Articles Posted in Clinical guidelines

covidshotlines1-300x170As the nation recoils from the deadly insurrectionist attack on Congress and the United States Capitol, a direct line also must be drawn to the huge health harms that President Trump and his administration incited with a flood of falsehoods, relentless attacks on science and expertise, and the reckless politicization of public health.

This administration will leave office with the nation hurtling toward 400,000 coronavirus deaths and 22 million infections. The disease is unchecked. New cases and hospitalizations are breaking records by the instant. The situation is likely to worsen significantly before it improves, experts warn.

The best efforts to battle Covid-19 also — due to a shambolic and too often counter-factual federal response — must combat the misinformation, mistrust, and animus sown during a needlessly destructive presidential term.

compare-202x300A lot of people in health care across the country are firing up their computers to dig into long-sought, confidential information from hospitals about their prices and deals they cut on them with an array of parties.

As the Wall Street Journal reported, the Trump Administration successfully battled with hospitals to get them to disclose previously secret pricing data, in the hopes that disclosing this key information will benefit the U.S. health care system, notably in curbing costs. Here’s why, as the newspaper reported:

“T]hose who pay for health-care premiums and medical bills — employers, workers and patients — were long in the dark about wide price differences among hospitals for the same service in the same city, according to research and efforts by large employer groups to compare prices. Hospital prices are under intense scrutiny as the sector consolidates and research points to price increases after mergers, but without the quality gains that hospitals often cite as rationale for the combinations.

artjanlett5-300x164In yet another instance of disregarding fact-based advice, the Trump Administration, after hearing public comments and assembling a panel of diet and nutrition experts, has rejected their  recommendations on how the federal government should update its counsel to Americans about optimizing their eating.

The federal advisories, refreshed every five years by the U.S. Department of Agriculture, will stay mostly the same, with the administration turning away experts who told the government that it should urge the public to reduce consumption of sugar and alcohol. USDA did tweak its guidelines for babies and toddlers.

But the agency decisions were a disappointing turn in a periodic process that affects real people’s lives, experts said, with the New York Times reporting:

chartnytnhomedeaths-300x213Nursing home owners and operators have pleaded “poor us” through a lethal 2020. But profit-seeking players in the industry clearly still see rapacious opportunity in long-term care facilities — with residents suffering the consequences.

NPR and the Washington Post both have dug into the results when investment groups or chains acquire and operate nursing homes, and, as the media organizations reported, resident care declined.

The newspaper focused one of its deep digs on long-term care on New Jersey-based Portopiccolo Group, and how it “buys troubled nursing homes and tries to make them profitable,” paying “hundreds of millions of dollars to acquire facilities in Maryland, Virginia and elsewhere,” with little federal, state, or local oversight of its acquisitions.

covidshot-126x300Even as medical scientists have detected a new, potentially more contagious variant of the coronavirus that also may pose greater risks to children, the high hopes for a faultless roll-out of Covid-19 vaccines are getting tempered with unhappy doses of reality.

Roughly 1 million Americans have been vaccinated already, most with a product from Pfizer and some with a vaccine from Moderna.

That is good news to start. It may, however, also start to raise concerns about the plans to inoculate more than 300 million Americans, many with a two-shot vaccine. That’s because Trump Administration officials had forecast with great confidence in recent days that 20 million Americans would be vaccinated before 2020’s end.

coronavirusshot-300x205The nation now has two potent vaccines to battle the coronavirus pandemic, and the federally approved Covid-19 vaccines are quickly getting into the arms of front-line health workers and vulnerable residents of nursing homes and other long-term care facilities.

Experts have hailed the speedy arrival of clinically tested vaccines as a turning point in the world’s response to the novel coronavirus.

But will the vaccine roll-out be fast enough and accepted by enough Americans to halt Covid-19’s unchecked savaging of the nation?

countylahospicegrafic-300x139With coronavirus infections and deaths rising anew in worrisome fashion from coast to coast, matters could not get worse with the nation’s long-term care, right? Guess again. Profit-mongering and “audacious, widespread fraud” apparently has run amok in hospice care in the Golden State.

