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Saturday, February 11, 2017

A primary characteristic of any authoritarian situation, from East Germany to high school, is the total uselessness of facts and evidence as a defense against anything. Trump is in the White House because he and his people understood this from the start. His movement isn't about facts. All that matters to his followers is that blame stays fixed in the right direction. While Trump's new staff spent the first few weeks tearing apart presidential tradition like a troop of apes let loose in the Louvre, progressives spent their energy pushing news outlets like The New York Times and CNN to begin using words like "lie" in headlines, as if this were somehow going to be a game-changer. When the Times finally began doing just that in its coverage of President Trump ("Trump Repeats Lie About Popular Vote in Meeting With Lawmakers" was the paper's proud January 23rd formulation), a parade of self-congratulation ensued. read more


WASHINGTON – A handful of lawmakers is again making attempts to open 24 new Department of Veterans Affairs facilities across the country, some of which have been held up by Congress for two years.

The VA must receive congressional approval to lease medical facilities with annual rent payments totaling more than $1 million, according to federal law. Combined, the 24 facilities – most of them outpatient clinics -- would cost about $228 million during the leases, which in some cases can last 20 years.

Congress has not approved a medical facility lease for the VA since 2014, said the office of Sen. Mark Warner, D-Va.

Warner and Sen. Susan Collins, R-Maine, reintroduced legislation that would give the VA the go-ahead to open the clinics. Rep. Julia Brownley, D-Calif., reintroduced a similar measure in the House. read more


Only 36 percent of Americans can name the three branches of government
www.washingtonpost.com

One-Third Don't Know Obamacare and Affordable Care Act Are the Same
www.nytimes.com

Are Americans as stupid as foreigners seem to think we are?
www.charlotteobserver.com read more


Monday, February 06, 2017

TechCrunch: Good riddance to one of the worst places to socialize on the internet. Amazon-owned IMDb announced today it will be closing down its discussion board later this month, and turning off the ability for users to private message each other. The company claimed the decision was made because the boards were "no longer providing a positive, useful experience for the vast majority of our more than 250 million monthly users worldwide." ... Instead, the boards were notoriously known for hosting some of the most pointless and hateful commentary around. They've been compared, in many cases, to YouTube's sort of unfettered brand of internet commentary -- which is another way of saying, these boards were full of trolling. ... Given the current political climate, where offensive language and hate speech have been normalized thanks to President Trump's rhetoric, it's not surprising that IMDb would want to take itself even further out of the fray. read more


Wednesday, February 01, 2017

WASHINGTON (AP) - The Latest on the Senate confirmation hearing for David Shulkin, the nominee to head the Department of Veterans Affairs: President Donald Trump's pick to lead Veterans Affairs is reiterating his support for VA's workforce, calling them the "best in health care."

David Shulkin says at his confirmation hearing that VA employees often get a bad rap and the vast majority seek to do the right thing.

He was responding to a question by Sen. Jon Tester... who asked his opinion on Trump's past description of the VA as "the most corrupt." Shulkin says he did not discuss with Trump the Republican's past comments on the campaign trail, but both agreed that much work needs to be done. But Shulkin says anyone who "beats up" the VA is counterproductive and "destructive" and "it's got to stop." ... Shulkin is pledging to use his best judgment to put veterans first - even if it means disagreeing with President Donald Trump. read more


Comments

Forget the leases. Just give all the vets vouchers to go to a private provider, should they choose to do so. Then if there are still a lot more vets who want the VA to treat them, find places to rent.

IMO the backlog disappears the first day you tell them they're free to see private docs. Let's find out.

#2 | POSTED BY WHITEDEVIL

Those who use the VA for their healthcare are veterans who either disabled or are poor, and studies continually show that they overwhelmingly do not want vouchers ...

bi-partisan poll of veterans shows they oppose privatization or voucherization of VA care

www.vetvoicefoundation.org

WASHINGTON – A new poll of 800 military veterans, performed jointly by Republican and Democratic pollsters, shows that veterans, while fully recognizing the issue with wait times at VA hospitals, believe the answer is investment in hiring more staff to deliver veterans care, not privatization or voucherization.

