#hospitals

Net Zero? An experience of child birth & why the only green new deal is a soiled diaper

If childbirth today is any guide, fossil fuel phase out is a pipe dream. Why?

Nearly every single piece of equipment that assisted in the delivery of our new bundle was dripping with fossil fuel derivatives.

Naturally, hospitals require sterilized, often single use equipment. Whether syringes, gloves, catheters, anesthetics, pill wrapping… you name it, this is a harsh reality.

Even bottle feeding the little’un requires we throw the mini milk bottles out each time they are used because her immune system is not anywhere up to the job of fighting bacteria for at least 6 weeks.

So if Joe Biden wants to “work out” fossil fuels, how does he intend to cater to the medical industry? One imagines if all of the equipment above had to be replaced by alternative materials, imagine just how expensive his BidenCare would become? We can just see bamboo beds and paper catheters.

Oh, one other thing. Hospitals don’t work very well on intermittent power sources, especially mid way through a surgery.

Cut the crap

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Labor Party MP Richard Marles posted this picture to his Facebook page pointing to the threat of the 2014 budget ahead of the 2013 election. It is all on the public record to see that this is blatant rubbish. Of course, the hope is that the “stupid” voters will not bother to fact check these claims 2 days ahead of an election. CM was fascinated to see how these numbers stack up against the actual budget papers. Complete fiction.

Entire health spending in 2013-14 was $64.6bn. In the 2014-15 projection, it was $68.1bn. Up $3.5bn. How does Labor get to -$57bn? In 2018-19, health spending was $78.8bn. The budget paper notes, “The increase in expenses of 6.8 per cent in real terms from 2013-14 to 2014-15 reflects the Commonwealth’s commitment to provide additional hospital funding from 2014-15 under current agreements with the States.

Education spending was $29.75bn in 2013-14 and projected $30.39bn the following year. (+$640mn). Technically if $30bn was cut from schools there would be no budget at all. In 2018-19, education spending was $34.7bn.

Government school spending in 2013-14 was $2.8bn which leapt to $5.1bn in the 2014-15 budget. In 2018-19 it was $7.7bn.

Indigenous Affairs welfare fell by $104m in the 2014-15 budget. In 2018-19, this budget was DOUBLE the 2014-15 number at $2.1bn.

ABC spending (split into TV & Radio – refer page 6-39) went up $18mn not -$35.5mn. In 2018-19 the budget was $1.03bn. As CM has written before, the ABC is a shoddily run organisation. Staff engagement at the ABC is 46%, down 6% from the previous survey. It isn’t a money problem. It is a management problem.

On page 6-11, income support for seniors went  UP from $39.5bn to $42.1bn). In 2018-19 it was $46.8bn. Total assistance to the aged went UP from $54.98bn to $57.97bn in 2014-15. In 2018-19 that sum was $66.77bn.

Welcome to pre-election political accounting 101.

Gladys Berijiklian wipes the floor with Michael Daley

Listening to the NSW Election debate, incumbent Premier Gladys Berijiklian wiped the floor with Opposition Leader Michael Daley. Daley’s opening remarks were well prepared but it was all down hill from there when it was impromptu.

Daley was short on figures on pretty much every issue. Berijiklian knew them off by heart. Schools, climate change spending, public assets, electricity costs, mental health, hospitals, tolls, unemployment, education, water etc etc. Daley mentioned numerous times in his answers that he needed to double check his figures. On TAFE spending he guessed $3 billion. In reality it is $64 million.

When asked for a show of hands over the contentious Allianz Stadium rebuild, the Penrith audience backed the Premier by around 2:1.

The Premier made the rebuild costings clear and pointed out they’ve been in the public domain for over 12 months. Daley didn’t even have clear costings on how much it would cost to renovate. At one point Berijiklian was telling him how much bringing up to meet building codes would be. One would think he’d be all over the numbers on an issue he has expressed much passion over. She said that the new stadium would cost the same as renovating the current one.

Whether 100 undecided voters influence the election is a moot point but Berijiklian was the clear winner. The end result. Of 100 undecided, 50 would vote for the Premier and only 25 for Michael Daley.

US Healthcare bankruptcies surge 270% in 2018 vs 2017

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6 months ago we wrote of the growing crisis of hospitals declaring bankruptcy in America. While The Affordable Care Act (Obamacare) is often lauded by some as noble legislation, according to bankruptcy lawyers, Polsinelli, the changes made to reimbursements that used to help cover hospitals who treated uninsured patients that were pulled under ACA have sent many hospitals to the bankruptcy A&E ward. Polsinelli wrote this month,

The Health Care Services Distress Research Index was 455.00 for the first quarter of 2018. This is an increase over 173 points from last quarter’s record high, approximately 62 percent. The index has experienced record or near-record highs in seven of the last eight quarters. Compared with the same period one year ago, the index has increased over 333 points, approximately 270 percent, and compared with the benchmark period of fourth quarter of 2010, it is up approximately 355 percent.”

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Polsinelli also wrote in 1Q 2017 that,

“Unlike the public markets, the Polsinelli/TrBK Distress Indices include both public and private companies, creating a broader economic view and one which may show developing trends on Main Street before they appear on Wall Street….Health care distress is high and it seems to be getting worse…

…The business of health care is unlike other industries, such as manufacturing, real estate, or retail. Health care faces all the traditional business challenges, such as competition, the impact of technology on services, and increasing wages. But more, the health care industry is needing to adapt to increasing regulations, changes in reimbursement rates from government or private payors, and a shift from traditional fee-for-service to value-based models that impact profitability…There is unprecedented pressure of major systemic changes to the existing health care system, particularly the implementation of the Affordable Care Act over the last several years and the current status of the program, which is alternately being repealed, repealed and replaced, phased out, or simply defunded…The (Obama) administration’s recent decision to terminate cost sharing reduction payments will also directly impact the health care market. Insurance companies may continue to provide insurance at a higher premium or decide to exit the markets. Eliminating these payments and the resulting premium increases may increase the cost to the government through premium subsidies.”

In short many Americans saw a doubling of premiums (an average increase of 113%) under Obamacare inside of 4 years causing many to forgo the insurance. The reimbursements under the old system (which helped compensate hospitals administering emergency treatment for the uninsured) that were stopped on the proviso people would take up ACA plans backfired. Not enough people signed up and more hospitals running on a days cashflow have been forced to close because the reimbursements designed to protect them against uninsured patients disappeared. When Jonathan Gruber, the architect of Obamacare, testified to Congress he candidly said,

The Affordable Healthcare bill was written in a tortured way to make sure the (Congressional Budget Office) did not score the mandate as taxes…If CBO scored the mandate as taxes, the bill dies, OK? Lack of transparency is a huge political advantage … call it the stupidity of the American voter or whatever … that was really, really critical to get the thing to pass … I wish … we could make it transparent, but I’d rather have the law than not.”

Makes one wonder what the status of the medical equipment suppliers who lease equipment to these hospitals does with the machines they repossess.