Parody on Bush's veto position...View the link below to see an actual discussion about those who are one step away from disaster...BD
Bush calls children's health insurance bill a 'trick'
Trick or Treat on the SCHIP bill? BD
Halloween's an appropriate day to talk about it because there's a bill moving through Congress that's disguised as a bill to help children, but I think it's really a trick on the American people," the president told attendees of the Grocery Manufacturers Association/Food Products Association's fall conference.
WASHINGTON (CNN) -- President Bush on Wednesday again vowed to veto a renewed push to expand a popular children's health care program, saying it would play a "trick" on Americans by moving the country closer to a federalized health system.
Bush calls children's health insurance bill a 'trick' - CNN.com
FDA Approves Allergan Combo Eye Drop for Glaucoma
NEW YORK (Reuters) Oct 31 - Allergan Inc on Wednesday said U.S. regulators approved its combination glaucoma drug Combigan. The company said Combigan eye drops would combine "two strong agents in one bottle" -- brimonidine and timolol -- that work through different mechanisms to control intraocular pressure
FDA Approves Allergan Combo Eye Drop for Glaucoma
Technorati Tags: EMR
Health Insurers Target Early Retirees
After the "cherry picking", how do you market the left overs? The articles says that the over 50 group might be loyal, but also expensive as the aging process continues...BD
INDIANAPOLIS Health insurers trying to boost individual policy sales are making a new push into an older market _ the roughly 7 million uninsured Americans between the ages of 50 and 64. Financially stable baby boomers who either retire young or need coverage after a corporate downsizing are driving this push, experts say. Insurers also want to build ties to customers who may need Medicare-related insurance after they turn 65.
Big companies also are cutting jobs, and their former workers are less likely these days to land with another large employer that provides benefits, said John Wider, vice president of health products and services for AARP Services Inc.
"If you're an individual on your own in most states ... and you're over 50 years old, good luck trying to find health insurance," he said.
Health Insurers Target Early Retirees | Chron.com - Houston Chronicle
Doctors sue Memorial Hermann over 'bully tactics' - HOUSTON
The hospital was only open for 2 years...BD
Basically what Memorial Hermann did is they went to insurance companies like Aetna and United and said, 'If you deal with that hospital, we won't deal with you anymore,'" said Richard Zook, an attorney with Thompson & Knight, LLP, who represents some of the doctors that invested in Town & Country Hospital.
The lawsuit which alleges a violation of the Texas Free Enterprise and Antitrust Act asks for $100,000,000 in damages. “It is a crime that a hospital buys another hospital and shuts it down,” said Dr. Richard Pohil, one of 109 doctors suing Memorial Hermann Healthcare System for causing the closure of Town & Country Hospital in West Houston. "Put simply, if you were a member of Aetna or United and you were a patient and wanted to go to this hospital, you couldn't," Zook added.
"This isn't just about doctors having lost their investment. It's about the loss of a hospital and most importantly the loss of patients on the west side of Houston to have an alternative," Zook said.
Aerial surveillance gets computer boost - Sahara Tablet PC
Follow up on Initial post : Portable Tablets Help MSP Secure Homeland
I spoke with Gail at Tablet Kiosk to confirm that this is the Sahara i440D, and yes it is! From the medical side of things, what a great way to locate hospitals in the case of looking for terrorist type activities. 
Now if we can just get more of these in the hands of doctors for health care. BD
"The application is called the Critical Infrastructure Inspection Management System which was developed by the MD state police in cooperation with the Johns Hopkins University's Applied Physics Laboratory and the department of Homeland Security."
By poking a touch-screen computer, crews aboard Maryland State Police helicopters can now calculate more efficient flight plans to add inspections of dams, bridges and other "critical infrastructure" to their daily missions. The choppers were equipped last month with hand-held tablet computers linked to navigation satellites, digital maps and databases with the locations of hospitals, chemical factories and other sensitive facilities. That allows airborne troopers to quickly find and patrol such sites looking for damage or terrorist threats.
The new system replaces the stacks of notes, photocopies and road maps that flight crews have used since Sept. 11, 2001, to identify, find and inspect installations on their critical-infrastructure patrols. Flight crews also answer on-screen queries designed to assure the security of that facility or to address questions uploaded by public safety agencies. The crew's replies are later downloaded for analysis, eventually by the Department of Homeland Security.
Based on software developed at APL, the new FAA system will use radio-transmitted global positioning data and aircraft identification information. "It's targeted for Maryland but designed so any law enforcement agency can use it," said Jose Latimer, who oversees the homeland protection business area for the APL. It will also be adaptable for use in cars, on boats or by personnel on foot.
Hands-On Nabaztag 2 Wi-Fi Rabbit to the Office..
Nice addition to the office...it will read email to you among other fun things...nice perhaps for a pediatrician or anyone who likes something out of the normal PC products...Nice for RSS feeds as he will read an update every 20 minutes..saves a little time here in hearing the headlines...BD
I've been playing with the new Nabaztag for a few weeks, and I must say, this is one rabbit that'll keep you entertained for hours. As soon as I opened it, I headed to Nabaztag.com to configure my Wi-Fi settings so it could start updating me on everything. You see, Nabaztag is a Wi-Fi enabled bunny that can gather information from around the Internet, and reads it for you. Making friends internationally is easy, since the little genius speaks 16 languages, including Spanish, French, German, Swedish, Dutch, Portuguese, and of course English.
Since the bunny has speakers, you can easily stream music or play podcasts you find on the Web for an unlimited time. Not only does it communicate verbally, but it also communicates physically by moving its ears or visually by lighting up.
I especially think it's great that others can send messages to your bunny via widgets (it has a Yahoo! Widget) or by signing up for a Nabaztag account.
Hands-On Nabaztag 2 Wi-Fi Rabbit : Gina Hughes : Yahoo! Tech
Chemicals Flow Unchecked From China to US Drug Market
Do you know where all the ingredients come from with the medication you are currently taking? How many sell ingredients to our US pharma manufacturing companies? Will the FDA be able to protect consumers? Much of this end up on Internet pharmacies too and China can't keep up with certifying all factories according to the article..perhaps some items should not be outsourced when it comes to the medications we rely on to keep us alive...BD
Because the chemical companies are not required to meet even minimal drug-manufacturing standards, there is little to stop them from exporting unapproved, adulterated or counterfeit ingredients. The substandard formulations made from those ingredients often end up in pharmacies in developing countries and for sale on the Internet, where more Americans are turning for cheap medicine.
China has an estimated 80,000 chemical companies, and the United States Food and Drug Administration does not know how many sell ingredients used in drugs consumed by Americans. Because United States drug regulators require pharmaceutical suppliers to meet high standards, the American supply chain is among the world’s safest. But as China’s chemical suppliers multiply, Congressional investigators are questioning the F.D.A.’s ability to protect consumers.
Of the 37 suspect companies, all but one unnamed by the American authorities, The Times identified eight. Records show that six are uncertified chemical companies, including Hunan Steroid, which marketed its products at the Milan convention. “It is unrealistic for us to certify all factories that make intermediates and regulate them like medicine products,” said Ms. Yan, the agency official. But if companies make active ingredients, a more refined product, then they must be regulated by drug authorities, she said.
Pharmaceutical ingredients can pass through three or four trading companies, none of which check their quality. The ultimate manufacturer may not realize the ingredients came from an uncertified chemical company.
Chemicals Flow Unchecked From China to Drug Market - New York Times
Lizard spit and bongs - Medication Origins and Future
What is the future on diabetes treatment medications - article explores the recent number of medications, origins, and the potential future..BD
(CNNMoney.com) -- America's 20 million-plus diabetics mean dollar signs for drug companies that sell a slew of new products, including a successful drug based on the saliva of a Gila monster, and a failed inhalation device that's been compared to a "bong.
But other drugs, such as the pills Actos from Takeda and Avandia from GlaxoSmithKline, and the injectable drug Byetta from Amylin and Eli Lilly & Co., treat the disease more directly by controlling blood-sugar levels. When Glaxo announced plans to shut down a plant in Puerto Rico and reduce staff by 250 workers, the company blamed the hemorrhaging sales of Avandia.
Januvia, a pill from New Jersey-based Merck & Co., Inc., is the newest entrant to the diabetes field. Like the other drugs, it controls blood-sugar levels and is only used by diabetics with type II diabetes, which generally emerges in adults as a result of obesity.
