U.S. health system costs four times more to run than Canada’s single-payer system

In the United States, a legion of administrative healthcare workers and health insurance employees who play no direct role in providing patient care costs every American man, woman and child an average of $2,497 per year.

Across the border in Canada, where a single-payer system has been in place since 1962, the cost of administering healthcare is just $551 per person — less than a quarter as much.

That spending mismatch, tallied in a study published this week in the Annals of Internal Medicine, could challenge some assumptions about the relative efficiency of public and private healthcare programs. It could also become a hot political talking point on the American campaign trail as presidential candidates debate the pros and cons of government-funded universal health insurance.

Progressive contenders for the Democratic nomination, including Sen. Bernie Sanders of Vermont and Sen. Elizabeth Warren of Massachusetts, are calling for a “Medicare for All” system. More centrist candidates, including former Vice President Joe Biden and former South Bend, Ind., Mayor Pete Buttigieg, have questioned the wisdom of turning the government into the nation’s sole health insurer.

It’s been decades since Canada transitioned from a U.S.-style system of private healthcare insurance to a government-run single-payer system. Canadians today do not gnash their teeth about co-payments or deductibles. They do not struggle to make sense of hospital bills. And they do not fear losing their healthcare coverage.

To be sure, wait times for specialist care and some diagnostic imaging are often criticized as too long. But a 2007 study by Canada’s health authority and the U.S. Centers for Disease Control and Prevention found the overall health of Americans and Canadians to be roughly similar.

Some Canadians purchase private supplemental insurance, whose cost is regulated. Outpatient medications are not included in the government plan, but aside from that, coverage of “medically necessary services” is assured from cradle to grave.

The cost of administering this system amounts to 17% of Canada’s national expenditures on health.

In the United States, twice as much — 34% — goes to the salaries, marketing budgets and computers of healthcare administrators in hospitals, nursing homes and private practices. It goes to executive pay packages which, for five major healthcare insurers, reach close to $20 million or more a year. And it goes to the rising profits demanded by shareholders.

Administering the U.S. network of public and private healthcare programs costs $812 billion each year. And in 2018, 27.9 million Americans remained uninsured, mostly because they could not afford to enroll in the programs available to them.

“The U.S.-Canada disparity in administration is clearly large and growing,” the study authors wrote. “Discussions of health reform in the United States should consider whether $812 billion devoted annually to health administration is money well spent.”

The new figures are based on an analysis of public documents filed by U.S. insurance companies, hospitals, nursing homes, home-care and hospice agencies, and physicians’ offices. Researchers from Hunter College, Harvard Medical School and the University of Ottawa compared those to administrative costs across the Canadian healthcare sector, as detailed by the Canadian Institute for Health Information and a trade association that represents Canada’s private insurers.

Compared to 1999, when the researchers last compared U.S. and Canadian healthcare spending, the costs of administering healthcare insurance have grown in both countries. But the increase has been much steeper in the United States, where a growing number of public insurance programs have increased their reliance on commercial insurers to manage government programs such as Medicare and Medicaid.

As a result, overhead charges by private insurers surged more than any other category of expenditure, the researchers found.

In U.S. states that have retained full control over their Medicaid programs, the growth of administrative costs was negligible, they reported. (The same was true for Canada’s health insurance program.) But in states that shifted most of their Medicaid recipients into private managed care, administrative costs were twice as high.

America’s Health Insurance Plans, a group representing private health insurance companies, said administrative practices shouldn’t be blamed for escalating the cost of care in the United States.

“Study after study continues to demonstrate the value of innovative solutions brought by the free market,” AHIP said in a statement. “In head-to-head comparisons, the free market continues to be more efficient than government-run systems.”

AHIP cited a recent report by the Medicare Payment Advisory Commission (MedPAC), an independent body that advises Congress. The report showed that Medicare Advantage plans — which are privately administered — deliver benefits at 88% of the cost of traditional Medicare.

Even so, the study authors concluded that if the U.S. healthcare system could trim its administrative bloat to bring it in line with Canada’s, Americans could save $628 billion a year while getting the same healthcare.

