Happy SAINT URHO’S Day 2022

Happy Saint Urho’s Day on March 16th!

[By Staff reporters]

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Saint Urho is a fictional saint of Finland, created and elaborated by Finnish Americans.

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Finnish Americans comprise Americans with ancestral roots from Finland or Finnish people who emigrated to and reside in the United States. The Finnish American population numbered about 600,000 in the 1950s. To celebrate their heritage and pre-empted and extend celebrations of St. Patrick’s Day the day before.

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NOTE: Blue grapes denoted Finnish wine. Just as a green 4-leaf clover represented “good luck” on St. Patrick’s Day.

MORE: https://en.wikipedia.org/wiki/Saint_Urho

Assessment: Your thoughts and comments are appreciated.

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PODCAST: More on Health Insurance from a Medical Technology CEO

A Professional and Personal look at Health Insurance, with Karl Albrecht
Rich talks with the president of Action Benefits, Karl Albrecht about the state of Health Insurance. 

Albrecht also gives a candid insight to his personal fight with pancreatic cancer and how being a Health Insurance executive as well as a patient, has given him a unique perspective on how things work, and how they could improve.
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BY RICHARD HELPPIE

PODCAST: https://richardhelppie.com/karl_albrecht/

YOUR COMMENTS ARE APPRECIATED.

Thank You

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“For-Profit” Medicare Advantage Plan Growth

By Staff Reporters

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Chartis: For-Profit Medicare Advantage Plan Growth 2022

 •  UnitedHealth Group: 765K new lives
 •  Centene Corporation: 338K new lives
 •  CVS Health/Aetna: 323K new lives
 •  Humana: 315K new lives
 •  Bright Health: 109K new lives

Source: The Chartis Group, “Medicare Advantage Enrollment Continues to Surge in an Increasingly Complex and Competitive Landscape,” February 2022

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Ethics in Modern Healthcare

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The Access to Medical Care Dilemma

By David E. Marcinko MBA

By Render S. Davis; MHA, CHE

[Certified Healthcare Executive]

Crawford Long Hospital at Emory University

Atlanta, Georgia, USA

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In his book, “Back to Reform”, author Charles Dougherty writes that “cost containment is the goal for the healthy.  Access is the goal for the sick.” 

A Meaningless Distinction

So, for an increasing number of Americans, the concerns experienced in-vitro, in-vivo, or described on this Medical Executive-Post blog, are almost meaningless because they are, for the most part, outside the structure of the current health care system. Why?

  • Employers are downsizing staff or cutting out health insurance benefits in an effort to be financially successful in a global economy.
  • Demands for greater government accountability in the expenditure of tax dollars have brought about increasingly more stringent eligibility requirements for safety-net programs like Medicaid. 
  • As insurance becomes more expensive or government programs undergo budget cuts, people are being excised from the system.
  • New competitive demands have fostered unprecedented consolidations, mergers, and closures of healthcare facilities.

This shake-out may have served to greatly reduce the overcapacity that plagued the system, but it has been done with greater emphasis on cutting costs than on fostering efficiency and effectiveness in creating a true system of care delivery. 

The Healthcare Commodity Issue

Those who view health care as little different from any other commodity available through the free market see the present access concerns as simply a byproduct of the inevitable restructuring of the system. While they argue that we must adhere to market solutions to solve our health care access problems, others demand a different approach calling for governmental national health insurance or some form of subsidized care providing at least a basic level of treatment for all citizens. 

Moreover, while Americans continue to proudly tout that we do not explicitly ration care as do some other countries (notably Great Britain and Canada); we tacitly accept a health care system that implicitly excludes citizens who are unable to overcome financial barriers to access.

Care Access Issues

Access to care represents the most visible issue at the very foundation of the ethical principle of justice. 

In their text, “Principles of Biomedical Ethics”, authors Thomas Beauchamp, Ph.D. and James F. Childress, Ph.D. point out that “justice” is subject to interpretation and may even be evoked to support the positions of parties in direct opposition.

A Philosophical Mixed Bag

For example, those who support the predominant principle of distributive justice – the fair allocation of resources based on laws or cultural rules – still must decide on what basis these resources will be used. 

