Organizers protested at the Philadelphia headquarters of Independence Blue Cross' due to the insurer's request to increase health insurance premiums 20% to 58% for some plans available to individuals and families who do not get health insurance at work, but who buy it on their own. For example, in one plan, the monthly premium cost for a family with two parents in their 30s would rise from $1,069.15 a month to $1,634, a 52.8% increase, according to the company's filings with the Pennsylvania Department of Insurance.
Healthcare reforms aiming for universal coverage won't provide insurance for illegal immigrants and may not address the cost to state and local governments for providing medical care to this large group of the uninsured, the chairman of the Senate Finance Committee announced. "We're not going to cover undocumented aliens, undocumented workers," Sen. Max Baucus, D-Mont., said at a meeting with reporters. "That's too politically explosive."
For the first time, Richard Scrushy was confronted about the fraud at HealthSouth Corp. as a trial witness in open court. Stockholders of HealthSouth are suing Scrushy, saying he spent the company's money as his own and ordered phony earnings from 1996 to 2002. They are seeking $2.6 billion in damages.
Michigan Attorney General Mike Cox is challenging rate hikes proposed by Blue Cross Blue Shield of Michigan on nearly 200,000 senior customers who buy the insurer's Medigap plans. Cox filed a petition for a rate hearing with state insurance regulators to oppose the 31% increase, which could raise premiums on supplemental Medicare plans to as much as $140.29 a month for some.
One fight in the health-reform debate so far has been over whether to create a government-backed health plan to compete against private insurers. An option that is emerging in the search for a compromise: Give health insurers a few years to cut costs and increase access, and leave a government-backed health plan as a fallback option that would be created only if private insurers do not measure up.
GM and the United Auto Workers reached a tentative deal that could help GM reduce its $20 billion worth of retiree healthcare obligations. The costs of U.S. healthcare have taken a particularly heavy toll on the auto industry, which used to offer high-end, life-long health benefits to its workers. Now, the industry has been struggling to make good on its healthcare promises.
Parents in New York City have turned to hospital emergency rooms as the swine flu scare continues in the city. With school closings being announced daily due to the threat, parents have flocked to ERs with children who are feeling ill to find out if they have swine flu.
Want to compare the cost of getting a laporoscopic hysterectomy in Sacramento? Or a heart valve replacement in Riverside? How about correcting urinary incontinence in Santa Barbara?
California's Web tool will give you the numbers with a few clicks. For example, the charges for a lap hysterectomy range from $38,089 at Mercy General, $59,719 at Sutter Memorial and $78,418 at the University of California at Davis Medical Center.
The heart valve operation will cost $340,700 at Desert Regional Medical Center in Palm Springs, $146,793 at Eisenhower Memorial in Rancho Mirage and $146.793 at Riverside Community Hospital. And for urinary incontinence, Santa Barbara's Lompoc Valley Medical Center charges $10,070, Marian Medical Center bills it at $23,616 and at Santa Barbara Cottage Hospital, it will cost $25,642.
"This is just the beginning," says OSHPD spokesman David Byrnes.
The Web site also includes each hospital's average length of stay for each procedure.
Byrnes cautions that for those covered by health insurance policies, this is not what patients pay, but merely reflects what each hospital bills. Also, he points out, "if you're underinsured or uninsured, you can negotiate these charges."
"Anytime you can provide consumers more information on the healthcare they are receiving it is a bonus," Byrnes said. "While these prices are not what the typical health plan, Medicare or Medi-Cal actually pays, they do provide the average 'sticker price' for these common procedures. The 'sticker price' is like the MSRP in the car dealership world. No one really ever pays it, but it helps you shop around and get familiar with different price points."
Asked why the state doesn’t supply the actual price that consumers, health plans, and government agencies pay for such procedures, Byrnes says, "If that data was available we'd post that information too."
OSHPD director David Carlisle, MD, said offering value of cost and price information is important as consumers are given more healthcare decisions. "Using our patient discharge datasets, this tool allows consumers to access data about common inpatient procedure prices in an easy to use online setting," says Carlisle.
For now, the Web site offers county-by-county, and city-by-city comparisons for 28 procedures. They include surgeries involving the digestive system, female system, heart and circulation, male system, obstetrics, skeletal, and urinary tract.
One can compare gastric bypass procedures and gall bladder operations performed through laparoscopy versus open techniques, vaginal deliveries versus C-sections, and replacement of hip or a knee or the removal of a disc.
California is among the first states in the nation to use discharge data that hospitals are required to provide to help consumers make better choices. Other states that have similar Web-based tools include Wisconsin, Texas, Iowa, Utah, and Virginia.
