Archive for the ‘Healthcare’ Category
Single-payer healthcare and non-profit hospitals look better and better. Lena Sun reports in the Washington Post:
A year ago, a study about U.S. hospitals marking up prices by 1,000 percent generated headlines and outrage around the country.
Twenty of those priciest hospitals are in Florida, and researchers at the University of Miami wanted to find out whether the negative publicity put pressure on the community hospitals to lower their charges. Hospitals are allowed to change their prices at any time, but many are growing more sensitive about their reputations.
What the researchers found, however, was that naming and shaming did not work. The researchers looked at the 20 hospitals’ total charges in the quarter of a year before the publicity and compared them to charges in the same quarter following the publicity. There was no evidence that the negative publicity resulted in any reduction in charges. Instead, the authors found that overall charges were significantly higher after the publicity than in previous quarters.
“We were thinking we would see a drop or lowering of some charges,” said Karoline Mortensen, one of the authors of the study published in the Journal of Health Care Finance earlier this year. “There’s nothing stopping them,” she said, referring to the hospitals. “They’re not being held accountable to anyone.”
Researchers say the main factors leading to overcharging are the lack of market competition, lack of hospital transparency and the fact that the federal government does not regulate prices that health-care providers can charge. Only two states, Maryland and West Virginia, set hospital rates.
When the original study was published, shares of Community Health Systems, which owns many of the 50 hospitals listed with the highest markups, traded with almost triple the volume of the preceding weekday, suggesting shareholders had concerns about the system’s pricing practices, the University of Miami researchers said. Share price fell by $1.39 that week, or more than 2.5 percent, but recovered by the end of that week.
Understanding hospital pricing and charges is one of the most frustrating experiences for consumers and health-care professionals. It is virtually impossible to find out ahead of time from the hospital how much a procedure or stay is going to cost. Once the bill arrives, many consumers have difficulty deciphering it.
After a Utah man posted a photo of his hospital bill on Reddit, showing a$39.35 charge for what he thought was for holding his newborn, his post triggered more than 11,000 comments. . .
Ross Benes reports in Rolling Stone:
At the conclusion of North Dallas Forty wide receiver Phil Elliott, played by Nick Nolte, gets blackballed by his team owner for “smoking a marijuana cigarette.” After being presented with a photo that shows Elliott toking up, the team owner patronizes Elliott and says, “Illegal drugs are forbidden by the league rules Phil, you know that.” To which Elliott replies: “Jesus, smoking grass, what are you kidding me? If you nailed all the ballplayers who smoked grass, you wouldn’t even be able to field a punt return team. Besides that, you give me the hardest stuff in Chicago just to get out of the goddamn locker room. Hard drugs!”
Though North Dallas Forty is technically fictional and came out nearly 40 years ago, its story is a classic example of the same-shit-different-day phenomenon. In recent weeks, Bills linemen Marcell Dareus andSeantrel Henderson were each suspended four games for using marijuana. And Cowboys running back Ezekiel Elliott caused a scandalby simply walking into a legal weed-friendly establishment. Meanwhile, the NFL was busy knuckling players into “cooperating” with a doping investigation based on scant and recanted evidence.
Given America’s growing acceptance of cannabis, the bad press the NFL gets when it punishes marijuana use more harshly than domestic abuse, and the personal tragedies and lawsuits that have stemmed from team doctors overprescribing opioids, it seems a little peculiar that the NFL continues to retain an authoritarian stance on marijuana use while team doctors simultaneously dole out powerful and addictive painkillers. Especially considering that the league is mired in concussion suits and there’s a possibility that cannabis could reduce the impact of head trauma.
To get a better grasp of this dissonance, let’s take a look at the changing national perception of marijuana, possible incentives the NFL has for maintaining its marijuana policies, upcoming football-related cannabis research initiatives, and what it might take to get the NFL to stop punishing players for using marijuana.
