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Public Health Can Reframe Debate about Minority Healthcare

Minorities get less adequate care, participants learn at Oregon Public Health Association conference.

Jan Johnson, for the Lund Report, 10-23-14

Minorities in the U.S. get less and less adequate care than non-minorities Margarita Alegria, director of the Center for Multicultural Mental Health Research and a professor at Harvard Medical School, told the Oregon Public Health Association’s annual conference.  To address the problem, public health needs to re-frame the debate.

“We’ve concentrated on race and ethnicity too long,” said Alegria.  “I think it has to do more with being a minority and how people react to you as ‘the other’.”

She cited research on patient and clinician interaction that shows “who saw you mattered on what diagnosis you got,” adding that bias happened both ways.  Patients thought providers earned more than they do.


Oregon Mess: Subsidies Key Defect In Obamacare

Op-Ed by Paul F. deLespinasse, Ph.D.,
Submitted to the Corvallis Gazette-Times Oct. 17, 2014

Two medical stories are headlined in recent  newspapers.  One is local,  but with national implications.  The other is national,  but with local implications.  A common denominator lies beneath both stories.

In Oregon,  more than ten thousand people got inflated tax credits when buying insurance through the exchange set up under Obamacare.  The excess credits may exceed $100 per month, so some people will have to pay substantial amounts back to the federal government.  

The national news is the death of Thomas Duncan from Ebola and the infection of several people who treated him.   Duncan was sent home, when he first visited a  hospital’s emergency room, despite highly suspicious symptoms.  After giving conflicting answers to embarrassing questions raised by this situation, the hospital has hired a public relations firm and allegedly has prohibited staff members from talking to the press. 


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We Are All Underinsured

The Many Faces of UnderInsurance
by davidgimlett Retired Family Physician and advocate of health care reform (not dated)
For The Health Care Reform Blog

As the Affordable Care Act (ACA) kicks in we are moving into an era where a larger and larger percentage of our population will be unable to afford medical care and we will see an increase in an already high number of medically preventable illnesses and deaths and medically related personal bankruptcies. This will result from lack of control over medical inflation and a tidal shift of medical insurance policies into a lethal pattern of underinsurance. The ACA is predicted to decrease the number of uninsured Americans to about 30 million. (1)  Lack of medical insurance leads to at least 55,000 unnecessary deaths a year in the United States. But inadequate medical insurance also takes its toll and it is likely that this problem will worsen dramatically over the next few years in response to the ACA.

 Definitions of Underinsurance
By the common definition, individuals are considered underinsured if their out-of-pocket expenses are more than 10 percent of their income  (5 percent if they were low-income) or deductibles are more than 5 percent. By current definitions 44 percent (81 million) of adults ages 19–64 were either uninsured or underinsured in 2010. 29 million of these adults were underinsured.


Turnaround pro Hamstreet reflects on Cover Oregon woes and solutions

Elizabeth Hayes
Staff Reporter- Portland Business Journal, Oct 14, 2014

Clyde Hamstreet, the business turnaround artist who took the helm of Cover Oregon last spring as the health exchange was sputtering, gives a detailed assessment of its "technology fiasco" and other problems, along with suggested solutions, in a memo released today.

Hamstreet stepped aside in late July, after the new executive director, Aaron Patnode, took over. He prepared his final overview and recommendations on Aug. 29.

“When my team arrived at Cover Oregon in April the organization was in serious disarray,” Hamstreet wrote. “Rarely, if ever, in my experience as a turnaround professional have I encountered so dysfunctional a leadership and management situation. Several executives and managers held positions they did not have the experience or ability to handle and were, consequently, failing.”


Cover Oregon told top consultant, Clyde Hamstreet, to not submit a written report

by Nick Budnick
OregonLive, October 10, 2014, updated October 11, 2014

A consultant's long-awaited report on the state's health insurance exchange was considered so sensitive that Cover Oregon officials asked him not to turn it in, The Oregonian has learned.

The story becomes yet another example of the secrecy that has often cloaked the troubled exchange due to high legal and political stakes.

Gov. John Kitzhaber recruited high-profile business consultant Clyde Hamstreet to take the reins of Cover Oregon last April, at the height of the health care exchange's chaotic technological failure.

Hamstreet's firm left the project in September after getting paid more than $600,000. But documents and interviews show that officials asked him not to deliver the written report he was contractually bound to produce, apparently thinking it would then remain a secret.

The firm's final report could provide valuable insight because Hamstreet, the corporate turnaround expert who heads the firm, served as interim director of the exchange during a crucial time, when the decision was made to shelve the project and move to the federal exchange instead.