The Star-Tribune had an article about one family’s fight for justice for their neglected dad.  Gerald Seeger was a resident of an assisted living facility, Lighthouse of Columbia Heights.  The facility failed to respond promptly when Seeger, repeatedly vomited and screamed for help while pointing to his badly swollen stomach. After hours of suffering, Seeger died of complications related to a common hernia. State investigators later cited the facility for failing to provide timely medical care.

In 2014 when Joan Maurer arrived at her father’s room at Lighthouse. She was shocked by what she found. Her father, a florist who just a week earlier had been laughing and stomping his foot to old-time music, had turned ashen and was vomiting in plastic cups, she said. Photographs from that day show that his stomach had swollen like a balloon.  Despite Seeger’s visible suffering, the staff had not called for emergency help.

“I knelt by his side, grabbed his hand and said, ‘Dad, I’ll get you to a hospital.”  Maurer called 911, and on the ambulance ride to the hospital, Seeger rated his pain as a “10 out of 10” on the pain scale, state records show. “I was horrified,” Maurer said. “I never want to see another human being in that much pain for as long as I live.”

Investigators from the state Department of Health later found multiple lapses in Seeger’s care. Despite a history of hernia problems, staff at the senior home failed to follow a physician’s instructions and notify medical professionals immediately if he had any pain or tenderness in the groin area, state records show. On the evening and overnight shift before he died, Seeger complained of stomach pain and vomited; but such symptoms were not promptly reported to a nurse, state investigators found.

His daughter had a strong legal case so she sued over the sudden death of her father.  But Maurer is still fighting for a chance to hold Lighthouse accountable in court. Attorneys for the facility claim that she forfeited the constitutional right to sue when she signed a densely worded contract that forced the family into private arbitration if a dispute arose, even one involving a wrongful death claim.

I never believed they would arbitrate my father’s life like he’s a piece of paper, and not a living, breathing human being,” said Maurer.

Over mounting objections from consumer groups and regulators, arbitration agreements like the one Maurer signed are proliferating in the senior care industry. Hundreds of Minnesota nursing homes and assisted-living centers now request that elderly people sign arbitration clauses on admission. The clauses require them to forfeit their right to a court hearing and, instead, lock elderly residents into a secretive process for resolving claims. Even in cases of extreme neglect and death, nursing homes use the clauses to block residents and their families from pursuing lawsuits.

 In Minnesota and nationally, more attorneys are seeking to throw out arbitration clauses, particularly in cases where there is evidence that elderly residents were coerced into signing the contracts. In a recent case, the Kentucky Supreme Court refused to enforce arbitration agreements in three wrongful-death cases, ruling that legal representatives of nursing-home residents lack the authority to waive another’s “God-given right” to a jury trial.

McKnight’s reported that the Trump Administration will continue the Obama Administration’s policy of discovering and punishing waste, fraud, and abuse in the nursing home industry.  However, based on Trump’s history of fraud himself, and the fact that he chose Tom Price as Secretary of DHHS, it does not appear that discovering and punishing health care fraud is on the top of the agenda.

Attorneys and former DOJ officials interviewed by Bloomberg BNA predicted that the new administration is likely to preserve several Obama-era policies in place. Those include the use of data analysis in fraud investigations, and the Yates plan to prosecute more individuals.

The department’s efforts to combat fraud in post-acute care will also likely remain a top priority, said Zane David Memeger, an attorney with Morgan, Lewis & Bockius. That may include the the DOJ’s regional nursing home task forces, launched last year to target “grossly substandard” facilities.

“We have an aging population, and nursing homes and home health, they’re vulnerable to fraud,” Memeger said.

He also indicated that fraud in the pharmaceutical and medical device industries will continue to receive DOJ scrutiny.

Jonathan Chait for NY Magazine had a great article explaining why the Republicans crusade to kill Obamacare was always based on delusions that are no longer possible to conceal.  The delusions include that ObamaCare is unpopular; too expensive; and not effective.

Chait quotes, Richard Hanna, a Republican from New York who just retired from Congress: “At the end of the day, the Affordable Care Act will in some form survive, and the millions of people who are on it will have insurance,” he said. “It’s something this country needed and something people want. Politically, it’s untenable to just wipe it away. So who really won? In my argument, the president, Obama, won. At the end of the day we will have some sort of national health care that’s going to look very similar to what we have.”

