A Moment of Silence for Tom Turkey

 

Health Train Express is almost to the TurkeyDepot.  I won’t be posting until Monday, November 29,2010.

I leave  you with this thought.

A Poem  for Thanksgiving

 

Thanksgiving Friends

Thanksgiving is a time
For reviewing what we treasure,
The people we hold dear,
Who give us so much pleasure.

Without you as my friend,
Life would be a bore;
Having you in my life
Is what I’m thankful for.

By Joanna Fuchs

Belly Stuffer

Thanksgiving brings a terrible chore,
'Cause I’m forced to eat and eat some more.
If I don’t eat it up right down to dessert,
I fear the cook’s feelings will surely be hurt,
So I do my part, even though I suffer;
To be a good guest, I’m a belly stuffer.

By Karl Fuchs

If you wish to learn more about the authors of these poems (two incredible people click on the “ A Poem for Thanksgiving

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Why We Do Need Or Do Not Need HIT Or EMR

 

Bad Fonts         Font you

Some of us may remember college, med school, and post graduate training.  I remember my handwriting deteriorating in medschool as I attempted the losing battle of taking hand written notes.

I also remember looking forward to the progression of chart notes and the time when I would write that last note, below.

There is no justice in this world!

 

EMR will have a profound negative effect on medical students, by reducing motivation to become an attending.

For those interested trainees you can obtain “bad handwriting font” for  EMR notes.

Health Train Express LTE 4G

G et what you pay for

G et better quality

G et government out of health care

G et more primary care physicians

Next will be:

G et EMR

This is what Health Train needs.  Perhaps this will cure what ails health care in America

The Christmas Gift we all Wish for.

 

Don’t we all wish it could be this simple?

Important News Today Top Stories

 

FDA Approves New Stem Cell Line

Advanced Cell Technology (ACT), of Marlborough, Mass., announced that it has received FDA approval to begin treating children with Stargardt's macular dystrophy using retinal cells derived from ESCs.

(Photo: A fluorescent microscope image shows human embryonic stem cells at Stanford University  March 9, 2009/California Institute for Regenerative Medicine)

 

Eat Your Fruits and Veggies

HHS Releases New Insurance Rule

 

HHS Releases Final Medical Loss Ratio Regulations

 

So Long, Darvon and Darvocet: FDA Requests Pain Meds Be Pulled

 

 

Non invasive Fat Removal

 

Has The Obama Administration Created a Monster

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Accountable Care, or Count the Care?

 

            

 

The consolidations have started. Humana announced it will purchase Concentra. Humana has been a health insurance carrier. Concentra, a privately held health care company based in Addison, Texas, delivers occupational medicine, urgent care, physical therapy and wellness services from more than 300 medical centers in 42 states. The transaction involved a cash price of 790 million dollars.Concentra earns about $800 million in annual revenue. Humana projects that the acquisition will add slightly to its earnings for the year ending Dec. 31, 2011. For Humana, the deal signals that the health insurer is branching back into its origins as a health care provider, but the new business would still amount to just a fraction of its overall revenue.

Humana entered the health insurance segment in 1984, and was a combination managed care and hospital company until 1993, when the company split in half - resulting in a hospital company and today's Humana. The hospital company was later sold.

"This builds on our caregiving heritage and offers new opportunity in a growing part of health care," Noland said in an interview. "The demand for primary care services will increase partly as a result of demographic trends, notably the aging of baby boomers, and also because of some of the incentives in the new health reform law."

Concentra, a privately held health care company based in Addison, Texas, delivers occupational medicine, urgent care, physical therapy and wellness services from more than 300 medical centers in 42 states.    Besides its medical center locations, Concentra also serves employer customers by operating more than 240 worksite medical facilities.

Humana spokesman Tom Noland said the deal announced Monday moves the company "into promising new territory." Humana already operates a few clinics in south Florida.

More than netting immediate financial gain this may signal the first major merger  stimulated by forecasts of  “Accountable Care Organizations”.

Humana’s previous experience with HMOs and managed care gives it previous experience in regulating health costs.  Then again this may fail just as HMOs failed to develop into what was  projected, and rejected by physicians. 

