Saturday, July 27, 2013

Woman with 'shy bladder' syndrome sues Iowa hospital

Woman with 'shy bladder' syndrome sues Iowa hospital
April 28, 2013
Associated Press

DES MOINES, Iowa – A woman who sought a job as an administrator at Iowa Methodist Medical Center is now suing the hospital, saying it failed to make accommodations for her shy bladder syndrome.

Jennifer Conner, who graduated from Des Moines University in May 2012 with a master's degree in health care administration, applied for a job as an organ transplant financial coordinator with the hospital, the Des Moines Register reported. Her lawsuit says she was offered the job June 22, with the stipulation that she take and pass a drug test.

Conner was diagnosed in her teens with the anxiety condition paruresis, or shy bladder syndrome, that leaves her unable to urinate in public restrooms or near other people.

Conner's lawsuit says she has managed the condition by running water or flushing a toilet in public restrooms to help mask the sound of her urination.

But when she reported to the hospital's designated facility for a drug test, she was put in a room with no running water and asked to provide a urine sample, according to her lawsuit. Nurses at the facility increased her anxiety by knocking on the door seeking her urine sample, she said.

Conner's lawsuit says she asked the facility and Iowa Methodist officials to make other arrangements for her, including taking a blood-based drug test or using a catheter to extract urine, and offered to pay the cost of such accommodations. They refused. Iowa Methodist officials told her she had until the end of the day to produce a urine sample at the facility or she would be considered as having failed the test.

Shy bladder syndrome is considered a disability under the federal Americans with Disabilities Act, said Tom Foley, Conner's attorney.

A spokeswoman for UnityPoint, the health system that oversees Iowa Methodist, declined to comment to The Des Moines Register.

Conner's lawsuit asks the court to issue an order to keep Iowa Methodist from discriminating against those with disabilities. She is also seeking an unspecified amount in damages, including those for lost wages and benefits, attorneys' fees, emotional distress and pain and suffering.

Infection Ate Shoulder, Kaiser Patient Claims

Infection Ate Shoulder, Kaiser Patient Claims
Courthouse News Service
July 25, 2013

ANNAPOLIS, Md. (CN) - Kaiser's failure to diagnose and treat a woman's oozing bone infection resulted in part of her shoulder being eaten away, she claims in Anne Arundel County Circuit Court. Billie Jo and Ron Bonolis have sued Kaiser Foundation Health Plan of the Mid-Atlantic States Inc. and Mid-Atlantic Permanente Medical Group for malpractice and loss of consortium.

After Mrs. Bonolis had shoulder surgery, her Kaiser doctor thought she had an infection of the shoulder tissue for five months, when it actually was osteomyelitis, a bone infection, her complaint says. Within a month of the surgery, an MRI report suggested that the problem may be osteomyelitis, but no further testing was done, according to the complaint.

Three months after the surgery, and after several courses of antibiotics and attempts to clean out the surgical area, an infection consultant reported that a piece of bone used as an "anchor" during the surgery, was positive for MRSA, a "superbug" resistant to antibiotics, according to the complaint.

The infection had gone so long unchecked that it had eaten away the humoral head (the ball in the socket), and her new doctor was unable to estimate how many surgeries it would take to get rid of the painful infection, according to the complaint.

Once more of the bone had been removed to get rid of the infection, and Mrs. Bonolis was able to have her shoulder replaced, she went through a painful recovery and has suffered great mental anguish, in part due to knowing that she could have died from a superbug infection.

Mrs. Bonolis has a limited range of motion in her dominant arm and is no longer able to write normally, crochet, swim or take care of her grandchildren, among other things. Also, she needs help with personal hygiene, such as washing and combing her hair.

The new doctor told her it is unlikely that she will ever have full use of the right shoulder, the complaint says.

Roy L. Mason represents the plaintiffs, who are seeking $75,000.

Monday, July 22, 2013

Kaiser's Obamacare rates surprise analysts

Kaiser's Obamacare rates surprise analysts
Kaiser Permanente has offered some of the highest rates in the California health exchanges next year. It denies that it is doing so to avoid treating many of the sickest newly insured patients.
By Chad Terhune
Los Angeles Times
June 12, 2013

Despite its higher rates, Kaiser Permanente said it wants to enroll a large number of people in the state exchange.

