An intensive care unit nurse in a small-town hospital on Maryland's scenic Eastern Shore suspected that a patient had necrotizing fasciitis, the so-called "flesh-eating" disease. The condition is rare. Even experienced intensive care doctors seldom see it, and, since it was nighttime, no such physician was in the ICU. Pinning down the diagnosis was critical?and in this case Berlin, Md.'s Atlantic General Hospital had back-up. A critical care doctor 125 miles away was monitoring the patient's health via voice, video and high-speed data lines constantly streaming information about vital signs, medications, test results and X-rays, a telemedicine service known as Maryland eCare.
It may take weeks to render a verdict on the Obama administration's latest health care concession to employers. But that could make a difference for Democrats battling to keep control of the Senate in the fall congressional elections. All-important details are buried in more than 200 pages of dense Treasury regulations released Monday. The biggest change is that medium-sized firms got another delay in a heavily criticized requirement that they cover their workers or face fines. The administration said companies with 50 to 99 employees will have an additional year to comply, until January 1, 2016. For businesses with 100 or more employees, the so-called employer mandate will still take effect in 2015.
Nurse practitioners would be allowed to treat patients and prescribe medications independently under a proposal by Gov. Dannel P. Malloy's administration, a potentially significant — and controversial — change in the medical landscape aimed at expanding access to primary care. The ability of nurse practitioners to work independently of doctors has long been an issue of contention between the two professions, and states vary widely in how they allow nurse practitioners to practice. But the federal health law commonly known as Obamacare puts the debate in a new context: The expansion of insurance coverage to thousands more people is expected to raise the demand for primary care, at a time when the state already faces a shortage of primary care doctors and an aging physician population.
A database could help physicians avoid writing prescriptions for people who may be selling those potentially addictive drugs under a bill approved by the Missouri House. But senators involved in the issue said there's little chance of such a measure moving forward. The bill creates an electronic system to monitor who is being prescribed drugs such as OxyContin, Vicodin and Xanax. Bill sponsor Rep. Kevin Engler, R-Farmington, said keeping people from obtaining large quantities of drugs will save lives. "People have died from getting prescriptions from people that illegally bough them," Engler said. "We're killing people."
Lawyers have something to teach doctors. But it is not how to avoid medical malpractice claims, protect patients' rights, or negotiate better contracts with hospitals and insurance companies. Instead it is a cautionary tale—a tale of woe, really—about pitfalls the medical profession needs to guard against if it wants to avoid reprising the epidemic of de-professionalization and demoralization that has beset lawyers and the legal profession. Simply put, the law is not well. US law school applications are down by nearly half from eight years ago, and 85% of graduates now carry at least $100,000 in debt.
The Treasury Department on Monday rolled out more tweaks to the health-care law's requirement that all large employers--those with 50 or more workers--provide insurance coverage to their workers. This is the part of Obamacare was supposed to take effect at the start of 2014, but was delayed by the White House this past summer as the White House was facing significant push back from employers. In today's final rule, the Obama administration is essentially relaxing the employer mandate for 2015--in a big way for medium-sized businesses, and a smaller way for the largest employers. Here's a rundown of the key changes.