wyobilzfan Posted November 9, 2011 Share Posted November 9, 2011 If only somebody had a way to apply activity based costing/workflow/business intelligence to health care, while making the necessary feasibility study based changes to these methodologies to suit health care, while making it act like custom software, have it be able to changed broadly or slightly and without consequence, and have it be designed from the ground up to integrate to anything. (yes, the cloud too...as if we haven't been doing "the cloud" since the 90s in Major League IT ) Boy, that somebody would be able to tell use the cost of doing business per patient per day, or minute, second, week, whatever, in real time, and give us a true determination of how well our care processes are doing. That somebody would be able to provide GG with everything he is asking for, and a whole bunch of other things he doesn't know about but are just as critical to cost reduction. Wouldn't that be great! (For the new guys, yeah, that's pretty much what the F I do) Why bother hiring someone like you when it's much easier to just commit medicare and medicaid fraud and not have to bother with those pesky little details of yours that you have to offer? LOL... trust me, the AMA hates people like you. Don't tell them how to work more efficiently and cost effectively! Do you really think most at this point give a flying cowpie about all the number crunching? Much easier to hire someone who knows how to bilk the govt coding system. This "so-called" medicare and medicaid fraud system detection? Another waste of taxpayer dollars. There are so many ways to make more money by fraud than motivate greedy people into actually improving their business model. For them it works just fine. Between the HCPs and the lawyers, there's way too much money to be made than to actually care about silly things like health outcomes! Link to comment Share on other sites More sharing options...
B-Large Posted November 9, 2011 Author Share Posted November 9, 2011 If only somebody had a way to apply activity based costing/workflow/business intelligence to health care, while making the necessary feasibility study based changes to these methodologies to suit health care, while making it act like custom software, have it be able to changed broadly or slightly and without consequence, and have it be designed from the ground up to integrate to anything. (yes, the cloud too...as if we haven't been doing "the cloud" since the 90s in Major League IT ) Boy, that somebody would be able to tell use the cost of doing business per patient per day, or minute, second, week, whatever, in real time, and give us a true determination of how well our care processes are doing. That somebody would be able to provide GG with everything he is asking for, and a whole bunch of other things he doesn't know about but are just as critical to cost reduction. Wouldn't that be great! (For the new guys, yeah, that's pretty much what the F I do) We have already begin the process of implementing software that helps acheive the goals of seeing how pateints flow though the system. Various Bedboard program help inpatient hospital management insure that inpatient hopsital rooms are filled, turned, cleaned and ready for assignment in certain timeframe goals.... Length os Stay has diminished in many places around the country, and LOS recudution tend to equal lwer overall cost to the insurtance company, and perhaps makes it back to the premium payor. I see it happening everyday, the trick with healthcare, espcially hospital, is how do you implement the cutting edge IT systems (which are exopensive, as you know), build and expand new capacity, while have margins of 2-3%, and while absorbing 150 million in unreimbursed care every year? Link to comment Share on other sites More sharing options...
Alaska Darin Posted November 9, 2011 Share Posted November 9, 2011 judge silberman (the guy that struck down the widely supported DC firearms ban) disagrees with you. Which means he got the gun ruling right and this one wrong. Getting the gun ruling correct doesn't make him an "across the board" infallible decision maker. Link to comment Share on other sites More sharing options...
OCinBuffalo Posted November 9, 2011 Share Posted November 9, 2011 (edited) We have already begin the process of implementing software that helps acheive the goals of seeing how pateints flow though the system. Various Bedboard program help inpatient hospital management insure that inpatient hopsital rooms are filled, turned, cleaned and ready for assignment in certain timeframe goals.... Length os Stay has diminished in many places around the country, and LOS recudution tend to equal lwer overall cost to the insurtance company, and perhaps makes it back to the premium payor. I see it happening everyday, the trick with healthcare, espcially hospital, is how do you implement the cutting edge IT systems (which are exopensive, as you know), build and expand new capacity, while have margins of 2-3%, and while absorbing 150 million in unreimbursed care every year? Lucky for you I solved that problem too. I am well aware of your margins. When I was first approached to solve these problems, my immediate answer was "$2.5 million", that was as cheap as my brain could think of, but I was told that wasn't even close to being feasible. Basically, because of your margins, I had to come up with a new kind of software, of course, but also a new kind of software business model to support it. The reason you aren't able to get high end code is because the companies who make it can't afford to charge you less than what they charge. This is because as they add features, modules, etc., and new clients, their additional support cost increases exponentially. As we add features and clients, our support cost either remains nominal, or actually starts to decrease. We don't have their problems, because we don't have their(crappy ) software. Period. It's simply a matter of design. And, keep in mind, we capture ALL your reimbursement, because we capture ALL of what you do. Our research shows that without us, 40% of what you do is never recorded. We permanently remove that problem...which gives you more money...and also serves as an elegant way to show malpractice lawyers and surveyors to the door, and an even more elegant way to relate to a patient's family. Also: looking at the patient is absolutely the wrong way to go about workflow. You can benefit from my 3 year feasibility study that proves this, or, you can find out for yourself the hard way Edited November 9, 2011 by OCinBuffalo Link to comment Share on other sites More sharing options...
