RE: Healthcare Reform

[Guest guest]

,

That was an eloquent and very important addition to this thread.

Thank you.

Lane Blondheim, PT, MT

Montgomery, AL

>

> With regards to statements about writing members of Congress, it'd be nice if

that worked. However, if you look at this present financial/economic crisis and

the bailout situation, the mail against the bailout ran 100:1 against. Congress

ignored their constituents and capitulated to the powers that be. If we had any

real leadership in Congress, they would vote themselves a 10% pay cut as a

symbolic gesture to show their solidarity and support of the hard times most of

their constituents are experiencing. They haven't. They would downgrade their

healthcare benefits to the level of those experienced by the average Medicare

recipient. They haven't. They would vote for a graduated pension system

whereby they would not receive a full pension until having put in far more than

just one term, just like the retirement plans most of their constituents have.

They haven't. They are in it for the money and power, pure and simple. And

except for a few exceptions like Ron , they are corrupt and serving their

own interests over their constituent's interests.

>

> As for our executive branch, I'm not very optimistic about the outcomes there

either. We are no longer a democratic republic. We have become an executive

socialist plutocracy. And quite frankly, it doesn't matter which party is in

power. An one individual so accurately put it, " There isn't a Republican Party,

there isn't a Democratic party, there's just one one party ... the party of

Money " . The two party system where you appear to have a choice and where there

is constant friction and conflict between the two parties and their supporters

is part of " a divide and conquer " strategy that's been in place for a long,

long time (read about the Banker's Manifesto of 1892 for just one example).

>

> As for healthcare being a right, I have a hard time with that proposition. Is

that because it is essential for our well being? Well, to survive economically

in the modern world, a telephone is pretty essential. Should that be a right?

So is an automobile. So is good nutrition. Does that mean we have government

programs paying for phones, automobiles, food and nutritional supplements, etc?

Healthcare is certainly something we want to have for all but as for it being a

right, I think that contention is mistaken.

>

> Furthermore, health care reform without legal reform is nonsensical. The

average American family pays $10,000 per year in added costs to their goods and

services to cover legal liability. Many of the costs that have encumbered our

system, from healthcare to manufacturing, have come about due to legal excesses.

Some of the health care systems that we look at with lower costs also have very

different legal systems. In my career, I've talked with physical therapists

from Canada, Great Britain, Australia, New Zealand, Australia, South Africa,

Switzerland, Holland, Germany, France, Italy, Japan, the Scandinavian countries,

Iceland, Caribbean nations, Argentina, Chile, etc. Those who come from

countries with more efficient healthcare systems than ours literally laugh at us

due to the restrictions brought about by our legal system. The problem is that

lawyers control the legislatures and it's exceedingly unlikely that they will

ever take action against their own self-interests.

>

> There's much talk of the rise in the cost of health care. How many providers,

however, have seen these increased costs translate into increased incomes? Very

few I'd wager. The ones who have benefitted are the middlemen, the insurance

companies. You have individuals like the former CEO of United Healthcare who

received ONE BILLION dollars in total compensation during his time with the

company (before being forced to resign due to questionable activities such as

backdating stock option) and received a lump sum of 100 million dollars in stock

options. It's these individuals who are driving up the cost of health care, far

more than any providers, even the unethical and illegal ones. They're taking it

from us and taking it from the patients.

>

> The insurance industry and the pharmaceutical industry are two of the most

powerful lobbies in the country and they are vested in disease. If you want to

lower health care costs, you start with children in kindergarten, grade school,

and high school. You educate them in nutrition, posture, body mechanics,

exercise, and other preventative strategies. You encourage wholesome foods and

make soft drinks, candy, cookies, cake, chips, ice cream, white bread, processed

meats, sugary cereals, and other overly refined, highly processed, low fiber,

low micronutrient, high sugar, high trans fat, foods difficult to access. You

use government propaganda campaigns and spinmeisters to make it uncool to eat

this garbage. You, in fact, support small organic farms rather than legislate

against them as certain legislators are doing who've been bought off by

Monsanto, Archer s Midland, and others to support their agrichemical

business and their pseudo-food crops grown from genetically modified, hybridized

(meaning farmers have to lease the seed and can't buy it or produce their own)

seeds and laden with pesticides, NPK fertilizers (with no trace minerals), and

other chemicals that are not conducive to health. When recent food assays

replicating assays that were performed in the 1950s revealed that our modern

foods have approximately 50% of the micro-nutrient content of foods half a

century ago, something is dreadfully wrong.

>

> You reinstitute physical education classes in schools but make them into

something worthwhile rather than simply opportunities to play basketball,

football, and baseball. You teach posture and movement. You teach somatic

stress management principles so children learn to manage stress rather than

having it impact their health (especially considering that it is conservatively

estimated that at least 80% of disease has adverse stress as a significant

component). You perhaps teach them how to select, prepare, and even grow their

own foods. You structure classrooms to integrate movement with learning rather

than forcing children to sit still in uncomfortable, nonergonomic chairs until

they are bored out of their minds. I don't even want to go there as to the

shortcomings of our educational system.

>

> You encourage conservative interventions that work. When one compares the

Scandinavian systems (which have excellent conservative treatment of spinal

problems) with America and see 10 times the number of surgical interventions in

this country, something is wrong. You encourage nutriceuticals over

pharmaceuticals, herbs (many of which have various co-factors that negate many

of the side effects of our more purified drugs) over drugs, fasting (which can

add enormously to health) over gluttony, etc. You integrate effective

alternative and complementary therapies with conventional medicine rather than

trying to preserve the status quo.

>

> I could go on and on but I'd like to get to bed. However, when I look at our

governments' " efforts " at healthcare reform, they are as ludicrous as their

management of the present financial crisis. By the way, if anyone thinks the

government really is going to help or that the present financial crisis is

accidental, beware of someone selling you a bridge in Brooklyn.;-)

>

> , PT, OCS

>

>

> ,

> Healthcare reform

>

>

>

>

>

> Hi everyone,

>

> I don't think anyone is thrilled to be facing increased government

> intervention into healthcare but we must keep in mind that there is not a

> viable choice right now. We have had over 40 years to allow private

> industry and individuals with " choice " and " rights " to make the right

> choices and find a way to improve the health of this country and to improve

> healthcare itself. In some ways we have with the tremendous drop in cancer

> rates and heart disease. On the other hand private industry and individuals

> have not found the solution. Our lives are being bankrupted by healthcare

> costs and worst of all our health overall is not better. The government is

> stepping in because those with " rights " and " choices " have failed!

>

> With that said, I need also to remind us all to read the goals of healthcare

> reform that the Senate, House and President Obama each have outlined. Those

> goals present us with the framework to innovate a new system to address the

> concerns of most. There has been discussion in the last few days about

> individuals making the right choice but are we sure they always can? Within

> the goals of all the plans is a move towards more preventative care

> including suggestions for increased use of health " coaches " to help educate

> and guide more people to make the right choice. It will be up to us as it

> always is to make sure that this goes no farther than guidance but the

> exciting thing is that there are numerous suggestions on how to tackle the

> problem of individual health choices.

>

> The same thing can be said about providing coverage to the current uninsured

> and addressing some of the reasons that they are uninsured in the first

> place. There are many proposals to meet the goal of eliminating the

> uninsured. Have pre-existing conditions? Well a goal is to remove this

> limitation completely.

>

> We all need to be involved in the process right now. The time for talking

> about the problems in health care is passing. The time for talking

> solutions is passing. What we need is the will to draft an innovative

> program that addresses the goals we have before us. It will not please all

> of us but we must have the collective will to go forwards. Let's keep

> talking solutions but let's all back that up with action in our daily lives

> with the " rights " we have and in political action through continued

> grassroots action. In the time it takes to post on this listserve, you

> could write you members of Congress. Have you?

>

> Tom Howell, P.T., M.P.T.

>

> Howell Physical Therapy

>

> Eagle, Idaho

>

> thowell@...

>

> This email and any files transmitted with it may contain PRIVILEGED or

> CONFIDENTIAL information and may be read or used only by the intended

> recipient. If you are not the intended recipient of the email or any of its

> attachments, please be advised that you have received this email in error

> and that any use, dissemination, distribution, forwarding, printing or

> copying of this email or any attached files is strictly prohibited. If you

> have received this email in error, please immediately purge it and all

> attachments and notify the sender by reply email.

>

>

[Guest guest]

,

That was an eloquent and very important addition to this thread.

Thank you.

Lane Blondheim, PT, MT

Montgomery, AL

>

> With regards to statements about writing members of Congress, it'd be nice if

that worked. However, if you look at this present financial/economic crisis and

the bailout situation, the mail against the bailout ran 100:1 against. Congress

ignored their constituents and capitulated to the powers that be. If we had any

real leadership in Congress, they would vote themselves a 10% pay cut as a

symbolic gesture to show their solidarity and support of the hard times most of

their constituents are experiencing. They haven't. They would downgrade their

healthcare benefits to the level of those experienced by the average Medicare

recipient. They haven't. They would vote for a graduated pension system

whereby they would not receive a full pension until having put in far more than

just one term, just like the retirement plans most of their constituents have.

They haven't. They are in it for the money and power, pure and simple. And

except for a few exceptions like Ron , they are corrupt and serving their

own interests over their constituent's interests.

>

> As for our executive branch, I'm not very optimistic about the outcomes there

either. We are no longer a democratic republic. We have become an executive

socialist plutocracy. And quite frankly, it doesn't matter which party is in

power. An one individual so accurately put it, " There isn't a Republican Party,

there isn't a Democratic party, there's just one one party ... the party of

Money " . The two party system where you appear to have a choice and where there

is constant friction and conflict between the two parties and their supporters

is part of " a divide and conquer " strategy that's been in place for a long,

long time (read about the Banker's Manifesto of 1892 for just one example).

>

> As for healthcare being a right, I have a hard time with that proposition. Is

that because it is essential for our well being? Well, to survive economically

in the modern world, a telephone is pretty essential. Should that be a right?

So is an automobile. So is good nutrition. Does that mean we have government

programs paying for phones, automobiles, food and nutritional supplements, etc?

Healthcare is certainly something we want to have for all but as for it being a

right, I think that contention is mistaken.

>

> Furthermore, health care reform without legal reform is nonsensical. The

average American family pays $10,000 per year in added costs to their goods and

services to cover legal liability. Many of the costs that have encumbered our

system, from healthcare to manufacturing, have come about due to legal excesses.

Some of the health care systems that we look at with lower costs also have very

different legal systems. In my career, I've talked with physical therapists

from Canada, Great Britain, Australia, New Zealand, Australia, South Africa,

Switzerland, Holland, Germany, France, Italy, Japan, the Scandinavian countries,

Iceland, Caribbean nations, Argentina, Chile, etc. Those who come from

countries with more efficient healthcare systems than ours literally laugh at us

due to the restrictions brought about by our legal system. The problem is that

lawyers control the legislatures and it's exceedingly unlikely that they will

ever take action against their own self-interests.

>

> There's much talk of the rise in the cost of health care. How many providers,

however, have seen these increased costs translate into increased incomes? Very

few I'd wager. The ones who have benefitted are the middlemen, the insurance

companies. You have individuals like the former CEO of United Healthcare who

received ONE BILLION dollars in total compensation during his time with the

company (before being forced to resign due to questionable activities such as

backdating stock option) and received a lump sum of 100 million dollars in stock

options. It's these individuals who are driving up the cost of health care, far

more than any providers, even the unethical and illegal ones. They're taking it

from us and taking it from the patients.

>

> The insurance industry and the pharmaceutical industry are two of the most

powerful lobbies in the country and they are vested in disease. If you want to

lower health care costs, you start with children in kindergarten, grade school,

and high school. You educate them in nutrition, posture, body mechanics,

exercise, and other preventative strategies. You encourage wholesome foods and

make soft drinks, candy, cookies, cake, chips, ice cream, white bread, processed

meats, sugary cereals, and other overly refined, highly processed, low fiber,

low micronutrient, high sugar, high trans fat, foods difficult to access. You

use government propaganda campaigns and spinmeisters to make it uncool to eat

this garbage. You, in fact, support small organic farms rather than legislate

against them as certain legislators are doing who've been bought off by

Monsanto, Archer s Midland, and others to support their agrichemical

business and their pseudo-food crops grown from genetically modified, hybridized

(meaning farmers have to lease the seed and can't buy it or produce their own)

seeds and laden with pesticides, NPK fertilizers (with no trace minerals), and

other chemicals that are not conducive to health. When recent food assays

replicating assays that were performed in the 1950s revealed that our modern

foods have approximately 50% of the micro-nutrient content of foods half a

century ago, something is dreadfully wrong.

>

> You reinstitute physical education classes in schools but make them into

something worthwhile rather than simply opportunities to play basketball,

football, and baseball. You teach posture and movement. You teach somatic

stress management principles so children learn to manage stress rather than

having it impact their health (especially considering that it is conservatively

estimated that at least 80% of disease has adverse stress as a significant

component). You perhaps teach them how to select, prepare, and even grow their

own foods. You structure classrooms to integrate movement with learning rather

than forcing children to sit still in uncomfortable, nonergonomic chairs until

they are bored out of their minds. I don't even want to go there as to the

shortcomings of our educational system.

>

> You encourage conservative interventions that work. When one compares the

Scandinavian systems (which have excellent conservative treatment of spinal

problems) with America and see 10 times the number of surgical interventions in

this country, something is wrong. You encourage nutriceuticals over

pharmaceuticals, herbs (many of which have various co-factors that negate many

of the side effects of our more purified drugs) over drugs, fasting (which can

add enormously to health) over gluttony, etc. You integrate effective

alternative and complementary therapies with conventional medicine rather than

trying to preserve the status quo.

