A group calling itself Physicians for National Health Program (PNHP) has issued a press release revealing the failure of Hillarycare as it was resurrected in Massachusetts by former Governor Mitt Romney (who somehow has now seen the light of his transgressions from Republican orthodoxy).
Costs are up, services are hard to get, the state is going broke, and what was once free for the indigent now costs them money--that's the Massachusetts health care plan implemented in 2006.
So far, so good--these are the inevitable results of government interference in the free market. (Watch for higher costs and more rationing coming down the pike soon.)
However, PNHP then advocates the adoption of a single-payer national health care system "while maintaining the private delivery system." This plan is embodied in H.R. 676, the so-called United States National Health Care Act.
The group claims implementation of H.R. 676 would save Massachusetts alone "about $8 billion to $10 billion a year in reduced administrative costs," but it fails to say how except that it would eliminate (now, really?) the 31-percent administrative fees built into private insurance plans. Eliminate some admin costs, yes, but all, no, but PNHP never goes into detail.
Also, how does this differ from just putting everyone on Medicare? No clue in the press release.
What H.R. 676 really amounts to is a massive "fee-for-service" cash grab by the physicians of America who, once they got their hands on an "unlimited" federal money spigot, would open the valve as wide as possible with a) more patients and b) more services for every patient they see.
Unless they can provide better details than this crappy press release does, these physicians need to go back to the drawing board--and figure out how they can see more patients for the same, or less, than they do now.
Otherwise, it's just more greedy pigs lining up at the federal trough (see banks, the Big Three, the states, housing, unions, etc.).
Thursday, February 19, 2009
Wednesday, February 18, 2009
Watch What You Say, Young Man
The International Longevity Center and Aging Services of California have issued a media guide for writing about older people, which lists acceptable (PC) words and unacceptable (non-PC) terms.
However, it really depends on the audience reading what's written to define acceptable. Readers in their 20s or 30s said in a survey they would take no offense at reading "senior citizen," for example. In fact, "senior citizen" is viewed as a neutral term by those under 54 but offensive by those 55 and older. Hmmmm....
Likewise, "retiree" is okay with those 54 and under, but disliked by those 55 and older. "Veteran" is acceptable to both groups, but that would seem to apply only to people who've served in the military, not generally to old coots. Oops, that's a no-no that never should be used. My bad (even though I do qualify as an old coot).
Some terms to be avoided at all costs include “golden years," “feisty,” “spry,” “feeble,” “eccentric,” “senile” and “grandmotherly.”
This is useful information for the workplace as well, so as to avoid EEOC and DOL inquiries and potential legal disputes over ageism or hostile environments.
Get your copy of Media Takes: On Aging.
However, it really depends on the audience reading what's written to define acceptable. Readers in their 20s or 30s said in a survey they would take no offense at reading "senior citizen," for example. In fact, "senior citizen" is viewed as a neutral term by those under 54 but offensive by those 55 and older. Hmmmm....
Likewise, "retiree" is okay with those 54 and under, but disliked by those 55 and older. "Veteran" is acceptable to both groups, but that would seem to apply only to people who've served in the military, not generally to old coots. Oops, that's a no-no that never should be used. My bad (even though I do qualify as an old coot).
Some terms to be avoided at all costs include “golden years," “feisty,” “spry,” “feeble,” “eccentric,” “senile” and “grandmotherly.”
This is useful information for the workplace as well, so as to avoid EEOC and DOL inquiries and potential legal disputes over ageism or hostile environments.
Get your copy of Media Takes: On Aging.
Tuesday, February 17, 2009
AHRQ: The (Scary) Little Agency That Thinks It Can
Can do the impossible, that is, which to prescribe which medicines and medical procedures are both most efficacious and most cost-effective. So far, I can find little proof of AHRQ's accomplishing anything near this goal on the site of the Agency for Healthcare Research and Quality.
AHRQ is in the news since it just got a whole new set of fangs in the Obama stimulus plan (aka the Tom Daschle stealth strategy for health care reform). Rush Limbaugh and the Washington Times have equated the new powers of AHRQ to Hitler's program of euthansia for the old, infirm and disabled of any age. These people are not productive, so why treat them and waste resources? Get rid of 'em.