On the other hand, this mix-ed bad of philosophical thoughts include among others:

  • Utilitarians, who argue for resource distribution based on achieving the “greatest good for the greatest number.”
  • Libertarians, who believe that recipients of resources should be those who have made the greatest contributions to the production of those resources – a free market approach to distribution.
  • Egalitarians, that support the distribution of resources based on the greatest need, irrespective of contribution or other considerations. 

Consequently, developing a system of access based on “justice” will be fraught with enormous difficulty.

The Current System

In the current health care environment, access to medical care is approaching crisis levels as increasing malpractice insurance premiums are driving physicians from high-risk specialties such as obstetrics, emergency medicine, and surgery in record numbers. 

The impact is most dramatic in rural and under-served areas of the country where sole-practitioners and small group practices are discontinuing services, leaving local citizens with no choice but to forego care or travel greater distances to regional medical centers to find necessary treatment. 

At the same time, significant budget cuts at both the federal and state levels have seriously eroded funding for Medicaid, leaving this especially-vulnerable segment of the population with even fewer options than before.

Issues Moving to the Forefront

Two areas of the medical care access dilemma are moving to the forefront.

1. The first is in emergency medicine.

An initial study by the Federal Centers for Disease Control and Prevention, cited statistics showing that in the decade ending in 2001, emergency room visits increased 20 percent, while the number of emergency departments shrank 15 percent. Increasingly, hospitals have closed emergency departments due to increasing costs, staffing shortages, and declining payments for services. This crisis comes at a time when post 9/11 fears of terrorism and global disease outbreaks like Severe Acute Respiratory Syndrome (SARS) have placed an even greater burden on the delivery of emergency services.  It continues and is exacerbated, even today.

For example, Arthur Kellerman, MD, former director of emergency services at Atlanta’s Grady Memorial Hospital, the city’s only level one trauma center, writes that “the situation is alarming and has been for some time… It’s unconscionable that we are not coming to terms with the Achilles’ heel of our health care system.”

2. The second area that will grow in significance is in the area of genetic testing.

As technological capabilities improve, medicine’s ability to examine an individual’s genetic makeup will open up remarkable opportunities to predict a person’s susceptibility to certain diseases or handicapping conditions. From a scientific standpoint, we are on the threshold of an extraordinary new era in medicine, where identifications of and treatments for potential illnesses may begin before the person is even born.

“Medicine’s Iceberg”

However, there is a more troubling access side to the potential of genetic testing as noted by Johns Hopkins University president, Dr. William R. Brody. He described genetic testing as “medicine’s iceberg,” where serious dangers for access to care are lurking beneath the surface. 

According to Brody, heated debate has already begun regarding the value of genetic information to insurance companies who could use the information to determine premium levels, even the overall insurability, for individuals and/or families with a member identified through testing as predisposed to a catastrophic and/or potentially expensive medical condition.

In this scenario, infants manifesting a genetic predisposition to certain illnesses or potential behavior disorders may find themselves faced with lifelong un-insurability based on the results of prenatal genetic testing.

Assessment

Furthermore, Brody persuasively argues that the potential of this technology, regardless of the incredible scientific potential it offers, could lead to dramatically diminished access to health insurance for tens of thousands of individuals and families and bring about an “end to private health insurance as we know it.”  He suggests that some form of community-rated, universal health insurance may be the only reasonable alternative to assure that Americans at all levels, from indigent and working poor, to the most affluent, may receive needed, basic medical care. 

CONCLUSION

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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Meth Mouth and TEETH!

More About Meth Mouth and Teeth [MMT]

By Anonymous DEA Agent

METH: Crystal meth is the common name for crystal methamphetamine, a strong and highly addictive drug that affects the central nervous system. There is no legal use for it.

It comes in clear crystal chunks or shiny blue-white rocks. Also called “ice” or “glass,” it’s a popular party drug. Usually, users smoke crystal meth with a small glass pipe, but they may also swallow it, snort it, or inject it into a vein. People say they have a quick rush of euphoria shortly after using it. But it’s dangerous. It can damage your body and cause severe psychological problems

Meth Mouth Teeth is severe tooth decay and tooth loss, as well as tooth fracture, acid erosion, and other oral problems, potentially symptomatic of extended use of the drug methamphetamine. The condition is thought to be caused by a combination of side effects of the drug and lifestyle factors, which may be present in long-term users.

However, the legitimacy of meth mouth as a unique condition has been questioned because of the similar effects of some other drugs on teeth. Images of diseased mouths are often used in anti-drug campaigns.

