July 23, 2009

What Healthcare Reform Means To Hospitals

You're all going to miss Big Pharma.

taking a scalpel to costs.JPG


As if hospitals weren't in ... (Below threshold)

July 24, 2009 12:43 AM | Posted by Steve : | Reply

As if hospitals weren't in the self-dealing business!

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We're all going to miss big... (Below threshold)

July 24, 2009 12:08 PM | Posted by Anonymous: | Reply

We're all going to miss big pharma? Why? Big pharma along with big hospitals and many doctor sponsored clinics are corporate entities whose overriding concern is the maximizing of profits. We get to chose the world's most costly and least effective health insurance by chosing from column 1, 2 or 3. That's why the phrase "murder by spreadsheet" gained so much currency.

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I love how something suppos... (Below threshold)

July 24, 2009 4:18 PM | Posted by Anonymous: | Reply

I love how something supposed to be centered around caring for people such as the healthcare system became something so cold and based on greed.

Crazy world we're in.

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The USA is facing a huge ch... (Below threshold)

July 26, 2009 2:15 AM | Posted by Psyshrink: | Reply

The USA is facing a huge challenge but going to a public system seems logical and necessary, especially given that Americans pay more for health care than any other Western nation and receive less.

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The Republican party's comm... (Below threshold)

July 26, 2009 1:06 PM | Posted by BHL: | Reply

The Republican party's commericals may claim what they want about people dying waiting for treatment in Canada (a real exaggeration, using the face of a woman who has been paid to trash her country), but the fact is that babies in Canada are not born with horrible infections because their mothers have had no pre-natal monitoring or treatment. People in Canada do not put off getting treated or tested for strep, or lumps in their breasts or blood in their stool because they can't pay for it. I've heard of all of these things in the American system.

So if this is socialism, I'm all for it.

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With all of the recent incr... (Below threshold)

July 26, 2009 7:15 PM | Posted by Gerald Solfanelli: | Reply

With all of the recent increase in emphasis upon national healthcare reform, I would like to offer the following sobering reminders. According to the American Psychological Association’s Dr. Lynn Bufka, "Physical and mental health are inextricably linked, as in the case with heart health and stress." Harvard Medical School's Dr. Herbert Benson is also renowned for having observed that "Sixty to ninety percent of visits to physicians are for conditions related to stress."

Jerry Solfanelli

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BHL makes an excellent poin... (Below threshold)

July 27, 2009 8:08 AM | Posted by fraise: | Reply

BHL makes an excellent point. I often mention prenatal care when discussing health care too, letting the numbers speak for themselves. Reference used: Wikipedia: Countries by infant mortality rate Numbers cited are per 1,000 live births, the first is infant mortality and the second is under-five mortality:
USA: 6.3 and 7.8
Slovenia: 4.8 and 6.4
France: 4.2 and 5.2
Iceland: 2.9 and 3.9 (they have the lowest numbers of all)

In France (again, because I live here, but am American), pregnant women have at least 3 sonograms and blood tests (one per trimester), a 3-hour blood test some time around the 4th month, and a postpartum checkup. All covered at 100%. Anything extra deemed necessary is also covered 100%. On top of that, mothers get 6 weeks of paid vacation before birth and 10 weeks after. Fathers get 11 days (18 days if there are twins or more). And France's health care costs us about half as much per capita as the US.
Total health expenditures per capita in 2003, USA: $5711, France: $3048

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As a Canadian and a critica... (Below threshold)

