Barbarians At The Hospital Gates | University Of Warcraft | Batwoman’s Warning
May 27, 2020
“America’s healthcare system is neither healthy, caring, nor a system.” ― Walter Cronkite
“There are more than 9,000 billing codes for individual procedures and units of care. But there is not a single billing code for patient adherence or improvement, or for helping patients stay well.” ― Clayton M. Christensen
Barbarians At The Hospital Gates
Justin Sullivan via Getty Images
Many organizations and institutions can be run just fine as strictly for-profit businesses. Two that can’t or shouldn’t be are the US government — and the American health care system.
Private investors used to be prevented from buying doctors’ offices. Corporate ownership contravenes the law in many states, as well as the American Medical Association’s tenet that if you want to make money on a medical practice you need to have a medical license.
Over the past decade lawyers devised a structure that allows investors to buy a medical practice without technically owning it: the management service organization (MSO). Theoretically, physicians continue to control all medical decisions, just agreeing to pay a management fee to a newly created company handling administrative tasks like billing and marketing.
Investment firms have bought up big, popular practices — with multiple doctors and several locations — then purchased smaller offices and solo practices to give the group a regional presence. The long-term goal has been to make an annualized return of 20 to 30 percent in five years or less. Doing that meant drastically cutting costs, multiplying procedures (necessary or not), then selling at a profit to another private firm that continues cutting costs, etc. Adding in-house labs and specialists are more ways investors make money off a patient’s treatment.
But these for-profit ventures can create problems unique to healthcare: pressure to perform unnecessary procedures, replacing doctors with nurse practitioners, missed or inaccurate diagnoses, limiting certain medical supplies, and patients who are almost always in the dark. Doctors who regret selling out are stymied by multi-year contracts with non-compete clauses.
The pandemic has made things worse. Despite sitting on billions in cash, the country’s wealthiest for-profit hospital chains have received billions from the federal program that was supposed to prevent struggling health care providers from going under during the crisis.
- COVID-19 cases among health care workers top 62,000, CDC reports (NBC News)
- Trump Team Killed Rule Designed To Protect Health Workers From Pandemic Like COVID-19 (NPR)
- Additional reference: Barbarians at the Gate & Barbarians at the Gate trailer (surprisingly a watchable movie)
- Additional painting: Norman Rockwell, Doctor and the Doll
Batwoman’s Warning
- Shi Zhengli (aka China’s bat woman), deputy director of the Wuhan Institute of Virology, is a virologist renowned for her work on coronavirus in bats. In an interview on state television at the start of the National People’s Congress in Beijing last Friday, Shi said that viruses being discovered now are “just the tip of the iceberg,” and called for international cooperation in the fight against epidemics.
- “If we want to prevent human beings from suffering from the next infectious disease outbreak, we must go in advance to learn of these unknown viruses carried by wild animals in nature and give early warnings,” she said, adding: “If we don’t study them there will possibly be another outbreak.”
- President Trump and Secretary of State Michael Pompeo have both contended the coronavirus sweeping the world is likely linked to the Wuhan laboratory. But Shi says the genetic characteristics of the viruses she’s worked with didn’t match those of the coronavirus spreading in humans, even posting on social media she would “swear on my life” the pandemic had nothing to do with her lab.
- In another weekend interview the director of Wuhan’s Virology Institute said the idea that the virus escaped from the lab was “pure fabrication.” (Bloomberg)
- Additional quotes: “You’re not the devil. You’re practice.” – Batman (but this quote feels to have encapsulated the entire summary above)
- “If you kill a killer, the number of killers in the room remains the same.” – Batman
Can The Poor Live Through This
- Peru’s president Martin Vizcarra has handled the coronavirus epidemic entirely differently from Brazil’s president Jair Bolsonaro. While Bolsonaro has continued to downplay the dangers posed by the virus throughout the pandemic, Vizcarra declared a state of emergency on March 15, closing the country’s borders, and ordering curfews and mandatory self-quarantine.
- Regardless, as of Monday, Peru had more than 123,900 confirmed coronavirus cases and 3,600 deaths, putting it second to Brazil both in number of cases and deaths in Latin America. A chief reason the virus has surged in Peru despite precautionary measures is the country’s deep socio-economic inequality. Many of Peru’s poor have no choice but to venture outside their homes for work, food or even banking transactions.
- Only 49 percent of Peruvian households own a refrigerator or freezer, meaning people must visit food markets daily because they can’t stock up. More than 30 percent of households exist in overcrowded conditions, with four or more people sleeping in the same room. Experts argue against laying all the blame for the continued spread of the virus on the peoples’ behavior; so many Peruvians must live and work in ways that simply can’t be reconciled with social distancing. (CNN)
- Additional reference: Live Through This, and a classic lyric: “And someday, you will ache like I ache” – Doll Parts by Hole
Additional World News
- By Air and Sea, Mercenaries Landed in Libya. But the Plan Went South. (NYT, $)
- China’s military says it is prepared to protect security in Hong Kong, as protests grow (Guardian)
- Japan to discuss cyberbullying laws after death of wrestler and ‘Terrace House’ star (CNN)
- Just because you’re in quarantine, doesn’t mean you have to let your grooming and hygiene routine go. One great way to feel productive during these challenging times is to keep looking and feeling groomed.
