Health Care Reform Articles-August 1, 2012

Medical Debt Collector to Settle Suit for $2.5 Million

By JESSICA SILVER-GREENBERG

Accretive Health, one of the nation’s largest collectors of medical debt, has agreed to pay $2.5 million to the Minnesota state attorney general’s office to settle accusations that it violated a federal law requiring hospitals to provide emergency care, even if patients cannot afford to pay.

The company has not admitted wrongdoing.

As part of Monday’s settlement, Accretive Health is also barred from contracting with hospitals within the state for at least two years, effectively ending its business at three Minnesota hospitals. For four years after that, the company will have to obtain permission from the attorney general before resuming business in the state.

In April, Lori Swanson, the Minnesota attorney general, disclosed hundreds of Accretive’s internal documents that outlined aggressive collection tactics, including embedding debt collectors in emergency rooms and pressuring patients to pay before receiving treatment.

Carol Wall, a 53-year-old Minnesota resident, said “a woman with a computer cart” told her she owed $300 as she was “vaginally hemorrhaging large amounts of blood” at an Accretive-affiliated emergency room in January, according to court records.

Another patient, Terry Mackel, 50, said he was asked to pay $363.55 at another Accretive-affiliated emergency room in Minnesota as he waited “alone, groggy and hooked up to an IV” waiting to see an emergency room doctor, according to court documents. Fearing that it was the only way to see a doctor, both patients paid.

http://www.nytimes.com/2012/07/31/business/medical-debt-collector-to-pay-2-5-million-settlement.html?_r=1&nl=todaysheadlines&emc=edit_th_20120731&pagewanted=print

More Treatment, More Mistakes

By SANJAY GUPTA

DOCTORS make mistakes. They may be mistakes of technique, judgment, ignorance or even, sometimes, recklessness. Regardless of the cause, each time a mistake happens, a patient may suffer. We fail to uphold our profession’s basic oath: “First, do no harm.”

According to a 1999 report by the Institute of Medicine, as many as 98,000 Americans were dying every year because of medical mistakes. Today, exact figures are hard to come by because states don’t abide by the same reporting guidelines, and few cases gain as much attention as that of Rory Staunton, the 12-year-old boy whodied of septic shock this spring after being sent home from a New York hospital. But a reasonable estimate is that medical mistakes now kill around 200,000 Americans every year. That would make them one of the leading causes of death in the United States. Why have these mistakes been so hard to prevent?

Here’s one theory. It is a given that American doctors perform a staggering number of tests and procedures, far more than in other industrialized nations, and far more than we used to. Since 1996, the percentage of doctor visits leading to at least five drugs’ being prescribed has nearly tripled, and the number of M.R.I. scans quadrupled.

http://www.nytimes.com/2012/08/01/opinion/more-treatment-more-mistakes.html?src=un&feedurl=http%3A%2F%2Fjson8.nytimes.com%2Fpages%2Fopinion%2Findex.jsonp&pagewanted=print

In a twist, Romney lauds Israeli health care system

By Matt Viser

 |  GLOBE STAFF

  AUGUST 01, 2012

WASHINGTON — Mitt Romney’s praise for the Israeli health care system, made near the end of his foreign trip, followed him as he returned home Tuesday, raising eyebrows because he lauded a system that has more government control than the Obama health law Romney so strenuously faults.

Romney, speaking to donors Monday, commented on how Israel — a “pretty healthy nation” — spends far less on health care than the United States does. Israel’s success in controlling costs is often attributed to the heavy role of its government and a requirement that everyone have coverage, some of the same qualities Romney condemns in the health law President Obama signed.

http://www.bostonglobe.com/news/politics/2012/07/31/mitt-romney-praises-israeli-health-system-even-though-more-government-run-than-obama-health-law/7FxThiiGMex7kCLUcXGjXN/story.html

Curbing the costs of high-tech health

By Robert J. Samuelson, Wednesday, August 1, 11:33 AM

Advances in medical technology are a double-edged sword. On the one hand, they have brought huge health gains to millions of Americans. Hip and knee replacements, heart operations, brain surgery, drugs — treating everything from high cholesterol to depression — have become routine when they were once considered exotic or unimaginable. The drawback is that these same breakthroughs have driven health spending upward, because they’re prone to misuse and overuse.

Can we curb waste without undermining new technologies? Well, maybe.

We now have a study suggesting, optimistically, that proper incentives can concentrate new technologies on the patients who might most benefit. The study involves advanced diagnostic imaging, including CT scans (for computed tomography) and MRIs (for magnetic resonance imaging). From 2000 to 2005, CT and MRI use among Medicare recipients grew 14 percent annually. Now, growth of both Medicare and non-Medicare spending has slowed to estimated annual rates of 1 percent to 3 percent, the study says.

http://www.washingtonpost.com/opinions/curbing-the-costs-of-high-tech-health/2012/08/01/gJQAwPPMPX_print.html

Universal coverage is not universal access

By Sarah Kliff
The Washington Post, Ezra Klein's Wonkblog, July 27, 2012
It’s well known that the Massachusetts health law increased health insurance coverage. The picture on how it changed access to health care is a little bit less clear. Some research has suggested that access has increased – a 2011 study found a 6.6 percent increase in residents with primary care doctors. At the same time, other research has shown access gains eroding.
New research from a team of Harvard researchers sheds some light on what might be happening: While access to care has improved, those in public programs have more difficulty finding doctors and paying for care.
“Most of the narrative about Massachusetts has been that we solved the coverage problem and the access problem,” says Harvard’s Danny McCormick, the study’s lead author. “We show that people with Medicaid and CommonWealth Care face challenges confronting a wide range of cost-related barriers not faced by the privately insured.”
CommonWealth Care is Massachusetts’ publicly-subsidized health insurance program, which covers those with incomes below 300 percent of the federal poverty line. About three-quarters of those who gained insurance through the Massachusetts expansion did so through a public program – CommonwealthCare and Medicaid – while the other quarter purchased private, unsubsidized policies.
McCormick and his colleagues interviewed 431 Massachusetts residents at a safety-net hospital in Boston. Their results, published in the Journal of General Internal Medicine, showed everyone was using outpatient care, such as prevention and normal doctor visits, at about the same rates.
http://www.pnhp.org/print/news/2012/july/universal-coverage-is-not-universal-access