Articles Posted in Accessibility of Healthcare

boxing-300x199Although corporate titans insist that Big Business can show more responsibility and not put profit ahead of all else, consumers are getting tough displays of how loath companies can be to owning up to dealing with harms their enterprises can cause or the rapacious pricing of their goods.

The most recent sketchy signals on product liability and costs came from a spectrum of enterprises and their executives, including nursing home owners and operators, a giant furniture maker, and, of course, Big Pharma.

Caveat emptor? Maybe. Or does the corporate ducking, bobbing, and weaving that would make a champion boxer proud also underscore that there are sound reasons for rigorous corporate oversight and regulation by governments, as well as a need for individuals, in keeping with their constitutional rights, to seek justice with medical malpractice and other safety and liability lawsuits in the civil system?

bronzekff-300x264President Biden has increased the access and affordability of health care for millions of Americans, issuing executive orders to reopen Obamacare exchanges and review rules or practices that targeted the aged, poor, sick, and chronically ill or mentally ill and hindered them from benefiting from Medicaid.

These were fast, early actions that Biden campaigned on and said that voters wanted him to take with urgency, as he did.

Allowing a “do over” of ACA enrollment will be a boon for millions of the pandemic jobless, many of whom may have lost employer-provided health insurance (which covers more than 150 million Americans, or most of us) and could not afford the daunting prices of so-called COBRA policies. That coverage requires consumers to may their own share of health insurance, plus the big chunk their employers cover, as well as an administrative fee.

coronavirusvaxallocationfmgao-300x167As coronavirus vaccine supplies  keep far exceeding demand, and as the new administration races to acquire and distribute more doses, as well as to kick start  plodding vaccination campaigns across the country, it may be a challenge not to ask the people who oversaw battling the pandemic before: What the heck were you thinking?

More on that in a second.

As of Jan. 29, the federal Centers for Disease Control and Prevention reported that ~49 million vaccine doses had been shipped and ~28 million were administered, with ~23 million patients now having received at least one of two shots required.

advanced-300x158Many Americans took a good step for themselves and their loved ones after getting shocked by learning about treatments, like prolonged machine ventilation, that coronavirus patients may undergo. Not for me, the healthy may have decided. They committed to determining end-of-life wishes, committing these to “advance directives” or POLST (portable orders for life-sustaining treatment) forms.

That may just the start of what people need to do with these formal documents, now easily found online, reported Paula Span, the New York Times’ “New Old Age” columnist. They need to do more. (Hint: Some of this even may be covered under older adults’ health insurance, especially Medicare).

They need to ensure that their doctors and their lawyers, too, support their recording of their end-of-life plans. These must be as clear, specific, and concise as possible, so there can be no mistaking what patients want with vague discussions, such as avoiding “heroic” or “unusual” interventions. They need loved ones to know where they may be stored, especially knowing how to locate them and give them to health workers, including first responders.

altarumfig-300x176The Biden Administration faces major challenges as it seeks to tame the coronavirus pandemic’s terrible toll on nursing homes and other long-term care facilities. The roll-out of vaccines for residents and staff plods along, while a big concern may be rising as facility staffing keeps eroding.

The New York Times reported that Walgreens and CVS, the chain pharmacies that the Trump Administration chose to partner with with to deliver vaccine shots to long-term care facilities, have vaccinated 1 million and 1.6 million residents and staff, respectively.

Both companies say the vaccination rollout has been rockier and tougher than expected, with issues in getting required consent for shots for the elderly, sick, and injured, as well hesitancy among staff. Vaccine supplies have been less predictable than would be optimal, though the pharmacies are not reporting shortfalls. Rina Shah, a group vice president at Walgreens, told the New York Times that the logistics and scheduling of vaccinations, with multiple visits at facilities, has required a “monumental effort.”

negron-150x150melgen-150x150bernadett-150x150President Trump’s term ended with a spree of executive clemency to health care crooks who ripped off taxpayers and harmed patients.

His last-minute actions infuriated advocates for health care reform and patient protection, as well as federal prosecutors. They were aghast by the inexplicable largess shown to Medicare and medical miscreants included in Trump’s last-minute, public pardons of 73 people and commutations for 70 others. 

The white collar crooks not only got get-out-of-jail-free cards from Trump, but also saw their debts to the government canceled to the tune of millions of dollars.

bidenPresident Biden kicked off his term by swiftly issuing a series of executive orders and sharing an actual plan to combat the unchecked, raging coronavirus pandemic — which he warned will get worse before it gets better and may kill as many as 600,000 Americans in grim days ahead.

Biden put the federal government squarely in the Covid-19 battle, promising to work with states and local governments but not, as his predecessor had, to shove huge roles and responsibilities on a host of others without talking with or helping them thereafter.

He said his strategies and tactics would rely on science and the best experts available, not on personal and political cronies or personalities popping up on TV broadcasts or extremist online sites.

bbaby-300x200A recent study of deaths among  black infants may provide another conscience jab to medical leaders who are confronted with mounting evidence of racial health care disparities in the United States.

As the Washington Post reported, researchers examined records of 1.8 million Florida hospital births between 1992 and 2015, finding in their published study these stark results:

“Although black newborns are three times as likely to die as white newborns, when black babies were cared for by black doctors after birth — primarily pediatricians, neonatologists and family practitioners — their mortality rate was cut in half. They found an association, not a cause and effect, and the researchers said more studies are needed to understand what effect, if any, a doctor’s race might have on infant mortality. ‘Strikingly, these effects appear to manifest more strongly in more complicated cases,’ the researchers wrote, ‘and when hospitals deliver more black newborns.’ They found no similar relationship between white doctors and white births. Nor did they find a difference in maternal death rates when the race of the doctor, usually an obstetrician, was the same as the mother’s.”

kneelady-300x222With so many older Americans entering their later years in better shape than earlier generations and wanting to stay active, knee and hip replacements have become some of the most common surgeries performed in pre-pandemic times. The cost of this work, however, varies greatly. And surgeons may be promoting procedural variants to not only build business but also to increase their revenue for these operations.

Consumers, policy makers, regulators, and politicians may want to keep an eye on developments with patients’ knees and hips as indicators of what may occur in health care finances, especially if hospitals’ case loads return to something of a pre-pandemic norm and because taxpayers bear burdens from so many of the Medicare-covered procedures.

New data is emerging about hospital costs as the institutions, many of them overwhelmed now by the coronavirus pandemic, comply with Trump Administration price-disclosure regulations. These called for hospitals to post online their base costs (as earlier described in the hard-to-read charge master lists) for hundreds of common procedures and medical items, as well as previously secret prices for same, as negotiated with insurers.

gofundme-300x130Modern medicine may be providing patients with significant improvements in key treatment areas, but the cost of care has become so crushing that online campaigns for charitable medical aid have become heartbreakingly common in the United States.

A team of researchers from institutions across the country reported that the well-known GoFundMe website, between May 2010 and December 2018, had provided a platform for more than 1 million aid appeals — with 281,881 of these (26.7%) created to cover individuals’ health care–related costs.

Most of the fund-raising sought to assist cancer patients, with individuals suffering trauma and injuries, or neurological disorders trailing in number of campaigns. As the authors observed in their published study of these pitches:

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