Monthly Archives: October 2016
Appeals court blocks Penn State Hershey Medical Center-PinnacleHealth merger
A federal appeals court has reversed a lower court ruling and ordered a preliminary injunction against the proposed Penn State Hershey Medical Center-PinnacleHealth System system merger.
The 3rd U.S. Circuit Court of Appeals in Philadelphia voted in favor of the injunction, which reversed a May decision by a federal judge, saying the U.S. Federal Trade Commission and Pennsylvania officials would likely be successful in showing the merger could cause price hikes for patients and would harm competition, according to the decision.
The injunction will allow the FTC to further review the proposed merger, would mean the combined system would garner support 76 percent of the population around Harrisburg.
Allina nurses reject contract, remain on strike
Allina Health hospital nurses voted Monday night to reject a contract offer from their employer, increasing the likelihood that their walkout over health benefits, staffing and safety concerns will go down as the longest nursing strike in Minnesota history.
While the Minnesota Nurses Association had not recommended a “no” vote, many nurses said they felt Allina’s latest offer was too similar to one they rejected in August, and to the terms their union negotiators rejected during last-ditch negotiations in September to avert a strike.
A new sign reading “New Lipstick, Same Pig” appeared at the picket line outside Allina’s Abbott Northwestern Hospital in Minneapolis Monday morning, foreshadowing the vote result that the union announced at 10:30 p.m. in St. Paul.
While she declined to provide exact results, MNA executive director Rose Roach called the vote margin “resounding” and said it sent a clear message from front-line nurses to go back to the bargaining table. “Each of them voted with their conscience, and with their patients and their families in mind,” she said.
The results mean that strikes will continue at Abbott as well as United Hospital in St. Paul, Mercy Hospital in Coon Rapids, Unity Hospital in Fridley and the Phillips Eye Institute in Minneapolis.
More than 4,000 nurses have been on strike for 29 days, since Labor Day, after a one-week walkout in June. The state’s longest nursing strike, in 1984, lasted 38 days.
Election 2016 FAQ: Proposition 52, Private Hospital Fees For Medi-Cal
The Basics
In California, private hospitals pay an annual fee to the state that in turn helps bring in additional federal funds for Medi-Cal, the state’s health care program for low-income Californians. One in three Californians get their health care through Medi-Cal. The funds generated by the fee cover hospital services for Medi-Cal patients and health care for low-income children.
Hospitals originally approached the Legislature to create the “Hospital Quality Assurance Fee,” which state lawmakers enacted in 2009. This law is slated to expire in 2018. Proposition 52 would make the fee permanent and would make it tougher for the Legislature to use the money for other purposes.
The federal government matches state spending on health care for the poor, so the more California puts up for Medi-Cal, the more federal dollars it receives. The hospital fee boosts the state’s fund for Medi-Cal and thus attracts more federal money. Those dollars are then paid back to the hospitals to reimburse them for caring for their Medi-Cal patients.
What you’re voting on
Hospitals say the fee system is crucial to California’s medical safety net. They say they spend more to treat Medi-Cal patients than government reimbursement covers. The supplemental federal money hospitals get helps shrink their deficits. The estimated net benefit to hospitals in 2015-2016 was $3.5 billion.
Hospitals also contribute around $1 billion annually for children’s health care. This extra money acts like a handling fee that hospitals pay the state so the Legislature partners with them on Medi-Cal matching funds. Hospitals want to cement this law rather than have it re-upped every few years to avoid uncertainty and to make sure the amount of the extra fee for children’s health care doesn’t continue to increase, as it has in years past.
Proposition 52 requires a two-thirds vote in the state Legislature to end the program or to divert money from the hospital fee away from Medi-Cal. That’s something that lawmakers did in 2011, when they used approximately half a billion dollars for other purposes.
Cartoon – Shared Leadership Model
Cartoon – Leadership by Words
Cartoon – Should there be a sudden loss of consciousness
A Bygone Era: When Bipartisanship Led To Health Care Transformation
People might be forgiven for thinking that the Affordable Care Act is the federal government’s boldest intrusion into the private business of health care.
But few know about a 70-year-old law that is responsible for the construction of much of our health system’s infrastructure. The law’s latest anniversary came and went without much notice in August.
The Hill-Burton Act was signed into law by President Harry S. Truman on August 13, 1946 — and its effect on health care in the U.S. was nothing short of monumental. Perhaps more importantly, it stands as an example, warts and all, of how a bipartisan Congress can forge compromises to bolster American infrastructure and boost the well-being of our people.
Known formally as the Hospital Survey and Construction Act, Hill-Burton started as a Truman initiative. In November 1945, only two months after the official end of World War II, he gave a speech to Congress outlining five goals to improve the nation’s health. The first and least controversial of these called for constructing hospitals and clinics to serve a growing and rapidly demilitarizing population.
Hill-Burton provided construction grants and loans to communities that could demonstrate viability — based on their population and per capita income — in the building of health care facilities. The idea was to build hospitals where they were needed and where they would be sustainable once their doors were open.
Over the subsequent decades, new facilities sprang up all around the country, including many in the 40 percent of U.S. counties that lacked hospitals in 1945.
By 1975, Hill-Burton had been responsible for construction of nearly one-third of U.S. hospitals. That year Hill-Burton was rolled into bigger legislation known as the Public Health Service Act. By the turn of the century, about 6,800 facilities in 4,000 communities had in some part been financed by the law. These included not only hospitals and clinics, but also rehabilitation centers and long-term care facilities.
In 1997, this type of direct, community-based federal health care construction financing came to an end. However, numerous Hill-Burton clinics and hospitals still exist around the country, specifically financed by a part of law to provide care to those unable to afford it.
A month after enactment of the law, Truman, a Democrat, appointed Republican Sen. Burton to the Supreme Court in a bipartisan gesture that doesn’t seem imaginable in today’s polarized political landscape. And consider this: Burton was unanimously approved by the entire Senate the same day he was appointed. With no committee hearings! He joined the court the very next day.
“Hill-Burton speaks to an earlier time in our history when the American people and those who represented them had confidence that government could do good things,” Markel said. “And that makes it all the more phenomenal to me.”
No one knows how many patients are dying from superbug infections in California hospitals
We, the community of physicians, had been watching these patients die and trundling them off to the morgue for years.— Dr. Barry Farr, former president, Society for Healthcare Epidemiology of America
California Governor Signs Flurry Of Health Laws
AB 72: “Surprise medical bill” legislation by Assemblyman Rob Bonta (D-Oakland) was among the most-talked-about measures of the year in Sacramento. It promises to better protect consumers against unexpected medical bills.
SB 482: Amid a national opioid epidemic, Brown approved legislation that requires doctors to check a patient’s prescription history in a state database before prescribing any potentially addictive drugs.
SB 586: The legislation, a compromise between the Department of Health Care Services and children’s advocates, aims to slow down and improve plans to overhaul the way the state’s most medically fragile children receive care.
SB 908: This bill will allow consumers to learn when their health insurance premium rates have been considered “unreasonable” by state officials. Current law requires that unreasonable rate hikes be posted online by one of the two state agencies that regulate insurers — the Department of Managed Health Care or the California Department of Insurance. But consumers don’t check online, the bill’s supporters argued.
SB 1076: This law, sponsored by the California Nurses Association, was designed to protect hospital patients in “observation” care. It requires that observation units meet the same staffing standards — nurse-to-patient ratios — as those in the emergency room.
HENRY KOTULA 