Tuesday, March 23, 2010

A guest post from Barbara O'Brien

On Sunday I linked to a Juan Cole post regarding the differences between the US and Iran regarding health care for the least of our citizens. Barbara O'Brien of MahaBlog has been gracious enough to allow me to post something she has written about health care in Iran and Mississippi, the least of our citizens.

Mississippians Turn to Iran for Health Care Help

Recently I wrote here that Mississippi has the worst health care in the nation. Now I want to tell the story about how desperate Mississippians, abandoned by their government, turned to Iran for help.

Bt first, I want to tell you about Mississippi’s infant mortality rate. The rate of infant mortality is the number of infants who are born alive but die before their first birthday, per 1,000 live births. In other words, if infant mortality is 5, that means that 5 of every 1,000 babies in that population will not survive the first year of life.

According to the CIA World Factbook, the estimated infant mortality rate in the United States for 2009 is 6.22, which is high for an industrialized democracy. But according to the U.S. Census Bureau, the infant mortality rate in Mississippi is 11.4. Only Florida is worse, at 14.1. By contrast, the infant mortality rate for Washington and Minnesota is 5.1.

Now, here’s where Iran comes in — according to the Times of London, last October “five top Iranian doctors, including a senior official at the health ministry in Tehran, were quietly brought to Mississippi” to advise Mississippians how to lower their infant mortality rate.

This exchange came about when James Miller, managing director of Oxford International Development Group, was consulting in a rural Mississippi hospital. “He was shocked to find that the state had the third highest medical expenditure per capita, but came last in terms of outcome,” the Times article said.

Miller remembered a conference presentation on how Iran radically lowered its infant mortality rates. Facing a shortage of doctors and hospitals, the government launched a program of “health houses” staffed by local people trained to be health workers. The health workers are authorized to provide basic medical services such as diabetes monitoring as well as prenatal and obstetric care. Infant and maternal mortality rates both fell dramatically as a result.

James Miller contacted Iranian doctors to find out if their program might be applied to Mississippi. So the Iranian doctors came to Mississippi to give advice. Although the idea of following an Iranian model was a hard sell in Mississippi, at least one community has begun work on an Iranian style “health house” to provide better care for pregnant women abandoned by Mississippi’s health care system.

Dr Aaron Shirley, who worked with James Miller on the Iranian project, admitted they were staying under the radar. Mississippi government officials, including Governor Haley Barbour, were not involved or informed.

This takes us back to the issue identified in the earlier post — Mississippi has the worst health care in the nation, but as far as Gov. Barbour is concerned, this is not a problem. The governor is perfectly clear, on his website and in public pronouncements, that Mississippi fixed its health care problems by passing a comprehensive tort reform bill in 2004. The 2004 law affected all kinds of personal injury lawsuits in Mississippi.

In the U.S., state after state has passed “tort reform” laws that make it harder for citizens to file personal injury suits and also limit the amount of damages they can receive. This is a critical issue for people with asbestos-related disease such as mesothelioma cancer, who so often need damage awards to care for themselves and their families. “Tort reform” also is being pushed by conservatives nationwide as the way to fix the nation’s health care crisis.

But Mississippi reformed tort in 2004, and it still has the worst health care in the nation. What did Governor Barbour “fix,” exactly?

-Barbara O’Brien




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