Zidane replaced Bale in Pamplona in the 71st minute.JESUS ALVAREZ ORIHUELA Maybe it was just that, seeing himself in a fast and hard-legged encounter, which caused him to withdraw thinking that in two weeks the Manchester City in the Champions catwalk. “Bale is afraid of getting injured again”, commented Dani Garrido in Sports Carousel. The Welshman was cheating on the sprints, leaded under the socks. Only two shots (none at Herrera’s arch), the least you have a good time (twenty-one), not a dribble and many, many losses (14, more than Isco and Benzema) … Zidane’s defense That is why or because they had agreed, Zidane replaced him in the 71st minute. “He is an important player, he has shown, he has made very good minutes defensively and offensively, “was the response of the Marseillaise when asked about Bale in the flash interview. “I do not agree with Zizou, I thought it was another Bale match … “Jorge Valdano added immediately in Movistar + LaLiga. The week of Bale did not end in full reintegration. Your agent (Jonathan Barnett) tried to reconcile Welsh with Real Madrid through this newspaper in pursuit of the four months he has left in the club (“Gareth loves Real Madrid, the city and his life there”) and Zidane gave him a complex match in Pamplona that was more a challenge than a real pardon. Well, Bale left The Sadar without winning any of those two particular matches. He was seen cold and not very participatory, that is, a standard match under the parameters of Welsh, unalterable even in a game as revolutionized as yesterday. Since Madrid returned from the Saudi Super Cup, Bale had only been taken out of the dungeon before Unionistas in Copa, party that also did not complete, but Zidane goes to the old resource of the external threat to corner the debate. “They want us to have a problem with Gareth, but there isn’t one.”he insisted. The highest paid player of the team stayed in July when he had the suitcase made, he has only completed five games throughout the season and his production is limited to three goals. Not to be a problem, Bale seems.
Bloomberg: How To Fix Drug Courts Modern Healthcare: Liberal And Conservative Reformers Press Candidates On ACA Changes JAMA: If You Can’t Measure Performance, Can You Improve It? U.S. News & World Report: Clinton’s Health Care Attack Makes No Sense The Wall Street Journal: Chronic Indifference At Veterans Affairs The New England Journal Of Medicine: Mr. Gilbreth’s Motion Pictures — The Evolution Of Medical Efficiency Again and again on the campaign trail, the presidential candidates have been faced by America’s rising concern about addiction, particularly to opioid painkillers and heroin. And from Hillary Clinton to Chris Christie, the politicians have responded by pledging their support for drug courts. This bipartisan reaction is correct, in principle: Drug courts, which now exist in every state, can motivate people to overcome their substance-abuse problems more effectively than punishment can. But to make the courts work in practice, states need to see that they’re adequately funded and properly run. (1/13) With the polls tightening in Iowa and voting both there and in New Hampshire just a few weeks away, the Kumbaya feeling in the Democratic primary is gone. In particular, the Hillary Clinton camp has evidently decided it’s time to go on offense against independent Sen. Bernie Sanders, lest 2016 start feeling like 2008 all over again. Predictably, one line of attack is on Sanders’ record on gun control, which certainly has its blemishes. Another, though, makes far less sense, particularly in a Democratic primary: Clinton is lambasting Sanders’ proposal for a universal, single-payer health care system. And she’s doing it in a pretty dishonest way. (Pat Garofalo, 1/13) The New England Journal Of Medicine: Shared Decision Making — Finding The Sweet Spot The New England Journal Of Medicine: Medical Taylorism The Wall Street Journal: In N.Y. Policy On Out-Of-Network Medical Bills, A Model For Other States? Medical bills for out-of-network providers can surprise consumers with thousands of dollars in costs they didn’t plan for and sometimes cannot afford. I’m among those who have experienced this surprise despite efforts to determine that all my health-care providers are in-network. … a significant share of people who had problems paying medical bills say that the issue was charges for providers they did not know were out of network. New York state has a solution to this problem that bears watching. Under the New York policy, patients who are surprised by out-of-network bills pay only the amount of their regular in-network cost-sharing provided they fill out a form authorizing the provider to bill the insurer for the remaining amount. (Drew Altman, 1/11) Des Moines Register: Repeal And Replace … With What? But when efficiency met medicine in the early 20th century, their relationship was no mere dalliance, and its form often diverged sharply from the Taylorist