And so it begins.

[Matt1970]

I get it, "to everyone by their need, from everyone by their ability."
It's interesting position for conservatives to take when opposing "Socialist Takeover of Medicine." But seeing how, day after day, Obamacare makes Republicans do backflips to oppose it, I can't say I am too surprised.

You have the quote wrong first off. And second, which sounds more Marxist? Dealing with what actually may be going wrong with these hospitals on an individual basis, or the one size fits all financial punishment?

 

[fskimospy]

You have the quote wrong first off. And second, which sounds more Marxist? Dealing with what actually may be going wrong with these hospitals on an individual basis, or the one size fits all financial punishment?

Just to be clear, paying all hospitals the same regardless of performance is way more Marxist.

I for one am amazed to see all the conservatives coming out as closet commies. Apparently all Obama has to do in order to make you all abandon your principles is simple endorse one of them.

 

[fskimospy]

Nobody but you is arguing "for the government to pay the same (or even more!) to hospitals that deliver a poor product."

The real issue is whether this is the best way to combat the problem of infections.

I don't know the details of this rule, but what happens the (small) 1% reduction?

If the answer is nothing, doesn't that indicate the govt is then content to allow this problem continue as long as it keeps the 1%?

If that's the case, can it truly be said that this rule is about fixing the problem? Or, is it just one of several 'revenue' measures inserted to make Obamacare look better in the CBO cost projections. You know, like 1099's required for everybody for everything (thankfully repealed), the tax on medical equipment (WTH is that about?) and the tax on gold plated plans (the 'let's encourage less coverage while we're encouraging more coverage' thingy).

And are we to believe that this issue is not already covered by state and fed regulations? That until this 1% reduction was enacted no rules covered excessive infections? I don't believe that. I think we should just fix the already existing regulations.

Oh, looks like states DO alreay regulate this:



Yup, starting to look more like a revenue measure than an honest attempt to fix the problem. Uncle Sugar wants his cut I suppose.

Oh look, the fed govt already doesn't have to pay for unnecessary costs such as avoidable complications from infections:



http://kaiserhealthnews.org/news/me...ls-with-highest-rates-of-infections-injuries/

These are two existing financial penalties I found quickly. May well be more, such as higher insurance rates for the hospitals. Hey feds, keep trying the same thing over and over, maybe you'll get a different result, huh?

Looks like low hanging fruit alright - for Obamacare finances.

Fern

Maryland, for example, instituted a similar policy to this in 2012 despite Medicare and Medicaid already having the policies you're talking about in place. It had a significant impact on hospital acquired infections.

So was Maryland just all about their budget and not about improving things too, despite the fact that it substantially improved things? Or does this logic only apply to the Hated Obamacare?

You're trying really hard to convince yourself to hate something that in any other situation you would support.

 

[theeedude]

You have the quote wrong first off. And second, which sounds more Marxist? Dealing with what actually may be going wrong with these hospitals on an individual basis, or the one size fits all financial punishment?

Medicare is an insurance plan. It doesn't run those hospitals on individual basis.
It can pay more for better care to create incentives to improve. Or pay same for good care and crappy care, as you are proposing.

 

[Hayabusa Rider]

So you don't believe in accountability for hospitals, and think the government should not pay even 1% less for worse care.
Do you also pay exactly same for expired food likely to make you sick as you would for fresh food?

I thought so. You didn't even think about what I said other than how to weasel out of answering. You aren't stupid so you are being duplicitous. You are the man who if a fire in time in your community would be blaming the firefighters if they were cut so they didn't have enough manpower due to funding cuts. Sent them to jail! That's accountability! Well, lets just cut their firehouse funding and show them! Do you like your firefighter grilled, homestyle, spicy, or extra crispy?

 

[Hayabusa Rider]

Medicare is an insurance plan. It doesn't run those hospitals on individual basis.
It can pay more for better care to create incentives to improve. Or pay same for good care and crappy care, as you are proposing.

So the government is too stupid to come up with better ways to do this. They are clueless and so had better take over everything so the whole system will be as much of a cluster as possible. Thanks for that.

 

[brycejones]

So the government is too stupid to come up with better ways to do this. They are clueless and so had better take over everything so the whole system will be as much of a cluster as possible. Thanks for that.

lol wut?!?!?

 

[fskimospy]

I thought so. You didn't even think about what I said other than how to weasel out of answering. You aren't stupid so you are being duplicitous. You are the man who if a fire in time in your community would be blaming the firefighters if they were cut so they didn't have enough manpower due to funding cuts. Sent them to jail! That's accountability! Well, lets just cut their firehouse funding and show them! Do you like your firefighter grilled, homestyle, spicy, or extra crispy?

