Attached two examples how the American Medical Association advocates on behalf of physicians. I encourage you to renew your AMA membership to support those efforts which are helping us to practice medicine.
Have a great Memorial Day Weekend.
Bernd Wollschlaeger,MD,FAAFP,FASAM
AMA Outreach Recruiter
FTC Delays Red Flags Rule
The Federal Trade Commission on May 28 announced it would delay enforcement of the Red Flags Rule from June 1 to Dec. 31, 2010.
The commission cited congressional consideration of legislation that would affect the scope of entities covered by the rule to require businesses to take specific steps to minimize identity theft. For instance, S. 3416, introduced on May 25 in the Senate, would exempt health care practices with 20 or fewer employees, as well as accounting and legal practices of similar size.
Covered health care professionals under the bill include physicians, dentists, podiatrists, chiropractors, physical therapists, occupational therapists, marriage or family therapists, optometrists, speech therapists, language therapists, hearing therapists and veterinarians.
The commission in its announcement urged Congress to quickly act "to pass legislation that will resolve any questions as to which entities are covered by the rule and obviate the need for further enforcement delays. If Congress passes legislation limiting the scope of the Red Flags Rule with an effective date earlier than December 31, 2010, the Commission will begin enforcement as of that effective date."
The American Medical Association, which on May 21 filed a lawsuit to prevent the FTC from applying the rule to physicians, applauded the delay. "We call on the FTC to exempt physicians from the rule completely."
The extension is a promising sign that the AMA lawsuit caught the attention of the FTC, the association says. "Last November, a federal court blocked the rule from being applied to attorneys after the FTC was found to be extending its regulatory power beyond that authorized by Congress. We hope this latest extension will be long enough for the FTC to take a good, hard look at the rule and finally exclude physicians from this unjustified and burdensome regulation of medicine."
AMA eVoice Logo
eVoice® Alert
May 28, 2010
Tell Congress enough is enough!
Congress failed to address this year’s Medicare physician payment cut before the June 1 deadline next week. Although the U.S. House of Representatives passed legislation at the last minute to suspend cuts for another 19 months, the U.S. Senate left for a week-long Memorial Day recess without taking action. When Congress returns from their vacation on June 7, the Senate is expected to take up the House-passed bill.
The Centers for Medicare & Medicaid Services already issued instructions to its contractors to postpone processing claims for Medicare physician services provided on or after June 1 for 10 days to provide time for Congress to complete its action and overturn the scheduled cut retroactive to June 1.
The new proposal being considered by Congress would provide payment updates of 2.2 percent for the remainder of 2010 and an additional 1 percent increase in 2011. However, in 2012 the SGR formula will once again go into effect and payments will be cut by an estimated 33 percent!
Congress needs to hear from you! Call your representative and senators today using the AMA’s toll-free grassroots hotline at (800) 833-6354 or send them an e-mail. Urge them to end their mismanagement of these important health care programs, and honor their commitment to military families and older Americans.
It is long past time for Congress to find a long-term solution to the SGR that does not create an even bigger problem in the future. Enough is enough!
Friday, May 28, 2010
Tuesday, May 18, 2010
AMA Advocates For Fair Medicare Reimbursement
Attached an urgent appeal by our AMA to call upon legislators to finally address and resolve the flawed Medicare physicians formula.
Now its time to unite and support our AMA in its effort. I call upon the FMA leadership to stop all of its efforts to undermine our AMA and to focus on the pragmatic resolution of real and not imaginary problems. Physicians deserve our attention to their problems.
Yours
Bernd
AMA Outreach Recruiter
eVoice® Alert
May 18, 2010
AMA opposes SGR proposal
Based on conversations with policymakers, the AMA cannot support an emerging proposal to address the flawed Medicare physician payment formula. The result in five years would be steeper cuts for physician practices, making it much more difficult—if not impossible—to achieve the objective of permanently repealing the “sustainable growth rate” (SGR).
It is our understanding that a draft proposal developed by the U.S. House of Representatives and the U.S. Senate congressional leadership would provide for statutory updates of 2.2 percent for the remainder of 2010 and an additional 1 percent increase in 2011. Short-term positive updates are no doubt attractive. From 2012 through 2014, physician updates would be determined by two expenditure targets that were proposed by H.R. 3961. We believe updates during this period would likely produce modest increases for E&M services and no less than a freeze for other Medicare services. In 2015, physician payments would be scheduled to revert back to the current SGR formula with a projected cut of no more than 37 percent. While this cut would result in a 2015 conversion factor in line with that projected under current law, the update baseline will continue to fall during these five years as a result of the underlying SGR formula. By 2015, we believe that the price tag to permanently repeal the SGR, or even to extend the proposed 2012-2014 policy, could exceed $500 billion.
The AMA fully appreciates the fiscal challenges confronting Congress and our nation today. The cost of permanently eliminating the currently scheduled Medicare cuts is approximately $250 billion. For the last several years, Congress has chosen short-term remedies that have resulted in larger future physician payment cuts and made it much more expensive to scrap a formula that Democrats and Republicans have both said should be repealed. Five years ago, the price tag for repealing the SGR was $49 billion.
Twice this year, Congress has allowed 30-day extensions to expire, creating turmoil for patients and physicians because a 21 percent cut became the operative policy. On June 1, the current extension will expire again.
Failure by Congress and the Obama Administration to properly solve this issue will intensify access problems for seniors and military families enrolled in the TRICARE program, and severely undermine implementation of recently enacted health system reform legislation. An existing physician shortage will be magnified and steeper cuts will prevent practice and delivery innovations.
Everyone in the health care community and Congress would like to see this problem go away. However, the AMA believes that greater long-term insolvency is too steep a price to pay for a temporary solution. We believe that policymakers must once again go back to the drawing board and make the tough decisions necessary to provide the funding to fulfill the obligations made to Medicare patients and military families, without steep cuts for medical services.
Contact your members of Congress. Urge them to pass legislation to avert a 21 percent cut on June 1 without increasing the cost of a permanent solution, and preserve access to medical services for Medicare patients and military families. We should not mortgage the future of the private practice of medicine. Growing the problem is not the solution!
Now its time to unite and support our AMA in its effort. I call upon the FMA leadership to stop all of its efforts to undermine our AMA and to focus on the pragmatic resolution of real and not imaginary problems. Physicians deserve our attention to their problems.
Yours
Bernd
AMA Outreach Recruiter
eVoice® Alert
May 18, 2010
AMA opposes SGR proposal
Based on conversations with policymakers, the AMA cannot support an emerging proposal to address the flawed Medicare physician payment formula. The result in five years would be steeper cuts for physician practices, making it much more difficult—if not impossible—to achieve the objective of permanently repealing the “sustainable growth rate” (SGR).
It is our understanding that a draft proposal developed by the U.S. House of Representatives and the U.S. Senate congressional leadership would provide for statutory updates of 2.2 percent for the remainder of 2010 and an additional 1 percent increase in 2011. Short-term positive updates are no doubt attractive. From 2012 through 2014, physician updates would be determined by two expenditure targets that were proposed by H.R. 3961. We believe updates during this period would likely produce modest increases for E&M services and no less than a freeze for other Medicare services. In 2015, physician payments would be scheduled to revert back to the current SGR formula with a projected cut of no more than 37 percent. While this cut would result in a 2015 conversion factor in line with that projected under current law, the update baseline will continue to fall during these five years as a result of the underlying SGR formula. By 2015, we believe that the price tag to permanently repeal the SGR, or even to extend the proposed 2012-2014 policy, could exceed $500 billion.
The AMA fully appreciates the fiscal challenges confronting Congress and our nation today. The cost of permanently eliminating the currently scheduled Medicare cuts is approximately $250 billion. For the last several years, Congress has chosen short-term remedies that have resulted in larger future physician payment cuts and made it much more expensive to scrap a formula that Democrats and Republicans have both said should be repealed. Five years ago, the price tag for repealing the SGR was $49 billion.
Twice this year, Congress has allowed 30-day extensions to expire, creating turmoil for patients and physicians because a 21 percent cut became the operative policy. On June 1, the current extension will expire again.
Failure by Congress and the Obama Administration to properly solve this issue will intensify access problems for seniors and military families enrolled in the TRICARE program, and severely undermine implementation of recently enacted health system reform legislation. An existing physician shortage will be magnified and steeper cuts will prevent practice and delivery innovations.
Everyone in the health care community and Congress would like to see this problem go away. However, the AMA believes that greater long-term insolvency is too steep a price to pay for a temporary solution. We believe that policymakers must once again go back to the drawing board and make the tough decisions necessary to provide the funding to fulfill the obligations made to Medicare patients and military families, without steep cuts for medical services.
Contact your members of Congress. Urge them to pass legislation to avert a 21 percent cut on June 1 without increasing the cost of a permanent solution, and preserve access to medical services for Medicare patients and military families. We should not mortgage the future of the private practice of medicine. Growing the problem is not the solution!
Sunday, May 16, 2010
Health Insurance Companies
Dear Friends and Colleagues:
Attached you find an article from today's New York Times highlighting how health insurance companies are trying to (re) shape the rules of the new health care law thereby potentially mitigating its adverse impact on their profitable business model.
The impact of the new health care law depends on regulations needed to interpret it and more than 40 provisions of the law require or permit agencies to issue rules.
Two of these rules are at the heart of the new conflict fought by insurance lobbyists.
One bars insurers from carrying out an “unreasonable premium increase” unless they first submit justifications to federal and state officials. Congress did not say what is unreasonable, leaving that to rule writers. Another provision, effective Jan. 1, requires that a minimum percentage (85%) of premium dollars be spent on true medical costs related to patient care — not retained by insurers as profit or used to cover administrative expenses. Insurers must refund money to consumers if they do not meet the standards, known as minimum loss ratios.
Therefore, insurance companies will make every effort to reclassify ANY expenses as activities " that improve health care quality” for patients.
Thus, insurers are lobbying for a broad definition of quality improvement activities that would allow them to count spending on health information technology, nurse hot lines and efforts to prevent fraud. They also want to include the cost of reviewing care by doctors and hospitals, to determine if it was appropriate and followed clinical protocols.
As physicians we should SUPPORT narrowing these definitions of quality improvement activities, limited to those that produce measurable benefits to individual patients.
Otherwise, insurance companies will continue to pad their bottom lines, continue to find reasons to increase insurance premiums and make it more difficult for the average American to pay for health care.
Its time that physician organizations STOP criticizing the new law and point the finger at the real culprit: insurance companies!
Yours
Bernd
Health Insurance Companies Try to Shape Rules
By ROBERT PEAR
WASHINGTON — Health insurance companies are lobbying federal and state officials in an effort to ward off strict regulation of premiums and profits under the new health care law.
The effort is, in some ways, a continuation of the battle over health care that consumed Congress last year.
Insurance lobbyists are trying to shape regulations that will define “unreasonable” premium increases and require them to pay rebates to consumers if the companies do not spend enough on patient care.
For their part, consumer groups say they worry that their legislative victories could be undone or undercut by the rules being written by the federal government and the states.
The health care overhaul provides a classic example of how the impact of a law depends on regulations needed to interpret it. The rules deal with relatively technical questions but go to the heart of the law, pushed through Congress by President Obama and Democratic leaders with no Republican support.
More than 40 provisions of the law require or permit agencies to issue rules. Lobbyists are focusing on two whose stated purpose is to ensure that consumers “get value for their dollars.”
One bars insurers from carrying out an “unreasonable premium increase” unless they first submit justifications to federal and state officials. Congress did not say what is unreasonable, leaving that to rule writers.
Another provision, effective Jan. 1, requires that a minimum percentage of premium dollars be spent on true medical costs related to patient care — not retained by insurers as profit or used to cover administrative expenses. Insurers must refund money to consumers if they do not meet the standards, known as minimum loss ratios.
Michael W. Fedyna, vice president and chief actuary of Aetna, underlined the importance of this issue, saying no other aspect of the law would be so “influential in shaping the future of the health care marketplace in the United States.”
The definition of medical loss ratio will “determine the willingness of health plans to enter new markets and remain in existing markets,” he said.
Senator John D. Rockefeller IV, Democrat of West Virginia, said the definition would be just as important for consumers and small businesses.
“The health insurance industry has shifted its focus from opposing health care reform to influencing how the new law will be implemented,” he said.
The law requires insurers to spend a minimum percentage of premiums on health care services and “activities that improve health care quality” for patients.
Insurers are eager to classify as many expenses as possible in these categories, so they can meet the new test and avoid paying rebates to policyholders.
Thus, insurers are lobbying for a broad definition of quality improvement activities that would allow them to count spending on health information technology, nurse hot lines and efforts to prevent fraud. They also want to include the cost of reviewing care by doctors and hospitals, to determine if it was appropriate and followed clinical protocols.
Some consumer advocates, like Carmen L. Balber of Consumer Watchdog, favor a strict, narrow definition of quality improvement activities, limited to those that produce measurable benefits to individual patients.
Alissa Fox, a senior vice president of the Blue Cross and Blue Shield Association, said that if the definition is too narrow, “health plans will come under enormous pressure to cut back quality improvement activities, including highly effective programs to reduce hospital infection rates.”
But Charles N. Kahn III, president of the Federation of American Hospitals, a trade group, said he feared that the quality improvement category would become a “catchall for a wide variety of expenses not directly related to patient care.”
Under the new law, insurers in the large group market are generally supposed to spend 85 percent of customers’ premiums on “clinical services” and quality-enhancing activities. The minimum is 80 percent for coverage sold to individuals and small groups.
Insurers and insurance regulators say that some companies will be unable or unwilling to meet the new standards.
Attached you find an article from today's New York Times highlighting how health insurance companies are trying to (re) shape the rules of the new health care law thereby potentially mitigating its adverse impact on their profitable business model.
The impact of the new health care law depends on regulations needed to interpret it and more than 40 provisions of the law require or permit agencies to issue rules.
Two of these rules are at the heart of the new conflict fought by insurance lobbyists.
One bars insurers from carrying out an “unreasonable premium increase” unless they first submit justifications to federal and state officials. Congress did not say what is unreasonable, leaving that to rule writers. Another provision, effective Jan. 1, requires that a minimum percentage (85%) of premium dollars be spent on true medical costs related to patient care — not retained by insurers as profit or used to cover administrative expenses. Insurers must refund money to consumers if they do not meet the standards, known as minimum loss ratios.
Therefore, insurance companies will make every effort to reclassify ANY expenses as activities " that improve health care quality” for patients.
Thus, insurers are lobbying for a broad definition of quality improvement activities that would allow them to count spending on health information technology, nurse hot lines and efforts to prevent fraud. They also want to include the cost of reviewing care by doctors and hospitals, to determine if it was appropriate and followed clinical protocols.
As physicians we should SUPPORT narrowing these definitions of quality improvement activities, limited to those that produce measurable benefits to individual patients.
Otherwise, insurance companies will continue to pad their bottom lines, continue to find reasons to increase insurance premiums and make it more difficult for the average American to pay for health care.
Its time that physician organizations STOP criticizing the new law and point the finger at the real culprit: insurance companies!
Yours
Bernd
Health Insurance Companies Try to Shape Rules
By ROBERT PEAR
WASHINGTON — Health insurance companies are lobbying federal and state officials in an effort to ward off strict regulation of premiums and profits under the new health care law.
The effort is, in some ways, a continuation of the battle over health care that consumed Congress last year.
Insurance lobbyists are trying to shape regulations that will define “unreasonable” premium increases and require them to pay rebates to consumers if the companies do not spend enough on patient care.
For their part, consumer groups say they worry that their legislative victories could be undone or undercut by the rules being written by the federal government and the states.
The health care overhaul provides a classic example of how the impact of a law depends on regulations needed to interpret it. The rules deal with relatively technical questions but go to the heart of the law, pushed through Congress by President Obama and Democratic leaders with no Republican support.
More than 40 provisions of the law require or permit agencies to issue rules. Lobbyists are focusing on two whose stated purpose is to ensure that consumers “get value for their dollars.”
One bars insurers from carrying out an “unreasonable premium increase” unless they first submit justifications to federal and state officials. Congress did not say what is unreasonable, leaving that to rule writers.
Another provision, effective Jan. 1, requires that a minimum percentage of premium dollars be spent on true medical costs related to patient care — not retained by insurers as profit or used to cover administrative expenses. Insurers must refund money to consumers if they do not meet the standards, known as minimum loss ratios.
Michael W. Fedyna, vice president and chief actuary of Aetna, underlined the importance of this issue, saying no other aspect of the law would be so “influential in shaping the future of the health care marketplace in the United States.”
The definition of medical loss ratio will “determine the willingness of health plans to enter new markets and remain in existing markets,” he said.
Senator John D. Rockefeller IV, Democrat of West Virginia, said the definition would be just as important for consumers and small businesses.
“The health insurance industry has shifted its focus from opposing health care reform to influencing how the new law will be implemented,” he said.
The law requires insurers to spend a minimum percentage of premiums on health care services and “activities that improve health care quality” for patients.
Insurers are eager to classify as many expenses as possible in these categories, so they can meet the new test and avoid paying rebates to policyholders.
Thus, insurers are lobbying for a broad definition of quality improvement activities that would allow them to count spending on health information technology, nurse hot lines and efforts to prevent fraud. They also want to include the cost of reviewing care by doctors and hospitals, to determine if it was appropriate and followed clinical protocols.
Some consumer advocates, like Carmen L. Balber of Consumer Watchdog, favor a strict, narrow definition of quality improvement activities, limited to those that produce measurable benefits to individual patients.
