Supreme Court Oral Arguments on the Constitutionality of the Affordable Care Act Set to Begin on March 26th

The much anticipated Supreme Court oral arguments on the Affordable Care Act are set to begin on Monday, March 26th.  The first day of arguments is set to cover whether the court can even decide on the Constitutionality of the Affordable Care Act this year, or if it must wait until the law actually takes effect in 2014.  The oral arguments on March 26th will cover the individual mandate, whether Congress can require individuals to purchase insurance and whether they can impose a penalty on those that do not purchase health insurance.  The last day of oral arguments is on March 27th and will cover the issue of if the Court does strike down the individual mandate, does it strike down the entire Affordable Care Act.  On the last day, they will also address whether expansion of the Medicaid program under the Affordable Care Act will encroach on the rights of the States.

It will be very interesting to see the arguments unfold.  Although the arguments will be completed this week, a decision from the Court won't be made until sometime this summer.

House of Representatives Passes Bill that Would Create National Medical Liability Reform

Today, with a vote of  223-181,  the Republican controlled House of Representatives passed what could be national medical liability reform, or what some call "Tort Reform."  The bill places a $250,000 cap on non-economic damages (pain and suffering), caps punitive damages at $250,000 or two times economic damages, sets a statute of limitations at 3 years.  These reforms would be similar to those regulations already in place in Texas and California. 

Proponents of national Tort Reform should not start celebrating yet.  Most believe it is unlikely that this bill will be passed in the Democratic controlled Senate.

I will be keeping a close eye on this topic and will update the blog with the latest developments.

Doctors Believe that Use of mHealth Technology by Patients with Chronic Medical Conditions may Reduce Clinic Visits

A few months ago I wrote a blog article about mHealth technology.  mHealth, or mobile health, is a method of enhancing health and medical practices with mobile technology.  This is technology that is used by both doctors and patients.  This area of technology is growing rapidly.  Apple currently has over 10,000 medical/health care related apps  (last year they only had about 1,500).

A recent study shows that physicians believe that as patients start to use mHealth technology that helps them monitor their medical conditions at home, for example, monitoring blood sugar or blood pressure, it may help reduce the number of clinic visits.

Bailey, R. mHealth: A Descriptive Analysis of the Technology that is Changing the Practice of Medicine, What’s Up in Emergency Medicine, February 2011, http://www.emra.org/emra_articles.aspx?id=43536

Murphy, S.  Doctors Believe Using Health Apps Will Cut Down on Visits, Mashable Tech, March 2012, http://mashable.com/2012/03/12/mobile-health/

Medicaid Beneficiaries have more Barriers to Obtaining Primary Care and are More Likely to Make ER Visits than those Individuals with Private Insurance

As the different phases of health care reform are implemented over the next few years, it is anticipated that more people will obtain access to health care in the United States than ever before.  A large number of these individuals will obtain health care through the current Medicaid program.  However, there are many concerns about how these individuals will be able to obtain timely access to care and how it will affect the overall health care system. 

A study recently published in the Annals of Emergency Medicine reports that compared with individuals with private insurance, individuals with Medicaid are more likely to have one or more barriers to obtaining medical care from primary care doctors and end up making more visits to Emergency Rooms for their primary care needs.  They identified 5 barriers that these individuals face:  (unable to get through on the telephone, unable to obtain a timely appointment, long wait in the physician’s office, limited office hours, and lack of transportation).

Some of the solutions the authors offer are to, increase the number of primary care doctors, as well as increase the number and hours of Community Health Centers.  This would aid to increased primary care access for these individuals rather than them having to go the ER.  This also may aid in slowing the current problem of ER overcrowding.

This issue is especially important in states like Washington where there is currently a consideration of not paying for non-emergent medical visits made by Medicaid beneficiaries.  I agree with the authors of this article.  There is definitely a huge need for the increase in the number of primary care doctors and a huge need for the increase of clinics and increase in their hours of operation.  These solutions may aid in reducing the number of primary care visits made in the Emergency Room.

The full article can be found here:

Cheung, PT et. al, National Study of Barriers to Timely Primary Care and Emergency Department Utilization Among Medicaid Beneficiaries, Annals of Emergency Medicine 2012; 20 (1) 1-9;  http://www.annemergmed.com/webfiles/images/journals/ymem/FA-PTCheung.pdf

Secret Recording Held Admissible in a Medical Malpractice Lawsuit

A court in Ohio recently held that a secretly recorded conversation made by relatives of a patient and a physician can be admissible in a medical malpractice, wrongful death case against the physician.  In this case the patient had cardiac arrest and was declared brain dead two days after knee surgery.   It was later determined that the cardiac arrest was caused by a high potassium level. The family of the patient met with the Chief Medical Officer of the hospital after the patient arrested, but prior to his death.  The doctor was apologetic and admitted fault on the part of the hospital. 

In some states, like Ohio, it is legal for one person to record a conversation without the other party’s knowledge.  If physicians are concerned that their conversations are being recorded without their wishes, they can create a no recording policy and visibly post the policy in their office or hospital.