January 1, 2011 Recent News
The Congress has not enough to do to keep busy so they are making sure that the laws have tricky acronyms. They are having a problem with Obamacare. This is a polarizing name and so the White House calls the law the Affordable Care Act. This is a problem since most people do not believe it will make healthcare more affordable. The new name may be Phu-pack-uh. This should catch on quickly, maybe for alpacas.
The People's Republic of Massachusetts, a forerunner to Obamacare, is finding funding is harder as time passes. They had 250,000 uninsured at the time of the passage and only 25% of that total received insurance from employers or purchased it on their own. The remainder that got insurance the republic paid for. This is now especially true with Medicaid. The republic is paying for the healthcare services by slashing the budgets of education, public safety, human services and local aid.
Bloomberg reports that most states are cutting back benefits in their Medicaid programs due to the feds cutting back on their payments. As all know Arizona stopped transplants, Washington is cutting vision care, and other states are also cutting other benefits. There are too many people on the program and not enough money. This is because under Obamacare states are not allowed to cut the cut off for Medicaid. It is the law of unintended circumstances and poor thought.
Maine hospitals will lose $800 million over ten years under Obamacare. This is part of a report to the state on the impact of Obamacare.
The Advisory Board is stating that hospitals are bracing for major financial hits if Obamacare is repealed. That is the reason that the AHA has filed an amicus brief in the Florida law suit for the government. The hospitals want the individual mandate to be part of the plan so that they will no longer have uncompensated care. This may mean that there is no need for non-profit hospitals and they will all need to pay taxes.
Congratulations to the Michigan hospitals and physicians who are or have formed accountable care organizations to increase quality and get the fed money. The problem is that no regs have come out as to how the ACOs are to be set up or function. It is hoped that they will be physician led and then contract with hospitals for care as vendors.
Sex sells. UMass Memorial Health hired the comely females to entice people to get gene testing that was not needed. The people were told it would be free but the hospital billed insurances over $4000 per test even though the test usually is only several hundred dollars. The people tested were in New Hampshire and after the state started an investigation the cost immediately dropped to $1700, a negotiated rate. Some Manchester, NH, city employees had their costs reversed after another investigation of the scam. UMass had paid up to $1 million for the models and their agencies.
Medscape reports that EHRs have mixed results regarding quality of hospital care. The material comes from the Health Information Management Systems Society which includes about 90% of the hospitals. The only place where EHR mad a substantial positive difference is in heart failure and that was a whopping 2.6% improvement. That is alot of money for a small improvement.
Czech physicians are threatening to leave the country due to low pay and go to other European countries. A gastroenterologist is working about 80 hours a week and is paid about $900 a month. He can afford a small apartment and food only. One fourth of the country's physicians are threatening to leave soon. According to the government the base salary for a physician is about $11,000 per year. They are entitled to overtime but nobody pays it. The Germans want the physicians as they have a shortfall and they pay $8000 a month. Top
The feds collected $26 Billion in fraudulent claims during 2010. That is excellent but it is only the tip of the iceberg. CMS hopes to bring their fraud finding up to close to real time. That would be a major improvement. Top
In Texas 17 providers have reported breaches of health records of over 500 people. Out of 17, 3 are on paper, the rest are electronic. This is happening all over the country. There are also many physicians worried the insurers will use the electronic records to determine the cheapest course of therapy and that is all that will be paid. The people behind EHR deny this is a concern.
No sooner had I written the above when I saw that Dean Health Systems and St. Mary's Hospital in Wisconsin have lost a laptop with the medical information of over 3000 patients. The physician had put the information on her computer and took the computer home at night to work on charts. The laptop was stolen from the physician's house. The physician was an idiot. It again shows how EMR is unsafe due to human error. Top
St. Joseph Hospital in Phoenix has been stripped of its Catholic affiliation by the local Diocese. The reason is because they saved a woman's life over that of an unborn fetus. The woman had severe hypertension due to pre-eclampsia and the treatment is termination of the pregnancy. The fetus was 11 weeks.
The Center for Studying Health System Change, a hospital organization, funded by the Robert Wood Foundation, put out a study by three people on the self referral of physicians who have their own equipment. The study was done by asking physicians in private practice owned or leased equipment for lab work, imaging, non-EKG cardiac studies and invasive procedures. Of the total asked 58% 0r 2750 responded. Of those, 25.2% had lab equipment, 22% had x-ray, 17% had advanced imaging, 28% had non-invasive equipment and 24% had invasive equipment. About 14% had three or more types of equipment. These figures seem reasonable. The "researchers" then state "Given the growing evidence that physician self-referral contributes to unnecessary and costly care, policy makers might reconsider the broadness of the in-office ancillary service exceptions to the Stark law." They based this statement of an article in Health Affairs, another hospital leaning organization. They do not mention that the use of the equipment speeds diagnosis and is cheaper than at hospitals. The article states that the methodology can be found on a web site but when checked it was not present. It is a shame that these types of biased papers are allowed to be printed without any effort to elicit comment from others.
The Zablocki VA hospital in Milwaukee, Wisconsin, halted their medical procedures due to sterilization problems. They are now resuming about half of the procedures. Top
The New Jersey police and fire fighters were shocked when Dr. Joseph Coleo, age 45, died of heart disease. Dr. Coleo was their supplier of steroids and they used Lowen's Pharmacy in Brooklyn as the source of the drugs. The above came from a huge expose on drug usage in the police and fire departments across New Jersey by the New Jersey Ledger.
There are two blogs worth mentioning. The first is Medscape where a several year rant on disruptive physicians is still going. A new one on the community hospitals and their takeover of physicians is on Sermo. Top
DISCLAIMER: Although this
article is updated periodically, it reflects the author's point of view at the
time of publication. Nothing in this article constitutes legal advice. Readers
should consult with their own legal counsel before acting on any of the