The Hammond Daily Star | 05.20.09
Dr. John Lombardi
The LSU Board of Supervisors commissioned a study released
this week that pointed to high costs and low efficiency at the LSU Interim
in New Orleans.
Consultants observed that the staff at the interim hospital still struggles
with the effects of Hurricane Katrina and think in “recovery terms” instead
of placing greater emphasis on savings.
Management consultants identified more than $66 million in
potential savings and imposing zero-based budgeting in staffing every
More importantly, the analysis called for hospital
administrators and to move away from a “reactionary approach” and adopt a
“business-oriented, fiscally responsible” strategy for providing quality care
and medical education.
Governance by committee at an academic teaching hospital
supported by state and federal taxpayers’ dollars is pure folly. It invariably is unproductive and
predictably wasteful. In New Orleans, past
attitudes and behavior have produced an institution that is overstaffed and
In meeting its responsibility to the taxpayers and medical
education, LSU has ordered $24 million in spending cuts over the next year
and is cutting more than 300 jobs from the payroll.
The real message of this study is that a well-run academic
medical center must include savings that will ensure a new facility is not a
continuing drain on taxpayers because of a continuation of historical
behavior that is not focused on efficiency and effectiveness.
Central to LSU’s not-for-profit, private-style governance
plan for the new Academic Medical Center
in New Orleans
is minimizing politics and governmental inefficiency. The kind of fiscal discipline recommended
by the nationally recognized consultants assures the new hospital will be
“well positioned to meet the healthcare needs of the community as it trains
healthcare professionals of the future.” LSU is being proactive in trying to
insure that the business plan for the new hospital works.
As the consultants also stressed, the biggest hurdle will
be separating this critical health care facility from the past. Change in such an organization is
historically difficult and never easy, but the payoff for Louisiana health care and medical education
could be enormous. We realize that
those who have historically benefited from the patterns of the past will
resist such a plan. LSU’s obligation
to uninsured patients and taxpayers, however, requires fundamental change.
Dr. John Lombardi
LSU System President, Baton Rouge
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By TED GRIGGS
Advocate business writer
The Senate Insurance Committee Wednesday stripped most of
the consumer protections from a controversial bill that would have prevented
patients from paying much higher out-of-network costs for care at in-network
Hospitals often contract with a single group of
radiologists, anesthesiologists and pathologists. While the hospital may be
part of a person’s health plan, the specialists may not.
Insurance Commissioner Jim Donelon
said the result is that a patient can go into the hospital expecting to be
responsible for a co-pay and deductible and find out
later he or she owes thousands of dollars in out-of-network charges.
The proposed bill, which Donelon
backed, would have made those additional costs the burden of health insurers.
Donelon said he was disappointed
that hospitals, doctors and health insurers defeated the effort to close a
loophole that costs policyholders millions of dollars a year.
Gil Dupré, chief executive
officer of the Louisiana Association of Health Plans, said forcing insurers
to pay the bill in full would have led to much higher insurance premiums for
workers and employers.
The bill would also have removed the incentive for doctors
to be part of a health network, Dupré said.
Physicians would make more money by opting out of the network; eventually no
one would be in the network, and health-care costs would increase even more.
The proposed bill needed a lot more revisions and a lot
more consensus, Dupré said. The amended version
does give consumers the right to request that services be provided by
in-network physicians. It also requires hospitals to tell patients before
they’re admitted that some doctors may not be part of the health plan.
Donelon said the bill’s author,
Sen. Sharon Weston Broome, D-Baton Rouge, is investigating the possibility of
adding back the consumer protection language when the bill goes before the
Dupré said the amended bill is
only a first step, and the Legislature will address a solution at the 2010
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The Associated Press
(AP) — GENEVA
- The World Health Organization has raised its tally of swine flu cases
around the world to 11,034 and 85 deaths.
WHO says most of the new 791 cases have been reported in Canada, Mexico
and the United States.
Mexico confirmed three
more deaths linked to swine flu, while the United States confirmed two since
At least 38 other countries have also reported cases since
the outbreak began last month.
