Dr. Thompson's Blog

College Health Care

I was waiting for my grandson's high school graduation to begin and asked the parents next to me where their son was going to college. The mother said he was going to a small college in Minnesota. I said I knew the college and health care in that state was some of the best in my experience. The mother looked surprised that I would bring that up.  When I told herthat I was a pediatrician she understood. The mother remarked "I hadn't thought about college health care." With that statement, I asked her if her son had had a meningococcal vaccine? The mother had no idea what I was asking and didn't realize the importance of the vaccine. I explained that college kids often don't eat well or get enough sleep and are more at risk than other kids unless there is some  underlying disorder. I noticed there was a teenage boy with the parents and said that he, too, should have the vaccine. In  San Diego last year a teenager died of meningococcal meningits. it was a preventable tragedy.

i also stressed the importance of finding a local internist, so that if the college health service  was inadequate, the youth could have an available doctor. Health insurance should also be checked to be sure a college student is covered. I have already started to make inquiries about a good internist in the city where my grandson will be in college. I wish all parents and, if necessary, the grandparents could be aware of the health risks when a child goes off to college.

More Options for Health Insurance

Hopefully, Congress will be able to put together a good health insurance so  everyone can have some kind of coverage.  Until that happens and since it may or may not be possible, we all have to be sure we have good health insurance. More and more bankruptcies are due to excessively high medical bills.

Lesley Alderman in the 5/16/09 New York Times gave a good list of options. Some of these were new to me and are certainly worth exploring if you do not have health insurance. They are: 1. Freelancers Union at wwwfreelancersunion.org or 1-800-856-9981. The insurance covers independent workers in specific jobs. it would be worthwhile to check to see if you fit into their group. 2. The Small Business Service Bureau at www.sbsb.com or 1-800-343-0939 has group health insurance for small businesses. 3. The Chamber of Commerce in your town may offer insurance if you are a member. 4. Media Bistro has health insurance for their members. So if you are a media professional, this could be an option. Their Web site is www.mediabistro.com/insurance.

For college students, there is a new law called Michelle's Law that will be effective this October. It states that all group insurance plans must remain in effect for a year when a college student is on medical leave. Individual coverage for college students can be viewed at eHealthInsurance.com. When your child goes to college, please be sure he or she is  covered with your plan or with the  college's health insurance. However, read the college policy very carefully because some colleges do not offer adequate coverage and some college health services are poor. I have cared for many college students and have had to find good medical care in other towns for former patients and friends of my children.

F.D.A. Lagging Behind Action By Parents and Companies

Two articles in yesterday's New York Times caught my eye. The first was that parents living in states where scorpions can sting their children have the option of giving one of their children a drug imported from Mexico. It is called Anascorp and is not yet approved  by the F.D.A.  However, a report was given of a doctor's child who received it and recovered in two hours. If you have ever spent time with children in Arizona or other desert states, you will be glad to have the choice of this antivenon. Oher children have also responded, the article noted. I was surprised to note that at least 8000 Arizona residents are stung by poisonous scorpions each year, but adults generally recover without needing medical care. I am so glad my days of being in Arizona with children are over. I am just not a fan of the desert! 

The other article noting how the F.D.A is not keeping up discussed the banning of baby bottles in Chicago. These are bottles that contain the chemical, bisphenol-A or BPA. Several companies have already kept these from their stores; Wal-Mart and Babies R Us were both mentioned. Since there are still questions about the toxicity of this chemical, it makes sense to remove it from baby bottles or other products that consumers buy.

Hopefully, with the additional money promised by the Obama Administration, the F.D.A, will be able to do a better job of policing toxic substances and approve medications and antiserums more quickly.

Deteriorating U.S. Medical Care

Our U.S. medical care seems to get worse and worse. I could not believe the article in the 5/12/09 New YorkTimes by Milt Freudenheim stating that the prestigious Mayo Clinic and also the Cleveland Clinic are teaming up with CVS drug stores to offer Retail clinics. These are staffed by nurse practitioners, not physicians. The American Academy of Pediatrics has come out strongly against these clinics. Nurse practitioners do not have adquate pediatric training and children must never,ever, be seen in one of these clinics. A child can become ill very quickly and die if a fatal diagnosis is missed. Even well-trained pediatricians often have to search hard for a correct diagnosis. I had a child that my partner saw on a Friday and did a spinal tap looking for meningitis. I had to convince the parents to let me repeat the tap the next day. The spinal fluid was filled with pus. That child would most likely have died had she been seen in a Retail clinic by a nurse practitioner.