“The United States is currently wasting at least $600 billion on healthcare paperwork — money that could be saved by going to a simple ‘Medicare for All’ system,” said senior author Dr. Stephanie Woolhandler, a health policy researcher at Hunter College and longtime advocate of single-payer systems.

That sum would be more than enough to extend coverage to the nation’s uninsured, she said.

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starsis applies terrazzo furniture to orthodontist surgery in south korea

in the south korean city of hwaseong-si, design studio starsis has realized the interior of an orthodontist practice. characterized by bright spaces and a rich material palette, the project has been formed by the architect to perfectly fit the needs and background of the client while creating a tranquil environment for awaiting customers.

all images © hong seokgyu

when approaching the design, starsis took inspiration from teeth and the layout of the human jaw to create a plan from rounded, overlapping shapes. after applying this idea to the architecture, it resulted in an internal space in which the oval forms overlap. by limiting straight lines and placing curves inside the tight space, the organic aesthetic is maximized, creating a soft and friendly atmosphere within the orthodontist surgery.

the reception desk and hardwood shelves made from terrazzo, viewed from the waiting area

the interior is defined by white walls lit with warm-colored lights, terrazzo furniture, wooden fittings built into the walls and plants full of lush greenery to provide a sense of ease and relaxation for those who visit the practice for treatment. these materials are combined by the steel furniture, which is finished with paint and placed above the terrazzo floor in perfect harmony.

the entrance viewed from the corridor, and wooden and steel furniture for waiting customers

the furniture and reception desk viewed through the glass window

the wall with the reception desk and hardwood shelves made from terrazzo

the walls are 3.7m high and made of steel for solidity

there is an inspection room, a corridor and a powder room

the triage room viewed through the glass where the floor and walls are finished with 50 x 50mm white tiles

the corridor leading to the examination room

the corridor leading to the consulting office and photography room

on the wall there is built-in furniture where examination instruments can be placed and stored

steel pillars with sketches of spatial symbols and geometric shapes

project info:

project name: malocclusion ; offbeat teeth

location: 127-5, dongtansunhwan-daero, hwaseong-si, gyeonggi-do, south korea

total area: 2198.31 ft2 (204.23 m2)

designboom has received this project from our ‘DIY submissions‘ feature, where we welcome our readers to submit their own work for publication. see more project submissions from our readers here.

edited by: lynne myers | designboom

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Bernie Vows to Raise Taxes On Everybody Making Over $29,000 to Fund Gov’t-Run Health Care

The following article, Bernie Vows to Raise Taxes On Everybody Making Over $29,000 to Fund Gov’t-Run Health Care, was first published on Flag And Cross.

During a speech in New Hampshire, 2020 Democrat Socialist presidential candidate Bernie Sanders (VT) told his fans how he plans to not only ruin their lives but the lives of every single person in America – legal or illegal.

Bernie noted, “What we will do is have a 4% tax on income exempting the first $29,000.” He then added, “You’re better at arithmetic than I am. Because what that means is if you are that average family in the middle who makes $60,000 a year, that means we’re gonna tax you on $31,000 at 4%.

The more Bernie talks, the more likely voters are to flock to President Trump next November.

At the end of the day, is a man who recently suffered a heart attack physically fit to deal with the rigors of being president of the United States on a day-to-day basis? The answer should be obvious.

Nope.

Bernie’s heart failing him is a lot like Hillary Clinton’s fainting spells back in 2016. Both instances showed the nation that neither far-left radical was prepared to handle the duties of office.

During a recent interview with a left-wing outlet, the embattled Democrat Socialist made it clear to those who weren’t yet aware: he is not a capitalist. Funny enough, though, Bernie says equally far-left radical 2020 candidate Elizabeth Warren is a capitalist.

Hmm.

From Free Beacon:

Appearing on ABC’s This Week, Sanders said that Warren considers herself a “capitalist through her bones,” while he does not.

[…]

Warren has become the 2020 Democratic frontrunner while largely allying herself with Sanders on issues of health care and tax policy. Sanders, who has struggled to differentiate himself from Warren, said he is the only candidate who will take on systemic corruption.

