As we enter the home stretch of ObamaCare implementation, this is the latest info on which states will accept Federal expansion of Medicaid effective 2014.
[Those of you keeping score at home will note that Oklahoma is solidly red.]
GlassHospital is a platform upon which I develop ideas about communicating medical and health policy topics to an informed lay audience (that’s you).
I’m pleased to say that some of those ideas develop from blog posts into more substantive articles (e.g. my first-ever post on the NPR “Shots” blog this week). Some also morph into radio commentaries and fuel my latest passion, guest-hosting a local NPR interview show.
Recently some readers made it known that they were not aware of the radio work or other publications. I list them under the “Fun Stuff” heading that you can reach from the home page of the blog.
To honor their request, I’m going to link below to some radio highlights. Here’s wishin’ all the Moms out there a very Happy Mother’s Day!
- A radio interview about Women In Recovery, an amazing Tulsa-based program that helps low-level female offenders get out of prison and back into life.
- An interview with Kevin Pho, the founder and curator of KevinMD.com, one of the most widely-read health care blogs and the author of a new book.
- My interview with John Silva, CEO of Morton Comprehensive Health Services, a Tulsa-based federally-qualified community health center.
- An interview with Jennifer Hays-Grudo, a nationally known researcher in health and development, who now focuses on “adverse childhood events” and how to minimize them.
There are many others. Check out “Fun Stuff.” And thanks for listening.
May 7, 2013
Reynolds Center, University of Tulsa Campus
Remarks of John Henning Schumann, MD
Graduates, Families, Friends, Staff, Faculty, Dignitaries:
Tonight, almost 500 of you are honored as graduates of our vibrant institution. En masse, you are an amazing collection of individuals.
The youngest of you is a mere 21—barely legal, while the most senior is five decades older. Age is only a number. What matters is the desire. The spark. The intrinsic motivation to keep asking and learning well beyond “school age.”
For every man graduating tonight, there are three women. What’s this we’ve been hearing lately about “Leaning In?” I reckon that this ratio is a sign that we are leveling our playing fields.
Amongst the graduates here tonight are OU staffers; one set of twins; and two married couples. Your scholarly activities range from Health to Design; Engineering to Organizations and Leadership; Teaching; Relating; Healing, Organizing and innovating.
The breadth of your fields are inspiring and lend meaning to the rambunctious democracy that gives us all the freedom to choose our way of life.
Wherever you go with your new degrees, I encourage you to continue using your intrinsic motivation as a pathway guide.
With a nod to a mentor of mine, Dr. Rachel Remen of the Institute for the Study of Health and Illness, I want to share the Parable of the Stone Cutters with you:
It was bound to happen.
By “it,” I mean that the small group of speciality hospitals (usually orthopedic or cardiology-focused) across that country that are owned by doctors were going to have their “See! We Told ‘ya so!” moment.
Doctor-owned hospitals: How many are there? Two hundred and thirty-eight of them in the whole country (out of more than five thousand)–somewhere between four and five percent of the total in the U.S. (numbers courtesy TA Henry from this excellent piece).
What are the issues?
- ObamaCare effectively bans doctors from owning hospitals in the U.S.
- Those already in existence are grandfathered in under the law.
- We know that doctor-owned hospitals have higher average costs–hence the rationale for banning them under a law with the intent of “bending the cost curve.”
Cue the iron-o-meter:
In the most recent Medicare data (December 2012 report on “value-based purchasing“), doctor-owned hospitals did well in terms of achieving quality milestones.
Really well. Physician-owned hospitals took nine out of the top ten spots in the country. And in spite of their low relative number, forty-eight out of the top one hundred.
What’s the secret sauce? Here’s a little tidbit on the #1 ranked hospital from another excellent piece on this issue (J Rau of Kaiser Health News):
The top one is Treasure Valley Hospital in Boise, Idaho, a 10-bed hospital that boasts a low patient-to-nurse ratio and extra attention, right down to thank-you notes sent to each discharged patient.
A 10-bed hospital? Thank you notes for each discharged patient? Sign me up to go there next time I need hospital services.
Who cares? Well, we all should. Why?
It boils down to incentives.
When doctors own the hospitals, they stand to directly share in profits. If you’re a doctor-owner, and the hospital you both run and own is functioning at a high level, you think, “This is what America is all about. Free enterprise. Why shouldn’t I make more money if my hospital runs well?”
As a taxpayer, do I want government incentives going to hospitals that are privately owned and known for cherry-picking insured patients?
Moreover, what does it say about public hospitals, or academic centers, that often see the sickest, poorest, most vulnerable patients? Yes, their quality is measurably lower, according to this data. But now, in spite of staying true to their core missions (serving the public) they’re being further penalized.
Is this just another case of the rich simply getting richer?
Maybe ObamaCare’s got it wrong. Maybe we should build upon the model of doctor-ownership and turn over public hospitals to their workers. All of them. Let the nurses buy in. And the food handlers. And the “environmental services” folks (i.e. custodial crews). Let’s really let the workers own the means of production. Then we can see where incentives get us.