Medical Malpractice Nursing Home Abuse Neglect: Illinois ranks high on bad nursing home report

Medical Malpractice Nursing Home Abuse Neglect: Illinois ranks high on bad nursing home report

Illinois ranks high on bad nursing home report

Illinois has the nation’s second-highest number of nursing homes that have been flagged as having poor quality, according to a new federal report.

Forty-seven Illinois nursing homes are among facilities that perform “most poorly” on quality-of-care measures, according to a study released by the General Accounting Office. It’s second only to Indiana’s 52 facilities.

The report rated homes on staffing levels, procedures to prevent bed sores, measures to prevent abuse and neglect and other factors. Ones that were included among the poorly performing facilities averaged a 46% greater number of serious deficiencies that harmed residents when compared to other homes.

The study recommends vastly expanding a federal program that closely monitors U.S. nursing homes with the worst quality ratings, to 580 facilities from the current 136. The GAO did not list the facilities by name.

It also highlights a shortcoming in the way that program, run by the Centers for Medicare and Medicaid Services, is administered. The 136 homes that now undergo more-frequent inspections are the worst performers in their respective states. But some states, like Illinois, perform worse than others, which means many homes that deserve closer scrutiny slip through the cracks.

The study urges CMS to consider a facility’s performance relative to other homes nationally, which likely would label many more Illinois facilities as poor performing.

CMS officials told the GAO they disagreed with relying solely on a national comparison. The agency said it would consider an approach that allows for a national comparison to have more weight.

Officials from the state’s largest nursing home trade group, the Health Care Council of Illinois, which represents for-profit facilities, said they hadn’t had a chance to review the report and would not be able to comment.

Homes rated as poorly performing tend to be larger, with an average of 102 residents; for-profit and part of a chain, and have an average of nearly 24% fewer registered-nurses hours relative to the number of patients.

Several large states had far fewer poor quality homes than Illinois, including Ohio (three), Pennsylvania (six); New York (18) and California (40).

Nationally, there are about 16,000 nursing homes. So the 580 homes that the GAO’s report describes as the worst-performing represents almost 4% of the nation's nursing homes.

Separately, the Chicago Tribune reported in a front-page story Tuesday that 15% of Illinois’ nursing home residents are mentally ill and more than 3% have been convicted of serious felonies. Illinois houses mentally ill patients in nursing homes at a rate greater than any other state, placing residents at greater risk of being harmed by other patients, the story says

http://www.chicagobusiness.com/cgi-bin/news.pl?id=35629

see also http://www.thesunnews.com/news/local/story/1079640.html

CNA Charged with Choking Elder Resident

PRINCETON — A certified nursing assistant at Good Samaritan Home and Rehabilitation Center in Oakland City is charged with choking and punching one of the facility’s residents.

Bryan C. Dillman, 29, of Oakland City, was arrested Thursday morning for a felony battery charge after police were called to the home in reference to a battery with injury on a woman living at the home.

According to an affidavit for probable cause, a nurse at the home, Sharlet Sillz, found Dillman asleep in a recliner in the room of DeeAnn Hoffman.

The affidavit says Sillz told Dillman she would not report him because “she knows that he is tired and that he has kids.”

Hoffman, who had been undergoing a test, went back to her room.

Sillz then told police she heard Hoffman yelling “please don’t hurt me” and Sillz heard a smacking noise coming from Hoffman’s room.

Dillman then quickly walked away and Sillz went into the room. According to the affidavit, Hoffman said to Sillz that Dillman had tried to choke her and hit her numerous times in the face.

After police spoke with Hoffman, she said she had told Dillman she was ready for a shower when Dillman jumped out of a chair, got behind her and put both hands around her neck and choked her.

According to the charging information, Hoffman told police Dillman punched her in the face with his fist."

Tri-State Media

Nursing Home Blamed For Patient Death | TriCities

Nursing Home Blamed For Patient Death TriCities: "BRISTOL, Tenn. – Ninety-eight-year-old Anne Brightwell died in a hospice bed June 16, family members said, after months of screaming over a fractured left femur that would not heal.
Her upper leg bone shattered Feb. 6, when a hammock sling, used by Cambridge House nursing home staff to hoist her from a bed to a wheelchair, snapped. A medical examiner listed the broken femur as the cause of death on Brightwell’s death certificate.
Daughter Ruth Countiss said the fall could have been prevented, and accuses the nursing home of regularly using aging and tattered slings, but throwing newer equipment into use only when Tennessee Health Department inspectors arrived.
Three former Cambridge House employees say administrators hid daily-use equipment from inspectors, only to later pull it out after tucking away the newer items until the next state visit.
On Monday, Countiss filed a $2 million personal injury lawsuit in Bristol, Tenn. General Sessions Court arguing that Cambridge House “knowingly, intentionally and recklessly placed the safety of its residents .... in harm’s way to save money.”"

