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What's making news in health care? Here's John G. Taylor's take. With 30 years experience as a journalist at newspapers around the country, John G. Taylor is Community's director of public affairs, responsible for government and community relations.
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A long-dead New York City eatery once sold its no-frills, on-the-cheap style of dining with the commercial: "You can't eat atmosphere."
Patients, medical staff and visitors who've experienced the environment of the labyrinthine clinics at the former University Medical Center will likely be clicking their heels with Dorothy-like joy when the Deran Koligian Ambulatory Care Center opens to patients on March. 29.
A couple hundred people watched March 17 as Mimi Koligian, widow of the former Fresno County supervisor, clipped the ribbon that unleashed visitors to the $25 million, nearly 80,000-square-foot facility. Supervisors Judy Case and Phil Larson were on hand, as were longtime community activists Luisa Medina and the Rev. Walt Parry.
It has been a very long walk from the day in 1996 when Supervisor Koligian gaveled to a vote the decision that transferred then-Valley Medical Centers into the hands of Community Medical Centers for 30 years. The reality is now "more real" -- with clinic service shifting from what is (in parking, traffic, mental focus) a very long nearly two miles from now-shuttered University Medical Center to the 58-acre Community Regional Medical Center campus.
More than 100 exam rooms, X-ray, lab, pharmacy and room for UCSF medical residents to review their charts and have educational exchanges. A sweet thought struck me as I entered the pediatrics residents' break room (heck, that's my name for it) -- and realized it looked out at Yokomi Elementary School, a Fresno Unified magnet school focusing on science and technology. Talk about seeing/growing the future!
Thanks to Community's staff -- among those recognized, Julie Cleeland, Sherry Hughes, Robyn Gonzales -- current and former board of trustees members, among them Manual Cunha Jr., Dr. Joan Voris and Ed Kashian, and the hospital system's donor-investors.
Amid tough and uncertain times at the state and federal level, it's the dawn of a new and better atmosphere for care-giving.
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Maybe it's because the New York Times has downsized, or because it's butting heads with the rough-and-tumble owner of the New York Post and Wall Street Journal. But, really, did it have to describe readers who visit just one online site for their news as "monogamous" and those who browse a number of places as "promiscuous"?
Really they did, in a story based on a Pew Research Center report issued March 15. I could find no such lingo in that study, which put some scale on the decline of the traditional media (using the old hourglass for how newspapers are slipping away) and attempts to stave off slippage by requiring paid subscriptions or fees for online news (like trying to force a butterfly back into its cocoon).
As a former reporter I remember one hospital CEO warning me 14 years ago: "Be careful what questions you ask me as I will only reply to exactly what you ask." So, I better know "charges" vs. "costs," and "licensed" vs. "staffed" hospital beds. Nowadays, the questions from politicians and other can be very basic: What's an ER? Intelligent questions, like reporting that advances dialog and engages (rather than enrages) the public, seem in short supply.
The Pew report noted that 5,900 newsroom jobs were cut last year, atop roughly the same number in 2008. The world is pretty bleak in other segments -- TV, radio and ethnic media -- with only cable showing some zip. News content is actually growing, if you include commentary and discussion across all media.
But the traditional media are focusing more on disseminating rather than gathering information, meaning they are more reactive rather than investigative, the report suggests. And there is a jambalaya style in vogue --"pro-am" -- where the shrinking crew of professionals are either drawing from or competing with amateurs (citizen journalists, some will say) who often lack credibility beyond putting words together and posting them.
The online world still leans on the traditional news gatherers for content. Thus, as the report says, "papers are now at risk of becoming insubstantial," translating perhaps into an even more rumor-filled, fact-devoid multiplicity of digital outlets, doing more service to self and less to the public good. To be sure, there are new models being developed, some sites with clout and credibility -- ProPublic is one example.
Back to the Times' sexual lexicon, apparently one-third of news grazers have a favorite site (monogamous) but only 19% would be willing to pay to stay attached to that site. More than 50% are site hoppers, relying on two to five site.
My job requires me to be a real "party guy" -- more than 50 online news sites that I regularly visit. Where do you get most of your news?
