Clinical Preventive Services for Women: Closing the Gaps

 

From the Institute of Medicine press release

 

As a centerpiece of the Patient Protection and Affordable Care Act (ACA) of 2010, the focus on preventive services is a profound shift from a reactive system that primarily responds to acute problems and urgent needs to one that helps foster optimal health and well-being. The ACA addresses preventive services for both men and women of all ages, and women in particular stand to benefit from additional preventive health services. The inclusion of evidence-based screenings, counseling and procedures that address women’s greater need for services over the course of a lifetime may have a profound impact for individuals and the nation as a whole.
Given the magnitude of change, the U.S. Department of Health and Human Services charged the IOM with reviewing what preventive services are important to women’s health and well-being and then recommending which of these should be considered in the development of comprehensive guidelines. The IOM defined preventive health services as measures—including medications, procedures, devices, tests, education and counseling—shown to improve well-being, and/or decrease the likelihood or delay the onset of a targeted disease or condition.

The IOM recommends that women’s preventive services include:

 

• improved screening for cervical cancer, counseling for sexually transmitted infections, and counseling and screening for HIV;
• a fuller range of contraceptive education, counseling, methods, and services so that women can better avoid unwanted pregnancies and space their pregnancies to promote optimal birth outcomes;
• services for pregnant women including screening for gestational diabetes and lactation counseling and equipment to help women who choose to breastfeed do so successfully;
• at least one well-woman preventive care visit annually for women to receive comprehensive services; and
• screening and counseling for all women and adolescent girls for interpersonal and domestic violence in a culturally sensitive and supportive manner.

HHS Secretary Released the National Strategy for Quality Improvement in Health Care Report

From the AHRQ  (Agency for Healthcare Research and Quality) press release

HHS Secretary Kathleen Sebelius released the National Strategy for Quality Improvement in Health Care.  The Strategy was called for under the Affordable Care Act and is the first effort to create national aims and priorities to guide local, State, and national efforts to improve the quality of health care in the United States.  The National Quality Strategy will promote quality health care that is focused on the needs of patients, families, and communities.  At the same time, the Strategy is designed to move the system to work better for doctors and other health care providers – reducing their administrative burdens and helping them collaborate to improve care.  The Strategy presents three aims:

• Better Care: Improve the overall quality, by making health care more patient-centered, reliable, accessible, and safe.
• Healthy People & Communities: Improve the health of the U.S. population by supporting proven interventions to address behavioral, social, and environmental determinants of health in addition to delivering higher-quality care.
• Affordable Care: Reduce the cost of quality health care for individuals, families, employers, and government

To help achieve these aims, the Strategy also establishes six priorities, to help focus efforts by public and private partners.  Those priorities are:

• Making care safer by reducing harm caused in the delivery of care.
• Ensuring that each person and family is engaged as partners in their care.
• Promoting effective communication and coordination of care.
• Promoting the most effective prevention and treatment practices for the leading causes of mortality, starting with cardiovascular disease.
• Working with communities to promote wide use of best practices to enable healthy living.
• Making quality care more affordable for individuals, families, employers, and governments by developing and spreading new health care delivery models.

The National Quality Strategy is designed to be an evolving guide for the Nation as we continue to move forward with efforts to measure and improve health and health care quality, and I hope that you will use it to guide your efforts to improve the quality and safety of health care services.  Select to read the National Quality Strategy.  Supporting documents are available on the AHRQ Web site.

(Obama Administration) Partnerships for Patients: Better Care, Lower Costs

From the HealthCare.gov Web page

Doctors, nurses and other health care providers in America work incredibly hard every day to deliver the best care possible to their patients.  Unfortunately, an alarming number of patients are harmed by medical mistakes in the health care system and far too many die prematurely as a result.

The Obama Administration has launched the Partnership for Patients: Better Care, Lower Costs, a new public-private partnership that will help improve the quality, safety and affordability of health care for all Americans.  The Partnership for Patients brings together leaders of major hospitals, employers, health plans, physicians, nurses, and patient advocates along with State and Federal governments in a shared effort to make hospital care safer, more reliable, and less costly.  The Partnership will help save 60,000 lives by stopping millions of preventable injuries and complications in patient care over the next three years and has the potential to save up to $35 billion, including up to $10 billion for Medicare.  Over the next ten years, it could reduce costs to Medicare by about $50 billion and result in billions more in Medicaid savings.  Already, more than 500 hospitals, as well as physicians and nurses groups, consumer groups, and employers, have pledged their commitment to the new initiative.

