Reform pits city hospitals vs. rural

From the Boston Globe:

Large, urban teaching hospitals – including hospitals that are the biggest engines in the Boston economy – are facing the possible loss of hundreds of millions of dollars under national healthcare reform as rural lawmakers on Capitol Hill wage a fight to win more federal cash for their local institutions.

Big hospitals affiliated with medical schools around the country receive heftier reimbursements for treating elderly patients covered by Medicare, part of a government policy that rewards them for maintaining things such as trauma centers and burn units, as well as for training future generations of doctors.

Rural members of Congress, however, angry at what they see as an unfair advantage to glitzier facilities in cities, are demanding a bigger share of the pie for smaller hospitals, which serve remote populations and often struggle to survive.

Doctors’ Payments Snag Health Bill

From the Wall Street Journal:

A plan to end a program that would cut government payments to doctors is emerging as the flash point in the debate over whether President Barack Obama’s effort to overhaul the health system would increase the federal budget deficit.

The proposal was crucial to winning support from the politically powerful American Medical Association — but it has also made it tougher to argue that the health overhaul would pay for itself.

President Obama this week plans to continue his bid to drum up support for his goal to expand health insurance to the nation’s 46 million uninsured Americans, after suffering some setbacks last week. On Capitol Hill this week, House members hope to pass their health bill through a third and final committee, and senators are expected to resume talks to hammer out an agreement on the only bipartisan health bill taking shape in Congress.

When time is short, air ambulances make haste

From the Lawerence Journal-World:

Each year, 400,000 helicopter medical missions are made nationwide, according to the Association of Air Medical Services. The number has increased each year for the past three decades.

Since 2002, Life Star has had a helicopter based at Lawrence Municipal Airport in North Lawrence, where a nurse, paramedic and pilot are stationed 24 hours a day.

Update: Baucus, Grassley Slam Physician-Owned Hospitals

Update of a posting last week on physician-owned hospitals, from the WSJ Health Blog:

As the nation awaits the unveiling of the Senate Finance Committee health-reform bill, advocates of physician-owned hospitals might be nervous about the  latest comments on the hospitals from Sen. Max Baucus, the committee chairman, and Sen. Chuck Grassley, the ranking Republican.

Baucus and Grassley point to a story in today’s Denver Post that describes the death of a 25-year-old student at a physician-owned hospital in Denver. The woman went in for brain surgery and died following administration of the wrong dose of a painkiller. State inspectors described the effort to revive her as “chaotic,” according to the Post.

State health officials found numerous problems when they investigated the death. The hospital management has agreed to improve its drug monitoring, hire more emergency room doctors and improve their procedures for handling emergencies, the Post says.

In a news release, Baucus said, “I have long been concerned about physician-owned hospitals’ ability to respond to emergency situations, and this tragic incident heightens that concern.” The Senators also say there are potential conflicts of interest when physicians self-refer patients and accuse the hospitals of a “tendency to cherry-pick healthier and wealthier patients,” the senators say.

Brett Gosney, president of board of directors of the trade group Physician Hospitals of America, said this in a statement to the Health Blog:

It is despicable that Senators Max Baucus and Chuck Grassley would use the tragic death of one patient to help support the efforts of corporate hospitals and bureaucrats … to undermine hospitals owned and operated by physicians themselves. The fact of the matter is, every independent study, including those by federal government, demonstrate physician-owned hospitals have lower mortality rates and lower morbidity rates by patient outcomes across the United States. There are over 100,000 preventable deaths in American hospitals every year.

The House version of the health-reform bill, which cleared two committees today, prohibits physician ownership in new hospitals. Baucus and Grassley say they want to improve patient safety at existing physician-owned hospitals and bar any new ones from participating in the Medicare program.