Connecticut Health Investigative Team (https://c-hit.org/author/sujatasrinivasan/page/2/)
Shawn was 4 years old when he watched his dad, Jonathan Whaley, keel over at their doorstep from a gunshot wound to his back. He remembers the pool of blood, the paramedics, and the police. Whaley, 34, didn’t make it. Shawn is now 8 years old. He lives with his grandmother and five siblings in one of Hartford’s rundown neighborhoods.
Advances in early detection and cancer treatments have resulted in a 27 percent decline in cancer deaths in the U.S. in the last 25 years, but those benefits are slow to trickle down to those who are lower on the socioeconomic scale, according to a report by the American Cancer Society. In the nation’s poorest counties, the cancer mortality rate is 20 percent higher than in the most affluent counties, and “the difference is much larger for cancers that are the most preventable: cervical, colorectal and lung,” said Rebecca Siegel, strategic director of Surveillance Information Services at the American Cancer Society and an author of the study. Robert Ciemniewski, 57, a longtime smoker from Connecticut, was on the wrong side of the statistical divide when he walked into the emergency room in 2017 with breathing difficulties from what he thought was pneumonia. He did have pneumonia, but he also had advanced lung cancer. Ciemniewski had not had a health checkup since 2013, when he quit his job as a mailman to care for his ailing mother.
With physicians’ compensation from pharmaceutical and medical device companies under increasing scrutiny, payments to doctors in Connecticut for consultant work rose to $8.5 million in 2017, up from $8 million in 2016. Payments for meals, travel and gifts also increased from $3.2 million in 2016 to $3.5 million in 2017, data from the Centers for Medicare & Medicaid Services show. Of the total $27.2 million in payments, $4.37 million – or 16 percent – went to 10 doctors holding licenses in Connecticut. The highest paid doctor was Dr. Paul Sethi, an orthopedic surgeon in Greenwich, who accepted slightly more than $1 million in 2017 in royalty fees, consulting work, and other services from several companies, including Arthrex Inc., and Pacira Pharmaceuticals Inc., maker of Exparel. The drug, Exparel, is marketed as an alternative to opioid painkillers post-surgery.
In February, Joan Goldstein of Monroe received a panicked call for help from her wife, Lauren Goldstein. Joan found Lauren rolled up like a ball on the floor in her office bathroom. “I have never seen her sick in 15 years,” Joan said. When Lauren couldn’t stop vomiting, Joan took her to the emergency room at St. Vincent’s Medical Center in Bridgeport, where she received fluids intravenously—“three bags,” Joan said.
Thousands of consumers statewide are experiencing sticker shock at the pharmacy this year after increases in deductibles and out-of-pocket expenses for employer-sponsored insurance, forcing some to choose between their health and their finances. Since 2003, drug costs in Connecticut have increased faster than prices across the nation, reports the nonprofit Connecticut Health Policy Project. The advocacy group also found that Connecticut residents spend more per person on prescriptions than residents in all states except Delaware and that rate is rising much faster than in other states. According to the State Comptroller’s Office, the total net costs of prescription drugs in the state employee health plan rose 29 percent, from $257.6 million in 2014 to $332.3 million in 2017, with diabetes drugs the most expensive therapeutic class. Some of the companies to hike prices on dozens of medications by more than 9 percent this year include Allergan Plc, Insys Therapeutics Inc., Horizon Pharma Ltd., and Teva Ltd, according to Jefferies LLC, a New York-based investment advisory firm.
On a snowy Saturday morning in January, Selvin, 13, and his mother were in the basement of the First and Summerfield United Methodist Church in New Haven, to support a friend in sanctuary. As they sat there, the boy tried to push away thoughts of how it would be when ICE came to take away his own mother, who is also under a deportation order. “I’m going to be alone with my little brother and my dad,” Selvin said. “Sometimes I feel I don’t want to talk to anybody. I just go to my room, lock the door, and I feel depressed.”
Selvin – whose family asked that his last name be withheld – is among thousands of immigrant children in Connecticut and nationally feeling the effects of prolonged stress, which can become so toxic it can damage the developing brain.
A few years ago, patient navigators at Project Access-New Haven set out to see if they could change the course of health care treatment for some Medicaid patients who frequently used emergency rooms.
They contacted emergency departments at Yale New Haven Hospital and its Saint Raphael campus and enrolled 100 patients in their study in 2013. Those selected had visited emergency rooms four to 18 times in the past year for chest pain, abdominal pain or chronic migraines, among other ailments. The navigators at Project Access coordinated health care for the patients. They scheduled appointments with primary care physicians, provided reminders, accompanied patients to physician visits and followed up to ensure compliance with the prescribed treatment. The preliminary results were eye-opening: “We saw an average cost reduction of $153 per member per month,” said Dr. Roberta Capp, assistant professor, Department of Emergency Medicine at the University of Colorado Denver, and lead investigator of the study.
When the lights power on in the operating room at Bridgeport Hospital, more than a half of the acute care team of surgeons peering from behind the masks are women. That’s unusual, given that only 28 percent of all surgeons in Connecticut are female, according to the latest figures from the American Medical Association (AMA). Flexible work schedules and hiring more surgeons to ease the on-call burden has helped to lure more women to the trauma surgical team, said Bridgeport Hospital’s chief medical officer, Dr. Michael Ivy, a trauma surgeon. Hospitals statewide have launched initiatives to help boost the ranks of women surgeons. There’s been progress, but gaps persist.
Edith Baker of Plainville faced a devastating reality that patients with advanced cancer inevitably confront. She had stopped responding to conventional treatment. Radiation and chemotherapy could no longer contain her stage 4 bladder cancer. But there was a ray of hope. Baker’s oncologist at Saint Francis Hospital and Medical Center referred her to a clinical trial at UConn Health involving two immunotherapy drugs: the FDA-approved Keytruda (pembrolizumab) from Merck & Co., credited with successfully treating former President Jimmy Carter’s melanoma; and Epacadostat (IDO1 inhibitor), an experimental drug from Incyte Corp.
Penalties levied against Connecticut companies for violations of occupational safety rules dropped by more than half between 2011 and 2015, and the number of cases with penalties fell by 40 percent in the same time period, according to a C-HIT analysis of federal Occupational Safety & Health Administration (OSHA) data. Data from the agency’s offices in Bridgeport and Hartford show initial penalties against Connecticut employers totaled $10.86 million in 2011 and dropped to $5.07 million in 2015. Companies were able to negotiate settlements, lowering penalty payments to $6.26 million in 2011, and $3.51 million in 2015. For the first nine months of 2016, the downward trends in cases and fines are continuing, the data show. Reasons for the declines vary: Government officials point to safer workplaces and more compliance with regulations.