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honors Paramedic of Year
By JASON BROWN
Advocate Acadiana bureau
BETTINA HANSEN/The Advocate
Glenn Naquin, left, a flight paramedic from Houma and
last year’s Paramedic of the Year, congratulates Chuck Benedict, a paramedic
in LaPlace, on winning the title of Acadian
Ambulance 2009 Paramedic of the Year at AASI’s
annual luncheon Wednesday at the Lafayette Convention Center.
— Acadian Ambulance Service named Chuck Benedict “Paramedic of the Year” on
Thursday shortly after a football great delivered a motivational speech
during the company’s annual Paramedic Luncheon.
About 1,400 people attended the event, which featured
keynote speaker Peyton Manning, the Indianapolis Colts’ star quarterback, a
three-time NFL Most Valuable Player and a New Orleans native.
State Rep. Fred Mills, D-St. Martinville,
served as master of ceremonies and introduced Manning’s father, New Orleans
Saints football legend Archie Manning, who gave a video introduction of his
Peyton Manning used anecdotes he has learned during his
nine years with the Colts; time that has taught him the importance of
leadership, accountability, learning from mistakes, playing as a team,
setting goals and remembering the fundamentals.
“This is the challenge: when you go back home look for
something, no matter how small, that can make a difference; that can make you
as an individual and your team and your company and your community better,”
The luncheon coincided with National EMS Week, which
honors those working in emergency medical services across the country.
“Our EMTs and paramedics are
critical assets in every community. Taking care of you in your hour of need before
you even get to the emergency department in the hospital,” said Dr. Ross Judice, chief medical officer for Acadian Ambulance
Benedict is a seven-year veteran of Acadian Ambulance and
is stationed in LaPlace
as a critical care transport paramedic. He was introduced as a family man who
was thankful for his life, his job and the love his family has shown him.
“If attitude is contagious, then what can spread better
than a smile,” Judice said. “He knows that he sees
people on their worst days and feels that is his opportunity to make their
In a video about Benedict, the narrator described the
paramedic’s most memorable call as the one that occurred just two days after
he received his paramedic status when Benedict saved three people trapped in
a van submerged in a waterway off the road.
Benedict himself was more modest.
“It’s never work if you enjoy what you’re doing and I
believe that,” Benedict said.
He encouraged other paramedics to remember what first
brought them to the field. He asked them to smile, even if they had to force
themselves, because perhaps the smile would catch on and become contagious.
“It’s the attitude that makes us No. 1,” he said of the
company and its paramedics.
The company singled out 11 others who were finalists for
They were as follows: Jay Authement, New Orleans Region;
Derek Bizette, Capital Region; Ken Dartez, Air Med Services; Frank Duke, Mississippi;
Barbara Husser, Northshore
Region; Paul Hux, Safety Management Systems; Scott
Johnson, Central Louisiana; Sharon Patton, Southeast Texas; David Savoy, Acadiana Region; Steve Simon, Southwest Region; Pedro Tamez, South Central Texas.
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Health System Selects MedAssets to Transform Its
Revenue Cycle and Drive Financial Improvement
Inc. (NASDAQ: MDAS) today announced a long-term strategic agreement to
provide transformational revenue cycle services to New Orleans-based Ochsner Health System for the realization of continued
consulting, and accounts receivable service expertise will be utilized to
fundamentally reengineer Ochsner’s revenue cycle
processes, from patient access through business office operations, to help
deliver improved net revenue and cash flow.
MedAssets and Ochsner currently have a relationship, with MedAssets providing spend management and revenue cycle
solutions, including group purchasing and supply chain analytics and
consulting and claims management. In recent months, Ochsner
has invested in MedAssets’ revenue cycle management
technology solutions to enhance revenue capture and integrity through tools
focused on chargemaster management, price modeling,
charge capture, denial management, and supply chain and revenue cycle
Ochsner Health System is a
non-profit, academic, multi-specialty, healthcare delivery system dedicated
to patient care, research and education. This award-winning system includes
seven hospitals and over 35 health clinics located throughout Southeast Louisiana. Ochsner
employs more than 750 physicians in 90 medical specialties and
subspecialties, and performs more than 300 clinical research trials annually.
