Health Train Express Fuel

Quote of the day: The real problem is not whether machines think but whether men do. - B. F. Skinner ************************************************ Most locomotives run on diesel fuel or electricity. In fact even the diesel engines use electricity to drive the wheels by converting the diesel energy with electric generators that drive the electric motors. In the case of our health train the fuel is not diesel, but beans, and not only one kind of bean, but many kinds: small red beans   Five kinds of beans   Actor Bean Jelly Beans and instead of having a fuel gauge we have an endless number of bean counters. Now we all know that beans produce an extraordinary amount of flatulence and methane...  This...

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Who Killed Healthcare?

Healthcare in America is not dead.  It is critically ill...it will not die, because it is the basic stuff of life....not to be denied. Darwinians know that the strongest survive....both as individuals and as a species. LIFE, DEATH AND HEALTHCARE (trailer) No one is writing 'DNR' in the chart nor on the forehead of our unconcious,  but not  quite vegetative patient. Maybe we all can resurrect our patient with miracles, and teamwork.....A medical home for healthcare, and not just for patients. What do you think it would take.....I've been doing it for 40 years, and don't pretend to know an answer....Most of my colleagues have been doing it a long time as well....ask them and you will receive a litany of answers.....Most have...

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Health Train Express reaches the end of the Tracks

Quote of the day: The best way to predict the future is to invent it. - Alan Kay ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ Today several health blogs are beginning to write about what is happening to the American and perhaps World Economy. We have been looking inward in healthcare, and most surgeons, and physicians are so busy with patients they at times don't even want to know what is going on in the world about them.  This is more than foolishness from a group of people who are far and away more intelligent than most others. ( I don't equate being smart with high intelligence).  Physicians need to be strong leaders not only in health care but in matters affecting finance, public policy, community health, education,...

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Health Train Confusion

Quote of the day: Calamities are of two kinds: misfortunes to ourselves, and good fortune to others. - Ambrose Bierce *************************************************** Confusion reigns in the financial markets.....do you really want the government making health care decisions for you and your family?? Imagine this scenario: " The U.S. Department of Disease Extermination today announced a freeze on all appendectomy's.  Future's on hemorrhoidectomies decreased immediately after this announcement, while the Fed was arranging a bailout for UCLA Medical Center. " We have a less than perfect health care financing system..no doubt about it, yet it functions....

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Health Train Discounts--at last

Illinois Law Compels Hospitals to Give Uninsured Patients a Price Break Posted by Jacob Goldstein Nobody pays list price at hospitals — except the uninsured. A new law in Illinois will change that for many families, the Chicago Tribune reports. The law allows hospitals to charge patients for the cost of care, plus a mark-up of 35%. That may not strike you as a fantastic bargain, but it’s still a lot less than list prices, which can run to two to three times the cost of care. In urban areas, the law applies to those making up to six times the federal poverty level ($127,200 for a family of four); in rural areas where the cost of living is lower, the law applies to those making up to three times the poverty level. The law also caps total...

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Health Train Express Slows down

Quote of the day: Don't worry about the world coming to an end today. It's already tomorrow in Australia. - Charles M. Schulz ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ The Wall Street Journal today reported that the annual increase in employer based health insurance premiums increased by only 5% in 2007/2008.  This data came from the annual report of the Employee Health Benefits Survey, published each year.  This is a one source reference which covers a wide range of topics. The  Bill of Health, a source for viewing an overall graphic of the state of our health system, and it's histor, "how we got here from there", produced by "Good", an internet site.The data for this graphic was obtained from these sources: CIA World Factbook, Congressional Budget Office,Emanuel Heritage...

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Health Train Bailout

Quote of the day: No man's life, liberty or property are safe while the legislature is in session. - Judge Gideon J. Tucker ****************************************************** Many blogs this week have turned their attention to the 'dire news' about our economy.  Although it is attributed to the 'meltdown' in the subprime mortgage market we all have a pretty good idea this is not the case.  It may have been the straw that  broke the camel's back , however we have had serious debt problems for many many years. At the outset I receive at least two credit card offers each week. ( I have not used a credit card for six or seven years. My first medical practice nearly was bankrupted by numerous payors who without much...

