New Jersey Hospital Problems and Health Reform Challenges

In the last 2 years of their lives, New Jersey patients on Medicare see consultants a mean of fifty times — twice as frequently as those in Connecticut and more than 4 times as frequently as those in Minnesota, according to the Dartmouth Institute for Health Policy and Clinical Practice.

But there is no clear benefit to the people’s overall health : New Jersey ranked 26th among states in a comparison of medicare indicators by the Commonwealth Fund, a personal foundation. Pros have found other high-cost areas of the country also don’t deliver phenomenal care.

“Substantial opportunities seem to exist to reduce medicare costs without hurting quality of care or outcomes,” Obama’s budget director, Peter Orszag, told a Senate panel early on in the year. But sharply cutting down on Medicare payments to high-expense areas, as congressional leaders are considering, could undermine hospitals’ capability to treat the poor and uninsured, pay off their impressive building upgrades and expansions or compete with stand-alone surgery centers that cherry-pick plenty of their most profitable patients.

“If we went into New Jersey and asserted, ‘New Jersey, you have got 2 years to appear like Rochester, Minn, which does quite well with less,’ basically medicare systems all across New Jersey would go bankrupt,” related Dr David Goodman, a lecturer at the Dartmouth Institute. Steep cuts to infirmaries, among the strongest political and commercial players in any community, also would inflict serious collateral damage. New Jersey’s hospitals spent over $18 billion in 2007 and employed more than 145,000 people, according to the New Jersey Hospice organisation.

“They have a vital role in the economy : they hire counsels, they hire accountants, they have their events to raise money at the local hotel,” expounded David Knowlton, president of the New Jersey medicare Quality Institute. “It creates a large sucking sound as roles go down the drain when they leave.”.

That is what’s happened to Westwood in 2007, when Pascack Valley Surgery applied for bankruptcy. The 48-year-old nonprofit hospice had a heavy debt from a new addition it had built, and had been unable to stop a dispersal of patients and doctors to other places. When it closed, Pascack was filling only a 3rd of its beds. “We experienced the General Motors thing,” declared Quiver . “That’s one thousand of my customers, one thousand mortgages that are in question.”. The state’s health commissioner allowed the closure, concluding that other infirmaries in the area could handle the increased patient load and basically would be reinforced. Indeed, The Valley Surgery in Ridgewood, at 6 miles west the nearest acute care center, and Englewood Hospice and Medical Center, 8 miles to the south, seriously improved their fiscal health.

But last summer, Hackensack Varsity Medical Center, a 775-bed teaching and research hospice that is an example of New Jersey’s most illustrious, requested state authorization to open a new hospice in Pascack Valley’s empty buildings. Though Hackensack is a nonprofit, it revealed that Westwood would be getting a for-profit facility sponsored by a personal equity firm from Texas. Hackensack isn’t looking to survive ; it’s planning to grow. One of the most frantic surgeries in the country, Hackensack took in over $1.1 bln in 2007, giving it an enviable 7 p.c operating margin, according to its tax records.

In its application to state regulators, Hackensack announced the new surgery would “relieve the bed pressure” at its main campus,” where nearly every bed is generally filled.

Hackensack managers claimed the fresh closings of 3 hospices in the area have eliminated the area’s surplus of beds, and therefore the area’s aging population will need more services in coming years. They revealed Hackensack can bring Westwood and surrounding areas better hospital therapy than can anybody else. “To me, this is a no brainer,” related John Ferguson, who till last week was Hackensack’s president and Head honcho . It’s just the other establishments are scared of competition, but in my judgment competition will make them even better.”.

But at Valley and Englewood surgeries, operatives translate Hackensack’s plan as a battle for dominance at the cost of their stability. “If that place were to reopen, we would need to have layoffs, we would need to close services,” Pietrowicz expounded. “To permit something similar to this, that flies in the face of sane medical care, would be desolating to Englewood Hospice and the communities we serve.”.

2 members of the commission allocated by Gov Jon Corzine, a Left winger , to size up the country’s surgery bed surfeit have written Corzine in opposition to Hackensack’s new undertaking.

“It makes no damn sense,” commission member David Hunter, an expert and previous surgery executive, recounted in an interview. He revealed adding a surgery was a particularly bad concept since Congress and Obama are targeting removing huge savings from the medical care system. “When you are heading into this much doubt, it is not a time to be adding any capacity,” Hunter claimed. Many residents and local officers are exasperated by opposition from Ridgewood’s and Englewood’s infirmaries, which can be up to a half hour away in heavy traffic. In early May, Mayor John Birkner Jnr arranged a four-mile march with fifty fans to Ridgewood that was stopped at the town border for need of a permit.

