It's so bad you have to pay people to move to Vermont - Page 22

AlpineZone

Page 22 of 55 FirstFirst ... 12202122232432 ... LastLast
Results 211 to 220 of 550
  1. #211
    Quote Originally Posted by Orca View Post
    "In Vermont, many people — both medical providers and the population at large — are beginning to see OneCare as something akin to the European Union. The University of Vermont Medical Center and Dartmouth-Hitchcock Medical Center clearly run the show. They have bought up most of the independent practices and hospitals in the state and the decisions made for those practices are now made in OneCare’s corporate boardrooms by very highly paid executives, few of whom have any clinical experience. Medical providers in the field are inundated by computerized paperwork and spend over half their time on non-medical clerical work. The medical practices have been homogenized by required algorithms for patient care and practices have become franchises — similar to McDonalds."

    -- Louis Meyers, VTDigger, 2 January 2020
    UVM Health is in the process of going live right now with a new EMR software from Epic at a cost of $200M. Epic is the Mercedes of EMRs, which might make sense in Burlington, but hardly does in Berlin or Middlebury whose hospitals and local networks will hardly see the benefits and don't have the need for the features Epic provides. Both could have gone with a lower cost EMR product. And those products and patient records can be accessed remotely from the Big House when patients need the advanced care that facility provides. The resulting manual charting required to do this would be infrequent and minimal work.

    You see the same thing with OR and Radiology equipment. The big house mandates the community hospitals use the same high cost equipment and it's totally unnecessary. UVM, Dartmouth and MaineHealth (the three big players in Northern New England) are all guilty of this. I've seen $90k Anesthesia systems in Critical Access Hospitals in their networks (which only exist because of government subsidies) who would never use all the features available for patient care on even a $25k system. Essentially, there is a massive lack of fiduciary responsibility in the capital planning of our hospitals in this country.

    And to be honest, that article is WAY off base pointing the fingers at Hospital Admins for much of the wasteful spending. The physicians demand the Mercedes no matter where they work. They have a ton of power over these choices. They typically work four days a week at the Big House and then one at the East Bumbfuck Medical Centers in the networks and demand the same equipment.

    The problem with this is what you end up seeing is EBF hospitals having no money for new equipment and end up holding onto 15 year old Mercedes that are expensive to maintain, instead of buying a Honda every 7/8 years and actually end up having newer, more reliable and more useful tech. Some of those EBF hospitals end up failing and close because of this and the low income communities they serve get screwed. The lower income patient populations relying on these facilities now have to drive hours to receive care in more urban areas. Those communities get doubly screwed because often times that hospital is the largest employer with the highest wages in town. Best case scenario for these places is the network flagship hospitals at least maintain a 24 hour ED at the former full service hospital.

    So, to circle back on the argument that US "capitalism" approach is better than government run healthcare, let's at least become educated first that under our current system, US hospitals don't have to run like an actual business. They're run HORRIBLY because they can. They get bailed out for their inefficiances. If they had to run like a real business, say a ski resort? 75% of hospitals would fold. That's not an exaggeration. And it's not capitalism.

    But, you know who does run healthcare more like a business? All those other Commi nations in the developed world who have more government control over their healthcare industries. They have more bargaining power with the drug manufacturers and tech companies like mine because they're the only customer. They're also often ultimately the only customer paying the providers, so they have maximum leverage over what the providers can charge their patients. It's a massively effective and efficient monopoly that sees these Commis spending only around 10-12% of their GDP on healthcare vs our 18%. And the results are often as good or better for 99.9% of the population.

    But F it! If Mick Jagger gets his heart surgery in the USA, we must have the best way of doing things AMIRIGHT?!?!!!!



    Sent from my XT1635-01 using AlpineZone mobile app

  2. #212
    JimG.'s Avatar
    Join Date
    Oct 2004
    Location
    Hopewell Jct., NY
    Posts
    10,544
    Quote Originally Posted by abc View Post
    Truth being, having seen many of those, my Mom is terrified of similar thing happening to her. She reminds me of her wish every so often. Her wish for a quality life and a dignified end.
    Most families do not discuss these issues and that is a big part of the problem.



