President Clinton speaks at #HIMSS13 today

Today, President Clinton delivered a keynote and the entire auditorium was completely packed and all the overflow areas were full as well. When you have 35,000 people in the New Orleans convention center, that's what you get: a very crowded room that overflows.

He spoke about a number of public health topics ranging from worldwide healthcare disparities, the pediatric obesity epidemic, and the need to provide patients with their own health data so that they can be empowered to manage their own health. He also emphasized the importance to understand people who are different from us. Very different from us. For example, do you know anyone who doesn't have health insurance? How about people in a different socioeconomic status? A different ethnicity? How well do you know and understand these people? How well do you understand how they are navigating the health care system in this country?

I admit that the health care system is a very confusing system for anyone to navigate. We are all consumers of the system and even health care professionals get confused with the processes, the paperwork, the billing, the insurance forms, and more.

Today, HIMSS announced the New Clinton Global Initiative Commitment to Action - an extension of the Clinton Global Initiative that HIMSS joined in September 2012 to advance its work on its Healthcare Transformation Project. The Healthcare Transformation brings senior healthcare provider leaders together, with year-round events, research and networking, as they decide and act upon their own commitments to action.

#HIMSS webinar on how the election will impact health IT

Here's information on a free HIMSS webinar on how the recent election will impact health IT on the federal, state, and local levels. This webinar is on Nov 14 at 12 pm ET (11 am CT) and you can find more information about it here.

EVENT AGENDA

• An Analysis of State Legislative Election Results
• An Inside the Beltway Perspective on the Presidential and Congressional Election Results
• The Impact to Health IT: The Way Forward

The AMA wants this YouTube video to go viral. Will you help?

The American Medical Association (AMA) wants to communicate to Congress that now is the time to repeal Medicare's flawed SGR (Sustainable Growth Rate) formula. They're hoping to get this YouTube video to go viral. Will you help?



This video is sponsored by the following organizations:

American Medical Association
American Academy of Dermatology Association
American Academy of Family Physicians
American Academy of Ophthalmology
American College of Cardiology
American College of Physicians
American College of Surgeons
American Osteopathic Association
American Psychiatric Association
American Society of Cataract and Refractive Surgery
Medical Group Management Association

US Presidents and their health ailments displayed at the Mütter Museum

Happy President's Day!

The Mütter Museum is a fascinating medical museum in Philadelphia, PA. If you've never had a chance to visit this museum, you'll definitely have to visit. You can learn about some of the medical problems faced by former US presidents (I doubt they'll have anything about Barak Obama). Did you know that John F. Kennedy had Addison's disease? How about Bill Clinton and his cardiovascular disease? Dwight Eisenhower, the 34th President of the United States, had Crohn's disease.

According to RoadsideAmerica.com:

Two celebrity body parts are must sees: the "Secret Tumor of Grover Cleveland," and the "Thorax of John Wilkes Booth." Grover's growth floats in a small jar, surreptitiously removed from his jaw while he was in office. Lincoln's Assassin's thorax was procured during the post mortem aboard a ship at the Washington Navy Yard. It ended up here.

If you enjoy US history and you wish to learn more about some of the specific medical problems that afflicted US presidents, then make sure to visit the Mütter Museum.

Are you waiting for the public option?

If you currently lack health insurance, are you waiting for the public option? What recently happened in Massachusetts has stirred a huge discussion about health care reform in this country.  As CNN is putting it: "Democrats scramble on health care after GOP win"

What's to happen to the public option?

All these recent discussions surrounding the health care reform bill(s) have been very emotionally charged. As President Obama states, "People are angry and frustrated." I'm sure many politicians are angry and frustrated as well. Perhaps our country needs more time to develop a better health care reform strategy. Perhaps we were rushing through all these changes.

If you're currently uninsured, I hope you will find a way to obtain the medical care you need. Let's hope that this country will find a solution that solves our current health care crisis.

Historic health care reform in the USA

We all know that the Senate passed a historic health care reform bill. It's hard for me to imagine $871 billion. According to CNN:

The bill passed in a 60-39 party line vote after months of heated partisan debate. Every member of the Democratic caucus backed the measure; every Republican opposed it.

Will it become law? Probably. Will it raise taxes? Yes. Will it reduce health care costs? No one really knows the answer, but there are many people who don't seem to think so. What do I personally think? I think that it depends on too many unpredictable factors at this point. We know that everyone needs health care, but we don't know how doctors are going to respond to this type of reform. If doctors choose not to accept certain types of health insurance policies, then we'll be stuck in a worse situation than ever before.

