newsweek--2019-01-23--Dementia and Gum Disease Alzheimers Linked to Gingivitis

Dementia and Gum Disease: Alzheimer's Linked to Gingivitis

A bacteria that causes gum disease has been linked to Alzheimer’s disease in a study scientists believe could pave the way for new treatments targeting the debilitating condition.  An enzyme called gingipains, which the Porphyromonas gingivalis (P. gingivalis) bacteria gives off, is the “main cause of Alzheimer’s disease,” Dr. Steve Dominy, study author and associate professor at University of California, told Newsweek. However, other experts in the field responded cautiously to the findings published in the journal Science Advances.  Read more: Common herpes virus could cause 50 percent of Alzheimer's disease cases, expert says  Researchers first compared the brain tissue of patients with and without Alzheimer’s disease. They found 96 percent of 53 patients with the condition had RgpB, or a form of the gingipains enzyme known as arginine-gingipain. And 91 percent of 54 patients tested positive for Kgp, or lysine-gingipain. These were detected at levels significantly higher than the control samples, the authors said.  DNA tests on three brains with Alzheimer’s disease and six healthy brains also had the gene associated with P. gingivalis in their tissue. The team also examined the cerebrospinal fluid and saliva of 10 patients believed to have Alzheimer’s disease, and found the P. gingivalis gene hmuY in seven, and P. gingivalis itself in all of them.  And in an experiment on mice, those dosed with gingipains had higher levels of the hallmark Alzheimer’s protein, amyloid beta, and greater damage to their neurons than those who didn’t. What’s more, when mice were treated with a drug blocking the enzymes, the neurodegeneration stopped.  Around half of adults have periodontitis. Some 10 percent experience a severe version of the disease, which erodes the gums and the bones that keep our teeth in place, the authors said. If the findings are shown to be correct, this could offer one reason for why 5.7 million Americans are currently living with Alzheimer’s disease: a figure set to rise to 14 million by 2050.  The researchers hope a drug that inhibits the spread of P. gingivalis in the brain could slow the symptoms of the neurodegenerative disorder.  Referring to tau, a protein associated with Alzheimer's disease, Dominy told Newsweek: “Studies reported in our paper indicate that P. gingivalis and gingipains can directly kill neurons, damage tau, elevate levels of beta amyloid, and increase markers of neuroinflammation.”  “In addition, our finding of DNA from P. gingivalis in the cerebrospinal fluid of living AD patients provides further evidence that P. gingivalis infects the central nervous system. Based on these findings, we believe that P. gingivalis is the main cause of Alzheimer’s disease, and the gingipains are the main drivers of Alzheimer’s disease pathology.  “These findings provide a new strategy for Alzheimer’s treatment by specifically targeting P. gingivalis and gingipains instead of amyloid beta,” he said.  However, he said the study was limited because the team has not yet determined if different strains of P. gingivalis are more virulent than others in causing brain infection. “This remains an area of active investigation,” he said.  Those concerned that poor dental health could increase their risk of Alzheimer’s disease are advised to practice good oral hygiene to preclude the prevalence of P. gingivalis in the mouth, said Dominy. But he stressed this won't prevent the brain from becoming infected by P. gingivalis.  "That is why we have created highly potent, brain penetrant, anti-gingipain small molecules to target P. gingivalis and gingipians in the brain," he said.  Dr. David Reynolds, a chief scientific officer at the charity Alzheimer’s Research UK who did not work on the paper, commented: “The presence of a single type of bacteria is extremely unlikely to be the only cause of the condition.”  Describing the study as “well-conducted,” he explained: “Previously the P. gingivalis bacteria associated with gum disease has been found in the brains of people with Alzheimer’s but it remains unclear what role, if any, it plays in the development of the disease.”  “We know diseases like Alzheimer’s are complex and have several different causes, but strong genetic evidence indicates that factors other than bacterial infections are central to the development of Alzheimer’s, so these new findings need to be taken in the context of this existing research,” he argued.  However, he welcomed the avenue of inquiry as no new drugs targeting Alzheimer’s have been released for over 15 years.  “It’s important we carefully assess all new potential treatments, and this drug is currently in an early phase clinical trial to establish if it is safe for people. We will have to see the outcome of this ongoing trial before we know more about its potential as a treatment for Alzheimer’s," he said.  Studies in the past have also associated the little-understood disease to the virus which cases herpes.  Ruth Itzhaki, author of one such study published in Frontiers in Aging Neuroscience and a professor in the Division of Neuroscience and Experimental Psychology at the University of Manchester, U.K., said last year: "HSV1 could account for 50 percent or more of Alzheimer's disease cases.  "Despite the involvement of a virus, the [Alzheimer's] disease is apparently not contagious," she told Newsweek.


newsweek--2019-02-01--2019 Could Be Worst Year for Measles in US for 30 Years Were Losing Ground to a Disease That On

2019 Could Be Worst Year for Measles in U.S. for 30 Years: 'We're Losing Ground to a Disease That Once Killed Millions'

Almost 20 years after measles was eliminated from the U.S., 2019 could see the highest rates of the dangerous disease in three decades, an expert has warned.  A combination of the efforts of the small but extremely vocal anti-vaccine movement and barriers to accessing shots in some communities has sparked outbreaks of the potentially deadly—but entirely preventable—disease across the country.  In the decade prior to the deployment of the first measles vaccine in 1963, an estimated three to four million people in the U.S. were infected with the disease. It killed between 400 to 500 people each year. An outbreak in school-aged children in 1989 prompted immunologists and pediatricians to push for a country-wide immunization program. The campaign was a success: By 2000, the disease was eliminated, defined as reduced to zero incidences for more than 12 months, short of eradication where this effect is seen worldwide.  However, efforts to prevent measles have unraveled, and 2019 could be the “worst year for measles” since 1989, Professor William Moss, a specialist in epidemiology and immunology at Johns Hopkins Bloomberg School of Public Health, told Newsweek. "[This forecast] points to the fact that we are losing ground to this disease that once killed millions of children each year,” said Moss.  While a spokesperson for the CDC tempered Moss’s prediction, and told Newsweek it is too early to predict how many cases there will be in 2019, the figures from 2018 lay bare the prevalence of vaccine hesitancy in pockets of the country.  Some 349 cases of measles were identified across 26 states and the District of Columbia last year: The second highest levels in the U.S. since an outbreak in 2014 sickened 667 people. Last year’s bouts included the worst in New York since the 1990s, mostly affecting members of Orthodox Jewish communities and unvaccinated travelers returning from Israel.  And the issue has bled into 2019. In Clark County, Washington, a total of 38 people—including 27 children under the age of 10—have so far been affected by a measles outbreak which led its governor to declare a state of emergency to channel public funds to tackling the problem. Three unvaccinated members of the same family have been diagnosed with the disease in Atlanta, Georgia. Meanwhile, outbreaks in New York State, New York City, and New Jersey, are ongoing.  The anti-vaccine movement has played an important role in the reemergence of measles, Moss explained. The swell of distrust towards the MMR vaccine—which safely protects against measles, mumps and rubella—partly stems from the false claims made by disgraced former doctor Andrew Wakefield. In 2010, he was struck from the medical register for publishing a 1998 study in The Lancet journal wrongly linking the MMR vaccine to autism. The work has since been shown to be false and with no scientific basis.  Regardless of this, his claims have been spread online by anti-vaccine campaigners on both sides of the political spectrum. Anti-vaccine sentiment has even been peddled by President Donald Trump, who invited Wakefield to his inaugural ball.  Last year, a study published in the journal PLOS suggested the number of children not being vaccinated due to their parents' non-medical, philosophical beliefs had risen in the 12 of the 18 states which allow this: Arkansas, Arizona, Idaho, Maine, Minnesota, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Texas, and Utah. Metropolitan areas including Seattle, Washington; Portland, Oregon; Phoenix, Arizona; Salt Lake City, Utah; Houston, Texas; as well as smaller counties in Idaho, Wisconsin, and Utah were identified as “hotspots” for anti-vaccine attitudes which leaves populations vulnerable to preventable diseases, the researchers concluded.  Indeed, an outbreak of measles among a Somali community in 2017 was a direct result of a targeted campaign by such groups, Professor Helen Bedford, an epidemiology expert at the UCL Great Ormond Street Institute of Child Health, U.K., told Newsweek. The rise of vaccine hesitancy has become such a concern that the World Health Organization named it as one of the biggest health threats of 2019 earlier this month.  But while the movement “must be taken seriously,” pinning the blame solely on anti-vaxxers risks giving the movement more credit than it deserves, she said. After all, only around 2 percent of the U.S. population opposes vaccines, Bedford said.  Importations, where an individual brings the disease from a country where vaccine rates are low, are another “major issue,” said Bedford, pointing to the cases in New York’s Orthodox Jewish communities linked to Israel.  "Research has shown that these communities are not necessarily opposed to the vaccine but often have difficulties with access, often having large families which can make it difficult to attend for vaccination,” Bedford explained.  Irrespective of the motivations for an individual being unvaccinated, the worrying outcomes are the same. Vaccines are able to eliminate conditions because of what is known as herd immunity. This is where a population is protected from an infectious disease because the vast majority of people have been vaccinated against it. That not only means an individual won’t fall ill themselves, but is less likely to pass it to the most vulnerable who can’t receive shots because their immune systems are too weak. Newborn babies and children with cancer fall into this category.  For herd immunity to work, at least 90 to 95 percent of the population must have up-to-date vaccines. Getting shots is therefore sometimes regarded as a public duty. Tellingly, between 2017 and 2018 only 77.6 percent of children from kindergarten to 12th grade in Clark County received all their shots. The graphic below was provided by Statista.  Often underscoring vaccine hesitancy is the false belief that measles is not particularly dangerous, while the measles vaccine is. But once herd immunity is compromised, individuals risk contracting a disease which can kill or severely disable sufferers, said Moss. "The measles vaccine is very safe" and measles is "completely preventable," he stated.  The disease poses the greatest risk to children younger than five, and adults above the age of 20, as well pregnant women, and those with weak immune systems.  Alyssa Hernandez, whose 2-year-old son is not healthy enough to be vaccinated after receiving a liver transplant, lives in California where some counties have vaccine rates lower than 90 percent. She recently told NBC News: "I’m scared to take him out. I’m scared to have him go to school, because you don’t know what’s around."  First, measles can cause a high fever, cough, and runny nose, followed by a rash that spreads from the head to the rest of the body. An infectious person can spread the disease four days before and after the rash appears.  It can trigger complications such as pneumonia—the biggest cause of death in young children with measles—as well as encephalitis, which causes the brain to swell and can trigger convulsions, deafness and intellectual disabilities.  Dr. Nancy Messonnier, director of Centers for Disease Control and Prevention’s National Center for Immunizations and Respiratory Diseases, told Newsweek outbreaks of measles such as that in Clark County should act as “a reminder to parents that many diseases rarely seen in the United States can affect their unvaccinated children.  “There’s no way to tell if a child’s case will be mild or serious. It is best to protect our children rather than treat them,” she said.  Moss advised parents who are confused by vaccinations "to speak to someone who is informed and who they can trust, such as their child’s pediatrician or nurse practitioner."  "Parents need to be very wary of information they find on the internet as many sites present false or misleading information about vaccines," he argued. "Websites to be trusted include those of the CDC or World Health Organizations. These are organizations with the goal of protecting children from disease."  To combat the wider issue of vaccine hesitancy, Bedford argues those on the right side of the debate should use tools like social media and celebrity endorsements—which have been harnessed by anti-vaxxers to devastating effect—to inform parents that the MMR shot is safe, and measles can be deadly.  “We need to have key community advocates talk about the danger of measles and the benefits and safety of measles vaccines, including physicians, lawmakers, celebrities, sports figures and parents whose children have suffered or died from measles," said Bedford.  "We need smart laws that promote public health while recognizing individual rights, and that are designed to reduce the risk of measles outbreaks,” she said, pointing to recent legislative changes in California following an outbreak in Disney as an example.  Bedford added: “There is no reason—other than medical contraindications, for example children with cancer—that a child in the U.S. should not be protected against measles."


