Unbiased Analysis of Today's Healthcare Issues
Recently, the San Diego Union Tribune reported that the Sharp Grossmont Hospital in eastern San Diego county was cited for a number of preventable deaths. Reporter Cherl Clark found numerous problems, which included: “staff members restraining a highly medicated, 25-year-old man with schizophrenia in such a way that he was allowed to suffocate. In addition,…
NPR’s Morning Edition reports on what happened when health economist Philip Musgrove brought a dying man to an emergency room. The receptionist with whom Dr. Musgrove interacted would not treat a the man until his health insurance information was collected.
There is an interesting article a few weeks back in the Wall Street Journal (“Opting Out“) which describes the plight of Amish and Old Order Mennonites who refuse to buy health insurance. Further, since these groups also refuse to participate in Medicaid government assistance will not bail them out either. Nevertheless, these societies do have…
The N.Y. Times reports (“Concerned about costs…“) that Congress is trying to impose new restrictions on physician-owned, for-profit hospitals. The legislators fear that these hospitals 1) drive up costs and 2) provide poor quality. Legislators worry that when physicians own the hospital, they may have more of an incentive to order more procedures to increase…
How much care should doctors give to terminally ill patients in the ICU? This is a question which can be answered on many levels (e.g., societal, individual, technical). One physician gives his thoughts in an n+1 magazine article titled “First, do no harm.” While advanced medical technology has lead to greater longevity and healthier lives,…
Many studies have attempted to determine how the manner in which physicians are compensated by health insurance companies affects the quantity of medical care provided. Today I will summarize some seminal studies in this field. Epstein, Begg and McNeil (NEJM 1986) In this study, the authors examine whether or not there is a difference in…
Paul Levy, the president and CEO of Beth Israel Deaconess Medical Center in Boston made about $1 million dollars in 2005. Of this, $650,000 was base salary, $195,000 was made up of incentive bonus, and the balance was composed of compensation for health insurance, life insurance, and retirement. How do I know these figures? Paul…
A recent article in the Journal of Health Economics found that increasing Medicare reimbursement may have no meaningful effect on hospital use or patient outcomes. “There is widespread concern about the quality of health care in the US, and the effect of provider payments on the quality of care is an important and unsettled issue…
An interesting article (“Sudden Death…“) at the Covert Rationing blog addresses the poor care given to cardiac patients in hospitals. Dr. Rich states that: “…hospitalized patients who have cardiac arrest (sudden loss of cardiac function due to the onset of a heart arrhythmia known as ventricular fibrillation) are often not receiving defibrillation (an electrical shock…
There has been a recent trend for more and more surgeries to take place in ambulatory surgery centers (ASCs). In fact according to the Medicare Payment Advisory Commission, in 2004 up to 70% of surgeries took place in these ASCs. Do ASCs offer better quality surgical procedures than Hospital Outpatient Departments (HOPD)? ASCs may be…