I wouldn't want to speculate on what T.O. was thinking. I'll let him speak for himself.
.
Bitter Pill: Why Medical Bills Are Killing Us (stunning expose)
- Thread starter sharkbait28
- Start date
I wouldn't want to speculate on what T.O. was thinking. I'll let him speak for himself.
.
I already speculated and gave him the answer consistent with his question.
Talk about regulation!
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source: New York Times
State’s Tort Reform Makes Lawyers Wary of Taking on Patients</NYT_HEADLINE>
Connie Spears had to have both of her legs amputated above the knee after an emergency room doctor failed to diagnose a clotted vein that nearly killed her.
The leg pain Connie Spears felt was excruciating and familiar. She’d had blood clots before, and doctors had installed a filter in one of her heart’s main veins. At a Christus Santa Rosa hospital in San Antonio, where Mrs. Spears sought help the Friday before Memorial Day, the emergency room doctor ran some tests and discharged her with “bilateral leg pain.” He told her to follow up with her primary-care physician.
Three days later, Mrs. Spears was delirious and her legs were the color of red wine when she called 911 and was transported to a different hospital in the area. Doctors determined that her vein filter was severely clotted and had led to tissue death in her legs, as well as kidney failure.
When she regained consciousness weeks later, Mrs. Spears, 54, learned doctors had amputated both legs to save her life.
Mrs. Spears’s outrage over the first emergency room doctor’s diagnosis and the loss of her legs has been compounded by her inability to find a medical-malpractice lawyer to represent her. One after another, they have told her the same thing: She has a great case — but not in Texas.
“Do you know what it’s like not to have any legs?” Mrs. Spears asked tearfully, trembling as she lifted her dress to reveal the thick pink scars stretched like pillow seams across her thighs. “It’s ruined all of our lives.”
Officials with the Christus Santa Rosa Health System, which operates the hospital, would not comment because of patient privacy and confidentiality policies. (Christus Health is a $25,000 donor to The Texas Tribune.)
The tort reform that state lawmakers passed in 2003 made it more difficult for patients to win damages in any health care setting, but especially emergency rooms. It capped medical liability for noneconomic damages at $250,000 per health care provider, with a maximum award of $750,000.
Less well known was new language to safeguard under-the-gun emergency room doctors from civil damages unless it could be proved that they acted with “willful and wanton” negligence — that they not only put the patient in extreme risk but knew they were doing it.
Malpractice lawyers say this is a near-impossible threshold to meet. “You’d have to be a Nazi death camp guard to meet this standard,” said Jon Powell, a malpractice and personal injury lawyer based in San Antonio.
Advocates of tort reform say that is not true and that patients across the state continue to sue doctors and hospitals over emergency care. They say the “willful and wanton” language, along with damage caps, has driven down malpractice insurance rates and attracted more emergency room doctors to Texas.
“It’s a higher standard, but they face a different type of risk than other provider settings,” said Charles Bailey, general counsel for the Texas Hospital Association.
Since this law went into effect, doctors’ malpractice insurance rates have fallen nearly 30 percent statewide, according to the Texas Department of Insurance. Eighty-two counties have seen a net gain in emergency physicians, including 26 counties that previously had none, said Jon Opelt, executive director of the pro-tort-reform Texas Alliance for Patient Access.
But malpractice lawyers say these developments have come at the expense of patients. They argue that the “willful and wanton” rule means emergency room care in Texas is some of the most dangerous in the country.
“What Texans don’t know is that their Legislature has mandated a very low standard of care — almost no care,” said Brant Mittler, a cardiologist in San Antonio who added malpractice law to his résumé in 2001.
Jennifer McCreedy said she believes that lack of care ruined her life. Ms. McCreedy, a San Antonio single mother, avid country line dancer and full-time mortgage counselor, broke her ankle after she stumbled on her front porch in July 2006. She called her older daughter, who took her to an emergency room with her foot dangling off her leg.
Ms. McCreedy had broken her ankle in three places, severely dislocating the bones. Despite spending four hours at Methodist Hospital, she never saw the doctor overseeing her case, never heard from an orthopedic surgeon and was kept in the “fast track” — or less critical — section of the emergency room. She never had her bones set back in place, which orthopedic surgeons say is vital to reducing swelling. A physician’s assistant put her in a splint, told her to follow up with an orthopedic specialist for surgery and sent her home.
By the time Ms. McCreedy got in to see an orthopedic surgeon the next day, the splinted ankle was so swollen that surgery was too dangerous. After 13 days of trying to reduce the swelling, her surgeon decided he could not wait any longer. A surgery that normally takes an hour ran more than four hours, her surgeon testified in a court deposition, and he had to slice her Achilles tendon to lengthen contracted muscles. Because of the swelling, Ms. McCreedy’s wounds refused to heal, her surgeon said, eventually requiring a graft.
Ms. McCreedy, 52, has had five operations over the last few years and is permanently disabled. She is in so much pain from end-stage arthritis that she can work only 15 hours a week. She went from being a financially secure, active parent to hiding from creditors, nearly losing her home to foreclosure and asking her older daughter for cash. The lowest point, she said, was sobbing as she watched her adolescent son empty her bedpan.