Daschle, of course, is not prescribing euthansia per se, but he wants a federal agency (which is now the AHRQ, ironically started under Dubya in 2004) to determine, among other things, when someone in the last stages of life should be denied services and asked to give up the ghost. Daschle says that seniors should gladly accept “hopeless diagnoses” and “forgo experimental treatments,” except when it comes to pols like himself who will get the gold standard of cradle-to-grave health care. (Can you imagine Ted Kennedy's being denied brain-tumor surgery last year even when a majority of doctors proclaimed it a waste of time and money, which they actually did?)
I keep bringing up Daschle's name because it was his prescriptions for a federal agency to determine most cost-effective treatments and to track everyone's health care through electronic records that was slipped into the stimulus bill under the innocuous-sounding name of the Health Information Technology for Economic and Clinical Health (HITECH) Act--and then rushed into law before anyone had a chance to thoroughly read it.
Except Betsy McCaughey, former lieutenant governor of New York who's been tracking health care matters, when she did read it and warned that you can "Ruin Your Health With the Obama Stimulus Plan," especially if you're a senior citizen.
Is the AHRQ really that scary and powerful? Not yet. I read through some of its Web site pages and found nothing revolutionary. In fact, it looks to be an impossible task for any person or agency to make valid health care cost-containing assessments. The best AHRQ could do was to compare findings of 61 studies on treating hypertension and to conclude that both angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are equally effective, though the former have generic brands available while the latter don't, yet.
Which means that the best anyone is going to do in measuring effectiveness in health care is to rule out quackery--and then just to rule out high-cost medicine, with a few rare exceptions (Daschle and company). Which is where it all really gets scary--down the line in the future when Obama and others call it a "health care crisis" and "we have to act now." Wham, bam, no more angioplasties (fill in the blank) after age 62 (fill in the blank) and so on.
What really got me scared came when MSNBC's Keith Olbermann, who's never gotten any fact or issue correct in his life, felt compelled to devote a whole show to "debunking" the charges by Limbaugh and McCaughey.
McCaughey's response? "Let's hold a debate."
Problem is, people like Olbermann don't won't a debate--they want a crisis, real or imagined.
AHRQ is in the news since it just got a whole new set of fangs in the Obama stimulus plan (aka the Tom Daschle stealth strategy for health care reform). Rush Limbaugh and the Washington Times have equated the new powers of AHRQ to Hitler's program of euthansia for the old, infirm and disabled of any age. These people are not productive, so why treat them and waste resources? Get rid of 'em.
Daschle, of course, is not prescribing euthansia per se, but he wants a federal agency (which is now the AHRQ, ironically started under Dubya in 2004) to determine, among other things, when someone in the last stages of life should be denied services and asked to give up the ghost. Daschle says that seniors should gladly accept “hopeless diagnoses” and “forgo experimental treatments,” except when it comes to pols like himself who will get the gold standard of cradle-to-grave health care. (Can you imagine Ted Kennedy's being denied brain-tumor surgery last year even when a majority of doctors proclaimed it a waste of time and money, which they actually did?)
I keep bringing up Daschle's name because it was his prescriptions for a federal agency to determine most cost-effective treatments and to track everyone's health care through electronic records that was slipped into the stimulus bill under the innocuous-sounding name of the Health Information Technology for Economic and Clinical Health (HITECH) Act--and then rushed into law before anyone had a chance to thoroughly read it.
Except Betsy McCaughey, former lieutenant governor of New York who's been tracking health care matters, when she did read it and warned that you can "Ruin Your Health With the Obama Stimulus Plan," especially if you're a senior citizen.
Is the AHRQ really that scary and powerful? Not yet. I read through some of its Web site pages and found nothing revolutionary. In fact, it looks to be an impossible task for any person or agency to make valid health care cost-containing assessments. The best AHRQ could do was to compare findings of 61 studies on treating hypertension and to conclude that both angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are equally effective, though the former have generic brands available while the latter don't, yet.
Which means that the best anyone is going to do in measuring effectiveness in health care is to rule out quackery--and then just to rule out high-cost medicine, with a few rare exceptions (Daschle and company). Which is where it all really gets scary--down the line in the future when Obama and others call it a "health care crisis" and "we have to act now." Wham, bam, no more angioplasties (fill in the blank) after age 62 (fill in the blank) and so on.
