birdog1960

here's the eye catching fact that i saw in the article. mary owen is the point person for the bills in the toronto series. so who is mary owen. i could only recall wilson relatives working in high positions in the organization as women. and yup, mary owen is ralph's niece. so the bigger implication is: do we really believe wilson isn't still stirring the pot in big decisions like this?

the single payor world. it would take time but a single ehr would be much more easily instituted in such a system as would other forms of "standard work".

the data is enlightening. hospitals in the same system with huge differences in outcomes and costs. why is it so difficult to see that a winning approach would be adoption of best practices with protocols and algorithms as guides? that doesn't necessarily require single payor. it's just much easier to implement in that type of system.

exactly. we're approaching 20% gdp and get poor quality in return. recent lecture i was at quoted 400,000 excess deaths per year in US hospitals due to medical errors. part of the solution proposed was standard work: algorithms, order sets, protocols... with built in flexibilty for physician discretion. kinda "one size fits most". and there's data to support that contention.also, when people mention denials, this is often through a private insurance medicare product. these existed long before obamacare. if you want to blame obamacare for these refusals you're probably best criticizing the fact that the bill didn't go far enough to standardize coverage. it's stiull fragmented and inconsistent. the aca however put a floor in place for what's covered. to make this floor more universal, you really need to invoke...wait for it...single payor.

this is truly historic: http://marysaggies.blogspot.com/2014/02/astounding-pope-francis-records-private.html also a video of the crowd and kenneth copeland's response. initially, they are in shock but it sinks in and they begin to celebrate and then pray for the pope! amazing!!!

they aren't and he did. that's the point. i think 4ever is just underscoring the absurdity of your criticism even though it's inconsequential.

http://www.mirror.co...russian-3162454

was there something in the nyt link to campaign finances that yall found difficult to comprehend? as ktf said, the amounts are similar. so given that (which you seem so reticent to accept), how do you explain the newsbusters linked data on top donors being predominantly dem leaning?

you really can't see the forest for the trees, can you. how bout this "we all know that"s false, excepting self delusional talk radio fanboys and morons".

you want me to link to evidence that all posters here are well informed and well read? sorry. it was a rhetorical statement.

thanks. saved me time away from the olympic gs upcoming. wonder what bode millers politics are..."um, what's politics?" but he is a very fine skier.

well geez, one might conclude that the repugs are far behind in campaign contributions overall. but we all know that is false. why the discrepancy?

those jerks aside (and our darwinian system produces guys like them frequently as a natural consequence), it's still ridiculous. i don't see why anyone finds a return to the gilded age desirable. the last time income inequality became this bad, it didn't end well. http://www.pewresearch.org/fact-tank/2013/12/05/u-s-income-inequality-on-rise-for-decades-is-now-highest-since-1928/

i thoroughly disagree with your assessment but would this not disqualify juan as a troll? not at all. there are many liberals of faith. that doesn't necessarily divorce us from reason. some would argue it links us more closely.

so, wait. it's appropriate to bandy about the nonpartisan cbo report findings but not to highlight what the director of the cbo stated as a clarification on that same report?

you're welcome. i think these numbers need to be widely disseminated along with salaries for top healthcare executives. is nearly $1mil necessary to incentivize students to go into orthopedics or nearly .5 mil to go into dermatology? obviously not, as evidenced by their presence in the rest of the world. yet that's the argument you often hear made to support extremely high salaries. it's really no surprise that a system based to a large extent on greed, leads to greed. i'm gonna read the oreilly and limpaugh transcripts tonight to get their take on this statement from the cbo. they'll be debating it, undoubtedly.

"it may be better to wait and see but waiting doesn't make you money....each patient is like an ATM machine". http://www.nytimes.c...comes-soar.html

yes. we can and do accommodate those requests.many seriously ill patients can't remember what medicines that they're on much less their past history. they walk in to cvs and the midlevel is often flying blind. but that rarely stops them from intervening in some, often worthless or potentially harmful way. after all, intervention is what the customer expects.

in theory,yes. my seeing only very sick patients would be most efficient. and you're certainly aware that there are metrics for a particular provider's patient population severity of illness. i'm happy that mine is relatively high. on the other hand, i'm reimbursed marginally more for a visit managing a patient with 4 or 5 chronic conditions than the walk in clinic is for treating a cold inappropriately with antibiotics or giving antibiotics that have significant interactions with the patients maintenance meds. (how much might that walk in clinc visit actually cost if it results in a bleed due to an interaction with a patients blood thinner?) and that's part of the systemic problem: patients are viewed more as customers and profit centers than sick people requiring care (i.e. patients). reimbursement models are ridiculously slanted towards procedures and against cognitive efforts and spending time with patients. it follows that hitting 2 irons all day is not financially rewarding and currently a barely viable option. you need some pitch shots to even things out. which brings up the question of why you are so certain quality is high in the walk in clinics. do you really want to see someone that either can only hit chip shots or chooses to only hit chip shots? until reimbursement is skewed away from disproportionately rewarding volume and procedures, walk in clinics at cvs make financial sense. the real question is whether they make sense in terms of improving overall care and lowering overall cost. for immunizations, perhaps (especially if ehr's talked to each other). for most other problems, i'm not at all certain. at any rate, i don't believe the ultimate answer lies here. much of it lies in reinventing the reimbursement system and incentives. if you haven't seen it, check out the front page op ed in the nytimes regarding costs and reimbursement with moh's surgery given as an example. i think it speaks directly to these issues.

except that they won't be doing any of the grunt work: refills of maintenance meds, reviewing consult letters from specialists, reviewing hospitalizations and scheduling follow up, scheduling immunizations, mammograms, colonoscopies... this is cherry picking at it's extreme. kinda like the radiologists rolling into town and selling $200 screening xrays, finding equivocal "abnormalities" and leaving it to people like me to explain it to the patient (when i never would have ordered the studies to begin with).. this is where the "medical home" concept becomes even more important. there needs to be adequate financial incentive to be one and disincentive to cherry pick. i think there will be.

perhaps you should read the majority SCOTUS decision on the ACA.

it's my opinion. isn't nearly everthing posted here opinion? even if it's an opinion originally generated and disseminated by the far right wing propaganda machine....

oh goody! is this like a ppp showdown? where someone with polar opposite political viewpoints from me judges a political argument that i'm involved in? and i'm still attempting to analyze the psychopathology involved in arguing under multiple aliases on an anonymous political opinion board. so far i've only concluded that it appears to be common but is definitely pathologic.

yes, but there's beauty in that. the right wing talk show dudes generally hang up on, never engage in the first place or plant a patsy to argue against. here you proxies for those propagandists that you can actually debate (well, sort of).

since b man seems impressed by the number of articles on a subject here's another on the cbo report that argues directly against most of what you said here: http://www.washingtonpost.com/blogs/plum-line/wp/2014/02/04/what-the-cbo-report-on-obamacare-really-found/