Alissa Fox, a senior vice president of the Blue Cross and Blue Shield Association, said that if the definition is too narrow, “health plans will come under enormous pressure to cut back quality improvement activities, including highly effective programs to reduce hospital infection rates.”
But Charles N. Kahn III, president of the Federation of American Hospitals, a trade group, said he feared that the quality improvement category would become a “catchall for a wide variety of expenses not directly related to patient care.”
Under the new law, insurers in the large group market are generally supposed to spend 85 percent of customers’ premiums on “clinical services” and quality-enhancing activities. The minimum is 80 percent for coverage sold to individuals and small groups.
Insurers and insurance regulators say that some companies will be unable or unwilling to meet the new standards.
Friday, April 02, 2010
Politicization of Medicine
Well, Florida doctors never stop surprising me. Here comes another kicker: a Florida Urologist posted a note on his officer door that reads ""If you voted for Obama…seek urologic care elsewhere."
I have plenty of issues with the health care legislation but it passed by majority vote and its the law of the land. Even though, I favor a single-payer system I accepted the legislation. My patients often ask me about MY opinion and I let them know but I always listen carefully what THEY have to say because I favor dialogue. Is dialogue such a bad word now? What happened with the concept of political discourse?
According to David W. Johnson and Roger T. Johnson from the University of Minnesota,http://www.co-operation.org/pages/contro-pol.html ,the purposes of political discourse includes
" (a) clarifying citizens' understanding of the issue, (b) helping citizens reach their best reasoned judgment as to which course of action will solve a problem, (c) increasing citizen participation in the political process, and (d) socializing the next generation into the procedures and attitudes they need to be active citizens."
The authors emphasize that
" Thomas Jefferson, and the other founders of the American Republic, considered political discourse to be the heart of democracy. Jefferson believed that instead of the social rank within which a person was born, the basis of influence within society should be discourse in a free and open discussion characterized by conflict among ideas and opinions. He noted, "Differences of opinion lead to inquiry, and inquiry to truth."
Unfortunately, we are far removed from this process and the further we deteriorate the more we degrade what generation before us tried to build.
A sad but true state of affairs.
I hope that the next sign a doctor will post in his office will read, " I welcome your opinion and your well-being should be my primary concern."
Yours
Bernd
OrlandoSentinel.com
Dr. Jack Cassell: Sudden celebrity
Mount Dora doctor's anti-Obama stance sparks firestorm nationwide
Urologist stands firm, appears on national news as blogosphere erupts over sign telling Obama voters to go elsewhere
By Stephen Hudak, Orlando Sentinel
April 3, 2010
MOUNT DORA — Doug Bell isn't a patient of Dr. Jack Cassell's, but he almost wishes he were.
The Sorrento salesman heard about the firestorm over a sign that the Mount Dora urologist posted on his office door — it reads, "If you voted for Obama…seek urologic care elsewhere" — and wanted to see it himself.
"We need more people like him to speak out and take a stand against Obama-care," said Bell, 37, who snapped a picture of the sign Friday with his camera phone and planned to post it on his Facebook page.
Reaction was swift and passionate to news of Cassell's declaration as friends and foes weighed in online and over the phone, emailing and calling the doctor's office in Mount Dora to commend or castigate him.
Fueled by Internet sites such as the Drudge Report and the Huffington Post, which linked subscribers to theOrlando Sentinel story, Cassell received invitations to appear on several national radio and TV programs, notably Neil Cavuto's Fox News show and AC360, a CNN news and commentary program hosted by Anderson Cooper. He appeared on Fox and accepted Cooper's invite Friday night.
Not everyone was a fan.
"If I was one of his patients, I would not walk away, I'd run," said Patsy Robertson, 73, of Winter Springs, a Democrat and retired nurse. "He does not need to be taking care of people's lives if that's his mentality."
Cassell, a registered Republican, believes the sharply partisan, health-care overhaul pushed through by Democratic members of Congress and signed into law by President Barack Obama will harm his practice and thus his patients.
He was applauded for his chutzpah by many who dubbed him a hero.
"Doctor Jack's a true American patriot," said Dan Evans, 34, a Georgia truck driver who detoured from a delivery in Apopka to shake the doctor's hand only to find the medical office is closed on Friday afternoons.
Sandra Boynton, 68, a retired Florida nurse now living in Idaho, described Cassell's sign as "repugnant" behavior.
"As a nurse, I was taught you don't refuse care to anyone based on anything that's your personal views," she said. "I simply cannot imagine any nurse behaving in this self-centered manner. This man is a disgrace to his profession."
Cassell told the Orlando Sentinel that he has not refused to treat any patient for his or her political views and does not quiz patients about their politics, but he also does not plan to take the sign down.
"I have plenty of Obama supporters in my patient base and we have a lot of political discussions. I'm not cutting anybody out of their care. I'm not refusing care on the basis of their political beliefs," he reiterated in an exchange with Cavuto. "I hope that more and more Obama supporters come through to find out what all the fuss is about because I think we have to do something about this."
But Cassell's former medical partner in Eustis, urologist Dr. James Young, 57, a self-described liberal Democrat, said a patient's politics should be no more important to a doctor than his favorite baseball team.
"It'd be like me saying I'm not going to treat a Cubs fan," said Young, a lifelong fan of the St. Louis Cardinals. "There are a number of thoughtful doctors who feel like Jack and probably a like number who feel the exact opposite, but they're not going to put a sign on their door. As doctors, our chief concern should always be what's best for the patient."
Cassell's story, picked up by The New York Times and driven by broadcast reports and conservative talk-show giant Rush Limbaugh, generated hundreds of e-mails and phone calls to the Orlando Sentinel from Web readers across the nation, a firm majority of whom not only support the doctor's view but also his right to voice them on his office door.
"I think he's saying, ‘If you voted for Obama, you made a decision and that decision has consequences,' " said Dr. William Crowley, 76, a retired neurologist living in Texas, who praised the doctor for provoking a discussion.
Margaret Taormino, 72, a retired social worker living in Tavares, expressed a common sentiment about Cassel.
"My husband and I don't need a urologist," she said, "but if we ever do, he's our guy."
Stephen Hudak can be reached at shudak@orlandosentinel.com or 352-742-5930.
I have plenty of issues with the health care legislation but it passed by majority vote and its the law of the land. Even though, I favor a single-payer system I accepted the legislation. My patients often ask me about MY opinion and I let them know but I always listen carefully what THEY have to say because I favor dialogue. Is dialogue such a bad word now? What happened with the concept of political discourse?
According to David W. Johnson and Roger T. Johnson from the University of Minnesota,http://www.co-operation.org/pages/contro-pol.html ,the purposes of political discourse includes
" (a) clarifying citizens' understanding of the issue, (b) helping citizens reach their best reasoned judgment as to which course of action will solve a problem, (c) increasing citizen participation in the political process, and (d) socializing the next generation into the procedures and attitudes they need to be active citizens."
The authors emphasize that
" Thomas Jefferson, and the other founders of the American Republic, considered political discourse to be the heart of democracy. Jefferson believed that instead of the social rank within which a person was born, the basis of influence within society should be discourse in a free and open discussion characterized by conflict among ideas and opinions. He noted, "Differences of opinion lead to inquiry, and inquiry to truth."
Unfortunately, we are far removed from this process and the further we deteriorate the more we degrade what generation before us tried to build.
A sad but true state of affairs.
I hope that the next sign a doctor will post in his office will read, " I welcome your opinion and your well-being should be my primary concern."
Yours
Bernd
OrlandoSentinel.com
Dr. Jack Cassell: Sudden celebrity
Mount Dora doctor's anti-Obama stance sparks firestorm nationwide
Urologist stands firm, appears on national news as blogosphere erupts over sign telling Obama voters to go elsewhere
By Stephen Hudak, Orlando Sentinel
April 3, 2010
MOUNT DORA — Doug Bell isn't a patient of Dr. Jack Cassell's, but he almost wishes he were.
The Sorrento salesman heard about the firestorm over a sign that the Mount Dora urologist posted on his office door — it reads, "If you voted for Obama…seek urologic care elsewhere" — and wanted to see it himself.
"We need more people like him to speak out and take a stand against Obama-care," said Bell, 37, who snapped a picture of the sign Friday with his camera phone and planned to post it on his Facebook page.
Reaction was swift and passionate to news of Cassell's declaration as friends and foes weighed in online and over the phone, emailing and calling the doctor's office in Mount Dora to commend or castigate him.
Fueled by Internet sites such as the Drudge Report and the Huffington Post, which linked subscribers to theOrlando Sentinel story, Cassell received invitations to appear on several national radio and TV programs, notably Neil Cavuto's Fox News show and AC360, a CNN news and commentary program hosted by Anderson Cooper. He appeared on Fox and accepted Cooper's invite Friday night.
Not everyone was a fan.
"If I was one of his patients, I would not walk away, I'd run," said Patsy Robertson, 73, of Winter Springs, a Democrat and retired nurse. "He does not need to be taking care of people's lives if that's his mentality."
Cassell, a registered Republican, believes the sharply partisan, health-care overhaul pushed through by Democratic members of Congress and signed into law by President Barack Obama will harm his practice and thus his patients.
He was applauded for his chutzpah by many who dubbed him a hero.
"Doctor Jack's a true American patriot," said Dan Evans, 34, a Georgia truck driver who detoured from a delivery in Apopka to shake the doctor's hand only to find the medical office is closed on Friday afternoons.
Sandra Boynton, 68, a retired Florida nurse now living in Idaho, described Cassell's sign as "repugnant" behavior.
"As a nurse, I was taught you don't refuse care to anyone based on anything that's your personal views," she said. "I simply cannot imagine any nurse behaving in this self-centered manner. This man is a disgrace to his profession."
Cassell told the Orlando Sentinel that he has not refused to treat any patient for his or her political views and does not quiz patients about their politics, but he also does not plan to take the sign down.
"I have plenty of Obama supporters in my patient base and we have a lot of political discussions. I'm not cutting anybody out of their care. I'm not refusing care on the basis of their political beliefs," he reiterated in an exchange with Cavuto. "I hope that more and more Obama supporters come through to find out what all the fuss is about because I think we have to do something about this."
But Cassell's former medical partner in Eustis, urologist Dr. James Young, 57, a self-described liberal Democrat, said a patient's politics should be no more important to a doctor than his favorite baseball team.
"It'd be like me saying I'm not going to treat a Cubs fan," said Young, a lifelong fan of the St. Louis Cardinals. "There are a number of thoughtful doctors who feel like Jack and probably a like number who feel the exact opposite, but they're not going to put a sign on their door. As doctors, our chief concern should always be what's best for the patient."
Cassell's story, picked up by The New York Times and driven by broadcast reports and conservative talk-show giant Rush Limbaugh, generated hundreds of e-mails and phone calls to the Orlando Sentinel from Web readers across the nation, a firm majority of whom not only support the doctor's view but also his right to voice them on his office door.
"I think he's saying, ‘If you voted for Obama, you made a decision and that decision has consequences,' " said Dr. William Crowley, 76, a retired neurologist living in Texas, who praised the doctor for provoking a discussion.
Margaret Taormino, 72, a retired social worker living in Tavares, expressed a common sentiment about Cassel.
"My husband and I don't need a urologist," she said, "but if we ever do, he's our guy."
Stephen Hudak can be reached at shudak@orlandosentinel.com or 352-742-5930.
Wednesday, March 31, 2010
Medicaid and Healthcare in Florida
Currently, we focus on healthcare insurance reform expanding access to million of uninsured Amercian's but we fall short in reforming healthcare delivery. We MUST focus on cost containment, quality and outcome improvement too.
Unfortunately, many of my colleagues in organized medicine focus on the "panacea" called Tort Reform to reduce to costs resulting from "defensive medicine." I seriously doubt that this approach will provide the cost reduction needed to save our healthcare system. Meanwhile, Florida Senate members call for
" a federal Medicaid waiver to permit the state, through legislative enactment, to limit annual spending on the Medicaid program to the amount appropriated in the state budget. The waiver request shall include authorization for the legislature to make changes to optional eligibility groups and services in order to prevent spending more in any fiscal year than is appropriated. In addition the waiver shall request authority to revise the benefit structure and delivery system to allow Medicaid recipients to be integrated into the private insurance market through the use of state vouchers. The wavier shall include a provision to require Medicaid recipients with higher incomes to participate in program costs through coinsurance and deductibles and to be provided incentives for cost effective utilization of the health care system."
This serves as an example for "soft" rationing by capping Medicaid and "allowing" Medicaid recipients to seek coverage on the private "market" utilizing vouchers. . This will jeopardize Medicaid and force patients to hunt for benefits among private HMOs, which can control and limit services as they want.
Instead, the medical home model is a viable alternative moving the savings back to the physicians in the Medical Home.
A good friend of mine got it right, " Someday, when nothing is left but employed physicians attached to corporate HMOs then maybe docs will get the message that the Medical Home was a good idea."
Unfortunately, many don't get it because they are (mis)lead by ideologues who set politics before policy.
Yours
Bernd
Unfortunately, many of my colleagues in organized medicine focus on the "panacea" called Tort Reform to reduce to costs resulting from "defensive medicine." I seriously doubt that this approach will provide the cost reduction needed to save our healthcare system. Meanwhile, Florida Senate members call for
" a federal Medicaid waiver to permit the state, through legislative enactment, to limit annual spending on the Medicaid program to the amount appropriated in the state budget. The waiver request shall include authorization for the legislature to make changes to optional eligibility groups and services in order to prevent spending more in any fiscal year than is appropriated. In addition the waiver shall request authority to revise the benefit structure and delivery system to allow Medicaid recipients to be integrated into the private insurance market through the use of state vouchers. The wavier shall include a provision to require Medicaid recipients with higher incomes to participate in program costs through coinsurance and deductibles and to be provided incentives for cost effective utilization of the health care system."
This serves as an example for "soft" rationing by capping Medicaid and "allowing" Medicaid recipients to seek coverage on the private "market" utilizing vouchers. . This will jeopardize Medicaid and force patients to hunt for benefits among private HMOs, which can control and limit services as they want.
Instead, the medical home model is a viable alternative moving the savings back to the physicians in the Medical Home.
A good friend of mine got it right, " Someday, when nothing is left but employed physicians attached to corporate HMOs then maybe docs will get the message that the Medical Home was a good idea."
Unfortunately, many don't get it because they are (mis)lead by ideologues who set politics before policy.
Yours
Bernd
Sunday, February 28, 2010
FMA and AMA
OOPEN LETTER TO THE DCMA LEADERSHIP:
According to the published summary of a recent Board of Governors meeting, the Florida Medical Association is actively pursuing a reevaluation of its relationship with the American Medical Association. "We also began the process of a very serious and methodical reassessment of the FMA’s relationship with the AMA. Specific time will be set aside at the spring Board meeting to continue the discussion. Please feel at liberty to share your thoughts on the FMA-AMA relationship with me."
In this context the Board also tried to pass a bylaws change making the FMA President Chair of the AMA Delegation. This attempt to undermine the AMA delegations role did not pass. Furthermore, the Florida AMA Delegation did not support Dr. David McKalip run for office in the AMA , but the FMA Board of Governors overturned their decision. This is the same Dr.McKalip who was forced to step down as President-elect of the Pinellas County Medical Association, apologizing profusely for forwarding an e-mail image that portrayed President Barack Obama as a witch doctor in a loin cloth and headdress with bones in his nose. In a statement, the Florida Medical Association said it found "the actions by Dr. Mc Kalip to be hurtful and in poor judgment" but he still remains on its board ( District C, David M. McKalip, M.D., St. Petersburg). At that time he said that he is taking a year's leave of absence from a leadership role at the American Medical Association. He also planned to take a lower public profile in the health care reform debate. Instead, he was celebrated by the Tea party activities and spoke at several meetings. Now the FMA is using him as the ideological bulldozer to destabilize the AMA and Dr. Miguel Machado, a neurosurgeon and former DCMA President, runs for FMA leadership office spearheading the separation from the AMA.
Whats the goal? The FMA want to take the lead to form a new and "pure" national medical organization based on their ideological principles.
Its just astounding that physicians never miss an opportunity to divide the House of Medicine. That's the reason why I left the FMA .
There are many other important issues we should focus on to help physicians to survive and succeed in the rapidly changing healthcare environment. We need leaders who base their decisions on rational thought but not partisanship and ideologies.
I call upon each you to challenge the FMA and Dr. Machado to clearly and publicly state their support for the AMA and their policies. Furthermore, they should assure each and every AMA member that they refrain from dividing the House of Medicine and that they stop collaborating with other state medical organizations(s) to create a separate national medical organization. Dividing us just plays in the hands of our political opponents. As a loyal DCMA and AMA member I expect that my county medical society supports my right to be represented by the AMA and to stop supporting candidates who undermine the important function and role of the AMA. Otherwise, I have no other choice but to relinquish my DCMA membership effective immediately!
Its your choice to unite or to divide the House of Medicine.
Yours
Bernd
Immediate Past DCMA President
According to the published summary of a recent Board of Governors meeting, the Florida Medical Association is actively pursuing a reevaluation of its relationship with the American Medical Association. "We also began the process of a very serious and methodical reassessment of the FMA’s relationship with the AMA. Specific time will be set aside at the spring Board meeting to continue the discussion. Please feel at liberty to share your thoughts on the FMA-AMA relationship with me."