GP pay £110,000 after a 10% rise
In contrast to what is happening to primary care physicians here in the US, pay is on the rise for GP physicians in the UK...but the patients are not happy about it...$220,000.00 a year is a nice income compared to the same type of practice here...patients can't get to them in many areas..and now there is a push to extend hours..BD
The data from the NHS Information Centre is for the year 2005-6 - the second year of the new GP contract. It comes after pay rose by 20% in the first year and means GPs have seen pay rise by about £30,000 in two years. The deal also allowed GPs to opt out of weekend and evening care, which critics say has suffered after private firms and groups of medics were taken on.
And many patients have said they are unhappy with the new out-of-hours arrangements with the number of complaints soaring as a result.
The GP contract overhauled the way doctors were paid. "We will be working with GPs to ensure that at least 50% of practices extend their opening hours and we are taking action to tie GP income more closely to patient experiences." "They are being treated, by this government, like well-paid production line employees."
BBC NEWS | Health | GP pay £110,000 after a 10% rise
Hat Tip: Kevin, MD
Vanishing Breed: What Happened to the Family Doctor?
Is this happening to a practice near you? He is closing as the system is not working. $60,000.00 a year is not much income for all the time and education invested to become a physician, yet with current contracts with HMO carriers, this is sometimes all that is left after the bills are paid. Specialists fair better under the system, but they have had cuts as well with contracts. In my travels, depending on the practice, it is not unusual to see family practice physicians at this level of income in California based on recent contract agreements, and they are the turnkey to our system, in other words we all need to start with a primary care physician for health care, so I ask, what is wrong with this picture? BD
For 26 years, Dr. Joseph Lalka has been a family doctor, treating 3,000 patients in his cramped office in Chatham, N.Y., a small town nestled in the rural northern part of the state. But Lalka recently told his patients he is taking down his shingle and closing his practice. He says he no longer can afford to maintain a family practice.
“Here is a doctor who is not retiring because he wants to,” says Constance Mondel, 81, who Lalka has treated for many years. “He is leaving because the system is not working. It’s a real shame.”
Lalka, 54, says that with an income of only $60,000 last year, and little opportunity to expand his practice, he no longer is able to make ends meet. Now Lalka will work for a company that assigns doctors to temporary work. “Unfortunately, our health system rewards the surgeon who amputates the infected foot of a diabetic much more than the primary care doctor who discovers the preliminary symptoms of the disease and recommends ways to prevent it,” said Grumbach.
Family doctors are in an untenable position because shrinking Medicare payments often cover only 60 percent of the cost of treating a patient. Medicare also allows no adjustment for inflation, and operating expenses increase 3 percent to 5 percent annually, said Dr. Terry McGeeney, the president of TransforMed, an organization established to address the quandary faced by family doctors.
Hat Tip: Kevin, MD
Doctor? Or Druggist?
More physicians are beginning to provide prescriptions right from the office...growing trend and certain a big convenience for patients...and a small additional income area for the MD...BD
When Anne Johnson recently visited the Nighttime Pediatrics and Adult Care Too! clinic near her home in Millersville with a case of hives, the doctor told her she needed steroids and several days' worth of antihistamines. But he didn't hand her a prescription. Instead, Johnson, 46, got a dose of each drug on the spot, and the chance to buy the rest on her way out the clinic door. Given the late hour -- 11 p.m. -- Johnson gladly accepted. Some area residents are taking advantage of similar services to buy their drugs at their doctors' offices. Such "point of care" dispensing is outlawed in some states but not in Maryland, Virginia and the District, where dispensing physicians need only authorization from pharmacy boards to assume a role once held almost exclusively by pharmacists.
Commonly prescribed medications such as antibiotics, pain drugs and allergy pills make up the bulk of the drugs doctors sell, Bard says. But specialists have also expressed interest in dispensing more-targeted prescriptions, such as cancer drugs. A recent change in clinic policy has made him rethink that decision. "Now that they're accepting insurance and only charging a co-pay," Newman says, "it might be worth my while to see the doctor and get the medicine all in one stop.
Portable Tablets Help MSP Secure Homeland
Great article on using a tablet pc, and I agree here, this looks like the Sahara i440D from Tablet Kiosk...it sure is much easier to work with a tablet rather than trying to work with a notebook in the helicopter...they were checking on return trips from hospitals here...they are taking full advantage of using the touch screen in the video..Homeland security will be releasing these units to other agencies soon...the brain child here was from one currently serving in Iraq...
It didn't take Homeland Security long to figure out how efficient it is working without paper. Anyone with mobility needs (which is pretty much all of us today) can take advantage of using a tablet without having to walk around with an "open pizza box" notebook to be productive. The tablets are at work helping to look and find terrorist type of activities. BD
There are more than 150 places in Maryland thought to be targets for terrorists. One of the police agencies responsible for their safety is the Maryland State Police. Mike Schuh reports homegrown technology is taking those troopers down a path others will soon follow. View pictures from a Maryland State Police Homeland Security mission and you'll likely see officials checking on a potential terrorist target like the Key Bridge.
One pilot kept a paper reference file of many sites. "He looked for a safer and more efficient way," said MSP Superintendent Col. Terrance Sheridan.That safer way is a portable computer tablet with files of data about each target already installed. It standardizes what the flight crew looks for, and alerts will be added or subtracted each day.
"The real beauty of this product is that I don't have to do any fancy integration with the airplane you carry this thing on the aircraft and you're set to go," said Boyd.
wjz.com - Portable Tablets Help MSP Secure Homeland
Hat Tip: jkOnTheRun (thanks for the story)
Snoring Men Transform Into Sleeping Beauties After Surgery
According to the article, this is a fairly simple procedure to have done with a plastic surgeon...BD
Millions of men who suffer from sleep apnea may sacrifice a good night's sleep because they don't know where to get treatment, don't realize relief is available, or are too embarrassed to get help. However, comfort may be as close as their local plastic surgeon's office. Plastic surgeons at the forefront of identifying and treating sleep apnea will discuss the latest surgical advances today at the American Society of Plastic Surgeons (ASPS) and American Society of Maxillofacial Surgeons (ASMS) Plastic Surgery 2007 conference in Baltimore. "Men over the age of 40 are the most common sufferers of sleep apnea due to their heavier build and shorter necks; however, women, children and overweight people are not immune," said Stephen Schendel, MD, ASPS Member Surgeon and lecture presenter. "Many men are extremely embarrassed to get help for sleep apnea even though it can lead to serious health issues.
Scripps Research Team Blocks Bacterial Communication System To Prevent Deadly Staph Infections
In hopes of combating the growing scourge of antibiotic-resistant bacteria, in particular drug-resistant staph bacteria, a team of scientists from The Scripps Research Institute has designed a new type of vaccine that could one day be used in humans to block the onset of infection. The advantage of the new vaccine is that it would work not only on current bacterial resistant stains but also would not induce the potential for new bacterial resistance because, rather than killing bacterial cells, it blocks their communication system, preventing the shift from harmless to virulent, thus allowing the body's natural defenses to combat the bacteria.
Scripps Research Team Blocks Bacterial Communication System To Prevent Deadly Staph Infections
1 in 8 veterans lacks health insurance
Sometimes a group we may not think about in the ranks of the uninsured..BD
WASHINGTON -- About one of every eight veterans under the age of 65 is uninsured, a finding that contradicts the assumption many have that all vets qualify for free health care through the Department of Veterans Affairs, says a new study. Researchers at Harvard Medical School projected that about 1.8 million veterans overall lack health coverage. That's an increase of 290,000 since 2000. The researchers said most uninsured veterans are in the middle class and are ineligible for VA care because of their incomes. Still others cannot afford their co-payments or lack VA facilities in their community.
"Like other uninsured Americans, most uninsured vets are working people -- too poor to afford private coverage but not poor enough to qualify for Medicaid or means-tested VA care," said Dr. Steffie Woolhandler, an associate professor and a physician at the Cambridge Health Alliance.
