Unpredictable Danger Looms Close to the Heart
By KATIE THOMAS
Monsters attacked Avery de Groh when she was 4. That is how she remembers the day in 2007 when the defibrillator in her chest misfired, sending nine electric shocks through her body in less than 30 minutes.
Today, Avery is a chatty 9-year-old who just learned to roller-skate. She is old enough to know that she was not really attacked by monsters. The culprit was a broken wire from the defibrillator that keeps her heart beating normally. Like her mother and two brothers, she has an inherited condition that makes her prone to a fatal heart rhythm. After Avery’s episode, doctors removed the faulty wire, made by Medtronic, and replaced it with a new one made by St. Jude Medical.
Now it is possible that one is damaged, too. The wire, or lead, known as the Riata, was recalled in December after St. Jude warned doctors that internal cables were poking through the outer casing, causing unwanted shocks or failing to work when needed. Nearly 20 percent of the 128,000 people worldwide who have the Riata may be affected, according to the company.
Molly de Groh, Avery’s mother, said she worried that Avery’s new lead would also malfunction. “When I think about how scary it was for her,” she said, “I feel like, give that to me, and let her be fine.”
Heart device specialists have struggled for months to determine how best to treat patients with damaged leads. There is no easy fix: removing the wires can be dangerous, but so can leaving them in. In August, the Food and Drug Administration recommended that all patients with the Riata undergo imaging to see if their lead was failing. But the guidelines did little to settle the matter after some doctors questioned the wisdom of the advice.
Patients are caught in the middle, forced to grapple with life-or-death decisions for which there are no easy answers
http://www.nytimes.com/2012/09/08/business/patients-with-st-jude-medicals-defibrillator-wires-face-a-dilemma.html?_r=1&pagewanted=print
With profits down, future of Mass. hospitals questioned
As they brace for an era of shrinking government funds and mounting pressure to cut prices for medical services, Massachusetts hospitals face growing financial strains.Two dozen — more than a third of the state’s total — lost money last year, including rural community hospitals, urban safety net hospitals, and even affiliates of renowned academic medical centers, according to a new reportfrom the Division of Health Care Finance and Policy.
Among the biggest money losers were Boston Medical Center, which posted a $25.1 million deficit, Steward St. Elizabeth’s Medical Center in Brighton, which lost $20.9 million, and Quincy Medical Center, which was $18.5 million in the red.The industry’s performance was worse than in 2010, when 16 hospitals posted losses, and in 2009, when 13 were unprofitable. Overall, profit margins for the state’s 65 acute care hospitals fell to a razor thin 2.1 percent in 2011, compared with 2.6 percent the prior year, the state report said.Those numbers provide a financial snapshot of a health care market that was scrambling to adjust to rapid changes even before the Massachusetts Legislature passed a law this summer designed to rein in soaring medical costs.With the state’s intensified focus on affordable care and additional cuts projected for Medicaid and Medicare, the government health insurance programs for low-income residents and seniors, the future of many hospitals across the state is uncertain. In some cases, their survival may be in doubt.http://www.bostonglobe.com/business/2012/09/07/with-profitability-down-questions-are-being-raised-about-future-massachusetts-hospitals/sp1cv8kAGaKZrW7LZbmDUM/story.html
Healthcare reform law to usher in new age of consumerism
Health insurance companies are developing services, tools and communication strategies to attract and retain customers.
The Patient Protection and Affordable Care Act is changing the way insurers do business. A few years from now, you may see your health plan in a different light. You might even decide you like it — even if it's not that much more affordable.
But it's not all good news: Future employers are also expected to shift more costs to employees, and consumers will generally take on more of their healthcare expenses.
"A greater role in cost sharing is really forcing consumers to take a hard look at the care they access," said Robin Gelburd, president of Fair Health, a New York City nonprofit that provides healthcare cost information.
The health reform law will bring millions of new potential customers to insurers' doorsteps starting in 2014, ushering in a new age of consumerism. New services, tools and communication strategies are being developed to attract and retain your business, much the way banks and retailers have for years.
Medical spending likely to remain high despite healthcare law
The U.S. spends more on healthcare than any other country. Unnecessary medical care, fraud and excessive administrative costs are among the causes.
