Michael Moore to John Stossel: 'Very Little Debate' About Health Care in Cuba

I will be on myself for watching next week as well...great health care coverage by ABC...there are always 2 sides to every story.  We have in the US the potential to do health care better than any other country in the world, we just need to get everyone on the same team..and realize this this is an expenditure that is not going to go away, or at least as long as the human race exists...and treat our citizens with dignity and care..budget the money..bring about some type of tax...perhaps sales tax..and just get the job done and stop the insanity that exists today with politics being the judge over who does and who does not get medical care as this battle is getting nowhere in a hurry. 

Sicko did a good job in bringing an awareness to the public on what goes on behind the scenes here, which is a shame, but other countries have their issues as well.  Again, we have the capabilities to do health care better than anyone and education is the key.  Some folks can't help the chronic conditions they may be born with and this is something they have to live with due to no fault of their own, some conditions can be made better with better living habits and some just cannot, and who's to be the judge, just take care of our citizens and use technology to improve health care and not have it be the vehicle to  judge who gets health care and who doesn't.  BD 

Anyone who's seen Michael Moore's film "Sicko" will recall the scene in which he shouts with a bullhorn as his boat takes a group of people, including Sept. 11 workers, to Guantanamo Bay in Cuba, where he says prisoners get better health care than Americans.

Watch "Whose Body Is It, Anyway?! Sick in America" Sept. 14 on "20/20" at 10 p.m. EDT

Darsi Ferrer, a human rights advocate in Cuba, issued an SOS via telephone, wanting the world to know that ordinary Cubans are "crazy with desperation" over the horrendous state of their health care.

Although Cuba claims to have low infant mortality rates, doctors have said the data is misleading because when there might be indications of problems with the fetus, there is a widespread practice of forced abortions. Other doctors have said that if a child dies a few hours after birth, they don't count it as ever having lived, which ultimately makes infant mortality in Cuba look better than that of the United States.

Why believe anything the Cuban government says about Cuba? Moore said, "Let's stick to Canada and Britain and this stuff because I think these are legitimate arguments that are made against the film and against the, the so-called idea of socialized medicine. And I think you should challenge me on these things, and I'll give you my answer."

ABC News: Michael Moore to John Stossel: 'Very Little Debate' About Health Care in Cuba

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Tenet hospitals laying off 346 in S. Florida

 

The Dallas-based hospital chain expects the layoffs to save $18.6 million a year. It has five hospitals in Palm Beach County, four in Miami-Dade County and two in Broward County. The layoffs, mostly affecting support staff, will be at hospitals in Broward and Palm Beach counties. "At some point, you've got to match the staffing levels with patient volume," a Tenet spokesman said. He said the company's hospitals are still recovering from the last round of hurricanes, which he said prompted many of Tenet's patients to move out of state. He also listed a decline in tourism and rising real estate prices for driving people out of the state and affecting patient volumes.

Tenet hospitals laying off 346 in S. Florida - Dallas Business Journal:

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On Covering The Kids' Health, The New Republic: Debunking Conservatives' Myths About S-CHIP

51k a year for a family of 4 is not a huge income to live on in some areas though...where you live has a big impact.  BD

This bill essentially extends a welfare benefit to middle-class households," the administration announced last month, after an S-CHIP expansion bill passed the Senate. Over at National Review's The Corner, David Freddosso put the issue a little less delicately. "Come on, people! We're talking about whether the government should pay for your two kids' health insurance plans when you make more than $51,000 a year (more than the new national median income). I know that health insurance is not cheap, but neither are your mortgage and car insurance. You're not going to ask the government to pay for those, too, are you?"

On Covering The Kids' Health, The New Republic: Debunking Conservatives' Myths About S-CHIP - CBS News

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Sahara i440D Tablet - Virtualization and Aero all working together

 

As everyone knows who reads this page or knows me, I am an avid tablet user.  I can't imagine functioning in my business without one as mobility and portability is everything.  This video is a short demonstration on how you can use Virtualization to accomplish what you may need to do.  Sometimes we have some old software that may have issues with Vista for example and using a virtual Microsoft XP system can be the answer for you.  Sometimes you may deal with other companies who run other operating systems and you have the need to connect and interact. 

If you are not familiar with Virtualization, it is used all over, by major corporations who use virtual web servers.  You may not be aware of the fact that when you access certain active web sites that you are using a virtual machine or virtual server.  Virtual machines allow for more than one operating system to run on the same hardware.  What this also means is that when you are using a virtual operating system, good hardware is needed.  In this example I used the Sahara i440D with Intel Dual Core processors and 2g of ram, and as you can see in the video the tablet handles everything with any hesitation. 

Virtualization also allows you to run other operating systems on one machine as well, such as Linux, Dos, etc. if you have the need.  The "guest" operating systems are sharing the hardware of one machine, thus you want to make sure you have enough power and juice for a seamless operation.  Some folks just seem to think that virtual machines are for servers and desktop PCs, but as you can see in this video, this tablet does virtual very well.  Myself I sometimes have a need to use XP for a software demonstration and will use my virtual XP, not necessarily due to software or driver issues, but more so because this is what my client is familiar with and used to seeing on their own PCs. 

http://youtube.com/watch?v=8W7NO1HNi-c

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Thousands Of Condoms Returned To Washington, D.C., Health Department Because Of Concerns About Packaging, Safety

Makes you wonder sometimes, does anybody get anything right these days..Mattel toys are potentially poisoned with too much lead these days and having issues...hope this item is not on the same track...thus far it only appears to be packaging, but it does make you wonder about the quality of the contents as well...BD

According to the Post, concerns about the condoms "arose almost immediately" after the program began. Demand at two distribution sites established by not-for-profit organizations dropped by more than 80% shortly after the condoms were introduced. More than 2,000 packets were being distributed weekly in mid-March, but by late May, about 400 were being dispensed weekly, the Post reports.

Volunteers said people complained about condom packets "ripping in purses or bursting open in pockets," and some recipients said they lacked confidence that the condoms would provide protection, according to the Post. In addition, the expiration dates on some of the condoms were illegible, the Post reports. Officials at about six organizations that had been distributing the condoms interviewed on Tuesday said they received negative feedback from clients. Many clients said that the condoms' packaging seemed substandard, according to the Post.

