Articles Posted in Health Care Reform

academies-300x90The nation’s nursing homes and other long-term care facilities are in dire need of drastic overhaul to dramatically improve the quality and safety of their treatment of the aged, sick, and disabled. They too often now get what one expert has described as “ineffective, inefficient, inequitable, fragmented, and unsustainable” care.

To repair the glaring, longstanding wrongs in these facilities — problems that critics say contributed to 150,000 resident deaths during the coronavirus pandemic — requires sweeping practical, regulatory, and financial changes in an industry focused on profits and resistant to change, according to newly published expert research report by the National Academies of Sciences, Engineering, and Medicine.

The academies, with members who are leaders in their fields, are private, nonprofit institutions that work outside of government to provide objective advice on matters of science, technology, and health.

sentimscottsc-150x150cathymcmorrisrodgers-150x150While regular folks howl about the need to slash skyrocketing prescription drug costs, Big Pharma is showering lawmakers on Capitol Hill with campaign contributions and favoring Republicans in the House and Senate who show political promise — and an aversion to efforts to ensure the affordability of medications for the sick.

The crushing costs of drugs has returned to the policy-making spotlight as Democrats in the House, with a few defecting Republicans, have approved a bill to limit the soaring price of insulin to $35 a month for most Americans who have insurance and whose health and lives depend on the increasingly unaffordable medication. As the New York Times reported:

“To become law, the bill will need to attract at least 10 Republican votes in the Senate to overcome a filibuster. Some lawmakers involved in the effort have expressed optimism that such a coalition might be possible, but few Republican senators have publicly endorsed the bill yet. Senator Susan Collins, Republican of Maine, has been working with Senator Jeanne Shaheen, Democrat of New Hampshire, on a broader bill related to insulin prices. The bill would have substantial benefits for many of the nearly 30 million Americans who live with diabetes. Insulin, a lifesaving drug that is typically taken daily, has grown increasingly expensive in recent years, and many diabetes patients ration their medicines or discontinue them because of the cost. About one in five Americans who take insulin would save money under the proposal, according to a recent analysis from the Kaiser Family Foundation.

Medical leaders and politicians carp endlessly about medical malpractice suits, but when an emergency medical specialist diagnosed staffing shortfalls that threatened patient safety, guess what legal mechanism became crucial to his corrective crusade? Why, yes, of course, it was a lawsuit. A big one over wrongful termination.

Let’s not over-focus on the irony of a legal process that has won the doctor at long last a $26-million judgment, and, instead, pay keen attention to the blaring alarm raised by Dr. Raymond Brovont, an emergency medical specialist in Missouri (shown, right). In brief, he was fired after objecting to persistent understaffing in a hospital’s emergency department as part of the policies of a private contracting firm. As NBC News reported of this increasingly pernicious health care problem:

“What happened to … a former Army doctor named Ray Brovont … isn’t an anomaly, some physicians say. It is a growing problem as more emergency departments are staffed by for-profit companies. A laser focus on profits in health care can imperil patients, they say, but when some doctors have questioned the practices, they have been let go. Physicians who remain employed see that speaking out can put their careers on the line.

califf-150x150The Biden Administration finally has a Senate-confirmed head of the federal Food and Drug Administration, as well as two new interim Cabinet-level appointees to advise the president on scientific matters.

Still, the struggles to fill top health policy posts shows that leadership in the field is tough to find and keep. And it is harder still for the chosen to keep the public and various constituencies satisfied — particularly during a coronavirus pandemic and with political partisanship at peak vitriol.

For regular folks, the quandary can mean that, at a time when government services may be needed most, they may be under their greatest pressure and least performance level.

cashflush-150x150While the folks who toil in the front lines of U.S. health care deserve the highest praise and support in the continuing battle against the coronavirus pandemic, those who run care systems deserve a Bronx cheer and worse for their rapacious pursuit of profits — at the expense of patients:

govyoungkin-150x150Gov. Glenn Youngkin has thrust Virginia into the ferocious battles over evidence-based efforts to quell the coronavirus pandemic, with the newly installed Republican issuing executive orders to bar schools from requiring face coverings and forbidding state employers from having vaccine requirements.

