This past summer, Hahnemann University Hospital—a teaching site for Drexel University College of Medicine in Philadelphia—closed their doors. When Hahnemann closed, its’ residents were essentially “orphaned,” losing their jobs overnight. Residency refers to the post-graduate training period following medical school graduation compulsory for a physician to be licensed to practice medicine. After “matching” to an open residency position at a given teaching hospital, resident training begins across the entire nation on July 1st every year once a contract is signed with the employing organization.
Health care inflation continues to exceed the base inflation rate. Health insurer CEO compensation has ballooned out of control –in 2017, Cigna CEO David Cordani took home $43.9 million, Humana CEO Bruce Broussard made $34.2 million, and Aetna CEO Mark Bertolini earned nearly $59 million. That’s approximately $162,000 per day.
For the first time in a decade, the number of uninsured children in the United States increased in 2018. Apple Health seemed like the quintessential success story because it expanded Medicaid coverage for children — in Kitsap County alone, the number enrolled grew from 9,000 to over 21,000 in the last 10 years. However, Medicaid reimbursement also decreased by more than 35 percent, after a federal provision that kept Medicaid payments on par with Medicare expired in 2015. Some states set aside funding to maintain rates equal to those of Medicare, but Washington was not one of them.
During the same period, the U.S. maternal mortality more than doubled, skyrocketing from 9.8 to 21.5 maternal deaths per 100,000 live births. That’s six times higher than most Scandinavian countries and three times higher than Canada and the United Kingdom. In the U.S., around 700-900 women die and another 65,000 experience life-threatening complications during or after childbirth. By any standard, the U.S. has the worst performance on this crucial measure of any country in the developed world.
In the fiscal fight over health care costs, pediatricians are on the chopping block. In hospitals and clinics across the country, pediatricians are being laid off in droves, leaving the clinical burden to mid-level providers, family physicians, and emergency room doctors. These decisions are being made by suits over scrubs, and they are putting patients at risk.
The unforeseen casualty in this story is the pediatric department at MedStar Franklin Square Hospital. On April 3rd, 2018, MedStar abruptly announced all pediatric inpatient care and emergency services were closing, effective April 6th, and all pediatric staff, including eight physicians, were terminated. Sadly, Baltimore County is home to some of the nations’ most vulnerable families, struggling with high rates of drug addiction, domestic violence, and poverty.
Our Government should be Of the people, By the people and For the people – not Of Target, By Amazon, and For Berkshire Hathaway. Being seen by a midlevel provider at a big box retailer cannot save money. Lawmakers sponsoring H.R 5138 are doing the nation a grave disservice by sponsoring this atrocious legislation.
While the American Board of Medical Specialties (ABMS) argues MOC participation makes for better doctors, no credible proof supports this assertion; only initial board certification has been scientifically validated. Seven states already eliminated MOC compliance to maintain licensure, physician hospital employment, or insurance contracting, however this same freedom must be extended to the other 43.
Mayo has fractured trust by misrepresenting operating losses in Albert Lea to justify hospital closure, Dr. Noseworthy condoned prioritizing patients based on their pocketbooks while third quarter earnings went through the roof, and hospital leadership condescendingly compared driving 23 miles in labor as being equivalent to buying ice cream.
Micro-hospitals are best suited to handle short-stay admissions anticipated to be less than 48 hours. Costs are slightly higher than for an urgent care center, yet lower when compared to traditional hospital settings. Micro-hospitals can meet 90 percent of patients’ basic healthcare needs and tend to flourish most in markets with critical service gaps by preventing at-risk populations from falling through the cracks. Ideally, micro-hospitals should be located within 20 miles of a full-service hospital, to facilitate transfer of patients to larger institutions should higher acuity healthcare needs arise.