Study: 1 in 8 veterans lacks health insurance | IndyStar.com
Many older doctors plan to phase out their practice
These are some pretty scary numbers in the survey...Marcus Welby no longer exists..and with all the additional pressures and reductions of income today...who knows what we would do in the same situation...problem though is that we need these folks...probably more now than ever...and the shortage of physicians will continue to mount...BD
NEW YORK (Reuters Health) - The results of a new survey indicate that 48 percent of physicians between 50 and 65 years of age are planning to reduce or end their clinical practice in the next 1 to 3 years. The findings also suggest that many older physicians believe that their younger counterparts do not have the work ethic they do. ADVERTISEMENT The survey, which was conducted by Merritt Hawkins & Associates, a Texas-based physician search and consulting firm, suggests that many older physicians are simply unhappy with the changes that have taken place in medicine over the year
The results of the survey, which included 1,170 respondents, show that 24 percent of older physicians are planning to leave clinical practice all together in the next 1 to 3 years. Specifically, 14 percent said they were planning on retiring, 7 percent said they were looking for a medical job in a non-patient care setting, and 3 percent said they were seeking a job in a non-medical field.
When asked about the work ethic of physicians entering practice today, 68 percent of the respondents said that these younger doctors are not as dedicated or as hard working as physicians who entered practice 20 to 30 years ago. Fifty-seven percent of older physicians said they would not recommend medicine as a career to their own children. Similarly, 44 percent said they would not select medicine as career if they were starting out today.
Many older doctors plan to phase out their practice - Yahoo! News
Is U.S. stuck in Internet's slow lane
Might be part of the reason that Health IT is dragging as well....BD
NEW YORK - The United States is starting to look like a slowpoke on the Internet. Examples abound of countries that have faster and cheaper broadband connections, and more of their population connected to them. Part of the problem may be that people don't see fast Internet access as an essential part of modern life, and may need more of a push to get on.
What's less clear is how badly the country that gave birth to the Internet is doing, and whether the government needs to step in and do something about it. The Bush administration has tried to foster broadband adoption with a hands-off approach. If that's seen as a failure by the next administration, the policy may change. In a move to get a clearer picture of where the U.S. stands, the House Energy and Commerce Committee on Tuesday approved legislation that would develop an annual inventory of existing broadband services including the types, advertised speeds and actual number of subscribers available to households and businesses across the nation.
"In the 1930s, we recognized that electricity was essential. We're not quite at that level in broadband," Correa said.
Several of the European countries that are doing well have forced telephone companies to rent their lines to Internet service providers for low fees. The ISPs use them to run broadband Digital Subscriber Lines, or DSL, often at speeds much higher than those available in the U.S.
In Paris, a "triple play" of TV, phone and broadband service costs less than half of what it does in the U.S.
Companies Tap RSS to Tame Info Overload
This site makes use every day of RSS Feeds....my choice is Attensa which is free and we have a link on the site. The NHS in the UK is even making use of RSS Reeds and holding frequent training sessions...overloaded with email...look at using RSS for relief....it sure makes getting the information you need a whole lot easier...BD
As employees struggle to read an increasing amount of work-related material, some companies have turned to RSS (Really Simple Syndication) technology to improve productivity. ADVERTISEMENT With RSS servers and readers designed for workplaces, IT departments set up internal information feeds that employees can subscribe to, a delivery mechanism that, for some information, can be more precise and effective than e-mail. "The first problem we see addressed regularly with enterprise RSS systems is e-mail overload. Most knowledge workers these days are just about completely fed up with e-mail," said Oliver Young, a Forrester Research analyst.
At NHS Orkney, few of the 600 or so users-- mostly doctors, nurses, physical therapists and business administrators-- are technically savvy. So, Rendall has reached out to departments and held frequent training sessions to promote the RSS system's use.
Seeing an opportunity, vendors like Attensa, NewsGator and KnowNow developed on-premise, behind-the-firewall RSS software for workplaces.
German hospital saves baby with pioneering surgery in womb
Nice story...and the baby was born healthy...BD
BERLIN (AFP) A German hospital is celebrating a world first after carrying out life-saving surgery that stimulated lung growth in a baby still in the womb. Doctors at Bonn University Clinic feared that baby Miriam would die when her mother's foetal membrane burst in the 20th week of pregnancy, removing the child's protective liquid cushion. Without the fluid, the organs pressed on the lung and Miriam's development was being fatally impaired. She was also unprotected against germs in the womb, leaving her susceptible to life-threatening infection.
There a miniature latex balloon was inflated, blocking the respiratory channel so that the fluid which is continuously produced by the prenatal lung cannot drain away. This build-up of the fluid stimulated the growth of Miriam's lung.
AFP: German hospital saves baby with pioneering surgery in womb
UCI Medical Center has fired 13 nurses
Not real good news with the current shortage of nurses...entering too much information? From the information in this article, it sounds like the one nurse was right on the job, noticing the dosage was wrong...BD
UCI Medical Center has fired 13 nurses in the last three months and is investigating a union activist who sought information about one of the dismissals, according to the nurses union. Eight of the nurses have more than 20 years of experience each, and four of those have spent their two decades at UCI, union officials said. Hospital officials would not comment on why the nurses were let go. Susan Mancia, a hospital spokeswoman, said UCI was ranked among the top five hospitals in Southern California in a survey for Nurses magazine, in which nurses graded the quality of care, organizational culture, development, communications and retention efforts.
Beth Kean, the California Nurse Assn. director for University of California hospitals, said a "witch hunt" environment exists at the medical center.
The most recent dismissal was of a nurse who worked in the newborn nursery for 27 years, said Beth Kean, the California Nurse Assn. director for University of California hospitals.
She was fired Oct. 23, shortly after determining that vaccinations in the baby area were adult dosages. She worked with the hospital pharmacy to dilute the medicine and administered it to a baby, Kean said.The nurse was fired because she wrote too much information about the incident in the patient chart, Kean said. The nurse has filed a grievance to try to get her job back, Kean said.
More young adults on cholesterol drugs
Blood pressure and cholesterol drugs both on the rise for young adults.....but losing weight can also be a big help too...perhaps a more natural approach....BD
TRENTON, N.J. - Use of cholesterol and blood pressure medicines by young adults appears to be rising rapidly at a faster pace than among senior citizens, according to an industry report being released Tuesday. Experts point to higher rates of obesity, high blood pressure and high cholesterol problems among young people. Also, doctors are getting more aggressive with preventive treatments. "This is good news, that more people in this age range are taking these medicines," said Dr. Daniel W. Jones, president of the American Heart Association.
Meanwhile, use of blood pressure medicines increased 21 percent, from about 7 percent of 20- to 44-year-olds in 2001 to over 8 percent in 2006. That translates into about 8.5 million Americans in that age group taking drugs to lower their blood pressure.
"It was a surprise to us," said Dr. Robert Epstein, chief medical officer at Franklin Lakes, N.J.-based Medco. "Maybe the fact that we're seeing more young people with high cholesterol and blood pressure is indicative of the epidemic of obesity and overweight that we're seeing in this country."
TV raises blood pressure in obese kids: study
I am guessing this relates to more hours of inactivity...BD
They found obese children who watched four or more hours of TV a day were three times more likely to have high blood pressure than children who watched less than two hours a day. "There is a significant association between hours of television watched and both the severity of obesity and the presence of hypertension in obese children," Dr. Jeffrey Schwimmer of the University of California, San Diego and colleagues wrote in the American Journal of Preventive Medicine.
The American Academy of Pediatrics recommends children watch fewer than two hours of TV per day.
Hospital to Screen for Staph Germ
Good step and certainly can't hurt...BD
CHICAGO (AP) Loyola University Medical Center on Monday announced plans to start testing all incoming patients for a drug-resistant staph germ and isolating those who carry the dangerous bacteria. The 589-bed hospital in Maywood, just west of Chicago, is among the first in Illinois to start universal screening for the superbug. The germ in question is called MRSA, or methicillin-resistant Staphylococcus aureus. A new Illinois law requires hospitals to test high-risk and intensive-care patients for MRSA. The nation's Veterans Affairs hospitals began universal MRSA testing this year. And Evanston Northwestern Healthcare has reported a substantial drop in MRSA cases at its three suburban Chicago hospitals since it began universal testing in 2005.
The Associated Press: Ill. Hospital to Screen for Staph Germ
Health costs squeeze workers
Open enrollment - employees finding the choice a lot different this year..higher deductibles..change in types of plans with employers watching the bottom line with health care...many workers are starting to opt out of employer health care plans as a result...BD
This year's open enrollment season will come with yet another jump in health care costs for Dallas-area companies and another shift of more of those costs to employees. Employees at companies from American Airlines to Wal-Mart should brace themselves for greater insurance costs and higher deductibles.
