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Entries in Healthcare (16)

Tuesday
Sep252012

"Waiting Room": Hundreds a Day Seek Hospital of 'Last Resort'

Stockbyte/Thinkstock(NEW YORK) -- Eric Morgan, in his 20s and planning to get married, arrives at Highland Hospital's emergency room, shaken that he has been diagnosed with a testicular tumor that is likely cancer.

Surgeons at a private hospital have turned him away for lack of insurance but tell him it's "urgent" he get care.

Demia Bruce -- out of work for a year -- anxiously waits in the same ER with his 5-year-old daughter, her face swollen and burning with fever.

Carl Connelly has overdosed on drugs and alcohol, and Davelo Lujuan can't bear the pain of his spinal bone spurs. They, too, wait.

A provocative new documentary, The Waiting Room, is a snapshot of Highland Hospital in Oakland, Calif., one of the nation's busiest safety-net hospitals, which is stretched to the limit with 241 patients a day, mostly uninsured, who need medical care they can't afford.

The film, directed by Peter Nicks and getting Oscar buzz, opens at the IFC Center in New York City on Wednesday, Sept. 26 and in the greater Los Angeles area at Laemmle Theaters in Santa Monica, Pasadena and Claremont on Friday, Sept. 28, before showing around the country. The Waiting Room will also be aired by PBS in 2013.

Nicks follows 24 hours in the lives of artists, small business owners, factory workers and unemployed parents who have been hit hard by the economy -- and hit harder still by a healthcare system that has left them out.

Watch the trailer:

 

"Bring your breakfast, lunch and dinner -- everything honey," an African-American patient, who has been waiting for days to see a doctor, tells a new arrival.

They take a number and they wait, sometimes coming back two or three days in a row. It might be months before they can get a doctor's appointment. With only one operating room, the most urgent cases go first and the rest wait. A man with a survivable gunshot wound has waited two days to be seen.

"It is the place of last resort," said Nicks, 44, whose wife is a speech therapist at Highland Hospital and came home with stories of patients' troubled lives.

"Historically, these hospitals serve the indigent, the homeless and the mentally ill -- the population on the fringe of the system," said Nicks.

But today, patients who are down on their luck also come in to have their prescriptions refilled or to be hospitalized when a disease like diabetes has escalated.

"These people are using the waiting room as their doctor because they have no continuity of care," he said. "More and more people are losing their jobs and are showing up at the public hospitals."

Lujuan, a carpet layer who took a pay cut, bemoans his life as an unemployed daughter moves back home. He returns to Highland for his back pain: "I can't sleep at night -- the muscle relaxers don't work… My checking account is down. I don't know what to do."

Some of the best-trained doctors in the country, from schools like Harvard Medical, do their residencies in trauma at Highland, according to Nicks. Though the care is exemplary, these safety-net institutions are at risk for survival.

Florida's Gov. Rick Scott has waged a campaign to cut safety-net hospitals to close budget deficits. Just last March, he closed A.G. Holley hospital, a 100-bed institution in Palm Beach County specializing in tuberculosis. In April, a TB outbreak among the homeless caused 13 deaths.

Those who wait and those who work long hours to care for them cope with sickness, bureaucracy, frustration and difficult choices, but Nicks finds hope in the system. The nurse assistant who is the patient's first point of contact, Cynthia Johnson, has both compassion and humor in this overwhelming environment -- and lots of patience.

Johnson, a cheerful African-American with pink glasses, takes pride in being able to "spell every name, no matter what country."

Some patiently wait in line and others jump the queue, losing tempers and swearing at the overburdened staff.

"Get a grip," Johnson firmly tells one aggravated man, without losing her temper. He waits.

To director Nicks, she is the "symbol of the system and what we all want in our care -- an empathetic, caring individual, who sits down next to you and says, 'How are you doing?'"

In such a high-stress environment, it would seem logical that doctors and nurses would also burn out. But Nicks said, "We didn't see a ton of that."

"What's more revealing is that these doctors at public hospitals are a very unique group of people, a self-selecting group. They could choose to go elsewhere and make a lot more money, but they don't. It's akin to M*A*S*H*, like they are in a war -- they have that mentality."