Article

CA Nursing Homes Carry No Insurance - Victims No Recovery for Abuse or Neglect

n 2007, Grover Brown, a paraplegic 37-year-old, debilitated by multiple sclerosis and Parkinson's disease, developed a pressure sore soon after arriving at the High Street Care Center in East Oakland.

The sore erupted in March. By August, surgeons had removed his tailbone because the wound had festered without treatment, court documents showed.

Brown is suing High Street Care Center, which had a long list of citations from the Department of Public Health — 164 between 2004 and 2008. The facility is owned by Trinity Health Systems, whose president, Randal Kleis, has operated about a dozen facilities across the state under several corporate names.

But Brown, now 39, likely won't see more than a token settlement from High Street Care Center because skilled-nursing facilities, nursing homes and assisted-living care facilities — charged with caring for the sickest and most helpless Americans whose numbers are rapidly growing each year — are not required to carry liability insurance. The amount of the settlement he may ultimately receive is unlikely to cover the cost of care Brown will require as the result of his shoddy treatment at the High StreetCare Center, Renneisen said. The government will end up picking up the tab for his care.

And Kleis' other assets are untouchable because they were legally registered as separate corporate entities — a common way operators shield themselves and their profits.

full article

Felons working in nursing homes?

Florida seniors and disabled adults too frail to live on their own have been beaten, neglected and robbed by caregivers with criminal records according to an article in the Sun Sentinel.

A cancer patient at a Pompano Beach assisted living facility watched helplessly from bed as a nurse's aide with a record for theft rifled through her handbag and stole $165.

A video camera caught an aide at a North Miami Beach group home for the disabled shoving a cerebral palsy patient face-first to the floor, busting her lip. The aide had previously pleaded guilty to criminal assault and never should have been working there.

More than 3,500 people with criminal records — including rape, robbery and murder — have been allowed to work with the elderly, disabled and infirm through exemptions granted by the state the past two decades, a Sun Sentinel investigation found. Hundreds more slipped through because employers failed to check their backgrounds or kept them on the job despite their criminal past.

Screening gaps

Florida has a patchwork of controls for checking caregivers of the elderly that seems to put more emphasis on protecting against embezzlement than safeguarding patients.

Article

Pressure Sore Kills

Verda Henry, a 73-year-old life-long NY resident, entered a County nursing home in 2005 after she fell and injured her arm, thinking she would receive therapy and be home in a month.

Two years later, after repeated denied requests to go home, the grandmother of 15 died in the New Rochelle nursing home, partially because of a horrific, infected bedsore, according to her family and court records.

Henry's daughter, Patricia, filed a Nursing Home lawsuit against the Sutton Park Center for Nursing and Rehabilitation and said she and her children visited her normally active mother every day at Sutton Park, often for eight hours.

"There would be a nurse and she would run between floors and they had no time," Henry said. "Nobody checks on her. Nobody feeds her. Every time we asked to take her home there was a reason we couldn't."

One day, Patricia Henry went to change her mother's gown and noticed the bedsore, already in an advanced stage, over her mother's tail bone.

Within days the sore was infected and she heard her mother's last words - screams - as doctors scraped at blackened skin.

"You could put your whole hand down in her back," she said. "You could see the bones and spinal cord. It was like raw meat. Mommy screamed until she couldn't scream no more."

An administrator at the home said it could not immediately comment on the case. South Shore Medical Center did not return a call for comment.

Bedsores, or pressure ulcers, are lesions caused by unrelieved pressure on the skin. They are largely preventable by making sure a patient is regularly moved or turned every two hours, but are also often fatal once infected.

Patricia Henry's lawyer said there is no systemwide recordkeeping of bedsores, so that patients or families comparing nursing homes can make informed decisions.

Henry said she wants justice for her mother, who died a painful death because of a negligent system.

"I'm sorry I saw it, but I'm glad I saw it," Henry said. "They weren't telling us how bad it was and my mother couldn't tell me anymore."

