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- McAllen, Texas and the high cost of health care : The New Yorker 1 day ago
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McAllen, Texas and the high cost of health care : The New Yorker on 2009-12-25
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“Any plan that relies on the sheep to negotiate with the wolves is doomed to
failure.” -
When I was in Tulsa a few months ago, a fellow-surgeon explained how he had made
up for lost revenue by shifting his operations for well-insured patients to a
specialty hospital that he partially owned while keeping his poor and uninsured
patients at a nonprofit hospital in town.
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McAllen, Texas and the high cost of health care : The New Yorker on 2009-12-25
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it created what Elliott Fisher, of Dartmouth, calls an accountable-care
organization. -
As economists have often pointed out, we pay doctors for quantity, not quality.
As they point out less often, we also pay them as individuals, rather than as
members of a team working together for their patients. Both practices have made
for serious problems. - 3 more annotations...
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McAllen, Texas and the high cost of health care : The New Yorker on 2009-12-25
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Powell suspects that anchor tenants play a similarly powerful community role in
other areas of economics, too, and health care may be no exception -
Agencies that want to compete on quality struggle to remain in business, the rep
said. Doctors have asked her for a medical-director salary of four or five
thousand dollars a month in return for sending her business. One asked a
colleague of hers for private-school tuition for his child; another wanted sex - 2 more annotations...
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McAllen, Texas and the high cost of health care : The New Yorker on 2009-12-25
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They were innovative and aggressive in finding ways to increase revenues from
patient care. “ -
They instruct their secretary to have patients who call with follow-up questions
schedule an appointment, because insurers don’t pay for phone calls, only office
visits. They consider providing Botox injections for cash. They take a Doppler
ultrasound course, buy a machine, and start doing their patients’ scans
themselves, so that the insurance payments go to them rather than to the
hospital. They figure out ways to increase their high-margin work and decrease
their low-margin work. This is a business, after all. - 1 more annotations...
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McAllen, Texas and the high cost of health care : The New Yorker on 2009-12-25
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They found that patients in higher-spending regions received sixty per cent more
care than elsewhere. They got more frequent tests and procedures, more visits
with specialists, and more frequent admission to hospitals. Yet they did no
better than other patients, whether this was measured in terms of survival,
their ability to function, or satisfaction with the care they received. If
anything, they seemed to do worse.
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- El Alto Costo De Tics En Colombia - Archivo - Archivo digital eltiempo.com on 2009-12-22
- Contratos de estabilidad jurídica: asegurando frente a riesgo cierto (opinión) - Portafolio.com.co on 2009-12-22
- CECODES: Boletín Junio: Grandes empresas, a salvo de impuesto al patrimonio por tener contratos de estabilidad jurídica on 2009-12-22
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A Strategy for American Innovation: Driving Towards Sustainable Growth and Quality Jobs | The White House on 2009-12-08
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But historical experience in this country and others clearly indicates that
governments who try to pick winners and drive growth too often end up wasting
resources and stifling rather than promoting innovation. This is in part due to
the limited ability of the government to predict the future, but also because
such exercises are distorted by lobbyists and rent seekers, which are more
likely to favor backward looking industries than forward looking ones. In the
United States such failures at picking winners and losers includes most
prominently the Synthetic Fuel Corporation, a $20 billion Federal project in the
1980s that failed to provide the promised alternative to oil. -
Therefore, we reject both sides of this unproductive and anachronistic
debate. The true choice in innovation is not between government and no
government, but about the right type of government involvement in support of
innovation. A modern, practical approach recognizes both the need for
fundamental support and the hazards of overzealous government intervention. The
government should make sure individuals and businesses have the tools and
support to take risks and innovate, but should not dictate what risks they
take.We propose to strike a balance by investing in the building blocks that only
the government can provide, setting an open and competitive environment for
businesses and individuals to experiment and grow, and by providing extra
catalysts to jumpstart innovation in sectors of national importance. In this
way, we will harness the inherent ingenuity of the American people and a dynamic
private sector to generate innovations that help ensure the next expansion is
more solid, broad-based, and beneficial than previous ones.
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