What I see

Post #310,808 by beepster 7/11/09 9:44:07 PM Reply	What I see is them lining up to do it again. Its hard not to be a cynic in this environment. Box hits it pretty squarely when he says this was simply a gambit to forward a social agenda (not a stimulus). Now you have folks claiming it wasn't big enough and wanting a do over. That doesn't inspire a ton of confidence. Besides, pessimists are generally never disappointed. I will choose a path that's clear. I will choose freewill.
Post #310,809 by Another Scott 7/11/09 10:35:07 PM Reply	Who is "them"? It's hard to have a fruitful argument with you when you don't deal in specifics. :-( Obama's ruled out a 2nd stimulus for now - he said today that it was a 2 year program and needs time to work. Reid has ruled it out as well. Who is this "them" that's going to get it past those two? Box hits it pretty squarely when he says this was simply a gambit to forward a social agenda (not a stimulus). Now you have folks claiming it wasn't big enough and wanting a do over. 1) The stimulus bill was large and covered a lot of things, many of which were inadequately funded under Bush and the Republicans. 2) Social spending is stimulative because it gets money in the hands of people who will spend it, quickly increasing economic activity. It's possible to kill many birds with one stone if the bill is structured in a reasonable way. 3) Since so much money needed to be spent to fill the hole, one couldn't efficiently do it by dumping it all into infrastructure. Most of those projects take a long time to get going. So, the efficient thing to do is to invest in a lot of areas, yes like electronic medical records, where there's a need and a long-term payoff. Saying it's "simply pork" or similar is a deliberate attempt to minimize the extent of the economic crisis the country was (and still is, in many respects) facing. It's posturing by those in the Republican party who cannot offer sensible solutions. I'm disappointed that you and Box apparently fall for this stuff. :-( 4) There you go again with "now" and "do over". Krugman and many others were saying before Obama took office that the hole in the economy was over $1T a year and a 2-year $750B stimulus wasn't big enough. There's no sudden realization that it was too small by those who are getting additional visibility now. Adding more stimulus isn't a "do over". Besides, pessimists are generally never disappointed. Optimists live, on average, 19% longer. ;-) http://www.encyclope...G1-129020518.html Cheers, Scott.
Post #310,810 by beepster 7/11/09 11:30:44 PM Reply	Ok, fine all federal spending is equal, there are no programs that are more effective than any other at creating jobs and growth. (no, I don't believe it...but I give up. You win by attrition). I will choose a path that's clear. I will choose freewill.
Post #310,812 by Another Scott 7/12/09 12:03:28 AM Reply	Beep! Leave Lineland! Join the rest of us here on the surface of the sphere! Three dimensions are so much more interesting than 1! http://www.geom.uiuc...anchoff/Flatland/ :-/ Am I really so obtuse that you take me as arguing anything like that? Cheers, Scott.
Post #310,813 by beepster 7/12/09 12:23:55 AM Reply	Sometimes it seems like it going on and on about the social stuff creating jobs, trickling down into the economy..as opposed to the more direct public works programs which are more now now now. I thought that, if we had to do it, the latter would be preferential Even better, just cut everyone a check for 100k and tell them they have 6 months to spend it. I would have enjoyed that stimulus check better than the 20 bucks I'm getting every other week :-) I will choose a path that's clear. I will choose freewill.
Post #310,830 by boxley 7/12/09 12:57:49 PM Reply	yeah, invest in medical records, sure you betcha http://www.wnd.com/i...iew&pageId=103419 , doctors have to give up autonomy and 'learn to operate less like solo practitioners,'" the lawsuit said. "The National Coordinator will be able to enforce his decision as to what is appropriate treatment through sanctions against health care providers. Health care providers that are not 'meaningful users' of the new system will face penalties. 'Meaningful user' is not defined in the Stimulus Act. That will be left to the HHS secretary, who will be empowered to impose 'more stringent measures of meaningful use over time.'" The result is that penalties that could be imposed against doctors that would "deter the plaintiff's health care providers from going beyond the electronically delivered protocols should (a medical) condition become atypical," the lawsuit said. Further, the demand that all health records be kept electronically would put the plaintiff's personal information "a mouse-click away from being accessible to [strangers]." That amounts to an unconstitutional release of her personal and private health information, the lawsuit says.
