Today, the Senate is debating a big healthcare bill. It will fundamentally restructure the way we pay doctors and hospitals to reward better quality care and help reduce the overall cost of healthcare.
Rherst made an awesome post with just three of Health Care For All’s amendments. Read it!
But, there are about 265 amendments to this massive legislation. So, I imagine that a few folks might be having trouble remembering which amendments to support.
Health Care For All has two posts up here and here which can be guides for those tracking amendments to the Senate bill. But that’s a lot of text.
So, I’ve come up with just a few handy images that might help. If you’ve got suggestions, I’d love to hear them in the comments!
We support a strong public health and prevention trust. It’s a way to get funding for community based public health programs. Amendment 30 from Senator Chandler doesn’t let the Prevention Trust Fund expire after 5 years.
Amendment 9 from Senator Chang-Diaz adds several important provisions to requirements for ACOs, including patient confidence measures, cultural competence, use of community health workers, and support for chronic disease self-management.
Amendment 134 by Senator Creem allows patients to choose their providers within a health plan. We want to make sure that patient choice of providers is not limited.
We want to reward better quality of care. Amendment 45 from Senator Montigny encourages ACOs to reward providers who achieve good outcomes, like reducing potentially avoidable admissions, readmissions, or complications.
Got more ideas about how to spice up that amendment list? Let me know in the comments!
UPDATE: This idea submitted via email:
very cool. Thanks Ari.
…what is “cultural competence” in this context? Does a patient’s cultural background make a difference in how he is treated? Doesn’t seem like it should.
“Cultural competence” is, at best, a silly term, but a patient’s racial background does affect his or her treatment.
The Globe gives a good summary here.
The culturally competent health care that Senator Chang-Diaz seeks to encourage is totally different from the issues of racial discrimination reported by the Globe and cited here.
It doesn’t sound like Christopher has spent much time in non-English cultures. When someone is sick and scared, or when someone’s children or loved ones are threatened by illness or in need of care, something as simple as being able to speak in your native tongue and be understood — or having those scary and unfamiliar concepts explained in your native tongue — is surely natural and understandable.
In some cultures, looking someone in the eye while speaking displays an insulting lack or respect. In white American culture, not looking in the eye while speaking is understood as distrust or dishonesty. Differences in culture are real and should be respected by health care providers.
I was thinking of racial discrimination in healthcare.
Senator Fargo had an amendment to “copycat” the ~20 cities and towns [representing ~20% of the MA population] which prohibit all health care institutions, including pharmacies, from selling tobacco products. It’s unethical to profit on tobacco, then profit on the COPD and other illnesses it causes. In the mean time, if Charlie prompts me enough, maybe I’ll do a diary this summer, hoping that some of you other do-gooders push your own city or town to implement the same restrictions.
…because I think we all agree that treating people less than equally is wrong. It sounds like what is being called for is a cultural consciousness that runs counter to my inclinations to see everyone as essentially the same and treat them accordingly. Maybe it makes sense to have some basic cultural understanding and certainly knowing another language never hurt, but I find myself reacting similarly to when I hear the way to correct racial profiling by cops who make traffic stops is requiring that they note the person’s race. If I were a cop I’d think, “I try so hard (pretty successfully if I do say so myself) to be colorblind, and now you WANT me to make it a point to observe the person’s race?”
Christopher, I think you might find this video helpful. It’s the story of Steve, who worked with a community health worker to manage his diabetes. At 2:25, Steve talks about how he is used to eating lots of rice because that is important in his culture. But eating a lot of rice was not healthy for his diet. And so, he needed to change the way he eats but that message has to get through in a culturally competent way.
http://youtu.be/0JD5GLmThK4
This video also helps highlight some of the benefits of community health workers in coordinating care, which is also what amendment 9 is all about.
[For some reason I couldn’t get the video to embed. Apologies!]
The way I embed videos is to first copy and paste the “embed video” html, then edit away the “ tags, leaving behind just the “embed” tag.
…maybe I’m just assuming something that isn’t as obvious to some as it is to me. The video looks like an excellent example of good wellness and care practices and while Steve specifically ate a lot of rice, the basic message of portion control is universal (Lord knows I could do better in that regard myself.) so the cultural difference still doesn’t click with me. If there were a severe diabetic of a different culture wouldn’t the advice very likely be, “You have to cut way back on (insert whatever that person eats too much of here)”?