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	<title>Comments on: Why Don&#8217;t Big Media Matt and Ezra Ever Use the Word &#8220;Profit&#8221;?</title>
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	<link>http://emptywheel.firedoglake.com/2009/09/09/why-dont-big-media-matt-and-ezra-ever-use-the-word-profit/</link>
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		<title>By: Sara</title>
		<link>http://emptywheel.firedoglake.com/2009/09/09/why-dont-big-media-matt-and-ezra-ever-use-the-word-profit/#comment-188615</link>
		<dc:creator>Sara</dc:creator>
		<pubDate>Thu, 10 Sep 2009 16:18:25 +0000</pubDate>
		<guid isPermaLink="false">http://emptywheel.firedoglake.com/2009/09/09/why-dont-big-media-matt-and-ezra-ever-use-the-word-profit/#comment-188615</guid>
		<description>&lt;p&gt;EW, Access as a concept is a fairly loaded and very inexact measure for Health Care. It shifts the burden to the individual to request specific services, as opposed to a focus on System designed to find and isolate those likely to benefit from a particular service.  The only good measure is essentially demographic — given a particular population, and the probability that a sub-group of individuals within that population likely would benefit from particular health care proceedures, what part of that population actually is screened for that, and if recommended, actually receives the proceedure?  &lt;/p&gt;
&lt;p&gt;Listening to a report on how the Student Health Service at the U of MN is dealing with H1N1 will give you an idea.  First, all fee paying students at the University are members of the Boynton Health Service, — Health Care fees are part of tuition.  All students are being “sampled” for the virus, but only one in 50 samples are being cultured.  The point is to keep looking for any mutation in the virus.  Students are all being interviewed with the purpose of identifying those with higher risk factors.  Those with Asthma, or the Pregnant, etc., get special monitoring, Otherwise they are being given a thermometer, and told to stay in their rooms till their temp is normal for 24 hours.  They are prescribed Tylenol and Cough Medicine, and are being told to expect to stay in for about five days.  First week of school Boynton was seeing an average of 40 patients per day, this week it is apparently 120 per day.  They have an internet connection to graph their progress and ask additional questions, or report complications.  Thus far, only two have been put in the health service in-patient ward.  This is a System’s approach to a particular known and characterized demographic, and given what is known about H1N1, it seems to be delivering and targeting appropriate service levels to all who need services.  The whole thing is designed around a demographic and a particular infection.  Whether it is good or not has nothing at all to do with access — all students have access.  The quality of the service will be determined by outcomes, essentially how many potential complications were identified and properly addressed, how few persons in the whole demographic have unsatisfactory outcomes.  And since it is a system, it clearly can produce economies.  I think most of this is being run by nurses and a few technicians.  Because it is a system, any new information about the behavior of the virus immediately goes into the feed-back loop, and thus the system is self-modifying based on a specialized information stream.&lt;/p&gt;</description>
		<content:encoded><![CDATA[<p>EW, Access as a concept is a fairly loaded and very inexact measure for Health Care. It shifts the burden to the individual to request specific services, as opposed to a focus on System designed to find and isolate those likely to benefit from a particular service.  The only good measure is essentially demographic — given a particular population, and the probability that a sub-group of individuals within that population likely would benefit from particular health care proceedures, what part of that population actually is screened for that, and if recommended, actually receives the proceedure?  </p>