"They love it, thrive on it," said Nicks. "You have to be wired a certain way to treat someone with empathy that smells and curses at you."

Nicks didn't want his film to be a typical "disaster documentary" like Waiting for Superman or Sicko, but storytelling.

"At this moment the health care debate voices are dominated by journalists and politicians and pundits," he said. "This is the voice of the people on the front lines."

"The waiting room was a metaphor for me," he said. "What are you waiting for? It really struck me that people wanted to talk about who they were."

Nicks dispels the myth that safety-net hospitals are free. The carpet layer with bone spurs who finally sees a specialist, but earns just a little too much to qualify for Charity Care, takes home a large bill for Highland's services.

Nicks shot 175 hours of raw footage over months, but captures just a day in the life of several characters in the hospital waiting room.

He previously worked as a staff producer for ABC News, as well as for the PBS series, Life 360.

"Some of the best scenes were not in the film," said Nicks. "In the end we wanted to make sure the patient population was represented in a diverse and accurate way."

Now he is creating an interactive digital project to continue the work of the film so people in waiting rooms across the country can share their own stories. "We want to collect cultural data that is valuable for the hospital," said Nicks.

Most of all, he said he hopes that the film will bring attention to the nation's ailing healthcare system just as the United States begins to roll out the contentious Affordable Care Act.

"I am not a policy expert and not even remotely a healthcare journalist," he said. "But what we do know from talking to people is that there is a lot going on behind the scenes … It's important to understand how the health care law affects the community and those served by the public hospitals."

As for Demia Bruce, his daughter was luckier than the son he lost at the age of 2 from a seizure. She was diagnosed with strep throat, given antibiotics and sent home.

Carl Connelly, whose drug addiction had sent him to Highland on repeated occasions, could not be released because the pastor who has given him shelter would not take him back. Connelly took up precious space in a bed that might have been given to another waiting patient.

The story of Eric Morgan, who is last seen standing alone and bewildered in the hospital parking lot, ends well, according to Nicks. Morgan was able to wade through the system and qualify for Charity Care and a $30,000 surgery revealed his tumor was not cancerous.

Morgan, who had banked sperm just in case, has since married the woman who accompanied him in such distress to Highland and they now live and work in Hawaii.

"We are all connected," said Nicks. "And we can't forget that. Insured or not, we must share the same values."

Copyright 2012 ABC News Radio

Wednesday
Nov092011

Is Doctor Walmart in the Future?

Justin Sullivan/Getty Images/Stockbyte(BENTONVILLE, Arkansas) -- Walmart has been working under the radar to be the “largest provider of primary healthcare services in the nation,” according to a request for health care partners leaked online Wednesday by NPR.

The 14-page request details the superstore’s mission to “expand access to high quality health services” and “dramatically lower the cost of healthcare.”

The plan would see primary care clinics popping up throughout  Walmart’s 3,500-store empire just in time for health care reform, which will mean millions more insured customers.
But before you start looking up your Walmart doctor, the retail giant is denying the claims.

“The RFI statement of intent is overwritten and incorrect. We are not building a national, integrated, low-cost primary care health care platform,” Dr. John Agwunobi, senior vice president and president of Walmart U.S. Health & Wellness, told ABC News in a statement.

Walmart spokespeople would not expand on whether the chain is attempting to increase its health care services in other ways. Walmart is already home to 140 primary care clinics — far fewer than CVS’ 550 and Walgreens’ 355.

Health care is the only large sector of the American economy that is growing at a consistent high rate, year after year, noted Dr. Mark Fendrick, professor of internal medicine and health management policy at University of Michigan.

Coupled with a large influx of newly insured patients expected after the Affordable Care Act comes into play in 2014, retail stores like Walmart may be the only place patients can go since primary care is so overstretched in the U.S. already.

“For those in areas of the country where there are not enough primary care providers, proximity to a retail store like Walmart should offer opportunities to expand access,” said Fendrick.

Another important piece is the business tactic: the clinics will bring customers to the store.

