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2 posts from October 2019


Essay: We Should Scrap Medicare Site Neutrality (October 23rd)

Last week The Hill published my essay/editorial, "We Should Scrap Medicare Site Neutrality."  At: https://thehill.com/opinion/healthcare/467169-we-should-scrap-medicare-site-neutrality.  For those who study Medicare payment policy, the essay explains site neutral payments have become viewed as sine qua non, or essential or indispensable policy.  The problem is, as I argue, the policy, among other things, is based on little supportive research evidence and MedPAC's argument constitutes circular reasoning, or where the proposition and premise support one another.  Here, HOPD volume increased because of additional physicians and additional physicians increased HOPD volume. 


NHCHC's Bobby Watts and Barbara DePietro Discuss Health Care for the Homeless (October 24th)

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Though difficult to accurately calculate for obvious reasons, the Department of Housing and Urban Development's (HUD's) 2018 point-in-time survey identified over 550,000 individuals living in emergency shelters, transitional housing or were unsheltered.  One-third were families, a disproportionate number were African American and/or veterans and a growing number were victims of wildfires or a severe climate event (think: Hurricane Florence or Michael).  The homelessness problem is worsening for numerous reasons including growing income inequality and the lack of livable wages, failed federal policy, an insufficient stock of affordable housing, the criminalization of poverty and health care that leaves nearly 30 million non-elderly uncovered and/or is ill equipped to diagnose and treat a homeless population that bears a heavy disease burden that includes psychotic and affective disorders.  

During this 30 minute conversation Mr. Watts and Dr. DePietro begin by briefly explaining how NHCHC is organized and its mission.  They discuss moreover upstream or systemic causes of homelessness, the inadequacy of affordable housing and the failure of related federal policy, the criminalization of homelessness and its effects,  the prevalence and largely unmet physical and behavioral health care needs, associated health care costs and what some health care institutions are doing to recognize the necessity of combining medical care with social service supports including housing. 

Mr. G. Robert (Bobby) Watts is the CEO of the National Health Care for the Homeless Council.  Mr.Watts has more than 25 years of experience in administration, direct service, and implementation of homeless health services. He began his work with people experiencing homelessness as a live-in staff member of the New York City Rescue Mission in Manhattan.   Previously Watts-photo-200x200he served as the ED of New York City’s Care for the Homeless where he significantly expanded the organizations FQHC and constructed a women’s shelter.   Mr. Watts is also the former Finance Officer of the New York City HIV Health and Human Services Planning Council.   He has served on the Steering Committee of the New York City Medicaid Managed Care Task Force and a member of the New York State Interagency Council on Homelessness and numerous other related committees, task forces and work groups.  He earned his undergraduate degree at Cornell University, his a MPH and Master's of Science in epidemiology from Columbia University and holds a Certificate of Theological Studies from Alliance Theological Seminary in Nyack,

Barbara DiPietro, Ph.D.,  directs the policy and advocacy activities for the National Health Care for the Homeless Council. Barbara-3-200x173This includes conducting policy analysis, providing educational materials and presentations to a broad range of policymakers and other stakeholders, coordinating the Council’s policy priorities with national partners, and organizing staff assistance to the Policy Committee and the National Consumer Advisory Board.   Previously, she worked for the State of Maryland in the Governor’s Office as well as the Department of Health.  Dr. DePietro holds a Master’s Degree in Policy Sciences and a Doctorate in Public Policy, both from the University of Maryland, Baltimore County.  Her dissertation research focused on the impact of homelessness on emergency departments in Baltimore City. 

For information on NHCHC go to: https://nhchc.org/  

Per my mention of the 2018 UN report on poverty in the US, i.e., "Statement on Visit to the USA, by Professor Philip Alston, United Nations Special Rapporteur on Extreme Poverty and Human Rights" go to: https://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=22533&LangID=E

Per my mention of Amazon's opposition last year to a Seattle tax that would have helped the homeless, see: https://www.nytimes.com/2018/06/12/technology/seattle-tax-amazon.html