“Standing on the edge of the tunnel shaft, it was apparent that the structure itself was substantial. At the top, the remains of a ladder hung over the lip of the opening. In the center of the round shaft, a center pole looked like a hub for a spiral staircase. The shaft itself extended down farther than we could see, especially in the meager light of our headlamps.
Video released by the IDF from inside the shaft showed what we could not see from the top of the opening. The video shows a spiral staircase leading down into a concrete tunnel. The IDF said the tunnel shaft extends downwards approximately 10 meters and the tunnel runs for 55 meters. At its end stands a metal door with a small window.
“We need to demolish the underground facility that we found,” said IDF spokesperson Rear Admiral Daniel Hagari. “I think the leadership of Hamas is in great pressure because we found this facility, and we are now going to demolish it. It’s going to take us time. We’re going to do it safely, but we’re going to do it.”
It is arguably the most compelling evidence thus far that the IDF has offered that there may be a network of tunnels below the hospital. It does not establish without a doubt that there is a command center under Gaza’s largest hospital, but it is clear that there is a tunnel down below. Seeing what connects to that tunnel is absolutely critical.
For Israel, the stakes could not be higher. Israel has publicly asserted for weeks, if not years, that Hamas has built terror infrastructure below the hospital. The ability to continue to prosecute the war in the face of mounting international criticism depends to a large extent on Israel being able to prove this point.
Hamas has repeatedly denied that there is a network of tunnels below Shifa hospital. Health officials who have spoken with CNN have said the same, insisting it is only a medical facility.”
“As the Israeli military shores up its strategic positions in northern Gaza, preparing to enter deeper into Hamas’ stronghold of Gaza City, one of the key points of battle, the army has indicated, is likely to be the Palestinian enclave’s largest medical center:
” The new study..compared the prices hospitals posted online (as required under new federal regulations) with the prices obtained in phone calls conducted by the team posing as potential patients.
They contacted 60 hospitals across the country, a mix of top-ranked facilities, hospitals that primarily serve low-income people, and the other hospitals in between. They asked about two procedures for which comparison shopping is more common: vaginal childbirth and a brain MRI.”
“It was rare for the advertised price on the web to be the same as the price quoted over the phone. Less than 20 percent of hospitals provided the same price through an online price estimator as they did when someone spoke to a member of the billing department. In many cases, the disparity was significant, with more than a 50 percent price difference depending on whether you checked on a website or called for a quote.
And in a handful of cases, the price more than doubled depending on how you asked. At two hospitals, MRIs were listed online at $2,000, but “patients” were given a price of more than $5,000 when they called. Five hospitals offered a price of $10,000 for vaginal childbirth over the phone, but the price posted online were twice that much.
There didn’t seem to be a clear pattern of which quotes were higher. Sometimes they were higher over the phone, sometimes higher on the website.
The researchers said they took pains to make sure they were getting apples-to-apples comparisons, going so far as to give specific billing codes during their scripted calls with hospital staff. It didn’t matter.”
“Research had already found prices for the same services vary wildly at different hospitals. The top-line findings of this new study reveal that it can be difficult to even determine what the price for a given service is at a given hospital. That is a problem both for the 10 percent of the US population that is uninsured as well as people enrolled in high-deductible health plans, which are becoming more common.”
“the researchers made one other note in their study: They found poor correlation between brain MRI and vaginal childbirth prices within an individual hospital. In other words, some facilities would have high MRI prices compared to others but low prices for delivering babies — with no discernible economic reason for that disparity. It’s chaos.”
“Starting your own medical practice is hard. In some states, it’s almost impossible due to the monopoly power of politically connected hospital associations. Independent doctors and patients tried for 10 years in South Carolina before finally scoring a victory last month.
On May 16, South Carolina Gov. Henry McMaster signed legislation to repeal most of the state’s medical certificate of need (CON) laws. A CON is a government permission slip that health care providers must obtain before they can launch or expand services. Spending money to provide safe, affordable care is illegal without this piece of paper.
