Tag Archives: Healthcare

Fear over healthcare locks Americans in jobs – and throttles creativity | Jonathan R Goodman

Millions of Americans are stuck in what some economists call “job-lock” or the inability to leave employment because of the risk of losing health insurance. A 2001 paper from Princeton’s Center for Economic Policy Studies showed, for example, that self-employed people are 25% less likely to have health insurance than office workers.

Uncertainty surrounding the future of the Affordable Care Act (ACA), widely known as Obamacare, has left many people feeling too scared to risk leaving full-time employment to attempt something on their own. After several failed attempts to repeal the ACA, the current administration may, in its latest tax plan, get rid of the individual mandate that requires most Americans be insured.

The cost of job-lock may, however, be more damaging than keeping people glued to full-time work: America may be becoming a less creative place – and a less attractive place for creative people.


Future generations who will be raised to shun creative careers in favor of healthcare-providing employment

A high job-lock rate is repeatedly linked to fewer small businesses, despite the seemingly universal agreement that small business is the “backbone” of the American economy. And yet a 2009 study by the Center for Economic and Policy Research showed that the US has fewer manufacturing small businesses than almost any other country – and a self-employment rate of about 7%, compared with 13.8% in the UK and 26.4% in Italy.

But what about the people who don’t want office jobs at all? America is full of creative minds, from mathematicians to photographers and artistic baristas. Shouldn’t Americans also place some importance on their country’s cultural position in the world?

The relationship between health insurance and economic freedom may be one reason the House minority leader, Nancy Pelosi, touted in 2012 that the ACA would allow Americans to quit their jobs and become “whatever”.

Becoming “whatever” doesn’t, after all, include only small manufacturing businesses – it includes an accountant becoming a comedian, a full-time steel factory worker becoming a poet, a tax lawyer opening an arts studio.

While the ACA’s effects on job-lock are not yet clear, the uncertainty of healthcare reform – coupled with the possibility that pre-existing conditions will be held against people by insurers – has left many people previously considering leaving salaried employment feeling trapped.

Expensive insurance rates for unemployed people are not the only concern. Drugs for chronic illnesses, from asthma to cancer, are hitting record highs in the US. Patients with a rare type of leukemia, for example, can now live a nearly normal lifespan with Imatinib, a kind of targeted therapy. The catch, however, is the drug can cost uninsured patients in America upwards of $ 145,000 per year – while in India a 30-day supply costs about $ 400.

Even with Obamacare, it’s understandable that people with insurance are terrified of leaving work to navigate the nebulous world of self-employment. If the ACA is repealed and pre-existing conditions lead to higher insurance rates, previous diagnosis of “chronic illnesses” from acne and anxiety to Crohn’s disease and cancer may prohibit people from obtaining health insurance at all.

Taken together, does it sound wise to strike out on your own in America just because you have creative talent?

Forcing people to remain employed for the sake of health has a high cultural cost: the cost of human creativity. This cost is, furthermore, not limited to the immediate workforce, but to future generations who will be raised to shun creative careers in favor of healthcare-providing employment.

Just imagine the absurdity of a parent convincing a talented child writer to plan for a career in public relations just because she has asthma, or a musically talented undergraduate switching majors to business just for a better chance at an office job.

Almost every European nation has signed the European social charter, which holds that healthcare is a human right. Combined with laws guaranteeing the freedom of movement of workers within the EU, this charter enables people from many backgrounds to work together, bringing innovation and creativity from one culture to many others. Why bother coming to the US?

Americans may be trapping the next William James, Herman Melville, or Bob Dylan in a cubicle: and for what? What cultural achievements are we costing this country by training future generations to aim away from their dreams only so they can afford exorbitantly priced medications? What could and should make America great is the freedom to follow one’s dreams, not a prison installed by unchecked insurance companies.

For America to really be great, it’s critical that people are given the freedom to be creative.

  • Jonathan R Goodman is the editor of Cancer Therapy Advisor and a researcher at the City University of New York’s department of biology, where he studies cultural evolution

Fear over healthcare locks Americans in jobs – and throttles creativity | Jonathan R Goodman

Millions of Americans are stuck in what some economists call “job-lock” or the inability to leave employment because of the risk of losing health insurance. A 2001 paper from Princeton’s Center for Economic Policy Studies showed, for example, that self-employed people are 25% less likely to have health insurance than office workers.

Uncertainty surrounding the future of the Affordable Care Act (ACA), widely known as Obamacare, has left many people feeling too scared to risk leaving full-time employment to attempt something on their own. After several failed attempts to repeal the ACA, the current administration may, in its latest tax plan, get rid of the individual mandate that requires most Americans be insured.

The cost of job-lock may, however, be more damaging than keeping people glued to full-time work: America may be becoming a less creative place – and a less attractive place for creative people.


