July 1, 2008 Recent News





A VA report states that female healthcare in the VA system is not up to the standards of male healthcare.  The females don't have the mammograms that they do in private practice, they get less quality of care in the outpatient services, the facilities do not have enough female bathrooms and changing areas

A recent study showed that oncologists were lax in having a talk with a patient that they were dying.  Those that did talk to their patients had less patients die in the hospital, less on vents and were no more depressed than those who were not told they were going to die.   

CalPERS, the huge California state pension fund has agreed to pay Blue Shield an increase of 3.7% for a family of four.  This would come to $1161 per month for the HMO.  The same family of four who chooses Kaiser will pay an additional 8.2% or $1227 per month.  

Illinois is showing the way to the reason healthcare insurance is so expensive.  Legislative fiats do the trick.  The legislature has mandated that insurers cover bulimia in their policies.  This will raise the cost of insurance for all in the state.  They mean well but they know not what they do.

In a recent article in JAPS by Sven Larson, Ph. D. told about many personal abuses that occurred recently in the Swedish Universal Health System due to the lack of caring of the people who controlled the system and were much more concerned with money than care.  His conclusion was that if we get universal health care here it would be the same within a generation. 

Over one million Brits have signed a petition against the Government's plan to put in polyclinics instead of the multiple GP clinics that they are used to.  This would also allow private health into the primary care world.  The Health Minister is not surprised that so many signatures have been collected since he accuses the British Medical Association of fear mongering and lies.

Speaking of fear mongering and lies, the AHA has put out a letter quoting a study on physician specialty hospitals by the Robert Wood Johnson Project and how bad they are.  However, when one reads the article the following statements are present: "overall, general hospital profit margins have not been affected by specialty hospitals", "self referral is not inherently bad and may be good practice of medicine", "patients referred to ASCs are only slightly healthier than those referred to hospital outpatient departments for the same procedures", "transfers out of specialty hospitals are rare but higher than in general hospital", "there is no data to determine whether the increased utilization of cardiac surgery or spinal surgery is clinically appropriate or inappropriate", "Medicare copays are lower in specialty hospitals than general hospitals".  The study does state the obvious that when surgery or tests are done in office there is no supervision as to the quality of the service.  That does not mean the service is bad just that there is no supervision.  I agree with the statement that quality of care, especially for procedures requiring sedation or aesthesia may be lower for surgery performed in physician offices than in ASC or hospitals. I wish the AHA would tell the truth for once without their spin.

For those that continue to love universal health care comes a story from southern California about Inland HMO that handles Medicaid patients in two counties not having any money to pay hospitals or providers since there will be no California budget approved by the July 1 deadline.  That means that nobody that service Medicaid patients will get any money until a budget is reached by the legislature and governor.  The HMO has had to take out a line of credit of $20 million to last through August.  The HMO will pay for normal services to the primary care providers but not for immunizations or for specialist care.  Of course starting July 1 a 10% pay decrease for providers goes into place meaning there will be less providers to be worried about.

The one year anniversary of the People's Republic of Massachusetts health plan is upon us.  The program has worked in getting adults to buy health insurance.  The adult uninsured has halved from 13% to 7%.  However, the cost is astronomical.  The original estimate was $472 million but that quickly became the real $625 million.  The next year budget asks for $869 million.  Those with state insurance will see their insurance rise over 9% but those with non state insurance will see an increase of only 5%.  Physicians and hospitals have seen a dramatic rise in patients since the plan's inception which is good for patients and preventative care.

A recent study of California HMOs show a $4 Billion profit within the last year with less patients and more money per patient coming in and less going out.     

New York Physicians are getting madder at insurers for practicing medicine without a license.  The insurers are telling physicians to use generics or to change meds when no cheaper generic is available.  The insurers do this by putting higher copays on prescriptions that are not generic or on their cheap list.  At times patients are forced to stop using meds that they have been on for a long time and be switched to others before they can go back on their original meds (step therapy).       Top


A new report on electronic prescribing show that 35,000 prescribers were prescribing over 35 million prescriptions on line.  That represents about 2% of the potential.  Americans get about 3.52 BILLION prescriptions annually. 

Despite all the ballyhoo about putting physician ratings on line almost no one uses them.  Word of mouth is still the usual way a physician is chosen.  A study by California Healthline showed only 2% actually used the rating to pick a doctor and only 1% used ratings to pick a hospital.  People did look at the rating sites but didn't use the information in their decisions.  It seems people understand that insurer ratings are all about money and not quality.

Some physicians are not happy with the government's study on the use of EHRs.  The reason is that if the physician is in the control group, not given incentive payments to defray the costs of purchase of hard and software, they will need to come up with the money themselves and this may lead them not to do it.  

Some providers are very happy they don't have electronic records, especially when they hear about the 2.2 million billing records with patient identifications stolen from a University of Utah courier. The hospital will offer free credit monitoring.  Of course, a shyster attorney the day following the computer theft filed a suit he hopes to turn into a class action windfall for him.  He couldn't care less about the people or the tax money to defend the shyster suit.   

 A report in Modern Healthcare states that physicians in the ambulatory care area aren't using EHR.  This is certainly not surprising since physicians in their offices and in the hospitals are not using EHR unless it its provided to them.  The article states that 4% of physicians have EHR available to them in the ambulatory care system.      Top


The Advisory Grp. that is a hospital organization is telling hospitals that the real money is not in spine surgery but in outpatient pain management.  They break in down by spine volumes.  Outpatient pain management is 82%, inpatient back care is 3%, outpatient spine procedures are 7% and inpatient spine procedures are 8%.  They warn hospitals not to let any of the money fall through the cracks.  

Lee Memorial Hospital in Ft. Meyers, Florida is having physician administration problems.  The physicians are independent practitioners are want to stay independent.  A consultant from Pricewaterhouse opened his mouth to the press stating the hospital may want to consider employing the physicians.  The Lee president then had to reassure physicians they were not talking about employing all the physicians, just some. 

Tri-City Hospital in Oceanside, California administrators were accused of compromising patient care in a public meeting.  The employees of the hospital made the accusation. This was a union ploy but it did get the wanted publicity.     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.