By Lisa Zamosky, Special to the Los Angeles Times
5:00 AM PDT, September 8, 2012
With all the squabbling about healthcare, there's one fact on which all sides can agree: American medicine costs too much, especially when you consider what we're getting for our money. And as experts look toward the future, they don't see costs dropping dramatically any time soon.
"We spend more on healthcare than any other country in the world, and the quality is uneven at best and dangerous at worst," said Anne Weiss, director of the Quality/Equality Health Care team with the Robert Wood Johnson Foundation in Princeton, N.J.
Americans spent $2.6 trillion on medical care in 2010, or about $8,233 per person. That's more than any other country spends to keep its citizens healthy, dwarfing the per-person price tag of even the second-biggest spender on health, Switzerland, by nearly 60%.
The price of healthcare in the U.S. is generally expected to remain high. According to the Centers for Medicare and Medicaid Services, spending will climb to $4.6 trillion by 2020. If that happens, health spending will consume nearly 20% of our gross domestic product.
Curbing the rise in healthcare costs depends on our ability to gain control of the many forces causing them to climb today.
"Probably the most important thing in understanding why we keep spending more and more money on healthcare is technology and the way patients get treated," said Sean Nicholson, a healthcare economist at Cornell University in Ithaca, N.Y. "Generally, the newer technologies tend to be more expensive than the things they replace."
Technology has helped other industries lower costs by eliminating waste and increasing efficiencies, but it's done the opposite in healthcare, said Michael Thompson, a principal in PricewaterhouseCoopers' health and welfare practice in New York. Although engineers keep building more powerful CT and MRI scanners, for example, there's no evidence that more scans are helping to prevent disease.
http://www.latimes.com/business/la-fi-future-of-healthcare-costs-20120908,0,2252590,print.story
Lawmakers press Medicaid director for budget answers as debate on cuts goes to court
Posted Sept. 07, 2012, at 5:58 p.m.AUGUSTA, Maine — The state will face an estimated $20 million budget shortfall if federal officials don’t sign off on plans to reduce state Medicaid spending. Lawmakers Friday pressed the state’s Medicaid director for answers on how the state Department of Health and Human Services will fill the potential budget gap if cuts to the state’s Medicaid program are rejected by the Centers for Medicare and Medicaid Services.The state Medicaid cuts in question would affect 36,000 people by eliminating coverage for 19- and 20-year-olds, tightening income eligibility requirements for low-income parents and scaling back Medicaid access for elderly residents who also qualify for Medicare benefits.A spokesman for the Centers for Medicare and Medicaid Services has said only a portion of those cuts — changing the income threshold at which residents qualify for MaineCare from 200 percent of the poverty level to 133 percent — are likely allowed under the Obama administration’s Affordable Care Act, which largely prohibits states from cutting Medicaid before a 2014 expansion of the program.The state needs federal approval before it can implement any of the cuts, which lawmakers approved as part of two separate budget packages this year.Republicans and Democrats on the Appropriations Committee quizzed MaineCare Services director Stefanie Nadeau on Friday on the size of the budget gap they might have to make up if parts of the state’s Medicaid request are approved and others aren’t.“The federal government seems to have indicated they’re not in a rush to make a decision,” said Rep. Kenneth Fredette, R-Newport. “We’ve booked savings. If we were to get a denial in November or December, we would essentially have a shortfall for some of the savings that we booked.”Nadeau said the Department of Health and Human Services expects its Medicaid cuts ultimately will be approved, but a contingency plan is “something that the department is looking at and working on currently.”“This was one of the reasons — this irresponsible budgeting — one of the reasons the Democrats would not go along with the Republicans on this issue,” said Rep. David Webster, D-Freeport.
ACA vs. single payer: Bury the hatchet? An exchange
The Nation, Aug. 28, 2012
PNHP note: The following exchange among PNHP co-founders Dr. Steffie Woolhandler and Dr. David Himmelstein, attorney Oliver Hall, and former health-insurance-executive-turned-whistleblower Wendell Potter was prompted by an article by Potter titled “Healthcare advocates: Time to bury the hatchet” in the July 11 online edition of The Nation. A link to Potter’s original article appears at the end.
