Dear Friends and HAIMUSIC/HAIMUSIQUE listeners

All of us in HAIMUSIC wish you and your family a Happy New Year 2010; peace, prosperity and happiness.

Last year, you made us the third most listened Haitian radio on the Internet; thank you for standing with us in the pursued of ways to help improve the Haitian communities' social, economic and political development throughout the world. Through our community services and panoply of broadcasts aiming to inform and educate our listeners, we have gathered foreign and Haitian listeners around the world and created initiatives to improve Haiti's wildlife habitat and restore our natural resources, strengthen the operation and administration of the "Collectivités Territoriales", provide historical analysis of Haitian's politics and public administrative structures, and assist in local development projects at Guillème (Torbeck), Les-Cayes and Beaumont, etc.

This year, we count on your stewardship to continue this initiative and hope that you will invite all your friends, family members and colleagues to participate in this project by contributing to one or more of our broadcasts, field research, community services, fundraising, etc. While we are improving our technical settings and services to the community, we exhort you to continue standing by us in order to extend our services to a broader audience and to become more effective to our target populations.


Once again, we thank you for all your help and looking forward to continue working with and for you in 2010.


Best Regards,



HAIMUSIQUE
Customer Services and Public Relations
Queens, New York & Miami, Florida
516-252-9172
646-462-1339
Email: info@haimusique.com
URL: http://www.haimusique.com | http://www.haimusic.com | http://www.aux-cayes.com

Tying Federally Funded Health Care to Doctors' Orders?

Macceau Médozile
November 15th, 2009
Special thanks to prof. Madeline Jacobs, CUNY (Brooklyn College)

The West Virginia Case

United States spends more on health care than any other nation in the world, yet it ranks poorly on nearly every measure of health status (Schroeder, 2007), for the American health care system is very inefficient: high cost and poor outcomes. To address that health care issue, in 1965,United States Congress enacted Title 19 of the Social Security Act, under which, Medicare and Medicaid were created: one for the elderly (65 yrs. of age) or people of any age with kidney failure or long term disability, etc. and the other, for the “poor”. Managed by the states, Medicaid reimburses for health care services provided by hospitals and physicians to those who are unable to pay for their own medical expenses. It covers about 40% of the costs of childbirths and 60% of the costs of elderly individual health care. In 2002, The Kaiser Commission on Medicaid and the Uninsured reported that the Federal Medicaid expenditures were estimated at about $146 billion. In 2005, economists, physicians and politicians throughout the nation debated on the inefficiency of the health care system and proposed that patients be more involved in the promotion of their own health.

In 2006, the State of West Virginia required that Medicaid beneficiaries sign a Comprehensive Medicaid Redesign Proposal (CMRP) agreement, aiming to help the state to streamline the administration, tailor services to meet the needs of enrolled populations, coordinate care and provide members with opportunities and incentives to be responsible for maintaining their health and their family’s (Levine, p.260). The CMRP is supposed to be implemented through Healthy Awards Accounts (HRA) based upon a model called Consumer Directed Health (CDH) used mostly by the private sector. This model encourages health care beneficiaries to consume least expensive pharmaceutical drugs in order to help their insurance providers save money. The CMRP requires Medicaid beneficiaries to be constrained to their physicians’ expectations when it comes to addressing their unhealthy behaviors (smoking, using illegal drugs, drinking alcohol and being overweight), keeping their doctors’ appointments, annihilating their non-emergent use of emergency services and complying with “preferred drug list”. Those who sign this agreement are provided with enhanced benefits _ mental health counseling, long-term diabetes management, cardiac rehabilitation, prescription drugs, home health visit if needed and antismoking and nutrition classes (Levine, p. 258) _ but will lose them if they fail to sustain the State’s expectations. Beneficiaries who simply chose not to sign the agreement only receive the basic services required by the federal law. On the other hand, the plan raises fundamental issues of fairness, for the standard of behavior required of Medicaid participants are not required of patients with private insurance (Bishop, p. 267). When analyzing the social, economic and medical outfalls of this proposal many argue that the inability of Medicaid participants to meet the proposed standard is inherent to their socio-economic status (SES). The Medicaid population has an income below the national poverty benchmark, therefore, basic needs such as transportation (when it is not provided), healthy nutrition _ social and medical catalysts _ and
literacy can prevent the participants from keeping their doctor’s appointments and their bodyweight in proportion. This paper aims to support the idea of tying (federally) funded health care recipients to certain responsibilities towards their own health promotion.