Read more: http://www.nydailynews.com/ny_local/bronx/2009/09/09/2009-09-09_kin_sue_nursing_home_after_bedsore_horror.html#ixzz0RJRM0PNk

article

Pressure Sore Stats

Data from the National Nursing Home Survey, 2004

• In 2004, about 159,000 current U.S. nursing home residents (11%) had pressure ulcers. Stage 2 pressure ulcers were the most common.
• Residents aged 64 years and under were more likely than older residents to have pressure ulcers.
• Residents of nursing homes for a year or less were more likely to have pressure ulcers than those with longer stays.
• One in five nursing home residents with a recent weight loss had pressure ulcers.
• Thirty-five percent of nursing home residents with stage 2 or higher (more severe) pressure ulcers received special wound care services in 2004.

Pressure ulcers, also known as bed sores, pressure sores, or decubitus ulcers, are wounds caused by unrelieved pressure on the skin (1). They usually develop over bony prominences, such as the elbow, heel, hip, shoulder, back, and back of the head (1-3). Pressure ulcers are serious medical conditions and one of the important measures of the quality of clinical care in nursing homes (1,4). From about 2% to 28% of nursing home residents have pressure ulcers (2,3). The most common system for staging pressure ulcers classifies them based on the depth of soft tissue damage, ranging from the least severe (stage 1) to the most severe (stage 4). There is persistent redness of skin in stage 1; a loss of partial thickness of skin appearing as an abrasion, blister, or shallow crater in stage 2; a loss of full thickness of skin, presented as a deep crater in stage 3; and a loss of full thickness of skin exposing muscle or bone in stage 4. Clinical practice guidelines for pressure ulcers have been developed and provide specific treatment recommendations for stage 2 or higher pressure ulcers, including proper wound care (5). This Data Brief presents the most recent national estimates of pressure ulcer prevalence, resident characteristics associated with pressure ulcers, and the use of wound care services in U.S. nursing homes.

Article

Nursing home aide accused of muffling patient

GRAND JUNCTION, Colo. — An aide at a Grand Junction nursing home has been arrested on charges of using a pillow to silence a screaming patient.

Twenty-three-year-old Errin Hubbard of Grand Junction was arrested Saturday on suspicion of third-degree assault of an at-risk victim and neglect of an at-risk victim.

Hubbard had an unlisted phone number and couldn't be reached for comment.

A heavily redacted affidavit released by police alleges another nurse's aide saw Hubbard put a pillow over the face of a patient at Larchwood Inns nursing home.

The affidavit says the patient, a woman diagnosed with multiple sclerosis, cannot walk on her own.

http://www.google.com/hostednews/ap/article/ALeqM5hQ3VQ4yJ9vreZ1xl1g7UmF_A3VMQD9A9VDS81

Nursing Home Arbitration Preys on Vulnerable Seniors

More and more nursing home corporations are using forced arbitration clauses as a way to avoid accountability for their negligence. Inserted in the fine print of lengthy admission documents, many families are unaware they have signed away their rights until something tragic happens.

Families who face the stress and anxiety of placing a loved one in a nursing home are often in a frazzled state when signing these contracts and sometimes have no other options for care. Nursing homes frequently use tactics like allowing family members with no power of attorney to sign, asking patients with dementia or other debilitating conditions, forcing elderly spouses to sign and even gathering together a group of seniors without family members present in order to force them to sign.

The bipartisan Fairness in Nursing Home Arbitration Act (S. 512 / H.R. 1237), sponsored by Senators Mel Martinez (R-FL) and Herb Kohl (D-WI) and Rep. Linda Sanchez (D-CA) in the House, bans pre-dispute forced arbitration clauses from nursing home contracts. The House Judiciary committee passed the legislation in July and the Senate is expected to consider the legislation in committee before Congress goes out of session.

Legislation is needed to counter draconian Court decisions such as that in Massachusetts which recently upheld these agreements. See Decision. A major problem with Arbitration is that there is often very limited or no discovery allowed before a hearing.

The facts

Virginia Nursing Home Sexual Battery Charged

8-26-09
BRISTOL, Va. – The first time Patricia Davenport complained about a nursing aide’s mistreatment of a patient, she was told she saw it wrong.The second time Davenport complained – and no action was taken – she quit the nursing job she’d had for only six months at the National HealthCare nursing home on North Street.....

James W. Wright, 35, was indicted Tuesday on four counts of aggravated sexual battery. Each count stems from the investigation into the treatment of a different patient from 2000 to 2007, including the lady Davenport said she saw in the wheelchair and another patient who is blind, authorities said.

