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Five million families and children will now sleep a little easier. How will the new Latino/Hispanic immigrant status impact healthcare policy?

Being “in the shadows” has long been a healthcare access issue.  The broken healthcare system has been aggravated by a broken immigration system. Immigration and healthcare are tied together in many ways, especially for the economically disadvantaged.

According to the New York Times:

What Is President Obama’s Immigration Plan?

President Obama announced on Thursday evening a series of executive actions to grant up to five million unauthorized immigrants protection from deportation. The president is also planning actions to direct law enforcement priorities toward criminals, allow high-skilled workers to move or change jobs more easily, and streamline visa and court procedures, among others. NOV. 20, 2014 RELATED ARTICLE

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Who could be affected?

The president’s plan is expected to affect up to five million of the nation’s unauthorized immigrant population, currently 11.4 million according to the Migration Policy Institute. It would create a new program of deferrals for approximately 3.7 undocumented parents of American citizens or legal permanent residents who have been in the country for at least five years. Deferrals would include authorization to work and would be granted for three years at a time.

It would also expand a program created by the administration in 2012 called Deferred Action for Childhood Arrivals, or DACA, which allows young people who were brought into the country as children to apply for deportation deferrals and work permits. The plan would extend eligibility to people who entered the United States as children before January 2010 (the cutoff is currently June 15, 2007). It would also increase the deferral period to three years from two years and eliminate the requirement that applicants be under 31 years old. About 1.2 million young immigrants are currently eligible, and the new plan would expand eligibility to approximately 300,000 more.

It would not provide a path to full legal status or benefits under the Affordable Care Act. Officials have said that the president’s plan will not provide specific protection for farm workers or parents of DACA-eligible immigrants.

Filed under: ACA and Medicaid, Blogosphere, Data Trends - American Demographics and Public Opinion, Family Policy, Feminization of Poverty, Health Literacy, Health Policy, Healthcare Reform, Immigration, Latinos, Maternal and Child Health, Medicaid, News, Public Health, Public Policy,

America needs help building a more perfect union, again? “Scarcity changes how we think”

The current Republican victory either threatens healthcare access success or saves the day.  Perhaps it depends on what ideas you have to form an opinion on the matter.  Thousands of people inherit political and controversial opinions from their parents or grandparents.  But this is not our grandparent’s America.   Leadership today, and ideas to formulate solutions to our society’s most vexing social and economic challenges, must be as innovative as the ideas our forefathers forged to build our constitution.  They broke new ground to form a more perfect union.

America needs help in being more perfect today.  We need new ideas to help us support new social investments to address our collective responsibility to make sure that our form of government, and the leaders we put in charge, keep a fair balance regarding the social contract that makes us the greatest nation on earth.  Perhaps reading the current book “Scarcity: Why Having Too Little Means So Much,” by Mullainathan and Sharif, could help?

Jus about a year ago an important book was published regarding scarcity.  We were all probably a bit busy, so it did not cross our minds.  Interestingly, the book is about the very social and psychological reality that caused many of us to miss the opportunity.   We just don’t seem to have enough time in the day to do the things we need to do to make our life more manageable, more simple and, perhaps, more enjoyable.  Without mentioning the dated and overused thought model, “Maslow’s hierarchy of needs,” we are reminded of a person’s lack of efficacy when overwhelmed by environmental stimuli that dictate how we feel and perhaps what we do.  Such is the case in this important book on the effects on our minds and how our mind works when confronted by daily challenges.  The mind, the book’s thesis goes, has limits (“bandwidth”), and its focus is bound by our fixation on what matters among the many things coming at us.  The book is important for public health, healthcare services and health education, for example, because it gives us a less pejorative and judgmental way to look at people misbehaving.  Especially behaving in ways that seem irrational, or worse, lazy or undeserving, to us. Perhaps as health professionals, funders, planner and policy makers, we are distanced from the daily lives and realities of those confronted with our well intentioned helping systems and recommendations.   It can be daunting and frustrating.   This book may give us  hope.