As Kevin Seifert of ESPN pointed out, during the hysteria of the War on Drugs in the 1980s it was “politically and socially necessary” for the NFL to discipline marijuana users. But after the war on drugs proved to be a massive failure, people began viewing certain drugs more tolerantly, and now polls show that a majority of Americans support legalizing marijuana. As public support increased so did legalization, and today more than 60 percent (20 of the 32 teams) of NFL teams play in states that allow medical marijuana. Come November that percentage could grow as there are a plethora of state ballot initiativespushing for medical and recreational marijuana legalization.
There are also bills in the Senate and House aimed specifically at cannabinoids such as cannabidiol (CBD), which is a compound found in cannabis that doesn’t get people high. CBD is typically taken orally and it includes only trace amounts of THC, the psychoactive component of cannabis. A group of vocal ex-players are pushing the league to allow players to use CBD as a pain reliever. Because as the league’s policy currently stands, a player taking CBD could potentially surpass the league’s testing threshold and test positive.
“The risk [of testing positive for using CBD] is very low compared to the people using high-THC cannabis,” said Joel Stanley, CEO of hemp extracts producer CW Hemp. “But there certainly is a risk. But when you have something that you know is non-toxic, non-psychoactive, and non-addictive, and if you are in those high-impact situations, why not [allow players to] take that product?”
The NFL declined interview requests for this story. But a league spokesperson sent over the following statement:
Independent medical advisors to the league and the National Football League Players Association are constantly reviewing and relying on the most current research and scientific data. The league will continue to follow the advice of leading experts on treatment, pain management and other symptoms associated with concussions and other injuries.
It went on to say: . . .
David Epstein of ProPublica explains the idea of the SRSLY series:
Welcome to SRSLY, an (experimental) newsletter highlighting under-exposed accountability journalism. We’ll distill the important information from investigative reporting you probably missed, and deliver it to you in three-minutes-or-less worth of reading. Sign up to have it delivered to your inbox. (You can, of course, unsubscribe at the first whiff of a bad joke.)
This one is worth reading:
Pearl S. Buck said that “our society must make it right for old people not to fear the young or be deserted by them, for the test of a civilization is in the way that it cares for its helpless members.” Hubert Humphrey put it differently, suggesting that “the moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; and those who are in the shadows of life.” Figures from Gandhi to Winston Churchill weighed in similarly. Point being: a lot of people who are super good at quotes think we ought to treat the elderly with special respect. And, in a nice break from election news, there is some evidence we’re doing a bit of that. According to the Dallas Morning News, infractions for deficient care in nursing homes decreased by 8 percent nationally between 2010 and 2014. In Texas, however, infractions increased 20 percent over that same period. Your four Ws:
… the heck is going on with Texas?? (And I’m not just asking because the Washington Post reported that it’s now a swing state. If you saw that one coming, time for a vacay to Vegas.) The Dallas Morning News reported that Texas’s 1,200 nursing homes also reported 3 percent more “severe deficiencies” in nursing home care from 2010 to 2014 — the kind that might lead to serious injury of residents — while the national number declined 16 percent.
The usual suspect: money. The new figures come from a report commissioned by the Texas Health Care Association, a trade group for nursing homes, which is concerned about a “crisis” in state funding. The Morning News reported that this is particularly notable, given the association’s “traditional reticence” to openly discuss nursing home inspections. Nearly 70 percent of the state’s nursing home residents are on Medicaid and Texas Medicaid reimbursements “are near the bottom in the U.S.” The lack of funding has left Texas nursing home residents with less attention from staff than is the case in other states. Texas nursing home residents get 3.59 hours of attention from staff per day, compared to 4.64 hours in Florida, which has far fewer “immediate jeopardy” infractions, the kind that “if unabated, will cause serious harm or death,” the Morning News says.
What now? . . .
Daniel Denvir reports in Salon:
What liberal media? Nowhere is the false balance of mainstream media reporting more apparent than in coverage of the relentless Republican obstruction in Congress.
The latest episode: Republicans are refusing to pass a $1.1 billion package to fight the Zika virus unless it blocks Planned Parenthood from receiving funding. Yesterday’s New York Times print headline? “Senate Democrats Again Stymie Funding for Zika.”
