Procedure brings controversy but could become more commonplace as MRSA spreads.
By Mary Ann Roser - AMERICAN-STATESMAN STAFF - Monday, July 30, 2007
Worried about the spread of a superbug that no longer responds to penicillin and some other common antibiotics, hospitals across the country — including some in Central Texas — are starting to test new patients for the bacteria and isolate those identified as carriers.
Some hospitals even isolate patients who are at risk of being carriers of MRSA, or methicillin-resistant Staphylococcus aureus, a bacterium that experts say has become drug-resistant largely because of overuse of antibiotics.
The Seton Family of Hospitals, the largest health system in Central Texas, says it isolates people at high risk of carrying MRSA but hasn't decided whether to do testing. St. David's HealthCare hospitals and Cornerstone Hospitals say they test high-risk patients and isolate those who test positive for the bacteria.
The bacterium, which in recent years has taken root in some football locker rooms and jails, causes infections that look like a pimple or spider bite. The wound usually clears up after treatment, often with vancomycin, one of the strongest antibiotics, or by draining the abscess.
But MRSA can invade the bones, joints, blood, heart valves and lungs, creating a potentially lethal infection for the elderly or people with weakened immune systems.
Hospitals, which are full of people who fit that description, have seen MRSA infections spiral. A broad survey of the nation's health care facilities found that 34 out of every 1,000 hospital patients had active MRSA infections, and an additional 12 were carriers, the Association for Professionals in Infection Control and Epidemiology reported last month.
The report's author, Dr. William Jarvis, and MRSA expert Dr. Lance Peterson, a physician and epidemiologist at Evanston Northwestern Healthcare in Evanston, Ill., said that although the report did not examine death rates from MRSA, a conservative estimate is that 10 percent of hospital patients with the infections die.
Jarvis is a consultant and former director of a program specializing in hospital infections at the U.S. Centers for Disease Control and Prevention.
Health care experts are divided over how far hospitals should go to detect and contain the bacteria. There are no national requirements, and the CDC offers basic guidelines but recommends that hospitals decide for themselves the best approach.
"Some places across the country screen everybody; some just look at their high-risk populations," said Joanne Dixon, director of infection control at Seton. "We need to make a sound decision here."
Evanston Northwestern's three hospitals, which admit 40,000 patients a year, became the first in North America to test all patients for MRSA two years ago, Peterson said.
At the end of the first year, in July 2006, it found 1,260 MRSA infections, 90 percent of which were picked up in the hospital, Peterson said. Once the hospital began testing all patients and isolating those who were infected or carrying MRSA, the number dropped to 80, Peterson said.
"You have to do a lot of surveillance," he said, adding that the testing program costs $600,000 a year.
The infection control association's report found that just 28 percent of the facilities it surveyed test patients for MRSA.
And Peterson said that up to 30 percent of people in some high-risk groups are MRSA carriers and may not know it. High-risk patients include anyone receiving invasive procedures — from dialysis to heart surgery — that could give the bacteria an opening and those transferred from places where MRSA can be easily spread, such as nursing homes, jails and other hospitals.
"If we had this level of avian influenza on Earth, we'd have everyone screaming," Jarvis said. "I'm hoping it is a wake-up call to . . . hospital administrators and CEOs of hospitals that it's a very significant problem that we now have evidence-based data on how we can reverse it."
The association has urged hospitals to be more aggressive about MRSA.
President Denise Murphy said facilities getting the best results in controlling the bacteria identify the hot spots in their facilities for spreading MRSA, test high-risk patients and take extra precautions with those who test positive, stress good handwashing procedures by staff members and disinfect patient rooms daily.
Seton, which operates seven acute-care hospitals in Central Texas, has been isolating patients at high risk for the bacteria since 1996, Dixon said. Seton said positive MRSA tests at its hospitals have increased 11 percent in the past three years.
St. David's HealthCare, which operates five acute-care hospitals in Central Texas, started testing patients at high risk for MRSA in May, following a policy its parent company, HCA, instituted nationwide.
The hospitals swab a patient's nose to test for the bacteria, said Karen Degtoff, infection control coordinator at St. David's.
If the test shows that the patient is an MRSA carrier, he or she is put in isolation, which means staff members take special precautions when treating the patient, such as wearing a gown and gloves. Visitors also are instructed to wear protective garb, Degtoff said.
The patients may be restricted to their rooms, depending on their condition and whether their recovery depends on walking. Those who leave their rooms are told to wear a gown and gloves, hospital officials said.
Dr. Steve Berkowitz, chief medical officer for St. David's HealthCare, said that since testing started, 11 percent of patients facing high-risk procedures, such as heart bypass or orthopedic surgery, have tested positive for MRSA.
But not all doctors agree with what local hospitals are doing, and some patients have been downright bewildered.
Norman Tolpo, 71, of Austin said he was put in isolation after testing positive as a carrier for MRSA while he was a patient at St. David's Medical Center in Austin in early June.
Tolpo said he found the restrictions baffling and inconsistent. He protested to the staff that he didn't have an active infection and asked why all incoming patients — and the staff — weren't tested.
Even without an active infection, a person who is a carrier can still spread MRSA, he was told.
"Let's say they get nasal secretions on their hands and they shook the hand of a nurse," Berkowitz said. "It could still be spread to another person."
Michael Killiam, Tolpo's family practice physician, said Tolpo has raised some valid points. "If you're going to be consistent, you've got to test everybody," Killiam said.
The CDC does not recommend testing hospital staff members, and hospital officials said they think proper handwashing and protective garb is enough.
And Murphy, the association president, doesn't endorse testing all patients.
"We believe you need to use finite resources wisely by doing a risk assessment," said Murphy, who said she lost her mother to a hospital infection. "If we had all the money in the world, it would be different."
Read more & listen to report
Tuesday, July 31, 2007
Saturday, July 28, 2007
Children's Health Care Bill Loaded with Extras
by Julie Rovner - NPR Morning Edition, July 27, 2007
On Capitol Hill, two House committees have begun work on their version of a bill to renew and expand the State Children's Health Insurance Program.
Last week, a Senate committee overwhelmingly approved a bipartisan bill to continue the popular SCHIP program. But in the House, the parties are far more polarized.
Republicans and Democrats on two panels — Energy and Commerce and Ways and Means — said they want to renew the SCHIP program, which otherwise is set to expire at the end of September. But that was about all they agreed on at simultaneous meetings that stretched late into the night on Thursday.
Republicans like former House Speaker Dennis Hastert of Illinois said the bill written by House Democrats expands the children's health program so much that it will substitute government for private coverage.