Can you or anyone else here address the empirical evidence I linked earlier that showed this sort of policy was successful in reducing hospital acquired infections?

 

[Hayabusa Rider]

Can you or anyone else here address the empirical evidence I linked earlier that showed this sort of policy was successful in reducing hospital acquired infections?

Did I say that fines or other monetary sanctions never worked? Did I once say in this thread they were never justified?

 

[Hayabusa Rider]

lol wut?!?!?

I suggest you read the exchanges between the poster I quoted and myself. If the way to fix things in all cases is to cut funding (and it is the principle, not the percent which is at issue) then it translates elsewhere. If there aren't enough firefighters or equipment and there is a major fire then his solution would be to cut funding to firefighting. If that's the best the government running things can come up with than they are idiots. If on the other hand those people at the firehouse aren't doing their jobs and they do have enough staff then that's another matter. In any case I would expect an investigation to determine cause and effect and where the blame lies. Senseamp is against that. Are you too?

 

[theeedude]

So the government is too stupid to come up with better ways to do this. They are clueless and so had better take over everything so the whole system will be as much of a cluster as possible. Thanks for that.

Paying more for better service is the better way of doing it.
You are clueless, they didn't have to take over any hospital, they just created incentives for hospitals to improve themselves. That's how insurer should act in a capitalist system. None of this same pay for crappy service that you are peddling. That's some commie BS, go push it somewhere else.

 

[fskimospy]

Did I say that fines or other monetary sanctions never worked? Did I once say in this thread they were never justified?

No, but you seem to be arguing that it has a significant potential for adverse effects. The data that's available so far seems to indicate a strongly positive effect. Far from it being 'stupid', it appears to be quite successful.

If you want to argue that you could craft a policy that's even more successful that's fine, but that's hardly a reason to not implement this.

 

[Hayabusa Rider]

Paying more for better service is the better way of doing it.
You are clueless, they didn't have to take over any hospital, they just created incentives for hospitals to improve themselves. That's how insurer should act in a capitalist system. None of this same pay for crappy service that you are peddling. That's some commie BS, go push it somewhere else.

You aren't paying more. You are paying the same or less. Clueless you are not, that I could more easily let go. You embrace thoughtlessness and bureaucracy rather than informed action based on knowledge of a particular event because you must defend the cause of ignorance, which you do embrace. When an airplane crashes there is an investigation into cause. Well hell, why do that commie thing. Tax the airplane manufacturers or cut their military contract budgets. That will learn em! Anyone who proposed that an aircraft crash not be investigated before action taken, whether it's informative or in the form of sanctions of some type, or remedial by informed and planned action would be laughed at, and rightly so. Yet when a situation arises you are dead set against understanding the causes behind a particular situation. As Fern already has pointed out there are punitive measures that already exists, and as I have already said before your bizarre analogy to outdated food on shelves, I do agree that some financial penalty CAN be appropriate IF THE PARTICULAR CIRCUMSTANCES WARRANT. My question you dodge if the causal relationship to whatever problem is taken into account and APPROPRIATE ACTION taken, which might not be cuts, no more than cutting fire station funding would be in all cases.

But you know that's not the case, don't you? That's why you are trying your traditional tactics.

 

[DrPizza]

Hire more nurses, and these problems decrease.

Simple solution. More nurses = better care.

But, is better care really worth it?

That might mean slightly less profits for shareholders and administrators, and that's just a slippery slope to socialism, comrades.

Yes, when hospitals face a financial penalty for having excessive hospital acquired infections, they tend to work to lessen those, which saves money because we don't have to treat those hospital acquired infections.

This is econ 101. Guess you skipped that class, huh.

I will remember next time you complain about government spending that you were against even attempting to give hospitals an incentive to cut down on waste. Like I said, it's the Hated Obamacare so you have to be against it. It's a culture war thing.

I guess I disagree with Hayabusa to a degree, and to a little extent, Nickqt (though I do think that care could be improved with better staffing, but that doesn't mean many problem cannot be solved without a change in staffing.) I can give a specific example - hospital acquired bed sores - not being paid for. Hospitals eat the cost of the care. One local hospital made a ton of changes, mattress changes, etc., and dropped the rate of hospital acquired bed sores to almost nothing. Further, there was better training for the nurses who were trained to look even closer for bed sores upon admission to the hospital. Thus, more cases were spotted sooner, and were treated (with compensation) before they got worse. The investment to prevent problems cost far, far less than the cost of treatment. E.g., wound vacs (put a wound under a slight vacuum or something or other) cost 10's of thousands of dollars. 100 better mattresses cost a hell of a lot less than 1 stupid little machine that can only serve one patient at a time, let alone the staffing for care of the wounds.

