Hospitals

November 6, 2018

Gun violence takes terrible toll on kids too

As the nation struggles with grief from the latest mass shooting at a Pittsburgh synagogue, new research shows how grievous the mayhem that guns cause for the young, with weapons injuries over nine years sending 75,000 children and teen-agers to emergency rooms at a cost of almost $3 billion.

The Associated Press reported that researchers at Johns Hopkins found in their published study that:

[M]ore than one-third of the wounded children were hospitalized, and 6 percent died. Injuries declined during most of the 2006-14 study, but there was an upswing in the final year. … 11 of every 100,000 children and teens treated in U.S. emergency rooms have gun-related injuries. That amounts to about 8,300 kids each year. The scope of the problem is broader though; the study doesn’t include kids killed or injured by gunshots who never made it to the hospital, nor does it count costs for gunshot patients after they’re sent home.

November 4, 2018

Tuesday’s a crucial health care day, and health coverage deadlines loom

by Patrick A. Malone

Take some time this week to do something big for yourself, your loved ones, friends, work colleagues, and our country, for that matter:

Exercise your privilege, right, and duty as a citizen: Please vote.
You may wish to look now at your health insurance coverage, please, being mindful of onrushing deadlines especially if you may be seeking or renewing a policy through the Affordable Care Act exchanges (their 2019 enrollment period opened on Nov. 1), or Medicare.

October 31, 2018

Why are doctors and hospitals still bungling patients’ records requests?

by Patrick A. Malone

Uncle Sam more than ever wants it to happen, and patient advocates are pushing hard, too. So, why, when technology can make it easier than ever to do so, must patients struggle still to get easy, convenient, low- or no-cost access to invaluable electronic records about their own health care?

Judith Graham, a columnist focusing on aging issues for the Kaiser Health News Service, has written a timely, troubling update on perplexing challenges consumers still confront when trying to secure their electronic health records (EHRs).

She cites a study recently published by Yale researchers who gathered information from 83 leading hospitals that purport to assist their patients with EHR access. The experts swept up policies and forms the institutions said patients would need, then contacted them, telling hospital staffers not that they were academic researchers but that they were checking on behalf of an elderly relative in need of their records and how soon and how difficult and costly might it be to get them? This is an everyday dilemma for consumers, and the institutions should have dealt with these requests with ease and alacrity.

October 24, 2018

Health care advocacy group to expand ratings to include surgery centers

by Patrick A. Malone

A familiar health care advocacy group will expand its grading of 2,000 or so hospitals across the country to also provide new safety and quality information on 5,600 stand-alone surgical centers that perform millions of procedures annually.

It may seem like a small step, and the devil will be in the details of the new data that will be voluntarily reported, analyzed, and then made public by the Leapfrog Group, a national health care nonprofit that describes itself as being “driven by employers and other purchasers of health care.”

Surgical centers have burgeoned because they can be nimbler than the hospitals and academic medical centers they now outnumber. The centers can be set up without hospitals’ high overhead costs, including for staff and equipment that may be unnecessary for a specialty practice. The facilities also can be set up closer to patients, theoretically offering them greater access and convenience, including with easy navigation and parking.

October 21, 2018

Will counter-factual claims and Big Pharma cash sway critical midterm votes?

by Patrick A. Malone

At a time when Americans experience high anxiety and financial insecurity due to medical costs — with more than 20 percent of those with health insurance experiencing trouble paying for necessities, more than a quarter of them saying they had bills in collection, and 13 percent forced to borrowed money as a result of illness — politicians and special interests are closing the midterm campaigns as if they can prank voters. Just how gullible do they think the electorate can be?

Republican congressional candidates, after howling about the Affordable Care Act and campaigning unsuccessfully to repeal it in dozens of votes for years, including in the first of the Trump Administration, now are claiming to constituents that they support key parts of Obamacare.

Even as GOP state attorneys general argue in a pending federal court case to gut ACA protections on preexisting conditions, minimum benefits, and lifetime limits, Republican candidates are telling voters, counter factually, how much they embrace and support those Obamacare components. They’re trotting out sad tales about their own relatives’ illnesses to claim to support a position that they opposed in legislative votes and actions just weeks ago.

October 17, 2018

Hurricane Michael shows extreme planning may be key to protect medical care

by Patrick A. Malone

As Florida, Georgia, and the Carolinas struggle with Hurricane Michael’s devastation and slow-rising death toll, hospitals, nursing homes, and other caregiving facilities across the country may need to reexamine their disaster planning, paying heightened attention to extreme and worst-case scenarios.

