Medicare Buy-in Encounters Strong Opposition

If you're confused about the healthcare reform proposal in the US Senate to allow citizens aged 55 and 64 years to buy in to the Medicare program, you're in good company.

The details of the plan, first announced last week by Senate Majority Leader Harry Reid, D-Nevada, as part of a compromise to win over senators opposed to a "public option" — a federal health insurance plan to compete with private insurers — are shrouded in secrecy.

Reid is waiting for the Congressional Budget Office to complete a cost analysis of the measure before providing specifics. Even the No. 2 Democrat in the Senate, Richard J. Durbin of Illinois, said he was "in the dark" about aspects of the plan.

What is known about the measure has engendered rapid and fierce opposition from healthcare providers, including the American Medical Association, the American Hospital Association, and America's Health Insurance Plans, mainly because Medicare reimbursement rates are inadequate.

In broad strokes, Reid's compromise would expand Medicare eligibility to people aged 55 to 64 years who are uninsured or paying high premiums in the individual market. Most of those with employer-provided coverage would not be eligible.

Buy-in Plan Condemned

The American Medical Association, which had supported the bill passed by the House of Representatives that would create a public option, was quick to condemn the Medicare buy-in idea.

"The AMA has longstanding policy opposing the expansion of Medicare given the fiscal projections for the future," AMA president J. James Rohack, MD, said in a statement. "Currently, the flawed Medicare physician payment formula will cause a drastic 21% cut to physicians caring for Medicare patients in January, and 22% of Medicare patients looking for a new primary care doctor are having trouble finding one."

The Mayo Clinic, often cited by Obama as a model of what healthcare reform might look like, condemned the buy-in proposal in stark terms. "The current Medicare payment system is financially unsustainable," the group said in a statement posted on the Mayo Clinic Health Policy Blog last week. "Any plan to expand Medicare, which is the government's largest public plan, beyond its current scope does not solve the nation's health care crisis, but compounds it.

"Expanding this system to persons 55 to 64 years old would ultimately hurt patients by accelerating the financial ruin of hospitals and doctors across the country. A majority of Medicare providers currently suffer great financial loss under the program. Mayo Clinic alone lost $840 million last year under Medicare. As a result of these types of losses, a growing number of providers have begun to limit the number of Medicare patients in their practices."

Writing in Monday's USA Today, American Hospital Association President Richard J. Umbdenstock described the buy-in plan this way: "Imagine living in a house with a crumbling foundation and trying to repair it by adding more bedrooms."

"Making millions of non-seniors eligible for Medicare, at the same time that millions more Baby Boomers are reaching retirement age, will further weaken the program and put many hospitals at tremendous risk," Umbdenstock said. "Their ability to provide other critical services their communities need — such as trauma care, emergency care, disaster readiness and more — would be jeopardized. And, one key reason health care costs are higher for everyone is that Medicare does not pay its fair share of the cost of care. Reform should end this 'cost shift,' not make it worse."

Health insurers, who opposed the House bill because of its inclusion of a government-run public option plan, quickly opposed the Senate buy-in idea. "This would add millions of new people to a program everyone agrees is going broke," a spokesman for America's Health Insurance Plans said in a statement.

New information regarding routine mammograms and pap smears was presented today in the senate. The following is a newsclip from today.

December 3, 2009 — In a 61 to 39 vote, the US Senate today approved an amendment to its massive healthcare reform bill that would guarantee coverage of much-debated mammograms and other preventive screenings for women without any cost-sharing on their part.

The bill's primary sponsor, Sen. Barbara Mikulski (D-MD), had introduced the measure in response to the US Preventive Services Task Force (USPSTF) announcing last month that it no longer recommends routine mammograms for women aged 40 to 49 years. The USPSTF also stated that mammograms for women aged 50 years and older be performed every 2 years instead of annually. A number of medical societies and expert groups, including the American Cancer Society, have objected to the new recommendations.

Congressional Republicans point to the latest USPSTF guidelines as a preview of healthcare rationing that would occur if Democratic healthcare reform legislation passes. The Senate bill had originally required health plans to cover preventive services such as mammograms that were recommended by USPSTF and several other organizations.

The amendment offered by Sen. Mikulski would require both private and public health plans to cover preventive care and screenings specifically for women that are recommended not only by the USPSTF, but also by the Health Resources and Services Administration, a federal agency charged with expanding access to healthcare for the underserved. As a result, said Sen. Mikulski, the amendment would give all American women the same coverage for preventive care and screenings that female federal employees enjoy. And coverage for mammograms would be guaranteed.

"We don't mandate that you have a mammogram at age 40," she told the Senate earlier this week. "But if your doctor says you need one, you are going to get one."

