Metaphor #2

North Broward Hospital District

dba Broward Health

Fiscal Year              2000             2015

Gross Charges                                       
 Per adj. admissions       $19,823               $33,290
Deductions                     ($15,385)             ($26,751)              
  Bad Debt                        ($1,478)               ($3,281)
  Charity Care                 ($2,026)              ($1,357)
  Third Party                  ($11,881)           ($20,766)
Reimbursed                      $5,490                $7,884
Other Revenue                       $17                    $225
Tax Revenue                       $690                   $1,171
Total Revenue                   $6,198                $9,280
Total Expenses                ($6,296)             ($8,674)               
 System Surplus (Loss)      ($88)                 $606
FTEs                                      5,979                  7,636
Avg. Compensation         $52,131             $83,528
Adjusted admissions        91,666                119,319 
Surplus (Loss)                    ($802)     $72,260,203
Per adj. admission           ($0.87)                  $606
Avg. Daily Census                 784                      876
Admissions                        53,242                61,053 

Uninsured admissions     10,555                 9,826 
Insured admissions          43,177                 51,227
Medicare admissions       11,493                 12,154

Medicare HMO/PPO        8,760                  9,665
Medicaid admissions        6,719                   6,370 

Medicaid HMO/PPO        1,393                   5,273
Other Insured                   14,812                 17,775.

ER Visits                         186,397              293,693
ER admissions              34,600                45,200

. 

                                      What, me worry?
                    Like it's only numbers

Metaphor #1

Sheela VanHoose

     Meet Miss VanHoose.

     An adorable career bureaucrat and stanch Republican,

she began her career as an appointment secretary for Florida Governor Rick Scott  -- after which she became a full-time,  Broward-based lobbyist.
     Fun Fact:

     The next time you're  rolled into a Broward Health Emergency Room with a heart attack, it's important to remember Gov. Scott appointed Miss VanHoose to help govern the North Broward Hospital District -- including the same ER you're rolling into aboard a stretcher.

      Sarcasm alert!

      So why should you worry about the politics at a facility in which you're betting your life?

      Especially since the North Broward Hospital has ALWAYS been driven by the various Political Big Dogs d'jour -- be they Democrat or Republican.      

      Naturally, the more thoughtful among you may be moved to ask, "WTF?"

      Especially since the current governing District Board of Commissioners were anointed by Broward Mega Lobbyist Billy  Rubin -- who served as Scott's political Corner Man way back when the Governor launched today's humongous Hospital Corporation of America (HCA) which provided  him with millions enough to bankroll his successful race for the Governor''s office.

    Anyhow...

    Next time they're cracking your chest, remember the masked man with the knife could be the best local politics can buy.

    

Frightening question

                How long can these 
                   trends continue?  
                 (Per adjusted admission)
                     1985      2014    %
   CPI                                       220% 
   Broward 
    Medical
     Uninsured     $4,241       $7,115       67.8%
     Medicare       $5,643       $10,313    82.3%
     Medicaid       $4,159        $11,397    174,0%
     HMO/PPO    $2,778        $9,107     227.8% 
  Memorial 
    Regional
      Uninsured    $2,189       $16,814    668.1%
      Medicare      $5,198       $19,535    275.8% 
      Medicaid      $1,776        $16,207    812.5%  
      HMO/PPO   $3,056       $16,814    548.4%

Confession

      For most of my career as a journalist, I took shameless pleasure in the fear and status that came with my press card.

      Even when working for a rinky-dink small town Ohio daily, I enjoyed a hearing someone mutter:

      "Better watch out for deGroot! He's with the Record-Courier."

       There was also the ego-feeding knowledge that most folks would return my phone calls promptly -- if they knew I was with the press.

      And finally...

      Nearly always, my healthcare blog includes a cruel and unspoken caveat:

      "When it comes to the nation's healthcare industry, most Americans are as dumb as a box of rocks and  as helpless as a one-legged man in an ass-kicking contest."

       Mea culpa?
       Mine is the venal sin of knowing when others don't.
       And flaunting it.

       Like this... 

