Author: cmh

The Never Ending Health Reform BS Machine

Just at the beginning of the month, I posted at the Doctors for America Blogabout a couple of ridiculous email campaigns that will not die, in spite of  how ridiculous they both were and are.
A friend sent me another one this morning, which is actually a YouTube video (link below). The video is based on previously debunked BS email that was going around in 2009, as noted by Snopes. At the time, Politifact covered it, and you can read the debunking here.
Sent: Saturday, May 5, 2012 4:57 AM
Subject: THIS WILL KNOCK YOUR SOCKS OFF!! Please WATCH!!!
More details on your healthcare bill.
Please watch the entire video…. Then forward it to everyone you know.
http://www.youtube.com/watch_popup?v=HcBaSP31Be8&vg=medium (10:29)!
What is most astounding to me is that you can have a steaming pile of BS, like the original letter, and then take the time and effort to turn it into a video without, apparently, using The Google to see if any of it is true! Who does this stuff?

Medicaid payments to primary-care doctors will rise under new regulation – The Washington Post

Medicaid payments to primary-care doctors will rise under new regulation – The Washington Post: Primary care doctors could get a pay raise next year for treating Medicaid patients, under a rule announced by the Obama administration Wednesday.

The proposed regulation implements a two-year pay increase included in the 2010 health-care law. The increase, effective in 2013 and 2014, brings primary care fees for Medicaid, which covers indigent patients, in line with those for Medicare, which insures the elderly and some disabled patients.

Although Medicaid is jointly funded by states and the federal government, the pay boost would be covered entirely with federal dollars totaling more than $11 billion over the two years it would be in effect.

Congress automatically appropriated those funds when it adopted the health-care law, so it will not need to act now.

However, the provision is among hundreds that could be instantly nullified if the Supreme Court decides to overturn the law in its entirety when it rules on the constitutional challenge. The court heard arguments on the case in March, and a decision is expected late next month.

The pay raise is one of several attempts in the law to address a fundamental challenge in U.S. health-care: Because primary care doctors focus on preventive care, they offer the best hope of curbing the nation’s health spending. Yet they are paid far less than specialists, contributing to a shortage of primary care doctors that is projected to grow with the aging of baby boomers, the retirement of physicians and an expected influx of more than 30 million Americans who will gain insurance through the health-care law beginning in 2014.

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Canadian doctors say fee cuts, pay inequalities will spur exodus | News | National Post

Canadian doctors say fee cuts, pay inequalities will spur exodus | News | National Post:

Despite repeated, expensive attempts to more logically divvy up fees, ophthalmologists earn almost 70% more on average than brain surgeons, who take in almost double the income of psychiatrists, according to Canadian Institute for Health Information (CIHI) figures.

“There are terrible inequities within medicine,” said Michael Rachlis, a Toronto physician and health policy analyst. “And this has really almost nothing to do with the actual value of services. It’s just that some services … often because of technological change, end up being relatively overpaid.”

Comparisons with other industrialized countries suggest that, on average, Canada is among the most generous in remunerating its doctors, though the U.S. continues to out-pay in some specialities. Statistics and recruitment agencies report a net migration of physicians into Canada lately.

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Slippery-Slope Logic vs. Health Care Law – Economic View – NYTimes.com

Slippery-Slope Logic vs. Health Care Law – Economic View – NYTimes.com:

There is a DirecTV ad that humorously illustrates the basic form of the slippery-slope argument. A foreboding announcer intones a list of syllogisms that are enacted on screen: “When your cable company puts you on hold, you get angry. When you get angry, you go blow off steam. When you go blow off steam, accidents happen.” Later, we reach the finale: “You wake up in a roadside ditch. Don’t wake up in a roadside ditch.”

Although this ad is intended to be funny, arguments that make no more sense can and do affect public policy. The idea is that while Policy X may be acceptable, it will inevitably lead to the terrible Outcome Y, so it is vital that we prevent Policy X from ever being enacted. The problem is that such arguments are often made without any evidence that doing X makes Y more likely, much less inevitable. What percentage of people who are left on hold on the telephone end up in a roadside ditch?

The anecdotal track record of people making slippery-slope predictions in the political domain is replete with bad forecasts. An opponent of women’s suffrage once predicted that giving women the right to vote would create a “race of masculine women and effeminate men and the mating of these would result in the procreation of a race of degenerates.” Another opponent, noting that women represent more than half the population, predicted that allowing women to vote would mean that all our political leaders would soon be women. For the record, women now hold 17 percent of the seats in Congress.

