Essays, poems and Stories of an African-American

Saturday, 9 July 2016

All competition is good even in healthcare delivery. Or is it? From a Public Health Perspective

The Business Dictionary defines competition from an economics point of view as: rivalry in which every seller tries to get what other sellers are seeking at the same time: sales, profit, and market share by offering the best practicable combination of price, quality, and service. Where the market information flows freely, competition plays a regulatory function in balancing demand and supply.

The Merriam-Webster's Learner's Dictionary gives what it calls a simple Definition of competition: the act or process of trying to get or win something (such as a prize or a higher level of success) that someone else is also trying to get or win : the act or process of competing; actions that are done by people, companies, etc., that are competing against each other. The competition: a person or group that you are trying to succeed against : a person or group that you are competing with.

I would use the terms access, quality and price more instead of competition as far as public health and medicine go. Why? Because public health and medicine as services are different for  each individual. Public health is a science of protecting and improving the health of families and communities through promotion of healthy lifestyles, research for disease and injury prevention and detection and control of infectious diseases. Overall, public health is concerned with protecting the health of entire populations. According to CDC. Public health is about protecting the safety and improving the health of communities through education, policy making and research for disease and injury prevention.

fee-for-service.Source: Wikimedia


Competition. Retrieved from: Retrieved on July 9th 2016.

Simple Definition of competition. Retrieved from: Retrieved on July 9th 2016. 

What is public health. Retrieved from: Retrieved on July 9th 2016.

Barriers or quality assurance? From a Public Health Perspective

Technology, the patents surrounding breakthrough inventions and computer platforms that facilitate exchange of information have helped in the organization of healthcare delivery. The HIPAA Privacy Rule establishes national standards to protect individuals' medical records and other personal health information and applies to health plans, healthcare clearinghouses, and those health care providers that conduct certain health care transactions electronically.

The HIPAA Security Rule establishes national standards to protect individuals’ electronic personal health information that is created, received, used, or maintained by a covered entity. The Security Rule requires appropriate administrative, physical and technical safeguards to ensure the confidentiality, integrity, and security of electronic protected health information. key elements of the Security Rule including who is covered, what information is protected, and what safeguards must be in place to ensure appropriate protection of electronic protected health information. 

The Security Rule, provides room for interfacing providers to negotiate measures that separate tradecraft  secrets from providing quality care to a given patient.

EMR/EHR. Source: Wikimedia


Summary of the HIPAA Security Rule. Retrieved from: Retrieved on July 9th 2016.

The Security Rule. Retrieved from: Retrieved on July 2016. 

Access, Care, Costs, Quality outcome-focused performance measures promote accountability; From a Public Health Perspective

I was tasked to reconcile the heavy load of health mobilization and promotion that I engage in with an inventory that can be used to measure performance. I want to see the clients I help go to hospitals smile again or I want to hear them talk about a plan to continue seeking professional health care.

The U.S. health care system today seeks to address broad themes such as: access, quality and affordability. Approximately 46 million Americans are uninsured, many who are insured face rapid increases in premiums and out-of-pocket costs. Congress and the Obama administration are seeking ways to invest new funds to reduce the number of Americans without insurance coverage. 

However, with price discrimination there is need to simultaneously address shortfalls in the quality and efficiency of care that lead to higher costs and to poor health outcomes. To do otherwise casts doubt on the feasibility and sustainability of coverage expansions and also ensures that our current health care system will continue to have large gaps — even for those with access to insurance coverage. 

Preventive care is underutilized, resulting in higher spending on complex, advanced diseases. Patients with chronic diseases such as hypertension, heart disease, and diabetes all too often do not receive proven and effective treatments such as drug therapies or self-management services to help them more effectively manage their conditions. There are variations in hospital inpatient lengths of stay, visits to specialists, procedures and testing, and costs — not only by different geographic areas of the United States, but also from hospital to hospital in the same town. Many patients often do not receive medically necessary care, others receive care that may be unnecessary, or even harmful. 

