Jennifer Moxley of Charlotte had her children early, so when she had problems with her birth control method she decided to get a tubal ligation. Under the Affordable Care Act, that sterilization surgery is one of the preventive services that's supposed to be fully covered by insurance. But when her gynecologist checked with her insurance company, Moxley was told she'd end up paying $9,000 for anesthesia, medication and the hospital room. "It's a ridiculous loophole," Moxley said. In North Carolina and across the country, hidden costs have popped up on "fully covered" services ranging from contraception to cancer screening to annual checkups.
As the Obama administration dramatically scales up its response to the Ebola outbreak, it is trying to navigate a tricky course: Can officials increase public vigilance about the deadly virus without inciting a panic? That challenge has been evident in almost every public pronouncement from the administration in recent weeks?from President Obama on down?as the government seeks to simultaneously emphasize the seriousness of the epidemic while projecting confidence that it can be contained and ultimately halted. "Ebola is scary. It's a deadly disease. But we know how to stop it," Dr. Thomas Frieden, the CDC director, said during a briefing Wednesday.
Dr. Igor Bidikov has been seeing patients in Heflin since 1997, and he said he loves it. "It's comfortable," he said. "People know you and you know them." As much as he likes working in Heflin, Bidikov said he has had a hard time recruiting doctors to work with him in Heflin. The doctors will come for a little while and then they leave, he said. "It's very disappointing," Bidikov said. The problem is a symptom of a statewide shortage of doctors that has hit rural areas especially hard, say representatives of the medical field.
Don't let what happened in Dallas happen here. That's the watchword at U.S. hospitals after Ebola-infected Thomas Eric Duncan was sent home from a Dallas emergency room for two days, only to return in an ambulance and then, 10 days later, die in an intensive care isolation unit. "This is my entire job" now, said Michelle Peninger, system director of infection control at Inova Health System, which has five hospitals in northern Virginia, referring to Ebola preparation. "It's all I do every day." The incident in Dallas, along with the growing epidemic in Western Africa that has killed almost 4,000, has heightened concerns at U.S. hospitals that a new Ebola patient will emerge.
On Aug. 15, doctors and nurses at Children's Mercy Hospital in Kansas City, Mo., realized they had a problem. Children were coming into the emergency room with an illness that caused wheezing and breathing problems so severe that some children ended up in the ICU on ventilators. And it was spreading fast. "By Aug. 20, we were beyond our bed capacity," Dr. Mary Anne Jackson, chief of the infectious diseases section at Children's Mercy, said at the IDWeek meeting in Philadelphia. Since then, the virus that caused those illnesses, enterovirus D68, has sickened children across the country and may be responsible for the deaths of five children. Jackson and Dr. Aaron Milstone of Johns Hopkins Children's Centers briefed reporters on the outbreak Thursday morning.
The first person diagnosed with Ebola in the United States died on Wednesday, underscoring questions about the quality of care he received, and the government ordered five airports to start screening passengers from West Africa for fever. Liberian national Thomas Eric Duncan died in an isolation ward of a Dallas hospital, 11 days after being admitted on Sept. 28. The case has stirred attention and concern that someone with Ebola had been able to fly into the United States from Liberia, raising the specter more passengers could arrive and spread the disease outside of West Africa, where nearly 4,000 people have died in three impoverished countries.