Future generations who will be raised to shun creative careers in favor of healthcare-providing employment

A high job-lock rate is repeatedly linked to fewer small businesses, despite the seemingly universal agreement that small business is the “backbone” of the American economy. And yet a 2009 study by the Center for Economic and Policy Research showed that the US has fewer manufacturing small businesses than almost any other country – and a self-employment rate of about 7%, compared with 13.8% in the UK and 26.4% in Italy.

But what about the people who don’t want office jobs at all? America is full of creative minds, from mathematicians to photographers and artistic baristas. Shouldn’t Americans also place some importance on their country’s cultural position in the world?

The relationship between health insurance and economic freedom may be one reason the House minority leader, Nancy Pelosi, touted in 2012 that the ACA would allow Americans to quit their jobs and become “whatever”.

Becoming “whatever” doesn’t, after all, include only small manufacturing businesses – it includes an accountant becoming a comedian, a full-time steel factory worker becoming a poet, a tax lawyer opening an arts studio.

While the ACA’s effects on job-lock are not yet clear, the uncertainty of healthcare reform – coupled with the possibility that pre-existing conditions will be held against people by insurers – has left many people previously considering leaving salaried employment feeling trapped.

Expensive insurance rates for unemployed people are not the only concern. Drugs for chronic illnesses, from asthma to cancer, are hitting record highs in the US. Patients with a rare type of leukemia, for example, can now live a nearly normal lifespan with Imatinib, a kind of targeted therapy. The catch, however, is the drug can cost uninsured patients in America upwards of $ 145,000 per year – while in India a 30-day supply costs about $ 400.

Even with Obamacare, it’s understandable that people with insurance are terrified of leaving work to navigate the nebulous world of self-employment. If the ACA is repealed and pre-existing conditions lead to higher insurance rates, previous diagnosis of “chronic illnesses” from acne and anxiety to Crohn’s disease and cancer may prohibit people from obtaining health insurance at all.

Taken together, does it sound wise to strike out on your own in America just because you have creative talent?

Forcing people to remain employed for the sake of health has a high cultural cost: the cost of human creativity. This cost is, furthermore, not limited to the immediate workforce, but to future generations who will be raised to shun creative careers in favor of healthcare-providing employment.

Just imagine the absurdity of a parent convincing a talented child writer to plan for a career in public relations just because she has asthma, or a musically talented undergraduate switching majors to business just for a better chance at an office job.

Almost every European nation has signed the European social charter, which holds that healthcare is a human right. Combined with laws guaranteeing the freedom of movement of workers within the EU, this charter enables people from many backgrounds to work together, bringing innovation and creativity from one culture to many others. Why bother coming to the US?

Americans may be trapping the next William James, Herman Melville, or Bob Dylan in a cubicle: and for what? What cultural achievements are we costing this country by training future generations to aim away from their dreams only so they can afford exorbitantly priced medications? What could and should make America great is the freedom to follow one’s dreams, not a prison installed by unchecked insurance companies.

For America to really be great, it’s critical that people are given the freedom to be creative.

  • Jonathan R Goodman is the editor of Cancer Therapy Advisor and a researcher at the City University of New York’s department of biology, where he studies cultural evolution

Children’s tsar savages NHS over paucity of mental healthcare

The children’s commissioner has launched a savage attack on the head of the NHS, accusing him of denigrating research that shows an “unacceptable” lack of children’s mental health provision.

In a highly unusual move, Anne Longfield has published an open letter to Simon Stevens, chief executive of NHS England, accusing him of ignoring young people’s experiences of the service and the frustrations of their parents. Laying out a list of grievances against him and his team, she also threatens to use the law to compel him to hand over data on waiting times for children’s mental health services.

Longfield made the decision to go public with her complaints – published on the commissioner’s website – after Stevens rubbished many of the claims in her recent report into children’s mental health, an issue she identified as her top priority after consulting with children.

“Many told me about their desperate attempts, sometimes lasting years, to access support, and even primary school children raised concerns about anxiety,” Longfield told Stevens in the letter. The report, published to coincide with World Mental Health Day last week, estimated that only between a quarter and a fifth of children with mental health conditions received help last year. It stated: “Progress in improving children’s mental health services has been unacceptably slow.”

Stevens is standing his ground. In a response to Longfield, obtained by the Observer, he suggests NHSE was “bounced” into giving a response to the report only after aspects of it were shared with journalists. He said that a key finding of the report, that “the government’s much-vaunted prioritisation of mental health has yet to translate into change at a local level”, was “demonstrably factually inaccurate”. Stevens writes: “I’m afraid we stand by our view that your report did indeed in places give a misleading view of NHS care.”

Longfield had warned that provision for young people was a postcode lottery and said that “children’s inability to access mental health support” was leading to a range of extra problems, “from school exclusions to care placements breaking down to children ending up in the youth justice system”.

