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Good For Michelle Obama!

The Chicago Sun-Times has an article that exposes just what sorts of things Michelle Obama did for the University Of Chicago Hospital to earn her $317,000 salary as "Vice President for Community and External Affairs." And despite the tone of the article, I'm fairly impressed.

One of the biggest problems hospitals face is the sheer number of people who use their emergency rooms as their primary-care centers. People with all sorts of emergencies but no health insurance show up at the ERs, clogging up the system and racking up bills the hospital will most likely end up writing off. It's gotten so bad in some places that some hospitals have just shut down their ERs as too expensive to maintain.

Well, Mrs. Obama got the idea of setting up a network of doctors in the neighborhood who would see and treat these people, instead of having them show up at ERs. She worked with several other people in the hospital, two of whom are also advisors to her husband's campaign, and they hired a PR firm run by another Obama advisor to "sell" the program to the community.

Yeah, there is a whiff of a bad odor of croniness here (I am especially impressed at how the Sun-Times managed to work Tony Rezko into the story), but I'm going to disagree with John McCain and say that this program, as described, was a good idea. It wasn't about denying health care to poor people, it was about getting them care in a more cost-efficient and appropriate manner. The hospital wasn't dumping its poor patients on other hospitals or clinics, it was arranging for them to get the attention they needed in ways that wouldn't impair its own emergency room operations.

Also, you gotta remember that this is Chicago. By Chicago standards, this is squeaky-clean. The only thing that has a real possibility of corruption is in hiring David Axelrod's firm to do the "selling." Axelrod, in addition to owning the PR firm, is also Obama's top political strategist.

A lot of Obama's policies strike me as potentially disastrous, and his plans for health care reform are no exception. I think we'll be in for a very rough four years if he gets elected.

But in this case, it seems his wife was involved in a health care reform move that makes a lot of sense, and could not only improve care for those most in need of basic services, but save money all around. It's the kind of thing that we should be experimenting with, trying out and seeing how well it works. It strikes me as a common-sense plan, a possibly good solution to a building crisis. (If only we could say the same about so many of her husband's notions...)

I'd even go so far to say that, for the first time in my adult life, I'm proud to share a nationality with Michelle Obama.


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Comments (16)

From the Sun-Times article:... (Below threshold)
Mac Lorry:

From the Sun-Times article:

"The medical professionals who have come to me are accusing the university of dumping patients on its neighboring institutions. ... " -- Toni Preckwinkle

So it does look like the UofC hospital is in fact dumping poor patients, even giving them free bus rides to other hospitals.

Fewer poor patients are showing up at the U. of C. emergency room for basic medical treatment and are no longer admitted to the hospital. That frees beds for transplants, cancer care and other more-profitable medical procedures that the university prides itself on.

See the whole thing was and is about money, which explains why UofC paid Michelle Obama $317,000-a-year. There's nothing wrong with doing a good job for those who pay your salary, but this has little to do with improving health care for poor or finding ways to pay for it.

I believe Obama has said th... (Below threshold)
Mike:

I believe Obama has said that his wife is one of the many many things off limits to talk about.

The reason people go to the... (Below threshold)

The reason people go to the emergency rooms of hospitals is because they know they won't be turned away due to an inability to pay. The article doesn't say how or if they pay at these new facilities at the time of treatment. Just that it's cheaper. It gives no real information on how the system works, just a lot of name dropping and such.

I'm really curious, because if patients are discouraged from using the UofC emergency room and are rerouted to satellite facilities which expect some form of payment, and they cannot pay, then they'll just go to another hospital. In that case, then the charge that UofC is "dumping patients on its neighboring institutions" is right.

If people like Michelle tru... (Below threshold)

If people like Michelle truly wanted to bring down the costs of healthcare and unclog ER's, she should promote quick-care or redi-care type of facilities where you get in, pay $40-$60, don't need insurance and they take care of a wide variety of problems to alleviate the burden on ER's.