In 2008, Ochsner Health System supported almost 1.3
million patient visits and generated more than $1.3 billion in net patient
“We are proud to help support Ochsner
Health System’s unwavering mission to provide Louisiana communities with the
finest healthcare by implementing best-practice revenue cycle capabilities,”
said Rand Ballard, chief customer officer and chief operating officer, MedAssets, Inc. “We believe our proven experience in transforming
revenue cycle operations through the application of data-driven software
tools and services makes MedAssets the perfect
partner to help Ochsner achieve its short and long
“Through this agreement, we are building on a strategic
relationship that already exists within our organization and looking to
realize significant benefits in our revenue cycle,” said Jody Ohlmeyer, vice president, finance, Ochsner
Health System. “We look forward to improved revenue cycle operations that
will positively position Ochsner for the future.”
“Our revenue cycle services experts and technology will
work side-by-side with the Ochsner team to
implement best practice processes,” said Robert Wright, president, Revenue
Cycle Services, MedAssets. “This crucial program
will create more effective financial operations and improved net revenue
capture that will be experienced throughout the health system - from staff
training to customer service.”
MedAssets (NASDAQ: MDAS)
partners with healthcare providers to improve their financial strength by
implementing spend management and revenue cycle solutions that help control
cost, improve margins and cash flow, increase regulatory compliance, and
optimize operational efficiency. MedAssets serves
more than 125 health systems, 3,300 hospitals and 30,000 non-acute care
healthcare providers. For more information, visit www.medassets.com.
About Ochsner Health System
Ochsner Health System
(www.ochsner.org) is a non-profit, academic, multi-specialty, healthcare
delivery system dedicated to patient care, research and education. The system
includes seven hospitals and over 35 health centers located throughout Southeast Louisiana. Ochsner
employs more than 750 physicians in 90 medical specialties and subspecialties
and performs over 300 clinical research trials annually. Ochsner
has been listed as one of the “Best Places to Work” by New Orleans CityBusiness since 2005 and received the Consumer Choice
for Healthcare in New Orleans for 13 consecutive
years. Ochsner was ranked as “Best” Hospital by
U.S. News and World Report in 2007. Ochsner has
11,000 employees system-wide.
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U.S. Says Older People Appear Safer From New
The New York Times | 05.20.09
By DONALD G. McNEIL Jr.
Confirming the first impressions of many American and Mexican
doctors, federal health officials said on Wednesday that people born before
1957 appear to have some immunity to the swine flu virus now circulating.
Tests on blood serum from older people showed that they
had antibodies that attacked the new virus, Dr. Daniel Jernigan, chief flu
epidemiologist at the Centers for Disease Control and Prevention, said in a
telephone news conference.
That does not mean that everyone over 52 is immune, since
some Americans and Mexicans older than that have died of the new flu. But it
bears out what doctors in the field have noticed: that the new flu infects
and hospitalizes many more young people than seasonal flus,
which tend to sicken and kill the very old.
Only 13 percent of the 247 people hospitalized because of
the new flu are over 50 years old, Dr. Jernigan said. Many have other medical
conditions like pregnancy, asthma, heart disease, lung disease or obesity. In
a typical flu season, more than 90 percent of those hospitalized are older
There have been eight deaths in the United States from the new flu, the latest a
woman in Arizona.
The World Health Organization has confirmed cases in 41
In the United
States, 78 percent of the influenza
samples subtyped since the last weekly report are the new swine flu, meaning that it is persisting as
the seasonal flu is disappearing.
The protection theory, Dr. Jernigan explained, is that
from 1918 to 1957, all circulating seasonal type-A flus were weakened descendants of the 1918 Spanish
flu, which was an H1N1, as the current swine is. (All flus
are named for the shapes of hemagglutinin and
neuraminidase displayed on the virus’s shell. Hemagglutinin
is sometimes called the “spike”: the virus uses to enter a cell, while
neuraminidase is the “helicopter blade” that chops off receptors, allowing
newly made virus to escape.)
Then in 1957, an H2N2, the Asian flu, emerged and
displaced it. It was replaced in 1968 by the H3N2, called Hong
Kong flu, which has persisted as a seasonal strain.