It is highly unusual for the holders of two important public offices to be involved in such a public argument, particularly over an issue as sensitive as children’s mental health. Longfield, whose role is to promote and defend the rights of children, was appointed to the post by then education secretary Nicky Morgan in 2014. Stevens took his job at the head of NHS England (NHSE) in the same year.

Longfield’s report made difficult reading for the government at a time when concerns over the health service have reached a critical level. Theresa May identified improving mental health as a key issue but, before the busy winter period, there are concerns the NHS will struggle to cope with demand even for what are considered priority services, such as accident and emergency.

Stevens’s robust criticisms that the report contained “basic errors” were a powerful retort to Longfield’s claims. However, in a move that will ensure mental health provision for young people once again becomes a major political issue, Longfield has hit back, saying the report was published only after consultation with NHS England.

“The briefing was prepared using the NHS’s own data,” Longfield writes. “My conclusion on reading, checking and rechecking was that the service that exists at the moment is worryingly poor, a conclusion I stand by.”

In a highly personalised attack, Longfield tells Stevens: “I was very disappointed that NHS England’s response to our report, and your own personal response in front of the Commons health select committee, was to attempt to denigrate the research. Not once did you address the central issues raised. Instead, you and your team sought to undermine the important evidence that we are putting forward and strangely ignore the reality of children’s experiences of the service and the frustrations of their parents.”

Longfield suggested that Stevens’s claims that she and her team had not bothered to check the report were “untrue”. Similarly, claims that NHSE had not been given adequate time to review the report before commenting were also without foundation, according to Longfield. “I am under no duty or obligation to share my work in advance, yet we did so, out of courtesy.”

Stevens had indicated that NHSE was in possession of data that could be used to refute many of Longfield’s claims. However, the commissioner said: “If the NHS has data not in the public domain that disputes the picture we painted, then in the interests of transparency and accountability NHSE should publish it.”

She adds: “I hope you will feel able to share this data. As you will know, I am also able to demand such data under section 2f of the Children’s Act 2014.”

She concludes: “I hope in future we could all concentrate our efforts on tackling [health issues] rather than trying to undermine the work of those who make valid and constructive criticisms.”

Sarah Wollaston, chair of the health select committee, said the row would be discussed when the committee met on Tuesday.

“It’s very important that there is a constructive relationship between the Office of the Children’s Commissioner and NHS England,” she said.

Children’s tsar savages NHS over paucity of mental healthcare

The children’s commissioner has launched a savage attack on the head of the NHS, accusing him of denigrating research that shows an “unacceptable” lack of children’s mental health provision.

In a highly unusual move, Anne Longfield has published an open letter to Simon Stevens, chief executive of NHS England, accusing him of ignoring young people’s experiences of the service and the frustrations of their parents. Laying out a list of grievances against him and his team, she also threatens to use the law to compel him to hand over data on waiting times for children’s mental health services.

Longfield made the decision to go public with her complaints – published on the commissioner’s website – after Stevens rubbished many of the claims in her recent report into children’s mental health, an issue she identified as her top priority after consulting with children.

“Many told me about their desperate attempts, sometimes lasting years, to access support, and even primary school children raised concerns about anxiety,” Longfield told Stevens in the letter. The report, published to coincide with World Mental Health Day last week, estimated that only between a quarter and a fifth of children with mental health conditions received help last year. It stated: “Progress in improving children’s mental health services has been unacceptably slow.”

Stevens is standing his ground. In a response to Longfield, obtained by the Observer, he suggests NHSE was “bounced” into giving a response to the report only after aspects of it were shared with journalists. He said that a key finding of the report, that “the government’s much-vaunted prioritisation of mental health has yet to translate into change at a local level”, was “demonstrably factually inaccurate”. Stevens writes: “I’m afraid we stand by our view that your report did indeed in places give a misleading view of NHS care.”

Longfield had warned that provision for young people was a postcode lottery and said that “children’s inability to access mental health support” was leading to a range of extra problems, “from school exclusions to care placements breaking down to children ending up in the youth justice system”.

It is highly unusual for the holders of two important public offices to be involved in such a public argument, particularly over an issue as sensitive as children’s mental health. Longfield, whose role is to promote and defend the rights of children, was appointed to the post by then education secretary Nicky Morgan in 2014. Stevens took his job at the head of NHS England (NHSE) in the same year.

Longfield’s report made difficult reading for the government at a time when concerns over the health service have reached a critical level. Theresa May identified improving mental health as a key issue but, before the busy winter period, there are concerns the NHS will struggle to cope with demand even for what are considered priority services, such as accident and emergency.

Stevens’s robust criticisms that the report contained “basic errors” were a powerful retort to Longfield’s claims. However, in a move that will ensure mental health provision for young people once again becomes a major political issue, Longfield has hit back, saying the report was published only after consultation with NHS England.