Mac Lorry-I'll have ... (Below threshold)
tyree:

Mac Lorry-
I'll have to go with Jay Tea on this.

Example:
A hospital admits too many illegal aliens with serious but none life threating illnesses and without medical insurance.
Thus it has no room for expensive procedures for American citizens with insurance.
The hospital will lose money and American citizens will get worse care, even though they have in some cases been supporting the hospital through their taxes for generations. Eventually the hospital will go bankrupt and the people, legal and illegal, will get no care at that location.

I have never understood at what time making money was transformed into a bad thing. It's better than losing money.

Full disclosure:
My neighborhood has been taken over by illegal immigrants to the point that my grandson is the only child, out of 30+ students in his kindergarten that is not enrolled in ESL "English as A Second Language" class. A family friend had to wait an hour after a stroke to be admitted to an emergency room because they were giving free care to illegal aliens or their children. That is a really bad situation for a stroke victim. Anyway, I've lived with overcrowded emergency rooms for decades and that's serious enough situation that I can now use the word "illegal alien" without being called a racist. Thanks for your understanding.

Option A: public money funn... (Below threshold)
Baron Von Ottomatic:

Option A: public money funnelled through political supporters to establish and advertise a network of frontline healthcare providers to ease ER cases.

Option B: Walgreens, Wal Mart, CVS, etc. co-locate affordable, in-store clinics staffed by nurse practitioners to provide frontline healthcare and ease physician/ER visits.

I'd love to hear B&M Obama's views on companies like MinuteClinic.

I've got too much to do on ... (Below threshold)
epador:

I've got too much to do on vacation to investigate Michelle's clinic network, but here's how things work most places:

ER's are prohibited by Federal Law from turning anyone away for reasons of inability to pay.

Federally Qualified Health Centers (hugely promoted by President Bush, the network having received logarithmic increases in funding and number of clinics since his election) are established in both urban and rural settings to serve uninsured, under-insured and Medicaid populations. They are required to attempt to collect co-pays for all patients, even those on sliding scale (meaning they demonstrate limited to no income and pay based on ability to pay, with co-pays typically running from $15-20). They are not required to collect from every patient, but generally ask at the time of service for the co-pay. If the patient pays, fine, if not, they are generally not turned away. Folks that run up a huge bill are generally screened and financially counseled, and an attempt to set up a modest payment plan is attempted. Rare abusers of the system may be discharged from the clinic. The clinic's are required to have some form of support for in-patient care arranged -either the clinic providers or local hospitalists contracted to care for in-patients.

For-profit heath care systems set up Urgent Care clinics anywhere they think they can make a buck. Hospitals may set up adjacent UC centes to their ER;s in an attempt to unclog the ER. These are typically fee for service centers, and they make money off of labs, imaging and procedures. In the Fe for service centers, there is direct or indirect encouragement of maximum utilization of services to maximize profit.

Some UC centers have a flat rate, are cash only. One that was recently set up and then closed in our area had a $100 flat fee. They had an old x-ray machine for simple x-rays, a small simple lab and were able to keep costs down that way. Unfortunately they did not try to collect the co-pays aggressively from insured patients, and went out of business due to that sole poor financial practice.

Neither form of Urgent Care center provides in-patient care support - so any of their patients who require care get dumped on the local providers who work at the local hospitals. In our area, the UC centers are basically cherry picking the out-patient revenue and forcing the very providers they have taken this basic revenue from to then provide the in-patient care (usually much more time consuming and less well reimbursed per time unit). As they are also only opened limited hours, and don't take phone calls after hours, guess who gets woken up in the middle of the night with phone calls (for which there is no reimbursement)?

UC's operating in our area do not require payment at the time of service (except the one that went out of business).

