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NYT: A Health Care Success Story
IT may have been the most influential magazine article of the past decade. In June of 2009, the doctor and writer Atul Gawande published a piece in The New Yorker called “The Cost Conundrum,” which examined why the small border city of McAllen, Tex., was the most expensive place for health care in the United States. The article became mandatory reading in the White House. President Obama convened an Oval Office meeting to discuss its key finding that the high cost of health care in the country was directly tied to a system that rewarded the overuse of care. Five years later, the situation has changed. Where McAllen once illustrated the problem of American health care, the city is now showing us how the problem can be solved, largely because of the Affordable Care Act that Mr. Obama signed into law in 2010.
The problem was that doctors in McAllen were responding to reimbursement incentives in the American health care system that rewarded activity rather than value. The more procedures and visits a doctor billed, the more he got paid. The Affordable Care Act was designed to change that. One of its provisions created the Medicare Shared Savings Program, which rewards doctors for keeping their patients healthy. Participation in the program requires primary care doctors to create networks, called accountable care organizations, or A.C.O.s, to better coordinate patient care. These networks are reimbursed for delivering high-quality care below a baseline of historical Medicare costs. In 2012, doctors in McAllen formed the Rio Grande Valley Accountable Care Organization Health Providers, and signed up for this experiment. The early results are in, and they are stunning: From April 2012 to the end of 2013, the Rio Grande Valley A.C.O. saved more than $20 million from its Medicare baseline. These changes didn’t just save money; they also improved patients’ health. From 2012 to 2013, the number of patients achieving control of their diabetes rose 11.8 percentage points. The number receiving vaccinations rose 12.2 percentage points.
More here
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The Obama Diary 
great!
Congrats, dee!
A little bit of perspective as we rightfully question the 2011 debacle:
This plot wasn’t foiled, it just so happened that the President wasn’t home at the time.
Thank you
Good perspective!
This is such good news about Obamacare. Glad tor read it.
On another topic, one that has me going…..the Secret Service. Please contact people who can make a difference.
So far I have called the state Field Office for the Secret Service, have written both my Senator and Congressman and have written Rachel Maddow and asked her to investigate this situation. I am frightened. I think there are traitors in the ranks……
I also think the Secret Service needs to be put back under the aegis of the Treasury Department. It has slipped since being under the Dept of Homeland Security. Too big, and no oversight.
Please contact those who can do something about this awful situation.
♫Wait for me; wait for me, ♫Nerdy please wait for me!♫
I’m slow but I will arrive..♫
Ner-dy, please.♫ wait for meeeee♫
🙂 🙂 Seems perfectly reasonable, practical, even wise to me.
Got to add tho, despite the wisdom here there is no way under the sun I’d be traveling so close to a snail. Just clarifying. In fact that would be a sure way for my speed outta there to triple!
Hey Chips, when i saw this animation i exclaimed so suddenly…. now you owe me a new or refurb keyboard
Thanks a trab-zillion Nerdy, the stupendous Obamacare news just keeps on rollin’ in!!
You’re welcome, Chips.
Thanks for posting it.
I love POTUS in The Beast.
I was just thinking the same thing! Thought to myself, “Who is that masked man in The Beast?” Love him.
This country truly scares me beyond words. Something nasty is afoot. Truly nasty. I pray for the Obamas safety.
Yep. This has been my feeling for the past several months. There is something terribly terribly wrong
Forgive my ignorance, but I thought SCOTUS was on summer break since June, “First Monday In October,” and all that.
The same SCOTUS who gave G.W. Bush the Presidency.
Yea, I liked that McAllen, Texas story which I stumbled onto here sometime this past week. Thanks for front-paging it, NerdyW. Another example of PresO not only doing his homework, but taking the long view.
You’re welcome, VC.
They need to go. May God forgive me, but there are four Justices that I wish would have to leave the bench, whether it be impeachment or illness. Scalia, Alito, Thomas and Roberts.
Impeachment, illness or Final Breath.
I want the guys that protect Minister Farrahkahn to protect my President.
C’mon now.
Minister Farrahkahn is Never facing the threat this president has faced.
SS messed up bad. But we hear about the mess ups and Never about their 24/7 protections that have gone well.
You are probably 100% right Nena – but I DO have a serious problem with the way the media is reporting this. Their reports seem to be filled with details about and Maps of the WH interior that really shouldn’t be for public consumption. As vc said on the previous thread, it almost feels as if they’re writing a “how to” manual, disguised as reporting….
