Pacific Standard March-April 2013 Cover

Should Patients Determine How Much Hospitals Get Paid?

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This past October, the Centers for Medicare and Medicaid Services started linking hospital reimbursements paid to how well they perform on the Hospital Consumer Assessment of Healthcare Providers and Systems, or HCAHPS, survey. HCAHPS measures how satisfied patients were with a broad range of items which supposedly reflect the overall “hospital experience.” Among these are the quality of communication with the different healthcare providers; how clean (and quiet) the hospital was; and how responsive the staff was to the patient’s needs. The rationale behind tying reimbursements to ... Read More

Book Review: Helping, or Harming, in Haiti?

Killing with Kindness by Mark Schuller. Rutgers University Press, $26.95 (paperback).

Is humanitarian aid good for those who receive it? This deceptively simple question with a not-so-straightforward answer has been the subject of lively debate in recent years, as well as the subject of books by Timothy Schwartz, Dambisa Moyo and Linda Polman, among others. The answer is undoubtedly yes in an acute disaster—the sort of situation which temporarily overwhelms the ability of otherwise well-functioning local governments to marshal the necessary resources to mitigate its impact. The damage Hurricane Katrina inflicted on the city of New Orleans and rest of the Eastern Gulf ... Read More

Changing Parental Attitudes on Child Vaccinations

During the 15 years that have passed since I began my pediatric training, I have been involved in the care of dying children. Thankfully, this is not a regular part of my practice, and I can remember each of those children. Most were kids who succumbed to chronic disease that had slowly yet inexorably overwhelmed them: leukemia, cystic fibrosis, Tay-Sachs disease. Sometimes, when nothing more could be done medically, all that remained was to sit by the bedside with the family and embrace the child as he passed away. Any child's death is tragic. Hardest to reconcile, though, are those ... Read More

Review: Seeing Haiti’s Distress as People, Not Statistics

A Promise in Haiti

Confronted with large-scale natural or man-made disaster, most people have great difficulty making sense of, or being able to relate to, it in the context of their own experiences and daily lives. Suffering is much more easily dealt with when broken down into small, easy-to-digest portions. Reading Anne Frank’s diary lets us identify with her and almost able to imagine the tedium mixed with fear of detection while hiding from the Nazis, or the misery and horror of her final weeks in Bergen-Belsen. The tragedy of the Holocaust — too big, really, for anyone to fully comprehend — acquires ... Read More