Sanders opined, “I am, I believe, the only candidate who’s going to say to the ruling class of this country, the corporate elite, ‘enough, enough with your greed and with your corruption.’” We need real change in this country.

It physically hurts to read this tweet from Bernie Sanders.

But you have to see it.

LOOK:

Maybe I’m old fashioned. But I believe we should have a president who believes in the United States Constitution.

Maybe I’m old fashioned. But I believe we should have a president who believes in the United States Constitution.

— Bernie Sanders (@BernieSanders) October 6, 2019

That’s rich coming from a man who literally wants to tear America apart.

Continue reading: Bernie Vows to Raise Taxes On Everybody Making Over $29,000 to Fund Gov’t-Run Health Care

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M Health Fairview to cut staff, consider trims to hospitals – StarTribune.com

Leaders of M Health Fairview disclosed Friday that the giant health care system will cut as much as 2% of its staff, the first of several potential changes for the newly branded organization that could include reduced operations at the Bethesda rehabilitation hospital and the potential closure of St. Joseph’s Hospital in downtown St. Paul.

The workforce reduction, announced in internal memos by University of Minnesota President Joan Gabel and Fairview chief executive James Hereford, is one of several strategies to emerge from a five-week series of “war room” sessions convened to address looming budgetary pressures.

“The decision by Fairview to lay off employees is incredibly difficult,” Gabel wrote. “There are sound financial reasons why this action is necessary, but it does not lessen the pain employees will feel or the concern that patients may have due to this news.”

Sources familiar with the recent strategy sessions told the Star Tribune that they involved about 50 leaders and doctors from M Health Fairview, the brand created by this year’s operating agreement between Fairview Health and the university’s academic medical center and doctors.

The sources said the sessions produced plans beyond the job cuts, which would take place in early 2020 and affect the equivalent of 500 full-time jobs within Fairview. Most of the cuts will be achieved by closing open positions rather than layoffs. Possibilities include reducing operations at Bethesda, partly by reducing referrals to the unique long-term care hospital from other hospital systems, according to the sources, who spoke on condition of anonymity because they weren’t authorized to disclose these details.

Within three years, the organization also could close St. Joseph’s, a financially struggling hospital in downtown St. Paul that was converted in 2017 to serve more mental health patients.

In an interview Friday, Hereford declined to confirm the plans under consideration for the two East Metro hospitals, but said that “all facilities” are being scrutinized. He said the organization is responding to changes in health care financing that will produce an estimated $80 million loss in net income next year, as well as rising costs for patients.

“The affordability crisis that consumers are facing right now — it really does demand and give energy to the necessity of health care delivery transformation,” he said. “Health care has played the blame game and tried to deflect and say its been somebody else’s fault. We’re not going to do that.”

Clinics also might be closed or reorganized in the next three years, he said, but patients should expect that the end result is faster, better care and more specialty services closer to their homes.

“Our patients want to stay in their communities,” he said. “So the more we can bring that care to them, the better for our patients.”

Bethesda is an aging facility near the State Capitol and serves a vital role of providing rehabilitation for patients coming out of intensive care after strokes, heart attacks and traumatic injuries. However, Hereford said reimbursement rates for that service have declined and that M Health Fairview must prioritize it for its own patients coming out of intensive care.

“We will have a strong bias for ‘How do we use this as a core part of our … system?’ ” he said. “We can’t be the answer for other health care systems that need to free up their ICUs.”

Fairview Health merged in 2017 with HealthEast, largely to acquire its network of East Metro primary care clinics that could feed patients to Fairview’s specialists and to its flagship hospital, the University of Minnesota Medical Center. It also acquired HealthEast’s four East Metro hospitals, including St. Joseph’s, which was already losing money despite a multimillion renovation a decade ago.

Further losses were anticipated when St. Joseph’s increased its number of inpatient beds for poorly-reimbursement mental health care. Even so, M Health Fairview leaders were concerned when the hospital lost $32 million in 2017 and $44 million in 2018, according to figures from the Minnesota Department of Health.

St. Joseph’s also was the target of two federal Medicare investigations this year, including one that faulted the hospital for failing to prevent a patient from a suicide attempt using office scissors. The hospital also is canceling a contract with Universal Health Services, one of the nation’s largest hospital management companies, which it had hired in 2017 to improve the expanded mental health services at St. Joseph’s.

