Drug Testing for Welfare Recipients

Attached some food for thought regarding the mandatory drug testing for welfare recipients:

When Florida Gov. Rick Scott (R) signed the law requiring welfare recipients to pass annual drug tests to collect benefits, he justified the likely unconstitutional law by saying it would save the state money by keeping drug users from using public money to subsidize their drug habits. Drug use, Scott claimed, was higher among welfare recipients than among the rest of the population.According to preliminary results from the state’s first round of testing, however, has seemingly proven both of those claims false. Only 2 percent of welfare recipients failed drug tests, meaning the state must reimburse the cost of the $30 drug tests to the 96 percent of recipients who passed drug tests (two percent did not take the tests). After reimbursements, the state’s savings will be almost negligible, the Tampa Tribune reports:
Cost of the tests averages about $30. Assuming that 1,000 to 1,500 applicants take the test every month, the state will owe about $28,800-$43,200 monthly in reimbursements to those who test drug-free.
That compares with roughly $32,200-$48,200 the state may save on one month’s worth of rejected applicants.
Net savings to the state: $3,400 to $5,000 annually on one month’s worth of rejected applicants. Over 12 months, the money saved on all rejected applicants would add up to $40,800 to $60,000 for a program that state analysts have predicted will cost $178 million this fiscal year.
This should serve as an example that our government in Florida seems to base its decisions on ideological assumption instead on rational thought and consideration.
Yours

Bernd


Bernd Wollschlaeger,MD,FAAFP,FASAM
16899 NE 15th Avenue
North Miami Beach,FL 33162
Phone: (305) 940-8717
Fax: (305) 940-8871
Web Site: www.miamihealth.com
Blog: http://floridadocs.blogspot.com
Twitter: http://www.twitter.com/dadedoc

Primary Care Defunded

Attached you find a link to an article by John Dorschner titled "Clinics for poor threatened by cuts" http://www.miamiherald.com/2011/08/17/2366741/south-florida-clinics-threatened.html pointing out that " federal support of clinics [ community health centers] took a big hit in the recent deficit reduction deal in Washington and may be taking an even bigger one when Congress starts a new round of budget-cutting in the near future. At the same time, some free clinics in South Florida that also help the poor — often with little or no government support — are running out of funds and are in danger of closing."
Dorschner further reports that the creators of the federal healthcare reform act considered primary care such an important way to cut costs that the act authorized $11 billion to bolster care at “federally qualified health centers,” which include nine clinics with more than 30 locations in Miami-Dade and Broward. Congress authorized $1 billion for new federally qualified facilities or expansions of existing ones this year. But the $1 billion allocation was slashed to about $90 million for new facilities during the recent budget cuts. Only 67 of 2000 applications for new federally qualified centers were funded. More cuts may be coming as a new congressional deficit reduction committee gets under way.
In my opinion cutting primary care services is a penny-wise and pound-foolish decision . Now, those uninsured will be left with no other choice but to use the emergency rooms of local hospitals for their care resulting in far higher costs, poor care coordination and no continuity of care.
How can we talk sense to politicians who seem to ignore those facts? Are they really so detached from reality, or is is just about scoring points for their re-election campaigns? We must speak up and defend the rights of those who now do not have anyone left to speak up for them. Both parties in congress are at fault and our president doesn't dare to rock the boat. Enough is enough!!

