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Guest Post: How Hospitals Profit From Making Mistakes
Submitted by Michael Krieger of Liberty Blitzkrieg blog,
One of the many things holding the nation back at the moment is the complete lack of incentive to be a creative, productive and honest member of society versus the tremendous incentive to be a corrupt, thieving, lackey for the establishment. In a free market system, with a strict set of rules governing the game that is applied to everyone equally, market signals and incentives exist for companies to create a great product and to meet customer needs with great service. In contrast, within a crony capitalist system, the primary incentive is to get as close as possible to political and corporate power in order to financially benefit from their oligarchical ownership of the controlled economy.
It is only within a completely disconnected from reality, crony, fraudulent economy where you could have a situation in which hospitals actually earn much larger profit margins from making mistakes and harming their patients, than from providing excellent care. We learn from the New York Times that:
Hospitals make money from their own mistakes because insurers pay them for the longer stays and extra care that patients need to treat surgical complications that could have been prevented, a new study finds.
Changing the payment system, to stop rewarding poor care, may help to bring down surgical complication rates, the researchers say. If the system does not change, hospitals have little incentive to improve: in fact, some will wind up losing money if they take better care of patients.
The study and an editorial were published Tuesday in The Journal of the American Medical Association. The study authors are from the Boston Consulting Group, Harvard’s schools of medicine and public health, and Texas Health Resources, a large nonprofit hospital system.
The study is based on a detailed analysis of the records of 34,256 people who had surgery in 2010 at one of 12 hospitals run by Texas Health Resources. Of those patients, 1,820 had one or more complications that could have been prevented, like blood clots, pneumonia or infected incisions.
The median length of stay for those patients quadrupled to 14 days, and hospital revenue averaged $30,500 more than for patients without complications ($49,400 versus $18,900). Private insurers paid far more for complications than did Medicare or Medicaid, or patients who paid out of pocket.
The authors said in an interview that they were not suggesting that hospitals were trying to make money by deliberately causing complications or refusing to address the problem.
“Absolutely not,” said David Sadoff, a managing director of the Boston Consulting Group. “We don’t believe that is happening at all.”
But, he said, the current payment system makes it difficult for hospitals to perform better because improvements can wind up costing them money.
Dr. Barry Rosenberg, an author and a managing director of Boston Consulting, said the study came about because his firm was working with Texas Health Resources to find ways to reduce its hospitals’ surgical complication rates, which, at 5.3 percent, were in line with those reported by similar hospitals. Part of that work involved analyzing the costs, and he said the team was stunned to realize that lowering the complication rates would actually cost the hospital money.
“We said, ‘Whoa, we’re working our tails off trying to lower complications, and the prize we’re going to get is a reduction in profits,’ ” Dr. Rosenberg said in an interview.
If the above tale does not demonstrate how completely screwed up our economy and society is, I don’t know what will. Even if we assume every single person in a given hospital is a completely moral, decent human being who would never purposely prolong a patient’s stay, the mere fact that investing in improvements in the hospital and providing better care could lead to a dramatic decline in profit margins is a total tradegy. What do you think we are going to end up with if we have these kinds of incentives?
Full article here.
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Don't make assumptions at my expense, OK. I read patient charts every damn day where missing one small detail can cause major damage. I don't need some nobody like you impuning by reading comprehension based an a giant ASS-U-MPTION. As for the AMA, I hate them and loathe them. 95% of doctors feel the same as I do. Every month I get the same fucking bill from the AMA for dues in then hundreds of dollars, just for the half year mind you, assuming I want to become a member. Into the shredder it goes. I am not a member of the AMA and never shall I be. 95% of doctors are not members of the AMA. Why? Because the AMA is nothing but a money-grubbing political lobby arm-and-tool of the administration. I think the AMA is a bigger misnomer than the Federal Reserve Bank.
Join it, become its president, and change it. Or just bitch about something that has no other answer.
Ok boss, I'm on it. I'll call the AMA first thing and tell them that I want to be their next president so I can straighten them out good. I'll get back to you as soon as I'm in office.
Finally....a mission.
Enjoy your nice home while you're bitching about those who have no access to health care threatening your $350K salary.
I'm pretty sure that Castro has a flower shop in Havana, where you can be "equal" with everyone else. Hey everyone, LTER needs a boat ride to Cuba
Green arrow: I'll donate to the cause!
Red arrow: Naw, leave him here to wallow in his class-envy!
1) Only about 20% of doctors are members of the AMA. They also were big supporters of Obamacare. So, theyre not really the monolithic group as you imply and their credibility is now a bit stretched.
2) This is a study based on one system in one state. Payor contracts can differ greatly from hospital to hospital, system to system, and state to state. In other words, you cannot project this out across the entire country.
3) You assume a vacuum and that there are no other costs associated with these mistakes (either real or intangible).
4) I read Denninger. Ive agreed with a lot of what hes said in his healthcare rants last few weeks. Thats why Ive said the industry is about to change drastically over the next ten years. This isnt rocket science. It costs too much and regulations are too high. Thats why I believe it will fracture into a true two system industry where some hospitals will only treat Medicare and Medicaid (quasi-nationalized) and the rest will be completely private where all costs are paid out of pocket. There will be no insurance (as Obamacare has ensured those companies will fail). It may end up being where you pay the hospital system a premium like health insurance (aka boutique healthcare).