Although doctors, nurses, and other medical personnel deserve great credit, as always, for their courage and fortitude in helping the sick and injured, the New York Times reported that, even with disaster plans in place, care-giving facilities got caught short by the latest powerful hurricane:

As Michael bore down and then passed, some hospitals in the region closed entirely, and others evacuated their patients, but kept staff in place to run overwhelmed emergency rooms. In Florida, four hospitals and 11 nursing facilities were closed, according to the Federal Emergency Management Agency. Panama City has five hospitals, according to the Florida Health Association. Bay Medical, with 323 beds, and Gulf Coast Regional Medical Center, with 238, are the biggest. Florida officials also said food and supplies were being dropped in by air to the state’s mental hospital in Chattahoochee, which is cut off by land. The mental hospital has a section that houses the criminally insane, but the facility itself has not been breached, officials said. Gov. Nathan Deal of Georgia said 35 hospitals or nursing homes in that state were without electricity and operating with generators. Federal health officials said they were moving approximately 400 medical and public health responders into affected areas, including six disaster teams that can set up medical operations outdoors. Some were heading to an overwhelmed emergency department in Tallahassee. Other federal medical personnel were being assigned to search-and-rescue teams to triage people who were rescued. University of Florida Health Shands Hospital sent ambulances and four helicopters to assist in rescue efforts, transporting patients out of Panhandle hospitals.

October 15, 2018

Will Supreme Court reconsider government’s immunity from medical malpractice suits by active-duty military?

by Patrick A. Malone

Although Uncle Sam makes a special vow to provide medical care for those who fight for this nation, he also enjoys special legal shields from lawsuits from them if anything goes wrong with medical services they’re provided. But recent news reports show how past and present service personnel not only suffer shabby medical care but also “grossly unfair” situations when pursuing malpractice claims — and why lawmakers and courts may need to step in to provide fairer remedies.

Kaiser Health News (KHN) and the ABC-TV news affiliate in Los Angeles both deserve credit for spotlighting tough cases involving service personnel and medical malpractice, particularly the Federal Tort Claims Act and the Feres doctrine, a 68-year-old Supreme Court case that bars active-duty military members from suing the federal government for their own injuries.

Walter Daniel, a former Coast Guard officer, has petitioned the Supreme Court to “amend the 1950 [Feres] ruling, creating an exception that would allow service members to sue for medical malpractice the same way civilians can,” KHN reported, noting this would affect patients in a military health system “with 54 hospitals and 377 medical clinics, serv[ing] about 9.4 million beneficiaries, including nearly 1.4 million active-duty members.”

October 3, 2018

As partisans scuffle, Medicare surprises by reducing per-patient spending

by Patrick A. Malone

Critics may want to carve it up and make it tougher to join, while proponents would expand it and add more money to it. But what could the U.S. health system overall learn from real, rigorous research on Medicare, the major health coverage method for tens of millions of Americans age 65 and older?

Politico, the politics- and Beltway-focused news web site, has renewed attention on the work of Ph.D. economist Melinda B. Buntin, a professor who heads Vanderbilt University’s health policy department. She and her colleagues have spent years digging into the money flowing into Medicare, a program that in 2017 paid out $700 billion in benefits, compared with $425 billion in 2007.

As Politico reported, the research shows a surprise beneath the big, aggregate, and problematic Medicare cost: “One of the best-kept secrets in American health care might be that Medicare spending — in important ways — is going down.”

September 27, 2018

A harsh reminder: Medical errors are so common, they savage celebrities, too

by Patrick A. Malone

Celebrities can play an out-sized role in medicine and health care: Just consider the public attention paid to Angela Jolie or Ben Stiller and their discussions about cancer screening and the disease’s risks, or Michael Phelps, Mariah Carey, and Carrie Fisher raising awareness about mental health issues, or, yes, Gwyneth Paltrow promoting a rash of wellness goop.

But even with their wealth, accomplishment, looks, and social standing, public figures also can be savaged just like ordinary folks by medical errors that harm and even kill them and their loved ones, according to the Center for Justice and Democracy.

The group has put out a study with 22 cases, documented by lawsuits and medical board sanctions, to show that, “Celebrity is no safeguard when it comes to medical malpractice,” Emily Gottlieb, the report’s author and the center’s deputy director for law and policy, said in a statement. “As this report illustrates, patients with fame and fortune are just as likely to be horrifically injured or killed by dangerous health providers as the general public.”

September 23, 2018

Hospitals slammed for ventures that exploit patients and violate their privacy

by Patrick A. Malone

Big hospitals can’t exploit patients and violate their privacy by throwing open their facilities to Hollywood for television shows that plump institutions’ reputations. And academic medical centers need to think twice before letting their leaders strike cozy deals to enrich a choice few insiders by hawking important diagnostic information collected with best intentions by medical staff from patients for decades.

The roster of hospitals dealing with black-eyes from recent negative news stories about their activities includes well-regarded institutions in Boston and New York — Boston Medical Center, Brigham and Women’s Hospital, Massachusetts General Hospital, and Memorial Sloan-Kettering Cancer Center.

Federal regulators busted the Boston hospitals with fines settled for just under $1 million for “inviting film crews on premises to film an ABC television network documentary series, without first obtaining authorization from patients,” reported the U.S. Health and Human Services’ department’s Office of Civil Rights.