Dear Friends and Colleagues:
Attached two letters to the editor published in the Miami Herald. The first by our very own Dr. Arthur Palamara cautions against the expansion of the Medicaid reform program into Miami-Dade County.His letter from April 22nd is a response to the letter from Representative Galvano published on April 19th.
I congratulate Dr. Palamara to his pointed response. We have to be careful to let ideology trump reason. Based on the best evidence the current Medicaid pilot program in Broward county has not met the expectations, or (less euphemistically) has failed.
We should not jump on the Medicaid reform bandwagon but review the results of the current pilot.
Further reform implementation should be based on facts and not wishful thinking. We need to solve the problem of Medicaid financing and protect healthcare for those in need.Our voices need to be heard and I encourage you to particiapte in the political debate.
Yours
Bernd
Posted on Tue, Apr. 22, 2008
Flaws in Medicaid
Re state Rep. Bill Galvano's April 19 letter, Expand Medicaid reforms: His assumptions of improved care for Medicaid patients are unsubstantiated. If anything, the contrary is true. Medicaid has regressed from a coordinated system of services to one that is highly fragmented, erecting innumerable obstacles for patients and providers.
Transfering healthier patients into for-profit HMOs leaves sicker and more-debilitated patients in the public-supported Provider Service Networks (PSNs).
Escalating costs suggest that neither of the two Broward Hospital District's PSNs will participate within a year.
While Medicaid reform may look good on paper, Broward's experience suggests that it does not function as designed. The Florida inspector general and the regulatory Agency for Health Care Administration recommend that the program not be expanded until additional data are accrued.
While the Legislature's desire to curb expense is appropriate, its parsimony should not be borne on the backs of Florida's most vulnerable patients.
ARTHUR E. PALAMARA, M.D., Hollywood
Posted on Sat, Apr. 19, 2008
Expand Medicaid reforms
More than 400,000 residents of Miami-Dade County depend on Medicaid. They have limited resources; many of them have serious, chronic disease or disabilities. They have no other source of healthcare coverage. They need and deserve our help -- not just more money, but better care and better results.
It is time to expand Medicaid reform to Miami-Dade because reform offers a better way. The current Medicaid system is flawed. Although Medicaid seems to offer an extensive menu of services, access is uncertain, coordination is random and outcomes are unknown.
Medicaid reform puts patients first. In current reform areas, participants have more plan choices. When they select a plan, they are choosing a unique set of benefits. Reform plans are offering new services -- the first time Medicaid ever expanded services without additional funding. Preventive dental care for adults and over-the-counter drugs are two of the most popular add-ons.
In the second year of reform, four plans expanded the extras and four more added benefits. Reform plans also reduced patient cost-sharing. Reform offers incentives for healthy behaviors. The key to making Medicaid serve patients better is to make the patients themselves the bellwether of success.
To bring state spending back within bounds, Medicaid funding -- now 27 percent of Florida's budget -- must be reduced. We can cut eligibility, eliminate services or reduce prices. Medicaid reform offers a better way by providing incentives for innovations that deliver services more efficiently and effectively and the tools to manage Medicaid in a way that best serves both patients and taxpayers.
REP. BILL GALVANO, chair, state House Committee on Healthy Families, Bradenton
Tuesday, April 22, 2008
Wednesday, April 09, 2008
Mental Health Parity
Dear Friends and Colleagues:
Representative Ed Homan (R-Tampa) has been tirelessly working on a Mental Health Parity Bill.
Today, it passed with 18-Yeas and )-Nays the Healthcare Council.
House Bill 19 amends s. 627.6688, F.S., to add substance-related disorders to the mandated offering required
by that section. The bill repeals s. 627.669, F.S., which imposes a mandated offering for substance abuse
services. The bill further amends s. 627.6688, F.S., to specifically define those mental health conditions that
must be covered within the mandated offering, generally including all diagnostic categories of mental health
conditions listed in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders and as
listed in the mental and behavioral disorders section of the current International Classification of Diseases.
The bill deletes current law limiting mental health benefits by specific service areas, such as inpatient benefits,
and inserts a general statement that the mental health benefits may not be more restrictive than the treatment
limitations and cost-sharing requirements that are applicable to other diseases, illnesses, and medical
conditions.
The bill mandates that the parity requirements be separately applied to each benefit package offered by an
employer.
