November  15, 2016 Recent News





The NYT has a story asking if the high deductible insurance is worth it.  Should they pay high premiums or high deductibles?  In the past five years more employees are switching to the high deductible plans.  They may lead to foregoing care to save the deductible and paying the real not negotiated costs of tests and care.  However, people would rather take that risk than pay the ridiculous Ocare premiums caused by the mandates.  This is especially true with low income workers. The high deductible plans take less out of paychecks for the premiums which is important with premiums for the insurance out pacing wages.  

Anthem has warned that it may retreat from Ocare next year if the financials are not better.  The numbers of patients have been disappointing for the insurer.  

AstraZeneca has issued a warning to the UK that pharmaceutical companies will leave the country unless NICE starts to pay for the breakthrough drugs especially cancer drugs.  The current method of cost effectiveness the company says is not suited to the new cancer care since the drugs target small groups but are effective.  Brexit also will make the UK for obsolete in their attractiveness for big pharma.          Top


Nanaimo Regional General Hospital in Vancouver Island, Canada, is paying their physicians $260 a day for on call docs and $780 a day for ED docs to use their flawed EHR.  The payments were from July 1 to September 5 to compensate for the extra burden during the roll out period.  A critic of the EHR said it was inappropriate to pay to use an unsafe instrument. 

Coulee Medical Center in Washington, has quit Meditech due to increasing costs.  They have had to borrow money to continue with the project.  The cost kept rising as each new nuance was found and needed to be addressed.    

Another hospital is in the news for inappropriate billing.  This time it is Boca Raton Regional Hospital in Florida.  The hospital has billed a patient $7000 for a delivery room charge.  She delivered in a car in the parking lot of the hospital.  The husband caught the baby but the nurses helped with the rest.

Danger, a new Fungus among us!  The CDC reports that a fungus first seen in Japan six years ago has reached our hospitals.  To date 13 patients have become infected with Candida auris, a fungus that attacks those with poor immune systems.  It has killed four patients to date here in the US.

The 24/7 Wall St. published a list of places where one does not want to be sick.  The concluded from the Leapfrog information that the Hot Springs, Arkansas, and Visalia-Porterville, California were the two worst in the country.          Top


Tufts Medical Center physician network is losing over 400 physicians of the Suncoast Health System.  This happened after Suncoast and Care New England Health System did not merge.  They have decided to go alone for now.

How things have changed.  People now select a new physician if they have good on line reviews.  A study showed 77% of patients used the online reviews before selecting a new physician.  The good thing is that patients would go out of network for a physician who has similar qualifications as an in network doctor but has better reviews.  Scary!

Ocare has many problems not the least is that physicians are not taking the insurance.  In the past year physician participation has dropped 4%.  Why?  Reimbursement and the difficulty of HMOs that administer the plans.          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.