Hospitals usually don’t go farther than across town seeking new patients, but UCLA has set it sights across the Pacific.
The university’s medical center has entered into an unusual insurance pact that will bring in well-heeled Koreans for major orthopedic surgery and treatment of cancer, heart disease and neurological conditions.
Cambridge, Mass.-based WorldCare Inc., which until now facilitated second opinions by U.S. specialists to foreign patients via the Web, will provide the patients.
Its new insurance subsidiary is selling secondary insurance to Korean residents who otherwise are treated by that country’s national health service that will provide them access to UCLA and three other top U.S. health systems.
UCLA officials don’t expect that the agreement will immediately draw large numbers of foreign patients, but they say it should expand the number now being treated, which amounts to about 1 percent of its caseload.
“It does provide an opportunity down the road to see a larger number of patients,” said Mark Gelhaus, director of international relations at UCLA Medical Center. “It’s fairly unique.”
Officials with WorldCare say they brought UCLA into the network because of its West Coast location, top reputation and the fact that Los Angeles has the largest population of Koreans outside the Korean peninsula. Some Korean nationals already come to UCLA for treatment.
“It was very important to us that the hospital was able to cater to an international clientele,” said Dr. Joel Kahn, president of WorldCare’s Global Health Plan.
The plan is aimed at upper-income Koreans who can afford a supplemental insurance policy, with costs ranging from about $300 a year for children to $4,000 for a 50-year-old person. It provides up to $1 million in medical, surgical and travel expenses, but it’s a catastrophic plan limited to the four major illness categories.
Kahn said other international insurance carriers market secondary policies in countries with national health services but usually they only provide a cash benefit and patients are on their own in locating a U.S. doctor.
The other participating systems are the Cleveland Clinic, Duke University Health Systems and Partners HealthCare System Inc., which includes Massachusetts General Hospital.
Malpractice Debate
Just when does a doctor’s mistake amount to elder abuse?
That’s a big question these days among doctors who accuse patients’ attorneys of trying to get around the state’s tough law limiting medical malpractice judgments by suing them under the Elder and Dependent Adult Abuse law.
The California Medical Association is seeking publication of a recent appellate court decision that it believes limits use of the elder abuse law. The California Court of Appeal in Ventura recently ruled physicians cannot be sued under the law for acts of “simple professional negligence.”
The case involved several doctors who resuscitated a woman in respiratory and cardiac arrest despite a do-not-resuscitate order from the family. Life support was later withdrawn and the woman died.
The appeals court upheld a lower court decision that the patient’s family had to show doctors’ actions were “reckless, oppressive, fraudulent and malicious” to win a judgment under the act, a standard not met in the case.
Susan Penney, CMA legal counsel, is seeking to have the ruling published so it can be cited as precedent, contending it will help end to “meritless” elder abuse claims against doctors.
“We need physicians who are not always fearful of being sued,” Penney said. “I am not saying there is not a place for the (elder abuse) statute but we have to accept there is some abuse of the statute going on.”
Plaintiffs’ attorney Katherine Stebner maintains the ruling is not worth publishing because it broke no new ground.
“The case law is clear as to what elder abuse is and isn’t already,” Stebner said. “They are trying to muddy the waters.”
Strange Bedfellows
The California Nurses Association and the California Hospital Association have been fighting each other for months over attempts by the hospital trade group to weaken the state’s landmark nurse staffing law.
But now they find themselves on the same side of an issue.
Last month, a hospital association representative testified before the state’s Little Hoover Commission against a proposal by the governor’s California Performance Review committee to eliminate the Board of Registered Nursing as part of a plan to wipe out 118 boards and commissions.
The hospital association, which last year labeled the nurses association a “radical” group, agreed that the nursing board provided necessary oversight of the profession, including guidance and review of nursing practices.
Nurses, meanwhile, believe the board does a good job rehabilitating nurses with drug addictions and other problems, while protecting nurses from punishment as a result of dangerous hospital policies. The two groups also support merging the board into another board overseeing licensed vocational nurses.
“We were surprised. They are making the right choice,” said nurse Liz Jacobs, a California Nurses Association spokeswoman.
The two groups do not agree on everything, however. Hospital officials support moving nurse discipline to administrative law judges, something the nurses oppose.
Staff reporter Laurence Darmiento can be reached at (323) 549-5225, ext. 237, or at
[email protected]
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