Health Train Slows Down

Things are a bit slow this morning. A welcome respite. I spoke to wifey, who is still on the "left coast' tending to our adult children, who seem a bit reticent to step off into the world we are leaving them. I thought I would be retired by now, or at least tending to an alternate career, reading, writing, sitting on the park bench playing chess....or on the beach....not so. At times I thought I had my whole life well planned and structured, fool me!!!.This post is going to be mostly a long ramble...that's what happens when I have a few unstructured moments. For five years or more I have blogged on a variety of subjects, ranging from health information exchanges, EMRs, health reform, generalized sarcasm and humor as well as commentary on my fellow bloggers meanderings. I often wonder how...

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Health Train at Blair House

  Between patients yesterday I managed to watch the health reform forum at Blair House.  Thanks to the power of video streaming I was able to follow most of it. The conversation seemed to present most of the issues, and even malpractice reform was brought up (at a late hour).  President Obama did not respond directly to that issue but it was estimated that the savings would run into billions of dollars, not from premium reductions, but the secondary effects of  'defensive medicine'...This brought no response from President Obama. He seemed more intent upon pushing his own vision of health care. There were some central core issues that  both sides seem to agree upon. 1. Elimination of exclusions for insurance coverage (Universal coveragw) 2. Expanding medicaid...

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Meaningful Use of EMRs

Many physicians are wondering what that means, in the context of their clinical practice.   Here's my 'take' on the situation. 'It depends"  on: 1. The day of the month. 2..What the feds and payors want to extract from your medical records. It has nothing to do with your needs, or affordability The latest insider information this week is posted by the HIT Policy Committee So we have a moving target....and so do the software vendors. For some specialties the term meaningful use is meaningless....

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The Circus

  Four days from now the three ring circus begins (Dems, Repubs,and Obama) on Thursday and Blair House in Washington, D.C. Finally (maybe)an attempt at transparency will take place. It's been over a year since these plans for health reform were 'reconciled' in closed room, with secret deals, and legislative trade offs. I am sure it makes us all feel good to know our health  care is now legislated in a back room. I  belong to several specialty group listservs and professional health care blogs.  The tone on these forums has changed radically.  One of these groups is an ophthalmology forum. Many on this forum plan to announce this coming week they will no longer be accepting medicare patients in their practices....

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Bi-Partisan???

If you are like me, then you are fed up with hearing about “bipartisan support” for health care reform. Most of us would like to see non-partisan health reform. The recent pronouncement from on high is about the coming conference between Dems and Repubs regarding health care reform.  A dollar late and a dollar short. Most interested parties could  care less about ‘bipartisan support’.   This wraps the process in a shroud of chaos and cloaks what the people really want and that is  MEANINGFUL change in our health system, not just another step in the path to federalized and/or socialized medicine. The TEA (party), which is not  a political party, but a movement amongst both Democrats and Republicans who agree...

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Parachutes (and balloons)

Do you have your parachute on?   No, I am not speaking about the ‘golden one’ that many CEOs and financial wizards seem to deserve for their “financial wizardry”. I mean the one that you will need when you are swept off the cliff by the ‘lemings’ cascading before the onslaught of insurance companies, Medicare, software vendors, EMRs, RHIOs, P4P, QA and hundreds of other eponyms.  Even as I back-pedal my feet slip closer and closer to the cliff of doom. Sid Schwab in his most recent blog post of Cutting through the Crap seems to nail the problem on it’s head. (posted February 11, 2010…UNWORKABLE). It goes far beyond healthcare and medicine. It is a problem we physicians have recognized two or more decades ago.   Perhaps it is not because we are smarter or more...

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How Much is a Trillion Dollars

A trillion here, a trillion there. In the words of Governor Bobby Jindall of Louisiana fame, “This here is a fine pot of gumbo”.  He continues in his comments for the WSJ “I honestly do not know one single individual who is happy with this situation. Not one. Not a Republican, a Democrat or an independent. These actions are all problematic individually, but taken as a whole, they are devastating. So against that backdrop, we enter the health care reform debate. I honestly do not know one single individual who is happy with this situation. Not one. Not a Republican, a Democrat or an independent. These actions are all problematic individually, but taken as a whole, they are devastating. So against that backdrop, we enter the health care...

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You Lie, and Too Many mis-statements

Obama's lieutenants (Heads of Cabinet positions and Departments) seem to make outrageous statements that any simpleton can see through.  The first egregious mis-step was on the part of Secretary Napolitano (her name reminds me of an ice cream, a mix of pink, white, and brown flavors (like Obama's mindset). Her initial statement that all went well with DHS's methods of preventing terror attacks such as the one on a recent airline flight, was quickly retracted and modified into a politically correct statement.  The next misstep  was by the head of the Department of Transportation, that everyone owning a Toyota should stop driving it until a fix can be accomplished.  Obviously again retracted the next day. ...

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