RE: Update: Massachusetts Insurance mandate

[Guest guest]

If you're going to send a letter the address is letter@...Remember to include your full name, address, phone number and to cite the article that triggered your letter.Here's what I sent (also blogged it with additional comments - comment on the blog if you will - http://cli.gs/pAmSPA):High performing health system achieve better outcomes, improved experience of care and at lower per person cost than the non system we have in the US.High performing health systems have comprehensive primary care as their foundation.Comprehensive primary care is defined by a patient population who can say:"I can get care when and how I need it""I have a PCP who knows me as a person""My PCP cares for the bulk of my needs""If I need care outside my PCP office I know who to turn to, my PCP coordinates my care"Presence of these attributes has in published studies reduced hospitalization rates, emergency room use, improved presenteeism at work and school, improved rates of preventive care and the effectiveness of chronic disease management. Presence of these attributes results in improved experience of care and the aggregate effect on the population results in reduced per capita costs of health care.The work of comprehensive primary care is blocked by payment policies that make primary care a repugnant career choice and punish PCPs for engaging in the full scope of work of comprehensive primary care. The solution to the problem is health reform.Health reform requires three elements:1: Everyone has access 2: The money flow inside health care supports the desired health outcomes and the work it takes to get us there3: The work of health care is redesigned to support the desired health outcomesMA provides false access and maintains broken and dysfunctional delivery system. MA moved on #1 without making any substantive move on 2 & 3. That the current plan results in an angry disillusioned public and increased costs with no demonstrable improvement in health outcome was a foregone conclusion. Our nation is about to embark on the same path. If it continues on this trajectory I predict a disappointed and angry nation paying more for bad care in 2012. Woe to the party tagged with this disaster.L. Gordon MDSeattle WAThe Massachusetts Medical Society weekly newsletter made reference to a Boston Globe piece:http://www.boston.com/news/local/massachusetts/articles/2009/04/24/er_visits_costs_in_mass_climb/According to data provided to the Globe, ER visits and costs rose in Massachusetts despite the state insurance mandate. I'm not sure what to make of it. The data covers the years 2005-2007. However the law was not passed until 2006 and did not take effect until July 2007. There was a moratorium on the penalty for non-compliance until 2008. Incomplete data. But still, no question that ER visits and costs have gone up according to the Mass. Division of Health Care Finance and Policy. Geesh. I wonder why? Could it be...not enough PCPs?The reader comments are interesting, scattering the blame on the insurance industry, doctors and of all things, illegal aliens. Anyone have a letter to the editor, ready to go, to send to the Globe? Good venue.Kathleen

[Guest guest]

Test post. Yikes, I haven't gotten any list serve messages since yesterday 5PM!The Massachusetts Medical Society weekly newsletter made reference to a Boston Globe piece:http://www.boston.com/news/local/massachusetts/articles/2009/04/24/er_visits_costs_in_mass_climb/According to data provided to the Globe, ER visits and costs rose in Massachusetts despite the state insurance mandate. I'm not sure what to make of it. The data covers the years 2005-2007. However the law was not passed until 2006 and did not take effect until July 2007. There was a moratorium on the penalty for non-compliance until 2008. Incomplete data. But still, no question that ER visits and costs have gone up according to the Mass. Division of Health Care Finance and Policy. Geesh. I wonder why? Could it be...not enough PCPs?The reader comments are interesting, scattering the blame on the insurance industry, doctors and of all things, illegal aliens. Anyone have a letter to the editor, ready to go, to send to the Globe? Good venue.Kathleen

[Guest guest]

test answer.

Test post.  Yikes, I haven't gotten any list serve messages since yesterday 5PM!

The Massachusetts Medical Society weekly newsletter made reference to a Boston Globe piece:

http://www.boston.com/news/local/massachusetts/articles/2009/04/24/er_visits_costs_in_mass_climb/

According to data provided to the Globe, ER visits and costs rose in Massachusetts despite the state insurance mandate. I'm not sure what to make of it. The data covers the years 2005-2007. However the law was not passed until 2006 and did not take effect until July 2007. There was a moratorium on the penalty for non-compliance until 2008. Incomplete data. But still, no question that ER visits and costs have gone up according to the Mass. Division of Health Care Finance and Policy. 

Geesh. I wonder why? Could it be...not enough PCPs?The reader comments are interesting, scattering the blame on the insurance industry, doctors and of all things, illegal aliens. Anyone have a letter to the editor, ready to go, to send to the Globe? Good venue.

Kathleen

-- If you are a patient please allow up to 24 hours for a reply by  email/please note the new email address.Remember  that e-mail may not be entirely secure/     MD

        ph   fax impcenter.org

[Guest guest]

Thanks Jean. Thought I was in a vacuum or time warp. Eerie. -Ktest answer.:)On Sat, Apr 25, 2009 at 11:38 AM, Kathleen Patton <krpattoncomcast (DOT) net>wrote:Test post. Yikes, I haven't gotten any list serve messages since yesterday 5PM!The Massachusetts Medical Society weekly newsletter made reference to a Boston Globe piece:http://www.boston.com/news/local/massachusetts/articles/2009/04/24/er_visits_costs_in_mass_climb/According to data provided to the Globe, ER visits and costs rose in Massachusetts despite the state insurance mandate. I'm not sure what to make of it. The data covers the years 2005-2007. However the law was not passed until 2006 and did not take effect until July 2007. There was a moratorium on the penalty for non-compliance until 2008. Incomplete data. But still, no question that ER visits and costs have gone up according to the Mass. Division of Health Care Finance and Policy. Geesh. I wonder why? Could it be...not enough PCPs?The reader comments are interesting, scattering the blame on the insurance industry, doctors and of all things, illegal aliens. Anyone have a letter to the editor, ready to go, to send to the Globe? Good venue.Kathleen-- If you are a patient please allow up to 24 hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD ph fax impcenter.org

[Guest guest]

What about this:

The new data showing increase in health care cost and ER

utilization is no surprise. Effective primary care involves the doctor, the

patient, and their relationship all working in sync. Making sure all patients

have insurance is important but only addresses one of the three components. In

order to decrease ER visits, we must have enough primary care doctors and they must

have the time to focus on the patient’s wants and needs. But at this crucial

time, medical students are shying away from primary care due to pay inequity

and their correct perception that most primary care doctors are overworked and dissatisfied.

By removing useless administrative hassles which restrict the physician’s

sense of freedom and paying primary care doctors a membership fee based on their

patient satisfaction, doctor’s can be encouraged to jump off the

treadmill of payment for quantity, begin to initiate new quality programs like

e-mail and phone visits, start re-engaging with the patient, and find joy

in medicine again. The subsequent renaissance of primary care will decrease

overall medical costs.

We already know how to provide the great care which decreases ER

use (www.impcenter.com). Unfortunately, our

type of practices will never become mainstream without payment reform. Pay

doctors to give patients “exactly what they want and need exactly when

they want and need it” and amazing things will happen. The real question

is whether the political will exists to do this.

From:

[mailto: ] On Behalf Of k.doc90

Sent: Friday, April 24, 2009 11:20 PM

To:

Subject: Update: Massachusetts Insurance mandate

The Massachusetts Medical Society weekly

newsletter made reference to a Boston Globe piece:

http://www.boston.com/news/local/massachusetts/articles/2009/04/24/er_visits_costs_in_mass_climb/

According to data provided to the Globe, ER visits and costs rose in

Massachusetts despite the state insurance mandate.

I'm not sure what to make of it. The data covers the years 2005-2007. However

the law was not passed until 2006 and did not take effect until July 2007.

There was a moratorium on the penalty for non-compliance until 2008. Incomplete

data. But still, no question that ER visits and costs have gone up according to

the Mass. Division of Health Care Finance and Policy.

Geesh. I wonder why? Could it be...not enough PCPs?

The reader comments are interesting, scattering the blame on the insurance

industry, doctors and of all things, illegal aliens.

Anyone have a letter to the editor, ready to go, to send to the Globe? Good

venue.

Kathleen

[Guest guest]

Sorry Gordon,

I was typing when yours came through. Do you think it would be

ok to send both? Initially mine was closer to 350 words, but I think most

letters to the editor need to be like 250 or so, so this is as condensed as I

can get. J

From:

[mailto: ] On Behalf Of Dr.