The two goals of this new partnership are:

• Keep patients from getting injured or sicker. By the end of 2013, preventable hospital-acquired conditions would decrease by 40% compared to 2010.  Achieving this goal would mean approximately 1.8 million fewer injuries to patients, with more than 60,000 lives saved over the next three years.

• Help patients heal without complication. By the end of 2013, preventable complications during a transition from one care setting to another would be decreased so that all hospital readmissions would be reduced by 20% compared to 2010.  Achieving this goal would mean more than 1.6 million patients will recover from illness without suffering a preventable complication requiring re-hospitalization within 30 days of discharge….

…To see which organizations have already joined the Partnership, visitpartnershippledge.HealthCare.gov. …

…For more information about the Partnership for Patients, visitwww.HealthCare.gov/center/programs/partnership.  For more information about the Community-based Care Transitions Program funding opportunity visit: www.cms.gov/DemoProjectsEvalRpts/MD/itemdetail.asp?itemID=CMS1239313.

Related Articles

• Ohio Campaign for Better Care Launches “Healthy Hospital” Initiative, Vows Vigorous Work to Improve Hospital Care for Vulnerable Older Patients (prnewswire.com)
• HHS in Campaign to Cut Hospital Errors (abcnews.go.com)
• Improving Care for People with Medicare (whitehouse.gov)
• Coalition Applauds Congressional Champions for Protecting Access to Medicare Benefits (prnewswire.com)

HHS Announces Plan To Reduce Health Disparities

From the April 11 2011 Medical News Today article

The U.S. Department of Health and Human Services launched two strategic plans aimed at reducing health disparities.

The HHS Action Plan to Reduce Racial and Ethnic Health Disparities outlines goals and actions HHS will take to reduce health disparities among racial and ethnic minorities.

HHS also released the National Stakeholder Strategy for Achieving Health Equity, a common set of goals and objectives for public and private sector initiatives and partnerships to help racial and ethnic minorities and other underserved groups reach their full health potential. The strategy, a product of the National Partnership for Action (NPA), incorporates ideas, suggestions and comments from thousands of individuals and organizations across the country. The NPA was coordinated by the HHS Office of Minority Health.

 

Related Articles

• Webcast: HHS Action Plan for Reducing Health Disparities (aa47.wordpress.com)
• Health and Human Services: ‘LGBT people have been denied the compassionate services they deserve. That is now changing’ (miamiherald.typepad.com)

School-based health centers improving access for youth: School settings a boon to student health

From the Nation’s Health ( April 2011, vol. 41 no. 3 , pp 1-20)

During a recent office visit, Robert Wolverton, MD, provided a young woman with emergency contraceptives, helped her restart regular birth control, evaluated a rash she was concerned about and investigated the cause of her ear pain.

Some doctors discourage patients from discussing multiple problems during one appointment, Wolverton said, but that recent patient was like many he sees at the Teen Wellness Center at T.C. Williams High School in Alexandria, Va. She had health concerns and she wanted to handle them quickly and confidentially….

…Nationwide, the number of school-based health centers is climbing, according to Linda Juszczak, DNSc, MPH, MS, CPNP, executive director of the National Assembly on School-Based Health Care. The City of Alexandria has had a wellness center for adolescents for more than a decade, but the previous center was located in a trailer off school property that students had a hard time accessing, Wolverton said….

…

The new center is one of more than 1,900 school-based health centers nationally operating in 48 states and territories. Such centers provide access to primary health care, mental health services, immunizations, sexually transmitted disease testing and a host of other services to about 2 million children and youth, regardless of ability to pay.

The centers are an attractive option for young patients seeking health care, as no patient will be turned away because she or he is not able to pay, said Terri Wright, MPH, director of APHA’s Center for School, Health and Education. In some places, school-based health centers open their doors to adults during non-school hours and bill third-party payers for their care as a way to make ends meet, Wright said.

The growth of school-based health centers such as the one in Alexandria may speed up in the near future, thanks to the health reform law passed last year.

