Fewer people die from heart attacks at Sutter Memorial Hospital than at other hospitals like it. But Kaiser Permanente's Sacramento Medical Center does better with stroke care. New data posted by the Office of Statewide Health Planning and Development show wide variation among Sacramento-area hospitals in mortality rates for common medical conditions like heart attack, pneumonia and stroke. That's even after rates are risk-adjusted to take into account patients with pre-existing health conditions. The measures are indicators of hospital quality, but should be considered in context with other health care data, state officials say.
A few years ago, I was looking for a new primary-care doctor. I was hoping for someone who was kind, smart, and caring, someone who'd listen with full attention. I didn't care what the doctor looked like—or so I thought, until a woman clicked into the room in stilettos and a tailored expensive-looking suit. This wasn't a case of a low-cut blouse or a thigh-revealing skirt. And yet I felt put off. I felt like a slob. The doctor was nice enough, perhaps a little brusque, or maybe her clothes were brusque, and I didn't end up sticking with her.
In mounting the latest court challenge to the Affordable Care Act, House Republicans are focusing on a little-noticed provision of the law that offers financial assistance to low- and moderate-income people. Under this part of the law, insurance companies must reduce co-payments, deductibles and other out-of-pocket costs for some people in health plans purchased through the new public insurance exchanges. The federal government reimburses insurers for the "cost-sharing reductions." In their lawsuit, House Republicans say the Obama administration needed, but never received, an appropriation to make these payments to insurance companies. As a result, they contend, the spending violates the Constitution, which says, "No money shall be drawn from the Treasury, but in consequence of appropriations made by law."
U.S. officials trying to set up a network of hospitals in this country to care for Ebola patients are running into reluctance from facilities worried about steep costs, unwanted attention and the possibility of scaring away other patients. "They're saying, 'Look, we might be willing to do this, but we don't want to be called an Ebola hospital. We don't want people to be cancelling appointments left and right,' " said Michael Bell, director of laboratory safety at the Centers for Disease Control and Prevention. The reticence, although perhaps not surprising, complicates government efforts to ensure that the country can effectively treat people with Ebola and contain possible outbreaks.
Tony Banbury declined to say if targets he had set in the fight against Ebola, to be achieved by Monday, had been met. The targets were for the proportion of people being treated and for the safe burial of highly infectious bodies. The UN boss was speaking in Freetown, one of the worst-affected areas. On Sunday in Sierra Leone's capital, bulldozers were clearing large areas for a new burial ground. At the clearance site, near a rubbish tip, car after car was arriving with bodies, and several hundred workers were digging graves.
Dr. Prem Reddy almost seems evangelical when he talks about his life, his mission and his purchases of distressed hospitals across the country. The day last month that his company, Prime Healthcare Services, was awarded the bid to buy the struggling Bay Area-based Daughters of Charity Health System, Reddy boasted to reporters about his talent for turning near-bankrupt hospitals into moneymakers. He talked about the industry awards his 29 hospitals have captured over the years; the charitable foundation he and his family have established; and the tens of thousands of jobs he has saved by keeping struggling hospitals open.