Recent Newspaper & Online Columns by Kate Scannell MD

Healthcare -- Small steps lead to big strides in Kenya

October 19, 2014

Tags: Tiba Foundation, Matibabu Foundation, Gail Wagner, Daniel Ogola, Ukwala, Kenya, health care, philanthropy, Mary Ann van Dam School of Nursing

By Dr. Kate Scannell, Syndicated Columnist
First published in print: 10/19/2014


She jabbed her walking stick into the dirt path ahead, then she pulled her body forward. Her legs, paralyzed since childhood by polio, dragged behind. Over and over, she repeated this maneuver until, finally, she had arranged the corn she hoped to sell in front of her hut. A single mother, she needed the money to send her five children to school and buy their uniforms.

That is how community health workers found this woman during their outreach rounds through rural Kenya. Due to lack of mobility, she'd been isolated from health care and confined to a small area around her home. "It took her an average of 10 minutes for every 10 feet she could move along a path," said Gail Wagner, a Bay Area physician who founded the Tiba Foundation, which funded the outreach effort. “Can you imagine that?” she asked. (more…)

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An election victory for health reform, the Affordable Care Act

November 11, 2012

Tags: Victory for Obamacare, Affordable Care Act, Health Reform, individual mandate, state exchanges, health care

By Kate Scannell, MD
First Published in Print: 11/11/2012

President Barack Obama's health care reform law survived a couple of brutal battles this year. In the first major match of 2012, we watched 27 states try to kill the Affordable Care Act in the U.S. Supreme Court, claiming that it violated constitutional law. The punch line, however, was delivered in a 5-4 decision that left most of the act standing as the supreme law of the land.

Bruised but not broken, the health care act then began slouching toward November, through blistering bipartisan bickering, facing peril of extinction should Obama lose the election. Indeed, Republican candidate Mitt Romney had promised to begin repealing the act on his very first day in office.

But with Obama's re-election last week, the embattled health care act was again resuscitated and restored to health. And because the act was such an integral feature of Obama's campaign platform, American voters provided much of the saving life support for Obamacare. (more…)

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Nation needs to talk wisely and calmly about health care costs

September 18, 2012

Tags: health care costs, Institute of Medicine, wasted spending, health care, ABIM, Choosing Wisely, Medicare voucher

By Dr. Kate Scannell, Syndicated Columnist
First Published in Print: 09/15/2012

Years ago while hurriedly shopping at my local Safeway, I turned my cart into the bread aisle and nearly ran over one of my patients. Relieved that I had not injured him, I immediately pulled back and tried to escape his notice. While I generally enjoyed running into patients (without injurious instruments) in public, I had an appointment to make within the hour and could not afford a lengthy conversation.

Still, I had noticed that my patient held within his hands the same coupon circular I held in mine. Like me, he was selecting food purchases by price and special discount. Weeks earlier, that same man had been in my medical office, strong-arming me for an expensive antibiotic -- all the while I explained that it would provide no benefit for his mild cold. But he had read about the drug in a magazine ad, and, by all accounts, the antibiotic possessed amazing supra-human powers. It was a sniffle-buster, a mucus-vaporizer, a death-avenger; ostensibly, it could bring about world peace and ... well, cure the common cold.

At no point during our office encounter was the subject of cost brought up. My patient's insurance company would pay the bill, so perhaps it did not concern him. To me, it was important to base my refusal to prescribe the drug on "cold" medical facts -- not on a price tag. On clinically sound, scientifically-based reasoning that acknowledged both the uselessness and the potential harms of using bacterial antibiotics for a common cold.

But should I have raised the topic of wasteful spending with my fellow coupon-clipper? Should I have asked him to consider the consequences of resource utilization on a useless treatment that would only profit the drugmaker? That would help abet the escalating costs of health care and insurance premiums? (more…)

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