Tag Archives: public health policy

The Plight of the “Poor (as in underrepresented in politics, power and money) Boys”

The Plight of the “Poor (as in underrepresented in politics, power and money) Boys”

Posted on by • Posted in career development, leadership, personal development, Politics • Tagged , , , , , , , , , , , , , , , , • Leave a comment

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Recently, something magnificent happened to me!  A gifted writer with a great deal of following, upon whose article I commented earlier on, actually replied to me! You heard right. He not only replied, but also managed to, even if (slightly) patronizing me in his response, still connect with me on LinkedIn! Oh, the omnipresent and positive power of social media… What happened you ask? Well, before you’ll see my brilliant if I say so myself response, let me catch you up first:

This writer wrote a fabulous & empowering piece “Letter to My Fellow Men” where he questioned the ingrained gender-specific, ok let’s call them sexist, stereotypes, behaviors and views. It started with him noticing the treatment/ behavior his wife was getting from the men in Silicon Valley. So needless to say, from the get-go, I was a fan! It cut right into politics and democracy, into the make up of the 2015 U.S. Congress, it went right through to the issue of true representation of women in city/county/state or federal governments or to the dismally low number of nurses, for example, being elected to hospital boards. His Letter took a strong stance on gender, politics, sociological conditioning and the distribution of political power therefore on the learned, ingrained and enforced stereotypes we all face in everyday society. Right up my alley, yes?

The follow-up to the Letter, was a long article discussing a variety of issues among which was a paragraph commenting on the current heightened trend – if I may call it that – of supporting girls or ‘looking after girls’ and their empowerment, and how as a society we are now more cognizant of gender issues with #HeSheHero campaign. Still good, right? After the girls empowerment, he went on to list the shortcomings of the boys; how boys are medicated with Ridillin (no kids, no idea about the spelling) at much higher rate, how boys read at much lower grade level, and how boys don’t do well at school. At the end of this part he asked: so who is “looking after” the boys?

With that one sentence, my teeth started to grind especially since our ‘gender-barring friendship’ was going so well.

That one question stopped me in my tracks and while realizing we were perhaps on our way back to “Gender-Stereotype Central“, it all started to (not) make sense. One thing, however, was clear: if an educated man who publicly stands up, questions, critiques and calls upon his fellow men to end their gender stereotypes and sexist behavior, if he thinks that the current support for girls or the attention to girls empowerment (hurray for #GirlsLead) threatens the boys status or existence -> we have a very long way out of the frequently-jammed and traffic-impacted Gender-Stereotype Central. Perhaps I am not doing him justice, perhaps it was not meant like that. Perhaps. But on the other hand, why would you pose such a question?

Hmmmm…..

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So I gathered my courage to face fears of being publicly criticized and/or not liked, and I wrote: “…yes, and even with such dismal statistic, the “poor boys” still manage to make it to the top and control the power, money and influence.” And this is where the marvelous thing happened – he replied! Then however came the next round of courage in reading his response…

What I read was a slightly patronizing reply about how making comments like mine lead to no other purpose than to gender discourse and/or to the perpetuation of sexism, or something to that sense. He went on to say that he found my use of the phrase “poor boys” offensive or smarmy and was quite frankly surprised to hear it there, or from me, I can’t remember the exact wording. HUH?

As a good ol’ feminist broad with a keen feminist mind for analysis, I immediately started to count the ways in which he just patronized / offended me based on nothing but my gender… Yes, my Women’s Studies professor was thinking about me and didn’t know why… 🙂

…so here you have it, folks, all she wrote (well, not quite). You have been caught up.

=>> So Before you scroll down and read my brilliant and utterly awesome response, please do let me know if I am wrong (or how much wrong), if you encountered perhaps a similar situation, or felt like talking back or speaking up somewhere on a gender issue? What would you have said? Do you agree OR disagree with ascertaining that comments like mine, or similar in nature, serve no other purpose than to incite gender discourse or bias or sexist behavior?

I always enjoy your comments, I appreciate other people’s point of view, I learn from it. It is only through communication we truly learn <<=

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So, HERE WE GO: (due to word limited replies on LinkedIn, I had to edit my piece down and posted the second half only)

“Thank you Louis for your response.

