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    Dr. Marcinko is originally from Loyola University MD, Temple University in Philadelphia and the Milton S. Hershey Medical Center in PA; as well as Oglethorpe University and Emory University in Georgia, the Atlanta Hospital & Medical Center; Kellogg-Keller Graduate School of Business and Management in Chicago, and the Aachen City University Hospital, Koln-Germany. He became one of the most innovative global thought leaders in medical business entrepreneurship today by leveraging and adding value with strategies to grow revenues and EBITDA while reducing non-essential expenditures and improving dated operational in-efficiencies.

    Professor David Marcinko was a board certified surgical fellow, hospital medical staff President, public and population health advocate, and Chief Executive & Education Officer with more than 425 published papers; 5,150 op-ed pieces and over 135+ domestic / international presentations to his credit; including the top ten [10] biggest drug, DME and pharmaceutical companies and financial services firms in the nation. He is also a best-selling Amazon author with 30 published academic text books in four languages [National Institute of Health, Library of Congress and Library of Medicine].

    Dr. David E. Marcinko is past Editor-in-Chief of the prestigious “Journal of Health Care Finance”, and a former Certified Financial Planner® who was named “Health Economist of the Year” in 2010. He is a Federal and State court approved expert witness featured in hundreds of peer reviewed medical, business, economics trade journals and publications [AMA, ADA, APMA, AAOS, Physicians Practice, Investment Advisor, Physician’s Money Digest and MD News] etc.

    Later, Dr. Marcinko was a vital and recruited BOD  member of several innovative companies like Physicians Nexus, First Global Financial Advisors and the Physician Services Group Inc; as well as mentor and coach for Deloitte-Touche and other start-up firms in Silicon Valley, CA.

    As a state licensed life, P&C and health insurance agent; and dual SEC registered investment advisor and representative, Marcinko was Founding Dean of the fiduciary and niche focused CERTIFIED MEDICAL PLANNER® chartered professional designation education program; as well as Chief Editor of the three print format HEALTH DICTIONARY SERIES® and online Wiki Project.

    Dr. David E. Marcinko’s professional memberships included: ASHE, AHIMA, ACHE, ACME, ACPE, MGMA, FMMA, FPA and HIMSS. He was a MSFT Beta tester, Google Scholar, “H” Index favorite and one of LinkedIn’s “Top Cited Voices”.

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ME-P Picks [Public Viewpoints on Health Reform and Policy]

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By Staff Reporters and related sources

By http://www.MCOL.com

 Delolitte Employer Poll Gives Grades From 500 employers Regearding Healthcare Reform

  1. 33%  would give a grade of an A or B
  2. 38% say a C is an appropriate letter grade
  3. 29% believe a D or F would be more appropriate
  4. 22% of employers say the ACA will reduce costs by the year 2019
  5. 19% said it will improve quality of care by the year 2019
  6. 50% of respondents said it will widen access to health insurance.

Source: Deloitte

Some more new Lists:

Health Insurance

Assessment

Visit: www.CertifiedMedicalPlanner.org

Conclusion

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Will Healthcare Reform Impact a Spine Surgeon’s Retirement Plan?

Certified Medical Planner

Q&A With Dr. Brian Knabe of Savant Capital Management

Brian J. Knabe MDBy Ann Miller RN MHA

Brian Knabe MD CFP® CMP® is a former medical physician turned financial advisor at Savant Capital Management, a fee-only wealth management firm.

Here, he discusses the smartest moves for spine surgeons at various stages in their careers to ensure an enjoyable retirement.

###

retirement

LINK: Will Healthcare Reform Impact a Spine Surgeon’s Retirement Plan? Q&A With Dr. Brian Knabe of Savant Capital Management

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Understanding the House Democrats’ Health Plan [PP-ACA]

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An Organization Chart

By Staff Reporters

If you have ever wondered exactly how health care reform will work for the United States, there is unfortunately no easy answer.

But, with the democrats and republicans strongly divided on universal health care, it can be tough for the average American citizen to find answers.

Fortunately, the graphic below will help.

PP-ACA

Assessment

However, it is important to listen to both sides to make a well-rounded decision of whether or not you can get behind health care reform.

Conclusion

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How Americans Embrace Medicare Reform

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The 2012 Elections … and Medigap

[By Staff Reporters]

Americans are spending more on Medicare than is coming in.

In fact, Rand Paul states, “It’s your grandparents’ fault for having too many kids and then your fault for not having enough kids. It’s a demographic problem.”

Source: www.mostmedicare.com

Conclusion

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Healthcare Reform Thru 2018

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An Evolving System

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The Great Health Care Challenges [A Slide show]

The US Health Care Crisis and the Complexities of Reform

By Austin Frakt PhD

Dr. Austin Frakt blogs over at The Incidental Economist which contemplates health care with a focus on research, and an eye on reform. It is about economics, health policy, health services, health care and – yes – politics. And, Austin is a health policy wonk that we admire here at the ME-P

 www.TheIncidentalEconomist.com 

Last fall he created a slide show on the challenges presented by our health care system. He has updated it circa March 11 2011 and has now allowed us, and others, to post freely. We appreciate him for this educational gesture.

Thank you.

Ann Miller RN MHA

[Executive-Director]

Link: Frakt Great Healthcare Challenges

About Austin Frakt PhD

Austin is the creator, manager, host, and primary author of The Incidental Economist. He is a health economist with an educational background in physics and engineering. After receiving his PhD in statistical and applied mathematics he spent four years at a research and consulting firm conducting policy evaluations for federal health agencies. Austin now has a joint appointment with the Department of Health Policy and Management at Boston University’s (BU’s) School of Public Health and Health Care Financing & Economics (HCFE) at the Boston VA Healthcare System, U.S. Department of Veterans Affairs. He studies economic issues pertaining U.S. health care policy with a recent but not exclusive focus on Medicare and the uninsured. He has authored numerous peer-reviewed, scholarly publications, many relevant to health care financing, economics, and policy. His papers have appeared in Health Care Financing Review, Health Affairs, Health Economics, International Journal of Health Care Finance and Economics, Journal of Health Politics, Policy and Law, among other journals. For over a year, he has been a regular columnist for Kaiser Health News and he has contributed commentary for the New York Times’ Room for Debate forum.

Austin’s interests include economics and health care, of course, but also politics, personal finance, and the amusements of family life. Outside of his principal work duties, he manages his household’s finances, is CFO of a small business, and looks after his two children.

You are welcome to “friend” Austin on Facebook, follow the blog via his Google Buzz feed, and subscribe to his Google Reader bundles. Austin does not have a personal Twitter account. When he has something to communicate he does it on this blog. If you wish, contact Austin with anything on your mind via the contact form. (The views expressed in Austin’s posts are his own and do not necessarily reflect the positions of the Department of Veterans Affairs or Boston University.)

Conclusion

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Healthcare Reform at a Glance

A One-Stop-Look-See with Comparisons

By Staff Reporters

Link: Health-Care-Reform-Comparison-in-Brief

[Courtesy: BuckConsultants]

Conclusion

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Integration as a Competitive Strategy in Healthcare Reform

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Understanding Horizontal and Vertical Integration

[By Robert James Cimasi MHA, AVA, CMP™]

Health Capital Consultants, LLC

St. Louis MO

Several potential benefits are associated with the integration of companies in the same or related industries. These synergistic benefits depend upon the type of companies and their integration strategies, as well as whether the anticipated transaction is a manifestation of horizontal consolidation or vertical integration.

Horizontal consolidation is “the acquisition and consolidation of like organizations or business ventures under a single corporate management, in order to produce synergy, reduce redundancies and duplication of efforts or products, and achieve economies of scale while increasing market share.”

Vertical integration involves the joining of organizations that are fundamentally different in their product and/or services offerings, i.e., “the aggregation of dissimilar but related business units, companies, or organizations under a single ownership or management in order to provide a full range of related products and services.”

Healthcare Locality

As healthcare is essentially a local business, horizontal integration within the local market has been limited by antitrust laws. Therefore, in order to control greater market share, a hospital’s strategy has required vertical integration. Healthcare providers and organizations have placed much emphasis on the benefits of vertical system integration in the last 10 or more years, whereby a single healthcare organization owns all of the elements needed to provide a continuum of care for all the needs of a given patient population. Much of this effect has stemmed from the desire to be able provide a “continuum of care,” i.e., to be able to single source contract for the healthcare needs of a patient population and to profit from implementing preventative healthcare and utilization management measures. The relative economic benefits of this type of vertical integration versus horizontal integration strategies remain the subject of great debate in academia and among the strategic managers of other industries. One lesson that may be drawn from other industries is that neither of these forms of integration is universally applicable or beneficial to every organization and market. There are also great costs to integration, which must be outweighed by the benefits. Each specific benefit should be identified and researched when examining the probable effects of integration, consolidation, mergers or divestitures as a competitive strategy.