As far as Senate Finance Committee Chairman Max Baucus (D-MT) is concerned, healthcare reform is right on target.
"We planned for some time that our mark-up would be in mid-June. It's going to be mid-June," he said at a Thursday morning conference in Washington with reporters.
As for odds for a bipartisan agreement on legislation, he was optimistic—giving it a 75% to 80% chance of approval. "I've met with a lot of Republicans who want to vote for something that passes. They know it's the right thing to do."
The odds of having a public plan option in the final bill are good. Baucus was not saying exactly what that plan would look like--though he has one in mind. "Everything is going to stay on the table, but portions of it will be sculpted," he said, referring to the option. "That's a hot button."
Baucus said he wanted public and private health providers to work together on delivery system reform. The way he envisioned that happening was to direct the Centers for Medicare and Medicaid Services to work with the private sector to develop quality metrics so they would be "working on the same page."
Citing Congressional Budget Office figures, he said he anticipated that reform legislation would cover approximately 94%-95% of the American population. Those not likely to not be included for coverage, though, are undocumented workers. The issue of including those workers would be "too politically explosive," he said. "But the point I'm making is that you will get near-universal coverage."
Baucus said he still sees changes in practice patterns—by eliminating overutilization--as a way to bend the ascending healthcare cost curve. "There's a lot of waste in the system," he said citing CBO's estimate that 29% of the $2.5 trillion spent on healthcare annually--or $800 million--was waste.
Also on Capitol Hill, Republicans have introduced their own comprehensive legislation. The Patients' Choice Act, introduced Wednesday by Senators Tom Coburn (R-OK) and Richard Burr (R-NC) and Reps. Paul Ryan (R-WI.) and Devin Nunes (R-CA), includes goals similar to what Democrats are considering as they draw up their own legislation--although they make it clear they will oppose any "government-run programs." They proposed using "state-driven exchanges to facilitate real competition" between private plans to provide coverage.
If a patient sees armed security officers in your hospital, it's hard to predict how the person will react.
On one hand, seeing officers with guns, Tasers, or batons may provide patients with a sense of relief that security can handle violent incidents and deter dangerous behavior. On the flip side, armed security officers may contribute to an institutional feel at the hospital, which may not keep with the welcoming atmosphere facilities want to project to the community.
There is no concrete solution in the decision to arm security officers. With all of the regulations that govern the healthcare industry, decision-makers for hospital security remain free of guidelines for weapon use.
Liability concerns will ultimately influence the choice of arming or not arming security officers, says Earl Williams, HSP-M, safety specialist at BroMenn Healthcare in Normal, IL.
"CEOs would be interested in that [aspect]," Williams says. "If you arm guards and there's a death, do you have insurance to handle that? Do you want to deal with that?"
BroMenn doesn't arm its security officers, whose services are contracted out to a vendor. However, the officers do carry pepper spray, showing there is a gray line between what is and isn't considered a weapon.
Tasers and similar stun guns have grown in popularity at hospitals, as they have proven in some cases to be an effective step down from deadly force. Such was the experience at WakeMed Raleigh (NC) Campus, part of WakeMed Health and Hospitals, Inc., which began providing Tasers to its security officers about five years ago.
The hospital got an overwhelmingly positive response from officers who received the Tasers, says Lisa B. Pryse, BS, CHPA, CHSP, chief of campus police at WakeMed.
A trio of considerations
Ask your in-house or contracted security supervisors to evaluate the following three points regarding arming officers, as outlined by Williams:
Police cooperation. A strong relationship with local police could eliminate the need to arm hospital security officers if the police could respond to an incident quickly.
Security data about violence situations. Weapon use should in part be based on whether a hospital has historically dealt with violent people. "Most of the people you have problems with in the hospital are people who are mentally impaired or situationally impaired in that their brother or their wife or their mother or their dad is dying, and so they're mentally not really connected," Williams says. "Most of those can be handled in a nonviolent situation." For example, some hospitals choose de-escalation training or roving canines over weapons based on the cases they deal with and liability concerns. Other medical facilities, however, feel justified on arming security officers based on given threats, such as patients and visitors trying to bring their own weapons into the building.
Funding for weapons programs. Purchasing weapons, training staff members, certifying carriers, and licensing them all cost money, and there's no way to cut corners without risking officer safety and the hospital's reputation. Administration needs to earmark sufficient funds for any weapons program.
Answers to all of the above points may be clearer after conducting a security risk assessment to weigh the potential threats, Williams says.
The Joint Commission requires accredited hospitals to identify security risks as part of its environment of care standards. The commission has no position on arming security officers, instead letting individual hospitals make that determination.
However, surveyors have been known to pull training records of security officers with weapons at their sides, particularly those guarding the emergency department.
