Category Archives: Healthcare

Reclaiming Futures in Forsyth County (and Elsewhere)

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Reclaiming Futures is a project that tries to help young people in trouble with drugs, alcohol and crime.  They have a blog called Reclaiming Futures Every Day and it's there that I found a post about the site visit that Renate Reichs, the Network Coordinator for Cook County, Illinois made as part of her coaching of the Forsyth County and Crossroads (a collaboration of Iredell, Surry and Yadkin counties) networks.  From the post:

The strengths of both sites were readily apparent. Although
Forsyth County is more urban (think Winston-Salem), and Yadkin, Surry,
and Iredell (“R-dale”–?) are more rural (think Mr. Airy and Andy
Griffith), both sites have committed, experienced, and professional
fellows well versed in cooperative planning and collaboration. There is
also a zeal for the tasks involved in Reclaiming Futures that's very
energizing.
 
This is especially noticeable at the Crossroads site, as there are
three counties working together, meeting on a regular basis, and
assembling and smoothing disparate pieces to fit the Reclaiming Futures Model. Specifically, they have regularly-involved people who are not “Fellows”
to bring a wider pool of experience, commitment, and knowledge to the
table. For its part, Forsyth County has chosen to expand Reclaiming
Futures from its established drug treatment court, championed by its
Judicial and Justice Fellows, thus starting on a firm foundation.
 
All of that is good news. However, one of the challenges that both
sites face — and it is huge — is a lack of treatment resources.
There's great enthusiasm for implementing better screening and
assessment tools (everybody was off and running with their rapid cycle test for screening), but the “Then what?” question looms large:
  • What if the kids funneled through screening and assessment completely overwhelm treatment capacity?
  • How do we grow treatment—good treatment, administered by professionals?
  • Where do the dollars come from?
  • Is Reclaiming Futures capable of pushing treatment expansion, and exactly how does that happen? 

We'd love to hear from sites that have successfully answered these
questions or are grappling with the same problems. Forsyth, Crossroads
(is that “Ire-dale”?), and I await your wisdom.

This sounds like a worthy program and for the sake of our local at-risk youth I hope they are able to solve their treatment conundrum.

I Might Help Medical Science with My Quest

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Talk about kismet; just after posting my question about the best cup of joe in Forsyth County and my intention to check them all out and create a guide to local java shops (tough work, I know) I find this item over at Esbees.  The WFUBMC Department of Radiology is doing a study on people who drink more than six cups of coffee a day and they say that people who participate will be compensated for their time. My initial thought was, "Only six?" quickly followed by, "SUWEET!"  Esbee mentions that when she used to work fulltime, pre-kids, she would have qualified twice and I have to say that I'm amazed that she drinks less coffee post-kids than she did when she was working fulltime.  If I didn't have coffee I don't think I'd have made it through year one of kid number one, much less sixteen years (and counting) of multiple kids.  As it is I'd probably qualify for this thing three times over.

If the Wall Street Geniuses Created a National Health Insurance System

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A sadly realistic take on how to finance a national health insurance program:

1. Set up a large, well capitalized hedge fund. About $5B should do it.

2. The prospectus of the fund should note its purpose is to “Seek
out profit opportunities via arbitraging inefficiencies in the markets
and health care system of the United States.”  Include standard
“Socially Conscious” fund language in clauses such as Do well by doing good.

3. Launch the fund — and promptly max out your leverage. Today’s
environment makes it difficult to go 50 to 1, but getting 10 or 20 to 1
should not be much problem.

4. Use the money to write Credit Default Swaps with a notational
value of $3 trillion dollars. The premia on these CDS should be about
10-15% or so.

5. Rollover the cash premiums — about $350 billion dollars worth —
into a national fund. Use it to buy health care insurance for all US
citizens.

6. Declare that due to current credit conditions, your unfortunately
must announce to your counter-parties that you will be defaulting on
these CDS. Note that significant amounts of this paper are held by JP
Morgan and Citi. Another trillion is held by China and Japan, with
Sovereign Wealth Funds owning the rest.

