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	<title>Comments on: Healthcare Update &#8212; 07-02-2010</title>
	<atom:link href="http://www.epmonthly.com/whitecoat/2010/07/healthcare-update-07-02-2010/feed/" rel="self" type="application/rss+xml" />
	<link>http://www.epmonthly.com/whitecoat/2010/07/healthcare-update-07-02-2010/</link>
	<description>A blog from inside the emergency department</description>
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		<title>By: Steve Zeitzew</title>
		<link>http://www.epmonthly.com/whitecoat/2010/07/healthcare-update-07-02-2010/#comment-22872</link>
		<dc:creator>Steve Zeitzew</dc:creator>
		<pubDate>Tue, 06 Jul 2010 15:29:42 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=5114#comment-22872</guid>
		<description><![CDATA[When I was in private practice the Medicaid reimbursement did not cover my costs, let alone pay me, so when I saw fewer Medicaid patients I lost less money by doing less work. I always took lots of call, but it became increasingly difficult since the majority of trauma patients at my urban hospital were either uninsured or Medicaid. I was simply not paid for working quite hard. I enjoyed my work but understood my colleagues who stopped taking call and never understood why or how the financial responsibility for care came to rest on my shoulders. Meanwhile, our County hospital was re-built with a smaller capacity. National healthcare will need to include more than an insurance that will not cover the costs of care in order to actually provide care. Replacing the &#039;uninsured&#039; with &#039;insured without access to care&#039; will not be a big improvement.]]></description>
		<content:encoded><![CDATA[<p>When I was in private practice the Medicaid reimbursement did not cover my costs, let alone pay me, so when I saw fewer Medicaid patients I lost less money by doing less work. I always took lots of call, but it became increasingly difficult since the majority of trauma patients at my urban hospital were either uninsured or Medicaid. I was simply not paid for working quite hard. I enjoyed my work but understood my colleagues who stopped taking call and never understood why or how the financial responsibility for care came to rest on my shoulders. Meanwhile, our County hospital was re-built with a smaller capacity. National healthcare will need to include more than an insurance that will not cover the costs of care in order to actually provide care. Replacing the &#8216;uninsured&#8217; with &#8216;insured without access to care&#8217; will not be a big improvement.</p>
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		<title>By: Matt</title>
		<link>http://www.epmonthly.com/whitecoat/2010/07/healthcare-update-07-02-2010/#comment-22753</link>
		<dc:creator>Matt</dc:creator>
		<pubDate>Sun, 04 Jul 2010 03:07:01 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=5114#comment-22753</guid>
		<description><![CDATA[With the overall number of practitioners not decreasing, how are these people making a living?  Are they cutting back and making less money?  Being absorbed by larger facilities?]]></description>
		<content:encoded><![CDATA[<p>With the overall number of practitioners not decreasing, how are these people making a living?  Are they cutting back and making less money?  Being absorbed by larger facilities?</p>
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		<title>By: MN resident</title>
		<link>http://www.epmonthly.com/whitecoat/2010/07/healthcare-update-07-02-2010/#comment-22751</link>
		<dc:creator>MN resident</dc:creator>
		<pubDate>Sun, 04 Jul 2010 00:03:33 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=5114#comment-22751</guid>
		<description><![CDATA[For the Minneapolis nurses, the union conceded on staffing ratios.

&quot;In the deal, the nurses gave up their demand for rigid nurse-to-patient ratios, which they said was needed to improve patient safety, but the hospitals called expensive and unnecessary.

In exchange, the hospitals dropped proposed cuts to pensions and health benefits.  The two sides agreed to work on staffing issues through an existing system of committees at the hospitals.&quot;

http://www.kare11.com/news/news_article.aspx?storyid=856491&amp;catid=14

I read Madness&#039;s blog and see she isn&#039;t happy, so this isn&#039;t a dig, just the reality.]]></description>
		<content:encoded><![CDATA[<p>For the Minneapolis nurses, the union conceded on staffing ratios.</p>
<p>&#8220;In the deal, the nurses gave up their demand for rigid nurse-to-patient ratios, which they said was needed to improve patient safety, but the hospitals called expensive and unnecessary.</p>
<p>In exchange, the hospitals dropped proposed cuts to pensions and health benefits.  The two sides agreed to work on staffing issues through an existing system of committees at the hospitals.&#8221;</p>
<p><a href="http://www.kare11.com/news/news_article.aspx?storyid=856491&#038;catid=14" rel="nofollow">http://www.kare11.com/news/news_article.aspx?storyid=856491&#038;catid=14</a></p>
<p>I read Madness&#8217;s blog and see she isn&#8217;t happy, so this isn&#8217;t a dig, just the reality.</p>
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		<title>By: SeaSpray</title>
		<link>http://www.epmonthly.com/whitecoat/2010/07/healthcare-update-07-02-2010/#comment-22748</link>
		<dc:creator>SeaSpray</dc:creator>
		<pubDate>Sat, 03 Jul 2010 19:43:45 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=5114#comment-22748</guid>
		<description><![CDATA[Hearing about all these facilities closing or under threat of closing is disturbing.  I feel for the people that live in these areas and for the lost jobs and services.

