I recently learned that my home state of Texas has refused to participate in Medicaid expansion that is part and parcel of the Affordable Care Act. When I first heard this news on NPR, I nearly gasped in disbelief.  Gov. Perry and the Texas legislature will walk away from $100 billion of federal money to help the state’s poor, elderly and disabled.  Wade Goodwyn, the NPR reporter for this piece, went so far as to state that “Texas Republicans have moved steadily to the right — to where the very concept of public health insurance of any kind is looked at through narrowed eyes.”  The public perception of Medicaid is that it primarily covers the poorest of the poor adults.  In fact, children account for Medicaid’s largest percentage of enrollees (47%) and the largest amount of spending goes to the blind and disabled (44%).  Yet any expansion of Medicaid in the service of Obamacare is viewed as an expansion for the undeserving poor.  Texas has the distinct status of having one of the worst safety nets for the poor.…

Big brother is watching you. And calling you. And selling your medical information to a pharmaceutical corporation.

In the modern age of information as commodity, drugmakers buy database that tell them how much of what drug each doctor prescribes, which patients fill those prescriptions, and whether renewals are filled. They know your medical conditions, test results, insurance data, age, ethnicity, and income level.

Several companies have developed with the express purpose of tracking patients and their medical habits.…

When we think about primary care, we think about health promotion, disease prevention, treatment of acute illness and management of chronic disease, as well as an initial point of contact into the health care system for many. We also think about physicians, nurses, and physician assistants, but we rarely consider dentists and the integral role they can and should play in primary care. Access to such services is particularly important for our aging population–many of whom suffer from chronic conditions such as diabetes, hypertension and cardiovascular disease.…

Recently, the drugstore CVS Caremark implemented a health policy that if an employee would like to be covered through the company’s medical plan, he or she is required to submit information about how much they weigh, their body fat percentage and glucose levels…or else face a monetary penalty each month. The company is calling the participation “voluntary” despite the penalty.

Setting aside issues of consent, privacy and coercion that all come with a policy such as this, I raise the important question of whether the requirement is discriminatory, and if so, how?…

Do you smoke? Do you exercise? Do you have a yearly physical with your physician? Your answers to these questions could have an affect on the cost and coverage of your health insurance. The annual survey is a part of the work wellness trend that began nearly a decade ago and was an attempt to cut the cost of health care by providing incentives for employees to adopt healthier habits. The concept was that healthier habits would reduce use of medical services leading to lower insurance costs for the employer.…

A recent study found a strong association between the number of test strips covered by insurance and better medical care in type 1 diabetics. Test strips are impregnated with chemicals that react with glucose when sensed within a drop of blood. Strips are disposable and cost from 40 cents to $1 each, although this cost is often defrayed to some extent by insurance.

Type 1 diabetes, previously called ‘juvenile onset,’ is a chronic illness that affects over three million Americans.  It was previously referred to as ‘juvenile diabetes’ because it was believed that this condition only developed in childhood, a theory that has been disproven.  Individuals of all ages can and do develop type 1 diabetes.…