Ruling to the detriment of medical profession?
Ed Thomas - OneNewsNow - 8/19/2008 8:55:00 AM
By a unanimous vote on Monday, the California Supreme Court affirmed the right of a lesbian woman to be inseminated by doctors over their religious and moral objections. That ruling is being harshly criticized by faith-based groups that have fought to preserve physicians' right to practice their faith as part of their professional ethics.
The justices ruled that California's anti-discrimination laws extend to even medical treatment of homosexuals, and wrote that doctors at the North Coast Women's Medical Group, a private fertility clinic, had neither "a free-speech right nor a religious exemption" from the laws.
Attorney Mailee Smith of Americans United for Life (AUL), spokeswoman for the Christian Medical & Dental Associations and several other faith-based groups who presented amicus briefs in the case, said the ruling takes away a federally protected Constitutional right of physicians to freely exercise religion.
"The Supreme Court in California actually made the Constitution of the United states secondary to state-created law in California," says Smith.
AUL expects that by forcing healthcare professionals to choose between conscience and career, the medical field will lose doctors, nurses, and other healthcare professionals who are already in short supply. "It defies common sense that a patient would want a doctor to violate his or her conscience in practicing medicine," Smith laments. "A diminished physician population is not good for medical care."
Bob Tyler of Americans for Faith and Freedom, counsel for the fertility clinic physicians, says it is his firm's intent to appeal, and hopes the U.S. Supreme Court will take the case. In the meantime, he says state judges have set a destructive precedent to religious liberty with the ruling, which will affect state residents in a broad way.
"It affects physicians immediately...but it affects everybody in California, no matter your profession," says Tyler.
Meanwhile, Smith says the case is far from over in the trial court. After interpreting the discrimination law's application, justices must now decide if clinic doctors were telling the truth about their objection to Guadalupe Benitez being unmarried, as opposed to being a lesbian -- an issue which Smith says will determine if Benitez wins or loses her suit.
at 11:09 AM 2 comments
Tuesday, August 12, 2008
Medical Vacations: The Retiree Health-Care Solution?
By Billy and Akaisha Kaderli
The debate over U.S. health-care reform rages on.
But why wait for someone else to dictate your future? You have many options -- if you're willing to take a vacation. If recovering from a medical procedure while lying on a palm-swept beach, relaxing by the hotel pool, or shopping for terrific bargains sounds good, then medical vacations may be exactly the right solution for you.
From hip replacement to heart surgery, more people are discovering the advantages of traveling abroad for their medical needs.
A big growth industry
In just the past few years, medical vacations have gone from a tiny niche market to an impressive growth story with substantial market-share gains.
From Mexico to India, Costa Rica to Thailand, hospitals are taking advantage of this global trend. And U.S. companies are taking note as well.
Aetna (NYSE: AET) and Blue Cross Blue Shield of South Carolina are among the health-care companies tailoring their corporate health insurance plans to give employees the opportunity to head to India or elsewhere for surgeries such as knee replacements and the more modern, less invasive approach to hip replacement, hip resurfacing.
In the Western Hemisphere, Costa Rica is currently the "in" destination for travelers, especially for dental and cosmetic surgery needs. You can schedule online and receive a custom-made package, appointment and prices in your email response.
For years, people in the American Southwest have capitalized on the high-quality dental work available south of the border for a fraction of U.S. prices.
Now more people are traveling to Guadalajara in Mexico for body augmentation and other surgeries, too. Many of the doctors there are U.S.-trained, and the equipment is top of the line. (We know, because we've used it.)
In Asia, one of the world's most acclaimed hospitals is located in Bangkok, Thailand. Bumrungrad looks more like a five-star hotel than a medical facility -- until you get to the third floor.
World leaders from around the globe fly here for medical procedures. Bumrungrad's website is user-friendly, as is its professional, English-speaking staff. The hospital has more than 200 surgeons who are board-certified in the United States. We have quipped many times that the cheapest health care plan is an air ticket to Bangkok.
Also close by is the Bangkok Heart Hospital. Both of these facilities are located in the center of the city, with easy access to shopping and attractions. If necessary, they will arrange your hotel stay along with the medical procedure you're having performed, all without waiting times or disqualifications.
Your entire extensive physical will be done in one morning, with your blood results and consultation that afternoon. In and out in a single day. How's that for service?
Is it safe?
Many people interested in medical tourism are concerned about the quality and safety of going abroad for technical and complex medical care, and how to get post-operative care once they return home.
All of the hospitals mentioned here use the latest equipment and are either internationally accredited facilities or have U.S.-trained physicians on staff. Some U.S. health plans also provide an in-state network of physicians who will treat a patient who's gone abroad for medical care.
