McCleary MRSA Prevention

A a very supportive Senator informed me that there has been a fiscal note attached to my bill, Maine LD 1038.
We got one tiny part of the LD 1038 passed, and that is mandatory high risk screening. It may be small, but high risk screening is the first step in MRSA prevention in the State of Maine.
A Screening test costs between $0 and $100 in the State of Maine. There is no set price, but a fair average is around $20. I guess the actual charge to the patient is according to whether or not your hospital is going to put it to you on the price. If a person is found to be MRSA positive, and decolonization is started, a it can save a patient’s life or limb. It can also save other patients from being exposed to an unknown MRSA colonization or infection. So far that $20 screening culture is a good deal all around.

Now I will talk about my father’s expenses. If he had not been infected in his hospital while he worked to rehabilitate from a minor fracture he would be here today. Instead we buried him May 8th. So, the ultimate cost to Dad was his life. I cannot put a dollar sign on that.

However, his expenses for the hospital and doctors for 20 days for the infection and the complications he suffered because of the infection was about $30,000. Then when they deemed him “well enough” to be discharged, he went to a nursing home for almost 10 weeks to the tune of around $17,000. That amount was paid out of his life savings. No offer ever came from the hospital to help cover that expense, even though the hospital was responsible for his infection. My parents are not rich but they had a little too much money to qualify for Mainecare. And, because Dad was no longer at home or in hospital, they had to pay for his oxygen equipment out of pocket too. Dad’s prescription meds were also covered by his insurance except for his $2 copay for each one. The expense to the insurance company for his meds is unknown. But, I do know it was substantial. So, the total cost to my parents and their insurances for his MRSA Pneumonia was between $47,000 and $50,000.

If mandatory screening prevented, let’s say 4 invasive MRSA infections a year, in his small hospital alone, (and I KNOW it will prevent many more than that), the savings would be $200,000 in expenses to those 4 patient and their insurances. My father’s MRSA infection would be considered a “simple” and inexpensive case of MRSA because it didn’t involve numerous repeated surgeries to clean out pus and dead or infected tissue from a joint or belly or chest caused by MRSA. Many joint, chest or belly MRSA infections involve repeated surgeries. My guess is that those infections would cost up to $100,000 or much more. One of my new friends who lost his wife because of MRSA after having an ovarian cyst removed, stated that his wife’s bills added up to a half million dollars before she died. She had repeated surgeries and lost part of her intestines because of MRSA. For the purpose of “fiscal” notes, we will say that an average invasive Hospital Acquired MRSA infection costs $50,000. My father’s hospital has 25 beds. Of course we do not know their rate of MRSA, but I do know that 2 people died of MRSA after Joint replacements in the month prior to Dad’s first hospital admission. My educated guess is that their infections cost their families much more than $50,000. If their infections and Dad’s infections had been prevented, and they had lived and been discharge home to their loving families, there would have been a minimum of $150,000(more likely over $200,000) in savings to them, their families and insurance companies. That savings would have been for preventing those 3 infections in one month alone.
For the sake of making a solid guess on savings to famlies and hospitals by prevention of just 3 infections in a month’s time, I believe $150,000 is more than fair. Now if that number of infections is the average number for every month, it would be over a million dollars savings in a year. I hope to God I am wrong in stating there would be 3 invasive MRSA infectons that caused death in my father’s hospital every month, but I do know as fact that happened the month my father was first admitted. It may be nicer for me to just say that screening and contact isolation may prevent 3 simple HA MRSA Infections per month in my fathers hospital.c
To give my father’s hospital a huge benifit of the doubt and it is difficult for me to do that….we will guess that there is $500,000 spent out by patients and their insurances on invasive hospital acquired MRSA infections from my fathers 25 bed hospital every year. This amount would be a very conservative amount to say the least. Of course at this time MRSA infections are not reported, so we have no way of knowing for sure how many infections there really are in Maine Hospitals. But, again, giving Dad’s hospital a huge benifit of the doubt, we will guess that there would be a savings of $500,000 on MRSA infections a year in his 25 bed hospital.

Now we can look at the hospitals side of this. It is good “fiscal” business for hosptials to care for MRSA infected patients. It makes the hospital money. Just how much money it makes for the hospital? We can’t say for sure. Patients who are infected in hospitals spend a lot more inpatient days, spend tens of thousands more dollars for their care, and often times become reinfected so they are readmitted and it costs even more. Then of course they can only stay for just so long in an acute care setting, so they must find either long term care, or at home care after discharge. But, I am only covering the in hospital expense in this post. It’s sad to say, but these infections are huge money maker for hospitals, doctors, pharmceutical companies, protective gear companies etc. The antibiotics alone (around $200 a dose for IV Vancomycin) make a huge profit for the hospital. I really want to give the hospitals credit here and say they want to STOP HOSPITAL INFECTIONS, but the reality is that hospitals make a fortune on these infections. Even more money is made on studies and research.

And there is more benefit to hospitals regarding these infections. They are not held legally or morally liable in any way for these infections. If a surgeon cuts off the wrong leg, patients can sue a hospital and the doctor and be compensated for their pain, suffering and loss. I challenge anyone reading this post to tell me of ONE SINGLE SETTLEMENT in Maine over a MRSA infection that was contracted inside hospital walls. It is nearly unheard of. There is not one iota of doubt that my father contracted his infection in his hospital. In fact we were told more than once by his physicians that he contracted it in his hospital. But my research revealed that very few legal settlements have been made because of hospital acquired MRSA. There was however a huge settlement in a prison when many prisoners contracted MRSA…I know…this is off subject. My point here is that hospitals make a lot of money on MRSA infections and they are not held accountible (financially, legally or otherwise) in any way for those infections.

