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"Healthcare" in the US

Indeed, that same largest provider is, from what I can tell, actually too large (don't think its illegal but they're pushing their luck) and has a bunch of associated entities where the relationship isn't quite clear. One such entity offered off-market no prior authorization plans, a huge deal for certain treatments.

For thw past couple of years my wife would get call after call about their retrospective utilization reviews, where they'd essentially deny treatment after the fact and demand money back that they'd agreed to pay. Problem is Texas actually has some ok laws here, they can't deny or review more than x days after treatment, maybe 30, and if they don't pay there's and automatic fine levied paid to the provider. Either they never bothered to look up the applicable state law or they just figured that so few people would call them on it that it'd be worth it, and we're talking about treatments that easily cost more than the premiums and max out of pocket 60-150k a year, so I understand that it's not a sustainable business model for them, but at the same time they're part of a multibillion dollar conglomerate that turns a profit year in year out. As far as she could tell these reviews are systematic and either triggered by paying a certain amount for a certain treatment or just hitting a certain amount of spend on the enrollee, which isn't legal iirc but also kinda hard to prove without years of work.

They've done things like getting non-doctors to oppose doctors opinions and then moved to getting general doctors to oppose multiple specialists determinations. They've gone so far as to have their assessors actually contact the enrollees parents, without properly explaining who they were or the nature of the communication, to find any possible reason to deny. She's hurt them through the automatic fines on a few occasions, gotten back a lot of money for providers. Shes gone so far as asking for a conference with their attorneys to try and teach them the law. Didnt happen. But we know there's a ton more of this going on and she's only one person. She tried to train another attorney to get this stuff but the law is apparently pretty dense and a lot of the subject matter just inherently dull and complex.

This is why for-profit healthcare will never work. The more care they can get away with denying, the more money they can pocket for themselves. The incentive system is all wrong if the goal is to have a healthy population. It works quite well if the goal is to rake off as much money as possible and to hell with anyone else.
 
:(

An undocumented 10-year-old girl was intercepted by federal immigration officers in Texas as she and a family member were in an ambulance being transferred between two hospitals so that she could receive emergency gall bladder surgery.

Rosamaria Hernandez — who has cerebral palsy and was brought to the United States illegally from Mexico when she was just 3 months old — was with her cousin around 2 a.m. Tuesday traveling in an ambulance from a center in Laredo, Texas, to Driscoll Children's Hospital in Corpus Christi when Immigration and Customs Enforcement (ICE) officers stopped the vehicle at a checkpoint, according to her family, as reported by The New York Times.

The family says the officers allowed the ambulance to proceed, but followed it to Driscoll Children's Hospital in Corpus Christi. When the surgery was over, they detained the girl.

In an open letter addressed to the Department of Homeland Security's acting secretary, Elaine Duke, the advocacy group DreamActivist says Hernandez was told "she has two options; sign voluntary departure or spend up to 3 weeks in detention."

"Families should not have to decide between getting life saving help, or being deported," the group said in the letter.

The Times reports: "By Wednesday evening, according to family members and advocates involved in her case, immigration agents had taken her to a facility in San Antonio where migrant children who arrive alone in the United States from Central America are usually held, even though her parents, who both lack legal status, live 150 miles away in Laredo."

Alex Galvez, a lawyer representing Hernandez, tells Newsweek that "this wouldn't have happened during the Obama administration."

"This current administration wants to send a clear message to all undocumented immigrants — that if you want to go to [a] hospital, you better think twice about it because you might be deported," he told the magazine.
10-Year-Old Girl Is Detained By ICE Officers After Emergency Surgery
 
Fattest states in America: Did Florida tip the scales? 

A new ranking of the states that house the fattest people is in.

While, Florida came in around the middle of the pack for fattest states in America, at No. 23, it did rank in third place for having the highest percentage of overweight children, according to WalletHub.

The states that took the top five spots were mostly in the Southeast, with the exception of Arkansas: Mississippi, West Virginia, Tennessee, Arkansas and Louisiana.