"Now we're sending messages to families across the country: Drop your private health insurance plans, the American taxpayer will foot the bill," Hastert said.
Democrats like Rep. Henry Waxman of California, however, said the Republican substitute proposal doesn't go nearly far enough.
"With the amount of money they're proposing, they won't even be able to keep pace with current enrollees," Waxman said. "They'd have to drop kids out of the program, let alone cover more of the children that need it."
But differences over how much to expand the children's insurance program are only the start of the dispute — although the expansion alone is enough to have drawn a veto threat from the Bush administration.
What angered Republicans even more is how the bill proposes to pay for the additional $50 billion that would go to the SCHIP program over the next five years. In particular, they object to cuts in spending for private HMOs and other health plans that serve Medicare patients.
Rep. John Shadegg, an Arizona Republican, said that makes no sense.
"So we're going to take money away from our seniors to give it to children in families where those families already earn $82,600 a year?" he asked.
That's not exactly how it would work. That $82,000 represents four times the poverty level for a family of four. Only a few families who earn that much could qualify.
And the money being taken from the private Medicare plans is what budget analysts agree are overpayments. The cuts would simply pay the plans what the average Medicare patient costs.
But the disputes underscore what has become an unfortunate fact that seems to hold true no matter which party controls Congress, says Patrick Morrissey, a health care lawyer and lobbyist and former congressional staffer.
"Unfortunately, nothing is simple in health care these days," he says.
Part of the difficulty is how the Democrats are trying to pay for their health care expansion — using not only the controversial Medicare changes, but an even more controversial 45-cents-per-pack increase in the cigarette tax.
Morrissey says that over the past several years, Congress has also created its own problem in health care, by making Medicare payment policies that last for just a few years at a time:
"So you have this amazing amount of pressure, funneling in to one or two health care bills a year, which means that any one bill, even if it should be noncontroversial, ends up becoming bigger and bigger and bigger," he says. "You literally have dozens and dozens or hundreds of groups lining up saying 'we would like more money, because our payment policy expires at the end of the year.'"
This year, the big money problem is a 10-percent cut in Medicare payments to doctors starting next January. The House bill cancels that cut.
But it comes at a cost — a big one. Eliminating the cut for just two years adds more than $100 billion to Medicare spending over the next decade.
That's considerably more than the entire expansion of the children's health insurance program. And lawmakers had to find the money by trimming payments for other health care providers, who aren't very happy about it.
Still, House Democratic leaders hope to have the bill on the floor next week, their last before the summer break. The Senate bill is expected to come up for a vote next week, as well.
Read more on NPR
On Capitol Hill, two House committees have begun work on their version of a bill to renew and expand the State Children's Health Insurance Program.
Last week, a Senate committee overwhelmingly approved a bipartisan bill to continue the popular SCHIP program. But in the House, the parties are far more polarized.
Republicans and Democrats on two panels — Energy and Commerce and Ways and Means — said they want to renew the SCHIP program, which otherwise is set to expire at the end of September. But that was about all they agreed on at simultaneous meetings that stretched late into the night on Thursday.
Republicans like former House Speaker Dennis Hastert of Illinois said the bill written by House Democrats expands the children's health program so much that it will substitute government for private coverage.
"Now we're sending messages to families across the country: Drop your private health insurance plans, the American taxpayer will foot the bill," Hastert said.
Democrats like Rep. Henry Waxman of California, however, said the Republican substitute proposal doesn't go nearly far enough.
"With the amount of money they're proposing, they won't even be able to keep pace with current enrollees," Waxman said. "They'd have to drop kids out of the program, let alone cover more of the children that need it."
But differences over how much to expand the children's insurance program are only the start of the dispute — although the expansion alone is enough to have drawn a veto threat from the Bush administration.
What angered Republicans even more is how the bill proposes to pay for the additional $50 billion that would go to the SCHIP program over the next five years. In particular, they object to cuts in spending for private HMOs and other health plans that serve Medicare patients.
Rep. John Shadegg, an Arizona Republican, said that makes no sense.
"So we're going to take money away from our seniors to give it to children in families where those families already earn $82,600 a year?" he asked.
That's not exactly how it would work. That $82,000 represents four times the poverty level for a family of four. Only a few families who earn that much could qualify.
And the money being taken from the private Medicare plans is what budget analysts agree are overpayments. The cuts would simply pay the plans what the average Medicare patient costs.
But the disputes underscore what has become an unfortunate fact that seems to hold true no matter which party controls Congress, says Patrick Morrissey, a health care lawyer and lobbyist and former congressional staffer.
"Unfortunately, nothing is simple in health care these days," he says.
Part of the difficulty is how the Democrats are trying to pay for their health care expansion — using not only the controversial Medicare changes, but an even more controversial 45-cents-per-pack increase in the cigarette tax.
Morrissey says that over the past several years, Congress has also created its own problem in health care, by making Medicare payment policies that last for just a few years at a time:
"So you have this amazing amount of pressure, funneling in to one or two health care bills a year, which means that any one bill, even if it should be noncontroversial, ends up becoming bigger and bigger and bigger," he says. "You literally have dozens and dozens or hundreds of groups lining up saying 'we would like more money, because our payment policy expires at the end of the year.'"
This year, the big money problem is a 10-percent cut in Medicare payments to doctors starting next January. The House bill cancels that cut.
But it comes at a cost — a big one. Eliminating the cut for just two years adds more than $100 billion to Medicare spending over the next decade.
That's considerably more than the entire expansion of the children's health insurance program. And lawmakers had to find the money by trimming payments for other health care providers, who aren't very happy about it.
Still, House Democratic leaders hope to have the bill on the floor next week, their last before the summer break. The Senate bill is expected to come up for a vote next week, as well.
Read more on NPR
GOP senators offer tax-based insurance plan
By BARBARA BARRETT - McClatchy Newspapers = Fri, Jul. 27, 2007
WASHINGTON -- A group of conservative Republican senators put forth a plan Thursday that seeks to ensure that every American has health insurance.
The bill encourages families to find their own health coverage and offers tax credits of up to $5,400 per family. Advocates for the uninsured say the proposal could jeopardize low-income families and chronically ill patients, as well as the employment-based healthcare system, which covers 65 percent of Americans.
"It's time for a major debate on health care insurance," Sen. Mel Martinez, R-Fla., said in a statement. "Not enough people have access to affordable health care, and the Congress has not done enough about this crisis." Martinez was joined in introducing the bill by fellow Republican Sens. Richard Burr of North Carolina, Tom Coburn of Oklahoma and Bob Corker of Tennessee.
The bill could bring health coverage to millions of Americans now without it. But Burr said in an interview that it also would begin taxing the value of healthcare plans that many employers now offer workers, a provision sure to face opposition. Such benefits are now tax-free for the employer and the worker.
