Do The Wrong Thing

A day late and a dollar (gazillions) short. Robert Laszweski tell us: As the Democrats make their final push to pass their health care bill many of them, and most notably the President, are arguing that it should be passed because it is the “right thing to do whatever the polls say.” Their argument is powerful: We will never get the perfect bill. If this fails who knows how long it will be before we have another big proposal up for a vote. There are millions of uninsured unable to get coverage because of preexisting conditions or the inability to pay the big premiums and this bill would help them. Any big health care bill will be full of compromises—political or otherwise. But this bill doesn’t even come close to deserving to be called...

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My banker called me today

  This was posted some time ago, However I think that in light of the recent passage of Health Care Reform, it still applies. My banker called me today to alert me to the fact that my checking account was ‘over-deposited’. There were several deposits from the U.S. Treasury department that were transferred electronically over the weekend following President Obama’s signing the ‘stimulus bill’. My bank (one of those saved from the brink of extinction by a previous large U.S. Treasury check) alerted me to the fact that my check from the U.S. Treasury would take at least two years to clear, (and not count on the cash until they saw the green.) Unlike California my banker does not issue or accept I.O.U.s. Even with those precautions...

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Science and Passion

Someone recently pointed out that science and passion are not at opposite poles. The goal of finding truth and objectivity are not the polar opposite of 'faith' . For many years medicine has relied on some treatments that are patently useless or at least questionable. We have placed our faith (and the patient's) in some of these treatments.As medical students we are supposedly grounded in science, and evidence based medicine. The term 'evidence based medicine' to me is meaningless, invented by insurance companies and parroted by some physicians to be 'politically correct' The term evidence based 'science' is far more meaningful. The practice of medicine is and art as much as science. The placebo effect is evidence based, but not scientific. This is pseudoscience. So, evidence based medicine...

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More Butterflys

  Health Care Reform is here, or is it?  Frankly the whole thing is so complex that no one really knows how this is going to work, if it does.  True to form our government is telling us we are going to save so much money by spending more money now. 17,000 IRS workers to keep track of who has purchased insurance, and who has not.  There will be a new check box on your 1040 asking you to swear that you have purchased insurance.  Insurers will undoubtedly issue 'stickers' to place on your 1040 forms. Welcome to Deemocracy . On Thursday, the California Occupational Safety and Health Standards Board voted to set up a committee to examine whether condoms should be required on all pornographic film shoots within...

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The Fallout

  Health Train Express  has been around since 2005, and in those years I have posted 405 editions. It's been a catharsis, and I have looked forward to writing it. In the process I have made many 'literary giants' as I review the bloglists daily. (what was I doing with my time prior to this?) Health Reform Expectations: Most of us may go on practicing medicine as we did prior to the 'health reform' legislation. Truthfully it will change little for physicians, although it may threaten small to medium size practices just because of the bureaucratic overload which is already past implosion and critical mass. It will however spawn new parasitic administrative functions in government and the private sector of health care....

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Posted in: health reform,healthtrain,timeline

Just The Beginning

Words from a practicing surgeon:: Truth cannot be legislated! Good morning! The sun came up this morning in upper Michigan.  The air is crisp and clean as usual and another beautiful day is beginning.  As always, I'm operating on Monday.  I saw my first patient, a middle aged man with a hernia.  He smiled at me, we shook hands and I answered his last minute questions.  Soon I'll be in the OR doing the same work that I still love. My patient didn't watch the vote last night.  He wasn't aware of Pelosi's grand victory.  All that matters to him this morning is that I am his surgeon, he trusts me to do my job well, and I will. What we saw last night was a political manipulation of history.  A re-write of law to move the money around and change some...

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Personal Health Records

The personal health record is failing patientsBy Kevin on emr A personal health record (PHR) has been touted as a way for patients to better keep track of their health information. Google Health and Microsoft HealthVault lead the way.But what happens if the company storing your data gets bought, goes bankrupt, or simply decides to discontinue their system?Well, those who stored their data with Revolution Health are finding out first hand.The troubled company, which started off with so much fanfare, yet died in a whimper, recently announced they’re shutting down their personal health record service.According to American Medical News, “Industry insiders say Revolution joins a long list of vendors who launched PHRs with a big splash, only to find little interest from consumers.”Leaving the data...

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Do The Wrong Thing

Robert Laszweski tell us: As the Democrats make their final push to pass their health care bill many of them, and most notably the President, are arguing that it should be passed because it is the “right thing to do whatever the polls say.” Their argument is powerful: We will never get the perfect bill. If this fails who knows how long it will be before we have another big proposal up for a vote. There are millions of uninsured unable to get coverage because of preexisting conditions or the inability to pay the big premiums and this bill would help them. Any big health care bill will be full of compromises—political or otherwise. But this bill doesn’t even come close to deserving to be called “health care reform.” But as an unavoidable...

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It makes me sick, I see a lot of that

Distractible MD says it so eloquently and simply: Just ask your doctor what he is “sick of”. Doctors in training are flooding away from general Internal Medicine, Pediatrics and Family Medicine in droves. Only 2% of medical students plan to go into primary care. It used to be over 50%. A recent Jim Lehrer report discussed the reasons. We’ve been talking about it for years but things have only gotten worse, not better.The whole premise of health care reform ensures that everyone has access to good quality care. Every nation that provides good, quality access has a strong primary care base that is the foundation. Primary care is valued by the government, the payers, the population and even by the physicians.We have it all backward. It is time to revamp the system from the bottom up. Frankly...

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Last Helicopter out of Saigon

Plagiarized from The Health Care BlogLast Helicopter Out of Saigon! By JEFF GOLDSMITH In popular psychiatry, a classic passive aggressive gambit is “malicious compliance”- intentionally inflicting harm on someone by strictly following a directive, even though the person knows that they are damaging someone by doing so. In Washington, the most skilled practitioner of this dark art is Speaker Nancy Pelosi If health reform craters, Pelosi will disingenuously claim that she did precisely what the President asked of her, and blame the Senate and the President for its failure.In reality, Pelosi’s “leadership” almost fatally wounded health reform last summer. If the process does collapse, the blame should fall squarely on her shoulders. Her poor political judgment led directly not only to squandering...

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Reform ? or Revolution !

From my post here you may discern that I was in the 'self pity' mode, last week, something which I like to do once in awhile...'why me?" Well, I am over that now and into: 'I am mad as hell, and I am not going to take it anymore"  My next swing will be into "charge ahead...Don't look back".  I am sure (or at least hope) most of your can identify with this evolution of mood. For the past 14 months I have been a civilian contractor for the U.S. Army...I have been 'laid off'....A consequence of the financial crunch facing state and federal governments. Unfortunately I was not the beneficiary of all that "stimulus' money".  The health reform debate, continues in D.C., in the media, and around town.  I could 'pull a week's...

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