Health Insurance Policy

Attached a link to an interesting article http://online.wsj.com/article/SB10001424053111904253204576512494056148396.html published in today's WSJ reporting that as part of the health-care overhaul law federal regulators are expected to unveil on Wednesday the proposed health insurance policy summary form of health insurance policies , that will lay out the details of each policy, from deductibles to how much it might cost to have a baby. The requirement is supposed to take effect next March. Currently, states mandate certain disclosures from health insurers, but they vary by state. The information often comes as part of a document known as the certificate of coverage or evidence of coverage, which can run to dozens of densely written pages and is often supplied ONLY AFTER a consumer has signed up for a policy. Employers offering coverage typically provide materials to their workers, but these also don't follow any common national format.
The proposed new summary is expected to closely follow a draft version from a committee convened by the National Association of Insurance Commissioners, people with knowledge of the matter said. Health and Human Services is expected to finalize the form after a public comment period. Insurers said they were concerned about the potential cost and administrative burden of the new requirement, particularly if they have to create different iterations of the form for every possible plan design a consumer could explore and for every single employer.
Of course they are concerned because for the first time the policies will be readable, comparable and can form the basis of rational decision making in a complex market place. Who does understand his/her current health care policy? I don't !! I still struggle to understand how much my insurance will cover for a colonoscopy and how much I have to budget for this procedure. If we want a free market place then we should allow for measures that create accountability and transparency. Currently, insurance companies will make every effort to maintain the status quo, which disenfranchises the consumer. We should support these new federal regulation and to express our opinions during the public comment period. Let's not miss this opportunity.
Yours
Bernd

The Blues Treatment For Mental Health Providers

Attached a very troublesome article I just received today reporting that on July 27, 2011 Blue Cross Blue Shield of Florida began notifying ALL of their mental health providers (licensed social workers, licensed mental health counselors, psychologists, and psychiatrists) that effective November 30th, 2011 they would be terminated, without cause.
They were also notified that that if providers would like to join the new company they are partnering with, New Directions, so that they can provide services to their patrons, they would need to complete a new contract (sent under separate cover) within 15 days and agree to significant cuts (35-55%) in reimbursement rates, as well as other disturbing clauses such as only being able to refer to in-network providers, etc.
Since BCBS is considered to be one of the largest providers of insurance for mental/behavioral health in Florida, this termination could potentially place hundreds/thousands of providers in a position of being underemployed and/or unemployed, and worse, leave thousands of patients without coverage or access to mental health/psychological treatment.


CNN producer note
iReport -
On July 27, 2011 Blue Cross Blue Shield of Florida began notifying ALL of
their mental health providers (licensed social workers, licensed mental
health counselors, psychologists, and psychiatrists) that effective Nov 30,
2011 they would be terminated, without cause. That is, they will no longer
be providers for BCBS-FL. In this notice, current providers were also
instructed to notify BCBS subscribers/patients of this coming termination
directly and on behalf of BCBS-FL.

BCBS-FL also indicated that if providers would like to join the new company
they are partnering with, New Directions, so that they can provide services
to their patrons, they would need to complete a new contract (sent under
separate cover) within 15 days and agree to significant cuts (35-55%) in
reimbursement rates, as well as other disturbing clauses such as only being
able to refer to in-network providers, etc.

Interestingly, New Directions appears to be a subsidiary of BCBS-FL. So, as
if it isn't horrible enough that ALL of the mental/behavioral health
providers have been "fired" at the same time and patients will likely find
themselves with poor quality care or no care at all, it appears that they
(the same company-BCBS-FL) fired its contractors and then offered them the
oportunity to reapply for rehire within the same week, but only if they
agree to sign a new contract, with entirely different terms.

This action (termination of providers only in one area) also seems to be a
possible violation of the Federal Mental Health Parity Law which protects
against the discrimination of mental health services. It does not appear
that any of the other healthcare providers or "medical" providers had their
contracts terminated.

Since BCBS is considered to be one of the largest providers of insurance for
mental/behavioral health in Florida, this termination could potentially
place hundreds/thousands of providers in a position of being underemployed
and/or unemployed, and worse, leave thousands of patients without coverage
or access to mental health/psychological treatment.

The ripple effect of these actions by BCBS-FL could be deadly to the people,
communities, and businesses throughout FL. leaving many unable to make a
reasonable living and thousands (including Seniors with BCBS as a secondary
policy) unable to access and/or pay for mental health treatment and
psychological services.