Following a healthy lifestyle is likely to improve patients’ health status and reduce the amount of taxpayers’ money spent to cover Medicaid’s beneficiaries. When it comes to premature death, behavioral causes account for nearly 40.0% of all deaths in the country, followed by genetic predisposition (30%) and social circumstances (15%). In 2000, about 435,000 Americans (smokers) died up to 15 years earlier than non-smokers (Schroeder, 2007). The U.S. Center for Disease Control and Prevention (CDC) reported that from 2000-2004, Medicaid beneficiaries were accounted for about 30% of all smoking specific-mortality, while $35 million has been allocated yearly in educative programs targeting those specific lifestyles. Empirical studies indicated that smoking (cigarettes and illicit drugs) _ along with other unhealthy behaviors _ is correlated with low SES populations. However, since smoking is not a disease, federally funded health care participants (Medicaid, Medicare, VA Health Care program, etc.) _ idem for all other SES patients _ should be self committed to eradicate this costly and fatal habit. The Medicaid Patient’s Bill of Rights stipulates that patients/beneficiaries must take greater responsibility to maintain good health; this is the same goal that the West Virginia’s CMRP entailed to pursue. It is unfortunate that about 15.5 million smoking-related premature deaths (Shroeder, 2007) could be prevented if only federally funded health insurances rules (private and/or employers’ based heath care as well) along with state and federal regulations were more stringent.

In a study on national cost attributed to overweight and obesity, Finkeslstein et al (2003) reported that in 2002, $92.6 billion were spent in medical expenses in United States, from which, about $38.0 billion were covered by Medicaid and Medicare. The state-level estimated cost from 1998 to 2000 ranged from $87.0 million (Wyoming) to $3.5 million (New York). In 2004, Buescher et al conducted a study among enrolled Medicaid adolescents in North Carolina to examine
patterns of expenditure for medical care and the use of medical care services. The investigators reported that at-risk-for-overweight adolescents group had medical expenditures that were 33.0% higher than those of the normal-weight group. A significantly higher percentage of overweight adolescents had claims for diabetes, asthma and other respiratory conditions. The study concluded by affirming that overweight adolescents and those who are at-risk-for-overweight
had higher average Medicaid expenditures than did normal-weight adolescents. According to the U.S. Department of Health and Human Services (HHS), the percentage of overweight young people has more that triple since 1980. In addition to psychological and social issues of stigmatization, those adolescents are at far greater risks to developing cardiovascular diseases, type 2 diabetes and several other diseases that may likely contribute to reducing their length and
quality of lives (HHS, 2002 report).

On the other hand, Data from a cohort study on coronary heart disease and changes in diet and lifestyle in a population of 85,941 women (34-59 yrs. of age) suggest that a reduction in smoking, a change in diet (et al) can generate a decline in the incidence of coronary diseases.
For 14 years, Dr Hu et al (2009) documented 1,304 newly diagnose cases of coronary heart diseases and observed, over time, an overall decline in the incidence of myocardial infarction and other coronary diseases in those who adopted a change of comportment in their diet and other lifestyles. Many other studies have indicated a relationship between health status improvement and cessation of smoking cigarettes, dieting, exercising and suggest that lifestyle
changes can reduce health care cost in the U.S.