A different and milder H1N1 emerged in 1977. It was
isolated in China
but is called the Russian flu because of a suspicion it escaped from a Soviet
laboratory. That H1N1, the 1968 H3N2 and a B strain have all circulated in
humans ever since, and the seasonal flu shot is aimed at them.
Neither those shots nor the 40 million flu shots dispensed
during the 1976 swine-flu scare are known to provide any protection against
the new swine flu.
Dr. Jernigan said the Centers for Disease Control would
probably urge vaccine manufacturers to “have an earlier rollout of seasonal
vaccine this year.”
Flu shots are usually shipped in October, but the agency
hopes to make room in storage facilities and encourage people to get the
seasonal shot and then later the new swine flu shot that is being worked on.
Rapid progress is being made on a new seed strain for that
shot, and it may be shipped to vaccine makers by the end of May, he said.
After that it should take at least four to six months to produce the first
batches, the World Health Organization has said.
Dr. Jernigan also said that relatively few health care
workers had become seriously ill thus far in the current outbreak, but that
some of those who did had been infected not by patients but by work
“Folks who are sick should stay home,” he said, adding
that hospitals and nursing homes are supposed to make sick employees do so.
“We’re seeing some problems with administrative controls.”
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The New York Times | 05.20.09
By DONALD G. McNEIL Jr.
A 16-month-old boy is brought to Elmhurst Hospital
Center’s emergency room
blue and motionless, and is pronounced dead 40 minutes later. A preliminary
swine flu test is performed within hours — and turns out negative.
An 8-year-old, the son of a flu expert at Weill Cornell Medical
College, runs a high
fever and starts coughing heavily at 4 a.m. His mother, the flu expert and
also a pediatrician, diagnoses it as swine flu without testing him.
These two moments, which played out within 24 hours of
each other, illustrate the difficulties pediatricians all over New York City
face as worried parents of sniffling children ask for the swine flu test —
which most times cannot be done and which the Centers for Disease Control and
Prevention says there is no need for.
They also illustrate how important the tests can be.
In the case of the boy who died, Jonathan Zamora Castillo
of Corona, Queens, it was crucial to
establish the cause of death. His rapid decline — from a generally healthy
child in the morning to cyanosis and death by evening — matched reports from
the 1918 Spanish Flu epidemic of patients who drowned in their own lung
secretions. Although a few dozen children die that way in the United States
each year from seasonal flu, said Dr. Anne Moscona,
the flu expert, having such a rapid death in the middle of a generally mild
swine flu outbreak would have been very worrying.
In the case of her son, Ari, Dr. Moscona
had every reason to suspect swine flu. His school, Horace Mann in Riverdale,
shut down on Tuesday after positive cases were found, and he had the same
symptoms as schoolmates.
“Medically, it was the right thing to do,” Dr. Moscona said when asked whether she would have treated a
patient who was not her son the same way. “If I’d thought it might be
seasonal influenza, I would have ordered a test. But there were 40 kids sick
in his school.”
Rapid flu tests are right only 70 percent of the time when
they are positive anyway, she added.
The C.D.C.’s position is that if
a child’s symptoms are serious and exposure to the swine flu is likely, a
doctor should prescribe the antiviral drug Tamiflu
without waiting. If the symptoms are mild, neither a test nor Tamiflu is called for.
Some states cannot even perform the new test that the
C.D.C. created only three weeks ago. It has been shipped to all 50 state
laboratories, but only 44 have been certified to perform it thus far, Thomas
Skinner, a C.D.C. spokesman, said.
Dr. Max Kahn, a Manhattan
pediatrician, says his office performs a simple nasal swab test that can
distinguish influenza from more than 100 other viruses that can cause cold
“We can’t do anything more,” he said. “If the child is
significantly ill, we’ll give an antiviral medication.”
If the parent asks for the new swine flu test, he tells
them that the only laboratory performing it is the state’s,
“and they’re swamped and only doing people who are hospitalized or have
Asked whether that satisfied all his worried parents, he
paused, then said, “People are different.”