"Distribution of those condoms has been really difficult," he said, adding, "The question becomes, how do we fix this?"

Thousands Of Condoms Returned To Washington, D.C., Health Department Because Of Concerns About Packaging, Safety

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Hedge Fund Billionaires Eyed by Congress for More Medicare Tax

 

Sept. 7 (Bloomberg) -- James Simons, the highest-paid hedge-fund manager in the U.S. last year, could pay enough in Medicare taxes to provide health insurance for about 4,800 senior citizens. Such estimates are being cited by backers of a proposal in the U.S. House of Representatives to raise taxes on hedge-fund and private-equity managers. Simons, the Renaissance Technologies Inc. chairman, earned $1.7 billion last year, according to Institutional Investor's Alpha magazine; his income is largely exempt from Medicare and other payroll taxes because it is considered a capital gain.

Simons, 69, hasn't taken a position on the tax proposal, his spokeswoman Joan Campion said. She wouldn't confirm his reported income or comment on the Medicare tax. Democratic Senator Charles Schumer of New York said he would support a bill that raises capital-gains taxes on all partnerships rather than exclusively on investment firms.

Bloomberg.com: Politics

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M·Plan ends HMOs, retains Medicare

 

M·Plan will exit the HMO business, but continue to provide coverage to its 125,000 members until their employer contracts expire. The Indianapolis health maintenance organization, partially owned by Clarian Health Partners, said it decided to fold its commercial business in part because of the big investments needed to remain competitive. M·Plan will remain in the Medicare business. Medicare is a program of medical aid designed for those unable to afford regular medical service and financed by the state and federal governments.

M·Plan ends HMOs, retains Medicare | IndyStar.com

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The bad economics of switching health-care plans

And it continues to occur and grow...moving data and switching information leads to confusion with claims and eligibility as well, but what's the alternative?  BD

In the long-simmering argument over what's wrong with American health care, recent polls show that many people blame our market-based system of private health insurance. Private insurance companies are faulted for, among other things, failing to do enough to prevent disease. They have no incentive to do so, argue advocates for reform, ranging from Michael Moore in Sicko to some of the current presidential candidates. And yet if preventive measures today result in savings on treatment tomorrow, then what's good medicine should also be good business.

Instead, patients are forced to haggle over reimbursement for insulin pumps, and most are rationed only four test strips per day to monitor their blood sugar (sometimes enough, but often not). If better access to insulin pumps and blood-sugar monitoring will save money in the long run, why are insurers so miserly with their diabetes customers?

Employers are tempted into switching because of price disparities across plans. A partial solution would be to legislate away these differences by capping what insurance companies can charge.

The bad economics of switching health-care plans. - By Ray Fisman - Slate Magazine

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New Orleans Activists Call for Charity Hospital To Be Reopened

Would be nice if some of the hospital could be re-opened if in fact portions of the building are still in good condition and can be used...BD

New Orleans activists on Monday called on Louisiana State University to reopen Charity Hospital, which closed after Hurricane Katrina, saying the city needs more health services available to uninsured residents, the New Orleans Times-Picayune reports. The activists, from several local civil advocacy groups, said that major parts of the hospital are in good condition and could be reopened. LSU, which ran the hospital, said it would be irresponsible to spend money to fix the outmoded facility, the Times-Picayune reports. The university plans to replace the facility with a new hospital in 2012.

Coverage & Access | New Orleans Activists Call for Charity Hospital To Be Reopened - Kaisernetwork.org

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England - Bug outbreak shuts hospital ward

 

The unit was shut to new patients on Thursday evening after two patients showed an initial positive test for vancomycin resistant enterococci (VRE). If VRE gets into the systems of seriously ill people, like those in intensive care, it can infect wounds and the intestines. Patients have been moved to the Derby Royal Infirmary during further tests.

VRE, which can occur in the bodies of healthy people without causing harm, can be spread via contact with a carrier or an object on which the bacteria is present.

BBC NEWS | UK | England | Derbyshire | Bug outbreak shuts hospital ward

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Hospital To Take Pre-Payment For Non-Emergency ER Visits -Orlando

One hospital now charging $100.00 for non emergency type visits to the ER..and they are turning patients away...due to the cost of treating patients without insurance coverage...BD

Some emergency room patients in Orange County will need to pay up before getting any treatment. Health Central has now changed its ER policy for non-emergency patients. Patients without insurance will be sent away if they can't pay $100. A spokesperson for the hospital said it has been spending too much money treating patients without insurance. At least 15 patients have already been turned away this week.

Orange County Hospital To Take Pre-Payment For Non-Emergency ER Visits - News Story - WFTV Orlando

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Couple Charged With Illegal Surgeries

Going to a home for surgery might be the first indication that there's something not quite right...BD 

SAN JOSE, Calif. (AP) A couple were arrested after authorities said they performed illegal and disfiguring cosmetic surgeries in their filthy home, filled with drugs and syringes. Ha Nguyen, 48, and Zbigniew Makowski, 62, were arrested Wednesday on suspicion of practicing medicine without a license and child endangerment. Four children were removed from their home by child-welfare officials, authorities said. One woman who received a facelift and tummy tuck from Nguyen now has thick three-inch scars next to each ear, scars above each eyebrow and under her lower lip, and a 15-inch scar across her stomach, said California Medical Board spokeswoman Candis Cohen.

The Associated Press: Couple Charged With Illegal Surgeries

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Most Primary-care Docs didn't grow up tech savvy

I can pretty much agree with the fact that an EMR or EHR with a short learning curve almost does not exist today...can't get away from training to have an electronic records system be a success...BD 

In response to Bill Bysinger's letter, I would very much like to know which electronic medical record technology has been shown to be both cost-effective and easily adoptable by primary-care physicians in solo and small-group practices. I have explored many and have yet to find one with a short learning curve if it truly contains all the features needed to fulfill the promise of EMRs. It may be time to give up on the "short learning curve."