Mullainathan and Sharif elaborate on a conception of the haves and the have nots that is nuanced, insightful and perhaps more pragmatic than any construct we have heretofore seen; Yes, in the war on poverty.  To be sure, decades have passed since our last great poverty reform (PRWORA, 1996 or Bill Clinton’s Welfare Reform Law).  We now have the ACA reform (Barak Obama’s Law).  This second salvo on our nation’s efforts to address the needs of the “have nots” is once again putting the poor under the looking glass.  Back in the 90s version we were looking at people, being helped, being too lazy and needing to be made to work while getting help in order to get off of the government dole.  Millions of people were thrown off of the welfare rolls and when it was all said and done a Government Accounting Office (GAO) report declared that the majority of people remaining on the rolls were ill and not employable.  This was an important report, by “objective” pundits representing the federal government; and you would think that would have been enough to usher in healthcare reform to address the urgent plight of this government policy defined and “vetted” group.  It wasn’t.

Perhaps due to our national political discourse and the focus on levels of unemployment that could not longer be explained by the “lazy people on welfare” phenomenon, the nation began to focus on working people, many who were not faring much better than people on welfare.  The struggling middle class and the “deserving working poor” became the popular political constituency.  The increasingly divided electorate called for new issue that could wedge open the door to a new group that could tip the electoral balance.  This need fueled to drive for an electoral strategy focus on new votes and created the conditions and demand for strategies promising to move this demographic to the polls.  Enter today’s healthcare reform scenario.

Perhaps this is why healthcare reform remains a political fight with uncertainties and future possibilities for failure.  Just as the end of the PRWORA’s success, in throwing the poor of the welfare rolls, may now echo the present reality where we will have disrupted thousands of families’ lives, only to throw them off the insurance rolls.

“Scarcity captures us because it is important, worthy of our attention, but we cannot fully choose when our minds will be riveted. We focus on scarcity even when we do not want to. We think about that impending project not only when we sit down to work on it but also when we are at home trying to help our child with her homework. The same automatic capture that helps us focus becomes a burden in the rest of life. Because we are preoccupied by scarcity, because our minds constantly return to it, we have less mind to give to the rest of life.”

via Scarcity changes how we think – Salon.com.

Filed under: Behavioral Health Outcomes, Blogosphere, Children and Poverty, Congressional Activity, consumers, Health Policy, Healthcare Reform, Policy ThinkShop Comments on other media platforms

Gap in Diet Quality Between Wealthiest and Poorest Americans Doubles, Study Finds

Healthy food is not easy to prepare, does not have a very long shelf life, and is more expensive than cheaper canned and mass produced “food” that contains fillers and other ingredients that return adequate profits, facilitate transportation, refrigeration, and distribution.

America’s food consumption and health connection problem goes well beyond socioeconomic issues of lack of cash and proximity and access to healthy food.  Our society’s economy produces commodities and commodities are distributed based on market forces of supply and demand.  Supply and demand pressures have thus far overpowered the traditional forces on the side of promoting community health.  The loosing forces are:

  • Social do-gooders
  • Philanthropy
  • Public health officials
  • Conscientious parents
  • Suburban focused and lead prevention efforts

In short, economic forces have thus far trumped social ideas and groups aiming to undo what are basically the macro and micro consequences of food production and distribution.

Any successful efforts in this area will have to have for-profit corporations at the table with philanthropy and government officials providing public policy leadership and incentives that appeal to corporate America’s economic interests and social responsibility (good corporate citizen) commitments.

More via Gap in Diet Quality Between Wealthiest and Poorest Americans Doubles, Study Finds.