The poll was commissioned by the Vet Voice Foundation, and performed by Lake Research Partners (Democratic) and Chesapeake Beach Consulting (Republican).


I've posted numerous times, with sources, that show veterans as a whole do not want vouchers.

And most importantly, studies are showing that the VA is doing well ...

www.drudge.com

Although the transformation remains ongoing, they have made considerable progress after two and a half years:

Pending claims at VA have fallen by more than 90%; VA healthcare now performs better than the private sector on 96% of outpatient measures, according to RAND; and by the end of the year, all VA hospitals will offer same-day access to care, relative to none in 2014.

In a survey conducted last month, 75% of veterans reported that VA effectively delivers care and services, up from 65% just a year ago.

The crisis that emerged in the Phoenix VA was triggered by the pursuit of a 14-day wait time goal for all appointments.

However, upon digging into the data on wait times and patient satisfaction, the VA's leadership team discovered a curious fact: wait times weren't what mattered most to patients. "We were measuring the wrong thing," noted McDonald, "and we weren't even measuring the right thing."

What most patients wanted was a seamless, hassle-free experience that delivered the care they needed and that made them feel valued as customers. Yes, when people need urgent care, they want urgent care, but in most cases, being seen in 14 days is not a patient's first priority.

So although the VA now delivers more than one million same-day appointments per month, leaders have also worked to streamline customer journeys and empower employees to deliver more personalized and attentive service.

Sixty-eight percent of veterans now report feeling valued in their interactions with VA and 74% report getting the services they need, which is up from 47% and 65% a year ago, respectively.

VA's experience with wait times is an important reminder that sometimes what we think matters most isn't actually what moves the needle.


QFT

wow, so you are saying that Obama read his own Obamacare act?

#3 | POSTED BY MAVERICK

Why didn't you read the ACA? It was available on-line ... www.healthcare.gov

And if you don't want to read Obamacare, here's everything you need to know: the ACA is designed to address the monstrous amount of inefficiency and waste in U.S. Healthcare. Below is the great resource to help you understand what I'm talking about ...

U.S. Healthcare: where the money is going - 1999 - 2009

resources.nationalacademies.org

Do you like your taxes paying for the ~ $750 billion in annual waste?

And the fact is the Phoenix VA has not made any improvements in the last 3 years.

#11 | POSTED BY SNIPER

Since you're unable to respond with specific facts, I'll do it for you.

The Fox News link says ... "In one case, the VA found that a veteran who died of cardiovascular disease did not receive a cardiology exam his VA physician ordered. The VA determined that had he received the exam in a timely fashion, further testing and interventions could have prevented his death," the report said. ... that's one veteran who may have died as a result of delayed care, which is preventable and is indeed a tragedy. How many Americans die every year from preventable medical errors? Answer is hundreds of thousands hub.jhu.edu

The Fox News link says ... The report also found that during a week in October 2015, 3,900 appointments were canceled, and 12 patients "may have experienced harm that could have been prevented without the delay in care." ... If you'd have look at the Harvard Business Review in post #6 you'd see that wait time are actually up, but that's because the VA has been making easier for veterans to schedule them ... hbr.org

For example, when vets.gov, which simplified the process of enrolling in VA benefits, launched in June, the number of veterans signing-up online for healthcare on a daily basis increased nearly six-fold. Although VA has responded to rising demand by providing approximately one million same-day appointments per month, and the number of patients waiting extended periods for urgent care has fallen close to zero, the number of non-urgent appointments with extended waits is now even higher than it was during the height of the Phoenix crisis.

The rub is that the Harvard Business Review shows that veterans don't care as much about wait times as they care about a hassle free process when scheduling their appointments, which is why they're now giving higher marks to the VA ...

"Sixty-eight percent of veterans now report feeling valued in their interactions with VA and 74% report getting the services they need, which is up from 47% and 65% a year ago". respectively.

