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CAT | Rants
28
Medicare To Cover Smoking Cessation
No comments · Posted by bjmdjd in Medical Related News, Rants
I may be cynical but in my opinion rarely does the government do anything sensible and in the order in which it should be done. For instance, Medicare in the past has only covered smoking cessation counselling if the patient had already been diagnosed with a tobacco related disease or already had symptoms of such a disease. Seems a bit backwards to me.
But alas, the Dept. of Health and Human Services has announced that Medicare will now begin covering counselling for smoking for all Medicare patients! They must have done this by mistake but we’ll all hope that they don’t notice. This will be an excellent partner to the fact that Medicare Part D prescription drug plans already cover prescription smoking medications. bjmdjd
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While writing one of the installments for my radio show this past weekend I came across some alarming statistics concerning tanning booth use and melanoma. I’ve known about the possible connection for some time but it really struck me as to what a serious problem this is. And unfortunately the most affected group appears to be young females who might not be making decisions based on the most reliable information. Couple this with a dose of feeling bullet proof and you’ve got a recipe for disaster.
A recent study from the University of Minnesota found that there is strong evidence that ”indoor tanning increases the risk for melanoma and should be avoided.” In 2006 the World Health Organization’s International Agency for Research on Cancer stated that there was only a weak association between indoor tanning and the risk of developing melanoma. Recently the group changed their stance and now calls tanning devices carcinogenic.
The tanning industry is a big money maker and of course they refute the findings of the latest study saying that the lead researcher was not a neutral party. One of the main concerns of the authors was the same as mine. That the main users of the indoor tanning devices are teens. The study noted that in looking at 116 American cities the average number of tanning salons surpassed the average number of Starbucks or McDonalds!
To tan or not to tan. Indoor tanning appears to be a serious public health problem. As mentioned by the authors of the study it needs to be addressed in schools much like obesity and smoking. There is talk of possibly making it unlawful for anyone below the age of 18 to use tanning salons. At least not without parental consent. Do we need more laws or just allow common sense to prevail? While I hate more laws it doesn’t appear that common sense is working very well. bjmdjd
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indoor tanning · melanoma · tanning booths · University of Minnesota
I rarely feel the need to comment on commercials I see on television or in the print media. Even if it bothers me I’ll usually just blow it off. Not so with what I saw today.
The medical establishment had quite a few negative things to say about the retail store medical clinics that started popping up in stores several years ago. While I’ll admit that I’m sure much of it had to do with money there were some valid complaints made. One of the main problems was felt to be that patients need to get their primary care at one location. One person should know everything that is going on with a patient so they can direct their care. Fragmented care can be a bad thing.
To answer this complaint the clinics assured everyone that they were there to treat simple illnesses like sore throats, bad colds, sprains, etc. And they provide these services at times when most primary care physicians are not in their offices. They stressed that they treated only simple illnesses and that their non physician providers could easily treat these sort of problems and that they did not want to treat chronic illnesses.
Today I see a television commercial by one of these clinics promoting diabetes blood testing, related exams, and education. Everything that they advertise as the diabetic services that they offer are the services that should be provided and tracked by the patients primary physician. I’m sure that most of their providers are well trained to treat diabetes and that they try to get the results sent to the patients primary doc but not always.
My main complaint is that their needs to be a “medical home” for patients with chronic illnesses so that someone can be running the show. This home needs to be with the primary care physician. Many may disagree but that’s what I love about this great country. We can agree to disagree! I wonder if the fact that many of these retail store clinics are having financial problems is the reason that they are expanding their scope of care? Many physicians have certainly done that recently. bjmdjd
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15
Do We Really Need This Warning?
No comments · Posted by bjmdjd in FDA Alerts and News, Rants
I never really understood why we needed to be warned not to operate a bulldozer after taking medications that make us sleepy! But then again most every physician has heard of the pregnant women who had their partner take their birth control pills for them for a few days or they spread contraceptive jelly on toast and ate it. I guess instructions are just not obvious or understandable to everyone.
This week the Food and Drug Administration issued a warning not to swallow Benadryl Extra Strength Itch Stopping Gel meant to be spread on the affected skin. The problem is in getting too large of a dose of the active ingredient diphenhydramine. Large doses can cause confusion, unconsciousness, and hallucinations.
