DOCTOR REDISTRIBUTION ESSENTIAL

 Are doctors a solution to what ails the US healthcare system? Many areas of the country need medical care that's not available to them.  Will the healthcare reform have any impact on the problem of soaring medical costs and quality of medical care in the United States?

As a medical physician for over 51 years, I strive to give you the best medical information on controversial medical subjects, and help your read betwwen the lines. You must come to your own conclusions. I have no ties to any organization, pharmaceutical, or lobby group. As an practicing medical acupuncturist since 1982, I find western medicine and medical acupuncture are very complimentary. This results in astounding healing in pain management, addictions to cigarettes and food, and a host of other maladies. Visit drneedles is blogging" at the end of each blog for a complete alphabetical list of all my blogs

Visit http://www.americanacupuncture.com/ for more detailed information on mind, body, and spirit healing.

DOCTOR REDISTRIBUTION ESSENTIAL

Are doctors a solution to what ails the US healthcare system? Many areas of the country need medical care that's not available to them. Our US health industry accounts for 1/6 of our economy ($2.5 trillion). Will the healthcare reform have any impact on the problem of soaring medical costs and quality of medical care in the United States?

A battle for health care system redistribution will result in a bruising fight.  Access to top doctors, cutting edge procedures, and advanced lifesaving technology, deal with the quality-of-life issues a doctor considers when deciding where to live, and more importantly what will his income be?

REGIONAL PHYSICIAN DISCREPANCIES

We have created a nation of areas that have great health care and other areas that have none. This problem is likely to grow because doctors gravitate to affluent localities in the United States that have more than the medical help they need.

Doctors locate in coastal counties where the weather is fine and the living is great.  Orthopedists, urologists, and obstetricians are hard to find in areas where the heat is oppressive, the air quality is poor, and insurance reimbursement is difficult.  The coastal area is massively over served by doctors, while the nation’s most depressed regions along West Virginia coal mining states are at the mercy of the medical community.

As doctors cluster together, health care costs soar. This does not result in better outcomes in cities with large physician populations. The healthcare package talks about expanding benefits to uninsured patients, but does nothing about cutting medical costs.  Now that health care will be available to 46 million more United States citizens, and new taxes are levied on the rich, will this disparity in medical care be changed?

PHYSICIAN DISTRIBUTION

For every doctor who lives and practices in a poor area, four other doctors settle in an over served area. This poor distribution of our valuable and expensive healthcare resources has put great strain on areas that need doctors.  Neonatologists don't settle where the need is the greatest, and cardiologist don't go to areas where there are high rates of heart attacks.

Areas lacking in physicians offer visa assistance for foreign doctors and medical school repayments to entice doctors to practice in those areas.

UNNECESSARY TESTING
 
Is medical care better where doctors are abundant? In areas that have a great abundance of doctors, patients are more likely to receive more unnecessary procedures and tests.  More doctors are associated with higher costs of care and more procedures that don't really help patient medical care. High-cost states, like New York, are loaded with more patients getting admitted to hospitals, and who receive a battery of tests and treatments.   Poorer areas must rely on primary care doctors to keep patients out of the hospital.

FEE FOR SERVICE
 
The “fee for service” structure rewards specialists for performing complex procedures. Primary care doctors who practice preventive medicine don’t get  any monetary rewards.   A primary doctor sees about 35 patients a day and makes $150,000 a year. A brain or heart specialist makes four times that salary for performing complex procedures.

FOLLOW THE MONEY

If Obama is right, and it's true that $500 billion of dollars of costs can be eliminated through improved efficiency, rather than through government spending, from where will he cut this waste? How will this be affected?  There certainly will be consequences in any attempt to reform healthcare distribution.

The reform package is talking about expanding benefits to uninsured patients rather than cutting costs. We certainly must invest in more doctors and have additional costs to cover the 46 million added to the insured patient payroll.

Are we willing to take funds away from high-cost cities like Los Angeles and New York and give underserved cities more money? Will we let  urban hospitals struggle to care for the high percentage of uninsured patients that they have been treating in the past?

If Congress talked about pulling a third of the money out of the health care system they would've lost the support of the pharmaceutical industry and the American Medical Association.   Hence, the White House has decided to concentrate on talking about medical access to avoid alienating key industrial city allies.

It's hard to imagine that any health reform is going to have an impact on the soaring medical costs and uneven quality of care in the United States. Quality care should be reworded with good outcomes and not just more care.
Just because you've increased insurance coverage, we have not addressed the dilemma, nearly 50,000,000 people have.

 Not every small hospital can practice like the Mayo Clinic.  If we slowly improved health care efficiency, with time, we could get appreciable quality results. By pushing hard changes quickly, we risk triggering a wave of hospital bankruptcies.

WHY IS CANADIAN MEDICINE SO GREAT?
 
IT'S NOT!  Canadians complain about long waits for elective care, including appointments with specialists, and selected surgical procedures. There are shortages of Canadian doctors and nurses, especially in rural areas.  The growing cost of covering an aging Canadian population keeps increases.

As we American spends 16% of our income on health care, the Canadians spend only 10%. However Canadians have a tax rate of 48% of their income, mainly to fund their health care system.  Canadians wait longer, than in Britain and Australia, to see specialists or to receive elective surgery. They wait 17 weeks for a specialist referral, compared to 12 weeks ten years ago.   In England, no one over 59, can get a stent, or a heart bypass because “it is too expensive and not needed”. 

As you approach 70, the health reform will probably tell you to discontinue some of the treatments you are now taking.  The government feels this money can be spent better on someone with greater longevity than you.  Twenty five percent of Canadian patients complain about unacceptable long waiting for non emergency surgery. Rationing occurs with coronary artery bypass, hip and knee replacement, cataract surgery, and radiation treatments.
 
Canadians now allow private medical insurance for services covered by the government, and they also allow doctors to charge patients extra fees. They buy supplemental private insurance through their employers for eye care, dentistry, and outpatient prescription drugs.
 
 Many lawsuits have been instituted in Canada, claiming these lengthy waiting lists violate their basic rights under the Canadian Charter of Rights and Freedom.
Outgoing Canadian Medical Association President, Robert Quillet, said:  “there is a urgent need to fix the Canadian healthcare system,  and Canadians must stop deceiving themselves into believing they have the best healthcare system in the world.


