Accessibility of Healthcare

May 21, 2019

Preventable hospital deaths’ terrible toll: at least 160,000 lives each year

Although the fatalities have declined, preventable hospital deaths kill more than 160,000 Americans annually — four times as many lives as were lost to vehicle wrecks in 2017, more than twice the deaths attributable to opioids and drug overdoses that year, and more than the toll of stroke or Alzheimer’s disease.

The disturbing new report on hospital deaths comes from Johns Hopkins Medicine’s Armstrong Institute for Patient Safety and Quality and the Leapfrog Group, a national nonprofit founded by large employers and others concerned and focused on safety and quality in health care.

May 19, 2019

Terps draw new fire for staying mostly mum about a fatal viral outbreak

by Patrick A. Malone

Just as the nation grapples with the worst measles outbreak in a quarter century, the University of Maryland and public health officials are drawing fire for the way they handled the strange confluence of mold infections in dorms and the spread of an contagious virus among students on the College Park campus.

The university and its advisers tried to keep a lid on public information about the dual problems, leading students and parents to assail the school and to blame its sluggish response and silence for the death of an immune-compromised coed.

Her death late last year — following the fall heat-stroke fatality involving Jordan McNair, a 19-year-old football player — has renewed concerns that the university and its staff may lack the expertise, training, and sensitivity to protect vulnerable young people, the Washington Post reported as part of its investigation of the confused health scenario involving Olivia Shea Paregol.

May 17, 2019

For cancer patients in online support groups, another grief: illness fakers

by Patrick A. Malone

For all the benefits that the cyber world has bestowed on billions of users, it also has brought out trolls and bullies aplenty. It also potentially has created a new category of sick people. They use online forums to fake illnesses and gain sympathy and even money. There’s even a new term for it: Munchausen by internet.

To be sure, this is not yet a formal and widely accepted medical or psychiatric diagnosis but a description of a phenomenon that appears to be rising and has gotten media attention when exposed through the experiences of patients with serious and chronic illnesses who band together in online chat groups, writer Roisin Lanigan reported in the Atlantic magazine.

Lanigan says that patients with cancer, for example, find the cyber forums invaluable. They not only allow those with the disease to discuss their fears, emotions, and experiences, they can allow individuals to share tips and ideas on how to cope with situations that patients have never encountered and may be overwhelmed by.

May 16, 2019

Hospitals rip employer health plans with prices up to 3 times what Uncle Sam pays

by Patrick A. Malone

Big businesses, which beat on their employees to be more cost-conscious, efficient, and productive, may need to take a page out of their own books if they hope to better control the soaring health care costs that they’re also shoving off onto their workers.

That’s a key takeaway from new research by the independent, nonprofit RAND Corporation into prices paid in 25 states to 70 hospital systems by job-provided health insurers in 2017. They provide coverage for most Americans, more than 180 million of us, and RAND found that private employer-sponsored health plans paid hospitals on average twice or even three times as much as Uncle Sam did through the Medicare program for the same services at the same hospitals.

Hospitals bellyache about tight-fisted Medicare prices that Uncle Sam can negotiate due to big dollars and huge number of patients covered under its senior health care plan. Although hospitals call the government-negotiated prices too low and an unfair benchmark, they provide realistic insights into hospitals’ bottom-line charges in what is one of the biggest areas of Americans’ health care costs. As RAND researcher Christopher Whaley told Modern Healthcare, an industry-covering news organization:

May 14, 2019

Hundreds of moms die of preventable pregnancy-related complications

by Patrick A. Malone

Hundreds of mothers die of preventable pregnancy-related complications up to a year after delivering their babies, with black and native women experiencing notably high maternal morality risks.

The needless deaths of around 700 women nationwide each year due to cardiovascular conditions, infections, hemorrhages and other complications related to their pregnancies underscores the importance of improving maternal care, especially in increasing its access and quality, the federal Centers for Disease Control reported in a new study.

The Washington Post quoted Anne Schuchat, the CDC’s principal deputy director, commenting on the agency data:

May 10, 2019

Modern medicine may be great at making money but not at making sense

by Patrick A. Malone

Spending’s askew when billions go for unproven surgical robots while lack of affordable care leads thousands of poor, black, and brown patients to need diabetic amputations

If U.S. health care leaders look ahead to 2020 and wonder why their sector of the economy will be one of the key concerns of presidential candidates and voters, they can only blame themselves for allowing the public to conclude that the industry’s big money and big profit drives have gone haywire.