By Steffie Woolhandler and David Himmelstein
Wendell Potter’s insightful critique of his former bosses in big health insurance was marred by his reprimand of his newfound friends in Physicians for a National Health Program and the rest of the single-payer movement for failing to adopt the political style of his erstwhile employer.
Potter incorrectly implies that PNHP urged a no vote on President Obama’s health reform by the Supreme Court. Some PNHP members condemned the ACA for boosting private insurers’ financial (and future political) power with a trillion-dollar infusion of public subsidies and mandated premiums. Others welcomed its expansion of Medicaid. All agreed that the reform would leave at least 26 million Americans uninsured and most others underinsured; that it would accelerate the corporate takeover of medicine and increase costs; and that single-payer reform remains an urgent necessity.
http://www.pnhp.org/print/news/2012/september/aca-vs-single-payer-bury-the-hatchet-an-exchange
Healthcare reform law to usher in new age of consumerism
Health insurance companies are developing services, tools and communication strategies to attract and retain customers.
The Patient Protection and Affordable Care Act is changing the way insurers do business. A few years from now, you may see your health plan in a different light. You might even decide you like it — even if it's not that much more affordable.
But it's not all good news: Future employers are also expected to shift more costs to employees, and consumers will generally take on more of their healthcare expenses.
"A greater role in cost sharing is really forcing consumers to take a hard look at the care they access," said Robin Gelburd, president of Fair Health, a New York City nonprofit that provides healthcare cost information.
The health reform law will bring millions of new potential customers to insurers' doorsteps starting in 2014, ushering in a new age of consumerism. New services, tools and communication strategies are being developed to attract and retain your business, much the way banks and retailers have for years.
But it's not all good news: Future employers are also expected to shift more costs to employees, and consumers will generally take on more of their healthcare expenses.
"A greater role in cost sharing is really forcing consumers to take a hard look at the care they access," said Robin Gelburd, president of Fair Health, a New York City nonprofit that provides healthcare cost information.
The health reform law will bring millions of new potential customers to insurers' doorsteps starting in 2014, ushering in a new age of consumerism. New services, tools and communication strategies are being developed to attract and retain your business, much the way banks and retailers have for years.
Medical spending likely to remain high despite healthcare law
The U.S. spends more on healthcare than any other country. Unnecessary medical care, fraud and excessive administrative costs are among the causes.
By Lisa Zamosky, Special to the Los Angeles Times
With all the squabbling about healthcare, there's one fact on which all sides can agree: American medicine costs too much, especially when you consider what we're getting for our money. And as experts look toward the future, they don't see costs dropping dramatically any time soon.
"We spend more on healthcare than any other country in the world, and the quality is uneven at best and dangerous at worst," said Anne Weiss, director of the Quality/Equality Health Care team with the Robert Wood Johnson Foundation in Princeton, N.J.
Americans spent $2.6 trillion on medical care in 2010, or about $8,233 per person. That's more than any other country spends to keep its citizens healthy, dwarfing the per-person price tag of even the second-biggest spender on health, Switzerland, by nearly 60%.
The price of healthcare in the U.S. is generally expected to remain high. According to the Centers for Medicare and Medicaid Services, spending will climb to $4.6 trillion by 2020. If that happens, health spending will consume nearly 20% of our gross domestic product.
Curbing the rise in healthcare costs depends on our ability to gain control of the many forces causing them to climb today.
"Probably the most important thing in understanding why we keep spending more and more money on healthcare is technology and the way patients get treated," said Sean Nicholson, a healthcare economist at Cornell University in Ithaca, N.Y. "Generally, the newer technologies tend to be more expensive than the things they replace."
Technology has helped other industries lower costs by eliminating waste and increasing efficiencies, but it's done the opposite in healthcare, said Michael Thompson, a principal in PricewaterhouseCoopers' health and welfare practice in New York. Although engineers keep building more powerful CT and MRI scanners, for example, there's no evidence that more scans are helping to prevent disease.
http://www.latimes.com/business/la-fi-future-of-healthcare-costs-20120908,0,2252590,print.story
Lawmakers press Medicaid director for budget answers as debate on cuts goes to court
Posted Sept. 07, 2012, at 5:58 p.m.
