Friday, March 22, 2013

Parents Threatened by Massachusetts Hospitals for Refusing Unnecessary Care Results in Threats and DSS Intervention – The Costs of ObamaCare in Massachusetts

"Obama Care" - is it forcing an unusual alliance between the state and your health care provider? - Image from: - article "What Soviet Medicine Teaches Us".

The situation appeared normal enough; one family, a woman, her fiancé, and their two children, ages 3 and 1 all came down with a bout of the flu. The infant was having difficulty keeping fluids in due to vomiting, in order to be pro-active in their child’s healthcare – brought the child to a Boston area hospital to get treatment (i.e. fluid by IV’s). There are few parents, who have not been in this situation, either with a baby, or older child, who due to a bad bought of the flue, is faced with a child who is dehydrated due to the inability to keep even fluids down, and either go directly to the emergency room, or are sent there by their pediatrician. It happens, the child is treated and taken home, or that is what is supposed to happen.

In the case presented in the preceding paragraph, the parents were told by the hospital staff that the child had an elevated white blood cell count and needed to be transported immediately to Boston Children’s Hospital. The entire family was sick with the flu, yet the mother, understanding that, generally, having a viral infection, such as the flu, may produce an elevated white blood cell count (see New York Times Health Guides Blood Differential Overview.) Additionally, the child appeared quite active, especially after having received the fluids, yet the staff at this hospital was insistent that the child needed additional test at Boston Children’s Hospital. They were so insistent that they told the parents, who were acting responsibly, that the costly and unnecessary and stressful trip by Ambulance to Boston Children’s Hospital, was a mandate by the staff – either let us take your child for further tests – or face the DSS (or Massachusetts Department of Social Services.

The Parents refused, left the hospital and called their personal health care provider who suggested that the Hospital was overreaching. They also contacted a lawyer, as the calls from the Hospital began – the Hospital had called to confirm that the parents had refused treatment (the child was, as checked by the familial pediatrician, quite healthy after having fluid.) They are now anticipating a full blown investigation by the Massachusetts Department of Social Services due to a trip to the emergency room.

What is interesting in this case, is not the fact that the hospital staff obviously was attempting to bully the parents into getting the child off the premises and into the hands of another institution to make a diagnosis (More on this later), but the fact that there has been an increase in these types of instances over the past three months. Boston area attorney, James Ianiri,is said to have seen an increase in such cases over the past few months, and one can read about instances where families, attempting to take care of their children, have been subject to abuse by both the hospital and the state at his blog It is an eye-opener.

The main reason for a hospital, today, in Massachusetts, to get the patient out the door and into another faculty is the new health care law. The cost cutting required under “Obamacare” puts the onus on the provider to insure that one leaves their care with cured – an impossibility in all cases. The truncated version: A hospital, doctor, or clinic, treats a patient, and that facility is reimbursed under the law, by the health insurance carrier, the health exchange under Obama care, or Medicaid/Medicare the first time a patient visits presenting any condition. Should that patient return presenting the same diagnosis before a 30 day time period, the provider must absorb those costs.


As there are very few private hospitals that are not run by giant corporations, or health care clinic, or private physicians available, one is now at the mercy of the ethical corporation/government – where the decision to treat or pocket the cash is presented.

What can this scenario produce? Increase in patients being pushed to other facilities, and an increase in patients being referred to specialists for treatment – treatment for illnesses that might require several more than a follow-up and can be performed in a physician’s office. In the case of the family seeking treatment for a temporary condition for dehydration due to the flu virus – the referral to their own pediatrician could have been sufficient. However, this hospital decided to override the parent’s decision to treat their child in this manner and began a DSS investigation –most likely due to the fact that they feared that family would return before a 30 day period, thus putting them on the hook for the costs.

The alternative theories would run counter to sanity suggesting a state/hospital alliance similar to those of the past, where children were taken from parents and placed into homes for political reasons.

If there are fifty families seeking legal help due to brining their child to an emergency room, and then refusing to have that child treated by shipping them to another facility, or if that family has religious objections to certain types of treatment, there is more than likely 100, or 1000 cases or more in just the Commonwealth – where this whole insanity of pitting doctors and Corporate health care providers against their patients began.

If there are fifty, perhaps the Hospital which appears to have the highest profile in this instance (Boston’s Children), would benefit from a good old fashioned class-action lawsuit. After all, these institutions appear not to be providers of Health Care, rather they appear to be infringing on the rights of parents, and or providing care in a reasonable and expedient manner – causing undo stress and loss of income to these families. One might suggest that Hospitals have fairly deep pockets.

It would be, obviously, different if the families had brought children into an emergency room battered, bruised and mistreated – in that instance a call to the DSS is mandated and appropriate/ However, for refusing to put a one year old in an ambulance, after that child had received adequate care, and was running around, and planning to take that child for a follow-up to the family pediatrician, revealing that to the staff at the hospital – to have that staff institute a DSS probe against the family, causing them to have to hire a lawyer, and face the potential loss of a child to the State, appears unreasonable and Unconstitutional.

See: ”The Limits of Parental Authority to Accept or Refuse Medical Treatment”, Ethical Perspectives, by Dr Geoffrey Miller, Yale University School of Medicine, Department of Pediatrics (in PDF)- This should be mandatory reading for all those ER providers – of course, the piece suggests ethics – which fly in the fact of the almighty dollar.

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