In a new twist, some employers are even veering from the tradition of extending coverage to employees' spouses if those spouses are covered by their own employer's plans. An increasing number is either denying such spouses coverage or charging extra.
This is leading many employees to drop coverage. "Increasing employee contributions, deductibles, co-pays and premiums are causing many workers to opt out of their employers' health plans," said David Guilmette, a Towers Perrin consultant.
Wal-Mart, the world's largest retailer and the biggest employer in North Texas, with 32,500 local workers, has become a local advocate for high-deductible plans. Wal-Mart offers its 1.3 million U.S. workers plans with deductibles ranging from $350 to $1,000, as well as ultra-high deductible plans of up to $6,000, Mr. Emerick said in May.
Meanwhile, Nortel Networks Corp., the telecommunications giant with 4,000 local employees, is one of those making it harder for spouses to piggyback on their employee health plans. Nortel sent letters to employees this month telling them they will have to pay an additional $50 per pay period if their spouses or domestic partners sign up despite having access to employer-provided medical coverage at work.
Health costs squeeze workers | Dallas Morning News | News for Dallas, Texas | Business Casual
US makes new push on e-health records
Some physicians could stand to make some extra income on the pilot program...directed at Medicare patients..but the administration is also contacting insurance companies to encourage more to participate...BD
WASHINGTON - The Bush administration is recruiting about 1,200 doctors nationally to remove the paperwork from their medical practice in return for higher Medicare payments. Health and Human Services Secretary Mike Leavitt billed the project Monday as one of the administration's most important steps yet toward meeting President Bush's goal of nationwide adoption of electronic health records by 2014. Medicare will pay the physicians extra for completing tasks online, such as when ordering prescriptions or recording the results of lab tests. The highest payments will go to those physicians who most aggressively use the technology and who score the highest in an annual evaluation.
Participating doctors could see their reimbursements increase by several thousand dollars annually when they treat Medicare patients. The administration has also contacted insurance companies and asked them to consider similar rate increases for participating physicians. That way, doctors would have more incentive to participate.
Doctors test hot sauce for pain relief
Hot sauce may be the next pain killer...purified of course. Don't try this at home the article states next time you need some relief for an open wound...interesting study going on...BD
WASHINGTON - Devil's Revenge. Spontaneous Combustion. Hot sauces have names like that for a reason. Now scientists are testing if the stuff that makes the sauces so savage can tame the pain of surgery.
ADVERTISEMENT Doctors are dripping the chemical that gives chili peppers their fire directly into open wounds during knee replacement and a few other highly painful operations. Don't try this at home: These experiments use an ultra-purified version of capsaicin to avoid infection and the volunteers are under anesthesia so they don't scream at the initial burn.
Among early results: In a test of 41 men undergoing open hernia repair, capsaicin recipients reported significantly less pain in the first three days after surgery, Aasvang reported this month at a meeting of the American Society of Anesthesiologists.
How could something searing possibly soothe? Bite a hot pepper, and after the burn your tongue goes numb. The hope is that bathing surgically exposed nerves in a high enough dose will numb them for weeks, so that patients suffer less pain and require fewer narcotic painkillers as they heal.
Prostate Cancer Effectively Cured In Young Men By Implanting Radiation Seeds
Alternative to surgery if used before the age of 60...BD
Radiation seed implants (brachytherapy) are just as effective at curing prostate cancer in younger men (aged 60 and younger) as they are in older men, according to a study presented at a scientific session on October 31, 2007, at the American Society for Therapeutic Radiology and Oncology's 49th Annual Meeting in Los Angeles. Brachytherapy is a minimally invasive procedure where a radiation oncologist places small radioactive seeds into the prostate in order to kill the cancer cells.
It is an attractive treatment option for patients with prostate cancer because it has a much shorter recovery time than surgery and studies have shown brachytherapy to be just as effective as surgery. However, surgeons have usually advised younger men to undergo surgery to remove all or part of the prostate (prostatectomy) over other treatments like seed implants because they believed younger men could physically tolerate surgery, plus they believed surgery was more effective than brachytherapy at curing prostate cancer long term. This meant that many younger men would undergo surgery without ever learning about other treatment options, like brachytherapy or external beam radiation therapy.
Prostate Cancer Effectively Cured In Young Men By Implanting Radiation Seeds
Email sent to your Cell phone, just a regular cell phone will do
Neat service that will enable email to your normal cell phone, you do not need a Blackberry or Windows Mobile device to get your email...required a one time sign up to get started and it is free...all you need to do is sign up and begin flipping your phone...the only requirement is the ability for SMS messaging...text messaging...the videos below do a good job on showing how the service is used, especially the one from the New York Times...as it does a comparison of 3 different services with Teleflip being on top. You can even schedule your service, so if you were a physician and wanted to select down time when not working, that can be done.
This is not a replacement for professional units that run Windows Mobile or the Blackberry operating system by any means, just a simple tool for those wanting email on a simple cell phone. For professionals, there's almost no way of getting around the full use of a Windows Mobile unit, but for the occasional and small user, this can work great. For the next step up, check out our section on Windows Mobile. BD
Teleflip connects you to your office, friends and family wherever you go. Dont miss important messages
again. Six reasons to use our service& * Get email on the go. Stay connected 24/7 without watching your email inbox all day * Get email ONLY from the people you want to hear from. You choose who and when you would like to receive email messages on your phone *
This service is free. You only pay for standard text messaging * Never miss out on time-sensitive opportunities * Responding to emails from your cell phone is as easy as sending a text message * We NEVER send spam to your phone
Video Links: Rueters ABC News New York Times
SEC steps into WellCare probe - HMO Medicaid Provider
This could be serious...whenever the Security and Exchange Commission sets foot inside, there's usually some type of alleged substantiation somewhere along the line to justify their participation...BD
The U.S. Securities and Exchange Commission asked WellCare Health Plans for information - one day after federal and state authorities executed a search warrant at WellCare's Tampa headquarters. The SEC's Oct. 25 request was disclosed in a release from WellCare late Friday. WellCare (NYSE: WCG) is the largest HMO provider under Broward's Medicaid reform program. The company has 28,700 members in Broward County, 40,400 in Miami-Dade County and 12,900 in Palm Beach County in the Medicare, Medicaid and Healthy Kids. The company did not say what type of information the SEC asked for, but said in the release that it is cooperating with all federal and state authorities.
Law enforcement personnel with the FBI, U.S. Department of Heath and Human Services/Office of Inspector General, and Florida Attorney General's Medicaid Fraud Control Unit executed a federal search warrant at WellCare Wednesday. The Justice Department has declined to detail the nature of the investigation.
SEC steps into WellCare probe - South Florida Business Journal:
New wave of job cuts hits health care
Including pharmaceutical industry...BD
NEW YORK (Reuters) - A lack of significant new drugs and products, declining sales of lucrative flagship franchises and fierce competition have set off a wave of "restructuring" moves among the biggest names in health care. In many cases, restructuring is a euphemism for eliminating thousands of jobs, and it remains to be seen whether these moves are quick fixes to prop up dwindling profits, or a recognition of the industry's harsh new reality.
The world's largest drugmaker, Pfizer Inc and the No. 1 biotechnology company, Amgen Inc are in the process of major restructuring, including dramatic workforce reductions. Previously, AstraZeneca said last July it would eliminate 7,600 jobs, and Boston Scientific rival Medtronic Inc last month announced some 500 job cuts from its cardiac rhythm management business.
New wave of job cuts hits health care | Special Coverage | Reuters
Health care crisis
Major finding...people just don't go to the doctor...and small employers continue to look for a way out..but our leadership just tells us to go to the ER room....BD
The debate now raging over how much money the federal government should spend to provide basic health insurance for poor children is just an opening skirmish in what is likely to be an all-out war in coming months and years over how to pay for health care in America.
The challenge is finding ways to provide every American with quality affordable health care without dictating how the care will be offered. Our failure to make progress toward that goal is causing a slow-motion health care crisis that is already threatening the well-being of millions.