Domino effect seems to be picking up speed.]]></description>
		<content:encoded><![CDATA[<p>Hearing about all these facilities closing or under threat of closing is disturbing.  I feel for the people that live in these areas and for the lost jobs and services.</p>
<p>Domino effect seems to be picking up speed.</p>
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		<title>By: Doc99</title>
		<link>http://www.epmonthly.com/whitecoat/2010/07/healthcare-update-07-02-2010/#comment-22746</link>
		<dc:creator>Doc99</dc:creator>
		<pubDate>Sat, 03 Jul 2010 13:46:36 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=5114#comment-22746</guid>
		<description><![CDATA[Healthcare Reform may not cover the sick, high risk.
http://thehill.com/business-a-lobbying/106887-health-law-risks-turning-away-sick

Critics of the $5 billion high-risk pool program insist it will run out of money before Jan. 1, 2014. That’s when the program sunsets and health plans can no longer discriminate against people with pre-existing conditions.

Administration officials insist they can make changes to the program to ensure it lasts until 2014, and that it may not have to turn away sick people. Officials said the administration could also consider reducing benefits under the program, or redistributing funds between state pools. But they acknowledged turning some people away was also a possibility.Administration officials insist they can make changes to the program to ensure it lasts until 2014, and that it may not have to turn away sick people. Officials said the administration could also consider reducing benefits under the program, or redistributing funds between state pools. But they acknowledged turning some people away was also a possibility.

Who knew that Hope and Change were buzzwords for a Penn &amp; Teller show?!]]></description>
		<content:encoded><![CDATA[<p>Healthcare Reform may not cover the sick, high risk.<br />
<a href="http://thehill.com/business-a-lobbying/106887-health-law-risks-turning-away-sick" rel="nofollow">http://thehill.com/business-a-lobbying/106887-health-law-risks-turning-away-sick</a></p>
<p>Critics of the $5 billion high-risk pool program insist it will run out of money before Jan. 1, 2014. That’s when the program sunsets and health plans can no longer discriminate against people with pre-existing conditions.</p>
<p>Administration officials insist they can make changes to the program to ensure it lasts until 2014, and that it may not have to turn away sick people. Officials said the administration could also consider reducing benefits under the program, or redistributing funds between state pools. But they acknowledged turning some people away was also a possibility.Administration officials insist they can make changes to the program to ensure it lasts until 2014, and that it may not have to turn away sick people. Officials said the administration could also consider reducing benefits under the program, or redistributing funds between state pools. But they acknowledged turning some people away was also a possibility.</p>
<p>Who knew that Hope and Change were buzzwords for a Penn &amp; Teller show?!</p>
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		<title>By: Doc99</title>
		<link>http://www.epmonthly.com/whitecoat/2010/07/healthcare-update-07-02-2010/#comment-22745</link>
		<dc:creator>Doc99</dc:creator>
		<pubDate>Sat, 03 Jul 2010 13:42:22 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=5114#comment-22745</guid>
		<description><![CDATA[Healthcare Reform may make for overcrowding and longer waits in the ED.
http://news.yahoo.com/s/ap/20100702/ap_on_bi_ge/us_med_er_crowding_8

There&#039;s already a shortage of front-line family physicians in some places and experts think that will get worse.
_People without insurance aren&#039;t the ones filling up the nation&#039;s emergency rooms. Far from it. The uninsured are no more likely to use ERs than people with private insurance, perhaps because they&#039;re wary of huge bills.
_The biggest users of emergency rooms by far are Medicaid recipients. And the new health insurance law will increase their ranks by about 16 million. Medicaid is the state and federal program for low-income families and the disabled. And many family doctors limit the number of Medicaid patients they take because of low government reimbursements.
_ERs are already crowded and hospitals are just now finding solutions.
Rand Corp. researcher Dr. Arthur L. Kellermann predicts this from the new law: &quot;More people will have coverage and will be less afraid to go to the emergency department if they&#039;re sick or hurt and have nowhere else to go.... We just don&#039;t have other places in the system for these folks to go.&quot;

