Groundbreaking option in Washington state could let dementia patients refuse spoon-feeding – Seattle Times

Anyone who has watched a terminally ill loved one who refuses to eat, will appreciate this new option. We need to continue to press for death with dignity. If you don’t think this is important you may not have experienced what some homes for the elderly who are mentally not in control will do when they decide that they will keep the patient alive at all costs. This is not a pretty picture of care for the terminally ill, but is all to real today.

A Washington state agency that advocates for medical aid-in-dying has created guidelines for dementia patients who fear losing control not only of their faculties but of their free will to live and die on their terms.

https://www.seattletimes.com/seattle-news/health/new-groundbreaking-instructions-out-of-washington-state-could-let-dementia-patients-refuse-spoon-feeding/

Washington state health authority limits quantities of prescribed opioids – Spokesman Review

So this is what happens when know nothing politicians get in the way of medical professionals. First, the pols allow the drug companies to run amok with little or no regulation, telling the medical professionals that opioids like oxycodone are safe to prescribe like candy. That was in the 90s. As it got worse, in Port Townsend, only one doctor would treat the growing pain related issues, the local medical society ostracized him (they didn’t have to worry about the outcomes of their rampant pain prescriptions, they just sent them to him after they were done),  the Feds raided his place, shutting him down, throwing hundreds of patients to the wolves, and never even finding a crime committed. And they did it in Seattle too. Now we find out that it’s at epidemic rate, and the pols  are going to seriously force a cutback on them, without funding more drug treatment beds and money for other treatments. Meanwhile our hospital CEO doesn’t offer help to the sheriff, who is having to often treat these addicts at the jail. Now with the state taking action to stop opioid use, the people with long term pain will likely find themselves drawn to heroin, or other street drugs that are killing thousands just north of us.

A mess, with nothing but finger pointing. Who’s going to take care of low income people with long term pain? Anyone? How?

http://www.union-bulletin.com/local/washington-state-health-authority-limits-quantities-of-prescribed-opioids/article_9c33d6ba-bb3b-11e7-af63-033034e4b32a.html

Medicare patients pay far more for outpatient care at critical access hospitals: 7 things to know

This article does a good job of highlighting why we pay more at Jefferson Healthcare, even though it’s a publically owned hospital. We are designated a “critical access” hospital, meaning we are rural, which gives JHC much greater flexibility of charging. JHC and Port Townsend are in a strange situation, in that we are designated the same as a very remote hospital, say in Eastern Washington, or Forks. Though we are only a short drive from non-rural designated systems in Poulsbo or Seattle.  The take away is that unless you can afford to pay more for your care, or weigh the cost and hassle of traveling, you will pay less (sometimes significantly less) for the same care by going to Seattle or even in some cases, Poulsbo.  I’ve personally found it to be dramatically less, especially for procedures and labs. If you can, always shop your medical care. Jefferson Healthcare is in the process of evaluating their charges, based on customer complaints. The unintended consequence of all this is that the poor and lower income people pay a much higher percent of their income for healthcare by living here and not shopping their healthcare. They often don’t have the time to do so, and often aren’t even aware of the problem in pricing.

Medicare patients’ out-of-pocket costs for outpatient care are significantly higher at critical access hospitals than at other acute care hospitals, and the reason for the difference in cost is buried in a 1997 law.

http://www.beckershospitalreview.com/finance/medicare-patients-pay-far-more-for-outpatient-care-at-critical-access-hospitals-7-things-to-know.html

 

http://www.beckershospitalreview.com/finance/medicare-patients-pay-far-more-for-outpatient-care-at-critical-access-hospitals-7-things-to-know.html

Letter to Center for Medicare & Medicaid Services on changes to 340B hospital programs

This was sent out by the Jefferson Healthcare on their concerns to changes to the 340B program. This program has been used to theoretically fund low cost prescriptions. There are a variety of points of view about what the program has actually achieved, but the hospital is adamantly opposed to the cuts to it.  We likely can discuss this more at the next Citizen’s Healthcare Access group meeting in September in Port Townsend.

340b letter PDF file. Here’s the first page so you can decide if you want to read the whole PDF.

340b letter_Page_1

The Company Behind Many Surprise Emergency Room Bills – NY Times

A good caution against getting overcharged at an emergency room visit. Though please don’t use the ER when you just need to see a physician.

Early last year, executives at a small hospital an hour north of Spokane, Wash., started using a company called EmCare to staff and run their emergency room. The hospital had been struggling to find doctors to work in its E.R., and turning to EmCare was something hundreds of other hospitals across the country had done.

That’s when the trouble began.

It appears that they are in use in Yakima, Sedro-Woolley and a few smaller cities in Eastern Washington.

The Company Behind Many Surprise ER Bills

First to lose Obamacare? The sickest county in the state – Seattle Times

The Seattle Times has a good article about the outcome of the Republican led move to sow uncertainty and doubt about Obamacare’s future. Gray’s Harbor joins the growing ranks of county’s without healthcare insurance for over 2200 of it’s residents. And if the Republicans in Washington get their way, there will be over 7000 more joining them soon. Oddly, out of all this, we may end up getting single payer, due to the Republicans apparently hell bent on committing political suicide by alienating their base of white rural lower to middle class voters. 47 counties nationwide now don’t have health insurance companies serving them, most of the counties voted Republican. Read it and weep. Because counties like ours, which are largely using Medicare and Medicaid to supply us with health coverage are next up on the Republicans chopping block.

Obamacare is starting to crack, starting in our state’s sickest spot, Grays Harbor County. But the plan isn’t to fix it. It’s to make it dramatically worse.

http://www.seattletimes.com/seattle-news/politics/first-to-lose-obamacare-the-sickest-county-in-the-state/

Payer snubs PTC’s Emflaza, signaling pricing trouble ahead of launch – FiercePharma

Washington State continues to battle for lower cost prescriptions. This is your government in action. It’s a good thing.

As Washington State’s HCA noted, PTC Therapeutics has not announced its new price. But the group published a report (PDF) stating that prednisone—at a cost of 5 cents per tablet and $55 per year—will be its preferred corticosteroid for DMD patients. It’s the “lower cost, equally effective” option, according to HCA.

Read the whole story here:

http://www.fiercepharma.com/pharma/policy-report-washington-s-largest-healthcare-purchaser-snubs-ptc-s-emflaza