WhiteCoat

Healthcare Update — 07-13-2012

Difficult ethical dilemma. With limited resources, what should be done about the 10% of Medicare patients who use nearly two thirds of the Medicare’s hospital spending? End of life care also accounts for a large amount of spending – rough estimates show that about 22% of Medicare spending is for end of life care. And what do we do with families of terminal patients who want “everything done” but who can’t or won’t pay for the care? Then read about this case where there really was a “death panel“. What do you think should have been done?

What are some of the strangest cases seen in New Zealand emergency departments? Pretty much the same types of things seen in American emergency departments. Some of the more notable cases: A man who put a nail gun to his head and pulled the trigger because he didn’t think nails could penetrate bone (he was wrong) … and a man who cut his foot with a shovel while “digging to Russia.”

I discussed a previous study on the same topic, but there was another study just published showing that insurance companies will not refuse to pay for a hospital bill if patients leave AMA — that is until they see the results of these studies.

“911, will this be Visa, MasterCard, or American Express?” Folsom, California fire department to begin charging $225 for every call requesting a paramedic. That’s a little less than Sacramento Metro Fire Department which already charges $275 for medical calls.
Wondering what happens if people don’t pay. Get kicked out on the side of the road if the credit card is over the limit?

Undocumented immigrant files complaint against Parkland Hospital in Texas because he allegedly was refused care without an ID and then because he had to wait too long for care once he did show an ID.

HOPING that this company doesn’t CHANGE its address because of health reform bill. Health care equipment manufacturer DeRoyal Industries contemplates layoffs of some of its more than 2000 employees due to the medical device excise tax in the health care reform bill. DeRoyal president states “The medical device tax constitutes the largest cost increase DeRoyal has experienced in its 40-year history.” Hat tip to Instapundit for the link.

California man refuses to leave emergency department. Police called. Man pulls down his pants then bites officer on hand.

Nova Scotia municipality of Digby holds hearing to discuss emergency department closures, board travels in from out of town … then two people show up.

It isn’t just the “meth mouth,” it’s also the burns. Meth lab fire victims cost 60% more to treat than other burn victims … prolly because the explosions ignite patient’s lungs and burn off the patient’s hands and faces. The article also shows a picture of a real life “meth lab” if you haven’t seen one before.

Meh. Old news — see this article I wrote about the same subject almost two years ago. Still worth repeating, though. Antibiotic resistance becoming a crisis. And pharmaceutical companies aren’t doing the research into creating new antibiotics because doing so isn’t cost effective. Now President Obama has signed an “FDA Safety and Innovation Act” that provides pharmaceutical companies with a total of 10 years exclusivity in selling any new antibiotics they develop.


2 Responses to “Healthcare Update — 07-13-2012”

  1. Question says:

    Are there limits on spending, or how is that determination made with Medicare?

  2. sch says:

    “death panels” reminds me of a weird experience when I was an intern on the renal service. The Feds
    had not yet taken over and dialysis services were
    highly restricted: not enough machines, maybe 1-2
    centers per state at the medical schools. Prospective dialysis pts were vetted by social
    workers and others. I sat in on a committee meeting
    and recall the chief nephron looking over a report and saying “John is not a good man” meaning a hx
    of unreliability, poor family support and a generally non accomplished life. It was effectively a death sentence. A year or two later
    the Feds stepped in and made nephrologists instant
    millionaires when dialysis was fully funded for
    all comers. I suspect something like this will occur for drug treatments that run 10k/mo or more for chemo and recombinant DNA derived drugs in
    10-15 yrs. Kind of like bariatric surgery now.

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