Rapid Consolidation Periods

During the rapid consolidation and integration of healthcare providers, insurers, and purchasers, in recent years, there was much discussion of a concept termed “managed competition.” This term appears to have been an outgrowth of the term “managed care” and was viewed by many as the logical result of the integration of healthcare markets nationally. The concept of “managed competition” apparently related to an idealized vision of competition between very large, integrated providers (organized into integrated delivery systems), large, national managed care payors, and purchasing group coalitions that could achieve a balance of power between these interacting groups. However, many believe that the result of such an arrangement would more likely be a reduction in competition between members of each of these three groups and the creation of powerful bureaucratic and intractable organizations. Further, this scenario does not appear to effectively remove any of the existing barriers to competition and therefore doesn’t introduce any additional incentives for innovation to produce value for consumers which, of course, is the “sine qua non” of competition.

Disadvantages

The disadvantages of integration are becoming apparent, including:

  • the loss of autonomy;
  • increased bureaucracy;
  • difficulty in aligning incentives; and
  • other failed expectations.

Many organizations that sought strategic advantage through integration are ending those arrangements and now divesting acquired organizations.

Other Industries

In other industries, specialized providers of goods and services are increasingly able to offer customers a full range of services through affiliation and affinity with other independent specialists, made more seamless through the use of increasingly sophisticated communications and computing technologies. However, this move to “dis-integration” must also be carefully considered if organizations are not to make further costly organizational changes inspired by a rushed judgment of general market trends.

Porter Speaks

Michael Porter (et al.) wrote in the Harvard Business Review that,

In industry after industry, the underlying dynamic is the same: competition compels companies to deliver increasing value to customers. The fundamental driver of this continuous quality improvement and cost reduction is innovation. Without incentives to sustain innovation in health care, short-term cost savings will soon be overwhelmed by the desire to widen access, the growing health needs of an aging population, and the unwillingness of Americans to settle for anything less than the best treatments available. Inevitably, the failure to promote innovation will lead to lower quality or more rationing of care — two equally undesirable results.

Assessment

Therefore, if the emerging healthcare industry is to respond successfully to the Affordable Care Act [ACA] and related market pressures to reduce costs, then the healthcare market must first create incentives for innovation. The barriers to competition cannot include barriers to innovation as many do now. Physicians, nurses, healthcare purchasers, managers, and legislators must ensure innovation takes the forefront of any reform, if it is to be effective.

Conclusion

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Drowning Out the Noise [A Career and Life Allegory]

A Man Lived by the Side of the Road
By Dr. David Edward Marcinko MBA, CMP™

The “Quiet” 

An old man lived by the side of the road and sold hot dogs. He was hard of hearing, so he had no radio. He had trouble with his eyes, so he had no newspaper.

But, he sold really – really good hot dogs. He put up a sign on the highway telling how good they were. He stood by the side of the road and cried, “Buy a hot dog, mister.” And people bought. He increased his meat and bun orders and he bought a bigger stove to take care of his trade.

The “Noise”

Soon, his son came home from college to help him. But, then something happened. His son said, “Father, haven’t you been listening to the radio? There’s a big depression on. The international situation is terrible and the domestic situation is even worse.”

Whereupon the father thought, “Well, my son has been to college. He listens to the radio and reads the papers, so he ought to know.” So, the father cut down his bun order, took down his advertising signs, and no longer bothered to stand on the highway to sell hot dogs. His hot dog sales fell almost overnight. “You were right, son,” the father said to the boy. “We are certainly in the middle of a great depression.”

-Author Unknown

Assessment

As a physician, professor or entrepreneur, how do you feel about this story? Does the managed care situation, PP-ACA and new healthcare reform focus, depress you? Do you feel alienated from your patients, profession or self?

What about you, financial advisors? Do layoffs in the industry affect your earning capacity? Or, does the market situation just hurt your self esteem? Which is worse; a real or psychologically negative impact?  What about failed mortgage derivative products, collapsed banks, and related ethical scandals? Demoralizing!

And so, are you an optimist or pessimist about life and career? Is it really “different this time?”

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Of Wants, Needs, Economic Sustainability and Even Healthcare Reform

A Social Domestic Healthcare Initiative?

By Somnath Basu PhD, MBA [www.clunet.edu/cif]

[Director California Institute of Finance]

Necessities, conveniences and luxuries are an articulation of the hierarchy within wants and needs. The scale and scope of this hierarchy seems quite seamless at the surface. Food, micro waved dinners to gourmet meals. Transportation needs become personal transportation needs and then into Ferraris. Family picnics are replaced by TVs and then by exotic vacations. Home rentals needs change to the wanting of mansions.

As we move up each of the needs totem poles, our monetary requirements stretch endlessly; otherwise if we were all able to bask in everlasting luxury, the end of capitalism and free markets would be in sight. The ideal of everlasting luxury forever too is therefore necessarily unachievable but something that is pursuable, forever. In this vein of reasoning, all of society’s resources and endeavors must go towards attaining this ideal. What then are the limitations of such pursuits?

The above concept of needs and wants also defines layers of society by their consumption abilities. It also defines the pressures imposed upon the growth of GDP from large sections of society to increase their consumption. It is a single-minded pursuit by the upper middle-class of society to strive towards the entering the class of the wealthy, followed by the middle class seeking upper-middle class status, etc. The wealthy comprise a group who are small in number (10% or less) but who account for more than 67% of the ownership and consumption of resources and production, respectively. As large numbers of people start striving to break into the next higher classes of citizenry, pressures increase for GDP to grow. Over time, the wealthy get wealthier, some new entrants appear in each socio-economic group while the general population at large become poorer and more frustrated from this sum-zero game. At some point, the sustainability of the economic system is tested and then broken; societies develop, peak and then wither through strife.

GDP Pressures

For the event of the entire upper-middle class citizenry of joining the class of the wealthy to happen, the GDP would probably need to grow at about a rate of 10 – 12% per year, for each of the next 10 to 20 years! We can easily deduce that for the remaining 80% of the population, the ideal is mostly unachievable. Thus, it may be useful to ask ourselves what is a desirable benchmark for our way of life? “How much money do we need to be happy?” may be another variable approach. Clearly, there are social costs arising from our relentless pursuits of wealth.

To properly assess the cost-benefits of our economic system we need to explore two issues at the heart of the situation. One is the production of wealth. The second is its distribution. Clearly, distributing some wealth inequally is preferred to distributing nothing equally. The question then becomes one of society’s tolerances of inequality. Thought another way, how is enough provided at each level of society such that there is strive and not strife, such that the entire society is better off.

The Elderly

One victim to the current economic system is the elderly. In relentlessly pursuing growth and consumption of luxuries over anything else, we often forget to save for the years where we are no more productive, in a GDP sense.  The retirement woes of the generation of unprepared baby boomers can be seen in articles and papers in many depressing data forms. The main reason we fall victim to being unprepared for retirement is the need to spend every penny we earn on consumption so as not to forget that we are striving to attain the ranks of the upper echelons of society and which demands that our consumption and lifestyles mimic those we aspire to emulate. Using this example, we can take a closer look at some of our spending patterns and understand the pressures we impose upon our savings, GDP growth and the limitations inherent in such growth.

 

What is Enough?

We spend about 17% on transportation, another 15% on food, and about 35% on housing. This is the national average. If collectively we wished to move into the class of the wealthy, we would impose immense pressure on GDP, one that would clearly not be sustainable. That begs the question as to what’s enough. There is somewhere along these lines of reasoning a place of social well being, where the pressures of producing wealth do not dominate our lifestyles.

Global Considerations

On another plane an argument can be made for the prolongation of our imperial life cycle. As with any cycle, micro or macro, our rein at the top of the global economic cycle is waning; the question then becomes as to what course of action can slow down our descent. It is the respite we need where we can also plan for our grandchildren and beyond, rather than be engrossed in current mindless consumption and the bequest of their repercussions for generations to come. Slowing down consumption is one way of prolonging our place near the top; our “apparent” successor, China, depends mostly on us to buy the goods that they produce on our behalf. Developing fully China’s own middle markets for consumption and reducing its dependency on our consumption will take more than one lifetime for the Chinese. On the same note, let us not give away our technological supremacy to India either. In pursuit of the bottom line and exporting many technical and business jobs to India in the name of bottom line economics will also eventually impoverish our own citizens.