                              Diagnostic Service Group
                              Congestive Heart Failure

                                  Broward     Memorial
                                  Medical       Regional        
        White                  656              1,337
          Avg. Charge            $89,925         $103,100
         Black                   869             588
          Avg. Charge             $76,877         $114,090
          Hispanic             95                313
          Avg. Charge             $105,530      $111,412
          Avg. All               1,641           2,137
          Avg. Charge             $83,645        $109,703
                               

Word for the day

Anomaly - Something unusual, or unexpected*
                                                      Merriam-Webster Dictionary
                                                  
                              Example

                                                                           

                           North Broward Hospital District  
          Governing Board of Commissioners
                         Scheduled Meetings
                             March 2015  - 3
                             March 2016  - 8

                                   Why?

Exploring the healthcare jungle - Part #1

     As a retired journalist, I've spent more than a decade wandering the surreal jungle created by the nations alleged "free market"  healthcare system.
     Cutting, as they say, to the  chase:
     Here in Florida, hospitals have been able to increase their profits for the same reason male dogs can lick their balls.
       Which is: Because they can.

        How so?
        Ironically, in an early attempt to slow the skyrocketing cost of hospital care, the Florida legislature created the Florida Hospital Cost Containment Board some four decades ago.
        Then, after several years, the the "Cost Containment" agency was renamed the Florida Agency for Health Care Administration (AHCA).
        But as AHCA, the agency's primary task remained the same as its predecessor: To track hospital costs (and profits) in Florida.
        That said, it seems AHCA has been successful in keeping hospital patient care charges under control - when adjusted for inflation.
         However, at the same time,hospitals have managed to reduce their patient care costs - they've failed to pass on the benefits of their efforts to the health patient consumer.
        Especially when it comes to the hospital industry's  increase in bottom line profits. 
                                      Florida Hospitals
                                 Trends - Costs v Profits
                          Per Adjusted Admission
      All Hospitals       1990          2000       2013
       Charges                $5,464       $6,916    $10,061
       In 2013 dollars        $10,244         $9,328      $10,061
       Cost                       $5,286       $6,674    $9,362
        In 2013 dollars          $9,927           $9,009      $9,362
       Profit                     $178            $242       $699
       In 2013 dollars         $317               $317           $699
       Margin                  3.3%            3.6%       7.5%      
          Today, AHCA has launched yet another website -- this time at www.floridahealthfinder.gov.
          Where once again, we find Florida hospital costs are more Persian market than free market.
          Only time, AHCA's data covers selected diseases.
          For example, consider the insanity of various Chargemasters at work in a comparison of hospital charges between 2007  and 2014  .                             
                                    Chronic Disease
                          "Congestive Heart Failure"
                                  Broward Hospitals
                                     Average Charge
                                             2007           2014
    Broward Health
     Broward Medical      $79,240     $83,645 
    Adjusted for inflation        $106,974       $83,645
    Coral Springs               $52,494     $39,753
    Adjusted for inflation        $70,867         $39,753
    Imperial Point              $37,682     $31,657
    Adjusted for inflation          $50,871         $31,657
    North Broward             $39,242    $48,920   
    Adjusted for inflation          $52,977         $48,920  
    Memorial Healthcare
    Memorial Miramar     $48,461     $72,911
    Adjusted for inflation          $65,422       $72,911
    Memorial Pembroke    $49,923    $73,848    
     Adjusted for inflation           $67,396        $73,848 
    Memorial Regional       $64,095   $109,703
     Adjusted for inflation          $86,598       $109,703
     Memorial South            $43,313    $51,556
     Adjusted for inflation           $58,473       $58,473
     Memorial West              $48,374   $87,678
     Adjusted for inflation          $65,305        $87,678
     Private Hospitals
     Cleveland Clinic            $43,648    $52,442
     Adjusted for inflation          $58,925        $52,442
     Florida Medical           $90,418     $103,908
     Adjusted for inflation          $122,064      $103,908
     Holy Cross                     $70,460     $65,475 
     Adjusted for inflation         $95,121          $65,475
     Northwest                     $58,882      $105,247
     Adjusted for inflation         $79,491           $105,247
      Plantation                     $86,009     $120,293
     Adjusted for inflation         $116,112          $120,293
     University                      $51,416      $73,869
     Adjusted for inflation          $69,412         $73,869
     Westside                         $83,095     $101,638
.    Adjusted for inflation          $112,178        $101,638

