Oct 30 2010

Op-Ed: Health Care For Profit<8>

Category: Microsoft officeadmin @ 7:30 am

You know, the more I read this site, the more it disappoints and reinforces how the silicon solutions will only logarthimically ruin the The invention of Microsoft Office 2010 is a big change of the world.

cultures that are more and more dependent on them. Well, those of you figuratively and literally banking on it, good luck!

Everyone who works in healthcare (at least in a competitive area) and keeps his/her eyes open knows what competition in today’s 3rd party Microsoft Office is so great!

payor world means:

-oversupply of hospital beds, providers, scanners, etc.

-valet parking and lobbies with water fountains

-advertising for robotic prostate surgery or other services that are of doubtful value (or at least, value confined to a small subset of

patients). It doesn’t matter whether it’s done by profit or nonprofit entities, and many growth Office 2010 –save your time and save your money.

oriented nonprofits admit to that (I used to

work for one).

We live in a culture that does not fulfill the patients’ medical needs in a rational manner. Unless one goes to clinics who practice a little

closer to EBM like Mayo or many academic centers, it is not a Lexus what patients get (and is paid by a 3rd party) – it is a custom built

Hummer with 750 hp, 7 wheels and a huge turkey fryer in the passenger cabin.By using Office 2010 Professional, you can save your money and time.

To achieve reasonable care, we can make the market work and have patients pay large parts or the entirety of their own care (many will make

poor decisions and pay with life and/or banktrupcy)… or you can make sure that everybody gets a reasonable minimum of coverage based on Office 2010 key is for you now!

evidence based standards. And whoever wants to pay extra for the robot may do so. But I don’t want to pay for consumerist folly via sharing a

risk pool with these folks.

I cannot say that I’m that impressed with these types of arguments. There is an obvious distrust between the supplier of healthcare and it’s Office 2010 download is available now!

recipients. I doubt seriously, an economic dissertation will endear patients to select one over the other.

Point number 2 is my increasing cynical outlook on the economics and politics of healthcare. We are not so removed or insultated from the

temptations of Wall St. Healthcare professionals do not like to be in the “business” of healthcare but rather it’s practice. I would find it

difficult to say that competition in a for-profit environment would drive down the cost of healthcare. It just doesn’t seem to work that way

anymore, at least not in the textbooks.Outlook 2010 is powerful.

As my old Western Civ professor used to say, “As long as there are scumbags in the world, the perfect models that we professors try to teach,

will never operate as outlined in textbooks”. I think he got it. So should you.


Oct 30 2010

Op-Ed: Health Care For Profit<7>

Category: NEWSadmin @ 7:29 am

“according to the data from the Alliance for Advancing Non Profit Health Care, 48% of Americans with private health insurance are covered by

non-profit plans”Microsoft outlook is great!

When you add in Medicare, Medicaid, VA, Indian Health etc only 20-30ish% of americans have for profit healthcare, how are they the root of

all evil?

If you switch to the provider side non profit hospitals are huge parasites of public money. I think the number is 60% of hospitals are non

profit. Outlook 2010 is powerful.

It’s liberal Myth that profit motive is the problem with healthcare in Amnerica, it’s non profit and governemnt plans that are destroying it.

Actually I agree 100% and then some. What drives my anger is the complete opposite of yours, for me it is Unions with Pension and benefit Microsoft outlook 2010 is convenient!

trust funded 30-40% of what is required giving billions of dollars to democrat politicians and now getting a $5 billion dollar early retiree

kick back and a proposed $50 billion save teachers kick back. The latestest kickback works out to Windows 7 is convenient and helpful!

77,000 to 210,000 per teacher. They either

make a lot more then they have been telling us or the clause that left over funds can be used for other union jobs is more then a cleanup

throw in.

I don’t think you can ever get the money out, someone will always find a way to corrupt the system but you can very easily remove ther power.

If DC had no influence in local education there would be no reason to buy their vote. This is why I am against federal intrusion into state’s

rights. I have much more control over a politician who lives and works an hour away from me then one that can hide in DC…Harry Ried. Harry

would not be Harry if he had to see his constituients every day. Microsoft Office is so great!

