Hospitals

April 7, 2020

With U.S. joblessness spiking, Obamacare once again stays front and center

With 10 million Americans suddenly jobless due to the Covid-19 pandemic, a smack in the face may be coming to partisans who have spent a decade assailing the Affordable Care Act, the landmark measure that offers people help with their health insurance.

Obamacare, studies have shown, already has helped to reduce the ranks of the uninsured by 20 million.

It may play a significant role now in helping the unemployed, too many of whom not only lost their steady income but also their employer-provided health insurance. The preponderance of Americans — more than 150 million of us — get our health coverage through our workplaces.

April 5, 2020

Rethinking end-of-life plans and nursing home care for ourselves and loved ones

by Patrick A. Malone

The Covid-19 pandemic is forcing many Americans to think and act on tough issues they otherwise might wish to avoid, and they’re getting thoughtful reminders on ways they may want to proceed with advanced or end-of-life medical planning and decisions on whether to keep elderly loved ones in nursing homes and other long-term care facilities or to bring them into their residences.

These are hard topics to deal with in the best of times. But failing to do so can leave families with not only a lifetime of regrets but also possibly significant financial consequences. Americans long have insisted that they want to have maximum control over medical decisions that affect their care.

So, thinking ahead about our own advanced medical plans, and revisiting the institutional care of beloved seniors may not only be appropriate, but necessary as the world struggles with the Covid-19 pandemic and medical caregivers are overwhelmed and may be stretched to their limits.

March 31, 2020

With pandemic straining U.S. health care, what did ACA get done in a decade?

by Patrick A. Malone

As the coronavirus pandemic causes Americans sky-high anxiety about their health and how they might access and afford extensive medical treatment if infected, the nation slid with only modest public attention into the second decade of one of its landmark health care experiments — the Affordable Care Act.

Obamacare became the law of the land on March 23, 2010, when the 45^th president signed the 2,000-page bill for which he had campaigned long and hard. Republicans in the White House and Congress have attacked the ACA relentlessly ever since.

Researchers have spent a decade scrutinizing the ambitious act’s outcomes with zeal. The New York Times summarized some of the independent, nonpartisan evaluations, finding key areas that the public may wish to recognize in how Obamacare changed the complex U.S. health care system, on which Americans spend more than $3.5 trillion annually. In brief, as a result of the ACA, the newspaper reported (with boldface emphases mine):

March 29, 2020

As virus slams U.S., courage and valor are on display — but some not-so-great behavior too

by Patrick A. Malone

As the Covid-19 pandemic slams the United States — with infections exceeding 100,000 and deaths spiking beyond 2,000 — the battle with the viral outbreak underscores the axiom that a crisis brings out true character, good and bad.

Our highest praise continues to go out to first responders and medical personnel who have demonstrated huge courage and resolve in treating the sick and dying, despite too few resources still and at giant risk to themselves.

Institutions have stepped up to provide valuable information and services, including:

March 22, 2020

As pandemic grips the globe, outbreaks, too, of ‘What were they thinking?’

by Patrick A. Malone

Even as Covid-19 wreaked unprecedented harms, there also have been actions that might lead even the most jaded observer to cry out: What were these people thinking?

The pandemic’s global toll has risen to hundreds of thousands of infections and thousands of deaths. The U.S. toll at the end of the third week in March, the New York Times reported, exceeded 21,000 infections and nearly 300 deaths, with 1 in 5 Americans also now living under tough restrictions that have shut non-essential businesses, schools, colleges and universities, restaurants, gyms and health clubs, and sports and cultural events.

In the throes of such calamitous circumstances, consider:

March 18, 2020

Don’t fall for malpractice malarkey: A briefing details medicine’s many harms

by Patrick A. Malone

Cold, hard facts — not hunches, arguments, or theories — matter most when tough health care decisions must be made. Americans have been reminded of this by painful headlines on the opioid and overdose crisis, the rise of lung injuries and deaths due to vaping, and, yes, now the rapid spread of a new coronavirus. Doctors, hospitals, insurers, Big Pharma, and other major parties in the U.S. health care system aren’t always as candid as they need to be, especially in disclosing how they harm and even kill patients.