July 27, 2009 1:38 PM | Posted by mo: | Reply

As a Canadian and a critical care nurse I can tell you all those Republican ads are bs. Yes, we do have rich, over entitled asses who want everything right now when it's not an emergency so they whine and go to another country for care. They don't want to wait the two weeks for the MRI they don't need as they could have a CT in a few days but they read on the internet that they needed an MRI and come hell or high water they are getting one right now!
Because Canadians never see a hospital bill they are spoiled rotten brats when they don't get what they want when they want it.
I would advise that if you do go to a public system make sure the patients still get to see their bill, it's a good reminder so they don't get spoiled rotten.
What is the big deal about waiting a few weeks for an appointment with a specialist? Your family doc is well equipped to manage your care and he/she will still be responsible for your care after you see the specialist.
My husband had a heart attack and got state of the art care without waiting so everybody relax all ready. Everyone is making this ridiculously over complicated. Basically the deal is an expansion of medicare for the uninsured and those that the insurance companies want nothing to do with. The system works just fine and the infrastructure can take the expansion without it costing much. I never hear medicaid/medicare recipients whining except about the fact that DOCTORS don't want to accept it and doctors are creating delays in treatment in the US much longer than any other country with Universal Health care and it's amazing to me how easily most Americans pretend they don't have wait lists because they can't find a doctor willing to accept their government insurance. In Canada doctors don't get a choice on what insurance they can take or refuse and it's US doctors that will be the biggest roadblock to Universal Health care.
Everybody else ? nothing changes except if you lose your job and you have a pre-existing condition you can get insurance now when you get a new job or just buy insurance on your own.
Republicans seem to me to be overly sensitive, constant over reactors to minor stimulus and generally a bit "off" so I wouldn't use them as an information resource. They see the bogeyman everywhere and are so afraid their critical thinking skills are overridden. It's too bad the Democrats are such laid back pot heads they cannot get anything done even when they have the advantage. They spend so much time obsessing about hurting the feelings of every potential voter they are paralyzed and can't make a decision. Each one of them is just waiting for that one more poll before they make their final decision and then the next poll. Having Universal Health Care is not about health care, it's a cultural philosophy that says every person has a right to health care and you Americans are no where near ready to make that declaration. I read these doctors blogs and they will never be ready to accept that every person deserves care without having to consider the cost.
Canadians believe that access to health care without cost is a basic human right, along with having enough food to eat, water to drink and a roof over your head. Americans are not believers in the idea that your government exists only to make sure every citizen has their basic needs met.
Why else would we bother with a government if that wasn't one of their most important jobs? You guys are very strange about what you think government is for and most of you think it would be better if half the government except the war department disappeared. Very weird.
You also have strange ideas about human rights so maybe that's the problem. There is nothing stranger than listening to a US government official chastising a foreign government about their human rights abuses while turning a blind eye to their own and then announcing to the world that they are the best country in the whole world. and every one needs to follow the US example. There is nothing about the US that I would ever want for Canada.
We are a civilized country that believes in human rights, we are fiscally conservative and don't believe in massive debt and we believe the only time you fight a war is when they threaten your safety and their civilians need to have their human rights to protected. Along with fighting and dying in Afghanistan our soldiers build roads,medical clinics and schools. They dig wells and fix generators to make life easier for the Afghan people.
I really wish US politicians would stop dragging Canada into US bs. You know nothing about us and have never made any effort to learn and to the rest of the world you sound moronic.

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mo, that was a whole lot of... (Below threshold)

July 27, 2009 2:49 PM | Posted by Jean Paul: | Reply

mo, that was a whole lot of words that I skimmed over but this:
"I would advise that if you do go to a public system make sure the patients still get to see their bill, it's a good reminder so they don't get spoiled rotten."

sounds like a fantastic idea.

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Conservatives view governme... (Below threshold)

July 27, 2009 7:31 PM | Posted by Kevin: | Reply

Conservatives view government schemes as wasteful and government employees as shiftless, lazy incompetents until they carry guns. Conservatives love armed government employees like cops and soldiers. Maybe conservatives would go for universal healthcare if doctors carried guns to shoot patients who make them angry.

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Don't tempt me Kevin. BTW ... (Below threshold)

July 28, 2009 4:38 PM | Posted by JadedMDstudent: | Reply

Don't tempt me Kevin. BTW its worth pointing out that a lot of those physician ran hospitals kick the shit out of the "community" hospitals because they offer superior service due to removing a middle man (the hospital's owners and administrators). Sure some suck, but they will go out of business just like crappy hospitals did back in the 1990s and 1980s. I was in a private hospital ran by a large "NPO" and was with a top physician in his field who was responsible for the hospitals greatly increased reputation. Not a day went by when I didn't see him bitched at by an administrative RN/MBA. The best doctors will still form physician owned clinics and the best would like an excuse to not take Medicare. It would just mean a few more hours on the greens or chasing TNA.

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You seen this on NY Times, ... (Below threshold)

July 28, 2009 11:26 PM | Posted by Tree Frog: | Reply

You seen this on NY Times, about the Wikipedia-Rorschach debate?


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Advertising for Dianetics o... (Below threshold)

July 29, 2009 3:16 AM | Posted by G. Day: | Reply

Advertising for Dianetics on your website?

I finally understand where you're coming from.

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You all Americans pay dearl... (Below threshold)

July 29, 2009 10:26 PM | Posted by Rudd-O: | Reply

You all Americans pay dearly for your health care, not because it's private or greed-based, but precisely because of the OPPOSITE. Watch this video that summarizes your "health" "care" system as best as possible, and understand that advocating "public options" and similar stupid bullshit is only going to fuck you up even more:


Wise up before it's too late, and start striking at the root instead of demanding "paper-over solutions" that will only hide the costs but will result in *more expenses* in the end.

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As for the morons who insis... (Below threshold)

July 29, 2009 10:30 PM | Posted by Rudd-O: | Reply

As for the morons who insist that health care is a human right: it's not a right if you need to *use threats* to get it. You do not have a right to get others to work for you for free. When you understand that, you will finally understand what respect for your fellow man is.

