December 24, 2011

The F Words of Health Care

Vassily Kandinsky, 1923
Fragmentation, Fee-for-service and Futile care are the trifecta of what is supposedly ailing our health care system, or non-system, as it is fashionably described nowadays. Modern health care has reached its crisis point not due to hordes of people keeling over and dying in the streets, as they did during historical health care crises brought on by plagues and famine, but due to exploding costs of delivering decent care to all people. Since the issue now is mostly financial, health care as a discipline is attracting the interests of those who practice the dismal science of Economics. Over the last two centuries, economists have successfully addressed the F words in other industries with spectacular results in developed countries, so why not apply lessons learned to health care? 

The obvious reason to treat economists with suspicion in health care is the quintessential argument that people are not widgets, but there is another problem. Most tried-and-true solutions for increasing availability and quality while lowering costs of products are not accounting for the other explosion occurring as we speak – the Internet.  How can this assertion be true when we are in the midst of a government sponsored spending spree to computerize medical records and adopt Health Information Technology (HIT)? Apparently, even those who lead and define the HIT revolution are reluctant (or unable) to grasp its full implication, thus they are consistently underestimating the power of the Internet to serve the individual, and as a result are hedging their bets on technology with classic industrial models from days gone by.

In a 2008 Health Affairs article, Dr. Donald Berwick has defined what has become the official goal of policy making for the Secretary of Health and Human Services. Better known as the Triple Aim, the goals are to create better health, provide better care and lower costs of care. If you look at health care as just another industry, the Triple Aim translates into a better product with a better process at a lower cost. Well, when put this way, the solution is pretty obvious and it has been obvious for over two centuries. We must address the F words: eliminate Fragmentation by aggregating independent artisans in one physical location, stop paying Fee-for-service (piecework) and pay salaries instead, and most important, eliminate Futile work by standardizing the process. In short, apply the industrial revolution to health care and realize the economies of scale that brought prosperity and happiness to the developed world. Except that for some strange reason, this solution doesn’t quite work in health care.

Case in point: Federally Qualified Health Centers (FQHC). FQHCs started out in the early 1960s as community run clinics to provide medical care to the poor. By the mid-nineties, and with the best of intentions, the Federal government and the Centers for Medicare & Medicaid Services (CMS), created funding grants and reimbursement methods to support these clinics. Today there are thousands of FQHCs of different types, operating in health care shortage areas and providing team-based comprehensive care including preventative care, basic primary care, behavioral care, dental care, lab and pharmacy services, mostly to Medicaid beneficiaries and the uninsured, but also to small numbers of Medicare and privately insured patients. FQHCs must use mid-levels to provide and coordinate care and must report on quality measures. In return, FQHCs receive millions of dollars in grants for building and improvements, have access to cost effective workforce, can obtain free malpractice protection, are tax exempt and are paid more than double what a private practice is paid for Medicaid services. By all accounts, FQHC are addressing the triple Fs of health care rather well, but how are they doing against the Triple Aim objectives?

Studies are mixed regarding quality of care provided by FQHCs, and patients cared for by FQHC are largely sicker than those seen in private practice. Interestingly enough, neither Medicare, nor privately insured patients are flocking to FQHCs, in spite of the financial advantages offered, particularly to Medicare patients, and in spite of the spiffy state of the art facilities. This may, or may not be, an indicator for perceived quality of care. How about lowering costs? Do FQHCs provide care at a lower cost than, say, an independent solo private practice?  Adding direct reimbursement rates, grants, tax breaks and other benefits, FQHCs visits cost more than twice the amount paid by Medicaid to private practices, which cannot compete with FQHCs and all but disappeared from areas where FQHCs operate. What would have been the results if twenty years ago CMS would have decided to increase Medicaid fees and pay for uninsured visits to independent practices, instead of exclusively backing the creation and operations of a separate but equal clinic system for the poor? We may never know for sure.