    All 3 of my boys are used to me reminding them of the same thing your mom fears.

  3. #213
    JimG.'s Avatar
    Join Date
    Oct 2004
    Location
    Hopewell Jct., NY
    Posts
    10,544
    Quote Originally Posted by deadheadskier View Post
    So, to circle back on the argument that US "capitalism" approach is better than government run healthcare, let's at least become educated first that under our current system, US hospitals don't have to run like an actual business. They're run HORRIBLY because they can. They get bailed out for their inefficiances. If they had to run like a real business, say a ski resort? 75% of hospitals would fold. That's not an exaggeration. And it's not capitalism.

    But, you know who does run healthcare more like a business? All those other Commi nations in the developed world who have more government control over their healthcare industries. They have more bargaining power with the drug manufacturers and tech companies like mine because they're the only customer. They're also often ultimately the only customer paying the providers, so they have maximum leverage over what the providers can charge their patients. It's a massively effective and efficient monopoly that sees these Commis spending only around 10-12% of their GDP on healthcare vs our 18%. And the results are often as good or better for 99.9% of the population.

    But F it! If Mick Jagger gets his heart surgery in the USA, we must have the best way of doing things AMIRIGHT?!?!!!!
    Fact is US spends the most on healthcare yet is 28th or so in the world for positive outcomes. Our system is a joke.

  4. #214
    Quote Originally Posted by deadheadskier View Post
    You see the same thing with OR and Radiology equipment. The big house mandates the community hospitals use the same high cost equipment and it's totally unnecessary. UVM, Dartmouth and MaineHealth (the three big players in Northern New England) are all guilty of this. I've seen $90k Anesthesia systems in Critical Access Hospitals in their networks (which only exist because of government subsidies) who would never use all the features available for patient care on even a $25k system. Essentially, there is a massive lack of fiduciary responsibility in the capital planning of our hospitals in this country.


    So, to circle back on the argument that US "capitalism" approach is better than government run healthcare, let's at least become educated first that under our current system, US hospitals don't have to run like an actual business. They're run HORRIBLY because they can. They get bailed out for their inefficiances. If they had to run like a real business, say a ski resort? 75% of hospitals would fold. That's not an exaggeration. And it's not capitalism.

    But, you know who does run healthcare more like a business? All those other Commi nations in the developed world who have more government control over their healthcare industries. They have more bargaining power with the drug manufacturers and tech companies like mine because they're the only customer. They're also often ultimately the only customer paying the providers, so they have maximum leverage over what the providers can charge their patients. It's a massively effective and efficient monopoly that sees these Commis spending only around 10-12% of their GDP on healthcare vs our 18%. And the results are often as good or better for 99.9% of the population.

    But F it! If Mick Jagger gets his heart surgery in the USA, we must have the best way of doing things AMIRIGHT?!?!!!!



    Sent from my XT1635-01 using AlpineZone mobile app
    Let's talk about capitalism a minute because I don't think our healthcare system is particularly capitalistic. As the guy with the flowery language about hitting trees mentioned, the consumer has no idea how much their healthcare will cost before they get it. Therefore, they have no way to determine which provider offers the best value. Clinics seem to be helping to break this mold, but we're far from a price transparent system. Without price transparency, it's very difficult to argue you're dealing with a functioning capitalist industry. Fixing prices is rarely the answer; enabling competition is a much more efficient solution.

    Before we go assuming that more government is the answer, I wanted to highlight that medicine and education costs are rising the fastest of just about any industry I can think of (I could genuinely be missing one though). Government has its hands all over these - medicine is well documented here, and the advent of government baked student debt has fueled skyrocketing education costs. My generation was sold a load of nonsense when we were told it didn't matter what we majored because our education was priceless. Just sign on the dotted line. I notice you cited that government subsidises these smaller offices that run perpetual losses. I have a feeling they've given hospitals perverse inventives to over spend, but that's just a hunch from reading the tea leaves of what you wrote.

