Tag Archives: health care

Who Made WHO: COVID-19, Global Class Warfare, and Booster Shots

Posted on by under COVID-19, Health Care Series

Who pick up the bill when who made who? Ain’t nobody told you?

–AC/DC

On August 18th, The New York Times ran a story on the front of its feed titled “Booster Shots ‘Make a Mockery of Vaccine Equity,’ the WHO’s Africa director says.” In case that statement sounds needlessly inflammatory and emotionally manipulative, here’s the actual quote from Dr. Matshidiso Moeti:

Moves by some countries globally to introduce booster shots threaten the promise of a brighter tomorrow for Africa. As some richer countries hoard vaccines, they make a mockery of vaccine equity.

To say that the introduction of a booster program in one nation poses a near-existential threat to a continent of 1.2 billion people is a stretch. But it’s not until you drill down to the factual details of the worldwide dynamic of COVID prevalence, vaccine production, and actual vaccination that you get a sense of how misleading and irresponsible that statement is, and how shaky is Moeti’s subsequent claim that as a consequence of boosters, more dangerous variants of COVID will arise.

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The JBMDL Afghan Account

Posted on by under Health Care Series

I was sitting in my cubicle mid-day when an email with an odd subject line tumbled into my inbox: “JBMDL Afghan.” It was from a bona fide sender, so I opened it and took a look. It turned out to be an email from the director of financial services at a major hospital system, making reference to a new medical services “payor,” as we spell it in the trade. It was, in other words, the Joint Base McGuire Fort Dix Lakehurst Afghan payor, i.e., the payor of medical services for Afghan refugees housed at McGuire Air Force Base/Fort Dix Army facility in Lakehurst, New Jersey. Otherwise known as the US military.

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Cancel Culture: A Recantation

Posted on by under cancel culture, Health Care Series

In previous posts here, I’ve argued that “cancel culture” is fake news–an ideological confabulation devised by the Right to discredit the Left, which is usually “credited” with having created it. I now realize that I’ve been deeply wrong, and wish to recant. Cancel culture certainly does exist, just not in the way its usual ideological adversaries would have you believe.

Think of any event that requires scheduling, e.g., an appointment, a work schedule, business hours, a conference, a travel itinerary, a date. Think of how ubiquitous such events are, and how complex and expensive the infrastructure required to keep them going–to keep the slots filled, to keep the workflow efficient, to make sure everything runs on time. Consider how much reliance the various parties place on the others in the scheduling process. If A schedules with B, A relies on B to be there, and B relies on A to show up. If A doesn’t show up, the failure (whether culpable or not) adversely affects both B and any third parties who would have used A’s slot but couldn’t, given A’s (let’s say) sudden absence. If B doesn’t show up, the absence affects A as well as a set of third parties.

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COVID Booster Shot Meets Health Care Monopoly

Posted on by under COVID-19, Health Care Series

This post is part of an occasional series on health care. Here’s the prologue to the series, which originally preceded the post below.

Here’s a fairly straightforward story from The New York Times from a few days back, reminding us of the fact that immunity from some of the COVID vaccinations is limited in time, and may well require a booster shot.

 WASHINGTON — Biden administration health officials increasingly think that vulnerable populations will need booster shots even as research continues into how long the coronavirus vaccines remain effective.

Senior officials now say they expect that people who are 65 and older or who have  compromised immune systems will most likely need a third shot from Pfizer-BioNTech or Moderna, two vaccines based on the same technology that have been used to inoculate the vast majority of Americans thus far. That is a sharp shift from just a few weeks ago, when the administration said it thought there was not enough evidence to back boosters yet.

On Thursday, a key official at the Centers for Disease Control and Prevention said  the agency is exploring options to give patients with compromised immune   systems third doses even before regulators broaden the emergency use authorization for coronavirus vaccines, a step that could come soon for the Pfizer    vaccine.

Skipping a bit:

Pfizer’s continuing global study of its clinical trial participants shows that four to six months after the second dose, the vaccine’s effectiveness against symptomatic infection drops from a high of 95 percent to 84 percent, according to the company.

As a (then) full-time hospital worker actively exposed to high concentrations of COVID, I got my second dose of the Pfizer-BioNTech shot on January 6. If the vaccine’s effectiveness definitely drops from 95% to 84% in four to six months, then I’m well past my due date for a booster. Though I’m no longer a full-time hospital worker, I’ve been waiting for twelve weeks now for the paperwork to go through on my bid to work per diem for Hunterdon Medical Center’s OR. Assuming it goes through, I’ll be back in the COVID-intensive environment I previously inhabited. And if it doesn’t go through, I intend to apply to do the same work at a different hospital. So one way or another, I intend to make my way back to hospital work, and (by implication) to re-immerse myself in COVID.