7. Send out a press release announcing “systemic risk.” Tell the
Treasury Secretary and the Federal Reserve Chief that your imminent
collapse will wreak global havoc. Apply for bailout.

The author then says just repeat the process to pay for things like global warming, school vouchers, missile defense, etc.

How You Doin’ Doc? DrScore.com Could Tell You

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DrScore.com is the latest entry into the market for physician rating sites, but the reason I find it particularly interesting is that it was started in the Wake Forest University Babcock Demon Incubator. So it's a home brewed web service.

So fare there are a little over 60,000 doctor ratings on the site, which is a nationwide site, not a site dedicated to just this area.  As with other rating sites the real value will come as more people use it, so for it to be of real value the site will need to attract far more users to get a critical mass of data for each doctor. DrScore.com is trying to get doctors to use it as their default patient satisfaction service for a $150-per-year fee, and if enough doctors do that then the site could boost its numbers quickly.

The article in the Winston-Salem Journal about the site points out some of the concerns for such a service (gaming the ratings in either a positive or negative direction being chief among them), but there's a need for more transparency in health care so I think this is a good thing.  Once the site gets much more data they'll also be able to provide some interesting data for researchers and that could eventually lead to more informed health care consumers.  As I mentioned in a previous post about the new "buyer beware" nature of health care in the US this is a necessary step for those of us who are now tasked with managing our own health care costs rather than the insurance companies.

Pricing Your Medical Care

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Due to changes in our health care system a growing number of us will be responsible for paying our medical bills directly.  Whether it’s because you don’t have insurance, or you have a high-deductible plan like my family has, you will be paying the doctors, hospitals and labs directly for their services.  Thus it stands to reason that you’ll want to know how much something costs and if it can be had cheaper somewhere else.  Well, good luck finding the information you want.

Yesterday I posted about my wife’s $1,900 MRI scan which was done on her shoulder in August.  I’ve gotten a couple of comments on that post plus some email sent to me directly that provide a few anecdotes from people who have dealt with similar situations.  The most interesting comment came from Mona Lori who dealt with a very similar situation to ours and decided to do some research into the cost of an MRI. She shares the results of her research in this report and what she found was a HUGE disparity between different providers for the same procedure, an MRI scan of a knee.  She found that one provider in Milwaukee would do the scan for $600 while another in New Hampshire charged $3,500.  At that discrepancy it would make sense to fly to Milwaukee to have the scan done because even with the cost of the airfare and cab ride you’d be saving a couple of thousand dollars.

Mona decided to do something about this and started a web service called OutOfPocket.com where people can share what they paid for services at various providers.  Of course that means you can also search to see what people paid for procedures at different places as well.  If enough people share their data there will soon be a rich database of prices for procedures which should lead to more informed shopping and hopefully lower prices as providers begin to lose their monopoly over the health service pricing information. Let’s put it this way, if I know that an MRI will cost $1,900 at one facility and $1,000 at another which do you think I’m going to use?  If those numbers become public and easily accessible how long do you think it will take the vast majority of people to shift their business from the more expensive facility to the less expensive one, and then how long would it take the more expensive facility to lower its prices?

A point I’d like to make is that most people think the cost of health care is equivalent to the cost of seeing their doctors.  Honestly the doctor’s costs is less than the x-rays, MRIs, lab tests or drugs.  In other words the parts often cost more than the labor, so if you want to reduce your health care costs you might want to start with the parts.  After all, whether or not a doctor is good is a highly subjective measure.  A doctor might be brilliant, but a real jerk that makes you feel horrible.  Is he still a good doctor, and is he worth paying three times more than the guy who didn’t graduate from Harvard Medical School but is still really good at what he does and also happens to be a really nice person who makes you feel good about yourself?  On the other hand an MRI, is an MRI, is an MRI.  Why pay triple for the exact same thing?

If you have information to share please use OutOfPocket.com or any other health pricing service you know of to share it.  Until the providers are forced to offer pricing up front in an easily accessible manner it’s the best way for us to control our health care expenses.

An MRI from Wake Forest? $1,900

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I’m going to give you fair warning that the language of this post might get a little strong.  I can’t promise that I’ll control my fingers because I’m just a little pissed.  Here’s the story.

