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joerene.aviles

The stakeholders are Dr. Atul Gawande, other healthcare professionals, and the patients with terminal illnesses. They have to decide what the patient's priorities are, treatment options, and basically how much time and quality of life patients are willing to trade for extended years to live. Is the treatment making the patient worse or better? Doctors have to put themselves in a position of vulnerability by personally getting to know their patients, and deal with the guilt and blame if their treatments aren't successful or what they had said to the patient's family.

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joerene.aviles

1. Under private equity ownership, some ambulance response times worsened, heart monitors failed and companies slid into bankruptcy, according to a Times examination of thousands of pages of internal documents and government records, as well as interviews with dozens of former employees. In at least two cases, lawsuits contend, poor service led to patient deaths.

2. “Private equity has, in this case, threatened public safety,” said Richard Thomas, the mayor of Mount Vernon, N.Y, which relied on TransCare. “It’s not the way to treat the public.”

3.  Do the Write Thing “didn’t sit well with the firefighters,” said Nico Latini, who has worked at Rural/Metro for a decade. “We operate under a high level of integrity and we do the right thing every day — with an R, not a W.”

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maryclare.crochiere

"Two FDNY EMTs who had to intervene to stop four police officers beating a handcuffed patient on a stretcher have turned the cops in to authorities"

""Three cops began to punch the patient in the face, EMS (had) to get in the middle of it to intervene. Pt's. wounds and injuries cleaned in the (ambulance)," the report said."

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maryclare.crochiere

I further researched the reliability of some of the funds that were donated to in the months after the disaster. The FBI issued warnings to those donating to be sure they were giving money to a reliable fund, as there was a lot of fraud taking place. With so much money being donated internationally in a short period of time, it was likely easy for such to occur, and that also took away from the amount of aid Haiti received.

I also looked into the improvements in the country over the first few years since the earthquake. The people of Haiti were cited as having a strong desire to help rebuild, they just needed to be shown how. http://www.nbc29.com/story/20596283/haiti-sees-improvements-since-earth…

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maryclare.crochiere
Annotation of

I looked up the rates of hospital bankruptcy/closing, the results looked to be interesting. The article (http://www.healthcarefinancenews.com/news/hospital-bankruptcies-result-…) makes it seem avoidable, if the warnings are taken seriously in the years leading up to the crisis. "What they found was that filing hospitals tended to be smaller, not part of a health system and were more likely to be in the Northeast or West Coast. Many factors were involved, including poor financial management, changes in payer mix, reimbursement reductions, overzealous construction and purchasing of physician practices, decrease in volume and demographic shifts that were the impetus for filing."

I also looked up ER wait time statistics, by state, over the course of several years, etc. (https://projects.propublica.org/emergency/) Very interesting!

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joerene.aviles

Emergency response isn't explicitly addressed in the article, but in order to incorporate structural interventions into public health, emergency response would have to be improved as well. As the article states, there are many "diseases of poverty" and medical emergencies would be more common in those populations. Noting these trends can streamline medical response and help with providing education/ resources to prevent emergencies.

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maryclare.crochiere

"History shows that, with time, a given community of engineers and scientists has generally proven able to explain the technical particulars of a structural collapse. Yet, the demands placed in an investigation have as much, or more, to do with defining the dominant investigator and quickly addressing the fears and anger of the press, government, and an outraged public than they do with discovering the defiinintive technical truths of a catastrophic event."

"Steam power...utterly transformed American economic and social life in the 19th century. With this promising technology, though, arrived a whole series of risks, catastrophic boiler explosions being the most dramatic, and the deadliest."