In the hallway outside meeting rooms at the North Carolina Public Health Association, exhibitors gave away pens, chocolate and brochures. The types of organizations that usually attend public health conferences were in attendance: companies selling electronic health records, vaccine manufacturers and advocacy groups such as the Alzheimer's Association. But at this year's conference, there were three new exhibitors – Centene Corporation, Amerigroup and UnitedHealthcare – all companies that potentially would bid for contracts with North Carolina should the state decide to privatize Medicaid, the program that provides health care to almost 1.6 million disabled and low-income patients in North Carolina.
Blood transfusions save lives. If you need one, there's no question you should get one. But a lot of patients who get transfusions probably don't need them. Doctors now say they get better results by using donor blood less often in patients who are medically stable. There's growing consensus that transfusions can increase the risk of infection and do more harm than good. It's a big change in how some physicians practice medicine and it's led to some Minnesota hospitals tightening their transfusion guidelines.
Orlando Health nurses rallyed this morning for unions at Lake Eola, according to a press release from the National Nurses Organizing Committee. According to the release, pay cuts are expected to cause the loss of 90 indirect jobs and have a $12 million economic impact in the community. Orlando Health delayed some of the pay cuts until January, originally announced in early August. Dr. Jamal Hakim is Orlando Health Inc.'s interim CEO after Sherrie Sitarik was ousted by the board Sept. 26.
Hospitals have been criticized, including by me, as wildly inefficient. Yet two new pieces of evidence suggest that the hospital market may be more efficient than conventional wisdom suggests. Hospitals practice medicine in drastically different ways, and the higher-spending ones don't seem to generate any better results than those that spend less. Because of third-party insurance and other distortions, though, the market doesn't punish the inefficient hospitals. That has been the traditional critique. A new study suggests, however, that hospitals actually do gain patients when they provide better value.
Shelly Ross of San Francisco was looking forward to the opening of the new health insurance marketplaces under the Affordable Care Act because she was hoping to get a better deal. But now that she's seen her options, Ross is disappointed. Turns out she earns slightly too much money to qualify for federal financial aid to help her buy coverage in the state's exchange, called Covered California. And because policies have to be upgraded to comply with the new law, her rates are going up nearly 10 percent.
Jyoti Bansal is the founder of AppDynamics, an application management company that, among other things "makes sure essential software applications of customers such as Netflix stay up and running." I gave him a call to talk about some of the technological challenges that have plagued HealthCare.Gov during its first week online, what's causing those problems, and what he would change if put in charge of the project. What follows is a transcript of our conversation, lightly edited for clarity.