Accessibility of Healthcare

December 12, 2019

Top experts, by failing to disclose conflicts of interest, shortchange taxpayers

Elite researchers — professors and staff with ties to 20 of the nation’s top universities and the respected National Institutes of Health — may be failing to be as candid as institutions and laws require about their potential professional conflicts of interest, notably the significant sums they get from Big Pharma and medical device makers.

ProPublica, the Pulitzer Prize-winning investigative organization, and the Los Angeles Times jointly scrutinized the experts’ required disclosures, finding they not only fall short. They may fail to give the public a fair view of the credibility of their findings. And, in California, they may be a unique rip-off of the state’s top university system. The “UCs” provide research faculty with costly facilities and other support, as well as sharing its global renown — in exchange for revenue the experts may earn outside the system.

In total, after examining records on tens of thousands of university scholars and NIH experts, ProPublica not only has made public its “Dollars for Profs” database, it also quotes federal watchdogs as estimating that with the NIH alone, conflicts of interest with agency grants amounts to $1 billion.

December 10, 2019

Hospitals’ preventable patient deaths add to big concerns in mental health care

by Patrick A. Malone

With mental health services stretched thin and failing to fill significant need, it may be more distressing still for the public to confront growing evidence of big problems in existing facilities that try to treat those with serious psychiatric ills.

The Los Angeles Times, based on its investigation, has found “nearly 100 preventable deaths over the last decade at California psychiatric facilities, including at La Casa Mental Health Rehabilition Center (shown here). It marks the first public count of deaths at California’s mental health facilities and highlights breakdowns in care at these hospitals as well as the struggles of regulators to reduce the number of deaths.”

The newspaper said it “submitted more than 100 public record requests to nearly 50 county and state agencies to obtain death certificates, coroner’s reports and hospital inspection records with information about these deaths.” Reporter Soumya Karlamangla said she had to look far and wide for data on problems in psychiatric facilities because, “No single agency keeps tabs on the number of deaths at psychiatric facilities in California, or elsewhere in the nation.”

December 8, 2019

Investigations rip FDA for laxity on asbestos-tainted talc and medical devices

by Patrick A. Malone

When it comes to medical products — devices put in or substances put on our bodies — consumers may be ill-served by the federal regulators who are supposed to protect them from injury.

The federal Food and Drug Administration has taken a double hit in recent news reports, with an investigation by Reuters news service raising big doubts about the agency’s oversight of products with supposedly safe talc — but that long may have been tainted with disease-causing asbestos. The Kaiser Health News service, meantime, has followed up on the wave of lawsuits and research that has resulted from its discovery that the FDA for years allowed device makers to hide from public view a million complaints about medical devices.

The scathing findings in these two reports, combined with other deep digs into agency work, might well prompt members of Congress to conduct hearings into whether the FDA is acting as the watchdog that the public deserves or as a lap kitten beholden to the rich, powerful, and booming medical device industry.

December 4, 2019

As life expectancy and fertility rates decline, health politics more key than ever

by Patrick A. Malone

Ohio, Pennsylvania, Kentucky, and Indiana — if you’re obsessed with national politics, these states might register in your mind as key partisan battlegrounds. But if you’re focused on Americans’ health and well-being, these states — along with New Hampshire, Maine, Vermont, and West Virginia — may be causes for different and considerable concern: the nation’s plummeting life expectancy.

These states are flashing warning signs, racking up the greatest relative increases in death rates among young and middle-aged adults (New Hampshire, Maine, Vermont, West Virginia, and Ohio).

Excess deaths among Americans in their prime, that is individuals in the 25 to 64 age group who would live longer if mortality rates improved, also were highly concentrated geographically, with fully a third of them in just four states: Ohio, Pennsylvania, Kentucky and Indiana, experts say.

December 2, 2019

Grim way to increase nursing home profit: Toss out frail seniors and disabled

by Patrick A. Malone

Profit-hungry nursing home operators persist in throwing out vulnerable seniors and disabled patients from needed care, too often because the facilities find they can get higher-paying patients to fill their already costly beds.

Thousands of complaints about potentially improper discharges or transfers from nursing homes and assisted living facilities dominate the work of ombudsmen, whose work is federally required, and state supported, an NBC News investigation found.

The broadcast journalists reported:

November 29, 2019

Virginia hospital assailed for seeking court actions to strip patients of decisions on care

by Patrick A. Malone

A Virginia hospital has found an eyebrow-raising solution to some of its struggles with elderly, poor, and sick patients who take up beds and medical resources that might generate more revenue and less headache for the institution: Administrators hired a law firm and turned to the courts to strip legal control over the frail seniors from their loved ones.