activistpost--2019-01-17--Axon Partners With a Public Hospital to Re-brand Stun Guns as Lifesaving Devices

Last month, an article in the Star Tribune revealed a disturbing partnership between Axon Enterprise Inc. (Taser) and a public hospital.  For 14 years Axon has been paying the Hennepin County Medical Center (HCMC) more than $1.1 million to help convince juries and the public that Tasers are lifesaving devices. Axon has been paying two doctors between $20,000- $36,000 a year to write hundreds of Axon-funded stories and serve as Axon medical advisors.  Two researchers in leadership positions at HCMC have served as medical advisers for Axon, and the hospital’s research arm conducted 22 Axon-funded studies, hospital records show. For at least eight years, Axon paid the hospital’s chief medical officer, Dr. William Heegaard, $20,000 annually to serve on the company’s medical advisory board until he resigned this year. Heegaard has disclosed in studies that he also has owned Axon stock. Dr. Jeffrey Ho, medical director for EMS at HCMC, doubles as Axon’s contract medical director for at least 32 hours per month. Every three months, the hospital bills Axon $34,344 to cover Ho’s shifts while he’s working for the company, records show. Ho bills the company directly for outside work, which amounted to $36,000 last year, according to Hennepin Healthcare spokesman Tom Hayes.  The Hennepin hospital also signed an additional contract with Axon “to make its security personnel available for conferences and other appearances promoting its use of Tasers to protect patients, staff and guests.”  Taser has been re-branded; they are now calling themselves “Axon/Protect Life.” Axon claims their shock devices save lives; “we create technologies and services that enable you to capture truth and protect life.”  I wish everyone would read Axon’s incredulous public safety mission…  Do You Want to Learn How to Become Financially Independent, Make a Living Without a Traditional Job & Finally Live Free?      Your mission every day is to protect life. So is ours. We are Axon, a team committed to pushing the boundaries of technology to help you feel more confident in the field, at the station, and in court. From Smart Weapons, like our TASER devices…  Axon’s “smart weapon” Tasers automatically reload and measure how much electric shock is being applied to a suspect. If the Taser thinks the suspect needs more of a shock it increases the voltage.


activistpost--2019-10-09--U.S. Hospitals Turning Away Patients and Canceling Surgeries Due to Ransomware Attacks

Being targeted by cybercriminals is no laughing matter – especially for health care facilities. Non-payment of ransomware puts lives at immediate risk.  Thanks to Threatpost for providing details about recently targeted hospitals, as well as plans being discussed to reduce risks:  Ransomware overall continues to be a concern for governments worldwide: The U.S. Senate this week in fact approved new legislation aimed at helping government agencies and private-sector companies combat ransomware attacks. The legislation comes as local governments and schools continue to be hit by sophisticated – and in some cases coordinated – ransomware attacks. The proposed law, the “DHS Cyber Hunt and Incident Response Teams Act,” authorizes the Department of Homeland Security (DHS) to invest in and develop “incident response teams” to help organizations battle ransomware attacks. Part of that means that the DHS would create teams to protect state and local entities from cyber threats and restore infrastructure that has been affected by ransomware attacks.  For many years, security experts have been warning about the vulnerability of 5G and Internet of Things (IoT) technology. IoT already has a 74% failure rate. This hasn’t stopped the U.S. and other countries from forcing its installation (see 1, 2). Cybercriminals must be pleased as punch.  Activist Post reports regularly about unsafe technology. For more information, visit our archives.  Subscribe to Activist Post for truth, peace, and freedom news. Follow us on Minds, Twitter, Steemit, and SoMee. Become an Activist Post Patron for as little as $1 per month.  Provide, Protect and Profit from what’s coming! Get a free issue of Counter Markets today.


birminghammail--2019-02-02--Hospitals could be set to offer FREE sanitary products

Doctors' leaders have written to the head of the NHS demanding that hospitals provide inpatients with free sanitary towels and tampons.  The British Medical Association (BMA) argued that it was inconsistent for some hospitals to give out razors and shaving foam but not offer women sanitary products.  The union said towels and tampons are a basic human need - like food - and should be made freely available at all hospitals in the UK.  Some patients cannot afford to buy their own products, while others unexpectedly find themselves in hospital with nobody to rely on, it said.  The BMA sent Freedom of Information requests to NHS trusts and health boards in the UK and received responses from 187.  The research found that 42% either did not supply sanitary products at all, will only supply small amounts, or will supply them only in the case of an emergency.  For those that did have a supply, tampons and towels were often only available on gynaecology or maternity wards.  Only 22% of hospitals said they could easily be bought on site by the patient.  Some trusts and health boards said they spent nothing on sanitary products for inpatients. For those that did, the average spend was 71p per bed per year.  A rough estimate from the BMA suggests UK hospitals could supply the products for around £120,000 per year.  In a letter to NHS England chief executive Simon Stevens, the BMA's board of science chairwoman, Professor Dame Parveen Kumar, said: "Action must be taken to ensure that patient experience of care is not jeopardised by the non-availability of these essential items.  "Patients must not be deterred from undergoing necessary treatment, or hindered in their recovery, because they are unable to access, or embarrassed to request, sanitary products.  "With patient experience and quality of care being such a clear priority for the NHS, sanitary products, which are relatively inexpensive, should be provided for free and readily available to all inpatients at hospital."  BMA medical students committee member Eleanor Wilson, who has championed the issue, said: "When patients are under our care in the NHS, we need to make sure that we make them feel as welcome and as looked-after as possible.  "By not providing them with something so key to their health and well-being, it has a big impact on their sense of self-worth - we are effectively withholding that dignity from them.  "While some hospitals have good provision, in others, patients have had to face embarrassment and hope that relatives can bring them in, which for some is not an option, and it can often become more challenging for young and teenage paediatric patients.  "Like razors, shaving foam, toilet paper or food, it should be part of a basic package that is available to patients when they come under our care in hospital."


birminghammail--2019-02-22--Windrush pensioner refused treatment at Queen Elizabeth Hospital until U-turn

Windrush pensioner 'refused treatment at Queen Elizabeth Hospital' until U-turn

THE family of a sick Windrush Generation pensioner are furious his hospital treatment was delayed after he was refused NHS treatment.  They were stunned when told Boysie Folkes, who suffers from amyloidosis - a rare, serious condition caused by a build-up of abnormal protein in organs - would have to go private.  The ensuing wrangle over the 81-year-old’s right to be dealt with as a UK citizen has, says daughter Jennifer, led to a deterioration in his condition.`  The great-grandfather has been told his condition is incurable, says 50-year-old Jennifer.  On Friday morning Boysie, from Kings Heath, WAS admitted to Edgbaston’s Queen Elizabeth Hospital after the Sunday Mercury contacted the QE about his plight 24 hours earlier.  That move has done nothing to pacify Boysie’s eight-children who expected their dad to be admitted weeks earlier.  Jennifer said: “The QE has failed my father - and if anything happens to him I’ll never forgive them.”  The controversy surrounds the issue of citizenship.  Boysie, who holds a UK passport, arrived in Britain as part of the Windrush generation in the early 1950s. He worked as a sprayer at British Leyland for 35 years.  However, 12 years ago he returned to Jamaica with wife Valda, 76. The couple intended to spend their twilight years in a property they purchased in picturesque St Catherine Old Harbour.  Those dreams were dashed during a visit to see family in Britain last September.  Boysie suffered crippling stomach pain and dramatic weight loss. Blood and bone marrow tests in London in January revealed he was suffering from amyloidosis.  His family say the disease has invaded his heart.  The stand-off between the NHS and the Folkes came to a head just last week when his condition worsened, said Jennifer.  Boysie was admitted to a ward, but told long-term treatment would come at a price - and that price could run into thousands, she claimed.  “The condition is serious, very serious,” Jennifer said.  “He now needs support when walking. He is very weak.  “We have been told new rules mean people who leave this country for a certain number of years have to pay, but I haven’t been able to find that new law.  “My mother even worked for the QE as a cleaner and my dad is still a UK taxpayer.  “Yes, he’s now in hospital, but I’m furious over the way he’s been treated. During the delay, he has deteriorated dramatically. As a UK citizen, he has been treated shoddily. I can’t sleep or eat - it’s taken its toll on me."  The family have been supported throughout by Birmingham community activist Desmond Jaddoo who has written to the hospital for an explanation.  He said: “This man worked hard in our city for British Leyland, yet was treated as though he had no right to be here.  “A Birmingham Council taxpayer and  homeowner was asked to pay for vital treatment despite his income tax and national insurance contributions.  “It is a complete farce. I have written to the hospital demanding that they treat him as they have a clear legal duty to do so. In this case Mr Folkes did have his citizenship and also his British Passport. What else do they need to treat him?”  A spokesperson for the Queen Elizabeth Hospital said: “NHS staff have a legal responsibility to check the eligibility of patients for non-emergency NHS treatment.  "We recognise this can be distressing for both the family and patient. In this case the Trust has treated and will continue to treat the patient with no charge.”