The Senate accepted an amendment by Sen. David Vitter (R-LA) to the Mikulski amendment to strengthen the guarantee of mammograms. The Vitter amendment states that required coverage of breast-cancer screening and prevention under the Senate healthcare reform bill will reflect USPSTF recommendations prior to those released last month.

Amendment Also Addresses Pap Tests

According to Sen. Mikulski, her amendment also would guarantee coverage of cervical cancer screenings. That promised coverage also addresses fears of healthcare rationing in light of a recommendation last month by the American College of Obstetricians and Gynecologists (ACOG) for less frequent cervical cancer screening. Previous ACOG guidelines had called for annual Pap tests for women ages 21 to 29 years as well as those younger than 21 years who have been sexually active for at least 3 years. ACOG now recommends biennial Pap tests for women starting at age 21 years regardless of sexual history and continuing through age 29 years. In addition, the new guidelines state that low-risk women aged 30 years and older should have Pap test every 3 years as opposed to every 2 to 3 years if they have negative tests 3 years in a row.

Sen. Mikulski said the cost of her amendment, $940 million over 10 years, would be funded from surplus funds in the Senate reform bill.

Nov. 9, 2009 -- Long-term use of a neti pot to clear stuffy noses and blocked nasal passages may actually encourage more sinus problems rather than keep them away.

A new study shows people who used nasal saline irrigation for a year and then discontinued use the following year had 62% fewer cases of sinusitis in the year that they didn't use the device.

Neti pots have become increasingly popular in recent years for the treatment of sinus infections and other forms of sinus disease. The pots deliver a stream of sterile saline solution to the nasal passages to loosen and clear nasal congestion.

Researchers say despite the common use of nasal saline irrigation to treat sinusitis, there has been little scientific research to confirm its effectiveness. Sinusitis is an inflammation or infection of the sinuses and nasal passages that can cause headache or pressure in the eyes, nose, and cheek area as well as nasal congestion, cough, and fever.

The study, presented this week at the American College of Allergy, Asthma and Immunology (ACAAI) Annual Meeting in Miami, followed 68 people who used nasal saline irrigation for 12 months and then discontinued use for another 12 months.

The results showed that the number of cases of sinusitis decreased by 62.5% during the discontinuation phase. Researchers also compared the rates of sinusitis among those who stopped using nasal saline irrigation and another group of 24 adults who used daily nasal saline irrigation for 12 months. Again, they found sinusitis among daily users was significantly higher (50%) than among nonusers.

Researchers say nasal mucus acts as a first line of defense against infections, and long-term nasal saline irrigation may interfere with this natural immune function.

Although use of a neti pot for nasal saline irrigation may temporarily improve sinus infection symptoms, they say "its daily long-term use may result in an increased frequency of acute [sinusitis] by potentially depleting the nose of its immune blanket of mucus," write researcher Talal M. Nzouli, MD, of Washington, D.C., and colleagues in their study.

How about that thunderstorm we had last night? I awoke at 22:22 with the sound of a large sonic boom...at least that is what it sounded like. That was thunder, no doubt. Wow, I thought I was in a hurricane. The wind was blowing, the rain was hitting the side of the house, and the lightening.........wow, the lightening was an amazing show of fireworks. The lady that works the front desk at night for DoctorsNow always gives me flack about my yard..........she tells me the lightening makes my yard greener than any fertilizer. Well, ok, she is right, but I am NOT going to tell her she is right!! :)

From a scientific description, lightning refers to one of the several forms of visible electrical discharges produced by thunderstorms. It is essentially a giant spark that jumps between vast pools of positive and negative electrical charge that form inside thunderstomrs. And what is a thunder??? Thunder is the sound emitted as a result of the rapidly expanding gases along the heated lightning channel.

Sounds pretty complicated, eh? It's not my intention to complicate nature, but I think it is fun to know how far a storm is from where you are located. Yes, you can use thunder to tell how far away a storm is. Next time you see a storm, count the number of seconds between when you see the lightning and hear the thunder. Take the number of seconds and divide by 5 and that will tell you how far away the storm is in miles. For example: If you counted 10 seconds between the lightning and the thunder, the lightning is 2 miles away! I counted less than 5 seconds last night so that must mean the storm was over my house and my lawn is bright green!!! yahoo!

Hello freinds! Let's take a break from the healthcare reform chit chat. Instead, let me tell you a little bit about low back pain. Many people with chronic low back pain can improve and even fully heal their backs by doing one simple thing: stretching their hamstrings.

Your hamstrings are the muscles that run along the back of your thighs, from behind your knees to the bottom of your pelvis. If your hamstrings are tight, they are causing a constant downward pull on your pelvis. What this does is flattens out the normal curve in the low back. Since your pelvis is the foundation of your lower back and spine, having tight hamstrings contributes to an unstable lower back and a greater chance of intermittent sprains and strains.

