Articles Posted in Accessibility of Healthcare

codes-300x220Hospital care accounts for a third of the nation’s $3 trillion in annual spending for medical services. And not only are these charges increasing—and driving up health costs—they’re infuriating patients and their families. Who can make heads or tails of hospital bills? And if consumers do, will they discover billing practices that only anger them more?

Elizabeth Rosenthal, a seasoned journalist, accomplished medical correspondent, and a non-practicing doctor, has created a stir with “An American Sickness: How Healthcare Became Big Business and How You Can Take It Back.” It’s her new best-seller, and was excerpted recently in the New York Times Magazine.

The book and magazine story delve, in part, into the sausage-making aspects of medical billing. These systems have enslaved American health care. They turn on bulky, balky coding systems that provide a short-hand summary for every therapy that patients receive from providers—physicians and hospitals. In turn, payers—patients, insurers, and Uncle Sam—rely on the codes to determine fees they will fork over for services and materials. In between are platoons of coders and billing experts for payers and providers, warring over ever number and the money they represent.

popularOcareRepublicans in Congress are heading home to their districts for a spring break. Will they hear again from angry constituents—but this time from zealous supporters angry that they failed to fulfill their seven-year promise to repeal and replace the Affordable Care Act aka Obamacare?

Maybe, maybe not. It seems the House GOP, especially, has remedied one of President Obama’s notable shortcomings: Republicans have churned through the ACA so thoroughly and publicly that they have convinced Americans that Obamacare’s pretty good.

It’s polling more strongly than ever, hitting a peak 55 percent approval rating. Americans say they want politicians to improve the existing ACA, not replace it with the failed American Health Care Act, aka Trumpcare.

IMG_1029-300x201At a time when drug costs are skyrocketing and Americans are demanding relief, President Trump’s nominee to be the chief regulator of Big Pharma and medical device makers says he initially must sidestep a lot of oversight of the industry because his deep ties to it might cause conflicts of interest.

Scott Gottlieb made his ethics disclosure as he gets set for congressional vetting of his appointment as head of the federal Food and Drug Administration.

Critics question if Gottlieb, a physician, is too cozy to crack down on excesses in an industry in which he has worked for most of his career and that has paid him millions of dollars. He has pledged to speed up FDA drug and medical device reviews, and to slash the agency’s bureaucracy and red tape.

howard-300x231It may be easy to forget. But hospitals not that long ago refused to care for black Americans. If they did so, they kept them separate and far from white patients, shunning African Americans in separate wards in “freezing attics or damp basements.” Blood transfusions were taboo. The medicine was dismal and unequal, with black patients sometimes resorting to becoming test subjects to get any kind of treatment.

The nation’s capital also contributed its own notable example of a once-thriving such spot: Freedman’s in Northwest DC, which opened in 1862 and “stood out for the medical care it offered freed slaves and became an incubator for some of the country’s brightest African American physicians.”

But that venerable haven, known now as Howard University Hospital, has fallen far, the Washington Post says. Howard’s care, still for predominantly black and now poor patients, is unequal and lagging, the paper’s investigation found:

vox-300x255Now that the blitzkrieg assault on Obamacare is over, the battle to repeal and replace the Affordable Care Act hasn’t gone totally up in smoke. It just has fallen, for now, into lots of still critical bits and pieces.

Keep your eye on:

Medicaid

cybertrollOnline trolls who have wreaked havoc on traditional news sources also are bedeviling scientific and medical publications. Although experts have benefited from much greater access to information about studies and key developments in their field, they’re also struggling to ensure the articles they get on the Internet are accurate, fair, and responsible. This  battle over the credibility of information is critical not just to academics in ivy towers. It could affect science, medicine, and the public’s health care. Some recent reports illustrate why.

Let’s start with some Polish researchers’ light-hearted way to lance, in deadly serious fashion, a nasty boil in medical-scientific publication—the viral spread of “predatory” journals. These online outlets have proliferated partly in response to an imperative in academia (including in medical-scientific research) to “publish or perish.” Rising PhDs  and even many MDs are under incredible pressure to build their credentials and institutional standing by showing they can get their studies disseminated in professional journals.

But gone are the days when these publications were scarce, based often in elite institutions, and engaged in glacial peer reviews, which often were back-scratching exercises among cadres of medical or scientific good ol’ guys, all familiar with each other dating, perhaps, from their days in prep schools.

Maryland_State_House_from_College_Ave-300x254Big Pharma’s skyrocketing prices are finally in for some real scrutiny by the U.S. Government Accountability Office (GAO), as well as new initiatives in the Maryland and New York statehouses.

The GAO—the independent, nonpartisan agency that works for Congress and often is called the “congressional watchdog”—has announced that it soon will undertake an investigation requested by three members of Congress of abuses of the federal Food and Drug Administration’s Orphan Drug Act.

That act is supposed to spur Big Pharma to develop drugs for “orphan diseases,” illnesses that affect fewer than 200,000 Americans. Drug makers have resisted investing time and money on therapies for these diseases because the medications may offer insufficient financial returns. So, Congress granted tax incentives and limited exclusive rights to makers of drugs targeted at patients with niche diseases.

Donald_Trump-1-225x300A GOP assault on American health care has been turned aside, for now. But major questions have been exposed that will need answering if we as a country are ever to come together over health care. Do we recognize that health care—comprising 17.5 percent of the Gross Domestic Product and trillions of dollars in spending annually— has become so costly, complicated, and critical that each of us, at some point in our lives, must have some assistance from all the rest of the collective us?

In short: Do we believe that health care is a right?

All other civilized countries answered that question long ago in the affirmative and have implemented systems that guarantee everyone living within their borders (or even visitors from places like the USA) a basic package of health care.  But we here in the United States still struggle with the world’s most expensive health care system that delivers care to a smaller percentage of its residents than anywhere else and that gets worse outcomes than most other advanced countries.

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