What really got me scared came when MSNBC's Keith Olbermann, who's never gotten any fact or issue correct in his life, felt compelled to devote a whole show to "debunking" the charges by Limbaugh and McCaughey.
McCaughey's response? "Let's hold a debate."
Problem is, people like Olbermann don't won't a debate--they want a crisis, real or imagined.
Friday, February 13, 2009
Stimulus: $789B, But Just 18.5 Percent* for Jobs
I just went through the list of items covered in the final version of the stimulus plan (so called) and added up all the sums that were targeted at projects that could actually lead to jobs. I came up with $146.2 billion, which figures out to be 18.5 percent of the whole pie. The rest goes to what could be called the welfare state.
The implication here is pretty obvious: The Democrats decided to expand their favorite federal programs (some implemented by the states with fed dollars) while masquerading the whole thing as a "job-creating" stimulus package.
The question remains whether the targeted projects will "create or save" three million jobs (I also heard that Obama had raised that promised figure to four million). I've got a feeling that the $146.2 will just go to support unionized workers who are already working. At any rate, how does one prove that something "saves" four million jobs.
Here are the areas where money will be spent on job-creating or -saving projects: 1) Create a new "smart" power grid (to replace our current "dumb" one, I guess), $30 billion; 2) Repair and make energy efficient public housing, $6.3 billion; 3) Extend broadband services, $7 billion (again, does this create or save jobs?); 4) Implement electronic health records (EHRs), $19 billion; 5) Modernize roads and bridges, $29 billion; 6) Improve public transit and rail, $16.4 billion; 7) Restore lean water and modernize flood control, $18 billion; and 8) Modernize federal and public buildings, $9.5 billion (again, already-existing union workers who will now get triple-time).
I guess that's why White House Chief of Staff Rahm Emanuel warned early on that "this is no time to waste a good crisis."
*N.B.: I loosely included the health IT's portion, $19 billion, but as I further thought about it, this really doesn't create any jobs; it just goes to buy equipment and services that are already available. If I delete this sum, the total going to "jobs" is reduced to $127.2, or 16 percent.
The implication here is pretty obvious: The Democrats decided to expand their favorite federal programs (some implemented by the states with fed dollars) while masquerading the whole thing as a "job-creating" stimulus package.
The question remains whether the targeted projects will "create or save" three million jobs (I also heard that Obama had raised that promised figure to four million). I've got a feeling that the $146.2 will just go to support unionized workers who are already working. At any rate, how does one prove that something "saves" four million jobs.
Here are the areas where money will be spent on job-creating or -saving projects: 1) Create a new "smart" power grid (to replace our current "dumb" one, I guess), $30 billion; 2) Repair and make energy efficient public housing, $6.3 billion; 3) Extend broadband services, $7 billion (again, does this create or save jobs?); 4) Implement electronic health records (EHRs), $19 billion; 5) Modernize roads and bridges, $29 billion; 6) Improve public transit and rail, $16.4 billion; 7) Restore lean water and modernize flood control, $18 billion; and 8) Modernize federal and public buildings, $9.5 billion (again, already-existing union workers who will now get triple-time).
I guess that's why White House Chief of Staff Rahm Emanuel warned early on that "this is no time to waste a good crisis."
*N.B.: I loosely included the health IT's portion, $19 billion, but as I further thought about it, this really doesn't create any jobs; it just goes to buy equipment and services that are already available. If I delete this sum, the total going to "jobs" is reduced to $127.2, or 16 percent.
Wednesday, February 11, 2009
Lilly Ledbetter Takes a Seat in Maine Legislature
I can see the headlines now: "Brawl breaks out in office over pay records." "Worker stabbed in parking lot for being paid too much." "Supervisor assaulted by angry employees over pay disparity."
This also falls under the category of "What were they thinking?"
After Congress passed and the president signed the Lilly Ledbetter Fair Pay Act, which makes fair pay discrimination cases the only other offense besides first-degree murder to have no statute of limitations, some states moved into action, one being Maine.
There, in the home of Democrat-in-Republican-clothing Senators Susan Collins and Olympia Snowe, a Lilly Ledbetter clone named Deborah Simpson, who happens to be a Democratic state senator, introduced a law to enable employees to share their paystub information.
