Those that need the most help may be SOL…

by Dave · February 4, 2015

An interesting development in the healthcare space:

A court ruling rejecting a settlement that would have allowed Partners HealthCare to acquire three community hospitals could have industry implications well beyond Boston. The decision casts doubt on expansion strategies that promise to deliver more coordinated and cost-effective care.
Suffolk Superior Court Judge Janet L. Sanders’ decision on Thursday comes as hospitals and health systems nationwide move to build bigger networks. In a case that has been followed across the country, Sanders rejected the argument that hospital consolidation would help control costs through increased efficiency and suggested that Partners’ expansion would result in higher prices for consumers across Massachusetts.

As I’ve mentioned before, the nature of healthcare today is putting the squeeze on the operating margins of hospitals, especially the not-for-profit hospital systems. The smaller community hospitals, especially those not affiliated with larger investment-grade rated not-for-profit systems with substantial balance sheets, are getting hit especially hard. They are prime candidates for acquisition and I’m aware of executives at these hospitals reaching out to the larger systems to see if they can facilitate a sale.

However, the hospitals in most of need of help may encounter difficulties getting it. While the Partners deal does not make a trend, there is an increasing amount of push back at the state and local level against attempts to acquire community hospitals. In another case, in Connecticut, a joint venture between a for-profit and a not-for-profit system was disbanded due to a failed attempt to acquire four struggling community hospitals within the state. How this plays out will depend on the regulatory environment in each state, community resistance to consolidation or relocation, whether or not further consolidation of healthcare delivery triggers anti-trust concerns and the public interest at large.

Dave

Dave is a part-time blogger that writes about whatever suits him at the time.

Damon says:
February 4, 2015 at 6:49 pm
They will just fold it all into a single payer program and get the cost savings there……
“Trust me”Report
Reply
- LeeEsq in reply to Damon says:
  February 4, 2015 at 7:26 pm
  Well, if you can give us an example of a single-payer program resulting in too few hospitals than provide your evidence?Report
  Reply
  - Kolohe in reply to LeeEsq says:
    February 4, 2015 at 7:57 pm
    The Department of Veterans Affairs?Report
    Reply
  - Damon in reply to LeeEsq says:
    February 4, 2015 at 8:18 pm
    My tongue was firmly in my cheek.Report
    Reply
This comment was spam says:
February 4, 2015 at 8:57 pm
[content of post deleted as spam — BL]Report
Reply
- Rufus F. in reply to This comment was spam says:
  February 4, 2015 at 9:25 pm
  You ask a good question here. I can’t really answer, due to my position on the site, but perhaps someone else can help you.Report
  Reply
  - Rufus F. in reply to Rufus F. says:
    February 4, 2015 at 9:38 pm
    Okay, fine, the answer is: MP3!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!Report
    Reply
    - Burt Likko in reply to Rufus F. says:
      February 5, 2015 at 1:42 am
      Not sure how this got through the spam filter. Since we have replies to it, I’ve dug in to the comment behind the scenes and extracted dangerous elements (URL’s and email addresses) that might inadvertently get someone in trouble with an inopportune click. In the future, when you see something that’s obviously spam, shoot an editor an e-mail, please.Report
      Reply
  - LWA in reply to Rufus F. says:
    February 4, 2015 at 11:54 pm
    I don’t know about- maybe he just needs to find a job working from home making money on the internet.Report
    Reply
  - Jaybird in reply to Rufus F. says:
    February 5, 2015 at 12:59 am
    Please stop replying to the bots.Report
    Reply
  - Road Scholar in reply to Rufus F. says:
    February 5, 2015 at 1:32 am
    I’ve sworn off replying to NotMe.Report
    Reply
  - Rufus F. in reply to Rufus F. says:
    February 5, 2015 at 8:33 am
    Yeah, I will. I couldn’t resist this one time because, well, it was such ridiculously composed spam.Report
    Reply

Ten Second News

Biden Sings Same Song, Second Verse

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Biden Sings Same Song, Second Verse

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[caption id="attachment_316702" align="aligncenter" width="750"] Photo by Pete Souza Public domain [/caption]

Meanwhile, in non President Trump vs "The Squad" news, current Democratic primary frontrunner Joe Biden was unveiling his healthcare proposal, and the tagline he laid on the folks at an AARP gathering sounds strangely familiar.

