You can cle rly ee where the
trend oin, nd in hurry! In
1990, 25,701 new c e ere
reported. nd, bee u e of
in dequ te fundin of public
he Ith dep rtment round the
country, thi tremendo gro th
reported 0 ctlve may even
be f r too low, ince the CDC
report th t m ny heal th
dep rtmen re imply unable to
keep up ith reporting of 11 new
n
HEALTH
"
Bill Cinton to pend more tim di-
c in lth care.
A era h eour
In r form
m intained, but under many private­
m rket propo I Medicaid would be
exp nded to cover more low-income
pe ons. Mo t private-mar et plans
I 0 promote insurance reform th t
would keep insurers from withhold­
ing coverage from persons with pre­
existing health problems (a practice
ometim called "cherry-picking").
Health insurance cove rag would
be expanded under a private-m rket
approach, but would not be "univer­
al"-meaning 11 Americans would
not be guaranteed coverage.
- The Employer-based ap­
proach. This approach, also known
as play or pay, would mandate that
everyone receive health insurance
through his or her employer or
through the government. Employers
New test identifies infants with
sickle cell an
ia
ould
n incentiv to
in ur nee to their
employ edi re ould remain
prim ry vehicle for i urin the
elderly, but Medi id ould be in­
corpo ted into th new public in­
urance pi n.
In ddi lion to t es, the new
overnm nt i u n e pi n ould be
fun d by co-payments nd deduct­
ibl levied on enrollee in the pI n.
Priv te i urance reform are also a
p rt of m t pi Y or P y propo a .
- Th government-b ed p­
pro ch. Thi pproach i also known
a ingle-p yer, national health in-
urance. Two commonly cited
model for the government-based
approach are the Canadi n nd
Briti h Helath care y terns. Under
a government-ba ed approach, the
government become the ole ad­
mini trator nd payer for all health
care rvices. Everyone is covered
for basic phy ician and ho pital er-
Not thl y ar, m yb next year
Dr. elson any reform p c -
ge that ultimately through Con-
gre may include some elemen
from all of the pproache outlined
above. 'But legislative ction on a
comprehensive reform bill ems
unlikely during thi election year.
Dr. Nelson believes the new Con­
gress and the next pre ident must
take up health care reform in earnest
in 1993. "Costs are ri ing too quick­
ly and too many Americans are
going uninsured to let another year
go by without reform."
Dr. Ronald A. White, r.c.
Dentistry For Adults & Children
•
17701 We t McNichol
(2 Blocks East of Southfleld Freeway)
Detroit, MI48235
HOURS By ApPOINTMENT
(313) 533-6500
and .
for
CARE
0ID8Il (Pregnant or Breastfeeding)
nfants
367
4,403
IDoome EUpbUlty Gul�
Effectin April I, len
Family .
'st.. W Idy ontbly Yearly
1 '243 '1,050 '12,5"
2 327 1,417 17,001
3 412 1,784 21�405
2,151 25,_
2,518 30,111
2,885 34,814
4
417
5
581
6
Me
Each·
additional
penon:
85
Fbr Infonnation
or'
l _:__ ..;::___� __,
urance" nd other terms commonly
h rd In the reform deba .
Experts y non of thi hould
come a urprise given the di7zying
rray of reform propo ls currently
under consideration by Congre or
being propo d by candidate for
political office, and the complexity
ofth plans, whichofferblueprin
for comprehensive chang in the
U.S. health care y tern.
oundblt
Inat ad
The worst proble are in Har­
lem, New Yor ' where the rate of
infection i 275 per 100,000
people, the me rate in Sub-
S har n Africa! Conditio in
parts of the city approach th of
75 years ago.
In ddition, too few vailable
hospital beds and not enough Isola­
tion rooms. have only added to the
number of today' drug-resistant
. Though'New York City and
1..0 Angele have reported the
highe t number of new es, cltte
like Newark, Miami, Atlanta, and
Oakland have even greater rates of
infection.
While the disease remains con­
fined to mo tly minority group in
these cities, health care workers are recent poll that indicates most
increasingly being exposed to the Americans want President Bush and
disease, and contracting it. Democratic pre idential nominee
TB is transmitted when people
with the active form cough or
sneeze and someone inhales the in-
fected droplets. However, it usual- HOUSTON _ A DNA-based test
Iy takes repeated exposure, often in i identifying newborns with sickle
an enclosed space, and over cell anemia and decreasing deaths
prolonged periods of time, to be- caused by the devasting blood dis-
come infected in this way. Forex- ease.
ample, sharing living quarters with "We are saving lives by starting
someone who has active TB is a .. treatment earlier," said Dr. Edward
typical 'mea f)bIe�'h' i - ,-c -'
::"'�1 • - '.;\ ._ \!b T-, IOU � .JI 11 C\,AI , I�� o�r, 9, ,\he ·and.
f�� .' " " � '.' .. ' o\"'pror'e or of molecular genetics at
While, people who live 10 Cl I Baylor Coliege of Medicine in Hous-
with high rates of the disease may ton.
worry that they'll be exposed on Sickle cell anemia mainly affects
buses or subways, the chance of African-Americans and is an in­
"catching" TB through this type of herited blood di ease that causes the
brief exposure is very small. · red blood cells to become sickle
ALSO, BY HANDLING ob- Shaped instead of round. The sickle
jects used by an infected person, cells can block blood vessels in al-
such as cups, glasses, plates, most any part of the body, causing
clothes, books, bedding, etc., you sudden pain as well as damage to
are not likely to become infected. tissue and organs. There is no cure.
