Gordon Howie and his right-wing echo chamber are having fun blaming government for driving doctors out of business. Authors David Houle and Jonathan Fleece say those doctors may have it coming. They contend that a third of hospitals will close by 2020, not because of government gone wild, but because of their failure to provide quality service:
...statistically speaking hospitals are just about the most dangerous places to be in the United States. Three times as many people die every year due to medical errors in hospitals as die on our highways — 100,000 deaths compared to 34,000.
...Currently in our non-transparent health care delivery system, Americans have no way of knowing which hospitals are the most dangerous. We simply take uninformed chances with our lives at stake.
...hospital customer care is abysmal. Recent studies reveal that the average wait time in American hospital emergency rooms is approximately 4 hours. Name one other business where Americans would tolerate this low level of value and service [David Houle and Jonathan Fleece, "Why One Third of Hospitals Will Close by 2020," KevinMD.com, March 2012].
What's going to shut down these under-performing health care providers? Connectivity, electronic medical records, and transparency:
...any American considering a hospital stay will simply go on-line to compare hospitals relative to infection rates, degrees of surgical success, and many other metrics.... Inevitably when we are able to do this, hospitals will be driven by quality, service, and cost — all of which will be necessary to compete.
What hospitals are about to enter is the place Americans, particularly conservative Americans cherish: the open competitive market. We know what happens in this environment. There are winners and losers [Houle an Fleece, March 2012].
Ah, transparency and competition, producing better care and weening out failure. I wonder why Gordon's friend Dr. Ed Picardi would be afraid of that?
Cory, ever consider the thought that the problem is the low reimbursement rates hospital receive from their Medicaid and Medicare patients? And how about the quality of service the government provides Indians? And you want to call this a market based system? No Cory, it is government controlled system run by corporate socialists. Today's healthcare in America is no more market based than Daugaard's education plan. If it was, then those receiving the benefits would be paying for them.
This post is intellectually dishonest, meant to deceive, and is very sad.
Senator Johnson is live on appropriations for VA:
http://appropriations.senate.gov/streamc.htm
Looks like Sibby has worn another hole in his marble pouch and just dropped a couple of steelies. Go, Larry go.
Long lines at the E.R. happen because of SooSan Hospital (Indian Health Service) shutting down at 5pm everyday. How's that for government health care?
IHS is a mess, no doubt. But that's not the same thing as the VA, Medicare and Medicaid. There are other political forces in play. Three guesses as to what I'm talking about, and the first two don't count.
http://en.wikipedia.org/wiki/Indian_Health_Service
This interested party confesses confusion over the varying administrative jurisdictions over health care.
As the Roman Church has virtual monopolies in many areas that begs prosecution under RICO statutes it seems appropriate that a single-payer system not only opens existing facilities to all, but offers options to more people to explore for-profit medical entrepreneurs for those who can afford it.
Testimony on shared IHS/Va in Alaska now on Appropriations.
Tangentially related: The US is stealing doctors from the rest of the world.
From the New York Times
In a globalized economy, the countries that pay the most and offer the greatest chance for advancement tend to get the top talent. South America’s best soccer players generally migrate to Europe, where the salaries are high and the tournaments are glitzier than those in Brazil or Argentina. Many top high-tech workers from India and China move to the United States to work for American companies. And the United States, with its high salaries and technological innovation, is also the world’s most powerful magnet for doctors, attracting more every year than Britain, Canada and Australia — the next most popular destinations for migrating doctors — combined.
The Council on Physician and Nurse Supply estimates that in 10 years, the United States could have a shortage of 200,000 doctors. Already, one in four doctors working in this country is trained in a medical school overseas (though this includes some American doctors who attended medical school outside the United States). American medical schools are producing more graduates, but many of them will become specialists who can command better pay. The demand for primary-care doctors is expected to stay high, perpetuating the demand for foreign medical graduates.
Even in the unlikely event that American medical schools produce more general practitioners, nothing but legislation would prevent American hospitals from cherry-picking the most promising young doctors the world has to offer, according to Laurie Garrett, a senior fellow at the Council on Foreign Relations. “If you can take from an applicant pool from the whole planet, why would you only take from Americans?†Garrett said. “For the foreseeable future, every health provider, from Harvard University’s facilities all the way down to a rural clinic in the Ethiopian desert, is competing for medical talent, and the winners are those with money.â€
http://www.nytimes.com/2012/03/11/magazine/america-is-stealing-foreign-doctors.html?_r=1&sq=doctors&st=cse&scp=2&pagewanted=print
Sibby this ones for you. http://grooveshark.com/s/Hot+Steel+Balls/iR52A?src=5
Fleming thanks for the laugh. I needed it this morning.