In August Celeste hurt her shoulder.  It got to the point that she couldn’t raise her arm past shoulder level without experiencing severe pain, and she couldn’t sleep comfortably because whenever she moved she experienced sharp pain radiating from the shoulder.  Eventually she scheduled and appointment to see a doctor for an examination.  He checked her out and thought maybe she’d torn her rotator cuff, but since he couldn’t be sure he ordered an MRI, which she had done late in the evening on August 25th.  The MRI came back negative so the doctor suspects that the rotator cuff is strained and that the because the shoulder is a complex joint that depends on all the non-bone stuff (my technical term) to keep the bones in place.  His thinking is that the strain has caused the ball to be pulled back into the socket and it is "catching" when she tries to raise her arm.  The prescription?  Physical therapy.  So Celeste and I went to Comp Rehab for one session where we were taught all the exercises, and she’s been doing all the exercises at home and making pretty good progress.

Here’s where it gets good.  Our insurance company informed us that the MRI wasn’t medically necessary.  That means that we’re paying it 100% out of pocket, which we would anyway since we have a high deductible policy tied to a Health Savings Account (HSA), but now it won’t count towards our annual deductible.  Then we get the notice from Wake Forest University Baptist Medical Center that our bill for the 1/2 hour MRI is $1,900.  What the hell?!

So here’s what kills me about this.  First, the medical necessity thing.  If Celeste hadn’t had the MRI the doctor would probably have ended up doing surgery.  At a minimum she would have had to have seen the doctor several more times in order to gauge what was going on with the shoulder, figure out a course of treatment, etc.  Even then he would not have been sure of his diagnosis and if she didn’t recover rapidly she’d end up under the knife.  As it is the rehab is taking time and without knowing for sure what’s going on with the shoulder Celeste and the doctor probably would have looked at alternatives by this point.  In other words it would have been much less efficient and much more costly to treat than the MRI was.  We’re going to appeal the BCBS decision, but I don’t think it will do us any good.

Second, no one ever told us what the MRI would cost.  The doctor ordered it and we went. Now, part of the theory behind HSAs is that since we are responsible for paying the bills directly we’ll help keep costs low because if something is too expensive we’ll squawk or go to a competitor.  Well, it’s kind of hard to do when no one tells you what it will cost.  There’s no price transparency!  Also, no one told us what our options were, if any, for alternative places to have the MRI done.  I’m willing to take some responsibility here.  We probably should have asked ahead of time if there were other places to do the MRI, what the MRI would cost, etc.  Unfortunately we’re still conditioned by our lifetime of working within a health care system that traditionally kept the decisions in the hands of the doctors and insurers.

Still, even with me acknowledging that maybe we should have been more diligent consumers I want to know what other business out there provides a service without telling you the price up front?  I guess there’s auto repair shops, but often they don’t know what the problem with the car is until they look at it and then they usually call you to tell you what the financial damage will be before they start to work.  With an MRI they know up front what it costs them to administer the test so why not publish their pricing?  Could it be that they have different rates for different people?  If you’re uninsured it’s one rate, but if you’re insured it’s another?  Could it be that maybe there’d be a mass revolt if everyone knew that an MRI process that takes 1/2 hour costs more than most peoples’ monthly rent?

Compare this to our experience at the dentist.  They always check with us before doing a procedure, and the pricing is readily available.  They understand that we may not deem teeth whitening to be worth $75, so they make their recommendation, tell us the price and then let us decide.  In the end they may not sell that one procedure, but they keep us happy and thus keep all five of us in their chairs.

I can tell you right now that if there’s another instance where one of us needs something done medically we will be much more active shoppers.  I’m not saying we’ll necessarily move away from Wake Forest, but if there’s a better alternative out there we’re going to take it.  Of course pricing isn’t the only consideration, but it is one of them.  Trust is another, and if they can’t provide pricing up front then they’ll probably lose us because I can’t trust someone who won’t level with me about the terms of our relationship. 

