Kerry Bashes Bush on Health Care Costs (AP)
Grok Headline matches for Kerry Bashes Bush on Health Care Costs (AP)
Heinz Kerry Bashes Health Care Plan Foes
(AP)
Heinz Kerry Bashes Health Care Plan Foes
(AP)
09/09/2004 10:29 AMAP - Teresa Heinz Kerry says "only an idiot" would fail to support the
health care plan proposed by her husband, Democratic presidential
candidate John Kerry.
Bush and Kerry Duel on Health Care,
Weapons Ban (Reuters)
Bush and Kerry Duel on Health Care,
Weapons Ban (Reuters)
09/13/2004 04:53 PMReuters - President Bush and Democratic rival
John Kerry dueled over health care and the expired assault
weapons ban on Monday, with Bush slamming Kerry for backing a
costly "government takeover" of health care that would lead to
higher taxes.
Kerry Bashes Bush on Assault Weapons Ban
(AP)
Kerry Bashes Bush on Assault Weapons Ban
(AP)
09/14/2004 12:14 AMAP - Sen. John Kerry sought to make President Bush pay a political
price Monday for the expiration of a partial assault weapons ban, but
other Democrats reacted warily on an issue that has hurt the party in
recent elections.
Kerry bashes Bush record on job creation
Kerry bashes Bush record on job creation
04/27/2004 02:27 PMMaking 'Sense' of Health Care Costs and
Other Complex Challenges
Making 'Sense' of Health Care Costs and
Other Complex Challenges
06/05/2005 11:12 PM
When
does the pursuit of 'best practices' make sense, and when do we need
to
apply less precise but more effective approaches instead?
 This week's New Yorker has another interesting
column by James Surowiecki, entitled Local Knowledge,
which laments the fact that there are huge anomalies in health care in
the US from community to community, a result of a combination of local
customs, patient demographics, and the varying supply and
accessibility
of practitioners and facilities. Great variations in treatment have
been noted in many diseases and conditions, including serious and
controversial ones like cesarean sections, spinal fusions,
mastectomies, and coronary-bypass surgeries. Different treatments and
variances in hospital stays mean great variations in medical cost,
Surowiecki says, and this could be costing the US health care system
billions it can't afford. His prescription? Not a new government
standards body, but increasing awareness of people about these
differences, so that the 'inefficiencies' are driven out of the system
by informed patients and caregivers.
What Surowiecki seems to be looking for is what in business is called
'best practices'. What's interesting to me is that business has
recently become disenchanted with 'best practices': In a world where
every job, every situation, every context is different, the
applicability of some documented 'best practice' in any situation
other
than the one it was identified in is increasingly dubious. Dave
Snowden
articulates these three
'heuristics' about real-world knowledge:
Knowledge can only be
volunteered; it can't be conscripted.
People always know more than they can tell and can tell more than they
can write.
People only know what they know when they need to know it. Human
knowledge is contextual and triggered by circumstance.
So what we have here is a clash of two new and exciting philosophies:
Surowiecki's argument that tapping the Wisdom of
Crowds
can allow much better answers to emerge than relying on experts,
versus
Snowden's argument that such 'wisdom' is possible and useful only in
relatively simple situations where apples can clearly be compared to
apples, and doesn't
work in the majority of more complex situations where every case
is arguably significantly different.
An identified 'problem' in Surowiecki's article is the large number of
facilities and practitioners providing over-long stays to patients in
Florida, compared to other states. They are drawn there, of course,
because that's where the customers are, and, as in all things, the
work
tends to expand to fill the available space, money and time. In public
health services we seem to try to offset these 'market' tendencies by
making sure both facilities and practitioners' time are in constant
short supply, in the presumption that this will yield less waste and
force greater efficiency, rather than posing a serious threat to
public
health. And this is exactly the problem with applying mechanistic,
industrial, simple-situation prescriptions to complex-situation
challenges.
So what should we do when doctors in one community perform
appendectomies and tonsillectomies four times as often as they do in
the next community, of the same size, a stone's throw away? Surowiecki
thinks we need to figure out "how to pay doctors for the quality,
rather than the quantity, of the care they provide" and hopes that
"eventually people will start paying attention to the data and
recognize how costly these variations can be". But even he seems
dubious of the possibility of either of these things happening. Of
course patients need to be better informed about preventative health
care, self-treatment and new knowledge about less invasive and
unnecessary procedures. But health care isn't like widgets, where
differences in 'unit' product cost, quality and service are
conspicuous. Every situation is truly different, and we'll never come
up with either a formula for determining the right health care answer,
or an expert system that will tell us precisely where the
'inefficiencies' in health care are and how they can be
eliminated.
