The Week in Review

New York attorney
general Andrew M. Cuomo sent a letter to UnitedHealthCare
demanding that the insurer cancel
the launch of an online service
that would rate doctors by the quality of
care they provide and the cost of their services. Linda Lacewell, an attorney
on Cuomo’s staff, noted that the program could be used to push patients toward
selected doctors. “To compound the situation, we understand that employers may
act on these ‘ratings’ to offer financial inducements such as lower co-payments
or deductibles to promote ‘cost-effective’ doctors to their employees."

The Wall Street Journal reports that state and federal officials are continuing
to ask tough questions about the status of non-profit hospitals
. Yesterday,
the IRS released a study that notes that "many" hospitals spend less
than three percent of revenues on charitable care. The analysis is based on a survey of  500 non-profit hospitals. Meanwhile, Senator Charles Grassley
released a memorandum in response that suggests that Congress may set new rules governing how
much charity care non-profits are required to provide. 

Dr. Anna Pou, the New Orleans surgeon charged with second degree homicide in the deaths of four patients in
her care in the days after Hurricane Katrina, filed
a lawsuit accusing Louisiana attorney general Charles Foti
of using the
case against her to "advance his political career." The suit argues
that Foti would better serve the state’s residents by investigating the inept
official response to the disaster."The real cause of loss of life is the
government’s abandonment of the patients and the doctors," the lawsuit
notes. "There can be no doubt that this will be the central issue in the
defense of this matter."

The thread on Dr. Pou and her case, which began more than a year ago when we ran a brief item about
the defense fund set up to help pay her legal expenses, has been surprisingly active for a long time. Various posters and acquaintances — including many doctors and other healthcare workers who have worked with her – have left messages of support,
encouragement and criticism. Many have had nasty things to say about Charles Foti. 
Bill writes in claiming to have an inside angle the case. (Note: These claims have not been verified.) He says:         

"Anna is also my friend and I promised her I would not talk about the
things we have talked about. I wish I could tell you more, but I made a
promise and I am therefore bound to keep it. What I can tell you is this: Foti was not the principle in the original investigation.  Instead Jullie Cullen, Director of the Criminal Division of the Attorney General’s Office spearheaded the original investigation. The case against Anna will not go further than the Grand Jury. There will be no court case and the charges will be dropped. I wish I could tell you more, but I cannot. But please know this: what happened on the seventh floor was done out of love."

Val responds: "First of all I am an MD and I did go through Katrina and I do know Anna
Pou. But trying to be objective and somewhat logical here no one is
allowed or justified to "play God" and decide when another’s life
should end. However, we are bound to reduce suffering whenever
possible. It is completely bogus to say that you cannot give versed and
morphine together– we do it all the time in ICU or the OR etc."

Jonathen sounds more Perry Mason-like. "The charges were based not just on the eye witness statements that
indicated Dr. Pou, in her own words, told them she was going to
administer lethal doses but on the original autopsy reports which
showed high levels of morphine, including a morphine overdose test, and
Versed and Ativan. Mr. Foti was doing his job. And as for Anna, this
case is not about whether she is a nice or not nice person, whether she
is a competent or incompetent doctor.This is a case about a doctor who
told multiple eye witnesses that lethal injections where going to be
administered to the remaining patients on the seventh floor."

The Center for Science in the Public Interest’s Merrill Goozner drew
attention to a post last week by Beth Israel Deaconess Medical Center CEO Paul Levy discussing a new treatment for severe asthma. Goozner noted
that that BDMIC is both
a clinical trial site for the procedure and a
consultant to the device’s maker
, Ashtmatx of Mountain View California. Levy mentioned neither fact in his post.  Medical
journals have rules that disclosure of potential conflicts. So do newspapers.
Yet "the blogosphere operates without rules, even when the blogger runs
one of the nation’s leading teaching hospitals," Goozner writes. Levy says
he was "unaware of the relationship" at the time he wrote about the treatment.

Two years ago, the University of Pittsburgh Medical Center ignored
the advice of consultants and pushed ahead with an ambitious $402 million IT
services contract with IBM. The deal was one of the most talked about of the
year. Did it pay off? UPMC CIO Daniel Drawbaugh says yes.

In Vermont, government
officials think "socialized data" could help develop a
new model
for fighting chronic diseases. Government Health IT News examines
the ways that the Vermont Information Technology Leaders program, a
public/private partnership, is combining the regional health information
organization with traditional disease management methods. The article
examines similar efforts around the country, noting projects in Kentucky and Calgary. Orion Health’s Dr.
Chris Hobson
, the star of a recent THCB podcast, makes an appearance to talk
about the company’s technology, which is being used in both Calgary and Vermont.  [Full disclosure Orion is a THCB sponsor.]

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2 replies »

  1. The scuttlebut on the AG’s United reprimand is that it has more to do with United than it does with quality/cost reporting. United has had compliance issues and so this was an attempt to keep United in line more than a general rejection of P4P, quality/cost reporting, etc. This is just a rumor, so please treat it as such.

  2. Having practiced in a nonprofit, faith-based hospital in marginal financial shape, from which the CEO and CFO took a total of 8 million dollars in compensation when they left together (that doesn’t count their salaries while they worked there), I think the IRS’ scrutiny is well deserved. It’s only “non-profit” AFTER they pay all their executives whatever the executives can negotiate from a naive Board – just like any for profit corporation.
    Having said that, I think Congress’ political motivation is to obtain acute medical care for the uninsured or underinsured without having to change much in our current screwed up health care system…..a cop-out in other words.