Archive for the ‘Health’ Category

By Sabrina Morello

The cost of healthcare is very important to consumers, especially those on tight budgets.  No one should have to choose between getting a needed medical procedure and putting food on the table.

We have previously blogged on the problem of overcharging in hospitals, and in this installment we highlight a solution to overcharging that will not only improve care but will also bring down health care costs.

Ballooning costs

Health care in this country costs $2.7 trillion a year, and according to a study by The Journal of the American Medical Association, about one third of that, or just under $1 trillion, accounts for hospital care.

And, by 2015, the government expects total costs to surpass $3.3 trillion, with more than $1 trillion attributed to hospital care. Our health care system is far more expensive than that of any other country, but our results are not far better. With hospital care alone accounting for such a large portion of the total health care cost, it is important to focus cost-related solutions on hospital systems in order to lower bills for consumers without sacrificing the quality of care.

Cost v. Charge

One possible solution for cutting costs is for hospitals to use a “cost master” system instead of a traditional “charge master” system, which has been the standard procedure in hospital pricing. Under the charge master system, hospitals estimate what something costs and then mark it up, sometimes as much as 400-500 percent. The New York Times published examples of charge master prices from California Pacific Medical Center in which one Tylenol with codeine pill, which should cost about $0.50, was charged to patients at $36.78.

In contrast, a “cost master” system tracks and displays the actual cost of each procedure, piece of equipment, and supplies used, which allows them to determine whether doing one thing is really more important than doing another thing, thus standardizing care and eliminating waste.

Based on a story in the Wall Street Journal, it was reported that Intermountain Healthcare, a hospital network in Utah and Idaho consisting of 22 hospitals and 185 clinics, has had great success in this area. The network’s mission statement is “the best medical result at the lowest necessary cost” and it has developed methods to accomplish that goal which are now being imitated across the country. Intermountain already has saved around $250 million and about 1,000 lives a year with its data-driven clinical management system, which Dr. Brent James, Chief Quality Officer for Intermountain, calls a “cost master” system as opposed to the widely used “charge master” system. Intermountain expects even greater savings once the system is incorporated into their electronic medical records system.

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Last week, The Occupational Safety and Health Administration (OSHA) heard testimony on modernizing and improving the tracking of workplace injuries and illnesses. These hearings were convened because OSHA has proposed a rule change that will directly benefit workers in “high hazard” industries, where workers suffer the most injuries and illnesses.

The proposed rule amends current reporting requirements to require all workplaces with 250 or more employees to electronically send all of their injury and illness data to OSHA quarterly. The improved tracking system also would require workplaces with 20 or more employees, in certain industries with high injury and illness rates, to electronically send their annual summary data to OSHA once a year. Presently, employers submit such reports on paper, and there is a significant lag in processing the data.

OSHA’s proposal would improve workplace safety and health through the collection of useful, accessible, establishment-specific injury and illness data. At present, OSHA does not electronically receive an establishment’s injury and illness data log. This void forces the agency to rely on data that is more than a year old when attempting to respond to hazardous workplace conditions. This is the opposite of a speedy response to hazards.

But OSHA has been met with strong opposition to this proposed rule change. During recent public meetings at OSHA headquarters, corporate lobbyists and spokespersons from the U.S. Chamber of Commerce voiced strong opposition to modernizing the tracking of workplace injuries and illnesses. These corporate interests complained that businesses would be “named and shamed” in the media, by labor unions and occupational safety and health researchers for publishing injury and illness rates on the Internet.

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TysonRTfrackingI did an interview with RT discussing the growing problems that chemicals used in fracking oil & natural gas pose to the environment and public safety. First, the Associated Press reports that there have been hundreds of complaints of water pollution from fracking, most from methane but some from the chemicals used in fracking. But this AP report only tells half the story, as it simply documents the different ways in which states handle and record complaints when folks call in to a hotline or send an email. That’s good info, but not nearly as important as sending scientists to investigate the complaint. And there’s the rub: when confirmed fracking pollution occurs, oil & gas companies quickly settle with the affected landowners, and, in return for providing cash and drinking water supplies, force families to sign non-disclosure agreements, forbidding them from even acknowledging that fracking pollution ocurred, or in some cases, requiring families to sign statements proclaiming that pollution didn’t occur. We challenged Jack Gerard on this point when he spoke at our offices earlier this year, and he denied knowing anything about these common non-disclosure agreements. In one famous case, the natural gas company forced parents to guarantee that their two young children would never speak about fracking pollution on their farm for the rest of their lives. The proliferation of these non-disclosure agreements distorts the policy debate because they interfere with the collection of data needed to draw conclusions about the saftety of fracking. It is unacceptable for the industry to continue to say “Fracking is safe, evidenced by the lack of water contamination proof!” at the same time they’re forcing familes to give up their right to talk about pollution (or in same cases, forcing the families to lie in order to qualify for the financial compensation). A simple solution is to disallow non-disclosure agreements that mask information on drilling contamination.