It's hard to believe that Medicare and Medicaid was enacted over 40 years ago. Now, we're about to see Medicaid get a massive expansion, but what good will that do if more physicians choose to drop Medicaid coverage? There are so many unanswered questions for practicing physicians in the United States. My personal prediction is that many more physicians will choose to drop Medicare/Medicaid and they will rely more on cash-based practice models. A large number will simply leave clinical practice to pursue other careers. 

The endless health care debate

As 2009 comes to and end, I often wonder what types of health care changes we will see in 2010. Will the health care debate continue? Will we see the beginnings of some type of universal health care coverage in the United States (AKA, public option)?

Will doctors embrace health IT and switch from paper records to electronic health records (EHRs) in 2010? Or will most wait until 2011 and try to delay that transition? (If they delay, they'll simply miss out on the benefits, so why delay?)

I personally think we'll see some significant changes occur in 2010. More physicians will probably decide to drop Medicare and Medicaid patients. More physicians will transition to cash-only practices. More physicians will look for non-clinical careers (see http://www.nonclinicaljobs.com/). And, more physicians will simply retire.

So, as more people get access to health care resources, there will be fewer physicians to care for them. Is there a national physician shortage? Some may argue that it's really a regional shortage of primary care physicians, but I think we'll see a real shortage as more people get health insurance and schedule appointments.

Increasing confusion about mammograms

Everyone is getting confused about mammogram guidelines. The U.S. Preventive Services Task Force (USPSTF) recently came out with new guidelines and these cancer screening recommendations are quite different from those published by the American Cancer Society (ACS). Now, the Senate is dealing with amendments of amendments. What do I mean by that? There was an amendment by Mikulski. Then, there was one by Vitter. Then the Murkowski amendment got rejected (I'm not sure if all this chronology is correct, but I think you get the picture). Soon, we won't remember what the original amendment said.

So what's with all these amendments? One key question is: how will insurance plans (including a possible public option) pay for screening mammograms? Who will need to pay a copay? What is the appropriate age to start breast cancer screening? 40? 50? How often should women get a mammogram?

I've heard some people argue that the USPSTF came up with these revised guidelines to reduce the number of mammograms the government would need to cover under the proposed public option. Does this make sense? Well, if the government can find a way to reduce health care costs, it would be to eliminate expensive tests. A mammogram isn't super expensive, but if you could stop all those women who are ages 40-49 from getting a mammogram, you would save a huge amount of money.

Are screening guidelines published to save costs or save lives? Where do you draw the line to declare that a screening test is indeed "cost effective?" How is that term even defined? At this point, I think that most of us have more questions than answers.

Do patients talk with doctors about health care reform?

Patients seem to love asking the question, "so what do you think about all these discussions regarding health care reform?"

How should doctors answer these types of questions? Should you get into politics? Focus on the public health issues that our nation faces? Talk about increasing taxes? Criticize the public option because it's doomed for failure?

I enjoy discussions and friendly debates regarding our current health care system. I don't believe we have any easy answers to the large question. I've worked in the VA system where every veteran has access to health care and medications. I've worked in free health clinics where care and even medications are freely given to those who are in need. I've seen patients in developing nations who appreciate receiving pain pills and vitamins.

The reality is that most doctors are probably too busy to get into long discussions about health care reform. However, what if you were sitting down at dinner with a handful of your patients?

Affordable Health Care for America Act (H.R. 3962)

You've probably seen the news by now. The House narrowly passed the health care reform bill and now it's headed to the Senate. The only Republican supporting this bill was Anh "Joseph" Cao (Louisiana). Is our nation ready to completely overhaul our existing health care system? Or will we try to place a few patches and hope that it lasts a few more years?

According to the latest from CNN, the Affordable Health Care for America Act (H.R. 3962) restricts insurance companies from denying coverage to anyone with a pre-existing condition or charging higher premiums based on gender or medical history. It also provides federal subsidies to those who cannot afford health insurance. And it guarantees coverage for 96 percent of Americans.

Will the Senate pass a bill that contains the controversial "public option?" Not if it's up to Sen. Joseph Lieberman. Maybe those who live in Connecticut don't really need a public option, but those who live in Louisiana probably do.

Senator John Cornyn collecting info on Sermo

Senator John Cornyn (R) from Texas is collecting info on Sermo about Comparative Effectiveness. Here are the questions he's asking Sermo physicians:

• What impact would one-size-fits-all coverage decisions from Washington have on your ability to make health care decisions with your individual patients?
• In your opinion, how effective would one-size-fits-all coverage decisions from Washington be in reducing “unnecessary” tests and treatments?

