USA is a big fat joke

swampman posted:


Now imagine having to do that while simultaneously being expected to care for five other people who also need intravenous medications that must be manually administered on a a strict dosing schedule. Being a nurse is fuckin hilarious in these modern times

meanwhilist in england


Richard Branson’s Virgin Care won a record £1bn of NHS contracts last year, as £3.1bn of health services were privatised despite a government pledge to reduce the proportion of care provided by private companies.

Overall, private firms scooped 267 – almost 70% – of the 386 clinical contracts that were put out to tender in England during 2016-17, according to a new report. They included the seven highest value contracts, worth £2.43bn between them, and 13 of the 20 most lucrative tenders.

The £3.1bn in contracts, a big rise on the previous year’s £2.4bn, prompted concern that profit-driven companies are increasingly involved in delivering care, in a development that undermines repeated assurances by the health secretary, Jeremy Hunt, that they play only a marginal role.

“These figures clearly show that privatisation has a strong momentum within the NHS,” said Paul Evans, the director of the NHS Support Federation, a campaign group which monitors the privatisation of NHS services and which produced the report. “The doors to private sector involvement in the NHS remain open despite promises to move away from market-based approaches by NHS leaders and politicians. Privateers continue to win huge new NHS contracts.”

Virgin’s £1bn haul means it now has over 400 separate NHS contracts.

Its growing role has prompted particular anger among anti-privatisation groups. It pays no tax in the UK and its ultimate parent company, Virgin Group Holdings Ltd, is based in the British Virgin Islands, a tax haven.

In addition, it came under fire for suing six clinical commissioning groups (CCGs) in Surrey, NHS England and Surrey county council last year after losing an £82m contract for children’s services to a rival bid involving a local NHS trust and two social enterprises. A settlement of the action appears to have involved the six CCGs paying Virgin an undisclosed sum.

Virgin said it had been so concerned over “serious flaws in the procurement process” that it had no choice but to launch the proceedings.

The private sector’s £3.1bn of wins last year represented more than two-fifths (43%) of the £7.2bn of contracts tendered by the NHS for services including babies’ health and out of hours GP care. That dwarfed the £2.55bn (35%) of tenders won by NHS trusts and £1.53bn (21%) by not-for-profit organisations, including charities.

The expanding role of for-profit firms comes despite a pledge by the NHS England chief executive, Simon Stevens – backed by Hunt – to abolish the purchaser/provider split in the health service introduced by Margaret Thatcher’s government in 1990, which helped facilitate competition in healthcare and the outsourcing of services, and promote greater integration of health and social care services.

“Private health providers now have a strong foothold,” said Evans. “Billions of pounds-worth of opportunities to bid for NHS business are still being advertised, despite numerous failures and widespread criticism.”

Critics say that the sector’s continued success stands in sharp contrast to a long history of winning contracts, often by undercutting rival bids from NHS trusts, only to then hand back those that do not yield a profit or have them taken away because they have provided inadequate care.

The report details “a catalogue of failures” – dozens of examples of private firms taking over NHS services since 2012 but then abandoning them, either because they cost them too much to provide, or could not recruit enough staff, or went into administration – or, often, because of serious complaints about the quality of their service.

For example, in 2014 Circle pulled out of its 10-year contract to run Hinchingbrooke hospital in Cambridgeshire – the first NHS hospital to be run by a private firm – two years early after encountering financial problems and heavy criticism from the Care Quality Commission (CQC), which regulates NHS care standards.

In 2013, Serco ended its contract to provide out of hours GP care in Cornwall after staff falsified data about its performance. And in 2015, Coperforma’s £63.5m takeover of non-urgent patient transport to hospital in southern England was branded an “absolute shambles” by health unions after kidney patients awaiting dialysis and cancer patients undergoing chemotherapy missed vital appointments. It finally lost the contract in late 2016.

“The NHS is currently going through the biggest financial squeeze in its history, which has translated into service closures and greater rationing. Now on top of that this report reveals more evidence of increasing NHS privatisation accelerating at an alarming rate, and yet this toxic outsourcing agenda is failing both patients and staff alike,” said Jonathan Ashworth, Labour’s shadow health secretary.

