What makes a patient comfortable or uncomfortable with one treatment or another, or with no treatment at all? Where do these views come from? And how can patients make better decisions? For answers, we spent four years interviewing scores of patients of different ages. We found that a host of powerful and often hidden influences, inside and outside the patient's mind, can sway thinking and distort judgment. We also discovered that, by unmasking those influences, it is possible for patients to gain greater confidence and control over their medical decisions. Many people decline treatment because they know someone who suffered from side effects or someone who lived well into old age without treatment. Stories deeply affect all of us, and they can make real the risks and benefits that might otherwise seem abstract—but they can also distort our vision by making the rare appear routine. Statistics can help to put lessons drawn from stories into a larger context, letting us make a more considered choice than we possibly could by using narratives alone.
Many Connecticut hospitals are seeing another spike in patients insured by government assistance programs like Medicaid that don't cover the full cost of service, putting pressure on their bottom lines and raising concerns about their long-term financial stability. Hospitals are also seeing fewer patients with private insurance coverage, which pays higher reimbursement rates than their government counterparts. The sour economy and high levels of unemployment continue to accelerate the cost shift, forcing hospitals to tighten their belts and look for new streams of revenue as more people depend on the government to pay at least part of their medical bills. And federal healthcare reform could add tens of thousands of new patients to Connecticut's Medicaid rolls in the coming years, creating long-term uncertainty.
Many would say that controlling costs is the toughest challenge facing the U.S. healthcare industry. But safeguarding patient information in a digital world isn't proving to be much easier. Consider this: In the two years since the Department of Health and Human Services mandated public disclosure of any exposure of data involving 500 or more patients, breaches affecting more than 10 million individuals have been reported. And most people think that's just the tip of the iceberg—many other individuals likely have had their data compromised and many more will in the future. Why are medical records so vulnerable?
Company-sponsored infant formula samples are still the norm at many hospitals, although fewer are giving out the freebies now than in 2007, according to a new report. Experts worry that giving new moms the free samples could undermine official recommendations that they stick to breastfeeding until their baby is at least six months old. "If a hospital gives it out... the patient thinks it's the best thing for the baby," said Anne Merewood from Boston Medical Center, who worked on the new study. "The bottom line is that the hospitals are marketing for the formula industry." The free samples typically come in diaper bags that maternity wards give out to moms when they leave the hospital. Sometimes those bags are funded by the hospital. But as research has shown, more often than not they're provided by formula companies. "The companies have an incentive to give as much away early on, because it kind of gets hospitals and mothers hooked on that," said Chessa Lutter, regional advisor on food and nutrition for the Pan American Health Organization, part of the World Health Organization.
Deb Barth is raking leaves for Lesley Jones. But Barth isn't earning money for her yardwork, at least not in physical currency. She's earning "time dollars" — for every two hours she spends doing odd jobs, she'll earn a free visit with her doctor. As a struggling artist, Barth's income qualifies her for the program at True North, a nonprofit healthcare clinic in Falmouth, ME. She's one of 33 patients who pay with time dollars there. "I do things like deep cleaning, organizing," Barth says. "I also offer caregiver support for people who may be caring for an older parent." So how does her doctor cash in these time credits? By getting free services from any of the other hundreds of people who belong to The Portland Hour Exchange Program. Tom Dahlborg, the executive director of True North, used to work in Medicaid, where he thought the patients weren't getting enough from their healthcare.
The CEO of the Jersey City Medical Center has reached out to state and local officials to let them know he is still willing to buy the Hoboken University Medical Center if bankruptcy settlement negotiations falter and the proposed sale collapses. Joe Scott, CEO of Jersey City Medical Center, said he contacted Hoboken Mayor Dawn Zimmer and the state Department of Health and Senior Services Thursday morning just hours after Hoboken City Council rejected a last-minute effort to salvage negotiations. Minutes after the vote, Zimmer said the oldest hospital in the state would close and roughly 1,300 people would lose their jobs. "I let them know we stand ready to do whatever it takes to ensure there is a organized transition with the hospital if this deal falls apart,'' Scott said. "We have a partner willing to buy the hospital and placed a bid…We were going to lease space from them.'' The partner is CHA Properties, he said.