Mariah Carey Interview: Discusses Nick Cannon's Health Scare, Says He Needs 'Lifestyle Change'

Singer explains how husband Nick Cannon's illness hit the couple "very hard."

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Health officials discuss Flagler needs, plans

Meeting the need

Federally Qualified Health Centers are defined by Medicare and Medicaid statutes and funded under the Public Health Service Act. They offer:

- Eligibility for a $650,000 start-up grant.

- Enhanced Medicare and Medicaid reimbursement.

- Medical malpractice coverage through the Federal Tort Claims Act.

- Medications for outpatients available at a reduced cost through the Drug Pricing Program.

- Safe Harbor to establish arrangements for goods and services.

- Access to National Health Service Corps.

- Access to the Vaccine for Children Program.

- Eligibility for various other federal grants and programs.

SOURCE: St. Johns River Rural Health Network

PALM COAST -- Flagler County needs a Federally Qualified Health Center that brings together all health care components in downtown Bunnell, especially primary and behavioral health care, within walking or bike-riding distance of some of the county's most economically disadvantaged residents.

That was one conclusion of the Flagler Community Health Assessment, a year's worth of personal interviews, summits with local healthcare providers, and hundreds of individual surveys compiled for a study conducted earlier this year by the Health Planning Council of Northeast Florida and the Flagler County Health Department. Officials summarized their findings, as well as plans for the future, at an invitation-only breakfast Wednesday.

"Many people who are able to access primary care are not getting behavioral health or substance abuse help. They just don't go," said Toni Barrett, spokeswoman for Stewart-Marchman-Act and a member of the Flagler Partnership for Community Health. "Likewise, people who are getting behavioral health or help with substance abuse are accessing primary care. There is a real need to get some integration of health care."

The study, funded through a $17,500 Florida Health Department grant via the Centers for Disease Control, was done to provide a comprehensive overview of Flagler County's health care needs for planning purposes.

The hard part starts now, said Dawn Emerick, president of the Health Planning Council of Northeast Florida, a nonprofit council that covers a seven-county area including Baker, Clay, Duval, Flagler, Nassau, St. Johns and Volusia counties.

"This is not unique to Flagler County," she said. "The needs are very similar (all over). This is all very community driven."

Ultimately, health care officials envision a health care corridor along the spine of downtown Bunnell. Creating this corridor will be key to getting $650,000 in annual grant money to maintain a Federally Qualified Health Center.

Patrick Johnson, Flagler County Health Department administrator, praised the successes of the Flagler Free Clinic, the Sheltering Tree, Feed Flagler, Access Flagler and the mobile benefits program, among others. But he said the pieces will have to be connected for officials to be able to create a competitive application for the highly sought-after federal grant money.

"Only 87 of these have been funded across the nation -- two in Florida," Johnson said. "It's very competitive. We have to have something unique. We have to piece this together as a health campus in application form. And we have to be patient."

Overall, the health of Flagler County is good, he said.

"Two years ago, Flagler was the healthiest small county in Florida," Johnson said, noting that health information reported is always a year behind. "That's when we started to head into really hard economic times, and last year we slipped a little bit. When we look at community health, we are looking at the entire community."

Top local concerns include a lack of easy access to health care, chronic diseases like diabetes, and "behavioral health" problems like drug and alcohol abuse, according to the study.

Statistically, Flagler County's percentage of adults who are smokers, obese, have high blood pressure and cardiovascular problems and high cholesterol is higher than the state average.

Johnson related that a nurse told him that if health care workers could "decrease smoking, weight, high blood pressure and cholesterol, we could solve 75 percent of the health problems."

Health care in general, he said, has moved away from the infectious diseases that were aggressively treated in the early 1900s and now is focusing more on chronic diseases that come with living a longer life.

"We all know the longer you live, you're going to probably develop some kind of chronic disease," Johnson said. "We want to live as long and as healthy as we can, but we're all going to die.

"We're trying to be younger and younger."

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Romania's health system needs intensive care

Underfunded and short-staffed, Romania's health system is in need of intensive care, analysts say, warning that recent mass street protests should not derail a drive for reform.

A draft law aimed at giving private operators a central role in the sector earlier this month sparked outspoken criticism from physicians and patients, who feared that health care would become unaffordable to average Romanians.

The bill also drove the founder of the emergency medical services unit to quit, but the widely-respected Raed Arafat was later reinstated and the bill withdrawn after tens of thousands of Romanians had protested in the streets.

But experts stress that the system cannot survive unless it is overhauled.

"Steps must be taken to reduce the hospitals' payment arrears, and improve access to and the quality of health care," Richard Florescu, human development director at the World Bank's office in Bucharest, told AFP.

Romania's centre-right government last year pledged to curb its public deficit in exchange for a back-up agreement with the International Monetary Fund (IMF), the World Bank and the European Union.

The deal included measures to streamline health expenses by closing dozens of derelict, poorly-equipped hospitals.

In 2011, funds earmarked for health care stood at 5.5 billion euros, four times more than in 2005. But the figure accounted for only four percent of the Balkan country's gross domestic product, a far cry from France's 11.0 percent or the OECD average of 9.0 percent.

Analysts however warn that much of the funding has been wasted, pointing to corruption and mismanagement.

The small number of contributors, barely 6.7 million for a total population of 21.5 million, is another key issue.

"No matter how big it may be, the health-care budget will never be enough because a lot of the money gets siphoned off," said Vasile Barbu, the head of the Patients' Protection Association.

He blamed the corruption on the current state-controlled health insurance system, which enables firms held by politically powerful cronies to get most of the public procurement contracts.

Under the scrapped reform bill, private insurers were to have replaced the state-owned ones, a move meant to uproot corruption. However, analysts warn that in the absence of a detailed roadmap and strong checks this will not lead to any improvement.

But corruption takes more than one form in Romania, where slipping money into the doctors' and the nurses' pockets is the rule.

"The first thing I did after being admitted to hospital for bladder surgery was to inquire about the surgeon's and the anaesthetist's 'fares'," said Monica Petre, 79, a Bucharest retired engineer.

Daily Evenimentul Zilei last week published a "fare guidebook" for patients, listing bribes of up to 500 euros for a Caesarian section and 3,000 euros for brain surgery.

A study financed by the World Bank showed that informal payments in Romania's health care amount to roughly 300 million euros a year.

Analysts warn that as long as physicians' wages remain around 500 euros a month, or a tenth of their western peers, graft will continue to flourish while medical staff will emigrate to western countries.

"If we solve the sector's major problems, the issue of doctors' pay will be resolved too," Dan Perieteanu, vice-president of the physicians' union, told AFP.

Despite health officials' efforts to encourage preventive care, many Romanians seem to trust hospital medics more than general practitioners and tend to go straight to emergency units when they fall ill.

Patients also complain of an "inhumane system", where a lack of respect and empathy is more of an issue than outdated equipment and drug shortages.

"There are dedicated doctors, but patients are often treated in a deplorable way, from the way medical staff address them to the care, or lack of, they get," Ana, a 31-year-old Bucharest philologist who suffers from a serious illness, told AFP.

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