Officials say NHS maternity units will likely remain short-staffed despite a recent surge in the number of midwives promised by the Government. The number of births handled by each midwife has increased over the past several years—the average midwife is now delivering nearly 25% more babies per year than is allowed under current safety standards. Many worry that this could be placing mothers and their babies at risk.
Beijing, China plans to invest 850 billion yuan ($125 billion) over the next three years to revamp the country's healthcare system. Leaders say this will provide all Chinese citizens, particularly those in rural areas, with access to basic care through expanded insurance and cooperative medical programs. Experts say, though, that the plan's success will not come easily.
Thailand's Bumrungrad International Hospital will soon install a wireless system to allow doctors and nurses to access electronic medical records. The system will feature Motorola handheld digital assistants for medical staff to be used for communications, to access medical records, and to scan barcodes on medicine labels to ensure they go to the right patient. The hospital will also soon feature computers in every patient room.
In a 15-8 vote, the Senate Finance Committee approved Kansas Governor Kathleen Sebelius' nomination Tuesday morning as secretary of the Department of Health and Human Services. Her nomination now goes to the Senate for a full vote.
No time has been scheduled for the confirmation vote, although it is expected to come soon. Two Republicans, Olympia Snowe of Maine and Pat Roberts of Kansas, supported Sebelius.
Before the committee vote, Sen. Jon Kyl (R Ariz.) said he was not satisfied with Sebelius' earlier explanations of her and the administration's position regarding of "comparative effectiveness," in which the government compares medical treatments to determine which are most effective. Kyl said that Sebelius, who was not in attendance for the panel vote, offered no guarantees that test results could be used by the government to deny payment for some treatments.
If confirmed by the Senate, Sebelius is expected to take a major role within the Obama administration of overseeing healthcare reform proposals.
Sebelius' nomination has not been without several bumps in the road. Several Republicans had voiced concerns about Sebelius' ties to a late term abortion physician in Kansas who had donated earlier to her campaign. Also, she recently paid nearly $8,000 in back taxes after discovering errors in her 2005, 2006 and 2007 tax returns.
Even with the passage last year of national mental health parity legislation, large gaps in access to mental healthcare services appear likely to remain—unless these issues are addressed in upcoming healthcare reform efforts, according to a new study.
In particular, the new parity law likely will have no major effect on severe access problems to mental health services for the uninsured, as well as problems related to the shortage of mental healthcare providers in some areas, says Peter Cunningham, PhD, a senior fellow at the Center for Studying Health System Change in Washington, who conducted the study. The study appears as a Web exclusive this month in the journal Health Affairs.
About two thirds of primary care physicians reported in 2004 05 that they could not get outpatient mental health services for patients, which is more than twice the rate reported for three other common referrals: other specialists (33.8%), imaging services (29.8%), and nonemergency hospital admissions (15.8%). This data was obtained through a survey that tracks the experiences of primary care physicians in 60 communities across the country.
While the survey data preceded passage of the Wellstone Domenici Mental Health Parity and Addiction Equity Act of 2008—which mandated mental health parity in private insurance benefits—the study found that some states' mental health parity laws only had a small effect on decreasing mental health access disparities.
"I don't think we'll see a big difference after parity is fully implemented," Cunningham said in an interview. "I think the question is if there is meaningful health reform this year. And, assuming health reform will include mental health care . . . then I think that's when you would expect to see a much bigger impact."
"What the parity legislation did is address the discrepancy in coverage of mental health services from physical health services—but that only applies to private insurance policies that provide any mental health coverage," he said. "It doesn't require health plans to provide mental health services. If they do, then it has to be comparable to the benefits for physical health problems."
The study also found that communities with high numbers of underinsured and uninsured people tended to have only small percentages of their insured populations enrolled in health maintenance organizations. Enrollment in HMOs might otherwise offset some of the coverage and provider shortage problems through better coordination and integration of care and lower cost sharing, Cunningham noted.
Provider availability was another issue. For example, pediatricians were more likely than other primary care physicians to report problems getting mental health services for their patients because of health plan barriers and shortages of mental health providers—and not because of lack of or inadequate coverage.
The lack of access to specialty mental health providers in turn is likely a contributing factor to the rising rates of mental health problems being treated in the general medical sector, the study noted. Also, problems with mental health care access are especially severe for the low income uninsured—even for many Medicaid enrollees—as public mental health services are cut back in many areas.
Hartford Hospital, which was placed on a one-year probation last February, remains on probation, and a Connecticut official said a new end date has not been determined. Earlier this year, state regulators identified a number of new healthcare violations at the hospital.
Some of the newly reported violations occurred before the hospital implemented policy changes or staff training programs to address problems that gave rise to the initial probation. Others occurred more recently.
House Speaker Nancy Pelosi visited a struggling Hollywood, FL, health clinic to put a positive spin on the federal government's massive spending plan, days after protesters across South Florida and the country decried government largess. Broward Community and Family Health Centers is receiving nearly $1.5 million in federal aid, saving a doctor and a nurse from impending layoffs and allowing 11 new employees to launch a satellite office. The nonprofit clinic says the additional staff will serve an estimated 6,600 low-income patients.
Mayo Clinic is the latest to offer a free, secure, online website for anyone to store and organize medical information. Such sites are designed to replace the proverbial shoebox of medical documents kept at home. Unlike some of its competitors, Mayo Clinic Health Manager will offer more than a place to organize medical data. It will also push out customized information, such as reminders for checkups.
Park Nicollet Health Services announced it is cutting 233 jobs, the second big round of layoffs in less than five months at the Minnesota-based hospital and clinic chain. The 233 jobs make up the equivalent of 118 full-time employees, or 1.8% of Park Nicollet's total workforce. Park Nicollet said it would also merge several leadership positions, make some employees take two weeks' unpaid leave before the end of the year, and do away with its 401(k) match for 2009.
Thousands of people could be kicked off the state-subsidized Basic Health Plan under a bill approved by the Washington House. The bill debated would kick off thousands of people who are getting separate medical benefits from the Department of Social and Health Services.
Basic Health officials would also get authority to remove more people, based on their income, their ability to get other health coverage, and how long they've been on Basic Health.