If you're a physician, what do you think about these questions? If you'd like to have some input, then vote on Sermo.

Donate a kidney and get stuck with a "pre-existing condition"

I received an e-mail today from Mitch Stewart (Director, Organizing for America). Here's the part that caught my attention:

Jenny U. from Missouri did what any parent would: When her son needed a kidney, she donated one of hers. But she didn't realize insurance companies would use her kindness as an excuse to never cover her again, calling her donation a "pre-existing condition."

Now, insurance companies are spending millions on a campaign of lies to kill health reform that would help folks like Jenny. So, today, with crucial negotiations taking place in Congress, we're raising our voices and making it clear: It's time to deliver on reform.

Would you donate a kidney if you knew that you would have a very difficult time obtaining health insurance in the future? I know many people who have donated kidneys, but I've never thought about the consequences associated with having a "pre-existing condition."

To get more information, visit: http://my.barackobama.com/TTDCalls

What's the fate of the public option?

The public option was rejected by the Senate Finance Committee. According to CNN:

Republicans unanimously oppose the government-run insurance option, saying it would drive private insurers from the market and eventually bring a government takeover of the health care system.

Democratic leaders reject that claim, saying the public option would provide needed competition for private insurers while making health coverage accessible to millions of people currently lacking health insurance.

Who's right? Is the public option simply a battle between the Republicans and the Democrats? I don't think it's that simple when we're talking about healthcare reform. Should they define a trigger? If they define such a "trigger," they will have proof that expanded coverage and lower costs are not possible unless major changes are made to our existing system.

At the end of the day, I think we will eventually see some type of public option emerge in the United States. In my opinion, it's inevitable. Our healthcare system is so broken that we need to go through a major overhaul. It's difficult to overhaul a system in small stages. On the flip side, a complete overhaul isn't practical. So, we're stuck between a rock and a hard place. This is a true dilemma.

Obama's health plan defined and outlined

What do you think about President Obama's health plan? He states that although he isn't the first president to address health care reform, he is determined to be the last. You've probably read the story on CNN. What do you think about all of this?

Here's my favorite line: "No one should go broke because they got sick."

Medical bills continue to be a leading cause of bankruptcy for the aging community. I'm curious to see how this public option will impact existing plans such as Medicare and Medicaid. Insurance companies are probably starting to create some plans to downsize if they face some steep competition from the government. However, maybe the government option will flop if providers refuse to accept it. Then where does that leave us?

More than 10,000 Sermo physicians sign an appeal

Watch this Fox News video clip about how 10,000 Sermo physicians have signed an appeal regarding healthcare reform (including tort/malpractice reform). "We need less frivolous lawsuits." I couldn't agree more.

Senator Tom Coburn, M.D. on Sermo discusing tort reform

Tom Coburn, M.D. is a US Senator, Oklahoma (R) and a physician. He posted something on Sermo recently to get some feedback about tort reform and I found it to be very interesting. The post has only been up for a few days, but there are already over 200 comments!

Physicians recognize the need for some serious tort reform, especially in the midst of major healthcare reform. However, do we know what that's going to look like? Two current ideas include:

• Expert panels to review medical disputes. In this scenario, the panel would consist of 3 attorneys and 3 medical professionals. That panel would review cases and determine whether a healthcare provider is responsible for wrongdoing and what, if any, relief is warranted.
  
• Formation of independent health courts. In this scenario, a judge who has expertise in health issues would preside over an independent health court. He/she would render a binding decision using the same legal standards as a traditional trial judge.

Sounds quite interesting, doesn't it? Which would you vote for? Sounds like the data will get published once it's all collected on Sermo, so stay tuned! I wonder how all the medical malpractice attorneys feel about all these talks regarding healthcare reform.

Hostile audiences at health care forum

I'm afraid that things are really going to get out of control soon. All these debates and civil discussions about healthcare reform may eventually turn into violent crime scenes. I really hope that doesn't happen, but it's hard to think otherwise when you see a story on CNN that says: "Specter faces hostile audience at health care forum"

A hostile crowd shouted questions and made angry statements Tuesday at a town hall meeting on health care in Pennsylvania led by Democratic Sen. Arlen Specter... The shoving incident occurred early in the 90-minute session when a man started shouting that he had been told by Specter's staff that he could speak, but he didn't get one of the 30 cards distributed to people allowing them to ask questions. Another man stood up and shoved the protester, and Specter approached the men shouting for calm.

Watch this video to see all the shouting, shoving, and big security officers standing by:


To read the CNN story, click here.

Are healthcare protests being orchestrated?