Modern Healthcare Online

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FDA Approves First Generic Versions Of Coreg

 

The U.S. Food and Drug Administration approved the first generic versions of Coreg (carvedilol). Coreg is a widely used medication that is FDA-approved to treat high blood pressure, mild to severe chronic heart failure and left ventricular dysfunction following a heart attack.

FDA Approves First Generic Versions Of Coreg

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Pfizer computers spew out Viagra spam!

We all get the Viagra spam and have for years, now it appears the spammers have targeted Pfizer itself with spam....BD

Pfizer has been one of the most active drug companies trying to combat fake Internet drugs sold by spammers. Pfizer is also a company which has been forced to admit three times in the last three months that tens of thousands of confidential employee records, including social security numbers, have been lost to identity thieves. But the biggest shocker came today when it was revealed that Pfizer has not responded to numerous warnings that its computers spew out spam emails for various drugs, including Viagra.

BrandweekNRX: Pfizer computers spew out Viagra spam!

Hat Tip:  Kevin, MD

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New York City Puts Hospital Error Data Online

I think there will be issues here as far as being completely accurate as there may be other factors that enter in to the process as well...did the patient have some of these conditions before being admitted as an example...or was it missed on the chart when the patient was admitted for a simple example...BD

The New York City Health and Hospitals Corporation, the nations largest public health system, plans to begin publicly releasing data today on infection and death rates at its 11 hospitals, in response to widespread concern about deadly, preventable and costly hospital-acquired conditions and pressure to crack open the shrouded culture of many hospitals.

While the new data available on the Web site includes some measures of mortality rates, it was not possible for the city hospitals to report the number of deaths caused by hospital-acquired conditions, a complicated assessment that should take into account patients’ medical histories, Mr. Aviles said.

New York City Puts Hospital Error Data Online - New York Times

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Congress looks into Mattel after toy recalls

Too much lead in the paint appears to be the issue...BD

NEW YORK (Reuters) - The U.S. Congress is looking into Mattel Inc's procedures for alerting federal regulators about hazardous toys, The Wall Street Journal reported in its online edition on Friday. ADVERTISEMENT Senior Democrats in the Senate and the House have launched separate probes, which are expected to focus on Mattel's dealings with the Consumer Product Safety Commission, the report said. Mattel said on Tuesday that it would recall more than 800,000 toys for excessive lead levels, its third such recall this summer. The CPSC has disagreed sharply with the toy company over the investigation of reports of dangerous products.

Congress looks into Mattel after toy recalls: report - Yahoo! News

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ICD-9-CM codes: The latest changes - Prepare your practice for the changes this fall

Great article from Medical Economics on the new codes...there are several pages of all the changes and additions...BD

You've barely gotten used to last year's ICD-9-CM changes but it's time to review your charge tickets and encounter forms again to see if any of this year's revisions affect your practice. Remember, these diagnosis codes take effect this Oct. 1, and CMS doesn't allow a grace period: Claims with invalid codes will be rejected. This time, at least, you have far fewer changes to contend with: 142 new, five revised, and 17 invalid codes compared with almost 300 changes last year.

As before, many of the new codes were created to allow you to be more precise in identifying signs, symptoms, and conditions. For example, there are more than 30 subtypes of non-Hodgkin's lymphoma, and all are currently indexed to code 202.8x. Come October, you'll be able to identify specific kinds of non-Hodgkin's lymphoma with any of the 54 new codes in categories 200 and 202.

NEW DIAGNOSIS CODES - use the link below to view changes and new codes

ICD-9-CM codes: The latest changes - Prepare your practice for the changes this fall. - Medical Economics

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California health reform puzzle: How to insure low-paid workers?

Still no real answer or viable solutions....BD

SACRAMENTOTo understand why it is so hard to cover the uninsured in California, consider the case of Brookfields, a small chain of family style restaurants near the state capital. Profits are low, and the owner, Sam Manolakas, says he cannot afford his workers' rising health care premiums. But since his waitresses, cooks and busboys earn so little, neither can they. So, like low-wage workers across California and the nation, many of Manolakas' employees are dropping their coverage. Now, reformers in Sacramento want to reverse this trend, which is a major reason why 6.8 million Californians had no insurance at some point last year.

A lot of the younger employees, they don't want to have anything to do with it," said Manolakas.

"I'm just too broke," she said.

San Jose Mercury News - California health reform puzzle: How to insure low-paid workers?

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Health insurer to pay $12 million settlement - Health Care

 

UnitedHealthcare on Thursday settled complaints about its past claims practices, agreeing to pay $12 million in fines to 36 states and the District of Columbia. The largest sum, about $4 million, is going to New York, where the health insurer covers roughly 1 million people.

The company also agreed to meet benchmarks for improving its claims accuracy and timeliness, appeals and handling of consumer complaints, or face up to $8 million in additional fines.

Health insurer to pay $12 million settlement - Health Care - MSNBC.com

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Merck wins reversal of Vioxx class-action status

No class action, some relief as the individual cases filed continue...BD

NEW YORK (Reuters) - Merck & Co Inc (MRK.N: Quote, Profile , Research) said on Thursday the New Jersey Supreme Court has reversed a lower court ruling that had granted nationwide class-action status to insurers seeking reimbursement for past spending on Vioxx, the drugmaker's withdrawn arthritis treatment. Shares of Merck rose 2 percent. "The Supreme Court recognized that a class action was improper because each insurance company and HMO considered different types of information in deciding whether to reimburse patients for Vioxx, and they all went through varied processes with different experts in making those decisions," said Ted Mayer, outside counsel for Merck.

Merck faces tens of thousands of lawsuits filed by former users of Vioxx who claim to have been harmed by the drug. The insurance companies and HMOs were seeking instead to be reimbursed for their spending on the former $2.5 billion-a-year pill, which was withdrawn in 2004 after being linked to heart attacks and strokes among long-term users.

