The global health community has been aiming at ensuring health coverage for all. To achieve universal health care coverage, the German Social Health Insurance model is one solution. However, one major disadvantage of Social Health Insurance is the fragmented insurance plans, exemplified by 3,500 insurance plans in Japan’s public universal health insurance system. To improve the financial sustainability of Japan’s public universal health insurance, policy options include consolidating fragmented plans as already implemented in Germany and South Korea.

This presentation has two major goals. One is to evaluate the optimal health insurance size in consolidating 3,500 insurance plans in Japan through a simulation analysis using the best available micro data in Japan. The other goal is to discuss the global policy implications based on the experiences of Japan's public universal health insurance.

Dr. Byung-Kwang Yoo is an associate professor in health policy in the Department of Public Health Sciences at the UC Davis School of Medicine. Yoo’s unique career includes clinical medicine (MD) in Japan and research experience as a health services researcher/health economist in the United States. He obtained an MS in health policy and management from Harvard University, and a PhD in health policy and management (concentration on health economics) from Johns Hopkins University. Yoo used to work as a research associate at the Center for Health Policy at Stanford University, as a health economist at the Centers for Disease Control and Prevention in Atlanta, and as an assistant professor in the Division of Health Policy at the University of Rochester School of Medicine in New York State. He has published his work in leading journals such as Lancet, Health Economics, Health Services Research, the American Journal of Public Health, and the American Journal of Preventive Medicine.

The production and distribution of counterfeit medications has become a significant global public health issue. Though not as rampant in the United States, the Food and Drug Administration (FDA) has seen a 10 fold increase in the number of cases investigated, particularly a rise in illegally imported and diverted medications entering our legitimate drug supply. In order to curb these illegal activities, California and the federal government have introduced various pieces of legislation to address this. In addition, international entities, State Boards of Pharmacy and the FDA have begun promoting utilization of radio frequency identification technology and other technology to effectively track the medication supply. In a recent California survey, pharmacists felt strongly that the presence of counterfeit medications poses a problem in their pharmacy practice, but they still face several challenges in identifying counterfeit medications, counseling their patients, and forging their role in implementing legislative requirements.

This presentation will aim to provide an introduction to the international and domestic counterfeit drugs situation, discuss possible factors facilitating patient exposure to counterfeit medications, examine potential sources for counterfeit medications in the United States, identifiy federal legislation issues, discuss various forms of technology being used to combat counterfeit medications, and recognize the role of pharmacists and the challenges they face in dealing with counterfeit medications.

Speaker Biography:

Dr. Elaine Law is currently a Clinical Pharmacist specializing in Adult General Surgery at UCSF Medical Center and an Assistant Clinical Professor in the UCSF School of Pharmacy. She received a B.S. in Molecular, Cell and Developmental Biology from UCLA, earned a Doctor in Pharmacy from UCSF School of Pharmacy and completed a General Practice Pharmacy Residency at UCSF Medical Center. She holds a Board Certification in Pharmacotherapy and her research interests include roles pharmacists can play in public health issues including counterfeit medications and pharmacist-based immunization programs. She is an advocate of patient care in underserved areas and reaches out regularly to the Tenderloin communities and elderly populations of San Francisco through pharmacy health outreach programs.

The large-scale industrial accident at the Fukushima-Daiichi Nuclear Power Plant was the culmination of three inter-related factors: external natural hazard assessment and site preparation, the utility’s approach to risk management, and the fundamental reactor design.

The reactor accident was initiated by a magnitude 9 earthquake followed by an even more damaging tsunami. However, it was the inability to remove the decay heat in the reactor core that led to core meltdown and radioactive release.

A review of the timeline of the major Fukushima accident sequences: The plant first experienced a station blackout (i.e. loss of all offsite and onsite power) due to flooding of backup critical emergency cooling equipment. The lack of an ultimate heat sink led to the fuel overheating. Subsequently, the generation of hydrogen through steam oxidation of of the fuel cladding led to chemical explosions causing significant structural damage.

The focus of this talk (presentation slides below) is on the engineering aspects of the reactor accident and the prospects for local environmental recovery. Radionuclide measurements in space and time provide important evidence for the exact evolution of fuel damage leading to partial core melting in multiple units. A review of the spent nuclear fuel pools is given where isotopic water composition and visual inspection images provide important evidence for the condition of the spent nuclear fuel.

While it will be several months to a year before we will be in a position to learn most of the lessons from this tragdy, several conclusions about defensive design, mitigation actions, and emergency response have been drawn by international organizations.

While the public health impact appears to have been low, the economic and nearby environmental consequences are severe, There is no doubt that land restoration will take over a decade and perhaps much longer. A review is given of actions taken by the Japanese government for land recovery in areas such as decontaminating top soil and local farmland as well as highly radioactive water used during ‘feed and bleed’ cooling of the core.

In spite of the economic advances and increases in GDP since the collapse of communism, Russia suffers from a range of dismal public health outcomes reminiscent of a much poorer country. This study seeks to understand what role political factors play in the country's high adult mortality rate and declining life expectancy by mining World Bank and World Health Organization data and examining how Russians access healthcare services and information.