With the help of Dr. Mittler and Mr. Powell, Ms. McCreedy sued the emergency room doctor, Robert Frolichstein, who testified that he should have seen Ms. McCreedy himself, should have called the on-call orthopedic surgeon and should have read her medical charts more closely before discharging her. Though he has no recollection of the patient or her condition, Dr. Frolichstein testified that he must have acted with the best information he had.
“Apparently there was some set of circumstances that made us develop this plan that at the time we felt was reasonable and safe for Ms. McCreedy,” he testified. Dr. Frolichstein did not respond to phone messages left at the emergency department where he works. Palmira Arellano, a spokeswoman for the Methodist Healthcare System, which operates Methodist Hospital, said patient privacy rules and pending litigation prevented her from speaking about the McCreedy case.
After a two-week trial this fall, it took a jury less than an hour to rule in Dr. Frolichstein’s favor, finding that his conduct did not meet the “willful and wanton” threshold.
“That standard — it was the biggest obstacle I had,” said Ms. McCreedy, who subsequently settled out of court with the hospital for a sum she is prohibited from disclosing. But she said she is still hounded by creditors.
Mr. Opelt, with the patient-access alliance, said people are still aggressively filing emergency room lawsuits. His research shows that from late 2003 to the end of 2008, 799 such suits were filed in Texas, resulting in 163 payouts totaling $31 million, with an average payout of $190,000.
Yet a preliminary study co-written by Prof. Charles M. Silver of the University of Texas School of Law shows that medical malpractice claims in Texas dropped by 60 percent from 2003 to 2007. Payouts per claim fell by a third.
For Mrs. Spears, the double amputee, the frustration — and humiliation — is daily. She used to cook, clean and care for her elderly mother, but now she needs help to go to the bathroom, to shower, to get around.
“I’m dead weight,” Mrs. Spears said. “And the more I piece things together, the more angry I get.”
Catastrophic Care: How American Health Care Killed My Father -- and How We Can Fix It
David Goldhill is the president and chief executive officer of the cable TV network GSN. This is a series of three excerpts from his new book, “Catastrophic Care: How American Health Care Killed My Father -- and How We Can Fix It,” to be published Jan. 8 by Alfred A. Knopf.
Focus on Health-Care Costs Causes More Spending
Obamacare Math Doesn’t Add Up to a Healthier U.S.
To Fix Health Care, Turn Patients Into Customers
David Goldhill is the president and chief executive officer of the cable TV network GSN. This is a series of three excerpts from his new book, “Catastrophic Care: How American Health Care Killed My Father -- and How We Can Fix It,” to be published Jan. 8 by Alfred A. Knopf.
Focus on Health-Care Costs Causes More Spending
Obamacare Math Doesn’t Add Up to a Healthier U.S.
To Fix Health Care, Turn Patients Into Customers
Re: Catastrophic Care: How American Health Care Killed My Father -- and How We Can Fi
Are you endorsing the "fix" ???
.
Are you endorsing the "fix" ???
.
Re: Catastrophic Care: How American Health Care Killed My Father -- and How We Can Fi
But mostly, just dump the pre-tax aspect of health insurance and the problem will mostly fix itself, because the insurance companies won't use a much richer employer as the middle-man to service a not-as-rich employee. Without health expenses being pre-tax, employers won't have an incentive to offer it at all.
I'm a believer that if insurance companies and hospitals' primary point of contact for bills were individuals, then cost would go down just like any service industry in general.
I read the articles when they first came out so I don't remember the specifics, but I do endorse treating health insurance like every other form of insurance like car insurance. You don't have insurance for oil changes or tire rotations, you have insurance for high-severity, unpredictably timed, and certain-to-happen (within the insurance pool) events. Stop having premiums reflect the cost of checkups and the most simple health care needs, then by definition premiums go down.
But mostly, just dump the pre-tax aspect of health insurance and the problem will mostly fix itself, because the insurance companies won't use a much richer employer as the middle-man to service a not-as-rich employee. Without health expenses being pre-tax, employers won't have an incentive to offer it at all.
I'm a believer that if insurance companies and hospitals' primary point of contact for bills were individuals, then cost would go down just like any service industry in general.
Re: Catastrophic Care: How American Health Care Killed My Father -- and How We Can Fi
I would add to this: force them to actually compete like car insurance companies. End their local/regional monopolies.
No matter what your record you can find affordable car insurance (as a person who got popped all the time, I know this to be a fact), the same should be true for health insurance.
I would add to this: force them to actually compete like car insurance companies. End their local/regional monopolies.
No matter what your record you can find affordable car insurance (as a person who got popped all the time, I know this to be a fact), the same should be true for health insurance.
Re: Catastrophic Care: How American Health Care Killed My Father -- and How We Can Fi
Sure, since those monopolies only exist because of government favors anyway. Get rid of them.
Re: Catastrophic Care: How American Health Care Killed My Father -- and How We Can Fi
They exist because government is bought off by the capitalists.
End corporate money in the election process!
They exist because government is bought off by the capitalists.
End corporate money in the election process!