Care UK, which has links to the Conservative party, gained the second biggest share of NHS contracts last year – worth £596.3m. It won a contract worth £169.5m in partnership with an NHS trust, and three others for £135.6m, £120.9m and £115m in its own right.

Both it and Virgin Care have benefited by changing tactics to target often high-value contracts for community-based health services as the NHS in England increasingly moves care out of hospitals, the report says. Care UK already runs the NHS 111 telephone advice service and walk-in centres in some areas. In 2009, its chairman, Sir John Nash, donated £21,000 to Andrew Lansley, who as the Conservative health secretary in the coalition a year later forced NHS bodies to tender out far more services through the controversial Health and Social Care Act.

“Dysfunctional” NHS procurement rules mean that private firms could land another £10bn of contracts in the next three years, said Evans. The NHS Support Federation, which is funded by individuals, charitable trusts and trade unions including the TUC, tracks publicly available information about NHS tenders.

Virgin Care and Care UK defended their role in delivering NHS-funded healthcare. A Virgin Care spokesman said:“We have a strong track record of delivering high quality, free NHS services over the last 11 years. More than 93% of people rating the services we run would recommend them, while the CQC have said in their recent report we can evidence the improvements we have made to community services.”

A spokesperson for Care UK said: “We have a very strong track record in partnering with the NHS to deliver high-quality and patient-focused care. This includes three services rated outstanding by the CQC and consistently high patient feedback scores.”

A Department of Health spokesperson said: “Spend on private healthcare by the NHS accounts for just eight pence of every pound and this government is fully committed to a world-class NHS owned and funded by the British taxpayer and free at the point of use, now and in the future.”

it's cool that if you're a rich enough businessman and you lose the bid for a contract you can just whine for the courts to make you the winner

in other news richard branson announced today Virgin Race, where drivers compete on the lands end to john o'groats run while hitting pedestrians for bonus points


le_nelson_mandela_face posted:

Also, if people are losing faith in the system, not because the system has a problem, but because they aren't getting the results they want, that isn't a problem with the system.


BATON ROUGE — Louisiana's Department of Health will begin sending nursing home eviction notices Thursday to more than 30,000 residents who could lose Medicaid under the budget passed by the state House of Representatives.

"The Louisiana Department of Health is beginning the process of notifying all impacted enrollees that some people may lose their Medicaid eligibility," Department of Health spokesman Bob Johannessen said. "The goal of the department is to give notice to all affected people as soon as possible in order that they begin developing their appropriate plans."

Gov. John Bel Edwards' staff has planned a press conference Wednesday for more details, a day before the notices are set to be mailed to 37,000 Medicaid recipients in nursing homes or other long-term care facilities.
However, on the other hand, https://www.bloomberg.com/news/articles/2018-05-08/patients-can-t-find-epipen-at-the-pharmacy-as-supply-runs-short

Keven posted:

OP: Check it out: this guy got a one million dollar medical bill and is going to have to declare bankruptcy basically because he got a really bad cold

Post 10: I myself have used cocaine, benzos, heroin and heroin derivatives, ketamine, and that special drug they give soldiers to make them only care about jacking off. Doctors say I got depression, dry brain, immoral sadness disease, and mental rickets. They put me on a secret SSRI that on the list of side effects says "Mind Roundness," I'm in college for poly sci and if I don't like something I say it only exists because of capitalism.

hi piss
it's piss! piss everybody.
i went to the doctor a year ago because of stomach issues, the exam was inconclusive so i asked about a cat scan, they said they could recommend me to another facility, under the same name and said it wouldn't be more than a few hundred dollars. i went and later found out even though the medical facilites were under the same name the facility I had a scan at wasn't under my coverage. full bill: $4000. i will never pay it.
that very same thing happened to me a few years back. fortunately at the time i lived somewhere where the hospital had a charity case program for folks hovering around the poverty line & i qualified so the fees were waived
been spending some time at the hospital in my hometown lately. everyone is completely run ragged and it's severely undersupplied, they don't have the budget to replace things when they break down. something like a TV sounds ridiculous to get angry about but my grandmother is a feeble woman dying of 3 different conditions, too farsighted to read books and too weak to do much other than sit, and because of covid limitations she can't even have visitors. the TV in her room was broken and the hospital literally couldn't afford to get it fixed or replaced, so she just sits with nothing to distract her from the pain.