wyobilzfan Posted November 10, 2011 Share Posted November 10, 2011 Lucky for you I solved that problem too. I am well aware of your margins. When I was first approached to solve these problems, my immediate answer was "$2.5 million", that was as cheap as my brain could think of, but I was told that wasn't even close to being feasible. Basically, because of your margins, I had to come up with a new kind of software, of course, but also a new kind of software business model to support it. The reason you aren't able to get high end code is because the companies who make it can't afford to charge you less than what they charge. This is because as they add features, modules, etc., and new clients, their additional support cost increases exponentially. As we add features and clients, our support cost either remains nominal, or actually starts to decrease. We don't have their problems, because we don't have their(crappy ) software. Period. It's simply a matter of design. And, keep in mind, we capture ALL your reimbursement, because we capture ALL of what you do. Our research shows that without us, 40% of what you do is never recorded. We permanently remove that problem...which gives you more money...and also serves as an elegant way to show malpractice lawyers and surveyors to the door, and an even more elegant way to relate to a patient's family. Also: looking at the patient is absolutely the wrong way to go about workflow. You can benefit from my 3 year feasibility study that proves this, or, you can find out for yourself the hard way Ooooooooooo.... I likey and am very interested in what you are doing. This is the only way that cost reduction can actually occur; along with forcing medical establishments to publish their prices like every other competitive industry and make it simpler for people to make a choice based upon factual data and not all the crap being spewed now with the horrible software designs you are talking about... seen some of them and they just make me shake my head. Link to comment Share on other sites More sharing options...
Doc Posted November 12, 2011 Share Posted November 12, 2011 Obamacare is a train wreck waiting to happen. Link to comment Share on other sites More sharing options...
B-Large Posted November 12, 2011 Author Share Posted November 12, 2011 Obamacare is a train wreck waiting to happen. The system as it existed before trainwrecked... It's a solution, let's see where it goes.... If it fails, cut loses and move on. Everybody said Medicare Part D would crash and burn.... In reality , it has cost less than projected. Link to comment Share on other sites More sharing options...
Koko78 Posted November 12, 2011 Share Posted November 12, 2011 The system as it existed before trainwrecked... It's a solution, let's see where it goes.... If it fails, cut loses and move on. Everybody said Medicare Part D would crash and burn.... In reality , it has cost less than projected. The problem with entitlements is that you can't simply cut losses and move on if it doesn't work. Once the government gives any qualified group resources and claims that they're entitled to it, you can't take it away just by legislation (so long as they remain qualified for the program). The group benefited by the government spending has a property right in that benefit, and it can only be taken away after due process. Link to comment Share on other sites More sharing options...
ExiledInIllinois Posted November 12, 2011 Share Posted November 12, 2011 The problem with entitlements is that you can't simply cut losses and move on if it doesn't work. Once the government gives any qualified group resources and claims that they're entitled to it, you can't take it away just by legislation (so long as they remain qualified for the program). The group benefited by the government spending has a property right in that benefit, and it can only be taken away after due process. Give anybody that serves and is honorably discharged free health insurance for life. Notice I said, health insurance... Let them pick and chose. That would be one heck of an entitlement program. Shouldn't vets be entitled to that? People woould be banging down the door to enlist. Link to comment Share on other sites More sharing options...
Doc Posted November 12, 2011 Share Posted November 12, 2011 The system as it existed before trainwrecked... It's a solution, let's see where it goes.... If it fails, cut loses and move on. Everybody said Medicare Part D would crash and burn.... In reality , it has cost less than projected. How do you figure it's a "solution?" Link to comment Share on other sites More sharing options...
IDBillzFan Posted November 12, 2011 Share Posted November 12, 2011 The system as it existed before trainwrecked... It's a solution, let's see where it goes.... If it fails, cut loses and move on. Kinda like Solyndra, but with trillions of dollars at stake. Cool. What could possibly go wrong? Cut loose and move on. It's just other people's money. Much more where that came from. We've seen where it's going. Higher costs and hiring freezes, combined with 57% of the US consistently polled saying they want it fully repealed. Let's dump this piece of crap and work on legislation that actually addresses the problems, not add to them. We can start with competing across state lines, a massive no-brainer that big government people are scared to death of trying for all the obvious reasons. Link to comment Share on other sites More sharing options...
