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Healthcare Reform Ventilation Nebulizers & Humidifiers Transport Sepsis H1N1 Influenza

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Healthcare Reform Ventilation Nebulizers & Humidifiers Transport Sepsis H1N1 Influenza Volume 4 Number 4 August-September 2009 The Journal of Pulmonary Technique HEALTHCARE REFORM VENTILATION NEBULIZERS & HUMIDIFIERS TRANSPORT SEPSIS H1N1 INFLUENZA BALANCING PAIN MANAGEMENT AND PATIENT SAFETY? YOU WANT MORE THAN A NUMBER. Know more than an SpO2 reading—at a glance. We give you warning about potentially harmful patterns of desaturation in ™ Nellcor your adult patients, so you can act sooner. With our alerts, you know that Puritan Bennett™ Airox™ your patients may be experiencing repetitive reductions in airflow—even Mallinckrodt™ if they haven’t crossed the SpO2 alarm threshold. DAR™ Shiley™ That’s just one feature of the new Alarm Management System for the Sandman™ Nellcor™ OxiMax™ N-600x™ pulse oximeter, offering more meaningful alarms and more pulse oximetry information, at a glance. You live and breathe patient safety. And so do we. Visit www.nellcor.com or call your Covidien representative at 800-635-5267 for details. COVIDIEN, COVIDIEN with logo, “positive results for life” and ™ marked brands are trademarks of Covidien AG. © 2009 Covidien. All rights reserved. Covidien Patient Safety 06/10/09 Respiratory Therapy Aug/Sept ad name: sent date: publication: run date: 8.125 x 10.875 [email protected] size: email Andre Naval xxxxxxxxx 09-PM-6375 contact: ftp Job Number 7PMVNF/VNCFS"VHVTU4FQUFNCFS The Journal of Pulmonary Technique Editorial The True Cost of Healthcare Reform HEALTHCARE REFORM Doug Wilder, RRT VENTILATION NEBULIZERS & HUMIDIFIERS TRANSPORT SEPSIS During the 2008 Presidential campaign, one of the promises made was healthcare H1N1 INFLUENZA reform. Now the President and the Congress are promising to draft a bill with possible passage by the August recess. In an effort to bring this issue to the forefront and meet this goal of having a signed bill, the White House has been very vocal. Christina Romer, chair of the President’s Vol. 4 No. 4 Council of Economic Advisers has stated, “Healthcare reform is more than a social impetrative—it is an economic necessity.” A new study by the Council has concluded August-September 2009 that the current American healthcare system is on an unsustainable path. Without reform, American workers and families will continue to experience eroding healthcare benefits and stagnating wages caused by escalating health insurance premiums. And without reform, rising spending on Medicare and Medicaid will lead to massive and Table of Contents unsustainable Federal budget deficits.”¹ DEPARTMENTS From this statement, it is clear that some reform will take place in the next few months. The great debate on healthcare between the White House, Congressional Democrats and Republicans and all special interest groups has begun, with the highest Editorial: Healthcare Reform 4 of stakes not only for the healthcare industry but also the economy for years to come. 1 3 News The following ideas were put forward by a bipartisan Senate Committee to meet this 1 7 News Feature goal: Tax the so called “Cadillac plans” they say promote the overuse of healthcare services and boost the cost of care. Scour Medicare for any and all cost savings. Raise 18 Executive Profiles alcohol, tobacco, soda, high fructose corn syrup and sugar taxes to generate revenues 19 Products to pay for the uninsureds’ insurance and alter lifestyle behaviors deemed unhealthy. Extension of the payroll tax for Medicare to include all state and local government 21 Spotlight on Ventilation employees. Place new limits and/or appeal processes of flexible spending accounts that allow individuals and employers to set aside tax-free income for out of pocket 22 Spotlight on Pulmonary medical expenses, and curb the 25% tax deduction allowed for claims and some other Function Testing expenses now allowed under Blue Cross Blue Shield plans. 22 Product Case Study One of the more popular ideas is to reduce payment to home health providers, which 23 Emergency Planning Roundtable has been cited as having the highest profit margin in the Medicare program. The Senators also said the government should seek more appropriate payments for some 5 5 GUEST COMMENTARY: types of medical equipment including oxygen and power chairs.² Respiratory Care Reform 57 Final Note All of these will reduce healthcare costs and raise revenues in the short term but will only result in higher costs over the long term, burden the healthcare system at the hospital level and slow economic growth. FEATURES In 2009, total healthcare expenditures by the Federal government will be 46% of 30 HME Effectiveness federal budget and it is projected to increase to 49% by 2017. With Federal debt projected to reach 14.07 trillion dollars by 2010 and the GDP of the United States 31 Humidifiers and Nebulizers projected to be 14.3 trillion dollars, the Federal debt is tracking to exceed GDP. Compounding the healthcare crisis, healthcare spending is growing at a rate of High Frequency Jet Ventilation 33 between 6 and 7.5% per year. 34 Relative Humidity In 2008, 38% of all hospital discharges were patients 65 years or older. Projections 35 Ventilating for Transport indicate that today’s over-65 population of 15.7% will grow to 20.2% by 2050, or 1 in 5 40 Swine Flu Management people in the United States will be over 65. 