American Economics Nobel laureates

A recent study conducted by two American Economics Nobel laureates (Joseph Stiglitz and Amartya Kumar Sen) examined the very issue of GDP focus on behalf of the Government of France. Their findings were of a similar vein where they questioned the government’s fixation with GDP and society’s need for a balanced, sustainable and comfortable lifestyle. They found that using only GDP as the benchmark lead to myopia of sorts amongst government officials that people are happy and satisfied or that their relentless pursuit of GDP growth does not matter to them. The scientists also found that a need exists among people to also have an achievable benchmark of happiness and satisfaction with life without the mires of just GDP alone.

In a sense, if people can be liberated from the necessary requirements of basic living (food, shelter, basic healthcare and retirement), the self-induced pressures to outperform economically, along with the accompanying social malaises, would not be necessary; our lifestyles would also possibly change in very meaningful and simplifying ways as we seek more sustainable allocations of our land, labor and capital.

While the idea above may sound utopian at first, it may be useful to note that there are some societies in the world (primarily Scandinavia) where a much smaller version of such a system exists. First, a visit to any of those countries will persuade any American that their style of life is no less than ours. This is in spite of lesser wages and a staggering (income and sales) tax burden. However, ironically, it is the latter reason (high tax rate) that allows the citizens in Scandinavia to enjoy free education (up to any academic level and including boarding, lodging and international studies!), adequate and free healthcare, subsidized and efficient transportation and a basic pension for all upon retirement. However, this magic is mainly because of a small and highly efficient government giving back probably 90 cents for every dollar worth of taxes collected. Now, that is public good.

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The First Issue

What are the issues for us to scale to such a system? Obviously, the first is not having such a big and unwieldy government. Unfortunately, a lean, mean and highly efficient government is not foreseeable for us either in the near future and neither are higher tax rates. Higher tax rates just drives high income individuals and businesses underground and is not a market solution. Can our society at large demanding such a welfare state, be willing participants in such a system and demand such a government? If it did, we certainly could sail smoother through our busy impersonal lives. Having the GDP monkey off our backs will certainly calm us; consider the intense polarization in political thought around the globe arising from inequities of both consumption and thought. A sustainable solution that creates a safety net for all citizens would indeed be desirable for any society.

The Second Issue

This brings back the second issue, the issue of wealth distribution among society. Even when a non-market system (such as taxes) does not work in making society more egalitarian, a reallocation of wealth is somewhat desirable but no tools exist to make this happen. Possibly, the only market solution is philanthropy where suppliers provide capital for fulfilling social needs.

In the true sense of a long run, the ethical decision of philanthropy is also utilitarian; the value of the family name pays back handsomely to the family over the years. It is well known that where moderately large inheritances are left purely to the children and family inheritors, the family descends into decadence and the wealth is squandered in about three generations.

Of Relentless Pursuits

In a society where economic demarcation lines cannot be drawn but exist, the population at large will go towards a state of constant strife for higher status and eventually self-destruct. In other words, a mass population fed on this idea of relentless pursuit of income or wealth will eventually not be able to sustain itself and disintegrate and decay in its social fabric. In the long run, keeping people distracted by wars, economic woes or other narrow global or domestic events will not keep people placated forever; people have a way of collectively being heard.

Our Global Role

While the above may seem like a commentary on our own social system, it is not. The recent financial disasters have taught us that going into the future, no solution can remain purely domestic in nature. This world, through the unifying effect of the financial disaster, has learnt like never before, that any sustainable solution has to be global in nature. Now, more than at any time before, we must shed any feeling of ethnocentrism and nationalism and prepare to enter and lead the world through global solutions. After all, in relation to the about 5.5 other billion people, our way of life is still grand and we remain the Mecca of all aspiring global citizens.

Politics

As a political nation, we have shown that we are more enlightened than any other nation when we elected the Mr. Barack H. Obama as the President of the country. Ask this simple question: which Caucasian majority country will next vote a non-Caucasian to its highest seat? Nowhere, not in our lifetimes, I think.

Yet by electing President Obama, we sent a clear signal to the rest of the world about our system of meritocracy which very few societies can show and also not brag about.  Through this action we have also shown that we have the political will and dedication to bring around changes in shape to global economic systems as well.

A social domestic healthcare initiative, even if it be a non-market solution, is one in the right vein, though only time will tell if we executed the policy correctly or not.

 

 

Editor’s Note: Somnath Basu PhD is program director of the California Institute of Finance in the School of Business at California Lutheran University where he’s also a professor of finance. He can be reached at (805) 493 3980 or basu@callutheran.edu. See the agebander at work at www.agebander.com

Assessment

As for myself, I would be willing to pay the costs for a social safety net. If I was assured of some basic amenities by way of food, lodging, healthcare and retirement, I would be quite willing to do the requisite work to pay the appropriate cost and spend the rest of my time in a warm sunny beach and eventually experience the liberating feeling of retirement and enjoy each day as the holiday it is.

Conclusion

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VOTE: New Healthcare Reform Legislation

Vote on Healthcare Reform and Tell us What you Think?

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Now that healthcare reform is law, tell us what you think and give us your vote.

You may wish to review this synopsis guide first: http://www.msnbc.msn.com/id/34609984/ns/health-health_care/?GT1=43001

Feel free to answer these queries, in prose form, as well:

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2. How does it affect the condition of the national economy?

3. Where do you go to seek succor and support?

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What’s Next with Health Care?

And, Why the Process was Madness

By Staff Reporters

With the House passing health care reform yesterday, resident ProPublica blogger Marian Wang explains what’s next for the bill, and why the process keeps on changing.

Main Concerns

Sometimes things are a little clearer in retrospect. Now that health care reform has passed in the House, it seems there are two main questions in people’s minds:

  • What’s next?
  • Why, procedurally, was the legislative process so confusing and painful to watch?

So, Marian will answer that second question first with some helpful infographics.

Assessment

http://www.propublica.org/ion/blog/item/whats-next-with-health-care-and-why-this-process-was-madness

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A Petition to the US Federal Government

For an Individual Opt-Out Request for Healthcare

By MyMillionSite

We The Undersigned Wish To Convey By Their Signatures Below That They Wish To Have The Same Rights Under The Current Health Care Legislation.

That Allows The Individual States That If This Would Place An Economic Burden On That State They Have The Option To Opt Out Of This Mandate.

Currently Over 35 Of The 50 States Have Or Will File A Legal Action Against Washington To Claim This Is An Unconstitutional Bill.

If The States Are At 35 against and 15 Not Yet Heard From, It Would Seem That “We The People” Are More That 51% Against This Health Care Bill.

THIS WOULD BE A CLEAR STATEMENT THAT IF AN UP OR DOWN VOTE WAS HELD TODAY BY THE GENERAL POPULATION OF REGISTERED AMERICAN VOTERS THIS BILL WOULD NOT EVEN SEE THE LIGHT OF DAY AND ANY LEGAL ACTION FILED BY THE INDIVUDAL STATES WOULD NOT EVEN BE REQUIRED.

IF THIS BILL WOULD Place an ADDITIONAL ECONOMIC BURDEN ON THE STATE, it Would Seem Logical That It Should Also Be AVAILABLE TO THE INDIVIDUAL PERSON AS WELL.

We the Undersigned Wish To Opt Out Of the Average $12,000.00 per Year Price Tag The Current System We Have In Place by Law Already Mandates That Any Hospital Cannot Refuse Medical Treatment to Anyone That Is In Need Currently Any One Who Asks For Help Will Receive It.

This Bill Will Be Imposed By A Federal Mandate On Each Man, Woman, Child, And Even Unborn Children That Live In This The United States If This Bill Passes.

That This Mandate Is Actually an Unconstitutional Bill in Many Ways:

The Federal Government Does Not Have the Right to Mandate that it’s Citizens Will Have to Purchase a Product Such As Health Insurance Policy.

To Mandate That An Unborn Child Will Have To Purchase This As Well Is The Same Taxation Without Representation.

We As Citizens Are Now Already Over Taxed the Federal Government It Takes the First 4 Months of Our Income and The States Take Another Two Months Of Our Income.