This is false. Democrats are happy to support funding the Zika fight, which might soon run out of money for crucial measures like mosquito-control programs in Puerto Rico. It is Republicans who have made Zika funding the latest hostage to their crusade to defund Planned Parenthood.
Balance is often false because facts have a bias. Sometimes, reporters try to split the baby, suggesting that both parties have equal blame for gridlock even when this is untrue. (From June: “Whichever side is more to blame, it was clear that no new government funds would be approved to fight the Zika . . .”). In this case, however, The Times is apparently accepting the Republican premise that stigmatizing reproductive health as something other than a basic part of medicine is somehow related to Zika. It’s not.
According to the relevant experts at the American Congress of Obstetricians and Gynecologists, reproductive health should be considered a basic feature of normal health care. What’s holding up the passage of Zika funding is that Republicans want to ensure that it’s not.
As has been long the case with the news coverage of issues like global warming, government shutdowns and voter identification, reporting on the politics of reproductive health shoves expert opinions to the sidelines. Instead, it not only gives readers the false impression that all sides are putting forth an opinion that has equal empirical weight but also fails to honestly evaluate the nature of the conflict at hand. I get that the Times can’t assert as fact that the anti-abortion movement is a wrongheaded and religiously inspired effort to control women’s bodies in its news section. But the Times can make it clear that it is Republican opposition to abortion and Planned Parenthood that is holding up Zika funding and not Democrats.
Journalism about politics becomes reduced to theater criticism.
That’s a damn good question and I would say that as the Democratic Party becomes increasingly dependent on the economic elites, the economic elites have an ever stronger voice in setting policy. In other words, Bernie Sanders really was an anomaly and Hillary Clinton and the Democratic Establishment are Republican Lite.
That was my initial take, but it turns out that I was completely wrong in this case. Read Edwar Zelinsky’s explanation in the OUP Blog:
The Democratic Party platform for 2016 repudiates a major provision of Obamacare – but no one has said this out loud. In particular, the Democratic Party has now officially called for abolition of the “Cadillac tax,” the Obamacare levy designed to control health care costs by taxing expensive employer health plans.
Tucked away on page 35 of the Democratic platform is this enigmatic sentence: “We will repeal the excise tax on high-cost health insurance and find revenue to offset it because we need to contain the long-term growth of health care costs, but should not risk passing on too much of the burden to workers.”
Even by the problematic standards of current political rhetoric, this statement is equivocal. This sentence avoids the popular term for the levy imposed by Internal Revenue Code 4980I, the excise tax on “Cadillac” health plans. This sentence does not disclose that President Obama advocated the Cadillac tax “on high-cost health insurance” as an important provision to control health care costs. This sentence promises to replace the revenue to be raised by repeal of the tax without specifying how that replacement will happen. This sentence pays nominal obeisance to the need to control health care costs even as it calls for repeal of the provision of Obamacare most directly designed to control such costs.
The only unambiguous thought expressed in this sentence is that the Cadillac tax on high cost health plans must go.
Since the Republican Party opposed the tax all along (and managed to delay implementation of the tax until 2020), the Democratic platform makes clear that there is now a bi-partisan consensus to abolish the Cadillac tax.
What neither party wants to admit is the larger implication of their opposition to the Cadillac tax: Neither party is willing to adopt serious, practical measures to confront the problem of our nation’s continually rising health care costs.
The background to the Cadillac tax is now well-known. Section 106 of the Internal Revenue Code excludes from employees’ gross incomes the value of their employer-provided health care insurance. Section 106 was adopted in an earlier age, before health care costs became a major national problem.
Conservative and liberal commentators alike agree that Section 106 stimulates health care outlays by sheltering employees from the costs of their employer-provided health care coverage. These commentators generally acknowledge that the correct solution is to repeal Section 106, so that employees will report as income the health care premiums paid by their respective employers. This would sensitize employees to the costs of employer-provided health care coverage and thus force employees and employers to confront and control those costs.
Repealing or limiting Section 106 is a political nonstarter, the classic case of good policy which no elected official is willing to embrace. . .