FQHCs are only a small example* of why economies of scale are not easily achieved in health care. Large hospital organizations and even fully integrated health systems, which may be providing better care (or not) seem equally incapable of reducing costs in spite of attacking all three Fs, or seeming to do so, and there are two reasons for this failure: a) larger health care facilities have disproportionately larger overhead costs and b) large systems are better equipped to charge more for services, which renders their efficiency efforts less urgent. And this is not a matter of opinion. CMS acknowledges this built-in inefficiency as evident in the physician fee schedule which pays an additional “facility fee” for services provided in hospital owned outpatient clinics, presumably to cover the extra overhead. Surprisingly, CMS is consistently creating incentives and regulations to accelerate provider consolidation into these big inefficient and expensive systems. The only possible explanation would be that CMS is betting that elimination of the last two Fs (Fee-for-service and Futile care) will be easier in a consolidated environment and the gains will ultimately exceed the losses from doing away with independent practice (Fragmentation). What about information technology? Well, it is supposed to help with process standardization, data collection and performance measurements, similar to what computers do in every other industry.

We have all seen the infomercials for high-tech hospitals, where a bunch of doctors are seated around a conference room table, each holding a laptop or tablet, presumably discussing patients in a team environment. There is something very wrong with these pictures. First, it costs us a fortune to have all these physicians in one room. Second, there is almost no added utility for them to be using computers instead of passing around a piece of paper, and computers are expensive. Third, there is no patient in the room. Now let’s imagine a different picture: a primary care physician sitting in his office, with a patient next to him, both interacting with a computer on which a Skype conference is taking place with an oncologist sitting in his own office thirty miles away, a surgeon in a hospital lounge in the city and perhaps a radiologist half a continent away. Everybody on the call has access to the same electronic medical record, appointments can be made in real time, literature can be consulted and shared, prescriptions can be changed and a common care plan agreed upon by all and understood by all can be created and by using intelligent predictive analytics tools various options can be explored. Perhaps a family member in a different country is conferenced in and perhaps the patient is at home or in a break room at work. Perhaps there’s an electronic sign-up sheet for the oncologist, if the patient wants to ask something else later and have a physician friend in New Zealand listen in. And with one click on a PayPal button all doctors are paid for their time.

In this Internet age, manufacturing style physical consolidation is not only unnecessary, it is cost prohibitive. Modern lifestyles and modern medicine have created a need for doctors and patients to collaborate and the Internet is providing the means to accomplish such collaboration without having to physically gather everybody under one expensive roof. There is no need to obliterate the operational efficiencies of private practice and replace it with the bloated bureaucracy of large institutions, and there is no need to dispense with long lasting doctor-patient relationships in favor of computerized care coordination, and there is absolutely no need to substitute a bunch of numbers in a computer for a real patient. The Internet is decentralizing and individualizing everything from politics to manufacturing. Health care is, and always has been, decentralized, individualized and based on the local patient-doctor dyad. The resemblance is striking. We either embrace the fully aligned collaborative nature of the Internet to achieve better health, better care at lower costs, or engage in a doomed effort to impose an unnatural centralized command and control structure in health care just because it worked well for nineteen century steel manufacturing and because policy makers don’t truly understand the magnitude of the connectivity revolution.

* According to the Kaiser Family Foundation FQHCs had about $12.7 Billion in revenues in 2010, 75% of which came from Federal and State agencies. They served almost 19.5 million patients with over 77 million encounters. Simple math yields a cost of approximately $165 per encounter.

December 21, 2011

Menu Diet Rendah Kalori Dengan Organik


Menu diet rendah kalori biasanya banyak mengandung pengawet dan katalis yang mempercepat proses diet pada tubuh manusia. Hal ini bisa dengan cepat membakar lemak tapi dengan efek samping yang kadang berakibat fatal pada tubuh manusia, karena perlu proses penetralan racun melalui hati.

Menu diet rendah kalori yang paling aman bagi tubuh manusi adalah dengan makanan organik murni tanpa polusi. Maksudnya tanpa polusi adalah makanan organik ini diproduksi dari pertanian yang bebas polusi dan berpredikat bintang 5. Sehingga dihasilkan makanan organik yan bermutu tinggi.

Dan makanan organik terbaik saat ini adalah Melilea Greenfield Organic yang telah banyak terbukti cepat menurunkan berat badan dan diet sempurna tanpa membahayakan tubuh manusia.

