Insurance

February 6, 2020

With U.S. health care costs sky-high, why gouge programs to help vulnerable?

If rigorous research drove policy making in a more optimal fashion than it now apparently does, how might politicians and regulators react to findings like these:

The well-respected Commonwealth Fund has revisited earlier studies, finding anew that the United States “spends more on health care as a share of the economy — nearly twice as much as the average [industrialized Western European] country — yet has the lowest life expectancy and highest suicide rates among the 11 nations. The U.S. has the highest chronic disease burden and an obesity rate that is two times higher than the average [in comparable Western industrialized and European countries.] Americans had fewer physician visits than peers in most countries, which may be related to a low supply of physicians in the U.S. Americans use some expensive technologies, such as MRIs, and specialized procedures, such as hip replacements, more often than our peers. Compared to peer nations, the U.S. has among the highest number of hospitalizations from preventable causes and the highest rate of avoidable deaths.”

Even while spending more than any other nation on health care and getting poorer outcomes, which Americans bear the heaviest burdens of the system’s costs? Here’s what researchers at the nonpartisan and independent RAND Corporation have found in a newly published study:

February 4, 2020

Calif. wins $344M mesh case, but $215M may not settle harmed gymnasts’ suit

by Patrick A. Malone

The public’s health and safety sometimes find protections in the civil justice system and sometimes under regulators’ threat. Here’s hoping that whatever means are required, just and proper outcomes result.

For women, two separate suits have sought a modicum of justice for sexual abuse of talented young gymnasts by a predatory caregiver and damages tied to the maker of what has become a notorious material for supposed surgical repairs in the pelvic area.

For parents, the positive but potentially inconvenient recent news is that regulators finally have cracked down on risky baby sleepers, ordering the recall of tens of thousands more of them.

January 20, 2020

On MLK Day, never forget his view: ‘Injustice in health is the most shocking …’

by Patrick A. Malone

With the nation taking a holiday to celebrate the remarkable life of the Rev. Dr. Martin Luther King and his pioneering push for Americans’ civil rights, it may be worth remembering that his far-reaching visions of equality and social justice were deeply unpopular in their time, as was he.

King infuriated many, including in medicine and health care, observing, for example, that:

“Of all the forms of inequality, injustice in health is the most shocking and the most inhuman because it often results in physical death.”

January 14, 2020

Here’s a cause for anger and despair: We’re all forced to pay $8,000 ‘health tax’

by Patrick A. Malone

Even as economic inequity and inequality fuel a nationwide plague of “deaths of despair,” a runaway and inefficient health system hits Americans hard in their pocketbooks, in effect imposing an $8,000 annual tax on every household, a pair of leading economists say.

The crushing cost of the U.S. health system, exceeding $1 trillion a year, forces all Americans to pay this “tribute,” as if it were going to a foreign power, except this is a toll on themselves that we tolerate and allow, say Anne Case and Angus Deaton. The Princeton economists have reached this conclusion, as part of their research for their upcoming book, “Deaths of Despair and the Future of Capitalism.”

Case told economists at a San Diego conference: “A few people are getting very rich at the expense of the rest of us.”

January 8, 2020

Hospital mergers and acquisitions aren’t great for patients’ care, study finds

by Patrick A. Malone

Big hospitals keep getting bigger. But, contrary to what the suit-wearing MBAs may claim, the rising number of institutional mergers and acquisitions isn’t necessarily better for patients and their care.

At hospitals subjected to corporate wheeling and dealing, the quality of care got worse, or, at best, it stayed the same and didn’t improve, a new study in the New England Journal of Medicine reported.

Researchers scrutinized federal data “from 2007 through 2016 on performance on four measures of quality of care … and data on hospital mergers and acquisitions occurring from 2009 through 2013,” they said. These measures, the Wall Street Journal reported, included: patient satisfaction; deaths within a month of entering the hospital; return trips to the hospital within a month of leaving; and how often some heart, pneumonia, and surgery patients got recommended care. They looked at 246 hospitals involved in M&A activity, controlling their findings with data from 1,986 institutions not similarly affected.

