Irwin Redlener and Paul Simon co-founded the Childen’s Health Fund twenty years ago. For two decades CHF has delivered free health care to disadvantaged kids in 20 sites around the country in both rural and urban areas using mobile medical units.

They try to fill in the gap for children who don’t have access to the health care they need. CHF does an enormous amount of advocacy in Washington on behalf of kids.

Paul Simon, who was a part of the We Are The World project to raise money for children in Africa, wanted to know if there was a need for money in the US for poverty related issues. One of the largest needs was health care.

Unfortunately, Health care for children in America has not improved in the past twenty years.

There is still a tremendouis amount of poverty in America.

Dr. Brent J. Pawlecki, Corporate Medical Director, Pitney Bowes Inc., presents “A Culture of Health” at the Healthcare Communications Forum, hosted by Insight Forums.

Recognizing that an organization’s overall success requires a healthy, engaged, and productive workforce, Pitney Bowes has created a “Culture of Health” that promotes healthy behaviors among employees, prevents disease and related complications, and results in overall long-term financial savings.

This session illuminates the steps Pitney Bowes took to promote a healthy lifestyle for its employees, a commitment that ultimately garnered recognition by the National Business Group on Health as a Best Employer for Healthy Lifestyles, and distinguished it as one of only five companies to be honored for three consecutive years as a Platinum Award winner.

Viewers will go inside Pitney Bowes’ award-winning experience and learn about the theory behind the Culture of Health, the components of the program, and the financial outcomes it generated.

Dr. Brent J. Pawlecki

Dr. Brent J. Pawlecki
Corporate Medical Director, Pitney Bowes Inc.

Dr. Pawlecki serves as the Corporate Medical Director, overseeing all health related issues and services of the organization, including the Pitney Bowes’ award-winning corporate clinics and wellness programs and the Absence Management Department. In addition, he serves as corporate medical consultant and as Chief HIPAA Privacy Officer. Dr. Pawlecki works closely with the integrated functions of Disability, Safety, and Worker’s Compensation, as well as the Health Care Strategy Group and the Crisis Management Team to direct corporate health and productivity for the global organization. Currently, he is heading the efforts of the global Pandemic Preparedness Team for the corporation.

Dr. Pawlecki completed his undergraduate and medical school training at St. Louis University, in St. Louis, Missouri. He completed a combined residency in Internal Medicine and Pediatrics in Connecticut at Bridgeport Hospital/Yale University. Since that time, Dr. Pawlecki has worked in the Emergency Department and in private practice before becoming involved as a medical director for a 70-site physician practice management group. He joined Pitney Bowes in 1999 as Associate Medical Director, and now serves as its Corporate Medical Director. He has completed the degree of Masters of Medical Management at the University of Southern California’s Marshall School of Business, and is actively involved in numerous professional and community organizations.

Steve Weissman leads a panel discussion at the Healthcare Communications Forum, hosted by Insight Forums.

A lot of times a hospital will have a family member calling on behalf of the injured or sick person. There is a need to communicate health care related information to someone other than the recipient of care. How does a hospital obtain permissions and ensure the family that their information will not leave the building?

The caregiver is often the last stop before a loved one is placed in a nursing home. Meeting the caregiver’s needs is as important as meeting the patients needs.

Successfully creating, producing, and delivering effective health care communications requires maintaining a precarious balance of especially complex issues: e.g., retrieving and presenting personal information on an EOB while still complying with privacy regulations, or imparting important program information to audiences of varying ages and ethnicities - and using the same technology backbone to achieve both!

This session explores these issues with a group of panelists selected specifically for their expertise in each of the key arenas. After watching this session, you will better understand the process, technical, and economic tradeoffs you’ll contend with when optimizing your communications process.

You’ll be better able to:

• Protect sensitive information while still providing access to it
• Achieve timeliness and completeness
• Orchestrate your systems components
• Avoid cultural land mines
• and more!