The bill would have an indeterminate negative fiscal impact on the State Employees’ Group Health Self-
Insurance Trust Fund.
The effective date of the bill is January 1, 2009.
For more detailed information please visit http://edhoman.com/public/parity.html
Bill Number: 0019
Bill Name: HB 19
Action: Favorable With Council Substitute
Committee: Healthcare Council
Location: Morris Hall (17 HOB)
Duration: 3.50
Date: 4/8/2008 8:30:00 AM
Sponsor: Homan (CO-SPONSORS) Anderson; Brandenburg; Brisé; ...
Subject: Coverage for Mental, Nervous, and Substance-relate...
Y Anderson Y Galvano Y Harrell Y Patronis Y Schwartz
Y Ausley Y Garcia, R. Y Hays Y Porth Y Skidmore
Y Bean Y Gibson, H. Y Hooper Y Roberson Y Zapata
Y Cusack Y Grimsley Y Hudson
Total Yeas: 18 Total Nays: 0 Total Missed: 0 Total Votes: 18
Please contact your legislator to thank them for their support and encourage them to move this bill forward for final passage.
Also contact Rep. Ed Homan to express your support for his efforts and contribute to his campaign.
Yours
Bernd
Representative Ed Homan (R-Tampa) has been tirelessly working on a Mental Health Parity Bill.
Today, it passed with 18-Yeas and )-Nays the Healthcare Council.
House Bill 19 amends s. 627.6688, F.S., to add substance-related disorders to the mandated offering required
by that section. The bill repeals s. 627.669, F.S., which imposes a mandated offering for substance abuse
services. The bill further amends s. 627.6688, F.S., to specifically define those mental health conditions that
must be covered within the mandated offering, generally including all diagnostic categories of mental health
conditions listed in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders and as
listed in the mental and behavioral disorders section of the current International Classification of Diseases.
The bill deletes current law limiting mental health benefits by specific service areas, such as inpatient benefits,
and inserts a general statement that the mental health benefits may not be more restrictive than the treatment
limitations and cost-sharing requirements that are applicable to other diseases, illnesses, and medical
conditions.
The bill mandates that the parity requirements be separately applied to each benefit package offered by an
employer.
The bill would have an indeterminate negative fiscal impact on the State Employees’ Group Health Self-
Insurance Trust Fund.
The effective date of the bill is January 1, 2009.
For more detailed information please visit http://edhoman.com/public/parity.html
Bill Number: 0019
Bill Name: HB 19
Action: Favorable With Council Substitute
Committee: Healthcare Council
Location: Morris Hall (17 HOB)
Duration: 3.50
Date: 4/8/2008 8:30:00 AM
Sponsor: Homan (CO-SPONSORS) Anderson; Brandenburg; Brisé; ...
Subject: Coverage for Mental, Nervous, and Substance-relate...
Y Anderson Y Galvano Y Harrell Y Patronis Y Schwartz
Y Ausley Y Garcia, R. Y Hays Y Porth Y Skidmore
Y Bean Y Gibson, H. Y Hooper Y Roberson Y Zapata
Y Cusack Y Grimsley Y Hudson
Total Yeas: 18 Total Nays: 0 Total Missed: 0 Total Votes: 18
Please contact your legislator to thank them for their support and encourage them to move this bill forward for final passage.
Also contact Rep. Ed Homan to express your support for his efforts and contribute to his campaign.
Yours
Bernd
Tuesday, April 08, 2008
OUR AMA IS THE VOICE FOR THE UNINSURED
Dear Friends and Colleagues:
Massive healthcare cuts on state level will further increase the number of Americans without health insurance. Now, the burden has fallen to cities and counties to tackle the growing problem that prevents millions of people from getting timely medical care.In Dade County almost 30% of all residents lack healthinsurance coverage. As a physician and citizen I will not remain silent! In my practice almost ALL of my patient have no health insurance and the number is growing every day. I am seeing more patients every day and many of my clients represent hardworking and lawabiding men and women. They desperately try to make a living amidst sharply increasing costs for food, mortgage, utilities and gas. They do not qualify for Medicaid but can't afford health insurance. They often ask me," Who speaks up for me?"