Filed under: ACA and Medicaid, Behavioral Health Outcomes, Blogosphere, Health Literacy, Health Policy, Healthcare Reform, News, Parenting, Philanthropy, Policy ThinkShop Comments on other media platforms, Public Health, Public Policy

RWJF Initiative on the Future of Nursing | The information from the experts has been published. What are you and other community stakeholders doing about it?

Are you familiar with the RWJ report titled “The Future of Nursing: Leading Change, Advancing Health” by the Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Penn Medicine (University of Pennsylvania Health System)?

As we know, initiatives like the one that produced this report, as recent as 2011, come and go.  What remains is the report and what committed professional like yourself and our colleagues do with the information.

We at The Policy ThinkShop were inspired by a nurse colleague not only to pullout this report but to post a comment on our blog for your benefit.

The link to the report follows:

http://www.thefutureofnursing.org/sites/default/files/Future%20of%20Nursing%20Report_0.pdf

According to the report:

“In 2008, The Robert Wood Johnson Foundation (RWJF) approached the Institute of Medicine (IOM) to propose a partnership to assess and respond to the need to transform the nursing profession. Recognizing that the nursing profession faces several challenges in fulfilling the promise of a reformed health care system and meeting the nation’s health needs, RWJF and the IOM established a 2-year Initiative on the Future of Nursing. The cornerstone of the initiative is this committee, which was tasked with producing a report containing recommendations for an action-oriented blueprint for the future of nursing, including changes in public and institutional policies at the national, state, and local levels (Box S-1). Following the report’s release, the IOM and RWJF will host a national conference on November 30 and December 1, 2010, to begin a dialogue on how the report’s recommendations can be translated into action. The report will also serve as the basis for an extensive implementation phase to be facilitated by RWJF.”

The report explains the committee of experts charge in producing the study and report as follows:

The committee may examine and produce recommendations related to the following issues, with the goal of identifying vital roles for nurses in designing and implementing a more effective and efficient health care system:

  • Reconceptualizing the role of nurses within the context of the entire workforce, the shortage, societal issues, and current and future technology;
  • Expanding nursing faculty, increasing the capacity of nursing schools, and redesigning nursing education to assure that it can produce an adequate number of well prepared nurses able to meet current and future health care demands;
  • Examining innovative solutions related to care delivery and health professional education by focusing on nursing and the delivery of nursing services; and
  • Attracting and retaining well prepared nurses in multiple care settings, including acute, ambulatory, primary care, long term care, community and public health.

“In 2008, the Robert Wood Johnson Foundation approached the Institute of Medicine (IOM) to propose a partnership between the two organizations. The resulting collaboration became the two-year Robert Wood Johnson Foundation Initiative on the Future of Nursing at the IOM. The committee was chaired by former U.S. Secretary of Health and Human Services Donna Shalala, and the goal was to look at the possibility of transforming the nursing profession to meet the challenges of a changing health care landscape. The report produced by the committee, The Future of Nursing: Leading Change, Advancing Health, makes specific and directed recommendations in the areas of nurse training, education, professional …”

More on the initiative via About | RWJF Initiative on the Future of Nursing.

Filed under: ACA and Medicaid, Blogosphere, Health Literacy, Health Policy, Healthcare Reform, Leadership, Maternal and Child Health, News, Philanthropy, Policy ThinkShop Comments on other media platforms, Public Health, Public Policy,

World Health Organization | WHO calls on governments to do more to prevent alcohol-related deaths and diseases

No other substance on the planet is so embedded in our happiness and in our suffering like alcohol is.  As Americans, we are moving away from some forms of alcohol but are embracing wine with new vigor.  The World Health Organization (WHO) recently released an comprehensive report that enumerates alcohol consumption issues and social problems.  You can follow the following link provided by The Policy ThinkShop to read the full report.

Find your country profile and alcohol statistical highlights:

http://www.who.int/substance_abuse/publications/global_alcohol_report/msb_gsr_2014_2.pdf?ua=1

 

“Worldwide, 3.3 million deaths in 2012 were due to harmful use of alcohol, says a new report launched by WHO today. Alcohol consumption cannot only lead to dependence but also increases people’s risk of developing more than 200 diseases including liver cirrhosis and some cancers. In addition, harmful drinking can lead to violence and injuries.