The one thing that sets these hospitals apart from many of their U.S. counterparts is their attention to customer service -- they are professional and courteous in a way you rarely see anymore at home.
According to 2005 statistics from the University of Delaware, Escorts Heart Institute in Delhi and Faridabad, India, performs nearly 15,000 heart operations every year, and the death rate among patients during surgery is only 0.8 percent -- less than half that of most major hospitals in the United States.
India also has top-notch centers for hip and knee replacement, cosmetic surgery, dentistry, bone marrow transplants, and cancer therapy. Virtually all of these clinics are equipped with the latest electronic and medical diagnostic equipment.
Sounds good, but what's the cost?
Even though you get high-quality care at these hospitals, prices are quite a bit lower than what you'll find in the U.S. Several sources report big cost savings in recent years for many procedures. For example, coronary angiography in Bangkok costs less than $900.
A metal-free dental bridge that runs $5,500 in the U.S. costs about $500 in India, and a knee replacement in Thailand with six days of physical therapy costs about a fifth of what it would in the States. Cosmetic surgery savings are even greater. A full facelift that might cost $20,000 in the U.S. runs about $1,250 in South Africa.
The attraction is straightforward. The costs for everything from facelifts, dental implants, or hormone therapy to reverse the effects of aging can be one-half or less for comparable procedures in the States. Have your surgery, then recover and recuperate in a beautiful mountain setting or at a resort hotel.
Most procedures can be found online, letting you know what's included in the cost. The figure quoted to you will cover everything, including follow-up visits. There are no hidden charges, and the price includes the room, doctor, and staff.
If you'd like to retire soon, but you're held back by health-care issues, or if you've got the health-care blues and need a holiday break, why not do some research online and take a vacation?
And when it's time to recover, don't forget your suntan lotion.
at 7:14 PM 2 comments
Saturday, August 9, 2008
Lack of school nurses puts kids at risk
By Susan Abram, Staff Writer
Article Last Updated: 08/08/2008 04:31:25 AM PDT
NORTH HOLLYWOOD -- The backpack Evangeline Arafiles slings across her shoulder each morning holds the tools of her trade: a lilac-color stethoscope, thermometer, oximeter, penlight and stopwatch.
There isn't a Band-Aid in sight.
As a school nurse at Lowman Special Education Center, Arafiles oversees about 150 students, and there often is another registered nurse with her on site.
And despite having to insert catheters, inject insulin, treat seizures and monitor asthma, because she only has to look after 150 kids, she's one of the lucky ones.
"If you were to compare a school nurse from 40 years ago, she was someone who usually waited for a student who needed a Band-Aid," said Nancy Spradling, executive director of the California School Nurses Association.
Once known as "Band-Aid Queens," Arafiles and other school nurses have increasingly become a safety net for thousands of children.
But as their roles have changed, the nurse-to-student ratios haven't, a concern among industry groups who say complacency, budget cuts, a personnel shortage within the profession and an overall misperception of what school nurses do all collide to place children at risk.
Federal guidelines require one nurse for every 750 students. But California ranks 44th in the nation, with a ratio of 1:2,300. Of the nearly 1,000 school districts statewide, half have no school nurses at all, Spradling said.
Within the Los Angeles Unified
School District, the second-largest in the nation, there are 600 registered nurses for nearly 700,000 students - or a ratio of 1:1,167, school officials said.
But in some parts of the city, that ratio can swell to 1:4,000.
The shortage comes at a time when children's health issues are grabbing more headlines:
The leading cause of absenteeism among LAUSD students with chronic diseases is asthma, which afflicts some 63,000 students.
Of children born in 2000, about one-third of the boys and 39 percent of the girls will develop type 2 diabetes, according to the California Center for Public Health Advocacy analysts' estimate.
Less than 21 percent of LAUSD students met all the criteria considered to comprise a healthy lifestyle, according to California's statewide fitness exam.
A school nurse's job already was challenging because of a federal mandate in 1975 that required schools to accommodate disabled students.
"We welcome those kids. We want them to come to school and they have that right," Spradling said. "But today, school nurses are managing kids who need pharmaceuticals, children with cardiac problems, cancer, kidney treatments."
Burden of care
The lack of nurses has placed a burden on teachers, office workers and other staffers, but many don't want to be in a position to give first aid, said A.J. Duffy, president of United Teachers Los Angeles.
"The ratios are too high," he said. "Teachers have been told in the past that they would have to do certain things. At one point, the district wanted teachers to give shots. Our nurses were up in arms."
The California chapter of the American Nurses Association filed a lawsuit last week against the state's Department of Education, which is calling on unlicensed volunteer school employees to administer insulin to students with diabetes.