Merck wins reversal of Vioxx class-action status | Reuters.co.uk

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ABC News: Seeing the Body as Never Before

This is set to air on Friday (tomorrow) on ABC News 20/20.  High definition views of the human body...also airing on National Geographic...be sure to visit the web site for more details...fascinating how all this is done.  BD

Recent technological advances have allowed for such dramatic and amazing views of the inside of our bodies that watching the footage can feel like you're in a science fiction film or on an imaginary expedition. In such a science fiction journey, the 1966 film "Fantastic Voyage," a group of scientists and their submarine were miniaturized so they could be injected into a body in order to eliminate an otherwise unreachable brain clot.

Palter, who has a medical technology blog called docinthemachine.com, is a pioneer of methods capable of producing spectacular high-definition surgical images.

ABC News: Seeing the Body as Never Before

Hat Tip:  MedGadget

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"Who's Right about Kaiser -- Michael Moore or SEIU?

I did see the movie and I had no idea myself on the involvement of Nixon in managed care, it was one of the true eye openers included in the movie "Sicko".  Was the bonus system in place in 2002 the start of P4P?  BD

Thanks to the Watergate scandal, Michael Moore's documentary SiCKO was able to report some history of the Kaiser Permanente health maintenance organization (HMO). It's history that Kaiser would prefer you do not know. Moore included tape of President Nixon and chief aide John Erlichman discussing what would become the HMO Act of 1973. Based on conversations with executives at Kaiser Permanente, the largest health plan in California, Erlichman assured Nixon that the incentives at Kaiser run toward less medical care. The less care provided to members paying a flat premium, the more money Kaiser makes. Nixon expressed his approval.

The drive to minimize care caused Kaiser much embarrassment in 2002 when the Los Angeles Times reported that Kaiser "awarded financial bonuses to call center clerks who spent the least amount of time on the phone with each patient and limited the number of doctors'

Charles Andrews, "Who's Right about Kaiser -- Michael Moore or SEIU?

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Medicaid Physician Payments Vary Widely Among States

It's no wonder why some physicians are either leaving or contemplating moving or not providing services to Medicaid patients...BD

States with the lowest rates were New Jersey, New York, Pennsylvania and Rhode Island, as well as Washington, D.C. (Philadelphia Inquirer, 9/6). The report found significant differences in state Medicaid reimbursement rates. For example, in New York, Medicaid reimburses physicians $20 for an hour-long visit with an established patient, while higher-paying states, on average, pay $49.20 for a 15-minute visit or $157.92 for an hour-long appointment (New York Sun, 9/6).

Medicaid | Medicaid Physician Payments Vary Widely Among States, Medicare Payments More Similar Across States, Report Finds - Kaisernetwork.org

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Headache for doctors: medical office rents - Los Angeles

Good story from the Los Angeles Times that addresses the high rent cost in the southern California areas...the rent increases just keep coming for the physicians...another cost item that cuts into their bottom line, along with all the other decreases and cuts they have been faced with the last few years...BD

Add to the list of woes for Southern California doctors: escalating rents for space in modest medical office buildings. These quarters are often more expensive than traditional office buildings such as the 72-story showcase U.S. Bank Tower in downtown Los Angeles. That may be great news for landlords but a harbinger of higher medical bills for patients and even a potential career ender for some doctors, says David H. Aizuss, president of the Los Angeles County Medical Assn.

The price of renting or buying medical offices is climbing fast, especially in popular markets such as Beverly Hills, Santa Monica and Newport Beach where medical buildings are selling for record prices and offices to lease are tough to find.

"Doctors need the synergy of being together. They rely on each other.""Developers are going to start figuring it out," Held said. When it comes to office space, he added, "Doctors are going to have to do more and more -- with less and less."

Headache for doctors: medical office rents - Los Angeles Times

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Senators block leases at L.A. vets hospital

If I read this correctly, this was an attempt to downsize Veteran care and enable the hospital to sublet space?  Is this about health care or about money?  BD 

WASHINGTON - California's U.S. senators thwarted a Bush administration attempt Wednesday to allow commercial leasing of a Los Angeles veterans hospital. In a 66-25 vote, lawmakers shot down an amendment that would have stripped protections written by Sen. Dianne Feinstein into a $109.2 military spending bill prohibiting development at the West Los Angeles Medical Center.

There are a lot of ways to make money, but I think the worst way is to make money off of veterans," Feinstein said.

The White House earlier this week said it opposed the protections and predicted it would eliminate more than $4 billion in revenue from the Veterans Administration.

LA Daily News - Senators block leases at L.A. vets hospital

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S.C. BlueCross to Integrate Care Management with Personal Health Record in Real Time

If I read this correctly, those with chronic illnesses could be targeted for an onslaught of information sent to their chart advising them on how to live healthier?  This is not a bad idea, but how big will the onslaught of information be and how often?  Will the patient be hammered with information on how to live healthier?   And what about privacy...all Blue Cross branches will have access?  In addition to insurers you can visit the Paradigm web site to also find a listing of clients to include some other large employers on the list...like Ford Motor Company. 

It is another data warehouse making medical data base information available..good for medical care, but who knows where else the data may go...the question we all must ask from time to time...is it in the interest of better medical care or for reducing cost?   BD

COLUMBIA, S.C., Sept. 4 /PRNewswire/ -- BlueCross BlueShield of South Carolina plans to electronically integrate personal health records with medical care plans and make these available in real time to BlueCross members and their health care professionals. Together with ParadigmHealth, a provider and integrator of care and disease management services, the two companies will make the new Integrated Care Management platform available to other insurance companies. The new platform is scheduled to go into use at BlueCross BlueShield of South Carolina by the end of this year. S.C. BlueCross also provides administrative services to a number of other Blues plans through its National Alliance division, and it will make this functionality available to those plans and their customers. S.C. BlueCross members will be able to access their personal health record, containing clinical and lab information along with their claims data, in the secure My Insurance Manager(SM) section of the company's Web site.

If a member has a chronic disease or high-risk condition, such as diabetes, individually targeted wellness information will be automatically included in their personal health record. In the case of a medical emergency, each member will be able to download and print their personal health record.

