Monday, April 30, 2012

Health Care Reform Articles-May 1, 2012

Today's blog contains only one posting - a remarkable presentation by Nobel Laureate Bernard Lown - made at a conference on "Avoiding Avoidable Care" held in Cambridge, Massachusetts last week.  It is well worth reading.

Dr. Bernard Lown’s Personal Blog
Social Responsibility of Physicians
Presented at the 
Conference on Avoidable Care
April 26, 2012
Cambridge, Massachusetts

Ever since starting clinical practice 62 years ago I have looked forward to this conference. Mercifully, good fortune and good genes enable me to attend.  From my earliest days in medicine I have struggled against the prevailing model of healthcare. My opposition in part was provoked by the growing prevalence of overtreatment. Resort to excessive interventions seemed to be the illegitimate child of technology in the age of market medicine. If more than a half century ago overtreatment was at a trickle pace, it is now at flood tide

health Care Reform Articles-April 30, 2012

Accretive Denies Accusations of Pressuring Patients to Pay

Accretive Health, one of the nation’s largest collectors of medical bills, took issue on Sunday with a report by the Minnesota attorney general’s office that it puts bedside pressure on patients to pay their bills.
The allegations “grossly distort and mischaracterize” the company’s revenue cycle services, it said in a statement. The suggestion that Accretive puts bedside pressure on patients to pay their bills out of pocket is a “flagrant distortion of fact,” the company said. It said it was working with its advisers to address those allegations.

Nonprofit Hospitals Faulted For Stinginess With Charity Care

Friday, 04/27/12 6:05pm - All Things Considered
Jenny Gold
Even before the hospital bills started coming, Lori Duff and her family were living paycheck to paycheck. So when the debt collector called the Columbus, Ohio, mother and demanded $1,800 for the prenatal visits she'd had while pregnant with her third son, she panicked.

Medical care shifting to electronic data files

Electronic health records are being used in hospitals and doctors’ offices. So how are they doing? Do the e-records protect and promote patient safety?

Quick Facts About High-Deductible Health Plans

APR 27, 2012
This story was produced in collaboration with 
High-deductible health care plans are no longer a novelty—they are becoming mainstream. According to the industry trade group America's Health Insurance Plans, the number of people with this kind of coverage reached more than 11.4 million in January 2011, up from 10 million in January 2010.
survey from the Kaiser Family Foundation found that about half of all workers in "small" businesses (up to 199 workers) who have health insurance have these plans. (KHN is an editorially-independent program of the foundation.)  Here is a brief guide to this type of health insurance:

New Millinocket health clinic a boon to the Katahdin region, officials say

Posted April 26, 2012, at 6:40 p.m.
MILLINOCKET, Maine — Stan Pettegrow loves his new workplace.
About 12,000 square feet of gleaming new offices and examination rooms, the new Katahdin Valley Health Center at Aroostook Avenue and Summer Street is a vast improvement over the 1,800-square-foot space it supplements, the licensed clinical social worker said.
“I think there is a really nice flow here,” Pettegrow said Thursday. “The clinical space can accommodate a lot more patients and providers. The most important part is that they [patients] can receive their mental health services right in their doctor’s office, and it [the new building] definitely opens the possibilities for even more behavioral health care services.”
About 50 people attended an open house at the facility on Thursday, the first held since construction of the $2.3 million primary care, behavioral and dental health care center began in January 2011.
The center is downtown Millinocket’s first new building in decades and represents a valuable addition to the Katahdin region for its ability to complement services offered at Millinocket Regional Hospital and by the region’s other health care providers, town officials have said.

Group backs human rights status for health care

Health Care for All-Oregon plans statewide campaign to put pressure on Legislature

By Bennett Hall
Corvallis Gazette-Times, April 24, 2012
Taking a page from Vermont’s playbook, Oregon reform advocates plan to launch a major campaign to have health care declared a human right.
“It means you get the care you need when you need it,” said Dr. Mike Huntington of Corvallis, the newly elected president of Health Care for All-Oregon.
The statewide organization’s ultimate goal remains single-payer health care — a taxpayer-funded system that would cover medical, mental and dental treatment for all Oregon residents, replacing private health insurance.
But despite some support in Salem, single-payer bills have never gotten very far in the Legislature.
Now, Huntington said, it’s time for a new tactic: a broad-based effort to mobilize public support for the notion that everyone deserves access to health care.
“We realized from others’ experience — primarily from Vermont — that it doesn’t really matter how good your argument is,” Huntington said. “It’s how well you can move people.”