Competition from Google?

Margins for Twin Cities’ hospitals systems had improved in recent years, in part through mergers that gave them stronger negotiating positions with health insurers over reimbursement rates. But signs of weakening have emerged. Bloomington-based HealthPartners recently announced 75 job cuts and the closure of its retail pharmacies. Minneapolis-based Allina Health reported revenue losses through the current fiscal year due to declines in federal Medicare reimbursement.

Hereford stressed that the latest moves aren’t just about balancing a budget, but about turning the loosely connected elements of HealthEast, Fairview and the U into an efficient and innovative care system.

One example is the new Mall of America clinic that opened this week and will provide on-demand medical care to shoppers and workers as well as travel medicine services for patients with airport layovers, he said.

“It’s not just HealthPartners and Mayo” that are competitors in health care, he said. “We’ve got to worry about Walmart. We have to worry about Google.”

Hereford said any proposed changes, at St. Joseph’s or any other facility, wouldn’t come at the expense of the system’s commitment to mental health. He said colleagues are looking for ways to invest in outpatient and community treatments that prevent the need for as much expensive inpatient care.

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7 summertime dental tips from Vestavia Family Dentistry and Facial Aesthetics

Sponsored

Vestavia Family Dentistry
The staff at Vestavia Family and Facial Aesthetics Dentistry staff

What is it about summer and forgetting to take care of our teeth?

Is it the oppressive heat in Birmingham, Alabama or just having more time on our hands? We all seem to lapse into some bad habits concerning our dental care. Think about it – Summer is the only time we all try “Pop Rocks and Cokes”… Right?

Let’s get the summer started off right in 2019. Dr. G. Robin Pruitt, Jr. and the staff at Vestavia Family Dentistry & Facial Aesthetics gave Bham Now some useful tips to pass along to our readers for the summer. Check them out.

Front entrance of Vestavia Family Dentistry & Facial Aesthetics

Tip #1 – Drink the right beverage

It is hot out there. Birmingham has already experienced record high temperatures reaching in the mid 90s in May. This summer, stay hydrated and healthy. But think carefully when you choose your beverage – some drinks can increase your risk of tooth decay.

For example – When you are hot, you sweat. Don’t reach for a sports drink to rehydrate. Many sports drinks contain sugar as their top ingredient and can be as bad for your teeth as drinking soda. If you are going to have a sports drink, look for one that is low in sugar to prevent damage to your teeth.

The best alternative? Water. Keep your mouth moist by drinking water throughout the day. This helps wash away plaque-causing bacteria and can even improve your breath. Also, save some money by choosing tap – fluoridated tap water which strengthens your enamel, making your teeth more resistant to decay.

Tip #2 – Avoid bubbles, try tea

Photo from Milos Tea Facebook page

Simply put, drinks with bubbles – the carbonated drinks which may contain acid – can wear down your enamel. If you must drink the carbonated drinks use a straw. This reduces contact with your teeth. Finish the drink quickly, instead of sipping over a long period of time. Same concept. Less contact, less damage to your teeth.

An alternative to the bubbles. Along with water, try tea. Tea contains compounds that suppress bacteria, slowing down tooth decay and gum disease. Just remember: Don’t add sugar!

Tip #3 – Don’t chew ice

Chewing ice may cool you off on a hot summer day, but it is not good for your teeth. Use ice as something to cool your drink and not as a food. Chewing ice can leave your teeth weak and vulnerable to breaking and can cause damage to your enamel.

Tip #4 – Teeth Healthy Snacks

Whether it is packing snacks for summer day camps or on vacation. Choose teeth-healthy snacks. Fresh foods are full of vitamins and dairy products such as cheese & yogurts are full of calcium. Make sure to pack a healthy snack for days on the go!

Tip #5 – Play Sports – Protect your teeth

. Photo via Children’s of Alabama’s Instagram

Stay safe during summer activities – Wear a mouthguard during summer sports. Even though summer sports may not be high contact, your teeth can still be at risk if you take a fall. Also, don’t run at the pool – wouldn’t want to slip and fall! Be safe and protect your teeth.