Brady

Sent: Saturday, April 25, 2009 11:52 AM

To:

Subject: RE: Update: Massachusetts Insurance

mandate

What about this:

The new data showing increase in health

care cost and ER utilization is no surprise. Effective primary care involves

the doctor, the patient, and their relationship all working in sync. Making

sure all patients have insurance is important but only addresses one of the

three components. In order to decrease ER visits, we must have enough primary

care doctors and they must have the time to focus on the patient’s wants and

needs. But at this crucial time, medical students are shying away from primary

care due to pay inequity and their correct perception that most primary care

doctors are overworked and dissatisfied. By removing useless administrative

hassles which restrict the physician’s sense of freedom and paying primary care

doctors a membership fee based on their patient satisfaction, doctor’s can be

encouraged to jump off the treadmill of payment for quantity, begin to

initiate new quality programs like e-mail and phone visits, start re-engaging

with the patient, and find joy in medicine again. The subsequent

renaissance of primary care will decrease overall medical costs.

We already know how to provide the great

care which decreases ER use (www.impcenter.com).

Unfortunately, our type of practices will never become mainstream without

payment reform. Pay doctors to give patients “exactly what they want and need

exactly when they want and need it” and amazing things will happen. The real

question is whether the political will exists to do this.

From:

[mailto: ]

On Behalf Of k.doc90

Sent: Friday, April 24, 2009 11:20 PM

To:

Subject: Update: Massachusetts Insurance mandate

The Massachusetts Medical Society weekly newsletter made reference to a

Boston Globe piece:

http://www.boston.com/news/local/massachusetts/articles/2009/04/24/er_visits_costs_in_mass_climb/

According to data provided to the Globe, ER visits and costs rose in

Massachusetts despite the state insurance mandate.

I'm not sure what to make of it. The data covers the years 2005-2007. However

the law was not passed until 2006 and did not take effect until July 2007.

There was a moratorium on the penalty for non-compliance until 2008. Incomplete

data. But still, no question that ER visits and costs have gone up according to

the Mass. Division of Health Care Finance and Policy.

Geesh. I wonder why? Could it be...not enough PCPs?

The reader comments are interesting, scattering the blame on the insurance

industry, doctors and of all things, illegal aliens.

Anyone have a letter to the editor, ready to go, to send to the Globe? Good

venue.

Kathleen

[Guest guest]

Go for it, , better to have different letters than duplicatesGSorry Gordon,I was typing when yours came through. Do you think it would be ok to send both? Initially mine was closer to 350 words, but I think most letters to the editor need to be like 250 or so, so this is as condensed as I can get. J From: [mailto: ] On Behalf Of Dr. BradySent: Saturday, April 25, 2009 11:52 AMTo: Subject: RE: Update: Massachusetts Insurance mandate What about this: The new data showing increase in health care cost and ER utilization is no surprise. Effective primary care involves the doctor, the patient, and their relationship all working in sync. Making sure all patients have insurance is important but only addresses one of the three components. In order to decrease ER visits, we must have enough primary care doctors and they must have the time to focus on the patient’s wants and needs. But at this crucial time, medical students are shying away from primary care due to pay inequity and their correct perception that most primary care doctors are overworked and dissatisfied. By removing useless administrative hassles which restrict the physician’s sense of freedom and paying primary care doctors a membership fee based on their patient satisfaction, doctor’s can be encouraged to jump off the treadmill of payment for quantity, begin to initiate new quality programs like e-mail and phone visits, start re-engaging with the patient, and find joy in medicine again. The subsequent renaissance of primary care will decrease overall medical costs.We already know how to provide the great care which decreases ER use (www.impcenter.com). Unfortunately, our type of practices will never become mainstream without payment reform. Pay doctors to give patients “exactly what they want and need exactly when they want and need it” and amazing things will happen. The real question is whether the political will exists to do this. From: [mailto: ] On Behalf Of k.doc90Sent: Friday, April 24, 2009 11:20 PMTo: Subject: Update: Massachusetts Insurance mandate The Massachusetts Medical Society weekly newsletter made reference to a Boston Globe piece:http://www.boston.com/news/local/massachusetts/articles/2009/04/24/er_visits_costs_in_mass_climb/According to data provided to the Globe, ER visits and costs rose in Massachusetts despite the state insurance mandate. I'm not sure what to make of it. The data covers the years 2005-2007. However the law was not passed until 2006 and did not take effect until July 2007. There was a moratorium on the penalty for non-compliance until 2008. Incomplete data. But still, no question that ER visits and costs have gone up according to the Mass. Division of Health Care Finance and Policy. Geesh. I wonder why? Could it be...not enough PCPs?The reader comments are interesting, scattering the blame on the insurance industry, doctors and of all things, illegal aliens. Anyone have a letter to the editor, ready to go, to send to the Globe? Good venue.Kathleen

[Guest guest]

,I like it. Send it! I just read Gordon's brilliant reply. ( I had to read it on the web site, because my email malfunctioned. I'll have to catch up.)I'm wondering if could mobilize her tenacious telephone crew to submit a few sentences to the Globe. If there is a large enough response they will often devote a large part of a page to the subject which of course generates more thinking and responses. The editorial board may weigh in with a considered, intelligent editorial.It's my observation, that in general, most people are so preoccupied with just living everyday, that they do not realize what the true problem with healthcare is, until they are sick. Then they are just too ill to do or say anything about it. rally your troops. The Globe is a really good venue. Healthcare is major enterprise in Boston, here in the state of Massachusetts, the home of mandated health insurance. People are listening and complaining.KathleeinPS: I'm the slowest writer in the world, I'm woikin' on mine. Plus, I have to get my 14 yo son to the hardware store to get supplies for his science project. @ : )Sorry Gordon,I was typing when yours came through. Do you think it would be ok to send both? Initially mine was closer to 350 words, but I think most letters to the editor need to be like 250 or so, so this is as condensed as I can get. J From: [mailto: ] On Behalf Of Dr. BradySent: Saturday, April 25, 2009 11:52 AMTo: Subject: RE: Update: Massachusetts Insurance mandate What about this: The new data showing increase in health care cost and ER utilization is no surprise. Effective primary care involves the doctor, the patient, and their relationship all working in sync. Making sure all patients have insurance is important but only addresses one of the three components. In order to decrease ER visits, we must have enough primary care doctors and they must have the time to focus on the patient’s wants and needs. But at this crucial time, medical students are shying away from primary care due to pay inequity and their correct perception that most primary care doctors are overworked and dissatisfied. By removing useless administrative hassles which restrict the physician’s sense of freedom and paying primary care doctors a membership fee based on their patient satisfaction, doctor’s can be encouraged to jump off the treadmill of payment for quantity, begin to initiate new quality programs like e-mail and phone visits, start re-engaging with the patient, and find joy in medicine again. The subsequent renaissance of primary care will decrease overall medical costs.We already know how to provide the great care which decreases ER use (www.impcenter.com). Unfortunately, our type of practices will never become mainstream without payment reform. Pay doctors to give patients “exactly what they want and need exactly when they want and need it” and amazing things will happen. The real question is whether the political will exists to do this. From: [mailto: ] On Behalf Of k.doc90Sent: Friday, April 24, 2009 11:20 PMTo: Subject: Update: Massachusetts Insurance mandate The Massachusetts Medical Society weekly newsletter made reference to a Boston Globe piece:http://www.boston.com/news/local/massachusetts/articles/2009/04/24/er_visits_costs_in_mass_climb/According to data provided to the Globe, ER visits and costs rose in Massachusetts despite the state insurance mandate. I'm not sure what to make of it. The data covers the years 2005-2007. However the law was not passed until 2006 and did not take effect until July 2007. There was a moratorium on the penalty for non-compliance until 2008. Incomplete data. But still, no question that ER visits and costs have gone up according to the Mass. Division of Health Care Finance and Policy. Geesh. I wonder why? Could it be...not enough PCPs?The reader comments are interesting, scattering the blame on the insurance industry, doctors and of all things, illegal aliens. Anyone have a letter to the editor, ready to go, to send to the Globe? Good venue.Kathleen

[Guest guest]

