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  1. #341  
    Quote Originally Posted by groovy View Post
    Surely you aren't saying we can just throw a couple hundred million to, oh say, MLK and boom! We have our next state of the art cancer center.
    For those with very little understanding of how federal research funding is awarded let me explain how the process works. Federal funding is not "thrown" at you, but fought hard for in the arena of peer review. Its awarded in highly competitive grants, typically only about 15 to 20% of applications actually get funded. Its almost unheard of nowadays that researchers get funded on their first submission, but typically take 2 to 3 rounds of review revision and resubmission before the funding is finally deemed good enough to fund. The criteria are mainly the merit of the proposal itself, the scientific validity of the hypothesis and the likelihood that the work will be successful. The publication track record and preliminary data of the researcher is the most important, but for new investigators, some latitude is also given for the research environment, which mainly means what other talented researchers are around to help the new researcher should they run into problems. As far as how supportive the institution is, and how much of a track record it has of producing, thats part of the process too, but its a minor component, compared to the other criteria above.

    The typical R01 grant, which funds the salary and operating expenses of a researcher is usually 250 thousand. In addition another 30 to 40% goes to infastructure costs, the so-called indirect component of the funding, so in total the funding for a typical R01 grant is around $325 to 340 thousand per year. So to get to that 200 million annual budget requires about 500 R01 grants to support the faculty and infastructure costs, along with a large cancer center grant (which is even more competitive than the R01s), and while R01s from the investigators supply most of the funding for postdoctoral fellows and students, typcially there are also some highly competitive federal training grants are also awarded to support the salaries of the postdoctoral fellows and students in the labs.

    So to start a center, you typically have to go incrementally, first you need a building, then you need to attract a core of researchers who will arrive with their own funding sources (R01s are portable and can go from one instutition to the other). Once you have that established, you can then use the federal indirect costs in combination with private funding to produce more facilities which will attract more researchers. The way you usually attract private funding for an area of research is to link it to already established federal funding as donors know quite well that the rigorous peer review the federal funding provides helps to validate the quality of the research, making it more worthy for supplementation by private funding. The most common private funding mechanism is to tie federal infastructure funding with a particularly large donor in the construction of a research building or portion of a building, so the donor can attach their name to it.

    So, one building at a time, one researcher at a time, thats how you build a center, you don't just throw 200 million and have it just pop up. It takes many years to do this. At first when you are small and not as well heard of, you are at a disadvantage, but gradually if you can achieve some research success and get more funding based on it, you can gradually grow into a national center. Of course you need a good administrative team of people to coordinate this, but, the fuel that drives this incremental building of a research center is in large part due to hard fought and highly competitive federal grants which help fund the researchers salaries, their operating expenses and infastructure costs.
    Last edited by cellmatrix; 10/13/2010 at 10:32 AM. Reason: corrected the subject of the first sentence from 2nd to 3rd person
  2. Micael's Avatar
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    #342  
    Quote Originally Posted by groovy View Post
    Surely you aren't saying we can just throw a couple hundred million to, oh say, MLK and boom! We have our next state of the art cancer center.
    Quote Originally Posted by cellmatrix View Post
    Your statement shows very little understanding of how federal research funding is awarded. Federal funding is not "thrown" at you.....
    Did I miss something? I think he just said that.
    The Law of Logical Argument: Anything is possible if you don't know what you are talking about.
  3. #343  
    Yes....here is what we have to look forward to....go government health care!

    Va. Medicaid paid out $39 million improperly in fiscal 2009 | Richmond Times-Dispatch

    Ever noticed that the word "fraud" (and it usually has many 00000's after it) seems to follow almost any government program? Maybe we should include the amount of fraud in Medicare and Medicaid when comparing the government programs to insurance companies? Maybe they already do....not sure....but seems like we should if we don't already do that. And remember, this is just ONE state.
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  4.    #344  
    Quote Originally Posted by clemgrad85 View Post
    Yes....here is what we have to look forward to....go government health care!

    Va. Medicaid paid out $39 million improperly in fiscal 2009 | Richmond Times-Dispatch

    Ever noticed that the word "fraud" (and it usually has many 00000's after it) seems to follow almost any government program? Maybe we should include the amount of fraud in Medicare and Medicaid when comparing the government programs to insurance companies? Maybe they already do....not sure....but seems like we should if we don't already do that. And remember, this is just ONE state.
    Yep. We need to crack down on those who take advantage of government funding sources. For instance, private health plans, in the largest fraud case in Medicare history below. Hopefully the government will shut down private companies that screw Medicare and Medicaid recipients by outright theft and fraud. Of course, that is more likely to occur if the people that administer the program are provided an adequate number of investigators. Read your own article. The reason Va. lost that money is because the state office lacked the resources to investigate fraud. That's a state issue, not a federal issue. I'm just guessing here, but I bet if there were just a few more fraud investigators hired by the state, they'd pay for themselves many times over.