Employer-provided insurance, the bedrock of health insurance, is eroding. Many companies, particularly smaller firms, faced with fast-rising health insurance expenses are asking workers to cover some of the cost, are limiting benefits or dropping insurance plans altogether. Thirty-nine percent of firms in the United States didn't offer health insurance at all in 2006 and 41.9 percent of "wage and salary" workers aged 18 to 64 were not offered health coverage through their own employers.
Still, a significant number of workers are balking at the rising costs of employer-sponsored insurance. Premiums for a family of four paid for by workers increased almost 12 percent between 2004 and 2005 -- from $222 a month to $248. Almost two out of three workers who chose not to participate in their employer's health plan in 2002 said the plan was too costly.
Humana Net Rises 90% - Medicare business
Income making the most from the Medicare business....and projecting earnings in 2008 to be around 5.30 to 5.50 per share..up from the average of 5.19 estimates...interesting comment from the article stating they don't have "a great commercial business". thus the need to maximize the Medicare portion...BD
Oct. 29 (Bloomberg) -- Humana Inc., the second-largest provider of U.S.-sponsored health plans, said earnings rose 90 percent, and raised its 2007 forecast after gaining customers for its most-profitable managed-care programs. Humana jumped the most in more than three months in New York trading. Third-quarter net income climbed to $302.4 million, or $1.78 a share, from $159.2 million, or 95 cents, a year earlier, Louisville, Kentucky-based Humana said today. Profit excluding some items beat analysts' estimates, as did revenue.
Medicare Advantage plans generate annual gross margins of about $1,650 per Humana beneficiary, more than 10 times as much as the profit from the company's drug plans for the elderly, McDonald said. Gross margin is revenue minus the cost of goods or services sold.
Consumer groups and members of Congress have criticized Humana and other insurers for misleading some elderly people into signing up for Medicare Advantage plans, and they support efforts to scale back payments. America's Health Insurance Plans, a trade group based in Washington, has urged Congress to leave the rates alone. Last week it brought 350 Advantage members to Capitol Hill from across the U.S. to urge lawmakers to back off.
``They don't have a great commercial business, so you have to make the most of your Medicare business,'' said Matt Perry, an analyst with Wachovia Securities in New York. ``It's been very good for the past few years and continues to be good.'' Revenue rose to $6.32 billion, surpassing analyst expectations of $6.11 billion
Humana's bigger-than-expected profit was driven by its lucrative, but controversial, Medicare Advantage program, which Congress recently criticized for receiving overpayments. The company's better-than-expected quarter was driven by higher enrollment in its Medicare program.
Executives from Humana and United Health said their companies pass overpayments through to seniors in the form of extra benefits, as required by law.
Medicare officials said they did not attempt to recover the money because they lack legal authority to do so, although GAO disputed the claim.
Record numbers go abroad for health - UK
Superbugs and lack of confidence in the NHS...India appearing to be the most popular choice..nurses all bogged down with administrative functions and don't have enough time to spend with patients, the report indicates...The US is not alone with folks looking for alternatives in health care with medical tourism...BD
Thousands of "health tourists" are going as far as India, Malaysia and South Africa for major operations such is their despair over the quality of health services. The first survey of Britons opting for treatment overseas shows that fears of hospital infections and frustration with NHS waiting lists are fuelling the increasing trend. "The confidence that the public has in NHS hospitals has been shattered by the growth of hospital infections and this Government's failure to make a real commitment to tackling it," she said. "People are simply frightened of going to NHS hospitals, so I am not surprised the numbers going abroad are increasing so rapidly. My fear is that most people can't afford to have private treatment – whether in this country or abroad."
Hungary's popularity rests on a boom in dentistry, thanks to a shortage of NHS dentists in Britain.
Record numbers go abroad for health - Telegraph
Hat Tip: Kevin, MD
Harmony and Synergy Merge to Form Leading On-Demand Health and Human Services Solutions Company
RESTON, VA--(Marketwire - October 29, 2007) - Harmony Information Systems, Inc. (Harmony), the industry leading provider of software solutions for the health and human services (HHS) sector, and Synergy Software Technologies, Inc. (Synergy), the leading software solutions provider to HHS entities serving the aging market, today announce the merger of their companies. The combined entity, which will operate under the Harmony name, gains the expanded capability to offer HHS software solutions with both on-demand and on-premise models. These solutions are deployed by tens of thousands of end users and support millions of clients within federal, state, tribal and local agencies, as well as small and large private non-profit organizations.
Harmony Billing™ - Works directly with service data captured at the source by program staff. Clinicians and case managers deliver services and enter corresponding progress notes; the services become immediately available for billing.
Harmony Claims Manager™ - Assists managed behavioral health care organizations, government agencies and other service payers in managing applications, member eligibility and enrollments, benefit plans, service authorizations and claims processing.
Harmony and Synergy Merge to Form Leading On-Demand Health and Human Services Solutions Company
Microsoft buying Global Care Solutions
International hospital software and systems management....BD
Microsoft Corp. said Monday it is buying software, intellectual property and other assets from privately held Bangkok-based Global Care Solutions. Financial terms were not disclosed. Microsoft said the acquisition will complement its portfolio of health solutions and give hospitals another option to help improve workflow and patient safety. Global Care's workers will join Microsoft's health solutions group, which will manage product development and delivery. Microsoft said it will continue to work with Bumrungrad International hospital, which uses Global Care's services.
An innovative, multilingual health information system, the Global Care Solutions system was built from the ground up on Microsoft’s user friendly and scalable server technology to meet the needs of international hospitals around the world. The end-to-end enterprise solution provides rich integration among all of its front and back office modules giving clinicians and administrators access to information within and across different departments. The Global Care Solutions hospital information system modules include Radiology (RIS/PACS) complete with image archiving, patient and bed management, laboratory, pharmacy, pathology, financial accounting, materials management and HR systems.
Medical-bill errors becoming more common
The direct result of the more complicated coding systems implemented for payment...hospitals have done itemized billing for a long time and some is now rolling over to the practices offices with proper and correct coding necessary for payment...if you need help though, don't call the insurers on Monday advised Aetna...it is the busiest day of the week. The patient advocate is also a help in these scenarios to help iron out differences...almost like hiring an attorney in essence, but it sure seems like at times professional help is needed as the whole process gets more complicated by the day as information is continuously queried and analyzed. BD
Don't assume that your complicated medical bill is correct. Errors on bills for doctors, medical tests or hospitals can result in overcharges that run from a few dollars to tens of thousands of dollars. Husband and wife Ron and Marilyn Hess, from Homer, Alaska, were left facing a bill of about $10,000 from a hospital after Marilyn needed an appendectomy. The hospital bill was about $45,000, of which her insurer agreed to pay $35,000.
Other common blunders include medical-coding errors, mistakes in how annual deductibles are applied and confusion over which providers are in or out of network. Fraudulent activity by some unscrupulous health care providers and medical-identity theft are other bugaboos, experts say.
“Sometimes you can get billed for tests you didn’t have,” says Johnson. You might want to enlist the help of outside experts. Your state insurance department or state health department can offer guidance.
Medical-bill errors becoming more common - Health Care - MSNBC.com
Safeway Offers Flu Vaccines In Stores, USA
Flu Shots are everywhere this year...even the grocery stores have joined in...BD
Safeway Inc. (NYSE: SWY) will offer flu vaccines at all stores in the U.S. Now through February 2008, or while supplies last, flu vaccines will be administered at stores. Most stores will give vaccines on a walk-in basis at in-store pharmacies, while others will conduct scheduled flu shot clinics. "The beginning of the flu season, October and November, is the best time to get vaccinated to ensure you are covered throughout the entire season," said Dave Fong, Safeway Senior Vice President, Pharmacy. "However, getting vaccinated in December or later can still be beneficial because the flu season can last as late as May."
Michigan House Passes Bill To Limit Insurance Rate Increases
This appears to be the first state action to put a limit on how high premiums can go...almost like regulating a utility, which is pretty close to what health insurance is today...BD
The Michigan House on Wednesday voted 89-17 to approve bills that would limit how much for-profit health insurers could increase their rates during policy renewals, the Detroit News reports. The bills, introduced earlier this month, also would require health insurers to contribute to a pool administered by Blue Cross Blue Shield of Michigan that would cover the health expenses of individuals who cannot afford health insurance.