COMMENTARY

 The health reform bill has provisions to ration senior healthcare. Former Sen. Tom Daschle, who authored this part of the bill, and says “health care reform will not be pain-free and seniors should except the conditions that come with age, instead of asking for treatment for these conditions”.   You will be encouraged to end your life sooner than you wished. As you grow incapacitated and increasingly ill, you'll find it more difficult to keep yourself alive. 
 
You'll be encouraged to draw up advance directives, have a power of attorney, a do not resuscitate order, and other documents to express your wishes.
You will be asked who's is authorized to make critical decisions for you? Medicare officials will propose ways of measuring the quality of end-of-life care, and doctors will get financial incentives to report this data to the government.

The House bill provides medical coverage for optional consultations with doctors who can advise you on health sustaining treatments and end-of-life services, including hospice care for you. Pay consultants will encourage you to accept approaching death, rather than receive costly medical procedures that could extend your life.

Interestingly, congressmen and senators have their own health care plan that is very local pay, and guaranteed for the rest of their lives. They will not give up this plan nor be a part of the new plan they are proposing for us.

WHAT DO YOU THINK?  YOUR COMMENTS ARE ALWAYS APPRECIATED.
Visit www.drneedles.com for more medical commentary on controversial medical health care issues.
 
Source: DARTMOUTH ATLAS OF MEDICAL CARE DATABASE

CAN YOU QUIT MEDICARE

 Soon you seniors may be able to remove yourselves from Medicare, still maintain your Social Security, and be able to choose a private insurance plan that fits your needs.

 

As a medical physician for over 51 years, I strive to give you the best medical information on controversial medical subjects, and help your read betwwen the lines. You must come to your own conclusions. I have no ties to any organization, pharmaceutical, or lobby group. As an practicing medical acupuncturist since 1982, I find western medicine and medical acupuncture are very complimentary. This results in astounding healing in pain management, addictions to cigarettes and food, and a host of other maladies. Visit drneedles is blogging" at the end of each blog for a complete alphabetical list of all my blogs

Visit http://www.americanacupuncture.com/ for more detailed information on mind, body, and spirit healing.

CAN YOU QUIT MEDICARE

Soon you seniors may be able to remove yourselves from Medicare, still maintain your Social Security, and be able to choose a private insurance plan that fits your needs.

A lawsuit, Hall versus Sibelius. Was filed on October 9 charging the Social Security Administration, (SA), and the Department of Health and human resources, (HHS), from continuing illegal and coercive policies that deny you your rightful Social Security benefits, if you want to quit Medicare.

Government lawyers argue that seniors have not been harmed by the current policies, and none of the plaintiffs in the lawsuit exhausted administrative remedies that were available to them.

The court denied the motion of the government to dismiss the case.  The court can now has a chance to void the five other rules (created by the Clinton Administration in 1993) that made individual Social Security a requirement benefit contingent upon your enrollment in Medicare.

The federal court said that federal law requires no such thing, and the SSA created this retirement ruling out of thin air without public notice in the Federal Registry, and without public comments.

The court asserted that since the POMS (Program Operations Manual) determines the plaintiff's rights and obligations, it must be subject to judicial review.    They added that the plaintiff’s failure to exhaust administrative remedies would be futile.

Plaintiff Hall tried to exhaust administrative remedies but was stalled for more than three years and was forced to roll into Medicare. He was told he could not get out of Medicare part D. and keep his Social Security. The court said that this show the government had no intent t to change the POMS.

The judge ruled, when an agency demonstrates an unwillingness to reconsider its position, and there is certainty of an adverse decision, and where the challenge to the agency's policy and practice were systematic failure to comply with the federal law, exhaustion of administrative remedies must and will be excused.  It's impossible to get legal recourse in the federal courts, it the system will not move you through the administrative appellate process.

Since there is no policy found in the Social Security act or federal regulations created by the SSA, that expressed exhaustion of appeals would be futile, the court denied the government's motion.

The POMS, (Program Operation Manual), determines the plaintiff's rights and obligations and is the source from which legal consequences flow.

THE FIVE POMS RULES CAN NOW BE CHALLENGED

The POMS manual requires enrollment in Medicare part D., as a condition to getting Social Security retirement benefits.  It mandates, if you want to do remove yourself from Medicare part A, you must surrender all the Social Security retirement benefits you received.

The POMS manual violates the social securities statute that Congress enacted making federal programs completely involuntary. No federal agency has the authority, either statutorily or constitutionally, to legislate requirements that deal with a person's entitlement to Social Security retirement benefits that are not specifically enacted by Congress.

THE FIVE PLAINTIFFS SUING ARE:

Former US Rep for Texas, Dick Armey the lead plaintiff Hall (a former HUD employee), John J. Kraus was (an aerospace and defense industry engineer, who retired in 2007 from the
U.S. Naval Air Systems Command), Lewis Randall (a private investor who served on the board of directors for E*Trade), and Norman Rogers (a UC Berkeley grad and founder and CEO of Rabbit Semiconductor).

PLANTIFF CLAIMS

Plaintiffs  claim that the Social Security act and Medicare act clearly state that applying for Social Security monthly benefits and enrolling in Medicare are both voluntary. The application for one of these programs is not dependent on the application for the other. The Social Security Act, and the Medicare Act are violated since the new SSA rules make enrolling in Medicare mandatory. This SSA also violates Article I, Section 1 of the Constitution.

To be forced to participate in Medicare, infringes on their right to privacy, and their right to make necessary choices about their own health care.   It also violates the First, Fourth, Fifth, Ninth, and Fourteenth Amendments to the Constitution.

The plaintiffs claim the new SSA rules violate the administrative procedure act.  The new social security rules were put into place without the required notice and comment rulemaking requirements. The policy should also have been published in the Federal Register, and open to comment by the general public, before the SSA rules were implemented.

Dick Armey, former congressman, had a government tax supported healthcare plan as a congressman and now as a retired government worker.   When his Medicare kicked in, he wanted to keep his own congressional taxpayer subsidized insurance, and SSA and Medicare prevented him from doing that.