S.C. BlueCross to Integrate Care Management with Personal Health Record in Real Time

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Blue Cross, Condell to part ways

Long time to go without payment for the hospital...June...BD

Thousands of Condell Medical Center patients are getting caught in the crossfire in an ongoing feud between the Libertyville hospital and one of the state's largest insurance companies. Beginning Sept. 30, Condell will no longer accept Blue Cross Blue Shield of Illinois PPO. The company's HMO Illinois and Blue Advantage HMO customers aren't faring much better. That insurance will be accepted by the hospital only through the end of the year. "This will have a significant effect on our patients as well as Condell," said Jodi Levine, vice president of business development for the hospital.

What this means is patients scheduled for cancer treatments, surgeries or births after the contracts expire will have to find a new doctor and hospital, or hope that their physician practices at another hospital still accepting Blue Cross Blue Shield.

Daily Herald | Blue Cross, Condell to part ways

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Horizon Air Employee Health Program With On-Site Clinic

One more employer on the bandwagon with on site medical care...sign of the times.. BD

ADDISON, Texas, Sept. 5 /PRNewswire/ -- Concentra ("Concentra" or the "Company"), a national leader in on-site employer health care, is known for its unique combination of medical services and general wellness programs. Horizon Air, a regional carrier based in Portland, Oregon, is known for its safe, reliable air transportation with caring, friendly, and professional service. When Horizon Air was searching for an on-site health program that matched its commitment to quality, superior service, and corporate philosophy, it chose Concentra.

Concentra Expands Horizon Air Employee Health Program With On-Site Clinic

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The Doctor that Googles....

Another good reason to use a Tablet PC with patient visits...doctor looks up dizziness and what happens is pretty funny as he turns up Dizzy Gillespie...patient was not impressed...anyway with a desktop the patient sees all...all your searches, typos..you name it...plus as you see his back is turned toward the patient...

MORAL OF THE STORY HERE:  GET A TABLET....(GRIN)

http://youtube.com/watch?v=ax0xoeDllnM#cooliris

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Placebo TV - Dr. Doug Farrago speaks out...

Here is one of his videos from You Tube and a link to the main site.  I hope he continues these as they are very good and funny!  The parody type commercials add even a bit more humor, but underneath all of the humor and wit...he makes some real good points!  This is the latest update, journal # 5...follow the link below for all the videos.  In this episode he talks about P4P and shows what the future office visit could resemble in a humorous way.  Good show!  BD 

View all videos and site here:  Placedo Journal - Iiopathic Wit and Wisdom

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The Clinton Spouse on Tour

Good point made below on not being able to pass health care reform...I caught a little bit of his interview with David Letterman last evening as well and health care is right up there on the agenda...and the humorous comments on how he was mistaken for Bob Barker...as he ages he and Bob are starting to look somewhat alike!  BD 

Former President Bill Clinton, promoting his new book Giving: How Each of Us Can Change the World, appeared on NBCs Today show this morning to voice a little bit of what he views as his wifes ability to change the world, too. Tucked within his answers was a veiled swipe at Senator Barack Obama, one of the Democratic rivals to the campaign of his spouse, Senator Hillary Rodham Clinton. As you may recall, over the weekend, Mrs. Clinton pretty much borrowed a line from another Democratic candidate, Gov. Bill Richardson of New Mexico. He had remarked at a recent debate that while Mr. Obama and Mrs. Clinton fought over ownership of those two battleground words Change vs. Experience voters didnt have to choose one or the other because he represented both.

"And keep in mind, that’s important, because we can’t pass health care reform, we can’t pass energy reform, which I think is the key to creating jobs, unless we get some Republican votes."

The Clinton Spouse on Tour - The Caucus - Politics - New York Times Blog

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Benoit's concussions may help explain killings

Did the wrestler overdose on medication...and was this a lethal mixture combined with concussions he had suffered?  Maybe some day we'll know more...BD 

ATLANTA, Georgia (AP) -- Pro wrestler Chris Benoit suffered brain damage from his years in the ring that could help explain why he killed his wife, son and himself, a doctor who studied Benoit's brain said Wednesday. art.benoit.gi.jpg A doctor who studied Chris Benoit's brain says the pro wrestler had signs of degenerative brain damage. The analysis by doctors affiliated with the Sports Legacy Institute suggests repeated concussions could have contributed to the killings at Benoit's suburban Atlanta home. Steroid use also has lingered as a theory, since anabolic steroids were found in the home and tests conducted by authorities showed Benoit had roughly 10 times the normal level of testosterone in his system when he died.

Authorities have said Benoit's personal doctor, Phil Astin, prescribed a 10-month supply of anabolic steroids to Benoit every three to four weeks between May 2006 and May 2007. Astin has pleaded not guilty to federal charges of improperly prescribing painkillers and other drugs to two patients other than Benoit.

Doctor: Benoit's concussions may help explain killings - CNN.com

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Survey: 60% Of Primary Care Physicians Would Choose Another Field

Not good news with upcoming shortages of PCPs...some areas are already facing this challenge..BD

Almost two-thirds of primary care physicians would choose another field if they had their careers to do over, a new survey indicates, while more than 50 percent consider themselves "second class citizens" compared to surgical and diagnostic specialists. The survey was conducted for Physicians Practice, an award-winning practice-management journal read by more than 275,000 physicians nationwide. Conducting the survey was physician search and consulting firm Merritt, Hawkins & Associates. The annual survey is intended to measure the career satisfaction levels and concerns of primary care doctors, defined as family practitioners, general internists, and pediatricians. The survey suggests that though primary care doctors are both busy and in increasing demand, they are not necessarily satisfied with their place in the medical hierarchy.

Survey: 60% Of Primary Care Physicians Would Choose Another Field

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State Behind Schedule to Regulate Shady HMO Termination Policies

 

The state agency that oversees HMOs says it's still not ready to issue new regulations that address insurers' practice of retroactively canceling policies. State officials had promised to come up with the new rules last spring. KPBS reporter Kenny Goldberg has more. Consumer advocates say it happens all too often in California: a person files a claim with a health insurer, and their policy gets terminated.