Several diagnostics companies, like Diatherix
Laboratories and Quest Diagnostics, have developed their own tests for the
new swine flu. Only the C.D.C.’s test is approved
by the Food and Drug Administration, but an F.D.A. spokeswoman said that if
other tests are done in a laboratory certified by the Department of Health
and Human Services as having met a 1988 law governing clinical labs, it is
legal for doctors to order them.
Dr. Diane Hochlerin, a Manhattan pediatrician,
said she had had only one parent insist on a test.
“I told him I couldn’t do it, but if he wanted to go to Elmhurst Hospital
in Queens, they might,” she said. “He said,
‘Oh, it’s not worth it.’ ”
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The New York Times | 05.20.09
By ROBERT PEAR
WASHINGTON — Even as Congress weighed options to finance
health insurance for tens of millions of Americans, lobbyists mobilized
Wednesday to head off proposed taxes on employer-provided health benefits,
alcoholic beverages and soft drinks.
Labor unions began attacking a proposal by Senators Ron
Wyden of Oregon and Max Baucus of Montana, both
Democrats, to consider changes in the tax treatment of employer-sponsored
insurance, the main source of health coverage for people under 65.
Radio advertisements, run this week in Portland
and Eugene, Ore., at a cost of $60,000, say: “Senator
Ron Wyden would tax the health care benefits we get at work, as if they were
income. Taxing health benefits? That doesn’t make sense.”
The advertisements were bought by the National Education
Association, with help from the United Food and Commercial Workers and the
American Federation of State, County and Municipal Employees.
Health insurance and health benefits provided by employers
to their employees are not counted as income and are not subject to income or
payroll taxes. Mr. Baucus and many economists say the tax break is
inequitable because its benefits go disproportionately to people with higher
“It’s too regressive,” said Mr. Baucus, the committee
chairman. “It just skews the system.”
Mr. Baucus and Mr. Wyden have suggested that
employer-provided health benefits above a certain value could be included in
The proposed tax is among two dozen options considered
Wednesday by members of the Senate Finance Committee as they looked for ways
to pay for coverage of the uninsured. Almost every option faces opposition
from some quarters.
Aides to Mr. Baucus admonished lobbyists this week not to
criticize the tax options, for fear that such
criticism could sink the legislation before it is unveiled.
The committee is also considering cutting special Medicare
payments to teaching hospitals and requiring drug companies to provide bigger
discounts to state Medicaid programs.
In addition, senior members of the committee, including
Senator Charles E. Grassley, Republican of Iowa, said they intended to
establish stringent new standards for nonprofit hospitals, which could
require many of them to provide more charity care and more services to
low-income people as a condition of keeping their tax-exempt status.
The federation of state and local employees denounced Mr.
Wyden’s idea at a new Web site, stopwydenshealthtax.com, which asserts,
“Under Wyden’s plan, we wouldn’t be able to keep the health care we have,
even if we like it and fought hard to get it.”
Josh R. Kardon, the chief of
staff for Mr. Wyden, said: “Cadillac health plans should be treated as
income, regardless of who is receiving them. The overwhelming majority of
American workers should not be asked to subsidize Cadillac health packages
through tax breaks, whether it’s for a wealthy chief executive or anyone
Labor unions say their members sacrificed pay raises to
get health benefits. Employers and employees assert that the proposed limits
on tax-free health benefits would destabilize the current system of insurance
provided through the workplace.
Another proposal would impose a federal excise tax on a
variety of soft drinks and other beverages sweetened with sugar or
high-fructose corn syrup. Supporters say the tax is justified because the
drinks contribute to obesity and drive up medical costs.
But the American Beverage Association, representing makers
of Coca-Cola, Pepsi, Dr Pepper and other soft drinks, urged lawmakers to
reject the tax.
“We agree with the need for health care reform,” said
Kevin W. Keane, senior vice president of the association. “We agree with the
need to address childhood obesity. But we do not support a soft drink tax.”
Frank L. Coleman, senior vice president of the Distilled
Spirits Council of the United
States, another trade group, said, “I
cannot comment on the deliberations of the Finance Committee.”
But on its Web site and an affiliated site,
stophospitalitytaxes.com the council says taxes on whiskey,
gin and vodka are already excessive.
