More Kids Than Ever Without Health Insurance

More than two million kids in the United States of America are without health insurance of any kind in any given year because their parents are out of work and have lost their health insurance coverage.

More than 2 million children in the United States become uninsured each year after their parents lose their employer-based health insurance, according to a new American Academy of Pediatrics study.

Isn't it time for some sort of Universal Health plan in the United States just like most other industrialized countries provide for their citizens?

I don't understand how we can spend billions a month on a war in Iraq when our children at home are going without basic health care.

Senators in Washington dither over steroids in baseball and the "nuclear option" dismanteling the fillabuster while Jennifer and Michael, and LaQisha and Da'Shawn can't get their vaccinations or antibiotics for their strep infections because their parents jobs have been outsourced to China and Wal Mart doesn't provide health insurance to its less than full time employees.

Link: Study: More Kids Than Ever Without Health Insurance.

Alcohol counseling saves hospitals money

It is stuff like this that probably should make me happy but instead make me want to cry.

I am getting close to the end of a 36 year career as a Psychiatric Social Worker which was practiced for the most part in hospital and community mental health center based settings. For 18 years I was a "psychiatric assignment officer" in three large urban emergency rooms. I have evaluated and made dispositions on more alcohol, substance abuse, psychiatric, and suicidal patients than anyone in the United States.

In the late 60s, 70s, and 80s I worked hard to build up behavioral health services that comprised a system of care that offered continuity and a continuum of care for patients. In the late 80s, and 90s I have watched that system disintegrate as funding diminished, managed care rose up to erect barriers to access to treatment, and it became increasingly difficult if not impossible to continue to link patients with the care they needed. Services were curtailed, programs were closed, and patients were left to fend on their own, went to jail, or started to clog up medical practices and services. I have argued for years that decreasing behavioral health services drives up the cost of medical care, but short sighted bean counters wanted to save the immediate bucks by declining authorization for behavioral health services and closing programs. Of course, it has been a decade now, or a decade and a half, and low and behold a new generation of bean counters have taken over and what have they discovered ladies and gentlemen? They have discovered that the very services they denied and closed could actually save them money. WOW! Now there's a discovery.

"Offering brief alcohol counseling to injured patients in emergency rooms could save U.S. hospitals almost $2 billion a year, researchers estimate.

Researchers at the University of Texas Southwestern Medical Center used prior studies to analyze how much money hospitals could save by preventing future alcohol related injuries through counseling. In 1999, for example, they found hospital admissions declined by about 50 percent over the following three years for patients with alcohol-related injuries who received just one 30-minute counseling session."

And so, I am happy, really. I don't want to be cynical and bitter. I'm not. I just feel like a wise old man who has been there and done that, and I wonder at the human folly of the high and mighty who make decisions affecting the lives of millions of people for short sighted gains to further their careers and the bottom line which a decade later they discover were poor, ignorant decisions after all.

Hopefully, behavioral health services will get the recognition and support they deserve in contributing to community health. Rather than looking at our health care system in a linear, reductionistic kind of way, a systemic appreciation would lead to better decisions and judgments. In the day of specialization and special interests, it is rare to find policy makers, managers, and practitioners that have a systems wide appreciation of how the health care system inter - relates to produce overall the best possible outcomes, in the most customer satisfying ways, at the most efficient costs. It is the comprehensive systems view that will keep us from robbing Peter to pay Paul and then realizing that impoverishing Peter has made Paul a very expensive player in the health care game.

Link: MedlinePlus: Alcohol counseling saves hospitals money.

Need a doctor? Don't bother with the emergency room

Emergency room.jpg

Having worked in three urban hospital emergency rooms for over 18 years, I have witnessed the human tragedy that crosses the threshold, and the dedicated staff that provides care in crisis situations and situations where no one else is available or willing to take care of.

It is very interesting that as we see a rise in "concierge" and "retainer" medical care for the rich, the options for the poor are shrinking. We have billions for Iraq and cut backs for services for Americans without health insurance.

Snippet from an article in the New York Times...

"But budget problems and other financial issues have forced more than 500 hospital emergency departments to close since 1990, according to the American Hospital Association. The Centers for Disease Control and Prevention in Atlanta estimates that emergency-room patient visits rose about 20 percent from 1992 to 2001.

Two out of every three hospitals sometimes reroute ambulances away from their emergency departments because of overcrowding, according to the General Accounting Office. Many specialists, meanwhile, unhappy with low payment rates for treating poor and uninsured patients, have left hospital staff jobs for specialty clinics or private practice, where call duty isn't required.

Now emergency care may be further compromised by a new regulation, effective Nov. 10, that eases requirements for on-call specialty coverage. The regulation, from the Centers for Medicare and Medicaid Services, gives hospitals discretion, based on patient needs, the hospitals' capabilities and the availability of on-call physicians, to provide on-call coverage as they see fit."

Gay-Straight Alliance Network

Adolescents who are gay have much higher suicide and substance abuse rates than straight kids. High school is tough enough without the added discrimination that gay kids experience.

I remember 12 years ago coming home from work when my kids and some neighbor kids were running around and rough housing on our front lawn jumping into piles of leaves. One kid got hurt, and some shoving and pushing started, and my son, Ryan, who must have been about 5 at the time, got mad and was screaming/crying at another kid "You faggot!!"

I called him over and told him not to ever say that word again, that it was a bad word, like "Nigger" or "Spick". Ryan looked at me confused. He didn't even know, of course, what the word meant, and it's origin as a hurtful epitaph. I realized then how deeply engrained, and taken for granted, homophobia and discrimination is in our society.

Kudos to Carolyn Laub who started the Gay-Straight Alliance in California about 5 or 6 years ago. It has grown from 50 to 350 schools in the network in the last 5 years.

Check out their web site at the link below. They have a lot of great materials.

Gay-Straight Alliance Network

Bad dreams? Want to talk about it?

As a therapist, I was never much into dream analysis. I am willing to talk about it if the client wants to, but I don't think that dreams have any special or esoteric meaning that is worth spending a lot of time analyzing.

I put dreams in one of three categories: wish fullfilment, problem solving, and/or mastery of fear.

Simply put, if I am dieting I dream of food all night. If I am horney, I have sexual dreams. These types of dreams are wish fullfilment.

Second, if I have some dilemna weighing on me, I will dream, often symbolically, of some sort of problem solving scenarios. I chew on it all night long. I sometimes wake up more tired than when I went to sleep, because I have been working hard in my dreams, thinking about and trying to solve my problems.

Third, if I have fears, I will dream about them and try to get away or fight them to prevail over them, the classic flight or fight coping mechanisms.

I find that talking about our dreams in our conscious mind, usually leads to a decrease in the dreaming in our unconscious mind. So if you want your dreams to fade and dissipate, talk about them with someone, and they probably will go away in pretty short order.

That's it. I guess we could make more out of it, but my waking life is more than enough to keep me occupied, I don't have to analyze my dreams to keep me amused during the day time. Dreaming at night is enough.

In case you want to talk about your dreams and have no one to talk to, the Association For The Study Of Dreams runs a 24 hour hotline you can call. N i g h t m a r e H o t l i n e : 1- 866 - DRMS911.

Sweet dreams.

The Association for the Study of Dreams