>

> I could go on and on but I'd like to get to bed. However, when I look at our

governments' " efforts " at healthcare reform, they are as ludicrous as their

management of the present financial crisis. By the way, if anyone thinks the

government really is going to help or that the present financial crisis is

accidental, beware of someone selling you a bridge in Brooklyn.;-)

>

> , PT, OCS

>

>

> ,

> Healthcare reform

>

>

>

>

>

> Hi everyone,

>

> I don't think anyone is thrilled to be facing increased government

> intervention into healthcare but we must keep in mind that there is not a

> viable choice right now. We have had over 40 years to allow private

> industry and individuals with " choice " and " rights " to make the right

> choices and find a way to improve the health of this country and to improve

> healthcare itself. In some ways we have with the tremendous drop in cancer

> rates and heart disease. On the other hand private industry and individuals

> have not found the solution. Our lives are being bankrupted by healthcare

> costs and worst of all our health overall is not better. The government is

> stepping in because those with " rights " and " choices " have failed!

>

> With that said, I need also to remind us all to read the goals of healthcare

> reform that the Senate, House and President Obama each have outlined. Those

> goals present us with the framework to innovate a new system to address the

> concerns of most. There has been discussion in the last few days about

> individuals making the right choice but are we sure they always can? Within

> the goals of all the plans is a move towards more preventative care

> including suggestions for increased use of health " coaches " to help educate

> and guide more people to make the right choice. It will be up to us as it

> always is to make sure that this goes no farther than guidance but the

> exciting thing is that there are numerous suggestions on how to tackle the

> problem of individual health choices.

>

> The same thing can be said about providing coverage to the current uninsured

> and addressing some of the reasons that they are uninsured in the first

> place. There are many proposals to meet the goal of eliminating the

> uninsured. Have pre-existing conditions? Well a goal is to remove this

> limitation completely.

>

> We all need to be involved in the process right now. The time for talking

> about the problems in health care is passing. The time for talking

> solutions is passing. What we need is the will to draft an innovative

> program that addresses the goals we have before us. It will not please all

> of us but we must have the collective will to go forwards. Let's keep

> talking solutions but let's all back that up with action in our daily lives

> with the " rights " we have and in political action through continued

> grassroots action. In the time it takes to post on this listserve, you

> could write you members of Congress. Have you?

>

> Tom Howell, P.T., M.P.T.

>

> Howell Physical Therapy

>

> Eagle, Idaho

>

> thowell@...

>

> This email and any files transmitted with it may contain PRIVILEGED or

> CONFIDENTIAL information and may be read or used only by the intended

> recipient. If you are not the intended recipient of the email or any of its

> attachments, please be advised that you have received this email in error

> and that any use, dissemination, distribution, forwarding, printing or

> copying of this email or any attached files is strictly prohibited. If you

> have received this email in error, please immediately purge it and all

> attachments and notify the sender by reply email.

>

>

[Guest guest]

This is the post I have been waiting for, as a private practice owner, an

advocate for the profession and the patient and also as the father in a family

of five I have looked at this matter from various sides, each side presents

different challenges. Yes, i want a plan that keeps private practice in

Physical Therapy as a viable option, no I dont want to become and employee of

the government. Yes, I want affordable health insurance for all of my patients

and potential patients, like the 24 year old girl, double amputee, s/p 51

surgeries for osteomyelitis who cant get insurance coverage here in Florida

because of pre-existing conditions (duh?) but can in her home state of Indiana

because of different state regs (I agree with you Jim). The prior administration

did a lot to the benefit of the insurance industry, the Medicare HMO policies

took money directly out of the providers hands and handed it to an insurance

company middle man, neither the patient, nor the providers benefited, only the

insurance companies. We must create competition for the Insurance industry,

they need to be held accountable for their actions (and inactions) on a Federal

level so that they cant just run to the states that treat them the best. I have

liked most of what I have heard from the current administration, if you avoid

listening to the rhetoric on both sides and actually listen to what is coming

from the White House it at least sounds like they are looking to put the patient

and providers ahead of the insurance and pharmacuetical giants of the world.

Finally, however, I dont see costs coming down sufficiently unless we deal with

tort reform and limits on malpractice and the current administration has refused

to adress this at all. Thanks for the discussion, I will be attending the Rally

tonight, should be interesting.

E. s, PT, DPT

Orthopedic Clinical Specialist

Fellow American Academy of Orthopedic Manual Physical Therapists

www.douglasspt.com

>

>

> These have all been interesting comments. What though this all comes down to

is whether as a society we feel healthcare is a right or a benefit. In a recent

NYT survey, over 70% want a public plan option. I think they have voiced that

they feel it is a right. why? I think its becasue all of the private options

have increasingly shifted the risk to the patient and created burocracies and

hoops to jump to that more than rival those that people are concerned about with

a public plan. the private insurers want to have a level playing field in

competing against a public plan. well if that public plan has ease of access,

portability between jobs and no pre exisiting condition stuff or variable

medical neccessity definitons ... sign me up! And so if the public plan is

competitive, then the private's have to react to that or lose market share ....

oops there goes those CEO bonuses! We have to get the double digit stockhoder

return expectations out of the health insurance business. What I am hearing so

far from Washington is positive.

>

> Jim Dunleavy PT, MS

>

>

>

>

>

>

>

> Healthcare reform

>

>

>

>

> Hi everyone,

>

> I don't think anyone is thrilled to be facing increased government

> intervention into healthcare but we must keep in mind that there is not a

> viable choice right now. We have had over 40 years to allow private

> industry and individuals with " choice " and " rights " to make the right

> choices and find a way to improve the health of this country and to improve

> healthcare itself. In some ways we have with the tremendous drop in cancer

> rates and heart disease. On the other hand private industry and individuals

> have not found the solution. Our lives are being bankrupted by healthcare

> costs and worst of all our health overall is not better. The government is

> stepping in because those with " rights " and " choices " have failed!

>

> With that said, I need also to remind us all to read the goals of healthcare

> reform that the Senate, House and President Obama each have outlined. Those

> goals present us with the framework to innovate a new system to address the

> concerns of most. There has been discussion in the last few days about

> individuals making the right choice but are we sure they always can? Within

> the goals of all the plans is a move towards more preventative care

> including suggestions for increased use of health " coaches " to help educate

> and guide more people to make the right choice. It will be up to us as it

> always is to make sure that this goes no farther than guidance but the

> exciting thing is that there are numerous suggestions on how to tackle the

> problem of individual health choices.

>

> The same thing can be said about providing coverage to the current uninsured

> and addressing some of the reasons that they are uninsured in the first

> place. There are many proposals to meet the goal of eliminating the

> uninsured. Have pre-existing conditions? Well a goal is to remove this

> limitation completely.

>

> We all need to be involved in the process right now. The time for talking

> about the problems in health care is passing. The time for talking

> solutions is passing. What we need is the will to draft an innovative

> program that addresses the goals we have before us. It will not please all

> of us but we must have the collective will to go forwards. Let's keep

> talking solutions but let's all back that up with action in our daily lives

> with the " rights " we have and in political action through continued

> grassroots action. In the time it takes to post on this listserve, you

> could write you members of Congress. Have you?

>

> Tom Howell, P.T., M.P.T.

>

> Howell Physical Therapy

>

> Eagle, Idaho

>

> thowell@...<mailto:thowell%40fiberpipe.net>

>

> This email and any files transmitted with it may contain PRIVILEGED or

> CONFIDENTIAL information and may be read or used only by the intended

> recipient. If you are not the intended recipient of the email or any of its

> attachments, please be advised that you have received this email in error

> and that any use, dissemination, distribution, forwarding, printing or

> copying of this email or any attached files is strictly prohibited. If you

> have received this email in error, please immediately purge it and all

> attachments and notify the sender by reply email.

>

>

[Guest guest]

This is the post I have been waiting for, as a private practice owner, an

advocate for the profession and the patient and also as the father in a family

of five I have looked at this matter from various sides, each side presents

different challenges. Yes, i want a plan that keeps private practice in

Physical Therapy as a viable option, no I dont want to become and employee of

the government. Yes, I want affordable health insurance for all of my patients

and potential patients, like the 24 year old girl, double amputee, s/p 51

surgeries for osteomyelitis who cant get insurance coverage here in Florida

because of pre-existing conditions (duh?) but can in her home state of Indiana

because of different state regs (I agree with you Jim). The prior administration

did a lot to the benefit of the insurance industry, the Medicare HMO policies

took money directly out of the providers hands and handed it to an insurance

company middle man, neither the patient, nor the providers benefited, only the

insurance companies. We must create competition for the Insurance industry,

they need to be held accountable for their actions (and inactions) on a Federal

level so that they cant just run to the states that treat them the best. I have

liked most of what I have heard from the current administration, if you avoid

listening to the rhetoric on both sides and actually listen to what is coming

from the White House it at least sounds like they are looking to put the patient

and providers ahead of the insurance and pharmacuetical giants of the world.

Finally, however, I dont see costs coming down sufficiently unless we deal with

tort reform and limits on malpractice and the current administration has refused

to adress this at all. Thanks for the discussion, I will be attending the Rally

tonight, should be interesting.

E. s, PT, DPT

Orthopedic Clinical Specialist

Fellow American Academy of Orthopedic Manual Physical Therapists

www.douglasspt.com

>

>

> These have all been interesting comments. What though this all comes down to

is whether as a society we feel healthcare is a right or a benefit. In a recent

NYT survey, over 70% want a public plan option. I think they have voiced that

they feel it is a right. why? I think its becasue all of the private options

have increasingly shifted the risk to the patient and created burocracies and

hoops to jump to that more than rival those that people are concerned about with

a public plan. the private insurers want to have a level playing field in

competing against a public plan. well if that public plan has ease of access,

portability between jobs and no pre exisiting condition stuff or variable

medical neccessity definitons ... sign me up! And so if the public plan is

competitive, then the private's have to react to that or lose market share ....

oops there goes those CEO bonuses! We have to get the double digit stockhoder

return expectations out of the health insurance business. What I am hearing so

far from Washington is positive.

>

> Jim Dunleavy PT, MS

>

>

>

>

>

>

>

> Healthcare reform

>

>

>

>

> Hi everyone,

>

> I don't think anyone is thrilled to be facing increased government

> intervention into healthcare but we must keep in mind that there is not a

> viable choice right now. We have had over 40 years to allow private

> industry and individuals with " choice " and " rights " to make the right

> choices and find a way to improve the health of this country and to improve

> healthcare itself. In some ways we have with the tremendous drop in cancer

> rates and heart disease. On the other hand private industry and individuals

> have not found the solution. Our lives are being bankrupted by healthcare

> costs and worst of all our health overall is not better. The government is

> stepping in because those with " rights " and " choices " have failed!

>

> With that said, I need also to remind us all to read the goals of healthcare

> reform that the Senate, House and President Obama each have outlined. Those

> goals present us with the framework to innovate a new system to address the

> concerns of most. There has been discussion in the last few days about

> individuals making the right choice but are we sure they always can? Within

> the goals of all the plans is a move towards more preventative care

> including suggestions for increased use of health " coaches " to help educate

> and guide more people to make the right choice. It will be up to us as it

> always is to make sure that this goes no farther than guidance but the

> exciting thing is that there are numerous suggestions on how to tackle the

> problem of individual health choices.

>

> The same thing can be said about providing coverage to the current uninsured

> and addressing some of the reasons that they are uninsured in the first

> place. There are many proposals to meet the goal of eliminating the

> uninsured. Have pre-existing conditions? Well a goal is to remove this

> limitation completely.

>

> We all need to be involved in the process right now. The time for talking

> about the problems in health care is passing. The time for talking

> solutions is passing. What we need is the will to draft an innovative

> program that addresses the goals we have before us. It will not please all

> of us but we must have the collective will to go forwards. Let's keep

> talking solutions but let's all back that up with action in our daily lives

> with the " rights " we have and in political action through continued

> grassroots action. In the time it takes to post on this listserve, you

> could write you members of Congress. Have you?

>

> Tom Howell, P.T., M.P.T.

>

> Howell Physical Therapy

>

> Eagle, Idaho

>

> thowell@...<mailto:thowell%40fiberpipe.net>

>

> This email and any files transmitted with it may contain PRIVILEGED or

> CONFIDENTIAL information and may be read or used only by the intended

> recipient. If you are not the intended recipient of the email or any of its

> attachments, please be advised that you have received this email in error

> and that any use, dissemination, distribution, forwarding, printing or

> copying of this email or any attached files is strictly prohibited. If you

> have received this email in error, please immediately purge it and all

> attachments and notify the sender by reply email.

>

>

[Guest guest]

Thanks Lane. Lucky it was late at night and I had to get up 5 AM to go fishing.

Otherwise, I'd be really long winded.;-)

Unfortunately, these government shenanigans have been going on way too long.

Anyone well acquainted with history is aware of them but they are now going way

over the top. As far back as the start of our country, Jefferson had

threatened to start a second American Revolution if he did not get his way on a

particular political issue (from an article in the sonian). He got his way

and the threat was forgotten. Read " The Book of Drew " about the illegal

stock market manipulations that went on back in the early 1800s. The conniving,

scheming, and machinations were unbelievable.