Surowiecki suggests the problem is geography and parochialism. But
geography is just one way of slicing community, and these days it's
not
even the most important one. The issue isn't isolation of community,
it's incomparability of situations with infinitely many different
contexts. When the data is a million cases of one, the significance of
patterns is likely to be illusory.
And health care isn't the exception either -- most of the products and
services that are essential to human well-being, like education,
nutrition, freedom, justice, security, transparency of government and
a
healthy environment are also enormously contextual, circumstantial and
relative. Experts and advocates in these fields have torn out their
hair trying to find benchmarks, standards, measures, scorecards and
'best practices' that will allow us to cajole improvements in
performance from those we assess to be falling short. It can't be
done.
Complicated solutions don't solve complex problems.
The essence of Snowden's new approach to
sense-making
and management 'science' is to first assess whether the situation
lends
itself to simple-to-complicated solutions and approaches (like root
cause analysis, systems thinking and The Wisdom of Crowds), or if it
requires more complex approaches (like cultural anthropology,
pattern-seeking, Open Space and emergent understanding techniques like
the AHA! Discovery Framework diagrammed above). It doesn't take much
thought to realize (a) that most of the challenges we face in business
and society today are complex, and (b) attempts to force simple and
complicated-situation solutions in complex situations, like the
deliberate starving of the health and education systems (and like the
ubiquitous imposition of lousy
service
in all areas of business today), in the ill-conceived belief these
will
somehow mechanically force efficiency and productivity improvements in
them, are doomed to make the situations worse, not better.
It's time we woke up to the realization that industrial-age solutions
are increasingly inapplicable in the information age, and it's time we
got over our discomfort with the imprecision, uncertainty, lack of
causality, and non-amenability to command-and-control hierarchy that
complex approaches entail. Managers, grit your teeth and prepare for
some revolutionary new, difficult and important learning.
So sorry, health care fans desperate for solutions to spiraling costs.
No 'best practices' or 'popular wisdom' answers here. Move along,
please.
|
Health-care costs shoot up, millions in
U.S. left gasping
Health-care costs shoot up, millions in
U.S. left gasping
07/04/2004 12:09 PM
Health-care costs shoot up, millions in U.S. left
gasping "...there are signs of growing frustration. The
Gallup Organization reported in January that for the first time since
1992, when Americans are polled about urgent health problems facing
the country, the cost of health care is No. 1, ahead of issues such as
cancer, obesity, and smoking..."
Kerry Focuses on Health Care (AP)
Kerry Focuses on Health Care (AP)
05/11/2004 02:10 AMAP - Democrat John Kerry is focusing on health care reform in a very
complex environment, one complicated by the furor at home and abroad
over the abuse of Iraqi prisoners by U.S. soldiers.
"lgf: Kerry: Lying About Health Care"
"lgf: Kerry: Lying About Health Care"
08/22/2004 04:11 AMKerry releases health care study
Kerry releases health care study
05/10/2004 02:41 PMOutsourcing, Rising Health Care Costs
and HSAs Highlight Media Coverage in
First HR Intelligence Trend Report for
2005
Outsourcing, Rising Health Care Costs
and HSAs Highlight Media Coverage in
First HR Intelligence Trend Report for
2005
03/29/2005 03:55 AMHRmarketer.com, the no. 1 online marketing and PR service in the human
capital industry, has introduced monthly trend reports that will track
companies and topics receiving most media attention, the top
advertisers, and the overall health of the human resource marketplace.
[PRWEB Mar 29, 2005]
Kerry decries outsourcing, speaks of
health care, tech
Kerry decries outsourcing, speaks of
health care, tech
07/30/2004 05:24 AMThe U.S. should close tax loopholes that provide incentives to
companies that want to ship jobs to other countries, provide its
military with the most advanced technology, while also focusing on
security and improving the health-care system, Democratic presidential
nominee John Kerry said Thursday night in a wide-ranging speech
accepting his party's nomination.