birminghammail--2019-02-26--Bullied stressed and dissatisfied - how Birmingham hospital staff are feeling the strain

Bullied, stressed and dissatisfied - how Birmingham hospital staff are feeling the strain

Stressed, dissatisfied, bullied and keen to find a new job - staff at Birmingham’s hospitals are increasingly feeling the strain.  The latest results from the NHS Staff Survey suggest people working in the area’s hospital trusts are increasingly unhappy with working conditions.  And a high proportion say they are unwell from stress and being bullied by managers and colleagues.  Bodies representing NHS staff have said the latest survey shows staff working in a system under extreme pressure, with urgent action needed.  At Sandwell and West Birmingham Hospitals, the proportion of staff that said they were satisfied with the quality of care they gave to patients dropped to its lowest level since the question was introduced in 2015.  Only 77.9% said they were satisfied, down from 85.2% in 2017.  Just 72.4% of staff at Birmingham Women’s and Children’s NHS Trust said they were satisfied with the care they provided, one of the lowest proportions in England, and down from 77.9% in 2017.  In the past 12 months, 43.5% of staff at Birmingham Women’s and Children’s NHS trust said they had felt unwell with work-related stress, one of the highest proportions in England, as did 42% of staff at Sandwell and West Birmingham Hospitals, and 39.2% at University Hospitals Birmingham.  One in seven members of staff at University Hospitals Birmingham (14.2%) said they had experienced at least one incidence of violence from patients, relatives, and other members of the public.  The figure was one in eight at Sandwell and West Birmingham Hospitals (12.9%) - the highest level in five years.  At Birmingham Women’s and Children’s NHS trust, one in five (21.7%) staff said they experienced bullying or harassment from colleagues at least once last year, while one in seven (14.8%) said they were bullied or harassed by managers.  At University Hospitals Birmingham, 13.6% of staff had been bullied and harassed by managers and 19.7% by colleagues. The figures were 13.5% and 15.5% respectively at Sandwell and West Birmingham Hospitals.  Staff at Birmingham Women’s and Children’s NHS trust were the keenest in England to find another job, with a quarter (25.3%) saying they would leave as soon as they could find another job. Some 41.5% said they often thought about leaving.  At University Hospitals Birmingham, 18% wanted to leave as soon as they found another job, while it was 15.4% at Sandwell and West Birmingham.  A BMA spokesperson said: “The findings of the 2018 NHS Staff Survey shows that doctors and other health care professionals across England are working in a system under extreme pressure due to chronic underfunding, workforce shortages and rising patient demand and are struggling daily to sustain high standards of patient care.  “Work related issues such as bullying, harassment and burnout caused by impossible workloads are damaging the physical and mental health of doctors. This then directly affects the quality of care they can give patients.  “Government and employers not only have a clear duty of care to the medical workforce but to patients as well and so must act urgently and decisively to tackle these issues by addressing their root causes.”  Across England, the proportion of staff who said they were satisfied with the care they have fell for a second year in a row to 80.7%.  The proportion of staff who said they had been ill with work-related stress hit a five year high in 2018, at 39.8%, while the proportion experiencing musculoskeletal problems as a result of work activities also rose to 27.6%.  Professor Andrew Goddard, president of the Royal College of Physicians, said: “It’s alarming that increasing numbers of staff report feeling unwell as a result of work-related stress and this should be a wake-up call.  “Urgent action is needed to protect the wellbeing of staff and to help them do the best job they can for their patients, safely and effectively. If we do not protect our staff and allow the pressures upon them to increase then we also put at risk our ability to attract healthcare workers in the future.”  More than a quarter (27.8%) of staff reported seeing an error, near miss, or incident that could have hurt patients or service users in the previous month.  That was the highest figure in the last five years, and up from 25% in 2017.  The proportion saying they had seen incidents that could have endangered staff also increased for the second year in a row to 17.8%.  Just under one in five staff reported having experienced harassment, bullying or abuse at work from other colleagues, an increase from 18% to 19.1%.  The proportion being bullied and harassed by patients and managers also rose.  However, fewer NHS staff reported experiencing physical violence from patients, relatives or members of the public, with the percentage dropping from 15.4% to 14.5%.  The proportion that agreed there were enough staff in their organisation for them to do their job properly was the highest in the last five years, at 32% - although that is still fewer than one in three.  The proportion satisfied with pay was also up.  Three in ten members of staff (29.9%) said they often thought of leaving their organisation, with 15.7% saying they planned on leaving as soon as they got a new job.  Dame Donna Kinnair, Acting Chief Executive and General Secretary of the Royal College of Nursing, said while some good work is being done on the shop floor to make staff feel happier, when close to a third of staff are thinking of going, the Government and NHS England must listen and redouble efforts to keep staff in post as well finding thousands of new recruits.  She said: "Half of all staff have raised low staffing levels as an issue, more are saying they are working unpaid overtime to keep the service running and increasing numbers report seeing errors that could harm patients.  "These are all indicative of a health service with a cavernous gap between the number of staff it has, and what it actually needs to meet demand.”  The survey was carried out between September and December 2018 across 304 NHS organisations.  There were 497,000 staff responses, an increase of 10,000 compared to 2017.  Neil Churchill, Director of Patient experience at NHS England, said: “NHS staff regularly go the extra mile for their patients and colleagues to deliver the best possible care, but it is equally important that local NHS trusts and foundation trusts are doing all they can to support our fantastic staff.  “Whilst there are a number of positives in this year’s survey, it is also clear that local employers can do more to improve and we would expect all trusts to listen to the results from their staff survey and take appropriate action.”


birminghammail--2019-04-04--Family fighting City Hospital for refusing to give back dead dads belongings

Family fighting City Hospital for refusing to give back dead dad's belongings

A grieving family is locked in a tug of war with a Birmingham hospital which has refused to give back their dead dad’s belongings.  Pensioner Ray Amphlett was taken to City Hospital by ambulance on November 8 suffering shortness of breath, and was diagnosed with acute vascular failure.  The 74-year-old from Great Barr was transferred to the Queen Elizabeth Hospital, where five days later, daughter Leah Ellison had to make the heartbreaking decision to turn off his life support.  As Leah and her brother Mark prepared to make funeral arrangements, they contacted City Hospital to ask for Ray’s belongings, including his flat keys, car keys, wallet and watch.  Leah, also from Great Barr, later visited the hospital, taking along the death certificate, to collect them.  But, despite being Ray’s next of kin, Leah was told that she would need a copy of his will to pick up the items.  Four months, on the hospital says it now needs a grant of probate, where legal authority is given to the executor of the will.  “I spoke to a solicitor and he’s never heard anything like it before,” said mum-of-two Leah.  “When I first went into the hospital, they said they couldn’t give me his things because he could ‘have kids anywhere’.  “My dad had just died, so I got pretty upset. The woman called for her manager and said there ‘was an irate woman downstairs’.  “I just don’t understand their reasoning, and by what authority they can withhold his personal things.”  Probate is only usually necessary if a person’s estate is worth more than £15,000.  As Ray did not own his flat, and only had a small amount of savings, the family did not need it to deal with his will.  “He didn’t have a lot of money,” said Leah. “He left money for the funeral and that was about it, so we didn’t need a probate.  “I’m his next of kin so I was the one who had to decide whether to turn his machine off. I’ve also closed his bank accounts.  “But I can’t get his watch, wallet and keys back from the hospital. It is ridiculous.”  Leah says that the family has been left unable to move forward in their grief with the situation hanging over them.  “There’s no closure,” she added. “It makes us wonder whether they’ve lost his things.  “My mum said maybe we should just forget it, but I can’t now on principle. It makes me think about the people who don’t have anybody to help, and would have to go through this on their own.  “If my Dad was here, he would be fuming. He wouldn’t want any of us to have to go through this. He loved to help out his friends and neighbours, and I think he would be pretty angry.  “They’ve shown us no compassion at all.”  After being contacted by the BirminghamLive, the Sandwell and West Birmingham NHS Trust insisted that asking for probate was standard policy.  Chief Nurse Paula Gardner said: “We offer our deepest sympathies to Raymond’s family and friends at this very difficult time.  “Our standard policy in this situation is to release personal effects to the person with the grant of probate, which identifies them as responsible for safekeeping the property.”


birminghammail--2019-04-23--Norovirus outbreak forces ward closure at Walsall Manor Hospital

