Tag Archives: responsibilities

Death Panels?

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The Affordable Care Act required Medicare to penalize hospitals with high numbers of heart failure patients who returned for treatment shortly after discharge. New research shows that penalty was associated with fewer readmissions, but also higher rates of death among that patient group.

Because sometimes readmission is necessary for quality care—whether that readmission was driven by later complications, by too-soon original discharge in the Medicare (which is to say Government) pressure to hold down costs first, or by some other factor—but that Government pressure to push the patient out the door also pushes against the patient’s return.  Even when necessary.

Here are a couple of numbers from a study soon to be published in JAMA Cardiology:

One in five heart failure patients returned to the hospital within 30 days before the ACA passed. That dropped to 18.4% after the penalties. Mortality rates increased from 7.2% before the ACA to 8.6% after the penalties….

In other words, an 8% drop in readmissions is associated with a 19% rise in death rates for heart patients.  That’s not a favorable trade-off.

There is a legitimate interest in improving the quality of care for all patients, including those for whose care us taxpayers are paying, but readmission rate is not an accurate measure of that quality.  Readmission rate can only measure…readmission rate.  That metric addresses neither the reasons for readmission nor the reasons for the prior discharge.

Government pressure to hold down readmissions doesn’t quite amount to death panels, but the outcomes seem dismayingly similar.  To be clear, the results of the study do not establish a causal relationship, for heart patients, between the lowered readmission rate and the higher death rate.  However, the magnitude of the apparent association between the two desperately wants further investigation.

Cornell Professors

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…apparently support racism and racist stereotyping.

Recall that George Ciccariello-Maher, Associate Professor of Politics and Global Studies at Drexel University, routinely says it’s whiteness, white victimization, all things white that are at fault for mass shootings and violence generally. For instance, this in an interview with Democracy Now!

Whiteness is never seen as a cause, in and of itself, of these kinds of massacres despite the fact that whiteness is a structure of privilege and it’s a structure of power, and a structure that, when it feels threatened, you know, lashes out.

What makes white men so prone to this kind of behavior?

And his tweet a year ago, All I want for Christmas is white genocide.

Cornell University’s professoriate demurred from Drexel’s decision to discipline Ciccariello-Maher ever so lightly (he’s on paid vacation leave) for his inflammatory and racist remarks (over Twitter proximately), wherein he blamed white victimization (and, of course, “Trumpism”) for the Las Vegas mass murder.

Seventy professors signed a letter on Wednesday protesting the university’s decision to take disciplinary action against George Ciccariello-Maher, saying it infringes upon academic freedoms, reported The Cornell Daily Sun.

Of course they do.  It’s entirely appropriate for college professors to “stereotype” groups of Americans of whom they disapprove.

Never minding that their favored groups of Americans became favored through precisely that “stereotyping.”

And Cornell, the school, is silent about it.

Hmm….

Training

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The Wall Street Journal is justifiably dismayed with the implications of the Navy report on the collisions of two of our combat ships with civilian ships in peacetime and in peaceful waters.  However, the op-ed’s Editorial Board give short shrift to the question of training for our sailors and officers.

…Congress needs to allocate enough money to adequately train sailors so they can fulfill their missions.

Funds for training—and equipage—certainly are important. But training, drills, scenario execution, all can be done daily on board each ship, they need to be done at least highly frequently, they need to drill the ship’s officer complement, and all of that is the responsibility of each ship’s commander and exec. If these two won’t do their duty, no amount of money for training, or equipage, will have value.

Disrespect

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The House of Representatives held a moment of silence Monday out of respect for and sympathy with the victims and surviving family members of the Texas church shooting.

Congressman Ted Lieu (D, CA) walked out on that moment, and he’s proud of his disrespect, posting a video of his excuse on the Internet.  That excuse centered on his crocodile tears over not being able to get knee jerk gun controls enacted.

Then he added empty rhetoric:

Because his feelings are more important than a respectful moment of silence.  And he’s paraphrasing Rahm Emanuel’s remark about crises: Lieu isn’t letting a tragedy go to political waste.

A Navy Veteran

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…refused an “award” from a dishonorable organization.

The New Orleans Saints was going to present Commander John Wells, Military Veterans Advocacy Executive Director, with the Peoples Health Champion award during the Saints’ game against the Chicago Bears last weekend.  What Wells said in his refusal:

Although I am touched and honored to be selected for such an award, the ongoing controversy with NFL players’ disrespect for the national flag forces me to decline to participate in the presentation.  I am unable, in good conscience, to enter an NFL stadium while this discourtesy prevails. Since this award is tainted with the dishonorable actions of the NFL and its players, I cannot accept it.

The Saints’ response, in its attitude, vindicated Wells’ decision.

We will not allow Mr Wells’ decision and subsequent media appearances to distract our players and organization from continuing to honor and support our military and veterans. We, as an organization, have decided to move on from this sad and divisive discourse and focus our attention on supporting our military and veterans.

The Saints’ statement also claimed

[W]e…contend we are leaders when it comes to financial support as well as the thousands of service hours our organization and players gladly contribute….

No, the divisiveness distraction here are in the players’ decision to attack our flag and national anthem and to insult our veterans and their families while masquerading their “protest” as commentary on social injustice and in Saints management’s decision to condone such miscreancy.  This misbehavior has rendered all the claimed support for our veterans into so much self-serving eyewash.  The financial support and service hours turn out to be nothing but indulgences, whether paid in advance or after the fact.

Good on the Commander.