Friday, December 28, 2012

The Health Reform Law and What will Happen to It

 

Some  are jumping for joy and dancing in the halls thinking, “Well I am glad that is over with.” Obamacare is now the   law of the land.

Many in Congress abdicated their responsibility either  by not  reading the  PPACA bill before  voting, or misguided to vote for it by others.

The decision was purely  a partisan decision passed  only because Democrats controlled the congress in both the Senate and the House of Representatives.

The one pervading evil of democracy is the tyranny of the majority, or rather of that party, not always the majority, that succeeds, by force or fraud, in carrying elections.

The History of Freedom in Antiquity, 1877

Close to 50% of the legislature were not enthusiastic about this law. The rights of the  minority were clearly ignored by the  majority, without any  consideration of the impact on the minority 1 .

Click  on   the image

 

In  addition  to the  basic  civics lesson,  there are   many  specifics regarding PPACA, which remain troubling.

A Resistance Movement Rises Against ObamaCare

(Grace-Marie Turner)

“Though approval of the unpopular law stood at only 38% on Nov. 6, the elections were not a referendum on ObamaCare mainly because Governor Romney was unable to prosecute the case against its most despised provisions – the individual mandate, employer mandate and state-run health exchanges – since all were in the law he signed in Massachusetts.

With the election over and no chance President Obama will sign legislation repealing the law, implementation is proceeding. But the ObamaCare Resistance Movement has begun. Some examples:

Congress: “ObamaCare has to go,” wrote House Speaker John Boehner. He said, “There are essentially three major routes to repeal of the president’s law: the courts, the presidential election process and the congressional oversight process. With two of those three routes having come up short, the third and final one becomes more important than ever.” He pledged “vigorous oversight” and said House committees are already conducting investigations of possible improper spending.

Governors: The health law relies on states to expand insurance coverage through Medicaid and to set up bureaucracies, called exchanges, through which new health insurance subsidies will be distributed. Governor Bobby Jindal wrote a letter to the Department of Health & Human Services explaining why Louisiana will not be creating a state ObamaCare exchange:  (“The full extent of damage the [Patient Protection and Affordable Care Act] causes to small businesses, the nation’s economy, and the American health care system will only be revealed with time. The State of Louisiana has no interest in being a party to this failure,” he wrote.

 

At least 21 states have said they definitely or probably will not set up state exchanges, with Ohio, Wisconsin, Maine, Nebraska, South Carolina, Georgia and Indiana most recently joining the opposition.

Businesses: Companies with more than 50 employees are searching for ways to avoid the penalties for not complying with the law’s employer mandate. They must either provide government-approved health insurance or pay a fine of $2,000 for each full-time worker.But companies can escape the fines if they make the painful decision to cut workers to part-time – defined in the law as less than 30 hours a week. (certainly  not an option where unemployment remains   high and shows little real evidence for improvement.

Religious leaders: The Obama Administration’s decision to force employers to provide access to contraception, abortion-inducing drugs and sterilization at no cost to their employees has prompted 40 lawsuits by Catholic dioceses and other organizations claiming it violates their First Amendment protection of religious liberty.

Although churches themselves are exempt, the mandate applies to religiously affiliated hospitals, colleges, charities and social service agencies. Cardinal Timothy Dolan recently said the Catholic Church will “not obey” the Obama Administration’s HHS mandate, a policy he classified as “immoral.”

There are three major   constituencies opposed to implementation of Obamacare; Religious, Business, Governors and Congress

There is  much more to play out in the next 12   months.  The current plan is brittle, subject to much criticism and lack of faith in it’s ability to perform as mandated. “(end quote)

 

1. Tyranny of  the Majority (The phrase "tyranny of the majority" (or "tyranny of the masses"), used in discussing systems of democracy and majority rule, envisions a scenario in which decisions made by a majority place its interests so far above those of an individual or minority group as to constitute active oppression, comparable to that of tyrants and despots.)

 

National Library of Medicine How to Analyze Your Internet Information Source

 

Health Train Express began publishing in 2004. The  internet and platforms have changed radically since then, and so too has healthcare. Not so silently EMR and EHR have been adopted by many physicians   in some form or other. Social media has exploded  in the last 24   months and is being used by early adopters in very creative ways, adhering at all times to  HIPAA regulations. While social media can be used for many   innovative and creative ways in healthcare, it cannot be used for direct patient care.