Tip #6 – Pack a dental “kit” for those vacations

Don’t you hate checking into a hotel or beginning that camping trip on that summer vacation and you notice your remembered the shampoo and soap, but forgot the toothbrush, floss and mouthwash. Hop on over to the local drugstore and fully stock your travel bag with all these dental necessities for the whole family.

Tip #7 Make your summer appointment now

Stay on routine and go ahead and schedule your end-of-summer appointment – it’s a good idea to make your child’s back-to-school appointment early in the summer to avoid the August rush and help ensure you get the appointment time that works best for you.

If you have any questions about any of these tips, Dr. Pruitt and the staff at Vestavia Family Dentistry & Facial Aesthetics welcome your questions and will try to provide you answers.

Also, feel free to re-visit their New Year’s resolution list of tips story – Vestavia Family Dentistry & Facial Aesthetics recommends 5 dental resolutions for 2019.

Who says you can’t make mid-year summer dental resolutions too!

Reach them at 205-823-3223 or visit their website at:

http://www.vestaviafamilydentistry.com

Sponsored by:

The post 7 summertime dental tips from Vestavia Family Dentistry and Facial Aesthetics appeared first on Bham Now.

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Viral video shows British people shocked as they guess costs of US health care | TheHill

A now-viral video shows British people appearing shocked at the cost in the United States for essential health care services like delivering a baby or purchasing an inhaler or an Epi Pen. 

The U.K.-based political news site JOE shared the video on Twitter Tuesday and it has garnered over 15 million views and more than 50,000 likes. It shows one person going up to multiple British people and asking how much they think essential health services might cost on the U.S.

“Ambulance call out, how much do you think that costs?” the questioner asks one man.

“Zero payment,” the man responds.

“For real?” He asks after the questioner revealed that receiving medical care in an ambulance can cost $2,500.

The questioner asked one woman how much she thinks a single inhaler would cost. When the questioner told her it can cost $250 to $300 dollars, she responded “For an inhaler? Man, so if you’re poor you’re dead?” 

Ambulance call out? $2,500. Childbirth? $30,000.

Our NHS is not for sale, @realDonaldTrump pic.twitter.com/q9z4r6Ni6g

— PoliticsJOE (@PoliticsJOE_UK)

When he told the same woman that an Epi Pen cost more than $250, she responded “shut the fridge,” looking shocked when the questioner revealed that the life-saving medicine can cost more than $600.

“You have to pay to do that?” the woman asked after the questioner said hospitals can charge for skin-to-skin contact between a mother and baby after a person gives birth. “To hold my own child that I’ve been carrying inside of my womb?”

“I’m genuinely speechless,” she continued. When asked what she thinks about the people profiting off of the medical industry in the U.S., she responded, “You’re bastards.” 

Another woman looked aghast when the questioner revealed that giving birth in a hospital can cost $10,000, and an IUD contraceptive device can cost $1,300. The woman called the National Health Service in the United Kingdom “Literally the gift that keeps on giving.”

“Literally, literally people are so dumb for taking advantage of it, and I don’t want it to change,” she said. 

Earlier this year, President TrumpDonald John TrumpTop Democrat: ‘Obstruction of justice’ is ‘too clear not to include’ in impeachment probe Former US intel official says Trump would often push back in briefings Schiff says investigators seeking to identify who Giuliani spoke to on unlisted ‘-1’ number MORE walked back comments he made that the NHS should be included in trade talks between the U.S. and the U.K., telling Piers Morgan that he doesn’t “see it being on the table.”

Trump again told reporters Tuesday that “If you handed [the NHS] to us on a silver platter, we want nothing to do with it,” Fox News reported.

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How Invisalign® Encourages My Teen’s Passion for Adventure

This post was sponsored by the Invisalign® brand and all opinions expressed in my post are my own.

My teen is always up for an adventure. If you asked Ryan what his favorite hobbies are, he’d tell you traveling and photography. He loves an adventure. We all do. It’s one of the reasons I homeschool, or road school, to be able to take our learning on the go. Whether we’re at home or exploring El Morro in Puerto Rico we’re not ones to turn down an adventure!

