Word: heart
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Dates: during 2000-2009
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...peak, all manner of fixes have been proposed to the health-care system, from small tweaks to wholesale overhauls. There's pay-for-performance: compensation depending on doctors' success in keeping costs down and getting patients well. There's episode care: a fixed price for a procedure like a heart bypass that covers everything from pre-op to surgery to full recuperation. Most broadly, there's global care, which provides access to a diverse team of caregivers who cover all of a patient's needs for a single premium over the length of a policy - essentially episode care writ large...
...doctor on the night shift knowing little about a patient whose surgeon worked the day shift. Dr. Alfred Casale, Geisinger's chief of cardiothoracic surgery, tells stories of surgeons who don't even conform to the same rules for color-coding wires in a heart device, making it awfully hard for an intensive-care technician to do repairs if something goes wrong. "When there's a complication at 2 in the morning," he says, "too often nurses can't ask, 'What's his problem?' until they ask, 'Whose is he?'" (Read "Drive-Thru Medical: Retail Health Clinics' Good Marks...
...Steele decided to fix this, switching Geisinger over to a prix fixe, episode-care model for surgery, starting with the heart bypass. Under the new system, a closely coordinated team of caregivers would be responsible for every stage of a bypass patient's treatment and recovery. The hospital would submit a single bill for all work and include a 90-day warranty. If a patient checked back in with a complication like a postsurgical infection, that work would be on Geisinger's dime. "We'll do it right, or we won't send a bill" was how Steele...
Somewhere, the ghost of Lyndon B. Johnson is smiling. Senator Olympia Snowe's lone Republican vote for health-care reform in the Senate Finance Committee didn't just advance an issue close to LBJ's heart--as President, the Texan signed Medicare into law--it was also a masterstroke in political leverage. And no one loved Senate politics more than he. Snowe's yea earned her--a member of a weakened minority, from the lovely but not very influential state of Maine--a voice in the small group hashing out the final version of the bill. In the Senate...
...intimate portrayal of our troops broke my heart. In the 1960s, Pete Seeger wrote, "Where have all the soldiers gone?" and lamented the government's choices: "When will they ever learn?" A lot has changed since Seeger wrote those words, and then again, nothing has changed...