Regarding the Oct. 24 article about Medicaid and data tracking ("Better care and lower costs"): When I was a rotating intern at Hennepin County General Hospital in 1965, there was a not-so-secret list kept by the nurses at the emergency room registration desk to profile repeat ER users. It went by the (politically incorrect) name of "The GOMER List," standing for Get Out of My Emergency Room.
Over the years our safety-net hospital changed its name to Hennepin County Medical Center, and since Obamacare and Medicare ACOs, is less well known as the Hennepin Health ACO (see http://bit.ly/2erBSVO).
The GOMER List featured frequent visitors to the ER who were, for the most part, alcoholics, drug addicts, the mentally ill and homeless people. Almost all were lonely, and some wanted to raise hell (especially on Saturday night). The GOMERs stopped by for a chat, and many were escorted by the police.
I'm aware of no technical reason why in 2016 we cannot profile people who engage in frequent "emergency" or urgent health-care encounters, and after (compassionately) screening the situation, divert them to appropriate and less expensive venues and personnel. In 1965, most of us didn't know what a computer was. And, as physicians, we didn't know the costs of anything we were doing or not doing.
In 1965, there was little we and the nurses could do except to chat and delay for those on the GOMER List. It seems that little has changed in 2016.
Dr. Lee H. Beecher, Maple Grove
The writer is president of the Minnesota Physician-Patient Alliance.
NONPROFIT PAY
Take 'psychic income' into account for upper management
Great to see the front-page article "Nonprofits model higher pay" (Oct. 24). In my circles of nonprofit management for the past 50 years, that's always a "no-brainer" for people in lower and middle management. Nonprofits need talent to run the place efficiently to give the donors full value.
But the issue is how much upper management should be paid. From Aristotle to a more modern management guru, Peter Drucker, the industry has argued that executives in the nonprofit sector should get less because they are getting "psychic income" for their noble community work. Drucker even threw out the figure that executives should get about 65 percent, or $65,000, for a job that would pay $100,000 in the for-profit field.