My health care posts from 2013

David has a good idea. I often read the archives of my personal blog to see how I did in forecasting the future or understanding the present. A major concern of mine is, of course, health care and what is happening. When I retired from surgery after my own back surgery, I spent a year at Dartmouth Medical School’s center for study of health care. My purpose was to indulge an old hobby. How do we measure quality in health care ? I had served for years on the board of a company called California Medical Review, Inc. It was the official Medicare review organization for California. For a while I was the chair of the Data Committee. It seems to have gone downhill since I was there. First, it changed its name in an attempt to get more business from private sources. Then it lost the Medicare contract.

Lumetra, which lost a huge Medicare contract last November, is changing its name and its business model as it seeks to replace more than $20 million in lost revenue.
The San Francisco-based nonprofit’s revenue will shrink this year from $28 million last fiscal year, ending in March 2009, to a projected $4.5 million, CEO Linda Sawyer told the Business Times early this week.
That’s in large part because it’s no longer a Medicare quality improvement contractor, formerly its main line of work. And in fact, the 25-year-old company’s revenue has been plummeting since fiscal 2007, when it hit $47 million.

I see no sign that it is involved with Obamacare which is being run from Washington with a state organization that seems no better run than the parent organization.

Beginning Jan. 1, 2015, the Affordable Care Act no longer will provide federal grants to fund state health exchanges. In addition, California law prohibits using the state’s general fund to pay for the exchange.

Anyway, for what it is worth, here are the links to the 2013 health posts.

The Lost Boys

Alternatives to Obamacare.

Why the Obamacare Site Isn’t Working.

Where Healthcare May be Going.

Conservatives Invented the Mandate; say the Democrats.

A Critical Insight.

A Rolling Catastrophe.

Why Health Care is in Trouble.

Where Do We Go Now ?

Building the Airplane During Takeoff.

17 thoughts on “My health care posts from 2013”

  1. Health care in first world countries is partially overwhelmed by the vast number of out of shape, sickly people our societies produce.

    I have made two Doctor visits this last year. One was the first real checkup I have had in 20 years in January and the other was a mandatory checkup to keep my class one license, semi trailer etc. We just filled in the form.

    I’m in good shape and have just started up my regime again after Christmas break. Two weeks off and the weights are a little heavier. I will do my 3 mile 1200′ climb tomorrow and see how that feels. I expect to die on a mountain somewhere. The idea of dying in a hospital terrifies me. The regime, weights on a 3 day split and mountains on the forth day. This Christmas was the first time I have shut it down in about 10 months.

    Yeah it’s boasting. I work hard and there is always pain, I’ve earned it. How about you?

  2. I’m currently on hold with Anthem Blue Cross in California. Anybody want to guess how long it will take to get through to somebody? Here’s a hint; I have already been on hold for about an hour and a half. I picked a plan and then nothing showed up. This is going to be a long day. They won’t raise my rates if I’m slurring my words? I probably need some beer to get through this day. For the record, I took the dog for a nice long walk this morning which wasn’t a 3 mile 1200′ climb but for me it might as well be.

  3. Maybe you should ask These guys their opinion.

    Paperwork problems almost delayed suburban Chicago resident Sheri Zajcew’s scheduled surgeryThursday, but Dr. John Venetos decided to operate without a routine go-ahead from the insurance company. That was after Venetos’ office manager spent two hours on hold with the insurer Thursday, trying to get an answer about whether the patient needed prior authorization for the surgery. The office manager finally gave up.

    They did the surgery anyway. Hope they get paid some day.

  4. “Running from those cougars should have you in outstanding shape.”

    You can’t run from a Cougar. They can do 15′ straight up and a 20′ leap into a tree is a normal way to get in one. They can do 45 mph easy and your back will be turned. NO. All you can do is convince them you are not prey. You do that by offering battle. Get real big, wave anything you may have, and act real tough, do the large primate intimidation thing, it’s in there somewhere. Smack it with your tripod. ;)

    You can’t run from Bears either, they can go anywhere much faster than you can. Once you see one go boom right into the bush at 40 mph and just punch a hole without slowing down hardly at all, you don’t even try. You have to face them and stand your ground.