"Our aim is to remove inequities in our tax laws and make tax relief for health insurance available to everyone," Martinez said.
The legislation would offer special tax credits to help cover the cost of health insurance and other health bills: $2,160 per person, up to a maximum of $5,400 per family.
The legislation, called the Every American Insured Health Act, comes amid debate this week in the House of Representatives and the Senate over the renewal of a joint federal-state children's health insurance program.
Republican leaders, including President Bush, want to keep the program roughly where it is. Democrats are trying to expand the program to cover more children.
The GOP legislation also comes as the idea of universal healthcare continues to consume political debate. Polls show healthcare as one of voters' top concerns. Democratic presidential candidates are being pushed to unveil their healthcare plans. And several states are considering legislation to cover uninsured residents.
But Kathleen Stoll, director of health policy for Families USA, an advocacy group in Washington, said the plan isn't terribly new. Republicans have long been working to dismantle the employment-based health system that most Americans use, she said.
"When we eliminate that tax break for [the system], we should do that with extreme caution," Stoll said.
Advocates for the uninsured fear that employers could simply drop health benefits altogether. And for many families,
Read more
WASHINGTON -- A group of conservative Republican senators put forth a plan Thursday that seeks to ensure that every American has health insurance.
The bill encourages families to find their own health coverage and offers tax credits of up to $5,400 per family. Advocates for the uninsured say the proposal could jeopardize low-income families and chronically ill patients, as well as the employment-based healthcare system, which covers 65 percent of Americans.
"It's time for a major debate on health care insurance," Sen. Mel Martinez, R-Fla., said in a statement. "Not enough people have access to affordable health care, and the Congress has not done enough about this crisis." Martinez was joined in introducing the bill by fellow Republican Sens. Richard Burr of North Carolina, Tom Coburn of Oklahoma and Bob Corker of Tennessee.
The bill could bring health coverage to millions of Americans now without it. But Burr said in an interview that it also would begin taxing the value of healthcare plans that many employers now offer workers, a provision sure to face opposition. Such benefits are now tax-free for the employer and the worker.
"Our aim is to remove inequities in our tax laws and make tax relief for health insurance available to everyone," Martinez said.
The legislation would offer special tax credits to help cover the cost of health insurance and other health bills: $2,160 per person, up to a maximum of $5,400 per family.
The legislation, called the Every American Insured Health Act, comes amid debate this week in the House of Representatives and the Senate over the renewal of a joint federal-state children's health insurance program.
Republican leaders, including President Bush, want to keep the program roughly where it is. Democrats are trying to expand the program to cover more children.
The GOP legislation also comes as the idea of universal healthcare continues to consume political debate. Polls show healthcare as one of voters' top concerns. Democratic presidential candidates are being pushed to unveil their healthcare plans. And several states are considering legislation to cover uninsured residents.
But Kathleen Stoll, director of health policy for Families USA, an advocacy group in Washington, said the plan isn't terribly new. Republicans have long been working to dismantle the employment-based health system that most Americans use, she said.
"When we eliminate that tax break for [the system], we should do that with extreme caution," Stoll said.
Advocates for the uninsured fear that employers could simply drop health benefits altogether. And for many families,
Read more
Friday, July 27, 2007
Health Care Policy Seminar Scheduled Aug. 7 in Arlington at UTA
By Lorraine Levine - Thu Jul 26, 2007
Please consider attending this forum and inviting your friends.
You are invited to an Education Forum “Solutions to the Texas Health Care Crisis”
Location: Rosebud Theater UTA, Student Center UTA Arlington ,
When: August 7, 2007, 7 PM to 8:30 PM.
Subjects addressed will be:
· Can all Texans have affordable health insurance?
· Can a system be improvised without raising taxes?
· How can the total cost of health care be reduced in Texas ?
· How can doctors take the delivery of health care away from insurance companies and pharmaceuticals companies?
· Can rising health care cost be stabilized?
· Can drug costs be reduced?
· Does the state and federal government need to get involved?
· Is there a cost analysis that would demonstrate the financial feasibility of
state wide coverage?
Invitees: All DFW Legislators, various physician groups, nursing organizations, hospital executives, county and municipal benefit executives, UTA students, church
organizations, League of Women Voters, local chapter of National Nursing Association and the general public
Co-sponsors: Health Care for all Texas (HCFAT), Arlington and Tarrant League of Women Voters, Local National Nursing Association and the organization “Free Thinkers” of UTA.
Directions: Go south of Cooper off I30 to Abrams, turn left or East to S West St, turn right, dead ends at 1st St. Rosebud Theater is on the East end of Center.
Map of University Student Center
Please make plans to attend this important event and bring some tough questions. Hoyt West, DFW Coordinator Health Care for all Texas
Please consider attending this forum and inviting your friends.
You are invited to an Education Forum “Solutions to the Texas Health Care Crisis”
Location: Rosebud Theater UTA, Student Center UTA Arlington ,
When: August 7, 2007, 7 PM to 8:30 PM.
Subjects addressed will be:
· Can all Texans have affordable health insurance?
· Can a system be improvised without raising taxes?
· How can the total cost of health care be reduced in Texas ?
· How can doctors take the delivery of health care away from insurance companies and pharmaceuticals companies?
· Can rising health care cost be stabilized?
· Can drug costs be reduced?
· Does the state and federal government need to get involved?
· Is there a cost analysis that would demonstrate the financial feasibility of
state wide coverage?
Invitees: All DFW Legislators, various physician groups, nursing organizations, hospital executives, county and municipal benefit executives, UTA students, church
organizations, League of Women Voters, local chapter of National Nursing Association and the general public
Co-sponsors: Health Care for all Texas (HCFAT), Arlington and Tarrant League of Women Voters, Local National Nursing Association and the organization “Free Thinkers” of UTA.
Directions: Go south of Cooper off I30 to Abrams, turn left or East to S West St, turn right, dead ends at 1st St. Rosebud Theater is on the East end of Center.
Map of University Student Center
Please make plans to attend this important event and bring some tough questions. Hoyt West, DFW Coordinator Health Care for all Texas
Thursday, July 26, 2007
Medicare Disadvantage- Privatized Health Care For Seniors Can Leave Them In The Dark As Insurance Companies Reap A Windfall
CBS/AP - WEST HAVEN, Conn., July 16, 2007
CBS) It was the summer of 1965 when Medicare was created to provide government-sponsored health care for seniors. Today some $381 billion tax dollars a year are spent on Americans 65 and older.
