Slouching Towards Oblivion

Showing posts with label business of healthcare. Show all posts
Showing posts with label business of healthcare. Show all posts

Thursday, August 26, 2021

Today's Tweet



Life here in good ol' USAmerica, Inc.


 

Wednesday, April 29, 2020

Long Term Shit

Making the COVID-19 tests free didn't make them any more accessible.

I'm still not able to get tested if I'm not symptomatic.

Turns out that for a whole bunch of my fellow humans here in USAmerica Inc, another effect of this whole thing is that we've been forced to see that too many folks won't go in for the test even if they are symptomatic for fear of finding out they're in need of hospitalization - which makes them even more fearful that they can't afford to be cared for.

(yeah, it's The Independent, but still) Independent:

Around one in seven Americans would not seek medical if they developed a fever or dry cough because of concerns over costs, a new poll has found.

It suggests that almost 35 million people might avoid seeing a doctor for the symptoms, which are known manifestations of Covid-19.

The new poll was conducted by Gallup and non-profit organisation West Health and published on Tuesday. It further found that 9 per cent of people would avoid healthcare even when the question was “framed explicitly as believing [they] have been infected by the novel coronavirus“.

Wednesday, May 01, 2019

Back Off, Lady

Social media is a good thing - when it's a platform for good things to be done.

CNN:

About 1,700 decks of cards have been delivered to the office of a Washington state senator who said nurses "probably play cards for a considerable amount of the day," the senator said in a statement Wednesday.

Republican state Sen. Maureen Walsh apologized on Monday after facing a backlash for comments she made debating a bill, HB 1155, that would provide uninterrupted meal and rest breaks and mandatory overtime for nurses and certain health care employees.
Walsh said last Tuesday on the senate floor, "By putting these types of mandates on a critical access hospital that literally serves a handful of individuals, I would submit to you those nurses probably do get breaks. They probably play cards for a considerable amount of the day."

An open letter posted by Facebook user Shy Braaten called for people to send a deck of cards to the senator, and included her PO Box.

The letter reads, "I don't know any nurses who play cards, Senator Walsh. I know nurses who care for babies who were born with their spines on the outside of their bodies and brains that won't stop bleeding. I know nurses who hold infants that can't stop crying because they were born addicted to heroin and methamphetamines."

The letter is signed, "One of the millions of people who love a nurse."

Walsh issued a lengthy statement on Monday apologizing and said, "I was tired, and in the heat of argument on the Senate floor, I said some things about nurses that were taken out of context -- but still they crossed the line."


Gotta love the bullshit these "conservative" assholes are always willing to shovel when they issue the non-apology-apology for having said things that reveal what they really think: "...taken out of context..." - and - "...in the heat of the moment..."

If we check her donor list, do you suppose we might find a check from the hospital business group that stands to lose leverage over their nursing staff if things change a bit?

Maureen Walsh is too fucking typical of the system of Coin-Operated Politicians that we're allowing to kill our democracy.

https://ecuactionfund.org




Sunday, July 22, 2018

Today's Tweet



And back we've gone - to the good old days - when men are men, and people suffer and die because they can't afford treatment for easily-manageable conditions - because some of us are just too fuckin' stoopid.


Wednesday, September 20, 2017

High Level Fuckery

...of the lowest order.

First, I gotta bail on my general editorial tenet of not playing the same bullshit game the GOP plays when referring (eg) to the "Democrat Party". 

Now, most of ya'll know I have no problem calling lots of folks names - bonehead, rube, fuckwad or whatever.  But I've always referred to the parties as Dems and Repubs - maybe it's just my quiet still voice telling me, "You never go full dickhead", dickhead.

I dunno, but at this point, I'm suspending that particular standard, and going with my new nickname for the GOP:

Ratpublicans

Cuz holy fuck, kids, this Graham-Cassidy thing is nothing but the most cynical piece of shit to come down the pike in a good long time.

Vox, Jeff Stein:

In interviews with Vox on Tuesday, nine Republican senators primarily argued that their “Hail Mary” bill — spearheaded by Sens. Lindsey Graham (SC) and Bill Cassidy (LA) — would return federal power to the states, giving them greater flexibility to improve their health systems locally. “The heart of the legislation takes the policymaking role of Washington and sends it to the states,” Texas Sen. Ted Cruz said.

Far less clear is exactly how Graham-Cassidy would pull off this feat without resulting in millions of Americans losing their insurance — and the number of millions is still unknown, since any vote would likely have to come before the Congressional Budget Office completes its analysis of the bill. The GOP senators insisted that the tens of billions in cuts to federal health spending proposed in the bill would not result in coverage losses because, they said, the states would have more flexibility.

