'Bitter Pill,' Take 1

Editor's Notes: H&HN received a number of responses to "Umbdenstock Addresses Times' 'Bitter Pill'" by AHA President and CEO Rich Umbdenstock, which appeared in H&HN Daily on March 1. Here are representing different points of view:

Mr. Umbdenstock made a good point that health care institutions are complex and barely manageable. That's because we have a supply-driven medical market in America that is not a free market. There are many distortions in this market as pointed out in "Bitter Pill." What we need in the USA is a national single-payer insurance system that would lead to meaningful health care reform that would hold down long-term cost, improve delivery of care and provide universal access to everyone (the goal of the Triple Aim). Why can't we do this? All other developed nations have national programs of some type that cost less than half of what our market system costs, and do indeed have better population health than the USA. It's time to think out of the box and seriously study what an expanded and improved Medicare for All program would do to reform our outdated "non-system" of health care financing.

— Art Sutherland, M.D.
Tennessee coordinatorand national board member
Physicians for a National Health Program

'Bitter Pill,' Take 2

Time should have researched the subject in a bit more detail. No one pays the charges in the charge master file or on the patient's statement or bill. Medicare mandates that all patients are "charged" the same price. However, they never pay that price. One should look carefully at what is actually paid by Medicaid, Medicare and many other insurers. Medicaid pays between 50 and 70 percent of the costs (not the price) incurred in many states and Medicare pays substantially below the costs of serving the patient in most hospitals. Other large insurers with clout — market power — base their payments on percentages of what Medicare pays. Many physicians won't see Medicaid patients because their payments are so far below the costs of treating the Medicaid patients. Soon they will choose not to see Medicare patients for similar reasons.

— Signed, Bitter Pill

Cleveland Clinic Video: Pass It On

Re: Bill Santamour's March 19 H&HN Daily blog featuring a Cleveland Clinic video called "Empathy: Exploring the Human Connection." [To watch, go to http://bit.ly/14acEAq]

I shared this with my fellow nursing students as a reminder for not only our professional, but also our personal lives. We don't know always what other people we encounter are going through or how they are processing it.

— Andrew Rotella

Get Tough on Hand Hygiene

Re: "Patient Safety's Come a Long Way, but Wash Your Hands!" by Marty Stempniak in H&HN Daily, March 11

Florence Nightingale understood the need to wash hands more that 150 years ago and British surgeon Joseph Lister, one of the pioneers of antiseptic surgery, knew the importance of washing and sanitizing one's hands.

What is different today? Nothing. We know people die and get sick when proper hand hygiene is not carried out; we know there are more multidrug-resistant organisms present today than 150 years ago; and we know what the right thing to do is.

But why aren't health care workers doing what they know is right? Lazy? Indifferent? Inflated ego? Rules don't apply to them? They don't have time? You choose. Regardless of the reasons, health care-acquired infections are real, people are dying and lives are changed.

If health care professionals, including physicians, fail to practice proper hand hygiene, appropriate and measured corrective actions should be taken up to and including termination. That should not be open to any negotiation or interpretation.

Professionals and the general public have been discussing this problem for 13 years. That's long enough. How many more patients must contract an HAI or die from an HAI before health care decides enough is enough and begins to take a stand for life?

— jscherberger