The report also finds that harmful use of alcohol makes people more susceptible to infectious diseases such as tuberculosis and pneumonia.

The “Global status report on alcohol and health 2014″ provides country profiles for alcohol consumption in the 194 WHO Member States, the impact on public health and policy responses.

“More needs to be done to protect populations from the negative health consequences of alcohol consumption,” says Dr Oleg Chestnov, WHO Assistant Director-General for Noncommunicable Diseases and Mental Health. “The report clearly shows that there is no room for complacency when it comes to reducing the harmful use of alcohol.”

Some countries are already strengthening measures to protect people. These include increasing taxes on alcohol, limiting the availability of alcohol by raising the age limit, and regulating the marketing of alcoholic beverages.”

 

Report highlights

The report also highlights the need for action by countries including:

  • national leadership to develop policies to reduce harmful use of alcohol (66 WHO Member States had written national alcohol policies in 2012);
  • national awareness-raising activities (nearly 140 countries reported at least one such activity in the past three years);
  • health services to deliver prevention and treatment services, in particular increasing prevention, treatment and care for patients and their families, and supporting initiatives for screening and brief interventions.

More via WHO | WHO calls on governments to do more to prevent alcohol-related deaths and diseases.

Filed under: Behavioral Health Outcomes, Blogosphere, consumers, Health Literacy, Health Policy, Public Health, Public Policy

What Is the Result of States Not Expanding Medicaid?

Half the country seems to be moving along with ACA reform and the other half are paying a price for not fully participating.  According to an Urban Institute report released this month, the nearly half of states that have not expanded medicaid under ACA implementation may have missed an important economic boost during these tough economic times.

“In the 24 states that have not expanded Medicaid, 6.7 million residents are projected to remain uninsured in 2016 as a result. These states are foregoing $423.6 billion in federal Medicaid funds from 2013 to 2022, which will lessen economic activity and job growth. Hospitals in these 24 states are also slated to lose a $167.8 billion (31 percent) boost in Medicaid funding that was originally intended to offset major cuts to their Medicare and Medicaid reimbursement.

A review of state-level fiscal studies found comprehensive analyses from 16 diverse states. Each analysis concluded that expansion helps state budgets. State savings and new state revenues exceeded increased state Medicaid expenses, with the federal government paying a high share of expansion costs. Even if future lawmakers reduce federal Medicaid spending, high federal matching rates are likely to remain at the ACA’s enhanced rates, given historic patterns. Facing bipartisan gubernatorial opposition, Congress lowered the federal share of Medicaid spending just once since 1980, while cutting Medicaid eligibility, services, and provider payments more than 100 times. Medicaid expansion thus offers significant state-level fiscal and economic benefits, along with increased health coverage.”

The Policy ThinkShop provides you with this link to the full report: http://www.urban.org/UploadedPDF/413192-What-is-the-Result-of-States-Not-Expanding-Medicaid.pdf

Filed under: ACA and Medicaid, Blogosphere, consumers, Health Policy, Healthcare Reform

Health Literacy: Assess Your Practice

The North Carolina Program for Health Literacy has produced “Assess Your Practice” which included a questionnaire and tools.

The Policy ThinkShop provides this user-friendly link for your convenience:

http://www.nchealthliteracy.org/toolkit/tool2.pdf

The guide incorporates the Health Literacy Universal Precautions.

1. Improve Spoken Communication.

2. Improve Written Communication.

3. Improve Self-Management and Empowerment.

4. Improve Supportive Systems.

More via Health Literacy: Assess Your Practice.

Filed under: Behavioral Health Outcomes, Blogosphere, consumers, Culture Think, Health Literacy, Health Policy, Healthcare Reform

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