Moving on to the more modern era, read " War is a Racket " by Smedley

(Marine Corp major general, two time Medal of Honor winner, and a warrior's

warrior). He described the enormous and obscene profits made by US corporations

as a consequence of our involvement in World War I. He also described how

virtually all the conflicts he was involved in as a Marine (China and Standard

Oil, ines, Central America banana wars, Cuba sugar interests, etc.) were

all about corporate profits and had little to do with security, freedom, or

democracy. Also read about Bernays, the father of modern spin, and how

he coined the phrase " Making the World Safe for Democracy " used by Woodrow

to get us involved in WW I. Far more catchey than " Send your sons to

France to be slaughtered on foreign battlefields for corporate profits " .

Bernays had this to say:

" The conscious and intelligent manipulation of the organized habits and opinions

of the masses is an important element in democratic society. Those who

manipulate this unseen mechanism of society constitute an invisible government

which is the true ruling power of our country. " - Bernays, Propaganda

It's ironic that another book by Bernays, " Crystallizing Public Opinion " was one

of the favorite books on ph Goebbels' bookshelf, especially considering that

Bernays was Jewish and thought his book would benefit mankind. It did the exact

opposite, unfortunately.

Up to the Vietnam era, read " An Enormous Crime " by Hendon and that gives

overwhelming, undeniable, incontrovertible evidence for how we left hundreds of

POWs in SE Asia for political reasons. If you have any kind of heart for the

American serviceman, you will read it and cry.

In the more present day era, read " Free Lunch: How the Wealthiest Americans

Enrich Themselves at Government Expenses (and Stick You with the Bill) by

Cay ston about the plundering of America by the priviledged plutocracy. You

will get angrier and angrier, chapter by chapter. By the end of the book,

you'll want to head off with pitchfork and torch to confront the nearest

collection of politicians.

Remember all the hub-bub recently about the NSA illegally monitoring phone

conversations without court orders? Read about the Echelon system and find out

about how this has been going on for many years. Every single phone

conversation in this country is monitored without our consent.

On a further note, I'd strongly recommend that everyone read a book called " The

Web of Debt " by Ellen Hodgson Brown. It will give one a perspective on the

present financial crisis that one will not get from the mainstream media. It is

an eye-opener. The information contained therein is the reason that Henry Ford

was quoted as saying " It is well enough that people of the nation do not

understand our banking and monetary system, for if they did, I believe there

would be a revolution before tomorrow morning. " Also, if one understands the

controlling interests behind mainstream media, one would never again rely on it

as a substantive source of information.

Then there was all the fuss back in the fall about illegal naked short selling

of financials with the government eventually cracking down on this activity

while at the same time, there's been ongoing tacit support by the government

through the bullion banks for naked short selling of gold with nary a whisper of

opposition. The hypocrisy is sickening.

I could go on and on and on. In short, the deception, lies, manipulations, etc.

that have gone on throughout our history is overwhelming. I realize that these

type of things go on all over the world and probably more so in other countries

as compared to ours but until I educated myself in the last decade or so, I

never dreamed that the magnitude or scale of these disgusting actions was so

enormous.

Please don't get me wrong. I am patriotic a person as you will find. I love my

country but I don't trust my government with unbridled power and what the

wealthy and political elite are doing to it is dreadfully wrong. The Founding

Fathers, in fact, warned about these very things and designed a superb

Constitution to address these very issues. Unfortunately, the Constitution has

been thrown out the window in the name of security. And as Ben lin said,

" They who can give up essential liberty to obtain a little temporary safety,

deserve neither liberty nor safety. "

The Romans understood that to keep the populace appeased you had to give them

the games and you had to give them bread. In this country, we have the games

out the wazoo (professional sports, TV and movie entertainment, etc.) and we

have sufficient bread (both the type to eat and the Federal Reserve Note type)

.... for the time being. The games won't run out but the bread ... that's a

different matter.

The question is, what do we do about it?

Supporting HR 1207, the bill to audit the Federal Reserve, is a start.

Healthcare reform

>

>

>

>

>

> Hi everyone,

>

> I don't think anyone is thrilled to be facing increased government

> intervention into healthcare but we must keep in mind that there is not a

> viable choice right now. We have had over 40 years to allow private

> industry and individuals with " choice " and " rights " to make the right

> choices and find a way to improve the health of this country and to improve

> healthcare itself. In some ways we have with the tremendous drop in cancer

> rates and heart disease. On the other hand private industry and individuals

> have not found the solution. Our lives are being bankrupted by healthcare

> costs and worst of all our health overall is not better. The government is

> stepping in because those with " rights " and " choices " have failed!

>

> With that said, I need also to remind us all to read the goals of healthcare

> reform that the Senate, House and President Obama each have outlined. Those

> goals present us with the framework to innovate a new system to address the

> concerns of most. There has been discussion in the last few days about

> individuals making the right choice but are we sure they always can? Within

> the goals of all the plans is a move towards more preventative care

> including suggestions for increased use of health " coaches " to help educate

> and guide more people to make the right choice. It will be up to us as it

> always is to make sure that this goes no farther than guidance but the

> exciting thing is that there are numerous suggestions on how to tackle the

> problem of individual health choices.

>

> The same thing can be said about providing coverage to the current uninsured

> and addressing some of the reasons that they are uninsured in the first

> place. There are many proposals to meet the goal of eliminating the

> uninsured. Have pre-existing conditions? Well a goal is to remove this

> limitation completely.

>

> We all need to be involved in the process right now. The time for talking

> about the problems in health care is passing. The time for talking

> solutions is passing. What we need is the will to draft an innovative

> program that addresses the goals we have before us. It will not please all

> of us but we must have the collective will to go forwards. Let's keep

> talking solutions but let's all back that up with action in our daily lives

> with the " rights " we have and in political action through continued

> grassroots action. In the time it takes to post on this listserve, you

> could write you members of Congress. Have you?

>

> Tom Howell, P.T., M.P.T.

>

> Howell Physical Therapy

>

> Eagle, Idaho

>

> thowell@...

>

> This email and any files transmitted with it may contain PRIVILEGED or

> CONFIDENTIAL information and may be read or used only by the intended

> recipient. If you are not the intended recipient of the email or any of its

> attachments, please be advised that you have received this email in error

> and that any use, dissemination, distribution, forwarding, printing or

> copying of this email or any attached files is strictly prohibited. If you

> have received this email in error, please immediately purge it and all

> attachments and notify the sender by reply email.

>

>

[Guest guest]

Thanks Lane. Lucky it was late at night and I had to get up 5 AM to go fishing.

Otherwise, I'd be really long winded.;-)

Unfortunately, these government shenanigans have been going on way too long.

Anyone well acquainted with history is aware of them but they are now going way

over the top. As far back as the start of our country, Jefferson had

threatened to start a second American Revolution if he did not get his way on a

particular political issue (from an article in the sonian). He got his way

and the threat was forgotten. Read " The Book of Drew " about the illegal

stock market manipulations that went on back in the early 1800s. The conniving,

scheming, and machinations were unbelievable.

Moving on to the more modern era, read " War is a Racket " by Smedley

(Marine Corp major general, two time Medal of Honor winner, and a warrior's

warrior). He described the enormous and obscene profits made by US corporations

as a consequence of our involvement in World War I. He also described how

virtually all the conflicts he was involved in as a Marine (China and Standard

Oil, ines, Central America banana wars, Cuba sugar interests, etc.) were

all about corporate profits and had little to do with security, freedom, or

democracy. Also read about Bernays, the father of modern spin, and how

he coined the phrase " Making the World Safe for Democracy " used by Woodrow

to get us involved in WW I. Far more catchey than " Send your sons to

France to be slaughtered on foreign battlefields for corporate profits " .

Bernays had this to say:

" The conscious and intelligent manipulation of the organized habits and opinions

of the masses is an important element in democratic society. Those who

manipulate this unseen mechanism of society constitute an invisible government

which is the true ruling power of our country. " - Bernays, Propaganda

It's ironic that another book by Bernays, " Crystallizing Public Opinion " was one

of the favorite books on ph Goebbels' bookshelf, especially considering that

Bernays was Jewish and thought his book would benefit mankind. It did the exact

opposite, unfortunately.

Up to the Vietnam era, read " An Enormous Crime " by Hendon and that gives

overwhelming, undeniable, incontrovertible evidence for how we left hundreds of

POWs in SE Asia for political reasons. If you have any kind of heart for the

American serviceman, you will read it and cry.

In the more present day era, read " Free Lunch: How the Wealthiest Americans

Enrich Themselves at Government Expenses (and Stick You with the Bill) by

Cay ston about the plundering of America by the priviledged plutocracy. You

will get angrier and angrier, chapter by chapter. By the end of the book,

you'll want to head off with pitchfork and torch to confront the nearest

collection of politicians.

Remember all the hub-bub recently about the NSA illegally monitoring phone

conversations without court orders? Read about the Echelon system and find out

about how this has been going on for many years. Every single phone

conversation in this country is monitored without our consent.

On a further note, I'd strongly recommend that everyone read a book called " The

Web of Debt " by Ellen Hodgson Brown. It will give one a perspective on the

present financial crisis that one will not get from the mainstream media. It is

an eye-opener. The information contained therein is the reason that Henry Ford

was quoted as saying " It is well enough that people of the nation do not

understand our banking and monetary system, for if they did, I believe there

would be a revolution before tomorrow morning. " Also, if one understands the

controlling interests behind mainstream media, one would never again rely on it

as a substantive source of information.

Then there was all the fuss back in the fall about illegal naked short selling

of financials with the government eventually cracking down on this activity

while at the same time, there's been ongoing tacit support by the government

through the bullion banks for naked short selling of gold with nary a whisper of

opposition. The hypocrisy is sickening.

I could go on and on and on. In short, the deception, lies, manipulations, etc.

that have gone on throughout our history is overwhelming. I realize that these

type of things go on all over the world and probably more so in other countries

as compared to ours but until I educated myself in the last decade or so, I

never dreamed that the magnitude or scale of these disgusting actions was so

enormous.

Please don't get me wrong. I am patriotic a person as you will find. I love my

country but I don't trust my government with unbridled power and what the

wealthy and political elite are doing to it is dreadfully wrong. The Founding

Fathers, in fact, warned about these very things and designed a superb

Constitution to address these very issues. Unfortunately, the Constitution has

been thrown out the window in the name of security. And as Ben lin said,

" They who can give up essential liberty to obtain a little temporary safety,

deserve neither liberty nor safety. "

The Romans understood that to keep the populace appeased you had to give them

the games and you had to give them bread. In this country, we have the games

out the wazoo (professional sports, TV and movie entertainment, etc.) and we

have sufficient bread (both the type to eat and the Federal Reserve Note type)

.... for the time being. The games won't run out but the bread ... that's a

different matter.

The question is, what do we do about it?

Supporting HR 1207, the bill to audit the Federal Reserve, is a start.

Healthcare reform

>

>

>

>

>

> Hi everyone,

>

> I don't think anyone is thrilled to be facing increased government

> intervention into healthcare but we must keep in mind that there is not a

> viable choice right now. We have had over 40 years to allow private

> industry and individuals with " choice " and " rights " to make the right

> choices and find a way to improve the health of this country and to improve

> healthcare itself. In some ways we have with the tremendous drop in cancer

> rates and heart disease. On the other hand private industry and individuals

> have not found the solution. Our lives are being bankrupted by healthcare

> costs and worst of all our health overall is not better. The government is

> stepping in because those with " rights " and " choices " have failed!

>

> With that said, I need also to remind us all to read the goals of healthcare

> reform that the Senate, House and President Obama each have outlined. Those

> goals present us with the framework to innovate a new system to address the

> concerns of most. There has been discussion in the last few days about

> individuals making the right choice but are we sure they always can? Within

> the goals of all the plans is a move towards more preventative care

> including suggestions for increased use of health " coaches " to help educate

> and guide more people to make the right choice. It will be up to us as it

> always is to make sure that this goes no farther than guidance but the

> exciting thing is that there are numerous suggestions on how to tackle the

> problem of individual health choices.

>

> The same thing can be said about providing coverage to the current uninsured

> and addressing some of the reasons that they are uninsured in the first

> place. There are many proposals to meet the goal of eliminating the

> uninsured. Have pre-existing conditions? Well a goal is to remove this

> limitation completely.

>

> We all need to be involved in the process right now. The time for talking

> about the problems in health care is passing. The time for talking

> solutions is passing. What we need is the will to draft an innovative

> program that addresses the goals we have before us. It will not please all

> of us but we must have the collective will to go forwards. Let's keep

> talking solutions but let's all back that up with action in our daily lives

> with the " rights " we have and in political action through continued

> grassroots action. In the time it takes to post on this listserve, you

> could write you members of Congress. Have you?

>

> Tom Howell, P.T., M.P.T.

>

> Howell Physical Therapy

>

> Eagle, Idaho

>

> thowell@...

>

> This email and any files transmitted with it may contain PRIVILEGED or

> CONFIDENTIAL information and may be read or used only by the intended

> recipient. If you are not the intended recipient of the email or any of its

> attachments, please be advised that you have received this email in error

> and that any use, dissemination, distribution, forwarding, printing or

> copying of this email or any attached files is strictly prohibited. If you

> have received this email in error, please immediately purge it and all

> attachments and notify the sender by reply email.

>

>

[Guest guest]

Thanks Lane. Lucky it was late at night and I had to get up 5 AM to go fishing.

Otherwise, I'd be really long winded.;-)

Unfortunately, these government shenanigans have been going on way too long.

Anyone well acquainted with history is aware of them but they are now going way

over the top. As far back as the start of our country, Jefferson had

threatened to start a second American Revolution if he did not get his way on a

particular political issue (from an article in the sonian). He got his way

and the threat was forgotten. Read " The Book of Drew " about the illegal

stock market manipulations that went on back in the early 1800s. The conniving,

scheming, and machinations were unbelievable.

