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An ugly truth about malpractice lawsuits is that some of the most indefensible violations of patient safety are covered up by hospitals, clinics and doctors with the complicity of the lawyers representing the injured patients.  This happens when settlements are entered into that require the patient to keep confidential everything that happened, and sometimes to even pretend it never happened.

USA Today has a big takeout today that describes a particularly egregious example: the prestigious Cleveland Clinic covered up a rape allegation against one of its surgeons by settling the patient’s claim and requiring the patient to sign a settlement document promising to remain silent about the episode. Eventually the surgeon resigned quietly and moved onto another health care institution, which of course knew nothing about the allegations until informed recently by the newspaper.

Everybody is familiar by now with how secret settlements have allowed sex abusers in the entertainment and media world – Harvey Weinstein, Bill Cosby, Bill O’Reilly and the rest of the gallery of shame – to buy off their accusers and go onto perpetrate harms against others.

CRO-Candy-counts3-10-17-112x300You and the kids may decide to splurge a little, devouring some Halloween candy. (Know that just a few of these morsels pack a load of unhealthy excess calories and sugar — see the great infographic from Consumer Reports.)

So here’s the penitent-tradeoff: While muching on a choice few bites of candy, please also take the time to sign up for your 2018 health insurance. Many of you will get tons of information from your employer because you get coverage at work.

If you qualify for insurance on exchanges created under the Affordable Care Act, aka Obamacare, the big news is, yes, the program still exists. It can benefit many, but they need to review their options and get aboard during the program’s Nov. 1-Dec. 15 open enrollment period. The Trump Administration has made some of this process more challenging, decreasing the support for public outreach and shortening the qualifying time.

Republican leaders just can’t seem to help themselves. As they flounder in their assault on the Affordable Care Act, aka Obamacare, they have moved from the inaccurate and counter-factual, beyond partisan buzzwords and talking points, and into a territory where they keep uncorking one howler after another about American health care and the ACA.

Two health care experts just put out a list of seven questions that Congress needs to answer about its replacement for the Affordable Care Act. The list is simple and useful for all of us in any contacts we have with lawmakers. Here it is:

1. How many millions of Americans will lose coverage?

2. Will people over 55 pay higher health premiums for the same coverage?

3. Will the new plan let insurers charge women higher premiums than men while offering them less coverage?

4. What other services are likely to be cut?

5. Will the new plan let insurers reinstate annual or lifetime limits on coverage?

6. What will happen to the more than 130 million Americans with pre-existing conditions?

7. How much more will those with costly illnesses or injuries have to pay in out-of-pocket costs?

For more details about what the possible answers might be, read the op-ed in the New York Times that this list came from, by Harold Pollack of the University of Chicago and Timothy Jost of Washington and Lee University.

And if any readers of this blog feel moved to pick up the phone and call your Representative or Senator, here’s a website that has a dedicated phone line that will patch you through to the right member of Congress representing you.

Or just call: 866-426-2631.

braintraumaIt may sound macabre. But advocates say a critical step to address important gender disparities in the care and research on concussions’ harms may rest in convincing more women to donate their brains to science. This has already  helped to prove the debilitating and deadly effects of head trauma among men in pro sports.

In contrast to the many and growing number of male athletes (especially pro football players) and their families who have allowed post-mortem brain studies, far fewer elite female players have agreed to similar research. Stat, the online health information site, says soccer stars Brandi Chastain, Abby Wambach, and Megan Rapinoe are among the public few.

Autopsies are often the only way, for now, for experts to definitively diagnose debilitating conditions like chronic traumatic encephalopathy (CTE) that result from repeated head trauma (concussions).

CRO_Health_CROH_July_Medical_Bill_05-15Surprise! California lawmakers waited until the very end of their legislative session before joining an increasing number of states in protecting patients from unexpected out-of-network medical charges. As many as 70 percent of patients staggered by these often hefty bills say they didn’t know they were receiving out-of-network care when it was given.