A norovirus outbreak has forced health bosses to close a ward at Walsall Manor Hospital.  The highly contagious stomach bug has led to visitors being turned away from Ward 14 today (Tuesday, April 23) to keep patients safe and prevent further spread of the virus.  Visitors who have experienced sickness and diarrhoea in the last 48 hours have also been urged to stay away.  A spokesman for Walsall Healthcare NHS Trust said: "Ward 14 at Walsall Manor Hospital is closed due to the highly contagious norovirus infection.  "A temporary visitor restriction is necessary on this ward to protect patients, their families and carers and trust staff.  "All other ward areas, including the emergency department, are open as usual however please do not visit our hospital if you have had sickness and diarrhoea in the last 48 hours as stomach bugs spread quickly and we want to protect our vulnerable patients."  Relatives and friends of patients who are critically ill or receiving end of life care have been asked to contact the nurse in charge on 01922 721172, using extension 6731, so arrangements can be made for visiting at this time.


birminghammail--2019-06-25--Demolition begins on fire-ravaged hospital unit

Demolition is due to begin this week on the fire-ravaged west wing of the George Bryan Centre in Tamworth - with the future of the entire building hanging in the balance.  The blaze, which broke out in February this year, completely gutted the west wing, which was a 20 bed ward providing 24-hour inpatient assessment, care and treatment for people suffering from acute mental illness.  When the fire broke out, the building was evacuated in under four minutes, but it was severely damaged.  At a confidential meeting of the Midlands Partnership NHS Foundation Trust later that month it was decided that it was unsafe for both staff and patients to remain in the east wing at the isolated site and it was consequently closed, with its 12 vulnerable inpatients moved to Stafford.  The board decided that adults over 65 not requiring admission would be supported and cared for in their usual place of residence by specialists, whilst older adults requiring acute mental health admission were cared for at St George’s Hospital in Stafford.  All George Bryan Centre staff have been temporarily redeployed within the Trust.  The closure of the building has led to enhanced crisis home treatments being provided, enabling older adults to remain at their usual place of residence. The new structure has provided skilled experienced older adult specialists; the addition of a nursing/therapy lead; a new clinical psychologist to focus on older adults and a training plan for the team to ensure best quality care and then interventions prioritised according to evidence of outcomes for service users.  The focus of the team is on prevention and avoiding the necessity for hospital admission.  Where a person needs a hospital stay, they will be admitted to Bromley Ward at St George’s Hospital, Stafford.  The future of the George Bryan site is now under review and a group has been set up to plan an engagement exercise to discuss what happens next.  The engagement group includes a service user and staff representative, a member of the League of Friends of Tamworth Hospitals and staff from Midlands Partnership NHS Foundation Trust. At least four  meetings will be held, with two planned for Tamworth later this summer. The events will be open to all, but the target audience is people who have used the George Bryan Centre in the last two years and their families and carers, plus those who have been admitted to St George’s in the last two years.  Staffordshire and Stoke-on-Trent’s Sustainability and Transformation Plan (STP) is currently undertaking listening events relating to a number of different areas of health that need to be transformed. This includes mental health.  The George Bryan Centre engagement is a piece of targeted engagement being led by Midlands Partnership NHS Foundation Trust and will be received by the STP as part of their broader engagement.


birminghammail--2019-08-05--Heartlands Hospital - what new 971million medical centre will look like

Heartlands Hospital - what new £97.1million medical centre will look like

Plans have been unveiled for a new £97.1million centre at Heartlands Hospital.  The Ambulatory Care and Diagnostic centre (ACAD) - which will be approximately half the size of Wembley’s football pitch-  will house outpatients, endoscopy, day case surgery and imaging services – and treat 1,500 patients a day or nearly half a million each year.  Funding for the project was finally given the rubber stamp today (August 5) and once constructed, the four storey building is set to open in late 2020.  Jonathan Brotherton, Chief Operating Officer at University Hospitals Birmingham NHS Foundation Trust (UHB) which runs Heartlands Hospital, said: “This investment is an exciting step forward for the services we are able to provide to the people of Birmingham and Solihull.  “Receiving the positive confirmation of funding today is fantastic news for local people and is the result of three years of hard work and careful planning.  “The Ambulatory Care and Diagnostic centre (ACAD) will boost the Trust’s capacity to meet the growing and changing healthcare requirements of local people, with state-of-the-art facilities providing services including day case surgery, endoscopy, interventional radiology, outpatient appointments and imaging on the Heartlands Hospital site, seeing up to 1,500 patients per day.  “ACAD will also deliver new ways of working to streamline patient pathways - maximising efficiency - all whilst delivering the best possible care and high-quality specialist services for half-a-million patients every year.  The new building, which is expected to generate jobs in the area, will be located next to the main entrance and will be use solar panels to reduce its carbon footprint.  Planning permission for the centre was granted in September 2017.  UHB is one of the largest teaching hospital trusts in England and includes Heartlands Hospital, the Queen Elizabeth Hospital , Solihull Hospital, Good Hope Hospital in Sutton Coldfield and Birmingham Chest Clinic.


birminghammail--2019-08-12--MP calls for ministers to get a move on over unfinished hospital in Sandwell

MP calls for ministers to ‘get a move on’ over unfinished hospital in Sandwell

A Black Country MP has said the government has missed an opportunity to get the Metropolitan Hospital back on track after it wasn’t included in 20 new NHS projects announced.  John Spellar, member of parliament for Warley, was speaking after the announcement of an additional £850 million to pay for capital projects across the country.  The news came as Sandwell and West Birmingham NHS Hospital Trust waits for the Treasury to sign off on £358 million to allow work to restart on the Metropolitan, which has been at a standstill since January 2018 when the main contractor went bust.  Toby Lewis, the trust’s chief executive, recently warned a meeting of Birmingham and Sandwell councillors that if the deal wasn’t ratified soon, the hospital could miss its completion date of 2022 and end up costing more.  He said: “If we have not signed the contract by October, then it would not be possible to open by the time of the Commonwealth Games, moreover it won’t be possible to open the hospital for £358 million.”  Mr Spellar has said he is lobbying the Department of Health and the Treasury to ‘get a move on’ and approve the funding.  He is now writing to the Health Secretary, Matt Hancock, and the Chancellor, Sajid Javid, expressing his concerns.  He said: “I think they should have taken this opportunity to include this in the package, which would have been very welcome but I chasing them to say they need to get this site signed off.”  He added while the Metropolitan remained unfinished costs of maintaining the existing Sandwell General and City Hospital were increasing.  “All these delays means they have been putting off some maintenance work but clearly they will need to do it to keep the sites running.  “They need it. They need the extra bed space. Their plans for the West Midlands require those extra beds.”


birminghammail--2019-09-22--Mum spending thousands on Birmingham hospital parking as daughter 4 battles cancer pleads for help

Mum spending thousands on Birmingham hospital parking as daughter, 4, battles cancer pleads for help

The family of a four-year-old girl with cancer forced to spend thousands of pounds on petrol and parking to attend appointments in Birmingham have called on the government to help.  When the young giel was diagnosed with a rare cancer in 2016, paying for parking and petrol to get to her hospital appointments was far from her parents' minds.  Naomi Thomas, from the Midlands, has shelled out thousands since the harrowing diagnosis after the 45-year-old woman's four-year-old daughter was diagnosed with cancer three-and-a-half years ago.  Phoebe was diagnosed with Neuroblastoma when she was just six months old and now Naomi, from Leicester, in Leicestershire, in the East Midlands.  They never imagined that over the next three-and-a-half-years they would have to spend several thousands of pounds on those two charges, with much more to come.  Phoebe's mum, Naomi Thomas, told LeicestershireLive that the cost of parking at hospitals for appointments, as well as travelling to and from them, currently stood at £3,500.  She spoke out after cancer charity CLIC Sargent called on the government to create a Young Cancer Patient Travel Fund to help relieve the pressure on families in the same situation.  Recalling her daughter's diagnosis, Naomi said: "Everything else just falls by the wayside. All you can think about is your child's health.  "You just want them to get better. You'd spend every penny and travel every mile. Those things just don't matter at that point in time.  "But eventually you do have to give it some thought."  She added: "All of the parking we've paid for was subsidised too. I can't imagine how much more it would have been otherwise."  Phoebe, who has recently started school part-time, was diagnosed with neuroblastoma in 2016 at just nine months old. It came after her mum and dad, Naomi and Russ, took her to the doctor after a small lump appeared on her chest.  Naomi said: "It was November, and she had a cough and a lump appeared on her chest. We assumed it was a virus and took her to the doctor's.  "We were told to go to A&E, where the registrar said they were pretty sure it was developmental cysts but some tests were booked and an ultrasound.  "The appointment came through for January, and when we went along for the results we were told the news.  "We could think about nothing else. All we wanted was for her to get the treatment she needed.  "You go into what I call a cancer bubble. It's all you can think about and concentrate on."  A treatment plan was drawn up for the youngster, who lives in Wigston with her parents and sister Amelie, eight.  Naomi said: "For the first year she was treated at the Royal Infirmary.  "When the cancer wasn't responding, we were accepted onto a trial at Birmingham Children's Hospital.  "We were there for three-and-a-half months for one stint, and have travelled there and back countless times."  Since then, the family have made 25 trips to Birmingham Children's Hospital, travelling a total of 2,200 miles at a cost of £325 in fuel alone.  The family had to travel every three weeks for five days, going back and forth every day, for 12 cycles. They estimate that the six month period cost around £1,000 in fuel and parking expenses alone.  Naomi said: "We get to the hospital, park up and come to leave and stick it on the credit card. If I can pay it I pay it, if not I worry about that later.  "There's nothing you won't do. You'd never dream of not being there. You do all you can to get your child better."  She added: "I can't imagine the money that has been spent on her treatment. It must have cost the NHS so much, and we are so grateful for that."  The mum-of-two, who works part time in PR, has had to cut back on her working hours to support Phoebe.  About the call for the travel fund, she said: "At a time when the emotional stress is just so high, the added burden of financial pressures for things like parking and fuel are just another thing to worry about, something you haven't got the energy to deal with or control.  "It is what it is. You have to get there so you have to pay for fuel. You have to park somewhere so you have to pay for parking. You have to eat, so you buy food; I haven't even totted up what we must have spent picking up things to eat when Phoebe has been getting treatment.  "It is a stress you really don't need."  Phoebe is due to complete her latest round of treatment in October. All being well, she will then have scans every three months to monitor her condition.

