Can You Hear Me?

A free public service for a better community

Happy Wednesday Healthcare Advocates

I would like to encourage comments and suggestions from you if you have time. If there is a special topic you’d like to see please let me know. Please use the comment button below.

Can You Hear Me?

We have discussed maternal mortality many times. It is a key quality indicator of how well your healthcare system is working. It is measured in the number of deaths related to pregnancy/ 100,000 live births. In 2021 it was 32.9 in the US. For Black women it was 69.9, for Non Hispanic white women it was 26.6. Did you get that more than 2X if you’re Black.

First, these numbers are way too high. In our peer industrialized countries the numbers overall are much smaller. Germany 4, France 8, Canada 8.3, Spain 3.47. Somehow they are doing something right and we are not.

The conditions that kill women are hypertension/preeclampsia which occurs in 5% to 8% of all pregnancies, miscarriage management, infections, unsafe abortion, the list goes on and on. Allow me to mention that things are worse where abortion is banned. Procedures and medications are delayed and women suffer. Here is a youtube video interview with a physician describing the issue.

This metric demonstrates a significant health problem. We spend more than anyone on healthcare and this isn’t working. What’s going on?

There are several problems presented here. First is that women are not treated well by healthcare providers. Women’s bodies are far more complicated than men’s and that needs to be taken into account.

There have been numerous studies and investigations that demonstrate that women are not heard by doctors and their health suffers and it is worse if you’re not white. Here are a few examples:

1. Women do not always present with the same symptoms as men for heart attack. Doctors have for years not treated their symptoms as seriously (especially male doctors) and their fatality rate is much higher than men. They aren’t paying attention. PS here is a link that describes the heart attack issues women have and what to do.

2. Pain is not treated in women the same as men. Doctor’s frequently recommend meditation, stress reduction, sedatives and not treatment for pain in the same way they do for men. Dr. Daihnia Dunkley, a specialist in maternal child health and labor and delivery, identified how under-prescribed women’s pain is."There's an implicit bias there between the two sexes when it comes to pain management," Dunkley said. They aren’t paying attention. PS here is a link to a reference.

3. Black patients are treated differently. In a 2016 study, half of medical students and residents believed one of these three erroneous beliefs: "Black people's nerve endings are less sensitive than white people's"; "Black people's skin is thicker than white people's"; "Black people's blood coagulates more quickly than white people's." All of these are false and yet so many carry this around.

4. A recent investigation into an algorithm used to make sure that patients get appropriate treatment found that black patients were actually far sicker than the algorithm predicted and so they were receiving less treatment than was needed.

   Here is a link to the study. By the way the algorithm is used for over 200 million of us.

Summary

Doctors don’t always listen well and many come to work with a built in bias. They need to know how to listen to their patients and hear what the real problems patients are experiencing. They need to not be rushed to jump to solutions and move on to the next patient. If you have enough time to think through the problem you can actually make sure that you check yourself on bias and get the right answer, but you have to be aware of it.

Doctors are often incentivized to see more patients and generate more income. Much of our healthcare system is set up, not so much as a health delivery system, but as cash generating engine. Doctors are also overloaded with a tremendous amount of documentation to satisfy multiple insurance providers to make sure they get paid (one of the reasons so many want to retire early next year - but that’s another crisis).

The vulture capitalists that own so many medical corporations and the fee for service model are making this worse. A system of global budgets for medical institutions together with incentives to keep people healthy, will help everyone.

Amazingly enough, that’s what Single Payer, Improved Medicare for All offers. HR 3421 or S 1655. You know what to do.

ACTION

Let your representatives know that global budgets for medical institutions will give doctors enough time with patients so that they can improve health outcomes for black people, for women, for all of us. Tell them to support either HR 3421 or S 1655. Make sure you vote for people who will make this happen. Their contact info is below.

You can also use RESISTBOT to send that message by texting SIGN PDFYDO to 50409 to send the message below your Congressional Representative, Senators and the President.

“Women's maternal mortality rate is now at an all time high in the US. 32.9 deaths per 100,000 live births.  69.9 deaths/100,000 live births if you're black.  This is way out of line.  Germany is at 4, France is at 8.  We are worse than any of our peer industrialized countries (who have universal healthcare).  

There are several problems but doctor's don't always listen well to women and they have built in biases about women and people of color.  Study after study has shown this.

We can give doctors the time to listen well and check their bias at the door if they are incentivized to keep people healthy.  Today much of the system pays doctors to see as many patients as possible and increase their billings.

I want you to co-sponsor and support Improved Medicare for All (HR 3421 or S 1655).  Global budgets will give doctors the time they need to make sure that patients get the care they deserve.  Please support it.”

Find My Elected Officials

Contact the White House  https://www.whitehouse.gov/contact/

Contact State and Federal Representatives

https://www.commoncause.org/find-your-representative/addr/

Important Healthcare Resources

League of Women Voters Healthcare Reform Toolkit

Our Newsletter resources including reproductive healthcare

Healthcare Advocacy Reading List

Organizations to Contact

NARAL - Pro Choice America

Planned Parenthood

Physicians for a National Health Plan

Claims Denials and Appeals & What to Do

Appeal a Healthcare Decision

Appeal/Negotiate a Hospital Bill

Save Democracy

Chop Wood, Carry Water by Jessica Cravens

RESISTBOT

Link to the RESISTBOT site to learn more

Link to Chop Wood, Carry Water Resistbot write up