Medical Care

CHICAGO -- Tired of paying for botched medical procedures and low-quality medical care, some of the nation's largest businesses called on U.S. hospitals yesterday to agree to apologize and waive costs related to so-called "never events" - medical errors these employers say should never happen. Both the Leapfrog Group, a national coalition of large health care purchasers such as Boeing Co., General Motors Corp., General Electric Co., Lockheed Martin Corp. and Marriott International Inc., and the Midwest Business Group on Health, a Chicago business coalition representing more than 80 local employers, said hospitals should commit to new policy on 28 health care never events as a way to make providers of medical care more accountable.

Medicare must control wasteful spending As a primary care physician who cares for elderly patients, I read the editorial "Health care reform" (Dec. 26) with interest. The editorial correctly pointed to the obscene discrepancy between the salaries of primary care doctors and specialists as part of the problem in providing cost-effective medical care. But the real question is why specialists earn so much and use up such a disproportionate percentage of our health care resources. Medicare could easily fix the problem by altering its reimbursement policies and limiting visits to specialists, and leaders of Medicare have been talking about doing just that for 20 years.

Make medical care available for all I agree with Thomas Sowell that people should take responsibility for how they use health care dollars and insurance and for how they care for themselves and use medical facilities, including ERs ("Let's not confuse lack of insurance with lack of care," Opinion * Commentary, Sept. 5). I also see his point that national health insurance would not be free. However, Mr. Sowell notes that in the past he was "lucky enough not to have any heavy duty medical expenses that would have required major operations or a long-term hospital stay."

A Mount Airy man charged with murder in the shooting of an acquaintance early Saturday was to be transferred today from the Carroll County Detention Center to the Maryland Correctional Institution in Hagerstown to receive medical care.Dennis Brian Absher, 55, of the 4700 block of Roop Road uses a wheelchair and has extensive medical problems that the county jail cannot care for, officials said at a brief hearing yesterday in Carroll County District Court.Absher is being held without bail and has waived his right to a bail-review hearing.

If you are lamenting the cost and confusion of your Medicare or HMO health-care plan, just remember: It could be worse. You could be facing more difficulties in the Canadian health-care system. Its government-financed system is not the utopia it appears to be.Granted, Canada provides basic care and pays for everyone, no matter each citizen's employment status or income level. However, as I found out during a recent international conference on aging there, problems abound.An article in the National Post summed up the current struggle: "After five years of deep government cuts to health care that have affected every province and virtually every community, public confidence in government-financed medical care is faltering as more and more Canadians experience delays in receiving medical care and endure over-crowding in hospitals."

AN EARLY look at the HMOs that contract to provide medical care for Maryland's Medicaid recipients has turned up disturbing problems.In a state-funded audit, the independent Delmarva Foundation evaluated the nine HMOs providing medical treatment for some 300,000 Medicaid patients under the state's 19-month-old HealthChoice program. Among the failings identified: Six months into the program, not one HMO was providing the care required for new patients or diabetics. Only two HMOs provided required prenatal services.

BOSTON -- Start with the basic scenario. You are sitting in the doctor's office, dressed in one of those charming johnnies that open ever so attractively at the back.The doctor has probed various parts of your body and history that are not generally open to public scrutiny. The doctor now knows your age and weight (well, more or less), your blood pressure, your medications, your symptoms past and present, your reproductive history and any drugs that have been prescribed.HIV statusFor that matter he or she may know what genetic tests you've had and what your HIV status is, whether you've taken Prozac and if that's your original nose.

ZHENJIANG, China -- In the good old days of socialism, the state paid for everything when Comrade Lu got sick, including the medicine he consumed and the hospital bed he used."

YOU CAN'T take politics out of health-care issues. Too much money is involved -- for patients, insurers and the government.In Washington, Republicans are jockeying with Democrats to gain advantage in passing a "patients bill of rights." Initially, GOP conservatives opposed this notion, but pressure from voters propelled them to offer a limited plan to give consumers in managed-care situations greater medical choices.In Maryland, politicians are playing a similar game. Democratic gubernatorial candidate Eileen M. Rehrmann wants to punish medical directors of health-maintenance organizations for denying treatment to patients.

PHILADELPHIA - Ask some people at the mall how they chose their doctors and a big, but little heralded problem in health care quickly reveals itself.When a blood vessel in her husband's brain broke three years ago, Laura Pfeil let the ambulance take him to an Abington Memorial Hospital surgeon recommended by an emergency room doctor at Doylestown Hospital. She knew nothing about either doctor."I didn't know anything about neurosurgery at all," the 60-year-old Warrington, Pa., woman said. "I had no idea."