Now we can proudly answer that OUR AMA is stepping up to the challenge and has released a Health Insurance Reform proposal that can truly address the problem. As an AMA Delegate I have started to speak about the plan and just today spoke at a meeting of a local Democratic Party Club.
Most have never heard about the plan. The questions after the presentations reflect great interest and cautious support.
I encourage each of you to read about the proposal (http://www.ama-assn.org/ama/pub/category/17712.html) which hinges on three elements: 1) Tax credits instead of tax exclusion and subsidy for the high federal income tax brackets, 2) Individually Selected and Owned Health Insurance, 3) Development of New Health Insurance Markets.
Consumer choice is the cornerstone of the AMA's proposal to expand coverage. The AMA plan would limit the role of government to those who cannot afford any insurance, avoiding a one-size-fits-all approach.
The plan is not be perfect but can serve as a platform for discussion and can be amended or expanded.
I am developing a power point presentation about the proposal for the lay audience and am happy to share it with any of you.
As AMA members we should all engage in informing our patients, our families and legislators about this proposal.
Now is NOT the time to question if we have a problem with uninsured Americans but to focus on how to resolve the problem.
Our FMA should be an active partner in this campaign and not stand on the sidelines questioning the validity of the number of uninsured. Realism is the only -ism we should pursue. Our contribution to solve this problem will promote our public image!
I am carrying the message to community groups, the chambers of commerce and to anyone who wants to listen and debate the issue on a rational basis.
Now its your turn! Join us in this campaign!
Yours
Bernd
FOR MORE INFORMATION SEE:
* http://www.ama-assn.org/ama/pub/category/18351.html
* http://www.ama-assn.org/ama/pub/category/17712.html
* http://jama.ama-assn.org/cgi/content/full/291/18/2237
Massive healthcare cuts on state level will further increase the number of Americans without health insurance. Now, the burden has fallen to cities and counties to tackle the growing problem that prevents millions of people from getting timely medical care.In Dade County almost 30% of all residents lack healthinsurance coverage. As a physician and citizen I will not remain silent! In my practice almost ALL of my patient have no health insurance and the number is growing every day. I am seeing more patients every day and many of my clients represent hardworking and lawabiding men and women. They desperately try to make a living amidst sharply increasing costs for food, mortgage, utilities and gas. They do not qualify for Medicaid but can't afford health insurance. They often ask me," Who speaks up for me?"
Now we can proudly answer that OUR AMA is stepping up to the challenge and has released a Health Insurance Reform proposal that can truly address the problem. As an AMA Delegate I have started to speak about the plan and just today spoke at a meeting of a local Democratic Party Club.
Most have never heard about the plan. The questions after the presentations reflect great interest and cautious support.
I encourage each of you to read about the proposal (http://www.ama-assn.org/ama/pub/category/17712.html) which hinges on three elements: 1) Tax credits instead of tax exclusion and subsidy for the high federal income tax brackets, 2) Individually Selected and Owned Health Insurance, 3) Development of New Health Insurance Markets.
Consumer choice is the cornerstone of the AMA's proposal to expand coverage. The AMA plan would limit the role of government to those who cannot afford any insurance, avoiding a one-size-fits-all approach.
The plan is not be perfect but can serve as a platform for discussion and can be amended or expanded.
I am developing a power point presentation about the proposal for the lay audience and am happy to share it with any of you.
As AMA members we should all engage in informing our patients, our families and legislators about this proposal.
Now is NOT the time to question if we have a problem with uninsured Americans but to focus on how to resolve the problem.
Our FMA should be an active partner in this campaign and not stand on the sidelines questioning the validity of the number of uninsured. Realism is the only -ism we should pursue. Our contribution to solve this problem will promote our public image!
I am carrying the message to community groups, the chambers of commerce and to anyone who wants to listen and debate the issue on a rational basis.
Now its your turn! Join us in this campaign!
Yours
Bernd
FOR MORE INFORMATION SEE:
* http://www.ama-assn.org/ama/pub/category/18351.html
* http://www.ama-assn.org/ama/pub/category/17712.html
* http://jama.ama-assn.org/cgi/content/full/291/18/2237
Wednesday, April 02, 2008
Physicians Ranking
"The Patient Charter drafted by the Consumer-Purchaser Disclosure Project requires health insurers to be more transparent and balanced when providing information to patients. These crucial principles offer hope that patients will be able to trust the information to make informed health care choices. Safeguards must ensure that physician rating information does not result in reduced access to care or disrupt patients' longstanding relationships with their physicians.Efforts by health insurers to rate physicians must not be driven solely by costs and economics. The primary goal of these programs must be to promote quality care using meaningful measures. The AMA has long been involved in these efforts through the Physician Consortium for Performance Improvement and National Quality Forum."