In this context the Board also tried to pass a bylaws change making the FMA President Chair of the AMA Delegation. This attempt to undermine the AMA delegations role did not pass. Furthermore, the Florida AMA Delegation did not support Dr. David McKalip run for office in the AMA , but the FMA Board of Governors overturned their decision. This is the same Dr.McKalip who was forced to step down as President-elect of the Pinellas County Medical Association, apologizing profusely for forwarding an e-mail image that portrayed President Barack Obama as a witch doctor in a loin cloth and headdress with bones in his nose. In a statement, the Florida Medical Association said it found "the actions by Dr. Mc Kalip to be hurtful and in poor judgment" but he still remains on its board ( District C, David M. McKalip, M.D., St. Petersburg). At that time he said that he is taking a year's leave of absence from a leadership role at the American Medical Association. He also planned to take a lower public profile in the health care reform debate. Instead, he was celebrated by the Tea party activities and spoke at several meetings. Now the FMA is using him as the ideological bulldozer to destabilize the AMA and Dr. Miguel Machado, a neurosurgeon and former DCMA President, runs for FMA leadership office spearheading the separation from the AMA.
Whats the goal? The FMA want to take the lead to form a new and "pure" national medical organization based on their ideological principles.
Its just astounding that physicians never miss an opportunity to divide the House of Medicine. That's the reason why I left the FMA .
There are many other important issues we should focus on to help physicians to survive and succeed in the rapidly changing healthcare environment. We need leaders who base their decisions on rational thought but not partisanship and ideologies.
I call upon each you to challenge the FMA and Dr. Machado to clearly and publicly state their support for the AMA and their policies. Furthermore, they should assure each and every AMA member that they refrain from dividing the House of Medicine and that they stop collaborating with other state medical organizations(s) to create a separate national medical organization. Dividing us just plays in the hands of our political opponents. As a loyal DCMA and AMA member I expect that my county medical society supports my right to be represented by the AMA and to stop supporting candidates who undermine the important function and role of the AMA. Otherwise, I have no other choice but to relinquish my DCMA membership effective immediately!
Its your choice to unite or to divide the House of Medicine.
Yours
Bernd
Immediate Past DCMA President
Sunday, February 21, 2010
Words That Kill!
Words That Kill!! Hatred in America
"We need to address it as if it [Progressivism] is a cancer. It must be cut out of the system because they can not coexist. … You must eradicate it.”
In his speech on Saturday at CPAC (conservative Political Action Committee) in Washington, DC, the conservative news commentator Glenn Beck brought his chalkboard. He wrote the word "Progressivism" on it and said, "This is the disease." "Progressivism is the cancer in America and it's eating our Constitution, and it was designed to eat the Constitution - to progress past the Constitution," Beck said. He said that the only difference between a communist and a progressive is that communists seize power through revolution and progressives through evolution. "We don't want to evolve," Beck shouted. "It's big government. It's a socialist utopia." "We need to address it as if it is a cancer. It must be cut out of the system because they can not coexist. … You must eradicate it," Beck told the cheering crowd of conservatives.
The message is clear. Progressive are the enemy. We must get rid of them. Progressives are like cancer and cancer need to be dealt with.
No, this is not taken from a textbook of Hitler's Germany but it is being broadcasted in the United States of America in 2010! There will be those who will take it literally and act accordingly. From Timothy Mc Veigh, the Oklahoma city bomber, to A. Joseph Stack III,the suicide pilot, who targeted the IRS building in Austin. There will be more on the waiting list of right-wing homegrown American terrorists who will strike sooner or later. Hate mongers like Glen Beck may provide the disciples of hatred the ideological ammunition to strike. Its now open season on Progressive, and anyone can pick whom they consider a Progressive. So, because I am a Progressive , I am now a target, too?
When do we learn to stand up against hatred, intolerance and prejudice? What else has to happen before its too late?
Yours
Bernd
"We need to address it as if it [Progressivism] is a cancer. It must be cut out of the system because they can not coexist. … You must eradicate it.”
In his speech on Saturday at CPAC (conservative Political Action Committee) in Washington, DC, the conservative news commentator Glenn Beck brought his chalkboard. He wrote the word "Progressivism" on it and said, "This is the disease." "Progressivism is the cancer in America and it's eating our Constitution, and it was designed to eat the Constitution - to progress past the Constitution," Beck said. He said that the only difference between a communist and a progressive is that communists seize power through revolution and progressives through evolution. "We don't want to evolve," Beck shouted. "It's big government. It's a socialist utopia." "We need to address it as if it is a cancer. It must be cut out of the system because they can not coexist. … You must eradicate it," Beck told the cheering crowd of conservatives.
The message is clear. Progressive are the enemy. We must get rid of them. Progressives are like cancer and cancer need to be dealt with.
No, this is not taken from a textbook of Hitler's Germany but it is being broadcasted in the United States of America in 2010! There will be those who will take it literally and act accordingly. From Timothy Mc Veigh, the Oklahoma city bomber, to A. Joseph Stack III,the suicide pilot, who targeted the IRS building in Austin. There will be more on the waiting list of right-wing homegrown American terrorists who will strike sooner or later. Hate mongers like Glen Beck may provide the disciples of hatred the ideological ammunition to strike. Its now open season on Progressive, and anyone can pick whom they consider a Progressive. So, because I am a Progressive , I am now a target, too?
When do we learn to stand up against hatred, intolerance and prejudice? What else has to happen before its too late?
Yours
Bernd
Thursday, February 18, 2010
Why We Need Health Care & Health Insurance Reform?
The attached ABC news report highlights the fact that the largest health insurers in America have declared more than $12 billion worth of profits in 2009 but are requesting premium increases of anywhere from 20 percent to over 50 percent!
It was a banner year for health insurers. While those profits were coming in, 2.7 million of the companies' customers lost their insurance. Health insurance companies are dropping "unprofitable" patients and demand higher premiums from their remaining customers who cannot afford dropping their insurance. Meanwhile, CEOs and shareholders are collecting big paychecks, bonuses and profits.
What can be done? We must pass comprehensive health care reform now even without bipartisan support. Any reform proposal must contain provisions curbing the insurance companies profit margins, strip health insurance companies of their antitrust exemption, creating an health insurance exchange for those self-employed seeking insurance coverage, eliminating preexisting condition exclusions, full transparency of health insurance companies cost and expense structure and mandatory comprehensive insurance coverage. We also should support a strong public option!
We have to stop the bleeding now!
Yours
Bernd
Administration Says Insurance Companies Pull in Profits While Raising Premiums
By KATE SNOW, DAN HARRIS, HANNA SIEGEL and BRADLEY BLACKBURN
Feb. 18, 2010—
Health and Human Services Secretary Kathleen Sebelius railed against the insurance companies today for raising premiums at a time when companies still post profits.
"The five largest insurers in America have declared more than $12 billion worth of profits in 2009," Sebelius said at a news conference. One of those companies, WellPoint, is a for-profit company that owns Anthem Blue Cross of California. They are about to increase rates on coffee shop owner Jesse Fink.
Come May, he'll pay $325 more per month to insure his family.
"I felt like it was extortion. I felt like it was a crime. They had you by the throat and if you don't like it leave. That's not right," said Fink.
2009 a Record Year for Insurance Company Profits
it was a banner year for health insurers. While those profits were coming in, 2.7 million of the companies' customers lost their insurance and the average premium for health insurance went up -- 5.5 percent for family coverage and 2.6 percent for individual coverage, according to the Kaiser Employer Health Benefits Survey.
Today, the government pointed to examples in six states where insurers request premium increases of anywhere from 20 percent to over 50 percent.
Companies Say Higher Medical Costs Mean Higher Premiums
The insurance companies see it differently. Though in most states, the companies don't dispute the numbers in the government report, but they say the requests for higher premiums were not driven by profit.
Insurance Companies Say They're Losing Money
Brad Fluegel of Wellpoint told ABC News, "What we're experiencing in California is very rapid increases in medical costs."
And as more healthy people lose their jobs and drop their insurance coverage, more sick people -- the most expensive patients -- remain in the insurance pool.
Other insurers say they are actually losing money right now. Blue Cross Blue Shield of Michigan estimates they lost $280 million last year and by law have to ask for an increase in premiums to cover their losses.
"We're not prospering here. Our reserves have declined for 5 straight years. We're paying out $1.20 for every dollar we collect in premiums. We're losing hundreds of millions a year on only 7% of our total membership," said Andrew Hetzel, spokesman for Michigan Blue Cross Blue Shield.
Critics Say Insurers Are Dropping Unprofitable Patients
Critics of the companies don't buy it. "While everyone else seems to be in a recession, the private health insurance companies are making a tremendous amount of money," said Jackie Schechner, the National Communications Director for Health Care For America Now.
How could that happen? Schechner says the companies essentially get rid of customers who aren't going to make them any money -- old, sick, or high-risk patients. That way, healthy customers are still paying high premiums but the insurance companies have to make fewer big payouts. If that accusation were true, the companies could be in violation of the law.
"They raise rates and companies can't afford to cover their employees anymore" says Schechner. "People try to go out and get insurance in the private market and it's just entirely unaffordable for them because the prices of premiums are so high. And if you can get something you can afford and the premiums are low, chances are it's going to be lousy coverage and it's not going to actually give you the health care benefits you need."
Schechner says the answer is health care reform. That's one point that the critics and insurance companies can agree on. Brad Fluegel of Wellpoint said, "We're eager to have a fact-based, rational debate about the drivers of these issues and what we can do to fix them."
The trouble is that the insurance industry and the Obama administration have very different ideas about what that reform should look like.
Copyright © 2010 ABC News Internet Ventures
It was a banner year for health insurers. While those profits were coming in, 2.7 million of the companies' customers lost their insurance. Health insurance companies are dropping "unprofitable" patients and demand higher premiums from their remaining customers who cannot afford dropping their insurance. Meanwhile, CEOs and shareholders are collecting big paychecks, bonuses and profits.
What can be done? We must pass comprehensive health care reform now even without bipartisan support. Any reform proposal must contain provisions curbing the insurance companies profit margins, strip health insurance companies of their antitrust exemption, creating an health insurance exchange for those self-employed seeking insurance coverage, eliminating preexisting condition exclusions, full transparency of health insurance companies cost and expense structure and mandatory comprehensive insurance coverage. We also should support a strong public option!
We have to stop the bleeding now!
Yours
Bernd
Administration Says Insurance Companies Pull in Profits While Raising Premiums
By KATE SNOW, DAN HARRIS, HANNA SIEGEL and BRADLEY BLACKBURN
Feb. 18, 2010—
Health and Human Services Secretary Kathleen Sebelius railed against the insurance companies today for raising premiums at a time when companies still post profits.
"The five largest insurers in America have declared more than $12 billion worth of profits in 2009," Sebelius said at a news conference. One of those companies, WellPoint, is a for-profit company that owns Anthem Blue Cross of California. They are about to increase rates on coffee shop owner Jesse Fink.
Come May, he'll pay $325 more per month to insure his family.
"I felt like it was extortion. I felt like it was a crime. They had you by the throat and if you don't like it leave. That's not right," said Fink.
2009 a Record Year for Insurance Company Profits
it was a banner year for health insurers. While those profits were coming in, 2.7 million of the companies' customers lost their insurance and the average premium for health insurance went up -- 5.5 percent for family coverage and 2.6 percent for individual coverage, according to the Kaiser Employer Health Benefits Survey.
Today, the government pointed to examples in six states where insurers request premium increases of anywhere from 20 percent to over 50 percent.
Companies Say Higher Medical Costs Mean Higher Premiums
The insurance companies see it differently. Though in most states, the companies don't dispute the numbers in the government report, but they say the requests for higher premiums were not driven by profit.
Insurance Companies Say They're Losing Money
Brad Fluegel of Wellpoint told ABC News, "What we're experiencing in California is very rapid increases in medical costs."
And as more healthy people lose their jobs and drop their insurance coverage, more sick people -- the most expensive patients -- remain in the insurance pool.
Other insurers say they are actually losing money right now. Blue Cross Blue Shield of Michigan estimates they lost $280 million last year and by law have to ask for an increase in premiums to cover their losses.
"We're not prospering here. Our reserves have declined for 5 straight years. We're paying out $1.20 for every dollar we collect in premiums. We're losing hundreds of millions a year on only 7% of our total membership," said Andrew Hetzel, spokesman for Michigan Blue Cross Blue Shield.
Critics Say Insurers Are Dropping Unprofitable Patients
Critics of the companies don't buy it. "While everyone else seems to be in a recession, the private health insurance companies are making a tremendous amount of money," said Jackie Schechner, the National Communications Director for Health Care For America Now.
How could that happen? Schechner says the companies essentially get rid of customers who aren't going to make them any money -- old, sick, or high-risk patients. That way, healthy customers are still paying high premiums but the insurance companies have to make fewer big payouts. If that accusation were true, the companies could be in violation of the law.
"They raise rates and companies can't afford to cover their employees anymore" says Schechner. "People try to go out and get insurance in the private market and it's just entirely unaffordable for them because the prices of premiums are so high. And if you can get something you can afford and the premiums are low, chances are it's going to be lousy coverage and it's not going to actually give you the health care benefits you need."
Schechner says the answer is health care reform. That's one point that the critics and insurance companies can agree on. Brad Fluegel of Wellpoint said, "We're eager to have a fact-based, rational debate about the drivers of these issues and what we can do to fix them."
The trouble is that the insurance industry and the Obama administration have very different ideas about what that reform should look like.
Copyright © 2010 ABC News Internet Ventures
Sunday, January 31, 2010
Doctors versus Medicare
Attached a very interesting article from Saturday's Miami Herald emphasizing the issue of cost-control in healthcare and the resistance by physician groups to accept the inevitable truth: we must bend the cost curve, otherwise someone will bend it for us!We definitely need to shift our paradigm of thinking: from quantity to quality, from volume to value, from physicians- centered to patient-centered care. Now is the time to discuss and resolve the issue. Politicians from both parties must understand that concessions may only provide short-term gains but represent long-term loss. Lets not miss this opportunity.
Yours
Bernd
==============================================================================
Cardiologists battle Medicare over payment cuts
BY JOHN DORSCHNER
jdorschner@MiamiHerald.com
RICK NEASE / MCT
In a striking example of the conflict between controlling healthcare costs and providing quality service, a group of South Miami cardiologists has written a letter to patients complaining that huge cuts in Medicare rates may force many heart specialists out of business or mean reduced services for their patients.
The doctors of South Miami Cardiology said that on Jan. 1 Medicare reduced ``reimbursement for cardiac services on average by 40 percent. This is unrelated to the current healthcare reform, which is planning an additional 21 percent reduction, effective March 1.''
In fact, none of the cuts are related to the healthcare reforms before Congress. They're Medicare actions required by existing laws in an attempt to moderate doctor pay while not going broke -- a painful issue that reveals how difficult any kind of reform can be when strongly entrenched interests disagree on what should be done.
In this case, the nation's outraged cardiologists filed a federal lawsuit in Miami and have persuaded 50 members of Congress to co-sponsor a bill to rescind the cuts.
Some healthcare experts like the cuts.
``I'm not at all sympathetic with the cardiologists,'' said Robert Berenson, a doctor who was once in charge of Medicare payment policy and now is a fellow with the Urban Institute. ``Studies show they make well over $400,000 a year'' -- more than twice what a family practice physician earns.
In fact, Medicare is reducing pay to cardiologists as part of a rebalancing plan in which primary care doctors will get a 7 percent increase. ``This system is much more fair,'' said Lori Heim, president of the American Academy of Family Physicians. ``It's not the savior for primary care, but it's a start.''
Heim finds it ``disingenuous'' that the cardiologists' letter blames reform proposals for their rate cuts.
Most of the cuts involve expensive imaging diagnostics, like $800 nuclear stress tests. Studies show that when physicians have expensive imaging machines in their office, they tend to prescribe far more tests.
That's particularly true in Florida, where a study by the Government Accountability Office, the investigative arm of Congress, found that in-office imaging per senior cost $472 in 2006 -- eight times more than in Vermont.
Still, cardiologists say the changes have been devastating. Manuel Abella, a cardiologist in a large group practice in West Kendall, said he and his colleagues have been forced to lay off 15 people, cut salaries 10 percent and eliminate health insurance.
`BASIC TOOLS'
``When a patient comes in and says he has chest pains, you have to have state-of-the-art technology,'' said Romeo Majano, one of the three South Miami cardiologists who sent the letter. ``These are basic tools of our trade, and it's imperative patients have access to them.''
``This technology has greatly improved care,'' said Jack Lowen, president of the American College of Cardiology. ``We've seen a 30 percent reduction in morbidity and mortality in heart disease over the past 10 years.''
``The most affected, of course, will be the patients,'' the South Miami cardiologists warned in their letter, ``as cardiologists will be either forced out of business or forced to drastically increase the number of patients seen, most likely with physician assistants or nurse practitioners to help manage the increased volume.''
The cardiologists say that if Medicare won't pay for, say, a nuclear stress test in a cardiologist's office, the patient will have the test performed at a hospital where it might cost three to five times as much.
Medicare spokeswoman Ellen Griffith said, ``It is difficult to compare payments head-to-head because services may not always be directly comparable.'' Hospitals often get paid more for a service because they must be open around-the-clock and by law must provide coverage for the uninsured in their emergency rooms.
