Archive for the 'New York' Category
Add a comment February 11th, 2009 by Matthew Anderson
Health Information Tool for Empowerment is an excellent website maintained by the Greater New York Hospital Association and sponsored by a number of foundations and corporations. This site is useful both for people who need services and for providers who help patients with inadequate or no insurance.
This website has a very extensive list of resources. For example, it lists 170 dental providers and 687 clinics. Each listing provides detailed information about the provider, including address, phone, services provided and even links to provider web pages. It is also possible to search for providers by zip code and distance you are willing to travel. The site also has a help phone number: (866) 370-HITE.
Here is a description of the site taken from their FAQ page:
The Health Information Tool for Empowerment (HITE) is the first online directory of health and social services specifically for uninsured and under-insured New Yorkers. With the click of a mouse, HITE allows professionals to link their underserved clients with a broad array of health and support services.
HITE has two components:
- Resource Directory. A comprehensive directory containing thousands of national, state, and local organizations and programs available to low-income, under-insured, and uninsured people, as well as links to dozens of Web sites that provide information on everything from how to apply for public health insurance to where you can get free or low-cost medications.
- Eligibility Calculator. Eligibility screening tool for public health insurance, private health insurance, and other public benefits programs. HITE links to two screening tools. The NYC Human Resources Administration pre-screening tool helps determine whether their clients meet the basic eligibility requirements for one of New York’s publicly funded health insurance programs: Medicaid, Child Health Plus (CHP), and Family Health Plus (FHP); or for a low-cost private insurance program. ACCESS NYC, sponsored by the City of New York Mayor’s Office screens for eligibility for public health insurance and other public benefits/government entitlements.
This posting is one in a series on free and low cost health care.
Posted by Matt Anderson, MD
2 Comments February 6th, 2009 by Matthew Anderson
The Youth Leadership Project organizers
There has been snow continuously on the ground in New York since before New Year, a somewhat rare occurrence in these days of global warming. And saturday, January 31st was a particularly cold night. As one approached the basement of the St. Nicholas Tolentine church, a few brave souls stood outside smoking cigarettes and talking on cell phones.
Inside was the first annual fund-raising dinner of the Youth Leadership Project, a South East Asian community group. A dozen or so large round tables were spread around a long white room. At the tables was a happy crowd made up mainly of Cambodian immigrants. The room was filled with the sounds of people greeting friends. They saluted each other by putting their hands together as if in prayer and making a slight bow. Little kids zoomed in and out from a neighboring “children’s” room, mingling briefly with the adults and then returning. A small bar in the corner did a brisk business while people waited for the evening to start.
Chhaya and Khamarin, two of the YLP organizers, started the evening with a brief introduction to the Youth Leadership Project and appeals for help with two current projects. One is the Justice is Healing project (covered in detail in our blog of October 15, 2008); the other is a planned community center (more details below). They spoke in English and then Chhaya’s mother Ousara Phok, got up and translated their speech, a “translation” that involved copious thanks to many of the people sitting in the room.
The speeches were accompanied by a three course meal from Huynh Catering Services. The Huynh family, originally from Cambodia, has a long tradition of catering and Victor, we were informed, “does all the Cambodian weddings.”
With the speeches over, the very serious business of dancing began. Monorom, “one of the best Cambodian bands”, had been invited from Philadelphia and clearly knew what music the audience wanted to hear. Very quickly the dance floor was full. There were several different types of dances. Madison looked something like a line dance and can be seen at this link. Next came the circle dance (ramvong) a slow dance in which the dancers made elaborate movements with their hands as their hips swung slowly from right to left and back. Genders alternated in the circle. It was explained that in the old times unmarried people were not allowed to touch as they danced, thus the physical separation created by the circle. Finally, the Saravan dance which seemed to draw the most enthusiastic crowd.
We found a few minutes to catch up with Khamarin, one of the YLP leaders. He is a 20 year old student at New York College of Technology with plans to become a X-ray technician. He was born in the US and wasn’t entirely sure where in Cambodia his parents were born. His mother, he thought, came from Battambang and his father from a very small village.
Khamarin’s first experience in organizing came in 1999 when his aunt, a YLP
Chhaya and Khamarin
organizer had been campaigning against the welfare reforms of the Guliani administration. (This campaign was the subject of a film “Eating Welfare” made by CAAV: Organizing Asian Communities, the parent of YLP). Khamarin was quite young at the time but could not help being impressed by the fact that his aunt had brought people to the community to help. Thinking back now, he remembers how his elderly grandmother had started doing piecework about the time of the welfare cuts. She sewed small hair bands (scrunchies) in her apartment. He thought she was doing it as a hobby, but later he realized how many women in the community were doing this kind of piece work. “They would do the sewing and then the kids would cut the bands apart and sort them into piles.”