Health care protests 'clearly being orchestrated,' senator says
So, here are the story highlights from CNN:

• Democrat decries disruptions over health care reform at town-hall meetings
• Sen. Durbin: It's not right "when these people come in just to disrupt the meetings"
• Sen. McConnell slams complaints about citizens organizing
• "They need to deal with it. Americans are concerned," McConnell says

This CNN story starts with:

The Senate's second-ranking Democrat slammed recent town-hall protests over health care on Sunday, insisting they violate "the democratic process," while the Senate's top Republican accused Democrats of "attacking citizens" with such complaints.

So are healthcare reform protests getting out of control? Physicians don't like what's being proposed about healthcare reform. Politicians seem to be quite mixed. Are we rushing through these changes? I wonder if we'll see certain aspects backfire and cause problems that we didn't anticipate (for instance, what if physicians choose not to accept public insurance plans?). President Obama calls reforming health care the centerpiece of his current domestic platform. We will definitely see new jobs in health information technology (health IT) and we see new hospitals and medical schools being built. So will healthcare reform save our struggling economy? To read the story on CNN, click here.

Will Medical Technology Reduce Healthcare Costs?

This is a guest post by Adrienne Carlson. If you're interested in submitting a guest post, please contact me.

Will Medical Technology Reduce Healthcare Costs?

While the debate over the pros and cons of President Obama’s healthcare plans and reforms rage on, other measures are being taken to decrease the overall cost of providing healthcare to people in the long run. Companies that manufacture medical technology are jumping on this bandwagon with their inventions and innovations, with claims that their products will help reduce healthcare costs in the long run.

Medical technology businesses are already testing out digestible chips that check if you’re taking your prescribed medication correctly. The chips will be attached to your medication, and using a sensing device worn on your skin, will be able to tell doctors if you are getting the right dose of medicine and also read them your vital signs. The whole system works using wireless technology, taking advantage of the vast infrastructure that is already being used by mobile phones and notebook computers. The technology is supposed to allow doctors to monitor you even though you are at a distant location and to provide medical attention if your signs seem to show some anomaly.

The entire premise of this concept is based on the fact that hospital visits and hospital stays because of unnoticed and hence untreated symptoms contribute to a large percentage of healthcare costs. So if this cost can be reduced using this technology, it augurs well for the people who really need healthcare to be affordable. But, even though there may be some truth in this supposition, the fact remains that:

• The initial cost of the technology is going to be pretty high, especially when it is in its infancy and still in the post experimental stage.
• Only those who can afford it are going to buy it, given that they believe it will work.
• Insurers may not be willing to back this technology on the grounds that it is unproven and expensive, just as they refuse to cover other experimental treatments like bone marrow transplants.
• If the treatment is not covered by insurance, how does it help bring down the cost of healthcare?
• Most hospitals and doctors would not want to invest their time and effort in technology for which they are not reimbursed by insurance companies.

While it is true that such technology does help improve the quality and effectiveness of healthcare for those who can afford it, it is arguable if it will help bring down healthcare costs, even in the long run.

This guest article was written by Adrienne Carlson, who regularly writes on the topic of radiography technician salary. Adrienne welcomes your comments and questions at her email address: adrienne.carlson1@gmail.com

Public Insurance Plan

CNN Money.com has another article on healthcare reform. This one is titled, "Health reform follies: How to keep up" and it's a special report in the "Fixing Healthcare" section of CNN Money.com.

I'd like to focus on the section that discusses a public option. Let's begin with a small snippet:

Those who want a public insurance plan want it fiercely, saying it's the only thing that can force private insurers to reduce costs and be more competitive. Those who oppose it are equally fierce, saying it would result in a government takeover of the heath care system.

Where do you stand on this issue? Do you want to see a public insurance plan that's available for everyone and anyone? Is that really the right answer?

Two major bills that lawmakers will consider -- the tricommittee bill from the House and the bill put out by the Senate Health committee -- propose a public health insurance option. That public plan would compete with private insurers on a health insurance exchange -- or insurance supermarket -- that the bills also propose.

If we see a public plan emerge, will physicians choose to accept this plan? Already, we see many healthcare professionals who choose to only accept cash. They no longer wish to deal with the headaches of chasing reimbursement from insurance companies. As a result, they state that they no longer accept any forms of insurance and they use a fee-for-service model. If this trend continues, then the presence of a public insurance plan will yield no benefit for consumers who need outpatient medical care.

At the end of the day, will such public insurance plans mainly be for hospital admissions and major catastrophes? Maybe the government will take over all the hospitals. Sometimes I wake up in the middle of the night wondering if all of this is a dream.