In California's new state-run health insurance market, Kaiser Permanente will cost you.

The healthcare giant has the highest rates in Southern California and some other areas of the state, surpassing rivals such as Anthem Blue Cross and other smaller competitors. The relatively high premiums from such a strong supporter of the federal healthcare law surprised industry analysts, and it has sparked considerable debate about the company's motives.

Some experts say Kaiser intentionally bid high to avoid drawing too many customers next year who are sick or who have been uninsured for years and may be costlier to treat. Others suspect Kaiser was worried that lower premiums would bring an influx of newly insured patients that could overwhelm its in-house roster of doctors and hospitals.

Making health insurance affordable is a crucial factor in the expansion of coverage to an estimated 5 million Californians — many of them lower-income and the uninsured — who will be eligible for a state-run exchange next year. Price will be paramount to many consumers, even for those who receive federal subsidies to help lower their costs.

In one key barometer of rates, Kaiser has the most expensive premiums for a 40-year-old in Los Angeles, Orange, San Bernardino and Riverside counties for a mid-level Silver plan. Statewide, the nonprofit company has the highest or second-highest premiums for a Silver plan in 12 of the 18 regions where it's selling HMO policies in Covered California, the state market that opens for enrollment Oct. 1.

Kaiser's Silver plan premium for a 40-year-old in southern Los Angeles County is $325 per month, 34% higher than the cheapest policy in the area, from Health Net Inc., at $242.

"Kaiser is not as low cost as many people think," said Glenn Melnick, a USC health policy professor. "They appear to be protecting themselves because the people signing up in the first year are likely to be the sickest ones."

For its part, Kaiser says it was as surprised as others were when the state announced the 13 winning health insurers and their proposed rates for 19 regions last month. These rates are scheduled to be finalized this month after a regulatory review. Individual premiums will vary based on people's age, location and family size.

Despite its higher rates, Kaiser said it wants to enroll a large number of people in the state exchange. It blamed its lackluster showing, in part, on rivals offering cheaper plans that give consumers far less choice of doctors and hospitals.

Blue Shield of California, for instance, is offering 36% of its physician network in Covered California plans.

"We were surprised to see some of the rates," said Bill Wehrle, Kaiser's vice president of health insurance exchanges. "We were surprised at what looked like very narrow networks from our competitors. We don't cut off any slice of our network."

Of course, for years Kaiser has served as a model for the limited networks other insurers are now rushing to adopt. Kaiser is a unique healthcare system because it operates its own hospitals, physician offices and insurance company for its 9 million members nationwide.

"Blue Shield or Anthem could be a little more selective in putting together a network for this new market. Kaiser is one size fits all," said Marian Mulkey, director of the health reform and public programs initiative at the California HealthCare Foundation. "The question now is will people find Kaiser attractive enough compared to their other options. This could put pressure on Kaiser to be less expensive."

Overall, Kaiser is the state's biggest health insurer with a 40% share of the market, according to 2011 data from Citigroup. Anthem Blue Cross, a unit of industry giant WellPoint Inc., was second with a 23% share of employer and individual customers.

More than 5 million Californians who don't get insurance through work are expected to participate in the state's new market. About half of those people will qualify for federal premium subsidies because they are low or moderate income.

Individuals earning up to about $46,000 a year and families making $94,000 or less will qualify for government help with their premiums. Even with that financial boost, however, most consumers are expected to look for the cheapest plans available.

"I think the lowest and second-lowest plans will really be attractive," said Lucien Wulsin, executive director of the Insure the Uninsured Project, a nonprofit research group in Santa Monica. "I'm sure being at the low end of the spectrum puts you more on the receiving end of everybody."

One of the bigger unknowns in the federal healthcare expansion is how many people will sign up initially and who will they be. Patients with preexisting medical conditions or chronic illnesses who have been denied insurance for years should be eager to enroll. Younger, healthier people may not see much reason to buy, content instead to pay a modest penalty.

Starting in January, most Americans must have health insurance or pay a fine. The penalty starts at $95 per adult or 1% of income, whichever is greater. The penalties increase over time.

"Kaiser has structured this so they don't get a lot of the poorer and potentially sicker people," said Steve Valentine, president of the Camden Group, an El Segundo healthcare consulting firm.