Westwood residents are especially livid the 2 other infirmaries offered $2 million in bankruptcy court to buy and retire Pascack Valley’s old operating license, which Hackensack got given in May. “This is about cash and greediness, not about helping people,” declared Vivian Stubbs of Westwood. “If I did not know what was going on, I’d believe they were speaking about cattle, not people.”. Westwood’s aged say a resurrected hospital would make it better to get to doctors’ appointments, dialysis, radiation treatments and physical care.

“I’m supposed to go for lab work each 3 months,” related Theresa Giannone, 76, a retired housekeeper.

On June eight, the state health office will hear public affidavit before deciding whether to approve Hackensack’s plans. That call is certain to be closely observed by New Jersey’s 59 infirmary systems, about half which lost out last year, as an indication of whether the state is willing to put its regulatory muscle behind the commission’s findings. “Every hospice board thinks they can out-compete the local hospital,” asserted Joel Cantor, director of the Rutgers Center for State Health Policy in New Brunswick. “It’ll take time before infirmary boards recognize that enlargement isn’t the sole vital they have.”.

NY baby died of swine flu?

NY City’s medical examiner is allegedly looking into whether swine flu caused the passing of a Bronx baby. The family of 11-week-old Steven Montanez tells the Daily Reports that the baby had the influenza when his aunt found him comatose on Thu. .

The medical examiner’s office failed to straight away return a call.

As much as 4 deaths have been linked to swine influenza since the outbreak commenced in NY Town in Apr. Authorities say most examples of the pathogen have been mild.

More cigarette problems – this time for the Planet!

Everybody knows that smoking is bad for your fitness.

Turns out it is not so good for the healthiness of the planet, either. Cigarettes might go up in smoke but the butts remain and account for 1.7 bn. pounds of non-biodegradable trash. According to ButtsOut, fag butt litter is the planet’s best environmental litter difficulty with approx 4.3 trillion cigarette butts tossed onto roads, pavements, beaches, parks, forests and in waterways each year. Further breakdown suggests that smokers in the USA account for over 250 bln Marlboro butts, those in the United Kingdom account for two hundred tons of butts, and Australian smokers litter over seven bn. ciggie butts yearly. In reality, in most Western states cig butt litter accounts for around half of all litter. In America, while gasper smoking has reduced 28%, smokers are increasingly dropping cigarette butts on the ground, in planters, and throwing them into the waterway. This year, the World Health Organization’s No Tobacco Day on May 31st is targeting health cautions on tobacco product packaging as a means of inspiring smokers to give up.

But maybe instead they’ll be targeting teaching smokers about the damage that butt litter causes to the environment. Perhaps if they noticed that it takes over 25 years for fag butts to rot and they poison our waterways and kill sea life, they might stop simply throwing butts away.

Breast Cancer Reoccurance Risks are Elevated by Drug Combinations

Breast cancer survivors risk having their illness come back if they use certain anti-depressants while also taking the carcinoma prevention drug tamoxifen, worrying new analysis shows. About half a million ladies in the US take tamoxifen, which cuts in 1/2 the possibilities of a breast cancer recurrence. A lot of them also take anti-depression drugs for hot flashes, because hormone pills are not considered safe after breast cancer. ( See TIME’s studio : The faces of breast cancer ).

Doctors have long known that some anti-depression treatments and other drugs can lower the quantity of tamoxifen’s active form in the bloodstream. But whether this is affecting cancer risk is not known. The new report, reported Sat. at a cancer meeting in Florida, is the biggest to take a look at the issue.

It revealed that using these interfering drugs including Prozac, Paxil or Zoloft can virtually wipe out the benefit tamoxifen provides. Many doctors query the scale of harm from mixing these drugs, and a 2nd, smaller study suggests it won’t be massive. But the final analysis is the same : Not all anti-depressants pose this problem, and girls should talk to their doctors about which of them are best. “There are other alternatives we will consider” that are safer, asserted Dr Eric Winer, breast cancer chief at the Dana-Farber Cancer Center in Boston.