Dear Friends and Colleagues;
Attached you find a recent press release from the AMA regarding the Consumer-Purchaser Disclosure Project.
In this press release the AMA supports the coalition's call for transparency and accurate reporting among health insurers
I applaud our AMA to take this proactive approach and to call for an opening of the insurance companies physician rating programs for careful evaluation to assess accuracy, integrity and fairness.
As physicians we need to collaborate on establishing an accurate and transparent quality measurement and reporting system that provide our patients with an objective yardstick to measure and rank their physicians performance.
Yours
Bernd
AMA Delegate
==============================================================================================================
For immediate release
April 1, 2008
Statement attributed to:
Nancy Nielsen, MD
AMA President elect
"The American Medical Association applauds efforts by the Consumer-Purchaser Disclosure Project to raise the bar on the reliability and validity of information that health insurers provide to patients.
"The Patient Charter drafted by the Consumer-Purchaser Disclosure Project requires health insurers to be more transparent and balanced when providing information to patients. These crucial principles offer hope that patients will be able to trust the information to make informed health care choices. Safeguards must ensure that physician rating information does not result in reduced access to care or disrupt patients' longstanding relationships with their physicians.
"Efforts by health insurers to rate physicians must not be driven solely by costs and economics. The primary goal of these programs must be to promote quality care using meaningful measures. The AMA has long been involved in these efforts through the Physician Consortium for Performance Improvement and National Quality Forum.
"Instead of tiered and narrow networks, the AMA believes that providing valid data to physicians and patients will better improve the quality and efficiency of care.
"The work of the Consumer-Purchaser Disclosure Project reinforces the need to protect access to care and the patient-physician relationship by requiring insurers to open their physician rating programs for careful evaluation to assess accuracy, integrity and fairness.
"Although additional work must be done to accurately and fairly evaluate the individual work of physicians, the AMA sees the Patient Charter as an important step in the right direction and we offer our assistance in ensuring its criteria are appropriate and measurable."
###
Dear Friends and Colleagues;
Attached you find a recent press release from the AMA regarding the Consumer-Purchaser Disclosure Project.
In this press release the AMA supports the coalition's call for transparency and accurate reporting among health insurers
I applaud our AMA to take this proactive approach and to call for an opening of the insurance companies physician rating programs for careful evaluation to assess accuracy, integrity and fairness.
As physicians we need to collaborate on establishing an accurate and transparent quality measurement and reporting system that provide our patients with an objective yardstick to measure and rank their physicians performance.
Yours
Bernd
AMA Delegate
==============================================================================================================
For immediate release
April 1, 2008
Statement attributed to:
Nancy Nielsen, MD
AMA President elect
"The American Medical Association applauds efforts by the Consumer-Purchaser Disclosure Project to raise the bar on the reliability and validity of information that health insurers provide to patients.
"The Patient Charter drafted by the Consumer-Purchaser Disclosure Project requires health insurers to be more transparent and balanced when providing information to patients. These crucial principles offer hope that patients will be able to trust the information to make informed health care choices. Safeguards must ensure that physician rating information does not result in reduced access to care or disrupt patients' longstanding relationships with their physicians.
"Efforts by health insurers to rate physicians must not be driven solely by costs and economics. The primary goal of these programs must be to promote quality care using meaningful measures. The AMA has long been involved in these efforts through the Physician Consortium for Performance Improvement and National Quality Forum.
"Instead of tiered and narrow networks, the AMA believes that providing valid data to physicians and patients will better improve the quality and efficiency of care.
"The work of the Consumer-Purchaser Disclosure Project reinforces the need to protect access to care and the patient-physician relationship by requiring insurers to open their physician rating programs for careful evaluation to assess accuracy, integrity and fairness.
"Although additional work must be done to accurately and fairly evaluate the individual work of physicians, the AMA sees the Patient Charter as an important step in the right direction and we offer our assistance in ensuring its criteria are appropriate and measurable."
###
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