The Health Care Quality Improvement Act of 1986 does little
to protect doctors as citizens: Congress omitted due process from peer-review. Hospital boards (under
DARLING) can observe due process to attract doctors.
The ObamaCare vote in Congress.
http://healthinsuranceinfo.net/
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Video warning. Click here.
Unfunded debt in Illinois, Pennsylvania, New Jersey...
Hospital trustees naturally promote themselves as safe for
patients and doctors. For career-safety, we advise all doctors to practice in 3 independent hospitals: All
politics is local. There is no way to predict which states will treat doctors well by the time you start practice
~12 years after starting college, so all this information is retrospective and speculative.
States belong to federal court circuits some of which have
made decisions that bear on where to practice. See States 2. ~25
states have the Initiative or the Referendum. If patients as citizens
ever desire honest peer-review of their local hospitals, these measures may be relevant, but reform will take many years.
However, nothing stops a local hospital's board from adopting due process in order to retain doctors.
http://www.westandfirm.org/blog/2009/02/where-does-your-state-rank.html
#2551 of 2990, Added By: An_12681977, MD, Surgery, General, 11:21PM Sep 08, 2009 |
States that assumed contractual obligations without establishing them as of 2000:
Colorado,
see Even v. Longmont United Hosp. Ass'n, 629 P.2d 1100, 1103 (Colo. Ct. App. 1981)
Massachusetts, see Duby v. Jordan Hosp.,
341 N.E.2d 876, 879 (Mass. 1976)
Mississippi, see Wong v. Stripling, 700 So. 2d 296, 300-02 (Miss. 1997)
Ohio, see
Bouquett v. St. Elizabeth Corp., 538 N.E.2d 113, 115-16 (Ohio 1989)
Oklahoma, see Ponca City Hosp., Inc. v. Murphree,
545 P.2d 738, 742 (Okla. 1976)
Virginia, see Medical Ctr. Hosps. v. Terzis, 367 S.E.2d 728, 729 (Va. 1988)
States
where "medical staff bylaws alone are not a contract, but, in the context of the entire relationship between the physicians
and the hospital, they are enforceable as part of a larger contractual relationship":
Connecticut, see Gianetti v.
Norwalk Hosp., 557 A.2d 1249, 1252-55 (Conn. 1989); Owens v. New Britain Gen. Hosp., 643 A.2d 233, 239 n.25 (Conn. 1994)
States
where the medical staff bylaws are not a contract:
Georgia, see St. Mary's Hosp., Inc. v. Radiology Prof'l Corp.,
421 S.E.2d 731, 736 (Ga. Ct. App. 1992)
Iowa, see Tredrea v. Anesthesia & Analgesia, P.C., 584 N.W.2d 276, 284-87
(Iowa 1998) (establishing requirements for bylaws to qualify as a contract)
Mississippi, see Sullivan v. Baptist Mem'l
Hosp. - Golden Triangle, Inc., 722 So. 2d 675, 680-81 (Miss. 1998) (but see above)
Missouri, see Zipper v. Health Midwest,
978 S.W.2d 398, 415-17 (Mo. Ct. App. 1998) (but equitable relief is available under bylaws)
North Dakota, see Robles v.
Humana Hosp. Cartersville, 785 F. Supp. 989, 1001 (N.D. Ga. 1992)
Ohio, see Munoz v. Flower Hosp., 507 N.E.2d 360, 365
(Ohio Ct. App. 1985) (lack of contract because lack of mutuality of obligation); Holt v. Good Samaritan Hosp. & Health
Ctr., 590 N.E.2d 1318, 1322 (Ohio Ct. App. 1990)
States where hospital bylaws are contractually binding on a hospital,
but not medical staff bylaws:
Iowa, see Tredrea v. Anesthesia & Analgesia, P.C., 584 N.W.2d 276, 284-87 (Iowa
1998)
Maryland, see Ishak v. Fallston Gen. Hosp. & Nursing Ctr., 438 A.2d 1369, 1372 (Md. Ct. Spec. App. 1982)
Texas,
see Gonzalez v. San Jacinto Methodist Hosp., 880 S.W.2d 436, 438-39 (Tex. Ct. App. 1994) (but see above)
Tennessee rejects
the distinction, see Lewisburg Cmty. Hosp., Inc. v. Alfredson, 805 S.W.2d 756, 759 (Tenn. 1991)
Do numbers show you are needed: Do other doctors agree, or is the administrator trying to fill beds for financial, political, or personal purposes, even
controlling doctors with exclusive contracts, buying practices, and pursuing mandatory employment by the hospital?
Is there a nearby hospital so you can admit to two hospitals at all times, in case things do not work out here?
If that happens, can you take your charts? Is there a non-compete clause (restrictive covenant)?
Are doctors respected here? Are patients litigious?
What is the relative malpractice premium compared to other states? What is the trend in attempted control by managed
care, hospital corporations, or mandatory group practice?
Do you like this place? Does your
spouse like this place? Is the local economy stable?
Are the doctors collegial: Do they cooperate across
financial lines to care for patients, or are they covertly competitive in this regard? Does the state medical board
respect due process? The local medical society? The doctors on committees? Is the peer-review independent
of the doctors in the hospital and acceptable to both parties: Is
this a safe place to practice medicine?
Worst States To Retire: Fiscal Risk.