--
Bernd Wollschlaeger,MD,FAAFP,FASAM
16899 NE 15th Avenue
North Miami Beach,FL 33162
Phone: (305) 940-8717
Fax: (305) 402-2989
Web Site: www.miamihealth.com
Blog: http://floridadocs.blogspot.com
Twitter: @dadedoc

Florida Turns Down Federal Money

Attached a link to a recent article published in the NYT http://www.nytimes.com/2011/08/01/us/01florida.html pointing out that despite having the country’s fourth-highest unemployment rate, its second-highest rate of people without insurance and a $3.7 billion budget gap this year, the Florida has turned away scores of millions of dollars in grants made available under the Affordable Care Act. And it is not pursuing grants worth many millions more.
Although Florida is the fourth most populous state, it ranks 12th in the amount of money received from health care act grants, according to the government’s grant-tracking Web site. The law has directed $46.4 million to the state out of $1.98 billion awarded nationally. Much of the money has gone directly to local governments, community groups and medical providers. The Florida government even went so far to deny funding for community health centers! Three of four grants to expand community health clinics in Florida went to medical centers that are beyond the reach of the governor and the Legislature. The fourth was to the Osceola County Health Department, which under Florida law is effectively a unit of state government. The Legislature used its power to not authorize a grant won by the county to expand two health centers and build a third.
This represents not only irresponsible ideology driven behavior but it also threatens the fragile health of our communities.
Its time to raise our voices and to act as responsible citizens of our great state of Florida.
Yours

Bernd

Iraqi Healthcare

According to data analyzed by various think tanks the United States of America, i.e. taxpayers like you and me, spent (or wasted) almost ONE TRILLION DOLLAR in Iraq!! Among the many "gifts" we provided was our financial and logistical support for an Iraqi constitution.
It's of interest to note that Article 31 of the Iraqi Constitution, drafted by the U.S. administration in 2005 and ratified by the Iraqi people, includes state-guaranteed (single payer) healthcare for life for every Iraqi citizen!! Article 31 reads: "First: Every citizen has the right to health care. The State shall maintain public health and provide the means of prevention and treatment by building different types of hospitals and health institutions. Second: Individuals and entities have the right to build hospitals, clinics,or private health care centers under the supervision of the State, and this shall be regulated by law."
There are other health care guarantees, including special provisions for children, the elderly, and the handicapped elsewhere in the 43-page document.
So let me make it clear: Our taxpayer money was used to draft a constitution which contains state-guaranteed healthcare for life for every citizens BUT the same rights are being denied for the very same U.S. citizen who paid for this constitution??!!
Naturally, all of our legislators enjoy guaranteed state-funded healthcare, state-guaranteed pensions, state guaranteed salaries etc. BUT the same legislators want us to believe that all state-funded activities are evil and must be cut or eliminated! Naturally, excluding those benefits they enjoy!!
Churchill once said that " The inherent virtue of socialism is the equal sharing of misery." Maybe this is now a virtue of our democracy and our legislators want us to share the misery and allocate the benefits of freedom to those they choose.
Its up to us to let them do that.
Yours
Bernd

Child Abuse Prevention in Florida

The Miami Herald reports in today's edition  http://www.miamiherald.com/2011/07/20/2323475/florida-spurns-50-million-for.html that Florida lawmakers have rejected more than $50 million in federal child abuse prevention money because its is being offered through the Affordable Health Care Act which lawmakers oppose for  "philosophical", i.e. ideological,  reasons. The money would have paid, among other things, for a visiting nurse program run by Healthy Families Florida, one of the most successful child-abuse prevention efforts in the nation. And because the federal Race to the Top educational-reform effort is tied to the child-abuse prevention program that Healthy Families administers, the state may also lose a four-year block grant worth an additional $100 million in federal dollars!!
Its of interest to follow the "reasoning" of a key lawmaker, State Senator Joe Negron, opposed to Healthy Families Florida. State Sen. Joe Negron, who chairs his chamber’s Health and Human Services Appropriations Subcommittee, said he long has been philosophically opposed to Healthy Families, which he views as an intrusion into the private lives of parents.“I believe in providing basic information to parents at hospitals and medical settings,” said Negron, a Palm City Republican. “I am not persuaded that it is a good idea to show up at a family’s home year after year giving advice and guidance. I do not think that is a core, essential function of government.”
According to his "logic" its OK for government to censure  doctors free speech and to figure out by themselves, and under the threat of punishment,  what  basic information to parents at hospitals and medical settings is relevant to prevent child abuse.
Its also of interest to note that nobody wants to take responsibility for the rejection of federal funds.
On Wednesday, leaders of the state House and Senate and the governor’s office all insisted they had nothing to do with rejecting the money.“The grant was included in [the state Department of Health’s] legislative budget request, but beyond that, the executive branch never advocated for it and a budget amendment was not submitted,” said Katherine Betta, spokeswoman for Republican House Speaker Dean Cannon of Winter Park. Brian Burgess, a spokesman for Gov. Rick Scott, said Scott did ask for the money. Burgess produced a budget request that has the proposal. “If there is to be finger-pointing,” he said, “it should be directed elsewhere.”
In contrast to previous posturing the Governor and Republican lawmakers seem to be odds at whom to blame (or to cheer) for rejecting the grant money.
Meanwhile, more children will suffer and some may even loose their lives.
As physicians we are obligated to speak up!!

