Spike's Placetag:typepad.com,2003:weblog-3327822009-01-15T07:54:45-08:00Odds And Ends in Mental Health, Healthcare Policy, Religion, and MoreTypePadSpikesPlacehttp://feedburner.google.comReal Change in Healthcaretag:typepad.com,2003:post-614097702009-01-15T07:54:45-08:002009-01-15T07:54:45-08:00I met with the advisor to a local University's Health Administration Program yesterday to explore Grad School options. One thing from the conversation stood out in particular. During the initial phase of the discussion, I gave him a brief summary...spikeFox Guarding the Henhousetag:typepad.com,2003:post-475174002008-03-26T07:40:26-07:002008-03-26T07:40:26-07:00One of the most common responses to a call for greater government involvement in health care is that the government's susceptibility to fraud makes it unfit for a larger role. They say that because government employees gain nothing when a...spikeCharity Porntag:typepad.com,2003:post-471538142008-03-17T11:53:30-07:002008-03-17T11:53:30-07:00Watching pieces of ABC's Sunday Night Lineup last night, I was again struck by how revolting their "give back" shows are. The script for Extreme Makeover Home Edition is simple. Find a pathetic family with a giving spirit, glorify their...spikeWhat is the loving thing?tag:typepad.com,2003:post-470004182008-03-13T15:18:39-07:002008-03-13T15:18:39-07:00I wrote last week about our mission on earth to love each other. No question perplexes me more as to what "the loving response" is than homelessness. A commentary published at the San Francisco Chronicle highlights the complexities. In it,...spikeLottery Stupiditytag:typepad.com,2003:post-469376262008-03-12T11:00:44-07:002008-03-12T11:00:44-07:00When you work in Medicaid policy as I do, you learn that one of the main goals motivating state governments is trying to maximize the money they receive from the federal government and minimize the money they send to the...spikeRepublican Phariseestag:typepad.com,2003:post-468312162008-03-10T09:22:51-07:002008-03-10T09:22:51-07:00Another thought occurred to me as I was considering the passage in the Bible from my last post. It's been so well-documented around the web that it feels pointless to post links, so I won't, but the parallels between today's...spike"He was born blind so that God's works might be revealed in him"tag:typepad.com,2003:post-467311842008-03-07T13:35:56-08:002008-03-07T13:35:56-08:00John 9:1 As he walked along, he saw a man blind from birth. 9:2 His disciples asked him, "Rabbi, who sinned, this man or his parents, that he was born blind?" 9:3 Jesus answered, "Neither this man nor his parents...spikeLean Healthcare, Virginia Mason wrap-uptag:typepad.com,2003:post-374988002007-09-25T11:05:26-07:002007-09-25T11:05:26-07:00After thinking about Virginia Mason's experience with lean process improvement, it's become even clearer to me that the simplest, most a-political solution to the healthcare mess in America is a reworking of the reimbursement model to encourage value-add services and...spikeLean Hospitals - Provider reimbursementtag:typepad.com,2003:post-372609142007-08-02T20:11:26-07:002007-08-02T20:11:26-07:00I have at least one more post in my about the Virginia Mason lean experiment. So far, we've talked about how reporting near misses and medical errors is a key missing piece of hospital process improvement. We've also discussed how...spikeLean Hospitals, continuedtag:typepad.com,2003:post-369764082007-08-02T11:29:13-07:002007-08-02T11:29:13-07:00Last week, I began what I hope will be a series of posts on Virginia Mason's experience with lean process improvement and the effects it has had on their care delivery and their financial bottom line. Most of the commentary...spikeThe First Signtag:typepad.com,2003:post-119824772007-07-27T12:35:00-07:002007-07-27T12:35:00-07:00(I just realized I never actually posted this, but I think it's interesting, even if it is old news). The first sign that the party may soon be over for health insurance companies came in the form of a recent...spikeLean Hospitalstag:typepad.com,2003:post-369055342007-07-25T19:37:53-07:002007-07-25T19:37:53-07:00I've been reading a lot about lean production process improvement over the past couple months. The lean model got its start in Japan where the geniuses at Toyota created the Toyota Production Process. A process is "lean" when it has...spikePharmaceutical Valuetag:typepad.com,2003:post-364729642007-07-14T09:59:44-07:002007-07-14T09:59:44-07:00I had a little argument with a friend of mine about the role of pharmaceuticals in the current health care crisis. She works for a prominent investment research firm investigating and making recommendations on pharmaceutical companies. My contention was that...spikeSpend-down reformtag:typepad.com,2003:post-362077642007-07-07T09:16:42-07:002007-07-07T09:16:42-07:00Tucked in the end of John Holahan and Alan Weil's piece on Medicaid reform in Health Affairs (subscription required), they include this gem: The current spend-down provisions for acute care in Medicaid require people to potentially spend a considerable amount...spikeOutsourcing your billing work... to your patientstag:typepad.com,2003:post-361786082007-07-06T08:43:32-07:002007-07-06T08:43:32-07:00I had the displeasure of dealing with a local HCA facility over the past several months. I only went there once, but their billing practices were the gift that kept on giving. I had to go to their ER after...spike