“The briefing was prepared using the NHS’s own data,” Longfield writes. “My conclusion on reading, checking and rechecking was that the service that exists at the moment is worryingly poor, a conclusion I stand by.”

In a highly personalised attack, Longfield tells Stevens: “I was very disappointed that NHS England’s response to our report, and your own personal response in front of the Commons health select committee, was to attempt to denigrate the research. Not once did you address the central issues raised. Instead, you and your team sought to undermine the important evidence that we are putting forward and strangely ignore the reality of children’s experiences of the service and the frustrations of their parents.”

Longfield suggested that Stevens’s claims that she and her team had not bothered to check the report were “untrue”. Similarly, claims that NHSE had not been given adequate time to review the report before commenting were also without foundation, according to Longfield. “I am under no duty or obligation to share my work in advance, yet we did so, out of courtesy.”

Stevens had indicated that NHSE was in possession of data that could be used to refute many of Longfield’s claims. However, the commissioner said: “If the NHS has data not in the public domain that disputes the picture we painted, then in the interests of transparency and accountability NHSE should publish it.”

She adds: “I hope you will feel able to share this data. As you will know, I am also able to demand such data under section 2f of the Children’s Act 2014.”

She concludes: “I hope in future we could all concentrate our efforts on tackling [health issues] rather than trying to undermine the work of those who make valid and constructive criticisms.”

Sarah Wollaston, chair of the health select committee, said the row would be discussed when the committee met on Tuesday.

“It’s very important that there is a constructive relationship between the Office of the Children’s Commissioner and NHS England,” she said.

Children’s tsar savages NHS over paucity of mental healthcare

The children’s commissioner has launched a savage attack on the head of the NHS, accusing him of denigrating research that shows an “unacceptable” lack of children’s mental health provision.

In a highly unusual move, Anne Longfield has published an open letter to Simon Stevens, chief executive of NHS England, accusing him of ignoring young people’s experiences of the service and the frustrations of their parents.

Laying out a list of grievances against him and his team, she also threatens to use the law to compel him to hand over data on waiting times for children’s mental health services.

Longfield made the decision to go public with her complaints – published on the commissioner’s website – after Stevens rubbished many of the claims in her recent report into children’s mental health, an issue she identified as her top priority after consulting with children.

“Many told me about their desperate attempts, sometimes lasting years, to access support, and even primary school children raised concerns about anxiety,” Longfield told Stevens in the letter.

The report, published to coincide with World Mental Health Day last week, estimated that only between a quarter and a fifth of children with mental health conditions received help last year. It stated: “Progress in improving children’s mental health services has been unacceptably slow.”

Longfield warned that provision for young people was a postcode lottery and said that “children’s inability to access mental health support” was leading to a range of extra problems, “from school exclusions to care placements breaking down to children ending up in the youth justice system”.

It is highly unusual for the holders of two important public offices to be involved in such a public argument, particularly over an issue as sensitive as children’s mental health. Longfield, whose role is to promote and defend the rights of children, was appointed to the post by then education secretary Nicky Morgan in 2014.

Stevens took his job at the head of NHS England (NHSE) in the same year. Longfield’s report made difficult reading for the government at a time when concerns over the health service have reached a critical level.

Theresa May identified improving mental health as a key issue but, before the busy winter period, there are concerns the NHS will struggle to cope with demand even for what are considered priority services, such as accident and emergency.

Stevens’s robust criticisms that the report contained “basic errors” were a powerful retort to Longfield’s claims. However, in a move that will ensure mental health provision for young people once again becomes a major political issue, Longfield has hit back, saying the report was published only after consultation with NHS England.

“The briefing was prepared using the NHS’s own data,” Longfield writes. “My conclusion on reading, checking and rechecking was that the service that exists at the moment is worryingly poor, a conclusion I stand by.”

In a highly personalised attack, Longfield tells Stevens: “I was very disappointed that NHS England’s response to our report, and your own personal response in front of the Commons health select committee, was to attempt to denigrate the research.

“Not once did you address the central issues raised. Instead, you and your team sought to undermine the important evidence that we are putting forward and strangely ignore the reality of children’s experiences of the service and the frustrations of their parents.”

Longfield suggested that Stevens’s claims that she and her team had not bothered to check the report were “untrue”. Similarly, claims that NHSE had not been given adequate time to review the report before commenting were also without foundation, according to Longfield. “I am under no duty or obligation to share my work in advance, yet we did so, out of courtesy.”

Stevens had indicated that NHSE was in possession of data that could be used to refute many of Longfield’s claims. However, the commissioner said: “If the NHS has data not in the public domain that disputes the picture we painted, then in the interests of transparency and accountability NHSE should publish it.”