He had no role in the study, which was done by Medco Health Solutions Inc, a massive insurance benefits boss. Analysts used members’ medical records to spot 353 girls taking tamoxifen and other drugs that might meddle with it, and 945 ladies taking tamoxifen alone. Those taking a drug combo did so for roughly a year often. Next, analysts checked to see how many were given treatment for 2nd cancers in the following 2 years. Breast cancer recurred in about seven % of ladies on tamoxifen alone, and in fourteen p.c of girls also taking other drugs that would interfere principally the anti-depressants Paxil and Prozac, and, to a smaller extent, Zoloft. If ladies need to take an antidepressant, “you doubtless need to keep away from those three,” expounded Medco’s chief medical officer, Dr Robert Epstein.

No larger breast cancer risk was seen in ladies taking the antidepressants Celexa, Lexapro or Luvox with tamoxifen, and there are reasons to believe that other anti-depressants might be safe as well, Epstein asserted. A 2nd study controlled by Dr Vincent Dezentje of Leiden School Medical Center in Holland found small risk from mixing tamoxifen and preferred anti-depression treatments.

However, only 150 ladies in the study took such combos for at least 2 months, and they were compared to girls taking combos for a shorter time not to ladies using tamoxifen alone. The Dutch and Medco studies were presented at a meeting of the Yankee Society of Clinical Oncology. The Fed Food and Drug Administration has been considering a change to tamoxifen’s label to alert about the anti-depression treatments drugs and a gene variation some girls have that may make tamoxifen less effective. An advisory panel unanimously endorsed a change in 2006, but the agency is still considering it.

“This is a particularly questionable area,” announced Dr Claudine Isaacs, a breast expert at Georgetown College’s Lombardi Total Cancer Center.

“Until these data are completely clear, I might duck drugs that effect on tamoxifen metabolism.”. Breast cancer is the commonest major cancer in Yank ladies.

Top 7 Health Misconception

According to a new report, even doctors become a victim of common medical misapprehensions. Here’s the straight story on everything from postmortem hair expansion to Halloween candy dangers.

A study in the UK Medical Book’s December issue looked at 7 medical legends that doctors frequently accept as truth.

“Patients and folks should be at liberty to ask about why the things they are being told are true. They’ll be upfront about it.” To start your year off with less fiction and a touch more fact, here are 7 of the commonest medical parables debunked:. While this is one parable that folks around the globe have loved for generations, it has tiny systematic backing. Reading in the dark could cause a short lived strain on the eyes, but it fast goes away when you return to brilliant light.

The practice has been given the blame for augmenting rates of myopia ( nearsightedness ), but Carroll asserts those claims don’t align with the evidencewe’re living in the best-lit conditions the world has ever seen. “Seventy years back we were reading by candlelight and were not going blind,” asserts Carroll. “There’s no proof for this whatsoever.”.

Using cell telephones in hospices is deadly. Regardless of the signs in most emergency waiting rooms, studies have found almost no serious cell telephone interference with medical devices.

In 2005 the Mayo Hospital ran 510 tests with 16 medical devices and 6 cell telephones.

The prevalence of clinically crucial interference was simply a 1.2 %. “Growing hair and fingernails is a particularly complicated hormonal task,” asserts Carroll, one that can’t occur after one has expired. So how did this parable get off the ground? It might be because after death the skin starts to contract, which could give the appearance the nails are growing. The idea that our brains are not running at full speed simply does not hold up. “Numerous kinds of brain imaging studies suggest that no area of the brain is totally silent or inactive. Carroll announces the idea may go as far back as the snake-oil salesmen of the early 20 th century, who used the parable to sell a tonic that would increase mental power.

You need to drink at least 8 cups of water a day. Existing studies suggest that that often-omitted fact is key to understanding water intake. We get sufficient fluids from our classic daily consumption of juice, milk and even caffeinated drinks. And drinking too much water could cause water intoxication, a severe electrolyte imbalance in which cells swell with excess liquid, and even death. Wax, shave or cutno matter how you opt to remove your hair, you will not change the feel or speed at which it grows back.

Leg hair will appear coarser right as it starts to regrow. “The hair that at first grows back is blunt, hasn’t had time to taper off, so it’d look darker,” says Carroll. But as it is getting a bit longer and is exposed to the sun, it’ll look precisely like the hair you started with. Contaminated candy from strangers is a Halloween threat.

While not included in the Brit Medical Book study, this is an example of Carroll’s private pet peeves. There have been some examples of kin doing so.

Treat Heart Disease with a pill made of tomato

Scientists say a natural supplement made of tomatoes, taken daily, can stop heart problems and strokes. The tomato tablet contains an active ingredient from the Mediterranean diet – lycopene – that blocks “bad” LDL cholesterol that may block the arteries.