Big hospitals love the red tape. Instead of competing with would-be rivals on a level playing field, they can claim their turf and defend it using government interference on their behalf. Many states even allow established providers to object to rival CON applications, giving them something like veto power.
If McDonald’s had the same authority, local franchisees could block mom-and-pop burger joints from opening nearby. The Home Depot could block family hardware stores. And LA Fitness could block independent gyms.”
“Hospitals across the country are grappling with widespread staffing shortages, complicating preparations for a potential Covid-19 surge as the BA.5 subvariant drives up cases, hospital admissions and deaths.
Long-standing problems, worker burnout and staff turnover have grown worse as Covid-19 waves have hit health care workers again and again — and as more employees fall sick with Covid-19 themselves.”
“The argument here is not about whether nurses should be held accountable for their errors; everyone I spoke with about Vaught’s case agrees she bears responsibility for her actions and should face consequences. The real issue is that criminalizing a nurse’s error lets hospitals off the hook for the systemic changes that would improve patient safety.
“Almost no mistakes happen in a hospital by just one person,” said Gatter. Systems exist to prevent medical errors, he said. If those systems don’t work or exist only on paper, errors will happen.
In this case, the system failures were clear: During an unannounced visit to Vanderbilt University Medical Center in late 2018, federal investigators found multiple deficiencies, some of which placed patients at “serious and immediate threat,” according to the 105-page memo documenting the details. For example, hospital policies didn’t require that a second nurse sign off on the use of a highly dangerous medication like vecuronium, nor did it require that patients receiving sedatives be hooked up to a heart and lung monitor. Focusing the blame on one nurse’s error shifts the attention away from those deficiencies.
“I’m quite concerned that this nurse is getting thrown under the bus, and in the hubbub of giving her a jail sentence, that the system itself will escape close examination,” said Gatter.
Even if a nurse were solely responsible for a medical error resulting in patient harm, the way to prevent that nurse from causing further harm is to revoke their license, said Gatter. It’s much harder to explain how punishing a nurse with jail time further prevents them from endangering others.
However, it’s easy to see how that type of punishment can itself create and compound safety risks, he said.
That’s because severely punishing individuals for systemic problems has a chilling effect on others’ willingness to report mistakes.”
“Less transparency in error reporting also means hospitals have fewer opportunities to correct big problems. That means faulty systems stay in place, which translates into more vulnerability and stress for health care providers and less safety for patients.”
“The consequences for professional malpractice should ideally deter wrongdoing without discouraging people from entering the profession altogether — but finding that balance is challenging.”
“American nursing was under enormous strain well before the pandemic. But with the US population aging, surging retirements among bedside nurses and nurse educators, and nurse staffing levels reduced ever lower to contain costs, the pandemic has tipped parts of the country into a full-on nursing shortage.
The last thing the profession needs is another reason for nurses to leave jobs providing direct patient care, but that’s exactly the effect the Vaught ruling is having”
“Late last year, Laura Wing-Kamoosi visited her 79-year-old father at the hospital in northern Michigan. To her surprise, a worker asked her to remove her N95 and replace it with a surgical mask. She declined, layering the surgical mask atop her N95 instead.
She saw no staff wear N95s, among the best respiratory protection available, while they treated her father for a tear in his aorta and other medical issues, she told POLITICO. One doctor wore his surgical mask under his nose, she said. Her father, who was hospitalized for about a month, contracted Covid-19 during his stay, and while he survived, the virus slowed his recovery.
The hospital, Munson Healthcare, said it requests visitors wear the surgical masks it provides to ensure people are using quality masks and that it allows visitors to layer one over their own. The hospital is following guidance from the Centers for Disease Control and Prevention — and for many public health advocates, that’s exactly the problem.
They fear that surgical masks put the most vulnerable people at higher risk of catching Covid-19. N95s, which seal tighter to the face, offer better protection against the airborne virus, studies show. For more than a year, many have called on the Biden administration to change its guidance to offer more protection inside hospitals, even as mitigation measures have been dialed back and case counts decline.
And yet, patients across the country say they are often told to replace their N95s with surgical masks as they enter hospitals.”