Untuk tahu lebih banyak ,silahkan download panduannya disini, sekaligus dijelaskan bagaimana cara pakai yang benar menggunakan menu diet rendah kalori yang bermutu tersebut.

Cara Menjadi Member Melilea Mudah


Banyak orang yang telah menjadi member melilea, dan banyak pula yang telah menjadi milyuner-milyuner muda Indonesia. Cara menjadi member melilea sangat mudah sekali, panduannya ada di sini, download sekarang.

Keuntungan menjadi member Melilea:

  1. Mendapatkan produk-produk melilea murah
Ya, dengan bergabung anda dapat dengan mudah mengakses produk-produk melilea.

  1. Kesempatan mencapai taraf hidup lebih baik
Dengan bergabung, anda dapat mengembangkan kemampuan anda sebagai seorang enterpreneur sejati. Karena disinilah banyak mencetak milyuner-milyuner muda.

  1. Mencoba produk organik
Produk-produk melilea selain murah juga begitu mujarab dan banyak orang telah membuktikannya.

Selain itu menjadi member melilea akan berkesempatan mencoba satu produk melilea yaitu Organic Soya Drink yang saya sendiri sudah rasakan.

Rasanya begitu berbeda dari soya biasa. Dowload panduannya sekarang juga disini.

Langsing Dengan Melilea Cara Yang Benar

Langsing dengan melilea jika tidak dilakukan dengan benar maka hasil yang diharapkan akan sulit didapat. Salah satu produk terhandal dari melilea adalah Melilea Greenfield Organic. Banyak sudah yang merasakan hasil luar biasa dengan makanan organik ini.

Berikut cara benar langsing dengan Melilea Greenfield Organic:

Tambahkan satu sendok takar Greenfield Organic ke dalam 250ml air, lalu aduk dan kocok hingga rata kemudian minum segera. Setelah 30 menit dianjurkan minum segelas air putih.

Untuk diet dengan melilea, minum Melilea Greenfield Organic sebagai makanan pengganti untuk makan pagi, makan siang dan makan malam. Hal ini akan dapat menurunkan berat badan tanpa harus kehilangan zat-zat penting yang dibutuhkan oleh tubuh anda.

Untuk lebih jelas download panduan gratis disini. Rasakan kehebatan langsing dengan melilea sekarang juga.:)

Diet Dengan Melilea Cara Yang Benar


Diet dengan melilea jika tidak dilakukan dengan benar maka hasil yang diharapkan akan sulit didapat. Salah satu produk terhandal dari melilea adalah Melilea Greenfield Organic. Banyak sudah yang merasakan hasil luar biasa dengan makanan organik ini.

Berikut cara benar diet dengan Melilea Greenfield Organic:

Tambahkan satu sendok takar Greenfield Organic ke dalam 250ml air, lalu aduk dan kocok hingga rata kemudian minum segera. Setelah 30 menit dianjurkan minum segelas air putih.

Untuk diet dengan melilea, minum Melilea Greenfield Organic sebagai makanan pengganti untuk makan pagi, makan siang dan makan malam. Hal ini akan dapat menurunkan berat badan tanpa harus kehilangan zat-zat penting yang dibutuhkan oleh tubuh anda.

Untuk lebih jelas download panduan gratis disini. Rasakan kehebatan diet dengan melilea sekarang juga.:)

Mendapatkan Melilea Murah Terjangkau


Untuk mendapatkan melilea murah adalah dengan satu cara yaitu dengan menjadi member melilea itu sendiri.

Keuntungan menjadi member Melilea:

  1. Mendapatkan produk-produk melilea murah
Ya, dengan bergabung anda dapat dengan mudah mengakses produk-produk melilea.

  1. Kesempatan mencapai taraf hidup lebih baik
Dengan bergabung, anda dapat mengembangkan kemampuan anda sebagai seorang enterpreneur sejati. Karena disinilah banyak mencetak milyuner-milyuner muda.

