Americans unprepared to pay for long-term care
Filed under: Aging, Government, Health care reform
In the Chicago Tribune, Deborah Shelton examines how unprepared Americans are to pay for their own long-term care needs as they age. Long-term care tends to slip under the radar because, as one of Shelton’s sources told her, “People buy insurance for their life because they know they are going to die, for their car because they know that can get in an accident and for their health because they know they can get sick, but people don’t tend to buy insurance because they think they are going to need someone to help them take a bath.”
Long-term care encompasses everything from nursing home fees to in-home assistance with everyday routines. It all comes with a price tag; Medicare only covers a limited amount and Medicaid programs apply only to those below certain economic thresholds. That leaves the middle class, who can’t afford the services but don’t really qualify for Medicaid, in the lurch, Shelton writes.
Most people assume Medicare will pay the bills, but the program covers long-term care only under certain conditions and for a limited time. While Medicaid covers long-term care, beneficiaries have to be poor or willing to “spend down” their assets to be eligible. Private insurance can be expensive and excludes applicants with serious medical problems.
As a result, many families pay out of pocket until they exhaust their resources and then turn to Medicaid.
The Affordable Care Act attempted to fill in the blanks, but long-term care provisions of that reform plan withered under intense cost pressure.
An initiative that would have incorporated long-term care into the Obama administration’s health reform plan was scrapped in October after actuaries determined that it would not be financially self-sustainable over the long haul. The Community Living Assistance Services and Supports Act would have created a voluntary, self-funded, employer-based insurance option to help people save for long-term care.
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Cash-strapped Ill. goes after hospitals’ nonprofit status
Filed under: Hospitals, Hot Health Headline, Public health
A New York Times article written by Bruce Japsen, an independent journalist writing for the Chicago News Co-Op, digs into Illinois’ recent challenges to the tax exemptions granted to a trio of prominent hospitals by virtue of their nonprofit status. The challenge, inspired in part by the state supreme court’s willingness to uphold the revocation of the nonprofit status of an Catholic hospital in Urbana last year, could expand to more than a dozen other institutions as the state scrambles to cover a looming revenue shortfall.
In its case, the state alleges that the hospitals aren’t providing a high enough proportion of charity care to fulfill the mission of a nonprofit.
All three of the hospitals the state is focusing on provided free and discounted medical care that ranged from 0.96 percent to 1.85 percent of patient-care revenue, according to the revenue department. The state also said that each one had been operating as a “for profit” business when the state’s Constitution says that “only charities are entitled to a tax exemption.”
The hospitals, for their part, point to the other benefits they provide the community, such as neonatal intensive care and burn units, that don’t always bolster their bottom lines. Advocates answer that paying taxes provides a community benefit as well, one that can readily be measured in dollars and cents. And Japsen found that paying those taxes doesn’t even seem to preclude the provision of charity care, especially at the parsimonious levels provided by the hospitals currently targeted by the state.
“The relative amounts of charity care provided by not-for-profit tax-exempts are not materially different from the amount provided by for-profit hospitals,” said Jim Unland, a longtime analyst of Illinois’ health care industry and president of the Health Capital Group, a consulting firm in Chicago. “This raises the issue of whether the tax-exempts are getting prejudicially favorable treatment.”
The three hospitals whose tax exemptions have been stripped by the state department of revenue plan to challenge the action in court, and state hospital organizations are gearing up for a lobbying push they hope will put their tax status on firmer ground.
Baby’s death illustrates how health IT can introduce complexity, error to system
Filed under: Health care reform, Hospitals, Hot Health Headline, Pharmaceuticals
Chicago Tribune reporters Judith Graham and Cynthia Dizikes explore the pitfalls of health information technology through the story of an infant boy who survived despite being born months early and weighing just 1.5 pounds, only to be killed by a sodium chloride overdose when a pharmacy tech entered information into the wrong field of his electronic medical record.
Photo by Christiana Care via Flickr
The tech’s fatal clerical error was compounded by disabled alarms on a compounding machine, incorrect labeling on an IV bag and an ignored lab test. The heart of the errors, the reporters write, seems to be that all the different systems involved don’t communicate.