I guess that I just like to assume that common sense and reading/understanding simple instructions are a common thing. I guess it is the folks that don’t fall in this category that help keep the plaintiff attorneys (and the FDA for that matter) in business. bjmdjd
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I have never been shy about expressing my opinion concerning healthcare reform. I have always said that I am a huge supporter of healthcare reform but not a supporter of the bill that was recently passed. It may be a good start but it has some serious flaws that I feel if corrected would free up lots of money to take care of the currently under served population.
Maybe it’s because of my past experience working in the emergency room but the waste and abuse of the system by some patients gets under my craw more than I can even express. If you spent a couple of hours as an observer in an ER you would be absolutely sickened by the way the system is abused by some. I recently sent an email to this effect to someone and got an interesting response. In fairness to all I decided (with her permission) to print her response.
I am fortunate to be a friend and student of a nice lady named Nora Johnson. She is a medical billing advocate. In other words, she scours medical bills for mistakes and saves patients thousands of dollars. You may have seen her on CBS News, CNBC, The Wall Street Journal, Smart Money Magazine, and the list goes on and on. This lady is no slouch. In addition to a top notch education, her experience and resume make her an expert. And like one of the television commercials of the past says, “When she talks, people listen.”
I appreciate Nora allowing me to print her words of wisdom. She did not write this for publication and I did not check for spelling or grammar so read it for content only.
| “From a non-physician standpoint, but one who is involved in the daily plights of patients who can’t afford healthcare, permit me to share my perspective.
I have no love for healthcare insurance providers. I view them as subscribers to the modern day Machiavellian business philosophy of ‘profit justifies the means’…or ‘profit makes right’. It doesn’t take much of an intellectual leap to deduce why 45 million Americans can’t access the health care system…and why a substantial portion of the ‘have nots’ rely on Emergency rooms. It is a fact that Emergency rooms are the lowest or no-profit revenue centers for hospitals. It is also a fact that some patients abuse the privilege of accessing emergency rooms. What is completely overlooked by critics are the millions of uninsured people who, when diagnosed with cancer or other major illnesses, cannot afford chemo or radiation or any type of continuing treatment. Emergency rooms do not provide ongoing treatment for chronic diseases. I have talked with too many people who fall between the cracks in our current system. Too rich for Medicaid or charity care, and too poor or sick to afford astronomical premiums. The cannot cough up $200 thousand dollars IN ADVANCE, to pay the likes of MD Anderson or any cancer hospital for the first series of treatments. I believe these people constitute the majority of these 45 million uninsured…or under-insured. And, even if they don’t, are the rest of us willing to consign their plights to——you don’t deserve to live? From their perspective death is their reality, and potential life saving treatments are a privilege of the wealthy, or the lucky who have health care coverage through employment. I can hear the refrain——-let ‘em get jobs and work like the rest of us! Don’t be too cocky about your coverage through employment. This too is vanishing as self-insured companies are breaking under the cost burden, downsizing staff, outsourcing to the rest of the world, limiting employees to part time thereby escaping the mandate to provide health care coverage, decreasing coverage in general, and shifting more health care costs to the remainder of the employees. What about those folk who worked hard all their lives, and took the promise of early retirement and continuing health care coverage till Medicare kicks in, only to find their employers determined at some later date, that a good way to cut costs was to eliminate coverage for retirees? By now, many of these folks between 50 and 65 have conditions that virtually eliminate them from Blues, United, Cigna, Aetna, (BUCAs) coverage…or maybe if they can pay $3K a month for premiums. Even then, the BUCAs will do what they can to disqualify and deny these insureds from coverage——–after accepting months/years of premium payments. We cannot be so naive to imagine that the private profit making sector is going to care about anything or anybody other than profits. Hospitals are huge profit making businesses, and not-for-profit hospitals are even worse! I know how these bandits bill!! I know how they demand full payment from the uninsured when virtually 95% of their patient load doesn’t have to pay even half for the same services. So count them out of caring for non-paying patients, or doing the right thing because profit trumps compassion and responsibility. Does this mean that Obamacare is the answer? No, it is only a beginning, and one full of holes; the most glaring