Microsoft health reform actually works | ZDNet Healthcare | ZDNet.com

I believe this is going to make an important positive contribution to the current mess.

Microsoft health reform actually works | ZDNet Healthcare | ZDNet.com.

Obama advisors: weak? or what?

I find myself mystified by the systematically bad advice the President seems to solicit in these two critical domains of healthcare and financial services. See:

Kausfiles : Groopman 1, Orszag 0.

George Lakoff on the Languaging of the “Healthcare Debate”

George Lakoff, Professor of Cognitive Science and Linguistics at UC Berkeley, has made big contributions to those of us who have struggled to make sense of the linguistic gulf between right and left, progressive and conservative, and the often profoundly effective capacity of the right to defeat apparently intelligent initiatives mounted on the “left.” Here he asks how, after running such an effective presidential campaign, the new President has stumbled so badly with his number one policy concern, healthcare.

Read it here.

Robert Reich’s Political Perspective on the Mess

Friday night the Huffington Post published Robert Reich’s comments on the political positioning of the 6 Senators who are playing such a large role in the conversation about “healthcare reform.” I recommend reading the short piece.

Bob Franza’s take on the healthcare mess

Ok. It has been a long time since I posted here. Sorry to be away.

We have been busy attempting to start this new company, and it has been far more difficult than we had expected. The mess produced by the national discussion about “healthcare reform” – read healthcare insurance reform – has paralyzed developmental and innovation initiatives across the country, and we are entangled in it. Anything that is not following a traditional path or that has not been already demonstrated to the satisfaction of the general observer is stopped cold.

The following is the text of a note posted yesterday on the White House Contact Page by Dr. Robert Franza, CEO of Sustainable CyberLearning of Seattle, formerly of the Seattle Science Foundation and the man who convened the study group that invented the CareCyte innovations.

Dear Mr President,

In your radio address today you state – “This was the moment we built a health care system worthy of the nation and the people we love.”

Mr President, you have equated establishing “health care worthy of the nation and the people we love” with reforming health insurance.  Unfortunately, providing insurance is only a portion of the challenge.  You have yet to address the inadequate health care infrastructure and delivery system – a problem vastly larger than inadequate medical record management and access to affordable insurance.

Fortunately you have citizens who know how to solve both issues and what is remarkable is that you can eliminate all the policy speak, beltway spin salad that has characterized much of your White House messaging the past several months by doing two things:

1. Unequivocally and persistently until it is passed – Support Rep. Weiner’s amendment to replace Division A of HR 3200 with the text of HR 676, the “U.S. National Health Care Act,” sponsored by Rep. John Conyers. This would effectively transform HR 3200 into single-payer legislation – exactly what Americans need and exactly what you need to get out in front of the growing chorus of those questioning your commitment to sign a law that delivers to all Americans that which Medicare, for 44 years, has efficiently delivered to some Americans.  Thanks to the cogency of Rep. Conyers original bill, the resulting legislation will actually be something that most Americans could read and understand;

2. Give me a call – seriously.  During the past three years my colleagues and I in Seattle have devised a realistic, readily implemented, modern health care infrastructure.  We have been trying to inform you for the past two months of how that health care infrastructure can be accomplished, the jobs it will create, and the exportable US products it will generate, and the enormous waste it will eliminate while providing ALL Americans access to safe health CARE.  By the way, Sir, legislation is not needed to advance our plan – you have adequate funds available via your 2009 ARRA to launch.

Mr. President you can jump in front of all the distractions and simply demand passage of the Weiner (Conyers) amended HR 3200, and use it as the blueprint during reconciliation with whatever comes out of the Senate to provide Americans access to a competitive and proven health insurance plan.

Mr. President you can call us and we will explain to you how you can then do for our health care infrastructure what FDR did for provisioning access to electricity (TVA, BPA) and logistics (Liberty Ships) and truly transform not only the quality of health CARE in America, but create a new and sustainable manufacturing sector, jobs, and high quality exportable US products.

Yes. We. Will.

Thank you,

Bob

In his point #2, Bob is referencing a proposal for a new national mid-level healthcare infrastructure for the country that will accomplish the apparently irreconcilable objectives of lowering costs, making healthcare more accessible, and increasing quality, all at the same time. We have proposed the actions to the White House through Washington State Congressional Representatives. If you are interested in seeing our proposal, drop me a note at “info@carecyte.com” with your email address and I will send you a copy.

Best,

Chauncey

President Obama: The rising cost of health care is “the single, most pressing fiscal challenge we face, by far….”

From the opening remarks at the Fiscal Responsibility Summit convened by the President, today, in Washington, D.C.

