical school shortly after it opened as the 10th UC campus in 2005. While the school will recruit students from everywhere, it hopes that many of the students trained at UC Merced will stay in the area.

"We have a mission to train students that will meet the needs of San Joaquin Valley," Pallavicini said. "If medical students complete medical school in the valley and do their residencies in the valley, 80 percent will set up their practices there."

With its heavy science focus, UC Merced is well situated to develop the medical school. About 50 percent of its students major in science and engineering and 35 percent are biology majors.

The medical school will rely on the campus' interdisciplinary programs for research on issues such as population health and how communities respond to treatment and interaction between health and the environment, she said. It will focus on chronic diseases that are prevalent in the area, such as asthma and diabetes.

UC Merced's new school would open in 2013 with 32 medical students and would grow to 384 medical students and 70 doctoral students.

David Quackenbush, CEO of the Central Valley Health Network, a consortium of health centers focusing on low-income and underserved populations, said the new schools will be vital for communities.

"We are short on just the frontline doctors who determine what is wrong with you and teach you to be healthy so you don't develop a bigger problem," he said. "There will be a pool of doctors coming out of a valley institution."

UC Riverside plans to open its medical school by fall 2012 with a class of 50 medical students and build up to 400 medical students, 160 graduate students and 160 residents.

It would focus its research on the health needs of the area, such as cardiovascular diseases, insulin-resistant diabetes and metabolic syndrome, neurodegenerative diseases, emerging infectious diseases, and health services, public health and health care access, according to the campus.
UC's plans for new medical schools

Merced: Plans to open by fall 2013 with 32 students and would grow to 384 medical students and 70 doctoral students. Would use existing hospitals and clinics to train students, and would focus on chronic diseases prevalent in the area, such as asthma and diabetes.

Riverside: Plans to open by fall 2012 with a class of 50 medical students and increase to 400 medical students, 160 graduate students and 160 residents. Would use existing hospitals and clinics to train students, and would focus research on the health needs of the area.