 

Related Articles

• Columbus schools a center for students’ health care (dispatch.com)
• Oakland, L.A. schools to add health centers (sfgate.com)
• Health care part of Columbus schools’ services (dispatch.com)

New Survey: 72 Percent Of Americans Think Health Care System Needs Major Overhaul; Nearly All Want More Coordinated Care, Doctors Using Health IT

New Survey: 72 Percent Of Americans Think Health Care System Needs Major Overhaul; Nearly All Want More Coordinated Care, Doctors Using Health IT

From an April 5 2011 Health Day news article

Seven of 10 adults think the U.S. health care system needs to be fundamentally changed or completely rebuilt, according to a Commonwealth Fund survey released today. The concerns reflect widespread experiences with access barriers, poorly coordinated care and growing costs. The survey also reveals strong support for more patient-centered care systems and innovative use of teams and information systems.

The new survey found that a large majority of U.S. adults have concerns about access, with 71 percent reporting problems gaining access to needed health care. These concerns included the inability to get timely doctors’ appointments or advice from their doctor on the phone, or to obtain after-hours care without going to the emergency room. Nearly half experienced poorly coordinated care (47%), and more than half reported wasteful (54%) care. In addition, one in five reported they or a family member ended up with an infection or complication as a result of medical care, or said that a health care provider made a surgical or medical mistake. When asked about the future, three quarters of people surveyed (74 %) are worried they won’t get high quality care when they need it, or that they won’t be able to afford their medical bills if they become seriously ill……

Related Articles

• Poll on health care law: 52% in Calif. optimistic (sfgate.com)
• Breaking Down Health Care Costs (socyberty.com)

• High Health Care Costs Deterring Parents — Regardless of Income and Health Insurance Status — From Taking Children to the Doctor in U.S. (Science Daily, 2 May 2011)

• Prescriptions: Kaiser Permanent Opens Clinic in Washington (prescriptions.blogs.nytimes.com)
• The Coming Doctor Shortage (benzinga.com)

AHRQ Director Helps Consumers Navigate the Health Care System in a New Advice Column on the Web

AHRQ Director Helps Consumers Navigate the Health Care System in a New Advice Column on the Web

AHRQ Director Carolyn M. Clancy, M.D., offers advice to consumers in new, brief, easy-to-understand columns.  The columns will help consumers better navigate the health care system.  Select to read Dr. Clancy’s advice column on heart health.

Survey finds health-care reform bad for patients, worse for doctors

Survey finds health-care reform bad for patients, worse for doctors

Nearly 3000 doctors surveyed believe the Patient Protection and Affordable Care Act will hurt care quality and doctor pay

From a January 18 Eureka Health news item

he newly released 2011 Thomson Reuters – HCPlexus National Physicians Survey (NPS) links doctors’ fears that their pay will go down under the Patient Protection and Affordable Care Act (PPACA), commonly called Healthcare Reform Act (HCRA), with their concerns that the quality of care will also deteriorate. The study includes responses from 2,958 doctors of varying specialties and practice types, from all 50 states plus the District of Columbia.

The NPS is the most comprehensive survey of physicians surrounding their thoughts on the future of healthcare, including ideas on the PPACA, Electronic Medical Records (EMR), and Accountable Care Organizations (ACO).

Lower Pay Means Lower Quality Care

The NPS data show doctors’ fear that the quality of care will deteriorate under PPACA and that their reimbursements (pay) will go down as well. When asked about the quality of healthcare in the U.S. over the next five years, 65 percent of the doctors believed it would deteriorate with only 18 percent predicting it would improve. Interestingly, consumer perception is far more optimistic, with close to 30 percent of consumers believing care will improve under PPACA.

When asked who would treat the 32 million Americans receiving healthcare under PPACA, 55% suggested a Nurse Practitioner or Physician Assistant would administer care.

“It is likely that with increased demand for general surgeons, rising overhead costs and decreasing reimbursement, there will be many of us simply retiring or finding other opportunities rather than accept the risks of surgical practice and below minimum wage benefits,” said a surgeon from Arizona.

Patient Impact Shows Slightly More Positive Outlook

But when it comes to patients, doctors have a slightly different view. When asked about the impact of reform on patients, only 58 percent were negative with 27 percent saying reform would be positive. They also believe that PCPs and NP’s will end up treating most patients.

“I believe that specialists feel that the PCP’s will allocate the majority of their time to the patients with commercial insurance or sources that have higher re-imbursements and leave the lower level payers for their PA’s and Nurse Practitioners to manage the majority of the time. These patients also have a history of being less likely to take an active role in their own care and have more ‘self inflicted problems,’ i.e. smoking, obesity, etc,” responded an Illinois-based orthopedic surgeon.