Data as Metaphor

   Journalistic sins of omission or commission.
   Do you know the difference?
   Read the South Florida Sun-Sentinel*
    Because journalistic sins of this sort matter - given Governor Rick Scott's current policies impacting Florida hospitals.                   
   *Not that you'll find any of the startling data below in South Florida's "most valued information provider."
   
                            Broward County 
               Average Daily Hospital Census
                        Twenty Year Trend
                                            1995             2014
Broward Medical             369              409
Uninsured                                    84                    52
Medicare                                      108                  120 
Medicaid                                      105                  162 
Other Insured                              72                    75
Surplus (Loss)
per adjusted admission         ($311)             $325
Coral Springs                    102               138  
Uninsured                                   13                      16
Medicare                                      31                      49
Medicaid                                      10                      18
Other Insured                            48                      55
Surplus (Loss)                            
per adjusted admission          $21                    $302
Imperial Point                 101                 99
Uninsured                                18                         13
Medicare                                     48                     48
Medicaid                                     6                        18
Other Insured                            29.                     20
Surplus (Loss)
per adjusted admission        ($113)                 $96
North Broward                193               213
Uninsured                                  32                       32                     
Medicare                                    101                      105
Medicaid                                     23                       55
Other Insured                           37                         21
Surplus (Loss)
per adjusted admission         $164                    $372


Memorial Miramar        Not Open      85    
Uninsured                                                              7
Medicare                                                                27
Medicaid                                                                19 
Other Insured                                                       32
Surplus (Loss)
per Adjusted Admission                                    $2,116
Memorial Pembroke     Private          69 
Uninsured                                                             10
Medicare                                                               38
Medicaid                                                               11
Other Insured                                                      10
Surplus (Loss)
 per Adjusted Admission                                  ($518)      
Memorial Regional     436                 542 
Uninsured                               110                       62 
Medicare                                  157                      185
Medicaid                                  69                        174
Other Insured                        100                      121
Surplus (Loss)
per Adjusted Admission       $212                  $268
Memorial West              74                   258         
Uninsured                               7                            20
Medicare                                  32                         111
Medicaid                                  4                           49
Other Insured                          31                         78 
Surplus (Loss)
per Adjusted Admission     $423                   $2,267

Cleveland Clinic            67                  127
Uninsured                               3                           4  
Medicare                                 45                         69
Medicaid                                  2                           2
Other Insured.                        17                        52
Surplus (Loss)
per Admission                      $422                   $4,171
Holy Cross                     259                 221
Uninsured                              13                         9
Medicare                                 178                      135
Medicaid                                 17                        22
Other Insured                        51                        55
Surplus (Loss)
per Adjusted Admission     $779                  $620
Northwest                      74                   153
Uninsured                               2                          11          
Medicare                                 52                        86
Medicaid                                 3                           26
Other Insured                        17                         30
Surplus (Loss)
per Adjusted Admission    $415                    $690
Pembroke - Private     35                     Public
Uninsured                              1  
Medicare                                22
Medicaid                                2
Other Insured                       10
Surplues (Loss)
per Adjusted Admission     ($89)  
Plantation                      126                    NA           
Uninsured                               2 
Medicare                                 31
Medicaid                                 32
Other Insured                        61
Surplus (Loss)
per Adjusted Admission     $210
University                      128                    146 
Uninsured                              3                              16 
Medicare                                 81                            86
Medicaid                                 4                              19
Other Insured                       40                            25
Surplus (Loss)
per Adjusted Admission    $1,346                   $436
Westside                         111                    170 
Uninsured                               5                             9
Medicare                                 41                            113
Medicaid                                 4                              14
Other Insured                        61                           34
Surplus (Loss)
per Adjusted Admission    $561                      $1,552