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-   -   Spending for health care (http://cellar.org/showthread.php?t=19511)

sugarpop 02-20-2009 05:21 PM
Quote:
Originally Posted by TheMercenary (Post 533479)
Great, you tell us all what it means. Speak for Obama.
Good grief Merc. I have supplied you with links to what his plan looks like. In fact, I got one of them from a link YOU posted (at SMN) to PBR. WTF?

sugarpop 02-20-2009 05:27 PM
Quote:
Originally Posted by classicman (Post 533783)
One thing about computerizing all this data is that the system will probably be hacked at some point and the info manipulated, exploited or sold for profit somehow.
That already happens. I got letter a couple of years ago that my data might have been stolen. And ftr, people can steal data from paper just as easily, in fact probably easier.

sugarpop 02-20-2009 05:30 PM
Quote:
Originally Posted by TheMercenary (Post 533798)
How do you figure that. I speak as an end user of automated record keeping. It has many problems. When I start to see Obama give away money for people to purchase the programs, have them installed, and have them pay for the continual upgrades, fixes, and trouble shooting to interface the way they should, we can talk. Until then they are blowing smoke up everyones skirt.
Maybe they should use MACs instead of Microshit... :lol2:

TheMercenary 02-20-2009 05:33 PM
Quote:
Originally Posted by sugarpop (Post 536901)
Good grief Merc. I have supplied you with links to what his plan looks like. In fact, I got one of them from a link YOU posted (at SMN) to PBR. WTF?
His plans what not been well described, even by him. I have posted what some experts in healthcare were able to tell from the vague plans he put forth. Either way they are going to be VERY expensive. Expensive on a scale which this country has never seen. And now with the Demoncratic Bailout, most likely he will be unable to get one passed, even though he was elected on a platform where he promised affordable health care to all. Where's the beef?

TheMercenary 02-20-2009 05:34 PM
Quote:
Originally Posted by sugarpop (Post 536905)
Maybe they should use MACs instead of Microshit... :lol2:
The computer is not the problem, it's the software.

sugarpop 02-20-2009 05:45 PM
Quote:
Originally Posted by TheMercenary (Post 534144)
Say it brother, this time louder.

The military has gone kicking and screaming into the process. Due to the size and cost of these projects PER HOSPITAL, the money is allocated years before, which means that the purchase is made one year, and implemented sometimes 2 or more years later. Guess what? They don't get the free up grade. We are using Essentris. It is working. Guess what? The year after the bought this program they bought a different one. Next year they take this one out and everyone has to learn the new one. Oh, and Essentris DOES NOT INTERFACE with CHCS except in a very limited way. It does not interface with the outpatient notes program CHCS2 Alta. So now we have three programs that are required to take care of one patient. None of them interface with the monitors. No real time data. Guess what? We use a paper chart for that stuff.

The whole idea that Obama is going to pour money into the health care system and the private system at that is bullcrap. And if he does it is not going to fix it, but it will make a small group of people very very rich. So the private plastic surgery center is going to get free government money to go all electronic with their records? How about the privately owned doctors hospital? How about that 3000 bed inter-city hospital. Does anyone know just how much it would cost to wire up a 3000 bed hospital with computers, laptops, hard wire, training, programs, updates, onsite trainers, IT trouble shooters, etc.? The public is getting smoke blown up its collective skirt.
You keep talking about this making a few people very rich. I thought you were a capitalist? :lol2:

Maybe we need to change the capitalist system, and put a cap on how much individuals at the top can earn. Spread the wealth more evenly throughout the entire corporation and hospitals/doctor's offices. Allow all the people at the companies selling the stuff to make money off of it. Would that make you happy? Then it won't make a few people rich, it will make a lot of people more money than they have now.

(why are my quotes all in italics? *scratches head* Does it always do that?)

sugarpop 02-20-2009 05:57 PM
Quote:
Originally Posted by Flint (Post 535126)
People, here's the reality: you can't even pull up your x-rays from hospital A while you're at hospital B, even if hospital B is right across the street--much less another state. The two simplest reasons that spring to mind are NOT because we haven't invested billions into healthcare IT (because, believe me, we have).

They are: #1 Hospitals view your medial information as proprietary business data. Sure, you can sign a HIPAA form to get the data released, but they sure aren't going to let a BUSINESS COMPETIOR (i.e. another hospital) have free, unfettered access to data that they had to make an investment of time and money generate. To put it simply: HOSPITALS DO NOT WANT TO SHARE YOUR MEDICAL RECORDS. It's not a smart business choice.

And: #2 If the hundred hospitals from this county, and the next, and the next, and the thousands from the next state over, and so on and so forth, wanted to share your medical records... HOW WOULD THEY KNOW WHO YOU ARE? We are still struggling with getting every department WITHIN THE SAME FACILITY to use a common medical record number. It's not that the interoperability standards aren't attempting to deal with this, but what good are these efforts when the technology vendors fight to maintain the proprietray nature of their systems, so that you are compelled not to purchase another brand, lest you have to deal with a costly migration to untangle all the proprietary data you've been storing?