Gov. Jerry Brown is expected to approve the surprise medical bill legislation, which was bitterly opposed by providers. The measure won bipartisan support in providing that “patients who received care in in-network facilities would have to pay only in-network cost sharing” and only in instances of non-emergency care. As the industry publication Modern Healthcare describes it:

Emergency physicians in California already are barred from balance billing patients. The bill’s provisions [do not apply] to self-insured employer health plans, which are shielded from state regulations by the federal Employee Retirement Income Security Act. Health plans would pay non-contracting physicians the plan’s average contracted rate or 125% of the Medicare rate, whichever is greater. Doctors could appeal that through a binding independent dispute resolution process, which the state Department of Managed Health Care will establish.

gwuhospitalMore than 3,600 hospitals across the United States have taken a star turn. Many aren’t happy about it, and the same may be true for some members of Congress. Whether patients benefit is still murky. But federal officials, who have been planning a new and expanded hospital rating system for a long time now, have gone ahead with it because they say it will clarify for consumers some critical issues of safety, quality, and cost in health care.

Uncle Sam took 64 ratings it already publishes on its Hospital Compare website on measures like emergency room wait times and hospital acquired infection rates, and, summarized these into overall scores for institutions large and small. The Centers for Medicare and Medicaid Services, grouped them, weighted them, and, ultimately, converted the data into stars, from a low of one to a high of five.

Federal officials say this rating system, more common with restaurants and on review apps for the young, like Yelp, gives patient-consumers a fast, easy, clear, convenient way to start to deal with the complex, difficult issue of whether a hospital’s any good or not. The hospitals disagree, strongly, and some members of Congress have sided with them, and against the star ratings.

NFL-vector-logosWhat’s $30 million among friends? When the National Football League offered in 2012 to provide that sum to support concussion research by the National Institutes of Health, the conventional wisdom held that the sports powerhouse was finally coming around. The league basked in public praise for taking a more progressive approach to its challenges with deadly, debilitating head injuries.

But a congressional panel has found the NFL’s magnanimity was a sham. Instead, pro football sought to strip $16 million of its funding from the NIH when the agency wanted to bring in Dr. Robert Stern, a Boston University researcher who has been a major critic of the league.

The NFL, instead, tried to lateral its gift to members of its own committee on brain injuries.  As for these “experts,” the New York Times reports:

We wrote yesterday about contamination at the pharmacy of the NIH Clinical Center in Bethesda. Other big hospitals, judging by media reports, also may need to look at their pharmacy operations, especially when they compound ingredients together into custom drugs for patients.

A major hospital in a San Diego, Calif., suburb may have exposed more than 7,300 of its patients to infection risk due to contaminated medications served up in a pharmacy compounding lab. State officials fined Paradise Valley Hospital $17,500 not only for sanitary violations found in inspections but also because a hospital executive with oversight over the compounding lab was found to have falsified records; no patients came down with infections at the hospital due to the lab woes, otherwise the hospital could have been fined up to $75,000, state officials said.

And in Seattle, the flagship University of Washington Hospital between May 2014 and October 2015 produced medications for  surgical IVs, cancer care chemotherapy, and even simple injectable steroids for joint pain in pharmacies so dirty that they failed that state’s health department inspections, a TV station has reported.

Before they headed off to their holidays, Congress and President Obama wrapped up what many hope will be a helpful fiscal package to benefit Americans’ health: The 2016 omnibus budget bill, which got so much attention, also provided some of the strongest health care funding in more than a dozen years, news reports say. This should better support efforts to address an array of concerns, including fighting cancer and Alzheimer’s disease, improving food safety, and the bolstering initiatives to preserve the effectiveness of antibiotics.

The director of the National Institutes of Health issued a statement praising the $2 billion boost to his agency’s budget, the best he said he had seen in years. The health-related funding took significant bipartisan lobbying, particularly to overcome what has been a tide of partisan, rancorous, and downright anti-scientific activity in Washington.

Compared with what other national needs get funding when Uncle Sam figures how to spend more than $4 trillion annually, the increased healthcare spend might not seem sizable. But the added money is expected to:

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