But in recent years, more and more Americans — 8.3 million and rising — are getting Medicare through private insurance companies. Tonight, CBS News chief investigative correspondent Armen Keteyian takes a closer look at the program critics charge has turned into a disadvantage for seniors, and a windfall for the insurance industry.
It was the winter of 2003 when Congress, in the dead of night, overhauled Medicare.
"This prescription drug benefit is a good deal for all seniors," said Rep. Dennis Hastert, R-Ill.
But buried inside the bill was another deal — one that CBS News investigation has discovered was not necessarily a benefit for seniors.
A large portion of one of the most successful public programs in history was quietly placed in the hands of private insurance companies. The goal of Medicare Advantage: to provide seniors with more benefits, like vision and dental care, and control rising costs. But today, for seniors like Aaron Cohen, it's become Medicare Dis-Advantage.
"I'd rather go back to the old-fashioned Medicare," Cohen told Keteyian.
Cohen, an 86-year-old who lives in Connecticut, says he switched to an advantage plan only after a salesman assured him he would be completely covered while staying in Florida.
But after breaking his leg in that state, Cohen began to believe he had been sold a bill of goods.
"There was something radically wrong," Cohen said. "They wouldn't give me any home therapy, claiming that it wasn't covered."
But that's only part of the problem. With traditional Medicare, there's one plan for everyone, everywhere. Private Medicare Advantage offers as many as 50 different plans, causing untold confusion over coverage, premiums, co-pays, provider networks.
"These insurance benefit packages are very complicated. Almost nobody without really technical sophistication can figure out exactly what they are buying," said Robert Hayes, who runs the Medicare Rights Center.
Hayes said every year his staff fields thousands of calls from seniors scared to death they've made the wrong choice.
Not only are private plans more confusing, they are more expensive to taxpayers.
In fact, three independent reports found private insurance companies are paid, on average, 12 percent more than what it cost the federal government to run Medicare — in some cases, 50 percent more.
FYI: Find out more about private medicare and how to find help navigating the system.
The head of Medicare insists private plans give you more for your money.
"I think there is a lot more that we could do in regular Medicare that we aren't doing currently, that some of the Medicare Advantage plans are able to do because of how the payment structure works," Leslie Norwalk told Keteyian.
But how much of that money is going back into the pockets of the insurance companies?
"Well, it's required by law: 25 percent goes back to the federal treasury, 75 percent goes back to the beneficiary," Norwalk said.
So the insurance companies are doing this, what, out of the kindness of their hearts, asked Keteyian?
"There, there would be, I'm sure, some small amount to administer the additional benefits," Norwalk said.
But CBS News has found that's not always the case. An independent report found when it comes to the fastest-growing plans, known as private fee-for-service, half of that extra money goes back to the insurance companies. All these private Medicare plans are expected to cost taxpayers an additional $54 billion over the next five years.
"Taxpayers are losing; people in Medicare are losing," Hayes said. "And the structure of Medicare as a national treasure that we need to rely on moving forward, is being undermined."
So much so that key Congressional Democrats now want to cut payments to private plans. The insurance industry is fighting back with a direct mail campaign urging seniors to contact their representatives.
Ironically, Cohen got one of the letters. On the back, his very personal feelings about his Medicare Advantage plan.
"This plan is worthless," he wrote.
See broadcast and read more
© MMVII, CBS Interactive, Inc. All Rights Reserved.
CBS) It was the summer of 1965 when Medicare was created to provide government-sponsored health care for seniors. Today some $381 billion tax dollars a year are spent on Americans 65 and older.
But in recent years, more and more Americans — 8.3 million and rising — are getting Medicare through private insurance companies. Tonight, CBS News chief investigative correspondent Armen Keteyian takes a closer look at the program critics charge has turned into a disadvantage for seniors, and a windfall for the insurance industry.
Fast Fact
Three independent reports found private insurance companies are paid, on average, 12 percent more than what it would cost the federal government — in some cases, 50 percent more.
It was the winter of 2003 when Congress, in the dead of night, overhauled Medicare.
"This prescription drug benefit is a good deal for all seniors," said Rep. Dennis Hastert, R-Ill.
But buried inside the bill was another deal — one that CBS News investigation has discovered was not necessarily a benefit for seniors.
A large portion of one of the most successful public programs in history was quietly placed in the hands of private insurance companies. The goal of Medicare Advantage: to provide seniors with more benefits, like vision and dental care, and control rising costs. But today, for seniors like Aaron Cohen, it's become Medicare Dis-Advantage.
"I'd rather go back to the old-fashioned Medicare," Cohen told Keteyian.
Cohen, an 86-year-old who lives in Connecticut, says he switched to an advantage plan only after a salesman assured him he would be completely covered while staying in Florida.
But after breaking his leg in that state, Cohen began to believe he had been sold a bill of goods.
"There was something radically wrong," Cohen said. "They wouldn't give me any home therapy, claiming that it wasn't covered."
But that's only part of the problem. With traditional Medicare, there's one plan for everyone, everywhere. Private Medicare Advantage offers as many as 50 different plans, causing untold confusion over coverage, premiums, co-pays, provider networks.
"These insurance benefit packages are very complicated. Almost nobody without really technical sophistication can figure out exactly what they are buying," said Robert Hayes, who runs the Medicare Rights Center.
Hayes said every year his staff fields thousands of calls from seniors scared to death they've made the wrong choice.
Not only are private plans more confusing, they are more expensive to taxpayers.
In fact, three independent reports found private insurance companies are paid, on average, 12 percent more than what it cost the federal government to run Medicare — in some cases, 50 percent more.
FYI: Find out more about private medicare and how to find help navigating the system.
The head of Medicare insists private plans give you more for your money.
"I think there is a lot more that we could do in regular Medicare that we aren't doing currently, that some of the Medicare Advantage plans are able to do because of how the payment structure works," Leslie Norwalk told Keteyian.
But how much of that money is going back into the pockets of the insurance companies?
"Well, it's required by law: 25 percent goes back to the federal treasury, 75 percent goes back to the beneficiary," Norwalk said.
So the insurance companies are doing this, what, out of the kindness of their hearts, asked Keteyian?
"There, there would be, I'm sure, some small amount to administer the additional benefits," Norwalk said.
But CBS News has found that's not always the case. An independent report found when it comes to the fastest-growing plans, known as private fee-for-service, half of that extra money goes back to the insurance companies. All these private Medicare plans are expected to cost taxpayers an additional $54 billion over the next five years.
"Taxpayers are losing; people in Medicare are losing," Hayes said. "And the structure of Medicare as a national treasure that we need to rely on moving forward, is being undermined."
So much so that key Congressional Democrats now want to cut payments to private plans. The insurance industry is fighting back with a direct mail campaign urging seniors to contact their representatives.