our fascist provincial government just announced another wave of public health worker layoffs, budget cuts, and full fledged privatized two tier health care. may the plague take them all before they have a chance to benefit from it
solidarity to the wildcat striking health care workers fighting for the right to do their job saving people, and i spit on the nazi filth who thought they could prevent this inevitable resistance by legislating away their right to strike lmao

Bablu posted:

in america where the top students pick dermatology

This is one of a few threads where we touched on something that's become one of those sideline stories in current events when it should be a headline

One aspect of the U.S. medical system praised even by a lot of its liberal critics is that it provides top-level vanity care outside the insurance system if you have the money to purchase it, that if you're well-off it's the best place to go for elective, outpatient procedures because they're available all over the country, even from backwoods hospitals, and that draws skilled doctors from all over the world and builds an infrastructure to support them.

There are a lot of doctors per capita in the U.S. in other words, if you get real loose with the interpretation of "doctor". There are even more medical administrative staff, with hospitals often being the leading employer in rural areas. This led a lot of experts to suggest that in the event of a worldwide pandemic, the U.S. would be in a good situation because (somehow) all that would get turned into a national drive to prevent spread of the disease.

and now:


......................................................The health care model of the U.S. literally could not support providing health care.

in the before times, many hospitals relied on traveling temp doctors and nurses to cover shifts or weekends in order to be licensed to operate full time because somehow it was cheaper to get some guy to fly in from nebraska every weekend than hire enough regular staff to fill out rotations.
it's probably worth adding on that those lucrative elective outpatient procedures extend far beyond vanity care; cosmetic surgery is only one of the many classes of excessive medical procedure. going down the list of the most common procedures in the u.s., they should all be subjected to this sort of animosity. heart valve procedures exist because we're all obese. c-sections are widely elective because women are terrified of their bodies. then there's the whole class of surgeries to relieve chronic pain: spinal fusion, laminectomy, joint replacement, arthroscopic knee/wrist surgery, and so on. shockingly, the very few placebo-controlled studies that have been done on these procedures demonstrate their utter inefficacy. for example, americans spend ~$50 billion per year on spinal fusion for chronic lumbar pain but it simply doesn't work.

all of these procedures are the result of and the source of profitability. (broadly speaking, there are cures for all of the above conditions, but they are rarely profitable and often censured.) unsurprisingly, these surgeons, along with the more obviously reprehensible cosmetic surgeons, cannot have their labor repurposed in times of pandemic. even if we were to assume that these surgeons are performing legitimate procedures, they completely lack the most important and most transferable skill in the field of medicine: being "emotionally equipped to engage with patients on a meaningfully personal level," as written previously in this thread. those societies where medical practitioners are equipped in this way are suspiciously also the ones who have low per-capita covid death rates.

Edited by nearlyoctober ()


Doctors at a Houston hospital on Monday morning found themselves locked out with no way of treating their patients.

At the Heights Hospital, medical workers ready to open the on-site clinic discovered a notice on the door saying the hospital owed more than $1 million in back rent and fees.

"Please be advised that the door locks to the leased premises have been changed and tenant shall be excluded therefrom due to non-payment of rent," the note read, adding that keys would be provided "upon payment of delinquent rent and other sums due under the lease."

Miles Cohn, an attorney listed as the contact to receive the keys, did not return a call for comment from CBS News outlets.

"We showed up around eight this morning, myself and my staff to get ready for clinic ... we were told we were not allowed in the building anymore," Dr. Felicity Mack told local CBS affiliate KHOU.

"We've called owners, management, title company — nobody's really giving us any answers," Dr. Mack said. "They're pointing fingers back and forth."