The car insurance analogy is good but…….everyone is forgetting the preeminent difference between auto insurance & health insurance. You can not drive legally if you don’t buy auto insurance; this means all drivers must be insured.
This is not the case with health insurance. You can deliberately NOT BUY health insurance and thanks to Ronald Reagan you just go to any hospital emergency room when you do get sick and due to Reagans law the must treat you albeit at the highest cost available. The cost of these uninsured emergency room patients is eventually paid by the government and of course the people who did pay insurance premiums.
The health insurance mandate that is part of Obamacare will over time get everyone to purchase a policy (with government paying a portion of the premium for the indigent). This government supported partial payment of health care premiums and expanded medicare for the states which some stupidly ideological RepubliKlan governors like Koch Brothers slave-bitch Wisconsin governor Scott Walker have rejected — but other RepubliKlan governors in Florida, Arizona, New Jersey — have accepted; this system will inevitably over time move toward some version of a single payer system.
What is the barrier to decisively breaking the uniquely American extremely high health care costs as outlined in the Time magazine article that started this thread? The piñata that must be smashed is the “Health Care Mafia” oligopoly. This oligopoly feasts on American health care consumers wallets like a school of piranhas. At senior vice president and levels above (Executive VP’s, President, CEO, Chairman) — working at a top “Health Care Mafia” company earns far more than 90% of all American doctors!
These people are the middlemen between you and your doctor —the pimp who decides if you live or die.
For this they are paid anywhere from $750,000 to as much as $2,000,000,000 in a yearly paycheck. A prominent “Park Ave” or “Beverly Hills” specialty doctor can make $4,000,000 a year; fully taxable on a W2 (wages) which means he pays in New York & California including all taxes, federal, state, local as much as 50% of his income in taxes.
Meanwhile the “Health Care Mafia” ‘executive will receive most of his compensation in stock options which when vested he will pay a 15% capital gains rate when he turns the stock into cash. Look at the compensation figures below for the top “health care mafia” executives at the major companies. Remember that at each company and at many more not listed you have hundreds of workers who are earning at least $1,000,000 a year, more than most M.D.’s.
<img src="http://i.minus.com/iDpxySCWlwKdd.JPG" width="900">
In Germany the men on the assembly line who made my Mercedes S Class auto earn $67.00 an hour. They all have health care provided by Germanys single payer system. Unlike here in the U.S. the executives who run the company don’t consider them expendable scum. In fact when they have Mercedes board of directors meetings guess who’s at the table? —the labor who builds and engineered the cars are sitting around the giant boardroom conference table. In fact German law mandates that company boards consist of 50% labor representatives. The same Pfizer medicine that the “Health Care Mafia” sells to the American sheeple @ $5.25 per tablet costs 27 cents per tablet in Germany.
Now the subject of lawsuits and so called “tort reform” is best addressed in the film “Hot Coffee”. Download the film and watch it, I provided the link. After you view the film all the “corporate media” lies fueled by the RepubliKlans will melt away like ice in the Arizona desert. If you are an attorney and you haven’t seen “Hot Coffee” you have committed malpractice; everyone else who’s interested in reality should see it too.
Download Link Entire Film
734mb
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<div align="left"><!-- MSTableType="layout" --><br><img src="http://sg.wsj.net/public/resources/images/Reagan_Ronald-GC57101112004202930.gif" align="left">"Facts Are Stupid Things"
Ronald Reagan -1988
</div>
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Sorry
I forgot to turn on the video download permission
You can now download the HOT COFFEE video
Download Link Entire Film
734mb
Sorry
I forgot to turn on the video download permissionYou can now download the HOT COFFEE video
Download Link Entire Film
734mb
Code:
http://depositfiles.com/files/3x4idcpyb
Last edited:
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Planet Money - The Mysterious Power Of A Hospital Bill
This guy is getting popular.
Episode 439: The Mysterious Power Of A Hospital Bill
February 26, 2013 6:07 PM
If you have good health insurance, you've probably never even seen a full hospital bill. Count yourself lucky.
For a giant article in this week's Time, Steve Brill went line by line through a handful of bills from hospitals around the country. On today's show, he tells us about the crazy thicket of high prices and hard-to-decipher codes that he discovered, and we talk about what it means for the price of health care in America. (18 min 13 sec)
This guy is getting popular.
Episode 439: The Mysterious Power Of A Hospital Bill
February 26, 2013 6:07 PM
If you have good health insurance, you've probably never even seen a full hospital bill. Count yourself lucky.
For a giant article in this week's Time, Steve Brill went line by line through a handful of bills from hospitals around the country. On today's show, he tells us about the crazy thicket of high prices and hard-to-decipher codes that he discovered, and we talk about what it means for the price of health care in America. (18 min 13 sec)
Re: Catastrophic Care: How American Health Care Killed My Father -- and How We Can Fi
What is the purpose of insurance?
THURSDAY, MARCH 28, 2013
A friend points me to this passage:
I have the same problem with my other insurance policies. My homeowner insurance doesn't cover the cost when my gutters need cleaning, and my car insurance doesn't cover the cost when I need to fill the tank with gas. Instead, the policies cover only catastrophic events, like my house burning down or a major accident. Now that the Obama administration has fixed the health insurance system, I trust they will soon move on to solve these other problems.
http://gregmankiw.blogspot.com/2013/03/what-is-purpose-of-insurance.html?m=0
What is the purpose of insurance?
