Wednesday, September 17, 2008

Our Future....Hispanic Students

Our future is tied to this generation of youth.  If you are the parent, grandparent, teacher, mentor or friend of a Hispanic college student looking to a future in a science, technology, engineering, or math (STEM) field please encourage them to visit

Yesterday the National Alliance for Hispanic Health (the Alliance) announced the opening of the Alliance/Merck Ciencia (Science) Hispanic Scholars Program. We are making two types of awards:
  • High School Seniors -- $42,500 Scholar Package.  Promising Hispanic high school students from Brownsville, TX; Elizabeth, NJ; and Los Angeles, CA are invited to apply to become one of ten Alliance/Merck Ciencia Scholars that will be selected in the Spring of 2009.  Scholars will receive up to $20,000 in scholarship (up to $5,000 each of four years of college) and up to $22,500 in summer internship stipends (up to $7,500 each of three summers).  Scholars will also receive mentorship and professional development support to complete a Bachelor's degree in a STEM field and pursue a STEM career.
  • College STEM Majors -- $2,000 Scholarship. Hispanic college students from all 50 states, the District of Columbia, U.S. territories and Puerto Rico pursuing a Bachelor’s degree in a STEM field major are invited to apply for a $2,000 one-time scholarship of which 25 will be awarded in the Spring of 2009.
This program of the Alliance and the Health Foundation for the Americas (HFA) is being conducted in partnership with the Merck Institute for Science Education (MISE) with support from The Merck Company Foundation.

Just this morning the Census Bureau released new data showing that there are 1.7 million recent Hispanic high school graduates enrolled in college.  Innovation in communication, genomics, and earth sciences all hold the prospect for a golden age of discovery....but only if our youth have the educational background to lead such discovery.   At the Alliance we are working to help secure that future of hope and prosperity for all.

Friday, September 12, 2008

The Consumer and Direct to Consumer Advertising

How consumers make health care decisions is complex. Consumers do not make health decisions in the same way that they make choices about objects they purchase.

For this reason and many other reasons I was surprised at the backlash that pharmaceutical companies met when they began to push for direct to consumer advertising. The outcry was that consumers would see their health care provider and demand a particular drug. Really? More than likely what happened was that the consumer would TiVo the ad (along with their favorite program) and then skip it because it was “simply advertising.”

However, in some cases the consumer had new information and actually now had something to ask their health care provider about. For example, very few knew about ED and those that experienced it were reluctant to speak about it. This is no longer the case.

As consumers we do not ask enough questions. And while some health care providers bemoaned that they had to talk to their patient about why the medicine they were asking for was the wrong one for them, other providers saw it as an opportunity to engage the consumer in their own care. Conversations with a consumer are a good and essential part of health care. This needs to be encouraged and we need to reimburse providers for this one-to-one education. And of course in a multicultural world, the conversation must be in the language that the consumer speaks.

Thursday, September 11, 2008


My daughter goes to college 90 miles north of New York City. On her campus September 11 is remembered in a way to respect the lives that were lost. In Washington, D.C. there are variety of commemorations too including those personal ones…a moment of silence, a prayer…something to make us recall what time can make too easy to erase.

On September 11 we lost many precious lives. They deserve a moment of our time to reflect on how the events of that day changed every part of our lives.

Thursday, September 4, 2008

We are not Canada or Sweden

Having just visited Sweden and other countries in the region, and heard about their health system first-hand, I am reminded that our system is different because we as Americans have different expectations. We expect more from our health care system but paradoxically we do not want to pay higher taxes.

Think about your typical American; they want answers in real time. In Canada and Sweden consumers have to wait for everything from a visit to a specialist to test results. That same approach would be unacceptable in the U.S. and might even be considered malpractice in some instances.

More to the point is that in the United States we made the decision in 1965 to provide a level of health care to persons over 65 regardless of income that is unheard of in most other countries. We care for older folks. All this makes our American health care system, with all its flaws, operate under a different set of values and constraints; the comparison to some of these other national health plans is useless and too often misguided. And it’s an important distinction to make as a new Congress and Administration will take up health care reform and policy wonks start declaring that the grass is greener in Canada and Sweden.

Tuesday, September 2, 2008

Top 10 lessons I learned when I went to the hospital.

That most people say they are happy with their health care is not very meaningful when you consider that most people are healthy.

Like lots of other people, I have gotten to know the most about health care when I have been sick or have had to care for someone else.

Here are some key things I have learned:

1. Public or private insurance gets you in the door but not necessarily the care you need.

2. There is a shortage of health care providers.

3. Mistakes happen.

4. Patients and providers want answers immediately.

5. There is little time left for patients and providers to get to know each other.

6. There are communication problems even when everyone speaks the same language.

7. People have to take more responsibility for their own health records even when they do not want to or do not have the skills.

8. It is important to make clear what one wants.

9. While evidence based medicine is a factor to consider; clinical judgment must also be valued.

10. You need to have someone with you.

We have a lot of work to do to make our health care system better.

Monday, September 1, 2008

Economics does not apply to health.

Our biggest mistake has been to use economic models to explain consumer behavior towards the purchase of health care. The underlying economic assumptions of the “rational consumer” or “all things being equal” are not valid. When we purchase health care we make a decision that may not be seen by others as rational but to the individual represents a valid choice.

Even if there’s just a small chance a treatment may work, if you are in pain or suffering, any chance is better than none and you want access to that treatment. It may not be rational but it’s human nature.

The rules for how we make decisions about health are just not the same as when we buy a cell phone or any other item. Health is neither a brand nor a commodity. Each individual addresses health choices at a very personal level.

After all, it is about one’s life and you just can’t buy another one.

Finally, on another note, we're thinking of all the families who have been displaced and otherwise affected by hurricane Gustav today. And our prayers are with those who lost family members to the storm.