In 2001, 2002 the YLP organized ACE gatherings: Arts, Community, Empowerment. “We would be broken up into little groups and have to cook an entire Asian meal right there,” he said, “You would interact with people who you wouldn’t normally meet.” He learned about “the whole other side of the world.” This led him to training in community organizing and in 2006 he participated in the community health survey that was part of the “Justice is Health” campaign. He would knock on doors and ask questions about health problems and experiences with the medical system. health. He remembered one elderly woman. “My Khmer is not all that good, but it was enough to understand her.” She told him that it had been 5 or 6 years since she had seen a doctor. She had complaints. Back pains, leg pains and recurrent nightmares going back to the war. But it was too much trouble to go to the clinic and have no one there who would understand you. And if she had to take the children to translate, they would miss school.
We discussed YLP’s vision of a community center. The YLP house at 2473 Valentine Ave now serves as an unofficial community center and people gather there for holidays. But it is small for the group’s ambitions. They hope to create a Mekong Center that will serve local southeast Asians, not just Cambodians. It would be place to teach cooking, sewing, gardening, art, and dance. “These are our people’s skills, even though here they are not looked on as skills.” A group of urban planning students from Hunter College had helped them out. As a school project the students had created plans for rebuilding the current house into a real community center. Estimated cost: $2 million. Now it was YLP’s job to figure out what they would do with the plans.
Khamarin said that he had never been to Cambodia. He is afraid of flying. What he knew of Cambodian history he had learned from YLP. His schooling had not taught him much about his parent’s native country.
The Cambodian community in the Bronx has suffered multiple traumas. But this was not in evidence last Saturday night.
posted by Matt Anderson, MD
2 Comments January 9th, 2009 by Matthew Anderson
After our earlier posts on free and low-cost health care in New York, we were approached by someone seeking care for a broken tooth.
Our earlier post had suggested the NYU College of Dentistry Clinic and similar clinics at other dental schools. We also mentioned New York City Department of Health dental clinics for people up to age 21. (Our patient was 23).
The nagging memory of a 2006 social medicine rounds (12/19/2006) led us to the Mayor’s Office of Citywide Health Insurance Access, a part of the city government which tries to make health insurance available to as many New Yorkers as possible. Their website has an extensive listing of Health Resources for the Uninsured. This page provides links to low cost dental services, mainly in hospitals. The site also has links to community health centers, as well as information on medications, mental health resources, and vision services.
If you have no insurance, this is a useful site to visit. It provides a screening tool (it shows up as a sidebar on each page) to help you determine if you might be eligible for any public or private insurance plans.
Finally, – in terms of free non-dental services – this week we learned the NYC DOH offers free condoms and lubricants to organizations that will distribute them for free. Click on this link.
Brush your teeth and floss after each meal, stay away from sweetened drinks and have fun (safely).
Posted by Matt Anderson, MD
1 Comment December 12th, 2008 by Matthew Anderson
Herceptin costs $3,000 a month
As part of our series on free and low cost health care in New York I wanted to share a few resources on free and low cost medicines.
Dr. Brian Alper (a family physician who founded DYNAMED) has put together a very useful set of clinical links for physicians at: www.myhq.com/public/a/l/alper. Among the many categories in this list are six links to “indigent drug programs.” To test these sites out, I decided to look up Herceptin, an anti-cancer agent made by Genentech. [I was recently asked to find this drug for a medically indigent patient.]
Needy Meds: is a not-for profit “with the mission of helping people who cannot afford medicine or health care costs.” The information at NeedyMeds is available anonymously and free of charge. The most useful part of this website is the listing of drugs – both generics and brand – that are available from patient assistance programs (PAP’s). If you find a drug and a PAP, many of the applications can be downloaded from the website. Most of the links seem to be from 2008. The site also has a link to free clinics. I easily found Herceptin on the Needy Meds site with links to application form in English and Spanish as well as the Genentech website.
Rx Assist is managed by Astra Zeneca and claims to be the “Web’s most current and comprehensive directory of Patient Assistance Programs.” The Rx Assist site has a searchable database so you don’t have to scroll down lists. Herceptin was also easy to find on RxAssist, but the site linked only to the English application and the Genentech site.
Benefits CheckUp is run by the National Council on Aging and is a very different type of site. It provides information on a wide variety of benefits – housing, food, medication, medical care, utilities, “and more.” It works a little bit like an online social worker. To find information on Herceptin (for a fictious patient), I needed to input zip code, age, information about work, income, and assets; this process generally takes 10-15 minutes according to the website. I could easily imagine that it would take much longer if you had to find all the documentation. When this was through, Benefits CheckUp suggested I apply for New York State’s EPIC program (which helps elderly people with prescription costs), New York State Medicaid and also offered the Genentech program. There were links to the Genentech site, application forms, and even a list of documents I would need. Very complete, but a bit daunting in terms of the information I needed to supply.
All three of the above sites linked to a variety of health care resources, not just medications.