Moderator
Steve Weissman, Senior Analyst, Art Plus Technology

Panelists
Brian McKeen, Second Vice President for Compliance and Privacy Officer, AFLAC
Judy Roark-Mackey, Director of Marketing, Summit ElderCare
Christopher Nicholson, Director of Strategic Communications, Humana Inc.
Denise Miano, Chief Technology Officer, NEPS, LLC

Barbara Ficarra, RN, MPA, Award-Winning Journalist, Executive Producer and Medical Show Host of Health in 30 and Nurses in Motion recently sat down with Bruce Bonanno, MD, and ER Physician to talk about the complex issues surrounding the nursing shortage.

Barbara Ficarra and Dr. Bonanno navigate the viewer through the real ER. They talk about the challenges that face the ER, and the understaffing which leads to stress that many nurses face today. They discuss the vital role of nurses in society and how vital they are to patient quality health care. This only begins to describe the conversation between Barbara and Dr. Bonanno about the real problems facing hospitals and nurses today. Dr. Bonanno also answers viewer’s emails.

40,000 new cases of HIV are transmitted each year in the U.S., according to the Centers for Disease Control and Prevention (CDC). Over the last five years, public health officials have been challenged to reduce that amount by 50 percent.

To meet that goal, a new and unique strategy is redefining the idea of prevention.

Prevention with Positives is an HIV prevention program that targets those already infected with HIV.

“People realized that it takes a positive person to infect a negative one,” said Greg Cardona, Co-Director of Better World Advertising, a company specializing in social marketing campaigns. “Prevention with Positives provides support for people infected with HIV that are challenged by a variety of issues that could lead to bad decisions,” said Cardona.

One of the biggest issues still facing people that are HIV positive is stigma, according to Cardona. Twenty years into the AIDS epidemic, those infected by HIV face being ostracized by family and friends if they disclose their HIV status.

“Stigma keeps people from seeking medical care even though they know they are HIV infected,” said Cardona.

HIV Stops With Me, a Prevention with Positives social marketing campaign, was created by Cardona’s company in 2000. It uses the stories of HIV infected individuals to promote prevention messages and behavior change that address some of their issues.

Delano, one of the campaign’s models, has been used since 2006. A native of Haiti, Delano was in a committed relationship when he was diagnosed with HIV.

“I didn’t feel empowered to ask my partner his HIV status,” said Delano. “Getting HIV was a wake-up call.”

Cardona and Delano join us for an honest discussion of Prevention with Positives

After watching the show, please share your thoughts on this controversial prevention strategy. The comments section below the video should provide enough room.

“Could anyone have imagined six million Jews would be exterminated during World War II,” says Andrew Velez, Chair of the AIDS Coalition to Unleash Power Action Committee during the recent taping of our web TV series Reporting AIDS. “Nor did I think AIDS would become a world-wide epidemic killing millions of people.”

In 1981, recognized as the beginning of the AIDS epidemic, gay men mysteriously started getting sick and dying from rarely before seen forms of pneumonia and cancer. San Francisco, New York, Los Angeles, Miami and Key West — all gay-Meccas in the 1970’s, became paralyzed as thousands of men succumbed to the disease.

GRID (Gay Related Immune Deficiency), as it was called at the time, destroyed immune systems and left those afflicted powerless to fight the most minor infection.

Public health officials, doctors, nurses — those entrusted to help — retreated in fear, leaving the sick and suffering to die without basic care or dignity.

By 1987, when ACT-UP was formed, people were desperate.

I was fresh out college working in a restaurant on Market Street in San Francisco when I witnessed for the first time what AIDS was doing to people. There were scant ways to see the scope of the suffering from AIDS if you didn’t live in a city where people were dying.

Media attention and government information was sparce. Nothing had given me an understanding of the problem. Until I saw it.

A young man, maybe 35, walked into my restaurant around lunch-time. He seemed confused and slightly disheveled. It looked like he was unaware and unconcerned about being in the restaurant, but rather purposefully found a seat and waited for someone to approach him. He seemed to recognize the waiter helping him and somewhat acknowledge, though not warmly, what was happening. Nothing was said, but over a twenty minute interplay, he got food, ate, and left.

I asked a co-worker what was happening. I was told the man was suffering from Dementia, a symptom of AIDS much like the late stages of Alzheimer’s. It turned out the man had once been a waiter at the restaurant and knew it was a place where he could come to get food, no questions asked.