Obamacare isn't even in operation yet, yet this problem has existed for 40 years. Does Obamacare have time traveling capacity?
No, but Medicare/Medicaid is curiously about the right age that you expound upon...
That tells me ALL I need to know right there. Most of "Fianacial analysis" is BS these days just like the F-ed up Health Care system.
Just like the Health Care System the Financial System only cares about "revenue" whether you call it "reimbursement" or whatever. It is PAYMENT! Good Lord, go ead some Denniger on Market Ticker and wake the hell up.
And I don't really need a bank account. There are alternatives. Not so much when you suffer a heart attack and need urgent medical attention. Hey, let's all profit from that guy's heart attack!
Yes, there are alternatives to the current wealth-generation model of health care. Medical school does not need to cost $250,000 and we don't need the AMA telling us how many medical students we can have each year (hint, it's a small number to keep demand/salaries high).
Rand, Knowing how you swing politically I find it ironic that you rag on the AMA when the AMA is actually 30% of registered Drs. and 100% progressive politically. Not every Dr. is AMA. The AMA just happens to be the most vocal.
In this one thread we have seen AMA membership quoted at 5%, 20% and, now, 30% of "registered" doctors, by those claiming to speak with some [medical] authority!
However, Rand's point - while I strongly disagree with most of his politics - is that the AMA is the self-appointed arbiter and government policy-setter of how many/few doctors get "educated" (ie. indoctrinated into the allopathic production line) each year. They also largely dictate - through effective and relentless lobbying - the healthcare mechanisms and direction of government expenditure.
Being "vocal" is a totally inadequate description of the AMA's overriding and maleficent influence.
Hmm, what makes you think the AMA is separate from the Govt? The purpose of a System is what it does.
"Rand, Knowing how you swing politically I find it ironic that you rag on the AMA when the AMA is actually 30% of registered Drs. and 100% progressive politically."
Jesus FUCKING Christ. Do you know a single doctor?
Yes. I'm seeing a GP, a nerve doc and a Cardiologist.
Nerve and Cardio do not belong to the AMA. I asked
Edit: http://wiki.answers.com/Q/What_percentage_of_Doctors_in_the_US_belong_to...
Thank you.
"non-profit" and "for profit" are tortured terms in healthcare.
Charge $10k (call that revenue), get reimbursed $7k. Take $3k goodwill charge. Book $2k loss. Non-profit accounting
>>>>> With virtually everyone to be captive to a govenrment-run insurance program, you as patient will comply with the dictates of the care plan or you will not be covered. That means accepting vaccines, drugs (i.e. statins) and whatever else is mandated.
Based on a friends dying mother's experience, what you say is spot on. You are "Forced" to accept the mandated. It's bullshit!
Military contracts in the U.S. work the same way.
First land big contracts to build new missile systems, boats, planes, armored vehicles, spy software, drones, whatever.
Build pieces of shit with huge cost overruns. Everyone involved gets huge money. Then, get another shitload of funding to work out the bugs in the pieces of shit you built.
Fix some of the bugs at huge cost and time overruns. Everyone involved gets huge money. Get more funding.
Eventually, one of the things actually works. Drones, say. It's state-of-the-art weaponry. The Chinese & Russians are amazed at what the things can do. They build themselves some of those things.
You mean they wait until it works, then they just steal the plans. Why spend on R&&D, when a few hackers can run off with your plans and improve them?
The U.S. sickcare big-pharma system is corrupt and broken.
Obamacare does nothing to control costs, and simply furthers the parasitic insurance premium/hospital care crony capitalism cost structure.
Very disappointing screed from libertyblitzkrieg. After reading this, I decided I'll no longer read Michael's blog. Obviously none of the writer(s) have any direct experience in managing patients with disease, or setting medical policy. The premise of this research is that certain conditions (one example: pulmonary infections) are by definition (by diagnosis) preventable. Disease isn't like that. Disease is not always preventable. As an adversary, disease is formitable. True research is not conducted via 20-20 hindsight, as in this article. Also, physicians and nurses do not decide what to do based on whether or not it'll cost the medical system more money, they decide based on what they know is best for the patient.
These expensive bean-counting consultants who come out of Massachusettes to tell us all how it should be......are obnoxious elitists. And they're coming straight at all of us with Obama/Romneycare. If you follow their recommendations, it will always cost more (by definition!).
Both the crony capitalists and the government apparatchiks are in on this deal; they collude to increase costs and dependency on government programs.
No free market, no cost controls via competition - a monopoly of having to buy insurance with no cost controls, and treatments with no cost controls, either through competition or other means.
I agree. My aunt had a density anomaly spotted in her breast (first ultrasound, then $$$ MRI). The MD recommended a biopsy by surgery. The surgery went fine, and the 'anomaly' was benign.
The resulting copay was not so 'benign', even though she had "good" insurance from the large national company she works for. She's stuck with a bill in the thousands.