Moving on to the more modern era, read " War is a Racket " by Smedley

(Marine Corp major general, two time Medal of Honor winner, and a warrior's

warrior). He described the enormous and obscene profits made by US corporations

as a consequence of our involvement in World War I. He also described how

virtually all the conflicts he was involved in as a Marine (China and Standard

Oil, ines, Central America banana wars, Cuba sugar interests, etc.) were

all about corporate profits and had little to do with security, freedom, or

democracy. Also read about Bernays, the father of modern spin, and how

he coined the phrase " Making the World Safe for Democracy " used by Woodrow

to get us involved in WW I. Far more catchey than " Send your sons to

France to be slaughtered on foreign battlefields for corporate profits " .

Bernays had this to say:

" The conscious and intelligent manipulation of the organized habits and opinions

of the masses is an important element in democratic society. Those who

manipulate this unseen mechanism of society constitute an invisible government

which is the true ruling power of our country. " - Bernays, Propaganda

It's ironic that another book by Bernays, " Crystallizing Public Opinion " was one

of the favorite books on ph Goebbels' bookshelf, especially considering that

Bernays was Jewish and thought his book would benefit mankind. It did the exact

opposite, unfortunately.

Up to the Vietnam era, read " An Enormous Crime " by Hendon and that gives

overwhelming, undeniable, incontrovertible evidence for how we left hundreds of

POWs in SE Asia for political reasons. If you have any kind of heart for the

American serviceman, you will read it and cry.

In the more present day era, read " Free Lunch: How the Wealthiest Americans

Enrich Themselves at Government Expenses (and Stick You with the Bill) by

Cay ston about the plundering of America by the priviledged plutocracy. You

will get angrier and angrier, chapter by chapter. By the end of the book,

you'll want to head off with pitchfork and torch to confront the nearest

collection of politicians.

Remember all the hub-bub recently about the NSA illegally monitoring phone

conversations without court orders? Read about the Echelon system and find out

about how this has been going on for many years. Every single phone

conversation in this country is monitored without our consent.

On a further note, I'd strongly recommend that everyone read a book called " The

Web of Debt " by Ellen Hodgson Brown. It will give one a perspective on the

present financial crisis that one will not get from the mainstream media. It is

an eye-opener. The information contained therein is the reason that Henry Ford

was quoted as saying " It is well enough that people of the nation do not

understand our banking and monetary system, for if they did, I believe there

would be a revolution before tomorrow morning. " Also, if one understands the

controlling interests behind mainstream media, one would never again rely on it

as a substantive source of information.

Then there was all the fuss back in the fall about illegal naked short selling

of financials with the government eventually cracking down on this activity

while at the same time, there's been ongoing tacit support by the government

through the bullion banks for naked short selling of gold with nary a whisper of

opposition. The hypocrisy is sickening.

I could go on and on and on. In short, the deception, lies, manipulations, etc.

that have gone on throughout our history is overwhelming. I realize that these

type of things go on all over the world and probably more so in other countries

as compared to ours but until I educated myself in the last decade or so, I

never dreamed that the magnitude or scale of these disgusting actions was so

enormous.

Please don't get me wrong. I am patriotic a person as you will find. I love my

country but I don't trust my government with unbridled power and what the

wealthy and political elite are doing to it is dreadfully wrong. The Founding

Fathers, in fact, warned about these very things and designed a superb

Constitution to address these very issues. Unfortunately, the Constitution has

been thrown out the window in the name of security. And as Ben lin said,

" They who can give up essential liberty to obtain a little temporary safety,

deserve neither liberty nor safety. "

The Romans understood that to keep the populace appeased you had to give them

the games and you had to give them bread. In this country, we have the games

out the wazoo (professional sports, TV and movie entertainment, etc.) and we

have sufficient bread (both the type to eat and the Federal Reserve Note type)

.... for the time being. The games won't run out but the bread ... that's a

different matter.

The question is, what do we do about it?

Supporting HR 1207, the bill to audit the Federal Reserve, is a start.

Healthcare reform

>

>

>

>

>

> Hi everyone,

>

> I don't think anyone is thrilled to be facing increased government

> intervention into healthcare but we must keep in mind that there is not a

> viable choice right now. We have had over 40 years to allow private

> industry and individuals with " choice " and " rights " to make the right

> choices and find a way to improve the health of this country and to improve

> healthcare itself. In some ways we have with the tremendous drop in cancer

> rates and heart disease. On the other hand private industry and individuals

> have not found the solution. Our lives are being bankrupted by healthcare

> costs and worst of all our health overall is not better. The government is

> stepping in because those with " rights " and " choices " have failed!

>

> With that said, I need also to remind us all to read the goals of healthcare

> reform that the Senate, House and President Obama each have outlined. Those

> goals present us with the framework to innovate a new system to address the

> concerns of most. There has been discussion in the last few days about

> individuals making the right choice but are we sure they always can? Within

> the goals of all the plans is a move towards more preventative care

> including suggestions for increased use of health " coaches " to help educate

> and guide more people to make the right choice. It will be up to us as it

> always is to make sure that this goes no farther than guidance but the

> exciting thing is that there are numerous suggestions on how to tackle the

> problem of individual health choices.

>

> The same thing can be said about providing coverage to the current uninsured

> and addressing some of the reasons that they are uninsured in the first

> place. There are many proposals to meet the goal of eliminating the

> uninsured. Have pre-existing conditions? Well a goal is to remove this

> limitation completely.

>

> We all need to be involved in the process right now. The time for talking

> about the problems in health care is passing. The time for talking

> solutions is passing. What we need is the will to draft an innovative

> program that addresses the goals we have before us. It will not please all

> of us but we must have the collective will to go forwards. Let's keep

> talking solutions but let's all back that up with action in our daily lives

> with the " rights " we have and in political action through continued

> grassroots action. In the time it takes to post on this listserve, you

> could write you members of Congress. Have you?

>

> Tom Howell, P.T., M.P.T.

>

> Howell Physical Therapy

>

> Eagle, Idaho

>

> thowell@...

>

> This email and any files transmitted with it may contain PRIVILEGED or

> CONFIDENTIAL information and may be read or used only by the intended

> recipient. If you are not the intended recipient of the email or any of its

> attachments, please be advised that you have received this email in error

> and that any use, dissemination, distribution, forwarding, printing or

> copying of this email or any attached files is strictly prohibited. If you

> have received this email in error, please immediately purge it and all

> attachments and notify the sender by reply email.

>

>

[Guest guest]

Mr. Howell,

I enjoyed reading your post on healthcare reform. My views are as

follows:

The free market is the only model that can do all of the following three

things: a) bring down cost, be affordable to more Americans, c)

foster the innovation that keeps American healthcare on the cutting

edge. Items " a " and " b " have failed in the past, but not to the fault

of the free market. They have failed because of over-reaching

government regulation limiting competition (have any new antibiotics

been ok'd by the FDA recently??), outrageously high court settlements

for injury claims, the expense of malpractice insurance being passed on

to healthcare consumers, etc. Related to the litigious nature of our

healthcare system is the practice of " defensive medicine " , whereby some

physicians prescribe unnecessary medications or order unnecessary

diagnostic tests for fear of being sued if they do not, in the

off-chance that something bad should result.

You mentioned: " The government is stepping in because those with

" rights " and " choices " have failed! " Mr. Howell, when you refer to

" those " , you are referring to people like you and me. I (and I'm

assuming you as well) have done everything possible to be conscientious

about my health and I guess in my small way, I at least haven't

contributed to the burden on our healthcare system. I do not believe

that I have failed, I am merely playing the hand that I have been dealt.

Regarding increased government involvement, have you ever considered

that the " cure " may be worse than the disease? I don't recall a single

instance of when something ran more efficiently and presented with less

bureaucracy after government became involved.

While the nationalized healthcare plan is being touted as " just another

option available to the consumer " , it is not. It will be rolled out at

the expense of private insurance companies. For a vast majority of

Americans, including myself, my health coverage is through my employer.

When employers are presented with a less expensive government plan that

will save them money, they will likely jump at the opportunity. With

all due respect to my employer, they will not check with me before

making this decision, especially in the current economic climate. This

new plan may cost me the same or less, but access to care will be

significantly reduced, inclusive of OT and PT. Our services will be

reimbursed less, our pay will be less, the amount of care that the

consumer receives will be less, and the number of therapy applicants and

current practitioners will be fewer in number. There are only two

things that will increase: 1) the wait to access services, and 2) the

number of patients that we will be required to see in an effort to make

up in volume what we lose in reimbursement.

You also mentioned, " Have pre-existing conditions? Well a goal is to

remove this limitation completely. " My question is, at who's expense?

The answer is that you and I will be paying for not only the coverage of

the pre-existing conditions of others, but also for the coverage of

those who choose not to take care of their own health. Nationalized

healthcare, in effect, eliminates the need for me to take personal

responsibility for my health. After all, I have Uncle Sam more than

willing to cover the tab. No matter how President Obama spins it, what

he is proposing is socialized medicine. As President Regan so

eloquently stated, " Government is not a part of the solution, it is part

of the problem. "

As one of your justifications for government intervention in healthcare

you mentioned, " There has been discussion in the last few days about

individuals making the right choice but are we sure they always can? "

The answer is " no " , not everyone can or will make the " right " decision

about their own healthcare. That's ok. Somewhere along the line, I

believe that people actually should suffer the consequences for their

actions and decisions. That's what I've been teaching my 5 year old boy

and perhaps that's also an appropriate lesson for our government

officials. In a capitalist country, those who work hard win and those

who don't, lose. That's what drives our work ethic, our innovation, and

our competitive spirit. Am I saying that we should neglect the poor and

disadvantaged among us? Absolutely not. I am simply saying that that

is the role of charitable organizations, not the United States

government.

I would highly encourage all readers on this list serve, Democrat,

Republican, or Independent, to contact their representatives and

verbalize your opposition to anything that deviated from the free market

running our healthcare industry. If the government wants to mandate

that I wear a seatbelt when driving, I could really care less. But when

they want to encroach upon the ability for me and my family to access

healthcare, even life saving healthcare, that's where I draw the line.

Mr. Howell, I'm writing with some passion because I feel very strongly

about this subject. I don't want that to be misinterpreted as having a

lack of respect toward your position on this topic. Thank you for

considering my response.

Curtis Marti, OTR/L

________________________________

From: PTManager [mailto:PTManager ] On

Behalf Of thomas m howell

Sent: Tuesday, June 23, 2009 10:41 AM

To: PTManager

Subject: Healthcare reform

Hi everyone,

I don't think anyone is thrilled to be facing increased government

intervention into healthcare but we must keep in mind that there is not

a

viable choice right now. We have had over 40 years to allow private

industry and individuals with " choice " and " rights " to make the right

choices and find a way to improve the health of this country and to

improve

healthcare itself. In some ways we have with the tremendous drop in

cancer

rates and heart disease. On the other hand private industry and

individuals

have not found the solution. Our lives are being bankrupted by

healthcare

costs and worst of all our health overall is not better. The government

is

stepping in because those with " rights " and " choices " have failed!

With that said, I need also to remind us all to read the goals of

healthcare

reform that the Senate, House and President Obama each have outlined.

Those

goals present us with the framework to innovate a new system to address

the

concerns of most. There has been discussion in the last few days about

individuals making the right choice but are we sure they always can?

Within

the goals of all the plans is a move towards more preventative care

including suggestions for increased use of health " coaches " to help

educate

and guide more people to make the right choice. It will be up to us as

it

always is to make sure that this goes no farther than guidance but the

exciting thing is that there are numerous suggestions on how to tackle

the

problem of individual health choices.

The same thing can be said about providing coverage to the current

uninsured

and addressing some of the reasons that they are uninsured in the first

place. There are many proposals to meet the goal of eliminating the

uninsured. Have pre-existing conditions? Well a goal is to remove this

limitation completely.

We all need to be involved in the process right now. The time for

talking

about the problems in health care is passing. The time for talking

solutions is passing. What we need is the will to draft an innovative

program that addresses the goals we have before us. It will not please

all

of us but we must have the collective will to go forwards. Let's keep

talking solutions but let's all back that up with action in our daily

lives

with the " rights " we have and in political action through continued

grassroots action. In the time it takes to post on this listserve, you

could write you members of Congress. Have you?

Tom Howell, P.T., M.P.T.

Howell Physical Therapy

Eagle, Idaho

thowell@... <mailto:thowell%40fiberpipe.net>

This email and any files transmitted with it may contain PRIVILEGED or

CONFIDENTIAL information and may be read or used only by the intended

recipient. If you are not the intended recipient of the email or any of

its

attachments, please be advised that you have received this email in

error

and that any use, dissemination, distribution, forwarding, printing or

copying of this email or any attached files is strictly prohibited. If

you

have received this email in error, please immediately purge it and all

attachments and notify the sender by reply email.

[Guest guest]

Mr. Howell,

I enjoyed reading your post on healthcare reform. My views are as

follows:

The free market is the only model that can do all of the following three

things: a) bring down cost, be affordable to more Americans, c)

foster the innovation that keeps American healthcare on the cutting

edge. Items " a " and " b " have failed in the past, but not to the fault

of the free market. They have failed because of over-reaching

government regulation limiting competition (have any new antibiotics

been ok'd by the FDA recently??), outrageously high court settlements

for injury claims, the expense of malpractice insurance being passed on

to healthcare consumers, etc. Related to the litigious nature of our

healthcare system is the practice of " defensive medicine " , whereby some

physicians prescribe unnecessary medications or order unnecessary

diagnostic tests for fear of being sued if they do not, in the

off-chance that something bad should result.