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If the boss offered you steeply discounted or free medications for asthma, diabetes, hypertension, depression and other common chronic conditions, would you sign up for that insurance?
Would you sign up if it meant you'd have to pay sizable additional fees for heart bypass, knee replacements, hysterectomies, stents or trips to the emergency room?
Everyone is trying to put a lid on health costs. Many businesses are shifting additional costs -- and expectations -- onto their employees/consumers. Some, as in the scenario I painted above, are focusing on covering "less" and saving more all around, or so the pitch goes. In this case, with Evraz Oregon Steel, which signed on to the new "value-based insurance" coverage, according to Kaiser Health News/USA Today.
Other companies have tacked on additional fees for employees who smoke, decline to participate in weight loss or to make other lifestyle modifications. And the media have showcased examples of peer-pressure, where workers either cajole or deal a tongue-lashing to co-workers for whom breakfast is a Big Gulp, a jar of pickled pigs feet or a bag of Cheeto's, saying it's their excesses that are ballooning their waistlines and the company's premiums.
Consumer advocates say many tightly tailored policies force consumers to play doctor with themselves, perhaps masking minor problems until they morph into something far worse -- and far more costly.
Here's another approach being floated. Republican Assemblyman Tom Berryhill of Modesto has introduced AB 2587, allowing insurers to drop various thus-far mandated coverage -- overnight stay for maternity patients, various tests -- until California's unemployment rate drops to 5.5% and stays that way for four consecutive quarters. (The state's current rate for January is 12.5%; Fresno County's is 18.2%)
While the Payers & Providers newsletter says Berryhill's idea is designed to curry financial favor from insurers, and is dead-on-arrival at the Democratic-controlled legislature, it is another belt-tightening link in a chain that includes enormous online discussion groups, some of whom say let bad behavior (or poor luck with genetic material) be damned. Why should everyone pay for everyone else?
Do we need a national Federal Reserve Board for health, to cover baseline care for every American, and after that let every American fend for himself based on his budget? What about Tom Berryhill's idea, and the plan the Oregon steel mill has bought into?
Let me know what you think? It took 45 years from the inception of Medicare and Medicaid to get where we are today. Whatever happens in DC in the coming weeks, the key question remains: Wherever we're going, how can we make good health sustainable?
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As I yanked them, some as high as my thigh, I warned them to cease and desist. As they broke above the entrenched root, I swear I heard them laugh. I pledged I'd be back.
As I toted away my victims, I wondered how I'd ignored that side yard for so long. Oh yeah, allegiance to email and paperwork, with the odd trip to the driving range. I was amazed how relaxing it was to avoid thistle but still restore sanity to a fraction of my personal wilderness. The docs at Community Regional Medical Center would have been proud.
Recently, their mantra was relaxation. I am the consummate hard sell. But over a couple of days, interspersed with tests requiring a pitchfork to get past the acronyms, I tried -- watching TV programs I'd usually breeze past and paging through sections of newspapers that I'd put in the bird cage -- lying half-awake, on a narrow motorized bed.
Never knew about the flying snakes of Asia -- leaping 20-some feet from tree to tree, landing on their stomachs. (Gosh, hungry again. It's amazing how hard Regional's food deliverers work, going room to room).
Never knew what the Grizzly Man looked like, or the videos he shot for years, before one of his brood of grizzlies finally killed him in his solitary wilderness of the Yukon. (There's a forgotten feeling sometimes being hospitalized, and it was always heartening to see folks being visited by family and regularly cared for.)
Never knew that announcers (could scarcely call most of them journalists) on Fox, CNN and the Weather Channel have transformed their jobs into aerobic exercise -- shouting, cooing, cackling; and what's up with all the hands and arms flailing all over the place? Is this "Dancing With the Stars" meets "The Bachelor" meets the World Wrestling Federation? (Calm down, Taylor, just recall how physically fit and nimble the busy patient transporters are every day at Regional.)