What a racket! Unless you're a welfare case, nothing's free in the Land of the Free.
I do hope you understand that part of that bill is to pay for all the FSA members that did get all that medical service(s) for free!
Dear Clinteastwood, my reply to your comments repeats many points I made in my earlier comment:
The basic problem is that medicine IS, and should be, basically ecological. However, real human ecology has the history of being governed through the history of warfare, whose success was based on being the best at deceits. Therefore, our real human ecology operates through deceits, which has engendered the kind of medicine we actually have, which is based on deliberately ignoring the principles of evolutionary ecology as much as possible.
The dominant form of alleopathic medicine is dominant for similar reasons why our diets are so heavily tilted towards being carnivores. There is a very long and complicated social history, which has seen intermediate variables related to being the best at deceits, backed by destruction, becoming the dominant controlling factors within the established systems. Alleopathic medicine is murder medicine. Its preferred treatments are similar to declaring war on the diseases, which always tends eventually to backfire more and more badly. Alleopathic medicine is only good in limited circumstances, for a short period of time. However, just as in the context of military conflicts, the maximum power deliveries then and there are what matters. Therefore, the maximized systems of deceit and destruction have taken over American medicine, in similar ways to those short-term expediencies have taken control over everything else. The banksters took control over the money supplies, and then were able to use that awesome leverage to fund everything else. Thus, they decided to fund the kind of "medicine" which would make them the most profit, while they also controlled the powers of governments in order to discredit and destroy all alternatives.
OF COURSE "Disease is not always preventable." However alleopathic medicine deliberately minimizes prevention. In similar ways throughout every other layer of society, triumphant deceits maximize the social problems that they pretend to ameloriate! Just to point out one extremely obvious symbolic example, marijuana should be a very cheap herbal medicine. However, it was completely criminalized. The current Federal laws are based on the view that marijuana is totally useless and evil. That is the kind of legalized lies, backed by legalized violence, that runs throughout every aspect of alleopathic medicine systems, and they all trace back to the same social sources, i.e., THE SOURCE OF OUR MONEY SUPPLY!
The paradox we face is that medicine IS, and MUST be primarily ecological, BUT human ecology was primarily controlled by the murder systems, which were based on the maximum deceits. That infinite tunnel of deceits goes through and through the established medical systems. In that context, I find it ludicrous to assert that "physicians and nurses ... decide what to do based on ... what they know is best for the patient." Just as nobody can operate outside of the almost totally fraudulent monetary system, due to taxation and legal tender laws, nobody who works in the medical system can get outside of the legal systems that surround them, and condition their choices. There is a long history of many people's careers and lives being destroyed if they went against the AMA etc.! Of course, that is still getting worse, faster ... since the banksters control Obama, and therefore, the insurance companies wrote the Obamacare legislation.
We are all trapped inside the paradoxes of human ecology being controlled through the maximum possible deceits, which, of course, includes tranforming "health care" into a "profit from disease system." The banksters are the worst kinds of parasites, that have taken over the government of the USA, and are using the powers of government to direct America to commit suicide. However, any serious solutions to those runaway social insanities MUST be developed on the basis of an evolutionary ecology approach, which means they MUST deal more forthrightly with the profound paradoxes of death controls being operated best through dishonesty.
[quote]I find it ludicrous to assert that "physicians and nurses ... decide what to do based on ... what they know is best for the patient."[/quote]
Currently that statement is true for the most part; however in the future, it will not be. Stop being so dogmatic.
I would only stop being "so dogmatic" after there is enough evidence that things are getting better, instead of worse. Of course it is theoretically possible that doctors and nurses MIGHT start operating a true health care system. However, the overwhelming runaway social facts continue to be the take over of everything, more and more, by the banksters.
While some Americans are waking up to that, hardly anything has been done to stop the REALITY from automatically getting worse, since all the instutitions have already been set up, and are being controlled to maximize short-term profits, while that also maximizes longer term costs.
I see no reasonable basis to believe that is going to get any beter, before it gets a lot worse instead. E.g., Codex and Monsanto, etc., will probably continue to prevail, and so on ... Although it is theoretically possible that things might get better, the REALITY of the funding of political processes is ACTUALLY making them worse and worse, faster and faster ...
If marijuana has some usefulness in curing/preventing disease, it shouldn't be too hard to prove that. Please point out some evidence to back up that statement, any kind of evidence besides "well, I feel better when I'm stoned," which (forgive me) cuts no ice with me when the problem is cancer and pneumonia.
Or better yet, how about offerring up evidence of your main thesis, that medicine is/should be ecological. Have you ever noted the arithmetic certainty of genetics? Didn't think so.
I think this latest ecology-is-everything meme is itself a deceit, wishful (and simplistic) thinking by weak minds with no life experience, and probably leading us all to another great war of slaughter for Goldman Sachs carbon futures and derivaives.
HERE IS A THOUSAND PAGES:
http://www.greenpassion.org/
http://www.greenpassion.org/index.php?/topic/15486-absolutely-free-granny-storm-crows-list/
A free source of a huge collection of medical marijuana information.