I disagree with some of the other cuts - e.g., readmissions after heart problems. Unless I'm mistaken, and I don't think I am, if a hospital has a patient who is in for a heart attack, and after discharging that patient, they're readmitted within x-number of days, their subsequent care isn't covered. The way it was explained to me was, if they get hit by a car crossing the road on their way home, and are readmitted, the hospital eats the cost. This seems stupid, and I can only hope it's from someone who misheard something; but that person sits in on meeting covering such day after day, so I suspect they're at least semi-accurate (or I wouldn't have bothered mentioning it.)

 

[theeedude]

You aren't paying more. You are paying the same or less. Clueless you are not, that I could more easily let go. You embrace thoughtlessness and bureaucracy rather than informed action based on knowledge of a particular event because you must defend the cause of ignorance, which you do embrace. When an airplane crashes there is an investigation into cause. Well hell, why do that commie thing. Tax the airplane manufacturers or cut their military contract budgets. That will learn em! Anyone who proposed that an aircraft crash not be investigated before action taken, whether it's informative or in the form of sanctions of some type, or remedial by informed and planned action would be laughed at, and rightly so. Yet when a situation arises you are dead set against understanding the causes behind a particular situation. As Fern already has pointed out there are punitive measures that already exists, and as I have already said before your bizarre analogy to outdated food on shelves, I do agree that some financial penalty CAN be appropriate IF THE PARTICULAR CIRCUMSTANCES WARRANT. My question you dodge if the causal relationship to whatever problem is taken into account and APPROPRIATE ACTION taken, which might not be cuts, no more than cutting fire station funding would be in all cases.

But you know that's not the case, don't you? That's why you are trying your traditional tactics.

OK, commie, I will explain it to you again, slowly.
Lower quality service that endangers patients should be paid less than high quality service, in a capitalist system. Insurer shouldn't have to pay the cost from preventable complications without passing some of that cost to the hospital that is causing those complications, in a capitalist system. That 1% creates a financial incentive to address shortcomings that lead to these complications, in a capitalist system. I don't know how they do things in your commie country, but that's how things are done, in a capitalist system.

 

[Hayabusa Rider]

No, but you seem to be arguing that it has a significant potential for adverse effects. The data that's available so far seems to indicate a strongly positive effect. Far from it being 'stupid', it appears to be quite successful.

If you want to argue that you could craft a policy that's even more successful that's fine, but that's hardly a reason to not implement this.

It's a reason not to be happy with using a blanket solution to individual cases to improve real care. Statistically you and I should be dead, or at least myself. Statistically they shouldn't have spent the money to try. Enact a blanket policy to triage and not save someone like me who comes into the ER. Think if the money it would save. The statistics are there. Just cut hospital reimbursements for those who try.

That is a dramatic example of a real life application of the same thought process. Go with what statistically works. Sorry, but it's not good enough. If the policy were to be that if an institution were to be found negligent (and like I said hospital accreditation and outside review processes exist) then a financial punishment is warranted as an incentive.

If on the other hand there are circumstances where there are financial problems which lead to staffing shortages then depending on particulars there is no punishment. Hopefully someone would be clever enough to realize if they've gotten that many neurons to work so far that perhaps more money channelled towards improvements to improve treatment would be a better solution.

That took how many words to type out and those who came up with this 1 percenter idea weren't clever enough to consider realities ahead of bureaucratic and regulatory "one size solutions is all you are going to get"?

What fool would want that mentality running their health needs?

 

[Hayabusa Rider]

OK, commie, I will explain it to you again, slowly.
Lower quality service that endangers patients should be paid less than high quality service, in a capitalist system. Insurer shouldn't have to pay the cost from preventable complications without passing some of that cost to the hospital that is causing those complications, in a capitalist system. That 1% creates a financial incentive to address shortcomings that lead to these complications, in a capitalist system. I don't know how they do things in your commie country, but that's how things are done, in a capitalist system.

Wow, you did get beat harder than I thought. So tell me about this capitalist thing called the Federal Government? It's they who would cut reimbursements.

Is your house on fire yet? Keep a nose out for smoke.

 

[fskimospy]

It's a reason not to be happy with using a blanket solution to individual cases to improve real care. Statistically you and I should be dead, or at least myself. Statistically they shouldn't have spent the money to try. Enact a blanket policy to triage and not save someone like me who comes into the ER. Think if the money it would save. The statistics are there. Just cut hospital reimbursements for those who try.

Statistically they shouldn't have spent the money to try why? Cut reimbursements how? For performing authorized procedures? I'm not following. This is about hospital negligence.

