Also see the Satellite Edition of this week’s update over at ER Stories.net.
Many good Halloween safety recommendations from emergency department staff at UC San Diego Health System. Take a look before you go trick or treating.
Interesting infographic regarding emergency department visits, including the most common reasons for visits to the emergency department (not what I guessed), percentage of patients less than 25 years old, and percentage of visits that were not urgent (again, not what I would have guessed).
Nursing pays. Nurse in California earns $270,000, including overtime.
Walter Olson of Overlawyered.com fame creates an interesting piece at Cato’s blog. Why is it that courts won’t let physicians and patients contract around medical malpractice issues? For example, “Could you set this broken arm? I promise not to sue you for more than a half million if something goes wrong, nor for anything short of gross negligence, and yes, I agree to arbitration.”
Gastroenterologist pays $2 million to settle a claim that he perforated a patient’s colon during a colonoscopy. Perforation is a known complication of colonoscopy and the patient accepted the risk of perforation in the informed consent, but the plaintiff’s attorney argued that the gastroenterologist overinflated the colon during the procedure.
California gets OK from feds to cut Medicaid payments by 10%. The cut does not affect payments to hospitals or to doctors who treat children since those cuts would
According to the article, the cuts to physicians and clinics are expected to save the state $623 million.
So California is paying physicians and clinics – excluding hospitals and pediatricians – $6.2 billion per year to treat Medicaid patients? I thought that number was just a lit-tle high. So I researched the Medicare expenditures in California and wow. California accounted for $41.6 billion (11.4%) of the $336 billion spent on Medicaid in the US in 2009.
So California probably will save hundreds of millions of dollars with the cuts. It will save more money by the rationing that results. Fewer physicians will take Medicaid and patients will have to wait longer for care – or they will just go to the emergency department. Problem solved.
Prescription painkillers outpace alcohol as “drug of choice” in one Michigan county. Of course, there’s no Press Gainey for liquor stores where minors and intoxicated patrons can complain and get liquor store workers fired for not selling them beer.
Flu shots only 59% effective? Still worth the “risk”?
Patient safety now being “stretched to the limit” in Canadian emergency departments due to overcrowding.
Marie Osmond gets “rushed” to the hospital for treatment of an acute case of bronchitis. I’m sure that ZeePack cured her right up. Look for them to be rushing her right back to the hospital when she gets MRSA or c. difficile colitis from taking antibiotics to try to kill a viral infection.
Government “insurance” putting states in the red. Federal stimulus money to subsidize Medicaid spending is gone, state spending on Medicaid is up 29%, and more than half the states predict a budget shortfall due to Medicaid spending. “Every dollar spent on Medicaid necessarily comes out of somewhere else, so it’s taking away from every other item in the budget.”
United States spends more on health care than any other country and health care spending is the fifth largest economy in the world – matching France’s total Gross Domestic Product.
Great. We’ve known the definition of the problem for quite a while. The question isn’t how much the US spends, it is what drives the spending.
To answer that question, we need to ask how the US health care system differs from all of the other health care systems in the world. Off the top of my head, I’d say the largest differences would be our medical malpractice system, medical education costs, unreasonable patient expectations, and government over-regulation. If we controlled those four things, health care spending in this country would dramatically decrease.
Medicare benefits will now equal a Band-Aid and a bottle of Tylenol. Democratic supercommittee plans to cut Medicare spending by $400 BILLION – with half of cuts coming from reduced benefits and half of cuts coming from decreased payments to providers.
I read somewhere (can’t remember where) that hospitals were required to give discounts, so they inflate their prices, then discount until the “discounted” price equals what they would have charged to begin with. This practice makes it near impossible to determine the true cost of health care and inflates the “health expenditures” as compared to the rest of the world.
Is this conclusion something that you are aware of, or was it taken into consideration in the article you mentioned?
I would think part of the problem with the idea of contracting around medical malpractice is that in many situations the patient doesn’t have a personal agreement with a great many of the medical personelle they are going to interact with. Making such a contract with a lawyer (or even a firm) is far more straightforward that the current morass of medical billing. And unless you are going to get both patient and provider to make such a contract you are going to have a very hard time getting it enforced. Perhaps if it were the primary physician who made the major error that led to the suit, but maybe it was the anesthetist or a nurse or someone else the patient only barely remembers.
Now, if you were to change the contract situation so that the only person the patient has a payment agreement with is the doctor and the doctor is responsible for paying all those other folks you might be able to get such a waiver to work, but good luck on that one.
I’m not sure why the bronchitis needs the snark. Now that the rescue inhalers all seem to have some mandatory irritant in the propellant, breathing treatments are pretty appealing during the worst moments of a bout of bronchitis…especially if some activity (for example, appearing in a stage show…) outstrips breathing capacity. That doesn’t mean the patient demanded an antibiotic.
Because it might hurt the ozone!and Lord knows it is asthmatics who are hurtin the ozone, the FDA mandated that all the generic asthma inhalers swith to a high cost propellant that is both irritating and often ineffective.
Butterfingers….mmmmm. I don’t twitter, but I read yours in the sidebar…we had rain. I had four kids…17 pounds? yikes!!
Off topic – also responding to your twitter – we had SIX kids here for Halloween candy.
3 of them were our grandchildren and 1 of them was not even one yet. Country road and not any young kids around anymore. So they all got generous amounts of candy.
Also area hit hard with freak snow and cold weather and some towns cancelled.
Butterfingers? Good flavor, but stick to your teeth.
More of a Kit-kat girl myself …although for first time …they seemed a little too sweet.
17 pounds of candy – IMPRESSIVE. She must’ve been so happy about that.
What our health care system lacks is universal coverage. What we have is an ER triage system. Case in point: a single mother of one working two minimum wage jobs develops throat cancer. Dr. tells her she needs $8000 to begin treatment. She says there’s no way she can come up with that. He gives her papers to file for disability. She says, “But I’m not disabled; I work.” He says, “Cancer is a disability.”
In my part of the world the major source of health care funding is the barbecue benefit, raising between $5000 and $20000, depending on the importance of the patient to the community.
US spends far more on Tort Costs than the rest of the world as well.
http://tinyurl.com/3e4oe4x
$270,000 thats about what nurses should be making…
that’s because the graphic is based on cdc numbers. some months ago, i saw similar numbers and wondered why:
http://burnedoutmedic.com/2011/06/cdc-and-acep-say-only-8-of-ed-patients-are-non-urgent/
i’m referring to the infographic, in particular the (really low) percentage of “non-urgent” visits.