There it was, black and white, AIDS had the power to render a fully-engaged, ambitious, and hopeful human being down to the most basic level of human behavior, instinct. That’s what it was like when ACT-UP was formed.

“It’s amazing what desperate and dying people will do,” says Eric Sawyer, a co-founder of ACT-UP, during the show. Sawyer, along with the entire ACT-UP membership, turned rage and fear into targeted, effective political activism, taking non-violent demonstrations to entirely new levels. Their efforts changed the course of the AIDS epidemic and saved millions of lives.

To mark the 20th Anniversary of the first ACT-UP demonstration, March 24th, 1987, we invited Velez and Sawyer to talk on-camera about some of ACT-UP’s most important demonstrations; shutting down the FDA, protesting the Catholic Church and delivering political funerals.

After watching the show, we hope you’ll take a minute to share your thoughts on ACT-UP. The comments section below should provide enough room for you to be as concise or verbose as you’d like.

Tell us about your experience of ACT-UP, the impact they had on you personally, and how you think they changed our society.

John Mikytuck is a ScribeMedia.Org healthcare reporter. He’s hosting an ongoing series and dialog on HIV/AIDs.

Patrick Rooney was the recipient of the Consumers for Health Care Choices “Lifetime Achievement” award.

Anyone ever heard of Admiral Moritsugu??? 

Please allow me to the honor of introducing this truly great man.  Like any physician also at the political top of the ladder, Moritsugu has significant credentials that would fill a small book.  Health and Human Services has a detailed bio posted at: http://www.surgeongeneral.gov/aboutoffice.html#biosg.  Reading it will give you a sense of a man that seemingly never sleeps.  He has more awards, experience and credentials than most people dream of having.  I remember seeing an interview with Sally Ride just before she became the first American woman in space.  The reporter concluded by saying: this is a woman who has not wasted a minute of her life.  Surely the same is true of our current Surgeon General. 

Again, I do not believe I need to convince anyone that this man has credentials worthy of the office.  Looking at his credentials alone, he certainly ranks amongst the best.  The question really remains: who is this man? 

I have had the great fortune of having private meetings with this unique and great man.  The first thing he said during our first meeting was: “It is a great honor to meet you Mr. Gorton.”  I continuously observe his humble nature, which I believe brings out the best in the people around him.  It is the mark of a great leader. 

Over the past few months, I have shared some of the more complicated aspects of TelaDoc with Admiral Moritsugu.  He quickly understood the idiosyncrasies, and made comments about how the model works inside our health care system to solve some of our most pressing problems.  Certainly, he is a quick and clear thinker. 

On one occasion, I asked him to suggest ways that I and/or TelaDoc could help Moritsugu and the office of Surgeon General.  Because I  have a legal education, I used the term: quid-pro-quo.  The Surgeon General quickly pointed out that in his office, they make decisions to do things because they are RIGHT, not for any other reasons.  How incredibly refreshing to hear a comment like that in Washington, DC! 

In my second visit with the Surgeon General, I mentioned that I have two TelaDoc employees who are trying to quit smoking.  He immediately pulled out a business card and wrote them a personal Surgeon General’s warning to quit smoking.  Contrast this selfless, singular act to the to the authoring of countless documents, impacting millions, which Moritsugu has produced over the years, and you get a clear sense of a man capable of fixing the healthcare problems in our country.  Listen to this story, and you meet a man who is also wiling to focus on a single person in a personal encounter. 

Who is Kenneth Moritsugu?  He is the quintessential definition of a Surgeon General.  It is time more people know who and what this man represents. 

Michael Gorton is the CEO of TelaDoc, the first national network of telephone based physicians handling cross coverage for physicians and patients.

Michael has degrees in Physics, Engineering and Law and has served as adjunct Professor of Astronomy at Richland College. His hobbies are running, writing and mountain climbing.

We started HealthDot not so long ago because of a basic premise that seems shared by all with whom we speak: the American healthcare system is broken.

