Healthcare Update — 09-24-2012


Which is exactly why they’re going to cut reimbursement even more … Medicare requires providers to use electronic medical records to avoid being “penalized”. Now they discover that computerized medical records are better at billing and that Medicare had to pay $1 billion more in reimbursements in 2010 than it did five years earlier.

Goodbye toothbrush? Japanese scientists developing tooth “patch” that could prevent decay, whiten teeth. It is made from hydroxyapatite – the same mineral that forms most of the tooth structure.

Still not sure I’d be making out with someone who didn’t brush regularly, though. White teeth with a mouth that smells like tennis shoe insoles isn’t a particularly desirable combination, either.I was a little put off by Mitt Romney’s response to the question recently posed to him on 60 Minutes.
“Does the government have a responsibility to provide health care to the 50 million Americans who don’t have it today?”
Mr. Romney’s response was “Well, we do provide care for people who don’t have insurance … If someone has a heart attack, they don’t sit in their apartment and die. We pick them up in an ambulance, and take them to the hospital, and give them care. And different states have different ways of providing for that care.”
First of all the “we” who provide the care isn’t the government, in a vast majority of cases it is private businesses that provide that care.
When states “provide” for that care by paying private businesses pennies on the dollar to provide that care under the threat of large sanctions if they don’t provide that care, to me, it’s a stretch to say that the government is providing the care.
The government is relying on private entities to provide that care.
Big difference.

I’ll take Holy Pillpoppers for $1,000 Alex.
Answer: 4 billion.
Question: What was the number of prescriptions filled in this country in 2011?
Those prescriptions totaled $320 billion in sales.
Among the classes with highest sales … psychiatric meds with $29.2 billion, oncology with $23 billion, respiratory agents with $21 billion, lipid meds with $20 billion, diabetic meds with $19.6 billion.
Antidepressants were the most prescribed class of drugs with 264 million prescriptions being filled.
Top five drugs in terms of sales … Lipitor, Plavix, Nexium, Abilify, Advair

What happens when government forces hospitals to provide care without inquiring about means for payment … and then government doesn’t reimburse hospitals when the patients don’t pay? Medical resources are strained.
One hospital in North Dakota has seen its bad debt more than double to $900,000 in two years after people come to ND looking for work in its oil industry, go to the emergency department for care, and then give fake addresses to avoid paying the bill.Want to reduce emergency department visits by elderly patients? Monitor them over the computers. Wait, no, that doesn’t work, either. However, telemonitoring in high-risk elderly populations does increase the death rate. Now there’s something that can reduce healthcare spending … and it doesn’t even require death panels.

Maine found a better way to decrease emergency department visits. Make primary care physicians more available.

Brooklyn hospital gets chastised because there is junk food in its vending machines. Hospital CEO doesn’t do himself any favors by saying that people prefer junk food when they’re in the middle of a crisis.
I’m sure Comrade Bloomberg is trying to figure out some way to add junk food to the list of things like trans fats and big soda cups that NY City bans.

Patients gone wild turns into patients gone Greybar. Man in the UK gets six months in jail after shouting and swearing at ED staff then biting a nurse on the arm. The sheriff in the case warned that “medical personnel will not be subjected to violence and abuse.”
If only we could get as serious about protecting ED personnel in this country.

If you were one of the thousands that waited in line to get your hands on the new iPhone 5, just don’t use its “maps” app when you need to go to the emergency department for treatment of your exposure to the elements. Turns out the mapping system still has a few bugs in it compared to the iPhone 4S. According to this report, searching for an ED with the iPhone 5 brings will get you some private medical offices, a few pharmacies and some other medically related addresses, but no hospitals or emergency departments.
Maybe the government hired Apple to help cut down on emergency department use …

Man discharged from the emergency department dies while sitting in the waiting room for a ride. In fact, he was waiting so long for a ride that rigor mortis had set in when hospital staff went to check on him. Now the family is suing and most commenters to the article have already convicted the hospital for wrongdoing.

I was laughing at some of the comments on a Yelp message board about people’s best ER stories. A couple of my favorites:

A biker came in scalped from flying through a plate glass window. We were having fun showing off his skull just as his dad stepped into the ER. He DFO’d* [“Done Fell Out” – i.e. passed out] right there on the floor. Doc says “Great, another lawsuit!”
I completely crashed on my bike almost right in front of the hospital. I could walk, but I went flying and wanted to get checked out. So I go in and fill out all the ten million forms and take a seat.
The woman across from me has some really strange-looking bites on her leg. Like they were made by a bunch of small animals. She is also obviously on something. She keeps jerking her head up and staring at the ceiling like she’s expecting to find the Jolly Green Giant’s penis or something. I don’t know how long she was there before me, but it’s just me and her.
They call *me* and she jumps up and starts screaming, “No way! No way! I got bitten by f***ing rats and you’re letting this f**ko in?? F**k you, this is bullshit!”
Then she turns to me and starts interrogating me: ‘What are *you* here for, huh? What? What?!” — I’m like: “Get the f**k out of my way” and push past her and they buzz me through. I can still hear her yelling, “I see how it is! I see how it is!”
– What a show.


  1. The iPhone Maps thing is part of iOS 6.0, which is being pushed out to every iPhone/iPod/iPad. It’s not just the iPhone 5 that’s going to have this problem. (iOS 6 also deletes YouTube, requiring you to go get Google’s YouTube App…which plays ads at you.)

  2. From the WSJ this weekend:

    ” As I rotated through other hospitals during my training, I learned that many hospitals have a “Dr. Hodad” somewhere on staff (sometimes more than one). In a business where reputation is everything, doctors who call out other doctors can be targeted. I’ve seen whistleblowing doctors suddenly assigned to more emergency calls, given fewer resources or simply badmouthed and discredited in retaliation. For me, I knew the ramifications if I sounded the alarm over Dr. Hodad: I’d be called into the hospital chairman’s office, a dread scenario if I ever wanted a job. So, as a rookie, I kept my mouth shut.”

    . . .

    “Without telling his partners, Dr. Rex began reviewing videotapes of their procedures, measuring the time and assigning a quality score. After assessing 100 procedures, he announced to his partners that he would be timing and scoring the videos of their future procedures (even though he had already been doing this). Overnight, things changed radically. The average length of the procedures increased by 50%, and the quality scores by 30%. The doctors performed better when they knew someone was checking their work.”

    The author is a surgeon.

  3. Whoa! The family sure took a LOOOOONNNNNNGGG time in coming to pick up their “loved one”.

    I like the comments:
    -they should have done heart enzymes (I’m sure they did, that is standard of care even on those that they are 99.9% certain it is heartburn.)
    -they should have kept him even just for an abnormal ekg (what if that was his normal and the hospital knew that?)
    -“I was always under the impression when you had chest pains they keep you overnight for observation.” (Not if they have already ruled out any reason for staying. Or if they have already figured out the cause pneumonia, trauma, and heartburn are all causes of chest pain that don’t necessarily need hospitalization in all patients.)

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