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.

del.icio.us Tags: McAllen,Gawande,Brian Klepper,David Kibbe,Robet Laszewski,Alain Enthoven,Health Train Express

The Public Option

The AHIP  Singers

Thanks to The Health Care Blog for publishing this musical dedicated to the public option (not).

 

This is much more fun and better sung than traditional protests!

That is my humor for today. 

The following story is well worth the read

The Mike Gallagher Show....watch out Hannity

I just had to include this as a blog post...

 

Hal Scherz is just one of the many willing to  get down and invest his own capital in growing our grass roots efforts to influence health reform.  This is one of those things our organizations just cannot do as well.  Your interest,contributions and participation are essential.

As Dr Scherz states:

""I know how much everyone enjoys opening my TNTC emails (LOL) and I'm sure that you must have wondered where I disappeared to. I was down most of this week with what I'm convinced was H1N1, although the ER wouldn't test me. (A taste of what we have to look forward to under Obamacare). Now that I'm strong enough to sit up, I can start bothering everyone again. If you had any emails bounce back, please resend them. My box was filled up because I didn't clean it out for 5 days. If you sent me an email in the last few days, I promise that I will read it over the next 48 hours.

There are 2 things that I wanted to address tonight. As I have indicated to everyone, Docs 4 Patient Care will be an embedded sponsor of the Mike Gallagher show.

This is more like a partnership, because he has a strong, personal reason for wanting the doctor-patient relationship to be protected. Please begin to go to Mike's web site (http://www.mikeonline.com/) beginning on Monday and you will see Docs 4 Patient Care featured prominently. The exciting news regarding this, is that Mike is doing a 3 hour healthcare show this Thursday, Oct 29, and his co-host will be Hal Scherz. Yes, you didn't misread this. We will be discussing every aspect of the healthcare debate and we will try to have a guest or 2 to help to clarify the issues. His show is predominantly an audience participation show, so it would be a great opportunity for everyone to try to call in and to say what you would like to his national audience. If you are not familiar with his show, find out online which station his show is broadcast on in your area. It might even be a good idea to put this show on in your office waiting room and see if the hospitals will put this through into the doctors' lounges.

The second other important issue that I wanted to cover has to do fundraising. Please don't stop reading- this is different than usual.

I have received feedback from people that I have known professionally for over 20 years who I have reached out to in different parts of the country. When they heard about what we were putting together and that my practice was so committed, that we were putting up $40,000 in seed money, it was a "no brainer" for them. However, they are trying to convince people that they work with in their communities to dig into their pockets and write big checks. They are a bit reluctant because they don't know us, and they aren't sure where their money is going.

These are fair questions and concerns. First, let me assure everyone, that as a not for profit 527 political corporation, everything that we collect and spend has to be above board and transparent. If any member has any questions, they can contact our treasurer and board member, Joanne Thurston, who is a CPA.

Another question was whether I or any of the other officers have received any compensation. I wish. The truth is that not only do we not receive compensation, but we continue to put up our own money without asking for reimbursement for business related items- business cards, signs, etc. We have been to Washington twice already, and use our own money for these trips. And except for the past 4 days that I have taken off because of illness, I have averaged 5 hours of work daily for the past 5 months without any compensation. Anyone who sees what time the majority of my emails are timed can attest to this.

As to where does the money go? Well, there were start up expenses which we won't go into. But there are ongoing costs every month- mostly web site maintenance and our PR team. There are intermittent costs such as legal, marketing, other consultants.

However, we are now ready for prime time. We either move to the next level or pack up our toys and go home. What this means is that we spend a large amount of money getting out our message on a national platform and on a regular basis. This will open up more doors to us than we can possibly even imagine at this point. We need to hire an executive director, who will help to take the burden off of me. There are still many large initiatives that we need to launch, such as putting together the thousands of newsletter recipients who are not doctors and whose energy and enthusiasm is being wasted. We need to get these people working for us and contributing to our cause. The same for the allied health care professionals. There are thousands of doctors that we could get into Docs 4 Patient Care. We are poised for explosive growth. We need help to make this happen. We would like to at some point hire our own lobbyists and this will be very expensive. And there is so much more than this.