"So, you make $1,250 a week? Who the h--- do you think you are?" he exclaimed while cold-cocking his coworker across the aisle.
"You b----! You mean I've been working here ten years and you six months, and you make that much more than me!" she shreiked while pulling apart her coworker's perfectly coiffed bouffant hair by painful hair.
I may be making those scenarios sound unrealistic because they're too openly spiteful. No doubt the real retaliation would be more subtle, as in the Klingon prescription that "revenge is a dish best served cold."
Unless I'm missing something here, this all seems surreal, but the "Act to Ensure Fair Pay," as it's called, has surprising support in the Maine capital of Augusta.
Representatives from several organizations testified in support of the bill, including those from the Maine Women’s Lobby, the Maine Civil Liberties Union, the WAGE Project, and the Maine State Employees Association. William Peabody, director of the state Department of Labor’s Bureau of Labor Standards, also voiced support.
This also falls under the category of "What were they thinking?"
After Congress passed and the president signed the Lilly Ledbetter Fair Pay Act, which makes fair pay discrimination cases the only other offense besides first-degree murder to have no statute of limitations, some states moved into action, one being Maine.
There, in the home of Democrat-in-Republican-clothing Senators Susan Collins and Olympia Snowe, a Lilly Ledbetter clone named Deborah Simpson, who happens to be a Democratic state senator, introduced a law to enable employees to share their paystub information.
"So, you make $1,250 a week? Who the h--- do you think you are?" he exclaimed while cold-cocking his coworker across the aisle.
"You b----! You mean I've been working here ten years and you six months, and you make that much more than me!" she shreiked while pulling apart her coworker's perfectly coiffed bouffant hair by painful hair.
I may be making those scenarios sound unrealistic because they're too openly spiteful. No doubt the real retaliation would be more subtle, as in the Klingon prescription that "revenge is a dish best served cold."
Unless I'm missing something here, this all seems surreal, but the "Act to Ensure Fair Pay," as it's called, has surprising support in the Maine capital of Augusta.
Representatives from several organizations testified in support of the bill, including those from the Maine Women’s Lobby, the Maine Civil Liberties Union, the WAGE Project, and the Maine State Employees Association. William Peabody, director of the state Department of Labor’s Bureau of Labor Standards, also voiced support.
Tuesday, February 10, 2009
If You Work Here, Better Watch Out
You've no doubt heard of, or even participated in, the so-called online "dead pools," where odds are placed on which celebrity will be the next to meet the Grim Reaper.
That's a bit too morbid for me, but when it comes to business, I don't mind participating in some death watches since it's instructive to see how others can screw up a good thing.
I've been of the opinion for some time now that not only will it go, but Chrysler should go to cut down the glut in Detroit. Mind you, that's 50,000 or more layoffs, but capitalism is either creative destruction or it becomes socialism, where government picks the winners and losers. And let's hope our current president doesn't become this nation's Hugo Chavez.
Back to Chrysler: I came across a Yahoo Finance article about "15 Companies That Might Not Survive 2009," and sure enough, there was Chrysler's name right near the top.
Others on this dead pool include Krispy Kreme donuts and Rite Aid pharmacies, both of which I watched expand much too rapidly for their markets beginning back in the 1990s. (I don't think Starbucks will bite the bullet, and it's not on the list, but that coffee purveyor also got way too ambitious in its expansion plans.)
The name Trump, as in Donald, also appears on the list, but it's just one of the The Donald's holdings, specifically his casinos. It's "deja vu all over again" here as his Atlantic City holdings were near bankruptcy and forcibly restructured during the last great recession in the early 1990s.
So, if you work for one of these 15 (or anywhere else where things are shaky), polish up your resumes and be prepared for an "interesting" 2009, as in the Chinese curse, "May you live in interesting times."
That's a bit too morbid for me, but when it comes to business, I don't mind participating in some death watches since it's instructive to see how others can screw up a good thing.
I've been of the opinion for some time now that not only will it go, but Chrysler should go to cut down the glut in Detroit. Mind you, that's 50,000 or more layoffs, but capitalism is either creative destruction or it becomes socialism, where government picks the winners and losers. And let's hope our current president doesn't become this nation's Hugo Chavez.
