The billions of dollars in tax breaks granted to the nation's nonprofit hospitals are being challenged by regulators and politicians as cities still reeling from the recession watch cash-rich medical centers expand. Hospitals, among the largest landowners in many communities, are often designated as nonprofits, allowing them to benefit from state and federal tax breaks for providing "charity care and community benefit." The exemptions collectively amount to more than $12 billion annually, health economists say. Now, provisions of the Affordable Care Act, along with Internal Revenue Service reporting requirements imposed in recent years, are revealing how much medical centers give back to the communities they serve.
The nation's state and federal healthcare insurance exchanges are gradually overcoming a variety of technical growing pains but continue to face an uphill battle on one essential measure of success: closing the sale. In the weeks since repairs began on the federal government's online health insurance marketplace, HealthCare.gov has made big strides in improving the purchasing experience for visitors. The tech problems that dogged the site when it launched Oct. 1 -- long page-loading delays, mysterious error messages, and site crashes from too much volume -- have mostly been vanquished.
Waiting rooms are often full at community health centers, which operate on limited budgets and provide care even when patients can't pay. Private-practice doctors from the region who would be willing to donate services to help ease the burden on centers' staffs are stymied by a federal law. But members of Congress, including Rep. Tim Murphy, R-Upper St. Clair, are trying to change that. The Federal Court Claims Act provides malpractice protection for physicians employed by the health centers but doesn't cover physicians who want to volunteer. Mr. Murphy wants to extend to volunteer medical professionals the same malpractice protections given to paid clinic employees.
Doctors' personal preferences may influence when they discuss end-of-life care with patients, says a new study. Researchers found doctors who said they would opt for care aimed at preventing pain and suffering at the end of their own lives were more likely to discuss that type of care with a hypothetical dying patient. "Although most patients do ultimately talk about some end-of-life topics before they die, the vast majority of these conversations happen during acute care hospital stays and at the end of life," Dr. Nancy Keating, the study's senior author, said. Keating is an associate professor at Harvard Medical School in Boston.
Again and again, we hear that the country has too few doctors, particularly for primary care. And Obamacare is supposed to make the shortage much worse in the coming years as more Americans become insured and try to shoehorn themselves into already crowded medical offices. But why, exactly, are doctors in such short supply? I had always assumed the culprit was medical school enrollment. But when I looked into those numbers, I found that they are actually increasing noticeably. Thanks to the opening of new medical schools and expanded admissions at existing ones, enrollment is projected to rise by 30 percent between 2002 and 2017, according to the Association of American Medical Colleges.
Washington residents hoping to sign up for new health-insurance coverage on Healthplanfinder are not the only people who have been affected by technical glitches on the website and the overloaded customer support center. People who are currently enrolled in Medicaid are also running into problems on Healthplanfinder when they try to renew their eligibility, which they are required to do once a year to maintain coverage. Normally, about 60,000 Medicaid recipients complete the renewal process each month, which involves reporting household monthly income and other personal information. But only about half that number renewed eligibility in November, the first month Medicaid recipients were supposed to use Healthplanfinder to recertify.