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The Countdown To the Showdown: Political Wrestlemania in 2020
- President Trump is working hard to explain away what could be his loss in November’s presidential election. First he threatened to withhold funds from Michigan and Nevada, saying both states were preparing to commit voter fraud through mail-in ballot applications. Then he followed up Sunday with two more broadly worded warnings that November would be “the greatest Rigged Election in history.”
- Trump’s increasingly amped-up rhetoric surrounding the November election has his opponents increasingly anxious that he may attempt to undermine the results of the election if he loses — or worse, might attempt to cling to power regardless of the outcome.
- Vanita Gupta, a former head of the Department of Justice’s civil rights division under President Obama, tweeted Sunday: “[Trump] is planting the seeds for delegitimizing the election if he loses. [His ‘rigged election’ claim is] from the playbook. It’ll get more intense as he gets more freaked out.”
- Trump’s rhetoric isn’t anything new. The president has had a long preoccupation with voter fraud and “rigged” elections. After his general election victory, Trump made unsubstantiated claims of “serious voter fraud in Virginia, New Hampshire and California” — three states he failed to carry — and told congressional leaders that millions of illegal votes were the reason he lost the popular vote. Then in one of his first acts as president, Trump created an 11-member commission to study alleged voter fraud.
- Two years later, amid the GOP’s 2018 wipeout, he was lodging complaints about “electoral corruption” in Arizona and “missing or forged” ballots in Florida. (Politico)
- In case like us you were wondering: here is a countdown clock to the 2020 US Presidential election.
- Why Senate Republicans Still Support Trump (Atlantic, $)
- In crucial Florida, some senior voters cast a skeptical eye toward Trump’s reelection (WaPo, $)
- Tracing ‘patient zero’: why America’s first coronavirus death may for ever go unmarked (Guardian)
- What the Coronavirus Revealed About Life in Red vs. Blue States (NYT, $)
Flipping Twitter A Different Kind Of Bird
- President Trump has repeatedly used the 2001 death of a woman to attack his critics. Trump continues to spread the pernicious lie by tweeting about the death of Lori Klausutis as a means to smear MSNBC television host, Joe Scarborough. Scarborough and his wife, co-host Mika Brzezinski, frequently criticize Trump on the Morning Joe program.
- Scarborough had employed 28-year-old Lori Klausutis at the time of her death in July 2001, when he was a Republican congressman from Florida. The local medical examiner said Klausutis died from a head injury in a fall caused by a previously undiagnosed heart condition. At the time some far-left websites spread a smear that Klausutis died from foul play and that Scarborough, who was 1,000 miles away in Washington at the time, was somehow involved.
- Widower Timothy Klausutis, a civilian US air force contractor, has very rarely commented on lies spread about his wife’s death. But in a letter to Twitter chief executive Jack Dorsey, published on Tuesday by the New York Times, Klausutis made a heartfelt plea asking for the deletion of those tweets. “Her passing is the single most painful thing that I have ever had to deal with in my 52 years and continues to haunt her parents and sister,” Klausutis wrote. “Please delete those tweets … My wife deserves better.”
- The response the still-grieving widower got was that Twitter would not delete the tweets. (Guardian)
- Trump Promotes Posts From Racist and Sexist Twitter Feed (NYT, $)
- Twitter Must Cleanse the Trump Stain: The president is spreading a vile conspiracy theory on the platform. Maybe Twitter should finally hold him to its rules. (NYT, $)
- Bill Gates and Jack Dorsey both recommend this book—it can help with anxiety and decision-making (CNBC)
University Of Warcraft: Should I Spend My COVID-19 Time On MMOGs or MOOCs
- Online education websites like Coursera, edX and Udacity have struggled for years. But in the last two months, millions of adults have signed up to learn online during the coronavirus crisis. The new signup jolt could mean a renaissance for big internet learning networks known as MOOCs — massive open online courses. These high-profile university experiments sprang up almost a decade ago, with a proclaimed mission to “democratize education.”
- Udacity and Coursera were founded at Stanford University by professors in the hot field of artificial intelligence. Their creations were portrayed as tech-fueled insurgents destined to disrupt the antiquated ways of traditional higher education. Early courses attracted hundreds of thousands of students from around the world. However screen fatigue eventually set in, attention would stray, and few people wound up completing their distance learning courses. The sites even became a punchline among academics: “Remember the MOOCs?”
- But the online ventures adapted over time through trial and error, gathering lessons that could provide a road map for school districts and universities pushed online. EdX, created by MIT and Harvard University in 2012, is a non-profit. “Active learning works, and social learning works,” said edX’s founder and CEO. “And you have to understand that teaching online and learning online are skills of their own.” (NYT)
- Massively multiplayer online game (MMOGs)
- Opinion | The Future of College Is Online, and It’s Cheaper (NYT, $) Hurray, not only is the rent too damn high but so is college tuition. The best thing Daily Pnut’s Tim got out of going to West Point and Stanford was definitely NOT the education (grades don’t even matter at Stanford’s business and law schools and rightfully so because grades don’t predict success whether on the fields of unfriendly strife in Iraq or Silicon Valley) but the relationships-friendships. “Elite” schools are “elite” because they are just a way for capitalists to cavort in the most anti-capitalist way and that is to fraternize and create informal unions. As Peter Thiel notes, the most strident capitalists are secretly anti-capitalist monopolists: “If you’re the founder…entrepreneur starting a company, you always want to aim for monopoly and you always want to avoid competition.”