She adds: “I hope you will feel able to share this data. As you will know, I am also able to demand such data under section 2f of the Children’s Act 2014.”

She concludes: “I hope in future we could all concentrate our efforts on tackling [health issues] rather than trying to undermine the work of those who make valid and constructive criticisms.”

Stevens is standing his ground. In a response to Longfield, obtained by the Observer, he suggests NHSE was “bounced” into giving a response to the report only after aspects of it were shared with journalists.

He said that a key finding of the report, that “the government’s much-vaunted prioritisation of mental health has yet to translate into change at a local level”, was “demonstrably factually inaccurate”.

Stevens writes: “I’m afraid we stand by our view that your report did indeed in places give a misleading view of NHS care.”

Sarah Wollaston, chair of the health select committee, said the row would be discussed when the committee met on Tuesday: “It’s very important that there is a constructive relationship between the Office of the Children’s Commissioner and NHS England. This has raised important matters about the funding of mental healthcare.”

Gambling remains a hidden addiction because ‘healthcare staff lack training’

Gambling is often described as a hidden addiction. Yet there are an estimated 400,000 problem gamblers in the UK. Dr Henrietta Bowden-Jones, consultant psychiatrist at the National Problem Gambling Clinic – the only one of its kind in the UK – says that a lack of training among healthcare professionals could partly be to blame for the problem flying under the radar.

“For many years while drug and alcohol addictions were being researched and funded in terms of treatment, the issue of gambling wasn’t taught at medical school,” Bowden-Jones says. “Even as an addictions psychiatrist, we weren’t taught about pathological gambling – I came across it by chance.”

Problem gambling can lead to arguments and emotional violence in the home, she says, often because one person wants to spend money that was saved up for retirement, for example, or the mortgage.

Gambling, Bowden-Jones adds, also moves any focus or passion away from a loved one: “It’s linked to the emotional disconnection you end up having with your partner or children because you’re just not there, either physically because you’re in the bookmakers or mentally because you’re disengaged, thinking about the gambling.”

And problems can go beyond mental or emotional issues: “Physically, we see people who are very underweight because they’re not eating – either because they’re gambling or because they haven’t the money to do so. Addicts aren’t healthy because they sit in front of a screen at home. You can imagine the consequences of not moving for months or years on end.”

One of the biggest issues is that problem gamblers are not accessing treatment or people do not know how to get help. Last year, support charity GambleAware saw 8,800 clients – a fraction of those with a problem.

Dr Jane Rigbye, director of commissioning at the charity, says more resources need to go into raising awareness of the addiction: “Although the impacts are as detrimental to family life, development and health, the kudos it’s given by other professionals isn’t as high as other addictions, partly because there’s no clear pathway for treating someone with a gambling problem.”

One solution is to empower healthcare professionals and have more conversations with them. “They have the skills to deal with this,” Rigbye says. “They just need to have some awareness of where to push people for help.”

I’d lose everything by 11am. It was hard for me to accept the loss

Owen Baily, 34, from Oxfordshire, has learned how to manage his gambling addiction after attending a cognitive behaviour therapy course run by the National Problem Gambling Clinic.

Owen Baily


‘I’ve used drugs – crack cocaine, amphetamines – but the high I experienced when I won big at gambling surpassed anything else.’ Photograph: Graeme Robertson for the Guardian

I was in receipt of benefits for a long time. In the lead up to the day I got my money, I tried to convince myself that I wouldn’t gamble. As soon as I woke up, my thinking changed – I’d become consumed by gambling. I couldn’t think about anything else. I became tense and anxious. It was like the money was burning a hole in my pocket. I tried to resist, but I couldn’t.

I didn’t have breakfast. I was filled with anticipation, tension and anxiety. I became convinced that I could win some money. I dismissed all my past experiences that proved gambling was not a good idea. My mind focused on positive possible outcomes. I was in the bookies as soon as the doors opened. I was oblivious to anyone and anything. It was just me and the terminal.

I’d often lose everything by 11am. It was very hard for me to accept the loss, bearing in mind that I had another 13 days until I got paid again. I’d curse myself and go into a period of depression for 10 or 11 days. It was like I had just assaulted myself. My brain hurt. I felt frustrated and annoyed with myself.

I would go home and wallow in self-pity and make plans for how I was going to survive. I’d check phone boxes for money, wait outside clubs on a weekend night because I knew that’s when people dropped things, and look for loose change on the streets, so I could buy baked beans and bread.

I’ve used drugs – crack cocaine, amphetamines – but the high I experienced when I won big at gambling surpassed anything else. It’s very potent, very toxic, very powerful.

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.

If you’re looking for a healthcare job or need to recruit staff, visit Guardian Jobs.

How unexpected chats spark ideas to transform healthcare | Anna Howells

How often does the chat you didn’t expect to have end up being the best conversation of your day?