Several Senate Republicans have opposed repealing Obamacare without a replacement.  The plan to quickly repeal, and then figure out a replacement, appears to have been halted, and the party has yet to decide what will take its place.

President Trump conceded that health care was “very complicated,” and floated a timetable for devising a replacement that could extend into next year:

Yes, in the process and maybe it’ll take till sometime into next year, but we’re certainly going to be in the process. Very complicated — Obamacare is a disaster. You have to remember Obamacare doesn’t work, so we are putting in a wonderful plan. It statutorily takes a while to get. We’re going to be putting it in fairly soon. I think that, yes, I would like to say by the end of the year, at least the rudiments, but we should have something within the year and the following year.

As the Republicans continue their long retreat, they are encountering every false premise that brought them to this point. The most important of these is a misconception about Obamacare’s popularity. Now it is advocates of Obamacare mobilizing in anger and chasing terrified Republican members of Congress down the street. Conservatives spent years lionizing demonstrations against Obamacare as the justifiable anger of a free people.

The law’s growing popularity can be seen across several dimensions. Repealing Obamacare first, without a replacement, is wildly unpopular, drawing 20 percent approval or less. Repealing the law and starting over with a new one — the Republican position since 2010 — draws support from one-third of the public, while keeping Obamacare and fixing it gets nearly twice as much support. On the straightforward question of whether Barack Obama’s health-care reform was a good idea or a bad one, for the first time ever, “good idea” now wins:

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And Americans by a significant margin believe it is the government’s responsibility to make sure everybody has coverage:

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The chart above is especially telling. Notice that a huge majority agreed that the government should cover everybody before and after Obama’s presidency, but that support collapsed during the time of an administration attempting to implement this goal.

The second delusion is the cost of health care.  While GOP rhetoric has lambasted the cost of plans offered by Obamacare, their alternatives would all impose even higher costs. Hospitals are demanding that Republicans either keep covering the Americans who have insurance through Obamacare, or else compensate the hospitals for the losses they would suffer from facing millions of customers who can longer pay for their care. AARP has staked out opposition to one of the GOP’s favorite proposals to charge even higher rates to older customers. Obamacare only permits insurers to charge older customers up to three times as much as the young. Republicans have railed against the burden this places on younger workers buying insurance — and it’s true that Obamacare makes the young pay more so the old can pay less.

The pattern of the three months since the election shows the cause of Obamacare repeal collapsing because ObamaCare is effective in providing coverage, increasing access, and lowering the cost of health care. Obama and his party were able to design a plan that squared the minimal humanitarian needs of the public with the demands of the medical industry.

How does taking away rights of victims of medical malpractice increase insurance coverage or the quality of care provided?  Medical errors claim more than 250,000 lives annually, researchers estimated this year. That would make errors, which include cases of medical malpractice and negligence, the nation’s third-leading cause of death behind heart disease and cancer.

According to researchers, industry experts, and undisputed facts, the nation’s medical malpractice insurance industry is running smoothly and has not been in crisis for decades.

Doctors are paying less for malpractice insurance than they did in 2001 — even without adjusting for inflation, according to the Doctors Company, one of the nation’s largest malpractice insurersAnd the rate of claims has dropped by half since 2003.

“It’s a wonderful time for doctors looking for coverage, and it’s never been better for insurers,” said Michael Matray, editor of Medical Liability Monitor, a trade publication.

 

 

House Speaker Paul D. Ryan (R-Wis.) and Rep. Tom Price (R-Ga.), the nation’s top health official, are vowing to make tort reform a key part of their replacement plan for the Affordable Care Act.  Consumer advocates say the GOP political agenda isn’t addressing the bigger goal of reducing overall patient harm.  Republicans are going too far in reducing consumer access to the justice system and fair compensation for medical mistakes.

“What strikes me about these current proposals is that they really represent the agenda of medical professionals, which is all about limiting liability,” said Michelle Mello, a Stanford University law professor and health researcher. “To take any malpractice reform seriously, it has to offer something to improve the situation of patients and lead to safer outcomes.”  Price’s proposals do neither.

 

 

Researchers caution that caps do not keep premiums down, saying economic cycles and insurers’ investment returns are most significant factors. And they note that courts have struck down caps in some states as ineffective or unconstitutional.