THURSDAY, MARCH 28, 2013
A friend points me to this passage:
At a White House briefing Tuesday, Health and Human Services Secretary Kathleen Sebelius said some of what passes for health insurance today is so skimpy it can't be compared to the comprehensive coverage available under the law. "Some of these folks have very high catastrophic plans that don't pay for anything unless you get hit by a bus," she said. "They're really mortgage protection, not health insurance."
I have the same problem with my other insurance policies. My homeowner insurance doesn't cover the cost when my gutters need cleaning, and my car insurance doesn't cover the cost when I need to fill the tank with gas. Instead, the policies cover only catastrophic events, like my house burning down or a major accident. Now that the Obama administration has fixed the health insurance system, I trust they will soon move on to solve these other problems.
http://gregmankiw.blogspot.com/2013/03/what-is-purpose-of-insurance.html?m=0
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U.S. to Delete Data on Life-Threatening Mistakes From Website
U.S. to Delete Data on Life-Threatening Mistakes From Website
By Charles R. Babcock
May 1, 2013 11:01 PM CT
Two years ago, over objections from the hospital industry, the U.S. announced it would add data about “potentially life-threatening” mistakes made in hospitals to a website people can search to check on safety performance.
Now the Centers for Medicare and Medicaid Services is planning to strip the site of the eight hospital-acquired conditions, which include infections and mismatched blood transfusions, while it comes up with a different set. The agency said it’s taking the step because some of the eight are redundant and because an advisory panel created by the 2010 Affordable Care Act recommended regulators use other gauges.
The decision to pull the measures is a retreat from a commitment to transparency, according to organizations representing employers that help pay for health insurance.
“We have a right to know if hospitals are making errors that are catastrophic to patients,” said Leah Binder, president of the Washington-based Leapfrog Group, whose members include General Motors Co. and Verizon Communications Inc. “What they’re saying basically is hospital claims of unfairness have more weight than consumers’ right to know.”
The initial proposal CMS has made for new safety-assessment data suggests the Hospital Compare website won’t be as comprehensive as it is now, Binder said.
Bill Kramer, executive director for national health policy at the Pacific Business Group on Health, said removing the data “would be a significant step backwards.” The coalition, including Wal-Mart Stores Inc. and Walt Disney Co., was among 33 business, labor and consumer organizations that argued against taking the hospital-acquired conditions, or HACs, off the site.
Error Rates
The debate over public reporting of hospital errors underscores the challenges regulators face in balancing patient and provider interests in an economy that spends $2.7 trillion a year on medical care, about one-third of it at hospitals.
The statistics were first posted in October 2011. CMS officials have said they’ll be removed during the website’s annual update in July, according to Binder and the American Hospital Association. Binder estimated it could be two years before data from the new HACs appear on Hospital Compare.
Patrick Conway, CMS’s chief medical officer and top quality-control official, declined to be interviewed and didn’t respond to written questions about the HACs’ removal, the new measures and when they might appear on the site.
The hospital industry argued against adding the statistics to Hospital Compare from the beginning, contending the data, culled from Medicare billing records, aren’t precise enough and can paint inaccurate pictures.
‘Real Picture’
“Our members have long been in favor of transparency,” said Nancy Foster, vice president for quality and patient safety policy at the Washington-based American Hospital Association. “The only thing we have insisted upon is that the measures be accurate and fair, that they represent a real picture of what’s going on in an individual hospital if you’re going to put it up on a public website.”
Baltimore-based CMS, which oversees the government health insurance programs that pay almost half of all U.S. medical bills, revealed it would be stripping Hospital Compare of the HACs in an Aug. 31 regulation.
CMS said it was doing so in part because two of them, both involving catheter infections, are already mentioned in other sections on the site and that three more are included in composite scores in another category.
New List
In addition, the Measure Applications Partnership or MAP, the group created by the health-care overhaul law, recommended that CMS instead use hospital-acquired conditions endorsed by the National Quality Forum. MAP is part of the nonprofit, which advises the U.S. government and hospitals on best practices.
The health-care law requires CMS to cut Medicare payments starting in October 2015 to hospitals that score in the 25 percent of worst-offenders on a list of hospital-acquired conditions, which the law leaves to regulators to define.
CMS proposed on April 26 that the measures include versions of two currently on the site -- bed sores and objects left inside surgical patients’ bodies -- and others that cover accidental cuts and tears, collapsed lungs, blood clots after surgery and other post-operative complications.
Two now on Hospital Compare that aren’t among those proposed by CMS are transfusions of the wrong type of blood and air embolisms, which are air bubbles that become trapped in the bloodstream. Both are known in the medical community as never- events, because they should never happen.
The agency will accept comments from the public on the suggested new HACs until June 25.
‘Great Concern’
Binder said it “should be a great concern to every American” that blood transfusion and air embolism aren’t among the proposals. “We deserve to know where they happen.”