    Pharma is a huge issue, too. 100% agree. We subsidize the rest of the world's pharma costs. I don't know how it can get fixed the way our patent laws are set up. I'm no lawyer. Still, I don't see why nationalizing medicine is necessary to achieve pharma remuneration changes.

    Regarding people who point to foreigners coming to America for care. Actions speak louder than words. It's the same concept I brought up about Vail not being bought in on catastrophic climate change. There's a reason why people come to the US for treatment: universality ultimately leads to rationing. It's plenty noble to want care for everyone, but it's not wise to dismiss this simple fact as the misguided utterances of toothless fact-hating conservatives.

    Sent from my VS988 using AlpineZone mobile app
    Ski season is always too short

  5. #215
    Quote Originally Posted by deadheadskier View Post

    But F it! If Mick Jagger gets his heart surgery in the USA, we must have the best way of doing things AMIRIGHT?!?!!!!
    Yes. America has led the world in heart for many decades.

    Specifically, Denton Cooley & Michael Debakey were & still are legends in the field, & their multi-generation padawans have fanned-out across America to the major hospitals in most of the big cities (L.A., Chicago, Boston, NYC, etc...).

    I realize the cool kids bitch about medicine in America, but in general we are at the top or near the top in virtually all disciplines.
    President - Bicknell's Thrush Extermination Solutions (BTES), LLC



  6. #216
    JimG.'s Avatar
    Join Date
    Oct 2004
    Location
    Hopewell Jct., NY
    Posts
    10,544
    Quote Originally Posted by BenedictGomez View Post
    Yes. America has led the world in heart for many decades.

    Specifically, Denton Cooley & Michael Debakey were & still are legends in the field, & their multi-generation padawans have fanned-out across America to the major hospitals in most of the big cities (L.A., Chicago, Boston, NYC, etc...).

    I realize the cool kids bitch about medicine in America, but in general we are at the top or near the top in virtually all disciplines.
    It's a good thing because Americans sure need a lot of heart surgery.

  7. #217
    Yes, the Lamborghini docs reside here

    We're obviously the best! USA!!!! (spoken with Italian accent)



    Sent from my XT1635-01 using AlpineZone mobile app

  8. #218
    Quote Originally Posted by eastern powder baby View Post
    Pharma is a huge issue, too. 100% agree. We subsidize the rest of the world's pharma costs. I don't know how it can get fixed the way our patent laws are set up. I'm no lawyer. Still, I don't see why nationalizing medicine is necessary to achieve pharma remuneration changes.
    If patent laws didn't exist, why would pharma companies bother to invest millions in finding a new drug just so some other company could come along and simply copy it with minimal investment and effort?

    You could apply this same logic if we force pharma companies to charge low rates for drugs. I think the average person has absolutely no idea how much time, money, and effort goes into creating a single new drug. People are quick to say "well it only costs $1 to manufacture drug xyz so why do they charge $100 for it". Meanwhile they completely ignore the cost of the R&D and clinical trials and paperwork to get it discovered and approved in the first place. Who pays for that if we demand lower drug costs? Do we then rely on government grants to fund research? In which case we're now back to everyone paying for the R&D anyway (albeit indirectly so the cost is just part of that big black hole where taxes go).

  9. #219
    BG.....apologies for deleting your post and glad Jim quoted it to preserve it. I was meaning to edit my response and accidentally screwed up deleting both


    In response to your post

    Yes, we have the best Lamborghini docs!

    That's a fair judgment of what's best yes?

    USA!!?!!! (spoken with Italian accent)

    Sent from my XT1635-01 using AlpineZone mobile app

  10. #220
    I have a question for those who'd like universal, government-run healthcare for all. Who exactly, and I mean exactly, is "all"? Would that be citizens only? Would it include illegal aliens? Vermont is far from it, but what might you imagine would be the effect of our porous border with Mexico?

    I ask this because the source of funding for such healthcare (taxes) is finite in a practical sense, whereas needs could be imagined to multiply without end. All systems must have boundaries. Is the left willing to bound the problem in a serious way?

Thread Information

Users Browsing this Thread

There are currently 1 users browsing this thread. (0 members and 1 guests)

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
All times are GMT -5. The time now is 3:01 AM.