Not surprisingly, many of those same states ranked in the top five as having the highest percentage of adults with high cholesterol and inactivity.

Interactive maps --> Michigan ranked 18th fattest state in the US, study says
 
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States prepare to shut down children’s health programs if Congress doesn’t act – The Denver Post

My great nephew is (or was) covered by this in Indiana. :(

Officials in nearly a dozen states are preparing to notify families that a crucial health insurance program for low-income children is running out of money for the first time since its creation two decades ago, putting coverage for many at risk by the end of the year.

Congress missed a Sept. 30 deadline to extend funding for CHIP, as the Children’s Health Insurance Program is known. Nearly 9 million youngsters and 370,000 pregnant women nationwide receive care because of it.

Longtime physician William Rees remembers the years before CHIP’s safety net, when families without coverage would put off bringing a sick child to the doctor until symptoms were so severe they would end up in a hospital emergency room.

Some states operate CHIP as an independent program and would have to shut theirs down if federal dollars dry up. In Virginia, resources are expected to be exhausted by late January. Nablo said she has no choice but to send notices Dec. 1 to the families of the 66,000 children and 1,100 pregnant women in the state who are covered.
 
To get a patient out of their ER, this hospital in Baltimore, wheeled a woman in a hospital gown to a bus stop and left her there in freezing temps.

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In a serious bit of understatement the hospital said:

In a statement, the University of Maryland Medical Center said that they "share the shock and disappointment of many who have viewed the video. In the end we clearly failed to fulfill our mission with this patient."

The man who recorded the video called 911, and says medics ended up taking the patient back to the same hospital. Now a review is underway that could lead to personnel action against the hospital employees involved.

Video here:

Man captures video of "patient dumping" outside Baltimore hospital - CBS News

Personnel action?? They should be arrested and prosecuted.
 
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Peeved by price gouging and shortages, hospitals will now make their own drugs
1/18/2018
For four of the country’s largest hospital systems, enough is enough.

Sick of drug companies’ eye-popping price hikes and ridiculous shortages, the feisty hospital systems announced Wednesday that they’ve banded together and formed an unnamed non-profit to make their own steady supply of affordable generic medicines.

The leading hospital system, Intermountain Healthcare, released a statement explaining:

The new company intends to be an FDA approved manufacturer and will either directly manufacture generic drugs or sub-contract manufacturing to reputable contract manufacturing organizations, providing patients an affordable alternative to products from generic drug companies whose capricious and unfair pricing practices are damaging the generic drug market and hurting consumers. The company will also seek to stabilize the supply of essential generic medications administered in hospitals, many of which have fallen into chronic shortage.
Hopefully a step in the right direction
 
Amazon, Warren Buffett, JPMorgan team up to tackle ‘hungry tapeworm’ of U.S. health care costs

Amazon is diving into health care, teaming up with Warren Buffett’s Berkshire Hathaway and the New York bank JPMorgan Chase, to create a company that helps their U.S. employees find quality care “at a reasonable cost.”

The leaders of each company, Amazon’s Jeff Bezos, Buffett, and JPMorgan’s Jamie Dimon, offered few details Tuesday and said that the project is in the early planning stage.

“The ballooning costs of (health care) act as a hungry tapeworm on the American economy,” Buffett said in a prepared statement. “Our group does not come to this problem with answers. But we also do not accept it as inevitable.”
 
This is pretty fucking sick. :mad:

EXCLUSIVE: Trump officials discussed "reversing" abortion for undocumented teen

Scott Lloyd, a longtime crusader against abortion who heads the agency that oversees undocumented minors who enter the country without their parents, spoke with staffers about trying to reverse the abortion of a pregnant teen in their custody, according to a deposition he underwent as part of a lawsuit between the Trump administration and the American Civil Liberties Union.