His decisions, in keeping with what has become a GOP policy orthodoxy and reversing his predecessor’s approaches, led the major state universities to lift their vaccination requirements and created an instant battle across the state with school districts, their superintendents, and parents concerned about their youngsters’ health and safety.

Courts may be forced to decide the legality of Youngkin’s pandemic orders.

fdanulogo-300x126Critics are slamming the federal Food and Drug Administration for dropping the ball in informing the U.S. officials who run the Medicare, Medicaid, and veterans’ health programs about crucial regulatory decisions, leading the federal government apparently to pay hundreds of millions of dollars for patients to get a defective heart device and potentially to pay billions of dollars for a prescription medication targeted at Alzheimer’s but with questionable evidence of its effectiveness.

FDA officials insist that they acted in patients’ best interests when they posted on an agency website, along with thousands of other public communications, a warning letter issued to the maker of the HeartWare Ventricular Assist Device, or HVAD. That missive told the device maker HeartWare — and later its acquiring company Medtronic — that the FDA found serious problems with the HVAD tied to patient injuries and deaths.

The FDA eventually would amass “thousands of reports of suspicious deaths and injuries and more than a dozen high-risk safety alerts from the manufacturer,” ProPublica, the Pulitzer Prize-winning investigative new site found. “One horrifying device failure after another” led HVAD’s maker to halt the manufacture of the supposed life-sustaining heart pump. The firm has agreed to a long-term plan to deal with the calamity of patients who now cannot have the defective device removed.

hospitalbedhospice-300x200Profit-raking private investors, aka hedge funders, have taken aim at operations intended to help the elderly, desperately ill, and grievously injured experience a dignified death. The rapacious takeover of the hospice industry nationwide ought to be setting off political and regulatory alarms in a rapidly graying nation.

As is typically the case when MBA-driven interests buy up different kinds of enterprises, they not only don’t exhibit much concern about the whys or wherefores of a business. They focus, instead, on how they can build volume, while cutting services, staff, and costs, the Huffington Post reported, describing what private equity firms have targeted for hospices. As the online news site found:

“Today, private equity firms are acquiring American hospices at an astonishing rate. From 2012 to 2019, the number of hospices owned by private equity companies tripled. The pace of acquisitions seems to have only gotten faster during the Covid-19 pandemic. Industry brokers who have never before put together a deal involving private equity say they now field calls from private equity buyers multiple times a week. Tempted by a wave of retiring baby boomers, the-sky’s-the-limit Medicare payments, the mom-and-pop nature of the industry and a lack of regulation that is pretty startling even by U.S. standards, private equity now accounts for three out of every five new hospice acquisitions.”

femalemd-300x209They excel through four years of rigorous undergraduate study, then battle their way through four more years of tough, tough medical school. They cram to pass their medical boards and  grind through exhausting internships. They also pursue years more of exacting, sleep-deprived training in residencies and fellowships.

But, wait a minute: Women doctors earn over a professional lifetime an estimated $2 million less on average than their men counterparts? They experience gender pay gaps of 25% to as much as 50% over the course of a 40-year career?

Yes, those are the disconcerting findings of published research that analyzed data from surveys of 80,000 doctors between 2014 and 2019, the New York Times reported:

bidenbbb-300x199Leave it to lawmakers on Capitol Hill to wait until the year’s end to take up a major package pushed by congressional Democrats and the Biden Administration and that could potentially improve Americans’ health — big time.

The machinations by which the proponents hope to pass the “Build Back Better” program have, sadly and significantly, prevented too many people from knowing until this legislative endgame the exact content and effects of this initiative.

This occurred because Congress is so riven, including within the Democratic Party, that ambitious plans and money for them went in and out of the law like children in a hot house on a summer vacation. Media reports have zeroed in on the politics surrounding the measure and its possible financing — and less so on what it contains.

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
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