California hospital mistakes are now public
The L.A. Times reorted that 1002 preventable incidents happened in California between July 2007 and May of this year. Results are from a new California state law that makes it mandatory to report preventable incidents. The California legislation was passed in 2006.
These incidents are also known as “never events” because they never should happen. They include bedsores, leaving objects in after operations, operating on the wrong patient, operating on the wrong body part, improperly connecting equipment, prescribing the wrong drugs, etc. They result in serious injury and death.
Preventable incidents, called adverse events, harm hundreds of patients in California hospitals each year. Unlike California, most states do not require them to be reported. Other states that require reporting are Maine, Massuchsetts, Pennyslvania, New York, Minnesota, Washington, Vermont.
The legislation requires California hospitals to inform state regulators of occurences of 28 types of dangerous mistakes. By 2015 the public health department is supposed to post the information on the internet, although officials hope to start publishing it sooner.
Some suspect the 1002 number may be low since hospitals typically underreport. becausethis number may be larger than the reported by California. Dr. Donald Berwick, the president of the Institute for Healthcare Improvement, a Massachusetts nonprofit, said that “as many as 15 million patients each year are harmed in hospitals.”
Beginning in October of this year, Centers for Medicaid and Medicare has said they will stop reimbursing hospitals for eight kinds of mistakes. These include bedsores, objects left in patients, and infections acquired from surgery and from catheters.
Info from L.A.Times Hospital mistakes go public. 6/30/08
Has our food become more dangerous?
Since 1990 there have been 13 multistate outbreaks of Salmonella poisoning related to tomatoes. Milk and eggs are the most common sources of Salmonella, but Salmonella can originate from water, meats, fresh fruits and vegetables contaminated with human or animal feces. There have also been recent poisoning involving spinach, peanut butter, pancake mixes, frozen pot pies, and cantaloupes. Expect it to get worse.
One of the reasons is that instead of the locally grown food of the past, food is now being grown and processed in many different states and many different countries, then shipped to your local grocery store. Other producing countries may not be subject to the same regulations that US producers are subject to. These producers may use highly toxic pesticides that have been outlawed in the US, or they may not follow the sanitation procedures that are required of US producers.
Another reason is the commercialization of farming. Corporate farming is very much about profits, and in their pursuit of profits large agribusinesses routinely use methods that endanger the consumer’s health in order to keep overhead down. These methods include excessive use of chemical pesticides, poor sanitation methods, etc.
Big producers, both American and foreign, are able to get away with these practices because of the influence of lobbyists. Lobbying is done in the service of foreign government as well as big agri-businesses. Because of their influence, government watchdogs and legislation is routinely compromised. Unfortunately it is we the consumer who are the sufferer. As the NY Times recently wrote:
Federal authorities have yet to create a stronger set of rules and enforcement procedures. Many parties — food-safety advocates, food producers, Congressional Republicans and Democrats and even some within the F.D.A. — have said such rules are essential to make food safer.
In November the FDA put out a food protection plan, but the Bush administration refused to request money to fund it.
Senator Arlen Specter, Republican of Pennsylvania said that administration delays in seeking money for food protection efforts at the food and drug agency amounted to “criminal negligence.”
Although those most at risk are the very young and the elderly, this issue effects all of us since we do not know the long term risks current food processing methods pose to our health.
Nursing home employees strike for benefits
The NY Times recently ran a sympathetic article on striking workers. According to them, caregivers at Kingsbridge Heights Rehabilitation and Care Center in the Bronx have been on strike since February 20th to protest the owner’s decision to cancel their healthcare coverage.
This story was also run by the NY Post which reports that owner Helen Sieger stopped paying health care premiums in August 2007 violating an agreement she had with the union. It’s not that she can’t afford the premiums. Sieger’s nursing home is one of the most profitable centers in New York. It made $5 million last year, most of it from Medicaid and Medical.
Unable to afford the high cost of asthma medicine as a result of the loss of benefits, one of Kingsbridge Height’s workers has recently died. The employee had worked as a CNA for more than 30 years.
The need to stand up and demand decent working conditions in the health care sector is vitally important for a number of reasons. First of all at a bare minimum all workers should be compensated fairly for their work. Secondly, poorly paid workers who are unhealthy are a drag on the economy. As more and more workers become increasingly poor and unprotected, we can expect more people like the Kingsbridge’s employee experiencing poor health and dying from illnesses that are preventable. Since jobs in the health care and retail sectors are the fastest growing occupations, there needs to be a way to make sure that workers in these sectors earn enough through wages and benefits to at least escape poverty. The consequence of not demanding this as a minimum is dire. As one expert had said the US is fast becoming ”the richest 3rd world country in the world.”
