Husband, father, Iraq veteran, and emergency physician. Founder/CEO, Lightspeed Testing, providing no cost COVID testing to the people of Monterey County.
. @supervisoraskew@SupervisorAlejo @SupervisorLopez @MaryLAdams @PhillipsForSupe We need (a lot) more testing. Voluntary PCR is great but not enough. Workplace and community-based rapid testing, and lots of it, can help us stop the fourth surge.
Over past week, number of infections in U.S. has stopped declining
At about 50K infections every day
About where we were at height of summer surge
Why the stall?
Suspect B.1.1.7 is now starting to really have an effect
And states are opening up
This is a problem
Thread
@pammarino 1) payor mix - billionaires in Pebble Beach on Medicare; poor farmworkers on Medi-Cal. Neither insurer pays full cost of care
2) staff costs in a very high COL area keep going up, govt reimbursemts aren't enough to keep doors open > costs shift to commercially insured
@pammarino I know I'm a broken record, but no one has yet addressed the elephants in the room:
payer mix + VHCOL + not enough physicians to keep people out of the hospital
"we have higher hospital costs but much more affordable professional costs"
@pammarino Note: "people tend to be healthier" in her slide refers to Covered CA patients - not all patients. Sicker patients are often covered by Medi-Cal/Medicare, not Covered CA. Again, would be nice to see that data for all payers, not just commercial.
@pammarino Would be useful to see utilization rates by insurer. I would wager that utilization by the commercially insured has dropped, but not necessarily Medi-Cal utilization.
@pammarino He mentioned Medi-Cal only in passing. But when Medi-Cal/Medicare pay less than the cost of care, AND continue to cut rates, AND your community is VHCOL and 75% government payers...
@pammarino but actual PROFESSIONAL (e.g. doctor) prices were way under the state median, only 13% above national median.
When you go to the ER, you're not asking to see a hospital administrator...
.@Marriott really furious that the @RenDallasHotel decided to close their rooftop pool to REGISTERED guests for the eclipse, only 5 days beforehand. I had that reservation for almost a year. Atrocious customer service and lousy recognition of your elite members!!!
Soooooo…. After reserving the hotel with a rooftop pool - a year in advance! - with no previous notification of this closure and “private party”, Cory Burns decides to shake my family down for $400?
And then has the gall to send me viewing locations “as a courtesy”?