It can be obtained through email, and maybe on these Web sites:
http://www.facebook.com/GrannyStormCrowsList
http://hempembassy.net/forums/After-the-Facts/Medical-Cannabis/Granny-Storm-Crow–039-s-List-January-2013/8,3075,4694.html#forumpost4694
http://mmmclub.org/general-news-a-info/54-granny-storm-crows-list-2013
http://beyondchronic.com/2013/03/granny-storm-crow-lists-1000-pages-cannabis-research-links/
http://www.wakingtimes.com/2013/01/11/top-10-cannabis-studies-the-government-wished-it-had-never-funded/
Top 10 Cannabis Studies the Government Wished it Had Never Funded
http://www.popsci.com/science/article/2013-04/why-its-so-hard-scientists-study-pot
Why It's So Hard For Scientists To Study Medical Marijuana
http://www.youtube.com/watch?v=gWLrfNJICeM
Cancer - The Forbidden Cures
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What did philosophers back in the 1800s like Dostoyevsky and Nietsche say? Parasites, parasites, parasites!! That is what they judged, and it has only gotten worse. Fasting and calorie limitation is the smart path as the parasites will eat you alive if you let them; they will coddle you, parasitize you, medicate the hell out of your body when simple natural remedies would do. They should be lined up against the wall and gunned down for all the attrocities they have pulled!
Don't forget the three unnecessary tests they run on patients before every medical visit, and followup appointments to say "you're fine"
Don't get sick? Shivers<
complete lack of incentive to be a creative, productive and honest member of society versus the tremendous incentive to be a corrupt, thieving, lackey for the establishment.
JUNGLE/ZOO?
What is FREEDOM?
It is the same everywhere you go in the USA. The medical industrial complex is controlled by bigPharma. The food production industry is controlled by bigbiotech. The communications industry is controlled by bigTelecom. The environment is controlled by bigoil and gas. The university system and government is controlled by Wall Street.
As such the human is a commodity. When looked at by the medical industrial complex, the human commodity first off has to have money (insurance is money). If the human commodity has money, then this commodity should be kept breathing until all money is depleted. There is no consideration for health of the commodity; just the fact that it breathes and has money. The determination of what tests, pills, and protocols is based upon whatever BS has been marketed the best. (ex. Vaccines - Signs and banners everywhere for flu vaccines)
The US is insane. We deserve what we get for allowing corporations to get so big that they run everything. The average American joe blames government. Government just does the bidding of these big corporations. They are the real enemy.
I cant say with over 28 years as a clinical microbiologist that I have seen any purposeful damage to patients to overbill for their care. What I have seen is poor outcomes in what would be considered routine low risk procedures, but because of the astronomically bad health the average patient is in this is no longer the case. The average person I see is morbidly obese( BMI up to 50!) high blood pressure, type 2 diabetes, COPD, sleep apnea, GERD, hyperlipemia, various cardiac problems, multiple infections and carriers of ESBL, VRE,MRSA, non healing wounds and multiple amputations, end stage renal disease and on dialysis, and last but not least...anxiety and depression ( what a surprise!). It's not really surprising these patients often are in the hospital much longer than what would be expected. Plus, when they are discharged, they have a high rate of readmission with in a month. People like to believe that is because the hospital didn't adequately care for them. This is not always true. For example, I often see patients admitted with glucoses over 800. Within a few days the patient is stabilized around 150 and discharged. Two weeks later the patient is in the ER with their glucose over 800. Is the hospital at fault because of a patient's non compliance?
I'm not claiming hospitals don't screw up because they do. I've seen horrific cases that would make you afraid to set foot in their doors. Yes, I have seen cover ups. I've seen the wrong drs get sued and the truly incompetent ones walk around untouched because their patient just love them for their lovely bedside manner. Believe me, the added bureaucracy the government adds to medical care to improve things really often makes it worse and people just work around it. I knew of a prominent cardiac surgeon who often took very difficult cases. This meant he had a higher death rate than average. Because he was under scrutiny from hospital administrators, if he had a patient die he would perform CABGs ("cabbages") for a month to improve his stats.
Working in the medical field certainly isn't what is used to be and I bet most of us in all departments can attest to it. My only advise is to stay as healthy as you can and never need our services.
Miffed;-)
Miffed
How true!! Everyone of my patients this weekend have several of the ailments you list and all were frequent flyers never doing a damn thing to improve their health. The system is broke because the same POS who use the system for quick dips for fleeting improved health are sucking the system dry. When the SHTF I'll enjoy seeing this broke ass system crash and the cleansing can begin. Stay healthy -- it is the only alternative. And quit drinking fucking SODA 'it is poison".
A High Five from me to you! I was worried when I saw this article that everyone would simply assume its all Big Brother medical out to screw patients. I'm certainly not going to wholly defend hospitals but the idea patients don't have any responsibility for their own health! I had one of those patients who had ALL of the things I listed come into the hospital a few months ago. Apparently he was over 500lbs and was watching TV when 3 of his vertebrae literally disintegrated. He came into the hospital by ambulance. The dr tried to explain there was nothing they could do, he would not survive surgery. I'll never forget what he wrote at the bottom of the chart " I am having difficulty imparting the gravity of this situation to the family." I guess they figured this man was analgous to a broken car, just take it to a mechanic and it'll fix up fine! People here often laugh at sheeple being self deluded at the global financial situation. Well, there is a lot of disconnect between personal health and what medical technology can do. Some things are just not fixable and blaming outcomes just on hospitals is grossly unfair.