That’s one of the reasons we love Invisalign® treatment so much!

Invisalign aligners are transforming Ryan’s smile without compromise and with more predictability* thanks to SmartTrack® material. With over 20 years of innovation and 7 million+ smiles have enabled Invisalign treatment to correct simple to complex orthodontic cases, like Ryan’s. He can continue to go on all the adventures, eat all the things he likes (and even try new foods) while in treatment. Unlike traditional braces, there’s no restrictions when it comes to food! So there’s no holding him back when it comes to eating his way through our travels. (*compared to 0.30 inch off-the-shelf aligners)

Before we started his treatment, Ryan and I sat down and went over all the instructions from Dr. Segal, his orthodontist at Segal & Iyer. I made sure he understood that this was his responsibility. I cannot wear his Invisalign® aligners for him, only he can.

In order for his treatment to be successful, he has to make sure he follows all the directions Dr. Segal gave him. 

It’s been about 10 weeks since he started treatment and he’s done phenomenally well. He wears his aligners all day long, only taking them out to eat or drink. In just these 10 weeks, he’s already notified such a difference in his smile that it encourages him to keep going.

It’s boosted his confidence so much and he readily smiles more for pictures and throughout our whole trip.

Plus we didn’t have to worry about any unexpected office visits (like you do with traditional braces) while we’re away. If a set of aligners break, you just move back to your old set or up to you new set.* That’s it!

*Consult your Invisalign provider before reverting to previous aligners or wearing new aligners

When his case fell out of his backpack in Disney and his top aligners broke, we didn’t worry. He just moved onto the next pack. Simple as can be.

I always try to include an educational aspect into all our trips. Since we homeschool and travel a lot, I use every place we visit as a learning tool. Whether it’s through the local cuisine or just immersing ourselves into the local scene, he’s able to enjoy anything our adventures bring while not having to worry about his orthodontic treatment.

When it comes time to plan out our trips, we don’t worry that Invisalign treatment will hold us back. Invisalign aligners give him ( and me) the confidence to know that he can try all the new foods he wants and we won’t have to avoid any restaurants tough to chew foods. Plus since Invisalign aligners transform his smile without compromise, we can still get the perfect family shot or selfie where he’s actually smiling.  When we sit down and discuss what historical sites or things we want to learn more about and make a list of things to see and do, and Ryan makes sure to packing his aligners is at the top of that list!

Sometimes I even put him in charge of all our educational activities and I let him plan the whole itinerary.  It’s doubles as a research project. He’ll look into the different sites and activities available and pick out ones he thinks we’ll all enjoy.

If you or your child need orthodontic care, Invisalign aligners are a convenient choice for active and jet-setting families.

Invisalign aligners let you transform your smile without compromise, so nothing holds Ryan back from hiking, swimming and truly exploring and immersing himself into wherever we’ll be.

Parents, you can learn more about Invisalign treatment for your tween or teens here, and be sure to take the free Smile Assessment for them!

To find an Invisalign provider near you, check out the Doctor Locator!

Dawn

The post How Invisalign® Encourages My Teen’s Passion for Adventure appeared first on A New Dawnn.

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Canadian Man Accused Of Unauthorized Horse Dentistry: ‘A Display of Lawless Bravado’

A Canadian man is facing a lifetime ban on practicing veterinary medicine after accusations he’s been performing unauthorized horse dentistry.

The Manitoba Veterinary Medical Association (MVMA) is seeking a permanent injunction against Kelvin Brent Asham, accused of treating horses—including giving one horse a sedative—without veterinary certification.

An investigator described Asham’s actions as “a display of lawless bravado,” according to court documents.