Former Vice President Joe Biden on Monday said that under his new health care plan, people who like their insurance coverage won’t be forced to give it up.
Speaking at the AARP presidential forum in Iowa, Biden drew a contrast between his plan, which would give people a Medicare-like public option, and the “Medicare for All” plan championed by more progressive Democratic presidential candidates including Sens. Bernie Sanders (I-Vt.) and Elizabeth Warren (Mass.).
“If you like your health care plan, your employer based plan, you can keep it. If in fact you have private insurance, you can keep it,” Biden said.
Biden’s speech echoed the now-infamous “if you like your doctor, you’re going to be able to keep your doctor” catchphrase former President Barack Obama repeatedly said in 2009 and 2010 when he was trying to sell the public on the benefits of the Affordable Care Act.
The GOP seized on those remarks, and spent years throwing them back at Democrats to showcase what they said were ObamaCare’s failures. In 2013, PolitiFact called "if you like your health care plan, you can keep it" the "Lie of the Year."
But the law has provided 20 million people with health insurance, and it’s now more popular than ever.
Biden is running on protecting ObamaCare. He is banking the law’s popularity will convince voters that his plan of shoring up the law with more subsidies and a public option is a better approach than Medicare for All.
“You get your choice, you get full coverage … I think it’s the quickest, most reasonable rational and best way to get to universal coverage,” he said.
In formally announcing his plan on Monday, Biden equated the push for Medicare for All with the GOP attempts to repeal ObamaCare.
“I understand the appeal of Medicare for All, but folks supporting it should be clear that it means getting rid of ObamaCare, and I’m not for that,” Biden said in a video announcing his plan.

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Labor Secretary Alexander Acosta Resigns Amid Epstein Furor

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Labor Secretary Alexander Acosta Resigns Amid Epstein Furor

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[caption id="attachment_316589" align="aligncenter" width="739"] photo by Gage Skidmore via Wikimedia Commons[/caption]

The head many have been calling for since the details of Jeffrey Epstein's plea deal were first reported has finally rolled:

President Donald Trump alerted reporters this morning of Acosta's departure. "This was him, not me," said Trump as Acosta stood beside him.
Trump, who saw Acosta largely as a source of favorable monthly statistics about unemployment and job growth, called Acosta "a great labor secretary not a good one" and "a tremendous talent. He's a Hispanic man, he went to Harvard, a great student." Trump indicated that he was satisfied with Acosta's explanation for the plea deal in Wednesday's news conference, saying, "He explained it."
But Acosta has had a rocky relationship in recent months with other White House officials, including acting chief of staff Mick Mulvaney, over the perceived slow pace of deregulation at the department. And one person familiar with the situation said that although Trump initially thought Acosta handled the Epstein controversy well, over the last couple of days the president saw the negative press and didn’t like it.
“POTUS is not a fan of bad press, especially when other people make him look bad," this person said.
Acosta, a 50-year-old Harvard-educated lawyer, came newly under fire for the lenient 2008 plea deal after Epstein was re-arrested July 6 in New York City and charged with sex trafficking. Under the earlier plea agreement, Epstein served only 13 months of an 18-month term and was permitted daily furloughs to go to the office. Epstein also was required to register as a sex offender and to pay restitution to his underage victims.
At the White House this morning, Acosta told reporters: "Over the last week I've seen a lot of coverage of the department of labor. And what I have not seen is the incredible job creation that we've seen in this economy. more than 5 million jobs, I haven't seen that.... I do not think it is right and fair for this administration's labor department to have Epstein as the focus, rather than the incredible economy that we have today."

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A horrible story raises age-old questions about regulation, medical care, and people who make money insisting they know better than trained professionals.

At about 9:15 p.m. June 15, Omaha Fire Department paramedics were called to a home where a 25-year-old woman at full term in her pregnancy was in distress following complications during a breech birth.
The woman told police she went into labor at about 9 p.m. June 14. Hock reportedly arrived to help with the birth at 6 p.m. June 15, according to a criminal complaint.
After realizing the baby’s foot had been delivered, the mother told detectives that Hock asked her whether to continue with the birth at home “and stated she had trained in delivering breech babies,” court documents state.
The mother agreed to continue at home but said that after at least 30 minutes, the baby had only been delivered up to the shoulders, the documents state. That’s when Hock advised calling 911.
When police arrived, they found Hock assisting the pregnant woman and asking for medical scissors, court documents state. Paramedics said the baby was partially delivered at that time and that Hock performed a medical procedure during her attempt to deliver the baby.
The baby, delivered by paramedics while en route to a hospital, was limp and unresponsive, according to the criminal complaint. Resuscitation attempts were unsuccessful.
The baby was taken to the Newborn Intensive Care Unit upon arrival at the hospital and placed on life support, the documents state.
The obstetrics doctor in the ER that night reported to police that the baby was deprived of oxygen and suffered swelling in the brain and indicated the infant could die as a result of the injuries.
The doctor told officers Hock had revealed she was at the scene serving as a midwife, a service she advertises through her company’s website, Nebraska Birth Keeper, and “had known for a couple hours that the baby was in breech” position but continued with the birthing process for an hour before 911 was called, the court documents state.
The baby was pronounced dead June 17.
A warrant was issued for Hock’s arrest when it was determined by Nebraska Health and Human Services that she does not hold a medical or certified nurse-midwife license.
The mother told investigators she had signed an agreement for Hock’s midwife services and that she and her husband had paid Hock about $3,000 to $4,000 for those services.