December 18, 2019

When those medical bill slips and errors add up, honestly, isn’t it just fraud?

by Patrick A. Malone

If department stores, car mechanics, or restaurants billed their customers in the same way that hospitals and doctors do, prosecutors might have their hands full. That’s because what patients now accept in sheepish fashion as simple “errors” or misstatements or curious charges on their medical bills more correctly ought to be called something else: fraud.

That’s the reluctant but tough view now taken by Elisabeth Rosenthal, an editor, journalist, and onetime practicing doctor.

She has written an Op-Ed for the New York Times, her former employer, in which she recounted how she long has reported on health care costs and economics, including in her much-praised book, “An American Sickness: How Healthcare Became Big Business and How You Can Take It Back.” She said she has listened to too many patient complaints, as well as experienced problems of her own, to keep allowing establishment medicine to deem its relentless chiseling, oops, a little mistake.

December 17, 2019

As Americans struggle with soaring medical costs, top health officials bicker over their expense reports

by Patrick A. Malone

Here’s a point to ponder: A quarter of Americans say they or someone they know has put off treatment for a serious medical condition due to cost. That’s the worst such response pollsters at Gallup have gotten on this matter in almost three decades.

Two people have a lot to say about Americans’ health care finances, including their insurance, drug prices, and protections if they are poor, old, young, or chronically ill, physically or mentally. But, gee, the duo of Alex and Seema just can’t get along. They’re not playing nice. It’s gotten so bad that their big bosses, Don and Mike, have called them both in for a tough chat about working together.

Now, if it were you and me, and the office politicking got so out of hand that it attracted enough national attention to potentially embarrass majordomos of the organization, wouldn’t there be a screen door banging with some suits also getting tossed to the curb?

December 2, 2019

Grim way to increase nursing home profit: Toss out frail seniors and disabled

by Patrick A. Malone

Profit-hungry nursing home operators persist in throwing out vulnerable seniors and disabled patients from needed care, too often because the facilities find they can get higher-paying patients to fill their already costly beds.

Thousands of complaints about potentially improper discharges or transfers from nursing homes and assisted living facilities dominate the work of ombudsmen, whose work is federally required, and state supported, an NBC News investigation found.

The broadcast journalists reported:

November 29, 2019

Virginia hospital assailed for seeking court actions to strip patients of decisions on care

by Patrick A. Malone

A Virginia hospital has found an eyebrow-raising solution to some of its struggles with elderly, poor, and sick patients who take up beds and medical resources that might generate more revenue and less headache for the institution: Administrators hired a law firm and turned to the courts to strip legal control over the frail seniors from their loved ones.

Over families’ objections, the seniors’ newly appointed guardians then allowed the patients to be moved out of the Virginia Commonwealth University Health System hospital in Richmond and into poorly rated nursing homes. As the Richmond Times-Dispatch reported:

“A yearlong investigation by the Richmond Times-Dispatch, which involved analyzing more than 250 court cases and interviewing more than two dozen people, revealed that VCU Health System has taken hundreds of low-income patients to court over the past decade to remove their rights to make decisions about their medical care. This process, which frees up hospital beds at VCU Health System and saves thousands in uncompensated costs, often results in sick, elderly or disabled patients being placed in poorly rated nursing homes, sometimes against the wishes of their own family members. In these cases, VCU Health asks the court to grant an attorney at the ThompsonMcMullan law firm the power to make critical medical and life decisions for its patients. The court orders the attorney to represent the best interests of those patients, but the law firm continues to look out for the hospital’s interests on dozens of guardianship cases each year.”

November 24, 2019

On vaping, gun violence, and health insurance, the big talk flows, but action, not so much

by Patrick A. Malone

When it comes to key health concerns of the American public, President Trump and his administration have offered evidence anew that whatever they say may not last to the next political moment, that inaction is its own powerful kind of action, and that what officials say they’re doing may be exactly the opposite.

This is not intended as partisan commentary. It reflects the turn of a few news cycles and how Trump and his officials have dealt with:

The outbreak of serious lung illnesses and deaths tied to vaping