Back to Chrysler: I came across a Yahoo Finance article about "15 Companies That Might Not Survive 2009," and sure enough, there was Chrysler's name right near the top.
Others on this dead pool include Krispy Kreme donuts and Rite Aid pharmacies, both of which I watched expand much too rapidly for their markets beginning back in the 1990s. (I don't think Starbucks will bite the bullet, and it's not on the list, but that coffee purveyor also got way too ambitious in its expansion plans.)
The name Trump, as in Donald, also appears on the list, but it's just one of the The Donald's holdings, specifically his casinos. It's "deja vu all over again" here as his Atlantic City holdings were near bankruptcy and forcibly restructured during the last great recession in the early 1990s.
So, if you work for one of these 15 (or anywhere else where things are shaky), polish up your resumes and be prepared for an "interesting" 2009, as in the Chinese curse, "May you live in interesting times."
Saturday, February 7, 2009
If You Like EMRs and EHRs, You'll Love PHRs
I'm still not clear on the difference between EMRs (electronic medical records) and EHRs (electronic health records), but now we have PHRs (personal health records). At least PHRs I think I understand.
Back to the first two: I've read where there's no difference between EMRs and EHRs except that EHR is designed to be more marketing friendly for some reason. I've also read where EMRs are patients' electronic records maintained at one location while EHRs are shared electronic records available across a network.
Whatever the case may be, the stimulus package from our lawmakers includes a bundle of dough to implement EMRs and/or EHRs. (Could this be like Betamax v. VHS or Blu-Ray v. HD-DVD?)
However the stimulus package implementation turns out, and we won't know for years, PHRs are available right now on both Google and MSN. A personal health record is something that the individual chooses to create on one of those providers (I think WebMD offers PHRs as well).
Security issues aside, people have expressed fears that these providers might sell your data to pharmaceutical and other health marketing companies. Google denies this, if you trust what Google says.
Still, this is pretty exciting when you factor in IBM's development of Continua-compatible software, which you can use to upload your vital data to your PHR, where your physician can access it and make recommendations. Already, a pulse oximeter is available (whatever that is), and future devices will measure blood pressure, glucose levels, temperature, weight and so on. In other words, instead of going in for a physical, you can update your data and have your doctor analyze it.
Now, the question is--will physicians go along with this since they can't charge for an office consultation if you don't come in person? I doubt it unless the rules are changed so they can charge for e-visits.
Wouldn't it be great to sit at work, take your uploadable blood pressure, and sit back and wait for your doctor to call and say, "I think we need to change your Lisinopril level." Sure beats taking a morning off and waiting around two hours for your doctor to get to you.
Back to the first two: I've read where there's no difference between EMRs and EHRs except that EHR is designed to be more marketing friendly for some reason. I've also read where EMRs are patients' electronic records maintained at one location while EHRs are shared electronic records available across a network.
Whatever the case may be, the stimulus package from our lawmakers includes a bundle of dough to implement EMRs and/or EHRs. (Could this be like Betamax v. VHS or Blu-Ray v. HD-DVD?)
However the stimulus package implementation turns out, and we won't know for years, PHRs are available right now on both Google and MSN. A personal health record is something that the individual chooses to create on one of those providers (I think WebMD offers PHRs as well).
Security issues aside, people have expressed fears that these providers might sell your data to pharmaceutical and other health marketing companies. Google denies this, if you trust what Google says.
Still, this is pretty exciting when you factor in IBM's development of Continua-compatible software, which you can use to upload your vital data to your PHR, where your physician can access it and make recommendations. Already, a pulse oximeter is available (whatever that is), and future devices will measure blood pressure, glucose levels, temperature, weight and so on. In other words, instead of going in for a physical, you can update your data and have your doctor analyze it.
Now, the question is--will physicians go along with this since they can't charge for an office consultation if you don't come in person? I doubt it unless the rules are changed so they can charge for e-visits.
Wouldn't it be great to sit at work, take your uploadable blood pressure, and sit back and wait for your doctor to call and say, "I think we need to change your Lisinopril level." Sure beats taking a morning off and waiting around two hours for your doctor to get to you.
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