The BLindman
You betcha, Bill. Rock on brother.
http://www.doonesbury.com/strip/archive/2012/03/15
"You betcha, Bill. Rock on brother."
Using humor to avoid the truth is not something you should be proud of Bill. But you are a master at both...avoiding truth and being proud of yourself.
don't muck with the duck unless you want the bill(s).
Steve, go over to ip and comment on Ron Paul's next move.
Well, Steve, it's like the cowgirl says, "If you done it, it ain't braggin'."
Do you know what they call people who believe their own lies? Pathological. Get help, Sibby, now. Please. Before it's too late.
Fleming, you need to use a mirror for more than just admiring yourself.
I've had my share of therapy, Sibby, as both patient and provider. That's why I know what I'm talking about when I tell you you are certifiably delusional, brother.
http://www.bloomberg.com/news/2012-03-15/supreme-court-seen-influenced-by-politics-in-health-care-ruling.html
Bill, what is truly delusional are those who call a system where the benefits one receives is paid for by someone else a free market. No, a competitive free market is one in which each transaction is tested by the cost/benefit rule. How can a socialist economy apply a cost/benefit rule when those two components are separated from each other?
All insurance works that way, Sibby. Take it up with your local agent, why don'tcha?
Fleming, Insurance should be voluntary, Medicaid and Medicare are not voluntary. Stop with the deceptions.
“The lunatic, the lover, and the poet, are of imagination all compact.â€
― William Shakespeare, A Midsummer Night's Dream
So was Shakespeare really Francis Bacon?
"So was Shakespeare really Francis Bacon?"
Seriously? Please for the love of God and everything holy tell me that you're joking with that question.
The idea that a rich noble is the only one who can understand the human psyche and produce poetry and adapt history so that it reflects the drama inherent in everyday life.
I've put up with you New Age junk because it's mildly amusing, but this comment is beyond the pale.
Steve may have just mis-typed, LK. There is copious evidence that Bacon, a Rosicrucian, corresponded with Shakespeare who incorporated their disdain for the masses.
but in complete sentences....
Poing about fragments taken, Larry.
If I ever go back to grad school, I may do a paper on anger's effect on grammar
Notice how Sibby keeps moving the goalpost? It's like playing whack-a-mole. Never underestimate the appetite of the deranged for bouncing off of walls. It's why they have padded cells.
So you guys claim you are critical thinkers?!!!
Steve certainly brings light on how mental health access has become a national security issue.
Based on Fleming's reaction, it must be true.
Thank Goddess Steve's explosive vest is only virtual.
Steve-
Regarding the forced use of Medicare and Medicade. I just don't see any potential alternative solution that would work. Health insurance later in life is beyond expensive. People just get really really sick and slowly die during later life.
The problem with a "choice" is that you are assuming people are rational actors. Your model would be that people should put money away through out their life so that they could afford health care during the end of life. There are two obvious problems with this approach:
1. People are bad long term planners. Before these social welfare programs people wouldn't put anything away and when later life would come around they would simply pass on from easily treatable that they simply couldn't afford treatment for. This is similar to social security.
2. The expense of end of life care has become unpredictable. Some people pass very quickly with little expensive. Some incur hundreds of thousands of dollars in medical bills. Without some type of insurance it's nearly impossible to hedge against this unpredictability.
So in your world, those that didn't have the foresight to plan or the financial means for later in life healthcare should simply be denied and pass away. This approach has been tried and we as a society deemed it too demeaning to human life. We decided that it would be better to force everyone to pay into a system that provides a sufficient amount of care to preserve the sanctity of life. We can debate endlessly about whether the system actually accomplishes that goal, but the point is clear. Your approach has been tried and fails.
"Regarding the forced use of Medicare and Medicade. I just don’t see any potential alternative solution that would work."
So how did America survive before LBJ?