If You Live You Pay Sales Tax on All Purchase’s And Even More On Other Taxes Such As Property Taxes, City Taxes, Cigarettes, Alcohol, Death Taxes, And Soon Even A Carbon Tax On Breathing.

At The Present Time With All Of The Visible Taxes And The Taxes That Are Hidden In Every Item That Is Purchased We Are Taxed At If Not More Than 50% Of Our Income’s An Additional $1000.00 Per Month $12,000.00 For A Federal Health Care Product That Once Implemented Will Only Cover 60% Of Medical Expenses After An Already High Deductible This Will Place A Large Burden On Any If Not All United States Citizen’s.

WE CITIZENS OF THE UNITED STATE RESPECTFULLY REQUEST TO OPT OUT OF THE CURRENT HEALTH CARE BILL

PLEASE COPY AND EMAIL TO ALL OF YOUR CONTACTS AND ON SUNDAY WHO EVER HAS A COPY FORWARD IT TO THE HOUSE, SENATE, AND THE WHITEHOUSE

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Political Primer on Healthcare Reconciliation

What it is – How it Works

By Staff Reporters

Several ME-P readers have contacted us for a definition of the term “reconciliation” and what it means in the current political debates and the recent Healthcare Summit in Washington, DC.

Definition,

According to Wikipedia, Reconciliation is a legislative process intended to allow consideration of a contentious budget bill without the threat of filibuster. Introduced in 1974, reconciliation limits debate and amendment, and therefore favors the majority party. Reconciliation also exists in the House of Representatives, but because the House regularly passes rules that constrain debate and amendment, the process has had a less significant impact on that body.

Healthcare Significance  

“In 2009 the House and Senate each passed separate healthcare reform bills. The Senate bill passed only after all 60 members of the Democratic caucus voted for cloture to stop an attempted Republican filibuster. Negotiations to produce a compromise bill acceptable to majorities in both houses were thrown off track by Republican Scott Brown’s victory in the Massachusetts.

After Brown’s victory, the Democratic caucus no longer had enough votes to stop a Senate filibuster of the compromise bill. An alternative plan was for the House to pass the Senate bill verbatim, and for each house to pass another bill that would embody the compromises agreed to in the negotiations. This separate piece of legislation, which might possibly include a public option, would require use of the reconciliation procedure in the Senate.”

Of Minutia

No matter whether the House votes on reconciliation or the Senate bill first, the Speaker can ensure that the health care bill is signed into law before reconciliation. (The dirty little secret of Congress is that even if the House votes to pass the Senate health care bill tomorrow, the Speaker has unilateral power to hold that bill at her desk until January 3rd of next year before sending it to the President and starting the 10-day Constitutional veto clock).

Assessment

The Republican leader in the Senate, Mitch McConnell, said: “Using reconciliation would be an acknowledgment that there is bipartisan opposition to their bill, another in a series of backroom deals, and the clearest signal yet that they’ve decided to completely ignore the American people.” according to the New York Times, February 19, 2010.

Other opponents of Democratic legislative initiatives in the 111th Congress began to refer to reconciliation as the “nuclear option, although that term had previously been used to refer only to a majoritarian procedure to effect a formal change in Senate rules.

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Note: Cloture  is the only procedure by which the Senate can vote to place a time limit on consideration of a bill or other matter, and thereby overcome a filibuster. Under the cloture rule (Rule XXII), the Senate may limit consideration of a pending matter to 30 additional hours, but only by vote of three-fifths of the full Senate, normally 60 votes.

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Health Care and the Economy

The National Governors Association Meeting

By Staff Reporters

The National Governors Association (NGA)—a bipartisan organization of the nation’s governors—promotes visionary state leadership, shares best practices and speaks with a unified voice on national policy.

Healthcare Politics

The nation’s governors gathered this weekend to address critical issues, including health care reform and the economy. The Governors met with President Obama, members of the Administration, business executives and other experts for discussions on a host of issues and challenges facing states.

Opening Session

This 2010 winter meeting began with a robust opening plenary session highlighting the role states can play in improving health care delivery systems to provide cost-efficient and effective health care to all Americans.

http://www.nga.org/portal/site/nga/menuitem.b14a675ba7f89cf9e8ebb856a11010a0

Conclusion

And so, your thoughts and comments on this ME-P are appreciated; especially our colleague Somnath Basu, PhD.  Be sure to visit and watch the online video discussions, as well.

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Sales of Dental Equipment and eDRs Down

Peterson Dental Supply Reveals a Decline

By Darrell K. Pruitt; DDS

Yesterday, Kevin Henry posted “Dental news of the day for Thursday, Feb. 18” on the DentistryiQ Blog.

The source for the day’s dental news was a sales report provided by Patterson Dental Supply.

http://community.pennwelldentalgroup.com/profiles/blogs/dental-news-of-the-day-for

Soft Sales

“Sales of dental equipment and software declined 10% from the year-earlier level, which was consistent with Patterson’s forecast for this period.”

If one remembers the economy at the last of 2008, it is not difficult to understand why Patterson’s analysts forecast that sales of dental equipment would drop. But, how did they know that sales of Patterson EagleSoft, their clinical and practice management software would also fall by 10%? I find it interesting that their accurate prediction was made shortly after Patterson announced the release of EagleSoft Version 15.00 on October 10, 2008. That must have been discouraging to EagleSoft employees.

When is the last time you’ve heard of a company roll-out of a new version of software – expecting it to be even less successful the previous version? That’s interesting.

Health Policy and Politics 

What makes Patterson’s valiant prediction of a decline in software sales even more remarkable is that a year ago, President-elect Barack Obama was giddy enthusiastic for digital health records, which includes Patterson’s EagleSoft. Not to say I told you so [maybe-a-little], but Patterson’s analysts obviously recognized what I did long before: Digital dental records are losing popularity among dentists. What’s more, none of my patients have ever said that they wish I had digital dental records. Dental patients simply do not desire them.

As a matter of fact, some have expressed relief that my paper records are more secure than anyone’s digital records. They also like not having to sign HIPAA forms – a meaningless waste of trees and appointment time.

Insightful or clueless dentist?

Assessment 

A year after Patterson privately admitted doubt about paperless dental practices, the slow-moving ADA House of Delegates met in Hawaii in October ‘09 and officially encouraged ADA members to adopt eDRs. Why doesn’t the American Dental Association know at least as much about dentistry as Patterson Dental?

This is an intriguing time in dental history. I can’t wait until the ADA opens up about their mistakes in dental informatics. One of these days we’ll all have a good laugh about their lame, expensive shenanigans.

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The Scott Brown versus Healthcare Reform Poll

The Sott Brown Opinion Poll

By Staff Writers

In what some pundits are calling the “Boston Massacre” in liberal Massachusetts, Republican Scott Brown rode a wave of voter anger to win the US Senate seat held by the late Edward M. Kennedy for nearly half a century, leaving President Barack Obama’s health care overhaul in doubt and marring the end of his first year in office.

Our ME-P Audience

As a financial advisor, we know you are aware of the rise in healthcare stocks yesterday. And, as a medical executive or healthcare professional, we know you have been against the public option, and healthcare reform, in its current version.  The AMA is not your friend – nor does it represent you.

The Question Is?

And so, do you believe that last Tuesday’s Republican victory in Massachusetts means the current Democratic health care bill will not be on the President’s desk in 2010?

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Healthcare Reform and the US Constitution

Consider this Proposed 28th Amendment

Submitted by Cecelia T. Perez; RN

Author Unknown

For too long we have been too complacent about the workings of Congress. Many citizens have no idea that Congress members can retire with the same pay after only one term, that they didn’t pay into Social Security, and that they specifically exempted themselves from many of the laws they have passed (such as being exempt from any fear of prosecution for sexual harassment); while ordinary citizens must live under those laws. 

The Healthcare Reform Exemption

The latest is to exempt themselves from the Healthcare Reform that is being considered … in all of its forms.  Somehow, that doesn’t seem logical.  We do not have an elite class that is above the law.  I truly don’t care if they are Democrat, Republican, Independent or whatever. The self-serving must stop. This is a good way to do that.  It is an idea whose time has come.

Proposed 28th Amendment to the United States Constitution:

“Congress shall make no law that applies to the citizens of the United States that does not apply equally to the Senators and Representatives; and, Congress shall make no law that applies  to the Senators and Representatives that does not apply equally to the citizens of the United States.”

Assessment

Each person contact a minimum of twenty people on their address list, in turn ask each of those to do  likewise. Then in three days, all people in The United States of America will have the Message. We ask you to pass this idea to your friends for their consideration.

