Thursday, April 15, 2010

It Came From Below

Beneath Iceland's Eyjafjallajokull glacier, a huge volcanic eruption is belching smoke, gas, and ash into the sky creating large no-fly zone over parts of northern Europe that could continue for months. Two centuries ago, the same volcano erupted continuously for six months. There's no way to predict how long the volcano will spew gas and ash into the atmosphere.

The exceptionally explosive eruption was because the volcano lies under the glacier. When the super heated gasses and lava hit the glacier, the ice immediately and explosively vaporized blasting tons of rocks and fine mineral ash into the sky. When this material is sucked into jet engines, the engines clog and freeze-up, the airplane falls from the sky, and that's not good.

You Tube

In the distant future, we will be able to predict volcanic eruption and mitigate against the damaging effects. And Iceland will give pronounceable names to their glaciers, too.

The life of Indigo Red is full of adventure. Tune in next time for the Further Adventures of Indigo Red.

It Came From Above

Glowing green and travelling 100,000 mph, a large meteor streaked across the Midwest US sky Wednesday night around 10:15pm. The fireball that turned night into day in Wisconsin, Iowa,Illinois. and Missouri may have been as large as 6 feet wide, weighing about 1000 pounds was accompanied by a sonic boom heard for hundreds of miles.

You Tube
Read more National Geographic.

The life of Indigo Red is full of adventure. Tune in next time for the Further Adventures of Indigo Red.

Monday, April 12, 2010

Study Charges "Physician Induced Demand"

As bad as the closing of sixty physician-owned hospitals may be, there is some justifiable cause for concern. Medical News Today reports on a study of Florida "surgicenters" indicating "physician induced demand" of certain procedures over other procedures with lower "incentives".

Physician-Ownership Of Ambulatory Surgery Centers Linked To Higher Volume Of Surgeries -

The authors analyzed data from Florida, using the Healthcare Cost and Utilization Project's State Ambulatory Surgery Databases, revealing "a significant association between physician-ownership of surgicenters and greater use" of certain outpatient procedures. And, the "data reveal that the acquisition of ownership status coincided with significant increases in a physician's use of carpal tunnel release, cataract excision, colonoscopy, and knee arthroscopy," the authors report.

"If our observed trends do reflect physician-induced demand, then possible remedies include revising current federal law to require public disclosure of investment arrangements or barring surgicenter ownership by small groups of physicians, for whom incentives are greatest," the authors write (Hollingsworth, Ye, Strope, Krein and Hollenbeck, April 2010).
Health Affairs
There is definitely a problem here if it can be conclusively shown doctors are favoring increased profits over patient care, which is a charge made by supporters of government controlled health care, Obamacare. However, if the physician-owned facilities are providing the best care the patient requires as opposed to whatever care private or government insurance is willing to pay for, then I don't see any problem with doctors preferring one procedure over another or one facility over another. And to keep the services within a circle of like-minded providers is not uncommon in any activity so long as it is not done to the detriment of the patients physical or financial well being.

The life of Indigo Red is full of adventure. Tune in next time for the Further Adventures of Indigo Red.

Obamacare Cancels Over Sixty New Hospitals released the following story earlier today to which Drudge Report linked causing the CNS server to crash leaving the message, "Server is too busy". Fortunately, bloggers caught the story beforehand and made it available. This from Bride of Rove:

REPORT: 60 Hospitals Cancelled Due to New Health Law… Quote
Health Law Bans New Doctor-Owned Hospitals, Blocks Expansion of Existing Ones
Monday, April 12, 2010
By Fred Lucas, Staff Writer

( – The new health care overhaul law – that promised increased access and efficiency in health care – will prevent doctor-owned hospitals from adding more rooms and more beds.

These hospitals are advertised as less bureaucratic and more focused on doctor-patient decision making. However, larger corporate hospitals say doctor-owned facilities discriminate in favor of high-income patients and refer business to themselves.