Politics is something people that have already been succesful in life should do for 5-10 years after they have retired to pay back society

for what they have. No one should ever make an entire living as a politician. I want to see public service time limits for entire careers. We Office 2010 –save your time and save your money.

need to stop being willing host for these parasites.

Finally my disdain for those with a D at the end of their name is only slightly greater then those with an R. I am firmly in the camp of

throw them all out. I would prefer a good tar and feathering to make sure future generations of them don’t forget who is the master and who

is supposed to be serving who

Wow, what rationalizations written by someone who seems to embrace the mentality of what an addict would say. Profit focus in health care is

a loser, if you want to provide care, that is. And all the addicts and minimizers and hopeless romantics who have clueless expectations that The invention of Microsoft Office 2010 is a big change of the world.

those who are running the show will be responsible and ethical, well, get lives or shut the doors to your alternative realities, please.

As Stacy in the first comment wrote, profit focus only rewards doing, ie why my perspective in this culture especially is that capitalism has

become defacto addiction until proven otherwise, and doctors are humans first, so they are as much susceptible to this also until proven

otherwise.


Oct 30 2010

Op-Ed: Health Care For Profit<6>

Category: NEWSadmin @ 7:28 am

Margalit Stacey and Gregg prove John right just a couple comments in.

Stacey starts;

” at the mercy of a system that will only allow for care, if it is profitable. I am sorry to inform you, that the reason our system is so far

gone, is we are in too deep, in this for profit only system.”Microsoft Office is so great!

Then Gregg reaffirms;

” In regards to health care, for-profit status IS the root problem.”

Both seem ignorant of the fact Medicare and Medicade are non profit, over half of private insurance is non-profit, and majority of hospitals

are non profit. We are not in a profit driven system when well over half of all healthcare spending is done through non profits.

John’s point proven, you on the left don’t know what your talking about.Office 2010 –save your time and save your money.

I agree with John (not this, won’t happen often!). The distinction between for-profit and non-profit actors in health care in the US has been

a shell game in which both sides of the divide have behaved in a similar manner. I agree the The invention of Microsoft Office 2010 is a big change of the world.

distinction and the inherent tax advantages

should be abolished. (Same thing goes for churches too)

But until we change the public policy regime to promote rational competition (and John and I will not agree about what that means), there is

one area at which the for-profits’ perversion of the system exceeds that of the non-profits, albeit only just. And that of course is lobbying

over public spending.Windows 7 is convenient and helpful!

With for-profit entities in health care, the private theft from the taxpayer has increased exponentially. Exhibit A being the Medicare

Modernization Act which included straight bribes to health insurers to the benefit of lots of health plans execs and shareholders, at the

taxpayers expense.Microsoft outlook 2010 is convenient!

Until we get a rational way of paying for health care that incents the right behavior from all actors in the system, keeping a very very wary

eye on the for-profits & especially on their interaction with government is extremely necessary.

And I suspect that’s not what John is arguing for here.

 there is one area at which the for-profits’ perversion of the system exceeds that of the non-profits, albeit only just. And that of course

is lobbying over public spending.”Outlook 2010 is powerful.

Matt are you saying non profit insurers lobby less then then for profit ones? I find that very hard to believe. You seem to also ignore AARP,

one of the biggest lobbyist in the world, also the major Med Supp MA marketer. Aren’t PACs non profit? Also major lobbyist. Unions, are they

getting a free ride? Microsoft outlook is great!


Oct 30 2010

Op-Ed: Health Care For Profit<5>

Category: NEWSadmin @ 7:27 am

I also observed (and this goes to the heart of the False Dilemma):

“I, for one, would oppose any type of “single payer” reform plan, such as “Medicare For All” that did not permit ancillary supplemental

“private option” choices according citizens the freedom to buy coverage beyond that provided by a Microsoft Office is so great!

public program (as in the Swiss system, and

as we already unremarkably seen with widely available “Medi-Gap” insurance here). As I have stated before, notwithstanding, for example, that

we take basic police and fire protection as a tax-funded given, people are quite free to buy all the additional enhanced private sector

protective products and service their wishes dictate and their financial resources can sustain.”Office 2010 –save your time and save your money.