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Healthcare Reform Lawsuit in Florida Survives TestRobert Lowes October 14, 2010 — Elected officials from 20 states today
won a battle in their constitutional challenge to the new healthcare reform law when a federal judge in Florida ruled that
key portions of their suit could move forward. The suit mounts 6 different constitutional arguments against the new law, taking aim primarily at the requirement that individuals
obtain health insurance coverage or else pay a penalty. US District Judge Roger Vinson in Pensacola, Florida, dismissed 4 counts of the lawsuit as requested by the Obama
administration, but spared 2. One of those preserved counts claims that the so-called individual mandate exceeds the authority
that the constitution's commerce clause gives to the federal government to regulate interstate commerce, which the Obama administration
says includes the healthcare market. In the process, state officials contend, the individual mandate violates the 9th and
10th amendments of the constitution, written to safeguard individual and states' rights.  | | US District
Judge Roger Vinson |
The other count of the lawsuit that Vinson did not dismiss asserts that the law interferes with states' sovereignty —
a violation of the 9th and 10th amendments — by forcing them to participate in the new healthcare coverage infrastructure
and assume costs they cannot afford, such as the cost of expanded Medicaid programs. Vinson stressed in his ruling that just because he was allowing the 2 counts to go forward
did not mean that he had attempted to determine "whether the line between Constitutional and extraconstitutional government
has been crossed." "I am only saying
that (with respect to 2 of the particular causes of action discussed above) the plaintiffs have at least stated a plausible
claim that the line has been crossed," Vinson wrote, adding that he would make his determination based on motions for summary
judgment that he expects each side to file. In a summary judgment, a court decides a case without a trial because the facts
are not in dispute, and one side is entitled to a judgment simply as a matter of law. Vinson's ruling was the latest development in a string of similar lawsuits filed in federal
courts in various states. Last week, a federal judge in Detroit, Michigan, upheld the constitutionality of the individual mandate in a suit filed by a Christian legal defense organization called the Thomas More Law Center
and several individuals. The Thomas More Law Center intends to appeal the decision. Conflicting decisions by different federal courts — district or appellate — on
the law's constitutionality will likely trigger a hearing before the US Supreme Court. The plaintiffs in the federal court case in Florida include the attorneys general of Alabama,
Alaska, Colorado, Florida, Idaho, Indiana, Louisiana, Michigan, Nebraska, North Dakota, Pennsylvania, South Carolina, South
Dakota, Texas, Utah, and Washington, and the governors of Arizona, Georgia, Mississippi, and Nevada. All of the state officials
are Republicans except for Louisiana Attorney General James Caldwell, a Democrat. Other plaintiffs are 2 individuals who object
to the individual mandate and the National Federation of Independent Business. Based on a timetable set out by Vinson, each party in the Florida federal case has until November
4 to ask for a summary judgment. One party's opposition to another's motion for this judgment must be filed by November 23,
with the party asking for the judgment having until December 6 to make any reply. Vinson will hear oral arguments on the expected
motions for summary judgment on December 16.
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| ~4, 600 U.S. Hospitals: |
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| Click the state flags to see the hospitals. |
| States of Debt |
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| Ranking By Business-Costs: |
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| "Health Care Policy Cost Index." Click here. |
10 Best-Rated States for Retirement
10 Worst-Rated States for Retirement
Where Does Your State Rank? By Paul Hsieh, MD co-founder Freedom and
Individual Rights in Medicine "The Small Business & Entrepreneurship Council has come up with a handy guide to
rank the 50 US states (plus the District of Columbia) based on how badly their regulation raise the cost of health insurance.
Some of the measures include the number of mandates, whether the state requires "guaranteed issue", community rating,
and employer mandates, whether it allows tax-free use of Health Savings Accounts." Here's their guide: "Health
Care Policy Cost Index: Ranking the States According to Policies Affecting the Cost of Health Care" http://www.sbecouncil.org/uploads/SBEC%20polseries%2033%20-%20SBSI-Health%5B1%5D%202-3-09.pdf And their conclusions: Among the 50 states and District of Columbia, the best 15 states in terms of state
health care policies are: 1) Idaho, 2) Utah, 3) Iowa, 4t) Michigan, 4t) Ohio, 6) Alaska, 7) South Carolina, 8) South Dakota,
9) Pennsylvania, 10t) Nebraska, 10t) Wyoming, 12) District of Columbia, 13) Kentucky, 14) North Dakota, and 15) Oklahoma.
Meanwhile, the worst states are: 37) Minnesota, 38) New Hampshire, 39t) North Carolina, 39t) Rhode Island, 41) Florida,
42) New York, 43) New Jersey, 44) Colorado, 45) Maryland, 46) California, 47) Vermont, 48) Connecticut, 49t) Maine, 49t) Washington,
and 51) Massachusetts. Our elected officials talk a great deal about "solving the health care crisis." Unfortunately,
the origins of the crises can largely be traced back to governmental policies that raise the costs of health care, and thereby
limit the availability of health care coverage. If policymakers are serious about having a positive impact on health
care, then significantly limiting the number of mandates and regulations makes sense at the federal and state levels. Obviously,
I wish Colorado ranked higher than 44th. But at least we have the examples of lots of other higher-ranked states to point
to in the public policy debate! http://www.westandfirm.org/blog/2009/02/where-does-your-state-rank.htmlPoll: Have you seen this yes|no|
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