And I am very suspicious of the media ‘s reporting in a drip…drip…drip…manner. WHY are all these reports NOW coming out? How did the WH fence jumper have the presence of mind to wait until the President was safely up and away to Camp David before jumping the WH fence? Did someone clue him him in? Was he known to someone or does he know someone who works for the WH SS?!?!?
That guy has had the WH on his radar for months…..He was in the Military. A determined person never gives up, unfortunately, those with mental issues……Hinckley, the lady that shot Ford. The Man who shot JKF. MLK RFK, etc. I don’t think he had help. I am not 100% though. I am only going on the initial report from when DC Law Enforcement stopped him in Jun/Jul.
I read somewhere that he had surgery on his foot and walks with a cane. Yet he was running like Usain Bolt in the video. The man is not crazy, he was determined to do harm and the SS as far as I am concerned is not serious about protecting the President.
I tempted to agree with you, Nena, but the bullet holes in the windows of the first family’s living quarters in 2011, and more recently some guy overpowering a Secret Service Agent inside the White House leave me no choice but to stand by what I wrote. And on top of that, the shooting at the White House in 2011 was not given full attention because a Secret Service Supervisor dismissed the shooting as a shootout between two “gangs,” yes, gangs. Because most gangs usually shoot at each other in front of the White House or Police Stations, or whichever is more convenient.
I did read that the WH windows were hit then in 2011. That was the guy from OR/WA. I never read then that the 1st daughters and their grandmother were in the WH.
Re all the above comments and more, these are why we, once again, have to become the media, and why I posted a call to action for us to make our voices heard by influential people about the SS, and the absolute reorganization and attention to mission they need to undergo. Please call and write those who have influence…..also call the state field office of the SS…..voice your displeasure and disgust loudly. These people in government pay attention to numbers……the more people who complain, the more likely action will be taken. If all the people on this blog contact their Senators, and call…..some impact will be made.
Good point, Carolyn. I was pleasantly surprised to hear that you got a ‘body’ on your first call and were able to voice your concerns. I hope others here will follow your example.
I think I need to spend a week or so doing some serious thinking, preferably with cups of tea, and write some essays. I haven’t been writing much lately; partly due to my sleep issues; but partly also due to the fact that this world has reached a level of insanity I never thought I’d see, especially in my country. If I don’t make some sense of it, I may go spare.
Did you pass the sleep apnea test LLP?
I get my CPAP next week. Looking forward to it.
Great, you will get used to it and feel so refreshed after a good nights sleep.
That’s what I’m hoping.
Had mine for 7 years. I just got the new model and it’s so quiet.
That was my brother’s complaint that his cpac was too noisey and uncomfortable.
The new one is night and day from the old one. You need to use the old one for 5 years before insurance (BCBS) will pay for new one. Hope he can qualify for a new one.
Thanks. I’ll let him know
I think the new one is fairly recent. I could send you a link to it tomorrow. It might take me awhile to find what I use, then again it might just take me a minute. 😉 I’ll check.
Linecare is the company I use, but I’m sure the companies that supply them have same machine.
How does bullet proof glass not protect against bullets? Replace all those windows!
Interesting isn’t it – VOTE like the President’s life depends on it because it does.
These 5 are decimating the USA.
Until We Say No and loudly, it will continue. The best way if for people to care enough and VOTE.
It is an uphill battle. Women are now 54% of the electorate. Yet our bodies are still subject to legislative Gamesmanship………by Men, mostly?
There is shooting in the vicinity of the WH. SS agents report hearing shooting and are preparing to investigate and defend. Agent in charge tells them to stand down and not investigate?!?!?!
Hello everyone, I feel silly posting because I don’t haven’t been here for so long. The Secret Service stuff is bothering me too. I didn’t even know about what happened in 2011. I’m also concerned about the r rep who asked the Generals to resign or something.
The other thing bothering me is that someone has started a new Twitter account very similar to my Twitter name and real name. If we’re already following each other ignore any new requests. Guess my first Avi was a Hillary vampire but last I looked it was FLOTUS.
It’s no nice to catch up on reality here at TOD.
Well I should feel silly; my first sentence is terrible grammar. . .
Delighted that you are commenting, once again, CarolMae!!
Thanks Bob. I do have trouble keeping up though.
Very troubling news about your Twitter “stalker.”