So this is where the money is going. Most of you getting this email don't know me at all, although there are ways to check on people today that didn't exist in the past. However, I think that it is worth taking a flier on this one. Do you want to write a big check in hopes that your money will actually work for you, or do you want to pretend that everything will be ok and hope that if you play nice and don't make too much noise, that you'll be left alone? This is almost too insulting to even ask this question.

Enough tonight. But those who want to contribute but just aren't sure, just do it! ""

All the best

Hal

The Arrow through Your Head

I have taken a break from health reform politicking to return to some essentials about health IT.

” The definition of a pioneer is “the guy with the arrow through his head.”

This was just one of the 'takeaways" at a recent seminar hosted in San Diego regarding the IT stimulus money train.

 

The feds have not defined “meaningful user” or “certified” yet; they are key requirements of the plan.

MEANINGFUL USER IS IN THE EYES OF THE BEHOLDER. ONLY PART OF THE DEFINITION HAS BEEN ESTABLISHED, AND NOT BY THE USERS THEMSELVES....TIME WILL TELL WHICH AND WHAT IS MEANINGFUL AND IT MAY TURN OUT THAT MEANINFUL (DEFINITION) WILL CHANGE IN THE NEXT FIVE YEARS.

ARE WE GOING TO BE CAST INTO A USELESS MOLD?

Financial incentives, even the full $44,000 available, are not going to cover your investment.

The cost difference between implementing in 2012 versus 2011 is only $5,000 less (paid out over 5 years). That year could be huge. The definition of an early adopter is the “bug on the windshield of progress.” The definition of a pioneer is “the guy with the arrow through his head.” One year to let others make the mistakes may save you much more than $5,000.

WHY ARE THE FEDS IN SUCH A HURRY WITH CUT OFF DATES AND PENALTIES FOR NOT IMPLEMENTING HIT AND EHR BY 2012???

COULD IT BE THAT THE FEDS ARE IN BED WITH SOME BIG IT PLAYERS???  ALLSCRIPTS IS BUSY RUNNING NATIONAL SEMINARS ON 'HOW TO" (DIP INTO THE FEDERAL TREASURY)

DON'T SPEND MY MONEY!!!

If you implement a bad process, you still have a bad process. Now is the time to dig into your operations, make them better, and THEN automate.

There are four “I”s that are key in shopping for an EHR/EMR:

• Implementation—This is the hardest part; it can sink you, and the vendors may not there for the long haul.
• Identity—How are you going to secure your data? Big penalties for doing it badly.
• Interoperability—Will it work with a MAC, your hardware, your PM system?
• Intersection—Will it work with the hospital/s, or the IPA/s, or any other of the as-yet-unnamed entities that will be required? THANKS TO MODERN MEDICINE, AND JUDY BEE

del.icio.us Tags: meaningful use,stimulus package,health IT,health train express,EHR,EMR adoption,judy bee

Medical BlogWorld New Media Expo

If you missed it, here it is. Excerpts from Las Vegas and the Blog World New Media Expo.

I regret not being able to be there. 

Prudent Buyers-not another insurance company

from: iHealthbeat

 

Quote of the Day:
Intelligence without ambition is a bird without wings.
--C. Archie Danielson

MGMA: Many Physician Groups Not Yet Ready To Invest in EHRs

Many physician group practices are likely to delay electronic health record adoption because of logistical and financial concerns, experts said this week at the Medical Group Management Association's annual convention, Healthcare IT News reports.

MGMA represents 22,500 medical group administrators and managers from across the country.

Robert Tennant, senior policy adviser for MGMA, said most of the physician practices MGMA represents will not qualify by 2011 for incentive payments under the federal economic stimulus package.

Under the stimulus package, health care providers who demonstrate "meaningful use" of EHRs will qualify for incentive payments through Medicare and Medicaid. However, the federal government has yet to issue a final definition for meaningful use.

William Jessee, CEO of MGMA, said many physician practices experienced declining revenue in 2008. He noted that nearly 37% of MGMA members have said they are postponing capital expenditures, which could include EHR adoption (Healthcare IT News, 10/13).

Moreover, many physician groups are concerned that the federal government will reduce Medicare payment rates this year under its sustainable growth rate formula, Jessee said.