Remember, it usuall y takes Since July 1991, the State of
repeated inhalation of infected par-: Texas has used a DNA test as a
tic1es, in an enclosed space, over a second level of newborn screening.
long period of time, i.e., someone Sickle cell screening is mandatory in
you live with, or spend a lot of time Texas, and all positive or unclear
with. tests are sent to Baylor for DNA con-
If you believe tha you may firmation.
have been exposed to a person wi th
active disease, check with your
local public health department for
skin testing. In the event that your
skin test is positive and the disease
is still latent, treatment and cure
usually consist of taking medica­
tion for six months.
Hospi talization is usually not
necessary. Most people become
non-infectious and symptom free
quickly after they begin treatment,
However, drug-resistant strains of
TB are another matter. They
develop when people with active
TB receive or take only partial
treatment, l.e., they don't take all
their medication for the full six
months.
The problem with this is that
although the patient may feel better
for a while and even thinks that
he's cured, he actually has helped
to create a resistant strain of the
disease, and when symptoms
return, no current medication can
completely k�ij t� infection.
Such patierits may-die and may
also endanger the lives of others
they live with and the health
professionals taking care of them.
Bottom line, take all your medica­
tion for the full length of treatment.
THE GOOD NEWS? TB's
still preventable, and it's not too
late to tum the situation around.
Research is needed for new drugs,
and funds are needed for better
detection and to ensure that
patients being treated follow their
full course of care until they are
completely cured. ,
Tuberculo i never went away,
but the public concern did. It'
I time' to revive that concern. Until
then, beware the "new" TB!
of aubat nee
Do the poll reflect public indif-
. terence about health care reform?
Alan R. Nelon, MD, executive vice-­
president of the American Society of
Internal Medicine in Washington,
D.C., does not think o. "Don't con­
fu e the public's lack of under-
tanding with a lack of concern over
the serious problems that face our
health care system," he ays.
, DR. NELSON POINTS to a
MCCABE HOPES the test will
. be adopted nationally.
"This new test has allowed us to
shorten the time it takes to confirm
sickle cell to about 1.7 months of
age," McCabe said. "The middle
range for confirmation used tQ be
between 4- and 5- months-old be­
cause a second blood test was
needed."
The immediate treatment for in­
fants is daily antibiotics.
"The disease causes the baby's
spleen to become blocked and
damaged," McCabe said. "Normal­
ly, the .spleen functi�ns as part of the
." ·0
OJ. e on and othe would like
to ee greater public understanding
of health care reform, but where d
one tart? Single-payer, unive
health insurance, "play or p y"? It
can get COnfusing. Health policy ex­
perts ay m t reform pI have
imilar goal, including exp nding
availability of health insurance nd
controlling co .
But reform proponents differ on
how much government involvement
i needed to achieve the e goal , and
who should pay the bill for com­
prehensive Change in our health
care delivery y tem.
Years of debate over these que -
tions have produced three basic ap­
proaches to health care reform. The
specifics of individual health care
reform plans vary, but mo t have
financing mechanism that conform
to one of the following three model :
A private-market approach, an
employer-based approach and a
body's defense against infection by
removing bacteria from the
bloodstream." .
Once the spleen is damaged, in­
fections can be fatal. McCabe added.
that these children mus.t rely on an­
tibiotics, uch a penicilin, a the
"fi line of defense."
Although babies with sickle Cell
disease often look healthy, McCabe
cautions parents to. remember that
this is a life-threatening disease.
"The babies who die from sickle cell
are the ones who are not on
penicilin."
A PEDIATRICIAN CAN teach
parents to recognize the early
symptoms of serious complications,
such as a fever over 101 degrees
enlargement of the spleen, and swell­
ing and pain in the hands and feet.
Detecting sickle cell earlier is
making follow-up with families
easier, says McCabe. ,
"There is less chance that a family
will have moved, and families are
·much more receptive because they
get 8 definite answer rather than a
request for a second blood test," he
aid.
About one in 400 Black infants is
born with sickle cell anemia, which
occurs only when both parents carry
the sickle cell gene and pass it to the
baby. When bo�th pa�nts are car­
riers, each child will a have a 25
percent chance of having sickle cell
disease., .
People with one sickle cell gene
and one normal gene are carriers and
do not have the disease. It is es­
timated that one out of 10 blacks
carries the trai 1. d
, Th Right to Vote
I Void without
th Right to Bead
,
r to t ch omeon to READ!
how you how· ..
145-3118
o.tro L-.cy V •
I �
.",
hildren (up to age 5)
Call1-800-26-BIRTH
Call your Local Heal� Department
Women, Infants & Children Program (WIe)
Thi. il IUl Equal Opportunity Pro am. If you believe you have been d rimiDated ainst becau
of rae . color. national oriain, e. x. or handicap. write immediately to th.l Administrator. Food
Nutrition Servic s. 3101 P rk enter Driv . Alexandria. VA 2":';02.
"Sickle cell screening is avail­
able from the Sickle Cell Associa­
tion, physicians or county heal th
clinics," McCabe said. "Pre-natal
diagnosis is also available for at­
risk couple ."