Geesh. I think I typo'ed my own name. Oh dear. I'm melting....again.Kathleen,I like it. Send it! I just read Gordon's brilliant reply. ( I had to read it on the web site, because my email malfunctioned. I'll have to catch up.)I'm wondering if could mobilize her tenacious telephone crew to submit a few sentences to the Globe. If there is a large enough response they will often devote a large part of a page to the subject which of course generates more thinking and responses. The editorial board may weigh in with a considered, intelligent editorial.It's my observation, that in general, most people are so preoccupied with just living everyday, that they do not realize what the true problem with healthcare is, until they are sick. Then they are just too ill to do or say anything about it. rally your troops. The Globe is a really good venue. Healthcare is major enterprise in Boston, here in the state of Massachusetts, the home of mandated health insurance. People are listening and complaining.KathleeinPS: I'm the slowest writer in the world, I'm woikin' on mine. Plus, I have to get my 14 yo son to the hardware store to get supplies for his science project. @ : )Sorry Gordon,I was typing when yours came through. Do you think it would be ok to send both? Initially mine was closer to 350 words, but I think most letters to the editor need to be like 250 or so, so this is as condensed as I can get. J From: [mailto: ] On Behalf Of Dr. BradySent: Saturday, April 25, 2009 11:52 AMTo: Subject: RE: Update: Massachusetts Insurance mandate What about this: The new data showing increase in health care cost and ER utilization is no surprise. Effective primary care involves the doctor, the patient, and their relationship all working in sync. Making sure all patients have insurance is important but only addresses one of the three components. In order to decrease ER visits, we must have enough primary care doctors and they must have the time to focus on the patient’s wants and needs. But at this crucial time, medical students are shying away from primary care due to pay inequity and their correct perception that most primary care doctors are overworked and dissatisfied. By removing useless administrative hassles which restrict the physician’s sense of freedom and paying primary care doctors a membership fee based on their patient satisfaction, doctor’s can be encouraged to jump off the treadmill of payment for quantity, begin to initiate new quality programs like e-mail and phone visits, start re-engaging with the patient, and find joy in medicine again. The subsequent renaissance of primary care will decrease overall medical costs.We already know how to provide the great care which decreases ER use (www.impcenter.com). Unfortunately, our type of practices will never become mainstream without payment reform. Pay doctors to give patients “exactly what they want and need exactly when they want and need it” and amazing things will happen. The real question is whether the political will exists to do this. From: [mailto: ] On Behalf Of k.doc90Sent: Friday, April 24, 2009 11:20 PMTo: Subject: Update: Massachusetts Insurance mandate The Massachusetts Medical Society weekly newsletter made reference to a Boston Globe piece:http://www.boston.com/news/local/massachusetts/articles/2009/04/24/er_visits_costs_in_mass_climb/According to data provided to the Globe, ER visits and costs rose in Massachusetts despite the state insurance mandate. I'm not sure what to make of it. The data covers the years 2005-2007. However the law was not passed until 2006 and did not take effect until July 2007. There was a moratorium on the penalty for non-compliance until 2008. Incomplete data. But still, no question that ER visits and costs have gone up according to the Mass. Division of Health Care Finance and Policy. Geesh. I wonder why? Could it be...not enough PCPs?The reader comments are interesting, scattering the blame on the insurance industry, doctors and of all things, illegal aliens. Anyone have a letter to the editor, ready to go, to send to the Globe? Good venue.Kathleen

[Guest guest]

Gordon, well said! I am so glad you are on our side. I sure

wish you could be our ‘Primary Care General’ (who needs a SURGEON General

anyway?)!

Eads, MD

Pinnacle

Family Medicine

Colorado

Springs, Colorado

www.PinnacleFamilyMedicine.com

From:

[mailto: ] On Behalf Of L. Gordon

Sent: Saturday, April 25, 2009 9:26 AM

To:

Subject: Re: Update: Massachusetts Insurance

mandate

If you're going to send a letter the address is letter@...

Remember to include your full name, address, phone number

and to cite the article that triggered your letter.

Here's what I sent (also blogged it with additional comments

- comment on the blog if you will - http://cli.gs/pAmSPA):

High performing health system achieve better outcomes,

improved experience of care and at lower per person cost than the non system we

have in the US.

High performing health systems have comprehensive primary

care as their foundation.

Comprehensive primary care is defined by a patient

population who can say:

" I can get care when and how I need it "

" I have a PCP who knows me as a person "

" My PCP cares for the bulk of my needs "

" If I need care outside my PCP office I know who to

turn to, my PCP coordinates my care "

Presence of these attributes has in published studies

reduced hospitalization rates, emergency room use, improved presenteeism at

work and school, improved rates of preventive care and the effectiveness of

chronic disease management. Presence of these attributes results in

improved experience of care and the aggregate effect on the population results

in reduced per capita costs of health care.

The work of comprehensive primary care is blocked by payment

policies that make primary care a repugnant career choice and punish PCPs for

engaging in the full scope of work of comprehensive primary care. The

solution to the problem is health reform.

Health reform requires three elements:

1: Everyone has access

2: The money flow inside health care supports the

desired health outcomes and the work it takes to get us there

3: The work of health care is redesigned to support

the desired health outcomes

MA provides false access and maintains broken and

dysfunctional delivery system. MA moved on #1 without making any

substantive move on 2 & 3. That the current plan results in an

angry disillusioned public and increased costs with no demonstrable

improvement in health outcome was a foregone conclusion. Our nation is

about to embark on the same path. If it continues on this trajectory I

predict a disappointed and angry nation paying more for bad care in

2012. Woe to the party tagged with this disaster.

L. Gordon MD

Seattle WA

The Massachusetts Medical Society

weekly newsletter made reference to a Boston Globe piece:

http://www.boston.com/news/local/massachusetts/articles/2009/04/24/er_visits_costs_in_mass_climb/

According to data provided to the Globe, ER visits and costs rose in

Massachusetts despite the state insurance mandate.

I'm not sure what to make of it. The data covers the years 2005-2007. However

the law was not passed until 2006 and did not take effect until July 2007.

There was a moratorium on the penalty for non-compliance until 2008. Incomplete

data. But still, no question that ER visits and costs have gone up according to

the Mass. Division of Health Care Finance and Policy.

Geesh. I wonder why? Could it be...not enough PCPs?

The reader comments are interesting, scattering the blame on the insurance

industry, doctors and of all things, illegal aliens.

Anyone have a letter to the editor, ready to go, to send to the Globe? Good

venue.

Kathleen

[Guest guest]

Dear  KathleeinI sent a short letter. Doesn't hold up to G's  or Brady.'s eloquenceBut as to marshaling forces- my forces are  your forces  You are my force.JE an 

,I like it.  Send it!  I just read Gordon's brilliant reply.  ( I had to read it on the web site, because my email malfunctioned.  I'll have to catch up.)

I'm wondering if could mobilize her tenacious telephone crew to submit a few sentences to the Globe.  If there is a large enough response they will often devote a large part of a page to the subject which of course generates more thinking and responses.  The editorial board may weigh in with a considered, intelligent editorial.

It's my observation, that in general, most people are so preoccupied with just living everyday, that they do not realize what the true problem with healthcare is, until they are sick.  Then they are just too ill to do or say anything about it. 

rally your troops.  The Globe is a really good venue. Healthcare is major enterprise in Boston, here in the state of Massachusetts, the home of mandated health insurance.  People are listening and complaining.

KathleeinPS:  I'm the slowest writer in the world, I'm woikin' on mine.  Plus, I have to get my 14 yo  son to the hardware store to get supplies for his science project. @ : )

Sorry Gordon,

I was typing when yours came through. Do you think it would be ok to send both? Initially mine was closer to 350 words, but I think most letters to the editor need to be like 250 or so, so this is as condensed as I can get. J

 From:  [mailto: ] On Behalf Of Dr. Brady

Sent: Saturday, April 25, 2009 11:52 AMTo:  Subject: RE: Update: Massachusetts Insurance mandate

 What about this:

 The new data showing increase in health care cost and ER utilization is no surprise. Effective primary care involves the doctor, the patient, and their relationship all working in sync. Making sure all patients have insurance is important but only addresses one of the three components. In order to decrease ER visits, we must have enough primary care doctors and they must have the time to focus on the patient’s wants and needs. But at this crucial time, medical students are shying away from primary care due to pay inequity and their correct perception that most primary care doctors are overworked and dissatisfied. By removing useless administrative hassles which restrict the physician’s sense of freedom and paying primary care doctors a membership fee based on their patient satisfaction, doctor’s can be encouraged to  jump off the treadmill of payment for quantity, begin to initiate new quality programs like e-mail and phone visits, start re-engaging with the patient, and find  joy in medicine again. The subsequent renaissance of primary care will decrease overall medical costs.

We already know how to provide the great care which decreases ER use (www.impcenter.com). Unfortunately, our type of practices will never become mainstream without payment reform. Pay doctors to give patients “exactly what they want and need exactly when they want and need it” and amazing things will happen. The real question is whether  the political will exists to do this.

  

From:  [mailto: ] On Behalf Of k.doc90

Sent: Friday, April 24, 2009 11:20 PMTo:  Subject:  Update: Massachusetts Insurance mandate

 The Massachusetts Medical Society weekly newsletter made reference to a Boston Globe piece:

http://www.boston.com/news/local/massachusetts/articles/2009/04/24/er_visits_costs_in_mass_climb/

According to data provided to the Globe, ER visits and costs rose in Massachusetts despite the state insurance mandate. I'm not sure what to make of it. The data covers the years 2005-2007. However the law was not passed until 2006 and did not take effect until July 2007. There was a moratorium on the penalty for non-compliance until 2008. Incomplete data. But still, no question that ER visits and costs have gone up according to the Mass. Division of Health Care Finance and Policy. 