He added that uncertainty about the rate reductions is leading many medical groups to delay EHR implementation (Monegain, Healthcare IT News, 10/13).

It seems as if many physicians are reticent to spend money they do not have. (unlike our federal government).  Despite all the rhetoric and politically incorrect statements about how much HEALTH IT will save, the government programs will have physicians lay out the funds to start up the  HIT transition and will only  receive grants if they can prove they are using EMR effectively (meaningfully) and according to a standard which has yet to be defined by them. The deadline is 2011 for implementation.  This is less than one  year from the probably final passage of any health reform bill. Although the original stimulus funding took place several months ago, the reality of these funds filtering down to the medical community will take at least another 12 months, based upon previous experience with ARRA and other stimulus packages.

Care---DENIED!!!

Quote of the Day:

An argument is the longest distance between two points of view.
--Dan Bennett

Gov. Arnold Schwarzenegger vetoed AB 2 over the weekend, rejecting legislation that would put a stop to the insurance industry's outrageous practice of wrongfully canceling patients' coverage once they get very sick and run up large medical bills, the Los Angeles Times and other major papers report. Sponsored by the California Medical Association, AB 2 called for an independent review of decisions by insurers to rescind coverage.

The insurance industry's widespread abuse of the practice has drawn condemnation from Republicans and Democrats alike.

In June, a congressional investigation found that three insurers had rescinded coverage for 20,000 patients over five years, saving their companies $300 million.

"With this veto, the Governor told Californians that insurance company profits are more important than their access to health care when they get sick and treatment becomes costly," said Dev GnanaDev, CMA president. "Without the patient protections of legislation like AB 2, there is no guarantee that Californians will have health insurance when they need it most."

Dev GnanaDev, president of the California Medical Assn., said Schwarzenegger's veto told Californians that "insurance company profits are more important than their access to healthcare."
Insurance firms and business leaders countered that the bill proposed unnecessary regulation and would have hurt the state's economic recovery.

 

Why did Governor Schwarzenegger terminate this bill?

 Read on about the current federal legislation unfolding.....He punted this one over to the U.S. Congress, and maintained ties with the insurance industry, who wield a lot of power  in California, besides health insurance.

 

SENATE PASSES HEALTH BILL  (FINANCE)

AMERICAN HEALTH INSURANCE PLANS

A.H.I.P. for short, dropped a last minute 'bomb'.

This it !    A.H.I.P. chose to announce their disfavor on a Monday morning, which also happens to be a Federal Holiday.  It also came just after the latest media news cycle closed.  Scouring my blog list I did not see any mention of this perfidity of the AHIP.

I seem to remember several months ago how the head of Wellpoint announced how they were cooperating with the reform plans.  What happened?  Perhaps they don't like the idea of offering coverage to the uninsured, the sick and ill, and whoever else they can't make a buck off of.

Deep in the recesses of their accounting departments they have now estimated that the reform measures proposed by the Senate Finance Committee would increase a family's premiums by 4500 dollars/year. I guess what they are saying is "Sure, we'll participate in reform, but it's going to cost 4500 dollars/year for most families. " GIVE US A BREAK !

Reconciliation- Health Reform

Walt Whitman writing during the civil war penned this poem about irreconciliable differences, and how they can lead to destruction.  (This puts in proper perspective the current tone of health  politic)

Reconciliation

By Walt Whitman

1819-1892

---

Word over all, beautiful as the sky,
Beautiful that war and all its deeds of carnage must in time be
utterly lost,
That the hands of the sisters Death and Night incessantly softly
wash again, and ever again, this solid world;
For my enemy is dead, a man divine as myself is dead,
I look where he lies white-faced and still in the coffin--I draw near,
Bend down and touch lightly with my lips the white face in the coffin.

 

del.icio.us Tags: health train,walt whitman,reconciliation,health reform,death

Contact your Representatives

 

Keep an eye out for a link to Healthtrain's new audio blogcast, soon to be replaced with a video blogcast.

I hope you have all been busy writing to your representatives about your opinon on health reform.  Reading the media makes one question the accurateness of what is being reported.

The Secret Meetings

The Imperial Senate

Voting for Healthcare Reform before voting against it.

America's Health Future Act  Read this important document.

And after reading it see: 

Grassfire.org

 

There are several web sites to help you contact your senator and/or congressman, and others who are key players in health  reform.

