“Will that be cash, or charge?”: Many hospitals & doctors offer cash discount for care

Regular readers will recall the entry entitled “Q: Why do hospitals charge $75 for aspirin? A: Because they can.,” which was posted Wednesday, May 2, 2012.

In another venue, I had posted the following remark in response to the exorbitant healthcare costs, “It’s a simple concept, really. Anytime anyone gets in between you & who you’re buying from, it costs more. Insurance does that.”

And it’s true.

It’s not trite.

Let’s consider this example: You’re at the grocery store in the check-out line, about to pay for your groceries which have already been bagged and placed in your shopping cart. When the clerk announces the total, you have some strange feeling because the total is about ten times as much as you imagined.

When you double check the price of milk you find the sticker says $2.50/gallon, but your clerk rang up $25. You double check the price of frozen spinach. The sticker price says $1.37, but the clerk rang up $13.70. The chocolate was $4.50, but the clerk rang up $45.00. And the lean ground beef, instead of the posted $2.60/lb, the 5lb chub was… $130.00.

Talk about sticker shock!

You are aghast at the price, and in frustrated terms exclaim that “there is obviously some gross mistake!” – to which the clerk replies, “Let me check with your Food Insurance Agent,” picks up a phone beside the register, presses one button, and whispers into the receiver. 

Suddenly, out of a door leading to an inside office,

How is FaceBook’s IPO like Erectile Dysfunction?

{UPDATE: Tuesday, 22 May 2012 – 2d story added}

Read on, to find out why.

(Oh, and please, dear reader, don’t make me spell it out why.)

And, as an interesting note aside, Mr. Zuckerberg was married yesterday.

Here’s wishing him and his bride all the best.

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Nasdaq ‘embarrassed’ over Facebook IPO

By Telis Demos in New York, May 20, 2012 10:12 pm

Nasdaq OMX‘s chief executive admitted he was “embarrassed” by the delay in the opening trade of Facebook’s initial public offering and revealed that the exchange was in talks with regulators over potentially millions of dollars of customer claims.

Bob Greifeld said on Sunday that the 20-minute delay in trading of Facebook’s $16bn offering on Friday had been caused by a millisecond systems blip due to the largest IPO auction “in the history of mankind”.

The exchange has found itself in the spotlight after Facebook failed to deliver a first-day “pop” to investors, instead almost falling below its issuing price of $38. The shares, having risen briefly, quickly fell away to close the day with a gain of just 0.6 per cent, at $38.23.

As a result of the trading delay, Nasdaq was left with a position in Facebook shares that it was forced to liquidate, according to its own rules, generating $10m for the group. It plans to use that money, plus potentially more, to resolve disputes related to 30m shares that may have received improper trades.

It has requested approval from

MDs abandon Family Care, NPs step up to Care

A long-term trend in medicine in the United States has been that medical school students continue to abandon Family Care and Rural Practice.

The corollary trend among Advance Practice Nurses & Nurse Practitioners – many whom must also pass National Board Certifications in their area of practice – has been to fill the void formed in the delivery of healthcare by physician abandonment. Typically, the argument given for such abandonment is pecuniary. That is, by the time the medical student graduates from medical school & residency to assume full and independent practice, their debt load is not merely burdensome or impractical, but almost wholly impossible to repay.

More recently, however, medical schools and public health authorities have acknowledged the error of allowing that deterioration and abandonment to occur, and have begun to promote Primary & Family Care among medical schools and their students. Such strategies include not merely the promotion of community and the advantages of rural independent practice, but include full-ride scholarships while in medical school.

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Nurse practitioners look to fill gap with expected spike in demand for health services

By Sarah Kliff, Published: May 12

President Obama’s health-care law is expected to expand health insurance to 32 million Americans over the next decade. Health policy experts anticipate that

Nursing Salary Survey reports Western Nurses earn more

One category of expert nurses this survey omitted – perhaps purposely – was Certified Registered Nurse Anesthetists.

As a group, they have consistently earned six-figure salaries, typically upwards of $125,000/year.

Among Advanced Practice Nurses, CRNAs have continually earned significantly more than the average APN.

In fact, according to a salary survey report performed in 2005 by LocumTenens.com, CRNA respondents reported income ranging from $90,000-$250,000, with 63% reported earning between $110,000-$170,000/year.

The average salaries reported were: 2008-$163,467 / 2009-$169,043 / 2010-$166,833.

And, in 2011, the average reported salary for CRNAs in that survey was $168,998.

Research published by the American Association of Nurse Anesthetists in AANA Journal, April 2008, indicated that the median range for CRNA faculty – academic and clinical – earned between $120,000 and $140,000.

So, as you read the following items, please bear that in mind.

In the Occupational Outlook Handbook published by the Bureau of Labor Statistics, the overall average salary for Registered Nurses in 2010 was $64,690 per year, or $31.10 per hour. The job outlook (forecast) for 2010-2020 is that need is expected to grow 26% (Faster than average). According to the BLS, there were 2,737,400 Registered Nurses in 2010.