Foster at the American Hospital Association said she couldn’t comment yet on the specific CMS proposals. While the trade group is concerned some might not be reliable indicators, she said, AHA experts are still studying them.
The website’s current HAC data are for the period from July 1, 2009, to June 30, 2011. Hospitals are scored on incidents per 1,000 discharges, and compared to a national ranking.
Regulators have emphasized curbing infections and injuries since the Institute of Medicine reported in 1999 that as many as 98,000 Americans die annually from preventable hospital mishaps. While some states track them, Hospital Compare is the only national compilation.
‘Done Right’
“It’s better to have measures that might not meet the highest level of statistical reliability than to ask your next- door neighbor,” said Dolores Mitchell, executive director of the health-care program for Massachusetts state employees, who said she was the only member of the MAP panel that opposed removing the HACs.
In Los Angeles, the Ronald Reagan UCLA Medical Center has a Hospital Compare score of .079 per 1,000 discharges for air embolisms, compared to a national average of .003.
After a transplant patient died in 2010 because an air bubble blocked a vein, UCLA conducted a root cause analysis and identified and put into place several changes in procedure, said Tom Rosenthal, who is chief medical officer of the UCLA Hospital System. “We have done everything we can do to reduce patient harm, and we’ve had no cases since.”
Opposition to the HACs on the website doesn’t mean the industry is “trying to cover up our dirty linen,” Rosenthal said. “The public does have a right to know what’s going on at UCLA and every other hospital in the country. But it should be done right.”
http://www.bloomberg.com/news/2013-...n-life-threatening-mistakes-from-website.html
U.S. to Delete Data on Life-Threatening Mistakes From Website
By Charles R. Babcock
May 1, 2013 11:01 PM CT
Two years ago, over objections from the hospital industry, the U.S. announced it would add data about “potentially life-threatening” mistakes made in hospitals to a website people can search to check on safety performance.
Now the Centers for Medicare and Medicaid Services is planning to strip the site of the eight hospital-acquired conditions, which include infections and mismatched blood transfusions, while it comes up with a different set. The agency said it’s taking the step because some of the eight are redundant and because an advisory panel created by the 2010 Affordable Care Act recommended regulators use other gauges.
The decision to pull the measures is a retreat from a commitment to transparency, according to organizations representing employers that help pay for health insurance.
“We have a right to know if hospitals are making errors that are catastrophic to patients,” said Leah Binder, president of the Washington-based Leapfrog Group, whose members include General Motors Co. and Verizon Communications Inc. “What they’re saying basically is hospital claims of unfairness have more weight than consumers’ right to know.”
The initial proposal CMS has made for new safety-assessment data suggests the Hospital Compare website won’t be as comprehensive as it is now, Binder said.
Bill Kramer, executive director for national health policy at the Pacific Business Group on Health, said removing the data “would be a significant step backwards.” The coalition, including Wal-Mart Stores Inc. and Walt Disney Co., was among 33 business, labor and consumer organizations that argued against taking the hospital-acquired conditions, or HACs, off the site.
Error Rates
The debate over public reporting of hospital errors underscores the challenges regulators face in balancing patient and provider interests in an economy that spends $2.7 trillion a year on medical care, about one-third of it at hospitals.
The statistics were first posted in October 2011. CMS officials have said they’ll be removed during the website’s annual update in July, according to Binder and the American Hospital Association. Binder estimated it could be two years before data from the new HACs appear on Hospital Compare.
Patrick Conway, CMS’s chief medical officer and top quality-control official, declined to be interviewed and didn’t respond to written questions about the HACs’ removal, the new measures and when they might appear on the site.
The hospital industry argued against adding the statistics to Hospital Compare from the beginning, contending the data, culled from Medicare billing records, aren’t precise enough and can paint inaccurate pictures.
‘Real Picture’
“Our members have long been in favor of transparency,” said Nancy Foster, vice president for quality and patient safety policy at the Washington-based American Hospital Association. “The only thing we have insisted upon is that the measures be accurate and fair, that they represent a real picture of what’s going on in an individual hospital if you’re going to put it up on a public website.”
Baltimore-based CMS, which oversees the government health insurance programs that pay almost half of all U.S. medical bills, revealed it would be stripping Hospital Compare of the HACs in an Aug. 31 regulation.
CMS said it was doing so in part because two of them, both involving catheter infections, are already mentioned in other sections on the site and that three more are included in composite scores in another category.
New List
In addition, the Measure Applications Partnership or MAP, the group created by the health-care overhaul law, recommended that CMS instead use hospital-acquired conditions endorsed by the National Quality Forum. MAP is part of the nonprofit, which advises the U.S. government and hospitals on best practices.
The health-care law requires CMS to cut Medicare payments starting in October 2015 to hospitals that score in the 25 percent of worst-offenders on a list of hospital-acquired conditions, which the law leaves to regulators to define.
CMS proposed on April 26 that the measures include versions of two currently on the site -- bed sores and objects left inside surgical patients’ bodies -- and others that cover accidental cuts and tears, collapsed lungs, blood clots after surgery and other post-operative complications.
