Debate about some of the most pressing issues facing our country were lost in the horse race of the 2016 presidential campaign. Among those issues was healthcare. While millions of Americans received health coverage under the Affordable Care Act, an estimated 30 million remain uninsured and medical bills continue to be the leading cause of bankruptcy in the United States.
I only realized that I was an optimist on November 9. Crushing disbelief is cliche, and yet — as I walked home, hot-cheeked, through rain and yolk-colored streetlights just after midnight, past a dive bar where neighbors tallied states and feverishly refreshed fivethirtyeight — I felt trampled.
Gun violence as a public health issue is not a new phenomenon. In 2014 alone, there were 81,034 injuries and 33,599 deaths due to gun violence in the United States,which equate to 222 Americans injured, and 92 killed, by firearms every day.
It’s been a hard week. Hard, of course, because this election has caused an unprecedented wave of fear across our nation. Hard because those whose lives have been invalidated by our newest president elect are already exhausted by the daily struggle of living in a hostile country. And — not to be discounted — hard because bad days in medical school seem to hunt in packs and pounce all at once.
With the 2016 presidential election just days away, debates on the personalities and as well as the policy agendas of the respective candidates have become increasingly fierce. Donald Trump and Hillary Clinton may both be moderates at heart, but their official policy platforms represent near-extremes of the political spectrum. This holds especially true in their proposals regarding healthcare: Trump’s proposal, entitled “Health Care Reform to Make America Great Again,” and Clinton’s, “Universal, Quality, Affordable Health Care for Everyone in America” together paint a picture of the spectrum of opinions and debates surrounding healthcare.
2016 has been a turbulent year for health care in the United Kingdom. Aside from repeated strikes held by junior doctors in light of the government’s decision to enforce a new employment contract, the more recent widespread political discord resulting from Britain’s decision to leave the European Union (EU) — now notoriously known as “Brexit.” These changes have left the National Health Service (NHS) in a questionable position.
Major sporting events like the Olympics and the Super Bowl are often surrounded with excitement and drama. This year’s Olympics in Brazil is buzzing with talk of the Zika virus. The Super Bowl was fraught with drama surrounding Beyoncé’s half-time performance. It seems like everyone has something to say about these topics. But, one thing spectators don’t talk about is an unseen drama that often surrounds major sporting events: sex trafficking.
In today’s America, it is well documented that each year, more of our GDP is being devoted to healthcare spending, and a disproportionate amount of that healthcare spending is towards end-of-life care. According to a 2013 report from The Medicare NewsGroup, Medicare spending reached about $554 billion in 2011. This was 21 percent of the total spent on health care in the US that year. About 28 percent of that $554 billion — $170 billion — was spent on patients’ last six months of life.
During our many years of medical training, we study complex physiological processes running the gamut from acute sepsis to the equally devastating progression of chronic diseases. We spend countless hours in lectures and on the wards, attempting to gain exposure to proper medical management of bread-and-butter medical problems as well as more obscure diseases which may only affect a handful of patients annually. However, most medical schools neglect to teach one crucial area of expertise — training in advocacy skills to address social determinants of health.
While I could list close to 100 lessons, I believe focusing on three of the most important ones would aid other future health professionals in managing and ultimately treating the chronic illnesses that will become even more prevalent in many of our future patients. As a disclaimer, I do not claim to be an expert on this topic, but these ideas spring from my own personal reflections.
In the UK, there is currently a dispute over the new junior doctor contract. “Junior doctors” are defined as anyone in training and who is not a consultant. Many have deemed the new contract neither safe nor fair, and despite doctors striking, the Department of Health are intending to impose this contract in August 2016. On April 26, there will be a 48-hour full strike including emergency care — the first of its kind in the history of the National Health Services (NHS) — in the hope that the government will change their mind.
Recent announcements by the British government that a revised contract on junior physicians’ salary and working hours across England will be imposed has come under intense scrutiny. Criticisms from the national workforce to media figures and opposing party politicians have ranged from accusations of compromising patient safety to ensuing longer working hours with reduced pay as compared to the current scheme for around 55,000 affected doctors. But the retaliating strikes on part of the National Health Service (NHS) workforce in protest have certainly proved controversial.