Yours
Bernd

United Health Care Profits Rose 13%

Today's New York Times article entitled " Profit Up 13%, United Health Raises Outlook" http://www.nytimes.com/2011/07/20/business/unitedhealth-groups-2nd-quarter-profit-jumps-13-percent.html reports that The United Health Group one of the nation’s largest health insurers, reported its second-quarter results on Tuesday, and the good news for the industry appeared likely to continue. UnitedHealth announced a double-digit increase in profits and raised its estimates for 2011 earnings. Its net income rose 13 percent, to $1.27 billion, or $1.16 a share, compared with $1.12 billion, or 99 cents a share, one year ago. And revenue increased 8 percent, to $25.23 billion. UnitedHealth was the first of the big insurers to report this quarter, and once again, the high profits appear to be partly the result of more budget-consciousness by their customers, even as the insurers ask for higher premiums. As they have for many months now, Americans seem to be putting off or forgoing medical care because of the weak economy and the increasing amount they are required to pay in medical bills as their deductibles and co-payments climb. In late spring, many health insurers said it was too soon to tell whether utilization would eventually rebound to the same levels as before the downturn. They argued that they could not count on the demand for medical care staying at relatively low levels.So the company continued to benefit from consumers making fewer doctor visits as they try to save money in the tough economy.
Following the logic of a free market economy, they should lower their premiums to entice consumers to "buy" healthcare services. But these rules DO NOT apply to the so-called "healthcare market" which is controlled by a few monopolies, in which only one seller faces many buyers who have no choice but to buy the product regardless of price.
Unfortunately, these monopolies also are acting as monopsonies, in which only one buyer faces many sellers. In this cases providers of health care services (doctors, hospitals etc) have no choice but to sell their services to a large insurance company because its buying power dwarfs the remaining market.
Ironically, the Patient Protection and Affordable Care Act will inadvertently exacerbate this situation because for-profit insurance companies play an essential role in the provision of services.
Who will suffer? The consumer who is forced to buy these expensive insurance products and the doctors whose negotiating power has been curtailed by regulations.
In this context a single-payer system, or a model based on not-for-profit insurance companies (i.e. Germany), may serve as a solution.
Unfortunately, we are doomed because we swallowed the "free market" ideology bait with hook, line and sinker and in the end have no choice but to stick with the worst solution anyone can offer.

Yours

Bernd

Graduate Medical Education

Federal Budget Cuts Threaten Graduate Medical Education:

In their efforts to reduce the federal deficit the partisan negotiators seem to agree on one issue only: drastic cuts of the Medicare subsidy for postgraduate medical education and funding reduction for advanced equipment that teaching hospital require to train young doctors.

The recommendations made by the National Commission on Fiscal Responsibility and Reform, currently under consideration, would cut about $5.8 billion in graduate medical education funding from the nation’s teaching hospitals. This represents a 53% cut compared to the current $10.9 billion in payments!! The Simpson Bowles Commission, which advised President Obama on debt and deficit reduction called in December 2010 for reducing “excess” payments to hospitals for medical education. The commission said the payments could be brought in line with the costs of medical education by limiting the direct subsidy to 120 % of the national average salary paid to residents. A second, indirect subsidy, which pays for intensive services and advanced equipment should also be reduced.