You mentioned: " The government is stepping in because those with

" rights " and " choices " have failed! " Mr. Howell, when you refer to

" those " , you are referring to people like you and me. I (and I'm

assuming you as well) have done everything possible to be conscientious

about my health and I guess in my small way, I at least haven't

contributed to the burden on our healthcare system. I do not believe

that I have failed, I am merely playing the hand that I have been dealt.

Regarding increased government involvement, have you ever considered

that the " cure " may be worse than the disease? I don't recall a single

instance of when something ran more efficiently and presented with less

bureaucracy after government became involved.

While the nationalized healthcare plan is being touted as " just another

option available to the consumer " , it is not. It will be rolled out at

the expense of private insurance companies. For a vast majority of

Americans, including myself, my health coverage is through my employer.

When employers are presented with a less expensive government plan that

will save them money, they will likely jump at the opportunity. With

all due respect to my employer, they will not check with me before

making this decision, especially in the current economic climate. This

new plan may cost me the same or less, but access to care will be

significantly reduced, inclusive of OT and PT. Our services will be

reimbursed less, our pay will be less, the amount of care that the

consumer receives will be less, and the number of therapy applicants and

current practitioners will be fewer in number. There are only two

things that will increase: 1) the wait to access services, and 2) the

number of patients that we will be required to see in an effort to make

up in volume what we lose in reimbursement.

You also mentioned, " Have pre-existing conditions? Well a goal is to

remove this limitation completely. " My question is, at who's expense?

The answer is that you and I will be paying for not only the coverage of

the pre-existing conditions of others, but also for the coverage of

those who choose not to take care of their own health. Nationalized

healthcare, in effect, eliminates the need for me to take personal

responsibility for my health. After all, I have Uncle Sam more than

willing to cover the tab. No matter how President Obama spins it, what

he is proposing is socialized medicine. As President Regan so

eloquently stated, " Government is not a part of the solution, it is part

of the problem. "

As one of your justifications for government intervention in healthcare

you mentioned, " There has been discussion in the last few days about

individuals making the right choice but are we sure they always can? "

The answer is " no " , not everyone can or will make the " right " decision

about their own healthcare. That's ok. Somewhere along the line, I

believe that people actually should suffer the consequences for their

actions and decisions. That's what I've been teaching my 5 year old boy

and perhaps that's also an appropriate lesson for our government

officials. In a capitalist country, those who work hard win and those

who don't, lose. That's what drives our work ethic, our innovation, and

our competitive spirit. Am I saying that we should neglect the poor and

disadvantaged among us? Absolutely not. I am simply saying that that

is the role of charitable organizations, not the United States

government.

I would highly encourage all readers on this list serve, Democrat,

Republican, or Independent, to contact their representatives and

verbalize your opposition to anything that deviated from the free market

running our healthcare industry. If the government wants to mandate

that I wear a seatbelt when driving, I could really care less. But when

they want to encroach upon the ability for me and my family to access

healthcare, even life saving healthcare, that's where I draw the line.

Mr. Howell, I'm writing with some passion because I feel very strongly

about this subject. I don't want that to be misinterpreted as having a

lack of respect toward your position on this topic. Thank you for

considering my response.

Curtis Marti, OTR/L

________________________________

From: PTManager [mailto:PTManager ] On

Behalf Of thomas m howell

Sent: Tuesday, June 23, 2009 10:41 AM

To: PTManager

Subject: Healthcare reform

Hi everyone,

I don't think anyone is thrilled to be facing increased government

intervention into healthcare but we must keep in mind that there is not

a

viable choice right now. We have had over 40 years to allow private

industry and individuals with " choice " and " rights " to make the right

choices and find a way to improve the health of this country and to

improve

healthcare itself. In some ways we have with the tremendous drop in

cancer

rates and heart disease. On the other hand private industry and

individuals

have not found the solution. Our lives are being bankrupted by

healthcare

costs and worst of all our health overall is not better. The government

is

stepping in because those with " rights " and " choices " have failed!

With that said, I need also to remind us all to read the goals of

healthcare

reform that the Senate, House and President Obama each have outlined.

Those

goals present us with the framework to innovate a new system to address

the

concerns of most. There has been discussion in the last few days about

individuals making the right choice but are we sure they always can?

Within

the goals of all the plans is a move towards more preventative care

including suggestions for increased use of health " coaches " to help

educate

and guide more people to make the right choice. It will be up to us as

it

always is to make sure that this goes no farther than guidance but the

exciting thing is that there are numerous suggestions on how to tackle

the

problem of individual health choices.

The same thing can be said about providing coverage to the current

uninsured

and addressing some of the reasons that they are uninsured in the first

place. There are many proposals to meet the goal of eliminating the

uninsured. Have pre-existing conditions? Well a goal is to remove this

limitation completely.

We all need to be involved in the process right now. The time for

talking

about the problems in health care is passing. The time for talking

solutions is passing. What we need is the will to draft an innovative

program that addresses the goals we have before us. It will not please

all

of us but we must have the collective will to go forwards. Let's keep

talking solutions but let's all back that up with action in our daily

lives

with the " rights " we have and in political action through continued

grassroots action. In the time it takes to post on this listserve, you

could write you members of Congress. Have you?

Tom Howell, P.T., M.P.T.

Howell Physical Therapy

Eagle, Idaho

thowell@... <mailto:thowell%40fiberpipe.net>

This email and any files transmitted with it may contain PRIVILEGED or

CONFIDENTIAL information and may be read or used only by the intended

recipient. If you are not the intended recipient of the email or any of

its

attachments, please be advised that you have received this email in

error

and that any use, dissemination, distribution, forwarding, printing or

copying of this email or any attached files is strictly prohibited. If

you

have received this email in error, please immediately purge it and all

attachments and notify the sender by reply email.

[Guest guest]

We can all appreciate Tom's sentiment about working together to achieve common

goals. But it is incumbent upon all of us as citizens (we are citizens first,

therapists second!) to realize what sort of options are afforded us by our form

of government.

We are not, as is so often stated, a democracy. We are a constitutional

republic, with democratically elected legislators. There is a world of

difference between the two, and the main crux of that difference in the current

context is that in our form of government, a majority may never vote away the

rights of a minority.

We often discuss options for government actions as if we merely must choose or

invent the best program. But that skips over the critically important question,

" What part of our constitution allows for this? " Every single program we enact,

every program we implement, takes from one and gives to another. None of it is

compatible with our constitution, or with goodness. They tend only to engage the

law of unintended consequences, and make terrible trouble.

I think that we often do not appreciate the damage we do by acting outside of

our base governmental rules. The tangled, wasteful, anti-market forces at work

now in medical care and banking and seemingly everywhere else, are a direct

result of meddling with the constitution---a result of those infamous " special

interests " manipulating our government to achieve this or that goal.

We therapists are supposedly professionals with a servant's interest in our

country. Why then do we fight so hard to force our brethren to pay for this or

that? We may couch the debate in the language of philanthropy, of caring for

people, but true " giving " is, of course, a matter of heart--an individual's

prerogative. There is NO WAY to make giving " good " by systematizing it with

federal statutes! And in the end it only creates more opportunities for special

interests to extract money and power from the system. Our current social and

political disasters ought to be ample evidence of that.

True leaders would be stimulating our hearts to responsibility and goodness, not

applying systematic rules--bureaucratic chains, if you will--to the people.

Imagine, if instead of program developers we had real leaders... if we took care

of each other with our hearts instead of with systematized rules! What a country

we would be!

Oh, and by the way, differences between the states were not only anticipated by

our founders, but encouraged. There was an expectation of healthy competition

between the states--another sort of market force. Federalizing everything to

achieve uniformity among the states is a deadly idea.

Healthcare reform

Hi everyone,

I respect the differing opinions expressed here and I enjoy the debate but I

feel that many may be missing my point. President Obama has said it best

that we need " the will to change and the courage to compromise " . No matter

what your opinion or concern is about pending reform, let your voice be

heard. Even better, join with your fellow healthcare providers and find

common ground so we can all move forwards with a louder voice.

The APTA Virtual Rally for healthcare reform was tonight and here is the

challenge.

We need

10,000 emails sent

1000 phone calls

Meetings with your members of Congress at your facility or at their offices

(July 4th or August recesses)

Attendance at fundraisers

Let's get to work.

Go to aptavirtualrally.com for all the details about tonight's rally and

about how to act. The APTA now has a PATIENT ACTION CENTER as well at their

website so let's get our patients involved and have them contact Congress as

well. There are talking points about our priorities on reform at the

website. For our colleague's in other professions, consult your

professional organizations but please get involved.

It is up to us now. There are aspects of reform we know about already that

have been released in the last few weeks that could have negative effects on

our profession and on our colleagues professions and many that will have

positive effects. It is up to us, to you, to contact Congress now to let

them know what we are recommending, what your profession is recommending and

what we are all fighting for!

Let's go!

Tom Howell, P.T., M.P.T.

Howell Physical Therapy

Eagle, ID

thowell@...<mailto:thowell%40fiberpipe.net>

This email and any files transmitted with it may contain PRIVILEGED or

CONFIDENTIAL information and may be read or used only by the intended

recipient. If you are not the intended recipient of the email or any of its

attachments, please be advised that you have received this email in error

and that any use, dissemination, distribution, forwarding, printing or

copying of this email or any attached files is strictly prohibited. If you

have received this email in error, please immediately purge it and all

attachments and notify the sender by reply email.

[Guest guest]

We can all appreciate Tom's sentiment about working together to achieve common

goals. But it is incumbent upon all of us as citizens (we are citizens first,

therapists second!) to realize what sort of options are afforded us by our form

of government.

We are not, as is so often stated, a democracy. We are a constitutional

republic, with democratically elected legislators. There is a world of

difference between the two, and the main crux of that difference in the current

context is that in our form of government, a majority may never vote away the

rights of a minority.

We often discuss options for government actions as if we merely must choose or

invent the best program. But that skips over the critically important question,

" What part of our constitution allows for this? " Every single program we enact,

every program we implement, takes from one and gives to another. None of it is

compatible with our constitution, or with goodness. They tend only to engage the

law of unintended consequences, and make terrible trouble.

I think that we often do not appreciate the damage we do by acting outside of

our base governmental rules. The tangled, wasteful, anti-market forces at work

now in medical care and banking and seemingly everywhere else, are a direct

result of meddling with the constitution---a result of those infamous " special

interests " manipulating our government to achieve this or that goal.

We therapists are supposedly professionals with a servant's interest in our

country. Why then do we fight so hard to force our brethren to pay for this or

that? We may couch the debate in the language of philanthropy, of caring for

people, but true " giving " is, of course, a matter of heart--an individual's

prerogative. There is NO WAY to make giving " good " by systematizing it with

federal statutes! And in the end it only creates more opportunities for special

interests to extract money and power from the system. Our current social and

political disasters ought to be ample evidence of that.

True leaders would be stimulating our hearts to responsibility and goodness, not

applying systematic rules--bureaucratic chains, if you will--to the people.

Imagine, if instead of program developers we had real leaders... if we took care

of each other with our hearts instead of with systematized rules! What a country

we would be!

Oh, and by the way, differences between the states were not only anticipated by

our founders, but encouraged. There was an expectation of healthy competition

between the states--another sort of market force. Federalizing everything to

achieve uniformity among the states is a deadly idea.

Healthcare reform

Hi everyone,

I respect the differing opinions expressed here and I enjoy the debate but I

feel that many may be missing my point. President Obama has said it best

that we need " the will to change and the courage to compromise " . No matter

what your opinion or concern is about pending reform, let your voice be

heard. Even better, join with your fellow healthcare providers and find

common ground so we can all move forwards with a louder voice.

The APTA Virtual Rally for healthcare reform was tonight and here is the

challenge.

We need

10,000 emails sent

1000 phone calls

Meetings with your members of Congress at your facility or at their offices

(July 4th or August recesses)

Attendance at fundraisers

Let's get to work.

Go to aptavirtualrally.com for all the details about tonight's rally and

about how to act. The APTA now has a PATIENT ACTION CENTER as well at their

website so let's get our patients involved and have them contact Congress as

well. There are talking points about our priorities on reform at the

website. For our colleague's in other professions, consult your

professional organizations but please get involved.

It is up to us now. There are aspects of reform we know about already that

have been released in the last few weeks that could have negative effects on

our profession and on our colleagues professions and many that will have

positive effects. It is up to us, to you, to contact Congress now to let

them know what we are recommending, what your profession is recommending and

what we are all fighting for!

Let's go!

Tom Howell, P.T., M.P.T.

Howell Physical Therapy

Eagle, ID

thowell@...<mailto:thowell%40fiberpipe.net>

This email and any files transmitted with it may contain PRIVILEGED or

CONFIDENTIAL information and may be read or used only by the intended

recipient. If you are not the intended recipient of the email or any of its

attachments, please be advised that you have received this email in error

and that any use, dissemination, distribution, forwarding, printing or

copying of this email or any attached files is strictly prohibited. If you

have received this email in error, please immediately purge it and all

attachments and notify the sender by reply email.

[Guest guest]

Are you happy with Medicare? Imagine the entire country having a $1700

yearly cap on physical therapy. As most of you know I run a

multidisciplinary group consisting of medical doctors, chiropractors and

physical therapists. The medical doctors are complaining of the poor

reimbursement (much less than our Blue Cross, CIGNA or Aetna). Our

chiropractors complain that only spinal manipulation is covered and

reimbursement is roughly $30 per visit. Our physical therapists are

complaining about the $1700 cap per year. Everybody is complaining about the

paperwork.

