birdog1960

it was a "mountain stage" npr show to be aired in early May - worth a listen if your local station carries it or listen to a podcast. Benson just seems to be having so much fun and the crowd definitely is. He said someone facebooked him and said they thought about coming to the show but decided against it because they thought that "they'd only play for 10 minutes" (there were 5 bands for a supposedly 2 hour radio show - asleep was the last, headline act). after the 5th or 6th song, Ray related this story and said "i guess we put that to rest" and continued playing song after song. from my seat, i could see the npr guys getting more and more upset - they had a whole house band and recording crew on the clock. anyway, i was a fan before but now i'm a big fan. my wife kept sayings "i wish we could dance" but it was in a theater with steep aisles ...would love to see them in a bar or dance hall. there was a 5 year old girl next to us who obviously enjoyed all the music but she got really animated and rambunctious when asleep at the wheel was on...gotta see that as a sign of good, visceral, foot stomping music.

saw " asleep at the wheel" last night. been around 42 years so not quite long enough but i thought they were fantastic. really becoming a fan of western swing. haven't listened to much Bob Wills (who was big pre 1960) but several songs done last night were by him. "Bob Wills is still the king" is a great song (also done at last nights show)about him written by waylon jennings but unfortunately still not old enough. how bout just saying old western swing and leave it at that.http://www.youtube.com/watch?v=9TnP_NRLzlc

the greatest generations greatest music:

was he genetically engineered?....thought not. then it's ok for him. the rest of us, not so much.

right...nevertheless, any facility selling housing to octagenerians and above that has someone present whose job it is to call 911 for residents likely has a policy of determining code status at the time of lease (entry). interestly, both assisted and independent living facilities appear sometimes to be represented by the same entity. my first apt didn't have common meals and social events. occasionally cockroaches joined us for dinner however.

not sure what you mean by exchange programs but since Jan 1, medicaid has been paying 100% medicare rates for board certified primary care docs. that's actually a significant increase.

again, not really. her desires should have been documented on moving into assisted living with the person calling 911 then informing the dispatcher that the patient did not desire cpr or possibly not calling 911 at all. if nothing else, it's an opprtunity for a national discussion and possibly concensus on these issues.

which is a discussion for ppp...just pointing out what the current reality is as it applies to this event.

Well, not exactly. society as a whole has not formally agreed with most of you. the person, regardless of age, has the right to decide on whether they desire cpr in such an event. the default decision, if none is made by the person before the fact, is usually to perform cpr. major surgeries including open heart surgeries are done on people over 85 (eg barbara bush) and usually paid for by medicare. wonder what several octagenarian plus nfl owners have documented as to their wishes.

anybody notice this piece? http://finance.yahoo...Y3Rpb25z;_ylv=3 if 2007 was a bubble then what is this?

the way to address it is rapid f/u after discharge with the pts primary care physician so that he can make sure of improvement, compliance etc. medicare has actually just approved a new code for this. some hospitals have set up clinics for pt after discharge to be seen who don't have primary care docs. they give the visits away in many instances as it's cheaper than a readmission. surprise, surprise - the answer is strong primary care. now, if the answer to "what am i thinking?" includes fraud, then i'm sure i don't know.

get ready. i've heard it discussed as a fairly likely scenario by folks whose business it is to predict such things. the nonpayment for rehospitalization rule within a month is just the beginning (in itself a form of capitation) much of the problem in the past was the lack of intergrated delivery systems that could provide all care for a patient. that's not much of a problem anymore...and btw, it works pretty well for concierge practices, right now. a quick search revealed this: http://www.kff.org/medicaid/8407.cfm. pretty sure kaiser still works on a capitated model and have been quite successful re outcomes and costs.

so much writing, so little sense...there are examples of similar systems to what i described providing equal or auperior care to populations at half the cost. clearly, it can work. as i said in another thread, just because you can't envision it doesn't mean it can't happen.since we are rapidly moving towards a few huge systems as providers of all healthcare, a likely next step in reimbursement is capitation. the system gets x dollars for all the care provided to y number of patients. this reverses the incentive for overutilization while incentivizing quality through holdbacks for quality measures. same could be done for durable equipment manufacturers and retailers. this isn't reinventing the wheel...it's been done successfully before. i also like the idea of reverse capitsation for doctors. specialists are capitated and primary care doctors are fee for service. this encourages the use of cheaper primary care while discouraging the overuse of specialists.

read the 4th paragraph: http://circ.ahajournals.org/content/122/18_suppl_3/S685.full

yep. as described, this was likely agonal breathing http://www.theheart.org/article/924633.do. it's recognition is taught as part of the basic cpr curriculum.

no. there is no redemption for this gm. nix buddy. the reason he still has a job is the reason the bills continue to lose.

makes sense. when the swiss are responding to this i'm beginning to think we may have finally reached a tipping point on executive salaries and bonuses. your solution seems a good one.

agree completely. and when they get the huge bill, whatever goodwill once existed between the patients and "providers" is destroyed. that's why i think doc perceives that prestige and respect for the medical profession is gone (btw, i don't agree with him). in many cases the doctor patient relationship has become a business client:provider relationship. it shouldn't be but that's a direct result of this system.

you really think physician supporters of single payer don't understand that payments to doctors will decrease under such a plan? this argument that the quality of applicant will suffer has no basis in fact . we've been through this before and have seen applicant rates to med school in single payer countries face even more competition than in our for profit system. the fact is that in most single payer countries, docs are still relatively high earners and medicine is still a respected and honored calling. as to your last statement, so...? if it's less expensive to farm out clerical, billing, coding and payment functions to a 3rd party then they should do that. but with single payer, this all gets much less complicated. one process across the system for all these functions and consequently the need for less people to do them

didn't intend to be patronizing...just pointing out that this type of thing is so common here that, as bizarre as it is, we tend to accept it as normal. oh, please...estimating how many qualified candidates exist and paying a private company to provide scooters to those recipients for a set fee would require very little in resources while saving huge sums. certified would mean doctors tested on requirements and then providing exams for people that were not their patients. this is just common sense yet you dismiss it out of hand. have a lot of experience in the area, do ya?

watching recorded meet the press and fast forwarded through an ad for stryker knee replacements. so let me get this right - firstly, this is meant to encourage folks to go to their doctor and demand a knee replacement. then to demand from the orthopedist a particular brand. will you accept "profit driven" in place of free market?

http://www.bbc.co.uk/news/world-europe-21647937. this really surprises me. brilliant or stupid?

ok. i agree this article didn't support single payer or the aca as the solution. it wasn't really about solutions. it illuminated the problems, which are many. there is no single solution but for problems so deep i believe fundamental change is required. that's not what many folks are proposing. they believe the market place can solve these issues. i believe the free market in health care is much of the problem. buying and selling care for a heart attack isn't in any way similar to buying a big screen tv or car. and that truth is well illustrated in this piece.

and i contend that this is the only way a for profit medical system can evolve. it's the natural outcome for the design (which is really not a product of design but of lack of design). remove or severely limit the incentive (profit) and you remove much of the problem. devise a system that prioritizes providing care over providing profits. the aca isn't a perfect or particularly good solution but is more so than anything i've seen presented by the other side.

agreed. he didn't place much blame on private insurers and made the point that they are becoming less important. i agree with this also although i don't think they are part of the solution. . he also didn't greatly champion single payer as the solution. i do . his main point, as i interpreted it, was the perverse incentives that exist in the American heath industry and their negative effects to both patients and our economy. can we agree that the article was an indictment of the current system?