It might be with a colleague you don’t often get a chance to talk to, the person from another team you never have quite enough time to sit down with, or someone you happen to bump into. Such unexpected conversations can spark ideas, open up new ways of thinking and help solve problems.

To encourage these conversations, Kaleidoscope Health and Care partnered with the Guardian Healthcare Professionals Network to send brown paper envelopes with £100 to five lucky recipients to spend on whatever they liked – as long as it was in the cause of having an unexpected conversation on the theme of health and care.

We startled a few finance departments, which sent incredulous emails enquiring what the envelope full of money was for. Coffees, lunches and train tickets were all options; we didn’t mind. All we asked was that winners spent the money within a month, had fun doing so and wrote us two 750-word blogs about the conversations.

To be in with a chance of receiving an envelope, we asked applicants to blog about their best unexpected conversation to date. We were blown away by the response. Entries came from as far away as Pakistan. Applicants from a variety of professions entered, including occupational therapists, policymakers, GPs and charity chief executives. The resulting blogs covered a host of topics, ranging from elderly care to US politics.

Did these conversations fulfil our aim? We think they did – or at least laid the foundations. Our project revealed that unexpected conversations can take place wherever you are, between people of all ages.

Becks Fisher’s unexpected conversation with a US pharmacist while on the campaign trail for Hillary Clinton led her to think differently about our healthcare system – both how lucky we are to have it but also how fragile it is.

Rhiannon is a pharmacist unlike any I have encountered in the UK. She does dispense medications, and she can help people with weight management, self-limiting illness and flu shots, but that’s not what she spends most of her time doing … For her patients, a prescription isn’t the drugs they will take, it is a wish list of those they might take if they have means to do so.

More than one applicant chose to blog about care for older people. Charlotte Williams, chief of staff for UCLPartners Academic Health Science Partnership, described a conversation focused on thinking differently about how we consider elderly patients.

The best unexpected conversation I had was with a geriatrician I was working with a few years ago. She had the view that no older person she looked after was a single unit. She felt that the best physicians – or any member of the clinical team – knew to treat the unit, to ask as much about the accompanying support as the person … in the chair or on the trolley.

For occupational therapist Melissa Purkis and a nurse, the conversation considered innovative solutions to care.

We talked about the initiative in the Netherlands where residential and nursing homes are pairing up with colleges and universities to provide affordable living spaces for students, in return for the students interacting with the older people. In an age where the disparity between young and old is developing like a gaping chasm, and there are numerous reports about loneliness in both younger and older people, it surely makes sense to counter this.

We learned that an unexpected conversation between Kath Parsons and a Macmillan Cancer Support officer led to the establishment of the Older Peoples Advocacy Alliance, the only national organisation supporting independent advocacy for older people.

When the pair discussed a Macmillan report which found older people are often at a disadvantage when it comes to receiving cancer care, their conversation sparked an idea to recruit older people who have been affected by cancer to support their peers.

Peer advocates walk side by side with older people, providing whatever support is needed, from emotional support to housing, benefits or social care advice, treatment needs, and planning for end of life.

Prof Mah Muneer Khan learned that children can be unexpectedly knowledgeable about hand hygiene, which is promising in a world where there are more than 1.4m cases of healthcare-associated infections at any given time.

Our “Unexpected Fellows” have since had more conversations and blogged the results. We hope they inspire you to think about how you can get more of the unexpected into your everyday.

Anna Howells is a partner at Kaleidoscope Health & Care

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.

If you’re looking for a healthcare job or need to recruit staff, visit Guardian Jobs.

How unexpected chats spark ideas to transform healthcare | Anna Howells

How often does the chat you didn’t expect to have end up being the best conversation of your day?

It might be with a colleague you don’t often get a chance to talk to, the person from another team you never have quite enough time to sit down with, or someone you happen to bump into. Such unexpected conversations can spark ideas, open up new ways of thinking and help solve problems.

To encourage these conversations, Kaleidoscope Health and Care partnered with the Guardian Healthcare Professionals Network to send brown paper envelopes with £100 to five lucky recipients to spend on whatever they liked – as long as it was in the cause of having an unexpected conversation on the theme of health and care.

We startled a few finance departments, which sent incredulous emails enquiring what the envelope full of money was for. Coffees, lunches and train tickets were all options; we didn’t mind. All we asked was that winners spent the money within a month, had fun doing so and wrote us two 750-word blogs about the conversations.

To be in with a chance of receiving an envelope, we asked applicants to blog about their best unexpected conversation to date. We were blown away by the response. Entries came from as far away as Pakistan. Applicants from a variety of professions entered, including occupational therapists, policymakers, GPs and charity chief executives. The resulting blogs covered a host of topics, ranging from elderly care to US politics.