For this, we applaud George W. Bush’s comments last week during his State of the Union address. As reported, the Bush proposal offers tax deductions for those who purchase coverage up to certain thresholds while taxing those insured above those limits. Both outcomes would be a first for Americans if Congress passed laws that adhere to spirit of the Bush plan.

We view this as the beginning of a conversation though, not as an end. With a Bush White House and a Democratic Congress we don’t anticipate immediate resolutions.

After all, we remember 2004, 2000, 1996, 1992 ad nauseam as years in which we would finally and absolutely address America’s healthcare crisis and instead further postponed the issue.

As is well known, almost 50 million Americans are uninsured and the United States is well behind most industrialized nations in the quality of care afforded to its citizens despite spending more, per capita, on the problem.

Those on the right and left offer solutions and Bush’s, many agree would incentivise 5-6 million more Americans to insure themselves.

As Dr. Mark McClellan, former administrator for the Centers for Medicare and Medicaid Services and former commissioner of the Food and Drug Administration, told the Associated Press, “Most of the uninsured are people who are working and they’ve got a little bit too high of income to qualify for Medicaid or other government programs. If they buy health insurance they have to pay for it entirely out of their own pocket.”

And William Galston, a domestic policy adviser to President Clinton and a fellow at the Brookings Institution, countered, that while making insurance more affordable is a good idea, it doesn’t fully address the need for a comprehensive measure that covers all.

We believe healthcare solutions should solve a few issues: provide affordable insurance to all Americans, reduce the cost burden on business both large and small and increase the quality of our lives as late into our lives as possible.

The podcast above contains a conversation with John C. Goodman, founder of the National Center for Policy Analysis.

Sometimes called “the father of Health Savings Accounts,” he has a distinct position on resolving healthcare issues that is often associated with “conservative” or “Republican” positions. We don’t agree that labels such as these work though, as labels simplify positions and stifle dialog and debate.

We’re pleased to offer his thoughts on the Bush plan, as well as those being promoted by various States.

As 2007 begins, the leading domestic issue in the United States is healthcare. The costs in America are by far the most expensive in the world, but it produces the worst results among the developed member nations of the Organization for Economic Cooperation and Development. America is unique in the developed world in that it has no reliable, accessible and affordable source of healthcare for every resident. The United States has not made comprehensive healthcare available to all its people, which has been accomplished by every other industrialized democracy.

Healthcare in the U.S. has evolved into a complex and financially threatening crisis. The costs of insurance premiums and out-of-pocket expenses, including deductibles and copayments have risen, forcing middle class families to make painful and sometimes tragic choices. Only in the United States can sickness lead to financial ruin. Illnesses have pushed families and individuals into bankruptcy or into poverty. The high costs of health insurance for employees have burdoned American businesses by reducing the ability of many to compete in world markets.

The quality of healthcare in America has suffered, and professional morale and motivation have fallen sharply. Physicians and hospitals find themselves regularly in conflict with insurance carriers over diagnostic procedures and treatments and trying to collect their bills. Most practitioners find their incomes falling. The pricing of servicesis utterly confusing at the apparent instigation of the health insurance companies.

As plaintiff lawyers pursue lawsuits, premiums for professional liability insurance have escalated, forcing physicians out of some specialties and some locales. A phenomenon known as “defensive medicine” has become a prevalent practice. Doctors order more tests and procedures to protect themselves against illicit claims.

Facts are an essential element of an appropriate national conversation or debate. They can be contested but not answered with political rhetoric. The facts demonstrate that enourmous amounts of money will be saved in the U.S. by implementing universal healthcare, which is practiced so broadly throughout the industrialized world. The claim that America cannot afford universal healthcare is factually wrong.

Under the complex and chaotic American system, a multiplicity of health insurance companies exist. American businesses carry a major share of the health insurance costs. The insurance industry argues that American free enterprise will solve any problems of access and quality. They justify the high costs as simply those needed to provide America with the quality healthcare and technological advances expected of American institutions.