Geesh. I wonder why? Could it be...not enough PCPs?The reader comments are interesting, scattering the blame on the insurance industry, doctors and of all things, illegal aliens. Anyone have a letter to the editor, ready to go, to send to the Globe? Good venue.

Kathleen

-- If you are a patient please allow up to 24 hours for a reply by  email/please note the new email address.Remember  that e-mail may not be entirely secure/

    MD         ph   fax impcenter.org

[Guest guest]

All yall please read http://www.pnhp.org/news/2009/april/testimony_of_david_u.php

Hilsbos

Fairmont West Virginia

From: [mailto: ] On Behalf Of L. Gordon Sent: Saturday, April 25, 2009 11:26 AMTo: Subject: Re: Update: Massachusetts Insurance mandate

[Guest guest]

,

Great and to the point set of facts.... Challenges the entire factless, pie in the sky, paid for by well financed special interests of High Tech, Big Pharma and the Insurance rs, total farce head on... NOW this little print out needs to get to all of our newspaper editors and TV News Producers across the country... You keep these jems coming. Thanks for sharing....

To: Sent: Sunday, April 26, 2009 8:38:35 AMSubject: RE: Update: Massachusetts Insurance mandate

All yall please read http://www.pnhp. org/news/ 2009/april/ testimony_ of_david_ u.php

Hilsbos

Fairmont West Virginia

From: Practiceimprovement 1yahoogroups (DOT) com [mailto:Practiceimp rovement1@ yahoogroups. com] On Behalf Of L. Gordon Sent: Saturday, April 25, 2009 11:26 AMTo: Practiceimprovement 1yahoogroups (DOT) comSubject: Re: [Practiceimprovemen t1] Update: Massachusetts Insurance mandate

[Guest guest]

Glad you enjoyed/appreciated it. We have been members of PNHP for a long time and have always appreciated the scholarship and perspectives of its leadership, but since the returns on the Mass experiment have started rolling in, it seems their arguments are almost irrefutable.

From: [mailto: ] On Behalf Of BleiweissSent: Sunday, April 26, 2009 9:53 AMTo: Subject: Re: Update: Massachusetts Insurance mandate

,

Great and to the point set of facts.... Challenges the entire factless, pie in the sky, paid for by well financed special interests of High Tech, Big Pharma and the Insurance rs, total farce head on... NOW this little print out needs to get to all of our newspaper editors and TV News Producers across the country... You keep these jems coming. Thanks for sharing....

From: Hilsbos <NHilsboshilsbosfamilycare>To: Sent: Sunday, April 26, 2009 8:38:35 AMSubject: RE: Update: Massachusetts Insurance mandate

All yall please read http://www.pnhp. org/news/ 2009/april/ testimony_ of_david_ u.php

Hilsbos

Fairmont West Virginia

From: Practiceimprovement 1yahoogroups (DOT) com [mailto:Practiceimp rovement1@ yahoogroups. com] On Behalf Of L. Gordon Sent: Saturday, April 25, 2009 11:26 AMTo: Practiceimprovement 1yahoogroups (DOT) comSubject: Re: [Practiceimprovemen t1] Update: Massachusetts Insurance mandate

[Guest guest]

To All,

PNHP has the correct diagnosis but the wrong treatment. The danger with any

goverment run program is best illustrated by the scandal involving the New

Jersey school of Medicine and Dentristy were the school and hospital became a

dumping ground for political no show jobs! New Jersey does not have a monopoly

on corrupt polititians. Lets be carefull.

Teo Fernandez

>

> Glad you enjoyed/appreciated it. We have been members of PNHP for a

> long time and have always appreciated the scholarship and perspectives

> of its leadership, but since the returns on the Mass experiment have

> started rolling in, it seems their arguments are almost irrefutable.

>

>

>

> ________________________________

>

> From:

> [mailto: ] On Behalf Of

> Bleiweiss

> Sent: Sunday, April 26, 2009 9:53 AM

> To:

> Subject: Re: Update: Massachusetts Insurance

> mandate

>

>

>

>

>

> ,

> Great and to the point set of facts.... Challenges the entire

> factless, pie in the sky, paid for by well financed special interests of

> High Tech, Big Pharma and the Insurance rs, total farce head on...

> NOW this little print out needs to get to all of our newspaper editors

> and TV News Producers across the country... You keep these jems coming.

> Thanks for sharing....

>

>

>

> ________________________________

>

>

> To:

> Sent: Sunday, April 26, 2009 8:38:35 AM

> Subject: RE: Update: Massachusetts Insurance

> mandate

>

>

>

> All yall please read http://www.pnhp. org/news/ 2009/april/ testimony_

> of_david_ u.php

> <http://www.pnhp.org/news/2009/april/testimony_of_david_u.php>

> <http://geo.yahoo.com/serv?s=97359714/grpId=9360914/grpspId=1705061327/m

> sgId=33396/stime=1240673255/nc1=1/nc2=2/nc3=3>

>

> Hilsbos

> Fairmont West Virginia

>

>

> ________________________________

>

> From: Practiceimprovement 1yahoogroups (DOT) com [mailto:Practiceimp

> rovement1@ yahoogroups. com] On Behalf Of L. Gordon

> Sent: Saturday, April 25, 2009 11:26 AM

> To: Practiceimprovement 1yahoogroups (DOT) com

> Subject: Re: [Practiceimprovemen t1] Update: Massachusetts Insurance

> mandate

>

[Guest guest]

Teo,

I don’t get the analogy.  NJMD was a dual problem of

corrupt pay for performance politics, nothing to do with health care or

insurance, and the hospital problem was straight medicare fraud.  I do agree on

one thing, NJ is one of the most corrupt states in the union, at all levels.

I can point out to you that the “private companies”

Health First and Wellcare had their executives indicted and are defending

themselves for fraud due to bilking Medicare and Medicaid of millions on one

side and abusing their patients with denials and false misrepresentations. 

Those privateers are the ones that scare me.  Remember the only market economy

these 2 believe in, is the one subsidized by the government.   NYS even took

them out of the Medicaid business for a while.

Batlle, MD

From:

[mailto: ] On Behalf Of tlf1123

Sent: Wednesday, April 29, 2009 10:07 AM

To:

Subject: Re: Update: Massachusetts Insurance

mandate

To All,

PNHP has the correct diagnosis but the wrong treatment. The danger with any

goverment run program is best illustrated by the scandal involving the New

Jersey school of Medicine and Dentristy were the school and hospital became a

dumping ground for political no show jobs! New Jersey does not have a monopoly

on corrupt polititians. Lets be carefull.

Teo Fernandez

>

> Glad you enjoyed/appreciated it. We have been members of PNHP for a

> long time and have always appreciated the scholarship and perspectives

> of its leadership, but since the returns on the Mass experiment have

> started rolling in, it seems their arguments are almost irrefutable.

>

>

>

> ________________________________

>

> From:

> [mailto: ]

On Behalf Of

> Bleiweiss

> Sent: Sunday, April 26, 2009 9:53 AM

> To:

> Subject: Re: Update: Massachusetts Insurance

> mandate

>

>

>

>

>

> ,

> Great and to the point set of facts.... Challenges the entire

> factless, pie in the sky, paid for by well financed special interests of

> High Tech, Big Pharma and the Insurance rs, total farce head on...

> NOW this little print out needs to get to all of our newspaper editors

> and TV News Producers across the country... You keep these jems coming.

> Thanks for sharing....

>

>

>

> ________________________________

>

>

> To:

> Sent: Sunday, April 26, 2009 8:38:35 AM

> Subject: RE: Update: Massachusetts Insurance

> mandate

>

>

>

> All yall please read http://www.pnhp.

org/news/ 2009/april/ testimony_

> of_david_ u.php

> <http://www.pnhp.org/news/2009/april/testimony_of_david_u.php>

> <http://geo.yahoo.com/serv?s=97359714/grpId=9360914/grpspId=1705061327/m

> sgId=33396/stime=1240673255/nc1=1/nc2=2/nc3=3>

>

> Hilsbos

> Fairmont West Virginia

>

>

> ________________________________

>

> From: Practiceimprovement 1yahoogroups (DOT) com [mailto:Practiceimp

> rovement1@ yahoogroups. com] On Behalf Of L. Gordon

> Sent: Saturday, April 25, 2009 11:26 AM

> To: Practiceimprovement 1yahoogroups (DOT) com

> Subject: Re: [Practiceimprovemen t1] Update: Massachusetts Insurance

> mandate

>

[Guest guest]

,

The power resides with the ones that control the purse. A one payer system shift

control from the corrupt, greede insurance CEOs to the goverment not the

patients who are the consumers. A goverment were the decision makers are mostly

LAWYERS.