    Elk may benefit from a quick exit across really broken ground, they can get bogged down too, if you can find one. There is no reasoning with them at all.

  5. “Or, like Rick Perry does, carry a big caliber pistol………”

    I am not a coward. I do not need any firearms and will not use one. I am part of the wilderness when I am up the mountain, not just a visitor.

  6. I am part of the wilderness when I am up the mountain, not just a visitor.

    PenGun – that sounds like Timothy Treadwell.

    On Rick Perry – story as I recall is that he shot a couger while jogging with his .380 – to which a Texan replied: “That can’t be true – no self-respecting Texan would have a pistol with a caliber not starting with a “4”

  7. “I am part of the wilderness when I am up the mountain, not just a visitor.”

    Yes, just like the reporter who decided to investigate a bear attack on a camper even though he was warned by the ranger at Banff that the bear had not been caught.

    He became bear poop.

  8. You should understand the Black Bear on Vancouver Island is a opportunistic scavenger, not a predator. You have to do stupid things to get one to hurt you. I have met very many in my travels and have even been charged once.

    My daughter, at one time on the west coast of Vancouver Island, in her hippey “fight the loggers stage”, was the wildlife services go to person as to where and what the bears were up too. She, like me had named quite a few. She looks after my granddaughter these days. ;)

  9. The bear at Banff, as you probably know, was a grizzly. I have been around black bears camping for many years.

  10. MikeK – the classic way of determining whether it is a black bear or grizzly was told to me by a park ranger at Yellowstone years ago.

    If the bear is up the tree: Black Bear

    If you are up the tree: Grizzly.

    I think the Alaskans call Grizzlies “Brown Bears”. Might be a sub species.

    An old brown bear ate Timothy Treadwell (and unfortunately his girl friend) who were , incidentally, at one with nature ;-)

    I think respect, or lack of it, frequently determines whether you end up being part of the food chain.

    I visited Brooks Camp – the country’s smallest National Park in Alaska – entrance is by float plane (and lottery). You go there and the first thing you do is see a movie in a cabin on bear etiquette.

    The shoulders of some of these would come up to my shoulder. Make noise, jeep talking, defer to a bear if you meet them on the trail…they are interested in the salmon and as long as you don’t get in their way or otherwise piss them off you are fine.

    Despite all of this instruction I remember some Swiss tourists who would get in close with cameras and with the rangers screaming at them would “no habla”.

    Cases like that I wish we could let nature take its course.

  11. Bill, when in Alaska I was told that the “rule of thumb” was that if a bear was within 50 miles of the coast it was a Brown Bear, and that if further inland it was a Grizzly. Genetically, they are identical, and the differences in size and appearance due to the better diet of those closer to the coast.

    Now it has been proven that Brown Bears and Polar Bears are very close genetically and can interbreed.

  12. Mike –

    The Polar Bear is supposed to be the most dangerous. Never will forget an old National Geographic special – they are up in Churchill, Manitoba and took the “Tundra Bus” out in the snow and ice. They lower a cameraman in a a “shark cage” and this giant polar bear is just sitting beside the cage….waiting.

    Meals on wheels?

    You are probably right about the Brown Bear and Grizzly identification.

    I worked in the back country at Sequoia the summer of 1969 and the news that summer was a Grizzly attack on a woman in Glacier NP – bear came in to her tent, dragged her out in her sleeping bag.

    Story was, IIRC (always suspect these days) is that she was menstruating and the blood attracted the bear.

  13. Grizzly’s are terrifying. A fiend was part of a fishing crew up along the Alaska coast. He took the work boat to shore to get some beach things, clams or oysters, I think, and wandered up the little hill just past there to have look. He saw a Grizzly about 1/4 mile away and it just turned, looked right at him and charged. It came through the bush snapping small trees like twigs. He ran as fast as he could and just made it to the boast and pushed it out before he started the motor, the Grizzly followed for 100′ before turning around and swimming back to shore.

  14. PenGun there are some great typos in your comment.

    Grizzlies and Alaska Brown Bears are the same species. Black bears in California are pussycats compared to that.

    Nature is not your friend. It is life, though.

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