Doc Posted November 12, 2011 Share Posted November 12, 2011 Kinda like Solyndra, but with trillions of dollars at stake. Cool. What could possibly go wrong? Cut loose and move on. It's just other people's money. Much more where that came from. We've seen where it's going. Higher costs and hiring freezes, combined with 57% of the US consistently polled saying they want it fully repealed. Let's dump this piece of crap and work on legislation that actually addresses the problems, not add to them. We can start with competing across state lines, a massive no-brainer that big government people are scared to death of trying for all the obvious reasons. Speaking of which, I've been told that health insurance companies were all for Obamacare. And given the relative lack of outcry by them, that seems to be true. However, for the life of me, I can't understand why? There was a report today that fewer companies are providing health insurance benefits to their employees than ever before. Once Obamacare hits, it will make even more sense to stop providing benefits and take the (laughable) penalties. And the same goes at the individual level for all but the sickest, who would actually save money buying insurance, and those making well over $1M, since it would actually cost more to not have it than have it. Considering those are a small percentage of the population, how does that help insurance companies? Link to comment Share on other sites More sharing options...
DC Tom Posted November 12, 2011 Share Posted November 12, 2011 Speaking of which, I've been told that health insurance companies were all for Obamacare. And given the relative lack of outcry by them, that seems to be true. However, for the life of me, I can't understand why? There was a report today that fewer companies are providing health insurance benefits to their employees than ever before. Once Obamacare hits, it will make even more sense to stop providing benefits and take the (laughable) penalties. And the same goes at the individual level for all but the sickest, who would actually save money buying insurance, and those making well over $1M, since it would actually cost more to not have it than have it. Considering those are a small percentage of the population, how does that help insurance companies? Probably because the through the government exchange it opens a new market for them: people who can't afford health insurance. Plus...in a couple decades, when the whole "faux free market" structure of the system goes totally in the crapper, they probably expect a bailout...because who's not going to bail out the "health care" industry? Link to comment Share on other sites More sharing options...
DoYouSeeWhatHappensLarry Posted November 12, 2011 Share Posted November 12, 2011 So if rent seeking is one of the main drivers of health care costs, why are we to assume that a fully privatized approach to health care will eliminate rent seeking? As doctors/hcp's continue to bill in an attempt to get every dime possible, all that will happen is access to healthcare will continually dry up for people that can't "afford" it. The ACA is far from a good piece of legislation.....but acting as though the market has some internal sense of morality that will eliminate rent seeking and other price increasing pressures is completely absurd. Unchecked marketplaces always result in marketshare pooling and price gouging. Always. Link to comment Share on other sites More sharing options...
B-Large Posted November 12, 2011 Author Share Posted November 12, 2011 So if rent seeking is one of the main drivers of health care costs, why are we to assume that a fully privatized approach to health care will eliminate rent seeking? As doctors/hcp's continue to bill in an attempt to get every dime possible, all that will happen is access to healthcare will continually dry up for people that can't "afford" it. The ACA is far from a good piece of legislation.....but acting as though the market has some internal sense of morality that will eliminate rent seeking and other price increasing pressures is completely absurd. Unchecked marketplaces always result in marketshare pooling and price gouging. Always. Direct TV can attempt to bend me over the barrel, and I have choice to not participate. I go without , no loss other than no NFL Network... Healthcare, unless you are a ambivalent about Life, if you have Cancer you are 100% signed up to pay... Private interests know they have capitive customers..... That is a potentially dangerous prospect... The issue is that Medicine is unlike most other industries... Choice is often throw out the door.... That is why it is a tough problems to solve, and simple "free market" chants will not address the problem alone.... Although I do believe competitive pressures can have positive impact.... Link to comment Share on other sites More sharing options...
Doc Posted November 12, 2011 Share Posted November 12, 2011 Probably because the through the government exchange it opens a new market for them: people who can't afford health insurance. Plus...in a couple decades, when the whole "faux free market" structure of the system goes totally in the crapper, they probably expect a bailout...because who's not going to bail out the "health care" industry? People who can't afford health insurance now won't be able to pay premiums that are commensurate with the (aggregate) resources they will consume. As for bailing-out big bad insurance companies, good luck with that one. So if rent seeking is one of the main drivers of health care costs, why are we to assume that a fully privatized approach to health care will eliminate rent seeking? As doctors/hcp's continue to bill in an attempt to get every dime possible, all that will happen is access to healthcare will continually dry up for people that can't "afford" it. The ACA is far from a good piece of legislation.....but acting as though the market has some internal sense of morality that will eliminate rent seeking and other price increasing pressures is completely absurd. Unchecked marketplaces always result in marketshare pooling and price gouging. Always. On the flip side, people who are given a "buffet" will usually gorge themselves silly. Unless people are forced to engage in healthy activities, the basic problem will never be addressed. People are living longer with expensive diseases, taking worse care of themselves in general, and the prices of things continue to go up. Direct TV can attempt to bend me over the barrel, and I have choice to not participate. I go without , no loss other than no NFL Network... Healthcare, unless you are a ambivalent about Life, if you have Cancer you are 100% signed up to pay... Private interests know they have capitive customers..... That is a potentially dangerous prospect... The issue is that Medicine is unlike most other industries... Choice is often throw out the door.... That is why it is a tough problems to solve, and simple "free market" chants will not address the problem alone.... Although I do believe competitive pressures can have positive impact.... You can choose to not receive treatment. You don't "have to" be treated. You "want to" be treated. Link to comment Share on other sites More sharing options...