To reiterate, I don’t know if Wake Forest provides pricing up front or not because we didn’t ask, but the fact that we do have to ask in the first place tells me that the health industry isn’t yet ready for the "free market" that is represented by health plans like our HSA.

Last point: is there any question that our health care system needs fixing when you consider that one simple MRI costs $1,900?  Yes it’s an expensive machine and yes you have to pay a technician to operate it and maintain it, but if you do the math you realize that this is way out of whack.  If they charge that rate to everyone, average two scans an hour for twelve hours a day and work 365 days a year they are grossing over $16.5 million per year for that machine’s use.  Even if you cut that back to one scan per hour that’s $8.3 million per year.  Let’s say a new machine costs $2 million and lasts 10 years, that means that the machine averages $200,000/year for acquisition.  Then let’s assume that it costs $2 million a year to maintain and operate it, a number I think is high, then you have $2.2 million annual cost.  That means that the profit on the operation of the machine can be comfortably guesstimated at a minimum of 300-400%.  Feel free to correct me if I’m wrong, but my gut says this is highway robbery.

Oh, and Wake Forest University Baptist Medical Center is a "nonprofit."

Littany of Ills

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Sitting in the waiting room at WFU MRI Center and it’s 10 P.M. Some guy is telling everyone that will listen about his 200+ kidney stones. I quote:  "The ones you pass are different than the others. The ones that set will make me draw double like a guy having a heart attack."

We’ve also heard about the belts he’s had custom made since his size is hard to find. Oh, and he’s been a furr-fighter, oh wait, a firefighter. I was worried there for a second

The TV is tuned to NBC. Worst reality show ever is on now (Democratic Convention) and the second worst just ended…some show that had normal people pretending they were on Deadliest Catch. 

Now the guy is talking about Michael Moore’s health care movie (I believe that would be Sicko). Said it made a lot of sense

He says he’s been here for two hours. His wife girlfriend just got called back and set him loose on the rest of us

Now we’re hearing about the ills of health insurance. I’m with him there.

People are leaving and I might end up alone with him.

I’m trying to hide

Sent from my Verizon Wireless BlackBerry

Sick

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I just finished reading Sick: The Untold Story of America’s Health Care Crisis—and the People Who Pay the Price,  Jonathan Cohn’s surprisingly balanced book about America’s health care system.  Unfortunately for Cohn I think a lot of people will confuse his book with Michael Moore’s unbalanced film Sicko, so they probably won’t bother to read it despite the painfully long sub-title that seems to be symptomatic of all non-fiction books published these days.

When I say that the book is surprisingly balanced it’s because I kind of expected it to be a screed against the evil insurance companies, pharmaceutical companies and hospitals, but in reality it provides a nice historical perspective on the development of the modern US health care industry and uses half a dozen anecdotal cases to signify how real people are affected by the system.  Where I think Cohn earns his stripes is in not laying the blame for the current health care situation at any one group’s feet, but rather pointing out how the actions of the various players (insurance companies, HMOs, government, hospitals, pharmaceutical companies) are logical given the climate in which they exist. 

Not that Cohn doesn’t have an opinion.  He thinks that the fundamental flaw with the US health care system is that it doesn’t treat health as a function of the common good.  He’s very much in favor of some form of universal health care, and he seems to favor France’s model over Canada’s, the UK’s or other industrialized nations, but he doesn’t prescribe specific plans.  Rather he points out that even though we spend 16% of our resources on health care we put too much of a burden on the poor and middle class.  He says other industrialized nations spend less and provide more coverage for all of their citizens.

Throughout the book Cohn explores both sides of the health care debate as described as universal vs. non-universal health coverage.  He acknowledges some of the free market arguments, but de-bunks many of the sound-bite arguments you hear from the non-universal crowd: long lines in Canada, lack of resources in the UK, sub-standard care.  Just as an example he points out that the UK’s problem isn’t universal care but the fact that they are trying to have universal care on the cheap.  Ends up they spend just 7% of their resources on health care.