Kerry Questions Bush's Honesty on Health
Care, Iraq
Kerry Questions Bush's Honesty on Health
Care, Iraq
09/14/2004 12:53 PMReuters via Wired News Sep 14 2004 5:02PM GMT
Kerry Questions Bush's Honesty on Health
Care, Iraq (Reuters)
Kerry Questions Bush's Honesty on Health
Care, Iraq (Reuters)
09/14/2004 12:24 PMReuters - Democratic candidate John Kerry on
Tuesday sought the upper hand in his battle over character and
leadership with President Bush, by questioning his Republican
rival's honesty on issues from health care to Iraq.
Kerry vows to ease seniors health costs
(USATODAY.com)
Kerry vows to ease seniors health costs
(USATODAY.com)
09/15/2004 06:11 AMUSATODAY.com - Sen. John Kerry trumpeted his health care program
Tuesday as a recipe to bring down soaring medical costs, rejecting
Republican contentions that a Democratic plan would mean a government
takeover.
Kerry Blames Rising Health Costs for Job
Losses (Reuters)
Kerry Blames Rising Health Costs for Job
Losses (Reuters)
08/19/2004 03:58 AMReuters - Democrat John Kerry, citing a newly
commissioned study, said on Thursday that rising health care
expenses have cost American jobs and President Bush has done
nothing to solve the problem.
Michael Cannon on John Kerry and Health
Care on National Review Online
Michael Cannon on John Kerry and Health
Care on National Review Online
07/28/2004 04:25 PMCannon: HillaryCare, Take II .. proper
scrutiny
nationalreview.com/comment/cannon200407280009.asp
track this
site | 3 links
Bush unveils national health care IT
plan
Bush unveils national health care IT
plan
04/27/2004 05:17 PMPresident Bush called for development of a standards-based, nationwide
electronic medical record in 10 years and plans to appoint a
high-level health care IT czar to oversee the process.
Bush Radio Speech Touts Health Care Plan
(AP)
Bush Radio Speech Touts Health Care Plan
(AP)
01/24/2004 10:21 AMAP - President Bush, who has made health care a top item in his
election-year agenda, used his weekly radio address Saturday to
promote his plan to address rising medical costs and the growing ranks
of the uninsured.
Bush, Kerry Election Ad Costs Top
$90M (AP)
Bush, Kerry Election Ad Costs Top
$90M (AP)
04/17/2004 03:36 AMAP - Through next week, President Bush, Democratic rival John Kerry
and liberal interest groups will have spent at least $90 million
to air television ads since early March — a whopping total for an
election that's still about six months away.
Kerry, Sharpening Criticism of Bush,
Lists Costs of Iraq War
Kerry, Sharpening Criticism of Bush,
Lists Costs of Iraq War
09/08/2004 02:48 PMJohn Kerry said today that because of poor administration planning the
war had cost taxpayers $200 billion.
Kerry, Keeping Up Criticism of Bush,
Lists Costs of Iraq War
Kerry, Keeping Up Criticism of Bush,
Lists Costs of Iraq War
09/08/2004 12:44 PMJohn Kerry argued today that the president left a trail of broken
promises on the path to war and has squandered billions.
AHLA - Links to Selected Health Care and
Health Law Sites
AHLA - Links to Selected Health Care and
Health Law Sites
11/10/2003 10:50 PMAHLA - Links to Selected Health Care and Health Law
Siteshttp:
//www.healthlawyers.org/weblinks/weblinks_health.cfmAmerican Health Lawyers Association comprehensive set of links to
selected healthcare and health law sites.
Kerry Attacks Bush Over Ties to Health
Industry (Reuters)
Kerry Attacks Bush Over Ties to Health
Industry (Reuters)
05/11/2004 04:20 PMReuters - Democratic presidential
candidate John Kerry lashed out on Tuesday at President Bush
over his campaign contributions from companies picked to
administer the new prescription drug cards for seniors.
Bush Calls Kerry Health Plan
Bureaucratic Nightmare (Reuters)
Bush Calls Kerry Health Plan
Bureaucratic Nightmare (Reuters)
09/13/2004 02:23 PMReuters - President Bush derided Democrat
John Kerry's plan for reforming health care on Monday as a
bureaucratic nightmare and contended it would cost $1.5
trillion.
First Lady Bashes Kerry Stem Cell Stance
(AP)
First Lady Bashes Kerry Stem Cell Stance
(AP)
08/09/2004 04:50 PMAP - First lady Laura Bush defended her husband's policy on embryonic
stem cell research Monday, calling Democratic rival John Kerry's
criticism "ridiculous" and accusing proponents of overstating the
potential for medical breakthroughs.