Miffed;-)
+1Trillion! My wife (D.O.) see patients like this all the time too!
Loads of irresponsible people out there, expecting miracles.
Sedentary society, calorific abundance, ageing society, expectations that have more in common with Star Trek than the real world.
Your customer certainly experienced "a few trapped nerves"!! For the average (OK, Healthy) BMI, vertebral scaffold surgery is practicable but hardly routine. He is possibly looking forward to heavy-duty opioids and all the problem they bring (dose escalation as acclimatisation develops), but the constipating effect does not reduce!. Maybe add in something for management of spasticity / neuropathy (baclofen, gabapentin perhaps), then as oral meds become ineffective, we're in the realms of syringe driver or implanted dosage devices.
Diabetic of course, so a higher than usual infective risk (especially with easily colonised implants), so his lifespan will not be "considerable"! Presumably lumbar vertebral collapse, so he'll have at least some motor deficits (permanent), maybe partial paralysis, maybe rectal and or urethral problems (and for a very obese diabetic, a permanent IDC is not something to look forward to, in these days of MRO UTIs).
Guess what - we see this sort of thing in Melbourne too 500lb is "only" 227kg, and this is "upper range of "normal" " these days. Our largest (since Christmas) tipped the scales at a touch under 350kg (= 770 lb); we needed the Fire Brigade to assist in getting this one out of their house (via the window - had to be removed!)
ALL our imaging tables now have to be rated for 400kg (850lb), as do the Bariatric beds, chairs, walking frames, etc. We're moving all the "biggies" to the ground floor; a) because they are a bit big for the lifts, and b) because of floor loading - the floors are not rated to carry the load!!
Scary, isn't it!
It's a downward slope that would once be unimaginable but now is sad and rather predictable. About the only thing that can save him is if he can figure out some manner of exercise that will stop the downward spiral.
When in-house imaging tables aren't large enough to accomodate these extra large patients, I understand that zoos are quietly stepping in. And fire departments and emergency services are beginning to add surcharges for the extra freight to move and transport them.
Heard that too. For us, Sydney (NSW) has a significant bariatric capacity for planar, CT and PET (up to 500kg, or half a (metric) ton).
Problem is that these Patients often exceed the weight limit for the aeromedical service (they certainly exceed the Helicopter weight limit), so moving them in a timely fashion is tricky. Add in the complicating factors (usually really ill, usually unstable, usually requiring continuous monitoring / observation) and you have a problem.
Add in the Admin. complexities (Interstate funding transfers, etc.) and it can become a headache fast. Fortunately, the Royal Flying Doctor Service is really good at this sort of thing, and so far all of our "shipped out" patients have survived the trip.
Jena and Parrotile, I was reading your posts in abject horror to what state humanity had come to. I was vacillating between laughing hysterically and banging my head in my hands. I looked up and saw a huge girl, possibly 350 lbs, wearing hot pants and a tube top holding a sign " hungry anything will help". Mr Miffed was driving me home from work ( we carpool on Monday's) and nearly swerved and hit the car next to us. We both couldn't stop laughing for the longest time and almost circled the block to get a picture for you. We finally came to the conclusion maybe she really was hungry but she was not obviously feeding herself anything nutritious. This was the equivalent to starvation in America. Very different if you visit other countries like Calcutta or sri Lanka. I certainly don't know the solution. This situation just is not sustainable and I can't imagine what the future will bring. Thanks for the laughter. I guess Im just tired of being depressed about it.
Miffed:-)
That is some serious imagery, Miffed. I imagine the tube top had its work cut out for it.
You're right, it becomes an ironic statement when someone so obese is perhaps so under-nourished as well and yet it is certainly possible. It is hard to imagine, when dietary and physiological information is so readily available, that anyone could drink soda all day or eat nothing but junk food as a regular diet. But when information doesn't reach people or if they don't want to hear it or if the junk is all that is available or it's cheaper than nutritious food, bad things happen. Also, we've lost so much by people not learning how to cook either via family tradition or in Home-Ec where they at least got the concepts and the basics.
On the eve of graduation, I still wasn't positive that I was going to like being a nurse. I ended up being very lucky, being hired almost right away into an Emergency Dept. But that last month in school I remember thinking that even if this whole nursing thing didn't work out at least I had gotten what very few people ever did: A Complete Owner's Manual of the Human Body and What To Do When Things Went Wrong. That's how I thought of my education as I graduated. I still think of it that way.
Yeah, a lot to be depressed about. Hang in there.