That’s a truth (with a small “t”) that readers can discover quickly in the Center for Justice and Democracy’s latest edition of its annual “Briefing Book: Medical Malpractice by the Numbers.” The center, at New York Law School, provides evidence about a field that has become the bogeyman for politicians, policy makers, and medical practitioners eager to hide egregious errors with extreme counter factual assertions.

Malpractice cases in the civil justice system provide important insights and checks on how doctors and hospitals care for the sick, injured, and vulnerable.

March 17, 2020

Patients get rule-making boost to access and use important medical records

by Patrick A. Malone

The Trump Administration, to its credit, has put out finalized new rules that aim to give patients greater access to and use of their all-important medical records, now mostly captured and contained in electronic form.

Federal officials had to battle a handful of wealthy, powerful corporations that own and install proprietary software and computing systems to try to help patients.

They also instantly created major new concerns with their “interoperability” regulations for doctors and hospitals:

March 15, 2020

Life grinds to a halt as Americans start to deal with gravity of Covid-19 spread

by Patrick A. Malone

Across the nation, and throughout the DC region, Americans — finally — have started to come to grips with the gravity of a fast-spreading, new respiratory virus’ infections. The novel coronavirus has infected almost 150,000 internationally, killing thousands as part of what now is officially a global pandemic and a national emergency.

Cases of Covid-19 have been detected in Washington, D.C., Virginia, and Maryland, as public health officials have urged the public to increase safeguards against contracting the disease, notably by staying home and practicing not only hygienic measures (washing their hands, covering their coughs and sneezes, and foregoing handshakes and hugs) but also keeping their distance from others.

Businesses have urged their people to work from home. Schools have shut their doors. Concerts, plays, museums, and cultural events and institutions have closed and canceled. Professional and amateur sports have suspended play. Travel, domestic and international, has screeched to a halt. Panic buying has broken out at groceries and big box warehouse stores.

March 11, 2020

High court, for third time, takes up a GOP effort to kill popular Obamacare

by Patrick A. Malone

Timing may be everything in life and the law: The U.S. Supreme Court — while giving the Trump Administration a small political break for now — may give the president’s fall reelection campaign plenty of upset still. Whether the court will give the country a health care disaster is another question.

The high court, acting on a request by Democratic state attorneys general, has agreed once more to consider the fate of the Affordable Care Act, aka Obamacare, on an expedited basis, even before a federal trial court and appellate judges finish their consideration of the latest legal challenge to the ACA.

This will be the third time the justices have taken up an ACA lawsuit, with this challenge representing not only another Republican attack on government-assisted health insurance for the poor, working poor, and middle class. This also may be a legal extreme for questioning Obamacare, as the New York Times reported:

March 9, 2020

As virus spreads, concerns surge about testing, hospitals, and nursing homes

by Patrick A. Malone

The coronavirus outbreak spreading across the globe may be providing Americans with an unhappy view of the dirty downsides of the too-often dysfunctional U.S. health care system as it grapples with spiking Covid-19 infections.

Congress has appropriated more than $8 billion, so the federal government can provide the nation the support it needs in battling the respiratory illness that exploded out of central China a few weeks ago. Almost 100,000 people globally have been infected with the virus, which has killed thousands. The deaths in this country are rising into the dozens, while infections are increasing into the hundreds. In Italy, the government took a drastic step in dealing with steeply rising infections and ordered a virus-related quarantine of much of the northern part of the country — a tough lock down because the Lombardy area is the largest economic powerhouse of the nation.

In the U.S., federal efforts to stockpile needed medical supplies, notably masks, gloves, and gowns — personal protective equipment or PPEs — continue to lag. The administration is under fire for its slow and ineffectual roll-out of virus testing kits. Vice President Pence promised that big numbers of screening supplies would be available quickly — at least 1 million, asap — but he since has been forced to walk back that pledge. Even as he talked about 75,000 test kits becoming available soon, the Atlantic magazine reported that as few as 1,895 Americans have been tested so far for the virus.