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ACOs Junk-it

 

The latest round of junkets for hospital administrators, management consultants, is regarding ACOs or Accountable Care Organizations. Like managed care which became renamed “mangled care”  ACOs will earn a new moniker soon as well.  I will rename it, “Anonymous Care Organization” for want of a better term. 

Who is going to run this ‘entity’ designed for who knows what? Some say it will control cost, improve outcomes, and balance the federal budget.   Some say our country will not survive without reducing the percentage of GDP utilized  by Health Care.   Health care expenditures have increasedd to somewhere between 16.0% and 17.9% of GDP according to  Market Watch, Time Magazine, and the Center for Medicare Services (CMS)  and other  bean counters. How about fixing health care expense and increasing GDP?  Much of our  problem revolves around poor productivity, lack of manufacturing capacity,  and lack of diversity in the U.S. economy.

Many features of the robust pluralistic features of American economics have gone by the wayside, the milkman, the paperboy, the corner grocery store, bakery, delicatessen, gardener’s (in the form of after-school teenagers, handymen, bookeepers, #2 pencils, yellow legal pads,   Oldsmobile's, Pontiacs, vinyl records, tubes in radios.  Much of our workforce has been moved offshore, outsourced and/or replaced by computers, software, automation,  and technology resulting in fewer productive jobs, and increased unemployment requiring increased entitlement programs and burgeoning governmental morass.

The present situation in health care is not the fault nor cause of economic stress in America.  This dysfunctional and chaotic representation by the body-politic of America diverts us all from finding the ‘cure’.

 

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Medline Plus Connect

 

Sometimes paying taxes does bring a dividend. One giant time saving feature is being offered by the National Library of Medicine for those physicians who use EMR.

Medline Plus Connect is a free service of the National Library of Medicine (NLM) and the National Institutes of Health (NIH). This service allows any electronic health record (EHR) system to easily link users to Medline Plus, an authoritative up-to-date health information resource for patients, families and health care providers. Medline Plus provides information about conditions and disorders, medications, and health and wellness.

Medline Plus Connect accepts requests for information on diagnoses (problem codes) and medications. NLM has mapped Medline Plus health topics to two standard diagnostic coding systems used in EHRs. When your EHR submits a request to Medline Plus Connect, the service returns the closest matching health topic(s) as a response.

Medline Plus Connect can also link your EHR system to drug information written especially for patients. EHR systems can send Medline Plus Connect a request for a medication code, and the service will return link(s) to the most appropriate drug information

Medline Plus Connect web site offers technical assistance for software vendors to add links to their programs linking them to Medline Plus Connect.

Medline Plus Connect offers several demonstration programs as a sample of it’s operational features.

Take it for a spin.

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Tumultuous Friday

 

From the LA Times:

Reporting from Washington —

The Senate agreed Thursday to postpone for a month a giant cut in Medicare payments to doctors that had been scheduled to take effect Dec. 1.
The bipartisan deal is expected to clear the House, sparing physicians a 23% fee cut — at least for now. Doctors who care for the elderly under the federal program will be paid at current rates until Dec. 31.
But the compromise falls short of the 13-month solution sought by physicians groups and advocates for seniors. Unless Congress passes further legislation next month, doctors will face another massive cut Jan. 1.

 

' target=_blank>The Rand Paul  Spitzer Debate

Rand Paul vs. Spitzer

 

Elliott Spitzer pressed Senator-elect Paul about how he would propose to cut the 1.6 trillion dollar deficit. Paul responded that it would take an across the board adjustment. When pressed further about cuts to doctor’s fees and health care in general he responded that doctors should not take a 30% cut alone unless it applied to all federal employees as well. ie, defense, congress, and all federal agencies. Spitzer pressed further asking Dr. (Senator) Paul what his income was last year, Paul responded that was a personal matter, inappropriate, and that he was not about to discuss Spitzer’s previous personal business either.  Paul also noted that his Medicare fees were reduced by 50% already from 1993 until the present time.

Spitzer commented that Paul was ‘filibustering”.

My comments are:  “The Apple does not fall far from the tree” Seems like Ron Paul taught his son well.

