Articles Posted in Health Care Reform

NORC-chart-300x179Although the United States remains the world’s most affluent nation, it also is a country where money plays a driving, negative role in its people’s well-being. Sudden financial losses  may shorten some Americans’ lives, while dismal finances may keep many others from seeking medical care.

So why are politicians still pushing to slash the nation’s social safety net, even as millions of individuals and families are voting with their wallets to protect their health?

Lethal ‘wealth shocks’

superbugs-300x118Hospitals may be providing us all with too many causes for high anxiety, with reports on increasing findings of “nightmare” bacteria stalking more health care facilities than had been known, more disclosures about how taxpayers may foot an even bigger bill to deal with a beleaguered public hospital in Washington, D.C.,  and a respected reform advocate’s detailing of just how traumatizing many hospital stays may be.

Let’s start with the new research by the federal Centers for Disease Control and Prevention, a study that tried to determine just how many cases there might already be of patients infected in hospitals, nursing homes, and other medical care facilities with so-called Superbugs, bacteria that resist treatment not only with most standard antibiotics but also drugs that are deemed therapies of last resort. These include three types of bacterial infections deemed especially urgent but difficult to control: Clostridium difficile (C. difficile), aka C-diff; carbapenem-resistant Enterobacteriaceae (CREs, as shown above); and Neisseria gonorrhoeae.

CDC officials weren’t sure how many of the Superbug cases — which leave doctors and hospitals little option but to provide only supportive care — they might detect by scrutinizing records from pathology labs nationwide.

coveredcalif-300x169Although Republicans have ripped at the health insurance offered under the Affordable Care Act, a less known but also important aspect of Obamacare may soon benefit Californians. This West Coast ACA-related move also may be worth watching by patients and medical safety advocates, as well as employers and insurers.

The Golden State, the San Francisco public radio station KQED reported, soon will tell hospitals that “time’s up” for them to improve their care, and, if they fail to hit new quality and safety targets that will be part of an impending three-year contract with Covered California, the ACA marketplace operator, they will get the boot from Obamacare coverage.

Because bluer-than-blue Democratic California has gone all-in in supporting and putting ACA coverages in place, the state’s Obamacare exchange is big (more than 1 million customers and 11 approved companies) and lucrative — so much so hospitals and insurers can’t ignore the quality demands. They’re neither extreme nor should they be surprising, because state officials emphasize they have consulted with key parties for several years now in the “Smart Care California” collaborative about the plans they intend to put in place.

Dumpster-300x251Although enthusiasts still wax on about  how technology will improve lives, patients may want to be wary about purported advances that may end up complicating and even compromising crucial parts of their medical care — including how their medical records are kept and how payers decide if they’re covered.

Let’s start with some kudos for dumpster-diving doctors in Canada who discovered flaws in hospitals’ disposal of supposedly confidential and legally protected patient health records. They went around unidentified facilities collecting from various bins a half ton of paper that doctors, nurses, and hospitals were ready to toss.

After examining the piles of paper, they found most private records had been properly handled. But thousands of documents also were not: They were improperly disposed of, and contained identifying or confidential patient treatment information, the researchers found. Though Canada’s patient privacy laws differ from those in the United States, they agree that patient health records must be guarded, and the researchers found violations of practice, policy, and potentially privacy laws.

medbankruptcy-300x253Illness and accidents batter and beggar Americans worse than many of us realize. New studies show it’s not just the cost of medical services but also long-term care and loss of jobs staggering the lives and finances of too many.

Margot Sanger-Katz, writing in the data-driven New York Times column, “The Upshot,” reported that hospitalization can wreak havoc on Americans older than 50, with many suffering a significant loss in income from which they never recover. This is true, even if they have some financial protection through health insurance. That coverage may soften the blow of medical costs. It doesn’t help them if they can’t return to work, must spend long periods out of work, or must reduce their work hours so they are part-time or less, finds a new study, published in the American Economic Review.

As she wrote:

maryland-flag-300x200Yes, Virginia (and Washington, D.C., and the rest of the U.S.): Ever-rising hospital costs can be constrained without the world coming to an end. Maryland’s four-year-old experiment — converting hospitals from a fee-for-service model to a global payment system with total revenues set at the outset of each year — is saving millions of dollars annually for patients, taxpayers, employers, and others who pay for medical services in the state.

The Baltimore Sun reported that Maryland’s Health Services Cost Review Commission and the Maryland Department of Health, found that the state’s unique test, already produced $586 million in hospital-related savings for Medicare in its first three years.

As the Sun said:

medpricehikes-210x300With Americans spending more than $3 trillion annually on health care, the corrosive and crazy effects of all that big money can become almost common place. Even still, hospitals, doctors, and Big Pharma still manage to come up with plenty of, Aw, really, c’mon kinds of financial situations.

Recent news reports, for example, have focused on such dubious dollars and cents concerns like: bedside loans, disparities (price gouging) in cancer care, and, of course, skimpy health insurance plans.

Caveat emptor? Not already infuriated by some recent visual depictions of the upside-down state of costs in the U.S. health care system (see figures*) Read on:

carwreck-300x225Although Congressional Republicans and the Trump Administration may not want to stop their relentless assault on the Affordable Care Act, aka Obamacare, there may be other reasons to persuade them to do so.

Researchers at the nonpartisan, not-for-profit RAND Corp., for example, have looked at existing studies and data and asked if the recent GOP move, in the huge tax cut bill, to halt the ACA’s health insurance mandate will have unintended consequences.

They say the repeal of the requirement that all Americans show they have health coverage when they pay their taxes may “ripple out” to other insurances they carry — meaning that tens of millions of motorists may pay more for auto insurance and businesses could see hikes in workmen’s compensation costs they already struggle to pay.

schuchat-201x300fitzgeraldBrenda Fitzgerald, a rich doctor who not only wouldn’t pull her hand out of her personal cookie jar of investments and instead plunged it even deeper during her conflicted time in public office, finally has quit the top job at the respected federal agency charged with protecting the nation’s health from disease and other dangers.

The appointed chief of the Centers for Disease Control and Prevention (shown at top, left)  was ethically impaired before and during her half-year term, arguably to the major detriment of her job and the public’s health.

She was forced to resign after media disclosures that not only had she slow-walked her divestment in a multi-million-dollar portfolio, owned with her husband, of Big Pharma and other health care enterprises, but, even after she joined the CDC, she was caught buying and selling Big Tobacco stocks.

chips-300x192Let’s give the faintest cheer — maybe of the Bronx variety — to the Republican-controlled Congress for, finally, reauthorizing the Children’s Health Insurance Program, aka CHIP.

This means that months of high and needless anxiety will end for nine million or so youngsters who will get health insurance, coverage that their poor or working poor families otherwise could not afford, even under the Medicaid program that serves the underprivileged. The six-year cost to Uncle Sam will be relatively small — $124 billion, and 375,000 poor and expectant moms also will benefit from CHIP, which has halved the uninsured rate among kids in the last decade.

The much-liked program got caught in a bitter partisan cross-fire, becoming a last-minute bargaining chip by congressional Republicans in the battle over the short-lived  shut-down of the federal government. (Which, incidentally, ended up as a boondoggle that enriched health care industry players — who didn’t need the boost — by more than $31 billion.) GOP lawmakers, who in 2017 passed a $1.5 trillion tax cut package that chiefly will benefit corporations and the richest Americans, spent weeks, claiming the country could not afford CHIP.

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