How unbalanced have the nation’s health care priorities become that, on the one hand, surgeons and hospitals keep pushing to spend billions of dollars more for robotic surgeries that doctors themselves are doubting, while, on the other hand, researchers blame economic and racial disparities for playing a big role in requiring tens of thousands of patients — especially those who are black and brown and poor — to undergo diabetic amputations?

May 6, 2019

Bill takes aim at injustice for service personnel hurt by military medical care

by Patrick A. Malone

Members of Congress have taken steps aimed at allowing service members to pursue actions in the civil justice system when they suffer harms while seeking medical services, a fundamental civil right now denied to military personnel.

Members of the U.S. House Armed Services Committee heard powerful testimony from a Green Beret, an airman, and a judge advocate general about the need for a bill introduced by Rep. Jackie Speier (D.-Calif.) — a measure that has won bipartisan backing — to correct problems caused by a 69-year-old U.S. Supreme Court ruling in a case involving the Federal Tort Claims Act. That act governs who can bring a claim for negligence at a military or other government health care facility.

Active duty military personnel cannot bring a medical negligence claim for care at a military facility. This is called the “Feres doctrine,” after the U.S. Supreme Court decision, Feres v. United States, 340 U.S. 135 (1950). Under the Feres doctrine, members of the United States armed forces are barred from making a claim against the United States for personal injury or death arising “incident to service.” Military medical treatment received by a service member, while on active duty, has been held by the courts to be “incident to service,” and, thus not actionable, even if that treatment was for a purely elective procedure, and even if the procedure was performed negligently.

May 2, 2019

Middle-class seniors won’t be able to afford assisted care when they need it

by Patrick A. Malone

As the nation rapidly grays and income disparities widen by the day, a sizable number of Americans — a group that built the nation to greatness and has been its economic bedrock — is headed to yet another ugly indignity: More than half of middle-income seniors won’t be able to afford their medical expenses and the cost of assisted housing they will need at age 75 and older.

New research published in the journal “Health Affairs” has projected what already soaring medical and housing costs will mean to those whose incomes fall between $25,001 to $74,298 per year and are ages 75 to 84. These middle-income elders will increase in number from 7.9 million now to 14.4 million by 2029 and soon will be 43% or the biggest share of American seniors.

But the picture for them and their finances, housing, and medical expenses may be glum. Projections show they will lack the money, even if experts calculate in their home equity, to afford assisted living they may need in their late years.

April 24, 2019

8 billion indicators of how companies flounder with health care costs

by Patrick A. Malone

Even as American corporations twist themselves into pretzel shapes to persuade shareholders of their devotion to maximizing profits, why are they throwing an estimated $8 billion annually at workplace wellness programs that, according to a growing body of evidence, don’t work?

The zeal for wellness programs — which aim to get workers to exercise, lose weight, avoid smoking, drink in moderation, and stress less — is just one more flashing red indicator of political risks as companies grow more desperate to restrain skyrocketing health care costs.

Due to their post-World War II decisions to compete for workers in a fast rebuilding U.S. economy, companies long have been the go-to source for Americans’ health insurance: In exchange for a quarter of trillion dollars in federal tax subsidies, employers provide more than half of nonelderly U.S. workers — 152 million of us — workplace health coverage.

April 23, 2019

Ph.D. turns to Twitter to rat out too common species of medical research hype

by Patrick A. Malone

James Heathers is a Ph.D. with expertise in scientific methods and data. He works in a behavioral science lab at Northeastern University in Boston. He’s young, adaptive, and savvy enough to participate in social media, especially Twitter. There, he saw a problem and a challenge with the way medical scientific findings get presented to sizable audiences online.

As someone accustomed to dealing with academic and scientific rigor, he paused and thought he could title his planned effort, “handling the translational gap during the science media transition.” But this Aussie has a sense of humor—and he wanted impact. He thought a straight-laced approach would be as “popular as cabbage sandwiches.”

So, instead, he focused in on a broad number of reputable studies that he thinks get misrepresented and grab unjustified popular attention. This research involves the extrapolation of early results in animal tests, making them sound — incorrectly — as if they instantly have meaning for people. He created a Twitter account that is garnering lots of attention, including tens of thousands of unexpected followers.