Only one more day stands between me and freedom from anatomy! Although, as our awesome lecturers have reminded us, anatomy is a key component of the actual practice of medicine. If you don’t know cardiac anatomy, how can you listen to the various valves of the heart, one of the most basic exams in clinical medicine?
Since histology ended a week ago, most of my time has been spent with a Netter’s atlas in the anatomy lab learning the cranial nerves and all their innervations. My free time consists of going to the grocery store and maybe an episode of The Office before bed. But there is one recent JAMA article that I did take a moment to read and feel needs to be shared.
In case we haven’t met, hi–I’m Molly and I’m a huge fan of School House Rock. Thanks those VHS’, I grew loving the checks and balances built into our government–the legislative branch creates the laws, the executive branch enforces the law, and the judicial branch interprets laws as constitutional or unconstitutional. Today we’re going to focus on the Supreme Court, the ultimate arbiter of the judicial branch. It is comprised of nine Justices with a lifetime appointment who hear and rule on cases that question federal constitutional issues or conflicts between states.
If you’ve been on social media, any news site, or turned on the T.V., you know that Judge Brett Kavanaugh has been nominated to fill the current Supreme Court vacancy. But we’re not going to delve into the allegations of sexual assault against him or the Judiciary Committee majority’s complete disregard for process, order, or even common decency today. No, we’re going to talk about the impact that one person, Judge Kavanaugh, can have on the entire U.S. health care system.Health care has certainly been on the agenda at #SCOTUS in nearly every recent decade as the federal government as gotten more involved in that policy area since creating the Medicare and Medicaid programs in 1965. But even dating back to Jacobson v. Massachusetts in 1905, when the Supreme Court upheld the authority of states to enforce compulsory vaccination to protect the public health, SCOTUS has been involved in health issues.
It’s 7am and I’m sitting in bed with too many beverages (coffee, water, smoothie–gotta get those leafy greens in) and too many tabs open (embryology review, TeamRads, Twitter, and multiple newspaper homepages). And oh yeah, my second anatomy exam is this afternoon.
But what I’m actually stressing about how thousands of low-income Arkansas residents no longer have Medicaid coverage.
Hurricane Florence is poised to make landfall on the Carolina coast tonight, marking the first landfall on the U.S. mainland this hurricane season. Secretary of HHS Alex Azar declared a public health emergency for North Carolina and South Carolina to provide Medicare and Medicaid beneficiaries and health care providers greater flexibility in meeting emergency health needs, as well as readying personnel from the National Disaster Medical System. As we all watch Florence and her impact on millions of Americans, we thought it would be a good to take a quick look at the inexorable connection between emergency preparedness, weather, and medical care. [No discussion of hurricanes and health would be complete without addressing Hurricane Maria and the devastation it wrought on Puerto Rico, but that is a longer post for another day.]
The singular best assertion of the connections between health policy, clinical medicine, and public health comes from none other than Dr. Donald Berwick. As the former Administrator of the Centers for Medicare and Medicaid Services (CMS), former Vice Chair of the U.S. Preventive Services Task Force (USPSTF), a pediatrician by training, and dozens of other accolades, there is hardly anyone better versed in the interwoven web of medicine and policy. His expertise, coupled with experts in health care quality improvement and patient safety, resulted in The Triple Aim, a set of interconnected goals aimed at improving U.S. health care through political, rather than technological or biomedical, avenues.