Memo to: Tommy Thompson, HHS, Washington
From: Your pal Outliers
As much as your Advisory Committee on Regulatory Reform is a good idea, it has had a really big problem, which is that it had absolutely no one on it who might think first of the needs of Medicare beneficiaries and healthcare consumers.
So we were pleased last week when you said you might appoint three more consumer or beneficiary representatives to the panel. As it stands, we're a bit skeptical of the committee's outlook, as it appears to be skewed almost totally in favor of providers, insurers, suppliers and government.
We did our homework, and this is what we found:
* Those groups account for 25 of the current 27 committee members.
* The two lonely beneficiary representatives you already named don't seem, well, quite as interested in beneficiaries as it might seem. One is Mary Martin, executive director and board chairman of the Seniors Coalition. That Springfield, Va.-based group last made an appearance in Outliers in 1995 for disrupting a hearing on a Republican congressional budget plan that would have reduced Medicare spending growth by $270 billion over seven years. The coalition barged in with sacks of telegrams in support of that GOP plan. Meanwhile, the American Association of Retired Persons is represented on the committee, but cynics-and you could never call us cynics-often like to point out that the AARP will go along with a lot of things as long as its Medigap plan is protected.
* And those government representatives on the panel aren't exactly a cross-section of America. Four of the five are Republicans or have served Republicans. The "HMO regulator" seat on the committee is taken by Gary Mendoza, a lawyer with Riordan & McKinzie in Los Angeles and a former California HMO regulator who, incidentally, is a GOP candidate for California insurance commissioner.
So here's the thing. As long as you are considering candidates, may we suggest a few legitimate consumer advocates: How about Diane Menio, president of the National Citizens' Coalition for Nursing Home Reform and executive director of the Center for Advocacy of the Rights and Interests of the Elderly? Robert Hayes, president and general counsel of the Medicare Rights Center? Judith Stein, executive director of the Center for Medicare Advocacy? Although those three still wouldn't bring complete balance to the committee, they could help reverse the pro-industry tilt.
Thanks, Tommy, and good luck with the committee.
Vital problem. A piece of advice for health system executives considering closing a hospital: Don't ignore the phones or overlook the possibility of sabotage from disgruntled employees.
Vital Community Health Services, a not-for-profit, two-hospital system in Chicago, learned that lesson the hard way when officials failed to remember that the telephone system for its Edgewater Medical Center, which closed Dec. 6, was linked to sister facility Grant Hospital, which remained open. When the plug was pulled on Edgewater's phones Dec. 10, Grant lost its phone service as well.
For three days Grant officials had to rely on cell phones and old analog lines to communicate with the outside world as hospital officials and phone company representatives struggled to reconnect phone service.
What happened? Vital's attorney, Robert Baudino, says there may have been foul play.
"Some critical pieces of the phone system appear to have been deliberately removed from the system (at Edgewater), causing it not to work (at Grant)," he says. No suspects have been identified.
Grant COO Joyce Berry says her hospital has lost $400,000 from the debacle. "That includes the loss of revenue for patients we weren't able to admit, the income from having our emergency room bypassed for three days and outpatient services that weren't performed. We couldn't transfer in skilled-nursing patients because we couldn't communicate with physicians. And the phone equipment required to fix the system was expensive: Five parts alone cost more than $50,000. It's a fairly significant problem."
Berry advises health system executives to examine redundancies in their telephone and computer systems and reduce the systems' vulnerability to breakdown or attack.
The front line of defense. Congress may not be prepared to help, states are running out of money and hospitals say they need $11.3 billion before they can do anything, so it may be up to nurses to make plans to respond to future bioterrorism threats.
Minnesota nurses and other healthcare workers will gather this week in St. Paul to hear from state and national experts on a range of topics, including infection control, infectious agents and isolation/decontamination. Participants will also gain firsthand knowledge on regional and local disaster plans.
"In the wake of extraordinary events this past fall, nurses and their healthcare colleagues throughout the state are demanding practical information about biological agents and the illnesses and injuries associated with biological terrorism and any other type of terrorist activity," says Minnesota Nurses Association President Monica Vollmuth.