“It is clear that many physicians feel strongly that the proposed future state is counter to what they believe is the best way to serve patients,” said Raymond Fabius, MD, Chief Medical Officer at Thomson Reuters. “As practicing physicians are genuinely concerned for the health of their patients and their ability to serve them, any sustainable efforts to reform health care delivery would benefit from their inclusion and support.”

During the next 5 years, the quality of health care in this country will improve (18%) stay same (17%) deteriorate (65%)

The Affordable Care Act will result in physician reimbursement becoming more fair (9%) neither fair nor unfair (17%) less fair (74%)

Overall, the impact of the Affordable Care Act for patients will be positive (27%) neutral (15%) negative (57%)

Overall, the impact of the Affordable Care Act for physicians will be positive (8%) neutral (14%) negative (78%)

“The National Physicians Survey tells us that physicians have not been enlisted in the healthcare reform process,” said David L. Shrier, CEO of HCPlexus. Shrier continued, “The message they’ve taken from healthcare reform appears to be ‘Do more with less’. Doctors are telling us they feel disenfranchised and overburdened. In order for healthcare reform to succeed, physicians need to be engaged in dialog, and need to be communicated the benefits of the PPACA as part of a continuous messaging campaign.”

In addition to the broad answers, the survey data includes breakdowns of responses in different specialty areas, including those in primary care (such as internal medicine, Ob-GYN and pediatrics), medical specialties (including cardiology, dermatology and psychiatry), and surgical specialties. The data also includes breakdowns by group practice size. A complete copy of the survey can be accessed through the HCPlexus website at http://www.HCPlexus.com/survey.

 

 

 

Trust for America’s Health

Trust for America’s Health is a “non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority”.”By focusing on PREVENTION, PROTECTION, and COMMUNITIES, TFAH is leading the fight to make disease prevention a national priority, from Capitol Hill to Main Street. We know what works. Now we need to build the resolve to get it done.”

Trust for America’s Health includes the following

• How Healthy Is Your State? (home page link) where you can select a state from the drop-down menu. Statistics include adult health indicators (as cancer and asthma), child and adolescent health facts (as pre-term labor), obesity and diabetes rates, and program spending
  
• Current Report topics include the flu, liver diseases, preventative health care, how public dollars are spent on health care, and keeping America’s food supply safe
• Advice is given on Advocacy issues, including writing representatives and joining grassroot organizations
• The Resource Library provides links to organization and other Web sites in topics as Health Reform Legislation, Health Disparities, Environmental Health, and Food Safety

18.3 million baby boomers could benefit from the Affordable Care Act

18.3 million baby boomers could benefit from the Affordable Care Act

Affordable health insurance, comprehensive benefits and stronger financial protections will be available to 8.6 million currently uninsured adults ages 50 to 64, and 9.7 million who have inadequate health insurance

From the press release

December 14, 2010, New York, NY—18.3 million men and women ages 50 to 64 stand to benefit from provisions in the Affordable Care Act that expand access to affordable health insurance, assure that all health insurance provides a standard comprehensive benefit, prevent insurers from denying coverage or charging higher premiums to people with pre-existing conditions, and eliminate lifetime and annual limits in health insurance policies, according to a new Commonwealth Fund report released today.

Adults ages 50-64 are currently suffering the highest rates of longtime unemployment among working-age adults, and millions are without health benefits. Of the 8.6 million currently uninsured in this age group—4.3 million men and 4.2 million women—3.3 million with incomes under $29,000 for a family of four will gain Medicaid coverage, 3.5 million with incomes up to $88,000 for a family of four will be able to gain subsidized private coverage through the new health insurance exchanges, and 1.4 million with higher incomes will gain new coverage with consumer protections.

In addition, an estimated 9.7 million older adults who have health insurance but have such high out-of-pocket costs relative to their income that they are effectively underinsured, will gain improved coverage through the implementation of essential benefit standards, limits on out-of-pocket spending, and elimination of lifetime benefit limits.

Uninsured adults in this age group face serious difficulty with access to needed care: three-quarters (75 %) report forgoing needed health care and medications because of costs and nearly half (46%) report not getting recommended preventive care. More than half of uninsured women in this age group had not had a mammogram within the past two years. Nearly 70 percent of uninsured and underinsured baby boomers report that they have problems paying medical bills or are paying off medical debt.

