Articles Posted in Doctor-Patient Relationship

corridorhospital-300x200Although politicians have obsessed for a decade about affordable health insurance, frustrated patients have seen little or no relief on another crucial concern — the skyrocketing costs of medical services. What policy paths could best offer dollars-and-cents help to struggling people with health care prices?

New research from the independent, nonpartisan RAND Corporation offers intriguing clues about billions of dollars in annual savings, based on complex modeling of actual options confronting the public and policy makers.

These choices, the experts say, may come to the political fore with new force due to the economic shocks the U.S. health system has been hit with due to the coronavirus pandemic.

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.

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.

documentsigning-300x156Wealthy investors want to enrich themselves yet more, partly by pushing doctors to oust patients from their practices unless they sign away invaluable constitutional rights. These rights can protect them if they are harmed while receiving medical services.

Patients’ safeguards, however, too often vanish when businesses compel customers to sign on to “forced arbitration,” Bloomberg Businessweek reported, noting that this consumer menace is rising in medicine as hedge funds buy up physician groups. Rich investors see lucrative profits in these practices, particularly in specialties like dermatology, gastroenterology, and obstetrics.

It seems that doctors like practicing medicine and dislike the billing, managing, paper shuffling, and other bureaucratic aspects of their profession, the story reported. Some aren’t good at it. Many are struggling, especially as the coronavirus pandemic has slashed patient demand for all kinds of medical procedures, sending doctors’ revenues plummeting. As Bloomberg reported:

covidhealthcasualties-300x130As the nation closes out 2020 and months of a raging coronavirus pandemic, will old acquaintances be forgot and never brought to mind?

Covid-19, unchecked, has killed at least 330,000 Americans and almost 19 million of us have been infected with the disease.

Those numbers likely are underestimated. Based on still tallying “excess deaths” in this country — the higher than expected number of fatalities above the norm and likely due to the coronavirus, the truer toll from Covid-19 as of Dec. 16, likely exceeds 377,000.

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.

billsurprisemedica-300x167The do-little U.S. Senate and the House gave Americans an unexpected cause for glee at year’s end. Lawmakers approved long sought relief from “surprise medical bills,” the charges, too often whopping in size, that individuals and families rack up for care from all kinds of providers that their health insurers have not approved.

Multiple legislative committees and influential lawmakers compromised so Congress could mostly resolve this consumer nightmare as part of the 5,600-page bill that both provides desperately needed coronavirus relief and funds the government.

The legislative action exempted one costly area considered still too complex and fraught for Congress to deal with — pricey emergency transport by ambulances. The vehicular services, for which consumers can get staggering bills, are run by so many different providers, including local governments, and operate under such a patchwork of regulations that lawmakers decided against dealing with this extreme expense.

bentcostcurvekff-300x147The nation has gotten some long-desired, important health care economic news: The country  has “bent the cost curve,” seeing 2020 as the first year in at least six decades in which America’s health care spending went down. But this may not be a good thing.

As Drew Altman, president and chief executive officer of the Henry J. Kaiser Family Foundation (KFF), reported of his organization’s economic data:

Year-to-date spending on health services is down about 2% from last year. Health spending for the calendar year may end up lower than it was in 2019.  Adding spending for drugs, which are less affected by Covid-19 and have not fallen, total health spending is still down by about 0.5% from last year. At its low point in April when the pandemic first really hit, spending on health services had fallen an eye popping 32% on an annualized basis. This is the first time expenditures for patient care have fallen year-over-year since data became available in the 1960s. The largest drop-offs were in outpatient care as people put off elective services or [visits to] doctors’ offices and outpatient clinics shut down. Telehealth visits increased dramatically but did not make up all of the difference.”

oighhslogo-150x150Buh-bye? Arrivederci? Sayonara? Can it be that the coronavirus pandemic puts an end to one of the disgraceful ways that Big Pharma and medical device makers push their wares on all-too malleable doctors — with big-money speaker programs?

The inspector general’s office of the giant federal Health and Human Services (HHS) agency has warned drug- and medical device-makers that these pandemic-paused marketing shams should not resume. The $2 billion that industry players have forked out for the in-person gab fests in the last three years looks sketchy at best to federal watchdogs and prosecutors, the HHS inspector general warned in a rarely issued “special fraud alert.” It reported this:

“The Office of Inspector General (OIG) and Department of Justice (DOJ) have investigated and resolved numerous fraud cases involving allegations that remuneration offered and paid in connection with speaker programs violated the anti-kickback statute. The Federal government has pursued civil and criminal cases against companies and individual [health care providers] involving speaker programs … Our enforcement experience demonstrates that some companies expend significant resources on speaker programs and that some [health care providers] receive substantial remuneration from companies. This Special Fraud Alert highlights some of the inherent fraud and abuse risks associated with the offer, payment, solicitation, or receipt of remuneration related to company-sponsored speaker programs.”

bruinlogo-150x150The University of California has offered to pay $73 million to settle with 5,000 women their class-action lawsuit asserting a staff gynecologist sexually abused them during medical procedures. This is yet another big case involving claims of years of widespread and sordid professional misconduct that somehow went undetected at a major institution, which has acknowledged it reacted poorly when confronted with a problematic clinician.

The proposed settlement still requires the sign-off of a federal judge, and it may not go through if more plaintiffs decide against joining this deal, as lawyers in Los Angeles have said they will not.

James Heaps, 67, a one-time gynecologist who is at the center of the scandal at UCLA, also still faces criminal charges for his actions during his 1983-2019 career at the university, in its student health center and at its medical center. The Los Angeles Times reported that the doctor was first arrested  in June 2019 for sexually touching two patients in 2017. But then:

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