Affordable Care Act, Education, Health Reform, Medicaid, Pennsylvania, Philadelphia, Uncategorized

Affordable Care Act (ACA) Education & Outreach

This weekend I had the opportunity to discuss the Affordable Care Act (ACA) with Pennsylvania Senator Vincent Hughes and Philadelphia Department of Behavioral Health & Intellectual disABILITY Services Commissioner Arthur Evans on Philadelphia radio show Philly Speaks on 100.3 FM. The show gave us a chance to demystify “Obamacare” and what it really means for individuals. A few of the key messages that were expressed include:

  • Getting insurance coverage is essential for many individual and societal reasons.
  • The new Health Insurance Marketplace provides an opportunity for individuals to purchase health insurance on a more “level playing field” than in the past.
  • Through the Marketplace individuals could receive financial assistance to purchase coverage.
  • The Marketplace will screen individuals for public and private health insurance options and financial assistance to purchase insurance.
  • Individuals with behavioral health needs (mental health and substance use challenges) will have an increased opportunity to access services due to the Affordable Care Act’s provisions.
  • Expanding Medicaid in Pennsylvania is a “no brainer” and will be a huge missed opportunity if the state administration does not act soon.
  • Healthcare.gov, localhelp.healthcare.gov, and 1-800-318-2596 are valuable resources for individuals to learn more about their options and places to get in-person assistance.

Image

Education, Health Disparities, Health Equity, Inequality, Medication, Social Determinants of Health

Using Medication to Treat Social Ills

The critical need for a social determinants approach to health care is illustrated in an article in today’s NY Times.  In “Attention Disorder or Not, Pills to Help in School” Atlanta doctor, Michael Anderson, explains that he prescribes Adderall to help even the educational “playing field” for low-income students.  Prescribing Attention Deficit Hyperactivity Disorder (ADHD) medication helps provide an edge to low-income students who are often struggling in schools that are under-resourced, yet are competing with students from higher-income families and schools for college admissions.  Dr. Anderson sees himself as employing his form of “social justice” noting, “I don’t have a whole lot of choice. We’ve decided as a society that it’s too expensive to modify the kid’s environment. So we have to modify the kid.”

The possible short and long-term effects of prescribing stimulant ADHD medication to adolescents are discussed within the article, and some may find it shocking that parents and physicians would choose to prescribe medications in light of these risks.  However, a quick look at national disparities data shows that obtaining higher education is a matter of life or death.  According to the Robert Wood Johnson Foundation, college graduates are expected to live at least five years longer than those who do not graduate from college.  A mother’s education is also correlated with infant mortality; the lower her educational attainment the higher the risk for infant mortality.  Additionally, the higher one’s education the less likely they are to develop chronic diseases such as diabetes, heart disease, and obesity.  While Dr. Anderson’s clinical practices are certainly controversial and guaranteed to invite criticism, I applaud him for exposing such an important issue and calling for policies that address the true causes of health and social inequities.