Berenson at the Urban Institute looks at it this way: ``If the hospitals are getting paid too much, the answer is to reduce their payments.'' He doubted the cardiologists' threat of giving up Medicare patients, noting that oncologists made a similar threat several years ago when they saw certain payments taken away and it didn't bear out.
For years, Republicans were leaders in the movement to curtail soaring Medicare costs. Tommy Thompson, secretary of health and human services under President George W. Bush, has frequently given speeches that Medicare costs must be brought under control or aging baby boomers would bankrupt the plan.
But in recent months, as the reform debate intensified, Republican leaders warned that the proposed bills would cut seniors' benefits. A poll this month by the Kaiser Family Foundation found that 48 percent of those over 65 are opposed to the reform bills while 37 percent support them.
In fact, for the past 12 years, under the Clinton, Bush II and Obama administrations, Medicare has been ordered to find ways of curtail costs without reducing quality of care. The Balanced Budget Act of 1997 required physician payments by Medicare to be adjusted annually so that the program didn't go broke.
Every year since 2003, Congress has listened to doctors' complaints and halted pay cuts. Each postponed cut gets added to the next year's calculation and this year all doctors are facing a 21 percent reduction. Congress postponed the cuts until March 1, when they take effect unless lawmakers take action.
Meanwhile, Medicare made a second set of calculations -- about how to split up the budgetary pie among doctors. Both Republicans and Democrats have agreed for some time that primary care is a key to improved healthcare -- because these doctors can coordinate treatment and reduce unnecessary tests and repetitive care.
A 2009 study by Medpac, a federal group that studies Medicare costs, found that, even adjusted for severity of illness, cardiology patients going to a doctor with imaging equipment in his office were twice as likely to get a test as those seeing doctors with no equipment.
Going further, Medicare surveyed physicians about their costs. Based on those findings, Medicare decided to reduce overall payments to cardiologists by 13 percent over four years -- while payments for their imaging services were cut by 30 or 40 percent.
`ERRONEOUS'
The ACC complained that the survey data for cardiologists was based on 55 interviews -- out of 20,000 in private practice. It called the resulting data ``patently erroneous and unreliable.'' When Medicare refused to budge, the ACC filed a lawsuit on Dec. 28.
The government argued that the courts did not have jurisdiction over a Medicare fee dispute. The judge agreed. The cardiologists have now gone to Congress, where lawmakers have a history of reversing Medicare pay cuts to pacify providers.
Griffith, the Medicare spokeswoman, said the agency is ``confident that the policies we have adopted are the most appropriate and will enhance overall access to physician services for beneficiaries. . . . If we find that there are unintended adverse consequences . . . we will have the opportunity to revisit them as part of the annual rule-making.''
Yours
Bernd
==============================================================================
Cardiologists battle Medicare over payment cuts
BY JOHN DORSCHNER
jdorschner@MiamiHerald.com
RICK NEASE / MCT
In a striking example of the conflict between controlling healthcare costs and providing quality service, a group of South Miami cardiologists has written a letter to patients complaining that huge cuts in Medicare rates may force many heart specialists out of business or mean reduced services for their patients.
The doctors of South Miami Cardiology said that on Jan. 1 Medicare reduced ``reimbursement for cardiac services on average by 40 percent. This is unrelated to the current healthcare reform, which is planning an additional 21 percent reduction, effective March 1.''
In fact, none of the cuts are related to the healthcare reforms before Congress. They're Medicare actions required by existing laws in an attempt to moderate doctor pay while not going broke -- a painful issue that reveals how difficult any kind of reform can be when strongly entrenched interests disagree on what should be done.
In this case, the nation's outraged cardiologists filed a federal lawsuit in Miami and have persuaded 50 members of Congress to co-sponsor a bill to rescind the cuts.
Some healthcare experts like the cuts.
``I'm not at all sympathetic with the cardiologists,'' said Robert Berenson, a doctor who was once in charge of Medicare payment policy and now is a fellow with the Urban Institute. ``Studies show they make well over $400,000 a year'' -- more than twice what a family practice physician earns.
In fact, Medicare is reducing pay to cardiologists as part of a rebalancing plan in which primary care doctors will get a 7 percent increase. ``This system is much more fair,'' said Lori Heim, president of the American Academy of Family Physicians. ``It's not the savior for primary care, but it's a start.''
Heim finds it ``disingenuous'' that the cardiologists' letter blames reform proposals for their rate cuts.
Most of the cuts involve expensive imaging diagnostics, like $800 nuclear stress tests. Studies show that when physicians have expensive imaging machines in their office, they tend to prescribe far more tests.
That's particularly true in Florida, where a study by the Government Accountability Office, the investigative arm of Congress, found that in-office imaging per senior cost $472 in 2006 -- eight times more than in Vermont.
Still, cardiologists say the changes have been devastating. Manuel Abella, a cardiologist in a large group practice in West Kendall, said he and his colleagues have been forced to lay off 15 people, cut salaries 10 percent and eliminate health insurance.
`BASIC TOOLS'
``When a patient comes in and says he has chest pains, you have to have state-of-the-art technology,'' said Romeo Majano, one of the three South Miami cardiologists who sent the letter. ``These are basic tools of our trade, and it's imperative patients have access to them.''
``This technology has greatly improved care,'' said Jack Lowen, president of the American College of Cardiology. ``We've seen a 30 percent reduction in morbidity and mortality in heart disease over the past 10 years.''
``The most affected, of course, will be the patients,'' the South Miami cardiologists warned in their letter, ``as cardiologists will be either forced out of business or forced to drastically increase the number of patients seen, most likely with physician assistants or nurse practitioners to help manage the increased volume.''
The cardiologists say that if Medicare won't pay for, say, a nuclear stress test in a cardiologist's office, the patient will have the test performed at a hospital where it might cost three to five times as much.
Medicare spokeswoman Ellen Griffith said, ``It is difficult to compare payments head-to-head because services may not always be directly comparable.'' Hospitals often get paid more for a service because they must be open around-the-clock and by law must provide coverage for the uninsured in their emergency rooms.
Berenson at the Urban Institute looks at it this way: ``If the hospitals are getting paid too much, the answer is to reduce their payments.'' He doubted the cardiologists' threat of giving up Medicare patients, noting that oncologists made a similar threat several years ago when they saw certain payments taken away and it didn't bear out.
For years, Republicans were leaders in the movement to curtail soaring Medicare costs. Tommy Thompson, secretary of health and human services under President George W. Bush, has frequently given speeches that Medicare costs must be brought under control or aging baby boomers would bankrupt the plan.
But in recent months, as the reform debate intensified, Republican leaders warned that the proposed bills would cut seniors' benefits. A poll this month by the Kaiser Family Foundation found that 48 percent of those over 65 are opposed to the reform bills while 37 percent support them.
In fact, for the past 12 years, under the Clinton, Bush II and Obama administrations, Medicare has been ordered to find ways of curtail costs without reducing quality of care. The Balanced Budget Act of 1997 required physician payments by Medicare to be adjusted annually so that the program didn't go broke.
Every year since 2003, Congress has listened to doctors' complaints and halted pay cuts. Each postponed cut gets added to the next year's calculation and this year all doctors are facing a 21 percent reduction. Congress postponed the cuts until March 1, when they take effect unless lawmakers take action.
Meanwhile, Medicare made a second set of calculations -- about how to split up the budgetary pie among doctors. Both Republicans and Democrats have agreed for some time that primary care is a key to improved healthcare -- because these doctors can coordinate treatment and reduce unnecessary tests and repetitive care.
A 2009 study by Medpac, a federal group that studies Medicare costs, found that, even adjusted for severity of illness, cardiology patients going to a doctor with imaging equipment in his office were twice as likely to get a test as those seeing doctors with no equipment.
Going further, Medicare surveyed physicians about their costs. Based on those findings, Medicare decided to reduce overall payments to cardiologists by 13 percent over four years -- while payments for their imaging services were cut by 30 or 40 percent.
`ERRONEOUS'
The ACC complained that the survey data for cardiologists was based on 55 interviews -- out of 20,000 in private practice. It called the resulting data ``patently erroneous and unreliable.'' When Medicare refused to budge, the ACC filed a lawsuit on Dec. 28.
The government argued that the courts did not have jurisdiction over a Medicare fee dispute. The judge agreed. The cardiologists have now gone to Congress, where lawmakers have a history of reversing Medicare pay cuts to pacify providers.
Griffith, the Medicare spokeswoman, said the agency is ``confident that the policies we have adopted are the most appropriate and will enhance overall access to physician services for beneficiaries. . . . If we find that there are unintended adverse consequences . . . we will have the opportunity to revisit them as part of the annual rule-making.''
Saturday, January 23, 2010
Should We Stop Healthcare Reform Now?
Should We Stop Healthcare Reform Now?
After the election in Massachusetts many predict the collapse of the health care reform efforts. President Obama seems to seek a scaled back version, which is acceptable for Republicans who are blocking ANY reform efforts. But why do we need health care reform NOW? Lets look at the facts: If nothing will happen healthcare spending will continue to outpace the growth in the rest of the domestic product by at least 2.5% annually. Despite the overall slowdown in national health spending growth in 2008, increases in this spending continue to outpace the growth in the resources needed to pay for it! At that rate health spending will absorb 40% of GDP by 2050! The suggested reform proposal will provide 30 Million uninsured Americans adequate coverage requiring about $800 Billion to $1 Trillion in federal subsidies over the next decade. This represents only 3% of the $35 Trillion projected by actuaries to be spent on U.S. health care in the coming decade in the ABSENCE of reform. The relatively small $ 1 Trillion investment in preventing the surge of neglected chronic disease will save Trillions of healthcare dollars normally spent for the emergency room care needed to serve the growing numbers of uninsured! We need to invest money in order to save money!!!
Furthermore, health care insurance companies know very well that the initial rise in health care stocks, on expectations that the Massachusetts’s vote might derail health care reform, may symbolize a pyrrhic victory only! Even though, the reform package included mandated coverage for everyone, regardless of health status, it also offered to heavily subsidize the health care for 30 million Americans who are currently uninsured. This potential financial windfall may not materialize. Insurance companies are very well aware that selling insurance package to employers has slowed because of rising premiums, which reflect rising health care expenditures. The insurance companies must have an interest to bend the cost curve and to expand insurance coverage to offer competitive products. Insurers may gamble with their financial future by supporting the Naysayer because without an overhaul of the insurance industry and the health care market they may face an even bleaker future, which will force draconian government intervention to cut costs.
Therefore, we must support rational reform efforts and President Obama should stop pandering to the opponents of any meaningful reform efforts. We have to act now to avoid a future financial crisis!
Bernd Wollschlaeger,MD,FAAFP,FASAM
After the election in Massachusetts many predict the collapse of the health care reform efforts. President Obama seems to seek a scaled back version, which is acceptable for Republicans who are blocking ANY reform efforts. But why do we need health care reform NOW? Lets look at the facts: If nothing will happen healthcare spending will continue to outpace the growth in the rest of the domestic product by at least 2.5% annually. Despite the overall slowdown in national health spending growth in 2008, increases in this spending continue to outpace the growth in the resources needed to pay for it! At that rate health spending will absorb 40% of GDP by 2050! The suggested reform proposal will provide 30 Million uninsured Americans adequate coverage requiring about $800 Billion to $1 Trillion in federal subsidies over the next decade. This represents only 3% of the $35 Trillion projected by actuaries to be spent on U.S. health care in the coming decade in the ABSENCE of reform. The relatively small $ 1 Trillion investment in preventing the surge of neglected chronic disease will save Trillions of healthcare dollars normally spent for the emergency room care needed to serve the growing numbers of uninsured! We need to invest money in order to save money!!!
Furthermore, health care insurance companies know very well that the initial rise in health care stocks, on expectations that the Massachusetts’s vote might derail health care reform, may symbolize a pyrrhic victory only! Even though, the reform package included mandated coverage for everyone, regardless of health status, it also offered to heavily subsidize the health care for 30 million Americans who are currently uninsured. This potential financial windfall may not materialize. Insurance companies are very well aware that selling insurance package to employers has slowed because of rising premiums, which reflect rising health care expenditures. The insurance companies must have an interest to bend the cost curve and to expand insurance coverage to offer competitive products. Insurers may gamble with their financial future by supporting the Naysayer because without an overhaul of the insurance industry and the health care market they may face an even bleaker future, which will force draconian government intervention to cut costs.
Therefore, we must support rational reform efforts and President Obama should stop pandering to the opponents of any meaningful reform efforts. We have to act now to avoid a future financial crisis!
Bernd Wollschlaeger,MD,FAAFP,FASAM
Monday, January 18, 2010
What can we learn from Israel's efforts in Haiti?
Attached a video link to a CNN report contrasting Israels disaster response in Haiti with the US response.
In the words of Dr.DiGennaro, a Broward county physician, "it makes you almost embarrassed being an American."
Currently, the Israelis run the only fully functioning hospital in Haiti!
Its another example that we fail to understand that disaster and emergency preparedness is not measured by the amount of $$ we throw at the problem AFTER the fact but to continuously prepare and train teams of professionals in emergency and disaster response measures.This does not require a lot of money but dedicated leadership and commitment!
In 2006 I have witnessed the training of the Israeli team on a military base and participated in multiple training sessions myself. I can attest to the fact that they have mastered the art of perfection; each step is documented in a manual and everyone knows how to work in a team and per checklist.
Why we can't do it here? Because we are talking the talk instead of walking the walk. In October 2001 I was appointed by then Governor Bush to the Emergency and Disaster Preparedness Taskforce and urged on multiple occasions to follow the Israeli model. Nothing happened. Yes, we have special teams but too few and far apart. We need local teams that train on a quarterly basis and manage their own equipment and supplies. Do we need to learn another painful lesson from the next natural disaster or do we have to memorize the phone # of the Israeli team instead?
Kudos to their bravery and tireless efforts.
http://www.cnn.com/video/?/video/world/2010/01/18/dnt.cohen.haiti.patients.dying.cnn
Bernd
In the words of Dr.DiGennaro, a Broward county physician, "it makes you almost embarrassed being an American."
Currently, the Israelis run the only fully functioning hospital in Haiti!
Its another example that we fail to understand that disaster and emergency preparedness is not measured by the amount of $$ we throw at the problem AFTER the fact but to continuously prepare and train teams of professionals in emergency and disaster response measures.This does not require a lot of money but dedicated leadership and commitment!
In 2006 I have witnessed the training of the Israeli team on a military base and participated in multiple training sessions myself. I can attest to the fact that they have mastered the art of perfection; each step is documented in a manual and everyone knows how to work in a team and per checklist.
Why we can't do it here? Because we are talking the talk instead of walking the walk. In October 2001 I was appointed by then Governor Bush to the Emergency and Disaster Preparedness Taskforce and urged on multiple occasions to follow the Israeli model. Nothing happened. Yes, we have special teams but too few and far apart. We need local teams that train on a quarterly basis and manage their own equipment and supplies. Do we need to learn another painful lesson from the next natural disaster or do we have to memorize the phone # of the Israeli team instead?
Kudos to their bravery and tireless efforts.
http://www.cnn.com/video/?/video/world/2010/01/18/dnt.cohen.haiti.patients.dying.cnn
Bernd
Wednesday, December 30, 2009
Florida Doctors Lead The Fight Against Change
Dear Friends and Colleagues:
An article in today's (12/29/2009) New York Times, "Health Lobby Takes Fight to the States," reports that Florida is debating a proposed amendment to its state constitution that would try to block, at least symbolically, much of the proposed federal health care overhaul on the grounds that it tramples individual liberty. Its 42 co-sponsors, all Republicans, were almost all recipients of outsized campaign contributions from major health care interests, a total of about $765,000 in 2008. Last year, for example, the drug industry poured more than $20 million into political contributions in states around the country. In California alone, the industry spent an additional $80 million on advertising to beat back a California ballot measure intended to push down drug prices. The idea of amending state constitutions to block the core of the federal health care legislation, including the requirement that individuals and businesses buy insurance, began at the conservative Goldwater Institute in Arizona, the state where the first such measure will appear on the ballot next year. The states where the amendment has been introduced are also places where the health care industry has spent heavily on political contributions in recent years, according to figures from the National Institute on Money in State Politics. Over the last six years, health care interests have spent $394 million on contributions in states around the country; about $73 million of that went to those 14 states. Of that, health insurance companies spent $18.2 million, according to the institute. In Florida, where health interests have given a total of about $32 million over the last six years, the state medical association has become an especially important backer of the proposed amendment. In contrast to the American Medical Association, the Florida Medical Association has come out firmly against the current Congressional proposals, and a spokeswoman said the Florida group had embraced the proposed state amendment “to protect Florida from being forced into a federal government mandate that would hurt patients.” Dr. Madelyn E. Butler, president elect of the Florida Medical Association, said, “We are trying to ameliorate the effects of national health care reform on the State of Florida.” James Greer, chairman of the Florida Republican Party, said he too supported the proposal, which could be on the ballot in 2010 or more likely in 2012. Whatever its legal weight, Mr. Greer said, its mere presence on the ballot would give it political force. Its time that doctors stand up against those powerful interest groups. In some areas in Miami (Hialeah) the Uninsured rate has surpassed 50%. Many of my patients will be forced to drop health insurance coverage in 2010 because they cannot afford the high premiums. One of my family members was told that her back pain constitutes a pre-existing condition and her employer informed her that his small group insurance premiums will increase if he decides to continue providing coverage for her. As physicians we have the moral obligation to protect our patients interests and to stand up against the powerful and mighty insurance industry. Enough is enough!