Encouraging efforts at the state and regional levels to enable public and private payers, including Medicaid and Medicare, to participate in private-public initiatives is aimed at using better, outcome-focused performance measures to support payment and benefit reforms that promote accountability for greater value.

patient care. Source: Wikimedia

Access to Health Services. Retrieved from: Retrieved on July 9th 2016.

Drug Registration and Listing System (DRLS & eDRLS). Retrieved from: Retrieved on July 9th 2016. 

Jonathan Blum. 2011. Improving Quality, Lowering Costs: The Role of Health Care Delivery System; Committee on Homeland Health, Education, Labor and Pensions United States Senate. Retrieved from: Retrieved on July 9th 2016. 

Measuring Health Care Quality:An Overview of Quality Measures. 2014. Retrieved from: Retrieved on July 9th 2016.

Niall Brennan, Nicole Cafarella, S. Lawrence Kocot, Aaron McKethan, Marisa Morrison, Nadia Nguyen, Mark Shepard & Reginald D. Williams II. 2009. Improving Quality and Value in the U.S. Health Care System. Retrieved from: Retrieved on: July 9th 2016.

Friday, 8 July 2016

Living With HIV/AIDS: Myths and Facts

You Can't Get Lifesaving Drugs Without Insurance

Myth. There are government programs, nonprofit groups, and some pharmaceutical companies that may help cover of the cost of HIV/AIDS drugs. But be aware: These drug "cocktails" can cost $20,000 a year or more. Talk to your local HIV/AIDS service organization to learn about financial help.

Lifesaving Drugs. Source: WebMD/Getty

Living With HIV/AIDS: Myths and Facts

You Can’t Avoid Other HIV-Related Infections

Myth. Due to weakened immune systems, people with HIV can be vulnerable to infections like pneumocystis pneumonia, tuberculosis, candidiasis, cytomegalovirus, and toxoplasmosis. The best way to reduce the risk is to take your HIV medications. Some infections can be prevented with drugs. You can lessen exposure to some germs by avoiding undercooked meat, litter boxes, and water that may be contaminated.

Children at play. Source: WebMD/Getty

Living With HIV/AIDS: Myths and Facts

You Can Have a Baby if You Are HIV-Positive

Fact. Infected mothers can indeed pass HIV to their babies during pregnancy or delivery. However, you can lower the risk by working with your doctor and getting the appropriate care and medication. Pregnant women with HIV can take medications to treat their infection and to help protect their babies against the virus.

Mother and child. Source: WebMD/Getty

Living With HIV/AIDS: Myths and Facts

Sex Is Safe When Both Partners Have HIV

Myth. Just because you and your partner both have HIV, doesn't mean you should forget about protection when having sex. Using a condom or other latex barrier can help protect you from other sexually transmitted diseases as well as other strains of HIV, which may be resistant to anti-HIV medication. Even if you are being treated and feel well you can still infect others.

A condom. Source: WebMD/Getty

Living With HIV/AIDS: Myths and Facts

Anyone Can Get HIV

Fact. About 50,000 people in the U.S. get HIV each year, and almost 14,000 people with AIDS die each year. Anyone can get HIV -- men, women, and children, people who are gay or straight. Men who have sex with men make up about 29,000 new HIV infections each year. Women account for about 8,000 new infections. African-Americans continue to experience the most severe burden of HIV, compared with other races and ethnicities
AIDS WALK. Source: WebMD/Getty

Living With HIV/AIDS: Myths and Facts

HIV Can Be Cured

Myth. At this time, there is no cure for HIV in most cases, but treatment can keep virus levels low and help maintain your immune system. Some drugs interfere with proteins HIV needs to copy itself; others block the virus from entering or inserting its genetic material into your immune cells. Your doctor will consider your general health, the health of your immune system, and the amount of virus in your body to decide when to start treatment.