Improving, proportionally, the health status of the U.S. population is a challenge to all health care stakeholders. However, controlling the health indicators related to unhealthy behaviors should be the primary responsibility of all patients and everybody. Although the amount of federal dollars spent to provide health care services to the needy ones is disparately distributed, but all federally, employer-based, non-profit funded health care beneficiaries should be held accountable for improving their own health status. The State of West Virginia’s CMRP not only sought to reduce its spending but also wanted to promote patients’ self-responsibility by offering them medical incentives so they can meet and sustain the program’s expectations. It is obvious though that health status improvement is correlated with SES improvement. Thus, adopting a healthy lifestyle suggests that those families of three who are making $6,142 per year (in West Virginia) should be provided with more education and skills (along with transportation, more nutritive WIC food, among others) to sustain the CMRP’s requirements. Unhealthy behaviors are not immutable; the ban of cigarettes smoking in public buildings, restaurants and bars in many cities and states, proves how regulations can be used to change people’s lifestyles: the wearing of seat belt (Motor Vehicles) regulations of 1993 is a great example. All funded health care beneficiaries should be constrained to stop smoking cigarettes (and other illicit drugs), to reduce their alcohol consumption, exercise and control their BMI (as much as they can), check with their primary physicians prior to landing into an emergency room for “non-emergent” needs, etc. Improving the U.S. population entails also the enhancement of the workforce
productivity, “the boost of the national economy, the reduction of healthcare expenditures, and most importantly, the improvement of people’s live (Schroeder, 2007).



Levine, Carole. Taking Sides: Clashing Views on Bioethical Issues. 12th ed., McGraw Hill,2008. pp. 258-269

Schroeder, Steven. We Can Do Better – Improving the Health of the American People. The New England Journal of Medicine, 357;12. Sept. 2007

Finkelstein, EA; Fiebelkron, IC; Wang, G. National Medical Spending Attributable to Overweight and Obesity: How much and who’s Paying? Health Affairs 2003;W3;219-226

Buescher, Paul A; Whitmire, Timothy J., Plescia Marcus. Relationship Between Body Mass Index and Medical Care Expenditures for North Carolina Adolescents Enrolled in Medicaid in 2004. Preventing Chronic Disease 2008. vol. 5, No. 1. pp1 1-9.

Bishop, Gene; Brodkey, Amy C. Personal Responsibility and Physician Responsibility – West Virginia’s Medicaid Plan. NEJM;355;8;756-758 Aug. 2006

United States Department of Health and Human Services, Obesity and Adolescents. Report 2002

The Kaiser Commission on Medicaid and the Uninsured. The Medicaid Resource Book, July 2002

The Center for Disease and Prevention (CDC). MMWR, Nov 10, 2006. 55(44);1194-1197

Hu, Frank; Stampfer, Meir; Manson, JoAnn; Grodstein, Francine; Colditz, Graham; Speizer, Frank; Willet, Walter. Trends in the Incidence of Coronary Heart Disease and Changes in Diet and Lifestyle in Women. NEJM:343;8. Aug. 24, 2000

Bioethical Issues

Haimusique and Macceau Medozile invite you to brainstorm with them on important bioethical issues _ such as euthanasia, informed consent, abortion, etc. _ in order to help the Haitian community understand their medical niche and rights and provide moral and medical support to the terminally ill ones and their families. This Saturday, on DIALOGUE, we will talk about a variety of medical decision making issues (at 8 PM ET.).

Don't miss out!

HAIMUSIQUE (la radio cayenne d'outre-mer)
www.haimusique.com
www.aux-cayes.com

An Anthropology of Death

In his book "Anthropology of Death", Vincent Thomas analyzes the ethnological meanings of death as it separates one from his/her society and culture. In this context, the crossing of the Acheron becomes "a lost" of symbolism (holism) or the disturbance of established values and norms; even so, the weakening of social pylons. No ethnic group or society celebrates life's departure as a true gain individually and collectively. Because men are creators (of society) and shaped by society, it is reasonably understandable that they would choose to avoid this rigorous and funestral path as a way to sustain the anthropological equilibrium of organized life. However, being stupefied by the power of nature, the majority of human beings would prefer being trampled upon or surrendered to death (to repeat Dr. David Hawkins' terminology) .

