Spending for health care

[Flint]

Your medical treatments will be tracked electronically by a federal system.

This is light-years from practical implementation. And I say that as a person working on the front lines of integrating healthcare IT systems--I'm a PACS admin, I work under the IHE umbrella of interoperability standards such as DICOM and HL7 (which are poorly implemented by vendors who see propietary functionality as leverage against their competitors, and frankly, the customer having control of their own data). Healthcare IT is struggling to progress past the dark ages.

[TheMercenary]

Originally Posted by Flint

Healthcare IT is struggling to progress past the dark ages.

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.

[Flint]

Originally Posted by TheMercenary

How about the privately owned doctors hospital?

That's me. And I'll tell you. The big healthcare IT vendors are not structured to support implementations at smaller, rural facilities such as ourselves. The problem is that the basic infrastructure of a "paperless" hospital is NOT SCALABLE. (Because of the small size and lower volume of our facility, our resources in the IT department are very limited. However, we still have to build all the same systems and interfaces etc. as the larger facilities--which the big vendors are "tuned" to.)

This doesn't even approach the real issue: that the vendors approach the established standards of interoperability as a set of very loose suggestions, that they skirt or downright ignore at their discretion.

Throwing money at this problem isn't going to fix a broken industry. The solution will only come when the vendors adhere to the interoperability standards THAT ALREADY EXIST AND HAVE BEEN PROVEN TO WORK IF IMPLEMENTED PROPERLY.

Until that time, you will continue to need high-paid guys such as myself to stitch your disparate systems together.

[sugarpop]

Originally Posted by TheMercenary

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?

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?)

[TheMercenary]

Originally Posted by sugarpop

You keep talking about this making a few people very rich. I thought you were a capitalist?

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.

[sugarpop]

Originally Posted by TheMercenary

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]

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?

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.

[sugarpop]

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?

Originally Posted by Happy Monkey

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?

[classicman]

Originally Posted by sugarpop

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]

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?

Originally Posted by Happy Monkey

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]

Originally Posted by xoxoxoBruce

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!

[xoxoxoBruce]

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.

[sugarpop]

Originally Posted by classicman

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.

[classicman]

Originally Posted by sugarpop

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.