In the past few years, opponents of abortion have championed the idea of halting a medication abortion midway by using the hormone progesterone. Anti-abortion activists have pushed governors in four states to sign laws requiring healthcare providers to tell patients about this so-called “abortion reversal” method. But there is no credible medical evidence that such a procedure works, and the mainstream medical community worries that using it amounts to experimentation on women.
 
Friend of mine went to the ER a few weeks ago with extreme abdominal pain. He had a CT scan and bloodwork, they decided it was a kidney stone, gave him IV fluids and sent him home to pass it at his leisure.

Cost $7k, of which he had to pay $2k after insurance.
 
Health related, if not Healthcare as such.

Corn Syrup Lobbyist Is Helping Set USDA Dietary Guidelines

Tkacz was director of food policy for the Corn Refiners Association, a trade group for corn syrup manufacturers, for two years before immediately leaving for the Trump administration in July 2017, according to her LinkedIn profile. Before that, she lobbied for the Snack Food Association and the National Grocers Association. Prior to her lobbying days, she spent a year as a research analyst on tax policy at the American Legislative Exchange Council, a group of corporations and conservative lawmakers that work together to craft business-friendly model legislation, and a year at the Charles Koch Institute, named after its billionaire founder and the CEO and part-owner of the global fossil fuel and materials conglomerate Koch Industries.

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More than 70 people are dead in North Texas after one of the worst bouts of flu in recent years.

But Tarrant County televangelist Gloria Copeland, one of President Donald Trump's faith advisers, wants you to know there is no such thing as flu season.

"We got a duck season, a deer season, but we don't have a flu season," she said in a Facebook video posted last week that's making headlines. "And don't receive it when somebody threatens you with, 'Everyone's getting the flu!'"

She went on: "Jesus himself gave us the flu shot. He redeemed us from the curse of flu."

It’s NOT flu season! Yes, you heard it right. The flu is NOT a season we have around here because Jesus bore ALL our sickness on the cross. This includes the flu! If you’re overcoming the flu right now, listen in as Gloria prays for YOU!

Flu season is all in our heads, Texas televangelist says: 'Inoculate yourself with the word of God' | Faith | Dallas News
 


We have the same problem getting to appointments. Imo, the main problem is the high cost of hospital parking .

There are charities that will drive people from rural areas, such as ours, and others that can help with parking, food, and accommodation.

I used to work for a charity to help leukemia patients with costs. Many moons later, I found out that my neighbour benefited from the "little angels" charity. :)
 
Mississippi Woman Criminally Charged for Pregnancy Outcome After Home Birth

Latice Fisher, 32, reportedly delivered a child at her home on April 28, 2017, and the baby was pronounced dead after arriving at the OCH Regional Medical Center.

A grand jury on January 5 indicted Fisher on a second-degree murder charge. She was arraigned on Wednesday and bail was set at $100,000. If found guilty she could face 20 to 40 years, or life, in prison. Fisher has pleaded not guilty.

Laurie Bertram Roberts, co-founder of the Mississippi Reproductive Freedom Fund (MRFF), told Rewire that women of color are disproportionately the targets of prosecution and criminalized for their pregnancy outcomes. Fisher is Black.
 
I wish them luck....

Now the Planned Parenthood chapter, along with eight other groups, is suing HHS, saying it acted unlawfully when it canceled their five-year grants midstream and with no explanation. The organizations — which include city and county health departments, universities, hospitals and nonprofit organizations — operate across the U.S. providing sex education and health information to more than a million teens.

The Teen Pregnancy Prevention Program has been lauded by watchdogs as an example of good government at work. The program grants 80 percent of its budget to groups that implement pregnancy prevention programs that have been shown to be effective. The remaining 20 percent is dedicated to trying new strategies.

The efforts are focused on African-American and Hispanic teens, who have higher pregnancy rates, and those in low-income and rural areas.

And the organizations are required to measure whether their programs are effective in reducing pregnancy, delaying teen sex or increasing contraception use. The plans was to scale up the projects that work and eliminate the ones that don't.
Trump Administration Sued Over Ending Funding Of Teen Pregnancy Programs
 
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