Davenport said the first time she stumbled upon the abuse of patients was in August 2007. It was the sound of a rocking wheelchair that grabbed her attention, she said, as she strode down a hallway. She peeked into a patient’s room and saw a woman shaking in her wheelchair. The woman’s shirt and bra had been shoved high on her chest. A nurse’s aide was standing behind the wheelchair, and he was reaching around to fondle the patient’s breasts.“She looked like she was just getting ready to break down,” Davenport said. “She just looked at you like ... she was so confused and hurt.”

Davenport said she quit soon after that incident.“You look at those people every day in the face knowing they’re getting abuse and you can’t do anything because nobody’s got your back,” Davenport said. “I don’t want to go back to nursing.”

full article

Retraining after allegations of Elder forced to eat feces

According to the Quincy Patriot Ledger, Mon August 17th, 2009,
The resident aid staff at the Atrium at Faxon Woods in Quincy were 'retrained' following allegations described by the newspaper as "Horror" and including allegations of abuse that included an elderly alheimers victim having to "eat her own feces"

Elder Abuse "Horror" in Quincy, MA.

A 23-year-old nurse’s aide from Quincy has been arrested after police say she tormented and abused elder residents at a home for people with memory loss.

Kara A. Murphy, a nurse aide since 2004, manhandled at least four elderly residents at the Atrium at Faxon Woods during a shift last Saturday, police said They also said she boasted to another caregiver about force-feeding an 89-year-old woman her own feces.

The charges against Murphy are based entirely on the account of another employee who reported the incidents Tuesday to her director, police said.

None of the victims had any recollection of the incidents, police said.

Murphy, of 38 Scammell St., Quincy, pleaded innocent on Friday in Quincy District Court. She is charged with seven counts of assault and battery on disabled persons older than 60.

Judge Mark Coven ordered her to remain under house arrest until authorities can fit her with a GPS tracking device. Murphy is next due in court on Oct. 8.

A woman who answered the door at Murphy’s home said the family had no comment.

Teri Marinko, vice president of marketing and communications for Benchmark Assisted Living, which runs the facility, said Murphy was immediately fired after the company conducted its own investigation.

Marinko said she did not know when Murphy was hired. Department of Public Health records show that Murphy was registered as a nurse’s aide following a competency evaluation in June 2004.

Marinko said there were no prior complaints about Murphy. All potential employees are checked for criminal convictions, she said.

“All the families that have loved ones at the community have been notified,” Marinko said. “We remain confident in the safety and security processes in place to ensure the well-being of our residents.”

The Atrium, on Falls Boulevard, has 60 private apartments and caters to people with Alzheimer’s, dementia and other forms of memory loss. There are color cues in the halls to help residents navigate the facility. Monthly rates start at $5,500.

A report by Quincy police officer James Whedbee reads like a sordid tale of elder abuse that, according to witness’s account, began at 8 a.m. in the bathroom of an 89-year-old resident.

According to the employee who reported Murphy, when the woman tried to stand up from the toilet, Murphy grabbed her by the jaw and forced her back down, saying, “I should make her eat it.”

Murphy then admitted to having carried out that threat in the past, the witness said.

Afterward, when the woman refused to take her medication, Murphy allegedly forced open her mouth and poured in water, which spilled down her neck as the woman pushed her caregiver away.

Later, the co-worker said, she witnessed Murphy push a 92-year-old into her wheelchair and backhand the woman in the forehead because she “was not moving fast enough.”

Murphy mockingly bounced on the lap of another wheelchair-bound woman and punched a different woman in the shoulder, the report says.

In the afternoon, Murphy taunted her co-worker for changing the clothes of a woman who had urinated on herself and recommended she leave it for the next shift, police said.

Quincy’s elder services director, Thomas F. Clasby, said the allegations were stunning.

“If it’s true, it’s disgusting and sickening,” he said.

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Coverage Denied: How the Current Health Insurance System Leaves Millions Behind

New Gov Report

“Pre-Existing Conditions” Affect Millions of Americans

A large proportion of Americans have health conditions that insurance companies can qualify as “pre-existing conditions.”

A pre-existing condition is a medical condition that existed before someone applies for or enrolls in a new health insurance policy. It can be something as prevalent as heart disease – which affects one in three adults¹ – or something as life-changing as cancer, which affects 11 million Americans.²

But a pre-existing condition does not have to be a serious disease like cancer or heart disease. Even relatively minor conditions like hay fever, asthma, or previous sports injuries can trigger high premiums or denials of coverage.³

Unattainable Health Coverage

Insurance discrimination based on pre-existing conditions makes adequate health insurance unavailable to millions of Americans.