Teo.

> >

> > Glad you enjoyed/appreciated it. We have been members of PNHP for a

> > long time and have always appreciated the scholarship and perspectives

> > of its leadership, but since the returns on the Mass experiment have

> > started rolling in, it seems their arguments are almost irrefutable.

> >

> >

> >

> > ________________________________

> >

> > From:

> <mailto:%40yahoogroups.com>

> > [mailto:

> <mailto:%40yahoogroups.com> ] On Behalf Of

> > Bleiweiss

> > Sent: Sunday, April 26, 2009 9:53 AM

> > To:

> <mailto:%40yahoogroups.com>

> > Subject: Re: Update: Massachusetts Insurance

> > mandate

> >

> >

> >

> >

> >

> > ,

> > Great and to the point set of facts.... Challenges the entire

> > factless, pie in the sky, paid for by well financed special interests of

> > High Tech, Big Pharma and the Insurance rs, total farce head on...

> > NOW this little print out needs to get to all of our newspaper editors

> > and TV News Producers across the country... You keep these jems coming.

> > Thanks for sharing....

> >

> >

> >

> > ________________________________

> >

> > From: Hilsbos <NHilsbos@>

> > To:

> <mailto:%40yahoogroups.com>

> > Sent: Sunday, April 26, 2009 8:38:35 AM

> > Subject: RE: Update: Massachusetts Insurance

> > mandate

> >

> >

> >

> > All yall please read http://www.pnhp. org/news/ 2009/april/ testimony_

> > of_david_ u.php

> > <http://www.pnhp.org/news/2009/april/testimony_of_david_u.php>

> > <http://geo.yahoo.com/serv?s=97359714/grpId=9360914/grpspId=1705061327/m

> > sgId=33396/stime=1240673255/nc1=1/nc2=2/nc3=3>

> >

> > Hilsbos

> > Fairmont West Virginia

> >

> >

> > ________________________________

> >

> > From: Practiceimprovement 1yahoogroups (DOT) com [mailto:Practiceimp

> > rovement1@ yahoogroups. com] On Behalf Of L. Gordon

> > Sent: Saturday, April 25, 2009 11:26 AM

> > To: Practiceimprovement 1yahoogroups (DOT) com

> > Subject: Re: [Practiceimprovemen t1] Update: Massachusetts Insurance

> > mandate

> >

>

[Guest guest]

Teo,If the current system and one payer system won't work, what do you think is the ideal solution to the health care problem? SetoSouth Pasadena, CA , The power resides with the ones that control the purse. A one payer system shift control from the corrupt, greede insurance CEOs to the goverment not the patients who are the consumers. A goverment were the decision makers are mostly LAWYERS. Teo. > > > > Glad you enjoyed/appreciated it. We have been members of PNHP for a > > long time and have always appreciated the scholarship and perspectives > > of its leadership, but since the returns on the Mass experiment have > > started rolling in, it seems their arguments are almost irrefutable. > > > > > > > > ________________________________ > > > > From: > <mailto:%40yahoogroups.com> > > [mailto: > <mailto:%40yahoogroups.com> ] On Behalf Of > > Bleiweiss > > Sent: Sunday, April 26, 2009 9:53 AM > > To: > <mailto:%40yahoogroups.com> > > Subject: Re: Update: Massachusetts Insurance > > mandate > > > > > > > > > > > > , > > Great and to the point set of facts.... Challenges the entire > > factless, pie in the sky, paid for by well financed special interests of > > High Tech, Big Pharma and the Insurance rs, total farce head on... > > NOW this little print out needs to get to all of our newspaper editors > > and TV News Producers across the country... You keep these jems coming. > > Thanks for sharing.... > > > > > > > > ________________________________ > > > > From: Hilsbos <NHilsbos@> > > To: > <mailto:%40yahoogroups.com> > > Sent: Sunday, April 26, 2009 8:38:35 AM > > Subject: RE: Update: Massachusetts Insurance > > mandate > > > > > > > > All yall please read http://www.pnhp. org/news/ 2009/april/ testimony_ > > of_david_ u.php > > <http://www.pnhp.org/news/2009/april/testimony_of_david_u.php> > > <http://geo.yahoo.com/serv?s=97359714/grpId=9360914/grpspId=1705061327/m > > sgId=33396/stime=1240673255/nc1=1/nc2=2/nc3=3> > > > > Hilsbos > > Fairmont West Virginia > > > > > > ________________________________ > > > > From: Practiceimprovement 1yahoogroups (DOT) com [mailto:Practiceimp > > rovement1@ yahoogroups. com] On Behalf Of L. Gordon > > Sent: Saturday, April 25, 2009 11:26 AM > > To: Practiceimprovement 1yahoogroups (DOT) com > > Subject: Re: [Practiceimprovemen t1] Update: Massachusetts Insurance > > mandate > > >

[Guest guest]

Teo,

Just pointing out that I don’t believe it can be any worse

than it is know.  One thing I know for sure: what we have now is bad and only

getting worse.  I am open to suggestions but we should, at least, not mix

apples and oranges. 

By the way, we elect the government, at least there is a possibility

of change if we decide to participate and make it happen.  I can give you some

examples: universal suffrage (aka women’s vote), desegregation, family

leave (in most states) and gay marriage are some that come to mind.  If we

decide to bring our patients to the fight, while we approach the problem from

an open mind, inclusive and realistic point of view it can happen.  As long as

we try to selfishly protect our molecule of the pie we are doomed. I am talking

a Union with the power to stop al care that is not delivered in cash for a week

type of struggle.  As long as we are made to believe that making money in

medicine is somehow obscene, by the way only if you are a physician, we won’t

talk about it or fight for what is right.

 It won’t be easy but

change can happen.  Remember “If all you ever do is all you’ve ever

done, then all you’ll ever get is all you ever got”.

Personally, again, I believe that it is going to take a fight:

on the one side providers and their patients on the other the extraneous money

makers.

Just a thought,

José from Hoboken

From:

[mailto: ] On Behalf Of tlf1123

Sent: Wednesday, April 29, 2009 2:22 PM

To:

Subject: Re: Update: Massachusetts Insurance

mandate

,

The power resides with the ones that control the purse. A one payer system

shift control from the corrupt, greede insurance CEOs to the goverment not the

patients who are the consumers. A goverment were the decision makers are mostly

LAWYERS.

Teo.

> >

> > Glad you enjoyed/appreciated it. We have been members of PNHP for a

> > long time and have always appreciated the scholarship and

perspectives

> > of its leadership, but since the returns on the Mass experiment have

> > started rolling in, it seems their arguments are almost irrefutable.

> >

> >

> >

> > ________________________________

> >

> > From:

> <mailto:%40yahoogroups.com>

> > [mailto:

> <mailto:%40yahoogroups.com> ] On Behalf Of

> > Bleiweiss

> > Sent: Sunday, April 26, 2009 9:53 AM

> > To:

> <mailto:%40yahoogroups.com>

> > Subject: Re: Update: Massachusetts Insurance

> > mandate

> >

> >

> >

> >

> >

> > ,

> > Great and to the point set of facts.... Challenges the entire

> > factless, pie in the sky, paid for by well financed special interests

of

> > High Tech, Big Pharma and the Insurance rs, total farce head

on...

> > NOW this little print out needs to get to all of our newspaper

editors

> > and TV News Producers across the country... You keep these jems

coming.

> > Thanks for sharing....