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EDITOR’S NOTE: I do not know if this is a legitimate picture or not. But, I do suggest that we all “Just Say No to Drugs”. And; as a dental school drop out, I have an affinity for all pro-dentite colleagues.

MORE: https://www.maine.gov/dhhs/mecdc/population-health/odh/documents/downloadable-brochures/meth-mouth.pdf

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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IRS & PHYSICIANS: Married Filing Separately May Save Taxes?

By Staff Reporters

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The IRS considers taxpayers married if they are legally married under state law, live together in a state-recognized common-law marriage, or are separated but have no separation maintenance or final divorce decree as of the end of the tax year.

CITE: https://www.r2library.com/Resource/Title/082610254

Of the 150.3 million tax returns filed in 2016, the latest year for which the IRS has published statistics, 3.07 million belonged to twosomes who filed separately.

  • These partners reported individual income and expenses on individual tax returns.
  • They had to agree on either itemizing expenses or using the standard deduction.
  • By filing separately, their similar incomes, miscellaneous deductions or medical expenses likely helped them save taxes.

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Consequences of Filing Married Separate | SC Associates

Filing separately with similar incomes

A couple may pay the IRS less by filing separately when both physician spouses work and earn about the same amount.

  • When they compare the tax due amount under both joint and separate filing statuses, they may discover that combining their earnings puts them into a higher tax bracket.
  • Their savings depends on a variety of other factors, however, including their investment situation and whether they have children.
  • The “married filing separately” status cuts the deductions for IRA contributions and eliminates certain tax credits, among other tax breaks.

Using miscellaneous deductions by filing separately (for tax years prior to 2018)

Miscellaneous deductions can lower taxable income, but in order to enter them on Schedule A, they must add up to more than 2% of adjusted gross income (AGI).

  • Physician or other spouses with union dues, job-search costs, tax-preparation fees and un-reimbursed business expenses may find their miscellaneous deductions don’t qualify when their higher combined income raises their AGI.
  • A spouse who travel frequently for business could rack up a sizable tally in airline fees for baggage and itinerary changes that makes the miscellaneous deduction worth pursuing.

Beginning in 2018, these types of miscellaneous expenses are no longer deductible.

Filing separately to save with unforeseen expenses

Adjusted gross income also determines if a couple can use un-reimbursed health care costs and casualty losses on Schedule A to save taxes.

  • Unless out-of-pocket medical expenses exceed 7.5% of AGI for 2021, they don’t qualify as a deduction.
  • Casualty losses must also total more than 10% of AGI and occur in a federally declared disaster area.

The spouse with the loss or substantial medical outlay calculates deductibility against his or her own lower AGI when the couple files separate returns. When one spouse can lower taxable income this way, married filing separately might trim a couple’s overall tax burden.

Filing separately to guard the future

When you don’t want to be liable for your partner’s tax bill, choosing the married-filing-separately status offers financial protection: the IRS won’t apply your refund to your spouse’s balance due. Separate returns make sense to prevent the IRS from seizing a spouse’s tax refund when the other has fallen behind on child support payments.

Couples in the process of divorcing may shun joint returns to avoid post-divorce complications with the IRS, while a spouse who questions her partner’s tax ethics may feel more comfortable living a separate tax life.

Couples living in community-property states should consider state law when deciding how to file.

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PODCAST: Medical Supply Chain Management?

Our broken healthcare supply chain – what can be done

By Dr. Marion Mass MD

Dr. Marion Mass graduated from Medical School at Duke University. She completed internship and residency at Northwestern University’s Robert Lurie Children’s Hospital in Chicago. Dr. Mass has worked in the Philadelphia area as a pediatrician for 21 years.

Fixing Common Medical Device Supply Chain Break Points - # ...

PODCAST: https://www.youtube.com/watch?v=-BZEVnkkRAE

MARCINKO on SCM: https://medicalexecutivepost.com/2011/06/09/supply-chain-management-in-healthcare/

Your comments are appreciated.

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BUSINESS: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?ie=UTF8&qid=1448163039&sr=8-9&keywords=david+marcinko

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HIT: https://www.amazon.com/Dictionary-Health-Information-Technology-Security/dp/0826149952/ref=sr_1_5?ie=UTF8&s=books&qid=1254413315&sr=1-5

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