Did these conversations fulfil our aim? We think they did – or at least laid the foundations. Our project revealed that unexpected conversations can take place wherever you are, between people of all ages.

Becks Fisher’s unexpected conversation with a US pharmacist while on the campaign trail for Hillary Clinton led her to think differently about our healthcare system – both how lucky we are to have it but also how fragile it is.

Rhiannon is a pharmacist unlike any I have encountered in the UK. She does dispense medications, and she can help people with weight management, self-limiting illness and flu shots, but that’s not what she spends most of her time doing … For her patients, a prescription isn’t the drugs they will take, it is a wish list of those they might take if they have means to do so.

More than one applicant chose to blog about care for older people. Charlotte Williams, chief of staff for UCLPartners Academic Health Science Partnership, described a conversation focused on thinking differently about how we consider elderly patients.

The best unexpected conversation I had was with a geriatrician I was working with a few years ago. She had the view that no older person she looked after was a single unit. She felt that the best physicians – or any member of the clinical team – knew to treat the unit, to ask as much about the accompanying support as the person … in the chair or on the trolley.

For occupational therapist Melissa Purkis and a nurse, the conversation considered innovative solutions to care.

We talked about the initiative in the Netherlands where residential and nursing homes are pairing up with colleges and universities to provide affordable living spaces for students, in return for the students interacting with the older people. In an age where the disparity between young and old is developing like a gaping chasm, and there are numerous reports about loneliness in both younger and older people, it surely makes sense to counter this.

We learned that an unexpected conversation between Kath Parsons and a Macmillan Cancer Support officer led to the establishment of the Older Peoples Advocacy Alliance, the only national organisation supporting independent advocacy for older people.

When the pair discussed a Macmillan report which found older people are often at a disadvantage when it comes to receiving cancer care, their conversation sparked an idea to recruit older people who have been affected by cancer to support their peers.

Peer advocates walk side by side with older people, providing whatever support is needed, from emotional support to housing, benefits or social care advice, treatment needs, and planning for end of life.

Prof Mah Muneer Khan learned that children can be unexpectedly knowledgeable about hand hygiene, which is promising in a world where there are more than 1.4m cases of healthcare-associated infections at any given time.

Our “Unexpected Fellows” have since had more conversations and blogged the results. We hope they inspire you to think about how you can get more of the unexpected into your everyday.

Anna Howells is founder of Kaleidoscope Health & Care

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.

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Universal healthcare in America? Not a taboo now, thanks to Bernie Sanders | Ross Barkan

There was a time, not too long ago – the iPhone, Facebook and Twitter all existed – when the two leading Democratic candidates for president of the United States didn’t support the right of gay people to marry.

“I believe marriage is between a man and a woman. I am not in favor of gay marriage,” the inspiring tribune of hope and change, Barack Obama, declared in 2008. His rival, Hillary Clinton, concurred. Gay people shouldn’t be able to marry.

By 2012, Obama backed same-sex marriage. Clinton followed suit, later than most Democrats, in 2013. Three years later, when she would run for president again, there was not a leading Democrat anywhere – name a city, a county – who didn’t support same-sex marriage.

Single-payer healthcare, thanks to Bernie Sanders, may be the new gay marriage.

Once radical and taboo in mainstream Democratic circles, endorsing universal healthcare coverage is now de rigueur for anyone who seriously wants to run for president on the Democratic side in 2020. Kamala Harris, the California senator who seemed to be taking the Clinton route to the nomination by courting her Hamptons donors, is now co-sponsoring Sanders’ Medicare-for-all bill.

There are 16 Democratic senators in total supporting the bill, a remarkable number considering where the healthcare debate was two years ago when Sanders first campaigned for president as a democratic socialist long-shot. At the time, pundits, political operatives, and countless elected officials dismissed the single-payer Sanders dream as a disingenuous moonshot.

Now, the man who told Obama to lay off Bain Capital (Cory Booker) and the woman who once voted in favor of withholding federal funds from sanctuary cities (Kirsten Gillibrand) are co-sponsors of Sanders’ bill. Times, indeed, have changed.

Sanders is an unusual politician because he’s been willing to lead on an issue before its broad popularity was established. For decades, he has roamed the political wilderness crying out for European or Canadian-style single-payer healthcare. He has done it through Democratic and Republican administrations, no matter the electorate’s political orientation at any given time. It is something he earnestly believes in.

But most politicians, as gay marriage proved, have few firmly-held convictions beyond what they assume the public expects of them. If the people seem to cry out for war, we go to Iraq. If enough people say marriage is between a man and a woman, it stays that way. Few politicians are willing defy conventional wisdom. Politics is ultimately a game of self-preservation. Polls determine values.