"Not only is the California Department of Education breaking state law with this directive by violating the established scope of nursing practice, but by negating the need for licensed nurses to administer insulin, they are placing the children at risk," Rebecca Patton, president of the ANA, said in a prepared statement.
Duffy said even though the nurses could train teachers, the district training would likely fall short of what teachers need to know in a medical emergency.
"We have a certain degree of student population that are at risk and they have a right to have a medical professional to be there for their needs," Duffy said.
Last year, the LAUSD was ordered to pay $7.6 million to the family of an epileptic boy who suffered a seizure at a North Hollywood elementary school, according to published reports.
The boy's family said the response to his seizure in 2005 was inadequate because several minutes passed before CPR was administered by a playground supervisor. There was no nurse on campus that day. The district argued that adults responded as best they could.
Grants are sought
Federal legislation was introduced again in June by Rep. Carolyn McCarthy of New York and Rep. Lois Capps, D-Santa Barbara, once a school nurse herself. They are asking the secretary of health and human services to make grants available to eligible states to help reduce the nurse-to-student ratio.
"We're all very concerned about access to health care in the federal government," Capps said. "When kids come to school and they've never had a checkup, they come with a lot of health problems and it's a real challenge."
Still, in its most recent budget, the LAUSD cut funding for nurses to early childhood education classes or preschool.
"That, to me, is a challenge because how do we meet those needs of those in early education?" said Connie Moore, the district's director of nursing services.
"Through early detection, we can see if a child needs a pair of glasses or has an ear infection. If we just had a nurse in every school, we would be available to follow up with these children."
The district is now filling a dozen vacancies and has been able to hire 100 nurses in the past two years, especially for schools near downtown.
But there is competition for registered nurses from hospitals, and other health settings also are facing shortages.
Meanwhile, Arafiles considers herself lucky. She remains on campus all day. There is a second school nurse on staff. And she oversees fewer students than most of her peers.
Still, the job can be challenging.
"The work is rewarding," she said, "but we are stretched to the limit."
at 4:16 AM 0 comments
Monday, July 28, 2008
Faces Of The Health-care Crisis
By Chris Frates
Jul 28, 2008
The National Federation of Independent Business is on the Hill today, distributing a new booklet to congressional offices titled, “The Faces of the Healthcare Crisis: Small Business in America.”
The compendium details the difficulties small business owners face in getting health care. The effort is designed to send a message to Congress and the next president that “small businesses are demanding solutions to rising health care costs and they expect reform that works for them.”
One fairly typical vignette, Rich Gallo, owner of Office Outlet in Indiana, Pa., said he cannot afford to offer his employees health-care coverage.
And while he was searching for individual coverage, Gallo had a heart attack and put off going to the hospital because he didn’t have insurance – a delay that could have killed him. The $200,000 trip, he said, “makes me realize how we really need reform to make sure that small business people can get the coverage they need at the price they can afford.”
The push is part of NFIB’s Solutions Start Here campaign to pass health care reform that benefits small businesses.
Legislator wants legal review of GVSU's live-in partner health insurance benefit
Posted by Nardy Baeza Bickel | The Grand Rapids Press July 28, 2008 21:34PM
Categories: Breaking News
ALLENDALE -- A West Olive legislator has requested the state Attorney General's opinion on the live-in partner health insurance benefit Grand Valley State University approved for its employees earlier this month.
The benefit applies to gay couples, as well as any other live-in partner or friend who has lived with a staff or faculty member for 18 months or more. It does not cover relatives or tenants.
Republican state Rep. Arlan Meekhof sent the request last week, said his legal assistant, Bob DeVries.
It has been received by Attorney General Mike Cox, and it will be reviewed, said his spokesman Matt Frendewey, who declined to give a timeline on the issue. Cox has not been asked to review any similar policies that other universities have implemented, he said.
Other universities offering the partner benefits include the University of Michigan, Michigan State University, Central Michigan University and Michigan Tech.
GVSU trustees have said the change was necessary for the university to remain competitive in attracting talent. School officials also have said it is not same-sex benefits repackaged under another name. Same-sex plans are banned under state law.
DeVries said they are taking up the issue now that it has been enacted in West Michigan.
"Grand Valley is in (Meekhof's) district and is a more immediate interest by us.
"It's our opinion ... that these benefits are against the law, especially at a time when Grand Valley increased tuition by 13 percent. There's no reason they need to institute a new program that's going to cost them $180,000 a year."
As they have with other criticism of the change, GVSU officials remained polite but firm in their stance.
"Last Monday, Representative Meekhof advised the university of his plan to request an opinion from the Attorney General, a right that is available to all members of the Legislature. Grand Valley's trustees believe that the program they adopted complies with Michigan law," vice president Matt McLogan said.