Michigan House Passes Bill To Limit Insurance Rate Increases
CMS Awards Two Contracts To Process And Pay Medicare Part A And Part B Claims In 7 States And D.C., USA
More new contracts awarded from CMS for processing claims..this one includes California..will be the single point of contact once things are rolling for both patients and providers, including hospitals and physicians....BD
The Centers for Medicare & Medicaid Services (CMS) announced that it has awarded two contracts for the combined administration of Part A and Part B Medicare claims payment in seven states, the District of Columbia and three U.S. territories. These awards represent the fourth and fifth new Medicare Administrative Contractors (MACs) to be named by CMS as required by the Medicare Modernization Act of 2003. The MAC contracts are part of an effort to streamline the fee-for-service payment system. The two contracts announced today are among the largest, in terms of claims volume, of the 15 MACs that CMS will award.
The MACs will serve as the primary point of contact for the processing and payment of fee-for-service claims from providers, such as hospitals, nursing facilities, physicians and other practitioners. The MACs were selected in open competition under federal procurement rules.
As MAC contractors, Highmark Medicare Services and Palmetto GBA will immediately begin implementation activities. Highmark Medicare Services will assume full responsibility for the claims processing work in its jurisdiction no later than September 2008. Palmetto GBA will assume full responsibility for the work in its jurisdiction no later than June 2008.
Robot to lift and carry people
Could this be the next robot we see working at hospitals? He could use an appearance change though, scrub green is not too appealing for looks...BD
Intel Opens Clean Room manufacturing for 45 nm chips...cleaner than an operating room...
How clean is clean? The processor clean room is 100 times cleaner than the average operating room but chips don't have to worry about bacteria infections...BD
Big and Clean The transistors are tiny, but the new plant is not. Intel said the structure measures more than a million square feet, large enough to contain more than 17 football fields. About 184,000 square feet is Class 1 clean room space. That, noted Intel, means there is no more than one particle measuring 0.5 micron or larger per cubic foot of air.
"For comparison, hospital operating rooms are Class 10,000, meaning that the air inside Intel's Fab 32 clean room is 100 times cleaner than the air in an operating room," said Intel. "Outside air is near Class 3 million.
Technology News: Processors: Intel Opens Clean, Green Fab for New Penryn Chips
The RP-7 Robotic System - Dr. Chung discussion
More on the use of medical robots...the video from QualComm is also very good with the physician doing an in-room demo on the spot using wireless EVDO which helps with the bandwidth...BD
Hey, Dr. Chung, can I talk to you a minute?" Not an unusual greeting in a busy hospital hallway - unless Dr.
Chung is actually at home, or on temporary duty in another city, or perhaps sitting in a café while on leave. MAJ Kevin Chung, medical director for the Institute of Surgical Research\'s burn intensive care unit (ICU) at Brooke Army Medical Center, is accustomed to people addressing his image on an RP-7 robotic system while he is sitting at a keyboard in another location. "I have taken it to Salt Lake City, Las Vegas, St. Petersburg, Washington, Baltimore. I've accessed it on TDY. I've been called while on leave. If I have Internet access, I can access the ICU," Chung said. "Being mobile adds a dimension not available with other forms of telemedicine. It's like you are there.
In addition, QualComm has donated a robot, four remote control laptop devices and support services for one year to be used at Landstuhl Regional Medical Center. The initial goal is to enable members of the neurosurgical team to remotely monitor traumatic brain injury patients in the intensive-care unit.
"The ideal would be to beam to Baghdad as soon as a patient arrives there. Then connect to Landstuhl as the patient is evacuated. We could have continuity of care throughout the process."
"It makes you more efficient, and extends your capabilities as a physician," Chung said. "For me it has been a career saver," he added. "Availability 24/7 is very taxing. I can do that now without burning out."
Related fascinating story on military robot use These guys go to war....
Its Devices Bring Relief To Patients - ON-Q
The device can also deliver anti bacterial agents...perhaps helpful with the MRSA battle at surgical sites.....BD
Two things you don't want in a hospital: infection and pain. Infection can be fatal, especially with the rise
of antibiotic resistance. Opiate painkillers can be addictive and weaken the immune system, adding to the risk of infection. A publication of the Centers for Disease Control and Prevention puts the number of U.S. hospital infections at 2 million a year, with 500,000 from surgical sites. The cost to patients and the health care system is hard to assess, but it could be more than $10 billion a year, according to several reports. People who contract a surgical-site infection are twice as likely to die as those who escape infection. Much of that misery can be avoided, says Donald Earhart, chief executive of I-Flow IFLO. His company makes ON-Q, a device that pumps non-narcotic painkillers and anti-infection agents right to the wound site.
With ON-Q, the incidence of infection fell from 14.5% to 6.5%. The device delivers both painkiller and anti-bacterial agents to the wound through a catheter attached to a small pump. The surgeon can put it in place while closing the wound.
New Incisionless Surgery Offers Hope to Heartburn Sufferers - GERD
Many have GERD and if surgery would be deemed necessary, this sure looks to be a great way to to go...anytime you have less cutting and tissue to heal, that's always pretty much a winner for the patient..the website also has a video to watch the procedure...many can be treated with medications for GERD...and there is also laparoscopic surgery. BD
Surgeons at The Ohio Sate University Medical Center have performed the first incisionless operations in the United States to stop gastroesophageal reflux disease (GERD), also known as heartburn. They did it by using a device, known as EsophyX, which was recently approved by the Food and Drug Administration. "The medical device offers a treatment for patients who suffer from an advanced degree of GERD and, until now, would have been candidates for (traditional) surgery," said Dr. Scott Melvin, director of the Center for Minimally Invasive Surgery at OSU Medical Center, in a news release. 
Almost 30 million Americans are diagnosed with chronic reflux disease and millions of dollars are spent on over-the-counter and prescription medications for treatment of the condition. The new procedure leaves no outside scarring, results in minimal, if any, post-operative pain and reduces recovery time significantly, according to Melvin.
The Intensivist...hospital technology/physician occupation
This way the doctor can be there virtually...and it is working....they are also able to get the physical staff there immediately as well...the units will be able to track 100 patients when completed with each room and area set up with complete monitoring systems, 2 way video, audio and constant real time streaming of vitals, lab results and charts. Electronic charts and no paper used here....The virtual doctor can actually be there before the bedside team and already be at work...of course you do need the bedside team too, but I can see where this can be lifesaving...BD
He's a critical care specialist called an intensivist. His job is to intervene when critically ill patients are in crisis and 
guide the health care team through it.
"I do love what I do and I walk out of ICU after a crisis and I say, 'Whew…that was good,'" he laughed.
It's called E-Focus and it features two-way video and audio wired into patient rooms, along with constant streaming updates of vital signs, lab test results and patient charts.
In ICU rooms, patients hear a doorbell ring and then the doctor or nurse appears on the screen in front of them. Sensitive cameras allow the staff to pan around the room and zoom into monitors or read labels on medication.
Huerta said he's even diagnosed an infection inside a patient's mouth by zooming in with the camera.
Patient Louis Baker was in distress recently, after abdominal surgery at Midland's Hospital. His heart rate sped up and his blood pressure dropped. The virtual E-Focus team was in his room almost instantly, as the bedside team was coming down the hallway.
Hospital makes Chapter 11 filing - Los Angeles.
This hospital was also cited having financial difficulties in a post a couple weeks ago....BD
Brotman Medical Center in Culver City has filed for Bankruptcy Court protection from creditors but is expected to stay open and maintain most critical services, including its emergency room, hospital administrators said Friday. The 420-bed hospital is seeking reorganization under Chapter 11 of the U.S. Bankruptcy Code. It is expected to trim less-vital money-losing units, including several outpatient services, although details of the reorganization plan weren't included in court papers filed late Thursday. "Brotman Medical Center will continue to serve physicians and their patients in Culver City, West Los Angeles and the surrounding community," said hospital spokesman Charles Sipkins.
The failed promise of prompt pay ...how long does it really take to get paid..and what is a clean claim?