I cannot believe that the Mayo Clinic and the Cleveland Clinic are so hard up for patients that they would allow their good names to be tarnished by teaming up with CVS drug stores to sponsor Retail Clinics. What could they be thinking?  If general practitioners and pediatricians were paid adequately, more medical students would consider going into these specialties. I shudder when I hear the incomes that some of the other specialists make.

There are now 1000 Retail clinics in the country and Wal-Mart is planning to have 400 of these second-rate medical facilities by 2010. No one should ever have to accept such inadequate medical care. Our U.S. health care is an embarrassment when you look at the medical care received in France, Australia, and some of the other places where good health care exists.

Beware of the Tricky Health Care Lobby

As more and more people realize that they must speak out about health care, the health care lobbyists, who make millions of dollars, are suddenly deciding that they must persuade the insurance and drug companies to make some minor concessions about what they will cover. At this point with the threat of a public insurance program  that people could chose, the insurance companies are saying that they will charge men and women the same, which they have not done previously, and that they will cover everyone who applies. i will believe this when I see it. Now only healthy people are insurable. People with pre-existing conditions either are not able to get insurance, pay enormous premiums and sometimes are able to get high-risk insurance.

There is a wonderful paragraph in Paul Krugman's column in today's New York Times. He says "The point is that there's every reason to be cynical about these players' motives. Remember that what the rest of us call health care costs, they call income." He, of course, means the lobbyists.

The Diagnosis of Child Abuse

Parents of young children need to be particularly careful these days about the potential for being accused of child abuse. Little children who are climbers or hyperactive take lots of falls even with the best supervision. Now with the crazy notion that a playpen or gate on a child's play area will retard their development, kids are at risk for even more falls. Playpens and gates on a child's room or play area do not retard a child's development. That is nonsense and a playpen or gate might even save a child's life.

I saw a cute little three-year-old yesterday who had climbed up on a cabinet in the kitchen to get a snack. His good mother was in another room for a few minutes when the child slipped and fell. One side of his face began to swell and looked bruised. A trip to the ER was made, but  an X-ray of the face was not taken to look for a broken bone. The ER doctor felt the child's face and said it was O.K . However, the nurse was less than sympathic. I was relieved that the mother was not accused of child abuse. ER doctors often have little pediatric training and because they do see cases of child abuse, it is easy for them to assume that everything is child abuse since they do not know a family as does the pediatrician or family doctor.

I urged this mother that with the next accident, which could look like child abuse, she should call the child's regular doctor. Doctors are responsible to cover their patients for night and weekend calls, so they should always be called first. If a mother or father is directed to the ER when they call a doctor's number, it is time to find a different doctor.

Single Payer Health Care-Alert

Now that the administration is actively attacking our U.S. health care problems I think we all must make our voices heard. I am told that at the committee meeting on health care on April 21st that no one was invited to speak for Single Payer Health Care. It should be no surprise to anyone that representatives from Aetna and Blue Cross were there. We must get the insurance companies out of health care and also regulate the greedy drug companies. Our health care is looked at by the nations who have good health care as truly unbelievable. France and Australia are said to have the best health care in the world and we are at about 27th. I think this is embarrassing.

Senator Max Baucus is chairman of the committe that is discussing health care. if we all contact his office and insist on representatives for a Single payer plan, that could make a difference. His office numbers are 800-332-6106 or 406-657-6790 and also 202-224-2651. His e-mail is: http://baucus.senate.gov/contact/office.

The next two meetings of his committee are May 5th and May 14th. If you care at all about health care in this country, please call or e-mail Senator Baucus. Single Payer care may or may not be the best plan, but it must at least be discussed and our voices heard. The insurance companies have had control over our health care for far too long.