But some family doctors are skeptical about in-store clinics that seem to be popping up more and more.

The American Academy of Family Physicians opposes retail health clinics, particularly for the treatment of chronic medical conditions.

“The AAFP is committed to the development of a health care system based on strong, team based patient centered primary care defined as first contact, comprehensive, coordinated and continuing care for all persons and believes that the RHC model of care further fragments health care,” the AAFP said in a statement.

Copyright 2011 ABC News Radio

Wednesday
Nov092011

Chronically Ill Adults in US Worse Off than in Other Countries

Keith Brofsky/Photodisc/Thinkstock(WASHINGTON) -- Americans who are chronically ill are much less able to pay their medical bills and have to forego medical care because of the cost more often than their counterparts in other countries, according to a new survey by The Commonwealth Fund, an independent foundation that supports health care research.

The results, the researchers say, highlight some of the biggest flaws in the U.S. health care system.

The study data, reported in this week's Health Affairs journal, also found adults in the U.S. who suffer from chronic illnesses reported the highest rate of medical errors and most often said their medical care isn't well-coordinated between their doctors compared with adults in other countries.

Researchers at The Commonwealth Fund surveyed 18,000 "sicker adults" in the U.S. and 10 other countries – including Australia, Canada, France, Germany, Switzerland and the United Kingdom – and asked questions related to health care costs, access to care, coordination of care and medical errors.

Forty-two percent of Americans said the high costs of health care kept them from seeing doctors, getting medications and avoiding recommended treatments, a significantly higher percentage than in the 10 other countries.

"The number one finding is that the U.S. spends more on health care than other countries, but it doesn't get the most out of the health care system," said Karen Davis, president of The Commonwealth Fund. "The U.S. performs the most poorly on access to care and the financial burden that comes with chronic illness."

The study also found that people who have a "medical home" – a primary care physician or practice that coordinates treatment across specialties – felt better about their care and were less likely to report medical errors.

Chronically ill adults from the United Kingdom and Switzerland reported the most positive health care experiences, and were also more likely to have a medical home.

The data, said the researchers, suggest that all eleven countries need to step up their efforts to provide more organized primary care and can learn lessons from each other. In addition to focusing on developing medical homes, the U.S. can look to other nations for guidance on providing more affordable care.

The survey also found that American patients were the most satisfied with how doctors interact with them and help manage their care.

Copyright 2011 ABC News Radio

Monday
Aug292011

Federal Regulators to Probe Health Insurance Rates

Creatas Images/Thinkstock(WASHINGTON) -- On Thursday, the Obama administration plans to begin probing any proposed increases of health care premiums that exceed nine percent, The Wall Street Journal reports.  The close inspection of these rate increases are part of the administration's 2010 health-overhaul law.

Significant rate increases have taken place in recent years, particularly for those who received policies through small business employers and those who purchased their own.  The new attention to rate increases is expected to apply to nearly 34.8 million insurance policies, WSJ reports.

Industry lobbying group America's Health Insurance Plans found half of all increases on health insurance premiums in the individual insurance market were greater than 10 percent over the past three years, according to WSJ.

Now, insurers will be required to submit a seven-page form including justification for increases of 10 percent or more to federal regulators.  Though the government cannot legally prohibit these increases, the administration hopes that public disclosure of rate increases will be a deterrent for insurers.

Large increases will be posted on the Department of Health and Human Services' website.

Copyright 2011 ABC News Radio

Wednesday
Aug172011

Selective Use of Drug-Eluting Stents Saving Millions of Health Care Dollars

Jupiterimages/Thinkstock(DALLAS) -- With medical costs soaring, researchers have found a way to control expenses for heart stents without cost to patients.

More than half a million heart stents are implanted every year in the U.S.  The procedure, a less invasive alternative to bypass surgery, consists of surgically inserting a tube into a narrowed artery to keep it open and keep blood flowing normally.  Some are coated with medicine to help prevent blood clots.

These drug-eluting stents are the subject of a new study in the journal Circulation, published by the American Heart Association. It followed more than 10,000 patients at 55 medical centers.
 