Having large monopolies in the health care business certainly does not help issues..if everything meets current criteria without any additional information, it appears most of those filed electronically make the grade in 30 days or less; however, how many need additional information added? This is what drags the procedure down to a crawl as one additional item of information starts a process of form letters, response letters, and even phone calls for follow up..so exactly what is a clean claim? I don't think it is possible for all claims to be "clean", if you will, thus the continued delay in payment while going back and forth on some....others just flat out pay slow...but the industry states it is getting better...76 million in fines is a lot of money...what new certifications do physicians need to have or invest in to be guaranteed payment as being "certified" with each carrier...why do insurers find loopholes? AMA pushing for Congress to address....BD
Like all physicians, orthopedic surgeon Frank B. Kelly, MD, depends on steady cash flow to keep his office running. But Dr. Kelly, who directs the seven-doctor Forsyth Street Ambulatory Surgery Center in Macon, Ga., finds himself constantly battling private insurance companies to get payment for patient claims. Even though Georgia law requires reimbursement within 15 days, Dr. Kelly says payment can take as long as six months. His financial situation gets so bad that he sometimes delays purchasing new equipment and sweats the months liability premiums come due. "You don't make plans for capital expenditures unless you have the money in hand," he says. "You cannot depend on being paid by an insurance company.
His office administrator, Melissa Zediker, relates the example of a claim for hand surgery. It included the surgeon's name and license number, but the insurer denied payment because the claim didn't state the doctor's degree.
By 2007, all 50 states had some form of law penalizing health insurers for late payments. Yet the problem persists, physicians say. Insurers have found loopholes to get around the deadlines and are using federal law to slip out of state laws, doctors say. States have imposed at least $76 million in fines in the past 10 years against insurance companies for failure to comply with prompt-pay laws, according to the AMA.
What is needed, says the American Medical Association, is a tough federal law penalizing insurance companies that delay payment. One reason insurers can ignore prompt-payment laws is that they dominate the market in most communities, says Cecil B. Wilson, MD, immediate past chair of the AMA Board of Trustees.
"Most of it is really ridiculous -- standard form letters in their system that they shoot off and hope the provider doesn't address," she explained. "A lot of these claims get paid down the road, but they hold the funds 30 to 90 days longer than if it went through with a 'clean' claim," she said.
AMNews: Nov. 5, 2007. The failed promise of prompt pay ... American Medical News
Travel reservations: Push for offshore care ..
Employers and health plans are being courted...with the promise of huge savings over the same procedures in the US...BD
The companies aren't just waiting for that comfort level to rise, either. They are courting large employers and health plans by promising to find the best foreign hospitals they claim rival U.S. facilities in quality measures, all while saving them up to 80% in health care costs so they will offer employees and members incentives for seeking care abroad. And the medical travel companies themselves are being courted by countries and overseas hospitals eager to take American patients. For example, the director of medical services for the Singapore Tourism Board said 555,000 tourists had received medical treatment in that country last year. Singapore would like to bring that number to 1 million per year by 2012.
AMNews: Nov. 5, 2007. Travel reservations: Push for offshore care ... American Medical News
FDA warns about 'stay awake drug' Provigil
Provigil which is made by drug manufacturer Cephalon, is used to treat people suffering from narcolepsy and obstructive sleep apnea and stops them falling asleep at random times during the day. The FDA says patients should stop using Provigil and see their doctor if they develop a skin rash or other hypersensitivity reaction. According to government scientists negative side effects have included instances of Stevens-Johnson Syndrome, which begins as a red rash but can eventually cause skin to peel off the body, resulting in deadly infections. It seems most cases of the disorder occurred within five weeks of patients starting therapy with Provigil. The FDA also warns that there have been reports of hallucinations, anxiety and suicidal thoughts linked to the use of Provigil. Psychological problems generally stopped within 36 hours of discontinuing use of Provigil.
Additional References and Music Enhancements for the Blog
Over the weekend some new changes were added to the blog and hopefully useful and beneficial to all readers. Now it is easier to locate paste and archives posts under the main category listing. In addition, it will be easier to locate the most recent 10 comments posted as well. The right hand column will list in one section. There are 2 new section that post the latest from the New England Journal of Medicine and a section for some CME listings and information. The site is also open to anyone who would also wish to advertise. You can also use the listings for the major stories of the day, located at the bottom of the right hand side. Another new section has been added called "Blog Rush" that will also enable you to locate blogs with related subjects.
Last but not least is the Sky Radio button whereby you can listen to some music while browsing the blog. The music remains live as long as your browser is still set to the Medical Quack. Please keep the good comments 
coming too. We do appreciate it and please feel free to tell others about the site if you are finding it useful. I cover a lot of different areas from technology to medical stories here and hopefully it is enough of a blend to offer something for everyone and yet still be interesting and contain some valued information.
Thank you again for your support and contributions to the Medical Quack.
Barbara Duck (the Quack)
Small hospital in Clay Center, Kan., aims for a free MRI machine
The contest continues....so far 37 hospitals have submitted entries...BD
Thats what Clay County Medical Center, about three hours west of Kansas City in Clay Center, Kan., gets if it wins an online video contest sponsored by the MRI machines manufacturer. The 25-bed hospital does not have the resources to pay for its own MRI machine. Patients needing a scan must drive an hour to Manhattan or wait for the mobile MRI truck. Its really an inconvenience, said Tyce Young, the hospitals director of nursing. This would be a great tool for our patients. In the hospitals video submission, entitled Granny Gets an MRI, Young (a man) plays the title character. Clad in a dress and wig, Young plays an elderly woman who must face obstacles like a banana peel and a menacing bulldog while trying to get an MRI scan.
www.kansascity.com | 10/26/2007 | Small hospital in Clay Center, Kan., aims for a free MRI machine
Stones Legend Joins 15 000 On Hospitals March - UK
And other celebrities were present as well.....BD
Rolling Stones legend Keith Richards joined thousands of protesters for a rally and march against hospital cuts. A record-breaking crowd of up to 15,000 people brought the streets and roads of Chichester to a standstill in a mass show of support for the city's St Richard's Hospital. The 62-year-old rock star, who lives in West Wittering, near Chichester, was wearing a long black leather coat, trilby and sunglasses and was joined by his family for the march.
Stones Legend Joins 15 000 On Hospitals March (from The Argus)
DoD, VA still working on sharing e-health records
The government is working on this internally to have interoperable records between agencies...BD
October 24, 2007 (IDG News Service) -- The Department of Defense and the Department of Veterans Affairs still aren't able to share complete electronic health records of military members and veterans despite working on a project for nine years, employees of the two agencies told a congressional committee Wednesday. While the two agencies have begun to share some text records, including discharge summaries and emergency-room reports, it won't be until 2008 before they can share vital signs of patients, laboratory data and family histories, said Dr. Gerald Cross, principal deputy under secretary of health in the VA's Veterans Health Administration. Officials from both agencies told the U.S. House of Representatives Veterans Affairs Subcommittee on Oversight and Investigations they're making good progress, but issues remain. "The work to make data computable between two different health-care systems is very complex and requires complete standardization of data," Cross said.
Consultant hired to make sense of IT Soup
I would like this job...BD
What's the difference between an EMR, an EHR and a PHR? Why is an HIE not a RHIO? Does anyone really care? Well, yes, the Office of the National Coordinator for Health Information Technology at HHS cares enough to pay contractors close to a half million dollars to come up with the answers.
Are Hospitalists Killing Primary Care?
Good article and addresses many issues, including how to incorporate both the roles of the PCP and hospitalists together for better health care...PCPs have the weight of the world on their shoulders today...BD
Primary care physicians have an incredibly difficult job: trying to magically (in 15 minute visits) see complex, elderly patients with multiple medical problems, reconcile paper bags-full of medicines, and sort through stacks of Internet printouts that patients now helpfully (?) cart along. As I mentioned recently, one study found that just following recommended preventive practices would take a PCP nearly 8 hours a day, before dealing with any new or acute problems.
But we may have reached the point that primary care has become so unattractive for so many docs that the migration to hospital medicine truly is contributing to the PCP shortage.
In my judgment, three things will need to happen to resurrect primary care:
- Congressmen will need to be unable to find a PCP for themselves or their parents;
- All the primary care fields will need to band together and lobby with a single voice, rather than as general internists versus family physicians....
- Managed care will be resurrected, in some new garb, to deal with healthcare inflation. Two guarantees: It won’t be called “managed care” this time, and the inevitable strategy to promote primary care over more expensive specialist care won’t be called “gatekeeping”.
Can this get fixed? Since much of the crisis relates to changes in the payment system (not all, but much), and since physician payment is a zero-sum game, increasing compensation for PCPs will depend on significant cuts to highly-paid procedural specialists. The way to fix that is not by trashing hospital medicine – a rare generalist success story in medicine – but by continuing to work on making primary care viable again.
