The Clatter of the Hospital Room
By PAULINE W. CHEN, M.D.Clasping her chest and struggling to breathe, the small, birdlike woman had landed once again in the hospital for complications of kidney failure. It was her third visit in the last year and now, with fluid building up around her heart, she had come back in, but only after her family had pleaded with her for a day to do so.
"Oh, it's not because I don't want to feel better," she fumed as she lay gasping on her hospital bed. "It's because I can't get better here, with all those alarms and people waking me up to give me pills and take my blood pressure and get my blood." She stopped for a moment to catch her breath, then started crying. "I feel like I get sicker in the hospital because I can't get any sleep!"
Ask any person who has ever been hospitalized or stayed at the bedside of a loved one, and most will agree that hospitals are busy, noisy places. Patients have criticized the clatter for years, but their complaints have largely been ignored because hospital administrators, doctors, nurses and other staff have believed that a quiet environment is less critical for patient care than the alerts from the multitude of alarms, whistles and buzzers and the information garnered from frequent patient checks.
Over the last few years, however, that attitude has been gradually changing, thanks to a greater focus on patients, as well as new policies linking hospital reimbursement to patient satisfaction.
Plan to cut MaineCare at crossroads
The federal agency that must grant Maine a waiver to eliminate health care coverage for 27,000 people says the request appears 'inconsistent' with the law.
The LePage administration has raised the stakes in a confrontation with the federal government over budget cuts that would eliminate health care coverage for about 27,000 low-income Mainers.
Our View: Fight to cut MaineCare not one worth winning
A Harvard study shows that Maine's Medicaid expansion saves lives and avoids costs.
The LePage administration continues to push a MaineCare reduction plan that at best will result in a costly legal showdown, wasting state funds that could be better spent elsewhere. At worst this strategy will cost lives instead of just dollars.
LePage administration files plan for Medicaid cuts with feds; federal permission remains uncertain
Posted Aug. 01, 2012, at 6:38 p.m.
AUGUSTA, Maine — The LePage administration Wednesday laid out what it says is a clear-cut legal argument for allowing Maine to make cuts to its Medicaid program despite a provision in the Obama administration’s health care reform law that prohibits states from scaling back existing Medicaid services.
Maine’s Department of Health and Human Services on Wednesday filed paperwork with the federal Centers for Medicare and Medicaid Services requesting approval for Medicaid cuts that Republican lawmakers approved this spring and Gov. Paul LePage signed into law as part of a supplemental budget package.
“We fundamentally believe this is a very straightforward request that is absolutely within the state’s prerogative to make,” Health and Human Services Commissioner Mary Mayhew told reporters at a news conference.
Meanwhile, Democrats repeated Wednesday that they thought the cuts violated federal law, and a Health and Human Services official from former President George W. Bush’s administration said he thought it’s unlikely the Obama administration will allow Maine to make its desired cuts.
GOP health care agenda invites the reaper
Gov. Paul LePage and many of the Republicans in the Legislature like to talk about making tough choices.
But when it comes to their efforts around health care, the choices they are making aren’t tough. Instead, they are cruel, ideologically driven and unnecessary. But worse, they will likely cost lives.
This year, LePage forced through cuts in Maine’s Medicaid program, which is called MaineCare, that would take health care coverage away from thousands of low-income people in the state. While many of his cuts are likely illegal – against both Maine law and federal law – the intent is clear.
The governor and his supporters want to destroy public health programs that have over time expanded accesses to quality health care for Maine families, many of them working and still unable to afford insurance.
US Health Care Debate: From the Sublime to the Ridiculous
The American debate sounds absurd (and heartless) to the rest of the industrialized world
Nowhere is the phrase American Exceptionalism more appropriately used than when describing our debate over health care. Outside the bubble that is the United States health care is viewed as a right, recognition that sickness and injury can strike anyone and an acknowledgement of a basic obligation civilized societies have to its members.
If members of those societies were to tune in to the American debate I suspect they’d be baffled to watch grown men and women come up with ingenious ways to complicate a very simple moral issue.
The Sublime
Consider Richard Epstein’s response to the Supreme Court’s decision to uphold most of the health reform law. Epstein, an influential law professor at the University of Chicago chided Chief Justice Roberts in the New York Times for relying on Congress’ Constitutional power to “lay and collect Taxes.” He reminds us that the Constitution restricts the use of that power solely “to pay the Debts and provide for the common Defence (sic) and general Welfare of the United States.” And he insists that extending health care to 30 million Americans does not meet this standard because “general welfare” means “benefits that must be given to all citizens, if given to any.” That is, he explains, “matters that advance the welfare of the United States as a whole.”(Italics in the original.
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