Hope! Change!]]></description>
		<content:encoded><![CDATA[<p>Healthcare Reform may make for overcrowding and longer waits in the ED.<br />
<a href="http://news.yahoo.com/s/ap/20100702/ap_on_bi_ge/us_med_er_crowding_8" rel="nofollow">http://news.yahoo.com/s/ap/20100702/ap_on_bi_ge/us_med_er_crowding_8</a></p>
<p>There&#8217;s already a shortage of front-line family physicians in some places and experts think that will get worse.<br />
_People without insurance aren&#8217;t the ones filling up the nation&#8217;s emergency rooms. Far from it. The uninsured are no more likely to use ERs than people with private insurance, perhaps because they&#8217;re wary of huge bills.<br />
_The biggest users of emergency rooms by far are Medicaid recipients. And the new health insurance law will increase their ranks by about 16 million. Medicaid is the state and federal program for low-income families and the disabled. And many family doctors limit the number of Medicaid patients they take because of low government reimbursements.<br />
_ERs are already crowded and hospitals are just now finding solutions.<br />
Rand Corp. researcher Dr. Arthur L. Kellermann predicts this from the new law: &#8220;More people will have coverage and will be less afraid to go to the emergency department if they&#8217;re sick or hurt and have nowhere else to go&#8230;. We just don&#8217;t have other places in the system for these folks to go.&#8221;</p>
<p>Hope! Change!</p>
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		<title>By: Matt</title>
		<link>http://www.epmonthly.com/whitecoat/2010/07/healthcare-update-07-02-2010/#comment-22734</link>
		<dc:creator>Matt</dc:creator>
		<pubDate>Fri, 02 Jul 2010 21:01:01 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=5114#comment-22734</guid>
		<description><![CDATA[Are they so identifiable?  I wonder if he&#039;d had his license revoked?  

The vast majority of malpractice never even sees a claim file, much less a courtroom, so if suing them all is the plan, it doesn&#039;t appear to be working out.]]></description>
		<content:encoded><![CDATA[<p>Are they so identifiable?  I wonder if he&#8217;d had his license revoked?  </p>
<p>The vast majority of malpractice never even sees a claim file, much less a courtroom, so if suing them all is the plan, it doesn&#8217;t appear to be working out.</p>
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		<title>By: DensityDuck</title>
		<link>http://www.epmonthly.com/whitecoat/2010/07/healthcare-update-07-02-2010/#comment-22727</link>
		<dc:creator>DensityDuck</dc:creator>
		<pubDate>Fri, 02 Jul 2010 18:20:26 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=5114#comment-22727</guid>
		<description><![CDATA[On the other hand, it means that geniunely bad physicians are easily identifiable, and the &quot;sue everyone and let God sort &#039;em out&quot; plan isn&#039;t actually necessary.  Sure does work as a jobs program for lawyers, though!]]></description>
		<content:encoded><![CDATA[<p>On the other hand, it means that geniunely bad physicians are easily identifiable, and the &#8220;sue everyone and let God sort &#8216;em out&#8221; plan isn&#8217;t actually necessary.  Sure does work as a jobs program for lawyers, though!</p>
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		<title>By: midwest woman</title>
		<link>http://www.epmonthly.com/whitecoat/2010/07/healthcare-update-07-02-2010/#comment-22720</link>
		<dc:creator>midwest woman</dc:creator>
		<pubDate>Fri, 02 Jul 2010 15:14:28 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=5114#comment-22720</guid>
		<description><![CDATA[St. Louis psychiatric center definitely closing...great. Work in the river city. We have a two against four room ( a nurse and tech with four patients) It&#039;s supposed to be for the confused elderly patient  ripping off anything they can get their hands on or climbing out of bed constantly. But anything that says mental status changes will qualify you...Dts, methers (this is Missouri, ya know) off schizophrenia medicines etc.
Thanks for the update..I&#039;ll be looking for them.]]></description>
		<content:encoded><![CDATA[<p>St. Louis psychiatric center definitely closing&#8230;great. Work in the river city. We have a two against four room ( a nurse and tech with four patients) It&#8217;s supposed to be for the confused elderly patient  ripping off anything they can get their hands on or climbing out of bed constantly. But anything that says mental status changes will qualify you&#8230;Dts, methers (this is Missouri, ya know) off schizophrenia medicines etc.<br />
Thanks for the update..I&#8217;ll be looking for them.</p>
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		<title>By: Matt</title>
		<link>http://www.epmonthly.com/whitecoat/2010/07/healthcare-update-07-02-2010/#comment-22717</link>
		<dc:creator>Matt</dc:creator>
		<pubDate>Fri, 02 Jul 2010 13:24:37 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=5114#comment-22717</guid>
		<description><![CDATA[&quot;One physician with 350 medical malpractice claims and 22 criminal counts against him&quot;

That will cut down on the odds you think you have of being sued 12 times.  He just took nearly 30 of you out!]]></description>
		<content:encoded><![CDATA[<p>&#8220;One physician with 350 medical malpractice claims and 22 criminal counts against him&#8221;</p>
<p>That will cut down on the odds you think you have of being sued 12 times.  He just took nearly 30 of you out!</p>
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