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Health Train----continued

Last visit I was pontificating about the financial underpinnings of the financial markets and the parallel aspects of healthcare. One of the most compelling reasons for not adopting a universal payor system  is that it mimic many negative aspects of the federal government....increased regulatory mechanisms, inertia,inbred obsolence, guarranteed employment for civil servants regardless of their "outcomes" and payment for non-performance. Do you want all that  power and authority placed in the hands of one, or several governmental officials?? (L-R)  The financial 'rainmakers" Fed Reserve Chairman Bernake & Senator Tom Dodd, Chairman of the Senate Financial Oversight Committee. All these 'trusted public servants'...

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Health financing = f (financial markets)

Post revised 09/22 Quote of the day: Where humor is concerned there are no standards - no one can say what is good or bad, although you can be sure that everyone will. - John Kenneth Galbraith ******************************************************** While health care issues are still important, this week's pop quiz has switched to fundamental finance market dysfunction and chaos.  Sound familar?  We in medicine do not have a monopoly on that.  The diagram above relates the increasing mortgage foreclosure rate and the lower red line the decrease in the mortgage financial index.....We could equate this graphic display  to increasing health care utilization vs decreasing reimbursement.  Perhaps some of these...

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Health Train Design

I am in the midst of restructuring the blog. You may have noticed an increase in the amount of graphics and related links to other sites.  In my mind blogging allows one to freely associate, and click here and there....it is always a surprise where it will take you.   This requires the kind of mind that multi-tasks, and it may be an advantage to be somewhat bipolar........

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Health Train Brain Drain

Quote of the day: 'Tis better to be silent and be thought a fool, than to speak and remove all doubt. - Abraham Lincoln   Now and then Matt Holt will   publish opinions and revelations that are truly 'aha' and are 'I thought of that, why didn't I write it? True to this idea were the latest comments on his blog, THCB.    Uwe Reinhardt, who is well known in health care policymakers circles, authored a report for New Jersey Governor Tom Corzine (photo is clickable,, for details) regarding the state of health care in New Jersey. The bottom line of this report, which Governor Corzine asked not be published was " Who in their right mind would design a healthcare system revolving around employment? Enthoven...

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Where's My Wallet?

Quote of the day: A good listener is a good talker with a sore throat. - Katharine Whitehorn ************************************************* Anyone who comes out of the operating room, or hospital is greeted by news of the collapse of the financial markets, and the nationalization of  investment banking, real estate markets, and other institutions.  These large institutions seem distant and not related to our daily lives, however their 'greatness' has been built from the ground up. Will the same occur to health care....is universal payor really a politically correct synonym for "socialized medicine"?  Of course it is..... Federal government 'bailouts', emergency loans and subsidies which are capitalized by...

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Focus numero uno

Quote of the day: Perhaps in time the so-called Dark Ages will be thought of as including our own. - Georg Christoph Lichtenberg ***************************************************** In my last post I began to ask where do we focus? Can we reform the entire health system at once? I was not quite sure where to go from there, but in the  process of researching for today's article I came across an email from Greg Scandlen, who is affiliated with the Heartland Institute and Consumers for Health Care  Choices. Patrick Rooney Click on Photo for Newspaper Article who is credited with the original idea of medical savings accounts (renamed health saving accounts), recently passed away, but was given a "lifetime achievement...

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Health Care Reform, Where to Focus

Start the video for some 'listening music' whilst you read today' offerings. Quote of the day: One of the first duties of the physician is to educate the masses not to take medicine. - Sir William Osler ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ Steven Beller, PhD  has been blogging for over five years. His recent blog contribution at Curing Health reveals some important clues to where our resources should go in reforming our health care system. He and I became involved in what was probably one of the first blogs, Trusted.MD, started by Dimitriy Krygylak.  That was a time when I was really interested in RHIOs and the implementation of EMRs. We need a quality Health Train, one that can efficiently carry as many passengers as possible, and not leave patients at the train...

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PRO(TECH)T Act of 2008

Quote of the day:   Boys will be boys, and so will a lot of middle-aged men. - Kin Hubbard ******************************************************* The role of the Federal Government rears it's head  once again with the reactivation of H.R. 6357, as it winds it's way through the Ways and Means Committee chaired by our venerable and staunch representative, and defender of the coiffers of HCFA, Pete Stark of California. Elements of the draft bill call for: Maintaining the grant and loan programs included in HR 6357; Directing federal officials to coordinate the development of an open source electronic health record; Establishing Medicare incentive payments for health care providers who adopt and use IT systems;...

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