newsdesk@birminghamlive.co.uk (Amy Orton, James Rodger)


birminghammail--2019-10-14--MP John Spellar welcomes £350m to allow Midlands Metropolitan Hospital to go ahead

MP John Spellar has welcomed the announcement that the Government has given a green light to restarting construction of the Midlands Metropolitan Hospital in the Black Country.  It comes after the MP raised a series of questions in the House of Commons urging the Government to ensure work on the hospital could go ahead.  Mr Spellar, Labour MP for Smethwick, said: "This announcement is great news for Smethwick, the local Health Service and the wider West Midlands.”       “Ever since the collapse of Carillion, I’ve been badgering the Government to get construction restarted as soon as possible. I’m glad this campaigning has paid off.”       “I look forward to the opening of this much-needed new hospital, which I hope can start a new revival of the area.”  Construction of the Midland Metropolitan Hospital is to resume after Chancellor Sajid Javid announced the Government is to provide £350m to rescue the troubled project.  Work on the 669-bed hospital in Smethwick stopped in January 2018 following the collapse of developers Carillion.  The unfinished hospital was left exposed to the elements while the Government and Sandwell and West Birmingham NHS Trust negotiated a financial package to allow construction to resume.  An interim contract to repair damage to the unfinished hospital was awarded to Balfour Beatty last year - but there has been a long wait for funding to ensure the project can actually be completed.  However, funding announced last week by the Government will allow work to be completed by April 2022. It will replace many services currently provided by City Hospital in Birmingham and Sandwell Hospital.  It marks the formal sign off by Government of a business case produced by Sandwell and West Birmingham Hospitals NHS Trust. The Trust is finalising commercial terms with its preferred bidder, Balfour Beatty, and expects to sign a contract for the construction work in the next few week  Toby Lewis, Chief Executive of the NHS Trust, said: "Today’s announcement by the Treasury is hugely welcome news. We are working round the clock to conclude the commercial close, and the agreement of the Final Business Case and appointment of a Preferred Bidder is the last national approval hurdle overcome.”  "The promise from Government in February 2018 was that no local NHS funds would need to be diverted to remedy the national collapse of Carillion. That promise has been honoured in full, which has the overt support of all local stakeholders from across political divides. "


birminghammail--2019-12-18--Hospital first in UK to bring in disposable sterile hijabs for Muslim doctors

A hospital trust is the first in the UK to give female Muslim doctors and medical staff disposal HIJABS to wear to avoid germs being passed to patients.  Junior doctor Farah Roslan had the idea while undergoing her training at the Royal Derby Hospital.  After gruelling hours on the wards, where she had been wearing a traditional hijab, she became concerned with the risk of infection to patients.  Ms Roslan, who is originally from Malaysia, looked to her home country for ideas of how to implement her plan for a disposable sterile headscarf.  She created a design and used fabrics that maintained a balance between showing respect to her faith and being able to perform in her work.  She said: “I’d been using the same headscarf all day which obviously wasn’t clean and ideal.  “I didn’t feel comfortable taking it off and I was pulled out of the theatre, respectfully, due to infection control.  “A middle ground had to be found between dress code due to faith and the passion of being in the operating theatre.  "I am so happy my vision has become a reality and that these headscarves are now available for all of the staff.  "I'm really happy and looking forward to seeing if we can endorse this nationally.”  Consultant surgeon Gill Tierney, who mentored Ms Roslan, said the trust was the first to introduce the headscarves in the UK.  She said: "We know it's a quiet, silent, issue around theatres around the country and I don't think it has been formally addressed.  "It hasn't cost much and hopefully the effect will be enormous."  Commenting on Twitter, Andy Ibbs said: “Nice one - but on reflection, I wonder why it hasn’t been done years ago!”  Another user, Victoria Parker said: “This is inspired!”  The University Hospitals of Derby and Burton NHS Trust said the new headscarves have been available since early December.


breaking911--2019-11-05--First Lady To Visit Cuddling Program At Boston Hospital Wednesday

Wednesday, November 6th the First Lady will visit Boston, Massachusetts to highlight a treatment program for babies born with Neonatal Abstinence Syndrome (NAS), as part of her Be Best initiative. The program comforts infants who were exposed to opioids in the womb.  Mrs. Trump will visit Boston Medical Center to learn about their Cuddling Assists in Lowering Maternal and Infant Stress (CALM) Program developed to treat babies born with NAS.  In addition to CALM, Boston Medical Center developed several other programs aimed to assist pregnant women with Substance Use Disorder (SUD) and newborn babies suffering from the impact of SUD. Mrs. Trump will receive a briefing from the Boston Medical Center Staff on the status of these programs. Following the briefing, Mrs. Trump will tour Boston Medical Center’s Pediatric Unit to see first-hand how these programs are implemented and meet with the children and families who have been successfully treated.


breitbart--2019-09-03--Study 52 Rural Iowa Hospitals Could Close Under Bidens Public Option

Study: 52 Rural Iowa Hospitals Could Close Under Biden's Public Option

The Cedar Rapids Gazette wrote an analysis, citing a study commissioned by the Partnership for America’s Health Care Future and conducted by Navigant Consulting, which found that “adding a government-run insurance plan could decimate rural hospitals.”  The Iowa paper wrote that 52 rural Iowa hospitals could close under Biden’s public option plan and “rural hospitals could experience a loss of more than $476 million dollars under a public health insurance proposal.”  Former Vice President Joe Biden’s healthcare plan would create a “public option,” allowing a government health insurance option to compete with private health insurance on the Obamacare exchanges.  The study could serve as a dire warning for Biden in the upcoming Iowa caucus, even though he leads in recent state primary polling.  The Navigant Consulting study found that after having millions of Americans switch from their private insurance plan to the public option plan, the public option would pay hospitals at Medicare rates, which is typically lower than private insurance, and would cut rural hospitals’ revenues between $4.2 billion and $25.6 billion.  “They’re in trouble,” Kirk Norris, the president and CEO of the Iowa Hosptial Association, said. “Our community hospitals are in the worst financial shape they’ve been in over 30 years.”  To make matters worse for public option supporters, the study suggested that to prevent hospitals from closing under the public option system, Medicare would have to increase payments to hospitals between 40 to 60 percent above Medicare rates, which could cost between $4 and 25 billion annually depending on how many employers move employees onto the public option.  Jeff Leibach, the director of Navigant Consulting and one of the authors of the study, said, “rural hospitals are essential to the health and economic well-being of communities across the U.S., and often represent these communities’ largest employer.”


breitbart--2019-09-19--Cartel Gunmen Storm Mexican Hospital to Finish-Off Rival

The incident occurred Thursday in Morelia, Michoacán, at Hospital Acueducto. According to witnesses who spoke to local reporters, at least two gunmen entered the building at 7am and found the victim on the third floor. A gunman pulled a firearm from his waistband and shot the patient execution-style in the presence of doctors and support personnel. They then fled without further violence.  Jesús Cancino, 45, survived gunshot wounds during an earlier attack in Querétaro. Police believe the gunmen belong to a rival gang. Local media initially reported the victim was Jesús Cancino Téllez aka “El Apá Michoacano” or “El Chuy Cancino,” a high-ranking member of La Familia Michoacána. Representatives of the state attorney general’s office later disputed the claim and said the similar names were coincidental.  Jesús Cancino Téllez survived an ambush on September 4 in Querétaro while traveling in a white pickup truck with a driver who died during the attack, according to local reports at the time. Cancino Téllez was supposedly targeted by assassins of the Cártel Jalisco Nueva Generación (CJNG). Cancino Téllez was reportedly transported to a local hospital in Querétaro under heavy guard. La Familia Michoacána are involved in a bitter turf war with the CJNG.  Robert Arce is a retired Phoenix Police detective with extensive experience working Mexican organized crime and street gangs. Arce completed work assignments in the Balkans, Iraq, Haiti, and recently completed a three-year tour in Monterrey, Mexico, for the U.S. Department of State, International Narcotics and Law Enforcement Program. As the Regional Program Manager for Northeast Mexico in charge of the Mexican states of, Coahuila, Tamaulipas, Nuevo Leon, Durango, San Luis Potosi, Zacatecas) You can follow him on Twitter or reach him at robertrarce@gmail.com.


cbsnews--2019-10-15--Dems debate which proposal is best to tackle rural hospital crisis