Home births are illegal in Nebraska. This was the second time the Noes had used Ms. Hock in the birthing of a child. That pregnancy as well resulted in a breech birth, and the Noe's opted for the hospital and a C-Section delivery.

The couple paid about $4,000 for Ms. Hock’s services, according to Mr. Dornan, who said Ms. Hock served as a midwife when Ms. Noe gave birth to another child two years earlier.
“They wanted to have a birth in their bedroom,” Mr. Dornan said. “Didn’t want to go to the hospital."
Similar complications arose during the earlier pregnancy with a breech baby, he said, and Ms. Noe opted to have a C-section at the hospital after Ms Hock advised her of the risks. This time, he said, Ms. Hock once again warned Ms. Noe of the risks of a breech birth, but that she had opted to remain at home.
Mr. Dornan said Ms. Hock tried a maneuver to dislodge the baby, but was unsuccessful. She was accompanied by her 9-year-old daughter and a doula, who Mr. Dornan said called 911.
When the emergency responders arrived at the home, Mr. Dornan said, they gave Ms. Hock a pair of scissors to try to help make a wider opening for the baby, which is considered to be a surgical procedure and is mentioned in the criminal complaint against his client.

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Trump Meets Kim, Steps in North Korea

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Trump Meets Kim, Steps in North Korea

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President Donald Trump went there:

On Sunday, Mr Trump became the first sitting US president to set foot in North Korea, accompanied by leader Kim Jong-un.
Mr Trump had earlier tweeted asking Mr Kim if he would like to meet while the US president was in South Korea.
On Monday, KCNA carried extensive coverage of the unprecedented meeting.
North Koreans rarely receive news of the outside world, and the heavily controlled media has depicted the US as its most hated enemy for decades.
Images of the US president walking into the North as a friend of Mr Kim will be an extraordinary sight for ordinary North Koreans.
Negotiations over North Korea's controversial nuclear programme have stalled since the second summit between the two leaders ended without an agreement in February.
After their surprise talks on Sunday, they reaffirmed their claims to friendship and said talks would continue through their negotiating teams.
Critics have dismissed the occasion as an act of political theatre which does not make substantial progress towards North Korea giving up its nuclear weapons.
*
Negotiations with North Korea to try to convince it to abandon its controversial nuclear programme reached a peak last year when Mr Trump and Mr Kim had a historic meeting in Singapore.
They both committed to the "complete denuclearisation" of the Korean peninsula, but without clarifying what that meant.
It was hoped their second meeting, in Hanoi in February, would make some concrete agreement about North Korea handing over its nuclear programme in exchange for some of the tight sanctions against it being lifted.
But those talks ended with no deal, as they failed to agree on the pace at which sanctions should be eased.

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SCOTUS: “partisan gerrymandering claims are not justiciable”

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SCOTUS: “partisan gerrymandering claims are not justiciable”

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Whoa...people can over-react to Supreme Court rulings, but this ruling, and the reaction, is going to be big.

In a 5-4 decision along traditional conservative-liberal ideological lines, the Supreme Court rules that partisan redistricting is a political question, not reviewable by federal courts and can't judge if extreme gerrymandering violates the constitution.
"We conclude that partisan gerrymandering claims present political questions beyond the reach of the federal courts," Chief Justice Roberts wrote for the conservative majority. "Federal judges have no license to reallocate political power between the two major political parties, with no plausible grant of authority in the Constitution, and no legal standards to limit and direct their decisions."
The court's ruling came in two cases. In Maryland, Democrats who controlled the state legislature drew new lines for congressional districts to eliminate one of the state's two GOP seats in the U.S. House of Representatives; and in North Carolina, where Republicans controlled the state legislature, they used the same tactics to isolate and limit Democratic power, and maximize their own.

Lots more to come from this...

Read the full opinion here.

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