August 1, 2018 Recent News





The terrible USPSTF has gotten blasted by both the American Urological Society and the physicians at the recent American Society of Breast Surgeons.  They both say their guidelines are just wrong.  The patients should get screened for prostate and breast cancer at the established ages and early diagnosis gives the patient the choice of treatment of watchful waiting.  The complications of mammography or PSA are minimal compared to the risks of not doing the screening.  All want real clinicians from the specialty involved on the committees and not the geeks that are there now.

CAR-T therapy is very good therapy for some cancers.  It has been approved for both acute lymphoblastic leukemia and advanced lymphoma.  The patient needs to have failed two chemo regimes before the CAR-T therapy.  Even then the problems is cost.  There are no across the board payments.  All are done on a case by case basis.  Also only certain medical centers may give the therapy as it can be toxic.  Some Medicaid programs do not cover the therapy at all.  Medicare only pays a good price for the therapy as an outpatient and it is given as an inpatient with markedly reduced rates.

The papers are continuing their blasting of hospital billings and with good reason.  One article talks about a woman being stung by a bee.  she has had prior allergic reactions and did not have her Epipen with her.  She went to the closest ED which was out of network.  She was seen by several physicians and got many blood tests and an CG in the tow hours she was there.  She got a bill for $12,000 since her insurer would not cover her visit.  

In a callous display MultiCare Good Samaritan hospital billed a patient who was injured at the hospital.  While waiting surgery for a hip fracture she was hit in the face with an exploded oxygen regulator valve.  This resulted in a CT scan to rule out any cranial injury.  She was told this has happened before.  Her insurance was billed several thousand dollars for the scan and interpretation.  The patient found the error and contacted the paper who interceded and the bill was dropped.  It should never have been there in the first place.  

Enrollment in Ocare dropped 12% in the first quarter of this year.  It went from 17.4 million to 13.4 million.  Most of those who have dropped were without subsidies.  They dropped 38%.  

California has announced a 8.7% increase or $550 per month in Ocare premiums which almost no one will pay due to subsidies.  Those without subsidies will buy non Ocare policies at a cheaper rate.

California's budget is over 1/3 into healthcare.  Also it is supposed that $100 million is spent on private health insurance.  This puts the golden State at 40th of 50 states in accessibility and openness as ranked by Mercatus.  63% of California physicians will not take the state medical insurance and the study found that 75% of Ocare plans strictly limit choice of physicians and hospitals.

In Colorado Kaiser is pulling out of the Medicaid program in the rural parts of the state.  This leaves 2500 or so without their HMO.

China is reporting that hundreds of thousands of children had received faulty vaccines due to a drug producer cutting corners.  This hits hard at the county's pharmaceutical industry which is trying to mass produce meds for use worldwide.  This is the third major scandal in the past decade regarding the pharmaceutical industry.  The Chinese government has responded by running spot checks on vaccine makers.


St. Luke's Baylor is still in the news.  Their heart transplant program has lost its ability to bill Medicare starting August 17.  They have been directed by CMS to assist any patient who wish a transfer to another program.  This is a program on the downswing and termination should be considered.

Holy Cross Hospital in Taos has a CEO on the way out.  He hasn't figured it out yet.  Bill Patten got roasted and not in a good way at an open meeting at the Taos County Commission.  The staff, former employees and even the residents of the city blasted Patton.  The hospital has lost many nurses especially in L&D who were filled by travelers at higher pay.  There are also problems in the ED staffing as in the pharmacy.

Red Flag Alert.  A 9 year old had gotten gasoline in her eyes.  Her mother washed out her eyes and then took her to a local ED.  A physician was said to come into the room and say that she needed to go to the eyewash station.  He billed $800 and said he did a complete review of body systems and a full physical exam and billed a level three.  Terrible.  However, I do not know what a 9 year old was doing pumping gas.

Gulf Coast Medical Center has stopped its renal transplants due to loss of its surgeons.  The Lee Hospital program had a problem with the death of a transplant donor from bleeding while on the OR table.


I had no idea.  Being rather long in tooth I did not know about today's residency matching.  Modern Healthcare had an article about the matching program and the way it is done and cheated upon.  The medical students are now interviewing at 10-20 institutions to try to secure a spot using the National Resident Matching Program.  When I got my internship (rotating) I did not interview but only put down one hospital and got it.  

Doctor, your costs matter.  In North Carolina Blue Cross Shield is paying patients $500 to change to cheaper physicians.  The will offer between $25 to $500 per medical procedure for over 100 procedures depending on where they are done and by whom.  Of course the lower cost proceduralist may be not as good as the high price spread.  This may be part of the adage "you get what you pay for".

The four medics who were sent to a dying person's home and did not even take her vitals before telling her she could not afford an ambulance ride have been suspended. They told her mother to take her to the hospital instead.


 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 information presented.