<p>Listening to a report on how the Student Health Service at the U of MN is dealing with H1N1 will give you an idea.  First, all fee paying students at the University are members of the Boynton Health Service, — Health Care fees are part of tuition.  All students are being “sampled” for the virus, but only one in 50 samples are being cultured.  The point is to keep looking for any mutation in the virus.  Students are all being interviewed with the purpose of identifying those with higher risk factors.  Those with Asthma, or the Pregnant, etc., get special monitoring, Otherwise they are being given a thermometer, and told to stay in their rooms till their temp is normal for 24 hours.  They are prescribed Tylenol and Cough Medicine, and are being told to expect to stay in for about five days.  First week of school Boynton was seeing an average of 40 patients per day, this week it is apparently 120 per day.  They have an internet connection to graph their progress and ask additional questions, or report complications.  Thus far, only two have been put in the health service in-patient ward.  This is a System’s approach to a particular known and characterized demographic, and given what is known about H1N1, it seems to be delivering and targeting appropriate service levels to all who need services.  The whole thing is designed around a demographic and a particular infection.  Whether it is good or not has nothing at all to do with access — all students have access.  The quality of the service will be determined by outcomes, essentially how many potential complications were identified and properly addressed, how few persons in the whole demographic have unsatisfactory outcomes.  And since it is a system, it clearly can produce economies.  I think most of this is being run by nurses and a few technicians.  Because it is a system, any new information about the behavior of the virus immediately goes into the feed-back loop, and thus the system is self-modifying based on a specialized information stream.</p>
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		<title>By: emptywheel</title>
		<link>http://emptywheel.firedoglake.com/2009/09/09/why-dont-big-media-matt-and-ezra-ever-use-the-word-profit/#comment-188600</link>
		<dc:creator>emptywheel</dc:creator>
		<pubDate>Thu, 10 Sep 2009 08:30:20 +0000</pubDate>
		<guid isPermaLink="false">http://emptywheel.firedoglake.com/2009/09/09/why-dont-big-media-matt-and-ezra-ever-use-the-word-profit/#comment-188600</guid>
		<description>&lt;p&gt;Sorry, how does WORKLOAD of radiologists over a period that dosen’t cover most of the period in question (the last five years) prove that access has gone up? Particularly for a field that is 1) one of the few improvements in preventative care (increasing mammos) and 2) in the same area subject to significant malpractice exposure and therefore less lucrative than others?&lt;/p&gt;
&lt;p&gt;All you’ve shown is that for a period that doesn’t address this period one specialty has, at an individual level, gotten busier. But it doesn’t explain why. Is it because Congress has passed laws requiring mammos? Is it because MRIs are so easy to get (they’re not, as someone medically required to get them). Is it because there are fewer radiologists bc of some market failure? &lt;/p&gt;
&lt;p&gt;Now, contrary to you insinuation that asking for proof equates to not showing any semblance of truth in a post, a response to a request for proof that does not, in fact, prove anything related, is not very helpful.&lt;/p&gt;
&lt;p&gt;I’m happy to believe that radiology is an area where access has gone up, and easily believe it’s one driver of costs. But your link doesn’t prove that in the least, nor does an increase in the use of radiology prove an increase in access overall.&lt;/p&gt;</description>
		<content:encoded><![CDATA[<p>Sorry, how does WORKLOAD of radiologists over a period that dosen’t cover most of the period in question (the last five years) prove that access has gone up? Particularly for a field that is 1) one of the few improvements in preventative care (increasing mammos) and 2) in the same area subject to significant malpractice exposure and therefore less lucrative than others?</p>