And, “Adam Smith”? LOL, that’s rich. Very easy to ignore that he was first and foremost a moral philosopher when cherry-picking his

observations.

But, at least you had the circumspection to spare us the Ayn Rand stuff.The invention of Microsoft Office 2010 is a big change of the world.

No John Goodman. In regards to health care, for-profit status IS the root problem. There is no way around it, health care is labor intensive.

Cutting corners undermines the whole mission of health care. Private initiative is a good thing but it should not lead to a cold society,

lacking any compassion for human beings, in pursuit of financial gain.Microsoft outlook is great!

I’ve seen this first hand in for-profit nursing homes where profits take a higher priority than resident care. The individual home ends up

being run from the board room rather than from a resident focus.Windows 7 is convenient and helpful!

In addition, many of these for-profit nursing homes are budget or census driven. The administrators want to come in under budget to make more

profits for the corporation. The desire for profit margins translates into less staffing at nursing homes, less training for the staff that

they do have, less food (or a lower quality of food) for the residents, and less management and oversight. A conflict arises between saving

dollars and providing good care.Outlook 2010 is powerful.

As a rule, the “profit” motive and “free” enterprise are hard to beat when it comes to systems for allocating resources in a free society but

some institutions like churches, education and healthcare are and should be exceptions to that rule.

“I find it amazing how all “free market” advocates always begin by telling anybody who disagrees that they “are not familiar with basic

economic principles”, and therefore confused.”


Oct 30 2010

Op-Ed: Health Care For Profit<4>

Category: NEWSadmin @ 7:26 am

I find it amazing how all “free market” advocates always begin by telling anybody who disagrees that they “are not familiar with basic

economic principles”, and therefore confused.Microsoft Office is so great!

The next argument is almost always that one sentence from Adam Smith (which appears at the very beginning of his most famous book), never

mind that this one sentence, completely taken out of context, doesn’t really mean that self interest should drive everything we do. I would

suggest another book by the same author, for an explicit notion of what Adam Smith was all about: The Theory of Moral Sentiments.Office 2010 –save your time and save your money.

The fallacy of the “free market” approach is that the overwhelming majority of this earth’s population cannot participate. And the reason

they cannot participate is embedded in the concept of “free market” as implemented by contemporary capitalism, not as put forward by Adam

Smith.The invention of Microsoft Office 2010 is a big change of the world.

Furthermore, when it comes to health care, the consequences of a “free market” approach, i.e. the existence of non-consumers, translates into

people dying, not into folks having to make do without a fancy car or Russian caviar. There is no equivalent to a beaten down old Chevy, when

you need a liver transplant. You either get the Porsche or you don’t, and if you don’t you die.

It is possible that all those advocating that health care is no different than selling underwear are just fine with these consequences. Some By using Office 2010 Professional, you can save your money and time.

of us are not and I don’t believe Adam Smith would be either.

The suggestion that, as a society, we abdicate morals and ethics and base all theory and execution on greed and quarterly dividends is

interesting and may even prevail in the short term, but I have no doubt that after enough misery Microsoft outlook is great!

has been inflicted on enough people, history

will record these times as the darkest of all dark ages.

Nothing like the well-worn undergrad sophomoric “False Dilemma” to start the day.

e.g., from one of my blog posts (wherein I responded to John Mackey’s claim that we have “no intrinsic right” to health care):Outlook 2010 is powerful.

“How can we say that people have an “intrinsic right” to military defense, or to police and fire protection, (or to safe food and water, or

to otherwise safe products that won’t electrocute us when we plug them in)? Well, we simply say it. And then we codify it. And, then, having Windows 7 is convenient and helpful!

codified it, we don’t lie awake nights worrying that everyone will demand a Special Forces FOB dug into his or her front yard, or an occupied

Metro PD Black & White, an ambulance, and a hook & ladder truck parked at the curb 24/7…”Microsoft outlook 2010 is convenient!