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Among Nurses, NPs and Those in the West Earn the Most

Jennifer Garcia

Authors and Disclosures
Journalist
Jennifer Garcia
Jennifer Garcia is a freelance writer for Medscape.
Disclosure: Jennifer Garcia has disclosed no relevant financial relationships.

May 11, 2012 — Nurse practitioners are the top earners among nurses, according to the Physicians Practice 2012 Staff Salary Survey . The survey reports salary averages from 1268 respondents, including nurse practitioners, registered nurses, and nurse managers. Salary information from other staff members such as physician assistants, medical records clerks, medical assistants, front desk staff, billing managers, and medical billers was also included in the survey.

Physicians Practice collected data during the fourth quarter of 2011, and

Is Schizophrenic Science partially to blame for American Obesity?

There’s no question but that America’s increase in overall obesity is due in large part to two factors: Diet & Exercise.

More specifically, it is Poor Diet & Lack of Exercise which has brought about much – if not all – of our increased waistlines, and the accompanying health problems associated with obesity – diabetes, joint failure, etc.

To be certain, however, our nation is perhaps THE best fed – er, make that MOST fed – nation in the world, bar none. And, generally speaking, even when discounting obesity, we are a large people in stature precisely because of our excellent nutritional status. Other, lesser developed nations do not fare as well, literally and figuratively, because of that reason. People in Southeast Asian nations, the Far East, nations in the African continent, in central Europe and in South America… there are few people in the world whom are as giant – and I do NOT mean obese – as Americans.

Even before obesity became a public health issue, Americans were considered people of large stature because of our ability to produce food. There was no scarcity of it.

Now, however, the changing tide of work – with a move toward a computer-driven and service economy – Americans have increasingly become sedentary. Desk jobs, or jobs which require little physical activity, are commonplace, and along with those changes have come health problems as a natural consequence of extra weight.

Again, considering the technological changes which have occurred in our nation, the jobs some of our forebears once worked are nothing like the ones we work today. Whereas once, they labored manually, the mechanization of labor reduced their need to exert themselves as strenuously. And today, one farmer can sit in an air-conditioned tractor outfitted with GPS navigation, cellular telephone, and more, and work several hundreds – if not thousands – of acres, and not even break a sweat. Previously, that was unimaginable. Now, it’s commonplace.

Given that our lifestyles have been significantly changed because of mechanization & technology, it should also be understood that

Where the Jobs Are: Is the Nursing Job Market a mixed bag?

Eminent nursing researcher & scholar Dr. Peter Buerhaus, PhD, RN, FAAN has made a career studying Nurses, and suggests that the jobs picture for new nurse grads is good, and that they may be facing one of the best job markets in decades.

A 2009 study he conducted found that, “Registered nurse (RN) employment has increased during the current recession, and we may soon see an end to the decade-long nurse shortage. This would give hospitals welcome relief and an opportunity to strengthen the nurse workforce by addressing issues associated with an increasingly older and foreign-born workforce. The recent increase in employment is also improving projections of the future supply of RNs, yet large shortages are still expected in the next decade. Until nursing education capacity is increased, future imbalances in the nurse labor market will be unavoidable.“

A 2004 study of his said that, “Wage increases, relatively high national unemployment, and widespread pri- vate-sector initiatives aimed at increasing the number of people who become nurses has resulted in a second straight year of strong employment growth among registered nurses (RNs). In 2003, older women and, to a lesser extent, foreign-born RNs accounted for a large share of employment growth. We also observe unusually large employment growth from two new demographic groups: younger people, particularly women in their early thirties, and men. Yet, despite the increase in employment of nearly 185,000 hospital RNs since 2001, the evidence suggests that the current nurse shortage has not been eliminated.“

Most recently, research he worked upon which was published in the December 2011 issue of Health Affairs found that “because of this surge in the number of young people entering nursing during the past decade, the nurse workforce is projected to grow faster during the next two decades than previously anticipated.”

In essence, “...the nurse workforce is now expected to grow at roughly the same rate as the population through 2030.”

They also cautioned however, “that the dynamics of the nursing workforce are more complex than sheer numbers.“

Lead researcher and RAND health economist David Auerbach said, “Instead of worrying about a decline, we are now growing the supply of nurses.“

Here’s something very interesting, however.

In that same issue of Health Affairs, a survey conducted by Christine Kovner of New York University examined the low “mobility” of new RNs. The most striking finding was that

FDA Announces Food Recalls

To ensure public health and safety, the United States Food and Drug Administration has recently announced recalls of certain food items.

And, if you can imagine it – believe it or else – there are politicians and people who say the FDA should be eliminated. Hint: They’re “TEA Party,” Libertarian or Republican. And you know what their argument is? It’s not in Constitution.

Honestly, that stupefies me. It boggles my imagination.

Following are the two most recent recall announcements.

Q: Why do hospitals charge $75 for aspirin? A: Because they can.

It was once a long-standing joke that hospitals charged outrageous prices on medicines.

It’s not a joke anymore.

Once, a healthcare joke went like this:
Q: What’s the difference between a HMO, a PPO and the PLO?