Here's one more BS fact from the above Fox News link ... "Other concerns: On average, the Phoenix VA has 1,100 patients waiting longer than 30 days for appointments; the most overwhelmed is the psychotherapy division, with patients waiting an average of 75 days." ... there is a nationwide shortage of mental health professionals www.usnews.com ... And despite the national shortage in mental health, the VA still does better than the private sector.... www.rand.org

I cited specific facts that counters all the BS from the Fox News link -- what say you?

You won't admit it, but you're not the only person I know who works in healthcare and can attest to amount of waste in our system and the harm it causes.

#19 | POSTED BY EBERLY

I do remember you saying you had a couple of doctor pals. So there, I am admitting something.

That said, ask your doctor buddies there opinion on Doctors Sanjaya Kumar and David Nash's book 'Demand Better'

Here's an excerpt...

www.scientificamerican.com

Questioning the unquestionable

The problem is that physicians don't know what they're doing.

That is how David Eddy, MD, PhD, a healthcare economist and senior advisor for health policy and management for Kaiser Permanente, put the problem in a Business Week cover story about how much of healthcare delivery is not based on science.

Plenty of proof backs up Eddy's glib-sounding remark.

The plain fact is that many clinical decisions made by physicians appear to be arbitrary, uncertain and variable. Reams of research point to the same finding:

physicians looking at the same thing will disagree with each other, or even with themselves, from 10 percent to 50 percent of the time during virtually every aspect of the medical-care process -- from taking a medical history to doing a physical examination, reading a laboratory test, performing a pathological diagnosis and recommending a treatment.

Physician judgment is highly variable.

Here is what Eddy has found in his research. Give a group of cardiologists high-quality coronary angiograms (a type of radiograph or x-ray) of typical patients and they will disagree about the diagnosis for about half of the patients. They will disagree with themselves on two successive readings of the same angiograms up to one-third of the time.

Ask a group of experts to estimate the effect of colon-cancer screening on colon-cancer mortality and answers will range from five percent to 95 percent.

Ask fifty cardiovascular surgeons to estimate the probabilities of various risks associated with xenografts (animal-tissue transplant) versus mechanical heart valves and you'll get answers to the same question ranging from zero percent to about 50 percent.

(Ask about the 10-year probability of valve failure with xenografts and you'll get a range of three percent to 95 percent.)

Give surgeons a written description of a surgical problem, and half of the group will recommend surgery, while the other half will not. Survey them again two years later and as many as 40 percent of the same surgeons will disagree with their previous opinions and change their recommendations.

Research studies back up all of these findings, according to Eddy.

Because physician judgment varies so widely, so do treatment decisions;

Why are so many physicians making inaccurate decisions in their medical practices?

Most physicians practice in a virtually data-free environment, devoid of feedback on the correctness of their practice.

For example, consider deep-vein-thrombosis (DVT) prophylaxis, that means therapy to prevent dangerous blood clots in vessels before and after operations in the hospital.

Research offers solid, Grade-A evidence about how to prevent DVT in the hospital. But only half of America's hospitals follow these practices. That begs an important question: Why? We have the science for that particular sliver of care. How come we still can't get it right?

A guild-like approach to medicine -- where every physician does it his or her way -- can create inherent complexity, waste, proneness to error and danger for patients.


You should as your doctor buddies what they think of the above facts. If they offer excuses or long winded explainations, they're crappy doctors.

Why do you always point somewhere else and say "but they are worse"?

#15 | POSTED BY HOMERJ

Do your ears work? If so, click here ... youtu.be

Do your eyeballs work? If so, click here ... www.sciencedaily.com

Above is a 1:24 youtube video of Dr. Lucian Leape explaining that medical harm is pervasive in ALL healthcare settings in America.

The Science Daily link shows (yet again) that VA healthcare is as good and more often better than what veterans can get in the private sector.

If you support the troops, then you support politicians who are committed to strengthening the VA.

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