  1. Mencoba produk organik
Produk-produk melilea selain murah juga begitu mujarab dan banyak orang telah membuktikannya.

Bertindaklah sekarang, mungkin anda bisa juga menjadi milyuner muda. Di Indonesia, melilea sudah mulai menyebar dan anda jangan sampai ketinggalan. Rebut momen dan dapatkan produk-produk melilea murah sekarang juga. Panduan bisa didownload disini, dapatkan prioduk melilea murah sekarang. J

December 17, 2011

Melilea Bisnis Dahsyat Masa Kini | Go Organic


Melilea merupakan perusahaan kelas dunia dengan pengembangan makanan organik yang terbukti ampuh di samping bisnis yang sangat mudah dijalankan. Dengan medepankan kecantikan dari dalam dan dari luar menjadikan Melilea tidak hanya menciptakan produk aman dan ampuh, tapi juga menciptakan keseimbangan ygn sempurna dari tubuh kita sendiri.


Produk unggulan Melilea International :

  1. Meliea Greenfield Organic


 
Melilea Greenfield Organic bukan makanan organik biasa. Makanan ini bisa dijadikan makanan diet tanpa efek samping. Selain peluruhan racun kimia dalam tubuh yang tanpa kita sadari, kita makan, minum dan hirup setiap harinya.





  1. Melilea Organic Soya Drink
Meliea Organic Soya Drink mengandung protein nabati phytonutrients yang secara alami terdapat dalam setiap kacang kedelai. Kacang kedelai Melilea didatangkan langsung dari Heilong Jiang, Cina yang terkenal di seluruh dunia akan kandungan tanahnya yang hitam karena bebas polusi.





  1. Melilea Organic Henry Apple Orchard

Melilea Organic Henry Apple Orchard adalah minuman yang mudah disajikan. Campuran dari berbagai buah-buahan organik dan sehat yang diformulasikan secara unik untuk memuaskan dahaga dan memenuhi selera anda akan buah-buahan nikmat dengan sensasi kesehatan kesegaran yang luar biasa.



Mau tahu lebih banyak tentang bagaimana hebat dan bisnis dahsyat dari Melilea International.

Jangan khawatir download panduan lengkap gratis di sini. Terbatas khusus Indonesia bangsaku tercinta. :)

Melilea Greenfield Organic, Penyembuhan Alami Tanpa Obat


Benar-benar luar biasa, Melilea Greenfield Organic terbukti menyehatkan secara alami, tanpa bahan pengawet, dan berasal dari pertanian berpredikat bintang 5.



Memang tidak main-main, makanan organik ini telah banyak mendapat penghargaan di banyak negara. Dirumuskan oleh peneliti terkenal DR.Henry Chang.

Dasar dari penyembuhan alami adalah dengan tubuh yang sehat maka tercapailah kesehatan alami tanpa obat karena sesungguhnya tubuh adalah dokter yang sangat luar biasa.



Melilea Greenfield Organic membantu membersihkan racun dari tubuh, sehingga tubuh bisa beroperasi dengan sistem kekebalan tubuh yang terdiri dari tiga sistem, yakni :

  1. Sistem pencernaan (usus)
  2. Sistem penyaringan (ginjal, hati, rahim, kulit)
  3. Sistem endokrin (kelenjar tiroid, paratiroid, adrenal, ovari)

Tahukah anda bahwa zaman sekarang adalah zaman yang penuh polusi, pencemaran air, pertanian, udara, hingga makanan yang kita makan setiap hari, dan itu terjadi tanpa kita sadari.

Fakta :

  1. Walaupun setelah dicuci, kupas dan dibuang bijinya, tidak semua toksin dan bahan-bahan kimia dapat dihilangkan dari buah-buahan dan syur-sayuran (Departemen Pertanian Amerika Serikat)
  2. 3,5 – 5 juta oran di seluruh dunia menderita sakit akibat terkena racun serangga yang berlebihan setiap harinya
 (Organisasi Kesehatan Dunia (WHO))
  1. Rata-rata orang Malaysia memiliki 5 sampai 114 kali lebih kandungan racun serangga di dalam darah dibandingkan orang-orang Amerika.
(Persatuan Konsumen Penang – Malaysia)

Mau tahu lebih banyak tentang bagaimana hebat dan dahsyatnya Melilea Greenfield Organic banyak menghilangkan racun dalam tubuh kita ?