The new rules single out physician-owned hospitals, making new physician-owned projects ineligible to receive payments for Medicare and Medicaid patients.

Existing doctor-owned hospitals will be grandfathered in to get government funds for patients but must seek permission from the Department of Health and Human Services to expand.

The get the department’s permission, a doctor-owned hospital must be in a county where population growth is 150 percent of the population growth of the state in the last five years; impatient admissions must be equal to all hospitals located in the county; the bed occupancy rate must not be greater than the state average, and it must be located in a state where hospital bed capacity is less than the national average.

These rules are under Title VI, Section 6001 of the Patient Protection and Affordable Care Act. The provision is titled “Physician Ownership and Other Transparency – Limitations on Medicare Exceptions to the Prohibition on Certain Physician Referral for Hospitals.”

More than 60 doctor-owned hospitals across the country that were in the development stage will be canceled, said Molly Sandvig, executive director of Physician Hospitals of America (PHA).

“That’s a lot of access to communities that will be denied,” Sandvig told “The existing hospitals are greatly affected. They can’t grow. They can’t add beds. They can’t add rooms. Basically, it stifles their ability to change and meet market needs. This is really an unfortunate thing as well, because we are talking about some of the best hospitals in the country.”

The organization says physician-owned hospitals have higher patient satisfaction, greater control over medical decisions for patients and doctor, better quality care and lower costs. Further, physician-owned hospitals have an average 4-1 patient-to-nurse ratio, compared to the national average of 8-1 for general hospitals.

Further, these 260 doctor-owned hospitals in 38 states provide 55,000 jobs, $2.4 billion in payroll and pay $509 million in federal taxes, according to the PHA.

In one ironic aspect, President Barack Obama’s two largest legislative achievements clashed. The Hammond Community Hospital in North Hammond, Ind., got $7 million in bond money from the federal stimulus act in 2009. It will likely be scrapped because of the new rules on physician-owned hospitals, according to the Post-Tribune newspaper in Merrillville, Ind.

These hospitals have long been a target of the American Hospital Association, which represents corporate-owned hospitals as well as non-profit hospitals.

An AHA study from 2008 says that physician-owned hospitals “lessen patient access to emergency and trauma case;” “damage the financial health of full-service hospitals and lead to cutbacks in service;” “are not more efficient than full service community hospitals;” “use physician-owners to steer patients;” “cherry pick the most profitable patients;” and “provide limited or no emergency services.”

Meanwhile, one AHA fact sheet asserts that physician-owned orthopedic and surgical hospitals costs are 20 percent to 30 percent higher than average hospitals. Further, these hospitals just lead to higher profits for doctors, the AHA asserts.

“We don’t cherry pick patients, period, end of story. We take patients based on their need for care, not on their ability to pay,” Sandvig said. “It [the health care reform] puts control outside the hand of physicians and patients and into bureaucrats’ hands really.

The Association of American Physicians and Surgeons (AAPS) is one of many organizations suing to have the law declared unconstitutional on the grounds that the federal government cannot compel someone to buy a product.

While the provision on physician hospitals is not part of the lawsuit, it will affect it, Dr. said Jane Orient, AAPS executive director.

“If the law is declared unconstitutional, then the prohibition is part of the bill,” Orient told “There are vested interests in getting rid of physician-owned hospitals because they do a better job and are more affordable.”

The provision in the legislation and efforts opposing these hospitals can be simply explained from Sandvig’s view.

“It’s anti-competitive. I think it’s pretty clear,” Sandvig said. “We’re a model that makes sense that’s affecting innovation. We’re trying to do something better than it has been done. Anytime you do that, there’s going to be a clash between the existing and the new. Unfortunately, it’s a real David and Goliath battle.” – Health Law Bans New Doctor-Owned Hospitals, Blocks Expansion of Existing Ones

Not sure how this expands health care access to more Americans, but scarcity of service most certainly drives up costs.

The life of Indigo Red is full of adventure. Tune in next time for the Further Adventures of Indigo Red.