Over families’ objections, the seniors’ newly appointed guardians then allowed the patients to be moved out of the Virginia Commonwealth University Health System hospital in Richmond and into poorly rated nursing homes. As the Richmond Times-Dispatch reported:

“A yearlong investigation by the Richmond Times-Dispatch, which involved analyzing more than 250 court cases and interviewing more than two dozen people, revealed that VCU Health System has taken hundreds of low-income patients to court over the past decade to remove their rights to make decisions about their medical care. This process, which frees up hospital beds at VCU Health System and saves thousands in uncompensated costs, often results in sick, elderly or disabled patients being placed in poorly rated nursing homes, sometimes against the wishes of their own family members. In these cases, VCU Health asks the court to grant an attorney at the ThompsonMcMullan law firm the power to make critical medical and life decisions for its patients. The court orders the attorney to represent the best interests of those patients, but the law firm continues to look out for the hospital’s interests on dozens of guardianship cases each year.”

November 27, 2019

On the road, in the kitchen, at the table — have a safe, healthy holiday!

by Patrick A. Malone

With the launch of a season of eating, drinking, getting together with friends and family, and celebrating, it may be worth a moment to ponder how to keep those you care most about as healthy and safe as possible, but with a good dollop of fun too. Herewith some suggestions:

Food safety

When it comes to the centerpiece of Thanksgiving — the festive eating — hygiene and moderation matter. Nothing would ruin the holiday more than to sicken the guests, right? So, cooks and their helpers should take special care to keep their hands washed, the tools and prep areas sanitary, and to ensure that the food gets handled correctly, especially in thawing and thoroughly cooking the turkey and stuffing. It may seem counter intuitive, but experts warn against rinsing the turkey or any other fowl that might be store-bought and served. That’s because the birds get cleaned as part of the processing and rinsing with warm water may only spread microbial contaminants all around the kitchen. The key to kill off harmful bugs, by the way, rests in cooking foodstuffs for long enough and at high enough temperatures to ensure they’re safe to eat. Consult those published recipes carefully. Cooks need to plan well, so they get various menu items in and out of the stove and oven, so hungry diners get their fill at the appointed time.

November 26, 2019

Ignore doctors’ malpractice claims history? The U.S. did. 66 patients died. It cost $55 million.

by Patrick A. Malone

Although doctors, hospitals, and insurers may howl about the professional harms they claim to suffer due to medical malpractice lawsuits, research studies show that it’s just a tiny slice of MDs who lose in court and must pay up for injuring patients. Further, the data show that the problem few doctors don’t rack up one, but two or three malpractice losses before they even start to see their work curtailed.

Common sense would suggest that if judges and juries find doctors’ conduct egregious enough to slap “frequent flyers” with multiple losing malpractice verdicts, these MDs might best be parted of the privilege of treating patients. Not only doesn’t that occur often enough, a Wall Street Journal investigation has shown the terrible consequences that can result for patients and taxpayers alike when it doesn’t.

The federal government, the newspaper reported, long has struggled to provide promised care through the Indian Health Service (IHS) to those who live on rugged, spare, and sprawling reservation lands. This obligation to provide such medical services is embedded in the Constitution and old treaties. But if it’s tough to get doctors to practice in rural America — where the hours may be extra long and the pay decidedly lower than cities — it had become a nightmare for the IHS to fill its many vacancies.

November 24, 2019

On vaping, gun violence, and health insurance, the big talk flows, but action, not so much

by Patrick A. Malone

When it comes to key health concerns of the American public, President Trump and his administration have offered evidence anew that whatever they say may not last to the next political moment, that inaction is its own powerful kind of action, and that what officials say they’re doing may be exactly the opposite.

This is not intended as partisan commentary. It reflects the turn of a few news cycles and how Trump and his officials have dealt with:

The outbreak of serious lung illnesses and deaths tied to vaping

November 20, 2019

U.S. orders price postings in hopes of curbing hospitals’ trillion-dollar costs

by Patrick A. Malone

Tthe Trump Administration deserves credit for doing something right on hospital prices — but with what likely will be ineffective results.

The president and Alex Azar, the head of the sprawling Health and Human Services agency, have rolled out delayed new federal rules that will order hospitals, starting in 2021, to make public the discounted prices they negotiate with insurance companies and require insurers to allow patients to get advance estimates of their out-of-pocket costs before they see a doctor or go to the hospital.

Trump explained why, as reported by the New York Times, saying: “For decades, hospitals, insurance companies, lobbyists and special interests have hidden prices from consumers, so they could drive up costs for you, and you had no idea what was happening. You’d get bills that were unbelievable, and you’d have no idea why.”