"Some people have been unemployed and underemployed for years, and they may have a lot of healthcare needs. There could be a lot of pent-up demand, and Kaiser may be trying to dodge that bullet," Valentine said.

For years, some consumer advocates have faulted Kaiser for not doing more for the state's poorest residents on Medi-Cal, the state Medicaid program, and for building many of its hospitals and medical offices in more affluent areas.

Kaiser defends its record of charity care and denies any effort to duck certain customers. Last year, the Oakland company said it provided care to more than 560,000 Californians enrolled in Medi-Cal and other safety-net programs.

"There is a lot of uncertainty about whether the healthy show up as well as the sick," Wehrle said. "We are very competitive on rates in some regions, which is a pretty strong indication we are not trying to avoid anything. There is no question we want to grow in the exchange, and I think we will."

Mulkey of the California HealthCare Foundation said Kaiser has regretted being the low-cost option at times in the past and being overrun by too many members at one time. Other insurers may have more flexibility to add doctors and hospitals to their network as enrollment builds.

Kaiser, on the other hand, could face the costly decision to contract with outside hospitals to absorb some of its overflow.

"We are focused on sustainable prices for the long haul," Wehrle said. "If you make a large mistake in this environment, it can be hard to recover."

Saturday, July 20, 2013

Black Surgeon Wins $4.5 Million Settlement In Racial Bias Lawsuit

Black Surgeon Wins $4.5 Million Settlement In Racial Bias Lawsuit
Jul 19, 2013
By NewsOne Staff

Christian Head, a former surgeon at UCLA’s medical school, will receive a $4.5 million after settling a racial discrimination lawsuit against the University of California Board of Regents, the Los Angeles Times reports.

When Head, 51, filed the lawsuit in April, he accused the university of failing to prevent discrimination, harassment and retaliation against him after he used traditional channels to complain about racism he felt he experienced from his colleagues. The regents settled the lawsuit in a closed session Thursday.

Head alleged that he was routinely humiliated in public. During a meeting in 2006 with faculty, staff and graduating medical school residents, a slide show created by the residents — and typically reviewed by staff — was presented. In that presentation was a photo in which Head’s face was superimposed on a gorilla that was being sodomized by a department chairman, according to the lawsuit.

“The case presented difficult issues of alleged discrimination and retaliation that were strongly contested,” the university said in a statement. “…The matter was settled to the mutual satisfaction of the parties.”

Here is more from The Times:

Without admitting fault or liability, the university acknowledged that “an inappropriate slide was shown” and regrets the incident, the statement said.

Dr. Gerald Berke, chairman of the David Geffen School of Medicine‘s Department of Head and Neck Surgery, and Dr. Marilene Wang were named in the lawsuit and were accused of making “inappropriate racial comments and insinuations about blacks” and Head for years, the court document stated. Both are UCLA physicians and professors.

Neither Berke nor Wang could be reached for comment.

The settlement will be paid through a state general liability fund.

Head received his medical degree from Ohio State University in 1993. He joined UCLA’s medical school in 1993. He has resigned from his position. The Times was not able to reach Head for comment on the settlement.

Wednesday, July 17, 2013

Transgender teen settles with Kaiser Permanente in landmark health case

Kaiser Permanente's motive was simple: any excuse to save money. Kaiser has narrow treatment guidelines that harm patients, not infrequently causing death, but save a fortune. This is the reason Kaiser, a non-profit company, makes billions in profits each year. Kaiser then channels these untaxed profits into its for-profit Permanente companies.

Transgender teen settles landmark health case
Posted on 17 July 2013
By Katie Kerwin McCrimmon

FORT COLLINS — An 18-year-old college student who grew up as a girl and now identifies as a young man has settled a landmark civil rights case against Kaiser Permanente of Colorado.

In the rare case, the Colorado Civil Rights Commission found in March that there was probable cause that Miki Alexander Manigault suffered discrimination and unequal access to health care specifically because he is transgender. (Click here to read the determination of probable cause.)

On the same day, after pressure from advocates at One Colorado, Colorado’s Division of Insurance issued a bulletin and became the third state in the country to specifically bar health insurance companies from discriminating against people who are gay, lesbian, bisexual or transgender. (California and Oregon preceded Colorado. The District of Columbia also bans discrimination against LGBT patients and Vermont has since followed suit.)

