Wednesday, February 28, 2007

NOLA Euthanasia Case; AAHPM Position Statements; Stock Analysis of Hospice

Early this week I was getting really bummed because I was thinking I had nothing to write about for Pallimed, and then BOOM! it all came at me at once. Enjoy!

1) The NOLA case against a physician (Dr. Anna Pou) and 2 nurses (Lori Budo and Cheri Landry) being charged with murder/euthanasia is currently getting ready to go to the Grand Jury investigation. The jury was selected but the trial was delayed by Mardi Gras. (Seriously.)

Interestingly the coroner submitted the deaths as 'undetermined' early in February, and said there was not enough evidence for homicide after consulting with leading forensics experts. Apparently this has not deterred the District Attorney, and the Grand Jury will proceed.

One connection to a previous Pallimed post was that there was an outcry by supporters of Pou, Budo, and Landry before the airing of the Boston Legal episode. They felt that since the doctor to be found guilty (based on leaked information, sorry to give the ending away), and the trial had not started yet, that it would unfairly influence the public.

Wish I could show you some key scenes from the show, but all I could find was this promo clip. I had it on DVR but it got erased somehow, so now I cannot invite all of you to my house.

2) KPBS in San Diego headlined an article with:

Leading Hospice Organization Drops Opposition to Doctor-Assisted Suicide.

Pretty shocking headline. Let's read a little bit further. What the AAHPM (the organization) did was take a position of neutrality. Which is technically 'dropping opposition', but basically the statement moves to at least support health care providers in states where physician-assisted death* is legal (Oregon only, although multiple other states have tried and failed). With headlines like this, and knowing that few people actually
read the article, I wonder how this play when it hits more papers, and talk show radio? I encourage all members of the field to read the AAHPM statements as they are well written and have been re-vamped in the past few weeks.

*the AAHPM's choice of terms for more neutrality...although it does make the distinction between euthanasia and physician assisted suicide more murky, a point we have belabored here before. And interestingly the link to the physician-assisted death position statement is to 'suicide.html' (I feel like such a sleuth!)

3) I get some pretty interesting searches when I look for materials for the blog, but business and economics hits for 'hospice' are pretty rare. But I found this very interesting stock market analysis of Chemed the parent company of VITAS and Rotorooter** (thus the Chem I presume?). No plan to debate the for-profit versus non-for-profit here, but it does make for interesting reading.


Some of the more interesting quotes (I don't read business-ese, but they sound pretty bullish on hospice & palliative medicine, kind of like us here at Pallimed):

While the relatively low absolute capital requirements represent a low barrier to entry, the regulatory complexity associated with establishing a Medicare-licensed hospice location remains a significant barrier.
AND also...
This industry has benefited in the last few years from favorable demographic trends and expanded Medicare reimbursements. There have been several notable disasters in this industry recently (ironically, due to issues with Medicare reimbursements). However, a favorable pricing environment, with tiered benefit plans and double-digit premium increases, coupled with stable inflation, should result in estimated earnings growth of 15% to 20% for the industry over the medium term. Medical care organizations will benefit from continued volume growth, innovative plans designed to moderate cost increases (along with higher consumer co-payments), better claims handling (leading to improved reimbursements from insurers), and expanded Medicare coverage and reimbursements.
I guess no one told them Bush is planning to cut Hospice Medicare Reimbursements.

** Super side note and obscure reference here (thanks Wikipedia!): From the show Futurama, a ad jingle: "Call robo-rooter if you flush a towel. We can also help with that impacted bowel."

4) Some short entries:

Business and HPM again: The folks at the Freakonomics Blog (Very interesting read by the way) actually posted about the JAMA Grief article we just posted about here.

HospiceGuy with some great posts! If you have not been reading HospiceBlog by Hospice Guy, he is making some great posts over there. Especially his very interesting and well written take on different payment levels for home hospice versus nursing home hospice.

Hospice and the lottery. An interesting way to fund hospice programs in the UK. Hope it does not come to that here in the US.

I got a Drew style heavy duty analysis post coming up by the end of this week, for those who read Pallimed for the articles.

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