Journal of general internal medicine
-
Medicaid, which provides health insurance to low-income Americans, is a joint federal-state partnership that manifests as 50 unique state programs. States have policy flexibility to design programs within federal parameters. However, Medicaid also requires funding flexibility to encourage states to maintain services during times of crisis when more people need Medicaid. ⋯ In turn, during economic expansions, states should shoulder relatively more costs of Medicaid. Although the current FMAP boost provided under the Families First Coronavirus Response Act has reduced strain on state Medicaid programs, it does not account for the severity of state-specific downturns and is limited to the current emergency. Instead of ad hoc, across-the-board FMAP boosts to respond to each crisis, Congress should pass legislation making automatic adjustments based on changes in state unemployment rates.
-
The language of gratitude and of heroism, pervasive in public discourse about essential workers, is well-intended but belies a problematic blurring of the difference between gifts, contracts, and professionalism. "Heroism," a term frequently invoked by society, usually describes the giving of oneself beyond reasonable boundaries. This noble concept affirms our essential connections to each other. However, labeling someone's labor as a gift can make givers feel obligated exceed both contracts and professionalism. ⋯ Professionalism goes beyond special circumstances to address ongoing commitments to others. When the language of gifts, heroism, or professionalism are used to promote the ongoing performance of dangerous, excessive work, however, they become instruments of injustice and burnout. The experiences of the COVID pandemic can help identify the proper scope of gift-giving, heroism and professionalism - which cement our social bonds - while avoiding misuses of these terms, in order to improve the safety and fairness of the work environment.
-
Editorial Comment
Difficulty Taking Medications: a Corollary to Dementia Risk.