Medicare said: “If you give up Medicare, you give up your social security retirement plan”.  He could not get out of Medicare without losing his Social Security benefits.  He charged he was denied the government option to choose the medical services that best meet his needs.

By having a new government option for health insurance claims, the government would compete on a level playing field with private insurers. The lawsuit claims that seniors were coerced into enrolling in a Medicare program rather than purchasing private insurance. The government decreed, “those who opt out of Medicare for private insurance, must also forfeit all past and future Social Security benefits”.

Because of this enforcement of the POMS, plaintiffs lose their superior federal private healthcare benefits and health savings accounts, under their Federal Employee Health Benefits program.

Two of the plaintiffs had private health insurance and also health savings arrangements. Both would be disrupted by the POMS when they applied for their Social Security retirement benefits.  They claim that the POMS violated the Social Security Statute that Congress enacted which makes both federal programs completely voluntary. No federal agency has the authority to legislate requirements that link it with an individual's entitlement to Social Security retirement benefits, which was not enacted by Congress.

None of the plaintiffs wanted to be enrolled in Medicare, since they believed it restricted their senior access to health care.  They argued that since the retirement funds that were paid into the system for decades are threatened, they are forced to accept inferior care to what they can purchase.   They want to avoid rationed care that promises reduce services under the current health reform proposals.   By being forced into Medicare, they have each lost many of their federal employee health benefits, that amount to a price tag loss of about $30,000 to each of them.

COURT DECISION IS COST-EFFECTIVE FOR MEDICARE

The waste that is piled onto Medicare patients with a cumbersome competitive bidding process, results in longer hospital stays and blocks more cost-effective homecare.  If only 1% of Medicare eligible seniors choose not to participate, Medicare costs would decrease by about 1.5 billion each year. These savings would continue to increase for several decades as baby boomers retire.

You current seniors and boomers, have a choice to have Medicare forced down your throats or be robbed of your Social Security benefits. In 2030, the older population, will be twice as large as it was in 2000 (growing from 35,000,000 to 71,000,000), and representing nearly 20% of all Americans.

HISTORY

The current law says if you're getting a Social Security check, you're getting Medicare part A.

The Clinton Administration in 1993 said that the only way to avoid health insurance would be to withdraw from the monthly benefit application. No person could elect to withdraw only to Social Security claim  This change in Social Security regulation to those over 65, gave everyone a choice to enroll in Medicare, or wave their Social Security retirement benefits. If you apply for Social Security at 62, and received Social Security payments, you would have to pay all this money back if you opt out of the Medicare health insurance program.

The SSA also added two substantive rules in 1993 to it's POMS (program operations manual), covering those people who asked to waive hospital insurance because of religious or philosophical reasons, or preferred other health insurance.

 These rules were as follows:

 Individuals entitled to monthly benefits which makes them eligible for health insurance, may not waive health insurance entitlement.  The only way to avoid HIA entitlement is by withdrawing your monthly benefit application. This then required repayment of all retirement, survivors, and disability insurance, and all health insurance benefits payments. If you withdrew from the health insurance program, you must submit a written request for withdrawal and must refund any benefits paid on your behalf.

The Bush administration, in May of 2000, added to the social security POMS (program operations manual), that a claimant can withdraw an application for retirement or survivors insurance Social Security, cash benefits.  However, if you are entitled to monthly Social Security benefits, you cannot withdraw only from Medicare part coverage, because entitlement to Medicare part A. is based on entitlement to monthly Social Security benefits.

MEANING TO SENIORS

Government bureaucracy prevents you seniors from paying your own doctor with out-of-pocket money. It also forces you seniors to enroll in Medicare if you want to get Social Security and other government benefits.  Even if you have money, and want to get out of Medicare and a government program, you currently are stuck.

Recently a bill was sent to Congress, called the Medicare Beneficiary Freedom to Choose Act, HR 3356. This act would put you in control of their health decisions by allowing you to choose your own doctors in Medicare. We'll see where this Bill will go.

COMMENTARY

With a new health reform bill being planned, it would be nice if you seniors could have the freedom to make your own personal health decisions.  For the last 16 years, you thought that the only choice you had was between substandard medical care and getting Social Security retirement funds.   Now all that may change with the Hall versus Sibelius decision.

A fiscally unsustainable and unaccountable plan, with price controls regulate health policies that can harm your care, makes most of us want to get out of Medicare or other proposed government controlled healthcare programs.

Price controls prohibit you from using your own money to pay for any extra services or get better service that you may want from a doctor. You can't maintain a confidential doctor patient relationship and can’t offer a doctor any out-of-pocket money to achieve a better treatment program.

If you're smart enough to ask what the best treatment is for your particular ailment, you'll find that your umbrella policy will not cover your better alternative treatment since Medicare will pay for a less effective treatment. Lawyers in congress, who, unlike your doctor, know nothing about your specific medical situation, will tailor all the services and treatments you need.

The White House is attempting to convince you that by seizing control of your health care, they will better manage your medical costs.   All indications show otherwise.

If you want better care, which you can afford, Medicare, will not allow you to offer your doctors any additional money. If you would pay the doctor more, you might get you better care. Currently if he accepts any money, he could go to jail.

Under these health reform plans, everyone has to be treated the same. If you need an operation you might be told: “We'll get to you in six months”.

You the reader must evaluate the valid points raised here, and realize that the health reform package has everything to do with power and political control, and absolutely nothing to do with controlling medical costs.

Soon your healthcare options will be stripped away, unless of course, you are a member of Congress that is currently writing this reform bill.    CONGRESS will not accept  for themselves, the plan tailored for you.

Don't expect the government to settle this Hall v. Sebelius lawsuit before new health-care reform is law.

What do you think? Your comments are always appreciated.

Visit www.drneedles.com for more informative discussion of controversial medical subjects.

CANCER FIGHTING VEGETABLE

Asparagus has been found to be the perfect antioxidant vegetable, a perfect vitamin, and a strong cancer fighting vegetable. Asparagus is rich in glutathione and HISTONES, which stimulate the immune system is stimulated and heal many medical conditions as ulcers and cancers.

