The Senate lost an influential voice in the national healthcare debate with the death last week of Sen. John Chafee (R-R.I.).
The second-ranking Republican on the Senate Finance Committee, Chafee stood in healthcare reform's no man's land with such moderates as Sen. John Breaux (D-La.) as conservatives and liberals warred around them.
As criticism mounted in 1994 over President Clinton's healthcare reform initiative, it was Chafee and Breaux who pulled together the "mainstream coalition" to come up with a moderate proposal to keep the healthcare reform effort alive as health insurers and conservative politicians tore up the Clinton plan.
Meeting for weeks during the summer of 1994 in Chafee's hideaway office on the second floor of the Capitol, the mainstream coalition produced a package that eventually crashed and burned with the Clinton healthcare plan.
The following year, Chafee was instrumental in thwarting efforts to turn Medicaid into a state block grant program, even taking on Republican governors in the process.
And one of his last acts as a senator was a vote in the Finance Committee in favor of legislation to roll back Medicare spending caps imposed by the Balanced Budget Act of 1997. That was just three days before his death.
Chafee died of heart failure at Bethesda (Md.) Naval Hospital. He was 77.
Stealth offer. Some hospitals just refuse to die.
Just a month after Health Midwest, the huge Kansas City system, announced it would shutter Park Lane Medical Center in Kansas City, Mo., a purported small operator has offered to buy and reopen it.
Hometown Management, which gave a Liberty, Mo., address, submitted a proposal to Health Midwest two weeks ago, but the $2 billion-per-year system isn't sure what to make of it.
"We don't know anything about them but what we see on a letterhead," says Dennis McClatchey, Health Midwest's communications chief. "It's something to do with managing physician practices. We've asked for more information on who they are and what they do. They said they don't have a brochure, and they're not going to manage it anyway."
Officials of Hometown Management couldn't be reached for comment, but its president, John Parry, told the Kansas City Star that his company wanted to keep the hospital and the medical office building open for the convenience of patients who live nearby.
Parry also has a letter from another local hospital system offering to operate the hospital. G. Richard Hastings, president and chief executive officer of St. Luke's-Shawnee Mission Health System, told Parry that St. Luke's would be willing to run the facility if no risk were involved.
St. Luke's confirmed the existence of the letter but declined further comment.
Health Midwest tried to make a go of the 83-bed osteopathic hospital since acquiring it four years ago but threw in the towel in September. Several other hospitals are nearby.
McClatchey says Health Midwest, which runs 16 hospitals, was somewhat perplexed by the offer to buy Park Lane: "What are they going to do that we don't know how to do?"
Bridging the gap. The chasm between Presbyterian Healthcare Services and Heart Hospital of New Mexico narrowed for one day earlier this month.
When the heart hospital opened for business Oct. 18, Albuquerque-based Presbyterian, the city's largest healthcare provider, lent it some medical instruments so it could immediately perform procedures.
Their past relationship would suggest the providers would exchange punches, not equipment.
Presbyterian runs Albuquerque's premier cardiac program and had decided not to associate with the hospital because of its for-profit mission and concerns about creating a cardiac-care monopoly.
Two cardiology medical groups that once did business with Presbyterian decided to affiliate with the new venture, which is backed in part by Charlotte, N.C.-based MedCath. The groups began steering business to St. Joseph Medical Center, another Heart Hospital partner.
Presbyterian responded by dropping its contracts with the groups and hiring away 10 physicians to form its own cardiac group. The rivalries became so bitter that the Wall Street Journal published a front-page story on the situation earlier this year.
While some Presbyterian officials and physicians were amused by the irony of the loan, Presbyterian Chief Executive Officer James Hinton downplayed it. "Hospitals lend equipment to each other all the time," he says.
Vincent McVittie, the heart hospital's vice president of business development, agrees: "When it comes to saving lives, all the hospitals make sure we all have the right equipment."
Women up, everybody else down. Women continue to make inroads in medicine, outnumbering men in first-year classes at one-third of the nation's 125 medical schools, according to the Association of American Medical Colleges, which held its annual meeting last week in Washington.
Women account for 46% of first-year medical students, or 7,412, up 3.5% from last year. But strides in gender parity were coupled with a drop in minority representation. Particularly striking, according to the AAMC, is a dearth of black men, whose numbers dropped almost 16% to 383, the lowest this decade.
Overall, the applicant pool for medical students declined for the third straight year to 38,534, down from a high of nearly 47,000 in 1996. The AAMC blamed diminished interest in medicine on a strong economy and increasing variety in intellectually challenging career options. Other factors include a perceived loss of physician autonomy, concern about educational debt and anti-affirmative action efforts, the association said.