This is just an off-the-cuff rant; but the point is that this kind of thing IS MY JOB. This is what I do every day. There is no magic solution that a few billion dollars or a few hundred billion dollars is going to bring about. The healthcare industry is designed NOT to share data.
Well, hospitals do not technically OWN the data, do they? I mean, someone pays for them, right? (I'm asking, because I don't know. It seems like medical records should really be the property of the person they represent.)

the #2 rant, that just seems wrong, in soooo many ways. And IMHO, that is one of things that is so fucking wrong with this country. Competition and winning, at all costs. It is more to the benefit of society if people would not be so money-oriented. Sharing, anything, is baaaaad now. Why is that?

sugarpop 02-20-2009 05:59 PM
Quote:
Originally Posted by TheMercenary (Post 535146)
Flint, for the last 15 years I have watched the gobberment and large health care companies throw millions into making this work. I have not seen a single one that worked smoothly enough to make me stand back as an end user and say, wow, that really makes my job so much easier. Not one.
And private industry does SO much better at everything. That's why our economy is doing so WELL right now! Private industry! woot!

sugarpop 02-20-2009 06:02 PM
Quote:
Originally Posted by TheMercenary (Post 536907)
The computer is not the problem, it's the software.
EXACTLY!

TheMercenary 02-20-2009 06:03 PM
Quote:
Originally Posted by sugarpop (Post 536910)
You keep talking about this making a few people very rich. I thought you were a capitalist? :lol2:

Maybe we need to change the capitalist system, and put a cap on how much individuals at the top can earn. Spread the wealth more evenly throughout the entire corporation and hospitals/doctor's offices. Allow all the people at the companies selling the stuff to make money off of it. Would that make you happy? Then it won't make a few people rich, it will make a lot of people more money than they have now.

(why are my quotes all in italics? *scratches head* Does it always do that?)
No, see the problem is not that people get rich, the problem is that politicians speak out of both sides of their mouth, and in this case the Dems, who extol this virtue of rescuing the economy is merely, in this case going to make a few people rich with handouts of taxpayers’ money. It is a guise to make the electorate feel good about healthcare spending when in fact they are doing nothing to make healthcare affordable for all with this spending plan. I do support capitalism, where you earn it, not get a handout from the gobberment. Any spending on healthcare in this country will make corps in the back pockets of the Dems very rich, mainly the HMO’s and insurance companies. And in the end the people will get squat. IMHO everyone who voted for Obama because of our healthcare crisis is going to sorely disappointed.

TheMercenary 02-20-2009 06:04 PM
Quote:
Originally Posted by sugarpop (Post 536913)
And private industry does SO much better at everything. That's why our economy is doing so WELL right now! Private industry! woot!
I promise you, big gobberment is not the answer. Talk about a long sorid history of totally screwing things up. You should know that better than anyone. :D

sugarpop 02-20-2009 06:14 PM
Quote:
Originally Posted by TheMercenary (Post 536918)
No, see the problem is not that people get rich, the problem is that politicians speak out of both sides of their mouth, and in this case the Dems, who extol this virtue of rescuing the economy is merely, in this case going to make a few people rich with handouts of taxpayers’ money. It is a guise to make the electorate feel good about healthcare spending when in fact they are doing nothing to make healthcare affordable for all with this spending plan. I do support capitalism, where you earn it, not get a handout from the gobberment. Any spending on healthcare in this country will make corps in the back pockets of the Dems very rich, mainly the HMO’s and insurance companies. And in the end the people will get squat. IMHO everyone who voted for Obama because of our healthcare crisis is going to sorely disappointed.
Well IMHO, the government should tell people how much they will pay them for stuff, not the other way around. In my reasoning, that is part of the reason why some things cost so damn much now. The government hands out a contract, then the contractor goes over (I think on purpose, because you know how cynical I am when it comes to business), so they make more money, a LOT more. That shouldn't happen. If they go over, they should have to eat it.

I recently heard something on PBR about a nuclear power plant that was supposed to be built. Initially, the cost was, like, 300 million or something (I don't remember exactly). Now the cost has more than tripled. WTF? How exactly does that happen?

Happy Monkey 02-20-2009 06:27 PM
Business and government both have long histories of screwing things up. They also have long histories of doing things well.

One thing I'm not sure is up business' alley is defining a standard format for medical records. Everyone who contributes will want their own proprietary stuff to be part of the standard, and won't want to pay for anyone else's. Most of the truly interoperable file formats came from government or (often government-funded) academia.

I would think that one of the best things the government could do about medical records would be to have NIST come out with a standard, non-proprietarty format, require that all doctors and hospitals be able to at least export to and import from that format, and put the funding towards that effort.

Happy Monkey 02-20-2009 06:30 PM
Quote:
Originally Posted by sugarpop (Post 536926)
I recently heard something on PBR about a nuclear power plant that was supposed to be built. Initially, the cost was, like, 300 million or something (I don't remember exactly). Now the cost has more than tripled. WTF? How exactly does that happen?
Never attribute to malice what can be accounted for by malice and incompetence.

While they may have had no problem padding the cost, there's a good chance that they also woefully underbid the project in the first place.

