WhiteCoat

Healthcare Update — 03-18-2013

The Veteran’s Administration intentionally changed and hid data to avoid providing costly yet critical medical care to soldiers from the Gulf War? A head VA epidemiologist alleges that more than two thousand veterans responding to a study felt like they would be “better off dead”. In 95% of those cases, the VA did nothing to assist those veterans with follow up care. In a subsequent study when the same epidemiologist attempted to ensure follow up care for potentially suicidal veterans, he allegedly had disciplinary actions instituted against him. If that’s true, I wonder how everyone else will be treated once they have medical insurance under the UnAffordable Care Act.

American College of Obstetricians and Gynecologists advises against using the da Vinci robots for hysterectomies. Robotic surgery adds about $2000 to the cost of surgery and “there is no good data proving that robotic hysterectomy is even as good as, let alone better than, existing and far less costly minimally invasive alternatives.”
I hope that other specialty societies have the integrity to make similar inquiries.
All those hospitals that spent millions of dollars on these machines to keep up with the Joneses may just be in for a big surprise.

Insurance companies expect health insurance premiums to rise 20% to 100% once the UnAffordable Care Act is implemented next year. Department of Health and Human Services responds that it is misleading to look at the one provision of the UnAffordable Care Act because “taken together, the law will reduce costs.” Well, gee, that broad unsubstantiated assertion sure convinced me.

You know all those things your hospital does to stop the spread of clostridium difficile infections? Yeah. They don’t work (.pdf file). 42% of hospitals implementing such policies noted decrease in c. difficile rates while 43% of facilities noted an increase in c.difficile rates.
Can’t wait to see the spin that the Joint Commission puts on this one.

States that participate in Medicaid managed care plans on the hook for $15 billion in extra annual fees (or are they “taxes”?) imposed under the UnAffordable Care Act.

Several interesting studies recently cited in MedScape
BMC Neurology study shows that propofol is an effective treatment for patients suffering from migraine headaches. Too bad that many doctors are hesitant to give it and many hospitals restrict its use. Wouldn’t want to be thrown in jail if there’s a bad outcome…
Intravenous lidocaine works better than morphine in controlling pain from kidney stones. Unfortunately, administering lidocaine rather than morphine will undoubtedly result in a statistically significant decrease in your Press Ganey scores. Are we going to be seeing more lidocaine allergies on the horizon?
Would you rather have thin bones or die? Calcium can KILL you! Patients who ingested more than 1400mg/day of calcium were 49% more likely to die from cardiovascular disease and 40% more likely to die overall than those who did not take calcium. Patients who took more than 1400mg/day of calcium tablets were more than 250% more likely to die than those who ingested 600-999mg/day.

ZeePacks can KILL you, too! It only took 17 years, but through its diligent and exhaustive research, the FDA has finally come out with a warning to strike fear into the hearts of all those patients who take Zithromax. You could die from a heart arrhythmia just by taking Zithromax (or any other macrolide or many quinolone antibiotics).
I’m not sure what worries me more … the side effects from Zithromax or the fact that it took the FDA 17 years to figure this out.

Giving seniors money to come and receive Medicare screenings. In the past, the Department of Health and Human Services has fined entities that tried bribing patients to get more medical care. Providing monetary incentives to patients who have federal insurance is a violation of anti-kickback laws. Now the feds are condoning the same behavior.
Can you say “unintended consequences”?

And that’s why they call it “dope”. New Jersey woman goes to emergency department where staff discovers a big stash of heroin and a couple of hypodermic needles. Instead of getting a high, she gets a court date.

US Justice Department probes drugmaker Sanofi over disclosures about Plavix. When you make the #2 drug in the world based on revenue and pull in $9 billion/year from that drug, you’ve got some seriously deep pockets to pick at.

Should there be federal intervention to improve medical malpractice problems? This author argues that there could be many unintended consequences to doing so.

One reason why your asthma may not be controlled. Nearly half of asthma patients don’t use their inhalers correctly. That incorrect use results in poor asthma control and more frequent ED visits. The easiest way to remedy this problem is to purchase a spacer device – or make one yourself if you can’t afford one.

Remember the Obama claim that policies are working because there are fewer hospital admissions? Senator Chuck Schumer notes a concomitant “huge uptick in elderly patients under observation status.” New York hospital observation hospital stays increased by 32% in the past 6 years.
Observation status – as opposed to a full admission – means that seniors have to pay out of pocket for some services like rehab or nursing home care that is rendered after a hospitalization.

Lots of people still texting and driving in the US. I suppose that’s a good thing for hospitals that will take care of your paralyzed family members after your car accident.
Is the text message really THAT important? Put the phone away when you’re driving already.

Hospitals charging “facility fees” in addition to all of the other charges for medical care provided to patients. Should such fees be outlawed?
Goes back to free market principles. If hospitals are going to charge the fees, the fees should be clearly disclosed prior to the time that treatment is rendered. Then patients can decide whether the care they receive is worth the cost.
One hospital has the right idea – it advertises that it chooses “not to take advantage of its patients” by charging such a fee.

5 Responses to “Healthcare Update — 03-18-2013”

    • Peebles says:

      Great idea! Likewise, why pay accountants anything at all for providing tax preparation services? And why pay plumbers anything at all for providing septic-emptying services? And why pay mechanics anything at all for providing car-repair services? And why pay lawyers anything at all for providing legal services? And why pay public servants anything at all for their service to the Republic and its citizens?

      Everything should be freeeeeeeee! LOL.

  1. Peebles says:

    “Intravenous lidocaine works better than morphine in controlling pain from kidney stones. Unfortunately, administering lidocaine rather than morphine will undoubtedly result in a statistically significant decrease in your Press Ganey scores. Are we going to be seeing more lidocaine allergies on the horizon?”

    I’m very pleased to hear that. When I’m already weakened and in pain, I hate the nausea and muddle-headedness narcotic analgesics cause me. The “not-quite-there” feeling they give actually increases my anxiety, which doesn’t help anything. My ideal pain med would cut the pain without messing with my head at all. Faster, please!

  2. Mandy says:

    “Insurance companies expect health insurance premiums to rise 20% to 100% once the UnAffordable Care Act is implemented next year.”

    Obama: You will see ‘premiums fall by as much as 3,000 percent’ under Obamacare

    Hahahahaha.

Leave a Reply


+ 3 = eleven

Popular Authors

  • Greg Henry
  • Rick Bukata
  • Mark Plaster
  • Kevin Klauer
  • Jesse Pines
  • David Newman
  • Rich Levitan
  • Ghazala Sharieff
  • Nicholas Genes
  • Jeannette Wolfe
  • William Sullivan
  • Michael Silverman

Earn CME Credit