So a band aid has been the solution for 10 years now, do you not think it’s time for a fix?  Why does this not happen?  Well I think this PLOS One study has the answer and “it’s the fear of math giving people real pain”…I blogged that when it came out and it’s a real study with MRI images and so forth, so what in the hell else can explain a 10 year old band aid that puts doctors and hospitals through the hoops every year?  Congress is afraid of math and I think every member should be put in an MRI so we can determine which ones have this horrific fear of math…what else could it be I ask?  I’m open for suggestions…and along with this fear, they get duped over and over and over.

“Algo Duping” – PLOS One Journal Publication Explains Why The Fear of Math Plays a Big Role As One Underlying Reason We All Get Duped And Those Who Don’t Fear Math Take All the Money, Gradually, Using “Mathematical Formulas & Algorithms”

Read the summary of the study and I’ll be darned if this doesn’t fit those folks in DC and several White House executives too while I’m at it, like HHS and DOJ for a couple examples.   I’m doing a diagnosis for the reason we have the least productive Congress that we have ever had and what’s even more ironic that doctors, the group who’s reimbursement is affected here, did the study…duh?

“SUMMARY:  When anticipating an upcoming math-task, the higher one’s math anxiety, the more one increases activity in regions associated with bodily threat detection and the experience of visceral pain itself (INSp). Given our findings were specific to cue-activity, it is not that math itself hurts; rather, merely the anticipation of math is painful. Anticipatory anxiety about math is grounded in the simulation of visceral threat and even pain. These results also provide a potential neural mechanism to explain the observation that HMAs tend to avoid math and math-related situations, which in turn can bias HMAs away from taking math classes or even entire math-related career paths”.  Our data goimage beyond these results and suggest that even anticipating an unpleasant event is associated with activation of neural regions involved in pain processing.”

Now let’s add on the 2% sequester that doctors and hospitals have been dealing with since April 1st…more fear of math..they run…if it’s not a soap opera production on the floor of Congress they don’t seem to know what to do.  Here’s one suggestion I keep running into the ground and it would help all of them and they could lends the services to the White House folks too, is to re-established the Office of Technology Assessment.  We already know they run for the hills with Math so get an agency that will help make them smarter as they can’t be everywhere at one time so get the the help you need Congress and become productive again. 

They remind me of a hospital CEO I used to deal with that whenever technology was mentioned, he ran for the hills, especially if I had my table in hand and this was about 6 years ago.  I used to laugh at it and so did the staff as when I had to converse with him, bringing a tablet in to write notes scared the daylights out of him and he would cut the meeting short to about 2; minutes:)  After the show earlier this year, Senator Cruz is the hands down poster child for this project. 

“Little Paper Senator Cruz”–Yet More Startling Proof For the Need to Restore the Tool Congress Needs–The Office of Technology Assessment

Congress can’t model and needs another bigger brain…get IBM Watson in there to do the query work for them so they can all start with the same numbers and not look like a bunch of spreadsheet carpet baggers.  You have to laugh when you think of Ryan and his Medicare voucher idea as look at what we have with Healthcare.Gov…can you image the complexities and how everyone’s records would be screwed up with that one?  He’s another one that is bliss and maybe needs to learn how to model.  I mention IBM Watson as it has speech recognition built in so even the lowest common denominator we elect with tech skills could still participate and not be left out to get data and information.  Hell Citibank is using it, Blue Cross now is distributing IBM Watson, and it’s coming to the cloud…Citibank and Blue Cross know what models are and hire quants create those models. 

Put John McCain and Ted Cruz in the same room so John McCain can sit and play poker on his cellphone while Ted Cruz reads Dr. Seuss, a match made in heaven no less:)  Those boys need some basic math education. 


IBM Watson Going to Work At Citigroup on Wall Street–Congress Didn’t See Big Data As A Tool (Hadoop Framework) When They Had Their Chance…For Consumers The Attack of the Killer Algorithms–Chapter 22

We better put those folks in a wellness portal to fix them up, you know like insurers think that will fix us (grin).  We want their data, and maybe as citizens we could sell it and make a buck like Citibank and Blue Cross does, selling our data.  They need technology to model and begin creating digital centric laws, and that means attached a blue print for IT infrastructure to the law when it is passed that outlines what needs to be complied with from private industry, otherwise they sit around and look for loopholes and I’ll be damned if the banks and insurers aren’t good at it too, and we all suffer.  I’m sure you have noticed who has the money, right?  It was “math modeled” that way. 

Congress Needs a “Wellness Portal” As Predictive Behavior Analytics And Behavior Modification Is Needed So Consumers Can Start Scoring Congressmen To Create Risk Assessments Along With Adding Pay for Performance Assessments To Their Positions….

Now back to the SGR, please learn how to model or just flat out quit using this as delete the provisions in the law.  How ridiculous can you get doing this for 10 years and there’s enough data and history now to fix the it as when it gets delayed, you cost people money too and the billing is a nightmare to go back retroactive and change it back.  Do it right from the start…get a head on your shoulders and see what the antics and lack of modeling does to the rest of us. 

Look at the image off to the left of the Medicare SGR’s not that difficult and heck any Quant or Mathematician can help you out with it that builds models.  Forget the actuaries imagethough as this is a little above and beyond what they do, go for the quants and mathematicians. 


Get over the fear of math and fix this model, it’s stupid not too and now that we have the mess with the insurance exchange website, enrollments, insurers having hire more quants to figure out their new math models since some will be extending policies and we don’t know how the algorithms will shift out yet, fix this one as this is easy by comparison because if you don’t’ do it now, it’s going to get worse as someone comes along and attaches other economic models to it and then doctors will really be screwed. 

It’s bad enough that insurers like United are paying doctors all across the country at rates less than Medicare and this annual issue adds needless pressure to all of it.  Just wait until some insurance company decided to build some business intelligence model attached to this monster..then everyone will be running for the hills, afraid of that math! 

The AAFP Confronts United Healthcare On Reimbursements, Some Are Below Medicare Rates In Parts of the US–Payment Algorithms/Formulas Calculated Deep Within IT Infrastructures Do the Job

It’s about time the government hired some data sleuths and quants to fix things (link below) so we are not always behind the 8 ball and this would a good start.  You want to make it any more miserable to be a doctor in the US?  This would take one thing off their backs and it’s not that hard as it’s a broken model anyway, has been broken for 10 years and was flawed when it was created!  This is above where the head of HHS can go as she’s still waiting for the “algorithm fairies” to show up, link below tells that story loud and clear.  BD

Lack of Modeling and Algorithm sleuths and Stalkers In Government, Part of Why We See Such “Silly” HHS and Congressional News About Financial Donations And/Or Solicitations…

CMS has a released final rule for Medicare's physician fee schedule, starting Jan. 1, and physicians are expected to see a 20.1 percent reduction to their Medicare payments.

Under current law, physicians and other providers will face the pay cut based on the sustainable growth rate. The SGR is the formula used to adjust Medicare physician payment rates.

This past March, and also in the proposed rule, CMS said physician payments would have to be slashed 24.4 percent to make up for previous overrides of the SGR. The revised reduction of 20.1 percent is due to physician pay adjustments CMS calculated for this year. Members of Congress are currently working on both temporary and permanent fixes to the SGR. Every year since 2003, Congress has overridden the SGR so physicians would not have to endure sizable cuts to their Medicare pay.


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