In 45 states across the country, insurance companies can discriminate against people based on their pre-existing conditions when they try to purchase health insurance directly from insurance companies in the individual insurance market.⁴ Insurers can deny them coverage, charge higher premiums, and/or refuse to cover that particular medical condition.

A recent national survey estimated that 12.6 million non-elderly adults⁵ – 36 percent of those who tried to purchase health insurance directly from an insurance company in the individual insurance market – were in fact discriminated against because of a pre-existing condition in the previous three years.⁶

In another survey, one in 10 people with cancer said they could not obtain health coverage, and six percent said they lost their coverage, because of being diagnosed with the disease.⁷

It is still legal in nine states for insurers to reject applicants who are survivors of domestic violence, citing the history of domestic violence as a pre-existing condition.⁸

Even when offering coverage, insurers can exclude whole categories of illnesses related to a pre-existing condition. For example, someone with a pre-existing condition of hay fever could have any respiratory system disease – such as bronchitis or pneumonia – excluded from coverage.⁹

Losing Coverage When You Need It Most

Thousands of Americans also lose health insurance each year through a practice called rescission.

When a person is diagnosed with an expensive condition such as cancer, some insurance companies review his/her initial health status questionnaire. In most states’ individual insurance market, insurance companies can retroactively cancel the entire policy if any condition was missed – even if the medical condition is unrelated, and even if the person was not aware of the condition at the time. Coverage can also be revoked for all members of a family, even if only one family member failed to disclose a medical condition.¹⁰

A recent Congressional investigation into this practice found nearly 20,000 rescissions from three large insurers over five years, saving them $300 million in medical claims¹¹ – $300 million that instead had to come out of the pockets of people who thought they were insured, or became bad debt for health care providers.

At least one insurance company has been found to evaluate employee performance based in part on the amount of money an employee saved the company through rescissions.¹² Simply put, these insurance company employees are encouraged to revoke sick people’s health coverage.

The Need for a Solution

High-risk pools, which have been used by states to cover the “medically uninsurable,” do not work.

Thirty-five states offer a high-risk pool for people who have been denied coverage in the individual insurance market or otherwise cannot obtain insurance.¹³ However, high-risk pools generally charge significantly higher rates than they charge for a healthy individual in the individual insurance market,¹⁴ meaning that only relatively high-income people can afford the coverage. One study estimated that only eight percent of the uninsurable population is able to enroll in high-risk pools, mainly because of high premiums.¹⁵

Benefits through a high-risk pool are also not guaranteed. Some state high-risk pools have annual caps on enrollment, or limit eligibility only to people who had prior group health coverage in the preceding 63 days. And one state high-risk pool has been closed to new beneficiaries since 1991.¹⁶

All high-risk pools also impose pre-existing condition exclusions for six months to one year, during which time care for the very condition that made someone uninsurable is not covered.¹⁷

Health Insurance Reform Will Provide Stability and Security for All Americans

Under health insurance reform, insurance companies will be prohibited from refusing coverage because of someone’s medical history or health risk.

Insurance companies will be required to renew any policy as long as the policyholder pays their premium in full. Insurance companies will not be allowed to refuse renewal because someone became sick.

And insurance companies will be prohibited from dropping or watering down insurance coverage for those who are or become ill.

Health Care Reform - Obama's Coalition

With the push for health care reform in a critical stretch, some bizarre coalitions are stepping up the fight to see the legislation through to the finish line.

One of the most peculiar, Healthy Economy Now, is spending millions to pressure members of Congress to get on board with health care reform.

The organization has brought together stakeholders from across the spectrum -- the pharmaceutical industry, doctors, union interests, business interests and advocacy groups among them.

The common thread for these strange bedfellows? Self-interest, observers say.

"Either you're sitting down at the table or you're on the menu," said Ernest Istook, a fellow at the conservative Heritage Foundation.

With the option of a national coverage mandate on the table, industry groups stand to win tens of millions of new customers regardless of the concessions the federal government extracts from them. Advocacy groups get the reform they wanted and union groups can win added benefits for their members.

"This whole thing has a lot of fascinating coalitions," Istook said, calling them a "convergence of individual self-interests rather than a shared vision of what is going to be best for the country as a whole."