> >

> >

> >

> > ________________________________

> >

> > From: Hilsbos <NHilsbos@>

> > To:

> <mailto:%40yahoogroups.com>

> > Sent: Sunday, April 26, 2009 8:38:35 AM

> > Subject: RE: Update: Massachusetts Insurance

> > mandate

> >

> >

> >

> > All yall please read http://www.pnhp.

org/news/ 2009/april/ testimony_

> > of_david_ u.php

> > <http://www.pnhp.org/news/2009/april/testimony_of_david_u.php>

> > <http://geo.yahoo.com/serv?s=97359714/grpId=9360914/grpspId=1705061327/m

> > sgId=33396/stime=1240673255/nc1=1/nc2=2/nc3=3>

> >

> > Hilsbos

> > Fairmont West Virginia

> >

> >

> > ________________________________

> >

> > From: Practiceimprovement 1yahoogroups (DOT) com [mailto:Practiceimp

> > rovement1@ yahoogroups. com] On Behalf Of L. Gordon

> > Sent: Saturday, April 25, 2009 11:26 AM

> > To: Practiceimprovement 1yahoogroups (DOT) com

> > Subject: Re: [Practiceimprovemen t1] Update: Massachusetts Insurance

> > mandate

> >

>

[Guest guest]

,

Here are other options that do not force you to work for a hospital or trade six

corporate masters for one goverment burocracy:

http://www.ncpa.org/pdfs/health_plan112007.pdf

http://www.consumerdrivenhealthcare.us/

http://www.cdhci.org/

http://www.healthcareguaranteed.org/HealthCare_Guaranteed/Home.html

http://books.google.com/books?id=mCT6OXjlxP4C & dq=consumer+driven+healthcare & prin\

tsec=frontcover & source=in & hl=en & ei=Euf5SbnsB4aEtwf09PCoAw & sa=X & oi=book_result & ct\

=result & resnum=11

http://books.google.com/books?id=D4Afl4CEuFoC & dq=consumer+driven+healthcare & prin\

tsec=frontcover & source=in & hl=en & ei=Euf5SbnsB4aEtwf09PCoAw & sa=X & oi=book_result & ct\

=result & resnum=12

Teo.

> > > >

> > > > Glad you enjoyed/appreciated it. We have been members of PNHP

> > for a

> > > > long time and have always appreciated the scholarship and

> > perspectives

> > > > of its leadership, but since the returns on the Mass experiment

> > have

> > > > started rolling in, it seems their arguments are almost

> > irrefutable.

> > > >

> > > >

> > > >

> > > > ________________________________

> > > >

> > > > From:

> > > <mailto:%40yahoogroups.com>

> > > > [mailto:

> > > <mailto:%40yahoogroups.com> ] On Behalf Of

> > > > Bleiweiss

> > > > Sent: Sunday, April 26, 2009 9:53 AM

> > > > To:

> > > <mailto:%40yahoogroups.com>

> > > > Subject: Re: Update: Massachusetts

> > Insurance

> > > > mandate

> > > >

> > > >

> > > >

> > > >

> > > >

> > > > ,

> > > > Great and to the point set of facts.... Challenges the entire

> > > > factless, pie in the sky, paid for by well financed special

> > interests of

> > > > High Tech, Big Pharma and the Insurance rs, total farce

> > head on...

> > > > NOW this little print out needs to get to all of our newspaper

> > editors

> > > > and TV News Producers across the country... You keep these jems

> > coming.

> > > > Thanks for sharing....

> > > >

> > > >

> > > >

> > > > ________________________________

> > > >

> > > > From: Hilsbos <NHilsbos@>

> > > > To:

> > > <mailto:%40yahoogroups.com>

> > > > Sent: Sunday, April 26, 2009 8:38:35 AM

> > > > Subject: RE: Update: Massachusetts

> > Insurance

> > > > mandate

> > > >

> > > >

> > > >

> > > > All yall please read http://www.pnhp. org/news/ 2009/april/

> > testimony_

> > > > of_david_ u.php

> > > > <http://www.pnhp.org/news/2009/april/testimony_of_david_u.php>

> > > > <http://geo.yahoo.com/serv?s=97359714/grpId=9360914/grpspId=1705061327/m

> > > > sgId=33396/stime=1240673255/nc1=1/nc2=2/nc3=3>

> > > >

> > > > Hilsbos

> > > > Fairmont West Virginia

> > > >

> > > >

> > > > ________________________________

> > > >

> > > > From: Practiceimprovement 1yahoogroups (DOT) com [mailto:Practiceimp

> > > > rovement1@ yahoogroups. com] On Behalf Of L. Gordon

> > > > Sent: Saturday, April 25, 2009 11:26 AM

> > > > To: Practiceimprovement 1yahoogroups (DOT) com

> > > > Subject: Re: [Practiceimprovemen t1] Update: Massachusetts

> > Insurance

> > > > mandate

> > > >

> > >

> >

> >

>

[Guest guest]

Teo,

I really don’t understand where you are coming from? Here

is one example of what you propose as “change”, all others are

similar versions.

Of all of

the competing proposals for healthcare reform, only GHAP fully addresses all

seven essential elements of reform. Under this plan:

1. •The Federal government provides every American with a healthcare

certificate to redeem for a participating health plan

2. •Participating plans, private or public, must offer a standard set

of services in exchange for a healthcare certificate

3. •Individuals are free to choose among competing plans for one that

most closely matches their specific needs

4. •The competitive nature of this insurance market, together with

cost and quality standards established by a politically independent health

board, assure cost control and improved outcomes

5. •GHAP is funded by a dedicated tax managed by this same independent

health board

Personally, I don’t think that this evolution on Medicare

Advantage would work.  Why do we need to keep middle men in the loop.  What

benefit to society do insurance health care business men provide if they don’t

produce the only benefit insurance can provide: pool risk to make care

affordable.

The problem is not that people can’t choose insurance,

there is ample insurance out there but that insurance companies first cherry

pick healthy people and, second they don’t pay the providers of healthcare. 

Why do we need a system that skims 15% from the top to pay executives and share

holders?  Why do we need to spend tax payer money to subsidize these companies

that provide NO ADDED VALUE to the system?

Why is the business man, intended to skim money out of a system

where he does not add value, better than the government bureaucrat? Last I remember

the Blues, UHC, Aetna where as bloated with bureaucrats as the government, at

least last time a called.

If competition in the insurance market would have provided a

great system it would have happen by now, all we have got out of this 30 plus year

experiment is a very expensive and convoluted system that does not serve the

citizens of our nation but rather takes a lot of money out of their pockets and

when is needed makes a huge effort to kick you out of the system and put you on

the tax payer dime.  From the provider point of view it has decimated health maintenance

type care favoring treatment of disease that becomes an inevitable expense that

they may or may not have to pay for.

By the way, in case you want to know, the above is Ezekiel Emanuel’s

vision, he is the point guard for the administration.

Remember outpatient is a sideshow in the process, the real

expense that keeps people hostage to insurance is hospital expenses.  If we

adopt a “truthful billing” policy, in other words the hospital

charges the same to all comers, for example a procedure would cost X to cash

patients and insurance companies and not X-70% to insurance companies; we may

get to a point where citizens can truly afford health saving accounts and

cheap, most likely government sponsored, high deductible insurance that would

bring market pressures to the system.  No need for middle men skimming “profits”. 

Pharma would not be able to charge unconscionable prices for meds.  Our

citizenship would not pay for administrative fees, unnecessary incurred, because

hospitals have to “bill” for every piece of cotton, syringe, temperature

probe cover and suture they use and which motivates the need for huge billing

departments and staffers.

There are better ides out there the ones you proposed are not.

Just a thought,

José from Hoboken

From:

[mailto: ] On Behalf Of tlf1123

Sent: Thursday, April 30, 2009 2:31 PM

To:

Subject: Re: Update: Massachusetts Insurance

mandate

,

Here are other options that do not force you to work for a hospital or trade six

corporate masters for one goverment burocracy:

http://www.ncpa.org/pdfs/health_plan112007.pdf

http://www.consumerdrivenhealthcare.us/

http://www.cdhci.org/

http://www.healthcareguaranteed.org/HealthCare_Guaranteed/Home.html

http://books.google.com/books?id=mCT6OXjlxP4C & dq=consumer+driven+healthcare & printsec=frontcover & source=in & hl=en & ei=Euf5SbnsB4aEtwf09PCoAw & sa=X & oi=book_result & ct=result & resnum=11

http://books.google.com/books?id=D4Afl4CEuFoC & dq=consumer+driven+healthcare & printsec=frontcover & source=in & hl=en & ei=Euf5SbnsB4aEtwf09PCoAw & sa=X & oi=book_result & ct=result & resnum=12

Teo.

> > > >

> > > > Glad you enjoyed/appreciated it. We have been members of

PNHP

> > for a

> > > > long time and have always appreciated the scholarship and

> > perspectives

> > > > of its leadership, but since the returns on the Mass

experiment

> > have

> > > > started rolling in, it seems their arguments are almost

> > irrefutable.

> > > >

> > > >

> > > >

> > > > ________________________________

> > > >

> > > > From:

> > > <mailto:%40yahoogroups.com>

> > > > [mailto:

> > > <mailto:%40yahoogroups.com> ] On

Behalf Of

> > > > Bleiweiss

> > > > Sent: Sunday, April 26, 2009 9:53 AM

> > > > To:

> > > <mailto:%40yahoogroups.com>

> > > > Subject: Re: Update: Massachusetts

> > Insurance

> > > > mandate

> > > >

> > > >

> > > >

> > > >

> > > >

> > > > ,

> > > > Great and to the point set of facts.... Challenges the

entire

> > > > factless, pie in the sky, paid for by well financed special

> > interests of

> > > > High Tech, Big Pharma and the Insurance rs, total

farce

> > head on...

