COPN Scores a Kill
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44 responses to “COPN Scores a Kill”
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There’s always Riverside… but the two hour wait at the HRBT in the ambulance may be a tad costly.
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Why aren’t the citizens of Hampton Roads up in arms about the Sentara monopoly?
Where is the Virginian-Pilot? (Writing stories about housing discrimination and literally apologizing for the whiteness of its reporters. https://thevirginiastar.com/2021/01/24/virginia-newspaper-apologizes-for-whiteness-before-reporting-on-discrimination/)
Where are the region’s elected officials?
Where are the citizens groups?
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Where? Waiting for Sentara to give them their vaccines.
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Why aren’t the citizens of Hampton Roads up in arms about the Sentara monopoly?
Where is the Virginian-Pilot? (Writing stories about housing discrimination and literally apologizing for the whiteness of its reporters. https://thevirginiastar.com/2021/01/24/virginia-newspaper-apologizes-for-whiteness-before-reporting-on-discrimination/)
Where are the region’s elected officials?
Where are the citizens groups?
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Where? Waiting for Sentara to give them their vaccines.
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does China even have COPN
like a room full a bureaucrats can decide “need” -
does China even have COPN
like a room full a bureaucrats can decide “need” -
Hmm.. You see this as a monopoly: ” the Sentara website and it announced that Sentara had 264 locations of care near my home Virginia Beach. They operate hospitals, outpatient care facilities, imaging centers, home care services, emergency facilities, primary care offices, therapy and fitness operations, schools, urgent care facilities, specialists offices and senior care facilities.”
I see this as a business model that serves the community and the bar that would-be competitors have to meet to compete.
I don’t want to see Mayo come in and cherry pick the lucrative services and leave Sentra to have to figure out some other way to pay for those community facilities or close them in which case, the community gets cheaper high dollar services for some things but loses the community medical facilities.
The only way Mayo or others should be incentivized to come is if they too are going to provide community-based health care services (like UVA also does).
UVA and Sentra use the high dollar elective services to essentially subsidize the unprofitable community services. I see the idea of brining in Mayo as essentially taking away the method that Sentra uses to pay for community services.
Am I wrong?
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Have a nice rest of your day.
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Larry: “Am I wrong?
You are dead wrong.
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Hmm.. You see this as a monopoly: ” the Sentara website and it announced that Sentara had 264 locations of care near my home Virginia Beach. They operate hospitals, outpatient care facilities, imaging centers, home care services, emergency facilities, primary care offices, therapy and fitness operations, schools, urgent care facilities, specialists offices and senior care facilities.”
I see this as a business model that serves the community and the bar that would-be competitors have to meet to compete.
I don’t want to see Mayo come in and cherry pick the lucrative services and leave Sentra to have to figure out some other way to pay for those community facilities or close them in which case, the community gets cheaper high dollar services for some things but loses the community medical facilities.
The only way Mayo or others should be incentivized to come is if they too are going to provide community-based health care services (like UVA also does).
UVA and Sentra use the high dollar elective services to essentially subsidize the unprofitable community services. I see the idea of brining in Mayo as essentially taking away the method that Sentra uses to pay for community services.
Am I wrong?
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Have a nice rest of your day.
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Larry: “Am I wrong?
You are dead wrong.
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There’s always Riverside… but the two hour wait at the HRBT in the ambulance may be a tad costly.
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So, here is my thinking.
It’s claimed that medicare and medicaid do not pay the actual cost of providing the care, that whoever accepts their payment are taking a loss. Yet, a good percentage of people have Medicare and Medicaid and hospitals and other providers will accept them for payment even though they lose money on the transaction.
How do they make up these losses?
It appears to me that some (maybe more and more?) hospitals have moved to a business model where they sell profitable services and elective procedures for a tidy profit then use some of that profit to offset their losses on other patients who have Medicare and Medicaid.
This type of practice is not unheard of in the business world. Walmart as well as the auto manufacturers are said to bump the profit on the in-demand cars and products so they can essentially sell others at a loss.
Walmart sells 2 liter cokes for a whopping 100-200% markup while their milk is said to be sold at cost or less. Ford will get 5-10K profit on a big Ford Pickup , yet their gas-sipping compacts (that help them meet their CAFE standards) are sold at cost or at a loss. I read somewhere that Toyota’s Prius is sold almost at cost.