The movement towards single-payer is humane and sensible. It is also a reflection of the changing zeitgeist and the power of the Sanders movement, which represents the future of the party. As the nation’s most well-liked politician and the hero of millennials, he is now the ringmaster. Clinton’s bitter book tour, if anything, is an affirmation of this.

No one should discount just how arduous the road ahead remains. Single-payer would substantially disrupt our current system, now arrayed around employer-based health insurance. It’s an expensive and inefficient system, but there are people who like the health coverage offered by their employers.

Taxes would rise as healthcare costs are shifted over to the government. This is a trade-off other industrialized countries are willing to make – they also pay their doctors less – but one Americans aren’t used to. Mustering political will to eventually pass such legislation will be another Herculean challenge, as Obamacare was in 2010.

There is an argument, valid in its own way, that the safer approach is to just repair Obamacare. Offer a public option to compete with private insurers. Increase subsidies. Watch premiums fall, insurance companies cry.

Yet a party so moribund as the Democrats needs a worthwhile goal, and single-payer is it. There should be others, like a massive jobs program to halt the erosion of stable work that automation and globalization is killing for good.

In the meantime, freeing healthcare from the clutches of predatory insurance companies is what all Democrats should be thinking about. Better to have Democratic groupthink about guaranteeing healthcare than going to war or keeping people from getting married.

Universal healthcare in America? Not a taboo now, thanks to Bernie Sanders | Ross Barkan

There was a time, not too long ago – the iPhone, Facebook and Twitter all existed – when the two leading Democratic candidates for president of the United States didn’t support the right of gay people to marry.

“I believe marriage is between a man and a woman. I am not in favor of gay marriage,” the inspiring tribune of hope and change, Barack Obama, declared in 2008. His rival, Hillary Clinton, concurred. Gay people shouldn’t be able to marry.

By 2012, Obama backed same-sex marriage. Clinton followed suit, later than most Democrats, in 2013. Three years later, when she would run for president again, there was not a leading Democrat anywhere – name a city, a county – who didn’t support same-sex marriage.

Single-payer healthcare, thanks to Bernie Sanders, may be the new gay marriage.

Once radical and taboo in mainstream Democratic circles, endorsing universal healthcare coverage is now de rigueur for anyone who seriously wants to run for president on the Democratic side in 2020. Kamala Harris, the California senator who seemed to be taking the Clinton route to the nomination by courting her Hamptons donors, is now co-sponsoring Sanders’ Medicare-for-all bill.

There are 16 Democratic senators in total supporting the bill, a remarkable number considering where the healthcare debate was two years ago when Sanders first campaigned for president as a democratic socialist long-shot. At the time, pundits, political operatives, and countless elected officials dismissed the single-payer Sanders dream as a disingenuous moonshot.

Now, the man who told Obama to lay off Bain Capital (Cory Booker) and the woman who once voted in favor of withholding federal funds from sanctuary cities (Kirsten Gillibrand) are co-sponsors of Sanders’ bill. Times, indeed, have changed.

Sanders is an unusual politician because he’s been willing to lead on an issue before its broad popularity was established. For decades, he has roamed the political wilderness crying out for European or Canadian-style single-payer healthcare. He has done it through Democratic and Republican administrations, no matter the electorate’s political orientation at any given time. It is something he earnestly believes in.

But most politicians, as gay marriage proved, have few firmly-held convictions beyond what they assume the public expects of them. If the people seem to cry out for war, we go to Iraq. If enough people say marriage is between a man and a woman, it stays that way. Few politicians are willing defy conventional wisdom. Politics is ultimately a game of self-preservation. Polls determine values.

The movement towards single-payer is humane and sensible. It is also a reflection of the changing zeitgeist and the power of the Sanders movement, which represents the future of the party. As the nation’s most well-liked politician and the hero of millennials, he is now the ringmaster. Clinton’s bitter book tour, if anything, is an affirmation of this.

No one should discount just how arduous the road ahead remains. Single-payer would substantially disrupt our current system, now arrayed around employer-based health insurance. It’s an expensive and inefficient system, but there are people who like the health coverage offered by their employers.

Taxes would rise as healthcare costs are shifted over to the government. This is a trade-off other industrialized countries are willing to make – they also pay their doctors less – but one Americans aren’t used to. Mustering political will to eventually pass such legislation will be another Herculean challenge, as Obamacare was in 2010.

There is an argument, valid in its own way, that the safer approach is to just repair Obamacare. Offer a public option to compete with private insurers. Increase subsidies. Watch premiums fall, insurance companies cry.

Yet a party so moribund as the Democrats needs a worthwhile goal, and single-payer is it. There should be others, like a massive jobs program to halt the erosion of stable work that automation and globalization is killing for good.

In the meantime, freeing healthcare from the clutches of predatory insurance companies is what all Democrats should be thinking about. Better to have Democratic groupthink about guaranteeing healthcare than going to war or keeping people from getting married.