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Is It Health Care Or Hellth Care?
In 2006 Massachusetts passed a health care reform law that requires all residents to have health insurance through a state-subsidized plan, employer or private insurance. Now the demand for primary care in Massachusetts exceeds the supply of doctors. Nationwide 50% of primary doctors plan to scale back or stop practicing within 3 years because of the financial limitations put on them by insurance plans. To make primary care more attractive, Massachusetts has legislated loan forgiveness, home-buying help and better reimbursements for doctors. By being the first state to deal with universal health care, Massachusetts has revealed the unhealthy state of primary care.
According to a U.S. report, the nation's 100,000 medical residents - our future caregivers - aren't getting enough sleep. Although the Accreditation Council for Graduate Medical Education limited working hours for residents to 80 hours a week in 2003, the Institute of Medicine has recommended further easing of residents' workloads. The Institute recommended that anyone working the maximum 30-hour shift should get an uninterrupted 5-hour break for sleep after working 16 hours. Because studies have shown sleep deprivation clogs the brain, causing residents to make more mistakes when working longer hours, this is a recommendation the Council shouldn't sleep on.
More than 1.5 million Americans a year are injured by medication mistakes. To make prescriptions safer, Medicare wants doctors to e-prescribe to pharmacies. Not only will prescriptions be easier to read, but electronic prescribing can flash alerts when dosages seem wrong or if there could be dangerous drug interactions. Because doctors have to absorb the cost of converting to electronic prescribing, Medicare is offering an extra 2% in reimbursement rates in 2009 and 2010, with smaller bonuses for the following 3 years. Doctors still writing paper prescriptions in 2012 will receive Medicare payment cuts - cuts that can't be covered with bandages.
According to a study published in the journal Pediatrics, 10% of doctors who vaccinate privately insured children are considering stopping because they are losing money. For a vaccine that protects against pneumococcal disease the per dose reimbursement ranged from a $40 profit to an $11 loss. A chickenpox vaccine ranged from a $35 profit to a $30 loss. In the 1980's many doctors stopped vaccinating because of reimbursement problems. Then in 1989-1991 there was a major insurgence of measles that caused 11,000 hospitalizations and 123 deaths. If insurance companies don't reimburse doctors fairly, patients could pay with their health.
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