“They can do it with less money,” said Sen. Jim Inhofe (R-OK), who was unable to explain how or why.

Other Republican senators, meanwhile, fell back on political explanations for a bill that experts warn could result in millions losing their insurance.
“If we do nothing, it has a tremendous impact on the 2018 elections,” said Sen. Pat Roberts (R-KS). “And whether or not Republicans still maintain control and we have the gavel.”

Imhofe says it saves lots of money, but he can't tell us how.
Cruz hits the old standby - premiums are skyrocketing under Obamacare.


Kennedy, arguing the states' rights angle, and trying to explain his proposed amendment to prohibit states setting up their own single-payer system: "We have plenty of federal rules that apply to every state, but we still agree with states’ rights."


And in case you missed it, The Koch Bros et al, have told the RNC the 2018 money well is dry unless Obamacare is repealed (see Pat Roberts above).

By STEVE PEOPLES, Associated Press

COLORADO SPRINGS, Colo. (AP) — At least one influential donor has informed congressional Republicans that the "Dallas piggy bank" is closed until he sees major action on health care and taxes.

Texas-based donor Doug Deason has already refused to host a fundraiser for two members of Congress and informed House Majority Leader Kevin McCarthy, R-Calif., his checkbook is closed as well.

"Get Obamacare repealed and replaced, get tax reform passed," Deason said in a pointed message to GOP leaders. "You control the Senate. You control the House. You have the presidency. There's no reason you can't get this done. Get it done and we'll open it back up."

Friday, September 15, 2017

Cut Snip Hack Tear Shred


Vox, Sarah Kliff:

The Trump administration has informed government-funded Obamacare outreach groups of deep impending budget cuts next year, with some nonprofits having budgets slashed by as much as 98 percent.

“We’re letting 11 navigators go today, which leaves us with five navigators for the entire state,” says Brian Burton, director of the Southwest Louisiana Area Health Education Center. His funding was cut from a $1.07 million grant this year to $297,000 next year.

The Health and Human Services Department announced August 31 that it would cut funding for the health law’s in-person assistance program by 41 percent. Late Wednesday night, the administration sent each group its individual budget. It shows widespread variation in how big those funding cuts will be.

Louisiana and Indiana, for example, will have the outreach funding coming into their states cut by 80 percent. Maine, however, will have its budget held constant — while Kansas will only see a 9 percent funding cut.

Outreach groups are responding to the cuts by laying off staff and scaling back the geographic areas where they provide assistance.

Any time there's a significant decrease in Spending (government or otherwise), there's a downward push on the economy, and that has always cost us more than we've "saved".

As the funding is cut, the negative impact in those geographic areas left under- or un-served will be greater than it will be in the more densely populated and/or richer areas.  So I guess we can expect another hard round of "it may be tough for you Real Americans right now, but it's OK because you're helping us fuck over those big-city moocher-minorities, and we all know that's what you think is the most important thing".

Torpedoing the ACA is bad enough, but providing nothing to replace the economic benefits
of the ACA is a plain ol' straight up shitty thing to do.

So I have to ask the 'why' question.  It's not like they don't understand how an economy works.

I may be feeling paranoid, but that don't mean nobody's out to get me.

Monday, July 10, 2017

Goin' Back


Recently, 43 disabled protesters were arrested outside of Senate majority leader Mitch McConnell's office, and the clips went viral on social media. Since then, activists have kept up the pressure on the Republican health bill with similar actions across the country. For this short documentary, The Atlantic traveled to the heart of the disability rights movement in the San Francisco Bay Area to learn why some people with disabilities fear the Republican health plan. Mary Lou Breslin of the Disability Rights Education and Defense Fund says cuts to Medicaid could ultimately cost 3 million people with disabilities their freedom, and erode "40 years of hard won gains by the disability rights movement."

This documentary was produced as a project for the USC Center for Health Journalism's California Fellowship.

Taking an axe to Medicaid will prob'ly not leave all of these folks without some kind of coverage - it will just make sure that the Rent-Seekers and Profit-Takers will collect even more tax dollars than they're getting now.

The GOP is using that reliable scare-word, "Socialism", so they can change Medicaid to something that's more lucrative for their buddies and their in-laws.  Which equates to an effort to morph the thing into "Socializing Cost in order to generate Private Profit".

It's weird because the guys who're always bitching about the incompetence and inefficiency of Da Gubmint are the ones who're taking one of the very few federal programs that is actually cost-effective, and making it grossly inefficient by trying to shoehorn it into a business model based almost solely on an ideological belief - which obviously doesn't work for such things - which is why we hit on the idea of Medicaid in the first fuckin' place.

