Configuring_It_Out

They are destroying rural care. There has never been a more efficient delivery of care than the well paid private practice model. We have raised costs and added useless admin staff to collect useless data which does not benefit patients. The entire systems extracts shareholders value for insurers, hospitals and fake NFP healthcare systems and their overlords

"Section 6001 and Stark create an untenable double standard: corporate health systems are granted broad safe harbors that allow them to anti-competitively steer referrals within their system. Why should independent doctors be subjected to prohibitions on self-referrals when corporations aren’t?" youtube.com/live/SgsYVQf6Q…

@nickmmark @MollyJongFast Ok and what were his wins?

@Dadudoc @MollyJongFast The point is Musk rarely delivers what he says More examples: - build a “kid sized” mini sub to rescue kids in Thai cave - fund the world food program to end global hunger - remove lead from the water for everyone In Flint - cut $2 trillion from federal budget w/ DOGE

Checking back on this

@DrDiGiorgio OMG the amnount of bs required to do nothing is ridiculous

This reminds me of healthcare. Emasculating and demoralizing rituals. Sorry, can’t do emergency surgery on your patient until you put in the right CPT code and type out an estimated length of stay. Sorry, can’t admit your comatose patient to the hospital until you do a 10 point review of systems. Sorry, can’t let you close out that clinic visit unless you attest that you reviewed all the medications, even if you’re a sub specialist. Can you also please confirm if the patient had protein calorie malnutrition. Oh, you didn’t click all the meaningless things in your inbox? Your computer access is now cut off.

@nickmmark @MollyJongFast What is your point?

@MollyJongFast I remember during the pandemic, when Musk said that Tesla factories were going to build thousands of ventilators. He ended up sending a handful of home CPAP and BiPAP machines with Tesla stickers on them. thehill.com/policy/technol…

@BrentAWilliams2 It's worse than this. Medicine has become horrible

This is a very misleading post, completely devoid of the context needed to understand why so many IMGs are needed every year, mainly: not enough domestic residency spots, not enough interest in primary care, (for obvious reasons) by US graduates, and not enough interest in working in rural areas by US graduates. As an example, if nephrology, which is a very unpopular specialty for US graduates, did not take a significant number of IMGs every year, there would be almost no nephrologists.

@sdixitmd @DrDiGiorgio The problem with the academic class like Richard is they create nothing, grow nothing, build nothing employ no one and yet they feel they are underpaid teaching two classes a week working 5 hours a day for 8 months a year

Hot take: I make more than that and I’m underpaid for what I do. Shades of @DrDiGiorgio.

@RichardHanania Physicians in Europe work 8 hours a day. only

Average income of physicians US: $458,100 Canada: $194,700 Netherlands: $185,700 Sweden: $115,200 nber.org/papers/w34956

@cscla @DrDiGiorgio @ashishkjha The 2.5 percent reduction for efficiency has really helped the dumping industrial health complex where standard operations with extensive requirements for follow up such as vascular surgery, plastic surgery and orthopedic trauma are just not getting done

@DrDiGiorgio @ashishkjha It’s also the lowest hanging fruit. Wouldn’t it be something if there was some way to collectively prevent that?

If you're thinking about healthcare spending in the US, one fact worth noting About 9% of healthcare spending goes to physician compensation Another 9% goes to nurses Yes, doctors and nurses get paid more in the US than they do in other countries and yes, a small proportion of physicians really do get paid a lot But I've never thought we're going to solve our healthcare spending by going after physician and nursing salaries Not enough there -- and slashing physician or nursing compensation would be a great way to demoralize the core of the US healthcare workforce

@megynkelly @CarriePrejean1 @DanPatrick @Paula_White @tedcruz That's not a religious thing

@CarriePrejean1 @DanPatrick @Paula_White @tedcruz It’s absurd. Where is your own religious liberty? You have to have only one view to be on this panel?

Megyn, I have been removed from a religious liberty commission because of my religious beliefs. I won’t bend the knee to a foreign nation, or forsake my Catholic Church teaching to heretics like @DanPatrick @Paula_White and @tedcruz This is a fake religious liberty commission.

@BernieSanders No moral equivalence

Netanyahu led Trump into this horrific & unpopular war. Now he doesn’t know how to get out. Cost so far: • 1,200+ Iranian civilians killed • 13 U.S. troops killed • 3.2M Iranians displaced • 773 killed in Lebanon • 10,000+ Iranians injured • $16.5B spent in 12 days

@ZekeEmanuel @DrexelUniv @nytopinion You need a Great residency

@DrexelUniv College of Medicine just announced a three-year medical school program. It's about time. I've been making this case for years, including in a recent @nytopinion piece, and the evidence keeps piling up: you don't need four years to train a great doctor.

@AndreaBee00722 @DutchRojas The only purpose is to raise costs for healthcare but hiring additional management who create bee ess metrics. Increasing size results.

@DutchRojas Hahha! Love it. We can definitely talk. There are RX and medical supply/implant contracts where "unit price" is based on a volume commitment. Smaller, acquired entities can leverage volume of a larger system to lower price. Its why #5 is important ☺️💪👍

Reader question today: "If independent practice is the cheapest model, why is everyone pushing consolidation?" Because the people pushing consolidation aren't optimizing for cost. They're optimizing for control. Lower cost doesn't fund a $30 million CEO package. Lower cost doesn't justify a $2 billion campus expansion. Lower cost doesn't fill 45% of a hospital's employed physician roster. The system doesn't want to be efficient. The system wants to be captured. A bit more: 👇 buff.ly/XT0Kriq

@DoctorNazarian @FmrRepMTG Giver a cranioplasty

@FmrRepMTG Faaaaccccckkkk you, grifter!

