Thread: The Atlantic: Health Care Article

[quote name='PoliticalHotwire' date='24 October 2009 - 12:57 PM' timestamp='1256414223' post='43892']

http://www.theatlantic.com/doc/200909/health-care



I don't have much to add except:

• I don't necessary agree with everything he is saying
• I think it was very well written
• This is probably in my top ten of thought-provoking HC articles written in the past year.

[/quote]



Awesome article. We had a semi-scary bout with an infection my son picked up while in the hospital. Not a fun time.

[quote name='PoliticalHotwire' date='24 October 2009 - 02:57 PM' timestamp='1256414223' post='43892']

http://www.theatlantic.com/doc/200909/health-care



I don't have much to add except:

• I don't necessary agree with everything he is saying
• I think it was very well written
• This is probably in my top ten of thought-provoking HC articles written in the past year.

[/quote]



It's an excellent post PH, just outstanding. Thank you!



As you may know, I am a PA-C employed by a clinic that specializes in cardiology and cardiothoracic surgery. Just this past Thursday we lost a patient to post-op infection. At this point the investigation indicates that infection occured as a result of sloppy dressing change procedures two days post-op in CICU. Regardless, I've seen instances of rodent droppings and dead insects recovered within the sterile core of our surgery. I've witnessed general surgeons examine a surgical wound without first washing their hands for the standard twenty second period. And perhaps worse, I've witnessed nursing staff traverse from patient to patient without using hand sanitizer or washing their hands.



Hospitals need to control avoidable infection by means of an infection control officer, be that MD or RN, and by insisting that patient care staff use proper hand washing and other infection control techniques at all times or face employment termination.

[quote name='Bourne' date='24 October 2009 - 01:57 PM' timestamp='1256417855' post='43925']

It's an excellent post PH, just outstanding. Thank you!



As you may know, I am a PA-C employed by a clinic that specializes in cardiology and cardiothoracic surgery. Just this past Thursday we lost a patient to post-op infection. At this point the investigation indicates that infection occured as a result of sloppy dressing change procedures two days post-op in CICU. Regardless, I've seen instances of rodent droppings and dead insects recovered within the sterile core of our surgery. I've witnessed general surgeons examine a surgical wound without first washing their hands for the standard twenty second period. And perhaps worse, I've witnessed nursing staff traverse from patient to patient without using hand sanitizer or washing their hands.



Hospitals need to control avoidable infection by means of an infection control officer, be that MD or RN, and by insisting that patient care staff use proper hand washing and other infection control techniques at all times or face employment termination.

[/quote]



That's good information too. I like what you say about an infection control officer.



Patients also can be proactive in their medical care too.



My mother passed away from a long bout with breast cancer. She got in the habit of asking every nurse or doctor that came in to check on her if they had washed their hands. She said it with a smile and a friendly joking manner, but in a little over four years of going into and out of the hospital and then long term care, she never did pick up an infection (which I know could totally be coincidental too).



She was also really good about being proactive regarding medicines. Even though she had no formal medical background, she would always ask what a new medicine was supposed to accomplish, what the side effects were, and would it react any differently with the medicines she was already taking.

[quote name='boontito' date='24 October 2009 - 04:07 PM' timestamp='1256418431' post='43932']

That's good information too. I like what you say about an infection control officer.



Patients also can be proactive in their medical care too.



My mother passed away from a long bout with breast cancer. She got in the habit of asking every nurse or doctor that came in to check on her if they had washed their hands. She said it with a smile and a friendly joking manner, but in a little over four years of going into and out of the hospital and then long term care, she never did pick up an infection (which I know could totally be coincidental too).



She was also really good about being proactive regarding medicines. Even though she had no formal medical background, she would always ask what a new medicine was supposed to accomplish, what the side effects were, and would it react any differently with the medicines she was already taking.

[/quote]



Absolutely Boon. Never, ever hesitate to question your care giving staff about any aspect of your care. If they refuse to address your questions, ask to speak with a supervisor immediately. And if they refuse to contact the nursing supervisor, that's a violation of joint commision regulations. A very serious violation.

In your face, people.



[quote name='The Article']The housing bubble offers some important lessons for health-care policy. The claim that something—whether housing or health care—is an undersupplied social good is commonly used to justify government intervention, and policy makers have long striven to make housing more affordable. But by making housing investments eligible for special tax benefits and subsidized borrowing rates, the government has stimulated not only the construction of more houses but also the willingness of people to borrow and spend more on houses than they otherwise would have. The result is now tragically clear. [/quote]



What the hell?



This guy's a Democrat? He's saying what I've been saying!

In designing Medicare and Medicaid in 1965, the government essentially adopted this comprehensive-insurance model for its own spending, and by the next year had enrolled nearly 12 percent of the population. And it is no coinciÂ*dence that the great inflation in health-care costs began soon after. We all believe we need comprehensive health insurance because the cost of care—even routine care—appears too high to bear on our own. But the use of insurance to fund virtually all care is itself a major cause of health care’s high expense.

Holy shit, dude.

Society’s excess cost from health insurance’s administrative expense pales next to the damage caused by “moral hazard�—the tendency we all have to change our behavior, becoming spendthrifts and otherwise taking less care with our decisions, when someone else is covering the costs.

Yes, I'm bragging. That's exactly what I've been saying.

Cost control is a feature of decentralized, competitive markets, not of centralized bureaucracy—a matter of incentives, not mandates. What’s more, cost control is dynamic. Even the simplest business faces constant variation in its costs for labor, facilities, and capital; to compete, management must react quickly, efficiently, and, most often, prospectively. By contrast, government bureaucracies set regulations and reimbursement rates through carefully evaluated and broadly applied rules. These bureaucracies first must notice market changes and resource misallocations, and then (sometimes subject to political considerations) issue additional regulations or change reimbursement rates to address each problem retrospectively.

Better and better.

Many reformers believe if we could only adopt a single-payer system, we could deliver health care more cheaply than we do today. The experience of other developed countries suggests that’s true: the government as single payer would have lower administrative costs than private insurers, as well as enormous market clout and the ability to bring down prices, although at the cost of explicitly rationing care.



But even leaving aside the effects of price controls on innovation and customer service, today’s Medicare system should leave us skeptical about the long-term viability of that approach. From 2000 to 2007, despite its market power, Medicare’s hospital and physician reimbursements per enrollee rose by 5.4 percent and 8.5 percent, respectively, per year. As currently structured, Medicare is a Ponzi scheme. The Medicare tax rate has been raised seven times since its enactment, and almost certainly will need to be raised again in the next decade. The Medicare tax contributions and premiums that today’s beneficiaries have paid into the system don’t come close to fully funding their care, which today’s workers subsidize. The subsidy is getting larger even as it becomes more difficult to maintain: next year there will be 3.7 working people for each Medicare beneficiary; if you’re in your mid-40s today, there will be only 2.4 workers to subsidize your care when you hit retirement age. The experience of other rich nations should also make us skeptical. Whatever their histories, nearly all developed countries are now struggling with rapidly rising health-care costs, including those with single-payer systems. From 2000 to 2005, per capita health-care spending in Canada grew by 33 percent, in France by 37 percent, in the U.K. by 47 percent—all comparable to the 40 percent growth experienced by the U.S. in that period. Cost control by way of bureaucratic price controls has its limits.

It is important to note that in those countries many of the costs are hidden away.





I disagree with the majority of the sixth page (the guy's a Democrat, he has to go wrong somewhere). Otherwise, excellent article.





We need free market mechanisms.





Interestingly I have yet to see any conservatives write an article that is as close to my views as this one.