Almost all medication requests at Advocate are transmitted by a doctor’s keystroke to the hospital pharmacy’s drug-dispensing system. But in this case, there was no electronic connection with the automated compounding system that prepared the IV bag for baby Burkett, a specialized device that handles low-volume, highly individualized orders.
So a technician transcribed the order by hand, and an error was introduced.
Electronic communication gaps are common at large hospitals, which typically use upward of 50 to 100 different information systems at their facilities, with different technologies used in emergency rooms, labs, pharmacies and other medical departments, said Ross Koppel, a sociologist at the University of Pennsylvania who studies health information technologies.
“To some degree these systems talk to each other, but mostly they don’t, so hospitals have to design custom-made software ‘bridges’ to make this happen,” Koppel said. With each jury-rigged software solution comes the potential for new software bugs, transcription errors and other problems.
Community-led effort sparks public health wave
Filed under: Health policy, Hot Health Headline, Public health
Writing in The New York Times, Jessica Reaves writes about how a 2000-06 Chicago community survey embodies the block-by-block, community-reliant approach to public health that it helped inspire.
In the heavily Puerto Rican Humboldt Park neighborhood, researchers worked with community leaders to write study questions, then relied on community members to conduct the actual survey. From these roots, the level of community participation snowballed, and locals demonstrated an interest and investment in public health that researchers hasn’t seen before. Today, initiatives born out of that study still provide residents with access to fresh produce, free diabetes screenings, fitness classes and more.
Now, researchers are further localizing and intensifying their effort with a block-by-block approach. The Humboldt Park model has become one that others are working to replicate across the country.
The specifics of the Sinai approach (In Humboldt Park) — change-oriented and invested in the fate of a neighborhood — are distinctive, but they also reflect a sea change in the overall strategy of public health professionals, said Janine Lewis, executive director of the Illinois Maternal and Child Health Coalition, a nonprofit advocacy organization in Chicago.
“I think the field is becoming more responsive to the idea of community-based participatory research,” Ms. Lewis said. “Those of us in the field realize that community members are experts on the needs and gifts in their communities, and should be consulted” at every phase of research.
This approach, she added, not only helps investigators devise more meaningful questions, but also means residents feel a part of the process and motivated by the results.
Conference will deepen knowledge of health issues (#ahcj2010)
A list of expected sessions for Health Journalism 2010 has been released and it includes panels and classes on the most timely health topics.
The conference, April 22-25 in Chicago, will feature sessions about finding and using health data, as well as how to map it, on Thursday. 
Field trips to see research and clinical work in the Chicago area are also planned for that day.
Panels on Friday, Saturday and Sunday will help reporters who are interested in tracking stimulus spending, understanding medical studies, comparative effectiveness research, conflicts of interest in medical research, vaccines, health reform, veterans’ issues, seniors and nursing homes and much more.
Conference registration for journalists is just $150 ($99 for students) and AHCJ negotiated a hotel rate of $139 at the Hyatt Regency McCormick Place, the conference hotel. A number of fellowships will be offered as well.
For those of you on Twitter, the hashtag #ahcj2010 has been designated for news about and from the conference. Follow AHCJ_Pia for all of the latest news from AHCJ.
Trib’s Triage blog ends, Graham goes investigative
Filed under: Health journalism, Hot Health Headline
The Chicago Tribune’s Triage blog has closed its doors and Judy Graham – the face of the blog for the past year – has moved on to the paper’s investigative and watchdog team.
Graham will still find time twice a month to write the sort of stories Triage writers have come to know; fans will be able to find them in the pages of the Chicago Tribune’s Sunday section and in other Tribune papers.
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Join us in Atlanta
for Health Journalism 2012
Fellowship applications
due Feb. 27
New at HealthJournalism.org
- Data gives depth to investigation of patient safety
- What reporters should know about Alzheimer’s and related dementias
- Apply for fellowships to attend Health Journalism 2012
- AHCJ asks Supreme Court to permit broadcast of arguments in health reform case
- Tips for print, online journalists to embrace broadcast opportunities
- Numbers reveal how often, or how rarely, states check doctors’ disciplinary records
- How I did it: Falsified charts in nursing homes linked to patient care
- Access Denied: Looking at a lack of health care availability
- Transparency & medical errors: Public reporting of patient harm is a potent force
