Healthcare links

From John Goodman:

Before the 1990s, hospitals were thought to attract patients by attracting physicians, which they often did by investing in high-tech medical capabilities. This “medical arms race” led many hospitals to offer a costly array of duplicative services… Now, yet another style of competition appears to be emerging, in which hospitals compete for patients directly, on the basis of amenities…

[For example,] the Ronald Reagan UCLA Medical Center [has]…private and family-friendly rooms, magnificent views, hotel-style room service for meals, massage therapy, and “a host of other unexpected amenities.”

Medicare admits overpaying for common items like wheelchairs:

Alan Siegel of Fort Lauderdale discovered the overspending recently when he needed to replace a wheelchair for his wife. He wanted to buy one since she suffers from a form of muscular dystrophy and requires permanent use of a wheelchair.

But Medicare only covers the cost to rent one for up to 13 months. At that point, the chair belongs to the patient.

Two months into Siegel's rental, he learned just how much Medicare was paying. The total cost over the course of the rental would top $800.

"I checked further and found the chair being rented cost less than $350. . .I had the supplier stop the rental and I purchased the chair,'' Siegel said. "It is ridiculous for Medicare to spend so much more for a rental in situations when a cheaper purchase makes so much more sense.''

Weighing Medical Costs of End-of-Life Care:

The Ronald Reagan U.C.L.A. Medical Center, one of the nation’s most highly regarded academic hospitals, has earned a reputation as a place where doctors will go to virtually any length and expense to try to save a patient’s life.

“If you come into this hospital, we’re not going to let you die,” said Dr. David T. Feinberg, the hospital system’s chief executive.

Yet that ethos has made the medical center a prime target for critics in the Obama administration and elsewhere who talk about how much money the nation wastes on needless tests and futile procedures. They like to note that U.C.L.A. is perennially near the top of widely cited data, compiled by researchers at Dartmouth, ranking medical centers that spend the most on end-of-life care but seem to have no better results than hospitals spending much less.

...

At U.C.L.A., such palliative care — treatment devised to relieve pain and make patients more comfortable, particularly at the end of life — was essentially an afterthought until just a few years ago, when an internal task force recommended that the hospital add it to its many other specialties. The hospital now has a formal unit devoted to palliative care and is building up its expertise in the field. Residents, in training to be doctors, are being taught how better to discuss these issues with patients and their families.

Some doctors are resistant, particularly those with patients who had hoped for a transplant but were removed from the list when it became clear they had no realistic chance of recovery.