The proposed draconian cuts will jeopardize the sorely needed expansion of graduate medical education in the U.S . and exacerbate the looming physicians shortage. Who will care for the baby boomers seeking medical services? Who will provide primary care physicians once millions of Americans gain access to healthcare coverage in 2014?

The proposed measures are based on penny wise and pound foolish approaches to cover our federal deficit and ignore the long-term investments needed to protect our crumbling healthcare service infrastructure in the U.S. The suggestions were developed by politicians with a limited political life cycle instead by healthcare planners who are being tasked to develop policy and not politics.

I suggest to review thoughtful proposals such as the Nineteenth Report by the Council on Graduate Medical Education (COGME) entitled “ Enhancing Flexibility in Graduate Medical Education” http://www.hrsa.gov/advisorycommittees/bhpradvisory/cogme/Reports/nineteenthrpt.pdf before throwing out the baby with the bath water.

The future of our healthcare is at stake and politicians must step aside to let experts take charge.

Yours

Bernd

When Ideology Trumps Compassion

When Ideology Trumps Common Sense and Compassion:

In the past week, Florida lawmakers turned down a $2.1 million federal grant that would pave the way for the state to receive $35 million in federal funding that would move elderly and disabled patients from nursing homes to their own homes during the next five years. With the help of this federal funding elderly people could be moved out of nursing homes to independent-living facilities or to support care at home with their families resulting in less money to be spend on nursing-home care. Republican legislators defended their refusal of the latest federal grant, known as the Money Follows the Person funding. "Not only would accepting the Money Follows the Person grant go against our policy of implementing federal health-care reform, but it would be redundant to the multiple efforts that Florida has already made to improve the delivery of long-term care," said Rep. Denise Grimsley, R-Sebring, chairwoman of the state's House Appropriations Committee.
Grimsley said the federal grant came with "significantly higher administrative costs that have been unnecessary" because Florida already has been successful at moving people from nursing homes. Nan Rich, Leader of the Senate Democratic Caucus, disagrees. In a letter to the editor published in todays Miami Herald http://www.miamiherald.com/2011/07/02/2295756/rejecting-funds-to-help-elderly.html she argues that “ the funding would have garnered Florida $35,7 million in federal funds over the next five years.” She is correct stating that “ Florida's share of the federal funds will go to another state whose leaders aren't willing to shortchange their elderly and disabled for the sake of ideology.” The remainder of her letter speaks for itself and is worthwhile reading in its entirety:
“It just doesn’t make any sense for Florida to refuse the “Money Follows the Person” funds. The grant covered 100 percent of the staffing and administrative costs. The federal Medicaid match for this program would have increased from about 56 percent to almost 78 percent for the first year, and we would have been under no obligation to continue the program after that. Even if we did, however, we’d still save money by moving more eligible people out of nursing homes. Our state’s seniors, disabled people and taxpayers deserve better than the short-sighted political posturing that we saw last week.”
Is there any hope that rational thought will prevail in Tallahassee?
Yours
Bernd

Drug Testing for Welfare Recipients

Drug Test Law May Face Costly Legal Challenges:

Attached a link http://www.orlandosentinel.com/health/os-drug-tests-welfare-20110630,0,5410762.story to an article published in today's Orlando Sentinel pointing out that a new state law requiring welfare applicants to be drug-tested goes into effect today.

The law stipulates that parents with minor children who request temporary cash assistance must undergo a drug test. The average benefit check per family is $240 a month with a lifetime limit of 48 months.