Cohn also spends some time explaining why efforts by health care reformists have failed to get universal health care passed in the US.  Of course he focuses on Hillary Clinton’s failed efforts in the early 90s, but he also looks at earlier developments under FDR, JFK and LBJ.  In fact the story of how Medicare and Medicaid came into being is absolutely fascinating if for no other reason than to show that our current crop of politicians aren’t much different from 40 years ago. 

By the way, Cohn thinks that if things keep going the way they have been lately then health care reformers have a better shot in the near future than they’ve had in at least a generation.  Without getting too much into the details lets just say that in ’92 the average person still had adequate health coverage through their employers, but now that many middle class Americans are paying a very hefty price for their coverage AND can easily imagine themselves being devastated by a serious illness they are much more likely to support politicians who promise to take that very fundamental worry away.

There’s a lot for people to argue about in the book, but that’s what makes it a worthwhile read.  Heck, the guy provides literally dozens of pages of citations and notes at the end so you can’t say he hasn’t done his homework.   And for those who might wonder what I think it’s that I agree that we need some form of universal health care.  It fascinates me that as a society we seem to have no problem with the concept of paying taxes to fund our armed forces, our police and firefighters and our roads, but somehow it’s a problem to pay taxes to secure a basic level of health care for every citizen.  I also don’t think the system has to be 100% government administered, it can be some sort of public-private hybrid, but I do think that if we are going to continue to be the most prosperous nation in the world then we’ll need to make this change.

And here’s my own anecdotal evidence that there’s serious need for change: I have a relative who shall remain unnamed that is anything but poor or needy yet after retiring from her "career job" faced health care expenses so high that she took a retail job that paid minimum wage in order to secure health care benefits until she turned 65 and when she turned 65 she had a Medicare party. I’m told that Medicare parties are very common in her circle of friends.  So if government-provided health care is such a nightmare why are these middle and upper-middle class folks so happy to get it?

Are Novant and WFU Baptist Medical Center Non-Profits in Name Only?

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I had an interesting email exchange with a reporter from the Winston-Salem Journal about the hospitals that Novant and WFU Baptist Medical Center are proposing to build in Clemmons (Novant’s) or Advance (WFUBMC).  When I wrote that I’d really like to see Baptist build a new hospital on the site in Mocksville where it currently has an old hospital that by all accounts is old and in need of mothballs, she replied that Baptist can’t afford to build there because it is hemorrhaging money and market share.  I’m sure she’s right about that and I understand the business implications in both companies’ building proposals, but I think one issue that needs to be discussed is the fact that both companies are non-profits.  As non-profits shouldn’t the companies’ goals and agendas involve more than market share and profit?

In thinking about this I came to the realization that although I’ve worked in the non-profit industry for a long time I really don’t know what non-profits are supposed to be.  I decided to do a little research and when I Googled "history of nonprofits in america" the first listing was a 1998 USIS article titled Nonprofit Organizations: America’s Invisible Sector written by Dr. Lester M. Salamon, director of the Center for Civil
Society Studies at the Johns Hopkins University.  He provides a basic definition of non-profits:

As a first step in this process, it is necessary to clarify
exactly what the nonprofit sector is. In the United States, 26
different types of organizations are identified as worthy of tax
exemption, ranging from business associations through charitable
organizations and social clubs. Behind these 26 categories,
however, lie five critical features that all these entities
share. To be considered part of the nonprofit sector, therefore,
an entity must be:

    organizational, i.e., an
    institution with some
    meaningful structure and permanence;

    nongovernmental, i.e. not part
    of the apparatus of
    government;

    non-profit-distributing, i.e.,
    not permitted to
    distribute profits to its owners or directors, but rather
    required to plow them back into the objectives of the
    organization;

    self-governing, i.e., not
    controlled by some entity
    outside the organization; and

    supportive of some public
    purpose    .

While all organizations that meet these five criteria are
formally part of the nonprofit sector in the United States, an
important distinction exists between two broad categories of
these organizations. The first are primarily
member-serving organizations. While serving some public
purpose, these organizations meet the interests, needs and
desires of the members of the organization. Included here are
social clubs, business associations, labor unions, mutual benefit
organizations of various sorts and political parties.