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Medicare and the SGR

 

My apologies, for the next week I will be running the same post to link to twitter and facebook to spread this  urgent message to patients.

As you may know, on December 1st, Medicare physician payments will be reduced by 23 percent if Congress fails to act. If the December 1st deadline passes without congressional intervention,  it will mark the fourth time this year that Medicare physician payments have been cut more than 20 percent. While Congress retroactively stopped these payment cuts on each occasion this year, this uncertainty has made for a very unstable financial situation for surgical practices and for the patients they serve.  
Physicians in all specialties continue to strongly advocate that Congress immediately stop these cuts, but the College needs the grassroots support of Fellows around the country. I urge you to contact your Senators and Representative to stress the importance of stopping these Medicare cuts and reforming the Medicare payment system so all Americans can continue to have access to high quality surgical care.
Please call your Senators and Representative today and tell them to act THIS WEEK to stop the 23 percent cut in Medicare physician payments from taking effect on December 1st. 

Now is the time for patients and physicians together to voice our strongest protests. This proposed adjustment has been scheduled each year for the past ten years, and then postponed each year. Stop the insanity !!

PHONE MESSAGE

As your constituent, I urge you to stop the 23 percent cut in Medicare physician payments scheduled for December 1st.

The flawed Medicare physician payment system threatens access to care for millions of patients, especially our nation's seniors and military families. Health care coverage does not equal access to care, and Congress must ensure that patients have access to the physician services they require.

All senators and congressman maintain a web site which includes an email option, subject; and also a telephone number with which to contact them

  For Senators go to www.senate.gov and search by state for your senator

For Congressman go to www.house.gov Search by name or district, click on the contact tab and you will be given a choice between email and telephone number.

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Health Train Express and the impending SGR Adjustment

As you may know, on December 1st, Medicare physician payments will be reduced by 23 percent if Congress fails to act. If the December 1st deadline passes without congressional intervention,  it will mark the fourth time this year that Medicare physician payments have been cut more than 20 percent. While Congress retroactively stopped these payment cuts on each occasion this year, this uncertainty has made for a very unstable financial situation for surgical practices and for the patients they serve.  
Physicians in all specialties continue to strongly advocate that Congress immediately stop these cuts, but the College needs the grassroots support of Fellows around the country. I urge you to contact your Senators and Representative to stress the importance of stopping these Medicare cuts and reforming the Medicare payment system so all Americans can continue to have access to high quality surgical care.
Please call your Senators and Representative today and tell them to act THIS WEEK to stop the 23 percent cut in Medicare physician payments from taking effect on December 1st. 

Now is the time for patients and physicians together to voice our strongest protests. This proposed adjustment has been scheduled each year for the past ten years, and then postponed each year. Stop the insanity !!

PHONE MESSAGE

As your constituent, I urge you to stop the 23 percent cut in Medicare physician payments scheduled for December 1st.

The flawed Medicare physician payment system threatens access to care for millions of patients, especially our nation's seniors and military families. Health care coverage does not equal access to care, and Congress must ensure that patients have access to the physician services they require.

All senators and congressman maintain a web site which includes an email option, subject; and also a telephone number with which to contact them

  For Senators go to www.senate.gov and search by state for your senator

For Congressman go to www.house.gov Search by name or district, click on the contact tab and you will be given a choice between email and telephone number.

del.icio.us Tags: congress,house of representatives,senate,sustainable growth rate,cms,medicare

A Look Down the Road at Medicare Cuts

Moody’s Investor’s Report:

Doctor, your credit score will suffer. You will freeze plans for investing in capital assets, personnel, EMRs, and new equipment leases.

There will be multiple and extended domino effects triggered by health insurance reform. I do not believe anyone should call the APPA health care reform.  It is clearly not so.

Medicare pays more than $300 billion to providers annually, covering the care of more than 40 million Americans. About 70% of corporate health providers rely on Medicare and Medicaid for more than one-third of their revenue.

Certain industries stand to face the sharpest cuts in government money, Moody’s says, namely home health, as well as oxygen and durable equipment companies. Hospice care, nursing homes and specialty hospitals are also expected to lose millions off what they receive now. Moody’s says we can expect consolidation in health industries, as providers acquire different health-care entities to diversify.