About 4,000 Floridians each month may be affected by the new law. The 93,000 state residents already receiving such benefits would not be affected unless they reapply. In addition all parents who test positive for drugs — including legal drugs not prescribed for the parent — will be reported automatically to the state's abuse hotline. Applicants will have to pay for the drug tests themselves, though those who test negative will be reimbursed in the first benefit check they receive. Those who test positive also would have the chance to get a second, more-sophisticated screening — at their own expense of up to $100 — and have an official medical review of the testing (MRO) . It is still unclear whether those expenses would be reimbursed if the applicant is ultimately cleared. The law may violate the constitutional standard requiring that the government must have reason to believe an individual is using drugs before demanding a test. Michigan, the only other state to pass a similar law, had it struck down in court. Therefore, it most probably will face a costly legal challenge on taxpayers expense!! Furthermore, by implementing this policy the state government should have provided drug treatment options for those welfare recipients with children who test positive for drugs. The new law falls shot of this option, too.

In my opinion this new law is a bad idea which will face a long and costly court battle and will further divert scarce state resources from more important issues such as drug use prevention and treatment programs.

Happy 4th of July,


Yours

Bernd

Counterfeit-Proof Prescription Pads

Just want to remind all of you that as of tomorrow, July 1st, 2011, counterfeit-proof prescription blanks MUST be used by all physicians for prescribing of ANY controlled substances. A list of approved vendors of counterfeit-proof prescription pads can be found on the Department of Health web site at http://www.doh.state.fl.us/mqa/counterfeit-proof.html.It is also important o know that approved vendors are required to provide monthly reports to the DOH, documenting who purchased the prescription pad or blanks and how many were purchased.
Have spoken today with one of the vendors and was assured that they make every efforts to expedite deliveries of counterfeit-proof prescription pads.

Yours
Bernd

Mystery Shoppers

Attached a link to today's New York Times article http://www.nytimes.com/2011/06/27/health/policy/27docs.html reporting that the federal government plans to deploy  mystery shoppers who will call doctors in nine states to try to schedule an appointment first posing as someone with private insurance and another time as someone with public insurance. The goal is to ascertain access to care issues ,  especially as the healthcare system braces for millions more Medicaid patients in 2014.
Already doctors are lining up in opposition to these "snooping" tactics. In response Christian J. Stenrud, a Health and Human Services spokesman, said: “Access to primary care is a priority for the administration. This study is an effort to better understand the problem and make sure we are doing everything we can to support primary care physicians, especially in communities where the need is greatest.”
So shall we oppose in principle all tactics that are aimed to assess the scope of the primary care shortage and related access to care issues? Are there any meaningful alternatives to the proposed "snooping" tactics deploying mystery shoppers to doctors offices? What role can we play not only to highlight the problem but to offer solutions?
I look forward to your responses and comments.
Yours
Bernd

Medicare Claims Show Overuse For CT Scans

06/18/11

Attached a link http://www.nytimes.com/2011/06/18/health/18radiation.html to an interesting article published in today's New York Times entitled “Medicare Claims Show Overuse for CT Scanning.”

The authors highlight that according to Medicare claims data some hospitals overuse chest CT scans and, thereby, needlessly expose patients to radiation by scanning their chests twice on the same day. The Medicare agency distributed the data to hospitals last year to show how they performed relative to each other and to encourage more efficient, safer practices. The review of that data found more than 200 hospitals that administered double scans on more than 30 percent of their Medicare outpatients — a percentage that the federal agency and radiology experts considers far too high. The national average is 5.4 percent. The figures show wide variation among states as well, from 1 percent in Massachusetts to 13 percent in Oklahoma. Overall, Medicare paid hospitals roughly $25 million for double scans in 2008. Added revenue may not be the reason dual scans are ordered. But the absence of treatment protocols may explain the variation of CT Chest use among physicians.

Possible solutions should include standardized, evidence-based diagnosis and treatment procedures according to which physicians can tailor their approach to patient care accordingly.

I hope that Medicare will open its database for researchers and health economists to help all of us to make educated and smart medical care decisions which will benefit our patients, too.