TGRR 02-20-2009 07:39 PM
Quote:
Originally Posted by TheMercenary (Post 536919)
I promise you, big gobberment is not the answer. Talk about a long sorid history of totally screwing things up. You should know that better than anyone. :D
Big business isn't the answer, either.

Join us, Comrade...don't be afraid...

classicman 02-21-2009 01:19 AM
Quote:
Originally Posted by sugarpop (Post 536910)
Maybe we need to change the capitalist system, and put a cap on how much individuals at the top can earn. Spread the wealth more evenly throughout the entire corporation and hospitals/doctor's offices. Allow all the people at the companies selling the stuff to make money off of it. Would that make you happy? Then it won't make a few people rich, it will make a lot of people more money than they have now.
Whats that share the wealth philosophy called again? Everyone gets a share of everything....? Damn it sounds familiar. social something?

xoxoxoBruce 02-21-2009 02:33 AM
Quote:
Originally Posted by sugarpop (Post 536926)
I recently heard something on PBR about a nuclear power plant that was supposed to be built. Initially, the cost was, like, 300 million or something (I don't remember exactly). Now the cost has more than tripled. WTF? How exactly does that happen?
Quote:
Originally Posted by Happy Monkey (Post 536933)
While they may have had no problem padding the cost, there's a good chance that they also woefully underbid the project in the first place.
Nukes take many years to get from "lets build it", to bring it on line. During the entire process the regulatory powers are constantly changing the rules. Even after the final plan has all the necessary approvals and construction begins, they keep changing the rules, in many cases requiring the contractor to rip out work completed to accommodate those changes or redesign things that hook to the changes.

This has been the rule, with no exceptions, since they've been building them.

France has been successful with nukes by standardizing one design and let them build as many as they wanted, all alike. That way you know what you're building and how much it will cost, up front.

sugarpop 02-21-2009 10:05 PM
Quote:
Originally Posted by sugarpop
I recently heard something on PBR about a nuclear power plant that was supposed to be built. Initially, the cost was, like, 300 million or something (I don't remember exactly). Now the cost has more than tripled. WTF? How exactly does that happen?
Quote:
Originally Posted by Happy Monkey (Post 536933)
Never attribute to malice what can be accounted for by malice and incompetence.

While they may have had no problem padding the cost, there's a good chance that they also woefully underbid the project in the first place.
And if they underbid, they should have to eat that as well. Purposely underbidding a project when you know you will later jack up the price is unethical and immoral, and we really need to get rid of that mindset and practice, don't you think?

sugarpop 02-21-2009 10:07 PM
Quote:
Originally Posted by xoxoxoBruce (Post 537078)
Nukes take many years to get from "lets build it", to bring it on line. During the entire process the regulatory powers are constantly changing the rules. Even after the final plan has all the necessary approvals and construction begins, they keep changing the rules, in many cases requiring the contractor to rip out work completed to accommodate those changes or redesign things that hook to the changes.

This has been the rule, with no exceptions, since they've been building them.

France has been successful with nukes by standardizing one design and let them build as many as they wanted, all alike. That way you know what you're building and how much it will cost, up front.
Then maybe we should follow their example. Oh wait! We can't! We hate the French! :rolleyes:

sugarpop 02-21-2009 10:08 PM
Quote:
Originally Posted by classicman (Post 537061)
Whats that share the wealth philosophy called again? Everyone gets a share of everything....? Damn it sounds familiar. social something?
WTF? You are OK with socialism for corporations and rich people, but not for anyone else? Damn classic. Please, read some David Cay Johnston.

xoxoxoBruce 02-21-2009 10:10 PM
There is still the problem of nuke waste, where to store it.

Of course we couldn't put it where we did all those bomb tests, and won't be safe for a million years anyway. :rolleyes:

sugarpop 02-21-2009 10:44 PM
I would rather spend the money on alternative, green technologies than on nuclear power plants. It takes too long to build them, and there is a very real risk that goes along with it. Plus, it's way expensive to build them. I think developing newer, cleaner technologies will help create a LOT more jobs (even an industry boom, much like the computer boom), can be executed a LOT faster, and the risk is negligible.

TGRR 02-21-2009 11:32 PM
Quote:
Originally Posted by xoxoxoBruce (Post 537369)
There is still the problem of nuke waste, where to store it.

Of course we couldn't put it where we did all those bomb tests, and won't be safe for a million years anyway. :rolleyes:
You mix it with sand, fuse the sand into glass, and store it in caves in the Arizona mountains.

End of fucking story.

Problem is, once they agree on a place, half of the NRC has worked itself out of a job...so they'll keep putting it in 25 year barrels and stacking them up.

TGRR 02-21-2009 11:33 PM
Quote:
Originally Posted by sugarpop (Post 537384)
I would rather spend the money on alternative, green technologies than on nuclear power plants.
Like solar? You know, where the process used to make the panels creates a shitload of horrible chemicals?

classicman 02-22-2009 05:47 PM
Quote:
Originally Posted by sugarpop (Post 537368)
WTF? You are OK with socialism for corporations and rich people, but not for anyone else?
Nope - I'm not ok with that either - not at all.


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