Regardless, I am a huge supporter of a more critical evaluation of what makes sense to treat and how.

That is a dramatic example of a real life application of the same thought process. Go with what statistically works. Sorry, but it's not good enough. If the policy were to be that if an institution were to be found negligent (and like I said hospital accreditation and outside review processes exist) then a financial punishment is warranted as an incentive.

If on the other hand there are circumstances where there are financial problems which lead to staffing shortages then depending on particulars there is no punishment. Hopefully someone would be clever enough to realize if they've gotten that many neurons to work so far that perhaps more money channelled towards improvements to improve treatment would be a better solution.

That took how many words to type out and those who came up with this 1 percenter idea weren't clever enough to consider realities ahead of bureaucratic and regulatory "one size solutions is all you are going to get"?

What fool would want that mentality running their health needs?

This guy, for one. If the goal is to reduce the number of hospital acquired infections and we have a policy that through slight prodding is able to reduce them by 15% we are not only doing the taxpayers a huge favor, but the patients of those hospitals a huge favor.

 

[theeedude]

Wow, you did get beat harder than I thought. So tell me about this capitalist thing called the Federal Government? It's they who would cut reimbursements.

OK, Ural Rider, I will explain to you how things are done outside of CCCP. Government can also be a market player, and create incentives, in a capitalist system. In this case, government is acting as an insurer. Not hospital administrator, mind you, as an insurer. It is not their job to write performance improvement plans for hospitals, that's their administrator's job. If your hospital has high rates of preventable complications, don't expect to be paid same as one that doesn't. Want to get paid 100%, improve. That is all.

 

[Hayabusa Rider]

Statistically they shouldn't have spent the money to try why? Cut reimbursements how? For performing authorized procedures? I'm not following. This is about hospital negligence.

Regardless, I am a huge supporter of a more critical evaluation of what makes sense to treat and how.



This guy, for one. If the goal is to reduce the number of hospital acquired infections and we have a policy that through slight prodding is able to reduce them by 15% we are not only doing the taxpayers a huge favor, but the patients of those hospitals a huge favor.

I don't know how to make this clearer. When there is negligence due to things like hand washing that is one thing. If on the other there is not sufficient staff so that everyone is running around with no time to do everything which is required things aren't going to function well. The remedies required are more than pronouncing punishment. Until one knows why things are you cannot properly address the issue in an intelligent way. You are arguing against understanding in favor of mindless regulation because.. you are. It may get things most times, but it doesn't replace thought and solutions which are appropriate to resolving the issue globally. Why are you so devoted to regulation above informed action?

 

[Hayabusa Rider]

OK, Ural Rider, I will explain to you how things are done outside of CCCP. Government can also be a market player, and create incentives, in a capitalist system. In this case, government is acting as an insurer. Not hospital administrator, mind you, as an insurer. It is not their job to write performance improvement plans for hospitals, that's their administrator's job. If your hospital has high rates of preventable complications, don't expect to be paid same as one that doesn't. Want to get paid 100%, improve. That is all.

The government, Comrade? Stalin, you live!

I'm done mocking you for now and I'll let you continue in your Palinesque style.

 

[cbrunny]

Hire more nurses, and these problems decrease.

Simple solution. More nurses = better care.

But, is better care really worth it?

That might mean slightly less profits for shareholders and administrators, and that's just a slippery slope to socialism, comrades.

Hospitals with shareholders... now that's where the problem really begins.

 

[theeedude]

The government, Comrade? Stalin, you live!

I'm done mocking you for now and I'll let you continue in your Palinesque style.

Sorry, just sick of commies trying to ruin this country.

 

[fskimospy]

I don't know how to make this clearer. When there is negligence due to things like hand washing that is one thing. If on the other there is not sufficient staff so that everyone is running around with no time to do everything which is required things aren't going to function well. The remedies required are more than pronouncing punishment. Until one knows why things are you cannot properly address the issue in an intelligent way. You are arguing against understanding in favor of mindless regulation because.. you are. It may get things most times, but it doesn't replace thought and solutions which are appropriate to resolving the issue globally. Why are you so devoted to regulation above informed action?

I'm not arguing against understanding in favor of mindless regulation, I'm arguing for regulation that is easy to implement and is proven to be effective.

All the things you're talking about would require a much greater investment in staff, time, etc. It might be worth it, it might not. I'm certainly willing to entertain other solutions but literally nothing about them would dissuade me from implementing regulations such as these with a proven track record.

Much like with the ACA as a whole, you are using the perfect as the enemy of the good. No thanks.

 

[cbrunny]

Sorry, just sick of commies trying to ruin this country.

Spoken like somebody that has no idea what a communist is.