Yours

Bernd

Support Doctors in Bahrain

Attached a link to an AMA press release http://www.ama-assn.org/ama/pub/news/news/ama-expresses-concern-over-bahrain-trial.page? encouraging America's physicians to write to Bahraini officials, using a sample letter from the AMA website, and join the world's medical community in urging the fair treatment of the health care professionals detained in Bahrain.
Please participate because your support counts.
Yours
Bernd

Governor Scott Suspends Drug Testing Order

Attached a link to an article from today's Sun Sentinel http://www.sun-sentinel.com/health/fl-scott-suspends-employee-drug-testi20110616,0,6797555.story reporting that Governor Scott has suspended the order he signed earlier this year requiring random drug tests of all state employees in light of an ACLU law suit. The governor had signed the order for so-called "suspicion-less" drug tests – so termed because all state employees would be subject to them, regardless of their job or whether they were suspected of using drugs – in March. He also successfully urged the Legislature to require drug tests of all new applicants for welfare assistance, which the ACLU is also expected to challenge.
I encourage all of you to speak up loudly against the mandatory drug testing of welfare recipients which will be challenged in court, too.
Yours
Bernd

The Big Rip-Off

In today's Miami Herald http://www.miamiherald.com/2011/06/06/2254083/prescription-for-healthcare-shopping.html#storylink=misearch John Dorschner points out a painful truth: healthcare consumers are being ripped off every day by healthcare service providers.
According to Alan Sager, a healthcare policy expert at Boston University,  “Anytime I’ve read reports of patients or journalists seeking comparison pricing, they’ve encountered the same inconsistency, confusion, frustration and often misleading information,” he said. “When we go into a big supermarket, we all pay the same price for a gallon of milk. In healthcare, there are multiple prices in the same place.”
I myself have a hard time to find out the REAL costs of my own healthcare needs. Recently my daughter had to do undergo laboratory testing for which I was charged a $900 co-pay. I tried to appeal and as a result my case was immediately referred to a collection department. I barely saved my credit rating and paid. Its outrageous! The profit margins are beyond belief exceeding 1000 percent!! The so-called "free-market" argument is a joke!! An article in today's Wall Street Journal points out that in a survey of 1,000 British Medical Association members - all doctors - 80% of those surveyed were "mostly or very unwelcoming" towards the idea of privatization of the National Health Service. Meanwhile, American doctors and politicians continue to support the private health care market model. There is NO health care market but an aggregation of monopolies suffocating the average health care consumers. 
Its time to fight back! We should demand a single-payer system with uniform and transparent pricing structure.
Yours
Bernd

Governor Scott Signs Pill Mill Bill into law

After initially fighting one of its key provisions, Gov. Rick Scott signed a bill Friday aimed at cracking down on clinics that frivolously dispense pain pills, feeding a nationwide prescription drug abuse epidemic. The bill tightens reporting requirements to the database from 15 days to seven days, a change critics said the program needed to make it more effective. The measure also increases penalties for overprescribing Oxycodone and other narcotics, tracks wholesale distribution of some controlled substances, and provides $3 million to support law enforcement efforts and state prosecutors. It also bans most doctors who prescribe narcotics from dispensing them, requiring prescriptions to be filled at certain types of pharmacies. Scott has been under pressure from elected officials throughout the country to do something about the proliferation of so-called "pill mills" in Florida that attract people from other states seeking easy access to highly addictive, powerful painkillers.
We should now urge the Department of Health to provide education and training programs for physicians and other healthcare professionals on how to use the Prescription Drug Monitoring Program and to fund those necessary efforts.

For more information see http://www.miamiherald.com/2011/06/03/2249936/scott-signs-pill-mill-bill-into.html

ACLU Sues Governor Scott Over Drug test Rule

ACLU Florida has filed a lawsuit against Gov. Rick Scott over his executive order to force drug testing on state employees. The suit argues that Scott's order is an unreasonable search of the government that violates the Fourth Amendment of the U.S. Constitution.The ACLU maintains that the mandatory random drug testing Scott has ordered on about 100,000 workers is only allowed under special circumstances, such as workers who carry firearms or railroad workers involved in accidents.
I urge all medical professionals involved in federal workplace drug testing procedures to await the outcome of this lawsuit BEFORE deciding on their participation in the proposed state wide drug testing for state employees.