Ironically, Cohen got one of the letters. On the back, his very personal feelings about his Medicare Advantage plan.
"This plan is worthless," he wrote.
See broadcast and read more
© MMVII, CBS Interactive, Inc. All Rights Reserved.
Thursday, July 19, 2007
Report: Privatizing good for lobbyists, bad for taxpayers
Group calls outsourced social services a waste; official says that's wrong
By ROBERT T. GARRETT - The Dallas Morning News - Thursday, July 19, 2007
AUSTIN – Texas' efforts to hand off social services duties to private companies have enriched lobbyists while hurting poor people and wasting tax dollars, a watchdog group said Wednesday.
Over the past decade, 13 companies ultimately hired by the state after four big pushes toward privatization paid 102 lobbyists between $4.5 million and $11.3 million, according to a report by Texans for Public Justice.
The group, which tracks campaign money and lobby contracts in Texas, said the 13 companies hired well-placed lobbyists who nudged lawmakers to require outsourcing of work previously done by government health and human services agencies. The same companies then won bid competitions for $2.1 billion of contracts.
The report criticized the outsourcing efforts for failing to save as much money as was predicted – or, as with four privately run call centers for social program signups, not saving any money.
Health and Human Services Commissioner Albert Hawkins, who has run the privatization efforts during the past 4 ½ years, called the report "somewhat flawed."
Mr. Hawkins said $426 million spent since 2001 on a new Web-based computer system for processing applications for Medicaid, food stamps and cash assistance hasn't been wasted, as suggested by the report and even his own agency's inspector general.
"Funds expended for contract services, we've received services in exchange for those funds," Mr. Hawkins said. "That's not a boondoggle. That's not a waste. That's a point that I think is overlooked."
He also defended his actions to carry out a 2003 mandate from the Legislature to pursue replacing state eligibility workers with contract workers at private call centers. He said when problems arose, he ordered changes. And when those didn't work, he shut down the project and asked lawmakers for funds to fix it.
Mr. Hawkins said lobby expenditures didn't affect procurement decisions on the contracts mentioned in the report, some of which his predecessors awarded.
Contractors named in the report include HMOs, such as UnitedHealth and Amerigroup, which manage health care for elderly and disabled Medicaid recipients; and consulting giants Deloitte, which designed the eligibility computer software, and Accenture, which quit the call center project last spring.
Other firms in the report were Sagem Morpho, a French company that from 1996 until earlier this year analyzed food stamp applicants' fingerprints; and Convergys, which handles the health and human services agencies' payrolls, employee benefits and job applications.
Andrew Wheat, research director at Texans for Public Justice, responded, "He could say [lobbying] has no effect, but a shocking number of his agency's contractors clearly believe otherwise.
"Government contract lobbying is alive and well in the state of Texas. It's a massive, multimillion-dollar business."
Read more
By ROBERT T. GARRETT - The Dallas Morning News - Thursday, July 19, 2007
AUSTIN – Texas' efforts to hand off social services duties to private companies have enriched lobbyists while hurting poor people and wasting tax dollars, a watchdog group said Wednesday.
Over the past decade, 13 companies ultimately hired by the state after four big pushes toward privatization paid 102 lobbyists between $4.5 million and $11.3 million, according to a report by Texans for Public Justice.
The group, which tracks campaign money and lobby contracts in Texas, said the 13 companies hired well-placed lobbyists who nudged lawmakers to require outsourcing of work previously done by government health and human services agencies. The same companies then won bid competitions for $2.1 billion of contracts.
"Too often, architects of Texas' social services privatization schemes appear to have ensured that privatization would fill their own pockets and those of their past or future employers,"the report says.
The report criticized the outsourcing efforts for failing to save as much money as was predicted – or, as with four privately run call centers for social program signups, not saving any money.
Health and Human Services Commissioner Albert Hawkins, who has run the privatization efforts during the past 4 ½ years, called the report "somewhat flawed."
He said it suggests "that any money that you spend on a contract for service counts as wasted expenditures, and that's clearly wrong."
Mr. Hawkins said $426 million spent since 2001 on a new Web-based computer system for processing applications for Medicaid, food stamps and cash assistance hasn't been wasted, as suggested by the report and even his own agency's inspector general.
"Funds expended for contract services, we've received services in exchange for those funds," Mr. Hawkins said. "That's not a boondoggle. That's not a waste. That's a point that I think is overlooked."
He also defended his actions to carry out a 2003 mandate from the Legislature to pursue replacing state eligibility workers with contract workers at private call centers. He said when problems arose, he ordered changes. And when those didn't work, he shut down the project and asked lawmakers for funds to fix it.
Mr. Hawkins said lobby expenditures didn't affect procurement decisions on the contracts mentioned in the report, some of which his predecessors awarded.
Contractors named in the report include HMOs, such as UnitedHealth and Amerigroup, which manage health care for elderly and disabled Medicaid recipients; and consulting giants Deloitte, which designed the eligibility computer software, and Accenture, which quit the call center project last spring.
Other firms in the report were Sagem Morpho, a French company that from 1996 until earlier this year analyzed food stamp applicants' fingerprints; and Convergys, which handles the health and human services agencies' payrolls, employee benefits and job applications.
"Our process takes place in an objective structure," Mr. Hawkins said. "Lobbyists have no influence on that."
Andrew Wheat, research director at Texans for Public Justice, responded, "He could say [lobbying] has no effect, but a shocking number of his agency's contractors clearly believe otherwise.
"Government contract lobbying is alive and well in the state of Texas. It's a massive, multimillion-dollar business."
Read more
Tuesday, July 17, 2007
Farmers Insurance backs off rate hike plan
State was set to reject company's 6.6 percent hike for homeowners
By TERRENCE STUTZ - The Dallas Morning News- Tuesday, July 17, 2007
AUSTIN – Farmers Insurance withdrew a proposed 6.6 percent statewide increase in homeowners rates on Monday after the Texas Department of Insurance signaled that it would reject the proposal.
A spokesman for the insurance department said the agency was poised to oppose the rate plan when Farmers decided to pull it back, canceling a premium increase that was supposed to be effective on Monday.
Agency spokesman Ben Gonzales said state actuaries were concerned about the wide variation of rates in the plan – ranging from a 50 percent increase along the Texas coast to a 10 percent decrease for some customers in North Texas – as well as recent trends indicating the company's current rates are adequate.
"It was clear that we would disapprove the filing as it was written," said Mr. Gonzales, noting that it was "a lot simpler for them to withdraw the filing than to move forward" on a plan that was opposed by the state.