We learned in our work with MRSA that screening tests are already covered by insurance when they are done in the more progressive hospitals in Maine that are already doing some MRSA screenings. And we learned that federal stimulus money is available for programs to prevent Hospital Acquired Infections. So, a Maine fiscal note attached to high risk MRSA Screening for all of Maine is bogus.

The cost of mandatory screening is about $20 a pop. I don’t know the number of hospital admissions per year at my father’s 25 bed hospital, nor do I know how many of those patients would be considered at high risk for MRSA,, but the fact is they would NOT be doing over 20,000 high risk MRSA screenings per year. The savings that I guessed above…$500,00…. would cover more than 20,000 high risk screenings. Whatever is left over would undoubtedly be a huge savings for hospitals, patients and their insurance providers.

The savings to patients in terms of pain, suffering, death and devastating disabliity….PRICELESS.

The talk of cost for these infections is very difficult for me to discuss. My father, my family and I are personally hurt and harmed by MRSA that was caused by lax infection control in a hospital. Dad is gone. It hits me often how final that is. This is grief and sadness I have never before experienced. So, to hear that my State Governement wants to put a dollar sign on a solid proven MRSA preventative step makes me very angry.

In today’s Bangor Daily News, Meg Haskell has written a well thought out article about my proposal, and the need for prevention. Please read this article and comment.

http://www.bangordailynews.com/detail/105443.html

It’s wonderful to know that the CDC, homeland security and state health services can pull together and react to the very real possiblility of a pandemic of swine flu. Antiviral medicines are being shipped to the State of Maine as we speak. It’s only been a week or so since …was it 7 or 8 students in NY and a few others in California had contracted mild cases of Swine flu. All hell broke loose. We have seen doctors, nurses, the director of homeland security, the PRESIDENT, CDC representative etc all on TV talking about the flu. And of course EVERYBODY is talking about HANDWASHING!
So, I have to wonder why nobody from CDC, homeland security, state health services, Customs and Border protection, the President, Governors, doctors, nurses and other health officials NEVER address the 18,000 deaths caused by MRSA in 2006 and the many more thousands since then. NEVER, I have never heard it addressed in the news. I only learned of it while doing research. 18,000 is more deaths than AIDs/HIV, more than breast cancer and more than motor vehicle accidents. Yet, no big wigs have addressed it. And there hasn’t been one organized approach mandated to stop these horrible infections that attack us while we or our family members lie vulnerable in hospitals. I even saw Dr Salvatore the infectious disease doctor from Maine Medical Center on TV this morning speaking about Swine flu. He is the very same doctor who spoke out in strong opposition to my MRSA prevention bill,Maine LD 1038 and spoke of an upcoming vaccination for MRSA. Well a vaccine is a long way down the pike and we have to do something NOW about MRSA.

I think I know why there isn’t a huge alert out there about MRSA or C Diff or VRE or any other Hospital acquired infections. The answer is the last three words of the last sentence. They are acquired in the hospital. Citizens are not afraid to address Community Acquired MRSA. Schools and nursery schools have closed because of MRSA infections in their places. I have never heard of a hospital or even a hospital floor being closed because of MRSA infections, and believe me, there are plenty of outbreaks and deaths and disabilities because of these infections. But hospitals are not closed, and floors of hospitals aren’t closed, nor are they held responsible for the infections, nor do they report the infections to anybody, nor do they develop new strategies to stop the infections. They just bury their heads in the sand, fail to disclose the infections (in many cases) to the victims and families, and pretend it isn’t there…….well, until the NEXT infection. Until the next poor soul who’s knee joint fills up with MRSA pus, or the next person who can’t control their diarrhea from C Diff, or the next old person who develops MRSA pneumonia and dies, like my father did. Hospitals have remained untouchable when it comes to these infections. Believe it or not, hospitals are sometimes wrong. In Maine, they have been wrong about hospital acquired infections.
No, these hospital acquired infections don’t make the news, not much anyway. Then if they do, doctors, hospital officials and others who don’t want to face the music, downplay the stories and say there is way too much media hoopla over these infections. Hospitals and hospital officials,associations and doctors do NOT want exposure (no pun intended) of these infections.
Well, it seems that there is a lot of hoopla over several dozen mild cases of Swine Flu. It’s like a national disaster has struck. Unfortunately, there have been deaths in Mexico, but none here in the US.
Well, let me announce that there have been thousands upon thousands of deaths because of infections that patients are catching IN HOSPITALS. It is time the word was out there and the CDC, Federal government, State governments, doctors, nurses, Governors and THE PRESIDENT dealt with the reality of big numbers of deaths and disability because of infections people are catching in their modern hospitals. It is a disgrace and it is unnecessary. It is time to fight these infections. Investments in prevention need to be made and new precautions and practices need to be developed.
Wake up America. There is already a lot of deadly infection in this country and it comes out of hospitals. The threat isn’t your neighbor or your friend with Swine flu….it is your health care facility and the danger of infections spreading there.
I’d love to be able to make a living by going on TV and telling people they can avoid an illness by washing their hands and coughing into their elbow. My mother never made money teaching me that when I was a child but those experts are banking on it. It’s important, I know, to prevent the spread of flu. But, the experts aren’t really dealing with the tough horrible illnesses, like MRSA, C DIFF and VRE, now are they?