Progressives tout California Health care "success"

[IDBillzFan]

Man, you know it's bad when ever MSNBC is reporting on the embarrassing truth about Obamacare.

 

Doc shortage is here, and getting worse. But hey, that nurse will be there...

[Doc]

Man, you know it's bad when ever MSNBC is reporting on the embarrassing truth about Obamacare.

 

Doc shortage is here, and getting worse. But hey, that nurse will be there...

Good luck with that one. Nurses can do the simple stuff and some can do more, but there's a reason why you have to go through 4 years of med school and 3 years of residency.

 

And some schools are offering "doctorate of nursing" degrees so that nurses can call themselves "doctor." So the next time you hear someone without an ID badge introduce him/herself as "doctor," ask if he/she is a medical doctor.

[OCinBuffalo]

Obama Speech: I think his Obamacare comments were reasonable.

 

I'll give you all a second to get ove the shock of me saying that.....

 

From a purely political effectiveness standpoint, it's reasonable. Yes, when implementing new systems, bugs will occur. Yes, a certain amount of change management is to be expected. Yes, exposing it to the real world will show us opportunities for improvement. Reasonable.

 

But, if he wants to put this in terms of engineering? I can do that too.

 

First, define the problem PROPERLY. Obamacare has massive design flaws. Design flaws, especially pervasive ones? You don't treat those like bugs. No. You put the thing on hold. Then, you get EVERYBODY together, no matter how much that sucks, and how much you know it's going to be a contentious meeting, and you put 2 options forward:

1. Rolling back everything that is touched by the flaw, fixing it, and then proceeding from there

2. Throwing out the whole thing, going back to the requirements, and starting over.

 

Then, you don't let anybody out of that room, or, you make it clear that nobody is getting off the hook, until we choose 1 or 2, and immediately constuct a plan.

Then, you make it clear that everything prior to this minute no longer matters, and that you will deal with whoever F'ed up, after the project is complete.

 

Well, you do that, if you are an experienced project manager, who has the respect of the project team, because you've shown that you are about the work, and not about the blame/save ass/cover ass horseshit. You do that if you've proven that you aren't going to let egos, epsecially yours, get in the project's way.

 

If Obama wants to play at being project manager? Then he needs to act like one. I've just laid out exactly how that goes.

[DC Tom]

Obama Speech: I think his Obamacare comments were reasonable.

 

I'll give you all a second to get ove the shock of me saying that.....

 

From a purely political effectiveness standpoint, it's reasonable. Yes, when implementing new systems, bugs will occur. Yes, a certain amount of change management is to be expected. Yes, exposing it to the real world will show us opportunities for improvement. Reasonable.

 

But, if he wants to put this in terms of engineering? I can do that too.

 

First, define the problem PROPERLY. Obamacare has massive design flaws. Design flaws, especially pervasive ones? You don't treat those like bugs. No. You put the thing on hold. Then, you get EVERYBODY together, no matter how much that sucks, and how much you know it's going to be a contentious meeting, and you put 2 options forward:

1. Rolling back everything that is touched by the flaw, fixing it, and then proceeding from there

2. Throwing out the whole thing, going back to the requirements, and starting over.

 

Then, you don't let anybody out of that room, or, you make it clear that nobody is getting off the hook, until we choose 1 or 2, and immediately constuct a plan.

Then, you make it clear that everything prior to this minute no longer matters, and that you will deal with whoever F'ed up, after the project is complete.

 

Well, you do that, if you are an experienced project manager, who has the respect of the project team, because you've shown that you are about the work, and not about the blame/save ass/cover ass horseshit. You do that if you've proven that you aren't going to let egos, epsecially yours, get in the project's way.

 

If Obama wants to play at being project manager? Then he needs to act like one. I've just laid out exactly how that goes.

 

You have absolutely no idea how much **** I get for not following "proper project management procedures" by doing just that. Just today, I've received angry emails TWICE for fixing a problem and not finding a way to blame someone else for it.

[B-Man]

You have absolutely no idea how much **** I get for not following "proper project management procedures" by doing just that. Just today, I've received angry emails TWICE for fixing a problem and not finding a way to blame someone else for it.