The second group of nonprofit organizations are primarily
public-serving organizations.  These organizations exist
exclusively to serve the needs of a broader public. Included here
are a variety of funding intermediaries such as charitable,
grant-making foundations; religious congregations; and a wide
range of educational, scientific, charitable and related service
organizations providing everything from nursing home care to
environmental advocacy.

This distinction between member-serving and public-serving
organizations is far from perfect. Nevertheless, it is
sufficiently important to find formal reflection in American law.
Thus, public-serving organizations fall into a special legal
category — Section 501(c)(3) of the U.S. tax code — that makes
them eligible not only for exemption from federal income taxation
and most state and local taxation, but also for tax-deductible
gifts from individuals and corporations, that is, gifts that
the individuals and corporations can deduct from their own income
in computing their tax liabilities. It is these organizations
that most Americans have in mind when they think about the
"nonprofit sector" and it is these that we will focus on here.

If we accept this definition, and I think it’s pretty good, then we accept that both Baptist and Novant are public serving organizations.  And since a requirement of non-profits is to plow their profits back into meeting their objectives then a natural question would be "Are Novant and WFU plowing their profits back into their mission?"

Originally I was going to detail a bunch of numbers from both organizations’ 990 filings.  These are the forms that non-profits file with the IRS (kind of like an individual’s 1090) and they highlight the non-profit’s financial performance for the year.  But instead of getting into the details I’m going to provide you with links to the filings (see the bottom of this post) and simply say that without question both organizations are highly profitable and both could probably stand to spend more money on the community no matter what they say about how much they write off in serving the indigent and poor.  Believe me, they show a healthy profit even after accounting for those expenses.

So given that Novant and WFUBMC are already profitable should they look only at market share and profitability when building these facilities?  Baptist wants to build in Advance because they say they will be serving Davie county and the majority of Davie lives in that area.  Maybe, but it’s also true that the majority of high income Davie residents live in Advance and it’s no secret that they’d like to poach some of the high income Clemmons residents from Novant as well.  Novant claims that they already serve something like 60% of the residents in the area proposed to be served by either hospital so it makes more sense to give them their shot in Clemmons, but if Baptist gets to build their hospital those numbers could change.

The reality is that Novant and WFUBMC are businesses that happen to be designated non-profits, or in other words they are non-profits in name only.  If they were non-profits in the sense that I think an average person with common sense would think of a non-profit then they wouldn’t dicker about the Downtown Health Plaza and they would spend more money on operations that serve poorer and more rural communities.  They would also acknowledge that they already make plenty of money off of their existing operations in Winston-Salem and actually look at how they can serve communities in need and not just at market share. 

I’d like to see the state offer Baptist and Novant the following deal:  you can build your hospitals if you agree to set them up as for-profit subsidiaries that will allow the counties to collect property tax OR you can build your hospitals if you expand/improve your facilities and services in at least two rural operations.  With the first proposal the state would be saying to the organizations that we’re going to call a spade a spade, and with the second they’d be pushing the organizations closer to fulfilling their intended roles as non-profits.  Of course I’ll be ice skating in hell before either happens.

Links:

North Carolina Baptist Hospital 2004 990
WFU Health Sciences 2004 990
WFU BMC 2004 990
Novant’s 2004 990

Notes from My Afternoon as a Non-Reporter at a Public Meeting

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As I wrote last week I spent about 5-6 hours listening to people speak at the public forum regarding the proposals by WFU Baptist Medical Center to build a hospital in Advance and Novant to build one just four miles from Advance in Clemmons.  According to the Winston-Salem Journal about 700 people were there, which I think is as accurate a count as any.  Following are some notes and observations from the afternoon:

  • When I first got there I stood in the atrium outside the meeting room and watched the proceedings on a television for a few minutes.  I was holding a steno pad since I wanted to take notes and I also wanted to be prepared if I got an important business-related call.  I guess I looked like a reporter because a tall, snow-haired gentleman in a suit that probably costs more than my annual salary approached me and nodded hello while giving me the stink-eye.  I nodded back and waited for him to introduce himself.  When he didn’t I put out my hand and said, "Hi, I’m Jon Lowder."  He shook my hand and said, "Yes."  That’s when my prick-o-meter alarm started clanging.  Then he said, "You look like you might be a reporter" to which I replied, "No, I just carry this in case I get an important call."  He didn’t seem to be buying it and he just walked off and joined his colleagues from WFU.

