Saturday, September 26, 2009

Leaving the FMA


Dear James:
I hope that you are doing well.
For several months now I witness the relentless anti-AMA rhetoric applied by the FMA leadership and the continuous attacks on any meaningful healthcare reform efforts which are sorely needed. I am also outraged that you continue to ignore the reality of the growing number of uninsured in Florida calling it a "myth."
In Miami we reached a 36% Uninsured rate and in Hialeah alone 56%!!! This is not a myth but REALTY! Not only does this trend challenges our public health but also adversely affects the financial viability of medical practices and hospitals and we must find a solution to this problem!!
After long deliberations I finally reached the conclusion that I have no place in the FMA. I fundamentally disagree with the FMA policies and am especially appalled by the vitriolic criticism of the AMA. It already triggered an increase in the AMA member non-renewal rate and will further diminish our representation within the AMA House of Delegates. This criticism is especially difficult to understand because Cecil Wilson is the AMA's President Elect! Why are we stabbing him in the back? Therefore, I relinquish my membership privileges effective immediately. I am saddened that I was forced making this decision but I see no other option.
Stay well.
Yours truly,

Sunday, September 20, 2009

Ed Annis,MD: A Final Goodbye

Dear Friends and Colleagues:

Today, on the first day of Rosh Hashana, I attended the Memorial Service for Dr. Edward R. Annis who passed away on September 14th, 2009.
Ed's service was attended by many friends and fellow physicians including senior AMA representatives Drs. Hove,Heyman and Wilson.
Cecil gave a moving eulogy followed by very personal presentations of family members including Dr. Joe Annis. Ed's touched so many peoples hearts and minds but remained a humble and faithful person. I remember him as a patient listener who always provided me with advice and guidance. He had the ability to accept and tolerate other opinions and lead by example. I will never forget him and the seed he planted in my heart and mind will continue to grow. Thank you Ed.

Yours truly,

Friday, September 11, 2009

Healthcare Reform: A Different Perspective

New uninsured figures show Massachusetts, touted as model for national reform, is failing to cover the uninsured

17,000-member organization of physicians says latest numbers understate the problem and show urgent need for single-payer health reform

Official estimates released this morning by the Census Bureau showing a marginal increase in the number of Americans without health insurance in 2008 - now estimated at 46.3 million, up from 45.7 million in 2007 - masks the true dimensions of the problem, a national doctors' group said.

Significantly, in Massachusetts, where an individual-mandate health reform law, much like what President Obama is proposing on a national scale, was passed in 2006, at least 352,000 people, or 5.5 percent of the population, remained uninsured in 2008. That number was actually (but non-significantly) higher than the number of uninsured in 2007, before strict enforcement of the individual and employer mandates went into effect.

"The legislation championed by the president and the congressional leadership is a virtual clone of the Massachusetts plan," said Dr. Steffie Woolhandler, professor of medicine at Harvard Medical School and co-founder of Physicians for a National Health Program (PNHP). "Today's numbers show that plans that require people to buy private insurance don't work. Obama's plan to replicate Massachusetts' reform nationally risks failure on a massive scale."

Woolhandler said last year's job losses in the recession, and the corresponding loss of health coverage by many workers and their families, are inadequately reflected in the new data. An estimated 2.6 million people lost their jobs in 2008, most of them toward the end of the year. Those who lost insurance at the end of the year would probably be counted as insured in the Census data, she said.

Census officials cited a drop of 1.1 million in the number of persons who were covered by employer-based insurance, continuing an 8-year trend. Whereas 64 percent of Americans had employer-based coverage in 1999, only 58.5 percent had such coverage in 2008.

Dr. Quentin Young, national coordinator of PNHP, said had it not been for a leap of approximately 4.4 million people newly covered by government programs like Medicaid and Medicare, the overall uninsured rate would have set a new record.

Young said the "tragic and painful persistence" of tens of millions of uninsured persons in the country is "completely unacceptable" and underscores the urgency of enacting a Medicare-for-all program.

"The only way to solve this problem is to insure everyone," he said. "And the only way to insure everyone is to enact single-payer national health insurance, an improved Medicare for all. Even President Obama has acknowledged this fact."

Young noted that Rep. Anthony Weiner, D-N.Y., is introducing an amendment to the House leadership's health reform bill, H.R. 3200, which would essentially delete its present language and substitute the language of Rep. John Conyers' single-payer bill, H.R. 676. "It's not too late for Congress to do the right thing," Young said.

Dr. Don McCanne, senior policy fellow at PNHP, noted that the Census Bureau was once again silent on the pervasive problem of "underinsurance." People are usually defined as underinsured if they spend 10 percent or more of their income (or 5 percent if they are low-income) on out-of-pocket medical expenses in the course of a year.

"Not having health insurance, or having poor quality insurance that doesn't protect you from financial hardship in the face of medical need, is a source of mounting stress, anguish and poor medical outcomes for people across our country," McCanne said. He noted that a recent study showed 62 percent of personal bankruptcies in the U.S. are now linked to medical bills or illness and three-quarters of those who went bankrupt had insurance when they got sick.


State-by-state data on the uninsured from 2005-2009 can be found here:

For more information on Massachusetts, see:

Physicians for a National Health Program (, a research and educational organization of over 17,000 physicians, supports a single-payer national health insurance program. To contact a physician-spokesperson in your area, visit or call (312) 782-6006.

Sunday, September 06, 2009

Senator Nelson and the Public Option

UU.S. Sen. Nelson says “public option is dead,” believes Co-Ops will be possible alternative for nation’s 47 million medically uninsured

U.S. Sen. Bill Nelson, D-FL at the Greater Miami Chamber of Commerce monthly luncheon Wednesday said when it came to a comprehensive change in health care delivery and medical insurance being debated around the country, the Senate; a smaller body will likely craft much of the final product and believes it will involve the use of medical insurance “co-ops that are owned by the policy owners.”
Senator Nelsons support for a co-op sounds more like a cop out.
What does he really support? Few politicians can clearly define either of both entities. The only thing they know that it’s politically less risky to use the term co-op than the perceived evil word “public option.”
So what would it be? Insurance co-ops or health insurance purchasing co-ops?
An insurance co-op requires sustained funding, must develop a large network of providers offering discounted health care services, develop brand identity, figure out how to handle claims, develop actuarial expertise, establish reserves, meet state licensing requirements and solvency requirements. Once a co-op passes all those hurdles it needs to attract and retain customers, lots of customers, to compete with existing insurance companies. In contrast, health insurance purchasing co-ops are based on the idea that consumers bargain with insurance companies to buy insurance. They’re not insurance providers themselves. Most of such initiatives failed to provide the desired benefits for their member.
So what’s left? 1) a solid public option offering an insurance option for those who currently cannot afford to buy insurance or are underinsured; 2) a political consensus to strictly regulate insurance companies like we do with utilities; 3) a single-payer insurance plan, a public service financing the delivery of healthcare.
Single-payer health insurance operates by arranging the payment of services to doctors, hospitals, and other health care providers from a single source established and managed by government. This source replaces private insurance companies with a single, public entity.
These are the options and the choice is ours.Lets have a honest and unbiased debate about those options. Time (or better money) is running out!

Bernd Wollschlaeger,MD,FAAFP,FASAM
Immediate Past President, Dade County Medical Association