KPBS > News > Local News

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Figures getting more dismal -The Clarion-Ledger- Real Mississippi

Children will have to wait and be uninsured for a year to qualify?  BD 

If health professionals thought that the Bush administration's stance on federal health insurance assistance for children was abysmal, it's about to get much worse. Last week, Health and Human Services Secretary Mike Leavitt said that the Bush administration's new guidelines will mean children may have to be uninsured for at least one year before they can enroll in the State Children's Health Insurance Program. In Mississippi, the number of citizens lacking health insurance is rising, which would mean a heavier burden on federal and state programs for low-income residents. The number of uninsured in this state rose 24 percent from 2005 to 2006, according to the U.S. Census Bureau. A total of 600,000 people - a fifth of the state's population - were without insurance in 2006, up from 483,000. But, more ominously, the number of uninsured children increased 72 percent, from 85,000 to 146,000.

Health insurance: Figures getting more dismal -The Clarion-Ledger- Real Mississippi

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NJ hospitals are short on beds - Breaking News From New Jersey

And to quote one of the reader comments from the article:  "This is ridiculous.Union Hospital is closing very soon and Columbus Hospital in Newark is in danger of closing if there are no takers.Premiums are through the roof. Would someone please fix our health care system."  BD

New Jersey hospitals lack an adequate number of staffed inpatient beds to keep up with patient demand, leading to overcrowding in emergency rooms and frequent ambulance diversions, a report released today found. Conducted by researchers at Rutgers University's Center for State Health Policy, the report found that the stress on capacity is so bad - especially during peak periods like flu-season - that hospitals in the state would have an extremely difficult time responding to a major health disaster without displacing existing patients.

Report: NJ hospitals are short on beds - Breaking News From New Jersey - NJ.com

And the hospitals are doing their best...with picture boards with those who do not speak English as well...BD

RENTON, N.J. (AP) — With more ill and injured people unable to speak English, hospitals, clinics and rescue squads are turning to picture boards to bridge the communication gap with easily understood images.

The large, double-sided panels let patients point to icons showing their problem — such as pain, a burn, breathing trouble or a fall — as well as the part of the body that is affected. They also can point to their native language in a list so an appropriate interpreter can be located.

 

At University Hospital in Newark, up to 15 percent of patients speak Spanish, Portuguese or another language besides English, said triage nurse Robert Cagadoc. Since getting the picture boards last month, he's used them a couple times every shift to help patients arriving in the emergency department.

http://ap.google.com/article/ALeqM5jQr3mVdgQVyiQjGEGRW2rgOSD4rA

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AMA ads push reform; Sicko gets people talking

Sicko did create an awareness after all, even if folks did not see the movie...the AMA and Sicko though are on different sides of the table as far as solutions go...BD   

The American Medical Association plans to spend $5 million on the initial phase of a campaign designed to make health care reform the top issue on voters' minds in the 2008 presidential election. The ultimate goal is to win passage of legislation in 2009 that would provide health insurance coverage to every American. "This is a full-court press ... to get voters talking and politicians acting," said AMA President-elect Dr. Nancy Nielsen, an internist from Buffalo. "We're going to spend as much money as it takes to get all Americans covered.

A new Kaiser Family Foundation poll found the film has had a much bigger influence on the health care debate than its so-so box office numbers would suggest.

About half of those surveyed viewed health insurers and drug companies unfavorably. Hospitals and doctors were seen in a more favorable light.

bizjournals: Washington Bureau

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Questions on Medi-Cal Funding Remain After Budget Deal

What will be in store next year?  Expenses and cost increases don't seem to be on a downswing anywhere...BD

Before legislators and Gov. Arnold Schwarzenegger (R) agreed on a plan more than a month past their deadline, the state's Medi-Cal emergency fund ran dry and many health care providers were hard-strapped to provide -- let alone pay for -- services. Then, when the budget finally was hammered out and signed, the largest single hit in the effort to trim more than $700 million from the proposal came at Medi-Cal's expense. The new budget transfers $332 million from the Medi-Cal reserve fund to the state general fund reserve. State officials say the money can be shifted back if Medi-Cal runs low, but some critics say the state will be hard-pressed to make ends meet this year, with or without padded reserves. That bodes ill for Medi-Cal providers and beneficiaries.

The issue plays out on two levels: the policy, decision-making level in Sacramento and the grassroots "how-do-we-take-care-of-our-patients" level at local clinics and hospitals up and down the state. But cost increases and changes in accounting methods for Medi-Cal made the money disappear a lot quicker this year.

Questions on Medi-Cal Funding Remain After Budget Deal - California Healthline

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P4P on the rise...

155 programs compared to 39 in 2003...if you try to keep on top of this with paper, you will undoubtedly have one big administrative mess...make sure you have an EMR or something along the same line that will calculate the registry statistics of your practice, otherwise it will be their word against yours..and with so many plans and the variations, trying to figure all this out with paper...well...are they banking on the physician who continues to use paper and will not have the time to reconcile with their figures...something to think about for the near future and how to handle.  BD

The number of pay-for-performance programs has practically quadrupled in the last five years, according to a report released last week, andin the past few weeksit appears that the number of related items in the news has proliferated by a similar percentage.

Even as payers issue glowing news releases about the expansion of their programs' scope and the millions of dollars in physician rewards they're dispersing, government officials, research organizations and physicians are questioning the motivation and methodology of current pay-for-performance programs. In the end, the one industry segment that may truly be happy with pay-for-performance programs are health IT vendors who can persuade providers that their electronic systems are absolutely necessary for the data management that require such programs

The data, from healthcare informatics group Med-Vantage and the Leapfrog Group, projected there will be 155 pay-for-performance programs in place this year, compared with only 39 in 2003.

Meanwhile, the physician-ranking programs under consideration for use by insurers Aetna, Cigna HealthCare and UnitedHealth Group have come under scrutiny by New York State Attorney General Andrew Cuomo, who expressed concern that the rankings may be used to steer patients toward less-expensive rather than higher quality providers.

Modern Healthcare Online

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Study Shows Rasilez, The First And Only Approved Direct Renin Inhibitor, Reduces A Marker Of Heart Failure Severity And Is Well-Tolerated

Interesting initial information with this new class of blood pressure medication...BD

Rasilez (aliskiren), the first new type of high blood pressure medicine in more than a decade, is generally well-tolerated and can potentially reduce the severity of heart failure1 based on new data showing significant reductions in BNP, a substance secreted by the heart and whose levels are viewed as an indicator of disease severity.