vision. One of its key figures was the industrial efficiency expert Frank Gilbreth, though his techniques were considered by many to be simply publicity-seeking smoke and mirrors. In place of a stopwatch, Gilbreth employed still and motion-picture cameras in his measurements, and he expanded his visual efficiency services — dubbed “motion study” — from industrial settings to the medical profession in the early 1910s. When he gained access to hospitals, Gilbreth transformed their operating rooms into efficiency laboratories, covering all available surfaces with gridded lines, and requiring the masked surgeons and nurses to don numbered or lettered caps to aid in his analysis of their movements across the axes of the surgical space. (Caitjan Gainty, PhD, 1/14) “If you can’t measure it, you can’t manage it” is an often-quoted admonition commonly attributed to the late W. Edwards Deming, a leader in the field of quality improvement. Some well-respected health policy experts have adopted as a truism a popular variation of the Deming quote—“if something cannot be measured, it cannot be improved”—and point to the recent enactment of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) as a confirmation of “the broadening societal embrace” of this concept. (Robert A. Berenson, MD, 1/13) Forbes: Administrative Fixes Won’t Rescue Obamacare’s Broken Exchanges Frederick Taylor, a son of Philadelphia aristocrats who lived at the turn of the last century, became known as the “father of scientific management” — the original “efficiency expert.” … Meanwhile, the electronic health record (EHR) — introduced with the laudable goals of making patient information readily available and improving safety by identifying dangerous drug–drug interactions — has become a key instrument for measuring the duration and standardizing the content of patient–doctor interactions in pursuit of “the one best way.” … The EHR was supposed to save time, but surveys of nurses and doctors show that it has increased the clinical workload and, more important, taken time and attention away from patients. (Pamela Hartzband,, MD and Jerome Groopman, MD, 1/14) The importance of shared decision making in health care has been increasingly recognized over the past several decades. Consensus has emerged that of the various types of decisions we make, those that involve choosing among more than one reasonable treatment option should be made through a process in which patients participate: clinicians provide patients with information about all the options and help them to identify their preferences in the context of their values. (Terri R. Fried, MD, 1/14) Every remaining Republican presidential candidate supports repealing the Affordable Care Act. Yet their ideas for replacing the law are “still works in progress,” according to a headline last week in the Wall Street Journal. That’s a generous way of saying candidates have no comprehensive proposals. The newspaper said only Ben Carson and Jeb Bush have posted health plans, and both use “broad brush strokes.” (1/13) The healthcare sector is digesting an important speech by the man tasked with rescuing Obamacare’s exchanges. Andy Slavitt, formerly of UnitedHealth Group UNH -2.77%, joined the Administration in June 2014. Last February, he took over the Centers for Medicare & Medicaid Services. (John Graham, 1/13) During his Senate confirmation hearing in July 2014 to head the Department of Veterans Affairs, Robert McDonald pledged to “transform” the vast agency. After horrific reports of wait-time manipulation, coverups and even deaths at VA medical facilities across the country, veterans and the American people were calling for honest leadership to restore their trust in the department created to serve them. Sixteen months have passed but the VA’s culture of indifference persists, and the climate of accountability Mr. McDonald promised is nowhere in sight. (Jerry Moran and Jeff Miller, 1/13) : GOP Can Escape Health Care Trap Viewpoints: Kentucky’s Obamacare Escape Route; What Are The GOP Replacement Plans? A selection of opinions on health care from around the country. Some liberal healthcare policy experts are urging an ambitious, costly program to expand and improve the Affordable Care Act’s coverage. Meanwhile, conservative policy mavens are promoting an even more ambitious ACA replacement package they say would reduce the uninsured rate and lower healthcare spending with less government intervention. Falling in between, the centrist Bipartisan Policy Center recommended last month that the Obama administration meet with governors to advance new health insurance approaches, including flexible use of the ACA’s Section 1332 state innovation waivers allowing implementation of alternative coverage models. These proposals represent efforts from the left, right and center to frame the health policy options for the next president and Congress. (Harris Meyer, 1/13) This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.