Post #310,842 by Another Scott 7/12/09 3:57:25 PM Reply	Anyone can file a lawsuit. Film at 11:00. The bill (407 page .pdf): http://www.google.co...Kepc1_lJlu5Qrp8dA page 116 of the document ÂÂSubtitle AÂPromotion of Health Information Technology ÂÂSEC. 3001. OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION TECHNOLOGY. ÂÂ(a) ESTABLISHMENT.ÂThere is established within the Department of Health and Human Services an Office of the National Coordinator for Health Information Technology (referred to in this section as the ÂOfficeÂ). The Office shall be headed by a National Coordinator who shall be appointed by the Secretary and shall report directly to the Secretary. ÂÂ(b) PURPOSE.ÂThe National Coordinator shall perform the duties under subsection (c) in a manner consistent with the development of a nationwide health information technology infrastructure that allows for the electronic use and exchange of information and thatÂ ÂÂ(1) ensures that each patientÂs health information is secure and protected, in accordance with applicable law; ÂÂ(2) improves health care quality, reduces medical errors, reduces health disparities, and advances the delivery of patientcentered medical care; ÂÂ(3) reduces health care costs resulting from inefficiency, medical errors, inappropriate care, duplicative care, and incomplete information; ÂÂ(4) provides appropriate information to help guide medical decisions at the time and place of care; ÂÂ(5) ensures the inclusion of meaningful public input in such development of such infrastructure; ÂÂ(6) improves the coordination of care and information among hospitals, laboratories, physician offices, and other entities through an effective infrastructure for the secure and authorized exchange of health care information; ÂÂ(7) improves public health activities and facilitates the early identification and rapid response to public health threats and emergencies, including bioterror events and infectious disease outbreaks; ÂÂ(8) facilitates health and clinical research and health care quality; ÂÂ(9) promotes early detection, prevention, and management of chronic diseases; ÂÂ(10) promotes a more effective marketplace, greater competition, greater systems analysis, increased consumer choice, and improved outcomes in health care services; and ÂÂ(11) improves efforts to reduce health disparities. ÂÂ(c) DUTIES OF THE NATIONAL COORDINATOR.Â ÂÂ(1) STANDARDS.ÂThe National Coordinator shallÂ ÂÂ(A) review and determine whether to endorse each standard, implementation specification, and certification criterion for the electronic exchange and use of health information that is recommended by the HIT Standards Committee under section 3003 for purposes of adoption under section 3004; ÂÂ(B) make such determinations under subparagraph (A), and report to the Secretary such determinations, not later than 45 days after the date the recommendation is received by the Coordinator; and [...] It seems to me that unless Heghmann can show that those sections of the law aren't being followed, then it's likely that her lawsuit will quickly be thrown out. HTH. ;-) Cheers, Scott.
Post #310,853 by boxley 7/12/09 6:56:26 PM Reply	2,3,4 and 10 are where the argument lies
Post #310,855 by Another Scott 7/12/09 7:30:00 PM Reply	How can having better records give poorer results? I look at it this way - We know that 100 years from now people aren't going to be pushing paper medical records around in the US - it's too expensive, too inefficient, too wasteful, too prone to errors. Why not accelerate the transition? I don't know about where you are, but when we had to take the oldsters into the hospital we always had to fill out the same paperwork. Name, address, insurance policy numbers, ever had surgery, heart attacks, strokes, cancer, infectious diseases, drug allergies, family history of same, etc., etc. It was a colossal waste of time and money. Just recently, they finally started rolling out a computerized system with the staff able to call up old records instantly. It's nice to be able to just give your insurance card and they can call up your records - "Oh, you were here X months ago. How did that go?..." Cheers, Scott. (Who thinks the lawsuit is about other issues than the benefits of a computerized system.)
Post #310,866 by boxley 7/13/09 8:23:42 AM Reply	bingo on the last sentence I have worked with quite a bit of medical software. Its nice that the feds are spending money on an eds for medicine. Sit down with ins co's docs and feds to determine fields, queries, reports and exchange medium. Makes billing, patient recall an awesome task. However when the aim of the project is to rein in medical choices as the suit alleges, then its gone beyond eds and into a medical decision tree controlled by government bureaucrats and not the dr giving the treatment
Post #310,871 by Another Scott 7/13/09 10:10:35 AM Reply	We'll see. No doubt that there should be strong oversight.
Post #310,858 by a6l6e6x 7/12/09 8:19:57 PM Reply	Did you miss the Obama quip (borrowed from Newt) on records? ÂAs Newt Gingrich has rightly pointed out, and I donÂt quote Newt Gingrich that often, we do a better job tracking a FedEx package in this country than we do tracking a patientÂs health records." Alex

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