<p>All you’ve shown is that for a period that doesn’t address this period one specialty has, at an individual level, gotten busier. But it doesn’t explain why. Is it because Congress has passed laws requiring mammos? Is it because MRIs are so easy to get (they’re not, as someone medically required to get them). Is it because there are fewer radiologists bc of some market failure? </p>
<p>Now, contrary to you insinuation that asking for proof equates to not showing any semblance of truth in a post, a response to a request for proof that does not, in fact, prove anything related, is not very helpful.</p>
<p>I’m happy to believe that radiology is an area where access has gone up, and easily believe it’s one driver of costs. But your link doesn’t prove that in the least, nor does an increase in the use of radiology prove an increase in access overall.</p>
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		<title>By: bmaz</title>
		<link>http://emptywheel.firedoglake.com/2009/09/09/why-dont-big-media-matt-and-ezra-ever-use-the-word-profit/#comment-188595</link>
		<dc:creator>bmaz</dc:creator>
		<pubDate>Thu, 10 Sep 2009 04:15:39 +0000</pubDate>
		<guid isPermaLink="false">http://emptywheel.firedoglake.com/2009/09/09/why-dont-big-media-matt-and-ezra-ever-use-the-word-profit/#comment-188595</guid>
		<description>&lt;p&gt;I don’t know whether to call your comment pure crap or a bad joke.  You have the temerity to wander in from the cold, spew a link about freaking radiologists, completely impertinent and inapplicable to the discussion, and then bray like a wounded cat about the author here not having facts and being a shill??  Right back at ya moron.&lt;/p&gt;</description>
		<content:encoded><![CDATA[<p>I don’t know whether to call your comment pure crap or a bad joke.  You have the temerity to wander in from the cold, spew a link about freaking radiologists, completely impertinent and inapplicable to the discussion, and then bray like a wounded cat about the author here not having facts and being a shill??  Right back at ya moron.</p>
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		<title>By: visionbrkr</title>
		<link>http://emptywheel.firedoglake.com/2009/09/09/why-dont-big-media-matt-and-ezra-ever-use-the-word-profit/#comment-188590</link>
		<dc:creator>visionbrkr</dc:creator>
		<pubDate>Thu, 10 Sep 2009 04:02:29 +0000</pubDate>
		<guid isPermaLink="false">http://emptywheel.firedoglake.com/2009/09/09/why-dont-big-media-matt-and-ezra-ever-use-the-word-profit/#comment-188590</guid>
		<description>&lt;p&gt;Now, I’m really curious if Ezra has hard data to prove that the increase in the rate of cost increases came from more open access to care in the last several years. &lt;/p&gt;
&lt;p&gt;Are you serious?  So wait costs are going up and people with insurance are getting LESS care?  &lt;/p&gt;
&lt;p&gt;See below for an example of the truth.  Go into radiology.  There’s plenty of money there.&lt;/p&gt;
&lt;p&gt;&lt;a href=&quot;http://radiology.rsna.org/content/236/3/920.figures-only&quot; rel=&quot;nofollow&quot;&gt;http://radiology.rsna.org/cont.....gures-only&lt;/a&gt;&lt;/p&gt;
&lt;p&gt;At least have some semblance of the truth in your posts please, otherwise you’re left a left wing schill.&lt;/p&gt;
&lt;p&gt;Medicare’s fraud and abuse &gt;&gt;&gt;&gt;  Insurers profits.&lt;/p&gt;
&lt;p&gt;Fix medicare first and then we can talk single payer.&lt;/p&gt;</description>
		<content:encoded><![CDATA[<p>Now, I’m really curious if Ezra has hard data to prove that the increase in the rate of cost increases came from more open access to care in the last several years. </p>
<p>Are you serious?  So wait costs are going up and people with insurance are getting LESS care?  </p>
<p>See below for an example of the truth.  Go into radiology.  There’s plenty of money there.</p>
<p><a href="http://radiology.rsna.org/content/236/3/920.figures-only" rel="nofollow">http://radiology.rsna.org/cont&#8230;..gures-only</a></p>
<p>At least have some semblance of the truth in your posts please, otherwise you’re left a left wing schill.</p>
<p>Medicare’s fraud and abuse &gt;&gt;&gt;&gt;  Insurers profits.</p>
<p>Fix medicare first and then we can talk single payer.</p>