Have a Happy New Year.
Yours Bernd
An article in today's (12/29/2009) New York Times, "Health Lobby Takes Fight to the States," reports that Florida is debating a proposed amendment to its state constitution that would try to block, at least symbolically, much of the proposed federal health care overhaul on the grounds that it tramples individual liberty. Its 42 co-sponsors, all Republicans, were almost all recipients of outsized campaign contributions from major health care interests, a total of about $765,000 in 2008. Last year, for example, the drug industry poured more than $20 million into political contributions in states around the country. In California alone, the industry spent an additional $80 million on advertising to beat back a California ballot measure intended to push down drug prices. The idea of amending state constitutions to block the core of the federal health care legislation, including the requirement that individuals and businesses buy insurance, began at the conservative Goldwater Institute in Arizona, the state where the first such measure will appear on the ballot next year. The states where the amendment has been introduced are also places where the health care industry has spent heavily on political contributions in recent years, according to figures from the National Institute on Money in State Politics. Over the last six years, health care interests have spent $394 million on contributions in states around the country; about $73 million of that went to those 14 states. Of that, health insurance companies spent $18.2 million, according to the institute. In Florida, where health interests have given a total of about $32 million over the last six years, the state medical association has become an especially important backer of the proposed amendment. In contrast to the American Medical Association, the Florida Medical Association has come out firmly against the current Congressional proposals, and a spokeswoman said the Florida group had embraced the proposed state amendment “to protect Florida from being forced into a federal government mandate that would hurt patients.” Dr. Madelyn E. Butler, president elect of the Florida Medical Association, said, “We are trying to ameliorate the effects of national health care reform on the State of Florida.” James Greer, chairman of the Florida Republican Party, said he too supported the proposal, which could be on the ballot in 2010 or more likely in 2012. Whatever its legal weight, Mr. Greer said, its mere presence on the ballot would give it political force. Its time that doctors stand up against those powerful interest groups. In some areas in Miami (Hialeah) the Uninsured rate has surpassed 50%. Many of my patients will be forced to drop health insurance coverage in 2010 because they cannot afford the high premiums. One of my family members was told that her back pain constitutes a pre-existing condition and her employer informed her that his small group insurance premiums will increase if he decides to continue providing coverage for her. As physicians we have the moral obligation to protect our patients interests and to stand up against the powerful and mighty insurance industry. Enough is enough!
Have a Happy New Year.
Yours Bernd
Thursday, December 24, 2009
Doctors in the News
Well, I guess we can add another "present" under the Christmas tree.
Attached more information about the Zachariah saga which keeps getting juicier and more embarrassing.
Why does greed and lust for power seem to affect doctors more than others?
Because we do not speak up and thereby nurture those behaviors.
Its time to change our approaches and question the format and structure of our organizations.
Merry Christmas
Bernd
Print This Article
Posted on Thu, Dec. 24, 2009
2 Broward doctors settle insider trading case
BY DAN CHRISTENSEN
browardbulldog.org
The former chairman of the Florida Board of Medicine and another Fort Lauderdale physician have agreed to pay substantial sums to settle federal civil charges of insider stock trading.
Dr. Mammen P. Zachariah, appointed to the board of medicine by Gov. Jeb Bush in 2004, and Dr. Sheldon Nassberg allegedly reaped illegal windfalls by acting on stock tips supplied by Mammen Zachariah's brother, prominent Broward heart specialist and major Republican fundraiser Dr. Zachariah P. Zachariah.
Zach Zachariah, who has raised millions of dollars for Republican causes and candidates, including both presidents Bush, faces similar charges, but has declined to settle his case. A federal magistrate has set trial for Aug. 23, 2010.
That trial promises to offer a unique look at Republican fundraising and how political access is bought and sold. Among the expected highlights is witness testimony from two of South Florida's better-known corporate chieftains -- The Geo Group's George Zoley and Phil Frost, formerly of IVAX.
The Zachariah brothers and Nassberg, all of whom practice at Fort Lauderdale's Holy Cross Hospital, were named in a May 2008 civil complaint brought by the U.S. Securities and Exchange Commission. The complaint accuses them of collecting more than a half-million dollars in illegal profits during a fraudulent stock-trading scheme in 2005.
Without admitting or denying the government's allegations, Mammen Zachariah, 61, agreed to pay nearly $136,000 in what a judge labeled ``ill-gotten gains,'' plus an equal amount as a civil penalty. Nassberg, an endocrinologist, agreed to similar payments totaling $52,668. He admitted no wrongdoing. Both men are required to pay up by the end of the month.
The final judgments signed by U.S. Magistrate Linnea Johnson on Wednesday also include permanent injunctions that restrain both doctors from future securities law violations.
Zach Zachariah, another past chairman of the Florida Board of Medicine, is alleged to have used nonpublic information to buy and sell shares of two unrelated Florida companies, Miami-based generic drug maker IVAX and Sarasota's Correctional Services Corp. (CSC).
Zachariah was on IVAX's board of directors in July 2005 when company chairman Phil Frost informed him that IVAX had agreed to be acquired by Teva Pharmaceuticals for $26 a share. Within minutes, Zachariah bought 35,000 IVAX shares for about $21 a share, the SEC said. At the time of the alleged purchase, company insiders were forbidden from trading in IVAX stock.
Zachariah also allegedly tipped off his brother, who bought 2,000 IVAX shares for about $23 a share on the last trading day before the deal was announced in July 25. Zachariah allegedly used inside information to make even more money trading shares of CSC, which was acquired by The GEO Group of Boca Raton in 2005. According to the SEC, the Zachariah brothers and Nassberg turned $380,000 in quick profits.
The government says Zachariah acquired that inside knowledge in a couple of ways. One was through his son Zachariah ``Reggie'' Zachariah, who worked in GEO's mergers and acquisitions department. Reggie Zachariah has denied under oath tipping off his father to the deal. Another was through Zachariah's own moonlighting work for GEO. The SEC says Zachariah made ``millions of dollars'' as a corporate consultant, service provider and lobbyist for GEO, a giant prison contractor once known as Wackenhut Corrections.
Zachariah, who owns a $2.3 million home on the Intracoastal Waterway in secluded Sea Ranch Lakes, said under oath last winter that he was paid to provide access for GEO chief executive George Zoley to top federal and state Republican politicians.
Those politicians include former President George W. Bush, former Senate Majority Leader Bill Frist, former Florida Senate President Tom Lee and House Speaker Alan Bense and former attorney general Charlie Crist, now Florida's governor.
Dan Christensen, a former Miami Herald reporter and columnist for The Daily Business Review, is founding editor of BrowardBulldog.org, a nonprofit online-only newspaper.
Attached more information about the Zachariah saga which keeps getting juicier and more embarrassing.
Why does greed and lust for power seem to affect doctors more than others?
Because we do not speak up and thereby nurture those behaviors.
Its time to change our approaches and question the format and structure of our organizations.
Merry Christmas
Bernd
Print This Article
Posted on Thu, Dec. 24, 2009
2 Broward doctors settle insider trading case
BY DAN CHRISTENSEN
browardbulldog.org
The former chairman of the Florida Board of Medicine and another Fort Lauderdale physician have agreed to pay substantial sums to settle federal civil charges of insider stock trading.
Dr. Mammen P. Zachariah, appointed to the board of medicine by Gov. Jeb Bush in 2004, and Dr. Sheldon Nassberg allegedly reaped illegal windfalls by acting on stock tips supplied by Mammen Zachariah's brother, prominent Broward heart specialist and major Republican fundraiser Dr. Zachariah P. Zachariah.
Zach Zachariah, who has raised millions of dollars for Republican causes and candidates, including both presidents Bush, faces similar charges, but has declined to settle his case. A federal magistrate has set trial for Aug. 23, 2010.
That trial promises to offer a unique look at Republican fundraising and how political access is bought and sold. Among the expected highlights is witness testimony from two of South Florida's better-known corporate chieftains -- The Geo Group's George Zoley and Phil Frost, formerly of IVAX.
The Zachariah brothers and Nassberg, all of whom practice at Fort Lauderdale's Holy Cross Hospital, were named in a May 2008 civil complaint brought by the U.S. Securities and Exchange Commission. The complaint accuses them of collecting more than a half-million dollars in illegal profits during a fraudulent stock-trading scheme in 2005.
Without admitting or denying the government's allegations, Mammen Zachariah, 61, agreed to pay nearly $136,000 in what a judge labeled ``ill-gotten gains,'' plus an equal amount as a civil penalty. Nassberg, an endocrinologist, agreed to similar payments totaling $52,668. He admitted no wrongdoing. Both men are required to pay up by the end of the month.
The final judgments signed by U.S. Magistrate Linnea Johnson on Wednesday also include permanent injunctions that restrain both doctors from future securities law violations.
Zach Zachariah, another past chairman of the Florida Board of Medicine, is alleged to have used nonpublic information to buy and sell shares of two unrelated Florida companies, Miami-based generic drug maker IVAX and Sarasota's Correctional Services Corp. (CSC).
Zachariah was on IVAX's board of directors in July 2005 when company chairman Phil Frost informed him that IVAX had agreed to be acquired by Teva Pharmaceuticals for $26 a share. Within minutes, Zachariah bought 35,000 IVAX shares for about $21 a share, the SEC said. At the time of the alleged purchase, company insiders were forbidden from trading in IVAX stock.
Zachariah also allegedly tipped off his brother, who bought 2,000 IVAX shares for about $23 a share on the last trading day before the deal was announced in July 25. Zachariah allegedly used inside information to make even more money trading shares of CSC, which was acquired by The GEO Group of Boca Raton in 2005. According to the SEC, the Zachariah brothers and Nassberg turned $380,000 in quick profits.
The government says Zachariah acquired that inside knowledge in a couple of ways. One was through his son Zachariah ``Reggie'' Zachariah, who worked in GEO's mergers and acquisitions department. Reggie Zachariah has denied under oath tipping off his father to the deal. Another was through Zachariah's own moonlighting work for GEO. The SEC says Zachariah made ``millions of dollars'' as a corporate consultant, service provider and lobbyist for GEO, a giant prison contractor once known as Wackenhut Corrections.
Zachariah, who owns a $2.3 million home on the Intracoastal Waterway in secluded Sea Ranch Lakes, said under oath last winter that he was paid to provide access for GEO chief executive George Zoley to top federal and state Republican politicians.
Those politicians include former President George W. Bush, former Senate Majority Leader Bill Frist, former Florida Senate President Tom Lee and House Speaker Alan Bense and former attorney general Charlie Crist, now Florida's governor.
Dan Christensen, a former Miami Herald reporter and columnist for The Daily Business Review, is founding editor of BrowardBulldog.org, a nonprofit online-only newspaper.
Sunday, November 22, 2009
Medicare Payment Cuts Reversed
The Medicare Physician Payment Reform Act Of 2009 passed the House on 11.19.2009 with 243 Ayes and 183 Noes. The measure would reverse a 21.2% payment cut planned for Jan. 1, 2010, wipe out the accumulated physician spending debt and implement a new formula.
242 Democrtes and ONE(1) Republican (Michael Burgess,MD, Texas) voted in favor and 172 Republicans and 11 Democrates ( including Suzanne Kozmas, FL) voted against.
Lets be clear who our FRIENDS are: Democrats and NOT Republicans! But the FMA leaders are still supporting those politicians who voted AGAINST the passage of this reform act: Tom Price, Ros Lehtinen, Diaz Balart, Mack, etc.)
Go figure out there logic!!!
Bernd
For more information see AMA News.
House votes to scrap Medicare doctor pay formula
The bill, which would base pay more closely on costs, now moves to the Senate. That chamber has already rejected a similar measure this year.
By CHRIS SILVA, amednews staff. Posted Nov. 19.
Washington -- The U.S. House of Representatives passed a major bill Nov. 19 that would abandon the current Medicare physician payment formula and allow future rates to increase based more closely on doctors' costs, a revision that is expected to cost roughly $210 billion over 10 years.
By a vote of 243-183, the House approved the Medicare Physician Payment Reform Act of 2009. The measure would reverse a 21.2% payment cut planned for Jan. 1, 2010, wipe out the accumulated physician spending debt and implement a new formula.
The new spending growth rate target for physician services would be equal to the gross domestic product plus 1%. Preventive care and evaluation and management services would have a separate target of gross domestic product plus 2%, allowing primary care pay to increase at a higher rate over time.
"Without action by both houses of Congress, Medicare will cut payments to physicians by 21% in 2010, with more in years to come. Today's House vote is the first step toward preventing this cut and eliminating the formula that creates a roller coaster of uncertainty for seniors and physicians who care for them," said American Medical Association President J. James Rohack, MD, who called on the Senate to act on the legislation. "Promises have been made to seniors and military families -- and the House recognizes that those promises must be kept."
The White House in advance of the vote issued a statement strongly supporting the legislation. "The administration believes Medicare and the country need to move toward a system in which doctors receive better incentives to provide their patients with higher quality and more efficient care," said the Nov. 18 statement from the Office of Management and Budget. "A cut of this magnitude could reduce access to physicians for Medicare beneficiaries throughout the country."
The Senate must still approve the legislation before it can head to President Obama's desk. The upper chamber has already rejected a bill once this year that would have eliminated the Medicare physician payment formula. That legislation ran into opposition from Republicans and fiscally conservative Democrats who said they did not want to raise the federal deficit by hundreds of billions of dollars.
The House measure was originally part of the chamber's health system reform bill but was stripped out for separate floor consideration. The primary reason for this was to decrease the total cost of the main reform package and to keep the final dollar figure under a White House-imposed limit.
242 Democrtes and ONE(1) Republican (Michael Burgess,MD, Texas) voted in favor and 172 Republicans and 11 Democrates ( including Suzanne Kozmas, FL) voted against.
Lets be clear who our FRIENDS are: Democrats and NOT Republicans! But the FMA leaders are still supporting those politicians who voted AGAINST the passage of this reform act: Tom Price, Ros Lehtinen, Diaz Balart, Mack, etc.)
Go figure out there logic!!!
Bernd
For more information see AMA News.
House votes to scrap Medicare doctor pay formula
The bill, which would base pay more closely on costs, now moves to the Senate. That chamber has already rejected a similar measure this year.
By CHRIS SILVA, amednews staff. Posted Nov. 19.
Washington -- The U.S. House of Representatives passed a major bill Nov. 19 that would abandon the current Medicare physician payment formula and allow future rates to increase based more closely on doctors' costs, a revision that is expected to cost roughly $210 billion over 10 years.
By a vote of 243-183, the House approved the Medicare Physician Payment Reform Act of 2009. The measure would reverse a 21.2% payment cut planned for Jan. 1, 2010, wipe out the accumulated physician spending debt and implement a new formula.
The new spending growth rate target for physician services would be equal to the gross domestic product plus 1%. Preventive care and evaluation and management services would have a separate target of gross domestic product plus 2%, allowing primary care pay to increase at a higher rate over time.
"Without action by both houses of Congress, Medicare will cut payments to physicians by 21% in 2010, with more in years to come. Today's House vote is the first step toward preventing this cut and eliminating the formula that creates a roller coaster of uncertainty for seniors and physicians who care for them," said American Medical Association President J. James Rohack, MD, who called on the Senate to act on the legislation. "Promises have been made to seniors and military families -- and the House recognizes that those promises must be kept."
The White House in advance of the vote issued a statement strongly supporting the legislation. "The administration believes Medicare and the country need to move toward a system in which doctors receive better incentives to provide their patients with higher quality and more efficient care," said the Nov. 18 statement from the Office of Management and Budget. "A cut of this magnitude could reduce access to physicians for Medicare beneficiaries throughout the country."
The Senate must still approve the legislation before it can head to President Obama's desk. The upper chamber has already rejected a bill once this year that would have eliminated the Medicare physician payment formula. That legislation ran into opposition from Republicans and fiscally conservative Democrats who said they did not want to raise the federal deficit by hundreds of billions of dollars.
The House measure was originally part of the chamber's health system reform bill but was stripped out for separate floor consideration. The primary reason for this was to decrease the total cost of the main reform package and to keep the final dollar figure under a White House-imposed limit.
Friday, November 13, 2009
Appointment
Governor Crist appoints Past DCMA President to the Prescription Drug Monitoring Program Implementation and Oversight Taskforce.
http://www.flgov.com/release/11150
GOVERNOR CRIST APPOINTS NINE TO THE PRESCRIPTION DRUG MONITORING PROGRAM IMPLEMENTATION AND OVERSIGHT TASK FORCE
November 12, 2009
Contact:
GOVERNOR'S PRESS OFFICE
(850) 488-5394
TALLAHASSEE – Governor Charlie Crist today announced the following appointments:
Prescription Drug Monitoring Program Implementation and Oversight Task Force
· Andre Benson, 62, of Tampa, physician, Operation PAR Inc., appointed for a term beginning November 12, 2009, and ending July 1, 2012.
· Lora “Lorrie” Brown, 44, of St. Petersburg, pain physician, Coastal Orthopedics, appointed for a term beginning November 12, 2009, and ending July 1, 2012.
· Kristen Cortes, 45, of Panama City, Florida Department of Law Enforcement agent, appointed for a term beginning November 12, 2009, and ending July 1, 2012.
· David Craig, 41, of Tampa, clinical pharmacist specialist, H. Lee Moffitt Cancer Center and Research Institute, appointed for a term beginning November 12, 2009, and ending July 1, 2012.