How likely is it that Mayo would accept Medicare or Medicaid reimbursements for their services? How likely is it that some of
the services Mayo offers are not covered at all with Medicare/Medicaid?How likely is it that Mayo would stand up community clinics for primary care in the area that DePaul served and accept Medicare/Medicaid such that those satellite facilities are unprofitable and may run at a loss?
More than likely, Mayo would compete on the profitable services and just decline to provide services that are unprofitable.
And if Sentra was going to compete with Mayo, they’d be forced to cut their prices also – but if they did not , they’d also be cutting funding of their less profitable services. Over time, they’d have to close down the unprofitable satellite places.
where am I going wrong – seriously….. ????
how about it IZZO ?
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You neglected my advice.
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I decided to wait until after dinner to respond, Larry. I have grown to understand you, but you keep pecking away until I am forced to answer lest someone read my column and be diverted by your comments.
Sometimes, and this is one of those, you comment on things for which you have no background. OK, it happens. You are not the only one.
But you take it to another level.
In this and other cases you submit as a predicate an entirely unprecedented version of what might happen, fixate on it, and rail against it as if it was written on stone and handed down from the Mount and demand that I refute it.
That is the province of nightmares, not reality.
In this case, you submit as truth the proposition that Mayo Clinic or Cleveland Clinic will ignore the local population in search of rich medical tourists. If that had ever happened anywhere in America, it would be a reasonable topic for discussion. But in fact it never has.
If you ask me to prove it, I certainly can, but I don’t work at the beck and call of fantasists.
If you want to know the full stories of Mayo Clinic or Cleveland Clinic, research them. And by that I don’t mean Google “Mayo or Cleveland Clinic critics” and send me a quote, but really research it.
You will find, as I have in years of research, that both honor their charitable missions far more than Sentara. Hampton Roads and Virginia would be truly blessed if they would bring their business and charitable models here.
Try not to get in the way by wild, unsupported and unsupportable accusations as predicates to condemnation.
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So for some reason, commenting on this issue elicits strong reactions. Please note while I have my view, and yes it likely is not without some ignorance on the subject, that I typically do not initiate personal attacks and I encourage discussion and debate without doing so. If someone thinks I have engaged in a personal attack, then call me to account. But check yourself also.
otherwise – my comment:
My impression (perhaps ignorant) is that companies like Mayo and Cleveland are more specialty hospitals for difficult diseases rather than true community-based hospitals like UVA and MWC in Fredericksburg and I presume Sentra and Innova. Mayo/Cleveland do charity but only for the selective medical things they specialize in. As far as I can tell they do not provide primary care or help people with managing chronic conditions, and such like one might see with primary care. Again, perhaps they do and I’m dead wrong.
I actually don’t have a problem with Mayo and Cleveland existing as a business model or where they locate but from what I can see, they’re just not the same type of hospital as the existing community-based ones that provide continuing care to the entire community no matter whether they have a serious disease or a chronic condition, no matter if they are rich or low income or seniors on Medicare.
I just see those kinds of hospitals as necessary and fundamentally needed and that they need to be supported not undermined. Community-based hospitals is how we improve health care in the country overall and when we lose a community-based hospital – the ordinary people it served – lose if there is no replacement – both urban and rural.
COPN to conservatives is often a hot button issue, but my view is that if we made hospitals compete on services, that while we might see some price drops for some services , we’d not see price drops for general primary care and such and especially not for the lower income or seniors on Medicare.
It seems to feel like we’d be robbing Peter to pay Paul.
The problem is if the community hospitals use high-priced services to fund their unprofitable services what happens if they lose that method? Do they end up having to make a choice between staying open or shedding unprofitable services.
I’d ask if health care costs in this country are higher is because too many do not receive regular primary care and chronic conditions are not treated and managed. Things like obesity, diabetes, smoking, even drug use.
I just don’t see where “competition” for services like MRIs or other imaging or knee-replacements is going to help everyone and if those services are used by the hospitals to cross-subsidize folks who have Medicare/Medicaid such that they end up with losses they’ll be forced to shed the unprofitable services if they are to remain open.
That’s my 2 cents. Like a lot of things, it may well be based on some ignorance and on my part. The value of debate is to not only share views but to perhaps learn something that one did not know.