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Health Care: A Series

Posted on by under COVID-19, Health Care Series

This was originally a post on COVID booster shots, but I’ve now broken it into two separate posts, the first a prologue offering a very general summary of my approach to issues in health care, and the second, a post expressing skepticism about the need to wait any longer before we roll out a COVID booster, as well as skepticism about monopolistic institutional arrangements (distributive and/or regulatory) in health care.

I work in health care, but have no worked-out view on the political economy of health care. In fact, part of the reason I accepted the (full time) job I currently have, in hospital revenue cycle management, is to clarify my thoughts on that very subject. So I’m open to being schooled on issues in health care by anyone willing and able to do so–a category that probably includes a very large number of people. For the time being, I’m willing to remain at least temporarily in a state of curmudgeonly skepticism, willing to take pot shots at almost everyone, but unwilling to pledge allegiance to much of anything. You might regard that as a frivolous position to take, considering the stakes involved. But I don’t.

Since I’m going to be writing here at PoT about health care a fair bit in the near future (I’ve done some already), take what I say in the preceding skeptical (or dialectical) spirit. My aim is, through discussion and experience, to work my way from skepticism to something more definite.

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Too Much Time on Their Hands: The Underemployment of Our Managerial Class

Posted on by under cancel culture, EVS Journal

I keep hearing hand-waving stories from right-leaning members of our managerial class about how unemployment benefits are dampening the desire to work among rank-and-file workers. Let me give you a small glimpse into the work ethic of this same managerial class in my own case. I’ll leave you to decide, at least in this case, whose work ethic could use some improvement.

I’ve been writing here since October about the eight month gig I recently did working full time for Operating Room Environmental Services (OR EVS) at Hunterdon Medical Center in Flemington, New Jersey. About seven weeks ago, I gave notice at the hospital, telling both Surgical Services and HR that I would continue to work at HMC’s OR once a month as a per diem worker at the same rate as I’d earned before. They were delighted to hear it; OR EVS has been decimated by turnover, and was practically dying for weekend coverage. I could easily have insisted on a raise, but didn’t. This, by the way, for an institution that failed to give me bereavement leave after the unexpected death of my wife in March.

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Hospitals Are Not Safe: Infection, PR, and EVS

Posted on by under COVID-19, EVS Journal, Uncategorized

For at least six months now, hospital spokespersons have been coming before the public to assure would-be patients that hospitals have been thoroughly scrubbed clean of potential infectious agents, most of all SARS-CoV-2. So, they insist, “hospitals are safe,” and no one should hesitate to go. This video below is typical of standard-issue hospital propaganda.

No, hospitals are not safe. The video above, like so many in its genre, above confuses de jure policies with de facto realities. Yes, policies are in place “to ensure safety.” But as should be obvious, a policy’s being in place doesn’t ensure safety. People have to be following it, all the time, and to the last letter or decimal place. Even if they are, adherence to policy is not sufficient to ensure that a hospital is 100% infection free, or 100% safe. Nothing can do that.

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Code Blue to Code Green: EVS, RCM, and Health Care

Posted on by under EVS Journal, Uncategorized

As many readers will know, I just spent the last eight months working full time for OR EVS at Hunterdon Medical Center in Flemington, New Jersey. About a week ago, I started a new job as a junior analyst in hospital revenue cycle management (RCM) with Aergo Solutions in Iselin, New Jersey. People have asked how I like my new job. Get back to me on that when I know what the hell I’m doing, since for now, I obviously don’t.

For now, I can only comment on the transition between the one job and the other. And the only comment I can muster is that I’m having trouble putting things in words. The difference between working for OR EVS and working for hospital RCM is so stark and abrupt that I’m inclined to think that you really have to experience it first-hand to know what it’s like. One day you’re working with fracture tables; the next day, you’re working with pivot tables. The two things have about as much in common as the two jobs themselves.

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The Life She Saved

Posted on by under Uncategorized

I was cleaning out some computer files when I came across the folder from my old Felician University office laptop containing all (or most) of my student letters of recommendation. On a lark, I decided to look some of my former students up. Some might call this “stalking”; I call it Pedagogical Outcomes Analysis.

Here’s one of them, an RN-to-BSN student for whom I wrote a letter back in 2010, when she was applying for a position as a school nurse. I’m pleased to say that she got that position, and then some:

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EVS Journal (1): Kill ‘Em All

Posted on by under Uncategorized

Some readers may remember that back in May, I resigned my position as Associate Professor of Philosophy at Felician University in protest at malfeasance I encountered at the university, malfeasance that upper-level university administration wanted covered up. These same administrators apparently expected me to help them cover it up, but I wouldn’t and didn’t; after a ten-day standoff with these assholes, it became clear that they wanted me off of payroll and out of the way. As an at-will employee at a non-tenure-granting institution (five years on the AAUP’s censure list), I had no viable institutional options for dealing with corruption that willful and entrenched, so I quit before they fired me. I’m glad I did. As I’ve been saying for years, Felician is a sinking ship. It’s only a matter of time before it goes under. Continue reading →