For more information and the complete text of the law suit see http://www.tampabay.com/blogs/the-buzz-florida-politics/content/aclu-sues-gov-scott-over-drug-testing-order

Physicians Challenge Florida Goverment

Attached an article highlighting an issue which is going to be resolved in court. Unfortunately, Governor Scott signed HB 155 into law which will bar physicians from asking patients about gun ownership. Florida is the only state in the nation to have such a law which was pushed by the NRA.
Sadly, the Florida Medical Association does not oppose the new law exposing its members to charges of harassment if they "dare" to provide their patients information about gun safety. Any alleged violation of the new law will expose physicians to disciplinary action and even license revocation!
Now its time to stop government intrusion into the patient-physician relationship.
I encourage doctors to pay attention to this issue and to take action.
Yours
Bernd












PalmBeachPost.com



By DARA KAM

Palm Beach Post Staff Writer

Updated: 10:58 p.m. Thursday, June 2, 2011

Posted: 8:19 p.m. Thursday, June 2, 2011

Three groups of doctors are suing Gov. Rick Scott over a bill he signed into law Thursday restricting health care workers from asking patients questions about guns.

Lawyers representing members of Florida chapters of the American Academy of Pediatrics, the American Academy of Family Physicians and the American College of Physicians asked Scott last week to veto the measure (HB 155) and threatened to sue if he signed it into law.

The Florida Medical Association does not oppose the new law.

Bruce Manheim of the Washington-based Ropes & Gray law firm said Thursday he would file the lawsuit immediately after Scott signed the law.

Doctors say the law infringes on their First Amendment constitutional right to free speech by barring them from asking about gun ownership, something they say is necessary to do their jobs.

It will "have a muzzling effect on doctors" who routinely ask parents and teenagers about swimming pools, dangerous drugs, bicycle helmets and car seats as well as about firearms in the home, pediatrician Tommy Schechtman said.

Under the law, doctors and other health care professionals will face sanctions including fines and losing their licenses if they ask patients about guns in the home without a direct belief that the inquiry is relevant to the patient's safety or health.

"It is my job. It is my responsibility. I have a moral obligation, an ethical obligation to be doing this," said Schechtman, who has offices in Palm Beach Gardens, Jupiter and Boca Raton.

But Scott spokesman Lane Wright said the first-term governor is confident he is on solid legal ground by signing the bill.

"Others would argue it would be an infringement of a citizen's rights who owns a gun to have a doctor ask those questions," Wright said. "Why should any law abiding citizen have to report to a doctor that they have a gun?"

Florida is the only state in the nation to have such a law, according to National Rifle Association lobbyist Marion Hammer, a former president of the gun rights organization.

Hammer said some health care professionals are pushing anti-gun messages to their patients under the guise of home safety questionnaires. The measure was prompted by complaints from gun owners following an incident this summer in which an Ocala-area physician told a couple to find another pediatrician after they refused to answer questions about whether they owned a gun and how it was stored.

The NRA and other supporters don't object if doctors routinely distribute safety brochures to all patients that give instructions on swimming pools, firearms or other safety-related issues, Hammer said.

"But doctors should not be spending the time that patients are paying for to talk to them about matters they're not there for. They come to doctors for medical care and medical treatment, not to have politics in the examining room and not to be lectured on firearms. They are medical doctors; they are not firearms instructors," she said.

But Mannheim said the new law is so vague about when questions are permissible that it would have a chilling effect on health care practitioners fearful of having to defend themselves before the Board of Medicine.

"Questions about firearm safety, as innocuous as they may be to the ordinary person, could be construed by someone as constituting harassment by a physician and simply on the basis of that judgment a physician could be taken through these disciplinary proceedings," he said. "It immediately chills the speech of our clients and their members and accordingly we intend to move very quickly with a lawsuit."

Schechtman said the new law won't stop him, however. More than 1,500 children die each year from household gun-related injuries, he said.

"Some of us won't shut up. Sometimes you have to decide to do the right thing which is what I will do. It's not going to stop me from doing anything," he said.

But other physicians may feel it's not worth the risk.

"It will have its intended effect. That's the thing that's scary to me. And that's why I think we have to take this off the books. I think it's sending a wrong message that people shouldn't have to worry about guns," Schechtman said.