    WASHINGTON, D.C. - HCA Inc. (formerly known as Columbia/HCA and HCA - The Healthcare Company) has agreed to pay the United States $631 million in civil penalties and damages arising from false claims the government alleged it submitted to Medicare and other federal health programs, the Justice Department announced today.
    This settlement marks the conclusion of the most comprehensive health care fraud investigation ever undertaken by the Justice Department, working with the Departments of Health and Human Services and Defense, the Office of Personnel Management and the states. The settlement announced today resolves HCA's civil liability for false claims resulting from a variety of allegedly unlawful practices, including cost report fraud and the payment of kickbacks to physicians.
    Previously, on December 14, 2000, HCA subsidiaries pled guilty to substantial criminal conduct and paid more than $840 million in criminal fines, civil restitution and penalties. Combined with today's separate administrative settlement with the Centers for Medicare & Medicaid Services (CMS), under which HCA will pay an additional $250 million to resolve overpayment claims arising from certain of its cost reporting practices, the government will have recovered $1.7 billion from HCA, by far the largest recovery ever reached by the government in a health care fraud investigation.
    "Health care providers and professionals hold a public trust, and when that trust is violated by fraud and abuse of program funds, and by the payment of kickbacks to the physicians on whom patients and the programs rely for uncompromised medical judgment, health care for all Americans suffers," Robert D. McCallum, Jr., Assistant Attorney General for the Civil Division said. "This settlement brings to a close the largest multi-agency investigation of a health care provider that the United States government has ever undertaken and demonstrates the Department of Justice's ongoing resolve and commitment to pursue all types of fraud on American taxpayers, and health care program beneficiaries."
  5. #345  
    Quote Originally Posted by davidra View Post
    Yep. We need to crack down on those who take advantage of government funding sources. For instance, private health plans, in the largest fraud case in Medicare history below. Hopefully the government will shut down private companies that screw Medicare and Medicaid recipients by outright theft and fraud. Of course, that is more likely to occur if the people that administer the program are provided an adequate number of investigators. Read your own article. The reason Va. lost that money is because the state office lacked the resources to investigate fraud. That's a state issue, not a federal issue. I'm just guessing here, but I bet if there were just a few more fraud investigators hired by the state, they'd pay for themselves many times over.
    Fraud is fraud in my book....I don't care who it is....bad government workers, bad employees at insurance companies, bad doctors, bad hospitals....bad people everywhere. Of course states can't keep up with all this because most states don't have the money to handle all this crap. In case you haven't noticed, many states are in a bit of money crunch right now. If they can't handle it now, how are they going to handle it when they are required by the Federal Government to handle even more. I guess your answer is more taxes, right? When there is a problem, just tax everyone more, right? Oops....not everyone....just the people with lots of extra money laying around, right?
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  6.    #346  
    Quote Originally Posted by clemgrad85 View Post
    Yes....here is what we have to look forward to....go government health care!

    Va. Medicaid paid out $39 million improperly in fiscal 2009 | Richmond Times-Dispatch

    Ever noticed that the word "fraud" (and it usually has many 00000's after it) seems to follow almost any government program? Maybe we should include the amount of fraud in Medicare and Medicaid when comparing the government programs to insurance companies? Maybe they already do....not sure....but seems like we should if we don't already do that. And remember, this is just ONE state.
    Not surprisingly, your suggestion that fraud is worse in government health care is wrong, because like most of your statements, it's based on opinion and not data. The amount is similar in public and private....and in 80% of cases, it's private industry that is responsible for the fraud. This little study was published by the AMA.