I do appreciate it, and I’d like to welcome you to my professional network. Happy to have you as a part of mine.

I’ll take a wild stab here when I say I am not alone here; a woman, an immigrant, with an accent, without influential friends in Ivy colleges (or Towers but I would want some), fighting her way in men’s business every step of the way. Trust me when I tell you there was no offense or smarminess (is that a correct word?) intended in my comment because I know how it feels since I have been on the receiving end. As a discussion leader in Women’s Studies classes at a university, I brought the men in to talk about issues, I asked their opinion, I shielded them from emotional and un-constructive attacks and I always included them. So you are way off the mark here.

You take an offense at me using phrase ‘poor (as in underrepresented in politics, money, power and government) boys‘ but rest assured, I do not take offense at your shall-we-say smarmy or even-slightly patronizing response. I like your article, I enjoy reading your stuff, I love your Letter to Men and I think there should be more men, thought-proving leaders and husbands like you. Having said that….

My use of the ‘poor boys‘ phrase was meant not as an offensive derogatory terminology, but as an incredulous response to your question of who is looking after the boys. That quite frankly, I could not believe I was reading!

Men control if not all, than almost all, of U.S. power and money, in 2015 we’ll have still-a-laughable-number of mere 100 women in U.S. Congress, women make up 51% of population yet less than 24% of elected officials in city and/or county governments, and while nurses (majority of women) make the largest pool of healthcare professionals, they still make only 6% – 9% of elected hospital board members.

Taking it one step further, before the Mid-Term 2014 Election, even “Liberal” California has elected only I believe around 180 women in total during its entire political history to the CA State Legislature, furthermore, speaking of California, women candidates / possible legislators even lost several seats here. And I could go on….

So when your article asks who is looking after the boys, yes, the poor (as in underrepresented in politics, power and money) boys since we are now finally looking after the girls, I must ask if we are talking about the same playing field, because I do see little disparity here, don’t you? And that was THE intended point of my comment. I thought THAT could be something a great writer such as yourself with an impressive following could look into and write about. People would listen and attitudes would change! What happens that even if having such dismal initial statistics, as you write, boys (i.e. men) still end up at the top, controlling the power, wealth and the seat of influence? What happens?

That was the point I was trying to make, and clearly badly.

PS: Boy do I like this! Thank you for such a great topic and for this discussion.”

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Is ‘population diversity & behaviors’ to blame for lower U.S. life expectancy…?

Posted on by • Posted in health care, Program Administration, Uncategorized • Tagged , , , , , , , , , , , , • 3 Comments
Government Spending

Government Spending (Photo credit: Tax Credits)

Last week I posted article asking a pertinent question “If U.S. Spending is so Outrageous, Are We Getting the BEST?”

https://marketahouskova.wordpress.com/2013/04/22/if-u-s-health-care-spending-is-so-outrageous-are-we-getting-the-best-2/

The answer is “kind of”.

We do have the best technological and medical advancements in the world, and our acute care and treatments can deliver miracles.  We don’t have to wait 4-6 month for a surgery, we mostly get timely care, good care, and we do have great outcomes. However, as wonderful as that is, it does not impact the overall measurements of ‘life expectancy’ as it falls under the category of ‘acute care’ and we do really well here.

It is injuries or conditions lasting more than 6 months that are considered ‘chronic’ and require ongoing management, ongoing medication, follow-up doctors visits, repeated test, etc… and that’s where the U.S. is seriously lacking. So yes, while we are very good at acute care, we lack in chronic care management – and that does impact the overall ‘life expectancy’ and quality of life.

Which brings me to the fact that even after spending over $8,000 per capita in overall healthcare expenditure in 2010 (the highest in the world) , the U.S. has a lower life expectancy compared to other OECD nations. Why is that? Is “healthcare”  to blame? Is “public health” to blame? Or is it due to our “population diversity and behaviors“?  I have heard many  blaming it on the “diversity & behaviors” part, but in that case a question remains –  isn’t it the health and life expectancy of the whole population, no matter what diversity groups it includes, that makes for ‘life expectancy’ studies, surveys and measurements?