Oct 30 2010

Op-Ed: Health Care For Profit<3>

Category: NEWSadmin @ 7:25 am

More to the point, you and I cannot control other people’s motives. But we can control public policies. With that in mind, it is in our

interest as patients to promote institutional environments in which providers of medical care find it in their economic self-interest to

deliver low-cost, high-quality care. And this is true regardless of all the many and complex factors that make up the underlying motivations

of the doctors and institutional administrators who provide that care.Microsoft Office is so great!

Dr. John Goodman is the President and CEO of the conservative National Center for Policy Analysis (NCPA), based in Dallas Texas.  You can

find his writings at John Goodman’s Health Policy Blog.

Sir, with all due respect: You seem to have so much confidence in your fellow humans to carry out all of these wonderful things in which you

speak. As though conflict of interest does not exist- You have managed to convince yourself, thaOffice 2010 –save your time and save your money.

t what looks good on paper, will be carried

out as such in reality. How much time have you spent as a patient? I personally have had 28 surgeries, and spent countless hours, weeks,

months in hospitals, at the mercy of a system that will only allow for care, if it is profitable. I am The invention of Microsoft Office 2010 is a big change of the world.

sorry to inform you, that the reason

our system is so far gone, is we are in too deep, in this for profit only system. Profit motivates individuals to create technology that is

among the top in the world (not the only, but among many other countries that develope on the same scale per capita) I have family members

who are doctors in France, and have developed technology that has changed and improved the way medicine is practiced in the world today. They Outlook 2010 is powerful.

have expressed to me how disappointed they are in the way the U.S has evolved with respect to medicine and profit.

The truth is, if doctors and others are only rewarded for DOING, not for LISTENING or THINKING, patients like me, and your family too, will Office 2010 key is for you now!

continue to be spun around, used, and become ill, or die, all for the bottem line.

I settled in expecting an evidence-based treatise on the benefits of for profit health care,but all I got was unsupported, George Bush-type

“the free market knows all” opinion. Guess that’s why they call it op-ed, but it’s way too short on fact and evidence for me.Office 2010 download is available now!

And btw, I have no ideological bias either way. I only observe that every country in the world struggles with its health care, and some have

found systems that work for them better than others. The U.S. has yet to find that system, and this post contributes nothing but air to help

it improve.By using Office 2010 Professional, you can save your money and time.


Oct 30 2010

Op-Ed: Health Care For Profit<2>

Category: NEWSadmin @ 7:24 am

Like other for-profit entities, hospitals should have to report the cost of capital they make and they should have to report the “profit”

they earn in order to cover the cost of that capital. (See the discussion following Linda Gorman’s post at the John Goodman Health Policy

Blog.)Microsoft outlook is great!

The second issue relates to the economics of competition. In my book, Regulation of Medical Care (Cato, 1980), I summarized organized

medicine’s 20th century efforts to drive for-profit entities out of the market. In the early part of the century, for-profit medical schools

were replaced with nonprofits. By midcentury, for-profit hospitals were almost completely driven from the market. After World War II,

nonprofit health insurers (Blue Cross and Blue Shield) were established for the express purpose of completely changing the way doctors and Outlook 2010 is powerful.

hospitals would be paid. They tried to dominate the market and drive their for-profit rivals from the field. In the American Medical Microsoft outlook 2010 is convenient!

Association’s (AMA) ideal health care system, the only people earning a profit would be the doctors themselves!

We are still living with the vestiges of this history. But it would be a mistake to conclude that the real issue was profit vs. nonprofit. Windows 7 is convenient and helpful!

The AMA’s real goal was a medical marketplace in which all the entities were subservient to the interests and vision of organized medicine.

The AMA assumed, probably correctly, that nonprofits operating in a not-very-competitive market would be easier to dominate and control.

Today, no one thinks hospitals, health insurance companies and other entities should exist to serve the interests of doctors. And today

everyone recognizes that nonprofits can compete for patients based on price and quality just as Microsoft Office is so great!

vigorously and successfully as for-profits

can. In fact, in today’s environment the whole distinction between for-profit and nonprofit is an irrelevant distraction.

