Archive for the ‘Hospitals’ category

$4.3 Trillion in U.S. Health Care Spending?

May 9th, 2008

“Money doesn’t make you happy.  I now have $50 million, but I was just as happy when I had $48 million.”
–Arnold Schwarzenegger

According to an article in Internal Medicine News by Mary Ellen Schneider, spending on health care in these United States is projected to reach 20% of the gross domestic product on the one hundredth anniversary of my father’s birth, 2017.  Of course that projection is only an estimate made by CMS, the Centers for Medicare and Medicaid Services.  That estimate is, of course, based upon a continued escalation of nearly 7% each year for the next nine years.  In lay terms, that escalation would mean that the total dollars spent on health care would hit $4.3 trillion…Whatever a trillion is? I still can’t fathom a billion of anything.)

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We all should realize by now that this spending in the public sector, Medicare and Medicaid, will increase due to the first wave of Baby Boomers entering the Medicare system in 2011.  My 78 million peers, like the lemmings, are working their way toward the proverbial wall, and for those of you who will have to carry the load until we are wearing our wings, that is not a pretty financial picture.

The same economists from CMS are predicting a decrease in reimbursements to physicians over the next several years while Home Health will likely grow faster than most other sectors except perhaps prescription drugs.

What does it all mean?  We are spending more on health care in the United States than any industrialized country in the world and, truthfully, our overall age of death is significantly surpassed by many of those “spending less” countries.  How can that be?  Well, for one thing, we have 47 million uninsured citizens in this country and no one really knows how many illegal aliens. Why so many uninsured?  They don’t vote.  The vast majority are young, single mothers with small children, and this does not take into consideration the illegal aliens who are also not insured.

Back to the answer. . . prenatal care is inadequate and infant mortality in the United States is still an embarrassment. A few of the countries that do better than us in the world in infant deaths per thousand are:  Australia, Austria, Canada, Czech Republic, Denmark, Finland, France, Germany, Greece, Ireland, Japan, South Korea, New Zealand, Norway, Portugal, Spain, Sweden Switzerland and the United Kingdom.  Hmmmmmm?  Could it be because we spend 30% of our annual health care dollars on the last thirty days of life, and less than 4% of our monies on preventative and wellness care?

Of course, Hospice would be a tremendous help.  We could reduce expenditures on end of life care, properly care for our babies with the excess funds, and ensure that our uninsured are properly covered as well, but what politician is willing to touch that electric third rail of the electorial subway tracks?

We could begin by putting in a network of sidewalks, bike trails, and walking trails.  We could actually walk once in a while and treat our bodies like a true temple, not the “Temple of Doom.”

HospiceOne of the least often heard issues revolving around these expenditures is the continuation of our archaic hospital system.  It is based on the acute care model, and the vast majority of our diseases are chronic.  We rush the victim to the hospital, patch them up, send them home and then rush them back again without any commitment to behavioral modification.  I have seen individuals reverse their heart disease from diet, exercise, and stress management.  Why can’t we embrace this concept, reward these activities, and change our society?  The millions of bicycles in Europe are no accident.

So, as I’ve quoted in some other blogs, “Change or Die,” or just spend ourselves into oblivion as we attempt to prop up a system that should have gone out with the Industrial Revolution.  Good luck kids, your ole man needs you to keep working to cover my health insurance.

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From the Beach to the Beach

July 9th, 2006

Voorhaven_in_rotterdam4 It’s 5:48 PM and my last meeting is over for the day. That’s actually not a bad time to begin the evening, but it’s not a normal Sunday evening because I’m in the Netherlands looking out over the North Sea. (At least that’s what they tell me this beautiful body of water is outside my window.)

Actually, the meetings started as soon as we landed on Friday morning and, except for some down time yesterday, will be nonstop until we fly home Tuesday morning. (This was one of those week-ends where it was great to be me.)

For those of you who are younger, this date may not be particularly meaningful, but my last trip here was in 1969. In fact, it was December of 1969, and we actually stayed on The Continent to celebrate the beginning of the 1970’s. Who could have known that it would take this long to get back to the Netherlands, but it has been well worth the wait.

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I liked the Netherlands on my first trip, in fact, it was F-U-N for a 22 year old recent college graduate, but this time, I can honestly say that I have loved it here. The people have been wonderful. They are honest, straightforward, and very accommodating, and the towns: Utrecht, Rotterdam, The Hague have all been absolutely charming.

We are here to consummate our research partnerships with the various medical centers, and to establish a foot-hold in Europe.

In the past 50 hours, I have been exposed to art, antiques, museums, music and business as casually as I’m normally exposed to fresh air and mountain breezes back home. Each city has produced a special type of “drive by” entertainment that only a native of Western Pennsylvania can truly appreciate. The parks are filled with incredible musicians and the galleries are bursting with challenging new exhibits. The canals are lined with the most interesting and creative sculptures, and there is live music everywhere. The real beauty of it all is that it is just part of the landscape here, not a special event or a special week-end.

Erasmusmclogo_1We’ve been meeting with our representatives from Taskforce Europe, with members of the Ministry of Economic Affairs, with leadership from Erasmus Medical Center, and TNO. So, Ron, Steef, Conchita, Emmie, Ronald, et al… thanks for the beginning of a wonderful scientific and business relationship.

And Jude and Nina, if you’re reading this, I’ve got the “magic shoes.”

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The Herd Mentality?

May 21st, 2006

Herd_of_sheep_1Sometimes it really really helps to avoid the pack, to stand away from the herd, and to do your own thing; i.e. management from the gut.  Looking back over the past five million two hundred fifty six thousand minutes that have made up these last ten years, it is obvious that the primary strategy that has worked for us was not our focus on finance, but, instead, it was our focus on our patients, our people working here and on our processes.

A few blogs ago we lamented the budget process because of its obvious drain on positive energy.  We spend so much time in this business studying our financial history that it can cause us to lose sight of the real focus of our work.

During a post board meeting conversation with an old friend, mentor and brilliant strategist, we talked about our new pay for performance wage program and our attempts to inspire all of our employees to be all that they can be.  He turned to me and said, “The injection of meaning into human life should be your goal.  Once your people truly get it, the motivation takes care of the challenges.” Or something like that.  Anyway, the point was to bring meaning to their lives.

Planetree_logoOnce we knew our objectives, to become a model Planetree Hospital, we set our measurement scales, initiated targets, and determined our key actions required to achieve those objectives.

Niagara_falls2These accomplishments led to increased volumes, satisfied customers, and increased revenues that have allowed us to grow, to flourish and to ensure survivability.

Simple?  Absolutely, positively, NOT.  Is it common sense?  Yep, but lots of smart people have convinced me that common sense is really uncommon, and that, my friends, is the problem.

p.s. Thanks for the prayers. My brother did just great.

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