In its toughest crackdown yet on medical errors, the federal government is cutting payments to 721 hospitals for having high rates of infections and other patient injuries, records released this week show.Medicare assessed these new penalties against some of the most renowned hospitals in the nation, including the Cleveland Clinic, Brigham and Women’s Hospital in Boston, the Hospital of the University of Pennsylvania in Philadelphia and Geisinger Medical Center in Danville, Pa.One out of every seven hospitals in the nation will have their Medicare payments lowered by 1 percent over the fiscal year that began Oct. 1 and continues through September. The health law mandates the reductions for the quarter of hospitals that Medicare assessed as having the highest rates of “hospital-acquired conditions.” These conditions include infections from catheters, blood clots, bed sores and other complications that are considered avoidable.The penalties, which are estimated to total $373 million, are falling particularly hard on academic medical centers: Roughly half of them will be punished, according to a Kaiser Health News analysis.Dr. Eric Schneider, a Boston health researcher who has interviewed patient safety experts for his studies, said research has demonstrated that medical errors can be reduced through a number of techniques. But “there’s a pretty strong sense among the experts we talked to that they are not widely implemented,” he said. Those methods include entering physician orders into computers rather than scrawling them on paper, better hand hygiene and checklists on procedures to follow during surgeries. “Too many clinicians fail to use those techniques consistently,” he said.The penalties come as the hospital industry is showing some success in reducing avoidable errors. A recent federal report found the frequency of mistakes dropped by 17 percent between 2010 and 2013, an improvement U.S. Health and Human Services Secretary Sylvia Burwell called “a big deal, but it’s only a start.” Even with the reduction, one in eight hospital admissions in 2013 included a patient injury, according to the report from the federal Agency for Healthcare Research and Quality.
DENVER (AP) — Despite growing public support for legalizing marijuana, a lawsuit filed by Nebraska and Oklahoma shows that at least two segments of American society are prepared to fight the idea before the nation's highest court — social conservatives and law enforcement.
The lawsuit seeks to overturn Colorado's experiment in legalized recreational pot, alleging that the two conservative states are being overrun with Colorado marijuana that is making it harder for them to enforce their own drug laws.
Nebraska Attorney General Jim Bruning framed it as a public-safety issue, though the complaint provides little data to support its claim that Colorado pot is pouring into neighboring states.
The case emerges at a time when polls show growing public support for legal weed. Even Congress this week started to ease restrictions on the drug, barring the federal government from interfering with the 23 states that allow it for medical uses.
National law-enforcement groups have staunchly opposed the legalization of marijuana. The lawsuit filed to the U.S. Supreme Court cheered some police in Colorado who have been frustrated at the public's wide acceptance of that state's recreational marijuana market, despite some examples of people overdosing on high-concentration edibles.
"When you work in the public-safety industry, you're impacted by this all the time," said Jim Gerhardt, vice president of the Colorado Drug Investigators Association. "We're seeing it. The firefighters are seeing it. The hospitals are seeing it. But the general public can be apathetic."
Mason Tvert, the pro-marijuana activist who helped push legalization in Colorado, said he was not surprised by the resistance from Oklahoma and Nebraska, two socially conservative states that were reluctant to repeal Prohibition.
"When you think about who are the two types of people who'd never want to try marijuana, it's people who are looking at it morally, through religion ... and that law-enforcement attitude that this is the law and we want to keep it," Tvert said.
The legalization movement, he added, has seen some of its stiffest resistance in conservative, religious states in the Deep South and in Nebraska, where activists were unable to get enough signatures to put a medical-marijuana measure on the 2012 ballot.
Law-enforcement agencies have long said anecdotally that they are making more marijuana arrests and seizing more of the drug since Colorado voters legalized the drug. But there's no way to know exactly how much legal pot is leaving the state.
In a recent report, the agency known as the Rocky Mountain High Intensity Drug Trafficking Area wrote that the amount of Colorado pot seized on highways increased from an annual average of 2,763 pounds between 2005 and 2008 to an average of 3,690 pounds from 2009 to 2013. The weed was headed for at least 40 different states.
Mark Woodward, a spokesman for the Oklahoma Bureau of Narcotics and Dangerous Drugs, said his organization has seen at least a dozen cases of highly potent marijuana from Colorado entering his state. Before Colorado legalized the drug at the end of 2012, Oklahoma had never recorded a single case of high-grade pot trafficking from its neighbor.
In western Nebraska's Scotts Bluff County, Sheriff Mark Overman said Colorado marijuana is extra strong, making it more valuable in his region and giving sellers a greater financial incentive to do business there.
"I think this is overdue, and I think other states should jump on board," Overman said of the lawsuit. "I'm very frustrated. I take an oath of office, as does every other police officer in this country. I don't just get to pick and choose which laws I enforce."
Although organizations like the International Association of Chiefs of Police and the National Sheriff's Association have warned against legalizing marijuana, the legalization movement also has high-profile law-enforcement supporters. Washington state's legalization was supported by the sheriff of Kings County, which includes Seattle, as well as two former U.S. attorneys there, and the former head of its FBI office.
Inga Fryklund, a former Cook County, Illinois, prosecutor who is a member of Law Enforcement Against Prohibition, a pro-legalization group, said that many rank-and-file police officers and prosecutors secretly support marijuana reform.
"A lot of their time is taken up with stupid drug arrests," she said.
But she acknowledged deep-seated resistance in law enforcement because people there see marijuana as destabilizing.
"You have to step back a bit and say 'This is very much like Prohibition of alcohol. All the violence and corruption is there because the stuff's illegal,'" Fryklund said. She also noted that police agencies are increasingly funded by seizing assets of people accused of drug crimes.
Darrel Stephens, who heads the Major City Police Chiefs Association, said that law enforcement believes legitimate concerns about marijuana legalization have been drowned out by deep-pocketed donors who have funded pro-marijuana ballot measures. At this point, he believes complete legalization is inevitable.
"There's never any support to gear up a counter-campaign," said Stephens, a former police chief of Charlotte-Mecklenburg, North Carolina. "It's extremely frustrating to watch."