We've tried this All-Things-Privatized before. The whole world has tried this before - it was called Monarchy (aka: Daddy State - in one form or another).

240 years ago, some smart guys figured out that that was a pretty fucked up way to do things if the point of the exercise is to live your life without having to pay rent on the air you breathe, and the water you drink, and the dirt you grow your own food in.

And yet, for reasons passing understanding, the rubes who're always yelling "American Exceptionalism" are the ones enthusiastically buying into the plan to take us back to Government-By-Class-Based-Economic-System, to which the US was founded to be the fucking exception.

Saturday, February 04, 2017

Back To The Gilded Age

A little reminder of the damage a bad president can do.

Vox:
Since the election of Donald Trump, there’s been a lot of discussion in medical circles about bringing a Silicon Valley ethos to drug innovation in America.
This idea is embodied in Peter Thiel, the billionaire founder of PayPal, who has reportedly been helping the president vet a pool of candidates to lead the Food and Drug Administration.
Thiel, a libertarian iconoclast, has repeatedly made the case that the FDA gets in the way of drug innovation by making it too difficult for new medicines to get to the market. Some of the FDA candidates he’s identified — including Silicon Valley’s Jim O’Neill and Balaji Srinivasan — have similarly argued that the agency should dump its requirement that drugs be proven effective before reaching the market, and that we’d be better off if the FDA operated more like a “Yelp for drugs.” In other words, bringing the same speedy and disruptive approach to medical regulation that Silicon Valley brought to the taxi and hotel industries, for example, will unlock cures — fast.
But Thiel and his pals miss a very important point about developing new drugs: Manipulating biology isn’t the same as manipulating computer code. It’s much, much harder. Speeding up medical innovation will take a lot more than just stripping down the FDA — it’ll take huge leaps forward in our understanding of biochemistry and the body. Health care is also different from taxis and hotels in another key way: Consumers can’t really judge the safety and quality of medical products by themselves.

So, like, one of the things Da Gubmint is there trying to do for you is to keep some asshole from killing your dog.  If you can't quite work yourself up to giving a fuck about people, maybe you could think about finding a little compassion for their fucking house pets.

More from the Vox piece:
One of the key notions that undergirds the Peter Thiel view of the FDA is that if the agency just got rid of some of the pesky restrictions for drug approval, we’d usher in another golden age in drug development. (Thiel declined our interview request.)
To test this idea, I asked a longtime pharmaceutical scientist (and conservative), Derek Lowe, for his views. In his 28 years in the lab, Lowe has seen hundreds of thousands of compounds tested on a huge variety of drug targets, and never, not once, has he brought a drug to market.
The reason? “We don’t know how to find drugs that work,” he said.
For every 5,000 compounds discovered at this "preclinical" phase of drug development, only about five are promising enough to be tried in humans. That’s a success rate of 0.1 percent.
Drug innovation comes from painstaking tinkering and a dash of luck. “It’s very tempting for someone who has come out of IT to say, ‘DNA is code, and cells are the hardware; go in and debug it’,” Lowe said. “But this is wrong.”
Let's just try to remember one or two itty-bitty things, OK?


You were supposed to have read that shit way back in high school, y'know.

Friday, September 02, 2016

This Shit Is Bullshit

I've been listening in on this one for a while, and I think I've got my bearings now.

In short - this is more or less about a ConservaDem who needs to go the fuck away.  I don't want anyone to hurt him; I'm not wishing he'd get Ass Cancer and die after enduring long, bloody, painful attempts to save his miserable worthless hide; I just want him to be unemployed for a good long time.  I want him to live in a shitty basement for about 10 years while he works an occasional odd shift at The Dollar Store and has to eat what he can find in the dumpsters behind the local liposuction clinic.

Sen Joe Manchin D-WV
Seriously - fuck that guy.

In case you haven't heard, Joe Manchin's daughter (Heather Bresch) is the asshole CEO who has blown up the price on Epi-Pen.

According to reports, Bresch got her first job at Mylan working in the factory basement, when her well-connected dad asked the company’s then-CEO, Milan Puskar, for a favor. Later, a scandal erupted when it was discovered that West Virginia University, which had received a $20 million donation from Puskar and whose president was a Manchin and Bresch family friend, had awarded her an MBA although she had not completed the required coursework.
The school president and other administrators were forced to resign, but Bresch survived the controversy and has done very well indeed in the pharmaceutical business, rising through the ranks and at the same time learning how to adroitly manipulate government and its regulations — lessons for which life in a successful political family with its network of friends and colleagues prepared her well.
I guess what grates on my soul in the worst way possible is this: 

The drug is not the issue, the Epi-Pen itself is the issue. Epinephrine is pretty cheap and available as a generic - but the delivery method is the key. The Epi-Pen is amazing, and it's ridiculously effective and easy to use, and it's saved more than a few lives; and it's a great little peace-of-mind thing - and it's patented, which is the key to the whole banana.  