Meanwhile, plaintiffs’ lawyers say damage caps make them reluctant to take on cases, given the money often required for trial preparation and expert witnesses qualified to discuss medical practice.  Many victims receive no compensation when arbitrary caps on damages are in place.

Caps on noneconomic damages for “pain and suffering” can also disproportionately hurt women and the elderly. They more often cannot get significant economic damages, which are calculated differently than pain and suffering damages, because they are not big wage earners.

 

 

 

 

Price is a lunatic who only care about protecting doctors who commit malpractice. Price clearly does not care about compensating victims of malpractice or increasing the quality of care provided to Americans.

The New York Times reported on the list of demand that health insurers want if Trump and the Republican Congress repeal the Affordable Care Act.  The nation’s health insurers publicly outlined what the industry wants.

  1. A clear commitment from the Trump administration that the government will continue offsetting some costs for low-income people.
  2. Keep in place rules that encourage young and healthy people to sign up, which the insurers say are crucial to a stable market for individual buyers.

 If they do not come up with an alternative, more than 24 million people would be left uninsured, including the more than 10 million who have bought individual plans on state marketplaces.

Hospital groups also held a news conference to warn of what they said would be the dire financial consequences of a repeal if the cuts to hospital funding that were part of the Affordable Care Act were not also restored.

These insurers have no desire to return to the time before the law was passed, when people with pre-existing conditions were routinely denied coverage in the individual market.

The insurers are also beginning to discuss a potential overhaul of Medicare, pushed by the House speaker, Paul D. Ryan, who favors so-called premium support, or vouchers, as a way for people to find coverage. “We’re not big fans of that approach,” said Ms. Tavenner, although she said the industry would be open to discussing it.

Ms. Tavenner said the industry wanted to know more about what the Republicans were planning, including information on the fate of the Medicaid expansion under the law. “We still have more questions than answers,” she said. “We don’t want to disrupt individuals who are relying on our coverage,” she said.

There are plenty of reasons to be worried about Tom Price, President-elect Donald Trump’s choice for secretary of Health and Human Services.  Price is an orthopedic surgeon and U.S. congressman from Georgia with no relevant experience.

Price has often and repeatedly voted to cut Medicaid and Medicare,  and is an ardent opponent of female reproductive rights.  Price also belongs to a truly radical medical organization known as the Association of American Physicians and Surgeons with 4,000 members.

The AAPS statement of principles declares that it is “evil” and “immoral” for physicians to participate in Medicare and Medicaid.  In particular, it urges “non-participation” in the Social Security amendments of 1965 — also known as Medicare — “as the only legal, moral, and ethical means of concretely expressing their complete disapproval of the spirit and philosophy behind these amendments.

Its website features ridiculous unscientific claims that tobacco taxes harm public health and electronic medical records are a form of “data control” like that employed by the East German secret police. An article on the AAPS website speculated that Barack Obama may have won the presidency by hypnotizing voters.

Their views on medicine are controversial to say the least: such as blaming vaccines for autism, including that the “shaken baby syndrome” is a “misdiagnosis” for vaccine injury; denying about HIV/AIDS; that immigrants cause crime and disease; that abortion causes breast cancer to name just a few.

Dr Price’s political agenda is the same self-serving tort reform that does not increase quality, transparency, or accountability including in the Empowering Patients First Act, the bill he has offered as an alternative to the ACA since 2009.  His solution is the same type of ineffective federal tort reform which violates States’ Rights, and includes unconstitutional and arbitrary caps on damages.  The bill would also allow physicians to “balance-bill” Medicare beneficiaries—to charge them more than Medicare’s allowable charge—which is currently illegal.  The bill also proposes a modern day “Star Chamber” or “administrative healthcare tribunals” where a confidential proceeding by anonymous bureaucrats would decide if a jury gets to hear your case.

Be afraid.  Be very afraid.

 

The Week had an interesting article on the CDC and other federal health agencies latest report on Americans’ ability to pay medical bills: The last five years has marked a steady decline in the number of people who struggle to pay their medical bills.

“With the help of data from the National Health Interview Survey, a regularly scheduled poll of Americans’ health habits and behaviors, the authors found that, in 2011, 21.3 percent of Americans under the age of 65 reported living in a family that had problems paying their bills. By the first six months of 2016, that figure had dropped to 16.2 percent. This drop held across all racial, gender, and socioeconomic groups, but some of the largest gains, percentage-wise, were among the poor and lower income, those uninsured or with public health insurance (i.e. Medicaid), and Hispanics.”

