So "never events" never happen...

Monday, June 30, 2008

Jordan Rau at the Los Angeles Times has an important article (with lots of links to primary source documents!) on the key issue of "never events"--those things that should never, ever happen when you get care.

It's a list that includes getting severe ulcers from bedsores, having equipment left in a person during surgery, undergoing the wrong surgery or having the wrong limb amputated, or being given the wrong medication or wrong dosage. Unlike other parts of the art of medicine, these are problems that are preventable if the systems are in place.

The number of these adverse events reported is over 1,000 in a 10-month period. It's a wake-up call--Many in the health care community would not have predicted such a large number. These medical errors are serious--in some cases, deadly serious. By definition, these are "never" events--not "sometimes OK" events.

The article highlights AB2146 (Feuer), an important bill supported by many consumer groups like Health Access California, AARP, CALPIRG, Consumers Union, as well as business and labor organizations. It would have California follow the federal government in not paying for these adverse events, as part of a shift to change the financial incentives in this category.

I would also add AB2967 (Lieber), which would add more transparency to the cost and quality of the care being provided in California. This information is valuable in its own right, and will have a impact in getting hospitals to prevent these errors, which will improve health outcomes, and save money too. Information shouldn't be the only tool, but it should be part of more aggressive oversight.

Read the article. It's worth your time.

Labels: Hospitals, InTheNews, Legislation, Prevention, Research

posted by Anthony Wright | Permalink | 1:32 AM


 

Blaming the victim

Wednesday, October 03, 2007

The story that got my attention today was this LATimes story about saving $1 trillion through healthy living -- particularly the last sentence, where the researcher "blamed Americans' diet and sedentary lifestyle."

There’s something to be said about an individual proactively exercising, not smoking, etc.... I totally agree with that.

But these studies and stories don’t take into account the worker who must take 2 jobs to survive -- rides the bus, lives in an industrial area, has an aging parent at home to care for, maybe younger siblings, maybe children. Where does this person find time, beween family obligations, work and trying to get places on public transit, to exercise. And where could they exercise without exposing themselves to carcinogens. And if the answer is, "get a gym membership," where does a low-income worker find the $50 to $100 a month to join a gym?

Labels: Prevention

posted by Hanh Kim Quach | Permalink | 10:13 AM


 

"When is something less than nothing?''

Friday, August 10, 2007

That's what yesterday's USA Today article asks, in response to a recent JAMA study finding that underinsured children are vaccinated at lower rates than uninsured children.

For those buying health insurance through a group (such as work), in California, consumer protections guarantee that even flimsy health plans are required to provide preventive care for children following the American Academy of Pediatrics guidelines, which includes immunizations.

However, if you're buying coverage on your own -- it's not only more expensive, but as this study shows, it also doesn't cover the essentials.

The study confronts the insurance company's lines about creating "innovative'' products. Innovation comes at the consumers' expense. They argue that the reason health care is "expensive'' in California is because people have to pay for health coverage they don't need. But without "mandates'' this is what happens -- children don't get properly immunized, cancers don't get discovered, diabetes doesn't get treated.

And I would argue that in California -- the mandates aren't enough -- given that 464,000 children who have insurance in the individual market are not guaranteed proper preventive care in their most formative years.

Labels: Affordability, InTheNews, Prevention, Underinsurance

posted by Hanh Kim Quach | Permalink | 3:07 PM


 

All the President's Polyps...

Tuesday, July 24, 2007

San Francisco physician Margot Kushel delivered this succinct message to President Bush in today's NY Times' Letters to the Editor:

Mr. Bush: one cannot get a preventive colonoscopy in the emergency
room.

In case anyone missed it, earlier this month, the President insensitively remarked:

"I mean, people have access to health care in America. After all, you justgo to
an emergency room." -- President George W. Bush (Cleveland,7/10/07)

Of course. We can't all get presidential health care. But we can get preventive care -- like the President did on Saturday (does that mean it was a house call?) which eventually resulted in the extraction of five (!) polyps.

Well said, Dr. Kushel.

Labels: Bush, Prevention, Underinsurance

posted by Hanh Kim Quach | Permalink | 12:36 PM


 

Women and Health and the Glass Ceiling

Wednesday, June 27, 2007

We all know gender inequality issues still exist in the workplace. Men still get paid more than women. Fewer women are promoted than men.

Another place where gender discrimination is allowed to tacitly continue is in health care. As recently as 2002, women were charged copays of between $500 and $2,000 to deliver babies. Meanwhile (mostly or only men) who had prostate surgery, back surgery, brain surgery, coronary bypass surgery did not have to pay copays.

(Some might argue that maternity costs more. Not so. Average costs for labor and delivery was $1,980 then. Meanwhile, average costs for surgeries for those other procedures ranged from $4,422 to $29,539 -- okay, now i'm really annoyed).

Why am I upset about this now?

Here's the situation: Gov. Arnold Schwarzenegger and Republican cohorts are constantly calling for "flexibility" that would allow insurance companies to offer consumers more "choice'' and more "affordable'' options.

What they really mean is getting rid of a host of "benefits'' that California wrote into the law years ago to make sure health coverage actually covered health care.

Here are some of the benefits they're talking about. (see a full ist of mandates here) California mandates 23 benefits; six directly relate to women. They include coverage for:

• complications of pregnancy, (for plans that provide maternity benefits);
• breast cancer screening, diagnosis and treatment;
• mammograms;
• cervical cancer screening (if policy includes coverage for treatment/surgery of cervical cancer)
• prenatal in the Expanded Alpha Feto Protein program, if maternity benefits are included
• prescription contraceptive methods (if prescription drugs are part of the benefit package)

Two other mandated benefits are "tweeners,'' while they could apply to both genders, I would say they predominantly apply to women:

• diagnosis, treatment and appropriate management of osteoporosis
• immediate accident and sickness coverage for each newborn infant and adoptive child.

Of course, the biggest cost for women -- maternity coverage -- is not a mandated benefit and was actually vetoed by Schwarzenegger in 2004 on the grounds that it would make coverage too expensive for everyone. As I pointed out earlier in this post, the collective "we'' pays for a lot of health care that is used primarily by men, including the gov's various heart surgeries.

So don't buy the wrap about "choice,'' "flexibility'' and "affordability.'' It's just another way to help keep women in their place.

Click here for the San Francisco Chronicle's excellent Sunday Op-Ed about women and health care.

Labels: Affordability, Prevention, Schwarzenegger, Underinsurance

posted by Hanh Kim Quach | Permalink | 1:00 PM


 

Prevention...

Tuesday, February 06, 2007

Many of our consumer allies have been invited to major press event today by the Governor, focusing on prevention and wellness issues. Expect that he might release more details about the public health campaigns on diabetes, obesity, and smoking cessation.

You can watch the event at the Governor's website, here:
http://www.gov.ca.gov/

Labels: HealthyLiving, Prevention, Sacramento, Schwarzenegger, YearOfReform

posted by Anthony Wright | Permalink | 9:46 AM


 

Provider rate reductions sort of reversed

 

A Constituency Against Health Care?

 

Progress report

 

Killing us softly...

 

Provider rate cuts put in place today...

 

Deadbeat Insurers

 

"The choice is clear..."

 

Another year, another missed deadline

 

So "never events" never happen...

 

Follow along...