Congressional hearings on problems affecting older Americans
This week was nursing home week. In connection with this event, the senate held a hearing on enforcement of federal quality of care standards for nursing homes. The hearing was broadcast by Cspan. Click here to watch the testimony if you missed it. You’ll find it under “Recent Programs.” As I wrote earlier, the Government Acccounability Office (GAO) found that nursing home inspectors are derelict in their duty of identifying and enforcing violations.
Also, the Senate Special Aging Cmte. held a hearing on breakthroughs and challenges in treating Alzheimer’s. If you didn’t get a chance to watch it, videotaped testimony by Fmr. Supreme Court Justice Sandra Day O’Connor about caring for a spouse with Alzheimer’s can be accessed on Cspan’s website. Along with her testimony is testimony from a patient, health care specialists and other caregivers. I read a wonderful article awhile back about O’Connor’s ability to value her Alzheimer’s husband great fortune to be able to find love a second time. Although they have been married since 1952, he no longer recognizes O’Connor and has fallen in love with a patient who lives at the same Alzheimer’s facility. It is a touching story. I believe I wrote something about it, but can’t remember if I posted it.
Nursing home inspectors often miss serious problems
Latest reports show that nursing home inspectors routinely minimize or ignore potential life threatening problems. Added to the problem is the fact that nationwide, one-fifth of nursing homes were cited for serious deficiencies last year. Nursing homes are required to be inspected yearly. Inspection is done by a state employee. federal officials validate the reports by accompanying inspectors or through a follow-up survey.
More than 1.5 million people live in nursing homes. The federal government in the form of Medicare and Medicaid cover more than two-thirds of their residents. As a condition for participating in Medicare or Medicaid programs, nursing homes must meet stringent federal standards.
The chief counsel to the inspector general of the Department of Health and Human Services, Lewis Morris, said he often had problems identifying owners of nursing homes that provide substandard care. Some of the problems found were residents that were dehydrated or malnourished, maggot infestations in wounds, dead flesh, and broken bones that have gone unmended.
Should the elderly be protected from their bad decision making?
Thousands of older people are filing lawsuits against companies and salespeople who they believe have taken advantage of them. Although the elderly filing suit are not suffering from Alzheimer’s or dementia, they believe that old age has caused their judgment to become impaired. Because of this impairment, the government should step in to protect them from the results of their bad decision making. At the same time, they do not wish to give up their right to make decisions.
I am ambivalent about this issue. I strongly feel that just as we protect children from being preyed upon, we should do the same for older adults. At the same time I am afraid that taking this step might be the first step towards totally disenfranchising the elderly.
http://www.theledger.com/article/20071224/ZNYT01/712240475/1001/BUSINESS
Illinois Legislature Votes to Raise Wages for Workers who Care for the Elderly
The Illinois legislature approved higher wages for workers who take care of the elderly. Minimum wages for the more than 48,000 elder care workers in Illinois will be increased by one dollar an hour. The General Assembly also approved health care options for these workers. This is the type of legislation that all states need to enact. Caregivers for the elderly have been shown to be the most depressed workers. Providing them with decent pay and benefits will go a long ways towards making their lives easier and making them feel their work has value.
Doctors are rated according to have much they charge, not quality of care
Doctors are rated by insurers. The rating they receive helps to determine whether insurers will promote their services or discourage consumers from using them. Insurers do this by reducing deductibles or co pay.
Rating is done in the same way as are consumer goods such as hotel rooms or airplane service. A key rating measure is how much doctors charge to treat sick patients. I don’t know about you, but if cost is the only factor when recommending a doctor, I’d like to know that. This is information we currently do not have, since insurers even while they are steering us to the cheapest doctor, do not tell us that is the sole basis for their recommendation. Perhaps there are doctors who provide greater quality of care, but charge a little more.
This system might be about to change, at least in New York. Attorney General of New York, Andrew Cuomo, has negotiated agreement with several major insurers to make the system more useful to consumers and fairer to doctors.
http://www.nytimes.com/2007/12/08/opinion/08sat1.html
Long term care Insurers are Undergoing Scrutiny
The largest of the long term care insurers are Genworth Financial, Conseco and Penn Treaty American Corporation. According to a New York Times report, long-term care insurers such as these have established procedures that make it difficicult to impossible for some policyholders to be paid. In response to this report, the industry is undergoing increased scrutiny. Charles Grassley, the high ranking Republican senator from Ohio recently asked the largest providers to provide details on how claims are handled, and whether employees are rewarded for denying claims. The Times article also mentions that since private equity firms entered into this industry, conditions at nursing homes have changed for the worse.