What would be your ideal death? hey, you never know!

Improving Minrities Health Care in United States

When comparing the health of African-Americans to the Euro-Americans, there is a
relative disadvantage in terms of mortality and morbidity; many diseases have
remained the same or in some cases have increased among African-Americans
(Mullings, 1989). The history of public health in United States has been very
discriminatory. Public health interventions _ vis-à-vis African Americans _
have been modeled based upon bio-ethnicity and cultural differences. Thus, the
social context in which that population is living has always been ignored.
Despite the disproof of race-as-biology, many "scientists" continue to use
genetic variations to explain racial differences (Goodman, 2000); the syphilis
study in Macon County, Alabama is a vivid example. Socio-economic factors
appear to be powerful drivers of racial disparities in health. Lets focus on
the relationship between social inequality and health inequality as suggested by
David Williams and review some key actions that are needed to improve minority
health status in United States.

Improving the environmental factors among minorities is likely to improve their
health status. According to the National High School center, about one million
students drop out from High School every year, from which over 70.0% are
minorities. The Institute of Education Sciences reported that less than 30% of
minorities were conferred a college degree in 2003. Only 46% of African
American students and 47% of Hispanic students who enrolled in four-year
institutions in 1995-95 completed their degrees within six years in comparison
to 67% of whites and 71% of Asians (Swail, 2008). The lack of academic and
professional achievements among minorities lower their social economic status
(SES) and standard (white collar job) into the marketplace.

In April 2009, the Department of Labor reported that about 9.0% of the active
population were unemployed. The minorities (Black and Hispanic) unemployment
rate was almost three times higher than the non-Hispanic Whites. In the
construction and extraction occupations, where the majority of minorities work,
(particularly in urban environment), the rate of unemployment in April 2009 was
about 20.0% (Bureau of Labor Statistics, 2009). David Williams asserts that
"low SES male and disadvantaged racial/ethnic groups are differentially exposed
to economic marginalization and separation form the labor force". In fact, the
rate of white collar jobs among native born minorities' college graduates is
significantly lower is comparison to Asians and non-Hispanic Whites. As far as
the immigrants, Hispanics and Blacks (the Loas and Cambodians) have a higher
rate of poverty and a lower SES than non-Hispanic White born and many Asians
decent groups.

Rosenbaum (2005) suggests that racial disparities in access to health care and
outcomes appear pervasive because it affects a variety of health conditions and
health care settings. The U.S Health care system has been highly privatized and
favored discretions to entrepreneurs while marginalizing poor and minorities.
Although the civil rights movement played a major role in improving minorities'
health status, but the gap between those who can afford a decent health
insurance and the minorities who are covered under Medicaid is still wide. In
fact, even when minority patients have entered the health care system, they are
less likely to receive the same level of care than the non-Hispanic Whites
(Rosenbaum, 2005). In 2006, only 48 million Black and minorities (Hispanic,
Cambodians, Mexicans and other) had an employer-based health insurance when
comparing to 68% of non-Hispanic Whites. In contrast, for that same year, over
30 million minorities were covered by Medicaid for only 11.8 million
non-Hispanic Whites (CDC, 2007).
Health care utilization is also an ambiguous issue among minorities. Although
there are many affordable and even free health care services/programs in urban
environments, just a few Blacks, Hispanics and poor Whites take advantage of
them. David Williams suggests that language and other cultural barriers are the
major causes for lower health care utilization among minorities. Consequently,
they have the lowest life expectancy rate and the highest mortality rate in the
nation.

