The head of the new Beaumont Health not-for-profit — the result of an eight-hospital merger that became official this week — says there are no plans for layoffs to cut costs. Additionally, the eight hospitals will remain open under current plans, said Gene Michalski, head of the new $3.8-billion Beaumont Health, the result of what was billed as an affiliation of Royal Oak-based Beaumont Health System, Dearborn-based Oakwood Healthcare and Farmington Hills' Botsford Hospital. The new system became official Tuesday. Combined, the health care system will make up one of the largest in Michigan — employing 33,093 and operating 3,337 hospital beds.
In January, Linden Texas native Richard Bowden suffered a mild stroke. Within minutes, medics had taken the 68-year-old to the local hospital emergency room, less than a block from his house. "They checked me out real good," said the former city councilor, whose East Texas community of nearly 2,000 has relied on the Linden hospital since the 1960s. Shortly after returning home, Bowden learned he would outlast the hospital itself: the facility was about to close because there weren't enough patients. "It blindsided me," he said. "It's 15 miles to the next hospital. Out in the country, that seems like a long way." Small, rural hospitals like Linden have always struggled to remain viable, but things are getting worse, fast.
Currently, a donated liver is supposed to go first to the person who is most likely to die without a transplant, but the system also takes geographic factors into consideration. That means the sickest person in the country doesn't always get dibs. Instead, the system uses a "local, regional and national" algorithm. There are wide disparities in the number of organs available in the country's 11 regions. In the South and Midwest, donations are high. Donations on the coasts are low. So if you live in California, an area that has one of the lowest liver donation rates, you would probably wait longer to qualify for a transplant than someone who lives in Tennessee, in a region where the donation rates are much higher.
Fecal transplantation—transferring the feces of a healthy person into the bowel of someone with an infection—appears in published case reports as early as 1958. But in the past few years, scientists have established with more rigor that it can resolve recurrent C. diff infections around 90 percent of the time. In 2013, a randomized controlled trial published in the New England Journal of Medicine showed that the procedure worked better for this condition than antibiotics—so much better that researchers stopped the study early, saying it was unethical to continue to deny the transplants to the control group.
As a doctor and a lawyer, I like to think I'm pretty good at navigating the health-care system. So when my wife and I found a large swollen bruise on our 3-year-old son's head more than a week after he had fallen off his scooter, I was confident we could get him a CT scan at a reasonable cost. We live near one of the top pediatric emergency rooms in the country. The care was spectacular. My son was diagnosed with a small, 11-day-old bleed inside his head, which was healing, and insignificant.
The first year of enrollment under the federal health care law was marred by the troubled start of HealthCare.gov, rampant confusion among consumers and a steep learning curve for insurers and government officials alike. But insurance executives and managers of the online marketplaces are already girding for the coming open enrollment period, saying they fear it could be even more difficult than the last. One challenge facing consumers will be wide swings in prices. Some insurers are seeking double-digit price increases, while others are hoping to snare more of the market by lowering premiums for the coming year.