The Affordable Care Act in 2010 is one of the largest single factors explaining this trend. “Moreover, research from the Kaiser Foundation has shown that nearly 13 million non-elderly previously uninsured adults have obtained a health insurance plan as of the end of 2015, a sharp drop down from the 41 million uninsured in 2013.”

The current uninsured rate, 10.5% percent of non-elderly Americans, is a historic low.  ACA has acted as an economic stimulus while lowering general health care spending. See Commonwealth Report.

Medical malpractice premiums and claims are at historic lows.  Americans for Insurance Reform, a coalition of nearly 100 consumer and public interest groups representing more than 50 million people, has published two new studies of the medical malpractice insurance industry. Copies of the studies can be found here:

Stable Losses/Unstable Rates 2016

Premium Deceit 2016: The Failure of “Tort Reform to Cut Insurance Prices

Stable Losses/Unstable Rates 2016.

·      When adjusted for medical care inflation, both premiums and claims per physician are currently at their lowest level in four decades.

·      When adjusted by urban consumers CPI index (a more conservative inflationary adjustment) premiums are the lowest they have ever been, and claims are at their lowest since 1982.

·      Total medical malpractice payouts have never spiked and have generally tracked the rate of inflation, while premiums for doctors have sharply increased three times over the last 40 years: 1974-1977; 1985-1988, and; 2002-2006.

·     At no time were these three periods of severe rate hikes (i.e. “hard” insurance market) connected to any increase in claims or tort system costs, which have remained stable.

Genesis Healthcare, one of the nation’s largest for profit nursing home chains, purchased five nursing homes from Revera Inc. in Vermont.  Genesis owns about 200 facilities in New England and more than 500 nationwide.

Short-term rehab patients (generally staying for up to 100 days) make up about 15 percent of all patients and many are young and have sustained injuries or illnesses they are recovering from. Often they are looking for more privacy, as well as internet and other services.

During the months leading to approval of the sale by Vermont health care officials, Genesis operated the facilities under a management contract.

On its website, Genesis, based in Kennett Square, Pa., lists more than 500 skilled nursing centers and assisted/senior living communities in 34 states, as well as the Genesis Rehab Services division, provides therapy in approximately 1,700 locations in 45 states and the District of Columbia.

Northwest Arkansas Democratic Gazette reported the disturbing influence of Arkansas nursing home owner and operator Michael Morton and the Arkansas Health Care Association which represents the financial interests of the for profit industry.

The nursing homes industry and apologists are pushing to amend the Arkansas Constitution on the Nov. 8 general-election ballot. The proposal would limit trial attorneys to one-third of any damages won in lawsuits against health-care providers and set an arbitrary limit of $250,000 for noneconomic damages such as pain and suffering in lawsuits filed against health-care providers.

They are pouring money into the effort to arbitrarily and unconstitutionally limit monetary awards in nursing home abuse and neglect lawsuits.  Morton through his 31 nursing homes spent at least $125,000 toward the campaign.  Morton did not make any contributions under his own name.  AHCA has given at least $330,000.

The Committee to Protect AR Families opposes the unconstitutional effort.  Martha Deaver, a director on the opposing committee, is also president of Arkansas Advocates for Nursing Home Residents. Deaver said that nursing homes “are spending thousands of dollars in an attempt to take away nursing-home residents’ ‘right’ to hold them fully accountable when they abuse and neglect our most frail and vulnerable citizens.”  Deaver said nursing-home residents, not the industry, are the ones needing protection.

In 2013, Morton’s Greenbrier nursing home lost a negligence lawsuit over the 2008 death of Martha Bull, 76, of Perryville. A Faulkner County jury awarded $5.2 million to Bull’s family, but on July 10, 2013, the presiding circuit judge, Michael Maggio, cut the award to $1 million.  Maggio later was removed from office.  A corruption lawsuit pending accuses Morton and lobbyist Gilbert Baker of conspiring to funnel contributions to Maggio’s judicial campaign in exchange for Maggio’s reducing the $5.2 million judgment.  In January 2015, Maggio pleaded guilty to a federal bribery charge and implicated two other people, a nursing-home owner and a political fundraiser.