Channel Surfing

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By Ann Miller; RN, MHA

[Executive-Director]

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With more than 50 topic channels to select, the ME-P is sure to professionally inform and illuminate your day; almost each and every day. So, also feel free to review our top-left column, and top-right sidebar materials, links, URLs and related sites.

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Will eMRs Raise the Legal Standard of Care and Increase Malpractice Risk?

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Focus on Malpractice and Professional Liability

By Ann Miller; RN, MHA

By Dr. David E. Marcinko; MBA

[Executive Director]

We first postulated on this topic in our print book “Insurance Planning and Risk Management for Physicians and their Advisors.” Additional posts and comments are contained within this ME-P.

And now, Robert J. Mintz, JD wonders if medical provider liability increases with eHRs, even if the quality of care is vastly improved?

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Vote on Healthcare Reform

A ME-P Healthcare Reform Opinion Poll

By Ann Miller; RN, MHA

[Executive-Director]

According to a new NBC News/Wall Street Journal poll, the public has soured on President Barack H. Obama’s health care reform plan.

In fact, former Governor and Democratic National Committee Chairman Howard Dean MD told Vermont National Public Radio:

“This is essentially the collapse of health care reform in the United States Senate. And, honestly, the best thing to do right now is kill the Senate bill and go back to the House … You have the vast majority of Americans want the choices, they want real choices. They don’t have them in this bill. This is not health care reform and it’s not close to health care reform.” 

Now, as an informed ME-P reader, do you think healthcare reform overhaul is a good idea?

Please VOTE:

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Techno-philic versus Patient-phobic Medical Care

Medicine Needs to get Back to Hands-on Basics, Rather than Focusing on Technology

By Staff Reporters

According to Rahul Parikh MD, there is plenty to criticize in our bungling trek toward health reform. Leaders on the right, left and at 1600 Pennsylvania Avenue have sidestepped the crucial conversation of controlling the cost of care, in favor of partisan rhetoric about “death panels” and “rationing care.”

Technophilic Doctors, Legislators and Patients

Worse, our entire focus seems to be toward technology and away from hands-on basic patient-philic care; starting with a detailed history and careful physical examination [remember Barbara Bates MD?]. And, all stakeholders are partly at fault.

Assessment

Here are a few related posts from Kevin Pho, MD.

Channel Surfing

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Doctors versus Retail Bankers

Understanding Modern Reality

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]Dr. David E. Marcinko MBA

Doctors often carry notoriously heavy debt loads. Beyond the costs of a medical education are substantial costs for equipping, launching and staffing a practice. Technology changes fast these days and capital is required frequently. And, the era of eMRs, ARRA, HI-TECH and Obama-Care is upon us!

“I‘m a Banker – I’m Here to Help”

Unfortunately, retail bankers are now very conservative by nature; and the liquidity squeeze and financial meltdown of 2008-2009 makes credit even more difficult to obtain. It may be increasingly difficult to borrow money, especially since modern bankers know that a medical degree is no longer the guarantee of a steady and high income that it once was in the past. As more than one banker has often opined to me,

“We don’t usually loan money to doctors who really need it.”

Nevertheless, the more business a physician does with a bank, the better the terms that can be obtained; even thought hey may also not have a clue about what the practitioner can do to better compete in the managed care arena.

Why Big-Banks Hate Customers

http://articles.moneycentral.msn.com/Investing/JubaksJournal/why-big-banks-hate-banking.aspx

Local Community

Some bankers do have a good concept of local community politics however, for those not familiar with a practice venue. They frequently can provide references to more focused advisors, and bankers generally do not charge a fee for their advice. But, banks selling products are doing so according to their governing regulations as “prudent experts” under ERISA, and are not necessarily held to a fiduciary standard in any broader sense.

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Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Congressional Budget Office Healthcare Reports of Interest

Ten [10] Aggregated CBO Reports

By Staff ReportersIntegration

Courtesy of Healthcare Town Hall:

 

 

 

 

 

Assessment

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Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Healthcare Reform Articles from Kevin Pho MD

Aggregating Content – Disseminating Knowledge

By Ann Miller; RN, MHA

[Executive Director] Books

Here are five interesting new articles on the healthcare reform debates from colleauge Kevin Pho, MD. 

Kevin practices at the Nashua Medical Group near the Massachusetts border. He is board certified in internal medicine and provides both comprehensive adult and primary care services.

Related posts:

Give them a click, read em’ and comment now.

Assessment

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Remember, how we put things together – sets us apart!

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Get the New ME-P Widget

Spreading ME-P Content and Informaton with our Gift to You

By Ann Miller; RN, MHA

[Executive Director]Our Gift

As someone who reads far too many medical, healthcare finance, political and health economics blogs on a daily basis, I decided to compile our ME-P blog RSS feeds into a nice, clean widget which you can quickly cut and paste into your own blog, wike or website.

Why Would you Want this Widget?

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Assessment

If you’re not tech savvy, we’ve done the hard work – just cut and paste and you’re done. Please e-mail me if you have any questions.

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Channel Surfing

Get more from www.BlogSurfer.US  Be sure to visit our other topic channels too! Established to facilitate idea exchange and link our community together, the value of these topics is dependent upon your input. Please take a minute to visit. And, to prevent that annoying spam, we ask that you register. 

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Popular Healthcare Reform Articles

Aggregating Content – Disseminating Knowledge

By Ann Miller; RN, MHA

[Executive Director]Text Books 

Here are three interesting and related articles from The Incidental Economist:

 

 

Give them a click, read em’ and comment now.

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ReThinking Medical Professional Autonomy in the Era of Obama Care

Eying Contemporary Medical Ethics in Healthcare Reform

By Render S. Davis; MSA, CHE

And, Staff Reportersbiz-book

Not so long ago, a physician’s clinical judgment was virtually unquestioned. Now with the advent of clinical pathways and case management protocols, many aspects of treatment are outlined in algorithm-based plans that allied health professionals may follow with only minimal direct input from a physician. Much about this change has been good. Physicians have been freed from much tedious routine and are better able to watch more closely for unexpected responses to treatments or unusual outcomes and then utilize their knowledge to chart an appropriate response.  

Restrictive Protocols

What is of special concern, though, is the restrictive nature of protocols in some managed care plans that may unduly limit a physician’s clinical prerogatives to address a patient’s specific needs. Such managed care plans may prove to be the ultimate bad examples of “cook book” medicine. While some may find health care and the practice of medicine an increasingly stressful and unrewarding field, others are continuing to search for ways to assure that caring, compassionate, and ethically rewarding medicine remain at the heart of our health care system.

Assessment

Link: For another opinion: http://healthcareorganizationalethics.blogspot.com/2009/09/obamas-speech-good-ethics-and-good.html

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. How does the specter of HR 3200-3400 in the healthcare reform debate impact the concept of medical autonomy and professional ethics? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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About Docs4PatientCare

Politically Involved Physicians

By Staff ReportersUS Senate

Docs4PatientCare is a grassroots organization of concerned physicians committed to the establishment of a health care system that preserves the sanctity of the doctor-patient relationship, promotes quality of care, supports affordable access to all Americans, and protects patients’ freedom of choice.

Mission

According to their website, Docs4PatientCare urges patients and physicians to get involved in the current healthcare debates in order to preserve the good qualities of our healthcare system, address the problems, while preventing their bureaucratic destruction.

Board Members

President: Hal Scherz, MD
Vice President: Fred Shessel, MD
Secretary: Tod Rubin, MD
Treasurer: Joanne Thurston CPA

Board of Directors

Scott Barbour, MD
Carl Capelouto, MD
Ron Anglade, MD
Terry Murphy, MD
Mike Koriwchak, MD
Barry Zisholtz, MD

Assessment

D4PC is a group of practicing physicians uniting to represent the interests and concerns of both patients and doctors in the healthcare reform debate.  D4PC endorses the concept of needed healthcare reform, but recognizes it can only be accomplished by proceeding in a cautious and responsible manner. Their recommendations seek to enable them to reach this goal without requiring the nationalization of the entire American healthcare system.

But, should medical professionals be involved in such political organizations?

Link: http://docs4patientcare.org

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Are these sorts of organizations a form of self-aggrandizement; or not? Can you cite any others? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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The Largest Purchaser of Domestic Healthcare?