“If we do not change current policies, the national debt, which now equals about 45 percent of the gross domestic product, will soar to about 300 percent of GDP by the year 2050. By then, interest payments on the debt alone would consume 14 percent of GDP — more than we spent on Medicare, Medicaid, Social Security and all other entitlements combined.

“We must avoid such an explosion of debt. To do that, we must make sure that the debt does not consistently [grow] faster than the overall economy which, in turn, means that over time annual deficits should not average more than 2 to 3 percent of GDP.But under current policies, even after the economy starts to grow again, deficits will never fall below 4 percent of GDP, and eventually will go much higher. So, we are on the path to the very debt explosion we must avoid.

“What’s driving this problem? Let me start with what’s not driving it. First, the recent Economic Recovery Package is not driving the problem. That package is temporary and it increased the size of the long-term fiscal gap by only about one-tenth of 1 percentage point of GDP. Its costs are dwarfed by the bigger, longer lasting factors I’m about to describe.

“Second, entitlement programs in general are not driving the problem. Entitlements other than the three big ones, Medicare, Medicaid and Social Security, have actually been falling as a share of the economy and will continue to do so.

“So, what is driving the problem? The increases projected in federal spending in coming decades as a share of the economy are due entirely to the projected growth in Medicare, Medicaid and Social Security which, in turn, is driven by rising health-care costs and the aging of the population.The single biggest factor is rising health-care costs, not just in Medicare and Medicaid, but throughout our health-care system.

“For more then 30 years, costs per patient in Medicare, Medicaid, and private healthcare have all risen at about the same rate, and much faster then the economy.

“If healthcare costs per patient were somehow to rise at the same rate that the economy grows on a per capita basis, rather than growing faster, the vast majority of the long-term fiscal gap would disappear. So we face a daunting systemwide healthcare problem.” (I added the emphasis.)

Remarks of Robert Greenstein, Founder and Executive Director of the Center on Budget and Policy Priorities. Transcription from the NYTimes February 23, 2009.

Video of the opening session here. Transcript here.

An Alternative for Addressing the “Capital Crunch”

Tom Iglehart of Care Commons in Boston sent us this article from the January 23, 2009 issue of <Healthcare Finance News>.

The article says that nearly half of the hospitals surveyed* over the last two months have postponed projects that were to begin within the next six months, and many have stopped projects that were already in progress.

‘The vast majority of hospitals surveyed reported that borrowing funds through tax-exempt bonds – the main source of borrowing for most hospitals – is difficult or impossible. Loans from banks or other financial institutions are similarly difficult to obtain, and net income is down and philanthropic donations have slowed.’

Are you a clinician who needs space but is caught in the “capital crunch”? Surgical suites? Patient rooms? Technical space? Medical office space?

Do you know a clinician whose capacity to work is impacted by the “capital crunch”?

There is an alternative. Call CareCyte. We make healthcare facility and operating budgets go a lot farther.

* From a survey by the American Hospital Association, “Report on the Capital Crisis: Impact on Hospitals,” including data from 639 hospitals collected from late December 2008 to January 6, 2009.

Summary of the Proposal We made to the Obama Healthcare Team

I tried but failed to post the following to the comments section of the Change.Gov Briefing Book item dealing with the proposal that we made (updated 1/20/2009 3:50pm pst):

I thought a summary of this proposal might quiet some concerns and allow others to see just how interesting this proposal is.

The outline of the US healthcare crisis has been reported well. At $2.3 trillion per year and 16% of GDP our healthcare costs are unsustainable. Double the typical expenditures for developed countries, still we lack proper care for all. For example, we are 37^th in infant mortality. We have notoriously deteriorating services and bureaucratic styles of operation. Insurance companies, accountants, statisticians, and lawmakers are telling doctors what to do.

Primary care physicians – our first line of defense and our only hope of moving to preventative medicine – are overworked (2000-3000 patients each will not work) and underpaid. 50 million people are without health insurance. Even those with insurance are often unprotected. The leading cause of bankruptcy is now health problems.

Nearly everyone thinks they know what problem is, but the truth is that the public story is oversimplified and very few people, including the doctors, know what is wrong. In fact, many of the “improvements” of the last decades have made the situation worse in many respects.

We must address the problem on several fronts, all at once. The common solutions are incomplete and insufficient. Universal health care and/or insurance reform is only one of the changes needed. Others say “take the business out of medicine.” You cannot take “business” out of medicine – the investments required to do good modern medicine are too large.

Some parts of the problem remain hidden or only partly visible. Two examples are the costs of renovating our aging population of hospitals and moving services out into communities, and the degree of danger posed by hospital-acquired infections – now a leading cause of death in the U.S., and only the tip of the iceberg has appeared in the press.

Insured or not, patients are going to continue getting insufficient care and to suffer from the lack of doctors, aging inflexible facilities that we cannot possibly afford to repair or replace, and the tortured processes of care that doctors are compelled to navigate through – to a significant degree because of the facilities and the processes of building them.