I agree with you that our diverse population is an integral part of our society, however, it is 21st Century and everybody knows that if you want to live longer and have a good quality of life, when you are not feeling well or have certain episodes – you should go see a doctor. And this is where the crux of “it is population diversity & behaviors fault” argument weakens, as 50 million of low-income working Americans (yes, majority about 80% are working and 82% are legal citizens) DO NOT have options or access to a non-acute or preventive care, so they go without seeing a doctor, without taking medications, and without ongoing management of preventable conditions – NOT because of their population diversity or behaviors – but because under the current system they have no viable option for obtaining health plans!

This clearly and directly impacts the overall life expectancy and thus the overall quality of healthcare we as ‘all Americans’ get.
If 1 in 5 Americans don’t have access to health care – it seriously impacts all of us in terms of loss of economic potential, loss of productivity, and in the end, in an increase in overall health care spending.

I ask again, does $8,000 per capita (twice as much as others developed nations) deliver the best health care to our society? Does it…?

Now, since we established that “population diversity & behaviors” are not to blame for lower U.S. life expectancy, is it a fault of healthcare, or public health? The answer is “yes” as the status of U.S. health care and it’s overall total health care spending and expenditures is a direct result and implication of U.S. health policies implementations. States are responsible for health care but federal government plays its role in Medicare, Medicaid, CHIP & other programs.

Medicaid, for example, by covering health care needs of pregnant women and prenatal care is not only delivering health care, but also implementing a U.S. public health policy. Smoking cessation programs – public health issue, or health care issue? Both, as continued smoking leads to lung cancer, COPD, emphysema etc… and that is very costly in terms of health care spending. Public health programs are offering smoking cessation in order to prevent future health care spending, a clear integration of health care and public health policies.

Without proper public health policies we will not be able to deliver proper health care to our diverse population. Clear and simple.

P.S.

Yes, while certain “diverse” behaviors cause increase in health care spending (i.e. smoking, bad diet etc..), if we look at it closer – these behaviors span all socio-economic levels, not only diverse population often mentioned. So we are back at the beginning, why the U.S. has lower life expectancy that other OECD nations? The one clear answer is that it is not due to “population diversity and behaviors”.

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If U.S. health care spending is so outrageous, are we getting the BEST?

Posted on by • Posted in health care, Uncategorized • Tagged , , , , , , , , , , , , • 10 Comments

In today’s heated political and economic debates, healthcare reform and healthcare spending remain a hot topic of conversation – and rightfully so!

Why is it that while the U.S. spent over $8,000 per capita on health care in 2010 (almost 50% more than Norway and Switzerland in 2nd and 3rd place), per OECD ratings, we deliver only average level of care based on U.S. lower life expectancy, lower than Switzerland or Norway. Life expectancy graph puts the U.S. roughly in the middle of the developed countries in life expectancy at birth (the longest gevity is in Japan). How Does the United States Compare page 1.

The problem with that is that other developed countries who show even higher life expectancy than the U.S. are able to bring their population to such age for a fraction (or at least for 50% less) of total health care cost than here in the U.S. It shows that the huge per capital spending does NOT necessarily assure or ensure longer gevity delivered through better care or more advanced technological treatments.

So WHY does health care cost so much in the U.S.?

The answer comes under the cloak of science, as the most significant contributor to U.S. health care cost growth is technology innovation & medical advancement. Clear and simple. We have the best diagnostics, imaging, new-surgery-techniques, technological possibilities and acute care treatments & capabilities in the world – bar none. The fact that we are also a wealthy country contributes to our income growth meaning that the wealthier the country – the more of healthcare consumer spending and insurance-induced demand there is.

It stands to reason that while new medical technology may be expensive, when used in time and appropriately, it does extend patients lives, improves their quality of life which in turn makes them live longer and makes them more productive. So technology – it’s a go! But the need for increased healthcare efficiency with curbed spending will bring a major strain on the U.S. health system in the coming years.