 

Jeez, I don't know if I could control myself in that type of situation.

 

As I was steered away from years of direct patient care (RN) to being a manager (different types - Hospital, then Rehab Center, now Senior Center) thats all I do now adays.

 

When my kids ask me what my job is, I tell them "I solve problems"

[OCinBuffalo]

You have absolutely no idea how much **** I get for not following "proper project management procedures" by doing just that. Just today, I've received angry emails TWICE for fixing a problem and not finding a way to blame someone else for it.

Who the F's "proper project management procedures" are those? Jesus. I'd be asking for the project standard I'm violating by not affixing the blame.

 

This reminds me of my first project manager, and him beating the exact opposite into us...in a Hong Kong accent: "We work problem, not blame. I don't care if Joe F up. Look at him. He is F up. Stupid smile on his face. He stupid. You not. You work and shut you mouth. Maybe I let you go home this weekend. Ahhh....yes(grin)...you like that? See pretty girlfriend? I not tell you again. Eliminate her. You learn, I teach you. Soon you be quite good, like me. No stupid girlfriend. You like me, you buy any girlfriend you want."

 

"Eliminate her" was the best. I kept telling her I had been ordered to eliminate her, and, that the firm looks down on those who don't perform "as expected". It was funny for a while, but then, she really did have to go. No not that way. I found her a dream job with the Navy that meant, in her words, "You know, it's likely I'll never come back, for years?"

 

Yep.

[DC Tom]

Who the F's "proper project management procedures" are those?

 

The government's. Duh.

 

Seriously, I've been in meetings about risk management where managers have said "We have to find a way to make so-and-so the patsy here." Uh, yeah...that's not risk management. The amount of effort expended in government on having a chair when the music stops is absolutely amazing.

[birdog1960]

Good luck with that one. Nurses can do the simple stuff and some can do more, but there's a reason why you have to go through 4 years of med school and 3 years of residency.

 

And some schools are offering "doctorate of nursing" degrees so that nurses can call themselves "doctor." So the next time you hear someone without an ID badge introduce him/herself as "doctor," ask if he/she is a medical doctor.

the problem is not midlevels, if they're utilized appropriately. the problem is the number quoted in the piece:66/33 ratio specialists to primary care. for cost effectiveness and better outcomes the ratio should be reversed. since it isn't likely to soon be, midlevels will likely get more autonomy. that's not a good thing imo for the reasons you mentioned. the main reason their outcomes look ok is most likely due to them referring everything more than a sore throat out. that's not cost effective. once global reimbursement hits and the cost of all those referrals come to light, so will the false economy.

 

so what's the solution? change the ratio. pay primary care relatively more than currently and specialists less. i can anticipate your reaction.

[Doc]

the problem is not midlevels, if they're utilized appropriately. the problem is the number quoted in the piece:66/33 ratio specialists to primary care. for cost effectiveness and better outcomes the ratio should be reversed. since it isn't likely to soon be, midlevels will likely get more autonomy. that's not a good thing imo for the reasons you mentioned. the main reason their outcomes look ok is most likely due to them referring everything more than a sore throat out. that's not cost effective. once global reimbursement hits and the cost of all those referrals come to light, so will the false economy.

Exactly.

so what's the solution? change the ratio. pay primary care relatively more than currently and specialists less. i can anticipate your reaction.

I'd be fine with that. The problem is that more is taken away from all of us instead of taken from one and given to another.

[OCinBuffalo]

The government's. Duh.

 

Seriously, I've been in meetings about risk management where managers have said "We have to find a way to make so-and-so the patsy here." Uh, yeah...that's not risk management. The amount of effort expended in government on having a chair when the music stops is absolutely amazing.

I admire your patience then.

 

I was done with that 10 years ago. My architecture was partially predicated on engineering those people's power away. Consider: If it doesn't matter to you that Bob made a mistake, then how does blaming Bob matter to you?

 

Or: "IT should never be so poorly done, that it allows one VP to get over on another, because one or more is dependent on another."

 

I'm either an idiot, or, that quote is going to matter someday.

[B-Man]

 

 

 

 

 

 

 

and one more that's kind of "health related"........

