5 Provocative Articles Salvaged from the Shuffle

By Bill Santamour	October 20, 2011
From topnotch hospital management to 'quackademic medicine'

So much health care news comes at us so fast and furiously that no matter how diligently we try to keep up, thought-provoking and useful information is bound to get lost in the whirlwind. Here are five recent pieces from a variety of sources on a wide variety of health care issues that I found worthwhile ? and hope you do, too.

1. The Miami Herald in September reported how strong, "old-fashioned management" has allowed Memorial Healthcare System in South Florida ? which includes four public hospitals ? to improve services while cutting its tax rate by 41 percent. Keys to that success include a tight rein on expenses and expansion into affluent areas where paying patients balance the largely uninsured population the system has historically served. The lower 2012 tax rate is expected to bring in only $22.4 million, and longtime CEO Frank Sacco says all of it will fund outpatient services, particularly primary care for the uninsured. The Herald says Memorial will also use $2 million in tax money to fund uninsured patients in its nursing home.
2. After the Obama administration scrapped the Class Act, New York Times blogger Ron Lieber wrote that he's "enraged by the fact that nobody wants to talk about" how older Americans are supposed to pay for nursing homes and other long-term care that cost tens of thousands of dollars a year. You could try to buy private insurance, Lieber wrote in his Oct. 17 "Bucks" blog, but insurance companies that offer long-term care coverage "are either rapidly raising prices or getting out of the industry altogether." Reader response, including from the insurance industry, was lively, to put it mildly.
3. Reuters reported in October that millions of Americans who have lost insurance coverage or seen their insurance premiums and out-of-pocket costs soar are choosing to endure pain rather than undergo elective procedures that may alleviate it, such as hip or knee replacement. The article was primarily about the negative impact on the medical device industry, but you and I know that the drop in elective surgery also hurts providers' bottom lines. Reuters noted that some older patients are waiting until they are 65 and eligible for Medicare to get replacement surgery. With Medicare reimbursements expected to tighten under health reform, hospitals and physicians are likely to take a harder look at the pricing and use of medical devices.
4. Will older Americans take advantage of preventive services that will soon become available to them under Medicare? The question was posed in an October article in the Palm Beach Post, which noted that starting in January, everyone enrolled in either the original government-run plan or in Medicare plans provided by private insurers will be eligible for free or low-cost flu shots, mammograms, smoking cessation counseling and 15 other services. However, this year, when Medicare offered recipients free wellness visits to their doctors to assess their risk for such conditions as high blood pressure and diabetes, only 5 percent of Floridians enrolled in original Medicare took advantage of the offer. The Post notes that preventive care can catch conditions before they become more dire and more costly to treat, saving huge bucks for the nation's health care system. Hospitals, doctors and others must do a better job of getting the word out to seniors and counseling them on which services they should access.
5. The Oct. 5 KevinMD blog noted that more medical schools are starting centers of integrative medicine ? a fact that disturbs many health care professionals and which one physician refers to as "quackademic medicine." That hospitalist asserts that integrative medicine proponents make "quacky claims" unsupported by solid research and evidence, but that is "so appealing and sensational to the uncritical public that patients are willing to pay handsomely for it out of pocket." Another expert asks, "When did Jenny McCarthy become a medical thought leader?" and suggests that health care professionals must learn to use social media to spread the message about evidence-based medicine. If they don't, writes KevinMD, "others with less medical expertise will fill that void, and become online health authorities."

Bill Santamour is managing editor of Hospitals & Health Networks. Follow his tweets at www.twitter.com/hhnmag.

The opinions expressed by authors do not necessarily reflect the policy of Health Forum Inc. or the American Hospital Association.

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