In a statement, the senior vice president for Pharmaceutical Research and Manufacturers of America -- one of the coalition members -- said the groups came together because they share the goal of improving the economy through health care reform.

"We believe that without health care reform, America will continue to get sicker and poorer," Ken Johnson said, adding that a "healthier economy can happen if we have a healthier workforce."

Regardless of motive, such coalitions could prove vital to President Obama and his allies in Congress as opponents of health care reform flood town hall meetings to meet with their representatives during August recess.

According to a recent report, drug makers stand ready to spend $150 million to help Obama get the legislation passed.

The Healthy Economy Now ad buys have so far cost $12 million, according to another account. The group so far has run three ads in states targeting key lawmakers in the health care policy process.

The most recent ad warns that medical costs will skyrocket "if we don't act," and Americans will continue to lose coverage and benefits.

"But we can act," the narrator says. "The president and Congress have a plan to lower your costs and stop denials for pre-existing conditions. It's time to act."

The ads reportedly were made by companies with close ties to Democrats and the White House.

Healthy Economy Now includes Pharmaceutical Research and Manufacturers of America, the AARP, the American Medical Association, the Business Roundtable, Families USA and the Service Employees International Union, among others.

But at this murky stage in the debate, it's becoming less and less clear what is in the best interest of these organizations.

Several of them got on the bandwagon out of sheer survival instinct. They came to the table when public opinion was more favorable toward comprehensive legislation and Obama-led reform seemed inevitable. It was seen as better for industry organizations to get on board and shape legislation to their advantage than to actively oppose it while a bill that meets few of their needs tracked toward the president's desk.

"I think the groups just naturally want to be at the table thinking they're going to come out of it better," said Rick Scott, who heads Conservatives for Patients' Rights, one of the leading groups campaigning against the legislation in Washington.

But with public opinion starting to turn and town hall meetings getting raucous, it's unclear whether these groups backed the winning horse.

"We'll wait to see what September brings and if there's cracks in some of these coalitions," Istook said.

A crack started to show this week, after Obama claimed the AARP was "on board" with his health care plan. The line apparently hit a soft spot for the seniors group, which, though claiming to be nonpartisan and not behind any specific legislation, has appeared to side with Obama on health care reform -- even hosting a town hall-style event with him last month -- to the dismay of some of its members. The group drew the line after Obama claimed he had their endorsement, with Chief Operating Officer Tom Nelson calling the claim "inaccurate."

Istook said the industry groups also are "playing with fire," since they're dealing with other organizations and officials that ultimately want them "out of business."

The tension between the traditional forces for health care reform and the traditional forces against it flared most recently between Democrats and the insurance industry.

After coming to the table on health care talks earlier in the year, the insurance industry has been vilified by congressional Democrats and the administration in recent weeks. The Department of Health and Human Services just issued a report titled: "Coverage Denied: How the Current Health Insurance System Leaves Millions Behind."

Obama, though, insists he's not trying to pave the way toward a single-payer system -- one in which the insurance companies are mostly taken out of the picture -- despite past statements in favor of such a setup.

America's Health Insurance Plans is now conducting its own ad campaign advocating health care reform, but it is strongly opposed to the kind of public option that Democrats are calling for. A public option could significantly cut into insurance company revenue even if an individual mandate is part of the legislation.

Meanwhile, the groups in Healthy Economy Now have used some questionable tactics in pushing their agenda.

The New York Times reported last week that PhRMA struck a behind-the-scenes deal with the White House in which the administration would ensure nobody squeezes extra money out of the drugmakers in exchange for $80 billion in cost savings over the next decade. A PhRMA executive later walked that back in an interview with the Huffington Post.

Another unlikely alliance came with PhRMA and Families USA banding together to launch the sequel last month to the "Harry and Louise" ads that helped derail health care reform under the Clinton administration.

This time, though, the Harry and Louise actors, whose full names are Louise Caire Clark and Harry Johnson, are appearing in a multimillion-dollar ad campaign in support of health care reform.

AHIP spokesman Robert Zirkelbach said the scattered alliances stem from a desire to reach a mutually beneficial package and an acknowledgment that the status quo is not sustainable.

"You didn't see this type of collaboration 15 years ago. Never before have we had hospitals and doctors and employers and labor unions and health plans all coming together in support of health care reform," he said.

Despite the climate of advocacy for health care reform, several groups have lined up against the plans, including the U.S. Chamber of Commerce, the Association of American Physicians and Surgeons and the Blue Cross Blue Shield Association.