Judges Split on Healthcare Reform Constitutionality
Judges in Michigan and Florida have taken opposing positions on similar issues as each has been faced with cases challenging the constitutionality of healthcare reform.
On October 7, 2010, federal judge George Caram Steeh of Detroit became the first judge to rule on the merits of the constitutionality of healthcare reform. He ruled against a suit brought by the Thomas More Law Center in Detroit that challenged the new law. The plaintiffs claimed that the law had no constitutional right to require that a private citizen purchase a commercial product, in this case private health insurance. However, wrote Judge Steeh, “These decisions, viewed in the aggregate have clear and direct impacts on health care providers, taxpayers and the insured population who ultimately pay for the care provided to those who go without insurance.”
Just seven days later, Federal Court Judge Roger Vinson in Florida, rejected the federal government’s attempt to have a similar case dismissed in his district. That case will now move forward for a trial on the merits. “At this stage in the litigation,” wrote Judge Vinson, “this is not even a close call.” He characterized the insurance mandate as an unprecedented exercise of congressional authority. He went on to opine that “Of course, to say that something is ‘novel’ and ‘unprecedented’ does not necessarily mean that it is ‘unconstitutional’ and ‘improper’. There may be a first time for anything. But, at this stage of the case, the plaintiffs have most definitely stated a plausible claim.” Judge Vinson went so far as to use the President’s own language against the case. The government attorneys had tried to say that the legislature had the right to mandate the purchase of insurance under its rights to levy taxes. But the judge noted that President Obama had repeatedly denied that the law would increase taxes.
Texas Medical Board to Weigh in on EM Board Certification Question
The training necessary to advertise as a board certified emergency medicine physician is being debated in Houston, Texas, according to the Montgomery County Courier.
Physicians must currently complete a three year residency program to be certified by the American Board of Medical Specialties, a requirement that began in 1983.
In contrast, five years in practicing emergency medicine is considered an acceptable alternative to the supervised training in an EM residency to be certified by the American Board of Physician Specialties. The Texas Medical Board is scheduled to make a decision about the competing requirements for emergency medicine certification on October 29.
In response to healthcare reform, one emergency physician group crafts a new identity
Southeast Emergency Consultants, an emergency medicine group headquartered in Jacksonville, Florida, recently changed its name to The Titan Emergency Group in order to reflect a more aggressive, competitive growth strategy. This change was in part a response to the potential for health care reform to impact hospitals’ strategic use of emergency departments, according to Dr. Fred Jenkins, one of the company’s medical directors.
Could Clinics Save Us Billions?
Increasing usage of clinics and urgent care treatment centers as alternatives to emergency room visits could cut billions of dollars in national health care costs.
Approximately $4.4 billion dollars could be saved if patients with minor ailments such as strains, sore throats, minor infections and less urgent conditions were treated outside of the hospital, according to a study funded by the California HealthCare Foundation and researched by the RAND Corporation, a nonprofit research organization, as reported in MDNews.
Researchers looked at 2006 data to compare information about visits to urgent care centers, clinics and emergency departments. RAND reported that about 27% of all emergency department visits could have been treated at a clinic or urgent care center instead, but only about 16.8 percent could have been addressed during business hours, according to MDNews.
How Dangerous is Emergency Medicine?
A shooting at Johns Hopkins Hospital in Baltimore, Maryland on September 16, highlighted emergency department safety concerns. The gunman, Paul W. Pardus, 50, became emotional after learning of his mother’s condition, reported the New York Times. Pardus pulled a semi-automatic gun and shot Dr. David B. Cohen, an orthopedic surgeon. Pardus later proceeded to kill his mother and himself after a two-hour standoff, reported the New York Times.
“Hospitals are pressure cookers as people are often distressed, mentally disturbed or intoxicated by drugs or alcohol in a highly stressful environment,” wrote Madison Park of CNN, describing stories of violence in emergency rooms in 2010.
Possible solutions to address the violence include metal detectors, increased security officers, closed circuit TV cameras, panic buttons and prevention programs.