tag:blogger.com,1999:blog-32053362.post8342957965386150727..comments2024-03-29T05:39:11.334-04:00Comments on Not Running a Hospital: The adverse selection problemPaul Levyhttp://www.blogger.com/profile/17065446378970179507noreply@blogger.comBlogger8125tag:blogger.com,1999:blog-32053362.post-34429468986514432092009-03-23T17:18:00.000-04:002009-03-23T17:18:00.000-04:00Not only do I agree with most of the comments left...Not only do I agree with most of the comments left before me, but I also feel greatly attentive to what everyone here is expressing in their comments. Some of you I can say that I truly am able to relate to you, and some just make me wonder if I can ever relate to the way lots of you feel! In some ways it could be happy but if the feeling isn't really in the happiness stage of things then all I can say is I hope the becoming aware part of things does eventually work out for all of us in the end of things.. But alongside this topic, I love it! And it really is great to see a lot of us participating and really putting effort into collaborating one of the best blogs we've yet come to see!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-8984451801819150782009-03-17T09:13:00.000-04:002009-03-17T09:13:00.000-04:00The Massachusetts example supports that uninsuranc...The Massachusetts example supports that uninsurance is only a part of the problem. I think that the nation has a lot to learn from Oregon's example in which explicit rationing of care takes a central role as a part of the solution. In addition to focusing on insurance and services delivered, Oregon's newest legislative efforts (the Oregon Health Fund Board) focus on changes and improvements in financing, delivery, equity, and access to insurance for all Oregonians. <BR/>Thanks for bringing raising these important issues on the blog.Unknownhttps://www.blogger.com/profile/08852045808285379368noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-31963400950054097222009-03-16T14:53:00.000-04:002009-03-16T14:53:00.000-04:00Clay Christensen's new book, The Innovator's Presc...Clay Christensen's new book, The Innovator's Prescription, outlines ways we can increase access while lowering costs.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-35105676212742068972009-03-16T13:44:00.000-04:002009-03-16T13:44:00.000-04:00Paul,I read Boston Globe's article about the tough...Paul,<BR/><BR/>I read Boston Globe's article about the tough decisions being made at your hospital, and wanted to thank you and everyone at the hospital for teaming up together to avoid layoffs.<BR/><BR/>While, on occasions, they are inevitable, they are often avoidable. Your staff embraced a tough decision! I'm hoping that <A HREF="http://www.telesaur.com" REL="nofollow">my startup</A> will enable more companies to make changes (through telework) and preserve jobs.<BR/><BR/>Thanks for realizing that <I>all</I> people count! Find me on Twitter: <A HREF="http://www.twitter.com/telesaur" REL="nofollow">@telesaur</A>Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-37284862905815768152009-03-16T11:27:00.000-04:002009-03-16T11:27:00.000-04:00I just discovered your site two days ago and have ...I just discovered your site two days ago and have a lot of back reading to do, but two thoughts come to mind--<BR/>The amount of costs in Emergency Rooms where a bulk of the care(and squad runs) required is essentially primary care. Additionally, the emergent cases or those requiring critical care can easily get lost in the melee if their symptoms are more subtle(sepsis, some head bleeds,etc).<BR/>Secondly, it seems as a working bedside RN the amount of new procedures being put into place to appease JCAHO and intended to decrease mistakes simply creates more burden, more confusion, and less time to provide hands-on care. It seems like we're trying to prove improvements in care by paperwork alone and documenting care at the expense of actually providing the care. Sorry if this is off topic--it was a long 3 day weekend at work.Anonymoushttps://www.blogger.com/profile/15238905633085051322noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-12759636419377641022009-03-16T05:34:00.000-04:002009-03-16T05:34:00.000-04:00Paul, I agree with your assessment on what is need...Paul, <BR/>I agree with your assessment on what is needed to reduce costs in healthcare. IHI is about to publish a white paper on tools to measure process waste and some methods for eliminating costly complexity while improving care outcomes for patients. It's not a matter of coverage or not...we must cover all and do it efficiently. Thanks for leading on this issue.<BR/>Maureen BisognanoAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-59167552092061785772009-03-15T21:33:00.000-04:002009-03-15T21:33:00.000-04:00Raise co-payments. People don't want to throw away...Raise co-payments. People don't want to throw away their own money. They might even go looking for bargains and doctors might be required to compete on cost. <BR/><BR/>I would like to know why people in healthcare require incentives to do anything, surely witholding payments (the stick) would be equally effective. Too many providers have gotten fat on "carrots".<BR/><BR/>Of course it's impossible to tell doctors anything because that would be "folks practicing medicine without a license".Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-42768380978479384602009-03-15T20:49:00.000-04:002009-03-15T20:49:00.000-04:00History shows that lowering payments to providers ...History shows that lowering payments to providers "parodoxically" increases the volume of service...(providers don't want to go bankrupt). So, increasing access to healthcare, lowering payor costs, sustaining primary + specialty necessary care = raised copayments for those who receive care.Anonymousnoreply@blogger.com