Two now on Hospital Compare that aren’t among those proposed by CMS are transfusions of the wrong type of blood and air embolisms, which are air bubbles that become trapped in the bloodstream. Both are known in the medical community as never- events, because they should never happen.
The agency will accept comments from the public on the suggested new HACs until June 25.
‘Great Concern’
Binder said it “should be a great concern to every American” that blood transfusion and air embolism aren’t among the proposals. “We deserve to know where they happen.”
Foster at the American Hospital Association said she couldn’t comment yet on the specific CMS proposals. While the trade group is concerned some might not be reliable indicators, she said, AHA experts are still studying them.
The website’s current HAC data are for the period from July 1, 2009, to June 30, 2011. Hospitals are scored on incidents per 1,000 discharges, and compared to a national ranking.
Regulators have emphasized curbing infections and injuries since the Institute of Medicine reported in 1999 that as many as 98,000 Americans die annually from preventable hospital mishaps. While some states track them, Hospital Compare is the only national compilation.
‘Done Right’
“It’s better to have measures that might not meet the highest level of statistical reliability than to ask your next- door neighbor,” said Dolores Mitchell, executive director of the health-care program for Massachusetts state employees, who said she was the only member of the MAP panel that opposed removing the HACs.
In Los Angeles, the Ronald Reagan UCLA Medical Center has a Hospital Compare score of .079 per 1,000 discharges for air embolisms, compared to a national average of .003.
After a transplant patient died in 2010 because an air bubble blocked a vein, UCLA conducted a root cause analysis and identified and put into place several changes in procedure, said Tom Rosenthal, who is chief medical officer of the UCLA Hospital System. “We have done everything we can do to reduce patient harm, and we’ve had no cases since.”
Opposition to the HACs on the website doesn’t mean the industry is “trying to cover up our dirty linen,” Rosenthal said. “The public does have a right to know what’s going on at UCLA and every other hospital in the country. But it should be done right.”
http://www.bloomberg.com/news/2013-...n-life-threatening-mistakes-from-website.html
source: Ring of Fire
Still Think Medical Malpractice Claims Are Frivolous?
According to the Journal of the American Medical Association (JAMA), over 225,000 people die each year as a result of iatrogenic causes. In fact, this staggering number ranks as the third leading cause of death in the country, behind heart disease and cancer. The breakdown according to JAMA is as follows:
The merit of any case should be judged based upon the facts and circumstances surrounding it, rather than being immediately dismissed as frivolous just because of the industry in which it originates. In medical malpractice cases, more often than not, people have been severely injured or even killed. If it was your family member, would you want the case to be labeled as frivolous before the facts are even heard? Consider that question the next time you here a right wing spokesperson chastise the trial lawyers in this country for rising healthcare costs.
Did you know that in 2009, according to the National Association of Insurance Commissioners (NAIC), the total amount of money spent defending claims and compensating victims of medical malpractice was $6.6 billion, just 0.3 percent of the $2.5 trillion spent on healthcare in the country that same year. In 2004, the Congressional Budget Office (CBO) calculated that medical malpractice costs amounted to less than 2 percent of overall healthcare spending in the country. So, the question remains, are medical malpractice lawsuits the real problem behind rising healthcare costs? The math would seem to suggest not.
Still Think Medical Malpractice Claims Are Frivolous?
According to the Journal of the American Medical Association (JAMA), over 225,000 people die each year as a result of iatrogenic causes. In fact, this staggering number ranks as the third leading cause of death in the country, behind heart disease and cancer. The breakdown according to JAMA is as follows:
- 12,000 deaths/year from unnecessary surgery
- 7,000 deaths/year from medication errors in hospitals
- 20,000 deaths/year from other errors in hospitals
- 80,000 deaths/year from infections received in hospitals
- 106,000 deaths/year from non-error, adverse effects of medication
The merit of any case should be judged based upon the facts and circumstances surrounding it, rather than being immediately dismissed as frivolous just because of the industry in which it originates. In medical malpractice cases, more often than not, people have been severely injured or even killed. If it was your family member, would you want the case to be labeled as frivolous before the facts are even heard? Consider that question the next time you here a right wing spokesperson chastise the trial lawyers in this country for rising healthcare costs.
Did you know that in 2009, according to the National Association of Insurance Commissioners (NAIC), the total amount of money spent defending claims and compensating victims of medical malpractice was $6.6 billion, just 0.3 percent of the $2.5 trillion spent on healthcare in the country that same year. In 2004, the Congressional Budget Office (CBO) calculated that medical malpractice costs amounted to less than 2 percent of overall healthcare spending in the country. So, the question remains, are medical malpractice lawsuits the real problem behind rising healthcare costs? The math would seem to suggest not.
Can Hospitals Save Money By Making Doctors Squirm?
Can Hospitals Save Money By Making Doctors Squirm? (12:46)
December 18, 2013 9:05 PM
There's one part of Obamacare that doesn't get mentioned a lot, but that could end up being a big deal. It sets up experiments in hospitals all over the country to try to figure out how to save money without lowering the quality of care.
On today's show, we visit a hospital in Akron, Ohio that's engaged in one of these experiments. We sit in on a tense conversation where doctors argue about why it's so hard to start surgery on time. And we hear what happens when you change the way hospitals and doctors get paid.
