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February 15, 2010 Recent News Los Vegas' University Medical Center is attempting to get rid of its poor quality label. It now has electronic connections between its urgent care clinics and the hospital ED. That was not true in the past when a patient was transferred to the ED and was ignored since no one bothered to look at the papers went with her. Now the transfer is noted on the computer along with the labs already performed. The hospital also has changed from the cheaper medical assistants to registered nurses to do triage work in the ED. Of course this came after the hospital was investigated by both state and federal agencies for their deficiencies. If at first you don't succeed try try again. This is the motto for Northwestern University. It screwed up its takeover of Highland Park Hospital and is now taking over Lake Forest Hospital in the northern Chicago suburbs. This take over has received clearance from regulators in advance. This area is wealthy with good paying patients. Sutter Health has stopped using the services of their long time radiologists Radiological Associates of Sacramento. They are bringing radiology in-house for their Sacramento and environs hospitals. The outpatient radiology will continue with Associates for another year. This will save Sutter money and put the radiologists under the control of the hospitals. Top While all are concerned with cost there must be a balance with efficacy and patient health. Jolly Olde is now debating whether or not their NICE pane will allow dronedarone on the panel to treat atrial fibrillation. Currently most AF patients can only take amiodarone which is not the safest of drugs. The new drug is much more expensive but will help those people that can not take amiodarone. The NICE panel has certain people on it and does not have the specialists involved with the drug on the panel nor speak to the panel, a typical way governments and their subsidiaries can control the discussion. It will be interesting since the case of this drug and the way NICE has handled the problem has gone to the House of Commons. Still in Jolly Olde The Lancet has officially rescinded and article it published in 1998 on the link between autism and vaccines. The link has been shown scientifically to not be true but there are still those who are fervent believers. The author of the original paper, Dr. Wakefield, has been officially reprimanded for dishonesty in his paper. His research was funded by the attorneys who were suing the companies making the vaccines. Research has shown no relationship between autism and the preservative thiomerosal. England is also holding drug companies hostage by asking them to help fund expensive meds in order to get NICE approval. The latest one is a anti-leukemia drug, Sprycel. This drug would be used on those patients in whom the drug Gleevec does not work. Canada is finding their healthcare costs are also rising much faster than other parts of the economy. Several of the Provinces are spending at least 50% of their income on medical care, others are approaching the 50% range quickly. This is even in the face of gross rationing of care. This information comes from the 6th Fraser Report. The AMN conducted a survey of 1300 nurses and found frightening statistics. Almost half will be leaving nursing in the next three years due to job stress and general dissatisfaction. They would not recommend nursing as a career. There was nothing in the survey to suggest that physician disruption was the cause but it was mostly in burn out. It is ironic that the day after Clinton received two stents for chest pain (angina), the Wall Street Journal has a story on "Courage", the study that shows stenting for chronic chest pain is no better than putting patients on generic meds. The story is about comparative effectiveness and how it will be not used in American society, as Clinton so aptly showed. Top In Iowa the amount of med mal cases has dropped. The reason according to the trial lawyers is the cost of bringing a case to trial. It costs almost $100,000 to bring a case not including attorney time and the odds of winning is under 50%. The highest costs are for expert witness physicians who must be from out of state since it is difficult to find a physician within the state to testify against another physician. EHR is somewhat helpful to prevent med mal but minimal since it is mainly used for hospital billing and not quality of care issues. With all this the physicians continue to do significant defensive medicine. Top Parents are suing states for using their babies heel stick blood for research without the parent's consent. Heel sticks are routinely performed to test for genetic diseases but what parents do not know is that there is routinely blood left over that is placed in storage for future research. The question is is this legal. It is definitely not ethical. California sent patient's SSN on the envelope face to 500,000 people. Not very bright and now they have told the Medicaid patients to contact the three credit agencies and place a fraud alert on their account. Top Anthem Blue Cross of California has raised its premiums a whopping 39% on individual policies for this year. This is on top of a 30% increase last year. California does not have a law requiring insurers to justify its rate increases but does have a law requiring at least 70% of the premiums to go to medical use versus administrative use. The California Insurance Commissioner has asked Wellpoint, the national organization, to delay the increase until an outside agency can determine if Blue Cross meets the 70% test. If it doesn't then the raise will not be allowed. In a strange move Secretary of Health Sebelius has also put her nose into a state issue stating that this will be very hard on people in these economic times. She wants a reply by the company but the company has no duty to reply to her. Congress has also stuck its nose into the state's problem. The House is opening an investigation and has requested the Wellpoint CEO to testify before Congress. The state AG is seeing if this may be unfair business practices and the California Assembly is also holding hearings on the increase. Obama has also stated this is why healthcare reform is needed. Wellpoint stated the raises were necessary because healthy people were leaving the program and health costs were soaring. Sebelius again with no authority stated that some patients would lose coverage, a true statement. She then got into Democratic politics as did Obama and Reid to get the over $1 TRILLION Obamacare plan passed. With all the negative publicity WellPoint has agreed to defer the raise in premiums for two months to allow California to do a study making sure at least 70% of premiums are being spent on healthcare. While Wellpoint is catching the brunt of the wrath of all the pols, the other California insurers are also raising their rates up to 34% by Health Net and 40% by Aetna. WellPoint is also cutting therapists payments by up to 30%. California is not alone. Rhode Island insurers are also wanting increases but they are in the 16% area. Indiana Wellpoint is mimicking California is attempting to raise prices 38%. The People's Republic's Governor Patrick wants sweeping veto powers over rates charged by hospitals, clinics, physicians and insurers. Obviously, the socialized medicine experiment is not working very well. UnitedHealth is getting into the cancer treatment arena. They are collecting clinical data from physicians treating oncology patients and comparing them to NCCN guidelines. They have found that in lung and colon cancer patients Avastin is being used postoperatively instead of the cheaper chemotherapy. Avastin is FDA approved for these cancers and the insurer is sending letters to the physicians who prescribe this drug instead of the cheaper chemo. The letters state the guidelines and that the physician is not in compliance with same. They forget the definition of the word "guideline". California has taken a new poll regarding HMOs and found that patients are happier with them than they had been in the past. 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
information presented. |
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