The following was posted in the last update erroneously. "Kaiser Permanente is in financial trouble according to the San Francisco Business Times. They lost $794 million in operations in 2008. The plan is started the process of not using outside consultants and laying off their administrative staff, which was very top heavy." It should have read that "It appears by me that Kaiser Permanente is in financial difficulty based on an article in the San Francisco Business times. The article stated that Kaiser lost almost $800 million in investments and is scaling back the use of consultants along with building programs and laying off of administrative staffs." I apologize for the error.
The Orlando Sentinel has a story about health insurers in Florida pushing patients toward generic drugs. This would not be bad except their definition of generic is the same class not the same drug. They do not care if a patient can not take a certain drug due to side effects as long as it is cheaper. The Consumer Federation of the Southeast has put out a consumer alert about "drug switching". Of course, consumers are sheep and do not care they are getting a different drug as long as they do not have to pay any more out of pocket, even if may be harmful to their health.
Dr. John Muney of New York City has been charging $79 a month for his clinics in all the boroughs for unlimited office visits and some tests. The state Insurance people did not like this low fee and said it was a de-facto insurance company. The doctor agreed to charge $33 per visit instead of the low fee. The state is loco. Top
The Miami Herald has a story about the lack of HHS scrutiny in Miami Dade regarding Medicare fraud. Eighteen companies were closed for fraud in January, 2007, only to reopen after they appealed. They were then indicted again later for again fraudulently billing Medicare for an additional $10 million. Much of the $5 million actually paid was never recovered. Medicare acknowledges that their appeal system is deficient but has not fixed it in the past 18 months. Many of the businesses that submit claims have no offices or employees but this is not required by Medicare. Top
The AMA states that in 90% of the time physicians are ignoring electronic prescription medical alerts both in the outpatient setting and in the hospitals. The reason is they have learned the alerts are mostly irrelevant. An article in the Journal of Internal Medicine said that about 1/3 of all alerts lacked adequate scientific basis or were not clinically useful. One writer stated that alerts seem to be written by liability attorneys and not clinicians.
The issue is getting interesting. Wal-Mart is going to sell hardware, software and installation with training. The Sam's Club will half those of the overpriced standard outfits who have given the EMS a bad name. Sam's is partnering with Dell and eClinicalWorks.
Physicians find Electronic difficult to use says HealthcareIT News. There continues to be a lack of input by physicians who are actually practicing into the projects. The projects are therefore doomed to fail. The stimulus bill is another sham as it will also fail to give physicians what they need at a cost they can afford. A physician will need to put out about $70,000 over five years for a system which is about $14,000 per year more the incentive payments. The penalty is also less than the 8% of Medicare receipts that the system would cost. Come on Wal-Mart.
The physicians that are against the push to electronics continue to grow. A major opinion piece in the Wall Street Journal by two Obamamites from the Republic of Massachusetts and Harvard rejects "Obama's $80 Billion exaggeration" on electronic medical records. The two agree with the 2005 RAND study that shows electronics will not reduce med mal and that there is no compelling evidence to support RANDS's theoretical claims of decrease in costs. The RAND people had a premise and in spite of all scientific methodology against the premise, defended the illogic premise. The two Harvardites who use electronics agree that electronics are good for documenting for more money but also show if something is keyed wrongly it has a habit of staying there forever as opposed to the written word. As there are more physicians speaking up against the electronics, more should not put out the large amounts of money for the small advantage. Obama is currently rated very low (59 out of 100) by the economic sector according to the Wall Street Journal and soon this may move to the health sector as well. Top
The New York city hospitals are not reporting to the state their near misses and preventable mistakes. They are reporting about half of what the rest of the state hospitals report and they are no better. The city hospitals say the report may be flawed and not the hospitals. This is doubtful since the information is used for allowing consumers to judge hospitals. The state is also at fault for not fining the hospitals for their lack of reporting.
In the recent Stimulus package there was a $1 Billion item to do comparative effectiveness research for medical treatments. This sounds good but may have the problems of driving a wedge between the physician and the patient. The disabled consumers do not want the "comparative analysis" to become cost effectiveness. The original House version of the bill stated that expensive procedures "will no longer be prescribed." The final bill took out this language but the thinking that added it is still present.
The AMA is warning the fed regulators not to use evidence based medicine to tell physicians what they can or cannot do. The AMA will fight interference with the physician-patient relationship. If evidence based medicine comes in as the norm then the public will be greatly impacted with the great statement "no" to knee surgery etc.
The physicians at the University of Chicago are not happy with Mrs. Obama's plans to decrease the ED beds for community clinics. The consultants also advised against it and two high ranking physicians resigned over the plan. The administration is having second thoughts about the bad proposal. Top
DISCLAIMER: Although this
article is updated periodically, it reflects the author's point of view at the
time of publication. Nothing in this article constitutes legal advice. Readers
should consult with their own legal counsel before acting on any of the