September 25, 2009
Let’s cut the wheat from the chaff: Tort reform will do nothing to fix health care. Forty-six states have already done it, and costs have continued to skyrocket. The Congressional Budget Office and Government Accountability Office have said tort reform will save practically no money, and they found no evidence of defensive medicine. Medical malpractice suits are less than 1 percent of all civil filings — and this has declined 8 percent during the past decade. The research is definitive and absolute, and those claiming otherwise are just trying to obstruct health care reform altogether.
More than 98,000 people die every year from preventable medical errors, according to the Institute of Medicine. That report is 10 years old, and estimates are the number has gotten significantly worse. This is the equivalent of two 737s crashing every day for a whole year. If planes were crashing like this today, would we focus on giving airlines immunity or making air travel safer?
So this is how you really put trial lawyers out of business: Just cut down on the errors. Fewer errors mean fewer complications — or fewer people who will need legal recourse. Electronic medical records, bar-coding equipment, tagging surgical instruments and routine operating room checklists are just a few measures that can decrease errors. And there are countless more that can corral this epidemic and make patient safety a priority once again.
September 21, 2009
A minimum of 3.4 million doses of vaccine against H1N1 pandemic flu will be available in the first week of October, the CDC said.
Those doses — all in the form of a live attenuated nasal spray vaccine — may be supplemented by some injectable vaccine, according to Jay Butler, MD, the chief of the agency’s 2009 H1N1 vaccine task force.
“Additional vaccine may be available as well,” Dr. Butler told reporters, “but 3.4 (million) is the hard number that we have right now.”
After the first week of October, additional vaccine will become available, he said, eventually reaching 20 million doses delivered each week until the end of the year.
Butler cautioned that getting the vaccine to patients is likely to be logistically challenging, especially in the first days. “The flow of vaccine the first week or two may be slower than what we would like,” he said.
The U.S. has ordered 195 million doses of pandemic flu vaccine from five companies, and four of the vaccines have now been licensed by the FDA. (See FDA Approves H1N1 Vaccines)
To get them out, the government will use the same process employed by the Vaccine for Children program, which distributes medications to about 40,000 healthcare providers across the country, he said.
That network will be expanded by adding another 50,000 providers of various types.
But not all of those providers will have vaccine available for all patients immediately, he said. “There’s not a sudden appearance of vaccine in 90,000 refrigerators around the country,” Butler said.
The ordering process, he said, will begin with a request from a provider to the state health department, which will know from day to day how much vaccine is allocated to that state.
State allocations will be based on population.
September 15, 2009
The story of Ms. Whitaker’s two organ donations — the first from her mother and the second from her boyfriend — sheds light on a Medicare policy that is widely regarded as pound-foolish. Although the government regularly pays $100,000 or more for kidney transplants, it stops paying for anti-rejection drugs after only 36 months.
The health care bill moving through the House of Representatives includes a little-noticed provision that would reverse the policy, but it is not clear whether the Senate will follow suit. The 36-month limit is one of several reimbursement anomalies — along with inadequate primary care payments and incentives that encourage unneeded care — that many in Congress hope to cure.
Ms. Whitaker, 31, who describes herself as “kind of a nerd,” has Alport syndrome, a genetic disorder that caused kidney failure and significant hearing loss by the time she was 14. In 1997, after undergoing daily dialysis for five years, she received her first transplant. Most of the cost of the dialysis and the transplant, totaling hundreds of thousands of dollars, was absorbed by the federal Medicare program, which provides broad coverage for those with end-stage renal disease.
Despite that heavy investment, federal law limits Medicare reimbursement for the immunosuppressant drugs that transplant recipients must take for life, at costs of $1,000 to $3,000 a month.
September 14, 2009
Two million people in the U.S. died needlessly in the past ten years from preventable medical error and 200,000 more of us will die this year unnecessarily because half of the medical community won’t be washing their hands, or their equipment, or taking out catheters, or operating on the correct body part, or handing out the right medications, or infecting the patients with germs they have brought from hospital clothes worn out in the streets. How much money is spent because of these careless practices, as well as because of overuse, misuse, and abuse by our health care system?
Let’s have a true debate. What is the value of a human life? Is it worth a hand washing? Will it be possible to alleviate medical malpractice suits when the medical community adopts safety measures that have proven to lessen infections 70-100%? Will our government and the medical communities have a mandated discipline policy and transparency, rather than lie and deny? Why can’t we find out more about the costs of care, the error rates and deaths reported? Why hasn’t the Illinois law, co-sponsored by then State Senator Obama, for reporting infection and adverse events not been implemented as passed nearly six years ago? Why, after years of trying, is there no national law mandating patient safety in the USA?
If it were not for the heroes/heroines in the patient safety movement, those who have lost children, spouses, moms and dads in this senseless medical holocaust and the many brave doctors, nurses, health educators and workers, pioneering hospitals, journalists and media, this horror would continue to be our deep, dark, secret.
September 3, 2009
Pfizer will pay the government $2.3 billion to settle criminal and civil charges that it promoted off-label uses for the disgraced painkiller valdecoxib (Bextra) and three other drugs.
The Justice Department said it was the largest healthcare fraud settlement in history.
More than half the settlement — $1.3 billion — involves Pfizer’s efforts to promote valdecoxib, a COX-2 inhibitor withdrawn from the market in 2005 because of cardiovascular and other risks.
Pfizer’s sales staff had urged doctors to prescribe the drug for surgical pain and to prevent deep vein thrombosis, according to court records from a criminal trial of a Pfizer manager earlier this year.
The other $1 billion covered charges that Pfizer improperly promoted the antipsychotic drug ziprasidone (Geodon), the antibiotic linezolid (Zyvox), and pregabalin (Lyrica), approved for epilepsy, fibromyalgia, and neuropathic pain.
The settlement will be shared between the federal government, state Medicaid programs, and whistleblowers. The latter include a Pennsylvania psychiatrist and at least one former Pfizer employee whose allegations helped launch the investigation.
Their complaints, which had been sealed until the settlement was reached, provided details on Pfizer’s alleged transgressions.
For example, according to one complaint, Pfizer pushed linezolid for several types of infections not named on its FDA-approved labeling, and also claimed it was superior to vancomycin without FDA approval.
Similarly, Pfizer was said to have promoted ziprasidone — approved only for schizophrenia or acute manic or mixed episodes associated with bipolar disorder — for depression, obsessive-compulsive disorder, autism, and a host of other conditions.
In addition to promoting the off-label uses, Pfizer was also accused of paying kickbacks to doctors who prescribed the drugs.
Sales of ziprasidone, pregabalin, and linezolid in 2008 totaled about $2.5 billion, according to the consulting firm SDI Health.