    Health care fraud accounts for as much as 10% of overall health spending and is occurring just as frequently among private insurance plans as public programs, according to a recent report.
    The June study out of the George Washington University Medical Center in Washington, D.C., emerges as the Obama administration is becoming more vocal about cracking down on health care fraud as a priority in reforming the health care system.
    The report's authors called the issue "a systemic problem affecting public and private insurers alike, in the individual market, the employer-sponsored group market and public programs." Researchers cited fraudulent billing, kickbacks, upcoding and bundling services among the most common examples of fraud. They estimated that 80% of health care fraud is committed by health care entities, 10% by consumers, and the balance by others, including private insurers and their employees.
    While the public is more aware of Medicare and Medicaid fraud because the government is required to report it to taxpayers, "perhaps the most striking examples of fraud are those that involve the private insurance industry itself," according to the study.
    Researchers pointed to a January settlement by UnitedHealth Group, totaling $450 million, over allegations that the insurance firm manipulated out-of-network prices for physician services, resulting in an estimated 10% to 28% increase in costs. The Litigation Center of the American Medical Association and State Medical Societies, along with other physician organizations, had sued United, which denied any wrongdoing.

    amednews: Health care fraud widespread -- in public and private sectors :: Aug. 4, 2009 ... American Medical News
  7.    #347  
    Quote Originally Posted by clemgrad85 View Post
    Fraud is fraud in my book....I don't care who it is....bad government workers, bad employees at insurance companies, bad doctors, bad hospitals....bad people everywhere. Of course states can't keep up with all this because most states don't have the money to handle all this crap. In case you haven't noticed, many states are in a bit of money crunch right now. If they can't handle it now, how are they going to handle it when they are required by the Federal Government to handle even more. I guess your answer is more taxes, right? When there is a problem, just tax everyone more, right? Oops....not everyone....just the people with lots of extra money laying around, right?
    Really? You don't think $39 million would have been worth a little expenditure? No, of course not, because that would involve some thought processes that are lacking in most state legislatures, which respond almost exclusively to political garbage and not to what's best for their constituents. Most state legislatures make the congress look like winners. Thankfully we don't let states determine any more things than are necessary. Otherwise we'd still have segregated schools and people dying of lack of health care. We'd have a lot more prisons, though, I'm sure.
  8. #348  
    Quote Originally Posted by davidra View Post
    Really? You don't think $39 million would have been worth a little expenditure? No, of course not, because that would involve some thought processes that are lacking in most state legislatures, which respond almost exclusively to political garbage and not to what's best for their constituents. Most state legislatures make the congress look like winners. Thankfully we don't let states determine any more things than are necessary. Otherwise we'd still have segregated schools and people dying of lack of health care. We'd have a lot more prisons, though, I'm sure.
    Okay...so let me get this straight, you are opposed to Medicaid? Since you have no confidence in state's governing bodies, then you would rather take that away from them, correct? And yet....I believe (I'm sure you'll correct me if I'm wrong here) Medicaid is going to get larger under obama care, right?
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  9.    #349  
    Quote Originally Posted by clemgrad85 View Post
    Okay...so let me get this straight, you are opposed to Medicaid? Since you have no confidence in state's governing bodies, then you would rather take that away from them, correct? And yet....I believe (I'm sure you'll correct me if I'm wrong here) Medicaid is going to get larger under obama care, right?
    Medicaid could be improved, especially in comparison with Medicare. What's the difference? State involvement. I support Medicaid, but it needs higher reimbursement, and more central control, and with that control, more financial support to the states so that they can administer it appropriately, since they don't seem to want to spend the money necessary to save their own money.
  10. #350  
    Quote Originally Posted by Micael View Post
    Did I miss something?
    You missed the opportunity to address the substance of the post, - that federal funding is a major part of what drives innovation and advances in our health care system.

    By the way i corrected the way I worded the first sentence in the post above and apologies to groovy if I wrongly assumed she or he did not understand how federal funding is awarded.
  11. #351  
    Quote Originally Posted by davidra View Post
    Not surprisingly, your suggestion that fraud is worse in government health care is wrong, because like most of your statements, it's based on opinion and not data. The amount is similar in public and private....and in 80% of cases, it's private industry that is responsible for the fraud. This little study was published by the AMA.



    amednews: Health care fraud widespread -- in public and private sectors :: Aug. 4, 2009 ... American Medical News
    Well from that article, it said: Between 3% and 10% of the nearly $2.3 trillion spent on health care in 2007 was lost to health care fraud -- a figure that, if prevented, "would have been enough to cover the uninsured," the report said. "As the national health reform legislation takes shape, keeping an attentive eye on anti-fraud provisions will be a critical element of reform."

    And yes, it says 80% by "health care entities", 10% by consumers, and the balance to "others" (which they define as "including private insurers and their employees."). I'd be curious as to what their definition of "health care entities" is.