I have no problem with that. We are ALL ignorant – just on different issues… and I do have my share.
In closing, I’ve not said one word personally impugning Jim S personally. I never do, never initiate a personal attack. I almost always argue the points but for some reason, more often than it should, it devolves into personal attacks here in BR and it’s usually with the Conservative type. It seems to be a pattern.
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You’ll love my next column.
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I’m afraid to comment on it………;-)
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“How likely is it that Mayo would stand up community clinics for primary care in the area that DePaul served and accept Medicare/Medicaid such that those satellite facilities are unprofitable and may run at a loss?”
The Mayo Clinic is non-profit and they do accept Medicare/Medicaid as well as providing other financial assistance to under- and uninsured individuals. It took about 30 seconds of research to find this out.
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THey accept SOME medicaid but do they offer a full range of services like primary care and other than would benefit the local community on ordinary health care?
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https://communityhealth.mayoclinic.org/primary-care
Why don’t you look this stuff up yourself before posting insinuating questions based on your preconceived notions?
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So, here is my thinking.
It’s claimed that medicare and medicaid do not pay the actual cost of providing the care, that whoever accepts their payment are taking a loss. Yet, a good percentage of people have Medicare and Medicaid and hospitals and other providers will accept them for payment even though they lose money on the transaction.
How do they make up these losses?
It appears to me that some (maybe more and more?) hospitals have moved to a business model where they sell profitable services and elective procedures for a tidy profit then use some of that profit to offset their losses on other patients who have Medicare and Medicaid.
This type of practice is not unheard of in the business world. Walmart as well as the auto manufacturers are said to bump the profit on the in-demand cars and products so they can essentially sell others at a loss.
Walmart sells 2 liter cokes for a whopping 100-200% markup while their milk is said to be sold at cost or less. Ford will get 5-10K profit on a big Ford Pickup , yet their gas-sipping compacts (that help them meet their CAFE standards) are sold at cost or at a loss. I read somewhere that Toyota’s Prius is sold almost at cost.
How likely is it that Mayo would accept Medicare or Medicaid reimbursements for their services? How likely is it that some of
the services Mayo offers are not covered at all with Medicare/Medicaid?How likely is it that Mayo would stand up community clinics for primary care in the area that DePaul served and accept Medicare/Medicaid such that those satellite facilities are unprofitable and may run at a loss?
More than likely, Mayo would compete on the profitable services and just decline to provide services that are unprofitable.
And if Sentra was going to compete with Mayo, they’d be forced to cut their prices also – but if they did not , they’d also be cutting funding of their less profitable services. Over time, they’d have to close down the unprofitable satellite places.
where am I going wrong – seriously….. ????
how about it IZZO ?
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You neglected my advice.
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“How likely is it that Mayo would stand up community clinics for primary care in the area that DePaul served and accept Medicare/Medicaid such that those satellite facilities are unprofitable and may run at a loss?”
The Mayo Clinic is non-profit and they do accept Medicare/Medicaid as well as providing other financial assistance to under- and uninsured individuals. It took about 30 seconds of research to find this out.
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THey accept SOME medicaid but do they offer a full range of services like primary care and other than would benefit the local community on ordinary health care?
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https://communityhealth.mayoclinic.org/primary-care
Why don’t you look this stuff up yourself before posting insinuating questions based on your preconceived notions?
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Yes, yes. They lose money on the poor and old. But, they make up for it with volume.
It’s not a free market. It cannot be a free market. And fortune does not favor the bold. There’s no point in even thinking you can make it a free market unless you want the sick and dying on the sidewalks.
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Yes, yes. They lose money on the poor and old. But, they make up for it with volume.
It’s not a free market. It cannot be a free market. And fortune does not favor the bold. There’s no point in even thinking you can make it a free market unless you want the sick and dying on the sidewalks.
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“They lose money on the poor and old. But, they make up for it with volume.” Now THAT’s funny. That is nothing but S…T..U…P… (no, Jim will stop me.) The more volume, the more they lose, Larry.
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Here, maybe a picture… contra…
https://www.cartoonistgroup.com/properties/strangebrew/art_images/cg51f1aa241ea6c.jpg
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“They lose money on the poor and old. But, they make up for it with volume.” Now THAT’s funny. That is nothing but S…T..U…P… (no, Jim will stop me.) The more volume, the more they lose, Larry.
