Sunday, November 29, 2009

A Fairy Tale


Bricks, Straw, or ?    This is an interesting metaphor, and it may apply well to the  current health debate.

Too big to fail? Health care reform, or Dubai?

Obama's 'glow" is diminishing, even amongst the 'faithful, and gullible.

Matt Holt and THCB quote"

There’s a big to-do about whether there are really any cost-saving measures in the House and Senate bill. Most people say that the answers are “no” and “sort of”.

But let’s not dwell on that. Instead let’s have some fun. Regular THCB readers will know that AHIP’s Karen Ignagni has told half-truth after half-truth after outright lie to protect the position of her members. All the while somehow holding together a coalition that really should have broken apart long ago (and may yet still do that). And she gets paid very well for that role.

But today in the WaPo she told the truth:"


Karen Ignagni, president of America's Health Insurance Plans, said the Senate bill includes only "pilot programs and timid steps" to reform the health-care delivery system, "given the scope of the cost challenge the nation faces." Unless lawmakers institute changes across the entire system, Ignagni said in a statement Wednesday, "Health costs will continue to weigh down the economy and place a crushing burden on employers and families."

Tuesday, November 24, 2009

More Docs4Patient Care

Another rally....get involved, patients and providers alike.

Forward the link- 

Go Viral:

Meaningful Use and Incentive Payments

In one of my previous posts I alluded to this.


Read it here first !!



MGMA Letter Details Concerns About Health IT Stimulus Funds

On Sunday, the Medical Group Management Association sent a letter to National Coordinator for Health IT David Blumenthal detailing its concerns about the implementation of the federal economic stimulus package's health IT incentive program, Modern Healthcare reports.

Under the stimulus package, health care providers who demonstrate "meaningful use" of electronic health records will qualify for increased federal incentive payments (Conn, Modern Healthcare, 11/23).

In the letter, MGMA argues that health care providers could miss out on the stimulus funds if the government fails to appropriately define meaningful use and administer the program effectively.

To avoid these pitfalls, MGMA recommended that the federal government:

  • Allow for flexibility in approaches to meaningful use;
  • Create a pilot program to test the incentive payment initiative;
  • Develop a simple process to demonstrate meaningful use;
  • Emphasize tested and widespread criteria when defining meaningful use;
  • Enable physicians to test their reporting systems prior to full implementation;
  • Focus on appropriate and achievable meaningful use criteria;
  • Monitor the health IT industry; and
  • Simplify data reporting processes.

MGMA also called on the government to encourage the health IT vendor community to develop high-quality and affordable software (Hardy, Healthcare IT News, 11/23).

Docs4Patient Care

I've been gone for a week or so on a trip to the ancestral homeland in California. (ancestral in California means longer than five years ago.)

The Docs4Patient Care movment will be very active on November 21, 2009 with chapters now in many states, including Georgia, California, Texas, as well as many other videos. Here is a 'shout out' for recent activities.

Here is a brief video:

Monday, November 23, 2009

Failed California, Failed State,Failed Health Care Reform

Undoubtedly we will see some form of compromise and legislating 'Health Care Reform".  Whether it will truly be a health care reform will be open to debate. Let's face, it seeking perfection is anathema to seeking improvement. Never let perfection obstruct improvement in the status quo. Charlie Rose interviews Friedman.



NRO, National Review Online report from Grace-Marie-Turner reflects the following.

Further, endorsements by the AARP and the American Medical Association have been largely discredited as reflecting more the narrow interest of those organizations than the will of their members.

Readers should do their part by contacting the following representatives who are most likely to influence health reform decisions.