As a medical physician for over 51 years, I strive to give you the best medical information on controversial medical subjects, and help your read betwwen the lines. You must come to your own conclusions. I have no ties to any organization, pharmaceutical, or lobby group. As an practicing medical acupuncturist since 1982, I find western medicine and medical acupuncture are very complimentary. This results in astounding healing in pain management, addictions to cigarettes and food, and a host of other maladies. Visit drneedles is blogging" at the end of each blog for a complete alphabetical list of all my blogs
Visit http://www.americanacupuncture.com/ for more detailed information on mind, body, and spirit healing.


CANCER FIGHTING VEGETABLE

Asparagus has been found to be the perfect antioxidant vegetable, a perfect vitamin, and a strong cancer fighting vegetable. Asparagus is rich in glutathione and HISTONES, which stimulate the immune system is stimulated and heal many medical conditions as ulcers and cancers.

 It is a member of the lily family, which includes onions, leeks, and garlic. It is a hardy perennial. It grows while the long road size over a large part of our country.

ALLYL-ISOTHIOCYANATE (AITC)

Asparagus also contains Isglucosinolate, a substance that metabolizes to a cancer preventive substance known as othiocyanate.  

When food is chopped, or cooked, it may have a bitter flavor because of the release of this chemical, which stops the uncontrolled division of cancer cells.

AITC seems to prevent cancer cells from becoming immortal. This is the property that makes them different from healthy cells to commit suicide instead of constantly dividing.

CANCER FIGHTING HISTONES

Asparagus has a high content of a protein called histone. Histones are very strong alkaline proteins found in every human cell nucleus. There are about 300 million histone molecules in the body.  Histones package and make the DNA structurally into nucleosomes. They enclose the entire DNA content of a cell into the chromosomes of the nucleus.  Acting as spools around which DNA winds, they play a role in regulating genes. Active genes have less bound histone than inactive genes.

Histones regulate whether the genes in DNA are turned on or off. The DNA in chromosomes is wound around the histone proteins.  Without histones, the unknown DNA in each human cell would be 1.8 m long. But since DNA wraps around his stones there is only 90 mm of chromatin. Wound DNA is 15,000 times shorter than unwound ones.

The histones bind the entry and exit sites of the DNA and locked the DNA into place. When histones are assembled with DNA in the cell nuclei, they are called chromatin.

The nucleus of cells contains chromosomes, which are made up of protein and DNA. Each protein in the nucleus has multiple varieties of histones. Essentially,  histones in chromosomes, are basic amino acids with various sequences, depending on the organism.

Histones help the DNA repair, allow chromosomes to undergo mitosis, and regulate genes. They play an important role in forming telomeres, the natural end of a chromosome. If you lack histones, you will have cellular death.

EFFECTS OF COOKING

Cooking destroys the antioxidant effects of asparagus.

Chemicals in cruciferous vegetables, as asparagus, cabbage, cauliflower, broccoli, and Brussels sprouts decreased the risk of many types of cancer. They work in a similar way as some cancer drugs.

Steaming the asparagus keeps about 89% of its original antioxidant content. Boiling and microwaving kills nearly all the antioxidants present.

THE PERFECT VITAMIN

Asparagus contains all the ingredients of the most potent vitamin. A 10-ounce box of frozen asparagus spears as only 68 calories and 9 g of protein. It contains the minerals selenium, zinc, calcium, copper, and manganese.   Asparagus has highly alkaline salts and trace elements of silicon and molybdenum, all essential for the health of major organs.

It is also an excellent source of potassium, vitamin C, pectin, vitamin K, aspartic acid, and folate.  Asparagine, which is essential for prostate gland health, also lowers the risk of colon and cervical cancer. Having vitamin B6, asparagus is one of the top five diuretics ,along with watermelon, cantaloupe, leek, and artichokes.

COMMENTARY

Eat a little asparagus daily, and keep your body repair system functioning well.  Cancers and aging have been stopped with this 2500-year-old Greek vegetable.  It certainly has no negative side effects and may rejuvenate and heal your aging body.

Your comments are always appreciated.

Visit www.drneedles.com for more medical comments on controversial medical subjects.

SENATE BILL PACKED WITH PAYOFFS

 The Senate reform bill passed quickly with the help of late payoffs to several senators in a trade off to get the votes for senate passage of health reform bill.  It also provides payoffs for many other beaurocratic groups.

As a medical physician for over 51 years, I strive to give you the best medical information on controversial medical subjects, and help your read betwwen the lines. You must come to your own conclusions. I have no ties to any organization, pharmaceutical, or lobby group. As an practicing medical acupuncturist since 1982, I find western medicine and medical acupuncture are very complimentary. This results in astounding healing in pain management, addictions to cigarettes and food, and a host of other maladies. Visit drneedles is blogging" at the end of each blog for a complete alphabetical list of all my blogs

Visit http://www.americanacupuncture.com/ for more detailed information on mind, body, and spirit healing.

SENATE BILL PACKED WITH PAYOFFS

The Senate reform bill passed quickly with the help of late payoffs to several senators in a trade off to get the votes for senate passage of health reform bill.  It also provides payoffs for many other beaurocratic groups.

FIVE SENATORS ARE BIG WINNERS

Ending weeks of uncertainty, Democratic Nebraska Sen. Nelson was able to have scratched out a provision that would repeal the insurance industries antitrust exemption. He said he wasn't negotiating this issue but the Democratic leaders chose not to put it in.

Louisiana Sen. Landrieu, got a provision to give her state a bonus of $250 million in Medicaid funds. Louisiana was the only state given this money. This resulted in her support for the health reform plan.  Other senators will twist Obama’s arm for perks to their states, in exchange for their votes.

Sen. Blanche Lincoln. of Arkansas, was assured that her state would get extra government subsidies to help Arkansas's low and middle income families by coverage

Sen. Wyden, of Oregon, finally is supporting the measure because there will be $4 billion amendment designed to give workers greater flexibility to purchase health insurance outside the plan. He said this was his price for supporting the bill.

Sen. Reid, of Nevada, now can improve his precarious chances of being reelected next year.

OTHER WINNERS

LABOR UNIONS had taxes lowered for workers in dangerous fields as firefighters, coal miners, and all union members of the Communication Workers of America Union. Most unions already have generous benefits that will not be relinquished.

