The Truth About Covering the Uninsured

This week’s New England Journal of Medicine includes a study of the impact of expanding Medicaid coverage to more poor, uninsured adults under the age of 65 years. Comparing states that expanded their Medicaid coverage with surrounding states that did not, the Harvard School of Public Health researchers–Benjamin D. Sommers, M.D., Ph.D., Katherine Baicker, Ph.D., and Arnold M. Epstein, M.D.–reported that expansion of Medicaid eligibility is associated with reduced mortality,  a 25% increase in Medicaid coverage, 15% lower rates of uninsurance, a 21% reduction in cost-related delays in care, and a 3% increase in self-reported excellent or very good health.”

International Forensic Nurse addressing sexual violence in conflict zones in central & east Africa

Senior Fellow, Nancy Cabelus, DNP, MSN, RN, is an international forensic nurse consultant currently working with Physicians for Human Rights on a program addressing sexual violence in conflict zones in central and east Africa.

In recent weeks I visited impoverished areas in Kenya to specifically meet with women and talk with them about sexual violence.  In Kibera slum, the largest and most renowned slum on the African continent, I spoke one morning with 16 women.  The women I met with are HIV positive and receive antiretroviral (ARV) treatment.  I asked the women to whom they would turn if they or someone close to them were raped. All said that they would seek care from a doctor but most were not aware of places they could go where medical treatment was free. Only two reported that they would seek help from the police. Police are perceived as rude, accusatory, and often ask for bribes from women seeking help.  Two women stated they would speak to the tribal chief in the slum and eleven others said they would tell a trusted friend. None would tell a family member and would prefer to suffer in silence rather than deal with the stigma and family outcast attached to rape.

Health Homes- an opportunity for transforming substance use services

Daliah Heller, PhD, MPH, joins the Center for Health Media and Policy (CHMP) at Hunter College this year as a Visiting Scholar.

I’m beginning to think Health Homes are one of the best-kept secrets in the Patient Protection and Affordable Care Act (ACA). I’ve spoken with a lot of health care providers lately, and few seem to know about this provision, and that it is not the same as a Medical Home, though could be part of one.

Health Homes are case management-type entities established by the state health authority to
serve Medicaid-eligible people with chronic health conditions. ACA includes substance use
disorders among the eligible conditions, alongside mental health conditions, asthma, diabetes,
heart disease, and being overweight. And for the record, the term ‘substance use disorder’ refers
to a spectrum of excessive or harmful alcohol or drug use.