Longer looks: Dying at home; losing religion; Obamacare 2.0

Oct 3 2014

Each week, KHN's Shefali Luthra finds interesting reads from around the web.

The New York Times: A Father's Last Wish, And A Daughter's Anguish
He was still her handsome father, the song-and-dance man of her childhood, with a full head of wavy hair and blue eyes that lit up when he talked. But he was gaunt now, warped like a weathered plank, perhaps by late effects of an old stroke, certainly by muscle atrophy and bad circulation in his legs. Now she was determined to fulfill her father's dearest wish, the wish so common among frail, elderly people: to die at home. But it seemed as if all the forces of the health care system were against her -; hospitals, nursing homes, home health agencies, insurance companies, and the shifting crosscurrents of public health care spending (Nina Bernstein, 9/25).

The Atlantic: Why Don't We Treat Teeth Like The Rest Of Our Bodies?
About a third of people in the U.S. don't visit the dentist every year, and more than 800,000 annual ER visits arise from preventable dental problems. ... Since the beginning of time, dentistry and medicine have been considered inherently distinct practices. The two have never been treated the same way by either the medical system or public insurance programs. But as we learn more about how diseases that start in our mouths can ravage the rest of our bodies, it's a separation that's increasingly hard to rationalize (Olga Khazan, 9/25).

The Times-Picayune: Billing For Rape: Louisiana Sex Assault Victims Often Face Hefty Bills For Medical Care
She was questioned, prodded and photographed over the course of six hours. Nurses collected samples of tissue and fluid from her mouth and her body. They took her urine, drew her blood and bagged her clothes. They offered her drugs to prevent pregnancy, HIV and other sexually transmitted diseases. Then, they led her to a private shower and sent her home. Her life, she felt, was now divided into two eras: Pre-rape and post-rape. Eight days into the shock of this new reality, she received a letter she couldn't comprehend. The cost of some of the medical services she received totaled nearly $2,000, it said. Insurance would pay $1,400 (Rebecca Catalanello, 9/25).

Related, earlier KHN story: Rape Victims May Have To Pay For Some Medical Services (Andrews, 6/3)

The Atlantic: The Health Effects Of Leaving Religion
Americans are less religious than ever. A third of American adults under 30, and a fifth of all Americans don't identify with any religion, according to a 2012 study by Pew Research (an increase from 15 percent in 2007). But though scientists have studied people who leave cults, research on the health effects of leaving religion is slim. The most mainstream research on this is a 2010 study out of Pennsylvania State University, which examined data from 1972 to 2006. The study showed that 20 percent of people who have left religion report being in excellent health, versus 40 percent of people currently part of strict religious groups (such as Jehovah's Witnesses and Latter-Day Saints) and 25 percent of people who switched from a strict religion to a more lenient religion (Jon Fortenbury, 9/28).

Politico: Obamacare 2.0
Since President Obama signed the Affordable Care Act in 2010, the law has weathered a government shutdown, a Supreme Court challenge and scores of political attack ads. But while an estimated 20 million people have gained insurance under the law, it still has no shortage of opponents, from lawmakers trying to repeal it, governors blocking portions of it and lawyers challenging its constitutionality. More Americans, after all, still oppose the law than support it. So where does that leave us? One year after the ACA opened its new health insurance markets to the public, we asked some of the country's smartest health-care thinkers, from in and outside government and both sides of the aisle, to tell us what Obamacare hasn't fixed in the American health-care system-;and what we can do now (Stuart Butler, Peter Orszag, Vermont Sen. Bernie Sanders, Louisiana Gov. Bobby Jindal, Harold Pollack, Tennessee Sen. Lamar Alexander, Neera Tanden, Tevi Troy, Dr. Ezekiel Emanuel, Mike Leavitt, Donna Shalala, D. Taylor, Tom Daschle, Tennessee Rep. Phil Roe and Judy Feder, 9/29).