In his September 1993 speech to Congress on healthcare reform, President Clinton criticized past administrations for using their own, generally rosy, budget estimates. He promised to use Congressional Budget Office figures for all healthcare issues.
That didn't last long. In its half-year analysis of the fiscal 1995 budget last year, the White House used its own numbers, which showed that Clinton's healthcare reform plan would decrease the deficit by $26 billion over five years. The unused CBO numbers showed the plan would increase the deficit by $60 billion.
Now the White House is at it again. In its fiscal 1996 budget, the administration claimed that estimates of federal health spending through the year 2000 have decreased from projected levels by $212 billion. However, what the administration did not reveal is that, one week earlier, the CBO also said federal health spending would decline-but only by about $142 billion, or $70 billion less than the White House was projecting. Oh well, what's $70 billion between friends?
Gateskeeper. Want to tie your healthcare information systems together and add innovation as needed? Bill Gates is here to help.
That's the basic message the billionaire chairman and chief executive officer of Microsoft Corp. will communicate in his keynote speech Feb. 13 to the expected throng at the Healthcare Information and Management Systems Society conference in San Antonio.
The advance word is that his speech will emphasize ways to minimize the "life-cycle costs" of computing in healthcare. In other words, through the pizazz of Microsoft technology, healthcare networks won't have to continually replace or retrofit their hardware and software as they get bigger or the pace of innovation outstrips their capacity to use it.
Gates also plans to show how various healthcare information system vendors are using Microsoft's enabling software to further the cause of serving health networks rather than single institutions. He'll drop names such as IDX Systems Corp., Digital Equipment Corp., First Data Corp.'s Health Systems Group and Shared Medical Systems.
HIMSS to the world. The Gates speech kicks off four full days of HIMSS activities and news, and it's all going to be plugged into the Internet for anyone inside or outside the convention who wants to be in the know.
A so-called "home page" will give HIMSS its own address on the World Wide Web, a portion of the Internet global computer network that lets users cruise through a wide range of topics and interests.
A daily news line, special session and speaker information, and an exhibitor list will all be highlighted, along with "fun facts" and information about the San Antonio area. The service also will showcase the vendor "hosting" the electronic page- Sun Microsystems, which is pushing its computerization to access the Internet. To "visit" the HIMSS page, type http: www.himss.org at the URL prompt when using a browser such as Mosaic or Netscape. Have fun.
It's in the fundamentals. Standard & Poor's Corp.'s annual publication of financial ratios for the not-for-profit hospital industry used to be the chief financial officer's gospel. But even the rating agency admits that the ratios aren't much use in today's changing healthcare environment.
Standard & Poor's calculates more than a dozen different percentages and ratios that provide such benchmarks as occupancy, operating margin and return on assets. The ratios are given for each of the top investment grade categories, from AA through BBB-.
The 1994 ratios appeared in the Jan. 30 issue of Standard & Poor's Creditweek Municipal under a headline that warned of rating "by the numbers." Although the ratios remain popular, "their usefulness in predicting a rating outcome has greatly diminished," the agency said.
While financials remain an important element, "business fundamentals-such as competitive position, institutional characteristics and operating efficiencies-are increasingly critical components in determining the credit risk," Standard & Poor's said.
To offset increased risk, an institution getting an A credit rating today needs to have a stronger financial profile than it would have 10 years ago, said Joan Pickett, director of Standard & Poor's healthcare ratings group.
Pidgeon steps. Board members of the National Rural Health Association are taking a long look at the direction of its organization before selecting a new executive director.
The organization had hoped to have a replacement for Walter Pidgeon in January, but Outliers has learned board members want to review the NRHA's "strategic direction."
Pidgeon helped the organization erase a debt, and established a national presence by opening a headquarters office in Washington. An effort to create a $1 million foundation had raised less than $10,000 by the end of last year (Jan. 2, p. 46).
The board wants to ensure it takes even greater steps to ensure a dynamic presence for the NRHA and its members. So the new executive director may not be on board until the NRHA's annual confab May 17-20 in Atlanta.
The tuck position. Aspen, Colo., has long been one of the meccas for America's rich and beautiful to while away winter days. These days, they're able to leave even more beautiful than they came.
For the past year, Aspen Valley Hospital has been home to a year-round, full-service plastic surgery clinic. "We've had comments from the significant other, where the person would say, `I never thought you ought to have a face lift, but if I can get a week of skiing or fishing, maybe it's a good idea,'*" said plastic surgeon Dennis Cirillo, who moved his practice to Aspen from Manhattan.
News reports of his clinic have sparked the usual combat with Aspen's longtime rival, Vail, Colo., over which opened a clinic first. Neither wants to let the other get a nose up.
Because both towns have a reputation of hosting the beautiful people, Cirillo said, the pressure to look good brings in many patients.
Devinder S. Mangat, M.D., who operates a part-time clinic at Vail Valley Medical Center, said, "We've created an environment that is conducive to having plastic surgery so that people can have it done and recover in nice, comfortable, beautiful surroundings and go back looking great."