The theory that Canadians cross into the U.S. by the thousands seeking private healthcare is a myth, according to a new report in the journal Health Affairs.
For more than a decade, opponents of universal coverage or single-payer healthcare in the U.S. have claimed that hordes of "Medicare refugees" sneak south into this country in search of services that are unavailable or in short supply in their own country, which has universal coverage.
The theory has not appeared just in U.S. politics. Supporters of private funding in Canada have suggested Canadians spend $1 billion annually south of the border.
But those hordes are really just a handful, according to a report by a group of health policy experts on both sides of the border who looked at hospital discharge data in three states-Michigan, New York and Washington.
Almost 40% of the facilities had treated no Canadians. An additional 40% had treated fewer than 10 Canadians, 15% had treated from 10 to 25 patients, and only about 5% saw more than 25 patients. On the whole, Canadian hospitalizations in the three U.S. states represented 2.3 per 1,000 total admissions in their three corresponding border provinces-British Columbia, Ontario and Quebec.
"The anecdotal reports of Medicare refugees from Canada are not the tip of a southbound iceberg but a few scattered cubes," wrote the authors of the study, which appears in the May/June issue of Health Affairs. The lead author of the study is Steven Katz, associate professor in the department of medicine and health policy at the University of Michigan.
Singing praises of an unsung heroine
Our Lady of Lourdes Medical Center, Camden, N.J., is rightfully singing the praises of an unsung heroine who for more than half a century has done what hospital executives desperately wish more would do: be a nurse.
Agnes Berger, a 74-year-old operating room nurse, has been a constant at the 308-bed hospital since the days when Harry Truman was president. Our Lady of Lourdes hired her fresh out of nursing school along with a classmate as its first-and only-OR nurses at the time. That was July 1950, before open-heart surgery and kidney transplants, and during a time when average lengths of stay stretched into the sunset.
Berger says she knew she wanted to work at Our Lady of Lourdes from the first day she passed the hospital construction site. And she has no plans to quit. Hospital officials say Berger says that because she is so humble about what she does, she is reluctant to talk about it. She can't quite understand what all the fuss is about, says hospital spokeswoman Wendy Marano.
Berger told Marano that she first thought she would stay at Our Lady of Lourdes perhaps 10 years. "But then it got so exciting with all the new programs and types of surgery, I never wanted to leave," she said.
The hospital and the New Jersey Hospital Association used National Nurses Week May 6 to 12 to honor Berger. On May 8, Our Lady of Lourdes unveiled a portrait of their beloved nurse in a place of honor in the hospital. The next day at its annual meeting, the hospital association awarded her its 2002 Special Recognition Award for her lifelong dedication to the nursing profession and Our Lady of Lourdes.
Whoever said there's no such thing as a free lunch may have been right.
An offer of a free meal at some local restaurants to any patient who isn't seen by a physician or nurse within 20 minutes of arrival at the emergency room at 170-bed Deaconess Hospital in Cincinnati has gone uncollected in the two years since it was first made, the hospital reports.
Deaconess is one of a growing number of hospitals promoting service-based treatment guarantees in emergency rooms. Although the lunch offer has been good for a while, the hospital only started marketing it April 5, through billboards and mailers to residents in its core market area, says Barbara Lohr, corporate director of marketing and communications. Lohr said the ER has offered the "Ready Bed Admit" free lunch for two years, but the hospital just began marketing it publicly.
"It's not really something new; it's just the promotion is something new. It made sense to us to serve the community this way. We have not had to give away one gift certificate yet," says Lohr, who pointed out that Deaconess' ER recorded 10,000 patient visits in 2001.
If patients qualify for the free lunches, they have a choice between two popular Mexican and Italian eateries. "It's not as if we're offering cafeteria food," she says. "These are popular local restaurants."
Deaconess, an independent community hospital founded in 1888 by an order of German nuns, said the hospital can make the offer because it specializes in cardiac care, orthopedics and geriatric psychiatric care. Hence, its emergency room usually doesn't get jammed with throngs of obstetric and pediatric patients.
"Hospitals rarely purchased selected medical devices from small manufacturers."-A study by the General Accounting Office, Group Purchasing Organizations: Pilot Study Suggests Large Buying Groups Do Not Always Offer Hospitals Lower Prices.
A question for the GAO: Isn't that why the manufacturers are small?