It has been called one of medicine's "open secrets"—allowing patients to refuse treatment by a doctor or nurse of another race. In the latest example, a white man with a swastika tattoo insisted that black nurses not be allowed to touch his newborn. Now two black nurses are suing the hospital, saying it bowed to his illegal demands. The Michigan cases are among several lawsuits filed in recent years that highlight this seldom-discussed issue, which quietly persists almost 60 years after the start of the civil rights movement.
The number of requests by health insurers for double-digit rate increases fell about 41 percentage points since the end of 2009, according to a U.S. report that cited the success of the health-care overhaul. The data today by the U.S. Department of Health and Human Services showed one-third of requests last year asked states to approve premium increases of more than 10 percent. In 2010, three-quarters of petitions sought double-digit jumps, according to the report, which compared 15 states in 2012 with 11 in 2010.
Hospitals across the region are increasingly weaving "complementary" services such as healing touch, yoga and art and music therapy into their care—reflecting a resurgence in these healing methods nationwide and an effort to combine them with traditional methods to form "integrative medicine." Cancer programs at University and Baptist Health Louisville, for example, offer patients an array of services. Norton Healthcare is expanding its complementary offerings and re-emphasizing them. And KentuckyOne Health plans to launch a pilot "integrative health" program next year.
Americans spend far more on health care than people in other countries and we have little to show for it. And as we live longer after retirement, the share that will be paid by the government will rise. Unfortunately, no single change will transform our health care delivery system into one that we can afford. We are going to have to try lots of new approaches that depart from standard practices.
On Wednesday, Florida's Rick Scott became the seventh Republican governor to accept Obamacare's Medicaid expansion. His reversal was particularly important because Scott, a tea party-backed former hospital executive who won election in 2010 in large part due to his opposition to Obamacare, had sworn to reject the Medicaid dollars. In conducting a complete about-face, he created a template for other Republican governors who excitedly said no to the money before the election to reevaluate in light of Obama's win.
For over a year now, Marilyn Tavenner has run the federal government's largest agency: the Centers for Medicare and Medicaid Services. With a budget of nearly $1 trillion, Tavenner oversees everything from the implementation of the Affordable Care Act to programs that already administer health benefits to more than 80 million Americans. The White House nominated Tavenner for the post in November 2011, but with the fight over the Affordable Care Act still winding its way up to the Supreme Court, she never received a confirmation hearing. She was then renominated in January, and a hearing now looks likely. In her first interview since her renomination, Tavenner and I spoke about the work she's done over the past year.