WhiteCoat

Healthcare Update — 06-20-2012

Lots of propaganda ahead of Supreme Court’s decision on constitutionality of health care reform. 3 patients an hour die because they don’t have health insurance. A group called “Families USA” states that “only the Affordable Care offers the promise of access to affordable coverage and to a longer and healthier life.” The group cites a few statistics about how low income uninsured patients undergo less cancer screening, but again, notice how the focus is on patients getting “access to coverage” and not “access to health care.” Big difference.

3 patients an hour die because they DON’T have health insurance? That’s nothing. 15 patients an hour die because they DO have health “insurance.” The National Health System in Great Britain “kills off 130,000 elderly patients every year.” The “Liverpool Care Pathway” brings death to patients in an average of 33 hours. It is generally implemented when a patient is in a terminal condition and “death is imminent,” but a consultant who reviewed the system stated that it was an “assisted death pathway” for elderly patients who are difficult to manage or who take up needed hospital beds.
But the care is free …

Want health care insurance from your employer? Half of all employers plan to stop providing insurance plans to their employees and instead plan to give them a set amount of money to purchase their own plans. Other employers plan to stop offering coverage completely. Insurers, on the other hand, say that it is unlikely employers will stop providing policies.

Advocate Health Care in Chicago suburbs receives warning letter from FDA after performing study on patients receiving etomidate in the emergency department … without patient consent.

Lack of mental health beds causing delays in care and surges in patient volume at Australia hospital.

Emergency department in British Columbia closed until July due to lack of physicians. Town residents feel “helpless and scared.”

Police shoot Texas man who held several hostages at gunpoint in emergency department when one of hostages tried to grab the suspect’s gun.
However, according to this article, the emergency department “never stopped”.

6 Responses to “Healthcare Update — 06-20-2012”

  1. Always like your blog…just wanted you to know.

    Also, the B.C. emergency department closing was quite intriguing. As an ER doc with many disgruntled partners, I can see how this would be possible.

    • Anymouse says:

      I liked the first comment:
      “If these rural areas want doctors to go to small cities why dont they educate their own young graduates to become qualified doctors? Smart educated people do not want to live in a dump but since people born in rural places don’t know any better they would probably stay in their accustomed lifestyle and stay as a doctor in their community.”

      This says a lot about the commenter and lack of response to his comment shows why there is such trouble hiring.

  2. Steve says:

    Devil’s advocate on the etomidate study- while it sounds like the investigators and the IRB messed up on this one- the study probably could have been done under the same waiver of consent but with much more burdensome requirements (community meetings, give people the chance to opt out ahead of time, etc.).

    While people have the right not be involved in research if they don’t want to- consider this. Etomidate and midazolam are both acceptable medications to use for intubation. Any doctor could choose to use either one for an intubation and not be faulted for it. Now all the study adds is an element of randomization and follow-up of the patient. Doesn’t sound so bad in light of the alarmist sound-bite at the end about patient protections.

    Now if the study involved a drug that was not already widely accepted then that is a different story. For example- Polyheme was a blood substitute that was universally compatible and didn’t need refrigeration. This stuff looked like liquid gold. The company went through all the necessary regulatory hoops and hurdles to get study approved with a waiver of consent. They randomized hypotensive trauma patients to saline vs. polyheme and whoops- they had more MIs and higher mortality in the polyheme group. (I should know, I researched the heck out of this but lost a good chunk of change when their stock tanked.)

    My point is that when you are comparing two already accepted treatments for a situation in the emergency room- should consent be necessary? Would any consent obtained peri-intubation be valid? Just something to think about.

  3. Danica says:

    The ER closing is because fort st. james is in the middle of NOWHERE and NO ONE wants to work there. i’m sure there are other towns in both public and private medicine with less than 2000 people and no ER.

    • WhiteCoat says:

      True.

      As funding for medical care – especially for patients with government “insurance” – dries up throughout this country, are rural communities in the US going to be subject to the same fate?

  4. texasERdoc says:

    totally agree with steve. do we need to start consenting everyone we treat? we make hundreds of decisions a day of drug x versus drug y. why does it matter that they weren’t consented when its a research project but not in the everyday treatment when the 2 drugs are both considered perfectly acceptable?

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