Despite lacking access to medicine and supplies, Dr. Mack went ahead and treated patients outdoors.

"I'm treating patients out in the parking lot so that at least we can get them some sort of care," she said. "But we really just want to be able to care for our patients."

Dr. Mack said she's been giving about 100 COVID-19 tests a day.

A patient of hers, Linda Fisher, told local station ABC 13 that she visits the clinic several times a week to get treatment for lingering COVID-19 issues.

Without treatment, some patients aren't sure how they'll manage.

"I come here twice a week for wound care because I have a bedsore," patient Milo Johnson told KHOU. "Without it... it kind of set me back a little bit."

The hospital is owned by AMD Global, a Houston-based real estate group, which bought the facility in 2017, according to a press release. AMD Global runs two other hospitals, in Louisiana and Arizona, according to its website. The group did not reply to a request for comment from CBS MoneyWatch.

Two corporations, 1917 Ashland Venture LLC and 1917 Heights Hospital LLC, are listed as tenants of the venue, according to the notice filmed by KHOU. The Houston Chronicle reported that a Nevada-based company recently sued 1917 Heights Hospital, alleging it is owed more than $3 million in interest in connection with a $28 million loan. Miles Cohn is representing the company, Arbitra Capital Partners, the Chronicle reported.

"I think this is a shame. I've never seen this before, that sick people are locked out," Representative Sheila Jackson Lee told KHOU.

"We're in the midst of a pandemic, when doctors and health professionals have sacrificed their health to care for patients of all kinds," she said. "This is an insane action."

The Democrat said the hospital and a management company were supposed to meet Monday afternoon — and she's asking the local sheriff to get involved.

The hospital's website, which briefly went down Tuesday morning, says the Houston facility provides urgent care, surgery, behavioral health services and other treatments.

lets change the locks on an urban hospital because rent is really important, what could go wrong

[account deactivated]

In the field of organic chemistry, Maitland Jones Jr. has a storied reputation. He taught the subject for decades, first at Princeton and then at New York University, and wrote an influential textbook. He received awards for his teaching, as well as recognition as one of N.Y.U.’s coolest professors.

But last spring, as the campus emerged from pandemic restrictions, 82 of his 350 students signed a petition against him.

Students said the high-stakes course — notorious for ending many a dream of medical school — was too hard, blaming Dr. Jones for their poor test scores.

The professor defended his standards. But just before the start of the fall semester, university deans terminated Dr. Jones’s contract.

The officials also had tried to placate the students by offering to review their grades and allowing them to withdraw from the class retroactively. The chemistry department’s chairman, Mark E. Tuckerman, said the unusual offer to withdraw was a “one-time exception granted to students by the dean of the college.”

Marc A. Walters, director of undergraduate studies in the chemistry department, summed up the situation in an email to Dr. Jones, before his firing.

He said the plan would “extend a gentle but firm hand to the students and those who pay the tuition bills,” an apparent reference to parents.

The university’s handling of the petition provoked equal and opposite reactions from both the chemistry faculty, who protested the decisions, and pro-Jones students, who sent glowing letters of endorsement.

“The deans are obviously going for some bottom line, and they want happy students who are saying great things about the university so more people apply and the U.S. News rankings keep going higher,” said Paramjit Arora, a chemistry professor who has worked closely with Dr. Jones.

In short, this one unhappy chemistry class could be a case study of the pressures on higher education as it tries to handle its Gen-Z student body. Should universities ease pressure on students, many of whom are still coping with the pandemic’s effects on their mental health and schooling? How should universities respond to the increasing number of complaints by students against professors? Do students have too much power over contract faculty members, who do not have the protections of tenure?

And how hard should organic chemistry be anyway?

Dr. Jones, 84, is known for changing the way the subject is taught. In addition to writing the 1,300-page textbook “Organic Chemistry,” now in its fifth edition, he pioneered a new method of instruction that relied less on rote memorization and more on problem solving.

