Labor tensions are mounting at the Jackson Health System, with the public hospitals almost two months into the new fiscal year without crucial union contracts. "They're throwing grenades at us," said Martha Baker, head of SEIU Local 1991, which represents Jackson nurses and other healthcare professionals. She was referring to the recent announcements of two-week furloughs and the elimination of 240 positions. "I think they're going to keep throwing grenades until we come to the table and agree to their demands." But Jackson CEO Carlos Migoya said he's doing what he must to cut labor costs by $120 million in order to meet his break-even budget for a fiscal year that began Oct. 1. "We don't have a labor agreement. Therefore, we have to find other ways to get the savings."
A dozen nurses in New Jersey have rekindled the contentious debate over when health-care workers can refuse to play a role in caring for women getting abortions. In a lawsuit filed in federal court Oct. 31, 12 nurses charge that the University of Medicine & Dentistry of New Jersey violated state and federal laws by abruptly announcing in September that nurses would have to help with abortion patients before and after the procedure, reversing a long-standing policy exempting employees who refuse based on religious or moral objections. "I'm a nurse so I can help people, not help kill, and it just doesn't seem right to me," said Beryl Otieno-Negoje, one of the nurses.
Hospitals around the country have been spending millions of dollars to buy automated defibrillators to save the lives of more patients who go into sudden cardiac arrest. The purchases were spurred by a 2000 recommendation from an American Heart Assn. committee that said the equipment would bring patients speedier emergency medical help. But today the costly investment increasingly seems to have been a mistake. Research suggests that the new gear, now found in nearly all hospitals, saves fewer lives than the old, lower-tech defibrillators. By one estimate, the switch to automated defibrillators means that close to 1,000 more hospital patients die of cardiac arrest every year in the U.S.
Hospitals throughout the Puget Sound region are in the midst of a boom, building spiffy new free-standing emergency rooms and entire hospital towers with expanded ERs, and drastically remodeling existing ones. The ER building boom has prompted a backlash from some lawmakers and advocates of affordable health care, who complain that nearly all Washington hospitals get substantial tax breaks and construction financing through tax-exempt bonds. Free-standing ERs, these critics charge, are cash cows for hospitals, strategically built in affluent areas to lure busy, well-insured patients and collect fat reimbursements.
The Kaiser Family Foundation is out with this helpful brief explaining what the failure of the super committee could mean for health care spending. As a reminder, the Budget Control Act of 2011 includes a sequestration mechanism of cuts that go into effect if lawmakers fail to reduce the deficit by $1.2 trillion over 10 years—the reductions are in addition to the savings already included in the Affordable Care Act, which are "projected to reduce aggregate spending by 6 percent over the 10 year period."
In a new editorial in the Annals of Emergency Medicine, several emergency physicians warn of the challenges of incorporating what ER docs do into new models that move away from the current fee-for-service payment to an episode-of-care approach that reimburses providers for caring for a population of patients over time. In particular, the ER docs fret that they haven't been involved in current projects to develop new payment models, such as pilots being designed by federal health agencies, the National Quality Forum, the Brookings Institute and others.