A second issue involves transportation hazards posed by fracking chemicals. On December 30, Warren Buffet’s BNSF line was hauling 78,000 barrels of oil on 104 rail cars from the Bakken Shale to a refinery in Missouri when it was hit by another BNSF train carrying soybeans headed in the opposite direction, derailed, and started a massive fire. I spoke to ABC World News Tonight about this tragedy, and, as my friend Steve Horn reports, the crude oil was more volatile and dangerous because it was laced with fracking chemicals absorbed by the oil during the production process. Indeed, the Pipeline & Hazardous Materials Safety Administration just issued a warning that fracked oil is more chemically explosive. And corrosive agents used in fracking that are then absorbed by the oil, such as hydrochloric acid, “which federal investigators suspect could be corroding the inside of rail tank cars, weakening them.” This means that moving fracked oil by pipelines won’t be safer, since the caustic oil could corrode pipelines as well. Big oil is opposing federal efforts to retrofit the safety of rail cars hauling crude oil.

railAs I’ve written before, the fracking boom is failing to deliver affordable, safe or sustainable energy for America.

Tyson Slocum is Director of Public Citizen’s Energy Program. Follow him on Twitter @TysonSlocum

By David Palmer

In a 1992 presidential debate, President George Bush famously admitted that he did not know the price of a gallon of milk. Most Americans can probably tell the price of a gallon of milk, but most Americans probably cannot tell you the actual price of a hospital visit.

Because the majority of Americans are insured, the cost of a visit to the doctor is typically paid, at least in part, by the insurance company. The shadows that hide the price of medical care have allowed costs to grow like a fungus. The problem is not only that hospital-visit prices are not controlled by a traditional market, but also that the prices are hidden from customers, who often have no reasonable alternative.  It’s time we shed a little light on the price of health care and trimmed the lurking costs.

Take, for example, the gallon of milk. If the price of milk suddenly jumped to $20, most people would probably stop buying milk (or protest in outrage.) But what if someone in your family needed the calcium in milk to survive? And what if you didn’t find out about the jump in price until after you had already bought it?

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by Ashley Bender

Lobbying by corporate giants may have succeeded in swaying a powerful government agency from changing an outdated, expensive payment system that wastes taxpayer dollars on bloated corporate profits. And, while the industry did pay $8 million on its lobbying effort to prevent the changes, the annual future corporate return on the effort is projected to be as much as 100 times ($800 million) the lobbying cost.

The United States Government and Accountability Office found that Medicare overpaid dialysis treatment centers for services administered to seniors by between $650 and $800 million in 2011. Most of the overpayment went to two large corporations, DaVita HealthCare Partners Inc. and Fresenius Medical Care AG, which together control a majority of the dialysis center market.

To mitigate the gross overpayment to dialysis treatment centers, the Centers for Medicare and Medicaid Services (CMS) proposed to reduce future payment rates for expensive anemia drugs and other dialysis center services by a total of 9.4 percent for calendar year 2014. Reducing Medicare payments to dialysis centers Medicare would save an estimated $4.9 billion over the next ten years, according to the Congressional Budget Office. But the healthcare giants were able to convince more than 100 members of Congress to oppose the proposed CMS rule and suggest that the Obama administration either reverse the spending cuts or dramatically water down the spending cut proposal.

On Friday, November 22, CMS released a press statement acquiescing to the wishes and pressures of the health care corporate titans. In the end, CMS’ policies remain virtually unchanged. Rather than cutting reimbursement payments to dialysis centers by 9.4 percent, the payments will be kept essentially flat between the 2013 reimbursement rates and the 2104 reimbursement rates. Dialysis treatment centers will continue to be overpaid, and DaVita HealthCare Partners Inc. and Fresenius Medical Care AG will continue to reap hundreds of millions of excess taxpayer dollars.

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