After retiring from Princeton in 2007, he taught organic chemistry at N.Y.U. on a series of yearly contracts. About a decade ago, he said in an interview, he noticed a loss of focus among the students, even as more of them enrolled in his class, hoping to pursue medical careers.

“Students were misreading exam questions at an astonishing rate,” he wrote in a grievance to the university, protesting his termination. Grades fell even as he reduced the difficulty of his exams.

The problem was exacerbated by the pandemic, he said. “In the last two years, they fell off a cliff,” he wrote. “We now see single digit scores and even zeros.”

After several years of Covid learning loss, the students not only didn’t study, they didn’t seem to know how to study, Dr. Jones said.

To ease pandemic stress, Dr. Jones and two other professors taped 52 organic chemistry lectures. Dr. Jones said that he personally paid more than $5,000 for the videos and that they are still used by the university.

That was not enough. In 2020, some 30 students out of 475 filed a petition asking for more help, said Dr. Arora, who taught that class with Dr. Jones. “They were really struggling,” he explained. “They didn’t have good internet coverage at home. All sorts of things.”

The professors assuaged the students in an online town-hall meeting, Dr. Arora said.

Many students were having other problems. Kent Kirshenbaum, another chemistry professor at N.Y.U., said he discovered cheating during online tests.

When he pushed students’ grades down, noting the egregious misconduct, he said they protested that “they were not given grades that would allow them to get into medical school.”

By spring 2022, the university was returning with fewer Covid restrictions, but the anxiety continued and students seemed disengaged.

“They weren’t coming to class, that’s for sure, because I can count the house,” Dr. Jones said in an interview. “They weren’t watching the videos, and they weren’t able to answer the questions.”

Students could choose between two sections, one focused on problem solving, the other on traditional lectures. Students in both sections shared problems on a GroupMe chat and began venting about the class. Those texts kick-started the petition, submitted in May.

“We are very concerned about our scores, and find that they are not an accurate reflection of the time and effort put into this class,” the petition said.

The students criticized Dr. Jones’s decision to reduce the number of midterm exams from three to two, flattening their chances to compensate for low grades. They said that he had tried to conceal course averages, did not offer extra credit and removed Zoom access to his lectures, even though some students had Covid. And, they said, he had a “condescending and demanding” tone.

“We urge you to realize,” the petition said, “that a class with such a high percentage of withdrawals and low grades has failed to make students’ learning and well-being a priority and reflects poorly on the chemistry department as well as the institution as a whole.”

Dr. Jones said in an interview that he reduced the number of exams because the university scheduled the first test date after six classes, which was too soon.

On the accusation that he concealed course averages, Dr. Jones said that they were impossible to provide because 25 percent of the grade relied on lab scores and a final lab test, but that students were otherwise aware of their grades.

As for Zoom access, he said the technology in the lecture hall made it impossible to record his white board problems.

Zacharia Benslimane, a teaching assistant in the problem-solving section of the course, defended Dr. Jones in an email to university officials.

“I think this petition was written more out of unhappiness with exam scores than an actual feeling of being treated unfairly,” wrote Mr. Benslimane, now a Ph.D. student at Harvard. “I have noticed that many of the students who consistently complained about the class did not use the resources we afforded to them.”

Ryan Xue, who took the course, said he found Dr. Jones both likable and inspiring.

“This is a big lecture course, and it also has the reputation of being a weed-out class,” said Mr. Xue, who has transferred and is now a junior at Brown. “So there are people who will not get the best grades. Some of the comments might have been very heavily influenced by what grade students have gotten.”

Other students, though, seemed shellshocked from the experience. In interviews, several of them said that Dr. Jones was keen to help students who asked questions, but that he could also be sarcastic and downbeat about the class’s poor performance.

After the second midterm for which the average hovered around 30 percent, they said that many feared for their futures. One student was hyperventilating.

But students also described being surprised that Dr. Jones was fired, a measure the petition did not request and students did not think was possible.

The entire controversy seems to illustrate a sea change in teaching, from an era when professors set the bar and expected the class to meet it, to the current more supportive, student-centered approach.