These claims have long been a part of the resistance to reform disparities of access to American healthcare. The facts of the matter are as follows:

• The people of the United States paid 109% more for healthcare in 1998 than the average of the next nine largest industrialized democracies (the “comparison nations”). This reached 112% in 2002 and was 123% in 2005. The U.S. per capita cost was $6,553, and the comparison nations’ average per capita cost was $2,944 in 2005.
• A World Health Organization Survey of Healthcare System Performance in June 2000 found all of the comparison nations to be superior to the United States. France was first; Japan was third; and the U.S. 38th.
• In the ultimate measure of medical effectiveness, Potential Years of Life Lost Before Age 70, in 2001 the U.S. was worst among the developed nationsand all but the two developing member nations of OECD.
• Between 1990 and 2002 in the comparison nations, healthcare costs as a percent of GDP rose 28.9%. In the United States, however, the increase was 67.8%. The real (after-inflation) healthcare expenditure increased by 78% in the comparison nations and 160% in the U.S.

There are many purported explanations of the high costs and the unsatisfactory performance of American healthcare. The main reason is that a large number of American patients arrive at the doorstep of medicine much more seriously ill than they should be.

It is popular to believe that only uninsured Americans might be affected by an inability to access healthcare. The number 45 to 46 million is most often used. Many believe that even the lack of insurance does not impede such people getting care. Our multidisciplinary study shows that at least 102 million people are uninsured or underinsured and cannot get timely primary or preventative care. Without early diagnosis and treatment more become ill, disabled or even lose their lives with “care denial induced illness.”

• The Centers for Disease Control and Prevention reports that chronic conditions account for 75% of healthcare expenditures. Many of these conditions can be prevented and managed with primary care and early intervention. Others have suspected the possibility, but none have realized the magnitude of the costs from $370 to $430 billion in 2005 borne by businesses and taxpayers.
• THe excessive and reversible administrative costs paid in 2005 by physicians, clinics, and hospitals due to the American adversarial system of multiple payers, plus insurance companies and HMO administrative expenses and profits, are estimated to have been between $190 and $210 billion in 2005.
• American liability laws encourage patients to sue doctors and hospitals, which increased costs by $70 to $90 billion in 2005. The morale of professionals at all levels is undermined by reduced incomes and escalating professional liability premiums.
• The massive flow of cash in healthcare has motivated Wall Street interests to develop new strategies to profit from health insurance and healthcare delivery.

  When uninsured and underinsured people in America cannot access the medical care they need, particularly primary care, they get very sick or die from manifestations of chronic conditions, complications or untreated acute diseases. Much of the costs of their treatment is at public expense. Nations that provide universal access to healthcare recognize that it is significantly less expensive to provide preventative and primary care to all, compared to treating illnesses that result from not providing these services.

  The global competition of pharmaceutical, surgical, diagnostic, hospital equipment and medical supply producers has yielded remarkable results - the miracle of modern medicine. Care delivery, however, has historically been one of community service focused on the best possible care for patients. The market-driven model of competition in the delivery of healthcare has been a dismal failure.

  Health insurance at one time was in fact something like insurance. Owners’ policies felt protected from a disaster if illness. Now the hospitals and doctors obtain permission to order diagnostic or treatment procedures usually after intense arguing. Even so health insurance premiums have increased sharply in recent years. Many physicians feel beset by constraints. American healthcare has become complex, confusing, cumbersome and chaotic. American insurance companies now act as middlemen in the dispensing of payments, taking a cut of the action.

  In the absence of universal healthcare, plaintiff lawyers seek large settlements in professional liability actions, which include covering present and future medical costs. With universal healthcare the medical costs would be covered and the multi-million dollar settlements would become unnecessary. WIth universal healthcare and professional review plaintiff claims could be reduced to pain aind suffering or disability issues and professional liability premiums redeuced to earlier levels.

  Professor Jon Oberlander of the University of North Carolina recently wrote, “Most international systems did not control costs until after they had achieved universal coverage.”

  Debate or a national conversation about American healthcare requires an understanding of facts and evidence from other countries where many decades of experience demonstrate that healthcare for all is affordable, desirable and achievable.

  1. Thesis: lack of access to health treatment prior to the onset of a crisis by the uninsured and underinsured leads to significant cost in the system.
  2. Supporting data
  3. Metric we should be measured by and compared to other OECD countries: The potential years of life lost before age 70.