HCR -- A Few Fierce News Links

By John Ballard

Lots has happened since last week, but here is today's list.

?Malpractice claims against hospitals on the rise

Medical malpractice claims against hospitals likely will exceed 44,000 claims totaling $8.6 billion for incidents that occurred in 2009, risk management services provider Aon Corporation and the American Society for Healthcare Risk Management conclude in a new report. According to the two groups, the occurrence of claims has "entered a growth phase."

Total malpractice claims per hospital bed are predicted to grow 5 percent annually, according to a press release touting the report. Hospital professional liability claim frequency currently grows at 1 percent annually.

?How doctors hurt patients they're trying to help

Dragging yourself into work even if you're ill is still something many doctors do because they don't want to leave patients with inadequate care, burden their colleagues, or forgo pay. As many as 80 percent of physicians continue to work despite their own illnesses, according to a recent Journal of General Internal Medicine article. In the past, being present seemed to cause fewer problems than being absent, notes Dr. Pauline Chen in the New York Times.

But the tide may be turning, she suggests. Chen notes that researchers are beginning to see presenteeism--the practice of going to work sick and therefore, not fully functioning--as a problem to be avoided. From a business standpoint, presenteeism costs $150 billion in lost worker productivity, according to the Harvard Business Review. From a healthcare perspective, when doctors and other healthcare workers go to work sick, they pose patient safety risks as potential infectious disease vectors.

?Contaminated medical waste turns up at city dump

?Florida judge rules health reform suit will go to trial

Remember last week when a U.S. District judge in Michigan ruled that health reform was constitutional, calling the healthcare market one that is fundamentally necessary? Not so fast, according to a Florida judge.

Pensacola-based U.S. District Judge Roger Vinson ruled yesterday that he believes it has yet to be determined whether the mandate requiring people to buy health insurance is constitutional or not, reports the Associated Press, setting up a hearing in mid-December to hear more from both sides. He wrote that members of Congress who voted in favor of the bill never actually referred to the penalties for not buying insurance as "taxes" perhaps to minimize any backlash they might receive from constituents.

Further, Vinson wondered why states and taxpayers should have to wait until 2014 to file any lawsuits challenging the bill when some already are feeling the effects of the new law.

 

?Massachusetts General earns $1B via fundraising

?Next generation EMRs may include personal genome

As if putting medication histories and care plans into EMRs weren't causing enough consternation for doctors and nurses nationwide, wait until you hear what's coming down the pike, FierceEMR Editor Neil Versel writes. Richard Resnick, acting CEO of personal genomics firm GenomeQuest apparently said that the genome should also be a part of every patient's electronic medical record.

[Thought Question: Medical implants from breast implants to orthopedic joints to pace-makes have serial numbers which can be used to ID the recipient. What about implanted EMRs?]

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Here is another link from PNHP blog that caught my attention.

?Texas is No. 1 in lack of health insurance: lessons from other nations

Once again, Texas has the distinction of having the highest rate of people lacking health insurance in the nation � 26.1 percent. According to the Census Bureau�s new report, more than 1 out of every 4 Texans is uninsured, compared to the national average of 1 out of every 6 people.

These hard economic times show the woeful inadequacy of having an employer-based, for-profit health insurance system. Lose your job? Lose your health insurance. No health insurance? No access to health care. What�s the easiest way to fall into poverty? Get sick � even if you have health insurance at the time of your illness.

As T.R. Reid, author of �The Healing of America� says, �In the world�s richest nation, we tolerate a health care system that leads to large numbers of avoidable deaths and bankruptcies among our fellow citizens � that doesn�t happen in any other developed country.� Ironically, the U.S. spends twice as much as any other nation on health care without getting value for our money.

Nations with national health insurance spend about half as much as we do, have better overall medical outcomes and cover all their residents and citizens, according to the World Health Organization. The only real difference between us and them is that they do not allow for-profit health plans to play a central role in their health systems. And contrary to the popular myth of �socialized medicine,� nations with national health insurance mostly have less interference in medical practice and less government involvement in health care than we do.

There are just three models for universal health care in developed nations: Beveridge (the type of system used in the UK), Bismarck (used in Germany), and single-payer (in use in Canada and, since 1995, Taiwan, among others). The role of government varies with the model, but all three models exclude for-profit health plans from all but supplemental policies which cover extras such as private rooms. In other words, no insurance company bureaucrat determines whether a British, German, or Canadian patient will receive a needed test or treatment.

The Beveridge model, like our Veterans Administration system, is the nearest to �socialized medicine� because it features hospitals that are owned by government and doctors on government salaries. But there�s no government interference where it counts � in clinical practice. Doctors in other countries are shocked at the level of interference by insurance companies into medical practice in the U.S. In the other two models, doctors are in private practice. In the Bismarck model, private insurance companies function as quasi-governmental agencies � they are nothing like our Aetnas and Cignas � to assure access to all while government plays referee. Under the single-payer model, as in our Medicare program, government � the �single payer� � pays the bills for care, while the actual delivery of care is private.

Nations with single-payer systems reap tremendous savings on paperwork and bureaucracy by streamlining administration and keeping for-profit insurers out. Estimates are that the U.S. could save $400 billion annually by replacing our fragmented system of private insurers with an improved Medicare-for-all program, enough to cover all the uninsured and to upgrade everyone else�s coverage.

The for-profit, employer-based U.S. system only works for Wall Street and a handful of top executives who make millions by denying our nation what we are already paying for � high quality health care for all at an affordable price. Find out from nonpartisan sources what the other health care models are like. You will likely be surprised at how well these models work.

With single payer, Medicare for all, the United States will be able to truly have the best health care system in the world. That would be especially good news to us Texans.