Asked in September about her support for "Medicare for All," Elizabeth Warren insisted at the third presidential debate that all Americans—even those in rural communities—could still seek treatment at their local hospitals under the universal healthcare plan.  "So let's be clear about this. People will have access to all of their doctors, all of their nurses, their community hospitals, their rural hospitals," the Massachusetts Democrat vowed.  A Pew Research Study published last year, showed that "getting to a hospital is a longer trip—both in distance and time—for people in rural areas." The University of North Carolina has tracked some 160 rural hospital closures nationwide since 2005, including in Nevada, South Carolina, and Ohio, the host of Tuesday's Democratic presidential debate. Across the country, in fact, at least 99 rural hospitals have shut down since 2010.  After the Nye County Regional Medical Center was shuttered without warning in 2015, Nevadans in towns like Tonopah were left hundreds of miles from the nearest hospital.  "They shut the doors and that was it," Elaine Minges, a Tonopah resident, recalled earlier this year.  Minges' husband, Curt, suffered from a serious complication from diabetes some time later. The situation required prompt medical attention, but with the local hospital closed, none was to be found.  "That particular night, the helicopter was 45 minutes out before they could get to the airport, and in that time, he went into cardiac arrest," Elaine Minges said.  When Fairfield Memorial Hospital in South Carolina closed last year, residents in parts of Fairfield County were left with a 45-minute drive from their nearest hospital.  "It doesn't matter what kind of health condition you have, whether it's a stroke, or a heart attack, or a car accident," community health organizer Anton Gunn told CBS News. "It's hard for any community, particularly in a rural community like that to survive."  Gunn, who also worked for the Department of Health and Human Services and helped implement the Affordable Care Act, says that prevention is the pertinent to any substantive public health conversation.  "I've known plenty of people who've had coverage for years and still have died sicker and quicker than they should have because we haven't focused on a prevention framework," said Gunn. "It's not just looking at providing people insurance coverage but how do we help people to live healthy in their homes [and] in their communities."  In the final years of Nye County's hospital, an investigation by The Dallas Morning News found records of mismanagement and regulatory neglect. Behind rural hospital closures in South Carolina, local experts cite failing industry, diminishing populations, and poverty as some of the key factors.  But experts and candidates diverge on whether universal healthcare proposals—from Bernie Sanders' proposed Medicare for All, which would eliminate most private insurance in favor of a government-run system, to more modest efforts like giving Americans the option of choosing publicly-funded insurance — could drive America's remaining rural hospitals into the red.  "Until there's more details on these Medicare for All proposals, it's hard to say how that would impact," says Alan Morgan, CEO of the National Rural Health Association (NRHA). Though the NRHA has not joined other industry groups in lobbying against Medicare for All, Morgan is skeptical of the current single-payer proposals.  "If they pushed it forward just as it currently is, no I can't imagine how that would work and I can't imagine you wouldn't see more rural hospitals closing," says Morgan, adding that "the key" for rural hospitals is determining Medicare's reimbursement rates.  One study, funded by industry critics of Medicare for All, warned in August that a public option risked shuttering 55 percent of rural hospitals even if only a portion of patients fled "higher-paying commercial plans."  This possible risk to rural hospitals has been highlighted by candidates like John Delaney and Joe Biden. "Under the Biden Plan, which preserves individuals' ability to choose private insurance, these hospitals won't be threatened by having to get by on low Medicare reimbursement rates for all," the former vice president's campaign argues.  But several candidates, from Medicare for All proponents like Elizabeth Warren to public option boosters like Pete Buttigieg, have also explicitly vowed to increase reimbursement rates for rural hospitals.  They have also rallied behind creating new designations for rural hospitals with enhanced Medicare reimbursement. "Rural emergency medical centers" or "community outpatient hospitals," could allow for rural healthcare facilities to transition into more advanced "urgent care" facilities, while stopping short of full-fledged hospitals.  In a House hearing earlier this year, a Congressional Budget Office researcher estimated rural hospitals could benefit from a single-payer system.  "Many rural hospitals are in, they're called critical access hospitals, and they receive higher payments than would be otherwise provided under Medicare," Jessica Banthin testified in May. "They often treat a lot of public pay patients, as well as patients who are uninsured. It is possible under a single-payer that some of those rural hospitals would be better off."  Medicare for All proponents argue that savings from a reduced administrative burden and a revenue boost from a surge of patients could also buoy rural healthcare. A health assessment commissioned this year in Nevada found that even insured patients avoided seeking care, concerned with cost or confused with what services their plan covered.  "For starters, you're dealing with really low volume," Dr. John Packham, an associate dean researching rural healthcare at the University of Nevada Reno, told CBS News. "Some of the hospitals that I work with, literally have two or three inpatients a day but you nonetheless have to staff it for nursing 24/7. You have to have lab and radiology available."  But both Packham and Morgan agree that some rural communities may never have the volume of patients to sustain full-fledged hospitals.  "As a nation, we're paying these rural hospitals for volume and they're just never going to have volume," said Morgan. "We need to start paying them to keep their communities healthy."  Of the twelve Democratic candidates on the debate stage Tuesday in Ohio, at least six of the presidential hopefuls — Joe Biden, Pete Buttigieg, Julián Castro, Amy Klobuchar, Bernie Sanders, and Elizabeth Warren — have outlined specific written plans to tackle health outcomes for rural patients.  To address rural America's shortage of healthcare workers, most candidates have pledged to subsidize and incentivize medical professionals through programs like the National Health Service Corps and the Public Service Loan Forgiveness Program.  Both Klobuchar and Buttigieg's plans also explicitly call to expand the "Conrad 30" program, which allows immigrant doctors practicing in underserved areas to remain in the country.  And nearly every candidate has floated ideas to invest and expand "telehealth" options or "telemedicine," essentially doctor's appointments via video conference.  Biden would expand the U.S. Department of Agriculture's grant funding to emphasize telehealth "for mental health and specialty care." Buttigieg calls for doubling funding to the Federal Communications Commission's "Rural Health Care Program" subsidies.  Kellye McKenzie, a South Carolina-based public health practitioner, says that it's important for candidates to explore the power of telehealth because of the impact it can have on rural communities in places like schools.  "You can't talk about rural health in 2019 and not talk about what a game-changer telehealth would be in the conversation," said McKenzie. "Mental health issues are huge and the reality that these services aren't in schools however could be through telehealth, to me is incredibly exciting."  Warren's plan promises to set aside a $25 billion "capital fund" for improving care in these communities, listing possible projects like building a new "Rural Health Clinic" or "improving transportation to the nearest hospital."  CBS News spoke with multiple experts who cited that transportation and other social economic factors are vital components of a prevention-focused community framework that is pertinent to any healthcare discussion.  Biden is the only candidate to specifically endorse the NRHA-backed "Save Rural Hospitals Act" in his platform, though some ideas from the measure appear in many of the candidates' plans. And Buttigieg calls for the passage of the "Rural MOMS Act" in his plan, which would direct funding towards maternal health in rural communities.  But for Russell Pillers, a consultant working in Nye County in the wake of the hospital closure and a self-described conservative, even proposals he favors like telemedicine are far from the "silver bullet" to Tonopah's healthcare crisis.  "You're trying to be really creative and we're nibbling around the edge of the main issues to try to find any way we can make some progress," Pillers tells CBS News. "But the big issues to me is really that relationship between an insurance company, in-network providers, out-of-network providers, and patients."  "At the core of this, not to be too hyperbolic here, people are dying. To me that puts politics out the window."


channel4uk--2019-04-30--Police launch new investigation into Gosport hospital deaths

Families have reacted with frustration and disappointment after police said they need several more months to investigate hundreds of deaths by overdose at the Gosport War Memorial Hospital.  Over 650 mainly elderly people died during the 1990s after being given dangerous levels of diamorphine – the medical name for heroin – even though they were only suffering from minor ailments.  Families claim there has been a cover up – and have little faith in another police investigation, the fourth, into the deaths of their loved ones.


channel4uk--2019-04-30--Report finds serious failings in maternity services at two hospitals in South Wales

An independent report has found serious failings in maternity services at two hospitals in South Wales.  The damning review today prompted the Welsh government to put maternity services at the Cwm Taf health board into special measures. It follows concern about the deaths of a number of babies at the hospitals.  Our home affairs correspondent Andy Davies is at one of them, the Royal Glamorgan in Llantrisant.


channel4uk--2019-05-02--The London hospital teaching primary school teachers how to tackle knife crime

It is hospital A&E departments which end up coping with the victims of knife crime, like North Middlesex,  which serves the North London boroughs of Enfield and Haringey.  The hospital has now teamed up with police, councillors and youth workers, to teach primary school teachers how to tackle knife crime.


channel4uk--2019-08-23--Bake Offs Prue to advise new government review into hospital food standards

Bake Off’s Prue to advise new government review into hospital food standards

Hospital food doesn’t have the greatest reputation. But the government hopes – not for the first time – that, this will soon change.  Today, the Department for Health and social care announced a review into hospital food standards in England, with celebrity Bake Off star, Prue Leith on board to advise.  The move comes after six people died contracting listeria from food,  provided on hospital sites earlier this year.


channel4uk--2019-08-27--CCTV reveals 1500 incidents at Northern Ireland hospital

CCTV reveals 1,500 incidents at Northern Ireland hospital

Police in Northern Ireland say they have identified 1,500 incidents of abuse on a single ward of a mental health hospital in County Antrim.  The investigation has seen police officers watch hundreds of thousands of hours of CCTV footage from Muckamore Abbey Hospital.


channel4uk--2019-09-17--Public inquiry to be held into two Scottish hospitals

Together, they cost nearly a billion pounds to build. But now a public inquiry is to be held into two major Scottish hospitals.  Glasgow’s Queen Elizabeth University Hospital has been beset with problems since it opened in 2015, whist Edinburgh’s Royal Hospital for Children and Young People is yet to open.  The move was announced by Scotland’s Health Minister within the last couple of hours.


channel4uk--2019-09-29--Health Secretary Matt Hancock defends 40 new hospitals claim

Jamal Khashoggi’s fiancee on his murder: ‘Those in Saudi Arabia who carried this out should not be able to escape’


chicagosuntimes--2019-01-16--Old Cook County Hospital on track to become next city landmark

In the midst of an overhaul after sitting vacant for 16 years, the old Cook County Hospital, at 1835 W. Harrison St., may soon be given landmark status, solidifying its historical significance in Chicago.  The city’s 18-member Committee on Zoning, Landmarks and Building Standards will get the ball rolling Thursday on whether the building deserves the designation.  If the committee decides it does, the matter will go before the full City Council on Wednesday next week.  The Near West Side building already is listed on the National Register of Historic Places.  RELATED:   Sneed: Developer wants to make old hospital a community anchor  Ald. Walter Burnett (27th) was born in the hospital and is pushing for landmark status.  “It’s been in our history a long time,” Burnett said. “I think it’s something that … architecturally is historic, it’s solid and it’s part of Chicago and Cook County history and I think that’s something to preserve. The unique thing … is that it’s a building we’re trying giving life back to and it’s a place where so many lives started.”  Cook County Board President Toni Preckwinkle said she hopes the building receives the historical landmark designation. In June, Preckwinkle, Burnett and Mayor Rahm Emanuel were at a ceremonial groundbreaking for the building’s redevelopment. Plans for the structure include a hotel, office space and retail. Land around the building also will be part of the development, officials have said.  “I think it’s important to recognize that this is a building that has an important place in Chicago and Cook County history,” Preckwinkle said, comparing the hospital’s history of taking all patients regardless of where they came from or their ability to pay to Ellis Island in New York.  “It’s served wave after wave of immigrants and those who need care and can’t afford it or are uninsured and we’re very proud of that history,” Preckwinkle said.  The committee meets at 10 a.m. Thursday in City Council chambers.