45 Wheezing in Children The number of uninsured currently stands at 46 million and is projected to grow to 54 million by 2019. Left unchecked this number will rise to 74 million by 2030.³ 49 Jet Nebulization The combination of the continuous growth in healthcare spending, the aging 5 1 Diaphragmatic Electrical Activity continued on page 57… 4 Respiratory Therapy Vol. 4 No. 4 n August-September 2009 vortran_adFull_RespTherapyFNL copy.pdf 1 6/18/2009 12:51:46 PM C M Y CM MY CY CMY K Editorial Advisory Board Publisher Steve Goldstein Mohammed Al Ahmari, BSRT, MSc., RRT Surinder K. Jindal, MD Prince Sultan Military College Postgraduate Institute of Medical Published six times each year by Editor of Health Sciences Education & Research, Chandigarh, India Les Plesko Goldstein and Associates, Inc. Al-Khobar, Saudi Arabia Rebecca A. Mabry 10940 Wilshire Blvd., Suite 600 Senior Editor Muhammad Aslam, MD General Sleep Manager Los Angeles, CA 90024 USA Carol Brass Clinical Fellow in Newborn Medicine Viasys Healthcare, Yorba Linda, CA Tel: 310-443-4109 Harvard Neonatal-Perinatal Fellowship Assistant Editor Paul Mathews, PhD, RRT, FCCM, Fax: 310-443-4110 Laszlo Sandor Program, Children’s Hospital Boston Instructor in Pediatrics, Harvard Medical FCCP, FAARC, Associate Professor, E-mail: [email protected] Design and Production School, Boston, MA Respiratory Care, University of Kansas Website: www.respiratorytherapy.ca Management Medical Center, Kansas City, KS Video website: www.rttv.ca http://accugraphics.net Larry Conway, RRT North Mississippi Medical Center Nawal M. Mofarreh Tupelo, MS MBBS, Arab Board-Internal Medicine I, Cardiac center- Al-Thawra General Circulation, Coverage, Advertising Rates: Complete details regarding Ed Coombs, MA, RRT Modern Hospital, CPR instructor & circulation, coverage, advertising rates, space sizes, and similar information Sr. Marketing Manager–Ventilation co-ordinator, Saudi Heart Association are available to prospective advertisers. Closing date is 45 days preceding Draeger Medical, Telford, PA in affiliation with American Heart date of issue. Association, CPR center, Al-Thawra Antonio Esquinas, MD, PhD, FCCP Hospital, Sana’a-Yemen Change of Address notices should be sent promptly to Circulation Intensive Care Unit, Hospital Morales Department. Provide old mailing label as well as new address. Allow two Meseguer, Murcia, Spain Hossein Razavi, MD, FCCP months for change. Pulmonary, Critical Care & Dr. Javier Fernandez Sleep Medicine, St. Helena, CA Editorial Contributions will be handled with reasonable care. However, Director of Clinical Affairs & Education Respiratory Division Latin America Daniel D. Rowley, B.S. RRT-NPS, RPFT, publishers assume no responsibility for the safety of artwork, photographs or Miami, FL FAARC, Respiratory Therapy Supervisor, manuscripts. All submissions may be emailed to [email protected]. Every Pulmonary Diagnostics & Respiratory precaution is taken to ensure accuracy, but the publish ers cannot accept Gerardo N. Ferrero, PT Therapy Services, University of Virginia responsi bility for the correctness or accuracy of information supplied herein Clinical Specialist, Latin America Health System, Charlottesville, VA or for any opinion expressed. Editorial closing date is the first day of the Buenos Aires, Argentina month preceding month of issue. J. Kyle Schwab, MD Charles J. Gutierrez, PhD, RRT, FAARC Medical Director Assistant Chief, Neurorespiratory Care ©2009 by Goldstein & Associates, Inc. All rights reserved. Reproduction in Louisiana Sleep Foundation Program–Spinal Cord Injury Center Baton Rouge, LA whole or in part without written permission is strictly prohibited. James A. Haley Veterans Hospital Tampa, FL Respiratory Therapists and Nurses who The Only Airway use the SmartVest ® and SmartVest Wrap® Clearance System praise the following innovations: Featuring Single-Hose VERY user friendly! Convenient to place on immobilized patients ® and Soft Start Technology Full chest coverage Single-hose design Reversible wrap allows easy access Mobile pedestal provides stability yet requires from either side of the patient minimal space Contact us today to receive product and pricing information, or to schedule a demonstration. Accredited by The Joint Commission FDA cleared to market. ELECTROMED, INC. CE marked in accordance ® Creating superior care through innovation with MDD 93/42/EEC. Multiple patents and Phone: 800-462-1045 or 952-758-9299 patents pending. Requires prescription. Web: www.SmartVest.com Alternative to CPT. Made in USA Everybody has a great story to tell with Optifl ow™ Nasal High Flow - comfortable, effective oxygen delivery. Nasal High Flow with Optifl owTM nasal cannula. Nasal High Flow (NHF™) is a new level of support than what is provided by NASAL HIGH FLOW IS AN EFFECTIVE respiratory care therapy, providing a traditional nasal cannula, but who do not WAY OF DELIVERING OXYGEN IN A COMFORTABLE MANNER. THREE comfortable and effective method of tolerate a face mask.
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