The MVMA says it’s been trying to stop Asham for the past three years: It first became aware of his activities in 2015, when a complaint was filed about a 16-year-old gelding he had treated. Asham sedated the horse, filed down its teeth—a process known as “floating”—pulled one tooth and tried to extract another.

horse teeth dentist
The sharp edges of horses’ teeth occasionally needs to be filed down to save the horse from pain when eating or holding a bit in its mouth. The term “floating” comes from the file used in the process, known as a “float.”
Anna Elizabeth/Getty

Leon Flannigan, an animal protection officer in Manitoba, investigated the claims and determined the horse had suffered “irreparable damage.” In an affidavit, Flannigan said he’d met with Asham in 2016 at a Tim Horton’s donut shop in Selkirk. Asham allegedly told Flannigan he’d been floating horse teeth since 1996 and had performed the procedure on four other horses owned by the same person as the gelding.

Asham also told Flannigan that most vets float teeth improperly, and that he had different tools than vets use. “Off the record, I do thousands of horses,” Asham allegedly told Flannigan. “I do a good job. I am willing to fight this in court.”

This incident caused the MVMA to send Asham a cease-and-desist letter in 2017, as he is not a licensed veterinarian.

But last year, the MVMA found out that Asham was still working as a equine dentist and was recommended on Facebook. The MVMA hired private investigator Russ Waugh to go undercover and try to hire Asham.

According to Waugh’s affidavit, Asham told him the horse Waugh brought in could be treated for $200 CAD (about $150), the average price for floating teeth. After the investigation, the MVMA filed suit against Asham, asking a judge to ban Asham from acting as a vet.

“By engaging in the unauthorized practice of veterinary medicine, the respondent effectively declares himself to be outside the law,” writes Robert Dawson, an attorney for the association.

This isn’t Asham’s first run-in with the law: In December 2001, the then-37-year-old was arrested after admitting to carrying 10 one-kilogram bricks of cocaine in his truck. Asham and Barry Vaughan Hancock, who was also in the truck when it was pulled over, were each charged with possession of cocaine for the purposes of trafficking.

At the time, Hancock was an equine dentist.

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Health officials warn Denver airport travelers of potential measles exposure after 3 children hospitalized

Three children visiting Colorado have been hospitalized with measles, leading health officials to warn people who traveled through Denver International Airport earlier this week that they are at risk for the highly contagious disease.

The children tested positive after traveling to a country with an ongoing measles outbreak. They did not have the MMR — or measles, mumps and rubella — vaccine, according to a news release from Tri-County Health Department, which covers Adams, Arapahoe and Douglas counties.

The Centers for Disease Control and Prevention considers three or more cases of measles “linked in time and place” to be an outbreak. However, Tri-County Health spokesman Gary Sky said the department doesn’t consider this to be an outbreak because the patients are related.

Health officials said individuals who visited these locations may have been exposed to measles:

  • Denver International Airport between 1:15 and 5:45 p.m. Dec. 11
  • Children’s Hospital Colorado’s Anschutz Campus Emergency Department between 1 and 7:30 p.m. Dec. 12

Local health officials have not said where the family was traveling from. But the news of the measles cases in Colorado comes the same day that health officials in California warned about exposure from patients who traveled through Los Angeles International Airport.

It’s unclear how many people are at risk of exposure.

Officials at Denver International Airport said they do not know how many people potentially came in contact with the children. Roughly 179,000 people passed through the airport via departing, arriving or connecting flights on Dec. 11, said airport spokeswoman Emily Williams.

Health officials are contacting people who are believed to be at risk for measles, including those who visited Children’s Hospital on Dec. 12. The Tri-County Health Department will likely contact “well over 100” people in its investigation, said Dr. Bernadette Albanese, a medical epidemiologist.

“We’re doing this investigation for a reason, and that reason is precisely to prevent secondary spread — and having a non-ideal vaccination rate in Colorado isn’t helping matters,” she said.

There is no ongoing risk of exposure at these two locations, however, travelers should be on the lookout for measles symptoms, which can develop seven to 21 days after contact, the news release said.

Measles has various symptoms including high fever, cough, runny nose, watery eyes and a rash. The illness can lead to pneumonia and swelling of the brain, according to the Centers for Disease Control and Prevention.

Measles is highly contagious and up to 90% of people close to a person with the illness become infected if they are not immune, according to the CDC.

Representatives of the Colorado Department of Public Health and Environment and Children’s Hospital Colorado declined to discuss the measles cases and deferred questions to Tri-County Health Department.