Under the current file-and-use law, Farmers is allowed to raise rates once it has notified the insurance department, but the company is subject to a rate rollback – and refunds – if the commissioner of insurance determines the increases are not warranted. An insurer also has to pay interest on any refunds.
Not giving up
Michelle Levy, a spokeswoman for Farmers, said that while the proposal was pulled back, the company still believes it needs to adjust its rates and is working on an alternate plan.
"They had questions about our filing, so we're working with them to answer their questions and we expect to refile a proposal within 30 to 60 days," she said.
Mr. Gonzales said state actuaries had reservations about charging homeowners in certain parts of the state so much more for their policies.
"The increases are heavily weighted toward the coast, which may be appropriate because of the risks. But we need to see more documentation," he said.
He also cited concerns about the company's loss ratios over the past year, which indicated healthy profits. Farmers' primary home insurance subsidiary in Texas had a loss ratio of 35.5 percent in 2006, close to the statewide average of 34 percent for all companies.
In other words, Farmers paid out 35.5 percent of premiums it collected to cover property losses – a relatively low percentage. A loss ratio of 58 percent is often cited by experts as a good benchmark for profitability.
The other two subsidiaries of Farmers – the third largest home insurer in Texas – had similar percentages.
An actuary with the insurance department also said some of the expenses cited by the company in its rate filing appeared excessive.
Allstate's proposal
Allstate Insurance, the second largest home insurer, also has filed a rate increase with the state that would raise the average cost of its policies by 6.9 percent. Unlike the Farmers proposal, Allstate wants to increase rates in all areas of the state.
Mr. Gonzales said the Allstate proposal – which is supposed to go into effect on July 26 – is still being reviewed by the insurance department actuaries.
"There is no indication yet of which way we will go," he said of the Allstate proposal.
Leading consumer groups have sharply criticized the actions of the two companies for raising their rates at a time when industry profits are soaring.
"If this [rate plan withdrawal] results in real reductions for homeowners, it is good news. If this is just more posturing on the part of the company and the insurance department, then it is par for the course," Alex Winslow of Texas Watch, a consumer group active in insurance issues.
"Homeowners are relying on the insurance department to do its job and make sure that premiums come down once and for all," he said.
Read more
By TERRENCE STUTZ - The Dallas Morning News- Tuesday, July 17, 2007
AUSTIN – Farmers Insurance withdrew a proposed 6.6 percent statewide increase in homeowners rates on Monday after the Texas Department of Insurance signaled that it would reject the proposal.
A spokesman for the insurance department said the agency was poised to oppose the rate plan when Farmers decided to pull it back, canceling a premium increase that was supposed to be effective on Monday.
Agency spokesman Ben Gonzales said state actuaries were concerned about the wide variation of rates in the plan – ranging from a 50 percent increase along the Texas coast to a 10 percent decrease for some customers in North Texas – as well as recent trends indicating the company's current rates are adequate.
"It was clear that we would disapprove the filing as it was written," said Mr. Gonzales, noting that it was "a lot simpler for them to withdraw the filing than to move forward" on a plan that was opposed by the state.
Under the current file-and-use law, Farmers is allowed to raise rates once it has notified the insurance department, but the company is subject to a rate rollback – and refunds – if the commissioner of insurance determines the increases are not warranted. An insurer also has to pay interest on any refunds.
Not giving up
Michelle Levy, a spokeswoman for Farmers, said that while the proposal was pulled back, the company still believes it needs to adjust its rates and is working on an alternate plan.
"They had questions about our filing, so we're working with them to answer their questions and we expect to refile a proposal within 30 to 60 days," she said.
Mr. Gonzales said state actuaries had reservations about charging homeowners in certain parts of the state so much more for their policies.
"The increases are heavily weighted toward the coast, which may be appropriate because of the risks. But we need to see more documentation," he said.
He also cited concerns about the company's loss ratios over the past year, which indicated healthy profits. Farmers' primary home insurance subsidiary in Texas had a loss ratio of 35.5 percent in 2006, close to the statewide average of 34 percent for all companies.
In other words, Farmers paid out 35.5 percent of premiums it collected to cover property losses – a relatively low percentage. A loss ratio of 58 percent is often cited by experts as a good benchmark for profitability.
The other two subsidiaries of Farmers – the third largest home insurer in Texas – had similar percentages.
An actuary with the insurance department also said some of the expenses cited by the company in its rate filing appeared excessive.
Allstate's proposal
Allstate Insurance, the second largest home insurer, also has filed a rate increase with the state that would raise the average cost of its policies by 6.9 percent. Unlike the Farmers proposal, Allstate wants to increase rates in all areas of the state.
Mr. Gonzales said the Allstate proposal – which is supposed to go into effect on July 26 – is still being reviewed by the insurance department actuaries.
"There is no indication yet of which way we will go," he said of the Allstate proposal.
Leading consumer groups have sharply criticized the actions of the two companies for raising their rates at a time when industry profits are soaring.
"If this [rate plan withdrawal] results in real reductions for homeowners, it is good news. If this is just more posturing on the part of the company and the insurance department, then it is par for the course," Alex Winslow of Texas Watch, a consumer group active in insurance issues.
"Homeowners are relying on the insurance department to do its job and make sure that premiums come down once and for all," he said.
Read more
Monday, July 16, 2007
Rick Perry's on Community Colleges and Health Insurance
In a sepcial statement to the Bryan College Station Eagle, published Saturday, July 14, 2007
Governor Perry said:
Governor Perry said:
Perry: Our colleges must follow the law
By GOV. RICK PERRY - Special to the Eagle
Community colleges are the backbone of our higher education system in Texas. They provide a community-based way for Texans to get a quality education close to home. To help them succeed in their vital role, I have supported increased funding for community colleges throughout my tenure as governor. In fact, state funding for instruction at these institutions has grown by $121.1 million, or 16.4 percent, in the past 6 years and I have proposed another $86.1 million in incentive performance funding above and beyond what the Legislature provided.
However, just as I have repeatedly supported increased state funds for community colleges, I have also consistently called for community colleges to follow state law by paying their appropriate share of health insurance for their employees. Unfortunately, they have been unwilling to do this.
Unlike larger universities with a statewide reach, community colleges serve the needs of a specific local area. As such, they are empowered to raise taxes from the population they serve, not unlike a local hospital, school or utility district.
These community colleges then pay their employees from either these local taxes (combined with tuition and fees) or state funds which are allocated by the Legislature and collected from all the taxpayers in Texas. State law clearly dictates that any community college employee paid with state funds can have their health insurance paid the same way. However, state law also says that if a community college employee is paid from locally-raised funds, their health insurance must also be paid from that same local source.