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Subsidiarity (Catholicism) – Wikipedia, the free encyclopedia

Subsidiarity (Catholicism) – Wikipedia, the free encyclopedia:

Paul Ryan has referred to his philosophical bent as having more to do with subsidiarity than Ayn Rand.  I consider myself well read, especially about theology, Catholic or other, but I was not familiar with this term, so here is the Wikipedia section on the Catholic take on it:

The principle of subsidiarity was developed by German theologian Oswald von Nell-Breuning.[2] His work influenced the social teaching of Pope Pius XI in Quadragesimo Anno and holds that government should undertake only those initiatives which exceed the capacity of individuals or private groups acting independently. Functions of government, business, and other secular activities should be as local as possible. If a complex function is carried out at a local level just as effectively as on the national level, the local level should be the one to carry out the specified function. The principle is based upon the autonomy and dignity of the human individual, and holds that all other forms of society, from the family to the state and the international order, should be in the service of the human person. Subsidiarity assumes that these human persons are by their nature social beings, and emphasizes the importance of small and intermediate-sized communities or institutions, like the family, the church, labor unions and other voluntary associations, as mediating structures which empower individual action and link the individual to society as a whole. “Positive subsidiarity”, which is the ethical imperative for communal, institutional or governmental action to create the social conditions necessary to the full development of the individual, such as the right to work, decent housing, health care, etc., is another important aspect of the subsidiarity principle.

The principle of subsidiarity was first formally developed in the encyclical Rerum Novarum of 1891 by Pope Leo XIII, as an attempt to articulate a middle course between laissez-faire capitalism on the one hand and the various forms of communism, which subordinate the individual to the state, on the other. The principle was further developed in Pope Pius XI’s encyclical Quadragesimo Anno of 1931, and Economic Justice for All by the United States Conference of Catholic Bishops.
“ It is a fundamental principle of social philosophy, fixed and unchangeable, that one should not withdraw from individuals and commit to the community what they can accomplish by their own enterprise and industry. (Pope Pius XI, Quadragesimo Anno, 79) ”

Since its founding by Hilaire Belloc and Gilbert Keith Chesterton, Distributism, a third way economic philosophy based on Catholic Social teaching, upholds the importance of subsidiarity.

The Church’s belief in subsidiarity is found in the programs of the Catholic Campaign for Human Development, where grassroots community organizing projects are supported to promote economic justice and end the cycle of poverty. These projects directly involve the people they serve in their leadership and decision-making

So, as Inigo Montoya would say, “You keep using that word. I do not think it means what you think it means.” I think we have centuries worth of ample evidence that charity cannot provide health care to nations, that economic justice and ending poverty are not possible through devolved local or institutional efforts. Some things require government, and Paul Ryan and so many others like to pretend that if we just “get out of the way,” all of this will take care of itself. Never has, never will.
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Medical Professionalism Charter Principles | ABIM Foundation

Medical Professionalism Charter Principles | ABIM Foundation:

Principles of the Charter

The principles and responsibilities of medical professionalism must be clearly understood by both the profession and society. The three fundamental principles below are a guide to understanding physicians’ professional responsibilities to individual patients and society as a whole. 1. Primacy of Patient Welfare 2. Patient Autonomy 3.Social Justice

Primacy of Patient Welfare
The principle is based on a dedication to serving the interest of the patient. Altruism contributes to the trust that is central to the physician-patient relationship. Market forces, societal pressures, and administrative exigencies must not compromise this principle.

Patient Autonomy
Physicians must have respect for patient autonomy. Physicians must be honest with their patients and empower them to make informed decisions about their treatment. Patients’ decisions about their care must be paramount, as long as those decisions are in keeping with ethical practice and do not lead to demands for inappropriate care.

Social Justice
The medical profession must promote justice in the health care system, including the fair distribution of health care resources. Physicians should work actively to eliminate discrimination in health care, whether based on race, gender, socioeconomic status, ethnicity, religion, or any other social category.

We talk a lot about professional responsibilities within the medical profession. I think the first two principles of patient welfare and autonomy are uncontroversial (though not always easy!).

The last one, social justice, is just as critical, and I would argue largely uncontroversial around the world both within the medical profession and in societies as a whole. Only in America is this principle questioned, and only in a vocal and politically powerful segment of the population.

I think many physicians, especially our conservative fellow physicians, would be surprised (and disappointed) that every major medical organization in the US (and globally), and almost certainly their own specialty organization, have already endorsed the Charter, warts – social justice in their view – and all!

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Vatican Reprimands U.S. Nuns Group – NYTimes.com

Vatican Reprimands U.S. Nuns Group – NYTimes.com:

I often credit the nuns who taught me at St. Francis Elementary for the social justice subroutine that was programmed into me, and still runs, continuously. So, way to keep at it, Sisters!

The Vatican’s assessment, issued on Wednesday, said that members of the group, the Leadership Conference of Women Religious, had challenged church teaching on homosexuality and the male-only priesthood, and promoted “radical feminist themes incompatible with the Catholic faith.”

