The young woman spiraled toward death, withno hope for recovery from a crushing heart attack. Doctors at Massachusetts General Hospital delivered the dire prognosis to her family, who chose to disconnect the breathing machine that kept her alive. But a few hours later, they changed their mind. The reason stunned the medical staff: The family wanted to explore whether eggs could be harvested from the woman and frozen so that she could become a mother posthumously. “What they asked us to do made us very uncomfortable,’’ said Dr. David Greer, one of the specialists who treated the woman, “and forced us to think about what is the right thing to do here, what is the ethical thing.’’
We are scarcely 3 months into the reform era of health care, but already there are early signs of how the reform decade of the 2010s will play out. This will be a replay to a certain extent of the 1990s, for those that remember that era. Quick fact—the era of PPOs and negotiated discounts was set off by changes to the Medicaid program in 1983 that brought about competitive Medicaid provider contracts. We remember what ensued, from the dramatic decline in Medicaid payments to the growth of the managed care industry. The consolidation of providers, formation of physician networks and IPAs, development of disruptive delivery approaches, from ambulatory surgery centers to specialty hospitals, can all be traced to legislative changes. Will we look back at this decade and make the same comments about US health care? The answer is, unequivocally, yes! We can already see the signs of dramatic changes in rhetoric and actions of physicians, hospitals and government. And the regulations supporting the Patient Protection and Affordable Care Act have not yet begun to be adopted.
Hundreds of newborns in need of emergency surgery to save their lives are flown to Children's Hospital each year or rushed across campus from University of Colorado Hospital just moments after birth. But by early next year, women carrying babies known to have heart defects or other severe abnormalities will be able to give birth at Children's — inches away from a team of physicians and specialists ready to whisk an infant into surgery. Denver Children's will join only a handful of pediatric hospitals — in Boston, Houston, Cincinnati and Philadelphia — that have maternity wards when it completes a renovation in early 2011. The hospital's $228 million expansion, expected to open by the end of 2012, will devote an entire floor to the new maternal- fetal advanced-care program, a collaboration among Children's, University Hospital and the CU medical school.
Supporting oft-made statements from Louisiana officials, a new federal government assessment hails the region's burgeoning network of primary-care clinics and warns that an impending loss of federal taxpayer support will limit the newfound medical care for the working poor and uninsured. The Government Accountability Office report, conducted for the House Committee on Oversight and Government Reform, does not recommend any source of new financing for 90-plus clinics that have received almost $100 million from a grant that Congress approved for Gulf Coast states after the 2005 hurricane season.
<p><advertisement></advertisement>The Illinois Hospital Association has named longtime Democratic congressional aide Kimberly Parker as its first vice president of federal relations, opening the powerful state lobby's first-ever office in Washington. As health reform is implemented during the next four years, the association said, it wanted a stronger presence in Washington. Hospitals in Illinois are particularly concerned about rates they are paid by the Medicaid health insurance program for the poor, funded partly from federal dollars but also from state coffers, which are bleeding red ink. The association represents 200 Illinois hospitals.</p>
Texas is facing a shortage of 71,000 nurses by 2020 as demand continues to outpace supply, the Texas Department of State Health Services says. Tens of thousands of qualified applicants have been turned away from nursing schools for at least five years because there aren't enough teachers to conduct classes or enough clinical sites where students can get hands-on experience. Across the country, experts predict a shortage of more than 260,000 nurses by 2025. If the shortage is not addressed, the lack of trained caregivers threatens to flat-line the government's health care overhaul law, of which many provisions, such as widespread coverage of the uninsured, start in 2014.