Basic Health Access

A popular video on social media lists 20 areas of improvement around the planet. It lists a 50% decrease in homeless veteran numbers. The rapid declines in Veteran homeless counts in metro areas are not necessarily a positive result. The media has a hard time understanding demographics and this makes it difficult when attempting to report on positive and negative areas. Another popular poster notes that homeless veterans need attention before refugees. The fact of the matter is that many Americans are treated like refugees - as those who do well plan ways to do even better. Their designs continue to leave most Americans behind. The relevant areas to consider for Veteran situations are not immigrants. The relevant areas are declines of veteran benefits, deteriorations involving lower income, disabled, fixed income, and less healthy populations of which Veterans are part. Most important is the consideration of available and affordable housing. Factors Regarding Veteran Homeles...

Recent meetings of family physicians brought up the age old question of expanded scope. Some raised concerns about threats to this scope. As is the usual, what is most important is the context. Where half of Americans are found, there is not a reason to be concerned about scope.    Only in highest concentration settings are family physicians limited - since all specialties other than family medicine concentrate in higher concentration settings.   The competition is less and less of a problem regarding broad scope for family physicians in lowest physician concentration counties. Few of the other specialties remain and many are in decline.    This places more burdens upon the remaining family practice workforce. This comes at a bad time as the practices require more time for documentation and there is less time for expanded scope such as hospital and procedural activities.   As discussed previously in recent blogs, the payment designs ...

Foundation, association, and government leaders keep saying that access to care is about insurance. This "access is insurance" focus has wasted the 2010 reform effort for the purpose of restoring access. Access to care requires interactions between patients and health care team members. This requires the existence of local workforce to be available for any hope of access. Access is still lower or missing for most Americans because workforce is lower or missing where most Americans reside.   Leaders immersed in concentrations could assume that access is about insurance. Their web sites and reports promote insurance as the access solution. Where health care dollars and where health care workforce are most concentrated, it is entirely possible that expansions of Medicaid improved access where a few people were able to get insurance and also could engage health workforce and the necessary transportation. But this is only because these concentrations of workforce are su...

Health care designs helped rebuild health access 1965 to 1978 via JohnsonCare. Many of the current Red Counties were blue back then but have since switched. Health care designs 1980 under ReaganCare slashed and burned health care in Red Counties as seen in hundreds of closures of small and rural practices and hospitals. Designs 1990 - 2010 have also failed for Red Counties. Health care designs under ObamaCare 2010 to 2017 were worse for Red Counties already getting the least and compromised the most. Out of the Frying Pan into the Fire Health care is only one of many frustrations for those who feel that the established designs are failing. It is likely that Lowest Concentration counties will remain most frustrated by lack of design change. Health care designs 2017 to 2021 are likely to make situations worse for Red Counties. Red and Blue Lowest Concentration Are Similar - The Red Counties are bound together by many similar environments, situations, and determinants of health. ...