· Joel Kaufman, 57, of Ft. Lauderdale, vice president, United Way of Broward County, appointed for a term beginning November 12, 2009, and ending July 1, 2012.
· Nilesh Patel, 45, of Bradenton, interventional pain management physician, appointed for a term beginning November 12, 2009, and ending July 1, 2012.
· Donnie Reynolds, 41, of Weston, chief operating officer, Automated Healthcare Solutions, appointed for a term beginning November 12, 2009, and ending July 1, 2012.
· Paula “Pepper” Wakeland-Hewitt, 60, of Sarasota, pharmacy manager, Davidson Drugs, appointed for a term beginning November 12, 2009, and ending July 1, 2012.
· Bernd Wollschlaeger, 51, of Miramar, self-employed primary care physician, appointed for a term beginning November 12, 2009, and ending July 1, 2012.
http://www.flgov.com/release/11150
GOVERNOR CRIST APPOINTS NINE TO THE PRESCRIPTION DRUG MONITORING PROGRAM IMPLEMENTATION AND OVERSIGHT TASK FORCE
November 12, 2009
Contact:
GOVERNOR'S PRESS OFFICE
(850) 488-5394
TALLAHASSEE – Governor Charlie Crist today announced the following appointments:
Prescription Drug Monitoring Program Implementation and Oversight Task Force
· Andre Benson, 62, of Tampa, physician, Operation PAR Inc., appointed for a term beginning November 12, 2009, and ending July 1, 2012.
· Lora “Lorrie” Brown, 44, of St. Petersburg, pain physician, Coastal Orthopedics, appointed for a term beginning November 12, 2009, and ending July 1, 2012.
· Kristen Cortes, 45, of Panama City, Florida Department of Law Enforcement agent, appointed for a term beginning November 12, 2009, and ending July 1, 2012.
· David Craig, 41, of Tampa, clinical pharmacist specialist, H. Lee Moffitt Cancer Center and Research Institute, appointed for a term beginning November 12, 2009, and ending July 1, 2012.
· Joel Kaufman, 57, of Ft. Lauderdale, vice president, United Way of Broward County, appointed for a term beginning November 12, 2009, and ending July 1, 2012.
· Nilesh Patel, 45, of Bradenton, interventional pain management physician, appointed for a term beginning November 12, 2009, and ending July 1, 2012.
· Donnie Reynolds, 41, of Weston, chief operating officer, Automated Healthcare Solutions, appointed for a term beginning November 12, 2009, and ending July 1, 2012.
· Paula “Pepper” Wakeland-Hewitt, 60, of Sarasota, pharmacy manager, Davidson Drugs, appointed for a term beginning November 12, 2009, and ending July 1, 2012.
· Bernd Wollschlaeger, 51, of Miramar, self-employed primary care physician, appointed for a term beginning November 12, 2009, and ending July 1, 2012.
Sunday, October 25, 2009
Cover Florida
Attached an article in todays Miami Herald pointing out the problematic issues of the so-called " Cover Florida" insurance program touted by Governor Christ as the solution for the Uninsured.
Here are some facts:
* in many cases it offers a barebone service package.
* participating insurance companies still do not offer comprehensive services for competitive prices DESPITE the claims made by the Governor that" each provider was chosen by the state through a competitive bidding process."
* To date, about 4,500 people have enrolled -- about 0.1 percent of the state's uninsured population. More than 3800 Floridians loose their health insurance every week!!!
The question remains: is this program the result of an honest effort to find a solution to cover the Uninsured, or just another political campaign trick meant to boost the chances of Governor Christ to enter the US Senate?
Needless to say that he still refuses to accept a public option, but has yet to declare if Florida will opt out such an option if offered on federal level.
My gut feeling? He will do anything to get elected even if it means to scarify more Floridians on the altar of political vanity.
Yours
Bernd
Posted on Sat, Oct. 24, 2009
Crist exaggerates benefits of Cover Florida Health Care program
BY CATHARINE RICHERT
PolitiFact Staff Writer
In a recent Fox News interview, Florida Gov. Charlie Crist boasted about Cover Florida Health Care, an effort to provide low-cost healthcare coverage to the nearly four million uninsured in the state.
``There are no government mandates to it, no tax dollars utilized for it,'' Crist said on Wednesday. ``Just good, aggressive negotiating by our administration with health insurance companies. . . . And, really, the problem with healthcare is that it's expensive. And so what we've attempted to do is reduce the cost by reducing the expense and the premium of health insurance, and we've had success doing so. Usually it's about $900 a month to get health coverage. We've reduced that, on average, to about $150 a month.''
Given all the debate over the high cost of healthcare, we wondered if the plan could be as inexpensive as Crist claims. We found he was distorting the savings by mixing apples and oranges.
The program, which was started in 2008, allows individuals who have been without coverage for at least six months to pick from plans offered by six insurance companies. Each provider was chosen by the state through a competitive bidding process, and each offers at least two options -- one with catastrophic and hospital coverage, and another plan that can provide less coverage.
The program's website says that individual plans can be purchased for as little as $23 or as much as $800 a month, depending on age, gender and level of coverage. Patients pick and choose between various options offered through the six insurers. So, for example, a woman who is between 19 and 29 years of age can pay $130 a month for a plan that includes no deductible, $10 copays for doctor visits, but no hospital inpatient coverage.
NOT DOING ENOUGH
Since Cover Florida Health Care was enacted, critics have said the program hasn't done enough to cover the uninsured. To date, about 4,500 people have enrolled -- about 0.1 percent of the state's uninsured population.
The low-cost options so often touted by state officials don't offer patients much of a safety net, said Florida state Sen. Nan Rich.
``People are beginning to see that it doesn't cover anything,'' said Rich, a Democrat from Weston. ``It may be inexpensive, but it's inexpensive for a reason. It's a very low level of coverage.''
When we asked Crist's office about his claim -- that healthcare costs are on average $900 a month compared to $150 under Florida's plan -- we were told that the $900 figure cited by the governor came from the nonpartisan Kaiser Family Foundation and that it refers to the amount of money a family pays, on average, per month. Crist's office also noted that the figure is outdated (for instance, in 2006, the average monthly cost per family was about $950) and pointed us to a new Kaiser report released Sept. 15, 2009, that estimates families now pay about $1,114 a month.
So Crist is off by about $200 for family coverage.
AVERAGE COSTS
As for the average cost under the Cover Florida program, Crist's office pointed us to a document that lists the different providers and their rates for individuals. The average for the higher-end coverage, which would include hospitalization and catastrophic insurance, is about $227, while the average for the less-expensive ``preventive'' plan was $89. So Crist's $150 number is the approximate average of the two.
But wait. The first number Crist cited is the Kaiser estimate for a family. The second number is for an individual.
We went back to the Kaiser report and found that the average cost for an individual plan is actually around $400 a month, which would mean the gap was not as dramatically different as Crist claimed.
Crist spokesman Sterling Ivey acknowledged the apples and oranges comparison but said the underlying point is still valid that the Florida average is lower.
But we find Crist is using sleight-of-hand, comparing numbers that aren't comparable. He's used a higher family number with a lower number for individuals. We rate his claim False.
Herald/Times staff writer Steve Bousquet contributed to this report.
Here are some facts:
* in many cases it offers a barebone service package.
* participating insurance companies still do not offer comprehensive services for competitive prices DESPITE the claims made by the Governor that" each provider was chosen by the state through a competitive bidding process."
* To date, about 4,500 people have enrolled -- about 0.1 percent of the state's uninsured population. More than 3800 Floridians loose their health insurance every week!!!
The question remains: is this program the result of an honest effort to find a solution to cover the Uninsured, or just another political campaign trick meant to boost the chances of Governor Christ to enter the US Senate?
Needless to say that he still refuses to accept a public option, but has yet to declare if Florida will opt out such an option if offered on federal level.
My gut feeling? He will do anything to get elected even if it means to scarify more Floridians on the altar of political vanity.
Yours
Bernd
Posted on Sat, Oct. 24, 2009
Crist exaggerates benefits of Cover Florida Health Care program
BY CATHARINE RICHERT
PolitiFact Staff Writer
In a recent Fox News interview, Florida Gov. Charlie Crist boasted about Cover Florida Health Care, an effort to provide low-cost healthcare coverage to the nearly four million uninsured in the state.
``There are no government mandates to it, no tax dollars utilized for it,'' Crist said on Wednesday. ``Just good, aggressive negotiating by our administration with health insurance companies. . . . And, really, the problem with healthcare is that it's expensive. And so what we've attempted to do is reduce the cost by reducing the expense and the premium of health insurance, and we've had success doing so. Usually it's about $900 a month to get health coverage. We've reduced that, on average, to about $150 a month.''
Given all the debate over the high cost of healthcare, we wondered if the plan could be as inexpensive as Crist claims. We found he was distorting the savings by mixing apples and oranges.
The program, which was started in 2008, allows individuals who have been without coverage for at least six months to pick from plans offered by six insurance companies. Each provider was chosen by the state through a competitive bidding process, and each offers at least two options -- one with catastrophic and hospital coverage, and another plan that can provide less coverage.
The program's website says that individual plans can be purchased for as little as $23 or as much as $800 a month, depending on age, gender and level of coverage. Patients pick and choose between various options offered through the six insurers. So, for example, a woman who is between 19 and 29 years of age can pay $130 a month for a plan that includes no deductible, $10 copays for doctor visits, but no hospital inpatient coverage.
NOT DOING ENOUGH
Since Cover Florida Health Care was enacted, critics have said the program hasn't done enough to cover the uninsured. To date, about 4,500 people have enrolled -- about 0.1 percent of the state's uninsured population.
The low-cost options so often touted by state officials don't offer patients much of a safety net, said Florida state Sen. Nan Rich.
``People are beginning to see that it doesn't cover anything,'' said Rich, a Democrat from Weston. ``It may be inexpensive, but it's inexpensive for a reason. It's a very low level of coverage.''
When we asked Crist's office about his claim -- that healthcare costs are on average $900 a month compared to $150 under Florida's plan -- we were told that the $900 figure cited by the governor came from the nonpartisan Kaiser Family Foundation and that it refers to the amount of money a family pays, on average, per month. Crist's office also noted that the figure is outdated (for instance, in 2006, the average monthly cost per family was about $950) and pointed us to a new Kaiser report released Sept. 15, 2009, that estimates families now pay about $1,114 a month.
So Crist is off by about $200 for family coverage.
AVERAGE COSTS
As for the average cost under the Cover Florida program, Crist's office pointed us to a document that lists the different providers and their rates for individuals. The average for the higher-end coverage, which would include hospitalization and catastrophic insurance, is about $227, while the average for the less-expensive ``preventive'' plan was $89. So Crist's $150 number is the approximate average of the two.
But wait. The first number Crist cited is the Kaiser estimate for a family. The second number is for an individual.
We went back to the Kaiser report and found that the average cost for an individual plan is actually around $400 a month, which would mean the gap was not as dramatically different as Crist claimed.
Crist spokesman Sterling Ivey acknowledged the apples and oranges comparison but said the underlying point is still valid that the Florida average is lower.
But we find Crist is using sleight-of-hand, comparing numbers that aren't comparable. He's used a higher family number with a lower number for individuals. We rate his claim False.
Herald/Times staff writer Steve Bousquet contributed to this report.
Saturday, October 10, 2009
Healthcare Reform and Insurance Exchanges
Saturday, October 10, 2009
Letter To The Editor:
When reading John Dorschners article “Healthcare reform proposal on insurance exchanges was tried in Florida” I reached only one conclusion: why to try it again ?
The current system is broken. Costs are soaring and so are the numbers of uninsured Floridians.
The current reform proposal would require all Americans to purchase a flawed product: private health insurance which wastes one-third (31 percent) of Americans’ health dollars on nonsensical administration, huge profits and exorbitant executive pay. But there is one solution which few dare to explore: a single-payer system. Single-payer national health insurance is a system in which a single public or quasi-public agency organizes health financing, but delivery of care remains largely private. Single-payer financing is the only way to recapture wasted and precious healthcare dollars. The potential savings on paperwork, more than $350 billion per year, are enough to provide comprehensive coverage to everyone without paying any more than we already do. Under a single-payer system, all Americans would be covered for all medically necessary services, including: doctor, hospital, preventive, long-term care, mental health, reproductive health care, dental, vision, prescription drug and medical supply costs. Patients would regain free choice of doctor and hospital, and doctors would regain autonomy over patient care. Physicians would be paid fee-for-service according to a negotiated formulary or receive salary from a hospital or nonprofit HMO / group practice. Hospitals would receive a global budget for operating expenses. A single-payer system would be financed by eliminating private insurers and recapturing their administrative waste. Modest new taxes would replace skyrocketing insurance premiums and out-of-pocket payments currently paid by individuals and business. Costs would be controlled through negotiated fees, global budgeting and bulk purchasing. Lets not waste this opportunity for meaningful change. It’s not too late!
Bernd Wollschlaeger,MD,FAAFP,FASAM
Board Certified Family Physician & Addiction Specialist
16899 NE 15th Avenue, North Miami Beach, FL 33162
Phone: (305) 940-8717
E-mail: info@miamihealth.com
Letter To The Editor:
When reading John Dorschners article “Healthcare reform proposal on insurance exchanges was tried in Florida” I reached only one conclusion: why to try it again ?
The current system is broken. Costs are soaring and so are the numbers of uninsured Floridians.
The current reform proposal would require all Americans to purchase a flawed product: private health insurance which wastes one-third (31 percent) of Americans’ health dollars on nonsensical administration, huge profits and exorbitant executive pay. But there is one solution which few dare to explore: a single-payer system. Single-payer national health insurance is a system in which a single public or quasi-public agency organizes health financing, but delivery of care remains largely private. Single-payer financing is the only way to recapture wasted and precious healthcare dollars. The potential savings on paperwork, more than $350 billion per year, are enough to provide comprehensive coverage to everyone without paying any more than we already do. Under a single-payer system, all Americans would be covered for all medically necessary services, including: doctor, hospital, preventive, long-term care, mental health, reproductive health care, dental, vision, prescription drug and medical supply costs. Patients would regain free choice of doctor and hospital, and doctors would regain autonomy over patient care. Physicians would be paid fee-for-service according to a negotiated formulary or receive salary from a hospital or nonprofit HMO / group practice. Hospitals would receive a global budget for operating expenses. A single-payer system would be financed by eliminating private insurers and recapturing their administrative waste. Modest new taxes would replace skyrocketing insurance premiums and out-of-pocket payments currently paid by individuals and business. Costs would be controlled through negotiated fees, global budgeting and bulk purchasing. Lets not waste this opportunity for meaningful change. It’s not too late!
Bernd Wollschlaeger,MD,FAAFP,FASAM
Board Certified Family Physician & Addiction Specialist
16899 NE 15th Avenue, North Miami Beach, FL 33162
Phone: (305) 940-8717
E-mail: info@miamihealth.com
Friday, October 09, 2009
The Old Guard Reveals Itself!
In a recent member communication the President of the FMA reflects on the issue of "Advanced Medical Home" and the primary physician shortage. I agree with him that we need more primary care physicians but his remarks reveal the true attitude towards family physicians by stating that "We in organized medicine need to make sure that secondary providers don’t usurp our traditional role as captain of the ship." Who are those "secondary providers?"
Family doctors, general internists, pediatricians, ARNPs, PAs??? Are we second class citizens too???
This dismissive remark is indicative of the pervasive mind set within the leadership of the FMA which thrives on the cold war-like black-and-white view of the world. But the current healthcare industrial complex (HDIC) consists of a tight web of services delivered across a horizontally and vertically structured set of providers, including physicians and allied healthcare professionals.
Its takes an unhealthy dose of delusional thinking to claim that ANYONE will be the "captain of the ship."
Moreover, Dr.Dolan and other FMA leaders refuse to recognize this reality and want to roll-back in time to the Garden of Eden of medicine where doctors and patients lived together happily until someone introduced the forbidden fruit of health insurance and government intervention.
We have to strike back against the perpetuation of those false beliefs suggesting that family physicians are taking over medicine as THEY know it.
These ideologues are beyond education. They cannot be talked too anymore. Its also useless to work with them on any issues as it pertains to primary care!! We have to define who we are and what we want and work together with consumer groups, unions and patient advocates to create the healthcare delivery system that we all deserve. Change is tough but necessary. Success favors the prepared and open mind. The odds are in our favor. Lets not miss this opportunity.
Yours
Bernd
Family doctors, general internists, pediatricians, ARNPs, PAs??? Are we second class citizens too???
This dismissive remark is indicative of the pervasive mind set within the leadership of the FMA which thrives on the cold war-like black-and-white view of the world. But the current healthcare industrial complex (HDIC) consists of a tight web of services delivered across a horizontally and vertically structured set of providers, including physicians and allied healthcare professionals.
Its takes an unhealthy dose of delusional thinking to claim that ANYONE will be the "captain of the ship."
Moreover, Dr.Dolan and other FMA leaders refuse to recognize this reality and want to roll-back in time to the Garden of Eden of medicine where doctors and patients lived together happily until someone introduced the forbidden fruit of health insurance and government intervention.
We have to strike back against the perpetuation of those false beliefs suggesting that family physicians are taking over medicine as THEY know it.
These ideologues are beyond education. They cannot be talked too anymore. Its also useless to work with them on any issues as it pertains to primary care!! We have to define who we are and what we want and work together with consumer groups, unions and patient advocates to create the healthcare delivery system that we all deserve. Change is tough but necessary. Success favors the prepared and open mind. The odds are in our favor. Lets not miss this opportunity.