Birthday celebration. Source: WebMD/Getty

Living With HIV/AIDS: Myths and Facts

You'll Know You Have HIV Because of Your Symptoms

Myth. Some people don't show any signs of HIV for years after being infected. Many can have some symptoms within 10 days to a few weeks after infection. These first symptoms are similar to the flu or mononucleosis and may include fever, fatigue, rash, and sore throat. They usually disappear after a few weeks and you may not have symptoms again for several years. The only way to tell you have HIV is to get tested.

Man with a cold and fever. Source: WebMD/Getty

Living With HIV/AIDS: Myths and Facts

You Have Just a Few Years to Live

Myth. The truth is that many people live for decades with HIV or AIDS and have a normal or near-normal lifespan. You can help prevent HIV from progressing to AIDS by seeing your doctor regularly and following your doctor's guidance.

Seek medical services. Source: WebMD/Getty

Living With HIV/AIDS: Myths and Facts

It's Difficult to Get HIV From Casual Contact

Fact. You can't catch or spread HIV from hugging someone, using the same towel, or sharing the same glass. It's very rare to get HIV from a blood transfusion -- the U.S. blood supply is carefully tested. However, you can spread the disease from having unprotected sex, sharing needles, or getting a tattoo from unsterilized equipment.

Couple sharing a drink. Source: WebMD/Getty

Living With HIV/AIDS: Myths and Facts (Source: WebMD)

Having HIV Means You Have AIDS

Myth. Human immunodeficiency virus (HIV) is a virus that destroys the body's CD4 immune cells, which help fight disease. With the right medications, you can have HIV for years or decades without HIV progressing to AIDS. AIDS (acquired immunodeficiency syndrome) is diagnosed when you have HIV as well as certain opportunistic infections or your CD4 cell count drops below 200.

Inside a blood vessel. Source: WebMD/Getty

Monday, 4 July 2016

Happy 4th of July; The meaning of independence to an African-born immigrant living in USA.

I stay in one of the most diverse neighborhoods of San Francisco and for the past two weeks I have witnessed activities pointing towards a celebratory mood of the people. Two weeks ago, I got to be reminded of the 4th of July by flying pennants and banners at homes, corner stores and an occasional person with a flag draped over the upper body part. People were preparing themselves for the fourth.

Fast forward, on this day, I happened to take a long stroll around my neighborhood. A barbecue here, popping fireworks there,  more excitement, people wishing each other "happy fourth," more happy fourths exchanged and more merriment to boot.  

The ability for neighborhoods to be venues for celebrating independence and for homes to take charge and be able to conduct homemade events in regard to the fourth reminded me of a contrast between USA and Uganda. I am a Ugandan-born American and have seen both worlds of what it means to celebrate independence.

Happy 4th of July (USA)

Happy October 9th (Uganda)

In Uganda, where I was born, I realized independence celebrations remain the reserve of the government in power.  The mentality of a leader-prophet who knows it all is pervasive.  The government sponsors an event and only invitees attend. Security check points are a must. The opposition is not invited or if invited it is the moderate ones who restrain themselves from making any comment against the sitting government in public. Thus, the celebrations become a platform to list the achievements reached and an opportunity to lump the opposition into refuse destined for disposal. Aggrandizement takes centre stage. The opposition which is never invited also holds 'shadow' celebrations and castigates the sitting government in a manner laced with wistful remarks. The communities have long since done away with burning car-tyres amidst road junctions. The government had to do a lot of messages and police had to apprehend culprits until people changed.

In USA, the communities are allowed to take charge. Independence is so many things. It is the barbecue, the fireworks, the events at community and national level. Most of all it is symbolized by the turkey. Independence is like a meal served at table. Food is so central to independence in USA. In fact, it is said the first fourth of July is when Native Americans shared the little food they had kept to take them through the harsh winters with the pioneers who founded present day USA. The tradition has been kept and that is how it is handed down the subsequent generations. 

As I write this popping sounds and blinding light threaten to shutter ears and blind eyes. I see people moving back and forth happily sharing experiences. Independence is yet another opportunity to bind the Americans together. For me, it is a chance to witness belief in ownership of destiny and autonomy from individual to national levels.