And for those of you who lack critical thinking skills:
http://en.wikipedia.org/wiki/Baconian_theory
Cartoon activism? "The WH told Texas today that it will no longer fund its Medicaid women's health program, after it barred abortion providers:" WaPo.
Sibson vindicated:
http://blogs.scientificamerican.com/observations/2012/03/15/does-pi-encode-shakespeares-plays-video/
Tony, the operating principle is: No one should have to go bankrupt just because they get sick. (See US Constitution regarding "promote the general welfare.")
As for Steve, he simply fails to appreciate the plethora of options available to him should he truly wish to exercise his liberty rather than just sit around and whine about his not having any.
Among these, Here are some of the most obvious. There are of course many many more:
1. He can choose to opt out of the system, get a different job (or no job at all) and not pay any taxes at all. Get off the grid and live his life out on the land. No one will even notice. There are millions in our country doing this. Have been for decades.
2. He can start his own company and opt out in a similar fashion by making sure his company never turns a profit every year. There are many very brilliant entrepreneurs doing ths and have been for decades.
3. He can just stop paying taxes and face the consequences. No one is making him pay them. It's a voluntary deal. He can certainly choose the civil disobedience route.
4. He can move to a less oppressive, more liberated country. One that shares his woldview and socio-economic values, since under his new thesis, it appears he believes the USA was doomed from the git-go due to those pesky Masons and Enlightenment New Agers.
5. He can take a taxi to Yankton State hospital and check himself into the State Mental hospital for a little mental health break.
Like I said, there are more. Those are just off the top of my head.
Steve, Medicare appears to be voluntary. Ask Mitt Romney, whose Reagan dye job has kept me from realizing that he's 65.
Larry said, "Thank Goddess Steve’s explosive vest is only virtual."
Here I was trying to follow along with The Bill/Sibson Show, with an occassional Larry interjection, when he says the above. There I was, snorting tea out my nose again!! I had to go back to remind myself of what the topic was.
I don't refer to MN as some type of criticism of SD. But as a progressive, and reasonably wealthy state, plus highly competitive (for you market fans), they pioneer lots of innovations. The medical community especially is highly competitive. We have Mayo and the U of MN med school, and several others. Plus we have businesses that create some of the newest medical devices and procedures awaiting FDA approval. There are tons of medical options, to, from clinics to hospitals. There must be at least 15 large hospitals in the metro.
That being said, MN is also working very diligently to make medicine more transparent and less costly. The state government -- yes, the GOVERNMENT - is playing an important part by allotting funds to support and encourage these new innovations. They wouldn't be happening without GOVERNMENT support.
The two biggest hospitals, Hennepin County in Mpls, and Regions in StPaul, now share medical records. I can go to either hospital and they can instantly access my records at the other hospital. More hospitals are joining in that system so that electronic medical records are accessible anywhere anytime.
There is a rating system available on line now which lists hospitals, procedures, costs, length of hospital stay, and other information. It may not all be online right now. Some of it is, with more on the way as soon as they get it done.
That system also includes infection rates, morbidity rates, nurse/doctor/patient ratios, number of different procedures performed, etc. I couldn't swear to all that is on it, but there is not much that is omitted.
The state legislature has just finished, for now, arguing with the MN Medical Assn (doctors) about greater transparency in doctor records, specifically malpractice claims. The docs really don't want all that made available. They are claiming that it will be confusing to many of us lay people. Maybe, I don't know. Anyway, there was some loosening of the docs' grip. More is sure to follow in the next few months or years.
My point is, there are lots of ways to decrease costs. A huge chunk of it is in electronic record keeping and sharing. The big plus of transparency is in how much it increases public confidence and trust in a medical provider. It's very good for business.
It does require some consumer education to understand what the ratings mean and comprehend the comparisons. There have been lots of programs provided by hospitals and local agencies to provide that education. The media on all levels, have been very active in providing information too.
I would like to see SD's GOVERNMENT fund a small group to spend a lot of time in MN learning about this stuff. Why reinvent the wheel if they are doing it here? Send some USD med students and DSU computer students. It could be a great boon for SD health care.
Picardi convicted on 13 felony counts:
http://rapidcityjournal.com/news/jury-finds-doctor-guilty-of-income-tax-evasion/article_f7bc1252-7f55-5910-8e50-c269ca2b8443.html