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“Our nation’s 46 million uninsured often delay or forgo needed healthcare because the cost is prohibitive,” said study author Julie S. Darnell, PhD, MHSA, then of the University of Chicago and now with the School of Public Health at the University of Illinois at Chicago. The mean cost for a doctor visit for uninsured patients is around $50, Darnell wrote.
Traditional sources of care, including public clinics and federal health centers, both charge fees and bill patients. “Aside from cost considerations, care is frequently difficult to find, especially for those with the least resources,” Darnell added. For many poor, uninsured, and underserved patients, the only sources of care are emergency rooms or free clinics.
At the time of the survey, 1,007 free clinics were known to be operating throughout 49 states and the District of Columbia (Alaska was the lone exception).
If BP’s liability for the oil spill is limited to $75 million, who pays for the damages over that amount? If some fisherman loses a business he has had for 50 years and BP has paid out a day or two of its earnings for damages — reached the cap — does the fisherman absorb the loss or does the government (the taxpayer) pay the difference? I expect that in reality, BP will be responsible for more than the $75 million in damage claims, but I have to wonder what Congress was thinking when it adopted the limitation of liability.
Nearly 4,000 tests for heart disease performed over the last three years at Harlem Hospital Center – more than half of all such tests performed – were never read by doctors charged with making a diagnosis, hospital officials acknowledged Tuesday.
The echocardiogram tests, a type of ultrasound used to evaluate heart muscle and valve functions, were ordered by doctors at the hospital. The tests were stored on a computer and basically forgotten, officials said.
The lapse occurred because the cardiology service at the hospital had developed a system by which technicians were given the responsibility to scan all tests and flag any that looked abnormal, so that they would be given priority when doctors read them.
It appears, officials said, that the tests that were not flagged were put aside and forgotten.
The city’s Health and Hospitals Corporation, which runs the public hospital system, including Harlem Hospital, and Columbia University, whose medical school supplies the cardiologists who work at Harlem Hospital Center, acknowledged the problem in a joint statement on Tuesday, after being asked about it by The New York Times.
“While the process the doctors followed may have alerted cardiologists to those echocardiograms that were most likely to be abnormal, the failure to read the echocardiograms in a timely manner is inexcusable and may have placed patients at risk,” Alan D. Aviles, hospitals corporation president, said in the statement.
It was unclear who developed the screening system, hospital officials said.
If after David beat Goliath the government decreed that henceforth when people fight giants, they must do so with six-inch sling shots and pebbles instead of rocks, there would be a huge outcry of protest. However, the changes that are being imbedded in our legal system in the name of tort reform are attempting to do the same thing.
The auto-repair industry serves its customers profitably in a free market for several reasons that do not apply to the health care industry:
1. The cost of an auto repair rarely exceeds 50% of the cost of acquiring an equivalent vehicle and is usually less than 5% of that cost.
The patient cannot acquire another body. The cost of an illness may exceed the combined cost of a buying a home and raising a family of university graduates.
2. Garages stay in business by making good decisions and providing good service.
Health care providers stay in business (retain their medical license) by conforming to industry standards. The health care industry (as opposed to the health care INSURANCE industry) does not want customers. They do not have to attract customers. There is no point in advertising for customers. The doctor regrets that the patient needs his help. The patient regrets being a patient.
3. Auto repair is based upon commodities: widely available parts, repair manuals, tools, and mechanics. Costs are well known and prices are regulated by competition
Health care equipment is highly technical and very expensive. Doctors are mostly specialists, often researchers with few students. They sometimes build their own equipment. The customer’s life may depend upon finding the right doctor. If that doctor does not have a contract with the patient’s private insurance company, the claim will be denied. (http://www.creators.com/liberal/froma-harrop/free-market-death-panels.html)
4. All drivers can afford to drive – until they can’t. If too many drivers can’t afford to drive, some garages may suffer or fail. It’s tough on the ex-drivers and ex-garage owners, but that’s the free market.
Patients must be served whether they can afford to pay or not. If they cannot pay, the cost must be shifted to others.
That common sense conclusion is the recent finding from the RAND Corporation, a think tank and research center.
In a recent study, the group finds that when patient injuries were reduced in California hospitals there were fewer medical malpractice claims.
The cries for tort reform to limit a patients’ ability to bring an injury claim, frequently fail to look at the impact an improved patient safety picture can have on reducing malpractice claims against doctors.
The research group analyzed medical malpractice insurance records in California from 2001 to 2005. California was chosen because it initiated medical malpractice reform 35 years ago and any fallout would not be recent. It also has a large and diverse population.
Researchers studied medical malpractice claims – that is claims by patients who had received poor care such as contracting a hospital infection, having a surgical instrument left in them, and receiving the wrong medication, among other preventable adverse events.
Using the records from four of the largest medical malpractice insurers in the state, researchers analyzed 365,000 adverse safety events and 27,000 malpractice claims that followed.