The entities less likely to face severe trims: inpatient hospitals, contrary to what hospital associations and most CEO’s complain about. Moody’s buttresses their point with a list of for-profit hospital entities that have been assigned stable outlooks. The report doesn’t measure what these cuts might mean for already struggling nonprofits.

• What and Who They Won't Cut wrote:  commentary from the WSJ article.

Due to massive inflows of corporate cash into the offices of our Congress People the Following Hundreds of Billions of Dollars of Competition Killing Direct and Indirect Government Subsidies will Never Be Cut or Taken Away from the Insurance Companies….

1) Medicare Part D subsidies for insurance and drug companies.
2) Medicare Advantage subsidies for insurance companies.
3) A Federal ban on Medicare Insurance Bidding on a drug formulary through competitive bidding.
4) A federal exemption for private health insurance companies from antitrust regulations allowing them to collude against patients, doctors and hospitals.
5) A ban on Federal grants to develop a single EMR and billing system for physicians, hospitals and therapists which would reveal clinical, preventative and surgical outcomes. Outcome revelations would crush the health insurance companies, and allow for free-market competition among doctors and hospitals based on quality and efficiency.
6) Continued protection of private health insurance companies from medical malpractice lawsuits via federal ERISA laws.
7) Continued reckless and negligent medical rationing by private health insurance companies via their non-physician employees.
8) A continued government ban on collective bargaining by physicians.
9) An inability of Medicare to enlarge its limited risk pool beyond that of the most expensive oldest, sickest and most physically disabled citizens of our nation thereby insuring the bankruptcy of our most effective and least rationed health insurance product for the elderly.
10) A continued allowance of 1.25 million personal bankruptcies due to a medical illness.
11) Continued real change in malpractice reform. Real malpractice reform would allow internists and family practitioners to fulfill their role as primary care physicians efficiently and productively, tackling dynamic illnesses without prematurely referring their sicker patients to expensive specialists without medical benefit.

So what, in typical corrupt government fashion, the higher powers of our bribed public officials have declared war on oxygen vendors, super specialty hospitals, home health, durable wheelchair and bed equipment companies, those who comfort the dying in hospice care, and those who care for the senile and feeble in nursing homes. Moody’s says we can expect consolidation in health industries this is to be expected…bigger insurance companies protected from collusion/anti trust laws, and ever shrinking quality of care due to health care rationing by insurance companies for bondholder and shareholder and executive benefits.

Shame

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Statistics From United Nations International Health Organization

 

It seems there is a serious discrepancy being bandied about by our health reformers.  In this report from the U.N.I.H.O. their proclamations about quality and availability of health care in the United State do not match these statistics

A recent “Investor’s Business Daily” article provided very interesting
statistics from a survey by the United Nations International Health
Organization.

Percentage of men and women who survived a cancer five years after diagnosis:
U.S. 65%
England 46%
Canada 42%

Percentage of patients diagnosed with diabetes who received treatment within six months:
U.S. 93%
England 15%
Canada 43%

Percentage of seniors needing hip replacement who received it within six months:
U.S. 90%
England 15%
Canada 43%

Percentage referred to a medical specialist who see one within one month:
U.S. 77%
England 40%
Canada 43%

Number of MRI scanners (a prime diagnostic tool) per million people:
U.S. 71
England 14
Canada 18

Percentage of seniors (65+), with low income, who say they are in “excellent health”:
U.S. 12%
England 2%
Canada 6%

I don’t know about you, but I don’t want “Universal Healthcare” comparable
to England or Canada .

for more information

Some criticism may be valid as to the origins of these figures. (see commentary)

Health Reform for Idiots, or Chicken Soup for Health Reform

I found a very nice simple animated explanation which distilled 1200 pages of the Health Reform Act.

A terrific little animated video created by the Kaiser Family Foundation surfaced today, explaining in layman's language what's in store for us with the recently passed Health Reform Law.

Narrated by the wonderful Cokie Roberts, this video attempts to simplify the vastly complex law, with the emphasis on those portions of the bill that impact us as regular folks and as healthcare providers.

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