A CENTER FOR MEDICARE AND MEDICAID INNOVATION—a new part of the Health and Human Services Department—will receive  $1 billion annually to test payment reforms. The HHS secretary can implement nationwide any reforms that will reduce long-term spending, --all this without congressional action.

ILLEGAL IMMIGRANTS--will continue to go to emergency rooms, cannot be declined, will not have to enroll and pay into any plan, and will continue to get free services. They also have the right to sue in US courts, if their services are skimpy and inappropriate.

PEOPLE LIVING UNHEALTHY LIVES-- We can continue to smoke, over eat, and over drink, and under exercise, --with no need or incentives to encourage healthier lives to curb preventable diseases as high blood pressure, heart disease, and diabetes.

THE POOR--they will have no incentives to avoid emergency rooms, and will continue to overuse the emergency rooms for their everyday health problems. Despite being enrolled in a public option, they will not have to pay a premium for individual services. You the middle-class taxpayer will subsidize their costs.

MEDICARE ADVISORY BOARD—a new beaurocratic board to offer cost-saving proposals when Medicare spending rises too fast.

MANAGED CARE—new departments will manage patient care by allowing them to share in any savings they produce by reducing medical wasteful costs to seniors.

HOME CARE, a pilot program to coordinate home-based care for chronically ill seniors, rather than have them enters a hospital.

HEALTH ADMINISTRATIVE SERVICES--the budget will be increased to hire staff and expand the government bureaucratic empire. They will expand their power, influence, and capabilities to control health-care reform.

NURSE PRACTITIONERS--will replace general practitioners doing many of the routine work of routine examination, and giving advice you’re your doctors does now.

FOREIGN MEDICAL RESIDENTS--foreign graduates will fill the general practitioner residency slots that will be vacant due to lower primary care incomes.

MEDICAID--higher volume of Medicaid services will tax services of states,doctors, and medical care.

A NEW INDEPENDENT MEDICARE COMMISSION--it will continuously develop and implement new efforts to improve quality and contain costs.

DISABILITY BENEFITS-- a long-term care program is added to the bill, which will pay cash to people when they become disabled.

ABORTION ADVOCATES-- Pro-choice people are given the abortion amendment back on the Senate bill.   Planned Parenthood would be provided added financial income, since 65% of its clients are women who now do not have health insurance,

PUBLIC OPTION LIBERALS-- got their bill back into the reform package plan.   Private insurance will be eliminated.

TRIAL LAWYERS stay protected from tort reform and a continued to present frivolous suits in their malpractice claims

 HOSPITALS get 10-year exemption is from cost-cutting measures. They can continue to compete with other hospitals for the same services, get new technologies and expensive equipment even if they don't need them, as fancy birthing suites despite low birth censuses.

AARP gets many more Medicare gap insurance contracts.

DOCTORS blocked a 20% scheduled pay cut from their Medicare payments.

DRUG COMPANIES get patents extended to 12 years on biological drugs and vaccines.

YOUR CONGRESS keeps their federal insurance program and perks along with federal employees and stay exempt from reform programs that all of us must learn to enjoy.

LOSERS

SENIORS will have Medicare services cut by 50%, (called waste cutting measures). Medicare Advantage gap insurance rates will skyrocket.

EMPLOYEES Last-minute additions proposed to raise the Medicare payroll tax resulting and $54 billion being raised.

COSMETIC SURGERY Raise $6 billion over 10 years with a 5% tax on elective cosmetic surgery.

EMPLOYERS must pay for employee insurance programs.

COMMENTARY

Our health care system certainly has problems with cost, access, and quality, and needs major reform.  Speeches and news reports lead you to believe that this legislation will tackle these problems.  But that's not true.

The overall effort will fail to qualify as reform. The various bills expand Medicaid and mandate subsidized insurance at substantial costs. There are no provisions to  control the growth of costs or raise the quality of care.

Whatever the shape of the final legislation, healthcare leaders and economists, unanimously agree, that this bill will accelerate, rather than restrain, national healthcare spending. The quality and dysfunctional delivery of our health care system will become even worse.

Services may be covered, but it will become impossible to find a doctor to provide the medical care.  Doctors and other health care providers will be given limited dollars per patient to fight over, for all of their medical care (called bundling).

Doctors  will refuse to see the 31 million newly insured, the poor, and the Medicaid recipients. Since doctors will be judged by outcome, they will not treat a patient with a potentially poor result.  By providing medical care to the low risk patient, they will be rewarded. By treating a high-risk patient, your doctor’s malpractice risk will rise and his batting average ranking with the government will drop along with his income.

If the current legislation becomes law, our country will face great explosive challenges and you the patient will find it more difficult to receive the quality of medical care you desire and need.

Nothing will change a 2000 page bad bill and make it a good bill.  President Obama will sign any health bill, claim victory, and you will get a Christmas present you can’t return.

Visit www.drneedles.com for more discussion of controversial medical subjects.

ANALYZING THE CONGRESSIONAL THINKING MACHINE

ANALYZING THE CONGRESSIONAL THINKING MACHINE

What happens when you let lawyers’ reform health care?  We all know that the staff for each congressman must make sure that their boss remains electable. Since elections are very expensive, the congressman cannot offend a big contributor or deeply upset you the voting public.With  the   Senate hosting its 2074 page healthcare bill on the web, public scrutiny has begun.

As a medical physician for over 51 years, I strive to give you the best medical information on controversial medical subjects, and help your read betwwen the lines. You must come to your own conclusions. I have no ties to any organization, pharmaceutical, or lobby group. As an practicing medical acupuncturist since 1982, I find western medicine and medical acupuncture are very complimentary. This results in astounding healing in pain management, addictions to cigarettes and food, and a host of other maladies. Visit drneedles is blogging" at the end of each blog for a complete alphabetical list of all my blogs

Visit http://www.americanacupuncture.com/ for more detailed information on mind, body, and spirit healing.

 
ANALYZING THE CONGRESSIONAL THINKING MACHINE

What happens when you let lawyers’ reform health care?  We all know that the staff for each congressman must make sure that their boss remains electable. Since elections are very expensive, the congressman cannot offend a big contributor or deeply upset you the voting public.  With  the   Senate hosting its 2074 page healthcare bill on the web, public scrutiny has begun.