Whether practicing or not you probably made a smart move. I have a Buddhist friend who explained to me the difference between Sutra ( learning from texts) and Tantra ( learning through life experience and doing). Both are considered equally valued, and one should probably explore both in ones life.i think we are both truly fortunate to have had experiences in the medical field and perhaps can enlighten people here and all those lives we touch how things have become so critically bad.im so happy to have some distance being a microbiologist. I can't imagine what it must be like for the Drs and nurses today working the front lines. And now we've thrown Obama care on the heap as well. How much more can this broken system take?
Miffed;-)
+100
I am quite Miffed to, after I have learned what I outline in my reply below:
The psychological and social habits that people have in America have been the result of the cascade of scientific brainwashing. "The fish rots from the head." The American system went rotten gradually. The runaway destruction of America was primarily due to all the various ways that the funding of the political processes became the triumph of the methods of organized crime, covertly taking over the government, so as to legalize lies, and back those up with legalized violence.
Anybody who takes time to study the "profit from junk food system" will discover the same patterns, leading back to the same sources, as the "profit from disease systems." There is an almost perfectly perverse subsidization system, which subsidizes the worst junk food the most, while subsidizing more healthy food hardly at all. Plus, of course, advertizing is deliberately designed to generate a fantasy culture, so that junk food can be sold at high prices, to make more profits.
The profits made from subsidized junk food then pays for more of the same, i.e., scientific brainwashing of the American consumers, as well as corrupting the political processes, so that everything the government does in these respects is as backwards as it could possibly be. A sane government would tell people the truth about nutrition, and, if it subsidized food, it would subsidize healthy food. However, the triumph of political corruptions has resulted in governments doing the opposite of that!
The single simplest symbol of that is that hemp is the single best plant source for protein and oil for human nutrition, as well as for other animals, BUT, cultivation of hemp has been made completely criminal for decades. That is merely the most extreme particular example of the general pattern of social facts. Americans are surrounded by the best brainwashing and scientific advertizing that money could buy throughout their entire lives. They pay for that through their purchases, which feeds back to lie to them even more. Meanwhile, every economic decision they make takes place within that overall runaway triumph of the promotion of lies about nutrition, while simultaneously, the same factors control the price of food, with that all being systematically skewed and screwed up by the government being almost completely corrupt.
As always, to understand WHY Americans are so sick, follow the money to its source: the banksters, who profit from every possible evil thing that they can possibly do! The average American is the pathetic victim of legalized lies, backed up by legalized violence, operating against their real interests, for several generations. Sure, one might say that that is still their fault. However, most of them never had a fighting chance against the system that conditioned them so thoroughly that they never got the slightest clue how clueless they were.
P.S. As a microbiologist, I suppose you already know that the human body itself is an ancient ecology. From the symbiosis of the organelles inside the cell, to the all the various microbes, etc., that coexist beneficially within the human body. My belief is that the total genome of all the microbes that necessarily coexist with the human cells is bigger than the human genome itself.
That merely emphasizes my point in previous comments here, that medicine ought to primarily be based on evolutionary ecology.
The biological questions about "self and other" are profoundly spiritual, and our blood is actually the most spiritual system in our body, that responds to and answers that question within our bodies. The profound physical sicknesses that so many Americans suffer have sources in their spiritual sicknesses.
Well thought and provocative post. You touch on epigenetics which is cutting edge of scientific theories stemming from mapping the human genome. Basically it was determined humans are 1/10 human and 9/10 bacterial. Therefore our interactions with bacteria are critical for our health. We have spent a hundred years at war with bacteria and have only damaged ourselves in the process.. It has been theorized that mitochondria, which are organelles, are derived from bacteria. Many health issues today, autism ( now estimated in 1 in 50 births!!), depression, obesity may be related to intestinal flora. Much research in this area being done today and because this is a radical departure from conventional thinking( only good bacteria are dead bacteria) I am intrigued. Most people don't know 80% of human immunity is in the colon. However, with the closing of the human mind at this point I'm doubtful much will come of this. So much easier to eat a Pop Tart, watch TV and take an antibiotic when ill. People today seem to have lost all their inquisitiveness or passion for learning or living.
Miffed;-)
I've been seeing more article lately that obesity may be tied to gut flora. It makes sense that a diet high in processed sugar and chemicals will feed different strains of bacteria than a "cleaner" diet.
What do you think?
My brother-in-law took my sister-in-law in to the osteopath for a follow up appointment after she broke her arm. Turns out, the set screws had come loose in her plate. Bad plate. Too bad. This required an even BIGGER plate to replace the smaller one that had been installed the prior week. My brother-in-law got up out of his chair to view the MRI on the computer screen and said that the doctor literally jumped out of his chair. Thought some punches were gonna fly, I guess. Brother-in-law kept his cool though and said, "I'm not paying for that."
Osteopath != Orthopedist (although some Orthopedists are indeed Osteopaths!)
If you're held hostage by the healthcare industry, then maybe you're not free and don't live in the Land of The Free.
us health care is only one step above witch doctoring...cancer could be readily cured as doctors in previous generations did....however, the rockefeller nazis have a lockhold on health care, especially after their nazi puppet finally passed the nazi health act....
there never was a drug or operation which the nazi health system didn't like...american health and diets are deliberately sabotaged with quack medicine designed to enrich hospitals and drug companies....and i will save my tirade against vaccinations for another day...
it's a crooked system - stay away from it.