Partnership for Prescription Assistance also links to PAP programs. This site required me to enter information (age, location, income, insurance coverage, etc) before leading me to the Genentech site. It did not link directly to the Herceptin application. Unlike the sites listed above PPARx did not provide links to other types of social programs (such as free clinics).
Finally, Dr. Alper’s site links to an August 2004 article in the American Family Physician “Curbside Consultation: When Patients Cannot Afford Their Medications” This is a very thorough review of the topic with – in typical AFP style – lots of useful information. According to the AFP article 5.5 million people were enrolled in PAP programs in 2002.
I would note that – based on my personal experience – the typical patient who needs the PAP’s often times does not have access to the internet nor facility with completing forms. So having someone to be their advocate is crucial. This is a weakness of these websites.
A couple of additional suggestions:
Patients should always check to see if they are overpaying. Do this by looking up the prices of medicines on Drugstore.com. Oftentimes pharmacies charge unreasonable prices (people go, after all, to the local store) and lots of money can be saved by shopping around.
A recent blog from Suite 101.com entitled “How to Find Free, Cheap Drugs” offered (among other information) a list of retailers offering low cost or free medications. These include WalMart, Target, K-Mart, and various food chains. For example, “Publix supermarkets offer free antibiotics if you have a valid prescription, regardless of whether you have health insurance. A 14-day supply is offered.”
Some sites I have seen offer to help patients find low-cost drugs from a small fee. Clearly this is not reasonable since this information is available for free.
As I have noted in previous blogs these various efforts do not solve the root cause of the problem: lack of universal access to healthcare (including medications) in the United States. But for patients in need these resources can be helpful.
Posted by Matt Anderson, MD
11 Comments December 9th, 2008 by Matthew Anderson
The old Lincoln Hospital
In April of 2007, our journal Social Medicine, published the audio tapes of a 1971 Pacifica Radio documentary about the conditions at Lincoln Hospital, one of the largest public hospitals in the Bronx. Lincoln had been briefly occupied by the community in 1970 and this takeover was the subject of several articles in the journal.
Unfortunately, technical problems broke the link to this audio. Thanks to help from Sebastian Pais Iriart this has now been corrected and the audio file is available at this link in mp3 format.
The audio tape was accompanied by an article. Here are the first few paragraphs:
“Lincoln Hospital: the decline of health care” was broadcast on WBAI radio in New York City on April 22, 1971, roughly a year after the community takeover of Lincoln Hospital (see Fitzhugh Mullan’s article “Seize the Hospital to Serve the People” on page 98 of this journal). The documentary provides an opportunity to
hear the voices of some of the people at the center of the struggle to reform – or revolutionize – one of New York City’s most dysfunctional hospitals.
These voices include physicians (Drs. Martin Stein, Helen Rodriguez-Trias, Lewis Fraad, Arnold Einhorn, and Fitzhugh Mullan), a community activist (Cleo Silvers), administrators (Antero Lacot, Edmund Rothschild, Stanley Bergin) and several patients.
Much of the documentary focuses on the health issues of the Bronx and the inadequacies of the hospital. Dr. Lewis Fraad notes, for example: “Lincoln Hospital is full of lead poisoning. And until recently, we have seen children get lead poisoning while hospitalized at Lincoln Hospital.” Patients recount long waits in the Emergency Room. [...to read the rest of the article, click here]
What makes this documentary particularly interesting is the extensive discussion/debate regarding woker and community control of the hospital. This topic is essentially absent from the current corporate-dominated discussion of hospital management.
We hope in January 2009 to publish a video interview with Cleo Silvers, one of the key activists at Lincoln.
posted by Matt Anderson
5 Comments November 21st, 2008 by Matthew Anderson
La Casita de la Salud, the free clinic of New York Medical College
Since our last posting (on 10/8/2008) about free and low-cost health care, we have learned of the following additional resources:
A 2003 article in the Village Voice entitled Free and Low Cost Health Care describes various options available in the City. One of the key issues for many people is dental care and the Voice article suggests the NYU College of Dentistry Clinic. Similar clinics exist at other dental schools and generally charge less than private practice. The New York City Department of Health also has dental clinics for people up to age 21.
There are several additional free medical student clinics which we did not mention in our prior posting. The following list (hopefully complete) is taken from the Cornell site:
The NYU site has a rather extensive list of free and low cost services in New York. The Cornell Site has a shorter list, but it is still worth looking at.
Finally, New Yorkers may want to look at the website of the Mayor’s Office of Citywide Health Insurance Access to learn if they might be qualify for either public or private insurance.
Free and low cost services are vitally important to the many people who are denied coverage by the current US healthcare system. But it is equally important that our society provide care to all who need it, obviating the need for free clinics.
For addtional posts about this topic, click here. We would be happy to post additional resources.
Posted by: Matt Anderson, MD