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I did say that there are no... (Below threshold)

August 3, 2009 6:59 PM | Posted by mo: | Reply

I did say that there are no Americans who have evolved enough to ever accept that health care is a basic human right and if you choose to become a member of the health care team you are going to have to grow up and stop whining about where's my money, where's my money? I want my money it's the reason I am a doctor and I refuse to look after anyone without money and you can't make me so there! Don't you dare force me to care for a medicare patient, a medicaid patient, or god forbid a poor patient with no insurance. I am not a free service damn you all, I am a DOCTOR and the only people who have the right to access my experience are people with MONEY. F**K the poor, the addicted, the mentally ill, they aren't MY responsibility so why should I a DOCTOR be forced to treat them...have I got it right for you? Pretty close right...
See, you haven't evolved far enough for Universal Health Care because once again American DOCTORS will not tolerate it. Americans firmly believe if you are poor it's your own fault, if you are disabled it's your own fault, addicted? your own fault, elderly and sick? your own fault. The idea that a government is created to protect and serve it's population is bizarre to Americans because the majority of your population is so poorly educated, your school systems are in a shambles so the majority of the population fears and avoids their government, has no understanding of how it works and doesn't bother to vote because they don't know what the issues are unless it's about gay people getting married .
Your population is ignorant, you may have medical degrees but you are still ignorant. Until you as a country decide to grow up and stop acting like five year olds you can't evolve to a philosophy that says our government is here to serve and protect us, health care is a basic human right that is provided by professionals who understand that what they do is no more important than what their patients do for a living, health care providers are not special nor better than anyone else and do not deserve to be paid extravagantly for their time and experience.
The day American doctors ever agree to the above statement you will get Universal Health Care. Don't expect it any time soon. The Lobby they have is very powerful and they will get their way for many years to come and they will never, ever believe that what other people work at is as important as what they do.

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I am an American doctor, an... (Below threshold)

August 3, 2009 8:46 PM | Posted by commonreader: | Reply

I am an American doctor, and mo has it right.

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I am an American doctor, an... (Below threshold)

August 3, 2009 8:54 PM | Posted by commonreader: | Reply

I am an American doctor, and mo has it right. The money grubbing in American medicine is shameless. But the AMA membership represents a minority of MDs, and I think more of us are after a single payer, public plan. We just don't know how to get there, and anything less seems like more of the same.
Doctor run hospitals often specialize, so they can refuse patients with unattractive funding. They cream the best patients off the top, and build their "reputations.' I'm not sure what JadedMDstudent meant -- was the star MD brought to tears by a hectoring administrator? Jaded will do much better in finance.

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mo- keep posting! let us kn... (Below threshold)

August 12, 2009 9:09 AM | Posted by medsvstherapy: | Reply

mo- keep posting! let us know if you start your own blog!!!! i don't agree with everything you say (only 50+%), but it is honest and entertaining. Mo: more.

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"health care is a basic hum... (Below threshold)

August 18, 2009 2:34 PM | Posted by Anonymous: | Reply

"health care is a basic human right"

I'm honestly curious - How does something that involves, by default, access to the fruits of another individual's labor, be considered a basic human right?

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The comments and thoughts t... (Below threshold)

April 26, 2012 1:43 PM | Posted by gral: | Reply

The comments and thoughts that tend to attack "conservatives" and the perspectives imagined as held by "conservatives" are missing the point entirely. This is not about "conservative" versus whatever is assumed to be its adversary or opposite. A perfect example of this is the supposedly wonderful, meritorious and "progressive" POTUS Barry Obama and his gift to Big Rx, Big Techno, Big Hospital, Big Medicine while pretending with great false integrity to be opposed to those Evil Conservatives.

The presumed battle between Dem vs Repub has no stake in this matter -- both sides protect the Bigs and crush us littles. They differ in their rhetoric, their sales pitch, and their respective roles in baffling the littles while protecting the Bigs.

I'm surprised people say they "don't know how to get to" a national health care program. What does that mean? Does that mean you don't dare reduce the fees charged by MDs because they are beyond reproach and don't have to share in the equalizing of impact? Is it because you assume health care depends on expensive technology and god damn it we can't give that up? Is it because you think insurance companies, HMOs, TPAs all deserve their chunk of the health care income pie?

I don't understand it. It's very simple. Eliminate all the middle men, get rid of expensive testing, make MDs price their service on what people can actually pay without a middle-man, have MDs actually provide a service rather than treating people like revenue streams about whom little is cared other than ability to pay.

How do you do that? You strip away all the prestige and fat incomes currently held by MDs, which enables us to find out who's doing it because they like medicine and like helping people, and who's just trying to be Superior via Career.

Why is it so hard to imagine that situation? It's what will eventually happen anyway when the American economy reaches bottom of the crater trajectory it's on now!

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