Comments on: Hope Was Never a Strategy

By: Scott

Scott — Mon, 30 Mar 2009 08:23:11 +0000

Sorry to inject the facts IRT the Johnson Controls story, but, according to Bloomberg, "most of the plants will be in Europe." So much for the knee jerk Republican bashing.

By: Scott

Scott — Mon, 30 Mar 2009 08:01:13 +0000

I think you understood quite well. The easiest thing to do is the intellectually dishonest thing — criticize, without a modicum of understanding the competing pressures that lead to decisions you don’t agree with. Just like the JOs that don’t understand cuts in flight hour programs, many in a hospital don’t understand cuts in Medicaid reimbursement rates, insurance reimbursement rates, etc. The laziest road is to criticize those closest to them — when they are just the ones that have to balance all of the competing forces, to keep the doors open so the the enterprise can deliver quality care. The focus on that care isn’t the exclusive province of those on the front lines, no matter how much they may think so. They just have the luxury of ignoring all of the other forces.

By: Skippy-san

Skippy-san — Mon, 30 Mar 2009 02:51:38 +0000

I’m not sure what you mean about potshotting-but my sister feels strongly about her profession as a nurse. And she has been at it for over 35 years, all around the country. She works at a large hospital now and is pretty fried with some of the things they are doing. I don’t know all the details-but she can get pretty strident about it if the subject comes up. FWIW she is more conservative than I am-except when it comes to health care. She is adamant that the country needs a change in its health care system.

I don’t think your Navy analogy holds much water-unless you are of the school that JO’s don’t have any gems of truth worth listening to tucked inside their whining. All I know is I could not work in an ER like she does.

Seems to me though-there are several different issues in your comments here, not just one. Insurance is one, hospital profit margins is another, and uninsured patients who don’t have insurance is another.

By: virgil xenophon

virgil xenophon — Mon, 30 Mar 2009 02:19:14 +0000

Scott:

Hope you didn’t think my comment about “3rd rate administrators” was directed against not only your wife–or even most civilian administrators whom, although obviously I have my criticisms, I full well realize are certainly under the range of pressures you describe. I was thinking more of the bureaucrats to come that I see on the horizon with Nationalization. Sorry If I didn’t make myself clearer.

By: Scott

Scott — Mon, 30 Mar 2009 02:07:18 +0000

yea, kinda like how JGs can always give you an earful about the CO screwing them out of flight time. Hospitals are incredibly complex organizations to run. I didn’t have any idea, until I started hearing about an hours worth every night. Delivering quality care is important, but so is making a profit. That profit is what pays for indigent care, builds new operating suites, and a thousand other needs. It is incredibly competitive, under constant downward revenue pressures, for all payers — gov’t, third party, you name it. And a patient population that expects the moon, and wants someone else to pay for it. Every patient that shows up at the ER with a headache wants a CAT scan, even if their PPO won’t pay — and will never blame their crappy PPO — will blame the hospital (often, abetted by the care giver — one doc recently admitted a Medicaid patient, scheduled them for surgery that the state had already refused to pay for, and was livid that the hospital wouldn’t do it for free). You want stuff not fit for tender ears? How about the insurance company that is owned by a near monopoly hospital chain, and refuses to pay for procedures at a competing hospital, even when the surgical team is the only local one trained in them. Will pay at an out of town hospital, but not at the one that competes with their corporate bosses.

Skippy, if you sister wants to do something constructive, then she can get to work ridding her profession from the sizable number of toxic nurses. Sorry for thread hijacking, but this potshotting, based in incomplete knowledge, is off putting.

By: Skippy-san

Skippy-san — Mon, 30 Mar 2009 01:07:43 +0000

My sister is a trauma nurse and she could give you an earful about hospital administration-most of it not fit for tender ears.