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Uh, … never mind.
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Here, maybe a picture… contra…
https://www.cartoonistgroup.com/properties/strangebrew/art_images/cg51f1aa241ea6c.jpg
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Did COPN do away with DePaul? How about all the rural hospitals that are in trouble or have to close?
What exactly caused DePaul to close?
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Same thing that causes anything to close… not keeping up. Well, that’s a buncha psych beds if we increase security. Or hey! A Place for Mom?!
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COPN absolutely killed DePaul.
DePaul was too big a legacy facility to survive in the modern environment that I explained yesterday. It need to be extensively downsized and modernized to work, and Bon Secours needed the cash flow from its proposed new hospitals in Virginia Beach and Suffolk to finance that work.
You should read the brief that Bon Secours submitted before the March 2008 decision. It fully and accurately predicted what would happen if their COPN proposals were rejected – the closure of DePaul and the destruction of the viability of Bon Secours as a participant in the Hampton Roads market.
Those of course were considered features, not bugs, by Sentara.
The Deputy Health Commissioner, certainly not under the influence of his boss, who came to the job from Sentara, decided that it did not matter.
He dropped the hammer, resulting in the closure of two hospitals that served a disproportionate percentage of the poor in Norfolk and Virginia Beach and the realistic possibility that Bon Secours will close Maryview, the only civilian hospital in Portsmouth.
If you support that, then keep on asking the same questions. DePaul and Bayside were urban/suburban hospitals. That is where COPN does its work.
COPN has no effect on rural hospitals, because it only swings into action when someone proposes to add facilities or equipment. That is not happening in rural areas.
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two service stations get into a gas price war. What often happens?
If two medical facilities combined are bigger than their service area demand – both will starve.. cut corners… try to sell more medical services than people need, etc…
there is no real “free market” in health care as long as a lot of it is paid for by insurance.
AND it is irresponsible for the government to force hospitals to accept charity care and not provide them with a way to recover those costs. When they do that and leave it to the hospitals to figure it out – they do things like get together in an associated to fight getting rid of COPN.
Give the hospitals a way to pay for their charity care in concert with downsizing COPN and I’m on board.
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Did COPN do away with DePaul? How about all the rural hospitals that are in trouble or have to close?
What exactly caused DePaul to close?
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Same thing that causes anything to close… not keeping up. Well, that’s a buncha psych beds if we increase security. Or hey! A Place for Mom?!
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COPN absolutely killed DePaul.
DePaul was too big a legacy facility to survive in the modern environment that I explained yesterday. It need to be extensively downsized and modernized to work, and Bon Secours needed the cash flow from its proposed new hospitals in Virginia Beach and Suffolk to finance that work.
You should read the brief that Bon Secours submitted before the March 2008 decision. It fully and accurately predicted what would happen if their COPN proposals were rejected – the closure of DePaul and the destruction of the viability of Bon Secours as a participant in the Hampton Roads market.
Those of course were considered features, not bugs, by Sentara.
The Deputy Health Commissioner, certainly not under the influence of his boss, who came to the job from Sentara, decided that it did not matter.
He dropped the hammer, resulting in the closure of two hospitals that served a disproportionate percentage of the poor in Norfolk and Virginia Beach and the realistic possibility that Bon Secours will close Maryview, the only civilian hospital in Portsmouth.
If you support that, then keep on asking the same questions. DePaul and Bayside were urban/suburban hospitals. That is where COPN does its work.
COPN has no effect on rural hospitals, because it only swings into action when someone proposes to add facilities or equipment. That is not happening in rural areas.
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two service stations get into a gas price war. What often happens?
If two medical facilities combined are bigger than their service area demand – both will starve.. cut corners… try to sell more medical services than people need, etc…
there is no real “free market” in health care as long as a lot of it is paid for by insurance.
AND it is irresponsible for the government to force hospitals to accept charity care and not provide them with a way to recover those costs. When they do that and leave it to the hospitals to figure it out – they do things like get together in an associated to fight getting rid of COPN.
Give the hospitals a way to pay for their charity care in concert with downsizing COPN and I’m on board.
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[…] see, perhaps some Hampton Roads patients can go to DePaul Hospital in Norfolk. No, sorry, it closed under assault on its business by a certain regional […]
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