Great Mr President. Good job. You’re a billionaire and the American people, not the Iranian people, who voted for you are not billionaires. As a matter of fact many of them are flat out broke, in all time high credit card debt, can’t afford health insurance or car insurance for that matter, and most young people can’t afford to buy a house or even their rent payment. Your generation, the baby boomers, your families were able to thrive on single incomes and now that’s practically impossible for the vast majority of American families. Let alone, imagine being a single mother. Most of your baby boomer friends and supporters, I’m sure are cheering you the most. But us younger generations, Gen X (mine), Millennials, and especially Gen Z hate this fucking bullshit. Because we all know that in 10 years when the baby boomers that have been in charge of ALL of America’s disastrous decisions are retired or passed away, us younger generations will be left with no social security checks because it will have gone bankrupt, over $50 Trillion in debt, and a dollar that won’t be worth shit. We, as in YOU and me, campaigned on America First. And this is NOT it.

@MattWalshBlog IMEC

As always I only support military action anywhere, in any context, if it directly serves the interests of American citizens. It’s troubling that the arguments we’re hearing for this war in Iran, including from Trump himself, seem to revolve primarily around “bringing freedom to the Iranian people.” As Americans, the freedom of Iranians is not our responsibility. If a single American life is lost in the service of that goal, it will be a travesty. What nobody has even come close to sufficiently explaining is how this war will first and foremost directly benefit American citizens. That is a case that needed to have been made clearly and convincingly before this move, and it wasn’t. We’re also told how this will benefit Israel, and I’m sure it will. But Israel is not America. What does it do for America? How does it help us? That needs to be explained to us. And it isn’t “panicking” or demonstrating “disloyalty” to demand those very basic answers about how American tax money, and potentially American lives, are being spent. We hear about the danger of a nuclear Iran, but that’s odd because we were told that Iran’s nuclear capabilities had already been set back decades. We hear that this war will be over quickly and easily because Iran is powerless, which I hope and pray is the case, and maybe it will be. But that’s odd, too, because if Iran is such a paper tiger then how were they a danger to us in the first place? It seems hard to argue both that Iran is an existential threat to the United States and that we can topple them in 20 minutes with no casualties or negative downstream effects. Also the political calculation really matters here. A huge majority of American oppose this. That’s just a fact. If it costs Republicans in 26 and 28, then, no matter how things work out in Iran, it will not have been worth it. A free Iran at the cost of Democrat rule here at home is a bad deal. A free Iran for an unfree America would be just about the worst trade of the century. I’m praying for our great country today.

@DutchRojas It's not democracy, it's the new social contract

@DutchRojas "Man is born free yet everywhere in chains," and as those chains broke free we created indentured servitude through employer sponsored health insurance. Jean Jacques Rosseau proved right again 264 years later.

Site-neutral reform would save Medicare $157-180 billion over 10 years. The American Hospital Association (AHA) is stopping it. Lawmakers support the AHA. The calculation they're making is simple: $180 billion beats democracy. They're not wrong about the math.

@DutchRojas They have a named recipient. It usually the CEO and cadre of unnecessary administrative staff conducting a massive grift.

Here is a peculiar feature of nonprofit hospital finance. A hospital can hold an $11 billion investment portfolio, pay its CEO $6.1 million, maintain a parking garage at market rates, and collect $837 million in annual tax exemptions. The IRS requires only one thing: no shareholders. “Nonprofit” is not a description of behavior. It is a description of ownership structure. The profits still exist. They simply do not have a named recipient. They have unnamed recipients. That is a different problem entirely.

@JTLonsdale @Ravarora1 @GovMikeHuckabee His ratings suck. His voice is squeaky and his low budget staffers had him poorly prepare d. He isn't much smarter than Candice Owen.e

@Ravarora1 @GovMikeHuckabee So if a 15 year old is brainwashed for a decade to hate you and want to kill you, and trained to fight and given a gun by the terrorists, and his side has kidnapped your children, you would then refuse to fight to rescue them if it puts that armed 15 year-old in danger? Really?

Listen, I like @GovMikeHuckabee personally. He was kind enough to praise my writing on BLM on his show in 2020. However, as an outsider on this issue I was genuinely mystified by some of the things he said here such as his biblical justification for determining who the land of modern-day Israel belongs to. Also, there is vast range of arguments one can make for defending Israel’s response to Oct 7. But saying it is justified for children to be killed in the war because they were brainwashed and recruited by Hamas is quite morally questionable. Huckabee makes this argument very clearly - while also somehow saying all human life is equal and every death is a tragedy (that is incoherent). I get the rationale (the old “would you kill baby Hitler question”) but that line of thinking gets quite dangerous very quickly - you could get away with a lot of atrocities by that ethical rubric.

@DavidM_Friedman @TuckerCarlson @USAmbIsrael He is a failing podcaster

I’m coming in late to the @TuckerCarlson attempted food fight with the great @USAmbIsrael Mike Huckabee, since it dropped right before Shabbat and I then had to leave for a long flight. I agree with everything that has been said about how Huckabee absolutely massacred Carlson. With the benefit hindsight, I’ve synthesized in my mind all of Tuckers horrible comments in an attempt to determine whether he is one or more of the following. 1) simply ignorant 2) intentionally and recklessly ignorant 3) biased and manipulative, or 4) an antisemitic liar. Bottom line — he’s all those things but well ensconced in #4, the lowest form on the Jew-hating scale. He self-destructed in this interview and in the lies and spin that he used subsequently to hide his abysmal failures. Zero credibility at this juncture!