Yours
Bernd
Tuesday, October 06, 2009
FMA Board Member in the News
In an (attempted) scholarly treatise Betsy McCaughey, the self-declared patient rights advocate, cited another "scholar", a fellow Florida doctor, as the new oracle of Delphi predicting the demise of medicine. Dr. David McKalip, a Florida neurosurgeon and a board member of the Florida Medical Association, predicts: "The only doctors left in Medicare will be those willing to ration care and practice cookbook medicine." Well, I am glad to know that Dr.Mc Kalip's looney-tunes are hitting the national headlines because it illustrates how he, and his fellow FMA apostles, really think about the future of medicine in this country.
The editorial is filled with half-truth, delusional confabulations using fear-based agitprop, or political propaganda promulgated chiefly in the former USSR.
Well, read it yourself to understand how our fellow FMA colleagues really feel. Enjoy and if you need something for nausea call me.
Yours
Bernd
NEW YORK POST
The 'kill granny' bill
By BETSY MCCAUGHEY
Last Updated: 11:18 AM, October 5, 2009
Posted: 1:05 AM, October 5, 2009
AS the health-reform bills move through Congress, the prognosis for Medicare pa tients gets worse and worse.
The Senate Finance Committee bill (generally called the Baucus bill, after Chairman Max Baucus) robs the elderly to cover the uninsured -- like snatching purses from little old ladies. The House bills already cut future funding for Medicare by $500 billion over the next decade. The Baucus bill would slash a similar amount, just when 30 percent more people enter the program as baby boomers turn 65.
The Baucus bill also puts new limits on what doctors can do for patients in Medicare:
* A "race to the bottom" provision (p. 102 of the revised chairman's mark) would take effect each year for the next five years. The provision penalizes doctors who end up in the 90th percentile or above on the cost of what they use to treat their patients, compared with national averages. The intent is to force down the cost of care, year by year. Yet this blunt instrument can't determine which care is actually wasteful -- it will punish doctors for treating high cost patients with complex conditions. Inevitably, it will lower the quality of care.
* Even more devastating is the amendment Sen. Maria Cantwell (D-Wash.) got inserted into the bill (revised chairman's mark, pp. 102-3). It gives the Secretary of Health and Human Services the power to define quality, cost-effective care for each medical condition and penalize doctors who spend more on their patients.
The law establishing Medicare in 1965 barred the federal government from interfering in doctors' treatment decisions. Slowly, Medicare regulations have begun unraveling that protection. Now the Cantwell amendment finishes the job.
This is the most extreme change to Medicare ever. Dr. David McKalip, a Florida neurosurgeon and a board member of the Florida Medical Association, predicts: "The only doctors left in Medicare will be those willing to ration care and practice cookbook medicine."
It's reasonable for Medicare administrators to strive to get value for dollars spent. In recent years, Medicare has taken a slow, tight-fisted (and sometimes arbitrary) approach to paying for new drugs or medical devices. But Cantwell aims directly at doctors' decisions.
That's not surprising. President Obama and his advisers vilify doctors for over-treating patients. Dr. Ezekiel Emanuel, brother of White House Chief of Staff Rahm Emanuel and a key Obama health-care adviser, argues that the Hippocratic Oath is largely to blame for the "overuse" of medical care.
In his view, doctors focus too much on the needs of their own patients; they should be taught to ask whether the money they're spending on a patient is worth it. To curb doctors' spending, the stimulus legislation launched a process of sending doctors protocols via computer on what the government deems "appropriate" and "cost-effective" care. Doctors who are not "meaningful users" will be punished financially.
When I warned that this meant the government would be interfering in doctors' treatment decisions, CNN and FactCheck.org said that was untrue. But Dr. David Blumenthal, appointed in March to head the new system of computer-guided medicine, settled that debate. In the New England Journal of Medicine (April 9), he confirmed that "embedded clinical-decision support" (his term for computers telling doctors what to do) would be used to reduce costs, and he predicted that some doctors might rebel against tight controls.
The Baucus bill completes the framework for tying doctors' hands when treating the elderly.
Driving all this is the misconception that doctors spend wastefully on patients who are about to die. Newsweek's recent cover story, "The Case for Killing Granny," argues that "the need to spend less money on the elderly at the end of life is the elephant in the room in the health-reform debate."
Numerous studies prove that is false. In 2006, Emory University researchers examining the records of patients in the year before they died found that doctors spend far less on patients who are expected to die than on patients expected to survive.
The Emory researchers said it's untrue that "lifesaving measures for patients visibly near death account for a disproportionate share of spending." They also found that doctors often can't predict when a patient is in the last year of life.
In any case, the health-reformers' plan to cut spending on patients 65 and older won't simply reduce end-of-life care, it will also eliminate care for patients who are perfectly capable of surviving their illness and going on with life.
Betsy McCaughey is chairman of the Committee to Reduce Infection Deaths and a former New York lieutenant-governor.
The editorial is filled with half-truth, delusional confabulations using fear-based agitprop, or political propaganda promulgated chiefly in the former USSR.
Well, read it yourself to understand how our fellow FMA colleagues really feel. Enjoy and if you need something for nausea call me.
Yours
Bernd
NEW YORK POST
The 'kill granny' bill
By BETSY MCCAUGHEY
Last Updated: 11:18 AM, October 5, 2009
Posted: 1:05 AM, October 5, 2009
AS the health-reform bills move through Congress, the prognosis for Medicare pa tients gets worse and worse.
The Senate Finance Committee bill (generally called the Baucus bill, after Chairman Max Baucus) robs the elderly to cover the uninsured -- like snatching purses from little old ladies. The House bills already cut future funding for Medicare by $500 billion over the next decade. The Baucus bill would slash a similar amount, just when 30 percent more people enter the program as baby boomers turn 65.
The Baucus bill also puts new limits on what doctors can do for patients in Medicare:
* A "race to the bottom" provision (p. 102 of the revised chairman's mark) would take effect each year for the next five years. The provision penalizes doctors who end up in the 90th percentile or above on the cost of what they use to treat their patients, compared with national averages. The intent is to force down the cost of care, year by year. Yet this blunt instrument can't determine which care is actually wasteful -- it will punish doctors for treating high cost patients with complex conditions. Inevitably, it will lower the quality of care.
* Even more devastating is the amendment Sen. Maria Cantwell (D-Wash.) got inserted into the bill (revised chairman's mark, pp. 102-3). It gives the Secretary of Health and Human Services the power to define quality, cost-effective care for each medical condition and penalize doctors who spend more on their patients.
The law establishing Medicare in 1965 barred the federal government from interfering in doctors' treatment decisions. Slowly, Medicare regulations have begun unraveling that protection. Now the Cantwell amendment finishes the job.
This is the most extreme change to Medicare ever. Dr. David McKalip, a Florida neurosurgeon and a board member of the Florida Medical Association, predicts: "The only doctors left in Medicare will be those willing to ration care and practice cookbook medicine."
It's reasonable for Medicare administrators to strive to get value for dollars spent. In recent years, Medicare has taken a slow, tight-fisted (and sometimes arbitrary) approach to paying for new drugs or medical devices. But Cantwell aims directly at doctors' decisions.
That's not surprising. President Obama and his advisers vilify doctors for over-treating patients. Dr. Ezekiel Emanuel, brother of White House Chief of Staff Rahm Emanuel and a key Obama health-care adviser, argues that the Hippocratic Oath is largely to blame for the "overuse" of medical care.
In his view, doctors focus too much on the needs of their own patients; they should be taught to ask whether the money they're spending on a patient is worth it. To curb doctors' spending, the stimulus legislation launched a process of sending doctors protocols via computer on what the government deems "appropriate" and "cost-effective" care. Doctors who are not "meaningful users" will be punished financially.
When I warned that this meant the government would be interfering in doctors' treatment decisions, CNN and FactCheck.org said that was untrue. But Dr. David Blumenthal, appointed in March to head the new system of computer-guided medicine, settled that debate. In the New England Journal of Medicine (April 9), he confirmed that "embedded clinical-decision support" (his term for computers telling doctors what to do) would be used to reduce costs, and he predicted that some doctors might rebel against tight controls.
The Baucus bill completes the framework for tying doctors' hands when treating the elderly.
Driving all this is the misconception that doctors spend wastefully on patients who are about to die. Newsweek's recent cover story, "The Case for Killing Granny," argues that "the need to spend less money on the elderly at the end of life is the elephant in the room in the health-reform debate."
Numerous studies prove that is false. In 2006, Emory University researchers examining the records of patients in the year before they died found that doctors spend far less on patients who are expected to die than on patients expected to survive.
The Emory researchers said it's untrue that "lifesaving measures for patients visibly near death account for a disproportionate share of spending." They also found that doctors often can't predict when a patient is in the last year of life.
In any case, the health-reformers' plan to cut spending on patients 65 and older won't simply reduce end-of-life care, it will also eliminate care for patients who are perfectly capable of surviving their illness and going on with life.
Betsy McCaughey is chairman of the Committee to Reduce Infection Deaths and a former New York lieutenant-governor.
Saturday, September 26, 2009
Leaving the FMA
LETTER TO THE PRESIDENT OF THE FMA,DR.JAMES DOLAN:
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,
Bernd
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,
Bernd
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,
Bernd
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,
Bernd
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: http://www.pnhp.org/uninsured2008/Uninsured-by-State-2005-2008.pdf
For more information on Massachusetts, see: http://www.pnhp.org/change/Why-MA-style-Reform-Wont-Work.pdf
Physicians for a National Health Program (www.pnhp.org), 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 www.pnhp.org/stateactions or call (312) 782-6006.
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: http://www.pnhp.org/uninsured2008/Uninsured-by-State-2005-2008.pdf
For more information on Massachusetts, see: http://www.pnhp.org/change/Why-MA-style-Reform-Wont-Work.pdf
Physicians for a National Health Program (www.pnhp.org), 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 www.pnhp.org/stateactions 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
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
Tuesday, August 25, 2009
White House Conference Call
Dear Colleagues:
Today in the evening, I participated in a White House Office of Health Reform conference call to discuss health insurance reform. The call was intended as a briefing for physicians to discuss issues related to health reform. It started at 8:35pm and lasted for an hour. The call was moderated by Dr.Kavita Patel, who serves with Senior Adviser Valerie Jarrett and worked herself a practicing Internal medicine physician. According to her information ~ 1900 physicians participated and > 400 questions were submitted in advance.
After a briefing about the status of the current health reform efforts ( see http://www.healthreform.gov) Dr. Patel answered several questions submitted in writing and then also by people who queued for a life Q&A sessions.
Several of these questions can be grouped as follows but this does not represent a complete list:
1) Medicare Advantage plans and how they can be adjusted to provide competitive and similar-priced services to all Medicare recipients. This question focused on the preferred financing of CMS for Medicare Advantage plans.
2) Increased reimbursement for primary care services and emphasis on quality versus quantity of care. Dr.Patel clearly identified with practicing primary care docs because she herself experienced the grueling schedule and resulting deficiencies in quality of care.
3) Training of more primary care physicians by dramatically increasing funding for the National Health Service Corps programhttp://nhsc.hrsa.gov/. Unfortunately, she missed addressing the necessary funding increase and removing of restrictions for primary care residency positions.
4) One doctor suggested moving from a fee-for-service reimbursement system to a global fee schedule, which in my opinion is sorely needed.
5) Another doctor suggested an end-of-life conference at the White House to rationally discuss this controversial issue and to debunk the "death-panel" propaganda perpetuated by some media outlets and political pundits.
6) In a final question a doctor asked why CMS does not reimburse for preventive care services.Definitely, a golden opportunity to change the current reimbursement system to emphasize and validate our daily effortsd and hard work.
In summary, this was an excellent opportunity to connect, to listen and to ask questions in a relaxed, well organized and calm atmosphere. The focus is on primary care: to emphasize preventive services, and to provide funding for increased reimbursement.
I am pleased that rational thought can prevail and I applaud the White House of Health Reform for their efforts. They announced more phone calls in the future. I strongly urge each of you to participate and to engage in a thoughtful conversation.
Yours
Bernd
Bernd Wollschlaeger,MD,FAAFP,FASAM
Today in the evening, I participated in a White House Office of Health Reform conference call to discuss health insurance reform. The call was intended as a briefing for physicians to discuss issues related to health reform. It started at 8:35pm and lasted for an hour. The call was moderated by Dr.Kavita Patel, who serves with Senior Adviser Valerie Jarrett and worked herself a practicing Internal medicine physician. According to her information ~ 1900 physicians participated and > 400 questions were submitted in advance.
After a briefing about the status of the current health reform efforts ( see http://www.healthreform.gov) Dr. Patel answered several questions submitted in writing and then also by people who queued for a life Q&A sessions.
Several of these questions can be grouped as follows but this does not represent a complete list:
1) Medicare Advantage plans and how they can be adjusted to provide competitive and similar-priced services to all Medicare recipients. This question focused on the preferred financing of CMS for Medicare Advantage plans.
2) Increased reimbursement for primary care services and emphasis on quality versus quantity of care. Dr.Patel clearly identified with practicing primary care docs because she herself experienced the grueling schedule and resulting deficiencies in quality of care.
3) Training of more primary care physicians by dramatically increasing funding for the National Health Service Corps programhttp://nhsc.hrsa.gov/. Unfortunately, she missed addressing the necessary funding increase and removing of restrictions for primary care residency positions.
4) One doctor suggested moving from a fee-for-service reimbursement system to a global fee schedule, which in my opinion is sorely needed.
5) Another doctor suggested an end-of-life conference at the White House to rationally discuss this controversial issue and to debunk the "death-panel" propaganda perpetuated by some media outlets and political pundits.
6) In a final question a doctor asked why CMS does not reimburse for preventive care services.Definitely, a golden opportunity to change the current reimbursement system to emphasize and validate our daily effortsd and hard work.
In summary, this was an excellent opportunity to connect, to listen and to ask questions in a relaxed, well organized and calm atmosphere. The focus is on primary care: to emphasize preventive services, and to provide funding for increased reimbursement.
I am pleased that rational thought can prevail and I applaud the White House of Health Reform for their efforts. They announced more phone calls in the future. I strongly urge each of you to participate and to engage in a thoughtful conversation.
Yours
Bernd
Bernd Wollschlaeger,MD,FAAFP,FASAM
Monday, August 24, 2009
Universal Health Insurance
Attached you find a summary of a bill (HR676)which so far has not been discussed during the current healthcare refom debate.It should be at least considered as an option and not discarded just because its politically difficult to promote.
Bernd Wollschlaeger,MD
H.R. 676, “The United States National Health Care Act,”
Or “Expanded & Improved Medicare For All”
Introduced by Rep. John Conyers, Jr.
Brief Summary of Legislation
The United States National Health Care Act (USNHC) establishes a unique American universal health insurance program with single payer financing. The bill would create a publicly financed, privately delivered health care system that improves and expands the already existing Medicare program to all U.S. residents, and all residents living in U.S. territories. The goal of the legislation is to ensure that all Americans will have access, guaranteed by law, to the highest quality and most cost effective health care services regardless of their employment, income or health care status. In short, health care becomes a human right. With 47 million uninsured Americans, and another 50 million who are underinsured, the time has come to change our inefficient and costly fragmented non-system of health care.
Who is Eligible
Every person living or visiting in the United States and the U.S. Territories would receive a United States National Health Insurance Card and ID number once they enroll at the appropriate location. Social Security numbers may not be used when assigning ID cards.
Health Care Services Covered
This program will cover all medically necessary services, including primary care, inpatient care, outpatient care, emergency care, prescription drugs, durable medical equipment, hearing services, long term care, palliative care, podiatric care, mental health services, dentistry, eye care, chiropractic, and substance abuse treatment. Patients have their choice of physicians, providers, hospitals, clinics, and practices. There no co-pays or deductibles under this act.
Conversion To A Non-Profit Health Care System
Doctors, hospitals, and clinics will continue to operate as privately entities. However, they will be unable to issue stock. Private health insurers shall be prohibited under this act from selling coverage that duplicates the benefits of the USNHC program. Exceptions to this rule include coverage for cosmetic surgery, and other medically unnecessary treatments. Those workers who are displaced as the result of the transition to a non-profit health care system will be the first to be hired and retrained under this act. Furthermore, workers would receive their same salary for up to two years, and would then be eligible for unemployment benefits. The conversion to a not-for- profit health care system will take place as soon as possible, but not to exceed a 15 year period, through the sale of U.S. treasury bonds.
Cost Containment Provisions/ Reimbursement
The USNHC program will negotiate reimbursement rates annually with physicians, allow for global budgets (monthly lump sums for operating expenses) for hospitals, and negotiate prices for prescription drugs, medical supplies and equipment. A “Medicare For All Trust Fund” will be established to ensure a dedicated stream of funding. An annual Congressional appropriation is also authorized to ensure optimal levels of funding for the program, in particular, to ensure the requisite number of physicians and nurses need in the health care delivery system.
H.R. 676 Would Reduce Overall Health Care Costs
Families Will Pay Less
Currently, the average family of four covered under an employee health plan spends a total of $4,225 on health care annually – $2,713 on premiums and another $1,522 on medical services, drugs and supplies (Employer Health Benefits 2006 Annual Survey, Kaiser Family Foundation and Health Research and Educational Trust; U.S. Department of Labor, Bureau of Labor Statistics, Consumer Expenditure Survey.) This figure does not include the additional 1.45% Medicare payroll tax levied on employees. A study by Dean Baker of the Center for Economic Research and Policy concluded that under H.R. 676, a family of four making the median family income of $56,200 per year would pay about $2,700 for all health care costs.