So imagine you are existing on a relatively limited income with no significant property or resources, don't want to spend your beer and cigarette money on the doctor, and want to seek health care. Where will you choose to go? The place that can't turn you away, the place that you make rack up a big bill which you will never attempt to pay and won't ask for money up front, or the place that'll bug you for $15 bucks before you get in?

tyree,A h... (Below threshold)
Mac Lorry:

tyree,

A hospital admits too many illegal aliens with serious but none life threating illnesses and without medical insurance. Thus it has no room for expensive procedures for American citizens with insurance.

So you're saying UofC runs a background check on patients to see if they are illegal aliens? I didn't see that in the Sun-Times article. It just says they don't admit people for basic medical treatment. It's an emergency room, so they take everyone with a medical emergency.

I don't know than how you can agree with Jay Tea on this, as the illegal alien problem wasn't mentioned in the Sun-Times piece nor in Jay's piece.

I'm curious, if a patient s... (Below threshold)
JIMBOSTER:

I'm curious, if a patient shows up with health insurance, but not suffering an emergency, are they carted off to another hospital?

Mac Lorry - Illegal ... (Below threshold)
tyree:

Mac Lorry -
Illegal Aliens were not mentioned in the article, but that only proves that the article is biased. Last September 16th (Mexican Independence Day) I was watching the festivities in Spanish on a Los Angeles TV network and they cut away to the celebration going on in Chicago. They said there were over a million Mexicans living in the greater Chicago area. I am sure there are examples of Americans taking advantage of free care at emergency rooms, I just don't have any experience with that, so I can't write about it.

tyree, Il... (Below threshold)
Mac Lorry:

tyree,

Illegal Aliens were not mentioned in the article, but that only proves that the article is biased.

The Sun-Times article may well be biased, but not because they don't cover illegal aliens. The article is not about the makeup of the poor, but about what the UofC Hospital is doing to prevent them from getting basic treatment at their facility. I'm not even saying that illegal aliens aren't a problem, just that it's not relevant to this thread.

Its raining and the laundry... (Below threshold)
epador:

Its raining and the laundry is now done.

Here's a recent article by that usual bastion of bias, the WaPo:

http://www.washingtonpost.com/wp-dyn/content/article/2008/08/21/AR2008082103646_pf.html

Seems at least some of the local providers think this is a sham. I wonder what Paul Hooson would say about Michelle Obama's U of C's meager amount of charity care compared to its huge profit as a non-profit?

Whatever, Mac.I am j... (Below threshold)
tyree:

Whatever, Mac.
I am just giving examples based on what I know as opposed to acting like I am an expert in a field that is far outside of my primary area of study. I am sure somewhere there are American citizens who game the system, I just don't have any personal experience with that. Perhaps someone could find some actual examples of people you use this new system.

There is more to this story... (Below threshold)
Ken:

There is more to this story than what is being told!

I believe that Michelle is being paid way too much and keep in mind that the hospital did receive money because of Barack Obama being the politician.

i would to support mrs. oba... (Below threshold)
phillip white:

i would to support mrs. obama to take a closer look at a statement that she made while a guest on the show '"the view""that people are not used to strong women" now my mother mopped floors,while raising 8 children,and delivered the family from the local housing projects. as it is well known and documented that one of the greatest assects of the the african-american culture is the strong black woman,and not only is her statement an affront,but a slap in the face to strong black women throughout american history

[Oh dear, what happened to ... (Below threshold)
epador:

[Oh dear, what happened to the comment I THOUGHT I made earlier this AM? Hope its not in the wrong thread.]

Further sniffing about suggests that the South Side Health Collaborative has lofty goals, but my guess is that the golden trowel has been used to smooth and shine the muck underneath, in that the UCMC provides some paltry assistance to community clinics while cherry-picking patients and diverting patients away from its ER who are not revenue producers.

I haven't seen any evidence yet that they've made a significant contribution to networking the many SSHC clinics in an electronic medical record system, helped out with pharmacy support, staff support, or provided them with streamlined access to consultants for economically challenged patients.




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