It would be nice if we knew all the purposes and allegiances congressmen have.  Big business likes stability and predictability. Unpredictable financial solutions can hurt everyone.

Our legislators write our laws and levy taxes upon us. They have more effect on your life than our president or your governor. They are really accountable for their voting actions. Laws they pass benefit their sponsors, at our expense. We certainly have “the best government that money can buy”.

The healthcare bill proponents are companies, organizations, and individuals, who will benefit from the current healthcare reform. Their benefits will not take place for several years and they can get reelected in 2010 and 2012 before we notice.

The media act as cheerleaders for one side or the other, and will not tell us what our politicians are doing or which groups they are cuddling up to.

REPUBLICAN PLANS

Republicans plan to place a raft of amendments, showing their policy positions on a full range of issues, including issues that are not in the bill. All will fail.

The Democrats have been working for weeks on the bill in secret and are now pushing for an initial procedural votes within a couple days. Republicans want the courtesy to study the legislation, and deliberate how they should proceed. They feel that Congress must take the time to get this right.

AMA AND DOCTOR POLITICAL PAYOFFS

As a political payoff to the AMA, the Democrats have retained organized medicine as a supporter of Democratic health care reform legislation.

With arm twisting by the AMA and 127 national and state medical societies, the Democrats voted today to rewrite the controversial sustainable growth rate formula into Medicare, known as SGR, and eliminate a Medicare doctor pay cut of 21% from proposed cuts for next year.

Without this passage, the health industry said, they would not be able to back other reform initiatives. This bill, HR 3961, adds another $210 billion to the federal deficit according to the CBO. (This fix was put in a separate bill to avoid this additional deficit from showing in the reform bill.)   Thanks to this provision, the cost of the legislation now is over $1 trillion and adds another  $239 billion to the deficit.

The House Republicans had failed to introduce a substitute SGR bill that would have given physicians a 2% raise from 2010 through 2013.  They did not want to add to the federal deficit since it contained cost-saving reforms in the area of medical liability that would offset its price tag.

PUBLIC OPTION BACK IN BILL

The Senate bill includes a controversial public option, a government sponsored health plan that would compete with private plans.  Individual states could choose whether to make the government-sponsored plan available to their residents. The bill also calls for member owned co-op health plans.  If you don't obtain coverage will pay a penalty, but the government will subsidize low-income individuals and families.

If you own a business with more than 50 employees and do not offer coverage you must pay a penalty if the employees get government-subsidized coverage.  Small businesses would get tax credits toward their insurance premiums.
 
Many critics feel a government health plan would force private insurers out of business, leading to a federal takeover of healthcare.  Supporters of the public option feel that a government plan will make private insurers more competitive.

INSURANCE COVERAGE

Most Americans will be required to have insurance coverage, either through an employer, a government plan, or an individual policy--which could be purchased, by insurance marketplaces called exchanges.

With this new bill, employers will be charged $2500 per employee. There will be an excise tax on high premium insurance plans, and a 5% tax on elective cosmetic surgery. Spending cuts from Medicare of $491 billion are projected.

Once you transfer to the government option, you no longer have the ability to switch back to private insurance. The government does not have to show a profit unlike private companies.

ABORTION BACK IN THE SENATE BILL

Democratic leaders have alienated again abortion opponents with their new version of abortion health reform.  Although the bill says public option could not provide insurance for abortions, it allows the Sec. of Health and Human Services to determine that a payment plan for abortions that would not use federal money.

The bill contains an ambiguous provision that could bar any government run insurance plan or public option from providing abortion coverage. Page 118 of the bill authorizes the health secretary to require coverage of any and all abortions throughout the public option program. The Senate bill creates new tax supported subsidies to purchase private health plans that will cover abortion on demand.

No matter how hard they try to disguise abortion funding, it will still be federal government funding of abortion.  The abortion issue will come in the House-Senate conference where a final bill will be proposed.

NO ONE DENIED COVERAGE

Private insurers cannot deny coverage to individuals with pre-existing conditions for non-elderly legal residents, and must provide coverage for 94% of them. About 31 million people will be added to the bill.

Voters agree that a person who has cancer should get the medical care they need to save their life without being bankrupt or put into lifelong debt. To cover these people with pre-existing conditions, we have tragically layered that requirement onto insurance company saying that was part of a coherent scheme of pooling risk.

SENIORS MEDICARE ADVANTAGE CUTS

Medicare advantage will be drastically cut. The seniors love the Medicare advantage program because this private plan offers them many perks.

There is low copayment, comprehensive prescription drug, and coverage, even gym memberships. The downside is that many of these services are limited to certain doctors and hospitals.

The elderly can either participate in traditional Medicare administered by the government, or in Medicare advantage. The latter was subsidized as managed care plans administered by private insurance companies.

In 2003,  Congress wanted to make sure seniors and rural areas had access to a range of managed care plans.  So it agreed to pay health insurers more per person than it would cost if they were in a traditional Medicare plan. Today that gap is about 12%.

Higher premium subsidies have been a target for budget savings and cuts. The White House insists they are not cuts to Medicare and health care reform packages but others see it differently.

If the subsidy to Medicare advantage decreases, the plan will likely pass their increased costs to the people, resulting in higher premiums.  The house bill cuts $172 billion from the medical advantage plan and insurers will be paid the same amount now paid for traditional Medicare. As subsidies decrease, seniors living in rural areas, will have fewer Medicare advantage plans to choose from.

MANAGED CARE

The Senate bill blocks managed care plans from charging people more than traditional Medicare for services such as chemotherapy, renal dialysis, and skilled nursing care. Plans that offer superior quality of care and care coordination would be given bonuses. To obtain these bonuses, high quality plans would have to list high quality and improved quality plans.

Both Senate and House plans provide free preventive services. Both houses provide for reducing fraud and waste, which drives up Medicare costs.

HMOs generally require approval from a gatekeeper doctor's for many services. PPOs encourage patients to use providers in the network by imposing higher cost sharing for outside services.

COMMENTARY

After nine months of town hall meetings, numerous hearings, and CBO reports, the average Congressman has no idea what's within the thousands of pages of the health reform bill. They blindly will vote for it for political reasons.