Saturday, April 28, 2012

Health Care Reform Articles-April 29, 2012


A Doctor Breaks Ranks About Being Sick in America

Otis Webb Brawley, M.D., with Paul Goldberg

St. Martin's Press

Obamacare: How the Supreme Court Could Rule Unanimously

Many pundits predict the Supreme Court will decide the Obamacare case 5-4 along partisan lines. Justices Scalia, Alito, and Thomas and Chief Justice Roberts, they assume, will vote to strike the legislation down, and justices Breyer, Ginsburg, Sotomayor and Kagan will vote to uphold it. If these predictions are correct, the outcome will depend on Justice Kennedy, often considered the “swing” vote between Court conservatives and liberals.
The guessing is that Justice Kennedy will tip the case to the conservative side.
This is all most unfortunate. An extremely important decision about public policy is at stake, and policy decisions are supposed to be made by elected politicians, not by judicial ideologues.
Still, policy decisions by elected officials must not exceed the limits posed by the Constitution. And there are weighty reasons why mandated purchase of insurance could be considered unconstitutional.

In Hopeful Sign, Health Spending Is Flattening Out

WASHINGTON — The growth of health spending has slowed substantially in the last few years, surprising experts and offering some fuel for optimism about the federal government’s long-term fiscal performance.
Much of the slowdown is because of the recession, and thus not unexpected, health experts say. But some of it seems to be attributable to changing behavior by consumers and providers of health care — meaning that the lower rates of growth might persist even as the economy picks up.
Because Medicare and Medicaid are two of the largest contributors to the country’s long-term debts, slower growth in health costs could reduce the pressure for enormous spending cuts or tax increases.
In 2009 and 2010, total nationwide health care spending grew less than 4 percent per year, the slowest annual pace in more than five decades, according to the latest numbers from the Centers for Medicaid and Medicare Services. After years of taking up a growing share of economic activity, health spending held steady in 2010, at 17.9 percent of the gross domestic product.
The growth rate mostly slowed as millions of Americans lost insurance coverage along with their jobs. Worried about job security, others may have feared taking time off work for doctor’s visits or surgical procedures, or skipped nonurgent care when money was tight.

Use of antipsychotic drugs raises alarm

Federal data obtained by the Globe show many nursing homes make heavy use of antipsychotic drugs to pacify residents

Paramedicine holds promise

Posted April 27, 2012, at 2:46 p.m.
A law passed with little fanfare could end up making a big difference to people who need routine medical care, especially those in rural areas. It could also save money.
A bill, introduced by Gov. Paul LePage and sponsored by Rep. Mike Willette, R-Presque Isle, calls for the creation of up to 12 pilot projects that would allow paramedics to provide medical treatmentto patients in their homes.
For example, a patient with a chronic lung or breathing disorder who needs regular medication and breathing treatments would be referred to the program by a doctor or health care organization.
The paramedic would go to the patient’s home to check vital signs and make sure she is taking her medications and following through on other treatment. This would be done during down time between emergency calls.
Such care will lessen the chances of the individuals in the program needing to access the emergency room or be hospitalized once again. This is better for patients and could save money because hospital care is much more expensive.
It is important that review of the pilot projects include a close look at costs. Using paramedics during down time in their shifts is likely to save money. Paying paramedics to do the work of certified nurse assistants won’t.

Thursday, April 26, 2012

Health Care Reform Articles-April 27, 2012

(Editorial comment: Your money or your life.  A new American extortion racket.

Debt Collector Is Faulted for Tough Tactics in Hospitals

Hospital patients waiting in an emergency room or convalescing after surgery are being confronted by an unexpected visitor: a debt collector at bedside.
This and other aggressive tactics by one of the nation’s largest collectors of medical debts, Accretive Health, were revealed on Tuesday by the Minnesota attorney general, raising concerns that such practices have become common at hospitals across the country.
The tactics, like embedding debt collectors as employees in emergency rooms and demanding that patients pay before receiving treatment, were outlined in hundreds of company documents released by the attorney general. And they cast a spotlight on the increasingly desperate strategies among hospitals to recoup payments as their unpaid debts mount.
To patients, the debt collectors may look indistinguishable from hospital employees, may demand they pay outstanding bills and may discourage them from seeking emergency care at all, even using scripts like those in collection boiler rooms, according to the documents and employees interviewed by The New York Times.