I fully support this sensible dividing line between funding sources. If the state pays an instructor's salary, then the state should also fund his or her health benefits. However, I don't support the notion that all Texas taxpayers should cover the health benefits of those local community college employees who are not paid by state funds. This would be akin to the state of Texas paying the health insurance of a local city councilman or a county commissioner.
Unfortunately, this is exactly what has been happening. And this is precisely the reason I vetoed a portion of community college health insurance funding for the 2008-2009 biennium
For years, community colleges have approached the Legislature and, on the advice of their association, insisted the state pay health insurance benefits for employees not paid by the state, but by local funds. Despite the clarity of the law on this matter, community colleges have continually pursued a distorted interpretation by arguing that any employee who is eligible in theory for a state-funded salary is entitled to state-funded health benefits even if they are not actually paid by the state. Their argument clearly runs counter to state law.
I addressed this issue in my 2003 State-of-the-State address, asking community colleges to begin paying their fair share. In 2005, the Texas Legislature, through the Legislative Budget Board, produced an eye-opening report showing that every community college was circumventing the law, shifting millions in local health insurance costs to the state. In their 2005 budget, the Texas Senate reacted to this report by phasing out improper community college health insurance funding and reallocating those funds to the colleges for instruction. I supported this change as a reasonable approach to address the problem. Unfortunately, the Texas House of Representatives did not.
Then, in 2006, the Legislative Budget Board and my office provided detailed, specific instructions to community colleges for requesting state health insurance funding for eligible employees. Unfortunately, the community colleges again refused to follow the Legislature's directives.
When my staff questioned community colleges about this issue at a public budget hearing on Oct. 2, 2006, a representative of the Texas Association of Community Colleges responded that their mission "supersedes" the law as it is written. I wholeheartedly disagree: no community college's mission supersedes state law. During the 2007 legislative session, my staff reminded the community colleges on the specifics of the law. In conversations with their association, my staff implored them to play by the rules set by the Legislature. The association refused.
As governor, I owe it to Texas taxpayers to ensure the law is followed and that taxpayer dollars are spent as the law intends. I will continue to call for increased formula funding for our community colleges because they deserve our support as they educate our future leaders. However, I will also hold them accountable to the spirit and letter of the law. Community colleges are an essential contributor to our state's future success and I remain committed to helping them maintain the highest standards in pursuit of their mission.
Lawsuit limits lure doctors to Texas, creating backlog
Associated Press - Tuesday, July 10, 2007
AUSTIN - An influx of doctors lured to Texas by new limits on malpractice lawsuits has overwhelmed the state board that screens candidates for medical licenses, creating a backlog that forces many applicants to wait months before they can start seeing patients.
Officials said many of the relocating physicians are filling shortages in areas such as Beaumont, where trauma patients previously had to be flown other cities because there weren't enough surgeons to treat them.
But Austin psychiatrist Dr. James Kreisle Jr. said he fears the Texas Medical Board's backlog could prompt some physicians to rethink their decision to move.
Kreisle and his colleagues have been waiting since the fall for two psychiatrists from South Carolina and Georgia to get licensed in Texas so they can join their practice. In the meantime, patients are being forced to wait three weeks for appointments.
The board received 4,000 applications for medical licenses in 2006, up from 2,992 the previous year. Spokeswoman Jill Wiggins said the board expects to approve 2,750 new licenses this year, 235 more than last year. There is a backlog of more than 2,398 applications.
Lawmakers approved $1.2 million to hire six more employees to process applications more quickly. The board has also hired temporary workers and is paying staffers overtime, but they still can't keep up, Wiggins said.
"The pipeline is just clogged," she said.
Approving an application for a medical license involves verifying the doctor's medical education, doing a criminal background check and other steps. In 2003, it took 45 days to approve the most complex applications and 20 days to approve the simplest.
Data provided by the board shows it is now taking the agency more than six months to process the most complicated applications, including those that come from out-of-state doctors or veteran doctors who have long histories to be checked. The simplest applications are taking about 41 days to approve.
Wiggins estimated it will take "a little over a year" before the agency's new staffers can bring the applications backlog under control.
"You're turning a battleship around," she said.
Several doctors who moved to Texas from other states said they were drawn by lower malpractice insurance rates.
read more
AUSTIN - An influx of doctors lured to Texas by new limits on malpractice lawsuits has overwhelmed the state board that screens candidates for medical licenses, creating a backlog that forces many applicants to wait months before they can start seeing patients.
Officials said many of the relocating physicians are filling shortages in areas such as Beaumont, where trauma patients previously had to be flown other cities because there weren't enough surgeons to treat them.
But Austin psychiatrist Dr. James Kreisle Jr. said he fears the Texas Medical Board's backlog could prompt some physicians to rethink their decision to move.
Kreisle and his colleagues have been waiting since the fall for two psychiatrists from South Carolina and Georgia to get licensed in Texas so they can join their practice. In the meantime, patients are being forced to wait three weeks for appointments.
The board received 4,000 applications for medical licenses in 2006, up from 2,992 the previous year. Spokeswoman Jill Wiggins said the board expects to approve 2,750 new licenses this year, 235 more than last year. There is a backlog of more than 2,398 applications.
Lawmakers approved $1.2 million to hire six more employees to process applications more quickly. The board has also hired temporary workers and is paying staffers overtime, but they still can't keep up, Wiggins said.
"The pipeline is just clogged," she said.
Approving an application for a medical license involves verifying the doctor's medical education, doing a criminal background check and other steps. In 2003, it took 45 days to approve the most complex applications and 20 days to approve the simplest.
Data provided by the board shows it is now taking the agency more than six months to process the most complicated applications, including those that come from out-of-state doctors or veteran doctors who have long histories to be checked. The simplest applications are taking about 41 days to approve.
Wiggins estimated it will take "a little over a year" before the agency's new staffers can bring the applications backlog under control.
"You're turning a battleship around," she said.
Several doctors who moved to Texas from other states said they were drawn by lower malpractice insurance rates.
read more
Sunday, July 15, 2007
About this site
People Power Profit - Healthcare & Insurance is a site of DFW-RCC (DFW Regional Concerned Citizens, am activist network/think tank of citizens in the 16 county North Central Texas Council of Government (DFW Region) focusing on govermental/policy issues. This particular site focuses on issues pertaining to insurance and healthcare.
Friday, July 13, 2007
Insurance Premius rely on credit reports for setting insurance premium rates
By Texas Watch - July 12, 2007
Check Your Credit Report Every Year
81% of Credit Reports Contain ErrorsInsurance companies rely heavily on credit scoring when they set their rates. At Texas Watch, we believe that insurance credit scoring is unfair and should be banned outright. Credit scores are often based on flawed and inaccurate data. As a result, consumers see their insurance premiums increase. We will continue to push for an end to the unfair use of insurance credit scoring, but in the meantime, one of the most important things you can do as an informed consumer is to check your credit report annually.
