Docs Told They Must Drive Health System Change (focus on "cost value" first, not the patient)

Medpage Today ^ | April 11, 2013 | David Pittman

[Innovative]

Doctors are the only people who can drive the change in healthcare delivery that's needed to save the country from a financial crisis, a health policy expert said here.

Emanuel highlighted six elements that must underline payment and delivery reform efforts:

-- Focus on cost value

-- Focus on the patient

-- Standardize processes

....

"We need a big infrastructure to be able to deliver high-quality care going forward," Emanuel said.

[capecodder]

Ezekial Emanuel, hmmmm.

Department of Ethics
www.thelancet.com
Vol 373 January 31, 2009
Principles for allocation of scarce medical interventions

Remember this from Ezekial Emanuel?
Worth the read. Check out the “Reaper Curve” on p. 428
http://www.ncpa.org/pdfs/PIIS0140673609601379.pdf
*****
Betsy McCaughey’s take:
Obama’s Health Rationer-in-Chief
http://online.wsj.com/article/SB10001424052970203706604574374463280098676.html

[Pajamajan]

Bookmark and FYI to all seniors who vote democrat.

[Sioux-san]

The Price went up when the big employers and Medicare started covering everything under the sun, and we the “patient” continue to be left out of any responsibility to care what the price is or even necessity of the medical care we receive. So, up goes the Price. How much does it really ‘cost’ to provide hospital care? You will never find that out— Deep discounts are given to Medicare, Medicaid and many large private insurances, and then the hospitals can declare huge amounts of undercompensated care which helps keep the not-for-profit status. It’s long overdue to let true market forces have a chance. Time for us all to grow up and stop demanding things that won’t help and could hurt. True informed consent is needed, and transparency about potential medical outcomes.

[Tammy8]

The price also shot up when many began to use the emergency room as their primary care and didn’t pay the bill, leaving it to be spread among the rest of us.

Illegals are one of the biggest culprits of this. Illegals are the elephant in the room that no one wants to discuss not only with health care issues, but social services, education, court and jail systems.

That is why I cannot get too concerned about people that want to cut this and that from the military, veterans, elderly; but never cut services to people that should not be here to begin with.

I will believe someone is serious about cutting budgets if they address the issue of the cost of illegals first.

[pepsionice]

Only to point this out...because the US media won’t touch the story. Over the past six months...there’s been this mess openly discussed in Germany over public hospitals losing money.

After decades of having the local states fund the maintenance, repair and new construction of hospitals throughout Germany (public, not private)....the trend was halted in the last year because the states just don’t have the money anymore to do so, and there was no law dictating they had to do it.

Well...the hospitals are at a loss to move ahead with any plan on taking care of what they have. The people who control the purse strings of the national healthcare funds...have decided to hand out a one-time ‘bonus’ of one billion dollars. It’s enough to buy everyone about a year of time before the true answer emerges.

What the public is grasping in Germany...is that around sixty percent of all German public hospitals are unable to sustain themselves. The solution? So far, it’s believed that if they take out roughly 1/3 of all public hospitals...the remaining ones might be able to survive. So if you lived within ten minutes of a current hospital....you might find yourself in a new position in four years....where the nearest hospital is forty minutes away. A decade from now....maybe even sixty minutes away by car.

No matter how we all think of things....medicine is now a business, and cost will end up being the bottom line.

[rktman]

It’s been more and more about the bottom line for years and due to litigation and soaring malpractice insurance, the patients (us) have seen our costs soar also. I’m sure you know the ER’s are full of people who use it as their new base for their primary care. About the only way to jump to the head of the line at an ER anymore is by arriving in an ambulance and in the major population centers the indigents (are we “allowed” to call them that anymore?) know this so 911 gets called for someone with chest pains.......... Sad but true, we’ll end up like Great Britain and their socialized medical system. Or worse.

[MinuteGal]

Obama has brilliantly succeeded in getting opponents to national health care to expend time and energy on picking apart every jot and tittle in the bill....parsing, debating, analyzing every word, every phrase, every possible or impossible danger, every negative, every red flag, any dire consequences to our future health and well-being.....threads like these being an example.

All the while, ObamaCare marches forward unopposed. I don't see any mass movement for total repeal from conservative forces or leaders. I don't see any cohesive action from Tea Partiers. I don't see tons of newspaper ads and spot commercials calling for repeal flooding the print and air media. I don't know of anyone besides myself that has written my DC representatives on the subject.

All I see is tons of energy focused on ramifications of socialized medicine and talk, talk, talk about these ramifications with and to the choir.

Obama must be laughing his derriere off watching most opposition efforts going in the wrong direction in a misdirected and ineffectual effort to derail his baby.

Effective action for repeal is what we should be discussing. It must be total.....and quick.

Leni

[Innovative]

“Effective action for repeal is what we should be discussing. It must be total.....and quick.’

We did have a chance. That was what the November elections were all about — but we all know how that turned out. Those who contributed to Obama’s reelection by sulking — staying home, voting third party — are every bit as responsible as Obama.

[Candor7]

Its a horrible situation for doctors. A whole profession is about to lose its freedom.

There should be some wholesale protest from doctors.But we hear almost nothing.I wonder why?

[TigersEye]

I think most are too busy with their practices to know what's going to hit them yet. On the whole doctors are not great businessmen and they have a mindset that's conducive to believing that people who say they want to fix problems really are interested in fixing problems. That's how healers look at things.

The maliciousness of politics is foreign to them. Even people in politics haven't quite wrapped their mind around the "Cloward-Piven-destroy-it-all-to-rebuild-it" POV of 0bamugabe yet.

[Sioux-san]

You got that right - but once someone shows up at the ED, they must be treated no matter what by law. No one gets asked if they are here legally. We go to the expense of having translators for every known language under the sun and worry about their ethnic/cultural needs. Obamacare never intended to do anything about that huge elephant in the room. Rubio is such a liar when he says no one will get any services if we pass this latest piece of immigration crap. Pardon me if I don’t believe any of these bastards any more: Rome is burning, Senators and Representatives - what are you doing about it??? Traitors one and all.