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It’s the Government – Silly

By Ann Miller; RN, MHA

[Executive Director]ERT Prison Healthcare

By far, our federal government is the largest purchaser of healthcare services, according to Robert James Cimasi MHA, AVA, CMP™ of Health Capital Consultants, in St. Louis, MO; and many others.

Obama Care

Although the government faces immense pressure to control healthcare costs, especially during the current HR 3200-3400 debates, it also faces pressure to expend additional funds in order to achieve its ostensible primary mission in its involvement in healthcare, i.e., to expand and improve public health.

Federal Payment Schemes

In many ways the government has led the way for cost control through its development of resource-based reimbursement, prospective payment systems, budget limitations and other payment schemes. However, its conflicting goals have led it to approach these controls in a hesitant and piecemeal manner rather than effecting bold, comprehensive reforms.

Consider, for example, the lack of government intervention in the face of mounting pressure to remove some of the barriers preventing a reduction in US pharmaceutical costs.

Assessment

Today, most experts agree that Uncle Sam pays for at least 51% of domestic healthcare when Medicare, Medicaid, SHIPS, the VA, Indian and Prison Healthcare Systems are considered. In fact, according to our Publisher-in-Chief, Dr. David Edward Marcinko; MBA:

‘We already have a single payer health system in this country, but most folks just don’t realize it.”

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.

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A Doctor – Economist’s Solution for Health Reform

My Laundry Wish List for all US Healthcare Stakeholders

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]Fox News

As President Obama speaks, prods and cajoles, and Congress returns to session to begin work again on HR 3200-3400 or similar, I believe that for any healthcare reform effort to work successfully for the American people – not necessarily be adopted – we need to consider the following in no particular prioritized order:

  • Insurance portability uncoupled from patient employment
  • Health insurance regional exchanges with inter-state purchase competition
  • Doctor, drug, DME and hospital pricing and payment transparency for HSAs, and all of us
  • Modifying or eliminating AMA owned CPT Codes®; a huge money maker for them
  • Abandoning ala’ carte medicine for values-based outcomes
  • Reduce JCAHO influence; encourage competition from Norwegian Det Norske Veritas [DNV]
  • Reduce big-pharma influence thru-out the entire medical education, career and care pipeline
  • End DTC advertising from big-pharma
  • Promote wholesale drug purchase competition, MC bidding and generic drugs
  • Encourage evidence-based medicine, not expert-based medicine
  • Less pay for medical specialists with a  re-evaluation of the hospitalist concept
  • Advance the dying art of physical diagnosis, teach and embrace Paretto’s 80/20 rule for clinic issues
  • Reduce lab test, diagnostic imaging and testing
  • Encourage private 24/7/365 medical offices and clinics; and on-site and retail clinics
  • Abandon P4P, medical homes and disease management ideas
  • Give more economic skin-in-game to patients relative to health benchmarks
  • Concretize the “never-event” prohibitions and include a list of patient health responsibilities
  • More pay for primary care docs and internists
  • Adopt digital records and cloud computing for patients
  • Phase in true eHRs incrementally; and abandon CCHIT for open source SaaS
  • Promote Health 2.0 social media.
  • Augmented scope of practice, numbers and pay for NPs and DNPs, etc
  • Reduce pay for CRNAs and increase it for staff RNs
  • Develop step down triage and treatment units to reduce the number of full service ERs
  • Increase medical, osteopathic, dental, optometric and podiatric medical school classes
  • Increased practice scope for dentists, podiatrists and optometrists
  • Make some sort of catastrophic HI mandatory, much like auto insurance for all
  • End pre-existing conditon health insurance contract clauses
  • More choice  and end of life control for the terminally ill patient
  • Increase marketplace competition with fewer political and financial “externalities”.
  • Teach basic healthcare topics in school and encourage physical exercise
  • Health and insurance education should be, but is not, the “answer” for Americans
  • Protect borders and discourage undocumented illegals
  • Adopt medical malpractice tort reform
  • Make all stakeholders fiduciaries 
  • No public “option” unless you like food stamps, Section 8 housing, public transportation and schools
  • Budget deficit neutrality
  • Joe Wilson is both a bright guy – and a jerk
  • Slow down!

Assessment

Recently, while in the Baltimore/Washing area, I was asked by several reporters to opine on the healthcare debate; which I did so freely having never been known as the shy type. And, regular readers will note that many of these items have been used as posts or comments on this ME-P. Unfortunately, my “laundry list” interview was pre-empted by two local but boisterous town-hall meetings with respective passionate politicians. It was redacted no doubt, but never broadcast. Thus, I missed the potential for my “five minutes” of fame. C’est la vive!

Conclusion

There you have it; direct and straight forward. And so, your thoughts and comments on this Medical Executive-Post are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Off-Road Touring with Dr. Marcinko [Part VIII]

Interview with David B. Lumsden; MD

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

Dateline: Baltimore Maryland,Dr. Lumsden Formal August 10, 2009.

About David B. Lumsden MD

Dr. David Lumsden; MS, MA practices general orthopedic surgery and trauma as a board certified surgeon and partner with Orthopedic and Hand Surgery Associates in Baltimore, Maryland. He completed his training in community health at Towson State University, earned Master’s Degree in Anatomy / Neuroanatomy at University of Maryland/Baltimore and Exercise Physiology at University of Maryland, College Park. He is a graduate of Penn State University School of Medicine. Dr. Lumsden completed his internship and residency at Union Memorial Hospital with associative residency training at Johns Hopkins and the world renowned Shock Trauma Center at the University of Maryland, Baltimore City. 

Our Brief Interview

When I caught up with David during a recent house-call visit, we discussed many things; especially the American Affordable Health Choices Act [HR-3200]. Unfortunately; I did not have my audio-recorder with me. So, here are a few points of interest about him that I jotted down, from memory, in my ever-present reporter’s notebook. No doubt, I missed many more:

  • He became a physician as a career change in mid-life.
  • He has read HR 3200 in its’ entirety.
  • He hired an attorney for HR 3200 interpretation and review.
  • He is for healthcare reform, but against HR 3200.
  • He is against a public health care plan.
  • He is against individual insurance mandates.
  • He does 10-12 house-calls every month.
  • He does not charge MC, MD or VA house-call patients; rarely bills them and/or accepts assignment without balance billing.
  • He regularly operates on same, under similar terms.
  • He does other pro-bono work.
  • He practices defensive medicine.
  • He is for tort reform.
  • He is not a member of the AMA with no plans to join.

Assessment

Review and vote for -or- against HR 3200 here: http://www.opencongress.org/bill/111-h3200/text

About Off Road with Dr. MarcinkoDavid Lumsden; MD

These sporadic off-road segments will continue through-out my 2009 summer promotional tour. Formal attendance increased toward the later part of the summer as the Obama Administration’s healthcare debates heated up. Our many local book stores and sponsors noted a spike in our CD and book sales, as well as interest in our online www.CertifiedMedicalPlanner.com program and premier quarterly guide: Healthcare Organizations [Journal of Financial Management Strategies] www.HealthcareFinancials.com

Part VII: https://healthcarefinancials.wordpress.com/2009/09/01/off-road-touring-with-dr-marcinko-part-vii/

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

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Take the Hospital eHR Implementation Challenge!

Illustrative Case Model – Are You CMP™ Worthy?

By Staff Reporters Washington DC

The fictitional Washington Hospital is embroiled in the healthcare reform debate and interested in implementing an electronic health record (EHR) for its major clinic areas. The flagship hospital currently utilizes a legacy-based system and several of the clinics have independently purchased software programs to provide a more inclusive electronic data base particular to that clinic.

Scenario

In addition, each of the software programs purchased in specific clinics has been modified to serve their own needs. The other satellite hospitals and clinics are not linked to the flagship hospital and have independent systems, applications and software in place. The hospital is interested in obtaining one EHR system that can be used in a standardized and uniform methodology and process throughout all of its hospitals and clinics.

Key Issues

Should the Washington Hospital?

1) Abandon the clinic’s software programs in lieu of a more centralized EHR?

2) Assess various EHR systems for healthcare providers available in the marketplace, comparing a series of hospital and clinic developed requirements against vendor capabilities?

3) Obtain an EHR product that provides interface to the existing clinic software products?

4) Assess whether the EHR vendors totally comply with HIPAA and privacy regulations as well as update their systems automatically with HIPAA changes?

5) Have the vendors assess the existing system/applications/software programs currently in use at each of the hospitals and clinics and determine the best application configuration?

6) Utilize the internal Information Technology staff to develop an interface solution?