Study Shows Rasilez, The First And Only Approved Direct Renin Inhibitor, Reduces A Marker Of Heart Failure Severity And Is Well-Tolerated

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RNs At 10 Northern Calif. Hospitals Vote To Authorize Strike For Patient Care

 

Registered nurses at all 10 Northern California Sutter Health hospitals currently in bargaining have voted overwhelmingly to authorize a strike if an agreement with the hospital chain is not reached, the California Nurses Association/National Nurses Organizing Committee announced last week. There has been no progress in bargaining over the core issues of the contract, which includes important patient safety concerns, adequate RN staffing, and protection for nurse healthcare coverage. RNs at Mills-Peninsula Health Services in Burlingame and San Mateo, San Leandro Hospital and Eden Medical Center in Castro Valley all voted Wednesday and Thursday to join their colleagues at Sutter Delta in Antioch, Sutter Solano in Vallejo, California Pacific Medical Center and St. Luke's hospitals in San Francisco, Alta Bates Summit Medical Center in Berkeley and Oakland, Sutter Santa Rosa, Sutter Marin General Hospital and Sutter Novato Hospital in authorizing a strike.

Nurses Send Sutter A Clear Message - RNs At 10 Northern Calif. Hospitals Vote To Authorize Strike For Patient Care

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The World's Smallest Ultrasound Device For Initial Diagnosis In Emergency Situations - the pocket ultrasound

 

The first few minutes are instrumental in emergency situations. A new portable ultrasound device from Siemens Medical Systems supports medical personnel in these efforts. The device, known as Acuson P10, is a hand-held device intended for complementary initial diagnostic care and triage, particularly in cardiology, emergency care and obstetrics. It is poised to change the physical exam by providing immediate information to health care providers at the earliest possible patient intervention points, such as intensive care units, ambulances and medical helicopters. The advantages of the new system are its portability, easy handling as well as its fast and consistent availability to the physician. The device is barely larger than a Blackberry and weighs just a little more than 700 grams.

 

Siemens Introduces The World's Smallest Ultrasound Device For Initial Diagnosis In Emergency Situations

Additional Information:  http://www.medical.siemens.com/webapp/wcs/stores/servlet/CategoryDisplay?storeId=10001&langId=-11&catalogId=-11&catTree=100011,1008614,1009058&categoryId=1009058

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With $100 Million Debt, Grady Hospital May Close Doors

There is a web site set up to take donations and any other funds to help keep the hospital open.  You can search this blog for more information.  BD

Grady Memorial Hospital in downtown Atlanta the largest public hospital in the South and a major training ground for medical students from both Emory and Morehouse College could be forced to close if officials fail to find funding to pay off its $100 million debt. During the summer, advocates for Grady including doctors, medical students and Atlanta locals have stressed the need to keep the hospital open, especially for low-income patients in the Atlanta area.

“There must be a surrender of power,” they wrote. “Grady’s entire board must submit its resignation and ask for a total reorganization as suggested by the Metro Atlanta Chamber of Commerce.

With $100 Million Debt, Grady Hospital May Close Doors | The Emory Wheel

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Hospital seeks $42,000 -- from a homeless man

This should have been a charity case. The hospital knew one of his clients and sent the bills and made collection calls to her house, along with the huge bill.  BD

WALNUT CREEK -- The hospital bill stunned Mary Olsen. The half-inch-thick packet arrived at her home addressed to Phil Hughes, a homeless man she had befriended when he showed up one day and offered to paint her house number on the curb for cash. She gave him $5 and a lunch of turkey and mashed potatoes. During the next few years, she hired him for painting, yard work and other odd jobs. Hughes has no family in the area, so when he developed a high fever and blood infection a year and a half ago and sought treatment at John Muir Medical Center in Walnut Creek, Olsen told him to give her name and address as an emergency contact.

Phil is so obviously an indigent person that no one would expect he would have enough money for lunch," she said, "let alone a hospital bill."

ContraCostaTimes.com - Hospital seeks $42,000 -- from a homeless man

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Help Prevent Medical Errors - Forbes.com

Give as much accurate information to your physician...good tips on this page.  BD 

(HealthDay News) -- Medical errors can occur when doctors don't have all of the information they need from a patient, including a comprehensive list of medications the patient takes, patient symptoms, and advice the patient has received from other doctors

Health Tip: Help Prevent Medical Errors - Forbes.com

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Americans are ready to fight for health-care reform

One person's opinion, and probably a good one at that...BD 

A mother cant afford to take her sick child to the doctor. An elderly man is turned away at the pharmacy because his fixed income doesn't leave him with enough money to pay for his prescription drugs. A nurse cant offer care because her patient doesn't have health insurance. Everyone knows someone with a health-care horror story. This Labor Day, the health-care crisis in Missouri and across America has reached an apex. New figures released recently show that 47 million Americans dont have health insurance. Right here in Missouri, 772,000 people dont have health insurance, including 106,000 children.

Some people believe “the market” can make this happen. We disagree. If the only insurance available is a product of a profit-driven company there is little doubt that many of the people who need coverage the most — the chronically ill, for example — will not get it.

www.kansascity.com | 09/02/2007 | Americans are ready to fight for health-care reform

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Expats fear health cover could vanish as French tightens the rules

France is struggling with their health system as well, even to the point of asking to return his French health card.  The basic issue appears to be those individuals who retire in France from other countries, namely the UK that have things heated up.  BD 

Thousands of Britons who have moved to France for early retirement could lose their rights to state health care under a new law that limits benefits to nonworking expatriates. In a move that has spread alarm in the southern and western regions favoured by the British, the authorities have begun enforcing a 2006 law that bars unemployed EU citizens from joining the French health system. A few hundred cases have already been refused, said Larry Fulton, whose company in the south of France handles private insurance for British expatriates. We are dealing with about 350 calls a day from people who are worried.