The authors found that limiting the use of drug-eluting stents to a selected group of patients is saving the U.S. heath care system more than $400 million a year.
 
And while the use of the stents decreased from 92 percent between 2004 and 2006 to 68 percent in 2007, rates of patient death and heart attack remained virtually unchanged.

By targeting the highest-risk patients, doctors were able to do many fewer stent procedures while preserving the clinical benefits.
 
Copyright 2011 ABC News Radio

Thursday
Aug042011

Rick Perry Takes a Shot at Romney over Mass. Health Care 

Justin Sullivan/Getty Images(AUSTIN, Texas) -- Texas Governor Rick Perry took a shot at Mitt Romney for the healthcare plan he implemented as governor of Massachusetts, calling it a “failure” and likening it to Obama’s health care plan.

“If some state decides to do something like pass a health care plan that, you know, is kind of like this Obama thing and it's a failure then we kind of go, 'ooh, we don't want to do that,' and that state may have been harmed by it, but the whole nation was not,” Perry told CBN in an exclusive interview.  

This is the first hit Perry has taken at a presidential candidate since he announced he’s toying with the idea of a run, but this is not the first time Perry has taken a swipe at Romney.  In his most recent book, "Fed Up!," Perry said he supports states’ decisions on healthcare but said Texans would not favor a plan like the one developed by Romney or Obama.

Earlier this week, the Austin-American Statesman reported on a longstanding feud between the two governors.  In his 2008 book, “On My Honor,” Perry expressed anger with Romney for not allowing the Boy Scouts to volunteer at the 2002 Winter Olympics in Salt Lake City.

"Several years have gone by," Perry, who was an Eagle Scout himself, wrote, "and neither Mitt Romney nor anyone else who served as an official of the 2002 Winter Olympics has given a clear and logical explanation of why the door to volunteerism was shut."

"We know that Romney, as a political candidate in the politically liberal state of Massachusetts, has parted ways with the Scouts on its policies over the involvement of gay individuals in Scout activities."

The Romney camp has remained quiet about a potential bid by the Texas governor as many speculate Perry’s entrance in the race would affect Romney’s front-runner status.

Copyright 2011 ABC News Radio

(AUSTIN, Texas) -- Texas Governor Rick Perry took a shot at Mitt Romney for the healthcare plan he implemented as governor of Massachusetts, calling it a “failure” and likening it to Obama’s health care plan.

 

“If some state decides to do something like pass a health care plan that, you know, is kind of like this Obama thing and it's a failure then we kind of go, 'ooh, we don't want to do that,' and that state may have been harmed by it, but the whole nation was not,” Perry told CBN in an exclusive interview. 

 

This is the first hit Perry has taken at a presidential candidate since he announced he’s toying with the idea of a run, but this is not the first time Perry has taken a swipe at Romney.  In his most recent book, "Fed Up!," Perry said he supports states’ decisions on healthcare but said Texans would not favor a plan like the one developed by Romney or Obama.

 

“On the other side of the coin, Massachusetts is free to experiment with state run healthcare.  If federalism is respected, the people of Massachusetts are free to try it while the rest of the nation sits back and watches to see if they have any success, and whether any success they do have is worth the price of losing liberty.  Now, we in Texas are not too excited about the prospect of government -- run anything, much less health care, and the federal legislation -- known to most as Obamacare -- is a direct result on the principle of federalism."

 

Earlier this week, the Austin-American Statesman reported on a long standing feud between the two governors.  In his 2008 book, “On My Honor,” Perry expressed anger with Romney for not allowing the Boy Scouts to volunteer at the 2002 Winter Olympics in Salt Lake City.

 

"Several years have gone by," Perry, who was an Eagle Scout himself, wrote, "and neither Mitt Romney nor anyone else who served as an official of the 2002 Winter Olympics has given a clear and logical explanation of why the door to volunteerism was shut."

 

"We know that Romney, as a political candidate in the politically liberal state of Massachusetts, has parted ways with the Scouts on its policies over the involvement of gay individuals in Scout activities."