All policy interventions aiming to improve the health status of minority in
United States should take into account "the historical and cultural factors that
shape the experiences and living conditions of various social groups" (Williams,
2005). The implementation of programs that would increase academic achievement
among minorities along with the annihilation of racial barriers that prevent
minorities (mostly African Americans) from excelling in the market place are
likely to reduce their stress level and increase their social economic status.
More efficient health insurance policies, better health care and the improvement
of their environmental settings are also likely to shorten the health inequality
among minorities.


Literature cited:


Leigh Mullings. Inequality and African-American health Status: Policies and
Prospects. W. Van Horn ed., Madison. University Institute of Race and
Ethnicity, 1989.

Goodman Allan H. Why Genes Don't Count (for Racial Differences in Health).
American Journal of Public Health. Vol. 90, No. 11. pp. 1699-1702.

Scott Swail Watson, Redd Kenneth E. and Perna Laura W. Retaining Minority
Students in Higher Education: A framework for success. [San Francisco, CA]:
Jossey-Bass]: John Wiley & Sons, Inc., ©2004.ISSN 0884-0040

Williams David R. The Patterns and Causes of Disparity in Health. Rutgers
University Press New Brunswick, New Jersey, and London. 2005 ISBN 0–8135–3578–6

Rosenbaum Sara, Teitelbaum Joel. Addressing Racial Inequality un Health Care.
Rutgers University Press New Brunswick, New Jersey, and London. 2005 ISBN
0–8135–3578–6

The MRTG, New York.

Sexual Risk Behaviors and Drug Use Related HIV/AIDS Infection

Sexual Risk Behaviors and Drug Use Related HIV/AIDS Infection Amomg Male Adolescents in United States.

Abstract


An estimation of 33.2 million people were infected with HIV worldwide at the end of 2007, from which, 2.5 million were children under the age of 15 years old. That same year, 2.1 million people died from HIV/AIDS, from which, 300,000 were adolescents under the age of 15 years old (UNAIDS, 2007).

In United States, at the end of 2006, an estimated 1,106.400 adults and adolescents were living with HIV/AIDS infection and about 15,449 (per 100,000) of them were adolescents within 13-19 years old (CDC Facts, 2008). Among the HIV-infected population in 2006 in the U.S., 46.1% (1,715.1 per 100,000) were black, 34.6% (224.3 per 100,000) were white, 17.5% (585.3 per 100,000) were Hispanic, 1.4% (129.6 per 100,000) were Asian/Pacific Islander, and 0.4% (231.4 per 100,000) were American Indian/Alaska Native.

Men accounted for 74.8% of the prevalent cases (685.7 per 100,000) for that year. Heterosexual contact represented 27.6% of prevalent cases overall, from which 12.6% of cases among men and 72.4% of cases among women. Injection drug use (IDU) accounted for 18.5% of total cases (15.9% of cases among men and 26.3% of cases among women) (MMWR, 2006). The infection has a greater prevalence rate among African American males in all group age categories.

This paper intends to analyze the burden of sexual riskbehaviors and drug use related HIV/AIDS infection among male adolescents in United States.

A Health Plan Dilemma

Over 50 million people in United States do not have health insurance; this is not a good score for the "most powerful" country in the world. There is a conflict among private insurers, health providers and the general public vis-à-vis the idea of establishing a federal universal health care system in United States. Last month, during a health care forum, President Barack Obama proposed to offer a Medicare-like insurance plan to anyone, at any age, living in the states. Such a program would aim to cover the uninsured, give customers more choices and create some competition in the private health industry. President Obama's proposal will insinuate a reduction of prices from doctors and hospitals than private insurers are able to negotiate (Abelson, 2009).

Medicare is a self-financing system, in which workers and their employers are "required" to contribute to employees' retirement pensions during their (employees) working years and then workers establish moral claims. This has been an inherent weakness of Medicare, for any benefit increase has resulted into an increase of Medicare payroll taxes. A federal Medicare-like insurance is likely to follow the same trend, particularly when over 8% of the country's workforce is unemployed and over 50 million people are still not covered by any form of private or public health insurance plan.