“A loss of employer health benefits can be devastating to men and women in this age group since their older age and higher rates of chronic health problems places them at risk of facing exorbitant premiums, having a condition excluded from their coverage, or being denied insurance altogether if they try to buy it on their own,” said Commonwealth Fund Vice President Sara Collins, lead author of the report. “The Affordable Care Act will change all of that. Once its provisions are in full effect, older adults who lose their employer health insurance will have access to affordable and comprehensive health benefits regardless of their age or health.”…..

…

Additional Benefits for Baby Boomers in the Affordable Care Act

The Affordable Care Act includes many additional features that will improve health insurance coverage for adults ages 50 to 64:

• Beginning in 2010, adults in this age group with chronic health problems who have been uninsured for more than six months can join new plans for people with pre-existing conditions.
• A ban on lifetime limits on insurance benefits beginning in 2010 will help an estimated 102 million people who currently have these limits on their plans; older adults are at greater risk than younger adults of exceeding their limits and being saddled with a crushing debt load as a result.
• Requiring coverage of preventive care and immunizations without cost-sharing will assure access to services such as mammograms and colorectal cancer screenings for baby boomers beginning in 2010.
• Requiring health plans to insure all who apply, preventing health plans from charging higher premiums to sicker people, and limiting how much premiums can rise by age will remove many of the barriers baby boomers face when they have to buy coverage on their own beginning in 2014.

Two lesser-known ACA provisions will also provide significant benefits to baby boomers, the report finds:

• The Early Retiree Health Benefits Reinsurance Program for Employers helps public and private sector employers pay for health benefits for employees who retire before age 65. This $5 billion temporary program has already enrolled 3,600 employers and will run through 2014, when people who retire before age 65 will be eligible to purchase health insurance through the new insurance exchanges.
• The Community Living Assistance Services and Supports (CLASS) Program will provide employers and their workers as well as self-employed individuals the option of participating in a national long-term care insurance program aimed at providing better access to affordable long-term care insurance.

###

This report is part of a series of Fund issue briefs that examines the way the Affordable Care Act of 2010 will benefit different populations and groups, as well as improve insurance coverage and change the delivery of care. For more information, please visit: http://www.commonwealthfund.org/Content/Publications/Issue-Briefs/2010/Sep/A-New-Series-of-Briefs-on-the-Affordable-Care-Act.aspx

Related Articles

• In Its First Year, The Affordable Care Act Has Brought Health Care Benefits To Millions Of Americans (medicalnewstoday.com)
• Commonwealth Fund: Unemployment has made another 9 million uninsured (dailykos.com)
• Survey: Nine Million More Americans Added to Ranks of Uninsured in Recession (crooksandliars.com)
• The Affordable Care Act’s First Year: A Few Disappointments, Lots of Progress [The Pump Handle] (scienceblogs.com)
• “Who Will Be Uninsured After Health Insurance Reform?” and related posts (healthcare-now.org)
• Nearly 4 Million Medicare Beneficiaries Receive Help with Prescription Drug Cost under Affordable Care Act
• Health reform essential to young adults: Nearly half can’t afford needed health care (eurekalert.org)
• The Affordable Care Act is Working (economistsview.typepad.com)
• Affordable Care Act Helps Fight Unreasonable Health Insurance Premium Increases (medicalnewstoday.com)

How Will The Affordable Care Act Affect 15 Million Uninsured Young Adults?

From the Commonwealth news release

New York, NY, October 8, 2010—Young adults continue to represent one of the largest groups of Americans without health insurance, with nearly 15 million people aged 19-29 uninsured in 2009—an increase of more than 1 million over 2008, according to a Commonwealth Fund report released today. However, the Affordable Care Act (ACA) is poised to make a significant difference for this population, as up to 12.1 million could gain subsidized insurance once all of the law’s provisions go into effect in 2014

The report, Realizing Health Reform’s Potential: Young Adults and the Affordable Care Act of 2010, by Commonwealth Fund researchers Sara Collins and Jennifer Nicholson, is an update of a May 2010 report, with new numbers reflecting the latest data on the number of uninsured Americans released by the U.S. Census Bureau last month.