DC Tom Posted November 12, 2011 Share Posted November 12, 2011 People who can't afford health insurance now won't be able to pay premiums that are commensurate with the (aggregate) resources they will consume. As for bailing-out big bad insurance companies, good luck with that one. They'll have to bail them out. The "public" health coverage is private insurance purchased on a government exchange. Unless the government wants the public option to fail when the private insurers fail, they'll bail them out. Of course, "bailout" in this context is more like "take over" or "nationalize". At which point, our socialized medicine program is in place. Link to comment Share on other sites More sharing options...
DoYouSeeWhatHappensLarry Posted November 12, 2011 Share Posted November 12, 2011 Doc, your buffet analogy works well for some. For others (read: young people) I don't think it's quite as apt. When I was paying for good health insurance (from 2004-2008) I really didnt ever use it. I guess I did for the dentist but I've never been a fan of the rush to the doctor mentality. Most of my young friends are similar in that regard. But you're right, people do need to be more conscious of the consequences of their decisions to randomly go to the doctors/ER/urgent care because of a headache. And I would LOVE to see a focus on healthy lifestyles. I think American society has been trending that way for the last ten years or so, but its still a long way from being the dominant approach. I'd like to see the food stamps program take a more heavy handed approach at nutrition and even education. As someone who has been trying to get in better shape over the last few months, I appreciate the necessity of good food and how destructive an unhealthy diet can be, especially when its supplemented with a sedentary lifestyle. The best thing this country can do to solve ALL of its problems is to get dialogue going, develop understanding of the assorted problems and try to reach an understanding on how to fix them. Thats why I get so mad when people participate in the demonization of liberal/conservatives. I am an unabashed liberal....but that doesnt mean I think conservatives are the devil. They hold a different approach...one with some merit. So lets talk and see how we can both accomplish goals. Link to comment Share on other sites More sharing options...
B-Large Posted November 12, 2011 Author Share Posted November 12, 2011 People who can't afford health insurance now won't be able to pay premiums that are commensurate with the (aggregate) resources they will consume. As for bailing-out big bad insurance companies, good luck with that one. On the flip side, people who are given a "buffet" will usually gorge themselves silly. Unless people are forced to engage in healthy activities, the basic problem will never be addressed. People are living longer with expensive diseases, taking worse care of themselves in general, and the prices of things continue to go up. You can choose to not receive treatment. You don't "have to" be treated. You "want to" be treated. That is why I stated other than people who are willing to make the "no treatment, this s my time" choice, most opt for extending their life. We also live a society that values life, and in general we find it abhorrent to let people die who would prefer to live... And that is probably good policy... Like you said, we have growing population that has increasing chronic conditions that live very long unhealthy lives... To pretend cost will decrease is absurd.... Cost will rise until there are less people, less chronic illness, cure for chronic diseases, or until be decide that we are willing to stop treating people at a certain age.... Maybe a combination of all of those. I know someone who firmly believes that the US should spend no more than 6% of GDP on any kind of healthcare related outlays, and people can't afford to pay for it for themselves and they die, so be it.... He's a real prick Link to comment Share on other sites More sharing options...
ExiledInIllinois Posted November 12, 2011 Share Posted November 12, 2011 Why are people crying over rising premiums? Is it that they weren't paying anything before? Where I work, the employer (federal gov't ) picks up around 60%. Always has been that way. My premiums have been going up every year since I started working 20 years ago. When I started on with family insurance (high option)... I was paying about well under 100 bucks every two weeks... That was in the mid-1990's... Now my premium is around 300 bucks every two weeks. You figure my employer kicks in over half... So that has got to be over 15k that Humana gets from the both of us a year. At my young age, I would be better off banking that into an locked account and go fee-for service while carrying catastrophic. I am not sure what my threshold is... But it is getting closer where I will have to downgrade carriers... That and lack of service every year... And rising co-pays. Link to comment Share on other sites More sharing options...
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