The sisters were also reprimanded for making public statements that “disagree with or challenge the bishops, who are the church’s authentic teachers of faith and morals.” During the debate over the health care overhaul in 2010, American bishops came out in opposition to the health plan, but dozens of sisters, many of whom belong to the Leadership Conference, signed a statement supporting it — support that provided crucial cover for the Obama administration in the battle over health care.

The conference is an umbrella organization of women’s religious communities, and claims 1,500 members who represent 80 percent of the Catholic sisters in the United States. It was formed in 1956 at the Vatican’s request, and answers to the Vatican, said Sister Annmarie Sanders, the group’s communications director.

Word of the Vatican’s action took the group completely by surprise, Sister Sanders said. She said that the group’s leaders were in Rome on Wednesday for what they thought was a routine annual visit to the Vatican when they were informed of the outcome of the investigation, which began in 2008.

“I’m stunned,” said Sister Simone Campbell, executive director of Network, a Catholic social justice lobby founded by sisters. Her group was also cited in the Vatican document, along with the Leadership Conference, for focusing its work too much on poverty and economic injustice, while keeping “silent” on abortion and same-sex marriage.

“I would imagine that it was our health care letter that made them mad,” Sister Campbell said. “We haven’t violated any teaching, we have just been raising questions and interpreting politics.”

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Medicare to Expand Competitive Bidding on Equipment – NYTimes.com

Medicare to Expand Competitive Bidding on Equipment – NYTimes.com:

Medicare officials estimated that competitive bidding for home medical equipment would save more than $42 billion in the next 10 years — $17 billion for beneficiaries and $25.7 billion for the Medicare program.

Ms. Sebelius said the savings showed the value of the health care overhaul signed into law by President Obama in 2010.

The competitive bidding program was established, with support from many Republicans, under a 2003 law that added a prescription drug benefit to Medicare. In 2008, Congress temporarily delayed the program and terminated supplier contracts that were in effect. The 2010 law expanded the program.

Medicare has historically used a fee schedule to pay suppliers. Officials gave this example of the savings: Under the fee schedule, Medicare would have paid $2,080 for an oxygen concentrator last year, and the beneficiary would have paid 20 percent, or $416. By contrast, with competitive bidding, Medicare paid about $1,395, and the beneficiary paid $279.

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Off the Charts Blog | Center on Budget and Policy Priorities | “Double-Counting” Canard Quacks Again

Off the Charts Blog | Center on Budget and Policy Priorities | “Double-Counting” Canard Quacks Again:

Former Bush Administration official Charles Blahous has garnered some media attention by gussying up old, discredited arguments about the budgetary effects of health reform. But his paper adds nothing new to the debate.

Blahous claims the Congressional Budget Office’s cost estimate for the health reform law “double-counts” a considerable portion of the law’s Medicare savings. By subtracting these savings, Blahous asserts that — contrary to CBO — health reform increases the deficit.

But there’s no double-counting involved in recognizing that Medicare savings improve the status of both the federal budget and the Medicare trust funds. The outlooks for the budget and for the Medicare trust funds are two different things; some changes in law may affect one and not the other, but other changes affect both.

CBO estimates that health reform will modestly reduce the federal budget deficit. The Medicare actuary says that health reform will extend the solvency of the Hospital Insurance trust fund by eight years.

That’s no different than when a baseball player hits a home run: it adds to his team’s score and also improves his batting average. Neither situation involves double-counting.

CBO has accounted for deficit reduction in exactly the same way in previous Congresses, under both political parties. Until opponents of health reform latched onto the notion, no one accused CBO of faulty accounting.

For example, the Balanced Budget Act of 1997 and the Deficit Reduction Act of 2005 — both of which Republican Congresses approved — included Medicare savings that were counted as reducing the deficit and improving Medicare’s financial outlook. The Senate Republican Policy Committee rightly claimed credit for this result, and no one made charges of double-counting.

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Physician Salaries Vary Widely Among Academics

Physician Salaries Vary Widely Among Academics:

Go West, academic urologist. You may earn more than $455,000 annually there, compared to $300,000 in the Midwest.

(If you are an academic dermatologist, the Midwest is the place to be, not the West, if you want optimum income.)

Whatever you do in academic circles, if you seek a very nice, comfortable salary, be a department chair and a specialist. Then again, if you are engaged in academia, it isn’t all about the money is it? There’s more money in private practice, of course, but we’ll get to that later.

There’s a wide variation in physician-related academic salaries, often dependent on geography and rank within academic settings, says the Academic Practice Compensation and Production Survey for Faculty and Management of 2012. The Medical Group Management Association report, based on 2011 data, contains information on more than 20,000 faculty physicians and non-physician providers categorized by specialty, and more than 2,000 managers.

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