The authors of the study said they weren't trying to suggest hospitals deliberately cause complications.
Okay, I'll say it then. They do and there's a growing scandal in Chicago about the for-profit Sacred Heart Hospital which is doing exactly that.
http://www.bizjournals.com/chicago/news/2013/04/19/fifth-sacred-heart-ho...
There were doctors and cures and hospitals before health insurance! Just like there were roads and schools before Income tax! GAAH!
Men and Women build out of ne===cessity
On the plus side, hospitals finally are required to ask the patient which foot they are having amputated before they start cutting.
Yeah they mark it too: like, "This foot stupid"
"complete lack of incentive to be a creative, productive and honest"
You write about lack of incentive to be honest, but you forget to mention control as the endgame.
You write about control, but you are not quite sure where it comes from.
Creativity and honesty do not require "incentives" and I think you know that.
I like you Mike, I really do, but you are morphing into trying too hard.
"Well Mr. Jones, the surgery went badly and we cut off your nuts instead of the tumor. However, on the brightside, you get to stay and relax longer and the hospital will be more profitable. That means that we are more likely to still be here next year when you return to have that sponge that we left inside you removed. Now try to smile and each your Jello." hujel
Doctors don't buy boats to hide their PMs. They hide them in their patients, and retrieve them on follow-up visits.
I need help and know it ;-)
Hospitals are one of the Biggest unregulated Rip-off schemes in the country. if they make an accounting msitake good luck getting it corrected beofre months a fighting with them.
Oh, my gosh. Lighten up, everyone. It isn't necessary to be vicious to make a point.
Anyway, I think the health care system IS headed for collapse. Obamacare is driving the last few nails into it.
Just as No Child Left Behind is driving the last few nails into the public education system.
I hear commenters here on ZH railing against teachers, too. But guess what? The doctors and the teachers are not the problem. The systems they work in are.
And the systems aren't going to get any better until we in this country have a system of values that is grounded in reality.
Everything we bitch about in this system is a consequence of using fiat money, because when the fundamental basis for judging value is entirely fictional, the less tangible ways of judging value become utterly ephemeral.
Fix the monetary system, and a lot of the dust will clear, in regard to both the health care system and the educational system.
All this is true, and more. If a patent has only days to live he is moved to hospice if possible to improve hospital and doctor death stats. My brother died of a rare liver cancer with only one very expensive medication for treatment and it could only be bought in quantities for many times the mean survival rate to increase profits. Obama will screw medical care up even more.
Don't suppose the drug was Imatinib (Glivec) by any chance?
We're getting decent results using this in inoperable hepatocellular carcinoma. Not exactly "budget" treatment though - fortunately the Federal Government picks up the bill!
I believe it was soranifeb a generic of nexivar. Thank you for responding.
I am an MD, this is not new news by any stretch of the imagination
Good to see one MD here, dcb. I am surprised any are left with all the reimbursement problems and cut backs I read about. My family doc is closing up shop after only 8 years in private practice with a 3 person group. He said they have trouble taking home $96k a year. He reminded me, they pay for their own retirement plan and their own health insurance, not the taxpayers like municipal workers. They also have huge loans to pay back for undergrad, med school and so on he said.
I hope it's not a trend but I understand his concerns and struggles. Sad to see him go.
fee for service had it's problems (the poor, and in another time and world churches provided care to the poor), we now have a system that masks the reality that the care the wealthy can get is the same for all..it's not true, back then and not true now, even if obuma says so.
Fee for service is a great way to drive cost to what people can pay, socialism has no rewards for the effective and good healthcare..however it is a way to provide employment in your economy for all those who would have worked in a manufacturing non green economy we seem so driven to obtain (off shore anything dirty or non green)
Ha! Ha! You too can be a surgeon!
http://store.steampowered.com/app/233720/
Surgeon Simulator 2013
Ahhh - the flawed warblings of the freemarketeer. So tell us oh wise one - who sets these rules - and how do you keep the current without an army of (expensive) rulemakers who sit in a house which needs to be paid for - contributing to big Government?
...or are you supposing that the rules - once set - will never need changing?
...or are you supposing the rules will be 'defined by the market' - whenmonopolies and cartels clearly exist (and should do - as the driver is profit)
You keep refering to this 'crony capitalism' - can't you see this is simply capitalism? Just because it's now working against you - you now find complaint with it and demand a 'return' to a period when you weren't getting screwed.
Maybe if you had studied more you would realise that 'this' we see today is the INEVITABLE OUTCOME OF CAPTIALISM - as so many greater men than I have pointed out in the past - but no, you knew better - right?
This website was worthwhile when it simply reported 'what was going on' - now you have every crackpot and idiot writing 'ideology pieces' for college on here - and they do so, so badly.
Maybe the Free Market Capitalists need to review 'how we got here' before they start suggesting going back to something which is 'undefined and unclear'.
Government steps in to protect the consumer - because the free market fails -from that moment on the market is tarnished and the free market is dead.
Indeed - the free market was dead the moment Adam Smith commented on the phenomenon of the 'invisible hand'.
