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R. Lewis Dark: Judicial Earthquake Shakes Canada's Health System
IT'S BEEN CALLED A"BOMBSHELL SUPREME COURT RULING" by no less than the Wall Street Journal. On June 9, 2005, the Supreme Court of Canada ruled that the province of Quebec cannot prevent individuals from purchasing
private health insurance policies for healthcare procedures covered
under the Canadian health plan, called medicare.
The case started in 1997 when Quebec resident George Zeliotis learned he would have to wait a full year for a hip replacement, despite
his painful arthritic condition. His anger increased when he next learned
that it was against the law for him to privately pay for his hip replacement.
In collaboration with his physician, Jaques Chaoulli, the two filed
a lawsuit. They had lost in two provincial courts before prevailing in the
Supreme Court review of their case.
It is expected that this Canadian Supreme Court Ruling will open the
door for private health insurance to be sold as an adjunct to the government
health system. One consumer advocate noted that wait times are
much shorter in many European countries where a private health system
is allowed to operate alongside the government health system.
In an editorial, the Wall Street Journal observed that:
The larger lesson here is that healthcare is not immune from the laws of
economics. Politicians can't wave a wand and provide equal coverage for all
merely by declaring medical care to be a ‘right,' in the word that is currently
popular on the American Left.
There are only two ways to allocate any good or service: through prices, as is
done in a market economy, or lines dictated by government, as in Canada's system.
The socialist claim is that a single-payer system is more equal than one based on
prices [our italics], but last week's court decision reveals that as an illusion. Or, to
put it another way, Canadian healthcare is equal only in its shared scarcity.
Thoughtful lab executives and pathologists should consider these
words as they watch political forces battle in Washington over both the
design and funding of federal healthcare programs. Most health professionals
I know recognize that the manner in which elected officials and
bureaucrats handle the Medicare and Medicaid programs has done much
to erode the quality of healthcare services in the United States during the
past two decades. More market discipline in the U.S. healthcare system
would be quite beneficial to physicians and patients alike.
DOJ Sends Subpoenas To Quest & LabCorp
Unexpected development raises questions as to what lab business practice is of interest
CEO SUMMARY: In Newark, New Jersey, the Office of the U.S.
Attorney served subpoenas to each of the two blood brothers,
seeking information on"capitation and risk-sharing arrangements
with government and private payers for the years 1993
through 1999." At this point, little is known or understood
about the interest and motives of federal prosecutors in
researching this aspect of laboratory business practices.
Crime In the Lab Industry:
A Poor Track Record
Since 1990, almost 20% of public lab firms had
a CEO indicted or convicted of federal crimes
CEO SUMMARY: In a remarkable finding, THE DARK REPORT
demonstrates how 17.5% of the public laboratory companies
in operation since 1990 have had an existing or former CEO
indicted for federal crimes! This is a powerful statement
about business practices in the laboratory industry and the
allure of"skirting" the full intent and meaning of federal laws
governing the Medicare and Medicaid programs.
Phlebotomists in California Undergoing Certification
Get ready for new professional acronyms; CPT 1, CPT 2, LPT to be in lab lexicon
CEO SUMMARY: State certification of phlebotomists is
under way in the Golden State. By April 9, 2006, all plebotomists
in California will need to maintain state certification.
This development adds complexity to laboratory management
in California. However, there are no signs that
other states intend to follow California's lead in requiring
certification of phlebotomists.
Compliance Update: National HIPAA Conference Overlooks Patient ID Theft
Patient ABNs Can Save
On Expensive Send-outs
Detroit hospital lab develops a way
to minimize budget-busting test costs
CEO SUMMARY: Throughout the United States, the growing
number of high-priced, patent-protected specialty tests is
eating into the laboratory budgets of many hospitals. At
Hospital Consolidated Laboratories in Southfield, Michigan,
this budget-busting threat triggered an innovative
response. Now the lab uses ABNs to alert patients that they
will be personally responsible to pay for such tests.
Coding Update: Problems with ICD-9 Codes
Contribute to Coder Shortage
Slow progress toward U.S. adoption of ICD-10,
More providers are outsourcing coding
Unique Solution to Control
Reagents, Other Supplies
Innovative use of pharmacy automation
to store and manage laboratory reagents
CEO SUMMARY: This San Francisco hospital laboratory hit a
home run with its clever use of automated materials management
units, originally used in pharmacies. Reagents, phlebotomy supplies,
and other laboratory consumables are stored in an accesscontrolled
environment. Benefits have been significant reduction
in reagent and other lab supply costs, fewer stock-outs, and
reduced loss from unused lab supplies with expired dates.
INTELLIGENCE:
HMO RATE INCREASES EASE FOR 2006,STILL IN DOUBLE DIGITS
HUMAN STEM CELLS CREATE BLOOD CELLS
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