Health 2.0 Conference ver 3.0

I wanted to take a brief moment before I dash off to Health 1.0. Today marks the beginning of Health 2.0 in San Francisco. For t hose you who don't know what this is I refer you to Health2.0

Some interesting observations by Matthew Holt of  The HealthCare Blog.

What is Health 1.0 ?  It's the mess you are going to face in your office today, doctor.  I don't have to elaborate on it here. I hope you have a good day.

Meanwhile on capitol hill, things seem to have quieted down. The polls show a definite shift toward the Obama Plan (whatever that is)....The devil is in the details.  With the  recent outcry in August,  hopefully our elected representatives are reading the bill and having attorneys interpret congressional legalese.  The federal register will never be the same.

WASHINGTON (AP) - The fever has broken. The patient is out of intensive care. But if you're President Barack Obamayou can't stop pacing the waiting room. Health care...

Thanks to all of you...to the Todd Rubins, Scott Barbours, and Hal Scherz.....who participated and led the Million Med March last week.  We haven't heard anything from the doctors at the White House Rose Garden Tea Party, as yet. 

As you may know these docs were all fervent supporters of Obama's campaign for President.  Not much dissent there, and a safe bet for no demonstrations on the White House lawn. This was a real dog and pony show and a definite chance to land an autograph photo for that office wall.

Rose Garden at the White House

It’s Monday morning at 1600 Pennsylvania Avenue (The White House). President Obama has invited physician leaders to attend a meeting today regarding healthcare reform.

So, what is the agenda? There may be a hint of what will take place in an article in Medpage Today, describing Mr. Obama’s vision for health reform in America.

Here are President  Obama's  takeaway points:

"I don't believe malpractice reform is a silver bullet, but I have talked to enough doctors to know that defensive medicine may be contributing to unnecessary costs. So I am proposing that we move forward on a range of ideas about how to put patient safety first and let doctors focus on practicing medicine. I know the Bush administration considered authorizing demonstration projects in individual states to test these issues. It's a good idea, and I'm directing my Secretary of Health and Human Services to move forward on this initiative today."

"The only thing this plan would eliminate [in Medicare] is the hundreds of billions of dollars in waste and fraud, as well as unwarranted subsidies in Medicare that go to insurance companies ..."

To date, the White House has detailed hundreds of billions of dollars in cuts to the Medicare program. First, the administration outlined $634 billion in savings, about half of which would come from cuts to Medicare and Medicaid. These include elimination of overpayment to Medicare Advantage plans.

And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies -- because there's no reason we shouldn't be catching diseases like breast cancer and colon cancer before they get worse. That makes sense, it saves money, and it saves lives

There are those who claim that our reform effort will insure illegal immigrants. This, too, is false. The reforms I'm proposing would not apply to those who are here illegally"

"Some of people's concerns have grown out of bogus claims spread by those whose only agenda is to kill reform at any cost. The best example is the claim ... that we plan to set up panels of bureaucrats with the power to kill off senior citizens. It is a lie, plain and simple."

I know I will sleep much better tonight after our physician leaders meet with President Obama, knowing that our healthcare reform has been solved…

Did the Whitehouse Cherry-Pick the physicians who were invited to the Rose Garden??

Physician's for Obama

All supporters of President Obama who campaigned for his election

WHO WERE THE GATE-CRASHERS?

Another not as well known meeting today is the 

NATIONAL PHYSICIAN'S ALLIANCE PROGRAM

National Grand Rounds on Health Care Reform
Monday, October 5, 2009 12:00 PM Eastern

The meeting was held today at Columbus Square at Union Station.

To see the meeting WEBINAR, click on WEBINAR.

The meeting was sponsored by the AMSA (American Medical Student Association, and the  National Physician's Allliance Program.

Panelists included:

 

Arthur Kellerman, MD,MPH Dean for Health Policy, Emory University.

Meena Seshamani, PhD, MD
Director of Policy Analysis,
Office of Health Reform,
Director of Health & Human Services

The takeaway from both of these meetings is that we have 'their ear'. 

Physician involvement is critical, and now more than ever before, we are being heard.....WE must continue to be involved on a daily basis as legislation is developed.