So please ZH - stick to the FACTS and leave the ideology out - otherwise you simply encourage the "Goldand guns is great" T-party crazies who come because they think buying Gold is rebelling against the 13 states (or whatever) - when indeed the role of Gold in the world is far more important than the pointless rebelling against the state. They also believe they can use force to overthrow the Government - which will be hillarious to watch (if not a brutal massacre for those foolish enough to try)
They are - as they say - useful idiots and ZH has becomea breeding ground for them - discrediting a once respectablesite.
That first paragraph is great. Every student should memorize it. Not that any teacher or schoold admin will ever read it....
That paragraph could be about almost any industry in the old Soviet Union, unfortunately it is now true of many of ours... health care, banking, anything "green bullshit", TSA at airports, etc...
Nice article.
There is nothing in obamacare on prevention or actual reduction in costs. obamacare is all about how everything is paid for.
Two distinct and separate things. Actually lowering costs and who pays.
centralized control/socialized cost is a recipe for disaster. The completely opposite direction for a real solution.
As far as this post, I can't believe hospitals or doctors have any intention on making mistakes for the bottom line.
pushing obamacare to the side for a moment, why does not anyone comment on the robber baron mentality that consumed the healthcare industry? private practices are a thing of the past and in the city i lve (<million) we only have three health care providers.....
Private practices are extremely expensive to run in this age of regulation compliance. You can't put aside Obamacare in this discussion because it is driving it. Doctors are extremely concerned about their futures and what will happen, and many don't know if they will still be in practice in a few years or what that practice will look like. The ones who can will have concierge practices, further limiting your areas options for primary care providers -- but those docs will feel like they can breathe again. Others will make alliances with large groups or with hospiitals. There isn't much room for the single care practices.
This article is hogwash. You don't need any help making medical mistakes; they happen all by themselves. There are so many points at which mistakes may occur or things may just not go right. Or you may have a patient sabotage the whole process: I had a one day post-CABG patient wolf down a Big Mac so rapidly that he coded. A family member smuggled it in but we never learned which one. The anesthesiologist was picking bits of meat out as he was trying to intubate him. Yeah, I imagine that hospital stay was longer than the typical coronary bypass graft ought to have been.
Or things go wrong. Yes, there are infectious agents everywhere in the hospital. Guess what, THERE ARE SICK PEOPLE THERE! Even with good surveillance and decent infection control, these superbugs get passed around. With poor infection control, they move with lightening speed and some facilities haven't been so great about it. Or what do you think happens when an unhealthy person comes into the hospital to have major surgery done? Complications occur even in the best of conditions so when they're a little bit iffy? They get worse.
If you find yourself in the hospital or have a loved one there? Expect medical mistakes. They happen, just prepare for them. Question the nurses and doctors. Don't be an asshole, just know what is supposed to be going on when and where so you know whether you're getting the right drug or procedure. Make sure no one touches you/your loved one without first washing their hands. Keep hand sanitizer on the bedside stand for those whom you didn't see wash. And be as healthy as you possibly can be before going into the hospital in the first place. It's what will keep you healthier when you get out.
From an ID viewpoint, we suspect (though haven't "proved") that most of our MROs arrive via Patients needing Emergent Trauma intervention - not so much Traffic Accidents, but Asssault. Why? 'Cause our assault cases tend to be very heavily skewed towards the "rough end" of the Socioieconomic profile - the end where personal care (and personal health management - lack of hygeine, and / or dental hygiene, risk-taking behaviour) are all over-represented.
Having a chronic disease state (particularly diabetes / hepatic injury / pulmonary injury) really doesn't help much either.
It makes sense to me. Emergency/Trauma can and does happen to anyone but assault tends to happen to people who have chaotic lives. Along with alcohol and drug abuse there can be poor dietary habits, unprotected sex (often resulting in STD) and chronic illnesses. These factors can make such populations more vulnerable to infection by a single organism or multiple ones.
LTER has to resort to vitriol and bitterness; he has no legitimate reasoning on which to stand. Free markets deliver ever improving goods at cheaper prices. This also applies to the market for health care service.
LTER views this whole thing as some static system as though prices are inherently always going to be high for procedures, instead of looking at WHY they are so exorbitantly high. It's like government assuming college tuitions are going to be high in perpetuity, and then thinking more loans and lower interest rates allows more kids to go to/can afford school, when in fact this is PRECISELY why college costs are so high (and quality is way down, as almost everything is Keynesian/statist/communist).
The problem is an agency problem, as .gov intervenes in the medical marketplace, and people are insulated from paying the real costs. Not enough skin in the game; not directly, for sure. It's like inflation, which is not felt as keenly as outright taxation of nominal dollars, but just as odious. Socializing things raises costs all around and makes quality mediocre. In a free market people would pay per surgery/visit/whatever, and then for catastrophes there would be a hedge which would be insurance. HSAs are kind of like this, as people shop for the small stuff and have high deductible for the big things, but still not pure market.
And remember LTER, govt is nothing but force. Adding an organized system of theft (govt) always makes things worse. What is happening now is not capitalism, but cronyism.