> > > > NOW this little print out needs to get to all of our

newspaper

> > editors

> > > > and TV News Producers across the country... You keep these

jems

> > coming.

> > > > Thanks for sharing....

> > > >

> > > >

> > > >

> > > > ________________________________

> > > >

> > > > From: Hilsbos <NHilsbos@>

> > > > To:

> > > <mailto:%40yahoogroups.com>

> > > > Sent: Sunday, April 26, 2009 8:38:35 AM

> > > > Subject: RE: Update: Massachusetts

> > Insurance

> > > > mandate

> > > >

> > > >

> > > >

> > > > All yall please read http://www.pnhp.

org/news/ 2009/april/

> > testimony_

> > > > of_david_ u.php

> > > > <http://www.pnhp.org/news/2009/april/testimony_of_david_u.php>

> > > > <http://geo.yahoo.com/serv?s=97359714/grpId=9360914/grpspId=1705061327/m

> > > > sgId=33396/stime=1240673255/nc1=1/nc2=2/nc3=3>

> > > >

> > > > Hilsbos

> > > > Fairmont West Virginia

> > > >

> > > >

> > > > ________________________________

> > > >

> > > > From: Practiceimprovement 1yahoogroups (DOT) com

[mailto:Practiceimp

> > > > rovement1@ yahoogroups. com] On Behalf Of L. Gordon

> > > > Sent: Saturday, April 25, 2009 11:26 AM

> > > > To: Practiceimprovement 1yahoogroups (DOT) com

> > > > Subject: Re: [Practiceimprovemen t1] Update: Massachusetts

> > Insurance

> > > > mandate

> > > >

> > >

> >

> >

>

[Guest guest]

,

I included other view points to refflect the funding side for national helathcare as well as the need to reign in the uncontolled litigation mess. I think the important players, providers and patients are the ones best equiped to set the direction. I prefer a consumer driven system. It is the only one with the freedom for both providers and consumers.

Teo.

Subject: RE: Re: Update: Massachusetts Insurance mandateTo: Date: Thursday, April 30, 2009, 3:47 PM

Teo,

I really don’t understand where you are coming from? Here is one example of what you propose as “changeâ€, all others are similar versions.

Of all of the competing proposals for healthcare reform, only GHAP fully addresses all seven essential elements of reform. Under this plan:

1. •The Federal government provides every American with a healthcare certificate to redeem for a participating health plan

2. •Participating plans, private or public, must offer a standard set of services in exchange for a healthcare certificate

3. •Individuals are free to choose among competing plans for one that most closely matches their specific needs

4. •The competitive nature of this insurance market, together with cost and quality standards established by a politically independent health board, assure cost control and improved outcomes

5. •GHAP is funded by a dedicated tax managed by this same independent health board

Personally, I don’t think that this evolution on Medicare Advantage would work. Why do we need to keep middle men in the loop. What benefit to society do insurance health care business men provide if they don’t produce the only benefit insurance can provide: pool risk to make care affordable.

The problem is not that people can’t choose insurance, there is ample insurance out there but that insurance companies first cherry pick healthy people and, second they don’t pay the providers of healthcare. Why do we need a system that skims 15% from the top to pay executives and share holders? Why do we need to spend tax payer money to subsidize these companies that provide NO ADDED VALUE to the system?

Why is the business man, intended to skim money out of a system where he does not add value, better than the government bureaucrat? Last I remember the Blues, UHC, Aetna where as bloated with bureaucrats as the government, at least last time a called.

If competition in the insurance market would have provided a great system it would have happen by now, all we have got out of this 30 plus year experiment is a very expensive and convoluted system that does not serve the citizens of our nation but rather takes a lot of money out of their pockets and when is needed makes a huge effort to kick you out of the system and put you on the tax payer dime. From the provider point of view it has decimated health maintenance type care favoring treatment of disease that becomes an inevitable expense that they may or may not have to pay for.

By the way, in case you want to know, the above is Ezekiel Emanuel’s vision, he is the point guard for the administration.

Remember outpatient is a sideshow in the process, the real expense that keeps people hostage to insurance is hospital expenses. If we adopt a “truthful billing†policy, in other words the hospital charges the same to all comers, for example a procedure would cost X to cash patients and insurance companies and not X-70% to insurance companies; we may get to a point where citizens can truly afford health saving accounts and cheap, most likely government sponsored, high deductible insurance that would bring market pressures to the system. No need for middle men skimming “profitsâ€. Pharma would not be able to charge unconscionable prices for meds. Our citizenship would not pay for administrative fees, unnecessary incurred, because hospitals have to “bill†for every piece of cotton, syringe, temperature probe cover and suture they use and which motivates the

need for huge billing departments and staffers.

There are better ides out there the ones you proposed are not.

Just a thought,

José from Hoboken

From: Practiceimprovement 1yahoogroups (DOT) com [mailto:Practiceimp rovement1@ yahoogroups. com] On Behalf Of tlf1123Sent: Thursday, April 30, 2009 2:31 PMTo: Practiceimprovement 1yahoogroups (DOT) comSubject: [Practiceimprovemen t1] Re: Update: Massachusetts Insurance mandate

,Here are other options that do not force you to work for a hospital or trade six corporate masters for one goverment burocracy:http://www.ncpa. org/pdfs/ health_plan11200 7.pdfhttp://www.consumer drivenhealthcare .us/http://www.cdhci. org/http://www.healthca reguaranteed. org/HealthCare_ Guaranteed/ Home.htmlhttp://books. google.com/

books?id= mCT6OXjlxP4C & dq=consumer+ driven+healthcar e & printsec=frontcover & source=in & hl=en & ei=Euf5SbnsB4aEtwf0 9PCoAw & sa=X & oi=book_result & ct=result & resnum=11http://books. google.com/ books?id= D4Afl4CEuFoC & dq=consumer+ driven+healthcar e & printsec=frontcover & source=in & hl=en & ei=Euf5SbnsB4aEtwf0 9PCoAw & sa=X & oi=book_result & ct=result & resnum=12Teo.> > > >> > > > Glad you enjoyed/appreciated it. We have been members of PNHP >

> for a> > > > long time and have always appreciated the scholarship and > > perspectives> > > > of its leadership, but since the returns on the Mass experiment > > have> > > > started rolling in, it seems their arguments are almost > > irrefutable.> > > >> > > > > > > >> > > > ____________ _________ _________ __> > > >> > > > From: Practiceimprovement 1yahoogroups (DOT) com> > > <mailto:Practiceimpr ovement1% 40yahoogroups. com>> > > > [mailto:Practiceimprovement 1yahoogroups (DOT) com> > > <mailto:Practiceimpr ovement1% 40yahoogroups. com> ] On Behalf Of

> > > > Bleiweiss> > > > Sent: Sunday, April 26, 2009 9:53 AM> > > > To: Practiceimprovement 1yahoogroups (DOT) com> > > <mailto:Practiceimpr ovement1% 40yahoogroups. com>> > > > Subject: Re: [Practiceimprovemen t1] Update: Massachusetts > > Insurance> > > > mandate> > > >> > > >> > > >> > > >> > > >> > > > ,> > > > Great and to the point set of facts.... Challenges the entire> > > > factless, pie in the sky, paid for by well financed special > > interests of> > > > High Tech, Big Pharma and the Insurance rs, total farce > > head on...> > > > NOW this little print out needs

to get to all of our newspaper > > editors> > > > and TV News Producers across the country... You keep these jems > > coming.> > > > Thanks for sharing....> > > > > > > >> > > >> > > > ____________ _________ _________ __> > > >> > > > From: Hilsbos <NHilsbos@>> > > > To: Practiceimprovement 1yahoogroups (DOT) com> > > <mailto:Practiceimpr ovement1% 40yahoogroups. com>> > > > Sent: Sunday, April 26, 2009 8:38:35 AM> > > > Subject: RE: [Practiceimprovemen t1] Update: Massachusetts > > Insurance> > > > mandate> > > >> > > >> > > >> > > > All yall please read

http://www.pnhp. org/news/ 2009/april/ > > testimony_> > > > of_david_ u.php> > > > <http://www.pnhp. org/news/ 2009/april/ testimony_ of_david_ u.php>> > > > <http://geo.yahoo. com/serv? s=97359714/ grpId=9360914/ grpspId=17050613 27/m> > > > sgId=33396/stime= 1240673255/ nc1=1/nc2= 2/nc3=3>> > > >> > > > Hilsbos> > > > Fairmont West Virginia> > > >> > > >> > > > ____________ _________ _________ __> > > >> > > > From: Practiceimprovement 1yahoogroups (DOT) com

[mailto:Practiceimp> > > > rovement1@ yahoogroups. com] On Behalf Of L. Gordon > > > > Sent: Saturday, April 25, 2009 11:26 AM> > > > To: Practiceimprovement 1yahoogroups (DOT) com> > > > Subject: Re: [Practiceimprovemen t1] Update: Massachusetts > > Insurance> > > > mandate> > > >> > >> >> >>

[Guest guest]

Teo,

On that I am 100% with you.  Give me direct care and direct payment;

leave the middlemen by the side.