Dr. Jones “learned to teach during a time when the goal was to teach at a very high and rigorous level,” Dr. Arora said. “We hope that students will see that putting them through that rigor is doing them good.”

James W. Canary, chairman of the department until about a year ago, said he admired Dr. Jones’s course content and pedagogy, but felt that his communication with students was skeletal and sometimes perceived as harsh.

“He hasn’t changed his style or methods in a good many years,” Dr. Canary said. “The students have changed, though, and they were asking for and expecting more support from the faculty when they’re struggling.”

N.Y.U. is evaluating so-called stumble courses — those in which a higher percentage of students get D’s and F’s, said John Beckman, a spokesman for the university.

“Organic chemistry has historically been one of those courses,” Mr. Beckman said. “Do these courses really need to be punitive in order to be rigorous?”

Dr. Kirshenbaum said he worried about any effort to reduce the course’s demands, noting that most students in organic chemistry want to become doctors.

“Unless you appreciate these transformations at the molecular level,” he said, “I don’t think you can be a good physician, and I don’t want you treating patients.”

In August, Dr. Jones received a short note from Gregory Gabadadze, dean for science, terminating his contract. Dr. Jones’s performance, he wrote, “did not rise to the standards we require from our teaching faculty.”

Dr. Gabadadze declined to be interviewed. But Mr. Beckman defended the decision, saying that Dr. Jones had been the target of multiple student complaints about his “dismissiveness, unresponsiveness, condescension and opacity about grading.”

Dr. Jones’s course evaluations, he added, “were by far the worst, not only among members of the chemistry department, but among all the university’s undergraduate science courses.”

Professors in the chemistry department have pushed back. In a letter to Dr. Gabadadze and other deans, they wrote that they worried about setting “a precedent, completely lacking in due process, that could undermine faculty freedoms and correspondingly enfeeble proven pedagogic practices.”

Nathaniel J. Traaseth, one of about 20 chemistry professors, mostly tenured, who signed the letter, said the university’s actions may deter rigorous instruction, especially given the growing tendency of students to file petitions.

“Now the faculty who are not tenured are looking at this case and thinking, ‘Wow, what if this happens to me and they don’t renew my contract?’” he said.

Dr. Jones agrees.

“I don’t want my job back,” he said, adding that he had planned to retire soon anyway. “I just want to make sure this doesn’t happen to anyone else.”

Rhizone doctor squad weigh in, shbould the anesthesiologist at the botox clinic have to be an expert in organic celery


swampman posted:


I admit that before the pandemic, I would not have thought that bourgeois ideology would opt for self-sabotage by way of eliminating the last century of advances in medicine. Like... the cushion is bigger for the bourgeoisie as individuals, treatment for the problems caused is easier to obtain... but they are definitely depriving their own children of vaccines, nutrients, preventive medicine, etc. as the first step here. They are including themselves among the enemy as a demonstration of ideological fealty.

cars posted:

I admit that before the pandemic, I would not have thought that bourgeois ideology would opt for self-sabotage by way of eliminating the last century of advances in medicine. Like... the cushion is bigger for the bourgeoisie as individuals, treatment for the problems caused is easier to obtain... but they are definitely depriving their own children of vaccines, nutrients, preventive medicine, etc. as the first step here. They are including themselves among the enemy as a demonstration of ideological fealty.

fortunately the dire shortcomings in public service and regulatory oversight exposed by this incident were related to something relatively harmless. hopefully they learn fast, before kids in some podunk hamlet start shitting and puking themselves to death because an asshole got tired of hearing complaints from the local crank about how the water tastes like a swimming pool

im not a doctor, but the ones i know that do botox are super smart, way smarter than me in organic chemistry, with a long family history of practicing medicine or medicine adjacent things. i passed orgo a bunch of times and two pharmacology courses without figuring out that prilosec was omeprazole, or that the active ingredient in lipitor was calcium (lol jk pls dont shoot)

Edited by Bablu ()

the Harvard Hitler’s Peabody Hall of Racial Science
I say we need to have more Barefoot Doctors. Barefoot is legal, dammit!!