How is the government going to pay for this program. Will it be from the

40% of people who pay no taxes. Will he 37 million uninsured Americans

choose to foot the bill or at least pay their share. Or will my taxes the

increased to cover those who don't pay. I have been in practice for 26 years

and government reimbursement has been getting worse, paying less and

requiring more paperwork every year. The government decided how much

coverage they would cover and how much care we could provide with very

little or no input from us. And as far as direct access I see no way that

the government will grant direct access. I'm just venting please feel free

to delete this without reading it and no response is required.

From: PTManager [mailto:PTManager ] On Behalf

Of s

Sent: Wednesday, June 24, 2009 10:19 AM

To: PTManager

Subject: Re: Healthcare reform

This is the post I have been waiting for, as a private practice owner, an

advocate for the profession and the patient and also as the father in a

family of five I have looked at this matter from various sides, each side

presents different challenges. Yes, i want a plan that keeps private

practice in Physical Therapy as a viable option, no I dont want to become

and employee of the government. Yes, I want affordable health insurance for

all of my patients and potential patients, like the 24 year old girl, double

amputee, s/p 51 surgeries for osteomyelitis who cant get insurance coverage

here in Florida because of pre-existing conditions (duh?) but can in her

home state of Indiana because of different state regs (I agree with you

Jim). The prior administration did a lot to the benefit of the insurance

industry, the Medicare HMO policies took money directly out of the providers

hands and handed it to an insurance company middle man, neither the patient,

nor the providers benefited, only the insurance companies. We must create

competition for the Insurance industry, they need to be held accountable for

their actions (and inactions) on a Federal level so that they cant just run

to the states that treat them the best. I have liked most of what I have

heard from the current administration, if you avoid listening to the

rhetoric on both sides and actually listen to what is coming from the White

House it at least sounds like they are looking to put the patient and

providers ahead of the insurance and pharmacuetical giants of the world.

Finally, however, I dont see costs coming down sufficiently unless we deal

with tort reform and limits on malpractice and the current administration

has refused to adress this at all. Thanks for the discussion, I will be

attending the Rally tonight, should be interesting.

E. s, PT, DPT

Orthopedic Clinical Specialist

Fellow American Academy of Orthopedic Manual Physical Therapists

www.douglasspt.com

>

>

> These have all been interesting comments. What though this all comes down

to is whether as a society we feel healthcare is a right or a benefit. In a

recent NYT survey, over 70% want a public plan option. I think they have

voiced that they feel it is a right. why? I think its becasue all of the

private options have increasingly shifted the risk to the patient and

created burocracies and hoops to jump to that more than rival those that

people are concerned about with a public plan. the private insurers want to

have a level playing field in competing against a public plan. well if that

public plan has ease of access, portability between jobs and no pre

exisiting condition stuff or variable medical neccessity definitons ... sign

me up! And so if the public plan is competitive, then the private's have to

react to that or lose market share .... oops there goes those CEO bonuses!

We have to get the double digit stockhoder return expectations out of the

health insurance business. What I am hearing so far from Washington is

positive.

>

> Jim Dunleavy PT, MS

>

>

>

>

>

>

>

> Healthcare reform

>

>

>

>

> Hi everyone,

>

> I don't think anyone is thrilled to be facing increased government

> intervention into healthcare but we must keep in mind that there is not a

> viable choice right now. We have had over 40 years to allow private

> industry and individuals with " choice " and " rights " to make the right

> choices and find a way to improve the health of this country and to

improve

> healthcare itself. In some ways we have with the tremendous drop in cancer

> rates and heart disease. On the other hand private industry and

individuals

> have not found the solution. Our lives are being bankrupted by healthcare

> costs and worst of all our health overall is not better. The government is

> stepping in because those with " rights " and " choices " have failed!

>

> With that said, I need also to remind us all to read the goals of

healthcare

> reform that the Senate, House and President Obama each have outlined.

Those

> goals present us with the framework to innovate a new system to address

the

> concerns of most. There has been discussion in the last few days about

> individuals making the right choice but are we sure they always can?

Within

> the goals of all the plans is a move towards more preventative care

> including suggestions for increased use of health " coaches " to help

educate

> and guide more people to make the right choice. It will be up to us as it

> always is to make sure that this goes no farther than guidance but the

> exciting thing is that there are numerous suggestions on how to tackle the

> problem of individual health choices.

>

> The same thing can be said about providing coverage to the current

uninsured

> and addressing some of the reasons that they are uninsured in the first

> place. There are many proposals to meet the goal of eliminating the

> uninsured. Have pre-existing conditions? Well a goal is to remove this

> limitation completely.

>

> We all need to be involved in the process right now. The time for talking

> about the problems in health care is passing. The time for talking

> solutions is passing. What we need is the will to draft an innovative

> program that addresses the goals we have before us. It will not please all

> of us but we must have the collective will to go forwards. Let's keep

> talking solutions but let's all back that up with action in our daily

lives

> with the " rights " we have and in political action through continued

> grassroots action. In the time it takes to post on this listserve, you

> could write you members of Congress. Have you?

>

> Tom Howell, P.T., M.P.T.

>

> Howell Physical Therapy

>

> Eagle, Idaho

>

> thowell@...<mailto:thowell%40fiberpipe.net>

>

> This email and any files transmitted with it may contain PRIVILEGED or

> CONFIDENTIAL information and may be read or used only by the intended

> recipient. If you are not the intended recipient of the email or any of

its

> attachments, please be advised that you have received this email in error

> and that any use, dissemination, distribution, forwarding, printing or

> copying of this email or any attached files is strictly prohibited. If you

> have received this email in error, please immediately purge it and all

> attachments and notify the sender by reply email.

>

>

[Guest guest]

Are you happy with Medicare? Imagine the entire country having a $1700

yearly cap on physical therapy. As most of you know I run a

multidisciplinary group consisting of medical doctors, chiropractors and

physical therapists. The medical doctors are complaining of the poor

reimbursement (much less than our Blue Cross, CIGNA or Aetna). Our

chiropractors complain that only spinal manipulation is covered and

reimbursement is roughly $30 per visit. Our physical therapists are

complaining about the $1700 cap per year. Everybody is complaining about the

paperwork.

How is the government going to pay for this program. Will it be from the

40% of people who pay no taxes. Will he 37 million uninsured Americans

choose to foot the bill or at least pay their share. Or will my taxes the

increased to cover those who don't pay. I have been in practice for 26 years

and government reimbursement has been getting worse, paying less and

requiring more paperwork every year. The government decided how much

coverage they would cover and how much care we could provide with very

little or no input from us. And as far as direct access I see no way that

the government will grant direct access. I'm just venting please feel free

to delete this without reading it and no response is required.

From: PTManager [mailto:PTManager ] On Behalf

Of s

Sent: Wednesday, June 24, 2009 10:19 AM

To: PTManager

Subject: Re: Healthcare reform

This is the post I have been waiting for, as a private practice owner, an

advocate for the profession and the patient and also as the father in a

family of five I have looked at this matter from various sides, each side

presents different challenges. Yes, i want a plan that keeps private

practice in Physical Therapy as a viable option, no I dont want to become

and employee of the government. Yes, I want affordable health insurance for

all of my patients and potential patients, like the 24 year old girl, double

amputee, s/p 51 surgeries for osteomyelitis who cant get insurance coverage

here in Florida because of pre-existing conditions (duh?) but can in her

home state of Indiana because of different state regs (I agree with you

Jim). The prior administration did a lot to the benefit of the insurance

industry, the Medicare HMO policies took money directly out of the providers

hands and handed it to an insurance company middle man, neither the patient,

nor the providers benefited, only the insurance companies. We must create

competition for the Insurance industry, they need to be held accountable for

their actions (and inactions) on a Federal level so that they cant just run

to the states that treat them the best. I have liked most of what I have

heard from the current administration, if you avoid listening to the

rhetoric on both sides and actually listen to what is coming from the White

House it at least sounds like they are looking to put the patient and

providers ahead of the insurance and pharmacuetical giants of the world.

Finally, however, I dont see costs coming down sufficiently unless we deal

with tort reform and limits on malpractice and the current administration

has refused to adress this at all. Thanks for the discussion, I will be

attending the Rally tonight, should be interesting.

E. s, PT, DPT

Orthopedic Clinical Specialist

Fellow American Academy of Orthopedic Manual Physical Therapists

www.douglasspt.com

>

>

> These have all been interesting comments. What though this all comes down

to is whether as a society we feel healthcare is a right or a benefit. In a

recent NYT survey, over 70% want a public plan option. I think they have

voiced that they feel it is a right. why? I think its becasue all of the

private options have increasingly shifted the risk to the patient and

created burocracies and hoops to jump to that more than rival those that

people are concerned about with a public plan. the private insurers want to

have a level playing field in competing against a public plan. well if that

public plan has ease of access, portability between jobs and no pre

exisiting condition stuff or variable medical neccessity definitons ... sign

me up! And so if the public plan is competitive, then the private's have to

react to that or lose market share .... oops there goes those CEO bonuses!

We have to get the double digit stockhoder return expectations out of the

health insurance business. What I am hearing so far from Washington is

positive.

>

> Jim Dunleavy PT, MS

>

>

>

>

>

>

>

> Healthcare reform

>

>

>

>

> Hi everyone,

>

> I don't think anyone is thrilled to be facing increased government

> intervention into healthcare but we must keep in mind that there is not a

> viable choice right now. We have had over 40 years to allow private

> industry and individuals with " choice " and " rights " to make the right

> choices and find a way to improve the health of this country and to

improve

> healthcare itself. In some ways we have with the tremendous drop in cancer

> rates and heart disease. On the other hand private industry and

individuals

> have not found the solution. Our lives are being bankrupted by healthcare

> costs and worst of all our health overall is not better. The government is

> stepping in because those with " rights " and " choices " have failed!

>

> With that said, I need also to remind us all to read the goals of

healthcare

> reform that the Senate, House and President Obama each have outlined.

Those

> goals present us with the framework to innovate a new system to address

the

> concerns of most. There has been discussion in the last few days about

> individuals making the right choice but are we sure they always can?

Within

> the goals of all the plans is a move towards more preventative care

> including suggestions for increased use of health " coaches " to help

educate

> and guide more people to make the right choice. It will be up to us as it

> always is to make sure that this goes no farther than guidance but the

> exciting thing is that there are numerous suggestions on how to tackle the

> problem of individual health choices.

>

> The same thing can be said about providing coverage to the current

uninsured

> and addressing some of the reasons that they are uninsured in the first

> place. There are many proposals to meet the goal of eliminating the

> uninsured. Have pre-existing conditions? Well a goal is to remove this

> limitation completely.

>

> We all need to be involved in the process right now. The time for talking

> about the problems in health care is passing. The time for talking

> solutions is passing. What we need is the will to draft an innovative

> program that addresses the goals we have before us. It will not please all

> of us but we must have the collective will to go forwards. Let's keep

> talking solutions but let's all back that up with action in our daily

lives

> with the " rights " we have and in political action through continued

> grassroots action. In the time it takes to post on this listserve, you

> could write you members of Congress. Have you?

>

> Tom Howell, P.T., M.P.T.

>

> Howell Physical Therapy

>

> Eagle, Idaho

>

> thowell@...<mailto:thowell%40fiberpipe.net>

>

> This email and any files transmitted with it may contain PRIVILEGED or

> CONFIDENTIAL information and may be read or used only by the intended

> recipient. If you are not the intended recipient of the email or any of

its

> attachments, please be advised that you have received this email in error

> and that any use, dissemination, distribution, forwarding, printing or

> copying of this email or any attached files is strictly prohibited. If you

> have received this email in error, please immediately purge it and all

> attachments and notify the sender by reply email.

>

>

[Guest guest]

Curtis,

it is pretty hard for me to have much faith in what you are trying to sell me on

here, why? because the " free market " meaning private insurance companies are

failing our country. I, for one, think that these insurance companies neeed a

little competition. You state that on a government plan your access to care

will become limited, that reimbursement for your services will decrease and the

amount of care the consumer recieves will be less. I dont buy this, why?

because I have been in private practice for eight years now and MEDICARE, the

government run healthcare system for those over 65, is our best payer and I have

never heard one senior complain about limited access. Now contrast that with

those patients of mine on private insurance companies (of which we currently

contract with a total of one, why? because we cant stay open on what the rest of

them arbitrailily decide to pay us) and I could fill several pages with stories

of limited access, medically necessary care denied for no reason and payments

denied, checks lost in the mail, ect. So, why, Curtis, should I believe you

that a " free market " (how free is a market when providers can be denied access

to that market) system is the only system that will work when the facts of the

current situation and of my own experience state otherwise?

E. s, PT, DPT

Orthopedic Clinical Specialist

Fellow American Academy of Orthopedic Manual Physical Therapists

www.douglasspt.com

>

> Mr. Howell,

>

>

>

> I enjoyed reading your post on healthcare reform. My views are as

> follows:

>

>

>

> The free market is the only model that can do all of the following three

> things: a) bring down cost, be affordable to more Americans, c)

> foster the innovation that keeps American healthcare on the cutting

> edge. Items " a " and " b " have failed in the past, but not to the fault

> of the free market. They have failed because of over-reaching

> government regulation limiting competition (have any new antibiotics

> been ok'd by the FDA recently??), outrageously high court settlements

> for injury claims, the expense of malpractice insurance being passed on

> to healthcare consumers, etc. Related to the litigious nature of our

> healthcare system is the practice of " defensive medicine " , whereby some

> physicians prescribe unnecessary medications or order unnecessary

> diagnostic tests for fear of being sued if they do not, in the

> off-chance that something bad should result.