Although the idea of a national health insurance seems ethically reasonable, but many doubt that the government will be able to play the duo-niche of reducing health cost and insuring the non-insured in parallel without increasing the wage taxes on all employed Americans. In 1965, the enactment of Medicare was political obtainable (Jonathon, 2006) because of its target group and the successful social security model it was based on. In this state of distress economy (that the world is facing), employment' security becomes more uncertain because of capital displacement, bankruptcy, the cost of wars (Iraq, Afghanistan) , etc.; therefore, trust fund shortfalls are (and will be) inevitable.

The Obama's idea of a health plan for all may be unlikely to insure all Americans. Without eliminating or restructuring Medicaid and many other sub-health programs throughout the country, those who are not able to contribute to the wage-tax-pool (over 24 million unemployed and a good portion of the 40 million Medicaid beneficiaries) might be left out. But the real issue is the fear of health care providers and insurers of a government's mainmise over the health care industry and the threat of not providing health care services to those who are (or will be) covered by the government plan. Historically, there has been a conflict between health care advocate/interest groups and supporters of a public plan. The American Medical Association has been concerned about physicians' ability to make money when (or if) the government uses its pricing power to regulate the cost of health services. Other health organizations fear that the government will force them out of business by establishing an unfair competitive system. However, those who support the plan believe that lower health service cost will "impose a greater disciple on insurers by forcing them to keep costs in check and make their policies affordable" (Abelson, 2009). Because of persistent trends in the health care system, the public has favored extending insurance coverage since 1993 (Skocpol, 2004).

Nevertheless, the Obama's idea of a health plan for all has not been welcomed by private health care providers and a majority of Republicans. When will ethic mean something in politics?

Literature cited:

•Reed Abelson. The New York Times: A Health Plan for all and the concerns it raises. March 25, 2009. p. C1

•Engel Jonathon. Poor People's medicine: Medicaid and American Charity Care Since 1965. Durham, NC Duke University Press, 2006

•Theda Skocpol , Patricia Seliger Keenan. Policy Challenges in Modern Health Care: Cross Pressures: The Contemporary Politics of Health Reform. New Brunswick, N.J. Rutgers University Press, 6th ed. 2004.

By: Macceau Medozile

Kozman sou anvironman: Salt Marsh

On HAIMUSIQUE, this Saturday, on Kozman sou anvironman, we identified and analyzed the ecological importance of Salt Marshes and the way climate changes will alter their functionality. As one of the most productive ecosystems on earth, salt marshes have a rich and diversified plant and other aquatic lives ecology. They help to filter grease and pesticide related waste, along with aqueous and solid wastes prior releasing them into their adjacent waterbodies. They capture sediment through a low-high tide dynamic system and cleanup substrate to establishing functional plant communities.As a result of global warming, waterbodies (primarily oceans) will raise up and displace low and high-benchmark' s tides, reduce low and mid-tide surfaces and disturb the plant communities and the physiology of this ecotype.

Our listeners, local citizens and "Collectivité s Territoriales" elected officials were advised to educate their neighbors, fellow citizens and constituents on preventive measures to help local salt marshes sustain their ecological functionality. Some of the ways mentioned during that broadcast were:

* To avoid illegal dumping (industrial, household, universal wastes) particularly, plastic and glass-based products,

* To reinforce or strengthen the plant communities by maintaining current plots and diversifying their species,

* To encourage community services and organize waterfront cleanup projects to remove floatables from the shore, etc.