 

 

 

 

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Edited August 11, 2013 by B-Man

[IDBillzFan]

Harry Reid: Obamacare won't work forever and will lead to single payer.

 

In just about seven weeks, people will be able to start buying Obamacare-approved insurance plans through the new health care exchanges.

 

But already, Senate Majority Leader Harry Reid is predicting those plans, and the whole system of distributing them, will eventually be moot.

 

Reid said he thinks the country has to “work our way past” insurance-based health care during a Friday night appearance on Vegas PBS’ program “Nevada Week in Review.”

 

“What we’ve done with Obamacare is have a step in the right direction, but we’re far from having something that’s going to work forever,” Reid said.

 

When then asked by panelist Steve Sebelius whether he meant ultimately the country would have to have a health care system that abandoned insurance as the means of accessing it, Reid said: “Yes, yes. Absolutely, yes.”

[/dev/null]

Harry Reid: Obamacare won't work forever and will lead to single payer.

 

In other news, General Franco is still dead

[Koko78]

In other news, General Franco is still dead

 

That's just a right-wing conspiracy perpetrated by Faux News.

[Doc]

Harry Reid: Obamacare won't work forever and will lead to single payer.

Dirty Harry can dream, can't he? If the dems couldn't get single payer even on the table and ol' Joe alone could scuttle the public option back in 2008, what chance does it ever have of passing in the future?

[DC Tom]

Dirty Harry can dream, can't he? If the dems couldn't get single payer even on the table and ol' Joe alone could scuttle the public option back in 2008, what chance does it ever have of passing in the future?

 

The ACA is broken. It was designed broken. It needs to be fixed. ALL the fixes Congress applies will be towards greater government involvement in health care. It's inevitable.

[Doc]

The ACA is broken. It was designed broken. It needs to be fixed. ALL the fixes Congress applies will be towards greater government involvement in health care. It's inevitable.

Repeal will be the more popular decision. The government created Obamacare and now wants more control to "fix" it? Can't see that flying.

[3rdnlng]

Repeal will be the more popular decision. The government created Obamacare and now wants more control to "fix" it? Can't see that flying.

 

 

It's repeal or an eventual single payer healthcare system here in the U.S.

 

http://www.politifact.com/truth-o-meter/statements/2009/jul/16/barack-obama/obama-statements-single-payer-have-changed-bit/

 

 

"But back to our ruling: Did Obama flip on support of single-payer, as the woman at the town hall implied? The video shows he plainly said, "I happen to be a proponent of a single-payer universal health care program. ... A single-payer health care plan, a universal health care plan. That's what I’d like to see. But as all of you know, we may not get there immediately. Because first we've got to take back the White House, we've got to take back the Senate, and we've got to take back the House." Well, Democrats now have the White House, and the Senate and the House. And Obama still doesn't support a single-payer system.

 

We also have at least one eyewitness — the "Jim" mentioned in the video — who says the 54-second snippet shown on YouTube isn't a full accounting of Obama's more nuanced position. And we have a single-payer supporter, Dr. Quentin Young, who said Obama definitely was for single-payer and switched.

So let's put this to the Flip-O-Meter. Opponents of Obama's health plan who watch the video see a stark flip (and possibly hints of what they believe he's wanted all along). Indeed, his comments seem quite clear that he supported a single-payer plan. But a full examination of his comments then and now reveals they have not changed that drastically. Yes, when he was trying to appeal to the Democratic base, he was a bigger supporter of the single-payer plan. But as we note, he still says that he'd prefer such a plan if he was starting from scratch.

So what we see here is a candidate who in 2003 was trying to appeal to a liberal electorate and today has moderated his comments to appeal to a broader national audience. That's a Half Flip in our view."

[DC Tom]

Repeal will be the more popular decision.

 

Not with Congress, it won't.

[Doc]

Not with Congress, it won't.

I assume you're saying that Congress wants to see the gubment control health care. I can understand that sentiment. However repubs don't want single payer and hate Obamacare, so their druthers would be to repeal it. And if 2014 mid-terms ends up being a referendum on Obamacrap, you'll likely see a good number of dems who would rather just support repeal than repeal and replace with single payer and more government intrusion.

Edited August 12, 2013 by Doc