Jangan khawatir download panduan lengkap gratis di sini. Terbatas khusus Indonesia bangsaku tercinta. :)

Membentuk Pola Hidup Sehat Dengan Makanan Organik


Membentuk pola hidup sehat saat ini sangatlah sulit. Bagaimana tidak, biaya berobat yang begitu mahal, walaupun itu hanya konsultasi dokter saja. Padahal jika tubuh tidak sehat maka rejeki pun sulit untuk dicari.

Sebenarnya, sumber penyakit yang paling besar adalah dari apa yang kita makan. Sumber pencemaran air ,udara ,pertanian dan peternakan adalah hal yang sudah kita anggap biasa. Tanpa kita sadari ,ya….tragis memang. Itulah kenyataannya…..

Dari hal tersebut, maka sekarang timbul makanan organik. Makanan organik sangat baik terhadap tubuh manusia,. Selain mudah diserap ,makanan organik bisa membangkitkan penyembuhan alami tubuh manusia dengan membersihkan toksin akibat pencemaran yang terjadi saat kita makanan yang tercemar.

Penelitian di Jepang menemukan bahwa rata-rata orang dewasa menyimpan racun seberat 2 – 4 kg di tubuhnya !!!.

Tapi jangan khawatir, saat ini ada sumber makanan organik yang benar-benar sehat ,dan terbukti bagi banyak orang Indonesia tercinta ini.

Ingin tahu ,download ebook makanan organik di sini, segera bentuk pola hidup sehat segera, mumpung waktu sehat masih ada.

Gaya Hidup Sehat Tanpa Masalah Dengan Makanan Organik


Gaya hidup sehat zaman sekarang menuju gaya hidup yang praktis dan ekonomis. Cenderung tuntutan hidup sehat yang terlalu mahal amat menyulitkan terutama bagi masyarakat Indonesia yang rata-rata adalah pekerja keras, kantoran dan wirausaha. Tuntutan kerja yang sibuk, pergi pagi pulang petang menutup kemungkinan akan gaya hidup sehat yang banyak didambakan banyak orang.

Tapi sebenarnya, makanan yang mendukung gaya hidup sehat pun susah dicari. Inilah akibat pencemaran, baik pertanian, peternakan, bahkan banyaknya makanan siap saji yang penuh sensasi.

 Penelitian di Jepang menemukan bahwa rata-rata orang dewasa menyimpan racun akibat pencemaran seberat 2 – 4 kg di tubuhnya !!!.

Hal ini terjadi tanpa kita sadari. Dari kecil hingga dewasa.

Hasil dari penumpukan racun dan pola makan yang salah

Tidak salah jika ada yang bilang ,orang gemuk tanda tidak sehat. Dan kebanyakan itu benar.

Tapi, jangan khawatir tidak selamanya makanan sehat susah dicari, khusus bagi orang Indonesia, saat ini ada sumber makanan organik yang benar-benar sehat ,dan terbukti bagi banyak orang Indonesia tercinta ini.

Ingin tahu lebih lanjut ? Download ebook makanan organik di sini, segera bentuk gaya hidup sehat segera, mumpung waktu sehat masih ada.

Budaya Hidup Sehat Tanpa Makanan Berpolusi


Membangun budaya hidup sehat itu mudah. Memang pernyataan ini tidak logis jika dibandingkan dengan keadaan zaman sekarang dimana polusi begitu merajalela. Pencemaran air, udara, bahkan makanan yang kita makan setiap hari pun tak luput dari itu. 
Apa konsekuensinya dari polusi ? Salah satunya adalah menumpuknya racun di usus. 














Solusinya adalah membangun budaya hidup sehat yang cukup mahal saat ini. Tapi solusi mudah membangun budaya hidup sehat dengan terjangkau serta sekaligus berinvestasi sesungguhnya ada rahasianya.

Rahasia budaya hidup sehat yang disimpan oleh para orang kaya yang dengan gampang mendapat makanan berkualitas tanpa polusi. Khusus untuk orang Indonesia ,akan dibagi disini, jangan khawatir…..

Untuk lebih tahu download disini panduannya. 