    But according to your own article, fraud (again, I don't care who is doing it) if gotten under control could pay for the uninsured. My problem with the government side is they apparently either don't have people who can monitor the fraud or people who know how to monitor it. As we become more and more reliant on the government for our healthcare, it stands to reason that more and more fraud will occur.
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  12.    #352  
    Quote Originally Posted by clemgrad85 View Post

    But according to your own article, fraud (again, I don't care who is doing it) if gotten under control could pay for the uninsured. My problem with the government side is they apparently either don't have people who can monitor the fraud or people who know how to monitor it. As we become more and more reliant on the government for our healthcare, it stands to reason that more and more fraud will occur.
    I see. But the fact that the private side does absolutely no better would suggest that if more care was provided by the private sector, instead of the government, that things would be just as bad. But of course you don't realize that because it's too obvious.
  13. Micael's Avatar
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    #353  
    Quote Originally Posted by cellmatrix View Post
    You missed the opportunity to address the substance of the post, - that federal funding is a major part of what drives innovation and advances in our health care system.

    By the way i corrected the way I worded the first sentence in the post above and apologies to groovy if I wrongly assumed she or he did not understand how federal funding is awarded.
    Nope, didn't miss anything. Thanks for the correction!
    The Law of Logical Argument: Anything is possible if you don't know what you are talking about.
  14. #354  
    Quote Originally Posted by Micael View Post
    Nope, didn't miss anything. Thanks for the correction!
    I am sorry to have taken so much time on a point that must have been so obvious or tangential that you did not feel the need to comment further, but I hope that it was informative to others here.
  15.    #355  
    Quote Originally Posted by cellmatrix View Post
    I am sorry to have taken so much time on a point that must have been so obvious or tangential that you did not feel the need to comment further, but I hope that it was informative to others here.
    When reality and data interfere with political stance, it's amazing how many disappear. Being called arrogant is right around the corner for you. Take it from me. The new definition of "arrogant" must be something like:
    You seem to actually know what you're talking about, so therefore you must be arrogant. Makes no difference if that's what you've been doing for decades. You're still arrogant.
  16. Micael's Avatar
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    #356  
    Your snark is very very strong grasshopper
    The Law of Logical Argument: Anything is possible if you don't know what you are talking about.
  17. #357  
    Quote Originally Posted by clemgrad85 View Post
    Umm...yes....who else? If they have to provide more benefits and cover more unhealthy folks, then yes, rates will go up. What's your point? Were you under the impression that the government was controlling premiums? I'm sure that will come if the democrats stay in charge....but not the case thus far.
    Ok, they are raising their rates, hmmm, quick question, why do they automaticly assume person X is unhealthy? Is this another of the (real) death panels that the insurance companies got busted over? You know the ones, the ones that never kept any records of or minutes of, but where people were just cut off from coverage?! If they will be getting an additional 30 plus million people paying into the system, and they have raised the rates across the board, wouldnt they be making MORE money than they were before? Again, if they are not being forced to pay out more, they believe they will have to pay more, in the future, this rate increase is what ,, a) a hedge against future increase in costs, or b) fear mongering at the expense of the people of the US. Both are still bad, the latter being the worst in my mind. What better way to kill something than to raise the rates well prior to actual implementation. OHHHH look you will eventually get this, and WE think it is going to cost us, so you get to pay more now, without recieving one iota more in coverage.. hmmm
    Life is short, Play hard, and enjoy every moment as if it was your last.
  18.    #358  
    Quote Originally Posted by Micael View Post
    Your snark is very very strong grasshopper
    I'm trying my best to live up to the motto for the Rally to Restore Sanity which Stewart unveiled last night:

    "When in doubt, don't be d ouchey."
  19. #359  
    Quote Originally Posted by cellmatrix View Post
    You missed the opportunity to address the substance of the post, - that federal funding is a major part of what drives innovation and advances in our health care system.

    By the way i corrected the way I worded the first sentence in the post above and apologies to groovy if I wrongly assumed she or he did not understand how federal funding is awarded.
    Sort of ironic to be debating whether federal funding drives innovation on the Internet, isn't it? It was, of course, created with federal funding. And the web was devised with European government money, and the list goes on and on.
  20. #360  
    Quote Originally Posted by grappler View Post
    Sort of ironic to be debating whether federal funding drives innovation on the Internet, isn't it? It was, of course, created with federal funding. And the web was devised with European government money, and the list goes on and on.
    The future ain't what it used to be.
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