chicagosuntimes--2019-01-22--Inside the 1B restoration of the old Cook County Hospital a city unto itself

Inside the $1B restoration of the old Cook County Hospital, ‘a city unto itself’

The old Cook County Hospital’s grand, beaux-arts façade is mostly obscured by a white tarp-like covering these days as construction crews work at demolishing some of the old features of the historic building to make way for a hotel and office complex that county officials hope will transform the Illinois Medical District and Near West Side.  Efforts to restore the façade on the front of the building at 1835 W. Harrison St. started last fall. Once finished, it will be the extravagant face of a $1 billion plan to rebuild the 102-year-old building inside and out.  John Murphy, chair of the Murphy Development Group — which is one part of the Civic Health Development Group that was picked to redevelop the hospital — says the effort is on track to finish on time, by 2020, and they’re 70 percent through the demolition phase.  “What is old, and some view as ugly, is going to be restored to new,” Murphy said.  RELATED: Old Cook County Hospital on track to become next city landmark  Last week, the City’s Council’s Committee on Zoning, Landmarks and Building Standards moved to give the building landmark status. A vote by the full council is scheduled for Wednesday.  In addition to the iconic north face of the building, scaffolding covers the front and east and west sides of the building and is being used by crews repairing and replacing masonry — mostly bricks and damaged terra cotta. Thousands of pieces require removal in order to fix years-worth of neglect, said Matt Beach, the development project manager. The terra cotta is being sent to a reproduction facility and then sent back to be reinstalled over the course of several months.  Inside, much of the building has been gutted, though its high ceilings remain. Some of the original floor detailing, in black and white tile, is now covered in grit and dirt, and water leaks through in some spots.  There are plans for a dining room and bar and lounge on the second floor, though the back of the building on that floor is almost completely exposed to the elements.  After a groundbreaking ceremony in June, construction workers have demolished chunks of the building, but are keeping some of its facets, like a marble staircase leading from the first floor to the second and intricate detailing in the ceiling. Though it’s no longer a medical training ground, the redevelopments coming to the old hospital are intended to preserve its history while also bringing jobs and development to the Near West Side.  When the redevelopment of the hospital is done, it’ll include a Hyatt House and a Hyatt Place hotel as well as medical offices and retail spaces. There’ll also be an on-site museum that “recognizes the past and history of what this great building represented to the medical community for more than 100 years,” Murphy said.  “The old building maintains its place as the epicenter of the medical district,” Murphy said. “I think that people embrace the history and what pioneering medical procedures were developed here around the turn of the century and going forward. Some of the most brilliant minds in medicine have gone through that building, were actively trained, did their residencies there and there is just a tremendous digest of stories from the past and we believe by preserving this we take with us a piece of Chicago’s history for the next 100 years going forward.”  There are about 100 workers there a day, spread throughout the massive building, Kenneth Johnston, a senior project manager with Walsh Group said. At the peak of the restoration process, 250 to 300 workers are expected to work on the building, Johnston said.  The multiphase development will also have residential developments to the south of the hospital. Cook County Board President Toni Preckwinkle estimates that the total investment will be roughly $1 billion from “private sources,” she said, meaning no county dollars are going into the project.  It’ll also create about 900 jobs during the redevelopment process, from the construction phase to the end, a Preckwinkle spokeswoman said.  The old hospital was a proving ground for surgeons and other medical professionals — the first medical internship and first blood bank in the country were started there and doctors there did some of the first surgical fixations of fractures.  Some of the surgical halls, some with their old seats rusted over or covered in graffiti, still remain in fairly good condition and will likely be repurposed in some way in hotel rooms. An old exam light — and a mummified cat — found in one of the halls likely won’t be.  Harry Richter III, chairman of the general surgery division at Cook County Health, is the third generation of Harry Richters to have worked at the hospital — his grandfather and father both trained there and the Harrison Street hospital is also where his parents met. He said it would’ve been “a crime to lose the building entirely” and he’s looking forward to it being “back online.”  “In its heyday, it was a city unto itself,” Richter said. “It was a city block and more with many buildings interconnected with this great tunnel system. It was a hub of social and business activity and I think you’ll still see a glimpse of that once it’s open.”  Preckwinkle called it “a transformative development for the West Side, for Chicago and the county.”  “It’s really important to save our architectural heritage, and Chicago is known for its diverse and stunning architecture so I wanted to try to do everything I could to save this building, both because of its historical significance and because its kind of beaux arts classic,” Preckwinkle said.  “We hope it’ll be a catalyst for further development around it and contribute to the transformation of the Near West Side,” Preckwinkle said.  The old Cook County Hospital at 1835 W. Harrison St. under construction and renovation, Tuesday afternoon, Jan. 8, 2019. | Ashlee Rezin/Sun-Times


chicagosuntimes--2019-04-10--Melrose Park mayor accuses Westlake Hospital owner of defying judges order

Melrose Park mayor accuses Westlake Hospital owner of defying judge’s order

The bitter battle between Melrose Park and a California-based healthcare network continued Wednesday, as the Illinois House of Representatives passed a bill that would grant the governor power to reverse decisions on hospital closures.  Melrose Park Mayor Ron Serpico, along with local state Rep. Emanuel “Chris” Welch, D-Ill., accused Pipeline Health – owners of Westlake Hospital, 1225 W. Lake St. — of defying a judge’s order issued Tuesday evening.  Serpico said his phone has been “burning” with phone calls and text messages from people claiming Westlake has been removing equipment and canceling appointments despite a temporary restraining order issued by a Cook County Circuit Court judge preventing Pipeline from scaling down its operations until a decision is made by the Illinois Health Facilities Services and Review Board.  “I guess the law doesn’t apply to Pipeline,” Serpico said during a press conference Wednesday afternoon.  The Illinois House passed H.B. 0123, co-sponsored by Welch, 69 to 35 Wednesday and will now move to the state Senate for a vote.  The bill would allow the governor power to reverse decisions on hospital closures made by the Health Facilities Services and Review Board. It also would suspend any application to close a hospital until pending lawsuits over the closing are resolved.  “The allegations being made by the Mayor and Rep. Welch are patently false and absurd,” Natalie Bauer Luce, a spokesperson for Pipeline, said in a statement. “The chaos they seek to create is wildly irresponsible and putting patient safety in jeopardy. We are following the judge’s order and reviewing our legal options.”  Lilian Jimenez, a Melrose Park community organizer, along with others made a trip to Springfield Wednesday to hand-deliver 2,500 postcards and hundreds of letters to the Health Facilities Services and Review Board asking they deny Pipeline’s application to close Westlake.  “What we want is Westlake to stay open as a community hospital,” Jimenez said.  Manny Ramos is a corps member in Report for America, a not-for-profit journalism program that aims to bolster Sun-Times coverage of issues affecting Chicago’s South and West sides.


clashdaily--2019-09-04--Bidens Heathcare Plan Could Cause Rural Hospitals To Close According To Study

Biden’s Heathcare Plan Could Cause Rural Hospitals To Close According To Study

We can hardly wait for Biden to assure us… “if you like your rural hospital you can keep your rural hospital.”  And it will be just as true as the empty promises his ‘boss’ gave us.  One big problem with Democrats and their grandiose policies is their ignorance of how unintended consequences come into play.  Trending: YIKES! Father And Daughter From Georgia Bring In Record-Setting 700lb 14-Foot Gator  One decision creates a chain of secondary and tertiary effects, and Democrats regularly fail to anticipate how negative incentives buried in their policies create results that are easily predicted by disinterested outsiders.  It happened with the $15/hr minimum wage plan.  It happened with the ‘you can keep your doctor’ claim in Obama care.  And it’s happening again with the ridiculous 2020 Democratic promises.  Feasibility studies could easily rip apart most of their pie-in-the-sky plans. Here’s a look at one that came back evaluating the crippling damage it would have on the State of Iowa.  The [Cedar Rapids Gazette] wrote that 52 rural Iowa hospitals could close under Biden’s public option plan and “rural hospitals could experience a loss of more than $476 million dollars under a public health insurance proposal.” Former Vice President Joe Biden’s healthcare plan would create a “public option,” allowing a government health insurance option to compete with private health insurance on the Obamacare exchanges. …The Navigant Consulting study found that after having millions of Americans switch from their private insurance plan to the public option plan, the public option would pay hospitals at Medicare rates, which is typically lower than private insurance, and would cut rural hospitals’ revenues between $4.2 billion and $25.6 billion. …To make matters worse for public option supporters, the study suggested that to prevent hospitals from closing under the public option system, Medicare would have to increase payments to hospitals between 40 to 60 percent above Medicare rates, which could cost between $4 and 25 billion annually depending on how many employers move employees onto the public option.   Source: Breitbart  To suggest that Iowa is uniquely the ONE state whose hospital system would take a beating like this seems… improbable.  Speaking of ‘unintended consequences’, Obama and Biden still haven’t had to answer any questions about THIS:  Obama Loves Our Enemies: Damning New 411 Emerges About Obama & Hezbollah That’ll Blow Your Socks Off  Why ‘Free Healthcare’ Costs MUCH More Than Higher Taxes…It Can Cost You Your LIFE  Yo, Christians! Don’t Cave To Liberal Tyrants – Fight for Freedom, Family and Faith  Free-Spending Dems NOT The Party Of Our Fathers — Or Of America’s Future


cnn--2019-06-24--Trump to issue executive order requiring hospitals to disclose prices to patients

