Hospitals // Current

How did Americans end up with a system in which employers pay for our health insurance?

Accidents Of History Created U.S. Health System

If you want to understand how to fix today's health insurance system, you'd be smart to look first at how it was born. How did Americans end up with a system in which employers pay for our health insurance? After all, they don't pay for our groceries or our gas.

It turns out there never was any central logic at work. The evolution of the American health care system began in the 1920s, when choices boiled down to which crazy cure you preferred.

Dr. John Brinkley, for instance, was a huge hit in American radio with his health advice shows. For whatever problem folks had, Brinkley had one fabulous solution: transplant a goat gland into your body. He pitched it as being perfect for everything from dementia to impotence to flatulence. But if, somehow, a goat gland didn't cure your ills, you could always use Bonnore's Electro Magnetic Bathing Fluid or Clark Stanley's Snake Oil Liniment.

Before the birth of modern medicine, hospitals were poorhouses where the indigent went to die. Then came the advent of effective medicines, especially antibiotics, along with a revolution in medical schools.

Suddenly, says economic historian Melissa Thomasson, "hospitals are marketing themselves as places to have babies." The professor at the Miami University in Ohio says that in the early part of the 20th century, hospitals were able to focus on happy outcomes.

Health care became much more effective, and much more expensive. Clean hospitals, educated doctors and real pharmacological research cost money. People proved willing to pay for care when they were really sick, but it wasn't yet common to go for checkups or survivable illnesses.

By the late 1920s, hospitals noticed most of their beds were going empty every night. They wanted to get people who weren't deathly ill to start coming in.

"The war economy is an entirely different ballgame," Thomasson says. The government rationed goods even as factories ramped up production and needed to attract workers. Factory owners needed a way to lure employees. She explains that the owners turned to fringe benefits, offering more and more generous health plans.

The next big step in the evolution of health care was also an accident. In 1943, the Internal Revenue Service ruled that employer-based health care should be tax free. A second law, in 1954, made the tax advantages even more attractive.

Thomasson cites the huge impact of those measures on plan participation. "You start from 9 percent of the population in 1940 to 63 percent in 1953," she says. "Everybody starts getting in on it. It just grows by gangbusters. By the 1960s, 70 percent [of the population] is covered by some kind of private, voluntary health insurance plan."

Thus employer-based insurance, which started with Blue Cross selling coverage to Texas teachers and spread because of government price controls and tax breaks, became our system. By the mid-1960s, Thomasson says, Americans started to see that system — in which people with good jobs get health care through work and almost everyone else looks to government — as if it were the natural order of things.

But to Thomasson and other economic historians, there's nothing natural or inevitable about it. Instead, they see it as the profound result of historical accidents.Accidents Of History Created U.S. Health System If you want to understand how to... more

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Hospital worker may have exposed patients to hepatitis

A former hospital employee may have exposed hundreds, or even thousands, of surgical patients to hepatitis C after taking their fentanyl injections and replacing them with used syringes filled with saline solution, authorities say. Kristen Diane Parker, who worked at Rose Medical Center in Denver, has admitted to secretly injecting herself in a bathroom and using unclean syringes as replacements for patients, investigators say.

She had hepatitis C, which she believes she contracted through using heroin and sharing dirty needles while she lived in New Jersey in 2008, authorities say.

She was a surgical technician at Rose from October 2008 to April 2009.

Nine patients who had surgery there during that time have tested positive for hepatitis C. Investigators are looking into whether they contracted the virus from Parker.

According to an affidavit filed by an investigator with the Food and Drug Administration, Rose Medical Center knew Parker tested positive for hepatitis C. She was counseled on how to limit her exposure to patients.

Parker quit after she was found in an operating room where she was not allowed to be. She subsequently tested positive for fentanyl. Hospital officials then contacted the DEA. Parker is in federal custody facing three drug-related charges. If she is found to have done serious harm to a patient, she could face up to 20 years in prison. If a patient dies due to her actions, she could face life in prison.

In a statement to police, Parker said, "I can't take back what I did, but I will have to live with it for the rest of my life, and so does everyone else."

Her attorney could not be reached Friday.

Rose Medical Center is contacting 4,700 patients who had surgery at Rose during the time Parker was employed there. However, hospital officials do not believe that that many patients were exposed.

"We are taking a very conservative and cautious approach by contacting everyone who had surgery during this broad time period," a statement on the hospital's Web site states. "It is likely that most of the patients who receive letters will not have been exposed to hepatitis C."

Another 1,200 patients may have been infected between May 4, 2009, and July 1, 2009, when Parker worked at Audubon Ambulatory Surgical Center in Colorado Springs. Audubon is also contacting patients.

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More mistakes uncovered at V.A. Hospitals.

For patients with prostate cancer, it is a common surgical procedure: a doctor implants dozens of radioactive seeds to attack the disease. But when Dr. Gary D. Kao treated one patient at the veterans’ hospital in Philadelphia, his aim was more than a little off.

Most of the seeds, 40 in all, landed in the patient’s healthy bladder, not the prostate.

It was a serious mistake, and under federal rules, regulators investigated. But Dr. Kao, with their consent, made his mistake all but disappear.

He simply rewrote his surgical plan to match the number of seeds in the prostate, investigators said.

The revision may have made Dr. Kao look better, but it did nothing for the patient, who had to undergo a second implant. It failed, too, resulting in an unintended dose to the rectum. Regulators knew nothing of this second mistake because no one reported it.

Two years later, in 2005, Dr. Kao rewrote another surgical plan after putting half the seeds in the wrong organ. Once again, regulators did not object.

Had the government responded more aggressively, it might have uncovered a rogue cancer unit at the hospital, one that operated with virtually no outside scrutiny and botched 92 of 116 cancer treatments over a span of more than six years — and then kept quiet about it, according to interviews with investigators, government officials and public records.

The team continued implants for a year even though the equipment that measured whether patients received the proper radiation dose was broken. The radiation safety committee at the Veterans Affairs hospital knew of this problem but took no action, records show.

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tagged w/ Hospitals

How did Americans end up with a system in which employers pay for our health insurance?

DAMN! This Man Weighs 980 lbs And They Can't Move Him

The OxyContin Express

LA hospital: Error caused 206 radiation overdoses

Fujitsu develops autonomous gofer robot for the office

Supreme Court Justice Ginsburg Hospitalized

Hyerconcious Hypochondriasis

Blind woman can see after tooth is implanted in her eyeball

Women goes ablaze during surgery...later dies.

Illinois Woman Dies After Catching Fire During Surgery

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