The Fight Against Physician Owned Hospitals

Physician-Owned Hospitals (POHs) are for-profit hospitals that are both run by and owned by doctors. They are usually based on a specialty service, such as Cardiology or Orthopedic Surgery. The idea behind POHs is that because they specialize in one area, they are better in that area than anyone else. They have some issues that need to be addressed in terms of regulations, but mainstream Hospital Organizations are lobbying for policies that could eliminate POHs altogether.

Traditional Hospitals are regulated both by the federal government and by state governments. Because they are a newer phenomenon, POHs are not yet regulated in the same way that traditional hospitals are in every state. Problems have been cited, such as inadequate emergency care and staffing. In any hospital, especially one where surgeries are performed, medical emergencies will arise and any entity calling itself a “hospital” should be able to handle those emergencies. Certain aspects of hospitals are regulated federally, but not all. Facilities that participate in Medicare, Medicaid, and Veterans Care are heavily regulated, but POHs that are not adequately regulated in their states are falling through the cracks. The problems are difficult to pin down also because they are not required to report things like staph infections and other statistics that could be used to judge their effectiveness or track potential problems.

POHs are generally small and one of the complaints coming from the Hospital Lobby is that POHs are “cherry picking” healthy, insured patients. While this may be a valid concern, their claim that POHs are providing too much competition does not seem to be valid. The latter point may be why the Hospital Lobby is fighting so hard against them.

Senator Baucus and Senator Grassley, reportedly recipients of huge sums from the Hospital Lobby are, coincidently, fighting the hardest against POHs. Obviously, there does need to be adequate regulations on all hospitals, but Baucus and Grassley are taking the fight to another level. They have tried, and presumably still are trying to prevent any more POHs to be developed and they are also currently trying to prevent them from participating from the Medicare program, which, ironically, would subject them to more regulation than they would otherwise have.

The bottom line is that there is a well documented problem with Physician Owned Hospitals’ emergency services that needs attention in the form of more regulation and oversight. Senators Baucus and Grassley, however, are going too far by reacting to their benefactors and using the issue to attempt to wipe out the competition.

http://acutecareinc.wordpress.com/2009/07/20/update-baucus-grassley-slam-physician-owned-hospitals/
http://www.medicalnewstoday.com/articles/93681.php
http://www.access.gpo.gov/nara/cfr/waisidx_02/42cfr482_02.htmlhttp://www.consumeraffairs.com/news04/2009/07/physician_hospitals.html

Response to Euthanasia Fear-mongering

When I wrote the previous post, it was before anyone was talking about “death panels” or killing the elderly or forced euthanasia. Actually, nobody was talking about euthanasia or end-of-life care at all at the time. All the controversy broke out a week or two later. I knew what I said regarding euthanasia was controversial but I should have known that the topic would be blown way out of proportion. I naively expected a more intelligent level of discussion. Once all the exaggerated claims about forced euthanasia broke out, I considered editing that part of my post, but I decided to instead to add some clarity to why I wrote what I did.

There is absolutely no situation where euthanasia should be forced on anyone, and I made that clear the first time around but I’m saying it again anyhow. Also, I don’t believe that euthanasia should be legalized in the health care bill. I think that Congress’ approach of providing a higher level of support for end-of-life decision-making is the appropriate one.

What I was advocating was just another option for patients and/or their families who are in extreme situations. This is a true story. Two years ago, I had a friend who had brain cancer and died. Ian's battle had begun three years earlier when he’d learned he had a brain tumor. He had multiple surgeries over the course of his treatment and each time the tumor returned until the cancer finally took over and even with top notch care, he could not recover. Toward the end of his life, he was unable to walk, talk, or take care of himself. As the cancer affected more of his brain tissue, his sight, hearing, and memory were affected as well. Some people with brain cancer and even Alzheimer’s Disease aren’t able to chew or swallow and must be fed through a tube. I know this to be true because my Filipino grandmother went through this, which forced my family to make some difficult decisions. There are extreme situations, like advanced brain cancer, where I feel just having the option of euthanasia may be appropriate for certain people or families to make based on their individual situations and their end-of-life instructions or living wills.
To try to say that euthanasia should be mandated or used vicariously is just ludicrous. No one is advocating euthanasia in this health care bill, nor its’ legalization any time soon. I was only making a point about individual choice in extreme situations where a person may not even want the level of care they are being given.