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Billing Practices, Ofri, D; Uninsured, Unwanted, Unworthy?

Reviewed by: Thomas J. Mancuso, MD, FAAP

These two articles are about money and medicine. In the article titled Billing Practices, an MD discusses her involvement with an uninsured patient who suffered a fractured femur. The billing practices she discusses involve the difficulty with reimbursement for outpatient treatment vs. inpatient. Following treatment of the fracture, the patient was prescribed anticoagulation and the author describes how the care given to the patient was influenced by his lack of insurance. At first he was not prescribed expensive low molecular weight heparin but SQ heparin. Once home management of his warfarin was undertaken, it took much of the MD's (uncompensated) time to arrange prescription refills, phlebotomy to check anticoagulation etc. She closes with "Perhaps it is time to.view the patients medical treatment as an organic whole. Otherwise, there is no incentive to.increase efficiency and patient care efficacy".

A former patient, also a pedestrian MVA victim, who had no health insurance, authors the second paper. He expresses his feeling of humiliation and stigmatization as he was treated for his injuries.

Commentary

While these two short papers have no direct relationship to pediatrics or pediatric anesthesiology, I urge all to take the time to look up this issue of the Hastings report and read them. They look at the issue of free care from our medical perspective and also from that of a recipient of the free care we all provide. After reading the second one page report I will be more sensitive to a patient/family with "insurance problems."

Table of Contents

• President's Message
• Editor's Corner
• Bylaws Amended
• Genesis of a CPT Code
• Fellow's Corner
  Choosing a Career in Academic Pediatric Anesthesia


• SPA Elections
• Society for Pediatric Anesthesia Election Procedures
• Nominations


• Pediatric Anesthesiology 2004 Meeting Review
  Point Hilton Squaw Peak Resort - March 4-7, 2004
• Friday, March 5, 2004
• Saturday, March 6, 2004
• Sunday, March 7, 2004


• Reviews & Commentary
  • Perception of Child Vulnerability Among Mothers of Former Premature Infants
    Allen EC, Manuel JC, Legault C et al. Pediatrics 2004;113:267-273
  • Billing Practices, Ofri, D; Uninsured, Unwanted, Unworthy?
    Chesleigh, F. The Hastings Center Report Jan-Feb 2004
  • The Effect of Obesity, Gender and Ethnic Group of Left Ventricular Hypertrophy in Hypertensive Children: A Collaborative Study of the International Pediatric Hypertension Association
    Havevold C, Waller J, Daniels S et al. Pediatrics 2004;113:328-333
  • A Cautionary Tale About Supplemental Oxygen: The Albatross of Neonatal Medicine
    Silverman, WA Pediatrics 2004;113:394-396
  • EMLA Toxicity After Application for Allergy Skin Testing
    Parker JF, Vats A, Bauer G. Pediatrics 2004;113:410-411
  • Overweight, Ethnicity and the Prevalence of Hypertension in School-aged Children.
    Soro f JM, Lai DL, Turner J et al. Pediatrics 2004:113:475-482
  • Short term Use of umbilical Artery Catheters may not be Associated with Increased Risk For Thrombosis.
    Coleman MM, Spear ML, Finkelstein M et al. Pediatrics 2004;113:770-774
  • Recurrent Abdominal Pain, Anxiety and Depression in Primary Care.
    Campo JV, Bridge J, Ehmann m et al. Pediatrics 2004;113;817-824
  • The Ancillary-Care Responsibilities of Medical Researchers: An Ethical Framework for Thinking about the Clinical Care that Researchers owe their Subjects.
    Richardson, HS, Belsky L The Hastings Report Jan-Feb 2004;25-33


• Literature Reviews
  • The Effect of Small Dose Fentanyl on the Emergence Characteristics of Pediatric Patients After Sevoflurane Anesthesia Without Surgery
    Cravero J, Beach M, Thyr B, Whalen K. Anesthesia & Analgesia 2003;97:364-367.
  • Epidural analgesia in children. A Survey of Current Opinions and Practices amongst UK Paediatric Anaesthetists.
    Williams DG and Howard RF. Paediatric Anaesthesia 2003;13:769-776
  • Rapid emergence does not explain agitation following sevoflurane anaesthesia in infants and children: a comparison with propofol.
    Cohen IT, Finkel JC, Hannallah RS, Hummer KA, Patel KM. Paediatric Anaesthesia 2003;13:63-67

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