Telemedicine has arrived, and coincidentally the development of affordable web cameras, increased processing power in consumer electronics and more widespread affordable high speed broadband. Commercial consumer video conferencing platforms are sprouting. One innovative entrepreneur has even developed a multilevel marketing business model. The subscription service fee is $29.oo a month and that fee is waived if users bring in three additional recruits. There is the option to partner and develop a residual revenue stream. (not required). The service offers a 24 hour “hotline” and 800 board certified physicians to either deal with the questions via emai, telephone, or videoconference. If the online MD is unable to make a decision or it is recommended that a clinic visit is necessary the patient is referred to a local MD. Physicians may also join the network with the same residual income plan. It is HIPAA compliant and the infrastructure  is on MDlive.com. Webdocs Network however is a separate VAR (Value Added Retailer).

Today the information overload is considerable. Searches on Google will result in millions of ‘hits” much of   it  promoted, enhanced by search engine optimization to increase the chances of being listed on the first page of Google Search results.

HHS, CMS, hospitals and   providers alike have developed web presence directed at providers and patients as well.  Mayo  Clinic  has offered a ‘Residency in Social Media” This, originating from a high quality and credible  institution has bolstered and encouraged social  media applications for physicians stressing   HIPAA compliance

Users at any level of experience can benefit greatly from a National Library of Medicine video tutorial .

Medline (A service of the National Library of Medicine) also offers a series of Video Tutorials on many subjects

 

Wednesday, December 26, 2012

What Happened to 2012 ?

 

It’s that time of the year between  Christmas and the  New Year to assess events of 2012, successes and   failures, and also to predict for 2013.

Which events rank highest  for you ?  Rank them in order,  high to low.

Health Reform

Health Related  Technology

Social  Media

Career  plans and changes

Political events

Economy

Health Train Express is  curating your well thought out answers and will publish results on  December 30, 2013.

Send your opinion   to  Facebook    Google +  Twitter/glevin1   or   email  digitalhheallthspace@gmail.com

 

What Happened to 2012 ?

 

It’s that time of the year between  Christmas and the  New Year to assess events of 2012, successes and   failures, and also to predict for 2013.

Which events rank highest  for you ?  Rank them in order,  high to low.

Health Reform

Health Related  Technology

Social  Media

Career  plans and changes

Political events

Economy

Health Train Express is  curating your well thought out answers and will publish results on  December 30, 2013.

Send your opinion   to  Facebook    Google +  Twitter   or   email  digitalhheallthspace@gmail.com

 

Monday, December 24, 2012

A Social Media Holiday !

 

Health Train Express will be silent until December 26th. For those who may be overwhelmed with this “fiscal cliff” take measure in this musical feast. Enjoy the time with family !

 

Just a tiny Scratch….or is it?

 

 

Visit NBCNews.com for breaking news, world news, and news about the economy

It’s a crowded day in the emergency department . All the beds are full, the waiting room also a line  has formed at the registration desk. It’s also the flu season when high fevers, stomach aches and sore throats which are prevalent at certain times of the  year. Perhaps for every 1000 patients presenting with a triad of routine symptoms such as these only 1 may have a serious life threatening illness.

Mixed in with these routine sounding cases are trauma,overdoses, cardiac events, broken bones and other acute surgical illnesses.  Physicians balance their time efficiently assessing severity of illness, complexity of diagnosis and care with the need to go through possibly a hundred patients/shift. Insurance companies frown upon ED visits since they are expensive as compared to office visits.

So physicians tread a narrow line between being overly cautious and moving briskly with their patients.

The story above has set into motion a call for standards in the ED where events can overtake process.

This should be included in the ‘never events’ algorithm…..no one leaves the ED without their laboratory results in hand…in addition to their presumptive diagnosis, referred to doctor, and instructions with warnings to watch for.

 

Sunday, December 23, 2012

Health Care Apocalypse December 23, 2012

 

Whatever took place with healthreform the past two years will pale when compared to the next three years, when the plan unfolds.

Congress did  not (Democrats?) read the bill prior to passing it without regard to its content.  Yet the public did not hold congress accountable for it’s irresponsible passage of PPACA.  I am more flabbergasted than ever.  All the things I was taught in school, college, medical school are not there any more. Few really know or even respect our fundamental foundation for true freedom.

It is no wonder our youth are confused about what is right or wrong.   You can make up your own minds.  Those are my thoughts.

We don’t need a Mayan Apocalypse…..we have an American Apocalypse.

I am not certain if anything can be done to alleviate the financial pain and health system compromise at this point.  At some point the reservoir is empty. Our choice is simple but painful….stop spending now.  Our system needs to recover economically. Re-inventing health system paradigms will not work. It requires huge investment of sums we no longer have.  The billions of dollars HHS and congress have earmarked in incentives will in the long run yield only mountains of data, which may be inaccurate at the worst, misleading at the least, and ultimately wasted.

Survival

We talk a lot about fixing healthcare, but none of it matters if the people delivering care cannot survive the system themselves. More than ...