According to the report, by 2014, when most of the bill’s provisions will have taken effect, up to 7.2 million uninsured young adults will gain coverage through Medicaid expansions and up to 4.9 million will gain subsidized private coverage through new insurance exchanges. About 1 million uninsured young adults up to age 26 are projected to join their parents’ policies beginning in 2010. The report estimates that 1.8 million uninsured young adults are not legal residents and will not be eligible for federally subsidized health insurance under the new law.

The authors conclude that, “when fully implemented, the ACA will allow young adults of all income levels to undergo a new rite of passage: establishing necessary ties with the health care system, without fear of accumulating medical debt, as they pursue their educational and career goals.”

This report is the fourth in an ongoing series of Commonwealth Fund reports designed to explain how health reform will affect various groups. More on this series, as well as access to the Fund’s new Health Reform Resource Center, can be found atwww.commonwealthfund.org.

 

 

Health Care Reform Law – Informational Web Sites

From recent postings at Medlib-L, a discussion list for medical librarians about informational sources for the Patient Protection and Affordable Health Care Act (the Health Care Reform Law)

• HealthReform Source (The Henry J. Kaiser Family Foundation) with links in the areas of Basics, Research and Analyis, Public Opinion, The States (implementation and news), and Topics (as Employers, Health Care Costs, Long-term Care, and Uninsured.

• Health Insurance (MedlinePlus, published by US National Institutes of Health)
  Links to health care reform Web sites include

• Questions and Answers about Health Insurance: A Consumer Guide(Agency for Healthcare Research and Quality)
• Experts Assess Impact of Health Reform on Mental Health Coverage(11/01/2010, American Psychiatric Association) – PDF
• Affordable Care Act’s Early Retiree Reinsurance Program(Dept. of Health and Human Services)
• Frequently Asked Questions about the Health Insurance Portability and Accountability Act (HIPAA) Nondiscrimination Requirements(Dept. of Labor)

Take health care into your own hands

• Healthcare.gov (US Department of Health and Human Services)
  Topics include : Find Insurance Options,  Learn About Prevention, Compare Care Quality, andUnderstand the New Law

• Meaningful Use, Certification Criteria and Standards, and HHS Certification Process (Healthcare Information and Management Systems Society)

• Health Reform Center (US Centers for Medicare and Medicaid Services)
• User’s Guide to Health Care Refrom (AARP)
• Health Care Reform: An Introduction (April 14, 2009, US Congressional Research Service)
  Covers concerns (coverage, cost/spending, and quality) and likely legislative issues)
• Health Reform: An Online Guide (Last updated May 2010 Slate)
  “Links to everything you need to know about the Patient Protection and Affordable Care Act of 2010.”
• Health Care (US White House)
• Healthcare Napkins All (A slideshare presentation by Dan Roan)

Web sites I discovered through my parish’s Pax Christi meetings

Faithful Reform (http://www.faithfulreform.org/) with an email sign up…and easily found links to…

• “A Daily Dose of Truth” [currently 9 items, including the titles Medicare in Health Care Reform, The Requirement to Buy Insurance,The “R” word (Rationing), Small Business]

• Resources [currently includes items as  A Moral Vision for our Health Care Future, Power Point presentation: The Heart in Health Care Reform ]

Herndon Alliance: Healing America’s Healthcare (http://herndonalliance.org/) with an email sign up…and the tabs (links)

• The Resources tab includes talking point suggestions that can be used in discussions with others as well as mass communication and writing to representatives

• The Newsletter tab includes links to past Messages of the Week
  

A few journal/magazine articles (from Medlib-L postings)

• Beyond Repeal — The Future of Health Care Reform (New England Journal of Medicine Perspective Article)
• Health Care Reform (NY Times Topic page, updated Nov 3, 2010)
• A Primer on the Details of Health Care Reform (NY Times, August 9, 2009)
• Health Affairs articles*** (requires paid subscription) include: Fact vs Fiction [August 20, 2009] , Moving Forward with Health Care Reform [June 2010 feature issue] , and Key Issues in Health Reform (a Health policy issues brief)
• Finish the Treatment (April 11, 2010,The New Republic)
• Health Care Reform Bill 101 (March 22, 2010,Christian Science Monitor)
• Seven Falsehoods about Healthcare Reform (August 14, 2009, Newsweek)
• Pharmacists and Health Reform: Go for It! (Pharmacotherapy 2010; 30(10) : 967-972)

** For suggestions on how to get free/low cost medical articles, go to How to obtain free/low cost medical articles in medical and scientific journals