The same broadcast will be aired tomorrow at 2 PM (ET).SALT MARSHES ARE VERY IMPORTANT AND SERVED AS MORBIDITY REDUCERS FOR ADJACENT HUMAN POPULATIONS.. ..Please help us spread the words!HAIMUSIQUEMMedozile

1.1 billion dollars to access health treatment & effectiveness in USA

On February 16th, Robert Pear published an article in The New York Times, in which he reported that the Obama administration will invest $ 1.1 billion dollars towards the assessment and the effectiveness of health treatment in United States (as part of the stimulus package). This money will be used to improve several types of treatments including drugs, surgeries and medical technologies; and the President will appoint a
15-member commission to suggest how to allocate the fund. Historically, medical treatment in United States has been, for the most part, ineffective and uncompetitive when comparing the country's health care cost-benefits (efficiency) with different industrialized nations in the world. For examples, although the US is the world leader in newborn intensive care, but its international standard has declined from 6th to 27th for infant mortality rate (David, 2007). The cost of health care administration in United States is over thirty times bigger that the one in Canada (Aaron, 2003). In contrast, United States is the world's leader in medical technologies, where patients have access the most diverse (offer/demand basis) health care system. According to the Harvard School of Public Health, in 1974, doctors in United States performed 2.4 million unnecessary operations (surgeries), which cost about $3.9 billion and caused 11,900 deaths (Leape, 1992). The United States government, through Medicaid, spend billions of dollars each year to cover the cost of second/additional surgeries, ineffective drug treatments, treatment for medical/health conditions related to malpractice, etc. African Americans have been stereotyped, offered inferior treatment or treatment with lack of respect (Yu, 2009) that has created conditions for health care disparities in United States. Their health treatment has been conditioned in terms of biological difference _" race"_, which widens the country's health disproportion between African-American and Euro-American. All those facts affect the quality of health care in the country. Investing $ 1.1 billion to improve health treatment in United States _ at a time where more than 10% of the country's workforce is unemployed and over 47 million people are uninsured and/or don't have access to medical care _ is a moral and civic responsibility of the government. This initiative will help reduce unnecessary or wasteful treatments if the government's appointees find ways to work effectively with medical advocate groups, insurance and health care providers (among others) to set up medical guidelines for practitioners and change/improve the country's medical paradigm. A patient doesn't have to undergo medical surgery because his/her physician either thinks that is the best way to proceed or will benefit financially from that procedure. An African American cardiac patient doesn't have to be prescribed any race-based drug (BiDil) because of his physical difference (skin color or any type of anthropometric variable), but because the active ingredients will help cure his/her disease (not the label). Patients should be referred to specialist for further tests and analyses instead of being trapped by their primary health providers and watched their cases worsened. As a way to strengthen this initiative, Congress should enact laws to eliminate those wasteful procedures. Under the United States health care system, the doctor-patient relationship has always been ambiguous. Educated patients _ who learn about their conditions and available procedures to annihilate their health issues or cure them _ have a different relationship with their physicians than those who are socio-economically disadvantaged; those who do not ask questions about their treatment possibilities, who do not ask why they have an MIR or an Echocardiogram at each visit. Since most of those patients are classified as "poor" and covered by Medicaid, a government's intervention to help them fully benefit from their doctor's appointment is more than acceptable. This is not the only way to save money on the health care system; this may not be the best way to do so _ since we know that United States spend $ 294.3 billion on health care administrative cost, while Canada spend only 9.4 billion (Aaron, 2003): reducing the US health administrative cost in half would be ideal. However, I do think this is one way to save money on the system by eliminating all the non-useful drug prescriptions, unnecessary surgeries and updating the medical technology (which can help reduce on administrative cost) to improve data entries, patients' charts, and all medical information in general, which will reduce duplication of tests and diagnoses. This will provide a duo-advantage, for the government and the patients will save some money.
Literature cited:
Lucian L. Leape. Harvard School of Public Health: Annual Reviews. 1992 13:363-83
Richard David (et al.). Disparities in Infant Mortality: What’s Genetics Got to Do With it? American Journal of Public Health. July 2007, vol. 97, No. 7 pp.1191-1197
Henry J. Aaron. The Cost of Health Care Administration in the United States and Canada. NEJM 349:8. Aug. 2003 pp. 801-803