I am no expert obviously but their public health officials are estimating 40% by mid May. again, if they can get through the immediate term with less than .5 nyc deaths (and Sweden has worst icu bed ratio!)how can they not claim success?
14k probably reflects an abundance of not testing! If you are getting to let it rip, testing is not a priority. Will know more when more serological antibody testing deployed.
Assuming that means they are immune?
They aren't even discussing/mandating wearing masks in settings like nursing homes. Doubt they are doing Taiwan/sk level of testing...
As far as I understand they did not impose strict restrictions on social interactions. They did impose some restrictions, but not as harsh as in other parts of Europe.
You can't compare a densely populated city with an entire country in the context of a pandemic, as population density is one of the strongest factors in viral spread. It would be more accurate to compare Sweden with Finland or Norway.
fair point. I guess the question is does keeping schools and bars open offset the population density difference. Particularly Keeping schools open seems like a good way to make sure that corona spreads like wildfire. Sounds like swedes feel lockdowns are only effective if done early and are very restrictive.
Lots of European countries are re-opening schools in May. Spain has already re-opened some of its schools. It remains unclear if children are a major vector of this disease.
NYC has a population density of 66,940 per square mile, Stockholm has a population density if 13,000 per square mile. That's enormous when we're talking about viral spread. Agree with Philly tho.
They certainly could be carriers though
www.nbcnews.com
Not trying to be controversial but the same should be done in med onc and rad onc. If you’ve seen the rise of OneOncology that’s a private equity backed company that’s been growing and taking over practices. It’s one thing for a practice to want to organically grow but needs capital (and therefore lean on PE to get access to a lower cost of capital compared to say a bank) and it’s another for an aging partnership to sell the practice to a PE that’s chomping at the bit to grow thru “operational efficiencies”, cost cutting and at times limiting types of care, and making it difficult for the younger partners and next generation of physiciansDoctors sue Envision Healthcare, say firm shouldn’t run California ERs
The suit says California law bars corporations from practicing medicine. Many states have similar laws but haven’t invoked them.
While I think (hope) we're generally aware of this, it is UNBELIEVABLY dismaying to me now, in a community setting, to realize how much "the system" is built to profit off our actions.
Always Comes back to supply and demand and how radonc is obsessed with devaluating itself either through omission of xrt or oversupply.
Not to mention extreme price gouging.
It is not that easy to pack and leave...
Service contracts, centralized physics/dosimetry
There are multiple ways to “grow” with these entities. In general, from a Rad Onc perspective, they tend to want a relatively big percentage - from what I’ve heard it’s ~20%. It’s sort of like having an external partner purchasing a portion of ones practice and in return you get a management services agreement, access to lower COC (cost of capital), some centralization of technical services, access to tech like EMR that have pathways, a national network of physicians, marketing etc etc. As one poster alluded to, the model may work better in med onc due to the benefits of a group purchasing organization - OneOncology can source drugs cheaper from multiple sources (AmerisourceBergen, cardinal, McKesson etc) than a single practice can and can more easily float the money needed to purchase those drugs. What’s in it for the private equity? They purchase a stream of profits without having to establish a new practice and compete in an existing market and their valuations start to go up exponentially as they add more assets and income streams to their books (think discounted cash flow and relative valuation techniques). Eventually, 5-10 years down the line, the private equity sells the venture off to the next buyer. CareMore (capitated Medicare advantage program) good example of these problems - new private equity bought it out and even more difficult now for their physicians to dispense chemo of any kind…
Some elasticity in derm in that they can deliver a lot of cash pay cosmetic services.
The big question I would have is if they handle insurance contracts. If the large group can negotiate 50% more from private payers due to size or network compared to your local group that would easily justify their revenue percentage. If not it would be hard to justify unless they paid a goldmine. Remember with an overhead of 40%, 20% of revenue is 33% of your take home pay.
I’m pretty sure HCA is one of the largest providers of residency spots in the country (across all residencies and all their hospitals)
I’ve led our managed care team for a while and am part of a national network. Most of these contracts though are local and negotiated based on statewide leverage rather than nationwide leverage (consistent w the adage that healthcare is local). Although you’ll get some “expertise” in managed care from the national headquarters the negotiations are typically still local - at least my experience
And given most of these spots can’t receive Medicare funding, it really hammers home that residents are a cost savings, not a cost sink despite what academic centers say.
Agreed. Their ex-CEO Sachin Jain at CareMore was a big part of that. He’s doing similar things now at a new MA plan. Pretty sure he’s making many millions a year