As the Senate plan allows a public option, the government will subsidize it, and put the private insurance industry out of business.   As one gets older, Medicare will continue to be under-funded. And one would have to justify the cost of maintaining their medical care or be euthanized. Nurses and doctors will be forced into labor unions.

The Medicare part D. prescription drug bill denied the government the power to negotiate for the best drug prices. The drug industry, whose lobbyists wrote the bill, created huge budget problems and this new benefit was not funded. The prescription drug bill was a gift to the drug industry.  This bill will be a repeat performance with the AARP the big underwriters.

The Republicans have been constantly locked out from any input on this reform bill. President Obama promised bipartisanship during his campaign. Texas lowered their health costs by 20%, just by passing tort reform. Tort reform has been totally left out of the bill because the trial lawyers financially support the Democratic Party.

This health reform bill ensures health care costs will be 21% of the economy and costs will continue to go up. Obama said the current health-care of 16% was way too high. Yet Obama will declare it a victory. As this bill becomes law, we will realize that we will be worse off than we are now.

It would be nice to approach this reform and a slower more incremental manner. By prioritizing and fixing each problem one at a time, we would insure we don't take on more than we can effectively handle.

The relatively expensive Democratic health-care bill does not fix the fundamental problems with the current system. Why the rush to push this bill through so quickly dumbfounds me.

Visit www.drneedles.com for more discussion of pertient controversial subjects.  Your comments are always appreciated.

BREAST EXAM GUIDELINES CONFUSING

There's only so much a woman can do to protect herself against breast cancer. Science and medicine must figure out why some cancerous lesions kill women, and some don't. The panel never gave a list of other things women can do. It seems that HHS Secretary Sabelius,  is backing off from the new guidelines issued by her Task force on mammography.

As a medical physician for over 51 years, I strive to give you the best medical information on controversial medical subjects, and help your read betwwen the lines. You must come to your own conclusions. I have no ties to any organization, pharmaceutical, or lobby group. As an practicing medical acupuncturist since 1982, I find western medicine and medical acupuncture are very complimentary. This results in astounding healing in pain management, addictions to cigarettes and food, and a host of other maladies. Visit drneedles is blogging" at the end of each blog for a complete alphabetical list of all my blogs

Visit http://www.americanacupuncture.com/ for more detailed information on mind, body, and spirit healing.

 BREAST EXAM GUIDELINES CONFUSING


It seems that HHS Secretary Sabelius,  is backing off from the new guidelines issued by her Task force on mammography. Since these guidelines are complicating the healthcare debate the White House is also swiftly reacting.

Women were told: once you get to 40 your breasts will be more dangerous. Since the risk of mammograms is minimal, and the advantages far outweigh the advantages of early screening, you should get annual mammograms

Radiologists were looking at soft tissue images that might be cancers or suspicious lesions that could turn to cancer. Women with dense breasts, which include most young women, often needed a biopsy to see if the lesion is cancerous.  If the biopsy reveals cancer, this treatment would save a woman's life.

THE BOSS DOES NOT SUPPORT HER PANEL

One wonders why the government won't embrace the recommendations from the task force, which was appointed by the health secretary's department.  The administration fears the issue will be used to undermine support for the overall health care reform package in the same way that death panels deciding whether lifesaving care would be given was an issue against the summer.   They no longer want a return of the death panels.

HHS secretary admitted the guidelines caused a great deal of confusion and worry among women. Since mammograms have been a lifesaving tool against breast cancer, the secretary recommends you do what you've always been done, talk to your doctor ask questions, and make this decision that's right for you.

 Since this outside independent panel of doctors and scientists, which are under her direction, don't set federal policy and don't determine what services will be covered by the federal government.  She said her task force does not make policy decisions, or insurance coverage decisions.

Her statements challenged the recommendation of the very influential panel on preventative services task force. It is made of independent experts to address one of the most explosive issues in human health.

PANEL OPPOSITION

We can't over emphasize the actual lives saved when a young patient has cancer. Cancer in a young woman travels fast, and early detection is even more critical if they are under 50 years of age.  They also have younger children that are dependent on them.

These guidelines conflict with many recommendations from leading cancer organization.  It seems the mammogram debate has become a political football.

The recommendations reviewed older data and did not take into account new digital mammography, which picks up more cancers and dense breast tissue of younger women and probably saves more lives.

The panel may have had good intentions but they sure did a poor job of explaining their decision and did not present new data or alternative screening methods.

The panel looks at survival rates and harm and gives a lot away to pain and anxiety and survival as the only primary measure of any benefits. People, who had biopsies that turned out to be benign, are certainly glad they got screened and checked.

The basis for changing the recommended mammograms schedule has not been addressed. The question is: Are mammograms really necessary? Most women and many doctors are not simply ready to make such a drastic change.  It's hard to suggest that women should stop examining their breasts and for doctors to screen them. Why are we changing a practice that seems to work?

Women are saying the administration is now NO LONGER backing science decisions and just using politics.  This looks like a precursor to reduced insurance coverage.

SEEKING THE PERFECT FORMULA

Women find mammograms uncomfortable, and biopsies feared.   But most of them want it.
They are eager to act in what they believe the best interests of their health. The long accepted medical wisdom that women should get mammograms from the age of 40, are now told to put off the age of 50, and then every two years would be enough. There is no scientific information explaining this dramatic turnaround.

There seems to be a guessing game with women's health. I know most women can live with a little anxiety and distress, but can they live with a little cancer? We might be actually undoing a lot of good that's been done in the past few decades.

There is no one formula for every woman. Some have been over screened. This is an example of how difficult it will be to be to achieve successful health care reform in the United States.

Americans want every test and procedure possible, even if there is not much scientific evidence supporting it. Somewhere the thousands of procedures done every day uselessly must be stopped. 

COMMENTS

These guidelines will deprive patients of needed care and show the dangers of an increase government role in health care. This is how rationing is begun. You get a bureaucrat between you and your doctor.

Perhaps in the future new genetic markers might help understand which precancerous lumps are likely to turn into a fast-moving cancer. Today no tests like this exists.

Despite the White House reassuring women, these recommendations will have no immediate effect, the National Cancer Institute said it would include these guidelines and information to doctors and their patients.
 