Faced with charges of unequal treatment, Kaiser Permanente quietly settled Manigault’s case before it was slated to go to a hearing in June. Amy Whited, a spokeswoman for Kaiser Permanente, declined to discuss Manigault’s case. As a result of a settlement with the Civil Rights Commission, however, Kaiser, one of Colorado’s largest health insurance companies, has agreed to work with the commission to convene discussions among insurers regarding health care for transgender people.

Manigault’s case has already prompted at least one other complaint to the Civil Rights Commission and may open the doors for equal health care for LGBT patients in Colorado and elsewhere in the U.S. (Coming next week: read about Kelly Costello, another transgender person who has also filed a civil rights complaint.)

Manigault grew up as Michaela, a girl with irresistible Shirley Temple dimples who nonetheless loathed girly dresses. She has now evolved into Alex, a young man embracing the gender that he believes he was born with. It just never matched his body. Until now.

Alex finally had the chest reconstruction surgery that doctors deemed medically necessary but Kaiser previously failed to cover, according to the determination and complaint.

Alex and his family cannot discuss any details of his settlement with Kaiser. But the Colorado State University art major agreed to share his story of struggle and transformation.

Alex recently traveled to San Francisco to have an experienced surgeon remove his female breast tissue and sculpt a male chest.

They felt like tumors on my chest or phantom limbs,” Alex said of the female breasts, which he used to bind to try to flatten them.

He and his mom decided to bring the civil rights complaint and filed it in January of 2012, when Alex was just 17, because insurance companies provide all sorts of breast surgeries for other patients, including reconstruction for psychological well-being for cancer patients. It seemed fair to them that health insurance should also provide coverage that makes transgender people healthier.v “A lot of transgender people go through so much drama and so much heartache and waiting for years and sometimes decades to even talk about what it is they want and need,” said Alex. “When you can finally admit what you want and feel safe, then the insurance company tells you ‘No,’ and puts another obstacle in front of you, that’s wrong.

“I’m just as surprised as you that I’m transgender,” Alex says.

Alex credits his mom for being in his corner and pressing the case. Deborah Manigault is a civil rights law enforcement officer for the U.S. Department of Housing and Urban Development. So she knew how to file a civil rights complaint and felt it was clear that Alex deserved to win.

“These are not elective surgeries. They are medically necessary for their health, for their mental health and their medical well-being,” she said. “There are many insurance companies who are claiming to be LGBT-friendly, but they are denying coverage based on transgender status.” Alex has not decided how to proceed with what transgender people call bottom surgery. Many transgender people evolving from female to male don’t bother seeking a surgically created penis since the options are poor. Results are much better for males becoming female because an experienced surgeon can essentially tuck the penis into the body and retain sensation. Alex has been taking testosterone injections since his junior year of high school, so his voice is now deep and body hair has sprouted on his stomach and will fill his chest once it fully heals. Now a sophomore in college, he still thinks he looks somewhat feminine because of a long, graceful neck and fine cheekbones that any model would envy. But the testosterone he must inject every two weeks literally empowers him as it bulks up his muscles. In contrast to the famous “It Gets Better” campaign, Alex says it doesn’t get better overnight. Still, he is no longer hiding from friends and the world, afraid to hear his own voice. At last, he is embracing his manhood. He is becoming Alex. ‘I didn’t want to be transgender’ Alex doesn’t remember a light bulb moment when he suddenly knew that he should have been a boy. Instead, growing up in Maryland and the conservative South, he remembers being a weird kid who could beat all the boys in running races, but never fit in. “I went through a long process of feeling I was different in some way and not knowing what that difference was,” Alex says. Way back, at age 2, Michaela was a flower girl in a relative’s wedding. An outgoing toddler, Michaela pitched a fit over wearing the poufy floral dress for the ceremony. At the time, Deborah Manigault attributed the tantrum to a 2-year-old’s fickle independence. Now Deborah wonders if it was an early sign that Michaela didn’t feel right in her body. As a fifth-grader, Michaela remembers once being teased by a group of classmates for not fitting in. She sought solace in a large cubby where she curled up and hid.