Assessment

Medical management consultants, are you up to answering this challenge? We dare you to respond! Visit: www.CertifiedMedicalPlanner.com

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Are Today’s Doctors Desperate?

Emotions Rise with Healthcare Reform

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]dem2

Managed care is a prospective payment method where medical care is delivered regardless of the quantity or frequency of service, for a fixed payment, in the aggregate. It is not traditional fee-for-service medicine or the individual personal care of the past, but is essentially utilitarian in nature and collective in intent. Will new-age healthcare reform be even more draconian?

Unhappy Physicians

There are many reasons why doctors are professionally and financially unhappy, some might even say desperate, because of managed care; not to mention the specter of healthcare reform from the Obama administration. For example:

  • A staggering medical student loan debt burden of $100,000-250,000 is not unusual for new practitioners. The federal Health Education Assistance Loan (HEAL) program reported that for the Year 2000, it squeezed significant repayment settlements from its Top 5 list of deadbeat doctor debtors. This included a $303,000 settlement from a New York dentist, $186,000 from a Florida osteopath, $158,000 from a New Jersey podiatrist, $128,000 from a Virginia podiatrist, and $120,000 from a Virginia dentist. The agency also excluded 303 practitioners from Medicare, Medicaid, and other federal healthcare programs and had their cases referred for nonpayment of debt.
  • Because of the flagging economy, medical school applications nationwide have risen. “Previously, there were a lot of different opportunities out there for young bright people”; according to Rachel Pentin-Maki; RN, MHA”; not so today. In fact, Physicians Practice Digest recently stated, “Medicine is fast becoming a job in which you work like a slave, eke out a middle class existence, and have patients, malpractice insurers, and payers questioning your motives.” Remarkably, the Cornell University School of Continuing Education has designed a program to give prospective medical school students a real-world peek, both good and bad.

The Ripple Effects of Managed Care and Reform

“Many people who are currently making a great effort and investment to become doctors may be heading for a role and a way of life that are fundamentally different from what they expect and desire,” according to Stephen Scheidt, MD, director of the $1,000 Cornell fee program; why?

  • Fewer fee-for-service patients and more discounted patients.
  • More paperwork and scrutiny of decisions with lost independence and morale.
  • Reputation equivalency (i.e., all doctors in the plan must be good), or commoditization (i.e., a doctor is a doctor is a doctor).
  • The provider is at risk for (a) utilization and acuity, (b) actuarial accuracy, (c) cost of delivering medical care, and (d) adverse patient selection.
  • Practice costs are increasing beyond the core rate of inflation.
  • Medicare reimbursements are continually cut.

Mad Obama

Early Opinions

Richard Corlin MD, opined back in 2002 that “these are circumstances that cannot continue because we are going to see medical groups disappearing.” Furthermore, he stated, “This is an emergency that lawmakers have to address.” Such cuts also stand to hurt physicians with private payers since commercial insurers often tie their reimbursement schedules to Medicare’s resources. “That’s the ripple effect here,” says Anders Gilberg, the Washington lobbyist for the Medical Group Management Associations (MGMA).

Assessment

And so, some desperate doctors are pursing these sources of relief, among many others:

  • A growing number of doctors are abandoning traditional medicine to start “boutique” practices that are restricted to patients who pay an annual retainer of $1,500 and up for preferred services and special attention. Franchises for the model are also available.
  • Regardless of location, the profession of medicine is no longer ego-enhancing or satisfying; some MDs retire early or leave the profession all together. Few recommend it, as a career anymore.

Assessment

To compound the situation, it is well known that doctors are notoriously poor investors and do not attend to their own personal financial well being, as they expertly minister to their patients’ physical illnesses.

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Tell us what you think? Are you a desperate doctor? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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References:

  1. www.managedcaremagazine.com/archives/9809/9809/.qna_dickey.shtml
  2. www.hrsa.dhhs.gov/news-pa/heal.htm
  3. www.bhpr.hrsa.gov/dsa/sfag/health-professions/bk1prt4.htm
  4. Pamela L. Moore, “Can We All Just Get Along: Bridging the Generation Gap, Physicians Practice Digest (May/June 2001).

 

Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

 

Henry Louis Gehrig, eMRs and Healthcare Reform

What’s the “Iron Horse” Got to Do with Health IT?

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]Jacobetti VA

According to UPI reports from Charlestown, WVa on August 24 2009, at least 1,200 veterans across the country were mistakenly told by the Veterans Administration [VA] that they suffered from a fatal neurological disorder.

Link: http://www.msnbc.msn.com/id/32541579/ns/health-health_care/

Panicked Veterans

One of the leaders of a Gulf War veterans group is reported to have said that panicked veterans from the states of Alabama, Florida, Kansas, North Carolina, West Virginia and Wyoming contacted the group about the error. Denise Nichols, the vice president of the National Gulf War Resource Center, reportedly blamed a “coding error” for the mistake. In medicine, we call this a “false positive.”

About Henry Louis “Lou” Gehrig

Henry Louis “Lou” Gehrig (June 19, 1903 – June 2, 1941), born Ludwig Heinrich Gehrig, was an American baseball player in the 1920s and 1930s; chiefly remembered for his prowess as a hitter, the longevity of his consecutive games played record and the pathos of his tearful farewell from baseball at age 36, when he was stricken with a fatal disease. Of course, Gehrig was known as the “The Iron Horse” for his durability. Yet, the irony is that Amyotrophic Lateral Sclerosis [ALS], or Lou Gehrig’s disease [sometimes also called Maladie de Charcot] is progressive and fatal. Lou died in 1941 after developing the illness. Will the same death-spiral happen to eHRs and Obama care?

Link: http://www.lougehrig.com

Assessment

Having rotated through the VA system as a young medical student back-in-the-day, I have never been a fan. It smacked of socialized medicine and government plutocracy, and was never a leading-edge example of domestic healthcare, in my informed opinion. Recent HIPAA administrative, security, IT and clinical medical errors are well known. So, to blame the mix-up on an insurance billing and “coding error” seems somewhat disingenuous. Especially now, at a time when eMRs and the Obama Administration’s healthcare reform itself is being vigorously debated by the citizenry. I mean, are there no human checks and balances? Would there be any human intervention if a public healthcare policy was adopted?

Of course, we have written about military medicine previously on this Medical Executive-Post, and devoted an entire channel to it. And, I do realize that more than fifty percent of us receive similar governmental care in some form, or another [Medicare, Medicaid, CHIPS, the Indian and Prison Healthcare Systems, etc].

Link: https://healthcarefinancials.wordpress.com/category/military-medicine/

Nevertheless, shall we give a new moniker to this mistake? How about “Lou Gehrig’s coding error”, and document it in our www.HealthDictionarySeries.com

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Is it even fair to relate this “isolated incident” to the current healthcare reform debate, the eMR conundrum and/or similar discussions on health Information Technology [IT]? Tell us what you think. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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ME-P Healthcare Reform Survey?

Off-Road Touring with Dr. Marcinko [Part V]

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

About Marquette, Michigan

As our ME-P readers are aware, Marquette Michigan has a population of 20,714, and is the UP’s largest community. In addition to being a population center, it serves as the regional center for education, health care, and outdoor recreation. This regional draw is particularly evident due to Northern Michigan University and Marquette General Hospital [MGH]. Naturally, during my recent tour there, I was able to visit both small and large medical practices, clinics and hospitals. Everywhere, the topic of conversation was the Obama Administration’s vision of domestic healthcare reform. And so, after unofficially asking local residents on their feelings in the matter, we are pleased to offer this survey to all readers and subscribers to our Medical-Executive Post.

Bell Medical

 

About Off Road with Dr. Marcinko

These sporadic off-road segments will continue through-out my 2009 summer promotional tour. On the one hand, formal attendance at several engagements was a bit sparse because of the death of several recent celebrities and entertainer types. On the other hand, local book stores and sponsors noted a spike in our CD and book sales, as well as interest in our online www.CertifiedMedicalPlanner.com program and premier quarterly guide: Healthcare Organizations [Journal of Financial Management Strategies] www.HealthcareFinancials.com

Part IV: https://healthcarefinancials.wordpress.com/2009/08/13/off-road-touring-with-dr-marcinko-part-iv/ 

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

 

 

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About EHRWatch.com

A New Online Virtual Collaborative 

By Staff ReportersNurse Paper MRs

www.EHRWatch.com is a new online community dedicated to developments in electronic health records [eHRs], including practice, funding, product integration, standards developments and trends in implementation. The new site features blog posts, polling, commenting and a weekly e-newsletter.