>

>

>

> You mentioned: " The government is stepping in because those with

> " rights " and " choices " have failed! " Mr. Howell, when you refer to

> " those " , you are referring to people like you and me. I (and I'm

> assuming you as well) have done everything possible to be conscientious

> about my health and I guess in my small way, I at least haven't

> contributed to the burden on our healthcare system. I do not believe

> that I have failed, I am merely playing the hand that I have been dealt.

> Regarding increased government involvement, have you ever considered

> that the " cure " may be worse than the disease? I don't recall a single

> instance of when something ran more efficiently and presented with less

> bureaucracy after government became involved.

>

>

>

> While the nationalized healthcare plan is being touted as " just another

> option available to the consumer " , it is not. It will be rolled out at

> the expense of private insurance companies. For a vast majority of

> Americans, including myself, my health coverage is through my employer.

> When employers are presented with a less expensive government plan that

> will save them money, they will likely jump at the opportunity. With

> all due respect to my employer, they will not check with me before

> making this decision, especially in the current economic climate. This

> new plan may cost me the same or less, but access to care will be

> significantly reduced, inclusive of OT and PT. Our services will be

> reimbursed less, our pay will be less, the amount of care that the

> consumer receives will be less, and the number of therapy applicants and

> current practitioners will be fewer in number. There are only two

> things that will increase: 1) the wait to access services, and 2) the

> number of patients that we will be required to see in an effort to make

> up in volume what we lose in reimbursement.

>

>

>

> You also mentioned, " Have pre-existing conditions? Well a goal is to

> remove this limitation completely. " My question is, at who's expense?

> The answer is that you and I will be paying for not only the coverage of

> the pre-existing conditions of others, but also for the coverage of

> those who choose not to take care of their own health. Nationalized

> healthcare, in effect, eliminates the need for me to take personal

> responsibility for my health. After all, I have Uncle Sam more than

> willing to cover the tab. No matter how President Obama spins it, what

> he is proposing is socialized medicine. As President Regan so

> eloquently stated, " Government is not a part of the solution, it is part

> of the problem. "

>

>

>

> As one of your justifications for government intervention in healthcare

> you mentioned, " There has been discussion in the last few days about

> individuals making the right choice but are we sure they always can? "

> The answer is " no " , not everyone can or will make the " right " decision

> about their own healthcare. That's ok. Somewhere along the line, I

> believe that people actually should suffer the consequences for their

> actions and decisions. That's what I've been teaching my 5 year old boy

> and perhaps that's also an appropriate lesson for our government

> officials. In a capitalist country, those who work hard win and those

> who don't, lose. That's what drives our work ethic, our innovation, and

> our competitive spirit. Am I saying that we should neglect the poor and

> disadvantaged among us? Absolutely not. I am simply saying that that

> is the role of charitable organizations, not the United States

> government.

>

>

>

> I would highly encourage all readers on this list serve, Democrat,

> Republican, or Independent, to contact their representatives and

> verbalize your opposition to anything that deviated from the free market

> running our healthcare industry. If the government wants to mandate

> that I wear a seatbelt when driving, I could really care less. But when

> they want to encroach upon the ability for me and my family to access

> healthcare, even life saving healthcare, that's where I draw the line.

>

>

>

> Mr. Howell, I'm writing with some passion because I feel very strongly

> about this subject. I don't want that to be misinterpreted as having a

> lack of respect toward your position on this topic. Thank you for

> considering my response.

>

>

>

> Curtis Marti, OTR/L

>

>

>

>

>

> ________________________________

>

> From: PTManager [mailto:PTManager ] On

> Behalf Of thomas m howell

> Sent: Tuesday, June 23, 2009 10:41 AM

> To: PTManager

> Subject: Healthcare reform

>

>

>

>

>

>

>

>

> Hi everyone,

>

> I don't think anyone is thrilled to be facing increased government

> intervention into healthcare but we must keep in mind that there is not

> a

> viable choice right now. We have had over 40 years to allow private

> industry and individuals with " choice " and " rights " to make the right

> choices and find a way to improve the health of this country and to

> improve

> healthcare itself. In some ways we have with the tremendous drop in

> cancer

> rates and heart disease. On the other hand private industry and

> individuals

> have not found the solution. Our lives are being bankrupted by

> healthcare

> costs and worst of all our health overall is not better. The government

> is

> stepping in because those with " rights " and " choices " have failed!

>

> With that said, I need also to remind us all to read the goals of

> healthcare

> reform that the Senate, House and President Obama each have outlined.

> Those

> goals present us with the framework to innovate a new system to address

> the

> concerns of most. There has been discussion in the last few days about

> individuals making the right choice but are we sure they always can?

> Within

> the goals of all the plans is a move towards more preventative care

> including suggestions for increased use of health " coaches " to help

> educate

> and guide more people to make the right choice. It will be up to us as

> it

> always is to make sure that this goes no farther than guidance but the

> exciting thing is that there are numerous suggestions on how to tackle

> the

> problem of individual health choices.

>

> The same thing can be said about providing coverage to the current

> uninsured

> and addressing some of the reasons that they are uninsured in the first

> place. There are many proposals to meet the goal of eliminating the

> uninsured. Have pre-existing conditions? Well a goal is to remove this

> limitation completely.

>

> We all need to be involved in the process right now. The time for

> talking

> about the problems in health care is passing. The time for talking

> solutions is passing. What we need is the will to draft an innovative

> program that addresses the goals we have before us. It will not please

> all

> of us but we must have the collective will to go forwards. Let's keep

> talking solutions but let's all back that up with action in our daily

> lives

> with the " rights " we have and in political action through continued

> grassroots action. In the time it takes to post on this listserve, you

> could write you members of Congress. Have you?

>

> Tom Howell, P.T., M.P.T.

>

> Howell Physical Therapy

>

> Eagle, Idaho

>

> thowell@... <mailto:thowell%40fiberpipe.net>

>

> This email and any files transmitted with it may contain PRIVILEGED or

> CONFIDENTIAL information and may be read or used only by the intended

> recipient. If you are not the intended recipient of the email or any of

> its

> attachments, please be advised that you have received this email in

> error

> and that any use, dissemination, distribution, forwarding, printing or

> copying of this email or any attached files is strictly prohibited. If

> you

> have received this email in error, please immediately purge it and all

> attachments and notify the sender by reply email.

>

>

[Guest guest]

Curtis,

it is pretty hard for me to have much faith in what you are trying to sell me on

here, why? because the " free market " meaning private insurance companies are

failing our country. I, for one, think that these insurance companies neeed a

little competition. You state that on a government plan your access to care

will become limited, that reimbursement for your services will decrease and the

amount of care the consumer recieves will be less. I dont buy this, why?

because I have been in private practice for eight years now and MEDICARE, the

government run healthcare system for those over 65, is our best payer and I have

never heard one senior complain about limited access. Now contrast that with

those patients of mine on private insurance companies (of which we currently

contract with a total of one, why? because we cant stay open on what the rest of

them arbitrailily decide to pay us) and I could fill several pages with stories

of limited access, medically necessary care denied for no reason and payments

denied, checks lost in the mail, ect. So, why, Curtis, should I believe you

that a " free market " (how free is a market when providers can be denied access

to that market) system is the only system that will work when the facts of the

current situation and of my own experience state otherwise?

E. s, PT, DPT

Orthopedic Clinical Specialist

Fellow American Academy of Orthopedic Manual Physical Therapists

www.douglasspt.com

>

> Mr. Howell,

>

>

>

> I enjoyed reading your post on healthcare reform. My views are as

> follows:

>

>

>

> The free market is the only model that can do all of the following three

> things: a) bring down cost, be affordable to more Americans, c)

> foster the innovation that keeps American healthcare on the cutting

> edge. Items " a " and " b " have failed in the past, but not to the fault

> of the free market. They have failed because of over-reaching

> government regulation limiting competition (have any new antibiotics

> been ok'd by the FDA recently??), outrageously high court settlements

> for injury claims, the expense of malpractice insurance being passed on

> to healthcare consumers, etc. Related to the litigious nature of our

> healthcare system is the practice of " defensive medicine " , whereby some

> physicians prescribe unnecessary medications or order unnecessary

> diagnostic tests for fear of being sued if they do not, in the

> off-chance that something bad should result.

>

>

>

> You mentioned: " The government is stepping in because those with

> " rights " and " choices " have failed! " Mr. Howell, when you refer to

> " those " , you are referring to people like you and me. I (and I'm

> assuming you as well) have done everything possible to be conscientious

> about my health and I guess in my small way, I at least haven't

> contributed to the burden on our healthcare system. I do not believe

> that I have failed, I am merely playing the hand that I have been dealt.

> Regarding increased government involvement, have you ever considered

> that the " cure " may be worse than the disease? I don't recall a single

> instance of when something ran more efficiently and presented with less

> bureaucracy after government became involved.

>

>

>

> While the nationalized healthcare plan is being touted as " just another

> option available to the consumer " , it is not. It will be rolled out at

> the expense of private insurance companies. For a vast majority of

> Americans, including myself, my health coverage is through my employer.

> When employers are presented with a less expensive government plan that

> will save them money, they will likely jump at the opportunity. With

> all due respect to my employer, they will not check with me before

> making this decision, especially in the current economic climate. This

> new plan may cost me the same or less, but access to care will be

> significantly reduced, inclusive of OT and PT. Our services will be

> reimbursed less, our pay will be less, the amount of care that the

> consumer receives will be less, and the number of therapy applicants and

> current practitioners will be fewer in number. There are only two

> things that will increase: 1) the wait to access services, and 2) the

> number of patients that we will be required to see in an effort to make

> up in volume what we lose in reimbursement.

>

>

>

> You also mentioned, " Have pre-existing conditions? Well a goal is to

> remove this limitation completely. " My question is, at who's expense?

> The answer is that you and I will be paying for not only the coverage of

> the pre-existing conditions of others, but also for the coverage of

> those who choose not to take care of their own health. Nationalized

> healthcare, in effect, eliminates the need for me to take personal

> responsibility for my health. After all, I have Uncle Sam more than

> willing to cover the tab. No matter how President Obama spins it, what

> he is proposing is socialized medicine. As President Regan so

> eloquently stated, " Government is not a part of the solution, it is part

> of the problem. "

>

>

>

> As one of your justifications for government intervention in healthcare

> you mentioned, " There has been discussion in the last few days about

> individuals making the right choice but are we sure they always can? "

> The answer is " no " , not everyone can or will make the " right " decision

> about their own healthcare. That's ok. Somewhere along the line, I

> believe that people actually should suffer the consequences for their

> actions and decisions. That's what I've been teaching my 5 year old boy

> and perhaps that's also an appropriate lesson for our government

> officials. In a capitalist country, those who work hard win and those

> who don't, lose. That's what drives our work ethic, our innovation, and

> our competitive spirit. Am I saying that we should neglect the poor and

> disadvantaged among us? Absolutely not. I am simply saying that that

> is the role of charitable organizations, not the United States

> government.

>

>

>

> I would highly encourage all readers on this list serve, Democrat,

> Republican, or Independent, to contact their representatives and

> verbalize your opposition to anything that deviated from the free market

> running our healthcare industry. If the government wants to mandate

> that I wear a seatbelt when driving, I could really care less. But when

> they want to encroach upon the ability for me and my family to access

> healthcare, even life saving healthcare, that's where I draw the line.

>

>

>

> Mr. Howell, I'm writing with some passion because I feel very strongly

> about this subject. I don't want that to be misinterpreted as having a

> lack of respect toward your position on this topic. Thank you for

> considering my response.

>

>

>

> Curtis Marti, OTR/L

>

>

>

>

>

> ________________________________

>

> From: PTManager [mailto:PTManager ] On

> Behalf Of thomas m howell

> Sent: Tuesday, June 23, 2009 10:41 AM

> To: PTManager

> Subject: Healthcare reform

>

>

>

>

>

>

>

>

> Hi everyone,

>

> I don't think anyone is thrilled to be facing increased government

> intervention into healthcare but we must keep in mind that there is not

> a

> viable choice right now. We have had over 40 years to allow private

> industry and individuals with " choice " and " rights " to make the right

> choices and find a way to improve the health of this country and to

> improve

> healthcare itself. In some ways we have with the tremendous drop in

> cancer

> rates and heart disease. On the other hand private industry and

> individuals

> have not found the solution. Our lives are being bankrupted by

> healthcare

> costs and worst of all our health overall is not better. The government

> is

> stepping in because those with " rights " and " choices " have failed!

>

> With that said, I need also to remind us all to read the goals of

> healthcare

> reform that the Senate, House and President Obama each have outlined.

> Those

> goals present us with the framework to innovate a new system to address

> the

> concerns of most. There has been discussion in the last few days about

> individuals making the right choice but are we sure they always can?

> Within

> the goals of all the plans is a move towards more preventative care

> including suggestions for increased use of health " coaches " to help

> educate

> and guide more people to make the right choice. It will be up to us as

> it

> always is to make sure that this goes no farther than guidance but the

> exciting thing is that there are numerous suggestions on how to tackle

> the

> problem of individual health choices.

>

> The same thing can be said about providing coverage to the current

> uninsured

> and addressing some of the reasons that they are uninsured in the first

> place. There are many proposals to meet the goal of eliminating the

> uninsured. Have pre-existing conditions? Well a goal is to remove this

> limitation completely.

>

> We all need to be involved in the process right now. The time for

> talking

> about the problems in health care is passing. The time for talking

> solutions is passing. What we need is the will to draft an innovative

> program that addresses the goals we have before us. It will not please

> all

> of us but we must have the collective will to go forwards. Let's keep

> talking solutions but let's all back that up with action in our daily

> lives

> with the " rights " we have and in political action through continued

> grassroots action. In the time it takes to post on this listserve, you

> could write you members of Congress. Have you?