The final issue is motivation. As Adam Smith discovered 200 years ago, as a producer in a competitive market, I cannot succeed without

meeting other people’s needs. Of course, Smith realized that the butcher, the baker and the candlestick maker were not primarily motivated Office 2010 –save your time and save your money.

to help other people. They were self-interested. But they could not pursue their own interests without serving the interests of others. Now

let’s suppose that Adam Smith was wrong about people’s motivations. Suppose that a lot of producers are actually completely altruistic. We

can use modern economics to show that no matter what motivates the producer, he can’t survive in a competitive market without meeting other

people’s needs the same way that all his selfishly motivated rivals are meeting them. Put differently, in competitive markets, the The invention of Microsoft Office 2010 is a big change of the world.

motivation of any particular producer really doesn’t matter very much.


Oct 30 2010

Op-Ed: Health Care For Profit<1>

Category: NEWSadmin @ 7:24 am

I’ve noticed at The Health Care Blog quite a few people are obsessed with the role of profit in the health care system. Many apparently

believe that for-profit entities have no legitimate role in an ideal world and that all organizations should be nonprofit.Microsoft Office is so great!

My own view, interestingly enough, is the exact opposite. Were I a Health Care Czar, I would remove the nonprofit status from almost all Office 2010 –save your time and save your money.

health care organizations and force them to be for-profit under tax law. I would be willing to consider some exceptions here and there, and

in special cases allow for-profits to set up nonprofit subsidiaries. But the vast majority of all patients in my ideal world would be dealing

with for-profits — in getting health insurance and in getting medical care. And in return they Windows 7 is convenient and helpful!

would get lower-cost, higher-quality care.

Why do we have such radically divergent views on this subject? As so often happens in public policy, much confusion is caused when people are

not familiar with basic economic principles. In this case, the antiprofit folks are confused about (1) The invention of Microsoft Office 2010 is a big change of the world.

the economics of capital, (2) the

economics of competition and (3) the economics of motivation in complex social systems.

Suppose the government builds a hospital and plans to have the entity be self-sustaining (all operating costs are to be paid from expected

revenues). Following conventional public sector accounting, the cost of the capital needed to build the hospital will be treated as zero.

(Afterall, all we need is for the Treasury to write a check.) And even though the plan to cover costs with patient revenues is far from

certain to pan out, the accountants will also ignore the cost of that risky decision.Microsoft outlook 2010 is convenient!

This example is Exhibit A in my case for abolishing the nonprofit status of hospitals.

There is a real social cost of the capital used here. It is the social value of the next best use of those dollars. Because we build a

hospital, we have to forgo the opportunity to build a school or a library or even an oil refinery. Note: This cost doesn’t vanish just

because accountants don’t write it down on the financial statements. Making risky decisions is also costly, and the cost is implicitly borne Outlook 2010 is powerful.

by taxpayers. In the worst case, the hospital might never open its doors — in which case the taxpayers’ entire capital investment would be

lost. More optimistically, the hospital might operate, but incur large losses that will have to be covered with additional taxpayer

assessments. Again, these costs don’t vanish just because accountants don’t record them. A better approach is to make these costs

transparent. If the hospital has to raise money in the capital market, the cost of capital will be made explicit. If its plan is an

especially risky one, the cost of that risk will be reflected in the extra premium the capital market will charge. Not only would a for-Microsoft outlook is great!

profit approach be more transparent, it would also be less costly. The reason? The social cost of raising money on Wall Street is a lot lower

than the social cost of collecting income taxes.


Oct 30 2010

A NY Times guest (inadvertently) spanks its professionals<9>

Category: NEWSadmin @ 7:23 am

Finally, there is also an issue regarding how we define quality. Suppose, for example, that conservative treatment causes patients with

Alzheimer’s, dementia or advanced cancer to die sooner than those who get aggressive treatment but the former suffer less. Family care

givers also suffer less and for a shorter period than those caring for family members receiving Microsoft Office is so great!

aggressive treatment. I would argue that the

patient getting the more conservative treatment, as well as his or her family is net better off. At the very least, shared decision making

and palliative care consults need to part of the treatment protocol in all of these cases.