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		<title>By: PJEvans</title>
		<link>http://emptywheel.firedoglake.com/2009/09/09/why-dont-big-media-matt-and-ezra-ever-use-the-word-profit/#comment-188588</link>
		<dc:creator>PJEvans</dc:creator>
		<pubDate>Thu, 10 Sep 2009 03:48:26 +0000</pubDate>
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		<description>&lt;p&gt;A lot of people drive without insurance. (Was involved, peripherally, in an accident a couple of months back. Everyone handed over insurance information to the nice policeman - but a couple of weeks later one of the insurance companies said, nope, we don’t cover that person.)&lt;/p&gt;</description>
		<content:encoded><![CDATA[<p>A lot of people drive without insurance. (Was involved, peripherally, in an accident a couple of months back. Everyone handed over insurance information to the nice policeman &#8211; but a couple of weeks later one of the insurance companies said, nope, we don’t cover that person.)</p>
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		<title>By: PJEvans</title>
		<link>http://emptywheel.firedoglake.com/2009/09/09/why-dont-big-media-matt-and-ezra-ever-use-the-word-profit/#comment-188587</link>
		<dc:creator>PJEvans</dc:creator>
		<pubDate>Thu, 10 Sep 2009 03:46:28 +0000</pubDate>
		<guid isPermaLink="false">http://emptywheel.firedoglake.com/2009/09/09/why-dont-big-media-matt-and-ezra-ever-use-the-word-profit/#comment-188587</guid>
		<description>&lt;blockquote&gt;&lt;p&gt;The amount that an individual pays for health insurance is a fraction of her overall spending on health care. At a broader level, a substantial part of the cost of health insurance shouldn’t be considered part of health care costs.&lt;/p&gt;&lt;/blockquote&gt;
&lt;p&gt;Maybe they’d get it if ‘health’ was replaced by ‘auto’. Although most states do a better job of regulating auto insurance than they do health insurance.&lt;/p&gt;</description>
		<content:encoded><![CDATA[<blockquote><p>The amount that an individual pays for health insurance is a fraction of her overall spending on health care. At a broader level, a substantial part of the cost of health insurance shouldn’t be considered part of health care costs.</p>
</blockquote>
<p>Maybe they’d get it if ‘health’ was replaced by ‘auto’. Although most states do a better job of regulating auto insurance than they do health insurance.</p>
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		<title>By: bmaz</title>
		<link>http://emptywheel.firedoglake.com/2009/09/09/why-dont-big-media-matt-and-ezra-ever-use-the-word-profit/#comment-188586</link>
		<dc:creator>bmaz</dc:creator>
		<pubDate>Thu, 10 Sep 2009 03:45:37 +0000</pubDate>
		<guid isPermaLink="false">http://emptywheel.firedoglake.com/2009/09/09/why-dont-big-media-matt-and-ezra-ever-use-the-word-profit/#comment-188586</guid>
		<description>&lt;p&gt;Apples and oranges.  A citizen does not have to have auto insurance if he does not own/drive a car, an activity which is a privilege.  There is no mandatory penalty if you choose not too; with healthcare, there is.&lt;/p&gt;</description>
		<content:encoded><![CDATA[<p>Apples and oranges.  A citizen does not have to have auto insurance if he does not own/drive a car, an activity which is a privilege.  There is no mandatory penalty if you choose not too; with healthcare, there is.</p>
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		<title>By: SparklestheIguana</title>
		<link>http://emptywheel.firedoglake.com/2009/09/09/why-dont-big-media-matt-and-ezra-ever-use-the-word-profit/#comment-188585</link>
		<dc:creator>SparklestheIguana</dc:creator>
		<pubDate>Thu, 10 Sep 2009 03:37:11 +0000</pubDate>
		<guid isPermaLink="false">http://emptywheel.firedoglake.com/2009/09/09/why-dont-big-media-matt-and-ezra-ever-use-the-word-profit/#comment-188585</guid>
		<description>&lt;p&gt;Auto insurance is mandatory in some/many states.  (No idea how many.)  Has there been a constitutional challenge to that?&lt;/p&gt;</description>
		<content:encoded><![CDATA[<p>Auto insurance is mandatory in some/many states.  (No idea how many.)  Has there been a constitutional challenge to that?</p>
