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Tuesday, November 26, 2024

Dr Oz at the Center for Medicare and Medicaid Services: a chance to improve food service in hospitals

The people Trump proposes for the cabinet are mostly unqualified. And except for the fact that Trump wants to tear down government ("Trump takes aim at government as public faith in US institutions continues to erode," USA Today, "A big win for the Blow It Up Party, but what then?," Washington Post) not aiming for innovation ("Healthcare innovation: process redesign and innovation in DC and Prince George's County," 2011), so goes it for Dr. Oz, who has promoted Medicare Advantage plans, which tend to be a bad deal for patients and government spending ("Mehmet Oz loves promoting this inferior Medicare substitute," MSNBC, "The Great Medicare Advantage Marketing Scam," American Prospect). 

I have been admitted to the hospital a lot this year--5 times--once for 8 days (covid, pneumonia, myocarditis). One of the things that has surprised me about the hospital I use, which is a for profit owned by the largest hospital chain in the country, is that depending on time and availability, they send people from various units to talk to the patients, room by room (all private).  It turns out all for profit hospitals are not the devil.  And this one hasn't outsourced food service.

Last week when I was hospitalized, the leaders of the food service department happened to come around, and I had a long conversation with them (given my background in hospitality and familiar with some industry trends, it was pretty lively).  Despite various limitations, a few of their items are restaurant quality already, but certain key dishes are not and a majority of dishes are not.  

Opal Gordon and Sumei Rodriguez prepare fruit plates for patients at Lenox Hill Hospital. (Jeenah Moon for The Washington Post)

CMMS, among other things, regulates hospitals in many ways, including food service.  

While there are programs at various hospitals to improve ("Corewell Health among healthcare systems leveraging local farms for healthy food options," Rapid Growth, "Hospital Food You Can Get Excited About," New York Times, "Hospital food is a punchline. These chefs are redefining it," Washington Post) some of these efforts are hindered by CMMS.

One of the requirements is cooking proteins to extra well done.  Which makes eating cooked meat and fish--salmon should be medium rare--often intolerable when it comes to eating.  And I'd prefer to order salmon when it's offered because it is heart healthy.

"Dissatisfaction with food quality" was an element mentioned in the academic paper, "Hospital Food Service Strategies to Improve Food Intakes among Inpatients: A Systematic Review," Nutrients, 2021.

During his unsuccessful campaign for Senate two years ago, Oz complained about the high cost of crudités (a vegetable plate), for which he was pilloried for being out of touch ("Mehmet Oz’s crudité video gave opponent John Fetterman a golden opportunity," NBC News).  Regular people offer vegetable platters or trays and don't call it a crudité.

Instead Oz could redeem himself and focus on improving food service outcomes in hospitals.  

Except for that fact that the last thing the second Trump Administration cares about is improving services.

People claim government can't do (and there are serious problems with this, which I will write about), but Obama, Pelosi, the Affordable Care Act, Utah voters forcing the government to expand Medicaid, and Medicaid have saved my life.

I'm certain that is the case at least a million other times.  And there is plenty that the federal government does that is exemplary.  However, Republicans by focusing on cutting taxes, have made it impossible to provide the right amount of money to agencies necessary to fully fund services.

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