AUGUSTA, Maine — The state will face an estimated $20 million budget shortfall if federal officials don’t sign off on plans to reduce state Medicaid spending. Lawmakers Friday pressed the state’s Medicaid director for answers on how the state Department of Health and Human Services will fill the potential budget gap if cuts to the state’s Medicaid program are rejected by the Centers for Medicare and Medicaid Services.
The state Medicaid cuts in question would affect 36,000 people by eliminating coverage for 19- and 20-year-olds, tightening income eligibility requirements for low-income parents and scaling back Medicaid access for elderly residents who also qualify for Medicare benefits.
A spokesman for the Centers for Medicare and Medicaid Services has said only a portion of those cuts — changing the income threshold at which residents qualify for MaineCare from 200 percent of the poverty level to 133 percent — are likely allowed under the Obama administration’s Affordable Care Act, which largely prohibits states from cutting Medicaid before a 2014 expansion of the program.
The state needs federal approval before it can implement any of the cuts, which lawmakers approved as part of two separate budget packages this year.
Republicans and Democrats on the Appropriations Committee quizzed MaineCare Services director Stefanie Nadeau on Friday on the size of the budget gap they might have to make up if parts of the state’s Medicaid request are approved and others aren’t.
“The federal government seems to have indicated they’re not in a rush to make a decision,” said Rep. Kenneth Fredette, R-Newport. “We’ve booked savings. If we were to get a denial in November or December, we would essentially have a shortfall for some of the savings that we booked.”
Nadeau said the Department of Health and Human Services expects its Medicaid cuts ultimately will be approved, but a contingency plan is “something that the department is looking at and working on currently.”
“This was one of the reasons — this irresponsible budgeting — one of the reasons the Democrats would not go along with the Republicans on this issue,” said Rep. David Webster, D-Freeport.
ACA vs. single payer: Bury the hatchet? An exchange
The Nation, Aug. 28, 2012
PNHP note: The following exchange among PNHP co-founders Dr. Steffie Woolhandler and Dr. David Himmelstein, attorney Oliver Hall, and former health-insurance-executive-turned-whistleblower Wendell Potter was prompted by an article by Potter titled “Healthcare advocates: Time to bury the hatchet” in the July 11 online edition of The Nation. A link to Potter’s original article appears at the end.
By Steffie Woolhandler and David Himmelstein
Wendell Potter’s insightful critique of his former bosses in big health insurance was marred by his reprimand of his newfound friends in Physicians for a National Health Program and the rest of the single-payer movement for failing to adopt the political style of his erstwhile employer.
Potter incorrectly implies that PNHP urged a no vote on President Obama’s health reform by the Supreme Court. Some PNHP members condemned the ACA for boosting private insurers’ financial (and future political) power with a trillion-dollar infusion of public subsidies and mandated premiums. Others welcomed its expansion of Medicaid. All agreed that the reform would leave at least 26 million Americans uninsured and most others underinsured; that it would accelerate the corporate takeover of medicine and increase costs; and that single-payer reform remains an urgent necessity.
http://www.pnhp.org/print/news/2012/september/aca-vs-single-payer-bury-the-hatchet-an-exchange
PNHP note: The following exchange among PNHP co-founders Dr. Steffie Woolhandler and Dr. David Himmelstein, attorney Oliver Hall, and former health-insurance-executive-turned-whistleblower Wendell Potter was prompted by an article by Potter titled “Healthcare advocates: Time to bury the hatchet” in the July 11 online edition of The Nation. A link to Potter’s original article appears at the end.
By Steffie Woolhandler and David Himmelstein
Wendell Potter’s insightful critique of his former bosses in big health insurance was marred by his reprimand of his newfound friends in Physicians for a National Health Program and the rest of the single-payer movement for failing to adopt the political style of his erstwhile employer.
Potter incorrectly implies that PNHP urged a no vote on President Obama’s health reform by the Supreme Court. Some PNHP members condemned the ACA for boosting private insurers’ financial (and future political) power with a trillion-dollar infusion of public subsidies and mandated premiums. Others welcomed its expansion of Medicaid. All agreed that the reform would leave at least 26 million Americans uninsured and most others underinsured; that it would accelerate the corporate takeover of medicine and increase costs; and that single-payer reform remains an urgent necessity.
http://www.pnhp.org/print/news/2012/september/aca-vs-single-payer-bury-the-hatchet-an-exchange
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