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US Healthcare leadership oxymoron 12: an update

by Miki Saxon

healthcare.jpgAwhile back I wrote several posts (rants?) on healthcare problems and some of the really terrible things that make my blood boil.

Over the last couple of weeks several new article caught my eye and I wanted to bring them to your attention.

1. Following up a February post on doctors and medical researchers extensive conflicts of interest resulting from pharma industry funding and gifts.

Amazingly enough, two industry giants, Pfizer and Zimmer, which manufactures hip, knee, and elbow implants, are concerned about a potential conflict—although not about funding or gifts. This one is about ongoing physician education, often funded by industry players.

“At the center of this controversy are medical communications firms paid by pharmaceutical and device companies to produce physician-education courses. Critics say the manufacturers hire the marketing firms as intermediaries to help them influence doctors’ prescriptions and procedures.”

Gee maybe all the articles, investigations and general negative publicity coupled with a consumer revolt that might force action in Washington are having an effect.

2. It’s disgusting that financial institutions buy the debt of the un/under insured and then charge exorbitant interest rates on it.

Now the light is being shined on a practice that drives one more nail to the inability to buy insurance—assuming that you can even afford it.

“An untold number of people have been rejected for medical coverage for a reason they never could have guessed: Insurance companies are using huge, commercially available prescription databases to screen out applicants based on their drug purchases. … Most consumers and even many insurance agents are unaware that Humana, UnitedHealth Group, Aetna, Blue Cross plans, and other insurance giants have ready access to applicants’ prescription histories. These online reports, available in seconds from a pair of little-known intermediary companies at a cost of only about $15 per search, typically include voluminous information going back five years on dosage, refills, and possible medical conditions. The reports also provide a numerical score predicting what a person may cost an insurer in the future.”

3. We all know how important it is to wash our hands, but many of us are careless about doing it—including healthcare providers.

“Despite recommendations, nearly 60 percent of health-care workers do not wash hands while on duty. … Why? … For one thing, rigorous hand washing is time-consuming. Guidelines advise that we first rinse, then soap for 20 seconds, then rinse again for 30 seconds; after this, we paper-dry our hands and turn the faucet off using the paper towel. For health-care workers, the procedure is supposed to be followed before and after every patient encounter. That means two minutes per patient visit, which adds up to an hour for a doctor who sees an average 30 patients a day, and 2 1/2 hours per shift for an ICU nurse.”

Now, in an effort to force improvement, “Starting in October, hospitals will be penalized for the consequences of unwashed hands: Medicare will no longer pay for complications arising from certain hospital-acquired infections, which in many cases result from poor hand hygiene. This will be a powerful incentive for health executives to improve hand-washing compliance.”

Will it be an incentive? Or will the hospitals just bill the patient for what Medicare doesn’t cover and then sell the receivables to the highest bidder?

4. A possible bright spot—at least for those who work in large companies. It’s on-site medical clinics driven by the very best motivator—vested self-interest.

“[Toyota’s] medical center, which cost $9 million to build in 2007, could save the company many millions over the next decade. Managed by Take Care Health Systems whose business is running medical clinics, the program has helped Toyota slash big-ticket medical items including referrals to highly paid specialists, emergency room visits, and the use of costly brand-name drugs. Plus, there are big productivity gains because workers don’t have to leave the plant and drive to a doctor’s office for routine medical matters. … A recent study by benefits-consulting firm Watson Wyatt Worldwide found that 32% of all employers with more than 1,000 workers either have an on-site medical center or plan to build one by 2009. “We’re talking about a microcosm of health-care reform,” says Hal Rosenbluth, president of Walgreen’s health and wellness division. “Companies can take control and understand their health-care costs.””

In spite of a few bright spots, I honestly believe that the state of healthcare in the US is a mark of shame on the global stage.

What do you think?

Your comments—priceless

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