No one has thought that facilities would fundamentally alter the crisis in U.S. healthcare. We are going to turn that common sense on its head.

Two and a half years ago a distinguished team of doctors, researchers, architects, builders, and technologists in Seattle went to work on the question of how to make high quality healthcare available in the underdeveloped world, and they came up with the innovation that is presented here. (One member of the study group has been awarded a Nobel prize.) The centerpiece of the invention: build facilities out of steel and plastic, like an automobile, on assembly lines, to manufacturing standards, and then assemble them where they are needed. The important results of this innovation are drastic reductions in the time it takes to put a facility in place and decreased cost of the facilities, greatly increased flexibility to be repurposed and reconfigured, enormously improved patient care at much lower costs, and a systemic approach to reducing the dangers of hospital-acquired infections.

Only as the innovative ideas became clear did we realize that these same facilities fit exactly with the need in the U.S. for safe, inexpensive, fast neighborhood and distributed healthcare facilities, and that their availability could trigger vast and important improvements in the healthcare industry. The availability of these facilities will give doctors more room to do their work in many ways.

Our plan was always to use factories like automobile plants to do the manufacturing. It was only with the current economic collapse that we saw how the possibility of employing otherwise fallow assets in automobile plants and employees could help the economy in a big way if we move fast. We included that in the proposal found here. It is unlikely that the U.S. automobile industry can recover by simply selling more automobiles, and especially in this downturn. The industry needs additional products to manufacture, and the equipment and practices they now have are perfect for the kind of healthcare facilities we have designed.

One commentator spoke of no evidence. We have lots of evidence, but little room here in which to present it. For example, CareCyte’s CEO has built many of the most complicated buildings in the Northwest, including the first laboratory to work with live HIV, hospitals, and semiconductor fabrication plants. This is a proposal from a seasoned team.

Summarizing, this is a proposal directly addresses important healthcare problems facing our county – problems of access, costs, and quality – and does it in a way that simultaneously will provide jobs and economic support to the automobile and other industries.

Chauncey Bell
Chief Operating Officer, CareCyte, LLC.

If you like what you see in CareCyte, please help us …

THE CHANGE.GOV BRIEFING BOOK CLOSED SUNDAY AT 6PM EST.

Thanks to all who posted votes and comments there.

Adding to this post: I’ve put the Obama team proposal here as well, because some people were having trouble finding it.

We posted our proposal to the Obama Healthcare team around the first of the year. It is available at our web site. The introductory paragraph says this:

“This document is addressed to President-Elect Barack Obama’s healthcare team to suggest how we could work together to significantly reduce the costs of healthcare service delivery and increase quality at the same time. Additionally, our approach will contribute directly to the economic recovery—not only by creating jobs to build the new infrastructure, but also by using automobile plants for the manufacture of healthcare facility components. Finally, the facilities we are proposing are well-suited to satisfy urgent needs of the Department of Defense (DOD) and the Veteran’s Administration (VA) to provide better care for soldiers.”

Now the proposal has been entered into the change.gov “Citizen’s Briefing Book.” The most interesting proposals in that book are, I understand, headed for the President-elect’s hands after the Inauguration. Part of the process of getting it into the President’s hands is to have it get attention from those reading in the briefing book. People vote on the suggestions there.

Here is my request: Vote us up in the rankings!

How do you do that?

1. Read the document. It’s 10 pages of gripping stuff that is relevant to our world.
2. Go to the website and sign in. Click on this URL:

http://citizensbriefingbook.change.gov/ideas/viewIdea.apexp?id=087800000004lny&srPos=0&srKp=087

3. Once you have signed in, you will be taken away from our proposal, so you will have to click on the URL above again to get back to it.

4. “Vote” by pushing the “Vote up” button.

5. If you are inspired to do so, leave a comment there.

6. Let us know that you have done that.

7. Register on the CareCyte website or here on our blog so that we can keep you informed about our progress.

Thank you very much!

All the best,

Chauncey

CareCyte proposal for Obama Healthcare Team

We just posted, on the website of the Obama Healthcare Team, an abstract of a proposal to radically improve access, quality, and the cost of healthcare through the introduction of a new kind of healthcare facility.

The abstract and the full proposal are available here.

Many people have helped produce this proposal, through conversations, reviews and comments and re-drafts of our initial ideas. We are grateful for the help. What we are trying to do is something that will take the concentrated efforts and thoughts of a lot of people. Posting the proposal is just the beginning.

We invite your comments to our proposal, and we are interested in any help you may be able to offer us with what we are attempting to do with this proposal and the company CareCyte.

We wish you a successful and healthy new year.

To a healthier future for us and for our children!

– the CareCyte team.