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Monday, October 25, 2010

Obama Health Czar's Budget Cutting Plan

From the desk of Center for Unified Universal Health Services Czar Donald Berwick:

Dear Staff,

Since the implementation of my Triple Action Plan we have begun to see some reduction in costs and a more efficient delivery system for health care. Unfortunately, we still have not reached the level of efficiency needed to meet our short or long term goals in savings. Hence I would like to implement the following changes to our triage system:

1. Incentives. Many relatives of long-term patients who are unlikely to recover are holding up the process of end of life procedures through such as meddling as lawsuits, pickets, and even direct interference with medical professionals attempting to provide compassionate end of life medications. I would suggest that it would be cost-effective to provide incentives to the patient's legal guardian to "go along" with the process in these instances. For example, if long term care is running at $3500.00 per day, a one time cash payment of that amount to the legal guardian might convince them that termination of services really is the best option for the patient. Paying the $3500.00 on a one-time basis to make the family go away is certainly less expensive than paying it for the average of twenty-three days that many of these patients loiter around clogging up our facilities. As a side note, under our new power to enable and enforce guardianship orders, if the current guardian is still unwilling to co-operate, we can simply designate another relative, or social worker if need be, as the patient's guardian. This will be in the best interest of all involved.

2. Dealing with "super bugs". There are a number of new bacteria out there highly resistant to all of our current antibiotics. While this was initially a concern for many of our doctors and nurses, some of our new health professionals from end of life services have found a way to "make lemonade out of lemons", so to speak. They have suggested the surreptitious introduction of these bacterium into our long-term care wards, to clear things out, to use a vulgar but understandable phrase. Patients who are infected with an incurable, flesh-eating bacteria should also be much more amenable to end of life compassion services. We will be shipping vials of the necessary bacterium nationwide beginning next week.

3. Triage, triage, triage. Let's understand something people. There is a time when true compassion is letting go. This time is when dealing with the very old, the very young, the infirm and the weak. We need to get back to practicing medicine the natural way. In nature it's the very old and very young, the weak and the infirm, that pay the price for the rest of the herd. We should learn from this. We need more natural medicine. Triage will save us money.

4. Please remember to make reference to your affirmative action in quality care cards when making your triage decisions. We need to remember that certain racial groups have, in the past, unfairly exploited the resources of others to gain what should have been unaffordable health care for themselves. This must end. Historically under-served races should now be given first preference. Additionally, historically under-served groups should be given preference in our limited medical resources. Thus, homosexuals should be given first preference at treatment, especially as they do not insist on over-burdening our system by constantly churning out new pediatric services consumers.

5. Elimination of pediatric services. This one has been highly controversial, and, as you know, unpopular in many quarters, but it is essential. Face it, if they can breed one pediatric unit, the parents can squeeze out another. We just cannot afford the prices for these little parasites. The romantic notions held by too many of our populace about health care for pediatric consumers must be set aside for the greater good. They are simply too expensive for the benefits they provide.

I hope these guidelines have been helpful. I am certain that if we implement them immediately we can achieve our savings goals. And remember, under our new executive orders, you can always refuse services to one of those awful tea-baggers.


Center for Unified Universal Health Services Czar Donald Berwick

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