The Buzz About Health Care Reform and Community Health Centers

I have a new post on Erie Family Health Center's Beats per Minute Blog.

Where for art thou H1N1 (influenza)?

This blog post is re-purposed from Erie Family Health Center's Beats per Minute blog.

It just feels like the flu has gone away. Away from the headlines on TV, the web, radio. Away from the ERs and clinics. After H1N1 influenza ravished an unprepared America in the late spring of 2009 and again in the fall and early winter, it has basically disappeared. Should we let down our guard and stop worrying?

It’s true that most areas of the country are reporting either no or only sporadic (Illinois) flu activity. The most activity is in the South and in Maine. All of it is well below epidemic levels and it’s all H1N1, not other strains of flu virus that we sometimes call the “seasonal flu.”

H1N1 caused relatively mild illness for most people. Although this supposedly mild-mannered virus caused the deaths of thousands, it could have been much worse. The pandemic H1N1 of 1918 killed almost 500,000 in the US and at least 50 million world-wide. According to the Centers for Disease Control and Prevention, “from August 30, 2009 to March 6, 2010, 2,042 laboratory-confirmed influenza-associated deaths were reported to CDC” among them 277 children. Perhaps up to 14,000 actually died since not all patients had lab confirmed tests. By contrast, seasonal flu normally kills some 36,000 Americans annually and over 250,000 world-wide every year.

It may be a bit too early to declare that this year’s (2009-2010) regular old seasonal flu turned out to be none other than the lone H1N1, but that’s what it looks like. Very few other types of flu viruses are showing up in lab tests across the country.

But, H1N1 could come back, either soon, or next flu season. Young adults and children, pregnant women, as well as those with chronic illnesses are at higher risk get more severe flu symptoms.

That’s why the expert panel that makes recommendations to the CDC has decided to include the H1N1 virus in next year’s (2010-2011) seasonal flu vaccine, along with several other flu viruses, based on world-wide trends and predictions. Whereas this year there were two separate flu vaccines: H1N1 and the seasonal flu vaccine, next year they will be combined into a single seasonal flu shot, which is really a mixture of several different flu strains. The combination changes every year based upon worldwide flu trends. And the expert panel will now recommend that everyone, from young to old, be vaccinated unless there is a good reason not to.

Erie Family Health Center was a leader in providing H1N1 vaccinations this flu season, giving over 5,000 vaccines to children, more than 850 to pregnant women and over 700 to chronically ill adults. Erie opened its doors and made it easy for patients, relatives and others to walk in and get vaccinated.

Haven’t yet gotten an H1N1 shot? Should you still get one? Yes.

The CDC is now encouraging everyone to get vaccinated. This could give you a head start even if the flu season is over for this spring, since H1N1 may come back before the 2010-2011 seasonal vaccine is available next fall. Supplies of H1N1 vaccine are still available, but ironically, the 2009-2010 seasonal flu vaccine (which does not contain H1N1) is still in short supply.

Flu prevention business is a tricky one. Every year, we are reminded to wash our hands, cover our cough while public health experts try to outguess Mother Nature by predicting the best vaccine. We know that the TV weatherperson has a difficult time with telling us if it is going to rain or snow or be sunny tomorrow and predicting the patters of a virus is even more complex. H1N1 is still smoldering in certain parts of the country. We should be worried and prepared for the flu if and when it decides to return.

For weekly updates on the flu, visit flu.gov.

END OF POST. Thank you for reading.

Your Piece of the Health Care Pie: How much would you pay?

This post is re-purposed from Erie Family Health Center's Beats per Minute blog, with permission.


Would you pay $1.94 per day in health insurance for the privilege of unlimited access to comprehensive preventive and primary care services at the level of quality provided by Erie Family Health Center? It sounds like a pretty good deal.

Health care reform pie is on a lifeline in Washington, DC, and cost is of high concern. Meanwhile, around the country, at over 1,200 health centers like Erie, data staff hit the send button this week and uploaded information for 2009 on the 20 million medically disadvantaged people cared for at community health centers. The fix is in, and the data show that health centers provide very cost effective primary care and preventive services.

I’d like to show some of Erie’s results as example. (read more)


Over 33,000 patients now access primary care services at Erie. Perhaps an indication of our economic times, the number is up 10% from a year ago. And patient visits climbed accordingly, to 142,000 in 2009, up 7% in 2009 from 2008.

Our annual report to the feds allows us to calculate the average cost to provide a year of health center services to an Erie patient: $700 per year, or $59 per month, or $1.94 per day. This includes unlimited doctor visits, laboratory services, counseling, case management, oral health care, delivering your baby, 24/7 answering service and coordination of care with our hospital partners. Erie competes for federal grant dollars to help support the 34% of our patients who are uninsured. The annual cost to the feds per uninsured Erie patient is $360 – less than a dollar a day.

If you like a bargain, you are thinking – good deal!

A recent report by Lo Sasso and Bryck in the journal Health Affairs predicted that for every $500,000 additional funds a health center receives, 540 additional patients can be served -- $925 per patient per year, $2.50 per day. Erie is doing better than the national average.

But health the health care pie is really divided into three slices. The first slice is primary and preventive care like Erie provides, a good deal as we see. The second is both basic and sophisticated outpatient testing such as x-rays, mammograms, CT scans and MRIs, to which Erie arranges affordable and deeply discounted linkages with partners. The third is the most expensive – hospitalization, surgery, rehabilitation, and Erie provides linkages as well. And I’m not even going to touch the issue of long term care (a whole other pie).

It’s that first slice of pie, $1.94 per patient per day, which has the most potential to prevent over use of the other two slices. The other two slices are super expensive, their costs are rising, and they are breaking our health care system.

As negotiators try to resurrect health care reform in Washington, they should keep an eye on health centers as a cost-effective and expandable slice of the health care pie. We are ready to do more. END OF POST...Thanks for reading.

Health Care Reform: Where will the newly insured seek health care?

I have a new post on Erie Family Health Center's new blog: Beats per Minute. Enjoy the cross post. I have added Beats per Minute to my blog roll on this page.