For more, see our stories 3 Ways Obamacare Is Changing The Way A Hospital Cares For Patients and Hospital Puts Docs On The Spot To Lower Costs.
http://www.npr.org/blogs/money/2013...hospitals-save-money-by-making-doctors-squirm
Can Hospitals Save Money By Making Doctors Squirm? (12:46)
December 18, 2013 9:05 PM
There's one part of Obamacare that doesn't get mentioned a lot, but that could end up being a big deal. It sets up experiments in hospitals all over the country to try to figure out how to save money without lowering the quality of care.
On today's show, we visit a hospital in Akron, Ohio that's engaged in one of these experiments. We sit in on a tense conversation where doctors argue about why it's so hard to start surgery on time. And we hear what happens when you change the way hospitals and doctors get paid.
For more, see our stories 3 Ways Obamacare Is Changing The Way A Hospital Cares For Patients and Hospital Puts Docs On The Spot To Lower Costs.
http://www.npr.org/blogs/money/2013...hospitals-save-money-by-making-doctors-squirm
A $10,169 blood test is everything wrong with American health care
A $10,169 blood test is everything wrong with American health care
By Sarah Kliff
August 15, 2014 1:00 PM
A lipid panel is one of the most basic blood tests in modern medicine. Doctors use it to measure cholesterol levels in their patients, probably millions of times each year.
This is not a procedure where some hospitals are really great at lipid panels and some are terrible. There's just not space for quality variation: you are running blood through a machine and pressing buttons. That's it.
And that all makes it a bit baffling why, in California, a lipid panel can cost anywhere between $10 and $10,000. In either case, it is the exact same test.
"We're not talking twofold or threefold variation. It's a different level of magnitude."
"What we were trying to see is, when we get down the simplest, most basic form of medicine, how much variation is there in price?" says Renee Hsia, an associate professor at University of California, San Francisco who published the price data in a new study.
"It shows how big the variation really is. We're not talking twofold or threefold differences, its a completely different level of magnitude."
More than 100 hospitals — with more than 100 different prices
For this research, published Friday in the British Medical Journal, Hsia and her colleagues compiled reams of data about how much more than 100 hospitals charged for basic blood work. The prices these facilities charged consumers were all over the map.
The charge for a lipid panel ranged from $10 to $10,169. Hospital prices for a basic metabolic panel (which doctors use to measure the body's metabolism) were $35 at one facility — and $7,303 at another.
For every blood test that the researchers looked at, they found pretty giant variation:
This huge variation in the price of a really simple, incredibly basic blood test tells us a few things about the American health care system.
Blood tests aren't the only place with this variation
Hsia's previous research looked at the cost of an appendectomy in California and found similarly gigantic variation. For an appendectomy with no complications, she found that hospitals in the state would charge anywhere between $1,529 and $186,955.
One the issues with that study, she says, is that different hospitals might treat patients differently. "Some hospital might use more IV bags than others or one doctor could be ordering a lot of blood tests," she says.
Appendectomies can cost anywhere from $1,529 to $186,955
The point of comparing an incredibly basic blood test, and its prices, was to distill down to a very basic test that offers no space for variation — but still has a huge range in how much hospitals will charge.
Not every patient pays the full charge rate: insurance companies, for example, typically negotiate a lower rate with the hospital. Medicare, which covers seniors, has a set fee schedule it uses. But these are the prices that an uninsured patient — who doesn't have a health plan bargaining on her behalf — could face.
"If I'm hospitalized, don't have insurance and my doctor orders three days worth of blood tests, this is what I'm getting billed for," Hsia says.
What this tells us about American health care
For one, there's not much price transparency: it's really hard to know whether one hospital is charging $10 or $10,169 because prices are rarely listed. For this particular study, Hsia literally had to hire a software engineer to collect the data and line up all the different hospitals against each other.
The $10,169 blood test tells us we're suckers: we've developed a health care system where its hospitals have pretty full authority to name their price with little protest from consumers.
Americans are getting suckered on health prices
For people with health insurance, really big price variation often isn't a concern. If their plan covers the bill, it doesn't matter to them, personally, whether they get the $10 test or the $10,000 one.
For those without coverage (or those whose coverage only covers a certain percent of the bill), price variation matters a lot. Getting a $10,000 blood test can put a patient into bankruptcy. But right now, our health care system doesn't have the mechanisms to limit those high charges — nor would the patient likely have the tools to know the cost of his or her blood test to begin with.
"There's no other industry where you see this kind of extreme variation," Hsia says. "And nobody has ever really challenged it. It shows an extreme inefficiency, and something we really need to change."
http://news.yahoo.com/10-169-blood-test-everything-170003116.html
A $10,169 blood test is everything wrong with American health care
By Sarah Kliff
August 15, 2014 1:00 PM
A lipid panel is one of the most basic blood tests in modern medicine. Doctors use it to measure cholesterol levels in their patients, probably millions of times each year.
This is not a procedure where some hospitals are really great at lipid panels and some are terrible. There's just not space for quality variation: you are running blood through a machine and pressing buttons. That's it.