With heated debates about reforming health care swirling across the country, professors from the University of Maryland's graduate schools told more than 200 students about how proposed changes might affect their future careers in medicine, dentistry, nursing, law, pharmacy and social work at a panel discussion Thursday night in downtown Baltimore. All the professors agreed that the U.S. health care system needs to be reformed. "We do need to control spiraling costs, but we don't want to do that at the cost of stifling innovation," said Dr. Mandeep R. Mehra, professor and head of cardiology at the University of Maryland School of Medicine.

While Americans spent much of the August doldrums transfixed by the national debate over health care reform, state officials moved toward resolution of a long-running dispute involving the medical care inmates receive at the 150-year-old Baltimore City Detention Center. This week, officials announced a settlement in a lawsuit originally brought in 1971 aimed at ensuring jail inmates get adequate medical treatment for illnesses such as asthma, diabetes and infectious diseases, and that they are not held in facilities rife with safety hazards and vermin.

The 40,000 men and women held in Baltimore jails each year could receive speedier access to medical care and see improved sanitation conditions under a settlement between state officials and prisoner rights advocates filed Tuesday in federal court. Over the years, the advocates have documented what they say are dire problems at the Baltimore City Detention Center and the Central Booking and Intake Center: A longtime diabetic died after not receiving insulin. An asthmatic died because jail employees thought he was faking his condition and didn't give him an inhaler.

Mars? We have enough problems at home American narcissism has no limits. When the government has a deficit so staggering that the human mind has trouble wrapping itself around the amount, and when the homelessness, joblessness and hunger in this country are reaching record proportions, to propose that we increase that deficit to send men to Mars and ignore these and other dire problems is narcissistic insanity that only the delusional can embrace ("Destination...

At a time when some cash-strapped states are contemplating reducing Medicaid coverage, Maryland has boldly moved in the opposite direction. Today marks the first anniversary of a program that has brought taxpayer-financed medical assistance to more than 44,000 low-income parents, the vast majority of whom lacked health care before. That's nearly 20,000 more people than advocates had expected to enroll by now, and it's one of the more significant accomplishments of Gov. Martin O'Malley's term in office.

Maryland residents looking for a primary care doctor have a harder task every day, as the number of family doctors continues to shrink and those still practicing say they are squeezed for time and money by insurance companies and forced to shortchange patients. "The patients don't know what's going on," said Dr. Lindiwe Greenwood, a solo practitioner in Columbia. "They don't know why we won't take Medicaid." She was among a group of doctors and other health care professionals who met recently to make recommendations to the General Assembly on how to address a growing crisis in this vital main link between patients and medical care.

Oakley Henry Saunders Jr., a retired pediatrician who had been president of the old Provident Hospital and later worked in medical accreditation, died of cancer Tuesday at his Forest Park home. He was 81. Born in Baltimore and raised in West Baltimore, he attended Frederick Douglass High School and served in the Army. He earned a degree from Howard University and was a 1957 Meharry Medical College graduate. After an internship at Provident Hospital and a residency at what is now the University of Maryland Medical Center, he established a private pediatric practice in 1960 on Madison Avenue.

One doesn't have to be a doctor to question whether working 30 hours straight yields quality medical care. Small wonder that the hours medical residents are required to keep have become such a controversy over the years. But the latest study reported in the New England Journal of Medicine focuses on a key question: What would it cost for teaching hospitals to reduce residents' hours, and would the benefit (assuming there is one) be worth it? The cost is clear enough. If hospitals like Johns Hopkins Hospital or University of Maryland Medical Center were to follow the recent recommendations of the Institute of Medicine and limit shifts with no naps to 16 hours and reduce the workload of residents, it would cost the industry between $1.1 billion and $2.5 billion (much of it to simply hire more residents and doctors to supervise them)

Civilian workers who suffered devastating injuries while supporting the U.S. war effort in Iraq and Afghanistan have come home to a grinding battle for basic medical care, artificial limbs, psychological counseling and other services. The insurance companies responsible for their treatment under taxpayer-funded policies have routinely denied the most serious medical claims. Those same insurers - primarily American International Group - recorded hundreds of millions of dollars in profits on this business.

Could actress Natasha Richardson's tragic death have been prevented if her skiing accident had occurred in America rather than Canada? This is a legitimate question because of how Canadian and American medical care differ. Canadian health care de-emphasizes widespread dissemination of technology such as CT scanners and quick access to specialists such as neurosurgeons. While all the facts of Ms. Richardson's medical care haven't been released, enough is known to pose questions with profound implications for both countries.