Wish these people would get a life.
Thanks for posting your Tweet with @MTmarilyn, yesterday!
Thanks Arapaho. We had a great time. Wish we could all get together. Well we all will be in the voting booth soon!
The only ‘silver lining’ in this massive security screw-up are that the guy revealed a scale of vulnerability that should already have effected major changes in operating procedures and that he did not harm anyone. But, gotta tell ya every punk white supremacist, jihadist, etc., are likely emboldened to go for the big one – blowing a gaping hole in the WH and killing lots of folk in the process.
I don’t even like to see the mere mention of this.
Understood, df. But, the USSS needs to know that we fully appreciate the magnitude of their screw-up and it’s up to us to keep it in their face until they prove they’ve rectified their security vulnerabilities.
Someone earlier commented that they called and pitched a fit. Worth doing. Too many nutjobs walking around this country. Scares the crap outta me.
All of this news about the Secret Service has my head spinning.
I’m with HF2, wondering where this is coming from and why now?
I’m not a believer in conspiracy theories, but our dishonest and shameless MSM has me wondering about:
1) Who is the Secret Service “leaker” (Saturday’s blockbuster reveal about 2011 and today’s reveal about 2014 are from WaPo, who cites the same anonymous sources). Yesterday I heard a *single* report about 2011 on CBS radio news, today reports about 2014 incident are blanketing their airwaves.
2) Darrell Issa must have broken Congressional speed records to convene a hearing on this matter — Congress has more days off than on, and they don’t work on Mondays. Who lit the fire under Issa?
3) WaPo also cites anonymous tips to the House Oversight Committee on Homeland Security chairman, teabagger Jason Chavetz (R-Utah).
And at the 5 pm PDT hour, I heard someone (an author, didn’t catch who it was) #BlameObama. He was critical of the arrogance of the Secret Service, and said “It goes back to Obama, who keeps defending them.”
JHC.
But something is afoot — WaPo is the only news outlet “reporting” this info, and the rest of the MSM/Koch lapdogs obediently follow suit.
This stuff just enrages me.
In a democracy, why would you stop people from voting? Why would the SCOTUS be interested in impeding voting? in a democracy. Shouldn’t the focus be to encourage more citizens to vote, to ease the process, so we have a truly representative democracy? This Supreme Court is just a shameful, democracy-damaging bunch. It’s a real nightmare to think these wrongheaded, partisan decision makers have the final say on so many critical issues.
It’s frightening, Dotster, and there’s no way on the horizon that it can be changed. These SCOTUS wingers won’t retire until they’ve finished destroying our democracy and there’s isn’t anyway a decent nominee could get through the Senate in any case. It frightens me that their anti-democratic intentions are so out in the open now. They are working together and they simply don’t care about the consequences to ordinary Americans.
Because Lord knows I think we need the laugh.
😀 😀 😀
OH! This one’s getting sent around 🙂
That is disgusting.
Sorry, I don’t find this at all funny.
Obviously someone who didn’t need to work their way through college.
“Anonymous Ukrainian hackers have leaked a cache of documents revealing the interactions between separatists in eastern Ukrainian and a Russian far-right political party. Among the seemingly endless bureaucratic documents, a few hidden gems reveal plans for a fuel delivery network between Russia and the self-proclaimed Donetsk People’s Republic (DNR), as well as an elaborate political campaign.
On September 23, a group of Ukrainian hackers claimed to have stolen a large cache of files (nearly 2.4-gigabytes-worth) from the servers of the far-right Liberal Democratic Party of Russia (LDPR), headed by the notorious Vladimir Zhirinovsky. On September 26, someone leaked 11 files from the cache on the ex.ua torrent tracker. The data spread from there.”
F+++++
If the White House fence jumper were black his black ass would have been shot while his black ass was still on the fence. His black ass would not have been afforded the opportunity to open the front door and attack and overpower a Secret Service Agent and lived to talk about it.
Amen, Don.
Yep. And Fact, since Nixon, there have been numerous intrusions to and at the WH. Of all those….2 have been killed. Both were Black.
The Woman with a child in the back in 2013/2013. There was a guy during Nixon or Ford….he was a Black guy.
Don if he was black he would have been shot the minute his foot hit the ground on the other side of the fence.
the minute his feet
Agree, Don. In fact, this was what I tweeted upon learning of the incident …
Whoa.
Very troubling, indeed, Bob.