 

The Romney camp has remained quiet about a potential bid by the Texas governor as many speculate Perry’s entrance in the race would affect Romney’s front-runner status.

 

Copyright 2011 ABC News Radio

Thursday
Feb172011

Third of MRI, X-Ray Tests 'Wasteful' Spending

Photo Courtesy - Getty Images(PHILADELPHIA) - A new study suggests that if your doctor orders you to take an MRI or X-ray, they may simply be protecting themselves from being sued, reports WebMD.

A new survey by the Children's Hospital of Philadelphia found that among Pennsylvania orthopaedists, one in five order such imaging tests to avoid a potential lawsuit, not to help in a diagnosis.

According to researcher John Flynn, associate chief of orthopaedic surgery at Children's Hospital of Philadelphia, the study offers "a glimpse behind the curtain of what's happening in your doctor's mind."

Flynn and colleagues found that the so-called "defensive tests" made up 35 percent of total test costs, or as much as $325,000 among the 640 orthopaedists surveyed.

Flynn said the spending is wasteful and contributes to the estimated one-third of national health care spending considered unnecessary.

Copyright 2011 ABC News Radio

Thursday
Jan272011

HHS, DOJ Recoup More Than $4 Billion in Taxpayer Dollars

Photo Courtesy - Getty Images(WASHINGTON) – In a joint operation, the Department of Health and Human Services, along with the Justice Department, recovered more than $4 billion in taxpayer dollars lost to fraud in 2010, reports MedPage Today. 

The DOJ has said the funds represent the largest recovery of taxpayer dollars in the department’s history.

The prevention and enforcement operation was part of the Health Care Fraud and Abuse Control Program (HCFAC), which was implemented to recover and return such funds to the Medicare Health Insurance Trust Fund, the Treasury and other departments.

The HCFAC received $350 million from the Affordable Care Act to aid in its operations.

Copyright 2011 ABC News Radio

Tuesday
Jan252011

Cost of Treating Heart Disease, Stroke to Triple by 2030

Photo Courtesy - Getty Images(DALLAS) – The aging population of the United States is expected to cause the cost of treating heart disease and stroke to triple by the year 2030.

In a policy statement, the American Heart Association said the cost of treating the diseases in the U.S. is expected to reach $818 billion in the next 20 years.

"The burden of heart disease and stroke on the U.S. health care system will be substantial and will limit our ability to care for the U.S. population unless we can take steps now to prevent cardiovascular disease," said Dr. Paul Heidenreich, an associate professor of medicine at Stanford Medical School. Heidenreich is also the chair of the American Heart Association panel who issued the statement in the January edition of Circulation.

Along with an aging population, the dramatic increase in costs also accounts for an increasingly diverse racial mix in patients. The American Heart Association also points to “unhealthy behaviors and unhealthy environments” that have increased risk factors in Americans.

The percentage of Americans with some type of heart disease is expected to rise to 40.5 percent by 2030, compared to the current figure of 36.9 percent.

Copyright 2011 ABC News Radio

Friday
Jan142011

Geriatric Care Panel Suggests New Fall Prevention Guidelines

Photo Courtesy - Getty Images(NEW YORK) -- The American Geriatrics Society and the British Geriatrics Society recommended new prevention guidelines for elderly falls, stating that fall screening should be a part of all health care practices for older adults. 
 
A summary of the new guidelines was published in the latest edition of the Journal of the American Geriatrics Society and were compiled by a panel of specialists in fall prevention for the elderly after a series of randomized trials and extensive literature reviews and analyses.

The panel recommended that doctors and healthcare professionals try to determine whether older patients are at risks for falls by asking questions relating to fall frequency or unsteady walking.

"Falls are one of the most common health problems experienced by older adults and are a common cause of losing functional independence," said Dr. Mary Tinetti of Yale University School of Medicine and a panel chair.

The new guidelines focus on interventions including raising low blood pressure and managing heart rate and rhythm abnormalities, medication reduction, exercise or balance and gait strengthening and home and daily activity moderation.

Copyright 2011 ABC News Radio´╗┐







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