Meekhof's request came at the same time fellow state Rep. Dave Agema, R-Grandville, said he would push for universities to lose 5 percent of their state funding if they spend taxpayer dollars to provide unmarried partner benefits.
at 10:59 PM 0 comments
Thursday, July 24, 2008
Scrap Medicare Fee-For-Service System, Doctor Says
Posted by Jacob Goldstein
They way Medicare pays doctors encourages excessive testing and discourages spending time with patients, a doctor argues today on the New York Times op-ed page.
The fee-for-service system reimburses doctors not only for their time, but also for overhead — which includes the costs of expensive machines used to run tests such as CT scans.
This is why doctors who own their own imaging equipment order far more scans than doctors who refer patients elsewhere for scans, argues the author, Peter B. Bach of Memorial Sloan-Kettering Cancer Center. He writes:
Any first-year business school student can see the profit opportunity here. The cost of a CT scanner is fixed, but a doctor earns fees each time it is used. This means that a scanner becomes highly profitable as soon as it’s paid for.
Patient visits, on the other hand, don’t incur the overhead of fancy machinery and so aren’t big moneymakers in the current system.
Getting rid of this payment system would trim excessive use of expensive tests and encourage docs to spend more time with patients instead, argues Bach, who is a former adviser to Medicare’s top brass.
He suggests paying doctors a fixed amount for each patient, with higher payments for more complex patients to discourage cherry picking. Payment for overhead should be based on the typical costs of tests and treatments for a patient’s condition — similar to how Medicare pays hospitals.
Implementing such a program would be pretty complicated — you could run the risk of giving doctors incentive to under-treat patients, and you’d have to do a good job of setting fees to avoid cherry picking.
Still, it’s worth considering alternatives to the current system. The recent debate in Washington over Medicare payments to doctors is sure to be back next year. And the health-policy gurus we’ve been talking to say financial pressures mean some kind of radical restructuring of the payment system is coming sooner or later.
Photo by Associated Press
at 12:55 PM 0 comments
Southlake doctor pleads guilty to possession of child pornography
12:42 PM CDT on Thursday, July 24, 2008
By WENDY HUNDLEY / The Dallas Morning News firstname.lastname@example.org
A Southlake doctor pleaded guilty this morning to one count of possession of child pornography.
Dr. James Shin, 46, faces up to 10 years in prison and a $250,000 fine, and will be required to register as a sex offender.
Dr. Shin, also known as Young Jin Shin and James Young-Jin Shin, resigned in May from the staff of John Peter Smith Hospital in Fort Worth, where he had been the chairman of the internal medicine department in 2004, according to his attorney, Bob Webster.
The U.S. Attorney’s Office said that when Dr. Shin allowed Immigration and Customs Enforcement agents to search his home computer in September 2007, he acknowledged that he used the Internet to download images and videos of minor children engaged in sexually explicit conduct.
“Some of the images of child pornography contained images of real children that have been identified through other law enforcement investigations throughout the nation,” according to a press release from the U.S. Attorney’s Office.
at 12:54 PM 0 comments
Wednesday, July 23, 2008
Medical tourism needs 5k-10k professionals in 5 years
NEW DELHI: With medical tourism in India expected to grow 30% annually till 2012, the demand for talent is going up at a brisk pace even as it opens up a whole gamut of job opportunities in the sector. Little wonder then that a full-time course in medical tourism launched by the Indian Clinical Research Institute (ICRI) has generated a great deal of interest in the medical fraternity.
India’s medical tourism is expected to be a $2.2-billion industry by 2012, up from the current $1.2 billion. Encouraged by the growth momentum, the government has launched medical visas to be given on a priority basis.
Estimates suggest that there would be a demand for 5,000-10,000 professionals specifically catering to this industry segment in the next five years. These would include international marketing professionals, patients relation managers, backoffice employees.
However, analysts believe there’s an acute need for infrastructure to train people in these functions. And there are no institutions offering such niche courses. “There is a great demand for such modules as the manpower requirement goes up and the need for specialised roles arises,” says ICRI HEALTH director, health service, major general (Dr) M Srivastava.
The course from ICRI would offer training in hospital services, financial management, marketing, OR techniques, costing and budgeting. Pricing techniques, hospitality & patient relation & conflict resolution, healthcare laws & regulations, health insurance & regulations, business ethics & corporate governance are also part of the course. A major requirement, say experts, would also be for patient relation managers who can understand the needs of people from other geographies, their food habits, language and their comfort level.
Soft skills would be in great demand. Currently, individuals with a background in medicine deliver such services. As the need increases and the doctors become more engaged with the medical procedures, a different pool of people would be required to man those positions.
“Till now no institute offered such courses and the hospitals survived only on in-house resources and training,” says Apollo Healthcare and Lifestyle CEO Ratan Jalan.
at 11:35 AM 0 comments