of which is the healthcare profit mongers are still in control, and do not have meaningful sanctions to counter their new and creative ways to deny claims payment. The health of our nation cannot be consigned to monolithic entities that worship the profit gods. Obama missed the boat by not having a government agency compete with the BUCAs. Yeah, yeah, that’s socialism———-as is Medicare, Social Security, Medicaid, etc. For those who denounce socialism, please forgo your Medicare and Social Security and put your money in the same bag with your righteous indignation. What is true and evident is that our population of 45 million uninsured/underinsure Americans have made no progress, were denied healthcare and have died within the last few decades that subscribed to various economic policies, beginning with the trickle-down theory to business’ self-regulation. Now that’s a hoax promulgating the fox guarding the hen house theory that many bought into, excepting perhaps, the have-nots. If you are poor (http://www.partnershiptoendpoverty.org/PovertyGuidelines2009.pdf, ) sick, unable to access health care to survive, lost your home and believe that Obamacare or a dose of socialism will ruin our country, stand up and be counted. …I can’t hear you! If you don’t qualify, what is your responsibility to your countrywomen and men? Said better by many: “Any society, any nation, is judged on the basis of how it treats its weakest members; the last, the least, the littlest.” How will America be judged?” I told you. Whether you agree with her or not…this is one smart lady. If you are interested in a CBS story with Nora here is the link: http://youtube.com/watch?v=huOcg9uN5pw bjmdjd Material modifications since posting: none |
access to care · health · Healthcare Reform · Nora Johnson · underinsured · uninsured
I have referred you to Dr. Toni Brayer’s blog before when she posted something that I thought you really needed to see. Well I don’t know if you really NEED to see this or not but it is something that I strongly agree with her about!
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When I started this blog I didn’t promise that I would never get political or that occasionally there wouldn’t be a personal rant of some sort published. But I simply refuse to lower myself to the level of those who try to make everything partisan and resort to name calling. I’m afraid that I would need to do both of those things to adequately discuss my feelings about the passage of the healthcare reform bill. Not about healthcare reform which I support but about passage of the healthcare reform bill. Therefore, I won’t do it. It’s been talked to death anyway. bjmdjd
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Frankly I’m so disgusted that I just don’t have anything to say right now! I had plenty to say (not about reform) but I’ll have to wait until tomorrow. bjmdjd
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27
Medicare Disaster Is Near!
No comments · Posted by bjmdjd in Politics, Rants, Uncategorized
If you are a Medicare patient you need to know that a Medicare disaster is on the verge of occurring. The Senate adjourned before approving a bill that would prevent a 21.2% physician pay cut from becoming effective on Monday March 1, 2010.
To their credit (for once) Democrats have tried for months to pass legislation that would prevent this from happening but once again this past week they were thwarted by Republican Senator Jim Bunning from Kentucky. He stated that he just could not support this bill with all of it’s other expensive attachments because the Democrats had not figured out a way to pay for it and thus it would increase the deficit.
The bill was going to delay the pay cut for 30 days until something more permanent could be studied and possibly passed. Most physician groups have supported passage of a bill that permanently fixes this recurring pay cut problem.
If physicians are to be believed, it may be hard to get a doctor’s appointment as early as next week. I don’t think I am going out on a limb by saying that if the pay cut occurs, a primary care physician will LOSE money every time a Medicare patient walks in their office. NOT make less money, LOSE money! The average Joe may not believe it but it’s true!
I have no doubt that something will be done. Medicare payors have already informed physicians that if the pay cut occurs they will hold all Medicare claims for 10 business days starting Monday giving the Senate time to fix the problem and make it retroactive to March 1st.
If the physician pay fix doesn’t become a done deal, woe to those (including me) who need a doctor and their payor is Medicare! bjmdjd
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Medicare · Medicare physician pay cut · Sen. Jim Bunning · Senate Democrats
Well, I was correct but I’m sorry I was! The Healthcare Summit was a complete waste of time and C-Span broadcast resources. The only thing that I got from it was that the Democrats told everyone that they were going to pass the current bill no matter who opposes it!
As for me I’m sick on my stomach! You can read the details somewhere else (if you have the time to waste and the stomach for it)! bjmdjd
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