The Federal Trade Commission now offers you a free credit report every year from each of the three major credit bureaus-Equifax, Experian and TransUnion. We recommend checking all three of the bureaus each year to get the most in-depth report possible.
This free report offers a powerful tool to consumers so they can ensure they have the most accurate credit history possible. By checking your report every year, you can check for mistakes or even fraudulent claims. 81% of consumers have some kind of error on their credit report. Mistakes on your credit report can lead to higher insurance premiums and interest rates.
You can dispute the errors on your credit report by contacting the credit bureau that reported the error. Reviewing the reports gives you a chance to see what credit agencies see when they look at your history, and gives you the opportunity to make sure your report is as accurate as possible.
Be careful when using the internet to check your credit report. There are several credit reporting websites that will charge you for their service. You can access your free credit report at www.annualcreditreport.com, monitored by the Federal Trade Commission.
If you have seen your insurance premiums go up as a result of errors on your credit score, we want to hear about it. Please take a moment to share your story with us.
Check Your Credit Report Every Year
81% of Credit Reports Contain ErrorsInsurance companies rely heavily on credit scoring when they set their rates. At Texas Watch, we believe that insurance credit scoring is unfair and should be banned outright. Credit scores are often based on flawed and inaccurate data. As a result, consumers see their insurance premiums increase. We will continue to push for an end to the unfair use of insurance credit scoring, but in the meantime, one of the most important things you can do as an informed consumer is to check your credit report annually.
The Federal Trade Commission now offers you a free credit report every year from each of the three major credit bureaus-Equifax, Experian and TransUnion. We recommend checking all three of the bureaus each year to get the most in-depth report possible.
This free report offers a powerful tool to consumers so they can ensure they have the most accurate credit history possible. By checking your report every year, you can check for mistakes or even fraudulent claims. 81% of consumers have some kind of error on their credit report. Mistakes on your credit report can lead to higher insurance premiums and interest rates.
You can dispute the errors on your credit report by contacting the credit bureau that reported the error. Reviewing the reports gives you a chance to see what credit agencies see when they look at your history, and gives you the opportunity to make sure your report is as accurate as possible.
Be careful when using the internet to check your credit report. There are several credit reporting websites that will charge you for their service. You can access your free credit report at www.annualcreditreport.com, monitored by the Federal Trade Commission.
If you have seen your insurance premiums go up as a result of errors on your credit score, we want to hear about it. Please take a moment to share your story with us.
Friday, July 6, 2007
Healthcare Teleconference Monday July 8, 7 pm Central Time
Wondering what you can do about healthcare issues this summer after watching SICKO?
Democracy for America (DFA) has hired Illy Sheyman as their new Community Organizer. She will be holding a Texas (possibly nationwide) teleconference regarding Healthcare for America forums, legislative visits, and any questions we might have on Monday, July 8 at 7 pm Central time.
Please RSVP at : http//www.dfalink.com/event.php?=21412
Thanks,
lauri wiss
Democracy for America (DFA) has hired Illy Sheyman as their new Community Organizer. She will be holding a Texas (possibly nationwide) teleconference regarding Healthcare for America forums, legislative visits, and any questions we might have on Monday, July 8 at 7 pm Central time.
Please RSVP at : http//www.dfalink.com/event.php?=21412
Thanks,
lauri wiss
Wednesday, July 4, 2007
Surgeon's suit claims UT Southwestern patients mistreated
By BRETT SHIPP = WFAA-TV - Tuesday, July 3, 2007
The former chairman of Parkland Memorial Hospital's emergency room has made disturbing allegations about the care of patients.
In addition to claiming taxpayers are being cheated by his bosses who are breaking the law, he said patients are being mistreated. He also said the moment he voiced complaints to UT Southwestern officials, he was then demoted.
Dr. Larry Gentilello is recognized as one of the top trauma surgeons in the country.
However, he was demoted in March after he said he complained to his supervisor, Dr. Robert Rege, that UT Southwestern was cheating indigent patients and taxpayers by not properly staffing the emergency room with experienced surgeons as required.
Gentilello said he observed patients at Parkland's emergency room being treated by residents with no attending physicians. He also said he saw residents conduct surgeries without supervision.
In his lawsuit against UT Southwestern Health Systems, Gentilello claimed the situation at the hospital is not only "illegal," but has also resulted in "inadequate patient care," and at the very least, violates "proper operating room and patient treatment protocols."
UT Southwestern released a statement that said Gentilello's claims are "baseless" and that he was removed from his position for "legitimate reasons."
In fact, on the witness stand, Gentilello's supervisor said the ER director never talked with him about any problems.
But Gentilello said he did blow the whistle, not only because UT Southwestern has billed for services not rendered, but also because he said supervisory surgeons have been busy serving paying customers at Zale Lipshy Hospital next door.
Gentilello said he wants his old job back and wants UT Southwestern to treat patients and taxpayers fairly and honestly.
Watch report on WFAA
The former chairman of Parkland Memorial Hospital's emergency room has made disturbing allegations about the care of patients.
In addition to claiming taxpayers are being cheated by his bosses who are breaking the law, he said patients are being mistreated. He also said the moment he voiced complaints to UT Southwestern officials, he was then demoted.
Dr. Larry Gentilello is recognized as one of the top trauma surgeons in the country.
However, he was demoted in March after he said he complained to his supervisor, Dr. Robert Rege, that UT Southwestern was cheating indigent patients and taxpayers by not properly staffing the emergency room with experienced surgeons as required.
Gentilello said he observed patients at Parkland's emergency room being treated by residents with no attending physicians. He also said he saw residents conduct surgeries without supervision.
In his lawsuit against UT Southwestern Health Systems, Gentilello claimed the situation at the hospital is not only "illegal," but has also resulted in "inadequate patient care," and at the very least, violates "proper operating room and patient treatment protocols."
UT Southwestern released a statement that said Gentilello's claims are "baseless" and that he was removed from his position for "legitimate reasons."
In fact, on the witness stand, Gentilello's supervisor said the ER director never talked with him about any problems.
But Gentilello said he did blow the whistle, not only because UT Southwestern has billed for services not rendered, but also because he said supervisory surgeons have been busy serving paying customers at Zale Lipshy Hospital next door.
Gentilello said he wants his old job back and wants UT Southwestern to treat patients and taxpayers fairly and honestly.
Watch report on WFAA
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