Key Senator Contacts for Health Care ‘Reform’ Bill

State Senator D.C. Phone # D.C. Fax # State Office Phone # State Office Fax #

AR Blanche Lincoln (2010) 202 224 4843 202 228 1371 501 375 2993 501 375 7064

PA Arlen Specter (2010) 202 224 4254 202 228 1229 215 597 7200 215 597 0406

IN Evan Bayh (2010) 202 224 5623 202 2281377 317 554 0750 317 554 0760

OR Ron Wyden (2010) 202 224 5244 202 228 2717 503 326 7525 503 326 7528

LA Mary Landrieu 202 224 5824 202 224 9735 504 589 2427 504 589 4023

NE Ben Nelson 202 224 6551 202 228 0012 402 441 4600 402 391 4725, 402 476 8753

ND Kent Conrad 202 224 2043 202 224 7776 701 232 8030 701 232 6449

DE Tom Carper 202 224 2441 202 228 2190 302 573 6291 302 573 6434

CO Michael Bennet (2010) 202 224 5852 202 228 5036 303 455 7600 303 455 8851

CA Barbara Boxer (2010) 202 224 3553 202 224 0454 213 894 5000 202 224 0357

AR Mark Pryor 202 224 2353 202 228 0908 501 324 6336 501 324 5320

CO Mark Udall 202 224 5941 202 224 6471 303 650 7820 303 650 7827

CT Joe Lieberman (Indpndt) 202 224 4041 202 224 9750 860 549 8463 860 549 8477

VA Mark Warner 202 224 2023 202 224 6295 804 775 2314 804 775 2319

VA Jim Webb 202 224 4024 202 228 6363 804 771 2221 804 771 8313

MT Jon Tester 202 224 2644 202 224 8594 406 449 5401 406 449 5462

VE Bernard Sanders (Indpndt)202 224 5141 202 228 0776 800 339 9834 802 860 6370

MO Claire McCaskill 202 224 6154 202 228 6326 314 367 1364 314 361 8649

ME Olympia Snowe (Rep) 202 224 5344 202 224 1946 207 874 0883 207 874 7631

ME Susan Collins (Rep) 202 224 2523 202 224 2693 207 780 3575 207 828 0380

To obtain all the required contact information for these senators, go to (put this address in your favorites). When you are on the home page, just click the link Find who represents you in Congress. Go to the state of interest and you quickly get the information on every Representative and Senator by clicking on their respective state. You can copy and paste their office address in Washington, D.C. and their home district or state into your letters (with adjustments in fonts) and obtain or check their email addresses and the phone and fax numbers.

Compose your letters (cutting and pasting, inserting correct addresses, names, etc.) and fax them out! is a quick, easy and inexpensive service for sending many faxes quickly by email, not fax machine!!!

Sunday, November 1, 2009

Sunday Morning Bonus

Corruption in American Health Care

Saving Health Care, Saving America as written  By BRIAN KLEPPER, DAVID C. KIBBE, ROBERT LASZEWSKI and ALAIN ENTHOVEN in The Health Care Blog

"So far, Congress' response to the health care crisis has been alarmingly disappointing in three ways. First, by willingly accepting enormous sums from health care special interests, our representatives have obligated themselves to their benefactors' interests rather than to those of the American people. More than 3,330 health care lobbyists - six for every member of Congress - contributed more than one-quarter of a billion dollars in the first and second quarters of 2009. A nearly equal amount has been contributed on this issue from non-health care organizations. This exchange of money prompted a Public Citizen lobbyist to comment, "A person can reach no other conclusion than this is a quid pro quo [this for that] activity."

Continue reading "Saving Health Care, Saving America"

It goes further down hill from there.

This article should give every physician a gut wrenching reaction, if not disgust at the corruption which has become rationalzied and rampant in some parts of the country.  It  points out how immorality creeps in slowly and devours a system. I reacted to the article in such a manner. From personal experience in such an environment I can describe how market influences alter perception and actions in order to survive in such a market. The financial imperatives create overwhelming features which can only be avoided if the overall physician community reacts appropriately in unison rather than in self interest.   Beyond this the only moral choice for the individual physician is to leave that community (which in itself strengthens the hand of the 'cartel'.

In a second article on The Health Care Blog  By JEFF GOLDSMITH

Atul Gofigure: Why McAllen Should Have Mattered in the Health Reform Debate



Back in June, Atul Gawande, a Harvard trained surgeon, published a riveting article in the New Yorker   about the physician community in McAllen Texas.