Several measles outbreaks have occurred across the United States this year, but until now there was only one case reported in Colorado. In January, a Denver resident was placed in isolation and treated for the respiratory illness.

But health experts have warned that Colorado’s low vaccination rate makes communities here vulnerable to an outbreak. The immunization rate for the MMR shot was 87.4% during the 2018-19 school year, meaning the state doesn’t meet the threshold needed to protect a community from a measles outbreak.

The state’s low vaccination rate has come under scrutiny this year and a bill to make it harder to opt out of such shots was debated by legislators before it failed. Gov. Jared Polis has said he’s “pro-choice” when it comes to vaccinations. He said believes the solution to raise the low immunization rate is through education and access rather than eliminating nonmedical exemptions.

If a person has symptoms that could be measles they should call their doctor’s office or a hospital first, the news release said.

Due to incorrect information from a health official, this story originally mischaracterized the measles cases at Denver International Airport as an outbreak.

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15 Doctors Fired From Chicago-Area Health System | Medpage Today

At least 15 physicians have been fired from Edward-Elmhurst Health as the suburban Chicago-based health system moves to cut costs, sources told MedPage Today.

The doctors, who worked across its seven “Immediate Care” or urgent care sites, will be replaced by advanced practice nurses, according to an email sent by hospital leadership that was shared with MedPage Today. The physicians were informed late last week that they would be terminated as of April 1, 2020.

A physician who spoke on the condition of anonymity said the doctors were “broadsided” by the news. While they harbored some concerns that a few of the slower urgent care sites might be turned over to non-physician clinicians, they weren’t expecting so many of the sites to be impacted and for such a large number of doctors to be let go.

In their email, hospital system CEO Mary Lou Mastro, MS, RN, and Chief Medical Officers Robert Payton, MD, and Daniel Sullivan, MD, pointed to patient cost concerns as the reason for eliminating the jobs: “Patients have made it very clear that they want less costly care and convenient access for lower-acuity issues (sore throats, rashes, earaches), which are the vast majority of cases we treat in our Immediate Cares.”

“Beginning in the spring of 2020, we will move to a delivery model in which care is provided by Advanced Practice Nurses (APNs) at select Immediate Care locations,” they wrote.

Leadership also stated in the email that they are “working closely with these physicians to assist them with finding alternative positions within Edward-Elmhurst Health or outside our system,” but doctors noted that they face a saturated Chicago healthcare market and they’re likely to have to relocate.

When asked to confirm the layoffs, Keith Hartenberger, a spokesperson for Edward-Elmhurst Health, said in a statement: “We continue to assess our care delivery models in the interest of providing cost-effective care to our patients. We shared with physicians that we have plans to change the model next year at some outpatient sites and are working with anyone affected to find alternative placement.”

The move is becoming a more familiar one as some health systems try to save money by relying more heavily on non-physician clinicians.

Last year, 27 pediatricians at a chain of clinics in the Dallas area lost their jobs and were replaced by nurse practitioners — even though the chain subsequently changed its name to MD Kids Pediatrics.

Rebekah Bernard, MD, wrote in Medical Economics that she spoke with three of the pediatricians who were fired: “They told me that they and their physician colleagues were completely shocked by the sudden firing. ‘We thought we were going to retire from this place,’ one told me.”

Also in 2018, Charlotte, North Carolina-based Atrium Health ended a nearly 40-year contract with a 100-member physician group, signing up instead with Scope Anesthesia, which says it’s dedicated to forming partnerships with certified registered nurse anesthetists. Atrium said it too was looking to reduce patient costs.

“This trend of shuttering hospital departments and firing physicians to save money is dangerous and short-sighted,” Bernard wrote.

Purvi Parikh, MD, of NYU Langone Health in New York City, and a board member of Physicians for Patient Protection, which advocates against other healthcare providers replacing doctors, said that although non-physician clinicians “are vital members of the healthcare team, they are not trained to be substitutes of physicians and as a result diagnoses are missed and improper treatments and tests [are] prescribed.”

Parikh said patients “have the right to choose a facility that is physician-only or one with physician-led care. In Chicago, luckily there are other options among competitors.”

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