José

From:

[mailto: ] On Behalf Of Teobaldo

Fernandez

Sent: Friday, May 01, 2009 8:59 PM

To:

Subject: RE: Re: Update: Massachusetts Insurance

mandate

,

I included other view points to refflect the funding side

for national helathcare as well as the need to reign in the uncontolled

litigation mess. I think the important players, providers and patients are

the ones best equiped to set the direction. I prefer a consumer driven

system. It is the only one with the freedom for both providers and consumers.

Teo.

From: José Batlle, MD

Subject: RE: Re: Update: Massachusetts Insurance

mandate

To:

Date: Thursday, April 30, 2009, 3:47 PM

Teo,

I really don’t understand where you

are coming from? Here is one example of what you propose as “changeâ€, all

others are similar versions.

Of all of the competing proposals

for healthcare reform, only GHAP fully addresses all seven essential elements

of reform. Under this plan:

1. •The Federal government provides every American with a healthcare

certificate to redeem for a participating health plan

2. •Participating plans, private or public, must offer a standard

set of services in exchange for a healthcare certificate

3. •Individuals are free to choose among competing plans for one

that most closely matches their specific needs

4. •The competitive nature of this insurance market, together with

cost and quality standards established by a politically independent health

board, assure cost control and improved outcomes

5. •GHAP is funded by a dedicated tax managed by this same

independent health board

Personally, I don’t think that this

evolution on Medicare Advantage would work. Why do we need to keep

middle men in the loop. What benefit to society do insurance health care

business men provide if they don’t produce the only benefit insurance can

provide: pool risk to make care affordable.

The problem is not that people can’t

choose insurance, there is ample insurance out there but that insurance

companies first cherry pick healthy people and, second they don’t pay the

providers of healthcare. Why do we need a system that skims 15% from

the top to pay executives and share holders? Why do we need to spend

tax payer money to subsidize these companies that provide NO ADDED VALUE to

the system?

Why is the business man, intended to

skim money out of a system where he does not add value, better than the

government bureaucrat? Last I remember the Blues, UHC, Aetna where as bloated

with bureaucrats as the government, at least last time a called.

If competition in the insurance market

would have provided a great system it would have happen by now, all we have

got out of this 30 plus year experiment is a very expensive and convoluted

system that does not serve the citizens of our nation but rather takes a lot

of money out of their pockets and when is needed makes a huge effort to kick

you out of the system and put you on the tax payer dime. From the

provider point of view it has decimated health maintenance type care favoring

treatment of disease that becomes an inevitable expense that they may or may

not have to pay for.

By the way, in case you want to know,

the above is Ezekiel Emanuel’s vision, he is the point guard for the

administration.

Remember outpatient is a sideshow in

the process, the real expense that keeps people hostage to insurance is

hospital expenses. If we adopt a “truthful billing†policy, in other

words the hospital charges the same to all comers, for example a procedure

would cost X to cash patients and insurance companies and not X-70% to

insurance companies; we may get to a point where citizens can truly afford

health saving accounts and cheap, most likely government sponsored, high

deductible insurance that would bring market pressures to the system.

No need for middle men skimming “profitsâ€. Pharma would not be able to

charge unconscionable prices for meds. Our citizenship would not pay

for administrative fees, unnecessary incurred, because hospitals have to

“bill†for every piece of cotton, syringe, temperature probe cover and suture

they use and which motivates the need for huge billing departments and

staffers.

There are better ides out there the

ones you proposed are not.

Just a thought,

José from Hoboken

From:

Practiceimprovement 1yahoogroups (DOT) com [mailto:Practiceimp rovement1@

yahoogroups. com] On Behalf Of tlf1123

Sent: Thursday, April 30, 2009 2:31 PM

To: Practiceimprovement 1yahoogroups (DOT) com

Subject: [Practiceimprovemen t1] Re: Update: Massachusetts Insurance

mandate

,

Here are other options that do not force you to work for a hospital or trade

six corporate masters for one goverment burocracy:

http://www.ncpa.

org/pdfs/ health_plan11200 7.pdf

http://www.consumer

drivenhealthcare .us/

http://www.cdhci. org/

http://www.healthca reguaranteed. org/HealthCare_ Guaranteed/

Home.html

http://books. google.com/ books?id=

mCT6OXjlxP4C & dq=consumer+ driven+healthcar

e & printsec=frontcover & source=in & hl=en & ei=Euf5SbnsB4aEtwf0

9PCoAw & sa=X & oi=book_result & ct=result & resnum=11

http://books. google.com/ books?id=

D4Afl4CEuFoC & dq=consumer+ driven+healthcar e & printsec=frontcover & source=in & hl=en & ei=Euf5SbnsB4aEtwf0

9PCoAw & sa=X & oi=book_result & ct=result & resnum=12

Teo.

> > > >

> > > > Glad you enjoyed/appreciated it. We have been members of

PNHP

> > for a

> > > > long time and have always appreciated the scholarship and

> > perspectives

> > > > of its leadership, but since the returns on the Mass

experiment

> > have

> > > > started rolling in, it seems their arguments are almost

> > irrefutable.

> > > >

> > > >

> > > >

> > > > ____________ _________ _________ __

> > > >

> > > > From: Practiceimprovement

1yahoogroups (DOT) com

> > > <mailto:Practiceimpr ovement1% 40yahoogroups. com>

> > > > [mailto:Practiceimprovement

1yahoogroups (DOT) com

> > > <mailto:Practiceimpr ovement1% 40yahoogroups. com> ] On

Behalf Of

> > > > Bleiweiss

> > > > Sent: Sunday, April 26, 2009 9:53 AM

> > > > To: Practiceimprovement

1yahoogroups (DOT) com

> > > <mailto:Practiceimpr ovement1% 40yahoogroups. com>

> > > > Subject: Re: [Practiceimprovemen t1] Update:

Massachusetts

> > Insurance

> > > > mandate

> > > >

> > > >

> > > >

> > > >

> > > >

> > > > ,

> > > > Great and to the point set of facts.... Challenges the

entire

> > > > factless, pie in the sky, paid for by well financed

special

> > interests of

> > > > High Tech, Big Pharma and the Insurance rs, total

farce

> > head on...

> > > > NOW this little print out needs to get to all of our

newspaper

> > editors

> > > > and TV News Producers across the country... You keep

these jems

> > coming.

> > > > Thanks for sharing....

> > > >

> > > >

> > > >

> > > > ____________ _________ _________ __

> > > >

> > > > From: Hilsbos <NHilsbos@>

> > > > To: Practiceimprovement

1yahoogroups (DOT) com

> > > <mailto:Practiceimpr ovement1% 40yahoogroups. com>

> > > > Sent: Sunday, April 26, 2009 8:38:35 AM

> > > > Subject: RE: [Practiceimprovemen t1] Update:

Massachusetts

> > Insurance

> > > > mandate

> > > >

> > > >

> > > >

> > > > All yall please read http://www.pnhp. org/news/ 2009/april/

> > testimony_

> > > > of_david_ u.php

> > > > <http://www.pnhp. org/news/ 2009/april/ testimony_ of_david_

u.php>

> > > > <http://geo.yahoo. com/serv? s=97359714/ grpId=9360914/

grpspId=17050613 27/m

> > > > sgId=33396/stime= 1240673255/ nc1=1/nc2= 2/nc3=3>

> > > >

> > > > Hilsbos

> > > > Fairmont West Virginia

> > > >

> > > >

> > > > ____________ _________ _________ __

> > > >

> > > > From: Practiceimprovement 1yahoogroups (DOT) com

[mailto:Practiceimp

> > > > rovement1@ yahoogroups. com] On Behalf Of L. Gordon

> > > > Sent: Saturday, April 25, 2009 11:26 AM

> > > > To: Practiceimprovement 1yahoogroups (DOT) com

> > > > Subject: Re: [Practiceimprovemen t1] Update:

Massachusetts

> > Insurance

> > > > mandate

> > > >

> > >

> >

> >

>