And that all makes it a bit baffling why, in California, a lipid panel can cost anywhere between $10 and $10,000. In either case, it is the exact same test.
"We're not talking twofold or threefold variation. It's a different level of magnitude."
"What we were trying to see is, when we get down the simplest, most basic form of medicine, how much variation is there in price?" says Renee Hsia, an associate professor at University of California, San Francisco who published the price data in a new study.
"It shows how big the variation really is. We're not talking twofold or threefold differences, its a completely different level of magnitude."
More than 100 hospitals — with more than 100 different prices
For this research, published Friday in the British Medical Journal, Hsia and her colleagues compiled reams of data about how much more than 100 hospitals charged for basic blood work. The prices these facilities charged consumers were all over the map.
The charge for a lipid panel ranged from $10 to $10,169. Hospital prices for a basic metabolic panel (which doctors use to measure the body's metabolism) were $35 at one facility — and $7,303 at another.
For every blood test that the researchers looked at, they found pretty giant variation:
This huge variation in the price of a really simple, incredibly basic blood test tells us a few things about the American health care system.
Blood tests aren't the only place with this variation
Hsia's previous research looked at the cost of an appendectomy in California and found similarly gigantic variation. For an appendectomy with no complications, she found that hospitals in the state would charge anywhere between $1,529 and $186,955.
One the issues with that study, she says, is that different hospitals might treat patients differently. "Some hospital might use more IV bags than others or one doctor could be ordering a lot of blood tests," she says.
Appendectomies can cost anywhere from $1,529 to $186,955
The point of comparing an incredibly basic blood test, and its prices, was to distill down to a very basic test that offers no space for variation — but still has a huge range in how much hospitals will charge.
Not every patient pays the full charge rate: insurance companies, for example, typically negotiate a lower rate with the hospital. Medicare, which covers seniors, has a set fee schedule it uses. But these are the prices that an uninsured patient — who doesn't have a health plan bargaining on her behalf — could face.
"If I'm hospitalized, don't have insurance and my doctor orders three days worth of blood tests, this is what I'm getting billed for," Hsia says.
What this tells us about American health care
For one, there's not much price transparency: it's really hard to know whether one hospital is charging $10 or $10,169 because prices are rarely listed. For this particular study, Hsia literally had to hire a software engineer to collect the data and line up all the different hospitals against each other.
The $10,169 blood test tells us we're suckers: we've developed a health care system where its hospitals have pretty full authority to name their price with little protest from consumers.
Americans are getting suckered on health prices
For people with health insurance, really big price variation often isn't a concern. If their plan covers the bill, it doesn't matter to them, personally, whether they get the $10 test or the $10,000 one.
For those without coverage (or those whose coverage only covers a certain percent of the bill), price variation matters a lot. Getting a $10,000 blood test can put a patient into bankruptcy. But right now, our health care system doesn't have the mechanisms to limit those high charges — nor would the patient likely have the tools to know the cost of his or her blood test to begin with.
"There's no other industry where you see this kind of extreme variation," Hsia says. "And nobody has ever really challenged it. It shows an extreme inefficiency, and something we really need to change."
http://news.yahoo.com/10-169-blood-test-everything-170003116.html
OK, how about this. Let's eliminate the middle man, the insurance companies.
Let's go to the Single Payer model.
Re: A $10,169 blood test is everything wrong with American health care
I think you raise an excellent point (hospital/doctor costs are just as important in the healthcare equation as having insurance in the first place), but I haven't seen where anyone has limited the discussion to either/or as you have suggested.
Here again, in your typical style of arguing, you attempt to put words into the mouths of others, in an attempt to make your point superior
I think you raise an excellent point (hospital/doctor costs are just as important in the healthcare equation as having insurance in the first place), but I haven't seen where anyone has limited the discussion to either/or as you have suggested.
Here again, in your typical style of arguing, you attempt to put words into the mouths of others, in an attempt to make your point superior
In my example, the middleman is the employer-based system. Obviously, I don't want to see the government as the new middleman destroying the industry.
Re: A $10,169 blood test is everything wrong with American health care
I'm sure you haven't seen it. The same way you haven't seen anything but the goodness in the law after 6 years.
I think you raise an excellent point (hospital/doctor costs are just as important in the healthcare equation as having insurance in the first place), but I haven't seen where anyone has limited the discussion to either/or as you have suggested.
Here again, in your typical style of arguing, you attempt to put words into the mouths of others, in an attempt to make your point superior
subed
Why? Because of ideology.
Re: A $10,169 blood test is everything wrong with American health care
..or you nothing but badness.
..or you nothing but badness.
No, because of efficiency. I didn't say get rid of the middleman because I didn't prefer any one particular middleman. The concept of a middleman doesn't work.
Your ideology led you directly to the government babysitting everyone.
Single payer would be the most efficient.
Which dailyKos thread did you get that from?
. . . and you expect a fellow poster to do that which you adamantly refuse to do: answer a simple question.
. . . and you expect a fellow poster to do that which you adamantly refuse to do: answer a simple question.
He can kill the messenger, but can't kill the message.
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