Insurers limiting doctors, hospitals in health insurance market

“Insurers in California's new health insurance exchange are holding down premiums by limiting choices, raising concerns that patients will struggle to get care.”

Ryan Gabrielson of The Center for Investigative Reporting reports that "California regulators routinely have conducted cursory and indifferent investigations into suspected violence and misconduct committed by hundreds of nursing assistants and in-home health aides – putting the elderly, sick and disabled at risk over the past decade."

In two stories published yesterday, Gabrielson's examines how and why these cases are dismissed and details the case of an edlerly woman whose suspicious death was largely ignored by state regulators.

"The 2011 documents allege several instances of state inspectors taking bribes, one of many problems found in a six-month investigation of assisted living facilities by U-T San Diego and the CHFC Center for Health Reporting at the University of Southern California."

Dr. Christopher Duntsch began his medical practice in 2010, The Texas Observer reports, and by the time the state revoked his license in 2013, a series of botched surgeries had left two of his patients dead and four paralyzed. The real tragedy of the story, according to the Texas Observer, is how preventable it was: "Over the course of 2012 and 2013, even as the Texas Medical Board and the hospitals he worked with received repeated complaints from a half-dozen doctors and lawyers begging them to take action, Duntsch continued to practice medicine. Doctors brought in to clean up his surgeries decried his “surgical misadventures,” according to hospital records. His mistakes were obvious and well-documented. And still it took the Texas Medical Board more than a year to stop Duntsch—a year in which he kept bringing into the operating room patients who ended up seriously injured or dead."

The nation's state medical boards continue to allow thousands of physicians to keep practicing medicine after findings of serious misconduct that puts patients at risk, a USA TODAY investigation shows. Many of the doctors have been barred by hospitals or other medical facilities; hundreds have paid millions of dollars to resolve malpractice claims. Yet their medical licenses — and their ability to inflict harm — remain intact.

"In New York, inmates diagnosed with 'serious' disorders should be protected from solitary confinement. But since that policy began, the number of inmates diagnosed with such disorders has dropped," according to a ProPublica report.

The Fresno Bee reports: "The Fresno County Jail has been a place of terror and despair for mentally ill inmates who spiral deeper into madness because jail officials withhold their medication. About one in six jail inmates is sick enough to need antipsychotic drugs to control schizophrenia, bipolar disorders and other psychiatric conditions, but many sit for weeks in cells without medication previously prescribed by private doctors, say family members, lawyers and psychiatrists. If the inmates do get medication, it’s often at a lower dose or is a cheaper generic substitute that doesn’t work as well, they say."

KUOW in Seattle reports that about 30 times per year, a sponge or surgical instrument is left inside a patient at a hospital in Washington state. Foreign ojects left behind are among the state's most common medical mistakes. Medical experts told KUOW such an event should never happen, at that the system in place to check for sponges and other equipment left behind is not straightforward. New technology exists to ensure such equipment is not left behind, but it is not widely used.

The Star Tribune reports that one boy's struggle with “Mr. Angry” highlights a growing dilemma: Thousands of kids with mental problems rely on schools for care. Gianni is one of thousands of students afflicted with serious mental health problems who are flooding into Minnesota schools because they have nowhere else to go. Their complex needs are bringing huge and at times dangerous challenges to special education classrooms that are already struggling to handle increasing numbers of students with other handicaps, including multiple disabilities.

The Dallas Morning News investigation shows how Dr. Tariq Mahmood operated a chain of dangerous small-town Texas hospitals for more than four years until regulators finally started to crack down. Before they acted, repeated warnings about grave risks to patients and potential fraud reached multiple agencies. At least four patients died. 

The project details how federal and state regulators don't track problem hospital operators or hold them accountable. Nor do they look for patterns of care breakdowns inside hospital chains. Top regulators didn't know Dr. Mahmood owned multiple hospitals until The News began asking questions about them earlier this year.