In at least one case, a resident Briton has been asked to return his French health card. Charles Mochan, 59, a former British High Commissioner to Fiji, received a curt letter from his local office in the Pyrénées region telling him that he was no longer entitled to cover. “It was a bit of a shock,” Mr Mochan told The Times.

Mr Ross voiced understanding for the French position. “An awful lot of British people turn up here with no jobs and no money and think they can just stay on like that.”

Expats fear health cover could vanish as French tighten rules - Times Online

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States, not Congress take the lead on health care

This does seem to be the case...again, health care should be regulated like a utility, as just like gas, electricity, and water, if you don't have it, it is life threatening..and even more so is health care.  BD 

The number of Americans without insurance continues to rise, but Congress likely will let states and presidential candidates take the lead on health care reform for now. The Census Bureau reported Aug. 28 that 47 million Americans lacked health insurance in 2006, up 2.2 million from 2005. Many of these uninsured Americans work for small businesses, so these firms will play a major role in any initiative to cover more people. The health care issue immediately facing Congress is whether to expand a government program covering children. Both the House and Senate have voted to make more children eligible for the State Children's Health Insurance Program, but they disagree on how to pay for it.

bizjournals: Washington Bureau

Related post with comments from Sandra Day O'Connor:  We are all uninsured now

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Increased Risk Of Death In Patients Who Stop Using Statins After Stroke

 

Patients who stop taking cholesterol-lowering drugs within a year of surviving a stroke had a two-fold increased risk of death, researchers reported in Stroke: Journal of the American Heart Association. Statins can benefit patients who have suffered an ischemic stroke (caused by a clot). However, stroke survivors often stop taking these drugs -- an issue previously not studied in a clinical setting, said Furio Colivicchi, M.D., lead study author.

Patients were less likely to stop taking the statins if they had diabetes or a previous stroke.

Increased Risk Of Death In Patients Who Stop Using Statins After Stroke

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Medical waste, trash washes up, forces beach closures in N.J.

Not the best way to start a holiday...BD

TRENTON, N.J. (AP) _ Several beaches along the Jersey Shore were closed Sunday after medical waste and other trash started washing ashore, authorities said. The source of the waste _ which beachgoers said included syringes, tampon applicators, gauze and other debris _ was not immediately known, and there were no reports of injuries. Most of the waste was found on beaches and in the waters off Monmouth and Ocean counties, authorities said.

Medical waste, trash washes up, forces beach closures in N.J. -- Newsday.com

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California plan (Blue Cross) backs down from some scheduled fee reductions .

Sounds a lot like the Medicare article posted earlier...interesting comment on how the insurer came back with the comment on "those weren't intended to be reduced"?  I am curious what the process is before new compensation rates are set up though, is it scrutinized like the utility rate increases...I guess that could be wishful thinking...or even the fact that health insurers could be regulated by states like a utility...which could not be a bad idea as health insurance is in essence a utility as just like without heat, cooling, and water, we are all at risk of expiring..and health insurance even moreso.  BD

Days after a state hearing looking at whether Blue Cross of California had reneged on promises it made in order to get a merger approved, the plan said it would back down from some proposed reimbursement cuts.

But the plan's move might not be enough to keep some physicians from reversing their decisions to drop the insurer.

"When they looked at them they said, 'You're right, those weren't intended to be reduced,' " Blue Cross spokesman Nick Garcia said.

Among the services for which the insurer decided not to decrease reimbursement are hospital-based newborn care, mammograms and colonoscopies. Additionally, the company said immunization reimbursements would increase and would be reviewed quarterly as opposed to annually.

AMNews: Sept. 10, 2007. California plan backs down from some scheduled fee reductions ... American Medical News

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House bill creates 6 Medicare payment categories ...

Radiologists and other physicians are concerned that the variance of conversion factors could pit doctors against one another ...and the job of keeping track of these changes to anticipate payment amounts is yet a another issue...not to mention additional coding functionality changes as multiple conversion factors enter the picture.  BD 

Washington -- If House lawmakers have their way, the extent to which physicians see their Medicare payment rates rise or fall year by year would depend even more on what types of services they provide. A provision in the Children's Health and Medicare Protection Act of 2007, which the House passed Aug. 1, would alter the sustainable growth rate formula by establishing six separate categories for physician services. The categories would consist of primary care and preventive services; other evaluation and management services; major procedures; anesthesia services; imaging services; and minor procedures and all other services not falling into another category.

The American College of Radiology and the Society of Interventional Radiology are especially concerned, because the imaging category in particular would likely see major rate reductions under the six-category plan.  All physicians who provide imaging services would be affected by the service category plan. Radiologists in particular would be powerless to prevent payment cuts by limiting utilization, Dr. Moore said. That's because primary care physicians and other referring doctors generally are the ones who control how many patients are sent to the specialists to receive scans.

So when Medicare updates its rates at the beginning of a calendar year, for instance, the rate for an office visit might change by a different percentage from the rate for an imaging scan.

AMNews: Sept. 10, 2007. House bill creates 6 Medicare payment categories ... American Medical News

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Finances driving physicians out of solo practice ...

Something I think we may have all noticed...it is a lot of work to have a life and maintain the solo practice these days, and I prefer a solo practice MD myself...but do see the trials and tribulations it can have, not to mention not being able to have much of a life...BD

A survey released in August by the Center for Studying Health System Change found a marked increase in the percentage of doctors joining large, single-specialty groups, as well as entering employed situations. The survey, covering 1996 to 2005, also found a marked decrease in the percentage of physicians in solo or two-doctor practices, as well as a large drop in the percentage of doctors who have an ownership stake in their practices. The finding was especially apparent among older physicians.

Observers say this trend is not going away anytime soon and might well reflect a growing cultural change among physicians.

"The first wave [in the mid-1990s] was selling the doctors on being employees. You remember the whole herding cats thing," Miller said.

"Today, you have a lot of doctors, a lot of them specialists, who actually are coming to the hospital and saying, 'I'm sick of dealing with malpractice, I'm sick of fighting for reimbursement, I'm sick of dealing with a fractious staff -- just hire me.' "

AMNews: Sept. 10, 2007. Finances driving physicians out of solo practice ... American Medical News

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