Doctors And Hospitals

The economy has health insurers worried - fewer employed people means fewer members for the insurance plans. For those who provide health care, however, the impact of the economic slowdown is more indirect. "It's true that physicians and other health care providers are generally recession-proof," said T. Michael Preston, executive director of the state medical society, the Medical and Chirurgical Faculty of Maryland. However, "any downturn plays out over the longer term in the availability of insurance."

I was not surprised that die hard Democrat Mel Mintz is supporting the re-election of President Obama ("Romney is this year's Dewey," Sept. 5), but the reasons he gives for his support are amusing. He must be living in some other country. First, he correctly states that Osama bin Laden is dead and GM is doing well. The military and intelligence people found this terrorist and killed him. All this president did was give the OK. Any rational American would have done the same. General Motors is still alive today only because the taxpayer has given the company billions of dollars of borrowed money.

If you want to understand a major reason medical costs are out of control, breaking the federal budget and dividing the country, look at the types of people enrolled in XLHealth's Medicare insurance plans. Most suffer from diabetes, congestive heart failure or other long-term illness. They're like the millions of chronically ill Americans who visit doctors half a dozen times a year or more and, by some measures, account for 80 percent or more of all spending by the Medicare program for senior citizens.

If you want to understand a major reason medical costs are out of control, breaking the federal budget and dividing the country, look at the types of people enrolled in XLHealth's Medicare insurance plans. Most suffer from diabetes, congestive heart failure or other long-term illness. They're like the millions of chronically ill Americans who visit doctors half a dozen times a year or more and, by some measures, account for 80 percent or more of all spending by the Medicare program for senior citizens.

WASHINGTON -- Health maintenance organizations, which now serve 45 million Americans, proposed uniform federal standards yesterday for the operation and financing of health plans across the country.The HMOs, concerned about the possibility of 50 different sets of state regulations, would go much further than President Clinton's health care plan in trying to establish uniform national standards.Under Mr. Clinton's proposal, no health plan could do business unless it was first certified by one or more states.

NationsBank said yesterday that it would try to control health-care costs with a new system of managed care that includes negotiating directly with doctors and hospitals for discounted rates in some areas.The plan will allow many of its 55,000 employees nationwide, including 3,400 in Baltimore, to choose either a health maintenance organization or a preferred-provider organization.Employees who choose the HMO would receive medical care for a flat monthly rate. Workers who join the PPO and go to doctors and hospitals on the NationsBank plan's list would receive 80 percent reimbursement.

After a successful shakedown cruise, the Johns Hopkins Health System is seeking higher visibility for a plan in which it offers managed-care services directly to self-insured employers -- skipping over insurance companies and health maintenance organizations.The program, called Employee Health Plans (EHP), makes Hopkins the only hospital in Maryland contracting directly with employers, although other hospitals and doctors' groups have assembled care networks to contract with managed-care insurers.

WASHINGTON -- Federal investigators say that hospitals, under severe financial stress, are increasingly looking to doctors as a source of additional money and demanding payments for the referral of patients, in apparent violation of federal Medicare law.A recent study by the Department of Health and Human Services said there has been "a proliferation of contracts" requiring such payments by doctors in return for the hospitals' efforts to direct patients to...

WASHINGTON -- As part of its health-care plan, the Clinton administration is considering a proposal to dismantle the Medicaid program and integrate low-income people into the same networks of doctors, hospitals and private insurance companies that would serve more affluent people, administration officials say.But poor people would probably receive medical and social services beyond the standard package of health benefits to be guaranteed to all Americans, the...

WASHINGTON -- President Clinton will seek at least $35 billion in savings from Medicare over the next four years by limiting payments to doctors and hospitals and by trying to increase premiums for elderly people with high incomes, administration officials said yesterday.The proposed savings, three times what President George Bush sought unsuccessfully last year, are part of what Mr. Clinton describes as a bold program to reduce the deficit and its long-term burden on the U.S. economy. He will announce the outlines of that program in a speech to Congress on Wednesday, but the details may still be modified.

