The Healthy Memphis Common Table is an effort to help patients and providers take charge of improving the city’s health. It includes the results of about 24,000 patient ratings of 430 local primary care doctors, all conducted by the nonprofit Consumers’ Checkbook.
Manoj Jain, M.D., M.P.H., (bio) is on the table’s advisory committee and he, as part of its mission to publicize the effort, wrote a three-part series in the The (Memphis) Commercial Appeal on the results and potential of the survey. The first installment is the one with the broadest appeal, as it discusses survey results and consequences.
In the second installment, Jain profiles a highly rated doctor and includes his own musings on what makes a physician great. Jain then wraps up the series with anonymous profiles of two poorly rated doctors and further musings on how their ratings might be improved. Interestingly, Jain’s suggestions almost always focus on non-clinical factors such as office staff quality and communication skills.
In The New York Times, reporter Kevin Sack visits Nashville, Tenn. to tell stories from the front lines of health bankruptcy, stories which he folds into larger discussions about health care reform. Apart from compelling anecdotes, Sack’s most interesting angle was that bankruptcy is equivalent to a painful insurance safety net for many Americans.
The old Davidson County courthouse in Nashville, Tenn. Photo by Brent and MariLynn
“This has really become the insurance system for the country,” said Susan R. Limor, a bankruptcy trustee who calculated that 13 of the 48 Chapter 7 liquidation cases on her docket one recent afternoon included medical debts of more than $1,000.
Under Chapter 7, a debtor’s assets are liquidated and the proceeds are used to pay creditors; any remaining debts are discharged, and filers are left with a 10-year stain on their credit ratings.
“You can’t believe how many people discharge medical debts,” Ms. Limor said. “It’s a kind of trailing indicator of who’s suffering in this economy.”
Sack writes that proposed health care reform bills in both houses seek to solve the medical bankruptcy epidemic by expanding Medicaid eligibility, subsidizing health insurance and capping annual out-of-pocket medical costs.
AHCJ Immediate Past President Trudy Lieberman adds another anecdote to the mix in a post on CJR.org, this one based on an engineer from rural Illinois. Despite a relatively good health plan from his employer and the relatively good health of his wife and children, he was forced to declare medical bankruptcy earlier this decade and now the bills are mounting again. Lieberman carefully chronicles the man’s expenses, teasing apart premiums, deductibles and everything else, then comes to the conclusion that proposed health care reforms won’t do him much good.
The Associated Press’ Jay Reeves exposes systemic flaws in state medical licensing through the story of a physician who was twice accused of sexual misconduct and thrice fired in Tennessee, and who subsequently set up shop in Alabama, where he has been charged with rape and possession of child pornography.
The doctor’s offenses had never been reported to regulators, and he seems to have been able to repeatedly outrun his transgressions. Reeves reports that unfortunate situations like this are not unusual:
Patient safety advocate and consultant Ilene Corina said states too often let troubled doctors move and switch jobs when they get in trouble.
“There is not sufficient oversight in many cases,” said Corina, of Long Island, N.Y., a board member of the National Patient Safety Foundation. “Is it a problem? Absolutely.”
AP Medical Writer Carla K. Johnson takes a look at health care reform in Massachusetts and Tennessee and how the coverage plans in those states can inform Congress’ approach to a nationwide expansion of health coverage.
In Massachusetts, Johnson reports, folks adopted a coverage first, cost second approach, with the assumption that once universal coverage was in place, it would be easier to use that leverage to pare down costs.
The Tennessee method, on the other hand, was to provide a limited, cautious program at first with the understanding that it would be gradually expanded if possible.