Because California, alas, too often serves as a trend-setting locale, patients, their loved ones, clinicians, regulators, and politicians may wish to take heed of an investigation published by the Los Angeles Times. The newspaper reported that too many older, sick, and injured patients have been gulled into signing up for unneeded and undelivered services meant for folks at the end of their lives:

“[M]any [hospice patients] are unwitting recruits [of] unscrupulous providers who bill Medicare for hospice services and equipment for ‘terminally ill’ patients who aren’t dying. Intense competition for new patients — who generate $154 to $1,432 a day each in Medicare payments — has spawned a cottage industry of illegal practices, including kickbacks to crooked doctors and recruiters who zero in on prospective patients at retirement homes and other venues … The exponential boom in providers has transformed end-of-life care that was once the realm of charities and religious groups into a multibillion-dollar business dominated by profit-driven operators. Nowhere has that growth been more explosive, and its harmful side effects more evident, than in Los Angeles County. The county’s hospices have multiplied sixfold in the last decade and now account for more than half of the state’s roughly 1,200 Medicare-certified providers, according to a Times analysis of federal health care data.”

mckinseylogo-300x169Heaps of ignominy are not in short order for parties that played sketchy roles in fostering the nation’s deadly opioid abuse and drug overdose crisis. The stain has spread now to one of corporate America’s most-favored advisors — the giant McKinsey consulting group.

The firm has issued a rare public mea culpa for its work with Purdue Pharmaceuticals, a family-run drug maker that has gained notoriety, even among Big Pharma companies, for how it hyped its powerful painkiller OxyContin. The relentless push to sell that drug, officials have asserted, provided a ghastly template for peddling opioids, triggering abuse, addiction, debilitation, and death for hundreds of thousands of Americans in recent times.

Purdue was a McKinsey client, and the consultants now are re-examining their advice to the drug maker on how to fire up OxyContin sales and whether these suggestions fell short of the firm’s own standards. The New York Times, to its credit, dug into records to detail the consultants’ unacceptable conduct, reporting:

coverwithkareem-300x211A growing body of research is better explaining why the novel coronavirus has taken such a terrible toll on communities of color and especially black Americans. The evidence underscores the urgency for the nation to address racial injustice and inequities, particularly in health care.

As the New York Times reported, experts analyzing mountains of data are seeing that “there is no innate vulnerability to the virus among black and Hispanic Americans … Instead, these groups are more often exposed because of social and environmental factors.” The newspaper found this in talking to experts about their multiple, often sizable studies:

“The[ir] new findings do not contradict an enormous body of research showing that black and Hispanic Americans are more likely to be affected by the pandemic, compared with white people. The coronavirus is more prevalent in minority communities, and infections, illnesses and deaths have occurred in these groups in disproportionate numbers … [But among] many other vulnerabilities, black and Hispanic communities and households tend to be more crowded; many people work jobs requiring frequent contact with others and rely on public transportation. Access to health care is poorer than among white Americans, and rates of underlying conditions are much higher. ‘To me, these results make it clear that the disparities in mortality that we see are even more appalling,’ said Jon Zelner, an epidemiologist at the University of Michigan who led one of the new studies.”

covidnrsnghomenovdeaths-300x149While untold Americans tried to do right by older and more vulnerable friends and family members by taking extra precautions and even canceling Thanksgiving gatherings, the nation crossed a ghastly threshold for the aged, sick, and injured in late November: The coronavirus has killed at least 100,000 residents and staff in nursing homes and other long-term care facilities.

The number of deaths is likely under-reported in federal and other data sources, as several states lag in providing information about problems in the facilities. The deaths of those institutionalized also is spiking as Covid-19 cases have, too, from coast-to-coast. “Community spread” poses grave risks to those in institutions.

If these figures are not already bleak, the Wall Street Journal reported that its research finds that there also are “more than 670,000 probable and confirmed Covid-19 cases in long-term care, affecting both residents and staff members.”

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