Business Will Pay Less
In 2006, health insurers charged employers an average of $11,500 for a health plan for a family of four. On average, the employer paid 74% of this premium, or $8,510 per year. This figure does not include the additional 1.45% payroll tax levied on employers for Medicare. Under H.R. 676, employers would pay a 4.75% payroll tax for all health care costs. For an employee making the median family income of $56,200 per year, the employer would pay about $2,700.
The Nation Will Pay About the Same, While Covering All Americans
Savings from reduced administration, bulk purchasing, and coordination among providers will allow coverage for all Americans while reducing health care inflation in the long term. Annual savings from enacting H.R. 676 are estimated at $387 billion (Baker).
Proposed Funding For USNHC Program
· Maintain current federal and state funding for existing health care programs
· Establish employer/employee payroll tax of 4.75% (includes present 1.45% Medicare tax)
· Establish a 5% health tax on the top 5% of income earners, 10% tax on top 1% of wage earners
· ¼ of 1% stock transaction tax
· Close corporate tax loopholes
· Repeal the Bush tax cuts for the highest income earners
Bernd Wollschlaeger,MD
H.R. 676, “The United States National Health Care Act,”
Or “Expanded & Improved Medicare For All”
Introduced by Rep. John Conyers, Jr.
Brief Summary of Legislation
The United States National Health Care Act (USNHC) establishes a unique American universal health insurance program with single payer financing. The bill would create a publicly financed, privately delivered health care system that improves and expands the already existing Medicare program to all U.S. residents, and all residents living in U.S. territories. The goal of the legislation is to ensure that all Americans will have access, guaranteed by law, to the highest quality and most cost effective health care services regardless of their employment, income or health care status. In short, health care becomes a human right. With 47 million uninsured Americans, and another 50 million who are underinsured, the time has come to change our inefficient and costly fragmented non-system of health care.
Who is Eligible
Every person living or visiting in the United States and the U.S. Territories would receive a United States National Health Insurance Card and ID number once they enroll at the appropriate location. Social Security numbers may not be used when assigning ID cards.
Health Care Services Covered
This program will cover all medically necessary services, including primary care, inpatient care, outpatient care, emergency care, prescription drugs, durable medical equipment, hearing services, long term care, palliative care, podiatric care, mental health services, dentistry, eye care, chiropractic, and substance abuse treatment. Patients have their choice of physicians, providers, hospitals, clinics, and practices. There no co-pays or deductibles under this act.
Conversion To A Non-Profit Health Care System
Doctors, hospitals, and clinics will continue to operate as privately entities. However, they will be unable to issue stock. Private health insurers shall be prohibited under this act from selling coverage that duplicates the benefits of the USNHC program. Exceptions to this rule include coverage for cosmetic surgery, and other medically unnecessary treatments. Those workers who are displaced as the result of the transition to a non-profit health care system will be the first to be hired and retrained under this act. Furthermore, workers would receive their same salary for up to two years, and would then be eligible for unemployment benefits. The conversion to a not-for- profit health care system will take place as soon as possible, but not to exceed a 15 year period, through the sale of U.S. treasury bonds.
Cost Containment Provisions/ Reimbursement
The USNHC program will negotiate reimbursement rates annually with physicians, allow for global budgets (monthly lump sums for operating expenses) for hospitals, and negotiate prices for prescription drugs, medical supplies and equipment. A “Medicare For All Trust Fund” will be established to ensure a dedicated stream of funding. An annual Congressional appropriation is also authorized to ensure optimal levels of funding for the program, in particular, to ensure the requisite number of physicians and nurses need in the health care delivery system.
H.R. 676 Would Reduce Overall Health Care Costs
Families Will Pay Less
Currently, the average family of four covered under an employee health plan spends a total of $4,225 on health care annually – $2,713 on premiums and another $1,522 on medical services, drugs and supplies (Employer Health Benefits 2006 Annual Survey, Kaiser Family Foundation and Health Research and Educational Trust; U.S. Department of Labor, Bureau of Labor Statistics, Consumer Expenditure Survey.) This figure does not include the additional 1.45% Medicare payroll tax levied on employees. A study by Dean Baker of the Center for Economic Research and Policy concluded that under H.R. 676, a family of four making the median family income of $56,200 per year would pay about $2,700 for all health care costs.
Business Will Pay Less
In 2006, health insurers charged employers an average of $11,500 for a health plan for a family of four. On average, the employer paid 74% of this premium, or $8,510 per year. This figure does not include the additional 1.45% payroll tax levied on employers for Medicare. Under H.R. 676, employers would pay a 4.75% payroll tax for all health care costs. For an employee making the median family income of $56,200 per year, the employer would pay about $2,700.
The Nation Will Pay About the Same, While Covering All Americans
Savings from reduced administration, bulk purchasing, and coordination among providers will allow coverage for all Americans while reducing health care inflation in the long term. Annual savings from enacting H.R. 676 are estimated at $387 billion (Baker).
Proposed Funding For USNHC Program
· Maintain current federal and state funding for existing health care programs
· Establish employer/employee payroll tax of 4.75% (includes present 1.45% Medicare tax)
· Establish a 5% health tax on the top 5% of income earners, 10% tax on top 1% of wage earners
· ¼ of 1% stock transaction tax
· Close corporate tax loopholes
· Repeal the Bush tax cuts for the highest income earners
Sunday, August 23, 2009
Speak Up Against Propaganda
Sunday, August 23, 2009
Letter To The Editor:
RE: Recess Rally
Naturally, every American has the constitutional right to free speech but healthcare protesters are going too far by likening Obama to Hitler or claiming that government will control when people die. It especially puzzles me that the many of those protesters opposing meaningful and necessary healthcare reform are Medicare recipient benefiting from a government controlled, single-payer system! Would those same people be willing to turn in their Medicare cards in protest too? Would those people consider me a “death panelist” because I follow Florida Law and need to discuss advanced directives with them? According to their “logic” hospitals, nursing homes, home health agencies, hospices, and health maintenance organizations (HMOs), which are required to provide their patients with written information concerning health care advance directives, are part of the “death panels” too!
We have to tune down the hyperbolic and toxic rhetoric fueled by fearmongers and anti-government nut wings and return to a rational dialogue to resolve an urgent problem: how to provide healthcare for all Americans.
Bernd Wollschlaeger, MD,FAAFP,FASAM
Family Physician
Letter To The Editor:
RE: Recess Rally
Naturally, every American has the constitutional right to free speech but healthcare protesters are going too far by likening Obama to Hitler or claiming that government will control when people die. It especially puzzles me that the many of those protesters opposing meaningful and necessary healthcare reform are Medicare recipient benefiting from a government controlled, single-payer system! Would those same people be willing to turn in their Medicare cards in protest too? Would those people consider me a “death panelist” because I follow Florida Law and need to discuss advanced directives with them? According to their “logic” hospitals, nursing homes, home health agencies, hospices, and health maintenance organizations (HMOs), which are required to provide their patients with written information concerning health care advance directives, are part of the “death panels” too!
We have to tune down the hyperbolic and toxic rhetoric fueled by fearmongers and anti-government nut wings and return to a rational dialogue to resolve an urgent problem: how to provide healthcare for all Americans.
Bernd Wollschlaeger, MD,FAAFP,FASAM
Family Physician
Friday, August 21, 2009
Lets Get Real:
Over the last few months I witnessed the almost hyperbolic rhetoric used by my colleagues in organized medicine calling for a “battle for freedom” to protect the “sacrosanct patient-physician relationship” against the perceived intrusion by “big government.” They are now joining the chorus of fearmongers who paint the apocalyptic vision of a world dominated by government rationing of healthcare and imaginary death panels forcing seniors to sign living wills condemning them to die.
Meanwhile, those of us who call for a rational discussion about the issues are being marginalized.
The worst if still to come: in exchange for their support of health care reform health insurance companies are being handed the big price: to offer insurance to the uninsured without having to change their business practice. Fiercely defended by Republicans, ideologically motivated leaders in organized medicine and conservative Democrats the CEOs of health insurance companies can continue to reap fat profits by limiting and rationing healthcare for millions of policyholders who are clueless that their policies may not deliver the promised coverage. This win-win situation for insurance companies will result in a loose-loose situation for the average healthcare consumer because the basic principle of meaningful health care reform is missing: tight regulation of the health insurance market.
Uwe Reinhardt, a renowned economics professor at Princeton, got it right. In his recent blog entry “Who Needs The Public Option?” http://economix.blogs.nytimes.com/2009/08/21/who-needs-the-public-option/#more-27531 he states that “Citizens in the rest of the industrialized world have long had easy-to-understand, reliable, life-cycle health insurance. They do not wake up at night worrying that their health insurance might be rescinded over some willful or inadvertent omission on health status during the application for insurance. Nor do they worry that they and their families will lose their health insurance coverage when the family’s breadwinner loses a job or switches jobs or location of residence. It would be very rare, indeed, in those countries to see a middle-class family lose all of its savings and perhaps even its home over unpaid medical bills……….our health insurance system leaves most Americans basically “unsured”: Private, job-based health insurance purchased in the large-group market is stable and reliable only as long as an employee keeps that job. It is not permanent, nor portable. It leaves Americans exposed to considerable financial risk over their life cycle. It is not “insurance,” but “unsurance.”
Even though, I do not agree with his assertion that a public option is not a necessary condition for healthcare reform I wholeheartedly support his argument that we “must convince the public and the legislators who do not trust it that with the help of government – including a wide set of new government regulations – the industry can transform itself into a structure that can offer Americans the same permanent, reliable, easy-to-understand life-cycle financial security that citizens in other nations take for granted and Americans crave.”
The main challenge remains: either creating a purely private-sector model that will offer individuals reliable, life-cycle health insurance with relatively stable premiums, and at premiums that are defensible, or opting for a taxpayer funded single payer health care system (Medicare For All). As long as the typical employment-based health insurance premium for family coverage is $12,688 per year - and rising exponentially – I opt for the only logical solution: single payer healthcare for all Americans!
Bernd Wollschlaeger,MD,FAFP,FASAM
Meanwhile, those of us who call for a rational discussion about the issues are being marginalized.
The worst if still to come: in exchange for their support of health care reform health insurance companies are being handed the big price: to offer insurance to the uninsured without having to change their business practice. Fiercely defended by Republicans, ideologically motivated leaders in organized medicine and conservative Democrats the CEOs of health insurance companies can continue to reap fat profits by limiting and rationing healthcare for millions of policyholders who are clueless that their policies may not deliver the promised coverage. This win-win situation for insurance companies will result in a loose-loose situation for the average healthcare consumer because the basic principle of meaningful health care reform is missing: tight regulation of the health insurance market.
Uwe Reinhardt, a renowned economics professor at Princeton, got it right. In his recent blog entry “Who Needs The Public Option?” http://economix.blogs.nytimes.com/2009/08/21/who-needs-the-public-option/#more-27531 he states that “Citizens in the rest of the industrialized world have long had easy-to-understand, reliable, life-cycle health insurance. They do not wake up at night worrying that their health insurance might be rescinded over some willful or inadvertent omission on health status during the application for insurance. Nor do they worry that they and their families will lose their health insurance coverage when the family’s breadwinner loses a job or switches jobs or location of residence. It would be very rare, indeed, in those countries to see a middle-class family lose all of its savings and perhaps even its home over unpaid medical bills……….our health insurance system leaves most Americans basically “unsured”: Private, job-based health insurance purchased in the large-group market is stable and reliable only as long as an employee keeps that job. It is not permanent, nor portable. It leaves Americans exposed to considerable financial risk over their life cycle. It is not “insurance,” but “unsurance.”
Even though, I do not agree with his assertion that a public option is not a necessary condition for healthcare reform I wholeheartedly support his argument that we “must convince the public and the legislators who do not trust it that with the help of government – including a wide set of new government regulations – the industry can transform itself into a structure that can offer Americans the same permanent, reliable, easy-to-understand life-cycle financial security that citizens in other nations take for granted and Americans crave.”
The main challenge remains: either creating a purely private-sector model that will offer individuals reliable, life-cycle health insurance with relatively stable premiums, and at premiums that are defensible, or opting for a taxpayer funded single payer health care system (Medicare For All). As long as the typical employment-based health insurance premium for family coverage is $12,688 per year - and rising exponentially – I opt for the only logical solution: single payer healthcare for all Americans!
Bernd Wollschlaeger,MD,FAFP,FASAM
Thursday, August 06, 2009
Healthcare For All
Dear Friends and Colleagues:
Attached a superb article by Dr. Dennis Mayeaux,President of the Florida Academy of Family Physicians, which was published in todays Miami Herald.
Yours
Bernd
Posted on Thu, Aug. 06, 2009
Key to reform is doctor access for all
BY DENNIS MAYEAUX
dennismayeaux@yahoo.com
Comprehensive healthcare reform is a political and social challenge that has escaped this country for more than 30 years. This year, divergent interests are coming together to finally fix our healthcare system. There are proposals in Congress that would provide high quality, affordable healthcare and give people the choice of keeping their current insurance plan and their family physician, internist or other primary-care doctor.
As a family physician, I see the effects of our broken healthcare system every day. Let's face it. Access to coverage is never guaranteed. It is not easy to treat patients who are uninsured because they can't afford coverage or are unable to get coverage because of age or a pre-existing condition. Every day even insured patients are refused care because of coverage denials. I am tired of seeing my patients struggle paying for the healthcare they need. Healthcare reform can't come soon enough.
What does it take to make this happen?
• We first need legislation that covers everyone, requiring insurance companies to sell plans regardless of family history, or pre-existing conditions, and to guarantee that patients can renew their coverage after they've become sick.
• Legislation also needs to ensure that once people have insurance, they also have access to a primary-care physician. Unfortunately, there is a growing shortage of primary-care doctors to meet that need. The reformed system must value primary care if we want medical students to choose careers such as Family Medicine. We need family physicians to keep people healthy, provide early treatment for the most common health problems and coordinate comprehensive and seamless care when subspecialty attention is needed.
There is some good news. We have a vehicle that can begin making all these improvements happen. It's called the Affordable Health Choices Act being debated in the U.S. Senate. The House of Representatives is considering a similar bill, which also includes a focus on primary care. These proposals promise to ensure affordable health coverage for nearly everyone.
It's time to stop playing politics and solve the healthcare crisis. We must find a uniquely American solution that controls skyrocketing healthcare costs and gives our patients peace of mind when it comes to their healthcare.
Our Surgeon General nominee, family physician Regina Benjamin, hopes to be ``America's Family Physician.'' Having a family physician is vital to every Floridian's health. Let us support that goal by providing access to all.
Meaningful and sustainable healthcare reform is possible if Congress passes legislation that gives everyone in the United States access to a patient-centered medical home, where their doctor will ensure they get the care they need, when they need it and where they need it.
Dr. Dennis Mayeaux is president of the Florida Academy of Family Physicians.
Attached a superb article by Dr. Dennis Mayeaux,President of the Florida Academy of Family Physicians, which was published in todays Miami Herald.
Yours
Bernd
Posted on Thu, Aug. 06, 2009
Key to reform is doctor access for all
BY DENNIS MAYEAUX
dennismayeaux@yahoo.com
Comprehensive healthcare reform is a political and social challenge that has escaped this country for more than 30 years. This year, divergent interests are coming together to finally fix our healthcare system. There are proposals in Congress that would provide high quality, affordable healthcare and give people the choice of keeping their current insurance plan and their family physician, internist or other primary-care doctor.
As a family physician, I see the effects of our broken healthcare system every day. Let's face it. Access to coverage is never guaranteed. It is not easy to treat patients who are uninsured because they can't afford coverage or are unable to get coverage because of age or a pre-existing condition. Every day even insured patients are refused care because of coverage denials. I am tired of seeing my patients struggle paying for the healthcare they need. Healthcare reform can't come soon enough.
What does it take to make this happen?
• We first need legislation that covers everyone, requiring insurance companies to sell plans regardless of family history, or pre-existing conditions, and to guarantee that patients can renew their coverage after they've become sick.
• Legislation also needs to ensure that once people have insurance, they also have access to a primary-care physician. Unfortunately, there is a growing shortage of primary-care doctors to meet that need. The reformed system must value primary care if we want medical students to choose careers such as Family Medicine. We need family physicians to keep people healthy, provide early treatment for the most common health problems and coordinate comprehensive and seamless care when subspecialty attention is needed.
There is some good news. We have a vehicle that can begin making all these improvements happen. It's called the Affordable Health Choices Act being debated in the U.S. Senate. The House of Representatives is considering a similar bill, which also includes a focus on primary care. These proposals promise to ensure affordable health coverage for nearly everyone.
It's time to stop playing politics and solve the healthcare crisis. We must find a uniquely American solution that controls skyrocketing healthcare costs and gives our patients peace of mind when it comes to their healthcare.
Our Surgeon General nominee, family physician Regina Benjamin, hopes to be ``America's Family Physician.'' Having a family physician is vital to every Floridian's health. Let us support that goal by providing access to all.
Meaningful and sustainable healthcare reform is possible if Congress passes legislation that gives everyone in the United States access to a patient-centered medical home, where their doctor will ensure they get the care they need, when they need it and where they need it.
Dr. Dennis Mayeaux is president of the Florida Academy of Family Physicians.
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