    Just after that a nice young lady from Novant approached and asked me if I was there to speak.  I said that yes I was and she gave me a green sticker that all the Novant supporters were wearing on their chests.  I put it on my shirt, but since I hadn’t taken off my jacket you couldn’t really see it.  I went inside and found my cousin, a Novant employee, and made my way to the side of the room where she was sitting.  I decided to lean against the wall and wait until the speaker was done before disturbing anyone to sit next to my cousin and that’s when I realized that I was standing next to a reporter (I could tell by her steno notebook and the fact that she seemed to know shorthand) and when I looked up the snow-haired prick gentleman was watching me.  That’s when I decided to whip out my notebook and pretend to write furiously for a few minutes while glancing at him intermittently.  A guys got to have a little fun in life.  After he left I went ahead and sat down.

  • Listening to 150 people say essentially the same thing is very boring.  The reporter was smart and bugged out after number 20.  I was in for the long haul.
  • If I ever want to be a reporter, or even dream of being a faux-reporter, I need to learn some form of shorthand. If not I’ll be the king of paraphrasers.
  • Two paraphrases leap to mind.  First, when the folks from WFU were given their 10 minutes to respond to some of the citizen comments their VP said that they were shocked when they heard the outgoing mayor of Clemmons say that his citizens welcomed the Novant-proposed hospital and maybe his saying that is an indication of why he got his butt kicked in the election a couple of weeks back. 

    The second was from the Davie county manager who was invited by WFU to use some of their response time to share a personal story to help explain what all this is about.  He said that after they’d publicly announced the deal with WFU he was approached by Novant representatives and he asked them how they could have the gall to approach him after what they did to another local hospital (Stokes County).  He said their reply was that it was all about market share.  He then said he told them that it wasn’t about market share it was about the people of Davie County.  If this had been a Q&A I would have asked the guy if he thought WFU didn’t care about market share as much as Novant, because if they didn’t they would be building the new hospital in Mocksville or another central location in the county and not on the eastern edge that happens to be home to the county’s wealthiest component and just a stone’s throw from the western Forsyth population centers of Clemmons and Lewisville.

  • Yes I was there to back Novant, but I was also there to say that I would like to see both hospitals built and preferably for Baptist to build theirs in Mocksville near the current Davie County Hospital.  I wasn’t the only one of that opinion.
  • The guy running the PR campaign for Novant was Mike Horn of Horn & Stronach.  He’s a former mayor of Lewisville and a current town council member.  It’s probably not a coincidence that several representatives from the town council testified in favor of Novant, but they should anyway since it would be the better option for Lewisville residents (in my opinion).
  • It’s interesting seeing people who’s public lives become entwined in their private and professional lives.  Winston-Salem’s mayor gets questioned every once in a while about his dual roles as mayor and president of the Winston-Salem Alliance, and seeing a town council member like Mike Horn wearing his other hat as PR pro was also interesting.  He didn’t speak himself on behalf of Novant, but since many of the speakers had been recruited by either side (WFU or Novant) it wouldn’t be a stretch to conclude that he probably asked his fellow leaders in Lewisville and Clemmons to appear.  Again, I’m not saying anything untoward was going on, it’s just always interesting to me to see how people who serve in public office balance their duties with their private lives.
  • The people from Novant and Baptist were all well-behaved. No catcalls, no booing, only intermittent boosterism.
  • A few of the public speakers mentioned the astronomical costs of healthcare in their comments, but no one from Baptist or Novant addressed that in their responses at the end of the day.  We need a public hearing about that.
  • One’s butt tends to go numb after four hours of sitting.  And if that’s the kind of thing that’s representative of what reporters do day-in and day-out then they can have it.
  • Finally, I’ve determined that I’ll carry a steno pad where ever I go.  It scares people and it’s a lot easier to lug around than a Fancycam.