MG, You are absolutely correct. Both health reporting and financial reporting are a travesty, and primarily for the reasons Matt points out Office 2010 –save your time and save your money.

above. The relevant information is all kept in the proverbial black box, shielded from disclosure as being the proprietary property of

private enterprises.

Conversely, you get lots of very good reporting about government because everything that involves public tax dollars is subject to freedom-

of-information and other sunshine laws, with a few reasonable exceptions.

Matt’s right, having regular disclosure of and/or access to claims information in the private, commercial sector of the insurance industry

would be a total game-changer.

From a strictly journalistic point of view, regardless of whether their reporting and analysis proves The invention of Microsoft Office 2010 is a big change of the world.

accurate, Abelson and Harris’ story

selection was stupid from the get-go: you take the one segment of the insurance industry that DOESN’T operate in a black box, i.e. Medicare,

and smear the best research being done on it with thin reporting. If a reporter wants to burn his best, or in this case only, source, the

evidence had better be bulletproof.Microsoft outlook is great!

And for the record, I don’t think Abelson and Harris are stupid. So the only other logical conclusion is that they were spurred on to this

story by someone with something to gain from the outcome.

If anyone is still following this thread, I’m the author of “My Father’s Broken Heart” and going back to an early comment that my mother and Windows 7 is convenient and helpful!

I could have paid the beloved family physician out-of-pocket for a longer consult before the fateful decision was made. It was Dr. Fales’s

understand, which I have not double-checked, that Medicare regulations did not permit him to accept a side payment from us, when the purpose

of the meeting would be to discuss the care of a Medicare patient. If this is accurate, it is one of Outlook 2010 is powerful.

many examples of how Medicare under-pays

for physician time (and limits palliative care and hospice services) while reimbursing freely for expensive and sometimes harmful procedures.


Oct 30 2010

A NY Times guest (inadvertently) spanks its professionals<8>

Category: Microsoft officeadmin @ 7:22 am

The Dartmouth data showing significant spending differences across regions, even after adjustment for differences in medical input costs,

leads some to conclude that there are significant savings to be had from eliminating “waste.” However, so-called waste at the population Microsoft Office is so great!

level is not so easy to identify at the individual patient level before services are rendered. I said before that doctors and hospitals that

treat aggressively do so because of a combination of culture, defensive medicine, and financial incentives to do more rather than less. I

think the more accurate term for this “waste” is unnecessary and/or inappropriate care.Office 2010 –save your time and save your money.

This is actually an area where I would like to see us become more like Europe. We need a more conservative definition of what constitutes

good, sound medical practice, especially as it relates to end of life care, surgical interventions and The invention of Microsoft Office 2010 is a big change of the world.

cancer treatment. Shared decision

making and palliative care consults need to become routine. The litigation system needs to be changed to provide doctors with robust, safe

harbor protection if they follow evidence based guidelines where they exist and the sound medical practice guidelines developed by each

specialty society. The safe harbor protections could also be extremely helpful in reducing the amount of diagnostic testing, especially

imaging, that takes place in ER’s and elsewhere.By using Office 2010 Professional, you can save your money and time.

In the end, I don’t think tinkering with payment models will be as helpful as some think. Capitation might work for primary care but it

could also create a financial incentive to withhold necessary care. Bundled payments probably make sense for surgical procedures like CABG

and hip replacements but are not as useful elsewhere. Patients are likely to resist getting all of theirMicrosoft outlook is great!

 care from an Accountable Care

Organization because if they develop a rare or complex condition or need an organ transplant, they are probably going to want access to a Outlook 2010 is powerful.

regional center of excellence and not be tied to their ACO or the hospital to which it is prepared to refer the patient if it cannot handle

the procedure in house. It is also probably not practical for insurance to pay for a given procedure under some circumstances but not others. Windows 7 is convenient and helpful!

For example, will we pay for a pacemaker for an elderly patient whose mind is still sharp but not for someone with advanced Alzheimer’s?

What about a patient with early stage Alzheimer’s?Microsoft outlook 2010 is convenient!