See my comment about the Secret Service upthread.
Don..
You..me…JUSTLIKETHIS..
A Black Man can be shot for Walking While Black…
and neither one of these mofos was shot?
AT ALL?
Hope all of you read this …
“In one graphic and brave chapter titled “Whore,” Galpin, for the first time publicly, details her brutal rape at knifepoint in 1993, an attack that left her physically and emotionally shattered.
The event led her to drop out of dance school and forever altered the course of her life, taking her to Germany, Beirut and eventually Breckenridge. The rape came to define her. By how much, Galpin didn’t know until her bubbling rage over gender violence took her to the most dangerous place in the world to be a woman — Afghanistan.
Today, Galpin, a single mother of a young girl, runs the Mountain2Mountain nonprofit from her Breckenridge home. The group, founded in 2006, seeks to empower women in conflict zones through art- and story-based projects, among other efforts. Her work in Afghanistan led National Geographic to name her its 2013 Adventurer of the Year.
Galpin’s memoir comes out at a time when violence against women, namely within the NFL, has dominated the media conversation. Galpin’s book poses an unsettling question: Though America and Afghanistan are worlds away culturally, does the tolerance of gender violence link them more closely than we’d care to admit?”
TY Bobfr….Ms. Galpin is a true heroine.
more Obamacare good news
Earlier tonight I attended Celebration of Life service for a ‘young’ woman in our church. 50 years old….stroke last Sunday and passed away Wednesday. She LIVED LIFE TO THE FULLEST in everything she did…..parenting, wife, church member, community member, career. Filled with grace, hope, compassion. You get the picture. Want to share what our pastor said in his meditation. 1. Life is relentlessly short & precious. We have THIS moment. We get ONE shot. 2. We need each other. We’ve heard all our lives “Pull yourself up by your bootstraps.” Well, none of us can do anything alone. Life is meant for RELATIONSHIPS…..helping & giving. 3. Cling to HOPE. Hope is essence of human existence. Hope is to the soul as air is to the body. Hope is everything. It is LIFE. It is the glue that holds everything together. Hope is the reason we wake up every morning to face a new day. Those without hope become cynical, give up, become bitter and end up nothing but an empty shell.
I read this again (And I’ve heard this from our pastor many times!!!!!!!) and every time I hear him say these things, I think of the Sarah Palin and others who have made such fun of PO……been so sarcastic and cynical. This on top of the SCOTUS news about voting rights and the SS issues. I have so many emotions going through my head. Don’t know where to start to consume this jumbled mess. Sigh. Sigh.
Thanks for sharing TNmtgirl.
From the article…
Racial bias is powerful because it is systemically institutionalized. Our society views race as a set of permanent, heritable characteristics that include temperament, behavior and ability. If you belong to a racial minority, all the things that are thought of about people of that group are thought about you. Thus the police feel entitled to shoot, choke and beat black men because of the belief – engrained over centuries of enslavement, segregation and social racial stratification – that black people, and especially, big, black men, are dangerous.
😉
L.A. has probably the biggest Indian population after Chicago….my parents are there right now as a matter of fact!
Remind you of anything?
Half way through “Against Football” by Steve Almond. It makes for infuriating reading. One can say all American sports leagues are rackets extorting money from local communities and diverting resources from real needs. But the NFL has made those machinations into a dark science. I’m really starting to question my sports fandom.
Too much power corrupts.
Too much power and too much money in a monopoly that doesn’t contribute to society (i.e., tax-free status) is corrupted decadence.
That is why I will always vote down any state or city money for a sports stadium for these billionaire owners who get millions from television, use of their logo, and other sources. Sports need to pay for their own stadiums.
Can someone explain to me WHY SCOTUS is stopping early voting in Ohio? Having voting on a Tuesday has always seemed to me to be a way to ensure the working classes are less likely to vote – the current mode of stopping alternative voting opportunities is making a mockery of US as a democracy. Money seems to be the overriding power in the US.
At least when my country stupidly votes in a RW war crazy government, I know that everyone had the opportunity to vote – and no-one was working to stop them – least of all the highest court of the land.
About those WH intruders….
how come none of these muthaphuckas was SHOT?
That’s my big thing. Nobody unloaded on these mofos?
if ever there is a time for shoot and ask questions if they live afterward, it is someone attacking the White House.
New post:
http://theobamadiary.com/2014/09/29/a-tweet-or-two-132/