Rarely do stories occurring on opposite sides of an ocean so perfectly compliment one another.  Yet last week Santa Barbara Congresswoman Lois Capps described the new health care reform legislation as “a big gamble”, one whose effects could not be known with any degree of certainty.  This from a strong proponent!  Well, this week I read of some interesting developments in England where similar language was used.  Both are likely true, and it is fascinating to see the evolution of government administered care 60 years hence.  Gambles indeed, let’s take …

This week CMS (Medicare/Medicaid) released requirements as to what constitutes “meaningful use” of Electronic Medical Records (EMR). Shortly after Castle Connolly Medical, which publishes  “America’s Top Doctors”, announced it will incorporate this data into its guides.  John Connolly, president and CEO of the company, lauds the new requirement and feels people may want to choose their physician based on such criteria.  One should also note that Mr. Connolly sits on the Board of and owns shares in an EMR start-up company.  Hmmm?
As we embark on the forced marched into government …

Ideally we will dissect more of these things over the coming weeks and see where that gets us. Our concerns are not political- just our means. The real issue here is not policy, or even possible fibbing, its what this all means to how we do our day jobs. Despite the anger, sadness and fear, we still have doctoring jobs that pay the bills and we still like those jobs. The question for us is how long this state of affairs can last…

About six months ago we published this little gem. It outlined what happens after an Obamacare passage? Today no doubt there is talk of repeal. This is good, we think. But, absent that, what was the plan? Lets have a look….

Great. Our President literally handing out checks to seniors— to influence their opinions about a political concept. Its like we are back at Tammany Hall again.

We are standing in front of the same precipice, facing the same fall and fate as in 1917 and we have seemingly learned nothing. The current health care legislation being bantered about in Washington today is a direct extension of the line of reasoning that began in 1909 and was, by 1917, being fought with the same grit and determination as the foes against reform are fighting today.

The problem with the health care reform process was it was driven by a multitude of agendas. Many of these agendas were based on political ideology as much as anything else. Neither of those statements are particularly earth shattering. They are to be expected in a political debate especially amongst politicians, lobbyist and pundits.
Where we hope we don’t get ideology-driven agendas is in science. Especially a science whose direct end result is someone’s life. Unfortunately, this is not the case. Academics is a cauldron …

Just quit your job – ins’t HCR Empowering

Readers may recall some of our first articles which argued that despite assurances to the contrary, President Obama could NOT promise “people who like their present coverage can keep it”.  Simply, it is because employees have little or no say in what benefits an employer chooses to offer.  The Lewin Group, health care consultants, estimated that 118 Million people would lose their employer sponsored insurance and be forced into the National Exchange.  Of course some in Government were more candid in their assessment, at least in front of sympathetic groups.

So …

If you had any notion in your being that the government could run the highly complex world of health care…let us dispel you of that notion now. Hank Johnson voted for the health care bill and is one of those government bureaucrats who will be deciding your health care fate. Watch and shudder.

One key problem has always been how the health care system in America would cope with millions of new patients seeking primary care in the absence of new facilities or professionals to provide the service.

This site allows you to send faxes, the most effective format of communication for elected officials, so you can try and alter the health care vote. If nothing else its a very cheap form of catharsis. Imagine all those faxes on the floor when they arrive in the morning.
http://www.centerforamericanresponsibility.org/
Have fun…

This letter was written months ago to address the legislative body of a major, medical specialty society. It is dated but relevant especially in lieu of the recent Medicare cuts gymnastics that went on in the last few weeks. These cuts are centered around the decades long slog by physicians to address the SGR formula which governs much of physician payment in this country. The SGR is government controlled and therefore is a complete disaster.
Now that the beloved SGR is a mirage …

These articles get at the core issue of HCR from both sides: the administrative/hospital one, and the personal/patient one. Both offer the same insights and raise the same questions. Our contribution to this little dialogue? No matter what rules and laws are put in place to ‘reform’ health care, the fundamental issues that had the Bennett’s making the decisions they made, and the doctors making the ones they made– those issues all remain intact and untouched. Obamacare is foolish. Worse, after reading these articles it becomes plainly evident that Obamacare is also a mirage.

When Newfoundland Premier Danny Williams opted OUT of the vaunted Canadian Health Service, choosing instead to have his Mitral Valve repair done in the US, it received hardly a mention in the American Press.  But the reaction was far different in Canada.  On February 4th Mr. Williams traveled to Florida and received care, paid for out of his personal assets, to repair this cardiac defect.  What of other Canadians, ones without such personal resources?

“This is my heart, it’s my health, it’s my choice.”.  A reasonable premise.  Unfortunately one denied most …

Certainly we all remember the mad rush to complete the health care legislation this summer.  It was all so very imperative: after all 40,000 people were dying every day due to lack of coverage, weren’t they?  And besides, it was prerequisite to our economic recovery  (despite the $500B in new taxes that most sensible economists saw as an anchor on growth).
So it is just a little astonishing to hear Sen. Reid’s recent proclamation that  “there is no rush on health care”.  I guess those 40,000 Americans who die every day …

Trust us on this: the parent police are not too far off. Pretty soon– you just watch, someone, will make the argument that obese parents pose a risk and danger to kids no different from homes that have guns or drugs and that kids should be removed from those homes for their own safety and well being.

Richard Foster, the chief actuary for the Centers for Medicare and Medicaid Services, reports that under his analysis national health spending will rise under the bills by $222 billion over the next 10 years. In other words, ObamaCare really does “bend the cost curve”—up.

Our bodies are gradually becoming socialized. The choices we make about how to live, what to eat and drink and what pleasures we enjoy are increasingly to be guided by the hand of the state.

Well, 2009 is rapidly fading into history and the television talking heads and internet pundits are all a-flutter over the new year and new decade. We feel fortunate to have been a part of the noise and the chatter and hope that we kept true to our primary goal of rising above that noise as best we can.  As the year draws to a close, we did however want to re-iterate what we are doing here at TBM. This evening, I was faced with an interesting question: “With HCR almost …

The Patient Protection and Affordable Care Act (PPACA) of 2009 passed the Senate this morning, before dawn, on a strictly partisan vote. For the first time in history a major piece of legislation was approved without bipartisan support, in the dead of night and against the observed will of the American people.

Sometimes journalists get it right and capture a detail that is worthy of attention.

Clinical Benchmarks and Their Implicit Social Pressures
It appears as if the concept of quality has implanted itself firmly into the medical superstructure. depending on whom one listens to, widespread adoption of quality improvement measures will have effects ranging from moderate improvements in delivered care to a huge cost savings coupled to enormous improvements to the entire healthcare delivery pathway. Presently, the Center for Medicare and Medicaid Services (CMS) and the Congress have mandated the adoption of quality measures be tied in some way to reimbursement to hospitals and providers. Regardless …

All that we did was to dig just a bit below the surface for just one all those putative curve benders and look what happened.