One of the country's largest and most profitable hospital chains has been defeated in its effort to take away its nurses' sick days, according to the union that mounted nine strikes there over the past two years. "The nurses would've come to work sick, and the patients' health would've declined," said California Nurses Association Executive Director RoseAnn DeMoro. "Because the nurses would be exposing current patients to the past patients' illnesses." While nurses "take the risk of being around very sick people," DeMoro told Salon, they "are not super-women." According to CNA, eliminating paid sick days was one of nearly 200 concessions sought by California healthcare giant Sutter Health, in negotiations over union contracts covering 3,000 nurses and hundreds of other employees at central California hospitals.
Across Massachusetts, about half of primary care doctors aren't taking new patients, according to the Massachusetts Medical Society's 2013 Patient Access to Care Study. The rate for internal medicine specialists, or internists, who often also serve as primary care doctors, is 55 percent. If you've found a new doctor and want to schedule a routine visit, be prepared to wait. It takes an average of 39 days for new patients to get an appointment with a family physician and 50 days to see an internist. That's better than last year, when the average wait was a whopping 45 days, but up from 29 days in 2010.
Take a close look at how medical care is being delivered, and it's clear that doctors and hospitals are being asked to work more closely together to maintain quality even as payments start to shrink. If that's the case, would it help if more hospital administrators were also clinicians – doctors, nurses and other health professionals? Quite a few in the industry apparently think so. Today, Tarrant County has the unusual circumstance of its two biggest hospitals, Texas Health Harris Methodist Fort Worth and Baylor All Saints, being headed by clinicians. Both hospitals are in the Fort Worth medical district.
The U.S. spends nearly 18 percent of its GDP on health care—more than any other developed country. Rising health care costs strain government budgets and are passed on to American families through higher premiums and out-of-pocket spending. But America's spending on health care has slowed unexpectedly in recent years. Since 2006, real per capital spending growth has averaged 1.9 percent per year, compared with an average of 4.9 percent per year between 1960 and 2006. If this trend is sustained, total savings will be substantial; recent estimates suggest that if current lower growth rates continue, total U.S. spending will be $770 billion lower between 2011 and 2021 compared with the Centers for Medicare and Medicaid's previous forecasts.
The unexpected volume of visitors that overwhelmed the federally operated health insurance exchange last week is only one of many problems confronting this entity and the state-based exchanges. For starters, some insurance companies have received faulty enrollment data from the U.S.-run insurance exchange, according to insurance industry consultants interviewed by Bloomberg News. Either the plans have been unable to open files forwarded to them from the exchange or have found that the information on the enrollees is incomplete. According to consultant Bob Laszewski, the plans are trying to fix the errors manually. Another consultant, Dan Schuyler, told Bloomberg that unless these problems are rectified in the next few weeks, some enrollees might not have coverage on Jan. 1, 2014.
In March, Henry Chao, the chief digital architect for the Obama administration's new online insurance marketplace, told industry executives that he was deeply worried about the Web site's debut. "Let's just make sure it's not a third-world experience," he told them. Two weeks after the rollout, few would say his hopes were realized. For the past 12 days, a system costing more than $400 million and billed as a one-stop click-and-go hub for citizens seeking health insurance has thwarted the efforts of millions to simply log in. The growing national outcry has deeply embarrassed the White House, which has refused to say how many people have enrolled through the federal exchange.