The order -- which seeks to fulfill the President's promise to lower costs for Americans -- directs the Health and Human Services Department to develop a rule that would require hospitals to disclose prices that reflect what insurers and patients pay for common items and services.  However, the order does not specify what level of detail hospitals must provide -- whether it be the privately negotiated rates between hospitals and insurers for specific health insurance plans or aggregate data. Those particulars will be included in the forthcoming rule, senior administration officials said.  The agency must also draw up a proposal to require providers and insurers to give patients an estimate of their out-of-pocket costs before they receive treatment.  "Patient empowerment requires transparency around price and quality," said Health Secretary Alex Azar. "Every day, American patients are being taken advantage of by a system that hides critical information from them that they need to make decisions for them and their families."  The vision is to have consumers one day be able to get price and quality data on their phones, said Seema Verma, administrator of the Centers for Medicare & Medicaid Services.  Hospitals, insurers and other providers in the health care industry are already preparing to oppose disclosing their contracted rates, which they say will do more harm than good. The insurers' trade group has pointed to a 2015 Federal Trade Commission blog post that said too much transparency can interfere with competition in the medical market.  "(P)ublicly disclosing competitively negotiated, proprietary rates will reduce competition and push prices higher - not lower - for consumers, patients, and taxpayers," said Matt Eyles, chief executive of America's Health Insurance Plans, a trade group.  The main hospital lobbying organization has also opposed this type of disclosure, saying that patients are more interested in their out-of-pocket costs.  Also, some experts have questioned the administration's focus on giving consumers more access to prices, especially since most Americans don't shop when it comes to health care, they say.  This executive order is Trump's third related to health care. The first , which he signed hours after taking office, was aimed at undermining the Affordable Care Act. It directed agencies to interpret regulations as loosely as possible to minimize the financial burden on Americans, insurers, health care providers and others.  The second came shortly after Republicans in Congress gave up their effort to repeal and replace Obamacare in the fall of 2017. It also sought to weaken Obamacare by making it simpler for Americans to purchase alternative plans that are typically cheaper but don't have to adhere to all of the law's regulations. It led the administration to make it easier for consumers to buy short-term plans that last up to a year and for small businesses to join together to buy coverage, though that rule is now on hold pending the outcome of a lawsuit.  The most recent executive order will also direct the Health & Human Services Department to consolidate quality measures, broaden access to health care claims data for researchers and expand Health Savings Accounts, a favorite tool of Republicans.  Trump has long promised to tackle the high cost of health care in America, one of the nation's thorniest problems.  The administration has already taken some initial steps to require drug makers and medical providers to release more cost information, though it has generally focused on the industry's list prices rather than the negotiated rates or what consumers are actually billed.  And starting this year, the Centers for Medicare and Medicaid Services is requiring hospitals to post their standard charges for their services on their websites in a format that can be imported into a computer system.  Lawmakers on both sides of the aisle in Congress are also working together in hopes of increasing awareness of pricing and of the behind-the-scenes tactics that keep costs high.  However, experts say most of Trump's actions so far have not directly addressed the true problem: The high cost of what hospitals, doctors and drug makers charge for their services. Disclosing list prices or general data doesn't help most Americans since their rates are determined by their insurance -- and deductibles -- so this information will not tell them much about what they are on the hook for and could even dissuade them from pursuing care.  "I'm not sure how aggregate information on rates will help patients, many of whom will have different types of coverage or be at different places in spending down their deductible," said Niall Brennan, chief executive of the Health Care Cost Institute, a non-profit research organization.


cnsnews--2019-05-03--Time to End Hospitals Right to Blank Check for Emergency Care

Time to End Hospitals’ Right to Blank Check for Emergency Care

Emergency medical care is an exception to the general principle of market exchange, whereby services are voluntarily bought and sold, with sellers competing on price. Under federal law, hospitals are required to treat patients that arrive needing emergency medical treatment, regardless of their ability to pay—but allowed to subsequently charge whatever they wish.  In recent years, medical providers have increasingly exploited this arrangement by threatening exorbitant charges for out-of-network emergency care in order to force insurers to agree to generous reimbursement terms across the board. Patients have frequently been caught in the crossfire, and forced to pay large “surprise bills” for emergency care by hospitals or doctors who remain out of network.  Emergency care is necessarily an unfree market, but it is a small and discrete part of healthcare, accounting for less than 7 percent of hospital spending. Ending the right of providers to fill in a blank check for emergency medical procedures would directly help some of the most vulnerable patients, who are being subject to exorbitant bills. But it would also prevent providers from leveraging this exceptional situation to undermine price competition for the bulk of hospital services.  The seemingly narrow issue of payment for out-of-network emergency care therefore has broader significance. The rising cost of healthcare is often discussed as a general phenomenon afflicting medical services, but the problem is primarily a matter of medical costs and expenditures most closely tied to hospital care.  According to a recent study in Health Affairs, whereas between 2007 and 2014 inpatient hospital prices increased by 42 percent and outpatient hospital prices rose by 25 percent, inpatient physician prices increased by 18 percent, and outpatient physician fees increased by only 6 percent. Over the same period, while many expensive new drugs have become available, the price index for existing drugs increased by only 2 percent.  Much attention has been paid to the responsibility of hospital mergers for this trend, but prices at hospitals with local monopolies average only 12 percent more than those at facilities with four or more local competitors. By contrast, prices for equivalent services can be three times higher at different facilities within the same hospital market.  What gives hospitals such pricing power, if it isn’t just market share? A major factor is the current billing rules for emergency care.  Congress enacted the 1986 Emergency Medical Treatment and Labor Act (EMTALA) to require hospitals to treat and stabilize the condition of patients arriving at emergency departments, regardless of their insurance coverage or ability to pay. Yet, this legislation imposed no limit on the amount that hospitals and clinicians could then bill patients for the care they received—even if treatment began while they were unconscious.  The main constraint on hospital prices is normally the ability of insurers to steer patients to in-network facilities with which they have negotiated better rates. Yet this constraint is all but absent for emergency-care situations in which patients must often seek treatment at the nearest possible facility. Knowing that patients will expect their insurers to cover emergency-care costs, hospitals have increasingly used the threat of exorbitant out-of-network bills for emergency care to negotiate more generous reimbursement arrangements (high fees without constraints on volumes) for in-network elective care.  A similar dynamic has become clear among clinicians who frequently treat emergency patients. According to a recent Brookings Institution study, whereas physicians in general contract with insurers at an average of 128 percent of Medicare rates, those in specialties able to impose out-of-network emergency bills are able to drive a harder bargain: with emergency physicians billing an average of 306 percent and anesthesiologists billing 344 percent of Medicare rates. This has yielded a phenomenon known as “surprise billing,” where out-of-network providers of emergency care bill enormous amounts in excess of charges covered by insurers—leaving individuals to pay the balance. Most shockingly, this may even happen for out-of-network clinicians practicing at in-network hospitals.  As a solution to this specific problem, scholars from the Brookings Institution and the American Enterprise Institute recently recommended prohibiting clinicians from independently billing for emergency, ancillary, and hospitalist services—a reform which would make hospitals responsible for paying them and collecting reimbursement by affiliating with insurance networks. As the patient has little say over which emergency-care physicians, anesthesiologists, or pathologists will bill for services incident to their care, and hospitals have control over who operates within their walls, such a proposed reform makes a lot of sense.  Yet a broader reform is required to remedy the incentive for hospitals to themselves threaten emergency-care patients with exorbitant charges. Various legislative proposals regulating out-of-network bills for emergency care were introduced in the last Congress, and congressional staff have been working to develop reforms which could pass this year.  One prominent idea is an approach that has already been employed by some states—to subject out-of-network rates for emergency care to independent arbitration. This seems appealing because it does not appear overly prescriptive or rigid; but it is really just a form of buck-passing rather than an actual solution. Instead of having legislators weigh trade-offs in consultation with insurers, hospitals, patient groups, and research organizations, it would simply require judges with no healthcare staff, expertise, or relationships with effected stakeholders to improvise consequential decisions with complex unintended consequences. The administrative costs of appealing fees could be substantial, and under the pressure of interest-group lobbying, such an arrangement may inadvertently lead to payments drifting upwards.  A similar danger is involved in proposals to establish default out-of-network rates based on averages or percentiles of in-network rates: Hospitals may be able to inflate their permitted out-of-network reimbursements by manipulating in-network payment arrangements.  The best approach is rather to cap the rates that hospitals are allowed to charge for various out-of-network emergency-care services at a specified proportion of Medicare rates. Scholars at the Brookings Institution have recommended a tight cap of 125 percent of Medicare rates, under the belief that this could immediately improve insurers’ negotiating power with respect to reimbursements over elective care, and hence substantially drive down hospital costs.  Yet, such a cap would likely decimate hospital revenues overnight, and is therefore likely to be impractical. Nonetheless, a looser cap of 150 percent of Medicare rates (or higher for some specialties) would serve to protect patients from surprise bills greatly in excess of charges covered by their insurer, while preventing hospitals making use of the threat of out-of-network price gouging to cripple the ability of insurers to negotiate reasonable in-network payment arrangements.  A cap limited to out-of-network fees for emergency care could hardly be more different in spirit from proposed single-payer or all-payer reforms, which propose to effectively set a comprehensive floor on payment rates for all medical services—elective as well as emergency; in-network as well of out-of-network.  By eliminating hospitals’ default right to fill in a blank check for emergency care (whose provision is already mandated by federal law) a cap on out-of-network emergency charges would in no way restrict market forces from shaping the delivery of elective care (which accounts for over 93 percent of hospital spending). Providers could still insist on their preferred reimbursement arrangements before agreeing to deliver elective care, and insurers could still negotiate discounts from preferred networks of providers. Nor would such a cap restrict the freedom of hospitals and insurers to agree to better terms of contract to pay for emergency care in-network.  In fact, restoring balance to the default arrangement for out-of-network emergency care could encourage more reasonable payment agreements more broadly—by preventing hospitals from threatening exorbitant out-of-network bills to drive up reimbursement rates and veto cost-controls in payment arrangements across the board.  Chris Pope is a senior fellow at the Manhattan Institute. Follow him on Twitter here.  : This piece was originally published by Economics21 at the Manhattan Institute.