While the U.S. has the best diagnostic and acute health services in the world, we are lacking in preventive care and in management of chronic diseases and conditions affecting a large segment of U.S. (aging) population. Additionally, the wealthiest country in the world and we have around 50 million un-insured people from working families! Yes, you heard right, a vast majority are from working families – as in low-income workers unable to afford private or employer-based health plans premiums. Kaiser Family Foundation Primer (2010) states that 50% of ALL health care spending is used to treat 5% of the population and they are the people with 3+ chronic diseases needing ongoing medical & nursing care, list of medications, follow-up doctor’s visits and other services. http://www.kff.org/insurance/upload/7670-03.pdf

Needless to say that the un-insured have overall much worse health conditions as, due to financial constrains, they do not go see doctors with first symptoms, do not get medications to correct or manage conditions, do not go for tests or follow ups to see how such condition(s) can be treated or fixed or improved. So such condition(s) grow in silence and when finally there is a life-threatening event – they will go to emergency rooms where they will get the care including all those technology innovation & medical advancement tests, images, diagnostic procedures and latest treatments, but they will also get a bill for all that technology innovation & medical advancement. And anybody who went through ER and spent a couple of days in a hospital knows the amount I am taking about here! And without insurance plan to help cover the large amount, they are left with a stark total! http://www.kff.org/uninsured/upload/7451-06.pdf

Let’s not forget, these un-insured are not insured not because they don’t want to or feel like getting a health insurance, but because their low-income jobs leave them unable to pay for private or employer-sponsored health plans and not eligible for Medicaid and too young for Medicare (over 65 y.o.)  Yes, it is true, hospitals can write something off, but on average, it still leaves the low-income un-insured with a bill of about 1/3 of the hospital cost. And good luck with that!

 

Issues to ponder about U.S. emergency response in a small pox sentinel event [1/2]

Posted on by • Posted in Emergency preparedness, emergency response and disaster relief, Program Administration, sentinel event • Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , • 7 Comments

http://rt.com/news/uk-smallpox-terror-threat-379/

(this post is as a response to the above mentioned article)

My area of expertise is NOT discussing the threat level colors with national security experts and advisors arguing about a possible impending terror plot using biological weapons. I leave that complicated and complex discussion and decision-making to those experts, and God be with them and us…

My area of expertise is program administration, infrastructure coordination and immediate implementation of emergency response policies such as putting the correct SOPs to work, dealing with and trying to protect the first responders, dealing with city & hospital command centers, dealing with local,  state and federal agencies, organizing teams and rolling out regional plans… and of course managing & administering it all in the most productive, cost effective, safe and human capital most efficient way.

Reading about the split view between the US and UK on the response to small pox threat, while out of my area of expertise, nonetheless all I see in this are the problematic areas of such sentinel event response starting with the politics of preventing public panic, not knowing the degree of events we would be dealing with as the latency of small pox is up to 3 weeks and they are highly infectious – and that’s just for starters!
In today’s globalized and inter-connected world we would be probably looking at pandemic situation where 2 million doses of US vaccines – even when and if administered at the most opportune time to the right people – would barely scratch the surface of such disaster.    …Would antivirals save lives? In time?
So yes, from the administrator point of view, a band-aid solution… and didn’t we learn, band-aid solutions cause more damage and are followed by increased public anger and outrage plus are usually way more costly in the end?

The political and societal fall out of such health security threat sentinel event would reach heights we have never seen before with Twitter, Instagram, Facebook, instant messaging, YouTube, Pintrest etc… It would be up to the administrators and the politicians to calm and reassure the population that all the necessary steps are being taken… Are they? Would they?
Again, we are talking about small pox with 3 weeks prodromal stage, highly infectious spread and don’t forget – scary looking, as I can already see the horrible images floating on Instagram, YouTube and being posted on FB and the enormous public panic &  fear that would create as a result, because in today’s inter-connected and globalized world we all are much closer to one another, both literally and figuratively speaking.
(Highly developed, skilled and organized social crises media management during emergency response is and will be an indispensable and absolutely vital part of any emergency planning, preparedness and response).

So both countries better return to the point of origin and start thinking of the proper procedures, administration and coordination of such wide-spread effort with proper planning, training, established (and properly working and functioning!) channels of communications, assigned priorities, tasks, set ways of decision-making during such sentinel events – with proper management and foresight into what may come.
Without well prepared and well though-out massive plans of response, the division of views between the US and the UK on this issue will sadly be completely irrelevant.