How many lives will we save and are we making a decision whether it's worth saving the lives. The recommendations did not give anything to replace the advantage over mammograms.
We are all paying attention to how we can decrease the cost of health care.  And this decision seems to be economically motivated.

Our ability to detect precancerous cells has called paste our ability to understand how these cells work. Sometimes you treat with cancer preventing medications you're women then live with the knowledge there may be a time bomb living inside their bodies, even if the odds are slim.

There's only so much a woman can do to protect herself against breast cancer. Science and medicine must figure out why some cancerous lesions kill women, and some don't. The panel never gave a list of other things women can do.

With a public option, a near reality in health reform, one wonders what a politically dynamic panel might tell us about what is effective treatment. The politicians might modify their opinions on the basis of who hires the most expensive lobbyists.

Watch out folks, and get ready to pay for your necessary screening tests from your out-of-pocket costs, with what is left after you are taxed to death.

RELATED POSTS:

MAMMOGRAMS ARE USELESS

QUIT CHECKING YOUR BREASTS HONEY

VISIT www.drneedles.com for more discussion of more pertinent controversial medical issues.

QUIT CHECKING YOUR BREASTS HONEY

Why did that  government panel turn a thumbs down to teaching women breast self-examination—a low-tech, simple way to check for breast cancer?

As a medical physician for over 51 years, I strive to give you the best medical information on controversial medical subjects, and help your read betwwen the lines. You must come to your own conclusions. I have no ties to any organization, pharmaceutical, or lobby group. As an practicing medical acupuncturist since 1982, I find western medicine and medical acupuncture are very complimentary. This results in astounding healing in pain management, addictions to cigarettes and food, and a host of other maladies. Visit drneedles is blogging" at the end of each blog for a complete alphabetical list of all my blogs.

MAMMOGRAMS NOW CONSIDERED USELESS

A US task force has issued controversial and confusing guidelines on mammography that curtail your coverage and reimbursement for mammogram screening if they fall outside of the agency’s specific guidelines. The beginning of managed care has arrived, and you the reader must prepare yourself for being denied medical testing and treatments that you have enjoyed in the past. National healthcare is expensive, and it must be rationed.

As a medical physician for over 51 years, I strive to give you the best medical information on controversial medical subjects, and help your read betwwen the lines. You must come to your own conclusions. I have no ties to any organization, pharmaceutical, or lobby group. As an practicing medical acupuncturist since 1982, I find western medicine and medical acupuncture are very complimentary. This results in astounding healing in pain management, addictions to cigarettes and food, and a host of other maladies. Visit drneedles is blogging" at the end of each blog for a complete alphabetical list of all my blogs
Visit http://www.americanacupuncture.com/ for more detailed information on mind, body, and spirit healing.

MAMMOGRAMS NOW CONSIDERED USELESS

A US task force has issued controversial and confusing guidelines on mammography that curtail your coverage and reimbursement for mammogram screening if they fall outside of the agency’s specific guidelines.

The guidelines differ with a ton of scientific data on screening that shows mammography has significant benefit for women between 40 and 49 to be screened.

Despite the American Cancer Society, the American Medical Association, and the National Comprehensive Cancer Network, all who have recommended annual mammograms for women starting at age 40, managed-care restrictions seem to have begun.

The task force gets its funds from the Federal Healthcare Research and Quality Agency. They say, there might be a benefit of screening, however the benefit is small. You are now being told to talk with your doctor and decide with him whether you should put off screening for a few years. Since insurance won't pay for it, you will probably abide by these guidelines.

SELF EXAMINATION NOW OF NO VALUE

Regarding breast self-examination, the guidelines state that in China and Russia over 100,000 women in each country did self breast examinations and it showed no benefits. On this basis, they recommend American women forget doing breast self-examinations. Hence, if you find a lump in your breast, it need not be verified, since your discovery is negated by the federal guidelines. I guess the federal government no longer feels women can find lumps in their own breasts, since the Chinese and Russian women could not.

The guidelines do not take into account the fact that saving the life of a younger woman leads to more life years saved than it does for older women.

The bottom line is that you and your doctor have a right to make a decision about breast cancer screening, but if you don't have financial coverage, you lose that right.

NEW MAMMOGRAPHY GUIDELINES

The federal government task force new guidelines say: routine mammograms are not necessary for anyone younger than 50 years of age. If you are between 50 and 74 you don't need to have a mammogram more often than every two years. If you are over 74, don’t even think about getting a screening mammogram.

The task force also recommends that doctors quit teaching women how to examine their breasts for signs of cancer, because it has no affect.

These guidelines apply to all women who have no family risk of breast cancer and don't have generic genetic mutations associated with breast cancer, such as BRCA genes.

NOT COST EFFECTIVE

The guidelines weigh the benefits of screening compared with the harms of false positive and unnecessary additional tests and biopsies that of course are expensive and time-consuming.

Mammography has reduced cancer deaths by about 15% in women between the ages of 39 to 59. Since there are fewer cases of cancer in younger women under 40, the Federal task force feels it is not cost-effective for routine mammography.

By discontinuing routine mammography, the government will save over $3.3 billion annually. These guidelines will influence public and private insurers coverage decisions. You will probably see that your coverage will be denied for these tests. It is the beginning of managed national healthcare.

COMMENTARY

As a retired gynecologist, I found many patients came to me because they themselves found a lump in their breasts. Mammograms often revealed the reasons for the lump.

Recent Federal sponsored studies have shown that laparoscopy is of no value, that spine surgery or back pain is useless, that coronary bypass surgery and stent surgery is of no value if there is no cardiac pain, and now mammograms are also of no value.

There seems to be a trend to disclaim solid scientific data on many medical treatments. The beginning of managed care has arrived, and you the reader must prepare yourself for being denied medical testing and treatments that you have enjoyed in the past. National healthcare is expensive, and it must be rationed.

The numerous benefits of good medical care you have received over the years are being compromised because they are not cost effective. The beginning of national healthcare is upon us.

What do you think?

Visit www.drneedles.com for more medical information on controversial and pertinent medical topics.

Sources:
US Preventative Services Task Force guidelines
Annals of internal medicine November 2009
National Comprehensive Cancer Network
American Cancer Society
American Medical Association
Federal Healthcare Research and Quality Agency (provided funding for guidelines)