A Collaborative

www.EHRWatch.com is designed to encourage community participation, interaction, collaboration and reaction. Whether you need to select and implement an EHR solution or make sure your current system meets the requirements and timeline necessary to receive the Obama Administration’s ARRA, and HITECCH,  stimulus incentives, the site may offer the products, information, services and expertise to help.

Assessment

Visit www.EHRWatch.com to read the latest posts and join the virtual community. Just give em’ a click, today!

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Tell us what you think of this new site? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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

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Off-Road Touring with Dr. Marcinko [Part I]

“Using-Up” Health Insurance

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

Dateline: June 18-19th, 2009dem24          

I flew into Marquette Michigan last night on a puddle jumper from Chicago, Illinois. Marquette will be the home base on my current book promotion and public/private  speaking tour. This second leg of our trip, from Atlanta, was delayed for mechanical reasons. So, rather than follow directions from American Airlines regarding new arrangements, and rushing to wait in a long line of humanity for a new boarding pass on a much later flight, I simply called the travel assistance number on my cell phone. We were re-routed by computer from American, to a Delta Airlines flight, that caused no additional time lag as we later learned the other passengers boarded their American flight three hours late. Many of the elderly and slower moving folks even missed connecting flights which necessitated overnight hotel stays, in some cases.

THINK: outside the box independently, and don’t follow directions mindlessly.  

About Marquette, Michigan

The City of Marquette is located in the central region of Michigan’s Upper Peninsula. With a population of 20,714, it is the UP’s largest community. In addition to being a population center, it serves as the regional center for education, health care, recreation, and retail. This regional draw is particularly evident due to Northern Michigan University and Marquette General Hospital, both of which are located in the City of Marquette. Of course, I visited both.

Quality Healthcare for the Upper PeninsulaUPHC

So, the next morning I called some friends who suggested we head over to the Marquette Upper Peninsula  Healthcare Network System, on Washington Street, for an unplanned and unofficial stop on our current “signing and opining” tour. It seemed very busy for a Friday morning; so we gathered some colleagues and ambled over to Viering’s Restaurant where we discussed the local economy, current state of the healthcare industry and the Obama Administration’s ideas for healthcare reform. When I expressed my surprise at the number of patients in the clinic waiting room areas, I was informed that an unexpected corporate layoff resulted in patients “wanting to use their health insurance, before being RIFed [Reduced-in-Force].” Now, as a doctor, and insurance agent, I find this attitude both very strange; yet not uncommon.

“Using-Up” Health Insurance

I can honestly say that after more than three-decades in the business, I have never heard a single soon-to-be unemployed client say,” I need to use up my life insurance”, or “auto insurance”, or “homeowner’s insurance”, etc. So, what gives with health insurance?

Health Insurance IS Different

Insurance of all types is sold to economically protect against catastrophic events like pre-mature death, auto accidents, or home destruction. But life insurance doesn’t pay for non-lethal issues; auto insurance doesn’t pay for new tires, tune-ups or oil changes; and home owner’s insurance doesn’t pay for regular upkeep and maintenance, etc. So, why do some patients believe that health insurance necessarily needs to be used-up? Were they not healthy before the lay-off announcement; or did they suddenly become ill, thereafter? What do you think? Is this just a local phenomenon, or would it be [is it] pandemic in any community given the same or similar circumstances?

AssessmentUPHC-DEM

For me, this scenario clearly demonstrates two things. First, that Health Insurance is thought of as a personal right and/or corporate fringe-benefit; rather than true financial indemnification. Second, it demonstrates the ability of patients to think ahead; unlike the airline customers on my initial trip here. So, if patients can be forward thinking about their health insurance needs, why don’t they think ahead about their personal health care needs? Why don’t more of us exercise regularly, watch our blood pressure and weight, and/or avoid drugs, alcohol and promiscuous sex, etc.  If we can monitor and pay for routine auto and home maintenance ourselves; why not our routine health needs?  Isn’t good health our most important personal asset? Aren’t we worth it? Do we really want to abrogate our very lives to others? Do we want to concede our responsibilities to a third party, ie, a national [single-payer] governmental controlled healthcare? Those patients wanting to “use their health insurance”, before unemployment, certainly seem to think so.

About Off Road with Dr. Marcinko

These sporadic off-road segments will continue through-out my 2009 summer promotional tour. On the one hand, formal attendance at several engagements was initially a bit sparse because of the death of several recent celebrities and entertainer types. On the other hand, local book stores and sponsors noted a spike in our CD and book sales, as well as interest in our online www.CertifiedMedicalPlanner.com program and premier quarterly guide: Healthcare Organizations [Journal of Financial Management Strategies] www.HealthcareFinancials.com

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Tell us what you think. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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

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Health Care Costs and the Domestic Budget

The Real Budget Defecit

[By Staff Reporters]

money1The Obama Administration has made comprehensive health insurance, and health care, reform a priority.

The goal is to transform the domestic health-care system so that it improves efficiencies, increases value and provides care for all citizens.

Current Situation

Recently, two important facts that all ME-P readers know, were re-confirmed:

  • Health-care costs are the key to the nation’s economic future.
  • The medical community agrees that great efficiencies are possible in how it is practiced.

Variations

It is well known that health-care costs vary across significant regions of the country, as well as hospitals and doctors within a region – even for patients with a same/similar diagnosis. This must end, according to the Director of the White House Office of Management and Budget [OMB]. Director Peter R. Orszag explained in a WSJ interview below, that practice variation is unnecessary and wasteful, and that evidence-based-medical practices and comparative-effectiveness-research is a good idea for all healthcare stakeholders.

The Baucus-Grassley Policy Options for Expanding Healthcare Coverage report is also included for your review and commentary.

Two New Reports

Wall Street Journal on May 15, 2009.

1. Link http://online.wsj.com/article/SB124234365947221489.html

2. Link: http://finance.senate.gov/press/Bpress/2009press/prb051109.pdf

Assessment

Once accomplished, it is hope that the nation will be on a sustainable fiscal path that builds a new foundation for our economy for generations to come.

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Product DetailsProduct Details

Healthcare Projections and the US Budget 2007-09

Issues and Challenges for Obama Administration Reform

By Staff ReportersUS Capitol

Read the complete testimony and statement of Peter R. Orzag, OMB Director, to the US Senate, dated June 21, 2007.

For more information:

Congressional Budget Office

Second and D Streets; SW

Washington, DC 20515

Link: 06-21-healthcarereform

Assessment

Now, almost two years later, and with the new Obama Administration, has your opinion changed on the potential of healthcare reform; why or why not?

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated?

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

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Health Reform, the Stimulus and Hitler’s Aktion T-4

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Overhauling the American Healthcare Industry

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]dr-david-marcinko11

According to the Washington Times on February 11, 2009, a secreted House version of the new economic stimulus bill that President Barack Obama is trying to rush through Congress, may contain the germ of a major overhaul of the American health care system befitting German State of yester-year?

National Coordinator of Health Information Technology

For example, one provision causing much concern is the future role of the National Coordinator of Health Information Technology [NCHIT]. This is the organization that will be in charge of collecting and monitoring the health care being provided to every American. We have already commented, written, posted and warned our readers and subscribers about this item in our ME-P.

Link: https://healthcarefinancials.wordpress.com/2009/02/11/illuminating-the-congressional-federal-health-board

Hitler and Aktion T-4

The notion seems fully in the spirit of the partisans of efficiency, but historically may have originated from a program instituted in Hitler’s Germany – called Aktion T-4; as insinuated in the Time’s article. Under this program, elderly people with incurable diseases, young children who were critically disabled and others who were deemed non-productive, were euthanized. This was the Nazi version of efficiency, a pitiless expulsion of the “unproductive” members of society in the most expeditious way possible.

Link: http://en.wikipedia.org/wiki/T-4_Euthanasia_Program

Assessment

According to blogging tipster Matt Holt, and most right-minded folks, the Washington Times should be very careful before it starts comparing the people who support an improved national health care IT infrastructure to Hitler, and suggesting that they advocate mass slaughter of sick people.

Link: http://www.washingtontimes.com/news/2009/feb/11/health-efficiency-can-be-deadly

Industry Index Indignation Rating: 98

Conclusion

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Myths and Solutions for Healthcare Reform

Enter the Primary Care Docs, NPs, PAs and DNPs

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Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Would more family practitioners, and professional medical care extenders, help or hinder true healthcare reform?  

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