“The Burgeoning ‘Yelpification’ Of Health Care: Foundations Help Consumers Hold A Scale And A Mirror To The Health Care System”

“Electronic health records (EHRs), more than a decade ago, were expected to revolutionize how health information is stored and shared. Yet, even today,36 percent of office-based EHRs don’t permit secure messaging between patients and physicians, and 37 percent do not even allow patients to view their records. Instead, we see such sharing happening outside the traditional health care system, through Apple HealthKit and HUGO, mechanisms for people to carry their records in their pocket, on their phone.”

Read more here.

“School Lunches Are A Right, Not A Privilege”

Published in the HuffPost on May 23, 2017

As a candidate, Mayor de Blasio promised to enact universal free school lunch in New York City public schools.

The Mayor has aggressively pursued policies to decrease inequality in the City and clearly understands the important links among food access, health, and learning. From affordable housing to universal pre-K, the Mayor has worked to address the needs of poor and working class New Yorkers. But universal school lunch sticks out as an unfulfilled pledge.

I’ve written previously about the merits of eliminating school lunch fees and getting more kids to eat lunch at school. A hungry child can’t learn or realize her full potential. Hungry kids find it harder to do what is good for their health and engage in a natural part of growing up: being physically active and playing.

Many kids in New York City public schools do already qualify for free or reduced price lunch, but many of those who are eligible do not participate in the lunch program. What stops them? It’s simple: Stigma. Bullying. Shaming.

Students, especially in high school, skip the lunch program to avoid the embarrassment associated with being poor. Our schools provide textbooks, pencils, and other supplies to all students, regardless of income, but when it comes to food, public schools discriminate. Forcing kids to identify themselves as poor results in lasting shame and harm to fragile psyches. And make no mistake, the stigma is real and painful. It creates a false sense of inferiority, which is especially hard to shake when it is established at a young age.

Across the country, we see unconscionable examples of school staff—not just other kids—shaming students who can’t afford lunch. Cafeteria staff may throw out a perfectly good hot lunch if a student’s account isn’t paid up, giving him a cold cheese sandwich instead. Students may be given chores, like sweeping up the cafeteria, to pay off their debt. Other schools stamp students’ arms, a scarlet letter. Nearly 40% of all school districts have used these types of shaming tactics to get parents to square their accounts. To their credit, New Mexico and other states have now outlawed school lunch shaming. Just as there should be no shame in seeking help for mental health issues, there should be no shame for a child whose only “crime” is being poor and hungry.

When all kids have access to free lunch, the stigma and shaming disappear, and more students participate in the lunch program. Moving to a universal lunch policy dramatically increases the number of kids who eat. In New York City, some public schools were able to offer universal free school lunch in 2015–16, operating under federal provisions. Community Food Advocates analyzed school lunch data from the NYC Department of Education (DOE) for that school year and compared participation rates for students who had access to universal free school lunch with students whose schools offered the traditional lunch program. DOE’s own data reveal striking differences:

  • 60% of middle school students with universal free school lunch ate vs. 40% without universal, a 20-point difference.
  • 45% of high school students with universal free school lunch ate vs. 30% without universal, a 15-point difference.
  • 80% of elementary students with universal free school lunch ate vs. 70% without universal, a 10-point difference.

Proof that universal school lunch works also comes from the many cities that have already adopted it: places like Albany and Buffalo already have this program in place, as do big cities like Boston, Chicago, Dallas, and Philadelphia.

So it is not surprising that voters in New York City overwhelmingly support the implementation of universal free school lunch in all NYC public schools. A recent poll found that a whopping 82 percent of voters support universal school lunch. It is popular in all five boroughs, across income and race, and among individuals with and without school-aged children. New Yorkers view free school lunch on par with other key issues like opening shelters to address homelessness, implementing body cameras for police officers, and providing affordable senior housing. They agree that it is an important part of achieving the Mayor’s social and economic equality agenda by closing the economic gap for working families and closing the economic divide. And they understand that universal free school lunch will improve students’ physical health, emotional wellbeing, and academic performance and graduation rates.

Next month, New York City will enact its budget. The City Council’s proposed 2018 budget recommends the elimination of school lunch fees, but the outcome is far from certain. What we do know is that the inclusion of universal school lunch would do more than fulfill a campaign promise; it would be a sweeping pro-health, pro-child, and pro-equity measure for the nation’s largest public school system.

“Reimagining a Patient-Centered Health Care System”

“The term “patient-centered” has been around for a long time. The Institute of Medicine brought it to prominence with its 2001 seminal report “Crossing the Quality Chasm: A New Health System for the 21st Century,” and the term was interwoven into goals embodied in the Affordable Care Act. Most recently, the term has gained increasing use—sprinkled across the confirmation hearings of the new Secretary of the Department of Health and Human Services, and used in talking points for the American Health Care Act proposal.

At the New York Health Foundation (NYHealth), where we launched a new priority area, Empowering Health Care Consumersin 2016, it is gratifying to see that our nascent program is “on trend,” with both sides of the aisle extolling the virtues of a patient-centered health care system. But we have observed patient-centered become a Rorschach test, claimed equally by people with differing views as to what the term means.”

Read more here.