Wachter's World : Are Hospitalists Killing Primary Care?
Hat Tip: Kevin, MD
Change the Medicare rules that effectively deny patients needed rehab time
I agree this should be addressed somewhere along the line..my mother a few years ago was a perfect example as she had 2 knee surgeries, before and after the rules...first surgery...had adequate rehab...2nd surgery...not. Skilled care environments do make a difference, whether it is at the hospital or outsourced at a facility that has a connection with the physicians and their recommendations for the patients...the 2 have to work together for the benefit of both the patient and the doctors...BD
Given the crisis in getting affordable health care to the American people, the last thing Medicare officials should do is undermine medical institutions and make it harder for patients to get the rehabilitation treatments they need. Yet that is exactly what is happening with enforcement of a long dormant Medicare rule requiring rehab hospitals to limit three-quarters of their beds to only 13 specified maladies. The so-called 75 Percent Rule has resulted in the denial of appropriate medical care to thousands of patients, including those undergoing joint replacement operations, an increasingly common group of procedures that require extensive rehabilitation.
In the past three years, imposition of the rule has caused a 25 percent reduction in the number of patients treated at Texas rehab facilities, from 14,181 in the first half of 2004 to 10,609 in the first two quarters of this year. Nationally, as many as 88,000 patients have been denied needed rehab treatment since the rule took effect. The problem with sending them home or to a nursing home is that they need more intensive rehab treatment in a skilled care environment.
DARPA's robotic arm and driverless vehicles...
Absolutely a must watch....if you are not familiar with DARPA, this is the Defense Advanced Research Project Agency...working under the Department of Defense...pursuing technology and development projects. Commercial vendors are involved and donate time and effort as well to product development. This video from Engadget is phenomenal to watch to see the capabilities of an arm replacement. BD
Scroll down to the next video as well to see what DARPA is doing with cars...with no drivers...the race is on next weekend. My choice here just might be the team from Stanford...it has the brains from Intel...BD
http://www.engadget.com/2007/10/16/darpas-robotic-arm-demoed/
Oh, and it'll have to obey all California traffic laws--signal turns, obey speed limits, negotiate four-way stops with other vehicles...think of it as the kinder, gentler auto race. Watch the video below to see the brains of the vehicle, provided by Intel...fascinating...to watch "Junior"...with his Quad processors ready to go....BD
FEMA apologizes for news conference on fires - employees posed as reporters....
I think it would have been better to perhaps cancel and re-schedule...but there are a lot of good efforts with private industry jumping in to help with health related donations too. BD
WASHINGTON, Oct 26 (Reuters) - The U.S. government's main disaster-response agency apologized on Friday for having its employees pose as reporters in a hastily called news conference on California's wildfires that no news organizations attended. The Federal Emergency Management Agency, still struggling to restore its image after the bungled handling of Hurricane Katrina in 2005, issued the apology after The Washington Post published details of the Tuesday briefing.
But with no reporters on hand and an agency video camera providing a feed carried live by some television networks, FEMA press employees posed the questions for Johnson that included: "Are you happy with FEMA's response so far?" No actual reporter attended the news conference in person, agency spokesman Aaron Walker said.
According to Friday's Post account, which Walker confirmed, Johnson replied that he was "very happy with FEMA's response so far." A spokeswoman for Homeland Security Secretary Michael Chertoff, who has authority over FEMA, called the incident "inexcusable and offensive to the secretary."
Reuters AlertNet - US agency apologizes for news conference on fires
AT&T Offers Free Wi-Fi Access in Southern California - Fire relief
Another nice helping hand and welcomed by all....BD
To help California residents affected by the fires stretching across Southern California, AT&T announced that AT&T Wi-Fi service will be offered free of charge at nearly 600 hot spot locations across Riverside, San Diego, San Bernardino, Los Angeles, Santa Barbara, Orange and Ventura counties. Residents will have free access to the AT&T Wi-Fi service 24 hours a day beginning today, Saturday, Oct. 27. Residents or travelers can use Wi-Fi-enabled devices, such as laptop computers, iPhones or personal digital assistants (PDAs) to connect to the Internet or corporate networks by using any of the AT&T Wi-Fi locations.
AMA To Congress: Health Insurance Mergers Harm Patients, Physicians
Good points made here with the consolidation of carriers...as there appear to be fewer to choose from on the horizon in view of all the recent mergers, we are seeing a "lack" of competition and less health care for individuals with a more complex and diversified set of rules and regulations imposed, just to get health care...we all know what happens with lack of competition, so should the insurers be "regulated"? If our power, gas, and phone companies were not regulated to some degree, we could also have outrageous premiums and conditions to work with...why does health insurance have a free reign to pass along increases without a public hearing...especially when profits are so ominous? Could health insurance be regulated with public hearings before rates are increased? Something to ponder...BD
Oct. 25, 2007 -- Statement of William G. Plested, MD, Immediate Past President: Thank you, Madame Chair (ranking member, Chabot) and members of the Committee on Small Business. My name is Bill Plested. I am the Immediate Past President of the American Medical Association and a thoracic and cardiovascular surgeon from Santa Monica, California. I want to thank you for inviting me to testify today and for holding a hearing on this important issue health insurer consolidation.
.........Physicians’ ability to perform either of these vital functions, however, has been severely compromised by growing consolidation in the for-profit health insurance market. This consolidation has left physicians with little leverage against unfair contract terms that deal with patient care and little control over their own employees rising health insurance premiums......The United-Sierra merger would give United 94 percent of the HMO market in Clark County and 80 percent of the HMO market in the entire state of Nevada.
“Consolidation is not benefiting patients. Health insurers are posting record high profits, while patient health insurance premiums continue to rise. In fact, United and WellPoint have had seven years of consecutive double-digit profit growth that has ranged from 20 to 70 percent year-over-year.
AMA To Congress: Health Insurance Mergers Harm Patients, Physicians | All American Patriots
Health officials insist IS 211 students are safe
Thus far we have not heard much about his prior medical care...hope more will surface soon...and I think testing in hospitals at this point is not a bad idea...BD
Faced with panicked parents and amid calls for better medical screening, city health officials Friday insisted the classmates of a Brooklyn boy who died after catching the so-called "superbug" are not at risk, but admitted they may never know how the child was exposed to the infection. Children at IS 211 in Canarsie, where the boy was a seventh-grader, "are at no higher risk of getting a staph infection than children at any other school in New York City," City Health Commissioner Dr. Thomas Frieden said at a news conference Friday. "A death like this," he said, "is very rare.
Some classmates and friends recall seeing Omar scratching telltale boils on his legs and back, but Frieden declined to reveal any details about Omar's treatment. It was not clear Friday whether the boy had been diagnosed with MRSA before he died.
Health officials insist IS 211 students are safe -- Newsday.com
Related stories: http://www.newsday.com/news/local/newyork/ny-staph-sg,0,6443397.storygallery
GlaxoSmithKline Aids California Fire Relief Efforts
Nice contribution and I'm sure appreciated by all...BD
GlaxoSmithKline (NYSE: GSK) shares the nation's concern for residents and communities of California's San Diego region that are being ravaged by widespread fires. As a demonstration of support, GSK has offered to the people impacted more than $1 million dollars worth of respiratory medicines and $100,000 worth of consumer products, including Aquafresh products and Tums.
GSK has already shipped $300,000 worth of asthma medicine to Direct Relief International, a Santa Barbara-based relief organization with expertise in fast delivery of medicines in times of disaster. Direct Relief's close proximity to the regions affected by the fires means they have been able to provide immediate emergency relief to those in need.
SiCKO Health Care Card...
Michael Moore is back with his own health card..."don't get sick without it"....one of the readers of the blog brought this to my attention and asked if this could be posted...here it is....BD
You now have the opportunity to print and carry your very own "'SiCKO' Health Care Card." As seen on The Tonight Show with Jay Leno.
Carry the card in your wallet with your insurance card. If denied treatment, show your SiCKO card to your doctor/insurer. Ask your insurer if they'd like to be in Michael Moore's next movie, DVD, or appear on MichaelMoore.com. Tell them that, if denied, you will seek coverage from your local media. E-mail your story to michael@michaelmoore.com.
MichaelMoore.com : SiCKO : What can I do?
Source: Reader Tip