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Swallowing difficulties are complications in many diseases and conditions and are a recognized potential problem in the elderly, especially those with Parkinsons disease. Health care providers must be aware of these dangers of choking, learn methods to minimize them, and be prepared to intervene when choking occurs, regardless of the setting.
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Home care providers and patients remain concerned about the decisions that managed care organizations (MCOs) and other payers make about whether to pay for care.
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At the end of 2003, there was a flurry of reports on the problems of those without health insurance coverage for all or part of each year and what to do about them. The upcoming presidential campaign keeps the issue alive. Here is a summary of the reports and analyses that are likely to be the foundation for any policy changes.
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A literature review, state survey, and expert meeting to look at the design and operation of Medicaid buy-in programs as a way to cover the uninsured have found that such programs have increased in both number and enrollment in recent years, and states have demonstrated that they can design and implement participant buy-in programs using existing waiver mechanisms.
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Often considered a bellwether state in health policy, California is demonstrating the extent of the problem of lack of health insurance, but it also will be seeing how one possible solution could work.
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One of the possible solutions to the nations problem with lack of health insurance coverage for all is a pay-or-play program that puts the burden on employers to provide employees with health insurance or pay for insurance provided by the state. California will be implementing such a program as created in Senate Bill 2, which passed the legislature Sept. 12 and was signed by former Gov. Gray Davis Oct. 5, about six weeks before he left office.
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Twelve to 40 million uninsured Americans could receive health care coverage at an increase to total national health spending of 1.5% to 3.7%, or $23 billion to $57 billion a year, according to new analysis from the Lewin Group.
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As new information technologies continue to make person-to-person communications easier and more varied, they also are transforming the way that health care can be provided. Last month, the American Medical Associations Council on Ethical and Judicial Affairs in Chicago published two reports offering guidance on the appropriate use of e-mail and health-related on-line sites.
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In an action that may have national repercussions, voters in Washington state have rescinded the only preventive ergonomics rule in the country.