The Rueckert-Hartman School for Health
Professions, Regis University, Denver,
CO, Announces the Formation of the
Center for Health Care Ethics and
Emerging Technologies
The Rueckert-Hartman School for Health
Professions, Regis University, Denver,
CO, Announces the Formation of the
Center for Health Care Ethics and
Emerging Technologies
06/05/2005 11:58 PMUnder the direction of Dr. Pat Ladewig, Dean, Rueckert-Hartman School
for Health Professions, Regis University established the Center for
Health Care Ethics and Emerging Technologies. Dr. Mark Meaney,
Executive Director, stated that the goals of the Center include the
examination of the ethical and social implications of emerging
biotechnologies such as nanobiotechnologies, pharmacogenomics, and
stem cell research. [PRWEB May 22, 2005]
Fox News Poll: Bush 48% Vs. Kerry 42% --
Bush 47% Vs. Kerry 40% Vs. Nader 3% --
Bush Approval 49%
Fox News Poll: Bush 48% Vs. Kerry 42% --
Bush 47% Vs. Kerry 40% Vs. Nader 3% --
Bush Approval 49%
06/25/2004 07:24 AMon
foxnews.com/story/0,2933,123679,00.html
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site | 5 links
Here's to Your (Cheaper) Health Care
Here's to Your (Cheaper) Health Care
09/16/2004 03:27 PMMore Americans are looking to Canada for ideas on fixing the
health-care crisis.
GE Bets on Health Care
GE Bets on Health Care
04/13/2004 02:20 PMClosing a $9.5 billion deal for the U.K.'s Amersham assures a major
role for GE Healthcare.
Study: U.S. health care not always the
best
Study: U.S. health care not always the
best
05/04/2004 02:01 PMHealth-Care Opportunity
Health-Care Opportunity
02/11/2004 03:12 PMHealth Net looks like a value-priced managed care company.
The Health Care Implosion
The Health Care Implosion
05/25/2004 01:22 PMMercury News: Health costs hurting more small businesses. The cost of
health insurance -- ranked the top concern of small businesses since
1986 -- still holds that dubious distinction, a new nationwide survey
shows. But the percentage of firms affected by those costs has grown
substantially.
The health care system, or at least
the insurance system through which our health-care dollars flow, is in
a slow-motion collapse. This story is just one more data point.
Sooner or later, we'll have to make a choice. Should the U.S. go to
national health care, as every single other industrialized nation
provides for its citizens? Or should we go to a totally free-market
system -- not the bogus pretense of one we have now -- that leaves
millions without care of any kind? Or something else?
The insurance industry is systematically excluding people who will
someday need care -- shifting costs wherever possible to taxpayers.
This may be rational capitalism, but it's lousy public policy.
I'm working on some columns on this topic.
Let
me know what you think.
Health care conundrum
Health care conundrum
06/20/2004 03:53 AMBoston Globe Jun 20 2004 7:13AM GMT
More health care have-nots
More health care have-nots
07/01/2004 01:45 PMHealth Care IT Czar Speaks
Health Care IT Czar Speaks
05/19/2004 02:52 PMOn the job only a few days, Dr. David Brailer made his first major
speech to attendees of an industry conference entitled "Toward
Electronic Patient Records" in Fort Lauderdale, Fl. this morning.
XP SP2 puts the squeeze on health care
XP SP2 puts the squeeze on health care
08/10/2004 09:44 PMYou think IBM has problems? How about being a hospital dependent upon
devices that run Windows? They want to have the latest Windows
security patches installed, but how can they when the device
manufacturers haven't certified that their products run...
IBM chalks up two health care wins
IBM chalks up two health care wins
08/18/2004 06:40 PMThe deals with a university medical center and a California health
care provider come two weeks after a win with the Mayo Clinic.
World Health Care Congress
World Health Care Congress
01/25/2004 11:41 AMI'm in DC in a hotel with a nice view of the J. Edgar Hoover building.
Facilitating a Socialtext Eventspace for the World Health Care
Congress. The World Health Care Congress is the first focused and
inclusive conference to determine...
Health care gets more high-tech
Health care gets more high-tech
04/10/2005 12:54 PMChicago Tribune Apr 10 2005 2:26PM GMT
Grok Description matches for Kerry Bashes Bush on Health Care Costs (AP)
GrokA matches for Kerry Bashes Bush on Health Care Costs (AP)
Kerry Bashes Bush on Health Care Costs (AP)
