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U.S. doctors fear patients who are at risk because lower prices follow the secret trade

Kevin Robinson, a paramedic at a major hospital in the United States, was struggling to close his patient’s respiratory system when a neighbor suffered a heart attack.

In many hospitals of the same size, Robinson could consult an experienced physician to care for the second patient. But here he was alone. For 20 minutes he left a three-year-old student to test – and fail – the stability of arrhythmia while looking at the first patient.

Robinson does not work in the hospital. Instead, she is one of hundreds of thousands of emergency physicians employed by a specialized medical team.

Like many of his colleagues, Robinson – whose name has been changed – believes that his boss has reduced the amount of money that can be dangerous.

“Obviously this was a patient who would benefit from the care of a attending physician,” he said of a man with a heart attack. “For a place with a lot of volume and sound [medical urgency], it is best not to have a number of personnel supervisors and medical assistants. ”

Law enforcement agencies have funded U.S. medical care in recent years, because they see opportunities among the elderly who spend a lot of money to stay healthy. According to reports Writer Richard Scheffler at the University of California, Berkeley, and Laura Alexander at the American Antitrust Institute, annual private medical services rose from $ 42bn in 2010 to $ 120bn in 2019, before dropping to $ 96bn in 2020.

For emergency services, groups such as KKR and Blackstone have purchased medical companies that recruit doctors and refer them to a number of hospitals. Companies make deals with paying and taking part in insurance or patient payments, which one doctor told the Financial Times to be as high as 50 percent.

The operating industry is said to be able to provide hospitals with greater flexibility than the daily workforce.

But many doctors say that since the corporations seized a number of joint ventures five years ago, these companies have been cutting costs by reducing staffing and wages.

Declining prices have been particularly acute during the epidemic – although their agencies have received tens of millions of dollars in funding – in part because of legislation expected to reduce the number of companies that can pay patients.

The Federal No Surprises Act, which comes into effect on January 1, provides for the costs of providers to pay for unplanned and uninsured medical treatment – a practice known as “extraordinary payment”.

“Business companies have been pressuring doctors with fewer hours and staff,” said Robert McNamara, chief of the medical department at Temple University Hospital in Philadelphia. “There are fewer doctors working, fewer hours, reduced pay and loss of profits. All of this affects the safety of the patient.”

This has also raised concerns at Capitol Hill. Elizabeth Warren, a Democratic senator in Massachusetts, said in a statement to the Financial Times: “When commercial enterprises purchase nursing homes and other health care providers, the cost-cutting scale increases, leaving health workers struggling with staff and life-threatening shortages. of the sick. ”

There are two leading companies in the emergency medical services industry: Envision Healthcare, owned by KKR, and TeamHealth, owned by Blackstone.

Earlier this year Envision put its doctors on a new payroll system, which doctors told the Financial Times to make a 15% pay cut. The new system also integrates direct pay with doctors’ ability to pay patients. Doctors said this was encouraging for early testing and treatment.

Envision has also reduced doctors’ hours and is employing more experienced nurses to perform other medical duties for about a quarter of its cost, doctors said.

Immediately, analysis and Bloomberg found that their allies took out at least $ 60m in government loans that were supposed to help unfunded medical teams during the epidemic. TeamHealth has also reduced working hours and asked sleepers to continue working, he said. of reports $ 105m in government grants.

TeamHealth did not respond to a request for comment before the article was published. After the announcement Thursday, the company made a statement to the Financial Times.

“Like almost all service providers we had to change the number of staff members because of the low turnout – but we kept those levels above expectations during the epidemic despite the high cost,” TeamHealth said. “Our physicians continue to work hard for their patients and we are committed to providing them with the resources they need to provide the best possible care in the fight against the global epidemic.”

Envision said it “focuses on providing safe, high quality care that puts the patient first”.

“We tailor our care teams – doctors and gymnasts – with models to meet the specific needs of the regions, taking into account a number of factors, including location and number of patients, needs and acuity levels,” said Envision.

Some doctors are alarmed by the situation, however, and are pushing the American College of Emergency Physicians to conduct more research on patient outcomes at hospitals run by groups run by civilians.

“There is a crisis for emergency medical personnel,” said Mitchell Li, a physician who recently launched Take Medicine Back, a group campaigning against U.S. medical ownership. “Secret societies are reducing costs and making things worse for doctors and patients. We are not safe at all.”

Lesson earlier this year the National Bureau of Economic Research found that outpatient caregivers with 1.7 percent more likely to die within the next 90 days than those who traveled to other facilities.

No similar investigation has taken place in emergency rooms, even waiting times information sections for and the world rising rapidly.

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