Lead Poisoning: Gone but Not Forgotten

There was an article on April 21, 2010 featured in the http://www.nytimes.com which describes a mother in Staten Island who has a child who was tested for lead poisoning. The results show that he had double the level of lead than the federal government considers cause of concern about poisoning. This issue has decreased throughout the years that it was almost considered a thing of the past. There are jurisdiction that do not have lead hazard laws which require landlords to check exposed lead based paint if children are living in the home. The compliance in New York City is lacking despite a comprehensive law which was passed in 2004. There was a survey among 120 tenants in Bushwick, Brooklyn which reported 59% of landlords has not followed any of the law.

The Environmental Protection Agency (EPA) http://www.epa.gov will design a regulation that requires renovation and remodeling contractors to be certified in techniques for containing lead dust created during work. As a result, contractors are aware that the cost of renovation projects will increase in cost. This rule would apply to homes that were built before lead paint was banned in 1978. Governor David Paterson is researching ways to incorporate lead inspections into requirements for building permits and state assistance such as money for weatherization projects. The boroughs with the highest amount of lead in the soil are Brooklyn, Staten Island and Queens. The Department of Housing Preservation and Development (HUD) reported there were 31,463 violations in 2009 and the cost of repair reached $6 million. The Center for Disease Control (CDC) http://www.cdc.gov has prevention tips on how to protect children from lead paint, especially those under the age of 6 years who are at risk. It is estimated that 24 million housing units have leaded paint and lead contaminated house dust.

To illustrate this topic, the video "Lead Poisoning in Kids" was provided by the show How Stuff Works on February 20, 2009. It was aired on the Discovery Channel.

Medical Crisis and Healthcare Reform

There was an article posted on http://www.cnnmoney.com/ on March 17, 2010 written by Parija Kavilanz which focused on the medicaid issue faced by a pediatric practice in Georgia. A doctor had to refer a child to a pediatric orthopedic surgeon who would take Medicaid. The process took a long time and the injury healed on its own.

The Medicaid problem is causing doctors from taking new patients or dropping them. The reinbursement payments are low so businesses have closed. As a result, doctors are viewing more patients. Staff and doctors at this practice were laid off due to low income who are immigrants and refugee who have special needs.

For comparison, Medicaid payments are lower than Medicare. Medicare charges $100 for an elderly person's visit. Doctors are reinbursed $76, but if a child on Medicaid has the same illness the reinbursement is $50. There are differences between the two. Medicare rates are set by Congress and Medicaid allows the state to pay whatever they want. Doctors are concerned the budget crisis will cause more reinbursement cuts. I can relate with this article, when one of my patients was unable to locate a dermatologist for her daughter with Medicaid in New York City.

This brings up the controversey of healthcare reform. What concerns me are the penalties for people who do not get medical coverage both individually and for business owners. What if someone is not able to manage the financial responsibilities? I do not agree with this proposal. I favor how the managed care companies will not be able to discontinue coverage for someone with a pre-existing condition. At least this action will save many lives.