Sunday Open Thread

76,000 qualified nursing school applicants were turned away in the last 12 months.

My advice: don’t bother with the Danish raunch comedy movie, Klown.

Seven minutes of terror:

Despite speculation, the Castro twins are the future of the D Party in TX, if it has a future.  I will go further: they represent the future of the entire D Party, if it has a future.

Just why would Iranians have a “pilgrimage” to Damascus?

British jocks are performing so well in front of the home crowd.  Congrats to all the Brit medal winners.  Murray beat Federer.

11 Responses

  1. If MA is still using 3rd party payers, and they are, why would a patient give any consideration to cost?  I would look at quality only?  Isn’t that the rational thing to do? So why would anyone want to waste resources compiling “cost trends”?

    “Other useful provisions include a requirement that health care providers report regularly on cost trends and quality measures, which should help patients shop comparatively;”


    • So why would anyone want to waste resources compiling “cost trends”?

      So that someone will get around to seeing the point? NoVAH thinks this kind of program should have a % contrib by the individual so that the individual will have a stake in cost shopping, as I recall.

      George, under the most likely scenarios, I am sure you are right, of course.


  2. FWIW, I agree with George. I would not look at cost at all. Unless the % is really, really meaningful, NoVa’s idea would not move me either. A few bucks more would not make one lick of difference in what I would choose for my medical needs.


    • I may have not done NoVAH’s idea justice. It could have been that the plan pays 95% of the lowest cost for the procedure, so that the insured has a real incentive to go with the cheaper procedure. I just cannot find how he formulated it right now. I think it was here. NoVAH?


  3. I guess I’m not sure what the objection is to the MA initiative to control costs. As a consumer of health care who like many Americans is paying more and more for her health care needs, as insurance has taken such a hike, I definitely would support just about any feasible idea to control costs.

    Apparently by most accounts we’re all going to be paying a higher percentage of our health care costs, as the costs get shifted to individuals, and generally the only shopping that gets done is when you or your employer renews annually.

    I would welcome just about any savings.


  4. OT for jnc and anyone else interested in the debate he and I had last week re Obama and the Grand Bargain.

    Whatever benefit the White House had seen in raising Ryan’s profile, his increasing power, and his credibility as the leading authority on conservative fiscal policy, soon made his imprimatur essential for any Republican trying to reach a compromise with Democrats. Ryan helped scuttle three deals on the budget. He had served on the Simpson-Bowles deficit commission but refused to endorse its final proposal, in December, 2010. When deficit negotiations moved from the failed commission to Congress, Ryan stuck with the extreme faction of the G.O.P. caucus, which withheld support from any of the leading bipartisan plans. In the summer of 2011, when a group of Democratic and Republican senators, known as the Gang of Six, produced their own agreement, Ryan’s detailed criticism helped sink it. And, also that summer, during high-level talks between the White House and Republican leaders, Cantor and Ryan reportedly pressured Boehner to reject a potential deal with President Obama.

    Ryan had aligned himself with Cantor and the self-proclaimed Young Guns, who made life miserable for Boehner, their nominal leader. They were the most enthusiastic supporters of the Ryan plan, while Boehner had publicly criticized it. Cantor’s aides quietly promoted stories about Boehner’s alleged squishiness on issues dear to conservatives, and encouraged Capitol Hill newspapers to consider the idea that Cantor would one day replace Boehner. As the Republican negotiations with the White House fizzled in the summer of 2011, Barry Jackson, Boehner’s chief of staff and a veteran of the Bush White House and Republican politics, blamed not just Cantor, who in media accounts of the failed deal often plays the role of villain, but Ryan as well.

    Read more


  5. Olympic boxing should be ended as being corrupt beyond redemption.

    It’s also probably time to get rid of some other sports whose time has come and gone for other reasons, such as the triple jump, shotput and discus.


  6. I’ve just started looking at that bill in MA. HAve not read George’s link yet.
    So i’m not sure what changes, if any, patients will see.

    however, i do know that there’s no teeth behind the cost cuts. the bill creates a new agency (naturally) to monitor cost growth. if providers don’t meet the targets, they have to submit a plan to come into compliance. if they don’t? nothing. not yet anyway.

    the bigger deal is that the new ageny will investigate anti-competitive pricing and is tasked with breaking up hospital networks. there’s also a fee on insurers to fund a couple of things — community hospitals and wellness efforts. some seed money for EHR too.

    re: mark’s comment — my baseline is the need to push costs to the extent possible to the end user. otherwise it’s a circular firing squad of providers pushing cuts off on one another. the end user has to be in control. a tough sell, to be sure. currently, providers don’t consider the patients to be their customers. medicare and the other payers are the customers.


  7. Nova, interesting there’s no “teeth” in the cost cutting measures or with the new agency.

    the new ageny will investigate anti-competitive pricing

    What are they going to do issue a report and hope someone reads it. I think our rulers will find that a lot of consumers are becoming more and more interested in the costs of their actual health care as they begin to assume more of the actual costs, but how do we get across that bridge to apply actual pressure on the cost curve? Once you purchase an insurance policy you’re at their mercy and can’t do any “shopping” so to speak.


  8. i think (*think*) that this has to do with hospitals acquiring physician practices. so they’re might be some oversight of that. but i don’t know the details or what approval authority the new agency does/doesn’t have. just a guess. haven’t looked into it.


  9. Athe only way to get a consumer to shop on price is to allow them to keep all, or a significant portion of any unused funds. Or all of it if they forgo treatment.


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