A: You can negotiate with the PLO.

It’s not a joke anymore.

It should also be noted that a study conducted 26 years go by Jack D. McCue, Charles Hansen, and Peter Gal entitled “Hospital Charges for Antibiotics” found that:

“Hospital charges for intravenous antibiotics were obtained in a survey of 71 hospitals in 25 U.S. cities. Only 56.3% of the hospitals used their actual drug acquisition cost to calculate patient charges; the remainder used a base price derived from one of the wholesale price guides, which often seriously overstate the cost of antibiotics. Sixty-eight percent added a markup, averaging 134.5%, and 63.4% added a dispensing fee, averaging $5.47. A relatively high-dose, single-antibiotic regimen costs patients $50-$150 per day, independent of dose-preparation charges (average, $9.09 per dose) for a piggyback-type system or intravenous line-related charges. Antibiotics were least expensive in large hospitals and in those located in the northeastern United States. Charges for antibiotics are often inconsistently calculated, vary enormously among hospitals, and may be unfair to patients and confusing to physicians. Cost-conscious prescribing of antibiotics by physicians would be facilitated by a more consistent relationship between charges and true costs.”

That 1985 study may be found here.

The reader should also understand that in a hospital, ALL medications are administered by prescription only… even aspirin.

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Cost Spotlight: A 443% Markup on Prescription Drugs

Posted on April 30, 2012 by AHIP Coverage

Kaiser Health News/USA Today shines a spotlight on increasing hospital costs specifically the price markup of over-the-counter and prescription drugs hospitals administer to patients.  The story examines

Hello? Teens! Do NOT drink hand sanitizer. Duh!

Huh?

What IS up with that?

Please, please, please…

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More hand sanitizer drinking cases reported in dangerous trend

April 25, 2012, 10:36 am PST

The California Poison Control System has received 60 reports of teenagers drinking hand sanitizer since 2010, showing the dangerous trend is not unique to Los Angeles.

In an effort to get drunk, some teens are drinking hand sanitizer, shown here at Texas Star Pharmacy in Plano, Texas, although underage drinking in general is down. (Donna McWillia/AP/File)

Hand sanitizer, which has 62% ethyl alcohol, produces a potent drink that can cause alcohol poisoning. Some of the cases involve teenagers who used salt to separate out the alcohol.

There were also 147 cases involving children ages 6 to 12 and 2,180 cases ages 0 to 5, believed to have accidentally ingested the gel, according to poison control service, part of the UC San Francisco‘s Department of Clinical Pharmacy.

The vast majority of all the cases statewide were minor and treated at home, but about 50 of the youths went to a hospital or were referred to a hospital for treatment.

In Los Angeles County since March, there have been 16 cases of teenagers requiring medical attention, according to the California Poison Control System.

Officials began separately tracking hand sanitizer cases in 2010.

“It’s quite a concern,” said Stuart Heard, executive director. “It’s like

Chinese Junk: It ain’t just cheap crap made in China. It’s also hocus pocus herbal faith healers.

Kung Foo Panda.

Yeah.

It’s Chinese JUNK, folks.

Yes, I’m aware that’s a pun.

But, this AIN’T punny.

It’s your life we’re talking about.

So… who do you trust?

Something that has DEMONSTRATED SCIENTIFIC EVIDENCE – or some hocus pocus baloney baloney which is the equivalent of an old wives tale with utterly NO SCIENTIFIC EVIDENCE to support its specious claims?

Your “bullshit” detectors should be pinging 100% every time you pass by some “herbalist’s” corner.

If for no other reason, consider this: There is NO inspection of any ingredients used in such so-called “medicine.”

So, yeah… you could be ingesting arsenic.

Why?

Because there’s no inspection required.

Good luck!

And besides… are you really gonna’ believe that some root, gall bladder of bear, or powdered horn of an endangered specie will genuinely cure you?

Or, will it only relieve the symptoms of your wallet?

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Logo of Jiangxi University of Traditional Chinese Medicine ---

Samples of traditional Chinese medicine are found to contain harmful ingredients

By Kai Kupferschmidt, Published: April 23

Traditional Chinese medicine is enjoying increasing popularity all over the world. But two recently published studies show that the treatments can be harmful. The papers focus attention on the fact that not all of the ingredients in TCM treatments are listed, or even legal, and that some can cause cancer.

Critics have long warned that some mixtures can also contain naturally occurring toxins; contaminants such as heavy metals; added substances such as steroids, which can make them appear more effective; and traces of animals that are endangered and trade-restricted.

Now, researchers in Australia have investigated the issue using modern sequencing technology. The team analyzed 15 TCM samples seized by Australian officials.

“We took these traditional preparations, smashed them to pieces and extracted the DNA from the powder,” explained molecular geneticist Michael Bunce.

Some products contained material from animals classified as vulnerable or critically endangered, such as the Asiatic black bear and the Saiga antelope, just as the producers of the products claimed. But often, the medicine also harbored ingredients not mentioned on the packaging, the team reported online in PLoS Genetics.

In the herbal preparations that they tested, Bunce and his colleagues found