So how do you know if your hamstrings are tight? The best way to assess hamstring length is to lie flat on your back and have someone slowly raise one leg. Your leg must be completely relaxed, and you must not help lift the leg with your own muscles. If your hamstrings are at an appropriate length for your body, your leg can be raised to 90 degrees off the ground without any significant tightness anywhere along your hamstrings from behind your knee to your sitting bone (pelvis). If you start to feel tightness before 90 degrees, you know it’s time to stretch!

Many people with chronic lower back pain can experience dramatic improvement after stretching their hamstrings on a daily basis for 1-3 months. If you don’t have lower back problems, stretching your hamstrings everyday is an excellent preventive measure that will keep your lower back and pelvis balanced for the years ahead.

One more important point to remember........stretch those hammies after you are warmed up. Never stretch a cold muscle with static stretching.

The following is an appeal that is being signed by physicians from the Community group called, Sermo. Sermo has been actively telling lawmakers that they want to participate in a meaningful reform of our healthcare system. Please read the following.


----------------------------

The Physicians' Appeal:



To the American People,

We, the physicians of this country want to reform healthcare and improve the quality and access to care for our patients while reducing costs. True healthcare reform will only succeed if:

1. Unnecessary tests and procedures are reduced through tort and malpractice reform

2. Doctors are allowed to spend more time with their patients and less time on paperwork by streamlining billing and making pricing more transparent (create an alternative to CPT codes)

3. Medical decisions are made by physicians and their patients, not insurance company administrators

4. Adequate supply of qualified physicians is assured by revising the methods used to calculate reimbursements.

We invite policy makers to work directly with the men and women who are on the frontlines of healthcare each and every day caring for the citizens of this country.

We pledge to be partners in true healthcare reform, improving the healthcare delivery system in this country while honoring the Hippocratic oath that we all have taken.



Respectfully Yours,

America's Physicians.

Public opinion polls show growing doubts about some of Mr. Obama’s health care proposals, and in the last week, several members of Congress have been confronted by constituents, protesters and advocacy groups denouncing Democratic proposals.

I'm reading all this and find one of the best lines of all......tell me you have concerns........better yet, talk to your congressman! The following is something to think about:

“Why would you guys try to stuff a health-care bill down our throats in three to four weeks when the president took six months to pick” a “dog for his kids?” one protester said. The hecklers had a sign identifying them as members of the “Ft. Stanwix Tea Party Patriots.”

Many of us know the quote “Success is a journey, not a destination. The doing is often more important than the outcome” by Arthur Ashe. A good freind of mine always reminds me that life IS, in fact, a journey....not just a destination we try to arrive at. I wonder if she has heard this quoted over and over as it seems ever so popular these days. I think the reason for the popularity is the the fact that many questions arise when we ask ourselves, "what is our purpose?" "Why are we here?"

For thousands of years, humans have believed in an afterlife, and almost all religions see life as some progression, some journey, into the afterlife. Most would agree that all life ends at the same place: death. But even death is just part of the journey of life. Death is not the destination. It is not death that we hurtle towards at the speed of 24 hours per day. Rather, it is the afterlife.....the here-after that represents the culmination of life.

Aren't there days when you seriously wonder what life is all about? Is it about the things we aspire to? Prosperity, fame, fortune. Is it about the people we meet, the family we make, the job we get? Or is it about serving God and doing all things for the glory of God? Most likely, it is the combination of all these things.

As an infant, we are at the mercy of our caregivers.....to feed us, to clothe us, to put a roof over our heads. As a toddler, we gain a little more independence. We are learning to talk, to think, to react. As a teenager, we begin to learn the importance of friends and why it feels so good to be liked, to be "IN" with the crowd. We get the hottest and best clothes, haircuts, make-ups, and say the coolest words in the dictionary! Then, holy cats........high school.....more clothes! Boyfriends and girlfriends, fancy cars, and the thought of college. Ah, life is starting to take a little curve. What the heck am I gonna do? What will I be when I grow up?

Adulthood seems like life goes into reverse. Who doesn't like the thought of having another caregiver......to feed us, to provide for us, to tell us everything will be alright. Don't worry! You cannot help but to feel overwhelmed, you feel weak, and you feel like you are having bad luck. You don't have the answers. No one ever does.

In life, remember that for every time you feel weak, there will be times of strength. For the times of bad luck, you will have times of good luck. For the times you feel blinded by your life path, there will be times you will see perfectly clear the direction you should take.

My favorite quote is, "See through eyes of Faith." No one ever said life was going to be easy, but if you keep your chin up, and keep forging ahead, rather than behind, you can make the most of your journey or "dash" as you may refer to your life from birth to everlasting. See through eyes of faith and you can never be blinded. You will have light even in times of darkness!