Never knew, till I read it in the New York Times, that a Swedish inventor has come up with a way to deal with the lack of toilets, and often concurrent explosion of diseases, in the world's urban slums. It's something called a Peepoo, a single-use, biodegradable plastic toilet. (Suddenly, being asked for a "specimen" is no biggie.)
Can't say I've "upgraded" to a Type B personality. But when I last looked out at my yard, I'm sure I saw a nervous dandelion skitter behind a forsythia.
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I came across a full-page Wall Street Journal ad, in my routine "why have I saved this?" home downsizing. The headline played on a Chapter 11 filing by scratching out one of the one's. But listen to some of the content and then see what business placed the ad.
"There's one thing we all feel very strongly about at ( ****). Our future. ... And we will not be distracted from serving our customers at the highest level....
"And you can still count on us putting you first ... We believe adversity presents opportunity. An opportunity to renew our commitment to making travel just a little easier... You will feel the new energy and the new optimism. You will feel the new beginning."
The ad was published Dec. 10, 2002 by United Airlines. And it reminded me of a educational visit I made to a Valley congressman in DC a few years back about the relentlessly troubled funding and regulatory environment that safety-net hospitals like Community Medical Centers routinely encounter.
He listened a minute or two, then he lectured me on what hospitals need to do to muster real clout on Capitol Hill. If Ford and General Motors came to my office, he said, and said the nation really needs health care reform or it'll drag the big automakers under, well, they'd have my rapt attention.
Well, billions of bailout dollars later, they are fewer automakers, fewer jobs and way fewer people who can say getting on a plane is an enthralling experience. And health care -- for those with insurance and the 40-plus million without -- becomes a more worrisome experience every day. The price of doing nothing is only escalating. There are no cutesy words to frame that in an ad.
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The Olympians throw a rock, sweep its path clear with a broom. And they get their heart rates up to 185 beats a minute. Maybe that would dissolve some of the heartburn that politics provides these days.
Consider:
- Zero -- the number of times in 1957 and 1958 that the U.S. Senate invoked "cloture," a vote used to end what could be an endless debate called a filibuster.
- 112 -- the number of cloture votes taken in 2007-2008, a record that may be broken this year.
- 29,000 -- the number of lawyers currently practicing in Japan, up 68% from 2000.
- 1.18 million -- the number of active practice attorneys in the U.S.
- 1,321 -- the number of bills introduced in Sacramento between Feb. 16 and Feb. 19, the deadline for this session. That figures out to, according to the Sac Bee, 300 per day, nearly 14 per hour and 1.15 every five minutes.
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The scene: Hank Swank's driving range in Clovis, the dense fog of 8 a.m. Sunday. A solitary figure wearing an incongruous Pebble Beach hat addresses the ball -- go that way, please. Not a soul around. Sixty or seventy swings later, sweating, he drives home for a Valentine's Day kiss.
Eew, his wife says. Was working on my mechanics, he says. Couldn't tell where the ball went after 25 yards, he coughed. The fog was thicker Monday and so was the coughing. Grabbing for his albuterol, he wondered whether cool air could trigger a hellacious day of homebound hacking and wheezing.
No duh. The Feb. 16 Wall Street Journal yielded the truth, which should have been self-evident to someone in the health biz. Cold air can suck moisture from bronchial passages, inflame and narrow the airways. Yeah, asthma attack -- and, sure, they do make facial gizmos designed to basically mimick the effect of wrapping a scarf around your mouth. One's called the PolarWrap, another is the ColdAvenger.
Given my golf game, I should invent one called the Mulligan Mask.
Speaking of foolishness, this time about the state of California. New York Times columnist Gail Collins apparently took some heat for trying to decide which state in the union has the most dreadful political culture, and then assigning the boobie prize to Illinois.
Taken to task, she had this to say Feb. 13 about our Golden State of Dysfunction:
"It's certainly true that when it comes to finances, California is the new Mississippi -- the place that all the other states are glad to have around because it means that they can't come in worse than 49th. And the voters are in a terrible mood. Many Americans are ticked off at their governors these days. However, Californians not only blame theirs for bad state services; they also complain that he no longer looks all that great in a bathing suit."
Maybe the Governator and I need to partner on that Mulligan Mask.
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