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		<title>By: fatster</title>
		<link>http://emptywheel.firedoglake.com/2009/09/09/why-dont-big-media-matt-and-ezra-ever-use-the-word-profit/#comment-188584</link>
		<dc:creator>fatster</dc:creator>
		<pubDate>Thu, 10 Sep 2009 03:27:51 +0000</pubDate>
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		<description>&lt;p&gt;O/T, or please humor me.&lt;/p&gt;
&lt;p&gt;Some good news for a change.  (Yeah, I know they’ll pull us down with them, but I’ll take what solace I can get.)  &lt;/p&gt;
&lt;p&gt;&lt;strong&gt;Income Gap Shrinks in Slump at the Expense of the Wealthy&lt;/strong&gt;&lt;br /&gt;
BY BOB DAVIS AND ROBERT FRANK&lt;br /&gt;
SEPTEMBER 10, 2009&lt;/p&gt;
&lt;p&gt;“The deepest downturn in the U.S. economy since the Great Depression may finally shrink the gap between the very best-off Americans and everyone else.&lt;/p&gt;
&lt;p&gt;“If so, it won’t be by lifting up the bottom. It will be by pulling down the top.&lt;/p&gt;
&lt;p&gt;“Over the past 30 years, chief executives, Wall Street bankers and traders, law-firm partners and such amassed ever-greater incomes, while the incomes of factory workers, teachers, office managers and others in the middle grew much more slowly. In 2007, the top 1% of U.S. families accounted for 23.5% of all personal income in the U.S., according to economists . . . “&lt;/p&gt;
&lt;p&gt;&lt;a href=&quot;http://online.wsj.com/article/SB125254156520197777.html&quot; rel=&quot;nofollow&quot;&gt;Link.&lt;/a&gt;&lt;/p&gt;</description>
		<content:encoded><![CDATA[<p>O/T, or please humor me.</p>
<p>Some good news for a change.  (Yeah, I know they’ll pull us down with them, but I’ll take what solace I can get.)  </p>
<p><strong>Income Gap Shrinks in Slump at the Expense of the Wealthy</strong><br />
BY BOB DAVIS AND ROBERT FRANK<br />
SEPTEMBER 10, 2009</p>
<p>“The deepest downturn in the U.S. economy since the Great Depression may finally shrink the gap between the very best-off Americans and everyone else.</p>
<p>“If so, it won’t be by lifting up the bottom. It will be by pulling down the top.</p>
<p>“Over the past 30 years, chief executives, Wall Street bankers and traders, law-firm partners and such amassed ever-greater incomes, while the incomes of factory workers, teachers, office managers and others in the middle grew much more slowly. In 2007, the top 1% of U.S. families accounted for 23.5% of all personal income in the U.S., according to economists . . . “</p>
<p><a href="http://online.wsj.com/article/SB125254156520197777.html" rel="nofollow">Link.</a></p>
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		<title>By: bmaz</title>
		<link>http://emptywheel.firedoglake.com/2009/09/09/why-dont-big-media-matt-and-ezra-ever-use-the-word-profit/#comment-188582</link>
		<dc:creator>bmaz</dc:creator>
		<pubDate>Thu, 10 Sep 2009 03:13:49 +0000</pubDate>
		<guid isPermaLink="false">http://emptywheel.firedoglake.com/2009/09/09/why-dont-big-media-matt-and-ezra-ever-use-the-word-profit/#comment-188582</guid>
		<description>&lt;p&gt;Well, I would certainly defer to you on this and, ultimately, I think you are probably correct.  That said, I thought the contemplation was to make it recoverable through the IRS, and I think there better be some pretty bright thought put into how such a tax is appropriate when it is simultaneously a penalty provision.  Clearly it is a straight assessment of some nature and is intended to be administered per se without a due process consideration.  There are a lot of pitfalls available.&lt;/p&gt;</description>
		<content:encoded><![CDATA[<p>Well, I would certainly defer to you on this and, ultimately, I think you are probably correct.  That said, I thought the contemplation was to make it recoverable through the IRS, and I think there better be some pretty bright thought put into how such a tax is appropriate when it is simultaneously a penalty provision.  Clearly it is a straight assessment of some nature and is intended to be administered per se without a due process consideration.  There are a lot of pitfalls available.</p>
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