Ateronon, manufactured by a biotechnology spin-out company of Cambridge Varsity , is being launched as a diet supplement and should be sold on the high st. Mavens related more trials were wanted to see how effective the treatment is. But Professor Peter Weissberg of the UK Heart Foundation claimed : “As always, we caution folks to hang around for any new drug or altered ‘natural’ product to be medically proved to supply benefits before taking it. “It will take a little time, and many trials, to provide such proof for Ateronon. “In the meantime, our recommendation to heart problems patients or those at high risk is to depend on proved medicines prescribed by their doctor, and try to get the advantages of a Mediterranean diet by eating masses of fresh fruit and veg.”.

He revealed the UK Heart Foundation had supported some of the basic science at Cambridge University underpinning the development of the product.

Professor Anthony Leeds, trustee of the cholesterol charity Heart UK, recounted : “The new lycopene product Ateronon represents a wholly new approach to the treatment of high blood cholesterol and opens up the thrilling possibility.”. He revealed the initial findings were “very promising”. Lycopene is an antioxidant contained in the skin of tomatoes which gives them their red color. But lycopene ingested in its natural form is poorly soaked up. Ateronon contains a refined, more readily absorbed version of lycopene that was originally developed by Nestle.

Dr Peter Coleman of The Stroke Association asserted : “We know that diets loaded in antioxidants are advantageous in reducing the plaque build up and welcome the findings of this research.”.

Abortions Doctor Shot in Kansas

George Tiller, a gynecologist who performed late-term terminations, was shot dead at his church in Kansas on Sun.

Tiller’s eagerness to perform terminations later in the course of pregnancy than plenty of other consultants made him the object of years of protests and legal threats. In 1993, this A. M. ‘s WSJ notes, “he was shot in both arms by a termination contestant, but was back at work the following day with the protection of Fed. marshals as bodyguards.”. He was also investigated by 2 grand juries summoned by citizen-led petition drives, the NY Times asserts. Tiller graduated from the Varsity of Kansas Medical Center in 1967 and stayed approved at the time of his expiration, according to the Kansas Board of Healing Arts.

He called access to termination “a matter of survival for women,” the WSJ says. The US Marshals Service, acting on orders from the US lawyer General, will start defending certain termination hospitals and doctors, the Washington Post reported.

Online Healthcare Technology News

How many times have you wanted recommendation from a doctor, but failed to have some time to drive somewhere to see one? How frequently has a medical query gone unanswered because finding a doctor to ask was just too much of a hassle? How often have you delayed medical therapy as you could not reach your own doctor and failed to know who else to see? What if there had been a simpler way to get care for a minor illness or injury? Well, for voters of the state of Hawaii, there truly is another way!

In Jan , one of the biggest health plans in the state of Hawaii, HMSA, launched a new initiative that provides online care to each voter. Residents can get answers to medical questions or treatment recommendation for a minor sickness or injury from a participating doctor using online web messaging, video visits, or the phone. The sponsoring health plan even repayments costs related to using the on-line service. Partners in this exciting new initiative include Yankee Well Systems in Boston and Microsoft HealthVault.

This week, we have released a new audiocast for my home Calls for Healthcare Execs series. It explores the new online service from HMSA and what galvanized the company to supply it. Players in the debate include : Dr. Roy Schoenberg, founder and Boss man of Yankee Well Systems in Boston. Dr. Patricia Avila, Medical Director for online services at the Hawaii Medical Services organisation HMSA, an independent licensee of Blue Cross-Blue Shield and one of the biggest health insurers in the state of Hawaii. Dr. Avila is also a first care and preventative medication surgeon practicing in Hawaii. Dr. James Mault, a Director for Microsoft’s Health Solutions Group representing Microsoft HealthVault.

Flu news

Eton, the UK boys’ faculty set up in 1410, will be closed till June 7 because a 13-year-old student was diagnosed as having the H1N1 swine flu. The boy has mild symptoms and is recovering at home, the Times of London reports.

The UK has had a total of 203 confirmed influenza cases, with no deaths, according to this govt update. A liner bound for the Great Barrier Reef modified course and heading for shore after the H1N1 influenza was confirmed in 3 crew, the AP reported.

The cruise started on Mon. , just hours after the ship returned from a prior outing ; 2 dozen passengers and crew who were on the earlier cruise came down with swine influenza. A vaccine for the new H1N1 strain might be available in October, if everything goes smoothly, a CDC official said, according to DJX Newswires.