So Mylan expects a full and vigorous effort to enforce its patent rights under US Federal Law - at tax-payer expense of course - but they get to shift the jobs overseas; they get to dodge a shitload of the taxes by hiding out in The Netherlands, and they can jack the price by 500%, etc etc etc. And that little parlay is what pumps enough profit into Mylan's coffers to "justify" paying Ms Bresch almost $19 Million last year.

It's fucking immoral - and that's before we take a look at the campaign contributions bullshit that helps perpetuate it, because it's part of a fucked up System of Interlocking Interests that makes it profitable to hold people hostage while the people who take those hostages are doing it legally, and so, are completely out of the reach of "justice".

That's gotta change.

Like I said, I'm really not wishing for harm to come to any of them, but a well-placed runaway cement truck wouldn't exactly hurt my feelings.

Fight The Power

Friday, January 16, 2015

Some Charts

So Obamacare isn't quite the disaster we were told it would be.  In fact, it's begininning to work very much like it's supposed to work, which isn't as good as it could be, but a shitload better than what we had before.

More people have coverage, which means the risk is spread thinner, which means the average cost goes down some, which means more people can get coverage, which means etc etc etc - gee it's almost as if there's some kind of Basic Principle Of Economics at work or something.

Anyway, The Commonwealth Fund did their survey, and guess what:





For the first time there are fewer working people without coverage.
For the first time, there are fewer working people struggling to pay their doctor bills.
For the first time, there are fewer working people putting off a visit to the doctor due to cost.

For the first fucking time - seems vaguely significant to me.

And yet it still seems like we've got a particular bunch of rat-bastard politicians trying to pull a very standard maneuver - where they fuck something up and then stand aside and say, "Hey look everybody - it's all fucked up.  We need to trash this thing and start over" 

("so we can take the credit for solving a problem we caused in the first fucking place" - that's the part you don't ever say out loud).

These people have no soul and no honor.

hat tip = Democratic Underground

Sunday, December 22, 2013

Lost In The Shuffle

Way too many times, when we're busy sniping and ducking fire, we forget to look at what's actually happening.

WaPo:
Over at Health Affairs, Andrew Steinmetz, Ralph Muller, Steven Altschuler and Ezekiel Emanuel decided to see how health reform looked to hospital executives. They surveyed 74 C-Suite executives from institutions that, on average, employed 8,520 workers and saw annual revenues of $1.5 billion. The survey wasn't scientific by any means, but in a speculative conversation that's proceeding mostly by anecdote, these individuals have a better vantage point on the changes that health reform is making to actual health-care systems than virtually anyone else.
The results? Hospital executives think health reform is going to make the health care they deliver a whole lot better -- and a bit cheaper:
Fully 65 percent indicated that by 2020, they believe the healthcare system as a whole will be somewhat or significantly better than it is today. And when they were asked about their own institutions, the optimism was even more dramatic. Fully 93 percent predicted that the quality of care provided by their own health system would improve. This is probably related to efforts to diminish hospital acquired conditions, medication errors, and unnecessary re-admissions, as encouraged by financial penalties in the ACA.

These are the guys who make money on your being sick.  Not like the docs and nurses who mostly earn every penny trying to take care of us - an awful lot of these guys are cut-throat MBA types with no clinical background, who often speak of their patients as products, and who just as often believe they can't afford the luxury of having honest human emotions when it comes to the business of healthcare.

65% of 'em think healthcare in USAmerica Inc will be better under ACA.
91% think the cost aspects will improve.
And 93% are convinced that the quality of care at their own facilities will improve.

How can there possibly be any question as to why Repubs (and their Press Poodles) are constantly slagging Obama and "Gubmint Healthcare"?

Friday, July 12, 2013

USA! USA! USA!

We're #28 - FUCK YEAH - wait, what?

It's almost like there's somebody actively working against doing anything that might help make this whole mess better.

Sweet screamin' Jesus, I'm getting more than a little tired of this shit.

JAMA came out with a study of 34 "rich countries", and the US is ranked 28th in Health Outcomes.