A Towson attorney filed a foot-high stack of claims Tuesday in a state arbitration office on behalf of 101 patients alleging conspiracy, negligence and fraud against St. Joseph Medical Center and its former star cardiologist, Dr. Mark G. Midei, who is accused of performing hundreds of unnecessary cardiac stent procedures. The filings, a precursor to court action, came after settlement talks between the hospital and medical malpractice attorney Jay D. Miller broke down over the amounts his clients should be paid.

VERO BEACH, Fla. -With his stethoscope decorated with three tiny koalas, Dennis Saver looks every bit the family doctor as he steps into the examining room of his small practice on Florida's Treasure Coast. When Saver begins to examine his patient, however, he does something that four out of five doctors in America do not do: He pulls out a computer. The little black Toshiba, its edges worn to the bare metal, now gets more use than the stethoscope and has become key to the care Saver gives his patients.

For two decades, electronic health records have been the Next Big Thing in health care: a way to simultaneously improve care and reduce waste in a system clogged with paper and manila folders. In 1994, President Bill Clinton announced that all doctors would use computerized records within 10 years. In his 2004 State of the Union, President Bush called for universal use of digital health records. The result of all these grand declarations: 90 percent of U.S. doctors and more than two-thirds of U.S. hospitals still use paper for patient records.

By now you surely know the U.S. health care system is massively messed up. But the question is why. A few years ago, health journalist Shannon Brownlee was going through some global health statistics. She noticed that even as U.S. health care costs were rising steadily, Americans were not getting healthier. How to explain this apparent paradox? Brownlee became fascinated and began to collect data in search of answers. The result is Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer, her analysis of how American health care has failed.

What if medical care came with a 90-day warranty? That is what a hospital group in central Pennsylvania is trying to learn in an experiment that some experts say is a radically new way to encourage hospitals and doctors to provide high-quality care that can avoid costly mistakes. The group, Geisinger Health System, has overhauled its approach to surgery. And taking a cue from the makers of television sets, washing machines and other consumer products, Geisinger essentially guarantees its workmanship, charging a flat fee that includes 90 days of follow-up treatment.

WASHINGTON - In a victory for patients and their doctors, the Supreme Court ruled yesterday that health maintenance organizations can be forced by state law to open their networks to outside doctors and hospitals. The decision upholds so-called "any willing provider" laws in half the states. These pro-consumer laws permit patients enrolled in an HMO to see a favorite doctor or specialist, even if the physician is not part of the network. So long as the medical provider abides by the network's rules, the HMO may not "discriminate against" the doctor or hospital.

I was not surprised that die hard Democrat Mel Mintz is supporting the re-election of President Obama ("Romney is this year's Dewey," Sept. 5), but the reasons he gives for his support are amusing. He must be living in some other country. First, he correctly states that Osama bin Laden is dead and GM is doing well. The military and intelligence people found this terrorist and killed him. All this president did was give the OK. Any rational American would have done the same. General Motors is still alive today only because the taxpayer has given the company billions of dollars of borrowed money.

United Payors & United Providers Inc., the Rockville managed-care middleman, announced yesterday that it had agreed to be acquired by BCE Emergis of Montreal for $580 million cash, or $27 a share. The announcement pushed shares of UP&UP up $5.0625 to $25.5625, a jump of 19.8 percent. UP&UP has grown rapidly since it was founded in 1995 and went public in 1996 -- from less than a dozen employees to about 650 and from $35.2 million in revenue in 1996 to $108.7 million in 1999. The company offers a variety of services to health insurers and self-insured employers (the payers)

The economy has health insurers worried - fewer employed people means fewer members for the insurance plans. For those who provide health care, however, the impact of the economic slowdown is more indirect. "It's true that physicians and other health care providers are generally recession-proof," said T. Michael Preston, executive director of the state medical society, the Medical and Chirurgical Faculty of Maryland. However, "any downturn plays out over the longer term in the availability of insurance."

Doctors and hospitals scrambled yesterday to treat more than 2,000 burned, broken and crushed patients taken from the wreckage of the World Trade Center. Medical officials set up makeshift emergency rooms, appealed for volunteer staff and set up triage centers, including one at a New Jersey waterfront park where hundreds were ferried throughout the day. Meanwhile, patients injured when an airliner slammed into the Pentagon were taken by ambulance and helicopter to hospitals in Virginia and Washington.