The top official for the health care of veterans resigned Friday amid a firestorm over reported delays in care and falsified records at veterans hospitals. Veterans Affairs Secretary Eric Shinseki said he has accepted the resignation of Robert Petzel, the department's undersecretary for health care, effective immediately. Shinseki had asked for the resignation, a department official later said on condition of anonymity because he was not authorized to speak for attribution. Reports of long waits for appointments and processing benefit applications have plagued VA for years. The agency has shortened backlogs but allegations that veterans have died while awaiting VA care have created an election-year uproar.
Surgery patients covered by Medicaid arrive at the hospital in worse health, experience more complications, stay longer and cost more than patients with private insurance, a new study has found. The study, by researchers at the University of Michigan, may offer a preview of what to expect as millions of uninsured people qualify for Medicaid under the Affordable Care Act. Although Medicaid patients in the study were generally younger than the privately insured patients, they were twice as likely to smoke and had higher rates of conditions that made surgery riskier. Those conditions, which can arise from years of poor health habits, include diabetes, lung disease and blood vessel blockage.
That which walks like a duck, and talks like a duck, is not always actually a duck. That's the argument the American Medical Association has been using for decades to block public access to doctors' Medicare billing records. The AMA worries that people and the press will misinterpret the numbers when they see how doctors bill the government's $500 billion health care program for the elderly and disabled, and that doctors who are doing nothing wrong could be unfairly accused of fraud. But the medical association lost that argument last month and now doctors' Medicare billing data is a matter of public record– dense, complicated records. And those records are beginning to tell stories.
As rural hospitals struggle, Georgia is letting stand-alone emergency rooms treat people in the countryside who would otherwise have to drive far away when they break an arm, need stitches or have a baby. The state agency that licenses medical facilities changed its rules this year to allow a rural hospital that's failing or has already closed in the last year to scale back its operations and reopen as a freestanding emergency room. Before, emergency departments were only allowed at full-service hospitals that fulfilled criteria including having inpatient beds and other expensive requirements. Georgia's leaders backed the rule change allowing stand-alone ERs after three rural hospitals closed in 2013. Many are taking financial losses.
After two cesarean sections, Rinat Dray wanted to give birth naturally. But when she arrived at Staten Island University Hospital in labor, the doctor immediately began pressuring her, she said, to have a C-section. The doctor told her the baby would be in peril and her uterus would rupture if she did not; he told her that she would be committing the equivalent of child abuse and that her baby would be taken away from her, she said in an interview this week. After several hours of trying to deliver vaginally and arguing with the doctors, Mrs. Dray was wheeled to an operating room, where her baby was delivered surgically.
Office visits are the bread and butter of many physicians' practices. Medicare pays for more than 200 million of them a year, often to deal with routine problems like colds or high blood pressure. Most require relatively modest amounts of a doctor's time or medical know-how. Not so for Michigan obstetrician-gynecologist Obioma Agomuoh. He charged for the most complex — and expensive — office visits for virtually every one of his 201 Medicare patients in 2012, his billings show. In fact, Medicare paid Agomuoh for an average of eight such visits per patient that year, a staggering number compared with his peers.