When asked, most Americans say they?d rather die at home than in a hospital. A government report suggests that?s happening more than in the past, though nearly 40% of deaths still occur in hospitals -- a shift that experts say has been fueled by a greater acceptance and availability of hospice care. The percentage of at-home deaths increased to one-fourth in 2007, from one-sixth in 1989, according to the report by the National Center for Health Statistics. The figure would be higher if the National Center for Health Statistics had included nursing homes in its definition of dying at home, as many experts do, since 28% of people over 65 died there in 2007. Chris Feudtner, MD, lead author of a 2008 study that observed a similar shift in where children die, said there?s been a "sea change" over the past two decades, not in people?s attitudes about dying, but in the use of at-home hospice care.
After the surging ocean waters spawned by Japan's magnitude 8.9 earthquake receded, the drowned were only the first victims to be counted. In the coming days, physicians and public health officials along Japan's hard-hit eastern coast can expect a second wave of tsunami victims with aspiration-related illnesses, trauma and crush wounds, as well as the threat of disease spread by contaminated water. As they tend to survivors, Japanese officials can look to the experience of health workers who ministered to victims after the massive tsunami that inundated Indian Ocean nations on Dec. 26, 2004.
When New Hampshire Attorney General Michael Delaney announced last summer he objected to the alliance between Catholic Medical Center and Dartmouth-Hitchcock Medical Center, he also said his office would review the compensation paid the CEO's of the 24 nonprofit hospitals in the state. He noted the total compensation paid to CMC President/CEO Alyson Pitman Giles had more than doubled over four years -- to $1.36 million in 2009 -- and was significantly higher than her peers both in compensation and compared with operating revenues. During his budget address last month, Gov. John Lynch raised the issue of administrators' compensation at the state's nonprofit hospitals, noting the top 200 administrators earned $60 million. Lynch spokesman Colin Manning said the governor used executive compensation as an example to show that cash-generating nonprofits have areas where they can absorb the cuts he proposes. Lynch's budget proposal would reduce the money hospitals receive for uncompensated care by $20 million. Since that time, the House Finance Committee has proposed further reductions that would cut $167 million currently earmarked for uncompensated care payments to the hospitals.
Smokers, tobacco users, even those using nicotine patches to kick the habit, shouldn't bother applying for a job at Crittenton Hospital Medical Center in Rochester. Or Bixby Medical Center in Adrian. Same goes for Herrick Medical Center in Tecumseh. The three Michigan hospitals are among several health systems and some private companies across the country that have adopted policies to hire only nonsmokers and nontobacco users, citing the need to live up to their health missions. The policies, which come after most hospitals have already banned smoking on their campuses, also help lower employee health care costs, said Laura Ritzler, director of wellness for ProMedica, which owns the Bixby and Herrick medical centers. And several national studies have shown smokers use more sick days and have higher medical costs than nonsmokers. The policy changes, however, raise questions about the rights of the 1 in 5 Americans who smoke, using a legal product in time off the clock, and whether the move could lead to other employer bans.
The 1,000-plus waivers granted by the Obama administration to a portion of the healthcare reform law have become a political liability for the White House. Republicans are accusing the administration of rewarding Democratic allies in the labor movement with the waivers, which exempt recipients from the reform law's annual coverage limits. They say the large number of waivers granted so far -- 1,040 as of Thursday -- is proof that the law is unworkable and should be repealed. The drumbeat of GOP criticism has grown louder as the waiver awards have increased. Approval of waiver requests has jumped from 222 to almost 730 in December, and another 300 have been approved since then. The Department of Health and Human Services says waiver requests have slowed during the past two months, but that hasn't quelled the GOP outcry.
House Republicans will "lead with our chin" and offer politically explosive cost curbs this spring on programs like Medicare, Medicaid and perhaps Social Security, the party's point man for curbing crippling budget deficits said Thursday. Even then, Rep. Paul Ryan acknowledged, the government's budget still won't balance for quite some time. In a wide-ranging interview with The Associated Press, the Wisconsin lawmaker and chairman of the House Budget Committee said the House Republicans' budget proposal for the 2012 fiscal year that begins Oct. 1 will propose fundamental changes to Medicare and Medicaid, the giant healthcare programs that cover 100 million Americans and whose combined costs rival the defense budget. Ryan offered no specifics, saying details are still being hashed out.