Overall, population health in the United States has improved from 1990 to 2010. Life expectancy at birth and HALE have increased and all-cause death rates at all ages have decreased. Although life span has increased, rates of age-specific YLDs have remained stable, and morbidity and chronic disability now account for nearly half of the health burden in the United States. However, improvements in population health in the United States have not kept pace with advances in population health in other wealthy nations. Regular assessments of the local burden of disease and matching information on health expenditures for the same disease and injury categories could allow for a more direct assessment of how changes in health spending have affected or, indeed, not affected changes in the burden of disease and may provide insights into where the US health care system could most effectively invest its resources to obtain maximum benefits for the nation’s population health. In many cases, the best investments for improving population health would likely be public health programs and multisectoral action to address risks such as physical inactivity, diet, ambient particulate pollution, and alcohol and tobacco consumption.
For all you clear-eyed, pragmatic, bidness-savvy 'conservatives' out there, here's the deal:  Healthy people cost less than sick ones, and Prevention is way more cost-effective than Remedy. 

If you're the soul-dead corporate clods who care for nothing but the Quarterly Numbers that you seem to be, then you have to recognize that a healthy labor pool is more valuable to you than an unhealthy labor pool.  

Of course, since you guys are so highly attuned to the concept of Other People's Money, you can get around the inconvenience of operating within any kind of ethical boundaries  by adopting the Wal-Mart strategy, and simply dump all your healthcare costs onto the taxpayer, but hey - that's Wal-Mart; those guys are absolute masters of The Big Bamboozle.

C'mon - look:
  • We have a healthcare system that's Crazy Stupid Expensive which doesn't produce particularly healthy people
  • Unhealthy workers are more costly than healthy workers
  • Shifting the cost from one payer to another makes the system more complex and that complexity helps drive up the actual cost 
So here's what I really don't understand: Why are so many of you 'conservatives' so dead set against making changes to a system that is so obviously less efficient and more costly than it needs to be?

Tuesday, March 13, 2012

Wendell Rides Again

I'd not been aware that Wendell Potter was putting this stiff out regularly, but there he is over at MichaelMoore.com

Some of the best circularity I've come across in a long time:
Health insurers often complain that one of the chief reasons why they are having a difficult time at the negotiating table with hospitals these days is because of consolidation. The reason for that consolidation, however, is the exploding problem of uncompensated care, hospitals have no choice but to consolidate. Well, they actually do have another choice: close. Which is what many hospitals have had to do because they could not find a willing partner with which to affiliate.
Read some of Wendell's posts and then tell me Obama's not trying to do right by us.

(hat tip = VWE)

Saturday, December 03, 2011

Sounds Kinda Important, Actually

via Balloon Juice yesterday:
Today is the day that a significant part of the Affordable Care Act took effect. Today is the day that companies that sell and provide health insurance have to start spending 80% to 85% of their income from insurance premiums actually delivering the services for which they charge their customers. Overhead like office space and supplies, marketing expenses, salaries, and yes, profits have to come out of the remaining 15-20%. The rule is called the the medical loss ratio, and in an important decision recently by the Department of Health and Human Services, the insurance companies cannot count the sales commissions that they give out to the people who sell you your insurance plan against the medical loss ratio.
So lemme see - Repubs are promising to "repeal ObamaCare", which (so far) means:

  • they want 4,000,000 small businesses to lose their tax breaks
  • they want state governments to lose federal help in meeting their Medicaid obligations
  • they want the feds to stop cracking down on Medicare fraud
  • they want people taking early retirement to lose their Gap Coverage
  • they want 4,000,000 seniors to lose the donut hole discounts on Brand Name meds
  • they want the 15,000,000 young adults who can now stay covered by their parents' insurance to lose their coverage
  • they want insurance companies to go back to using tricks and traps to justify rescinding coverage; and they don't want any way for a patient to appeal rescission. 
  • they want the 20,000,000 Americans who used to be subject to denial of coverage due to "pre-existing conditions" to lose their coverage
  • they want the insurance companies to arbitrate payouts according to business considerations instead of clinical evaluation.
  • they want 20,000,000 low-income Americans to lose access to Community Health Centers
  • they want Americans living in (mostly rural) underserved ares to lose support for the docs and nurses who want to stay in those places, but can't afford it
And as of 02-DEC-2011, they want the insurance companies to continue to have the option of jacking up your premiums in order to pay sales bonuses, and to pay out nice fat stock dividends, and, and, and - the law now requires the insurers to pay out 80% of their revenues to healthcare providers.  As much as I hate strict regulation on actual levels of profit and reward, I can't help but see this as a common-sense attempt to get us all to understand that healthcare is just one of the things that can't be shoehorned into the standard business school model.

Take a quick peek at the ObamaCare Timeline.