In Congress, a Move to Look Into a Medical Debt Collector

A California representative is calling for an investigation into Accretive Health, one of the nation’s largest collectors of medical debt, for potentially violating a federal law that requires hospitals to provide emergency care regardless of citizenship, legal status or the ability to pay.
The congressman, Pete Stark, a Democrat who is the highest ranking member of the subcommittee that oversees Medicare and other health services, on Thursday asked Marilyn B. Tavenner, the acting administrator for the Medicare and Medicaid agency, to investigate the company’s practices.
He sent an identical letter to the inspector general of the Department of Health and Human Services, Daniel R. Levinson.
In an interview, Mr. Stark said that he was most alarmed about Accretive’s tactics of demanding that patients seeking emergency care pay outstanding balances before receiving treatment. Mr. Stark said he was spurred to action after reading about Accretive’s practices in an article in The New York Times on Wednesday.
“The behavior is potentially criminal,” said Mr. Stark, who wrote the Emergency Medical Treatment and Active Labor Act, the law mandating that hospitals provide care even to patients who are unable to pay for it.

Profit-Driven Medicine Violates American Patients Young and Old

Though my grandson and I are in two different sections of the country and both facing different cancer scares, we share one thing more prominently than anything else.  We are being violated as human beings in need of medical care by our health providers’ need to protect profits.  The money comes first; the patient is but a necessary cog in the healthcare revenue wheel.

Mercy: 'no aggressive collection practices'

Updated: 10:44 AM

The hospital says it will not tolerate its contractor using techniques that have made it the object of a Minnesota suit.

PORTLAND - Mercy Hospital said Thursday that it will not tolerate aggressive bill-collection practices, such as posting debt collectors in emergency rooms and at patients' bedsides, by a contractor it hired this month.

Health care reform: Is it ‘fair’?

A critique of the Affordable Care Act and a proposal for Maine

By Alice E. Knapp
Maine AllCare, April 24, 2012
Good people reasonably disagree on the merits of “Obamacare” (the federal Patient Protection and Affordable Care Act or “ACA”). Recent Congressional Budget Office estimates, however, project the ACA will leave approximately 27 million Americans uninsured in 2016 and beyond. While I might once have been persuaded that the law’s coverage gains justifies its failings, I now equate leaving 27 million Americans uninsured with having passed a law that freed but 90 percent of this nation’s slaves.
I view the ACA as symptomatic of this country’s corrosive slide into divisive, winners/losers politics. The law’s defenders have remained silent on why they believe it appropriate to extend through Medicaid expansions near free, comprehensive health insurance to millions of low income Americans while leaving millions of moderate income Americans similarly unable to afford comprehensive coverage to fend for themselves.
Visiting the Kaiser Foundation’s Health Reform Subsidy Calculator and entering two hypothetical, 52-year-old residents of a high-cost state like Maine illustrates the inadequacy of the ACA’s individual mandate premium subsidies and their arbitrary nature.‘fair’

Daily Activity Tied to Lower Alzheimer’s Risk

Higher levels of daily physical activity are associated with a decreased risk of Alzheimer’s disease, new research suggests.
The report, in the April 24 issue of Neurology, included 716 people, average age 82, without cognitive impairment. Each wore a wrist actigraph, a device that measures movement, for about 10 days to establish his or her usual level of daily physical activity. Over the next four years, 71 of them developed Alzheimer’s.
The researchers found that those in the lowest 10 percent for physical activity were more than twice as likely to develop the disease as those in the highest 10 percent. The association held after controlling for age, sex, education, vascular diseases, depression and the frequency of social activities.

Discriminatory health care law deserves challenge

Posted April 25, 2012, at 6:06 p.m.
Sometimes it takes a single heart-rending personal story to get things moving to right a wrong. That is what’s going on in the case of a legal immigrant, Hans Bruns of Fort Fairfield.
Bruns has suddenly lost the state health benefits that have helped him survive the pain and suffering from a rare form of cancer. A letter from the Department of Health and Human Services informed him that his health care coverage had been reduced because of a law that Gov. Paul LePage had pushed through the Maine Legislature last year.

Doctor Pay: Where The Specialists Are All Above Average

Making a living practicing medicine is more complicated and frustrating than ever. But it still pays. And pretty well.