December 04, 2011

What Is Green Tea Good For ?


What Is Green Tea Good For ?

When we hear the word “green tea” our thinking will be drink, cake or something which cure body. But from title “what is green tea good for” for this topic, I reveal 12 (twelve) what green tea good for at our daily job. Here they are:

  1. Cleaning carpet
Spread out used green tea on carpet. Let absorbed in 10 minutes, then vacum the carpet.

  1. Shining wooden floor
Clean floor as usual, then scrub tea which has been boiled in water slowly. Then let the tea dry itself, after that clean it up.

  1. Shining wooden furniture
Dip soft cloth in to tea which has been boiled to clean wooden furniture like table, chair ,and etc

  1. Cleaning mirror and window
Scrub tea pocket which has been damp on glasses

  1. Cleaning spot in toilet
Try put tea leaf into toilet in few hours, then clean toilet with water. After that scrub toilet with brush.

  1. Protect from UV ray
To restored burning skin from sun light, stick wet tea pocket at burning area.

  1. Relaxing tired eyes
Wet and warm tea pocket dan reduce swollen and pin at tired eyes area.

  1. Reducing bleeding gum
Try stick wet and colded tea pocket  at dent area. It can reduce bleeding and pain.

  1. Shining dry hair
Boiled tea dan be natural conditioner at dry hair. Clean hair with tasteless tea, and let hair dry for while. Then clean with water.

  1. Reduce acne
Try to clean face with green tea to reduce acne. Follow ancient way with cooling boiled tea one day, then use the water to clean face in the morning.

  1. Soften meat
Try to submerged hard meat into black tea water to make it soft meat.

  1. Help decorated plant grow
Spread used tea leaf around rose flower, then add fertilizer and water. Put some used tea pocket at pot base can help hold water at ground and add nutrition.

19 Benefit Of Green Tea


19 Benefit Of  Green Tea

Many people say a lot of benefit of green tea, here I share some benefit of green tea which may be useful information for you as my reader, these benefit have been collected from many resources:

  1. Antioxidant
  2. Reduce risk cardiovascular and cholesterol
  3. Weight loss
  4. Avoid H.Pylori bacteria
  5. Protect kidney from uremic toxic
  6. Avoid teeth problem
  7. Mouth deodorizer
  8. Slow down eye lenses blur in catarac process
  9. Antivirus
  10. Chemoprevention (Chemical prevention)
  11. Protect skin from UV ray
  12. Protect lungs damage by tobacco
  13. Protect liver
  14. Protect pankreas
  15. Make esofagus safe and healthy
  16. Protect flank skin
  17. Avoid prostat tumor and breast tumor
  18. Protect memorizing skill
  19. Make younger

Result from research in America, Europe and Asia show that green tea useful to reduce cancer risk on skin, digestion system, lungs, prostat, breast and liver also catarac. As antioxidant, polyphenol inside tea protect blood and LDL cholesterol from free radical which can cause cardiovascular and stroke. Role of polyphenol in antibody has given antivirus characteristic and anti-microbe also uremic toxic which caused fail kidney.

Green Tea As Detox


Green Tea As Detox

Green tea detox meaning that use green tea as detoxification process of human body. Is it alright? By the way, many benefit green tea which useful to us. But important material which very important content in green tea is epigallocatechin gallate. This content can reduce cancer growth in our body.

Beside epigallocatechin gallate there are two effect which powerful to avoid disease come into human body.
  1. Mouth deodorizer
Sulfur which emerge inside our mouth like methylmercaptan and som sulfida as result of protein dientangle by enzym and bacteria, it caused mouth smell (halitosis) after we eat. Green tea can reduce dramatically this halitosis effect.

  1. Antivirus
Virus come into human body through skin, sexual organ, breathing and digestion system. Virus which is contained DNA or RNA can grow using human cell. Green tea can influence bio-syntheses between virus with human protein cell. Catechin from green tea useful to avoid or cure any disturbances from virus, such as DNA patogen virus: adenovirus, herpes, pustular skin eruption also RNA virus: retrovirus (AIDS/HIV). Some of retrovirus and herpes also stimulating cancer.