The Iowa House overwhelmingly approved a narrowed version of a health insurance bill that sparked bitter arguments in the Senate last month.
The bill was approved without debate on a 92-3 vote. One of the main changes made by the House was deletion of a "health insurance exchange," a state commission that would have helped uninsured Iowans find affordable coverage. The bill now returns to the Senate, where Majority Leader Mike Gronstal predicted the two chambers would work out their differences.
Some doctors in retirement are taking a look at their shrunken investment portfolios and having second thoughts, but they're finding that getting back in front of patients isn't so easy. A report from the American Medical Association finds taht retired docs who want to make a comeback sometimes have to go through re-entry programs or catch up on continuing medical education, while at the same time having to contend with concerns that they won't stick around for long.
As lawmakers wrestle with how to pay for a proposed healthcare system overhaul, an emerging flashpoint of debate is whether higher-income employees should face steeper taxes on health benefits than those with more-modest income. The greatest chance for bipartisan accord, for now, is in the hands of two Senate players: Finance Chairman Max Baucus and his Republican counterpart, Sen. Charles Grassley of Iowa. Baucus favors taxing some employer-provided health benefits. But congressional Democrats and Republicans may have difficulty finding common ground on how to limit the tax benefits that currently favor employer-based health plans.
The physician in charge of the federal government's push to move healthcare to electronic records from paper files faces "huge challenges" as he starts his new job in Washington. That phrase comes from a paper David Blumenthal himself published recently in the New England Journal of Medicine. He cited low adoption rates, high costs, technical complexities, and physician and patient concerns about privacy.
The chairmen of two Senate committees told President Obama that by early June they would finish writing legislation on healthcare to "provide coverage to all Americans." The commitment came from Senator Max Baucus, the Montana Democrat who is chairman of the Finance Committee, and Senator Edward M. Kennedy, the Massachusetts Democrat who is chairman of the Committee on Health, Education, Labor and Pensions.
In 1989 and again in 1994, a clear majority of nurses at a Louisville, KY-based Norton Audubon Hospital signed cards saying they wanted a union. But each time a majority of the nurses later voted down the idea when it was put to a secret ballot. Organized labor points to the fight at Norton Audubon as proof that America's labor laws need to be overhauled: judges ruled that management had prevailed by illegally intimidating and firing nurses. Nurses who want a union plan to try again, and they had expected President Obama and Congress to retool labor laws to make it easier to win. Instead, organized labor may be facing a major setback in the contentious fight over labor laws.
As immigrant communities swell around the country, hospitals, clinics, and other healthcare providers are increasingly confronted with language and cultural challenges that can discourage people from seeking care and lead to calamitous errors in diagnoses and treatment regimens. Hospitals and doctors, however, are wary of the cost of interpretation services, which can run up to $190 an hour. They say the government, not them, should pay these costs.
As Congress returns to begin the debate over reshaping the nation's $2.2 trillion healthcare system, left-leaning organizations and liberal House members are telling their Democratic allies: Don't cave on us. The early skirmishing is perhaps the clearest indication yet of the uphill battle President Obama faces in delivering on his promise to make affordable, high-quality care available to every American. Disputes over whether to create a new government-sponsored insurance program to compete with private companies shine a light on the intraparty fissures that may prove problematic.
The fear of layoffs is prompting more employees to use their health benefits while they still have a job. This stepped-up plan participation comes even as companies are shifting the mounting costs for health benefits onto the backs of employees, according to a new survey by the International Foundation of Employee Benefit Plans.
"Plan participants are feeling anxious about the possibility of increased cost-sharing and a reduction in benefits due to the financial crisis," says Sally Natchek, senior director of research for the Brookfield, WI-based IFEBP. "These fears are not unfounded."
Survey responses indicate that only 3.6% of companies are cutting or considering cutting healthcare benefits, and many will increase cost-sharing. Thirty-five percent of the companies say they are increasing employee deductibles, coinsurance, or copays due to the financial crisis. A similar percentage of companies are also increasing employee premiums. Other cost-sharing actions that plan sponsors are taking include adding consumer-driven health plans as an option (12.8%), replacing a current plan with a consumer-driven plan (9.6%), and instituting spousal charges (10.8%).
Plan sponsors aren't the only ones reacting to the recession. Survey respondents are reporting that plan participants, perhaps fearing an impending layoff, are increasing their use of health benefits.
About one-third of plan sponsors have noticed an increase in the number of participants filling prescriptions and engaging in costly medical procedures before their insurance runs out. Another 24% of companies have seen growth in the number of dependents on their plans. At the same time, nearly 18% of companies have introduced or are considering dependent eligibility audits.
Even those who are hanging on to their jobs are struggling with healthcare costs. About one-fifth of survey respondents report plan participants are delaying medical care and skimping on prescription drugs because of financial problems.
"The financial crisis has led some to conclude that healthcare and the economy are inextricably linked. You can't separate one from the other," says Natchek. "Given the burden of growing healthcare costs, it's likely that healthcare reform will continue to be at center stage. Eighty-five percent of responding plan sponsors believes that the financial crisis has made major federal reforms more likely."
The upside of today's climate is a heightened focus on wellness programs. Eighteen percent of the respondents have introduced or are considering introducing wellness initiatives due to the economy. The survey of International Foundation of Employee Benefit Plans members was conducted March 30-April 6. Respondents included corporate plan sponsors, public/governmental plans, multiemployer benefit funds, and others with benefit plans.
Last Thursday, Diana Hendel, CEO of Long Beach (CA) Memorial Medical Center, had the unenviable task of flanking the city's mayor and police chief in a televised press conference to discuss a murder-suicide at the hospital earlier that day.
Hendel took the role of promising the public that the medical center—like other healthcare facilities, a pillar of the community—was still a safe place to go. "I can assure you that our patients are well-cared for and are completely safe," Hendel said during the press conference, which was also posted online.
There may have been no stopping the shooting, during which an outpatient pharmacy technician at the hospital shot and killed an executive director of the pharmacy and a supervisor before fatally turning the gun on himself.
Such situations should prompt CEOs to consider security-based training drills that involve one or more people brandishing firearms.
"Most hospitals haven't looked at how to keep people safe during an active shooter incident," said Richard Sem, CSC, CPP, president of Sem Security Management of Trevor, WI, who spoke in February to HealthLeaders Media's sister publication, Briefings on Hospital Safety.
Generally, healthcare workers are a caring group who don't always acknowledge real dangers in front of them. "They're so trained to help [people], but there are some situations where they just need to get out of the way," Sem said.
Eyewitness accounts given to the local press in Long Beach seem to indicate that clinicians and security officers at Long Beach Memorial Medical Center did in fact attempt to shelter patients and visitors after gunshots rang out.
Training drills involving gun scenarios are the best way to underscore how critical a real crisis is, Sem said. These exercises also help physicians and nurses to switch gears from trying to help the person with the gun to protecting the unarmed people around a suspect.
As of Monday afternoon, police had not released a motive for the shootings in Long Beach, according to a department spokesperson. But Police Chief Anthony Batts said during the press conference last Thursday that America's economic down spiral may be to blame in the bigger picture.
"I think this is a trend of active shooters that you've seen nationwide . . . probably because of the tension that is going on in our society today," Batts said.
In March, a man allegedly opened fire in a nursing home in Carthage, NC, hitting 11 people and killing eight of them, including residents and a nurse.
Less deadly gun incidents are common in hospitals. For example, in January, an agitated family member of a patient allegedly pointed an unloaded gun at a security officer at Crouse Hospital in Syracuse, NY.