Higher taxes would threaten jobs of manufacturers,
wholesalers and retailers, including waiters, busboys and
bartenders, the council says.
Michael F. Jacobson, executive director of the Center for
Science in the Public Interest, a consumer group, said higher taxes on
alcoholic beverages and nondiet soft drinks were
justified as a way to prevent illness and hold down costs.
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The New York Times | 05.20.09
By Daniel Gilbert
Mass. — Seventy-six years ago,
Franklin Delano Roosevelt took to the inaugural dais and reminded a nation
that its recent troubles “concern, thank God, only material things.” In the
midst of the Depression, he urged Americans to remember that “happiness lies
not in the mere possession of money” and to recognize “the falsity of
material wealth as the standard of success.”
“The only thing we have to fear,” he claimed, “is fear
As it turned out, Americans had a great deal more to fear
than that, and their innocent belief that money buys happiness was entirely
correct. Psychologists and economists now know that although the very rich
are no happier than the merely rich, for the other 99 percent of us,
happiness is greatly enhanced by a few quaint assets, like shelter,
sustenance and security. Those who think the material is immaterial have
probably never stood in a breadline.
Money matters and today most of us have less of it, so no
one will be surprised by new survey results from the Gallup-Healthways Well-Being Index showing that Americans are
smiling less and worrying more than they were a year ago, that happiness is
down and sadness is up, that we are getting less sleep and smoking more
cigarettes, that depression is on the rise.
An uncertain future
leaves us stranded in an unhappy present with nothing to do but wait.
But light wallets are not the cause of our heavy hearts.
After all, most of us still have more inflation-adjusted dollars than our
grandparents had, and they didn’t live in an unremitting funk. Middle-class
Americans still enjoy more luxury than upper-class Americans enjoyed a
century earlier, and the fin de siècle was not an especially gloomy time.
Clearly, people can be perfectly happy with less than we had last year and
less than we have now.
So if a dearth of dollars isn’t making us miserable, then
what is? No one knows. I don’t mean that no one knows the answer to this
question. I mean that the answer to this question is that no one knows — and
not knowing is making us sick.
Consider an experiment by researchers at Maastricht University
in the Netherlands
who gave subjects a series of 20 electric shocks. Some subjects knew they
would receive an intense shock on every trial. Others knew they would receive
17 mild shocks and 3 intense shocks, but they didn’t know on which of the 20
trials the intense shocks would come. The results showed that subjects who
thought there was a small chance of receiving an intense shock were more
afraid — they sweated more profusely, their hearts beat faster — than
subjects who knew for sure that they’d receive an intense shock.
That’s because people feel worse when something bad might
occur than when something bad will occur. Most of us aren’t losing sleep and
sucking down Marlboros because the Dow is going to fall another thousand
points, but because we don’t know whether it will fall or not — and human
beings find uncertainty more painful than the things they’re uncertain about.
A colostomy reroutes the colon so that waste products
leave the body through a hole in the abdomen, and it isn’t anyone’s idea of a
picnic. A University of Michigan-led research team studied patients whose
colostomies were permanent and patients who had a chance of someday having
their colostomies reversed. Six months after their operations, patients who
knew they would be permanently disabled were happier than those who thought
they might someday be returned to normal.
Similarly, researchers at the University of British
Columbia studied people who had undergone
genetic testing to determine their risk for developing the neurodegenerative
disorder known as Huntington’s disease. Those who learned that they had a
very high likelihood of developing the condition were happier a year after
testing than those who did not learn what their risk was.
Why would we prefer to know the worst than to suspect it?
Because when we get bad news we weep for a while, and then get busy making
the best of it. We change our behavior, we change our attitudes. We raise our
consciousness and lower our standards. We find our bootstraps and tug. But we
can’t come to terms with circumstances whose terms we don’t yet know. An
uncertain future leaves us stranded in an unhappy present with nothing to do
Our national gloom is real enough, but it isn’t a matter
of insufficient funds. It’s a matter of insufficient certainty. Americans
have been perfectly happy with far less wealth than most of us have now, and
we could quickly become those Americans again — if only we knew we had to.
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