The game of medical funding hot potato continues. Miami hospital system stops providing dialysis for indigent patients due to mounting budget losses. Instead, patients are encouraged to go to the emergency department so that Medicaid will be forced to pay the cost for the visits.
Rather than risk crowding in their hospital emergency departments, three other Miami area hospitals contributed $100,000 to pay for outpatient dialysis for one month while seeking a longer term solution

Boston Medical Center lawsuit accuses Massachusetts of illegally cutting payments to hospital for indigent care and of “financ[ing] its health insurance law, a model for national healthcare overhaul, on the backs of poor residents.”
BMC President Elaine Ullian makes similar comments in a speech to hospital donors. Massachusetts Governor Deval Patrick gets offended and writes letter to hospital’s board of directors calling Ullian’s comments “wrong” and “unhelpful.”
In other news, Ullian was then seen sneaking around Governor Patrick’s neighborhood at night carrying a carton of eggs and several rolls of toilet paper.

Need to see a mental health counselor? OK, our next open appointment is January 2015. The average wait in Polk County, Iowa is about 14 months for mental health care and can be “up to five years before some people can receive care.” At last count, there were more than 500 people on the waiting list. Cuts in services are being made as the state tries to balance its budget.

Medical malpractice judgments and settlements are now being posted online. The North Carolina Medical Board’s site is here. A story in Fox news about the innovation is here. According to the article, about two dozen licensing boards in several states publish malpractice information.
A number of years ago, there was a public outcry when a group in Texas posted names of plaintiffs who filed malpractice suits against physicians. Everyone seems content when physicians are exposed to public scrutiny.
Also interesting that the President of the NC Board, Donald Jablonski, was reprimanded by the Florida Board of Osteopathic Medicine. Amazing what you can learn on these sites.

It is an emergency department or a hockey rink? Patient punches emergency physician in the face (link from Gladwin, MI now changed to subscription only, so article unavailable). Meanwhile, a different patient punches emergency department nurse in face. Then, a mother threatens to kill ED staff then grabs security guard by throat. I need me a stun gun.
Then I read about a police officer being stabbed in the neck and killed while sitting in his car in an emergency department parking lot.
What is wrong with people?

More budget woes affect medical care. Cook County’s $75 million health care budget shortfall results in even more cuts in medical services. Nine hundred hospital positions were cut last year and an additional 450 positions will be cut this year. A patient notes that a 10 hour wait in the Stroger Hospital emergency department waiting room “isn’t bad” and that the longest wait he’s seen is 30 hours.

Gunshot victim seeks emergency care from naturopath? And the naturopath agrees? Somehow, I don’t think herbal extracts and rolfing are going to cure internal bleeding.

Increasing medical malpractice claims in Tennessee. Out of more than 3000 cases filed in 2007, only 7 went to trial and 492 were settled. The remainder “died on the vine.”

Emergency department staffing company Team Health’s IPO was disappointing, as they only opened at $12 per share rather than the $14 to $16 they were expecting. Even so, Team Health’s net income last year was nearly $2 billion. Talk about “going green” …

Also check out Part 2 of today’s update over on ERP’s site at ER Stories.

…

Medicare on Rye, Hold the Mayo. The Mayo Clinic is no longer accepting Medicare patients at one of its primary care centers in Arizona as the reimbursements are too low and the system lost more than $800 million treating Medicare patients last year.
According to the article, 92 percent of U.S. family doctors participate in Medicare, but only 73 percent of those are accepting new patients under the program. When Medicare cuts its reimbursement by 21% in a couple of months, look for those figures to drop precipitously.
I know, it’s like a skipping record, but I’m going to say it anyway … it sure is a good thing that all those Medicare patients have insurance, isn’t it? Because according to all the health care reformers, making sure that everyone has insurance is the most important part of reform.
Hat tip to 911Doc at MDOD.

From Dr. Wes … a gerontologist who opted out of Medicare because he couldn’t make ends meet at the rates Medicare was paying.
Medicare’s response? “Medicare was only too happy to have me opt out, because to them, I’m no longer part of their problem.”
This will be the modus operandi of the future, folks. Take money from our paychecks to “pay” for everyone’s medical coverage, then diminish payments until most of the providers leave. End result: we end up paying more and more to receive less and less – or to receive the promise of more medical care that never materializes. Heck, at this rate, Medicare might be turning a profit in 5-10 years.

Europeans express surprise about the speed with which an appendectomy is performed in the US.

See? At least one of us docs isn’t a malevolent quack. An emergency doc pays a patient’s rent so the patient will stay in the hospital.

We’re already closer to national health care than we think. According to a chart posted by Daniel Mitchell at the Cato Institute, American consumers pay for less than 12 percent of their health care costs. I’m not sure that is entirely accurate as a large amount of health care costs are funded by Medicare taxes taken from our paychecks, but the impression that we “aren’t paying for health care” likely explains why few people care about (or even know about) how much health care actually costs and why the system will crumble when 40 million members are added to its ranks.

Family awarded $20 million when woman aspirates stomach contents during surgery and dies.

Family of 3 year old child awarded $15 million when child dies after eighth surgery “in a desperate effort to save his life” from a heart birth defect. Surgeon leaves position as chief of surgery after lawsuit filed. Don’t worry, though. Direct medical malpractice is only a “tiny fraction” of all health care costs. Lawsuits like this are nothing to worry about.

Suing hospitals that “didn’t plan well enough” for Hurricane Katrina. The hospital systems “met or exceeded applicable electrical codes and standards,” but they didn’ t withstand flooding from the hurricane. With 200+ lawsuits now pending, some hospitals are deciding whether to spend money on equipment for the intensive care unit or on upgrading the emergency electrical system so they don’t get sued again.
Some lawyers just need to be castrated with a couple of bricks.
In other news, JCAHO has now deemed hurricanes a threat to patient safety and cited God for causing them. God has 30 days to come up with an action plan or risk being decredentialed as a deity.

Maybe we can sue our way to better health care. Opponents of the health care bill argue that the “individual mandate” in the health care bill is unconstitutional.

“Doctors Warn Cold Weather Causes Problems.” Phew. Glad they cleared that one up for me. Still have these nagging questions about loaded guns and intravenous drug abuse, though. Maybe they can do a follow up article.
The article states that “Flu, pneumonia, the common cold, even allergies can flare up, the problem arises when people assume they have these sicknesses and avoid finding underlying problems.” So rush to your doctors for all your snot noses boys and girls. Wouldn’t want to miss some underlying problem like nematode infestations or something.