>

> Tom Howell, P.T., M.P.T.

>

> Howell Physical Therapy

>

> Eagle, Idaho

>

> thowell@... <mailto:thowell%40fiberpipe.net>

>

> This email and any files transmitted with it may contain PRIVILEGED or

> CONFIDENTIAL information and may be read or used only by the intended

> recipient. If you are not the intended recipient of the email or any of

> its

> attachments, please be advised that you have received this email in

> error

> and that any use, dissemination, distribution, forwarding, printing or

> copying of this email or any attached files is strictly prohibited. If

> you

> have received this email in error, please immediately purge it and all

> attachments and notify the sender by reply email.

>

>

[Guest guest]

-

Vent away and while your at it do a little research regarding the exceptions

process to the cap, it is relatively easy to follow and a simple process to

implement in your facility. Compare this with trying to get authorization

beyond a policy holders arbitrarily decided apon max # of visits from a private

insurance company and tell me which is easier and more logical. And while

private insurance reimbursement has been in drastic decline in the last decade

for PT services (all while co-pays and premiums go up) Medicare reimbursement

for PT services has actually increased by a few percent (less than cost of

living increase but still an increase) and medicare deductibles have only

increased by 50 dollars in the last decade. Still, dont see how the private

insurance industry as currently constructed is better for the patient, the

provider of the country as a whole.

E. s, PT,DPT

Orthopedic Clinical Specialist

Fellow American Academy of Orthopedic Manual Physical Therapists

www.douglasspt.com

-- In PTManager , " Dr. Dan " wrote:

>

> Are you happy with Medicare? Imagine the entire country having a $1700

> yearly cap on physical therapy. As most of you know I run a

> multidisciplinary group consisting of medical doctors, chiropractors and

> physical therapists. The medical doctors are complaining of the poor

> reimbursement (much less than our Blue Cross, CIGNA or Aetna). Our

> chiropractors complain that only spinal manipulation is covered and

> reimbursement is roughly $30 per visit. Our physical therapists are

> complaining about the $1700 cap per year. Everybody is complaining about the

> paperwork.

>

> How is the government going to pay for this program. Will it be from the

> 40% of people who pay no taxes. Will he 37 million uninsured Americans

> choose to foot the bill or at least pay their share. Or will my taxes the

> increased to cover those who don't pay. I have been in practice for 26 years

> and government reimbursement has been getting worse, paying less and

> requiring more paperwork every year. The government decided how much

> coverage they would cover and how much care we could provide with very

> little or no input from us. And as far as direct access I see no way that

> the government will grant direct access. I'm just venting please feel free

> to delete this without reading it and no response is required.

>

>

>

> From: PTManager [mailto:PTManager ] On Behalf

> Of s

> Sent: Wednesday, June 24, 2009 10:19 AM

> To: PTManager

> Subject: Re: Healthcare reform

>

>

>

>

>

>

>

>

>

>

> This is the post I have been waiting for, as a private practice owner, an

> advocate for the profession and the patient and also as the father in a

> family of five I have looked at this matter from various sides, each side

> presents different challenges. Yes, i want a plan that keeps private

> practice in Physical Therapy as a viable option, no I dont want to become

> and employee of the government. Yes, I want affordable health insurance for

> all of my patients and potential patients, like the 24 year old girl, double

> amputee, s/p 51 surgeries for osteomyelitis who cant get insurance coverage

> here in Florida because of pre-existing conditions (duh?) but can in her

> home state of Indiana because of different state regs (I agree with you

> Jim). The prior administration did a lot to the benefit of the insurance

> industry, the Medicare HMO policies took money directly out of the providers

> hands and handed it to an insurance company middle man, neither the patient,

> nor the providers benefited, only the insurance companies. We must create

> competition for the Insurance industry, they need to be held accountable for

> their actions (and inactions) on a Federal level so that they cant just run

> to the states that treat them the best. I have liked most of what I have

> heard from the current administration, if you avoid listening to the

> rhetoric on both sides and actually listen to what is coming from the White

> House it at least sounds like they are looking to put the patient and

> providers ahead of the insurance and pharmacuetical giants of the world.

> Finally, however, I dont see costs coming down sufficiently unless we deal

> with tort reform and limits on malpractice and the current administration

> has refused to adress this at all. Thanks for the discussion, I will be

> attending the Rally tonight, should be interesting.

>

> E. s, PT, DPT

> Orthopedic Clinical Specialist

> Fellow American Academy of Orthopedic Manual Physical Therapists

> www.douglasspt.com

>

> >

> >

> > These have all been interesting comments. What though this all comes down

> to is whether as a society we feel healthcare is a right or a benefit. In a

> recent NYT survey, over 70% want a public plan option. I think they have

> voiced that they feel it is a right. why? I think its becasue all of the

> private options have increasingly shifted the risk to the patient and

> created burocracies and hoops to jump to that more than rival those that

> people are concerned about with a public plan. the private insurers want to

> have a level playing field in competing against a public plan. well if that

> public plan has ease of access, portability between jobs and no pre

> exisiting condition stuff or variable medical neccessity definitons ... sign

> me up! And so if the public plan is competitive, then the private's have to

> react to that or lose market share .... oops there goes those CEO bonuses!

> We have to get the double digit stockhoder return expectations out of the

> health insurance business. What I am hearing so far from Washington is

> positive.

> >

> > Jim Dunleavy PT, MS

> >

> >

> >

> >

> >

> >

> >

> > Healthcare reform

> >

> >

> >

> >

> > Hi everyone,

> >

> > I don't think anyone is thrilled to be facing increased government

> > intervention into healthcare but we must keep in mind that there is not a

> > viable choice right now. We have had over 40 years to allow private

> > industry and individuals with " choice " and " rights " to make the right

> > choices and find a way to improve the health of this country and to

> improve

> > healthcare itself. In some ways we have with the tremendous drop in cancer

> > rates and heart disease. On the other hand private industry and

> individuals

> > have not found the solution. Our lives are being bankrupted by healthcare

> > costs and worst of all our health overall is not better. The government is

> > stepping in because those with " rights " and " choices " have failed!

> >

> > With that said, I need also to remind us all to read the goals of

> healthcare

> > reform that the Senate, House and President Obama each have outlined.

> Those

> > goals present us with the framework to innovate a new system to address

> the

> > concerns of most. There has been discussion in the last few days about

> > individuals making the right choice but are we sure they always can?

> Within

> > the goals of all the plans is a move towards more preventative care

> > including suggestions for increased use of health " coaches " to help

> educate

> > and guide more people to make the right choice. It will be up to us as it

> > always is to make sure that this goes no farther than guidance but the

> > exciting thing is that there are numerous suggestions on how to tackle the

> > problem of individual health choices.

> >

> > The same thing can be said about providing coverage to the current

> uninsured

> > and addressing some of the reasons that they are uninsured in the first

> > place. There are many proposals to meet the goal of eliminating the

> > uninsured. Have pre-existing conditions? Well a goal is to remove this

> > limitation completely.

> >

> > We all need to be involved in the process right now. The time for talking

> > about the problems in health care is passing. The time for talking

> > solutions is passing. What we need is the will to draft an innovative

> > program that addresses the goals we have before us. It will not please all

> > of us but we must have the collective will to go forwards. Let's keep

> > talking solutions but let's all back that up with action in our daily

> lives

> > with the " rights " we have and in political action through continued

> > grassroots action. In the time it takes to post on this listserve, you

> > could write you members of Congress. Have you?

> >

> > Tom Howell, P.T., M.P.T.

> >

> > Howell Physical Therapy

> >

> > Eagle, Idaho

> >

> > thowell@<mailto:thowell%40fiberpipe.net>

> >

> > This email and any files transmitted with it may contain PRIVILEGED or

> > CONFIDENTIAL information and may be read or used only by the intended

> > recipient. If you are not the intended recipient of the email or any of

> its

> > attachments, please be advised that you have received this email in error

> > and that any use, dissemination, distribution, forwarding, printing or

> > copying of this email or any attached files is strictly prohibited. If you

> > have received this email in error, please immediately purge it and all

> > attachments and notify the sender by reply email.

> >

> >

[Guest guest]

-

Vent away and while your at it do a little research regarding the exceptions

process to the cap, it is relatively easy to follow and a simple process to

implement in your facility. Compare this with trying to get authorization

beyond a policy holders arbitrarily decided apon max # of visits from a private

insurance company and tell me which is easier and more logical. And while

private insurance reimbursement has been in drastic decline in the last decade

for PT services (all while co-pays and premiums go up) Medicare reimbursement

for PT services has actually increased by a few percent (less than cost of

living increase but still an increase) and medicare deductibles have only

increased by 50 dollars in the last decade. Still, dont see how the private

insurance industry as currently constructed is better for the patient, the

provider of the country as a whole.

E. s, PT,DPT

Orthopedic Clinical Specialist

Fellow American Academy of Orthopedic Manual Physical Therapists

www.douglasspt.com

-- In PTManager , " Dr. Dan " wrote:

>

> Are you happy with Medicare? Imagine the entire country having a $1700

> yearly cap on physical therapy. As most of you know I run a

> multidisciplinary group consisting of medical doctors, chiropractors and

> physical therapists. The medical doctors are complaining of the poor

> reimbursement (much less than our Blue Cross, CIGNA or Aetna). Our

> chiropractors complain that only spinal manipulation is covered and

> reimbursement is roughly $30 per visit. Our physical therapists are

> complaining about the $1700 cap per year. Everybody is complaining about the

> paperwork.

>

> How is the government going to pay for this program. Will it be from the

> 40% of people who pay no taxes. Will he 37 million uninsured Americans

> choose to foot the bill or at least pay their share. Or will my taxes the

> increased to cover those who don't pay. I have been in practice for 26 years

> and government reimbursement has been getting worse, paying less and

> requiring more paperwork every year. The government decided how much

> coverage they would cover and how much care we could provide with very

> little or no input from us. And as far as direct access I see no way that

> the government will grant direct access. I'm just venting please feel free

> to delete this without reading it and no response is required.

>

>

>

> From: PTManager [mailto:PTManager ] On Behalf

> Of s

> Sent: Wednesday, June 24, 2009 10:19 AM

> To: PTManager

> Subject: Re: Healthcare reform

>

>

>

>

>

>

>

>

>

>

> This is the post I have been waiting for, as a private practice owner, an

> advocate for the profession and the patient and also as the father in a

> family of five I have looked at this matter from various sides, each side

> presents different challenges. Yes, i want a plan that keeps private

> practice in Physical Therapy as a viable option, no I dont want to become

> and employee of the government. Yes, I want affordable health insurance for

> all of my patients and potential patients, like the 24 year old girl, double

> amputee, s/p 51 surgeries for osteomyelitis who cant get insurance coverage

> here in Florida because of pre-existing conditions (duh?) but can in her

> home state of Indiana because of different state regs (I agree with you

> Jim). The prior administration did a lot to the benefit of the insurance

> industry, the Medicare HMO policies took money directly out of the providers

> hands and handed it to an insurance company middle man, neither the patient,

> nor the providers benefited, only the insurance companies. We must create

> competition for the Insurance industry, they need to be held accountable for

> their actions (and inactions) on a Federal level so that they cant just run

> to the states that treat them the best. I have liked most of what I have

> heard from the current administration, if you avoid listening to the

> rhetoric on both sides and actually listen to what is coming from the White

> House it at least sounds like they are looking to put the patient and

> providers ahead of the insurance and pharmacuetical giants of the world.

> Finally, however, I dont see costs coming down sufficiently unless we deal

> with tort reform and limits on malpractice and the current administration

> has refused to adress this at all. Thanks for the discussion, I will be

> attending the Rally tonight, should be interesting.

>

> E. s, PT, DPT

> Orthopedic Clinical Specialist

> Fellow American Academy of Orthopedic Manual Physical Therapists

> www.douglasspt.com

>

> >

> >

> > These have all been interesting comments. What though this all comes down

> to is whether as a society we feel healthcare is a right or a benefit. In a

> recent NYT survey, over 70% want a public plan option. I think they have

> voiced that they feel it is a right. why? I think its becasue all of the

> private options have increasingly shifted the risk to the patient and

> created burocracies and hoops to jump to that more than rival those that

> people are concerned about with a public plan. the private insurers want to

> have a level playing field in competing against a public plan. well if that

> public plan has ease of access, portability between jobs and no pre

> exisiting condition stuff or variable medical neccessity definitons ... sign

> me up! And so if the public plan is competitive, then the private's have to

> react to that or lose market share .... oops there goes those CEO bonuses!

> We have to get the double digit stockhoder return expectations out of the

> health insurance business. What I am hearing so far from Washington is

> positive.

> >

> > Jim Dunleavy PT, MS

> >

> >

> >

> >

> >

> >

> >

> > Healthcare reform

> >

> >

> >

> >

> > Hi everyone,

> >

> > I don't think anyone is thrilled to be facing increased government

> > intervention into healthcare but we must keep in mind that there is not a

> > viable choice right now. We have had over 40 years to allow private

> > industry and individuals with " choice " and " rights " to make the right

> > choices and find a way to improve the health of this country and to

> improve

> > healthcare itself. In some ways we have with the tremendous drop in cancer

> > rates and heart disease. On the other hand private industry and

> individuals

> > have not found the solution. Our lives are being bankrupted by healthcare

> > costs and worst of all our health overall is not better. The government is

> > stepping in because those with " rights " and " choices " have failed!

> >

> > With that said, I need also to remind us all to read the goals of

> healthcare

> > reform that the Senate, House and President Obama each have outlined.

> Those

> > goals present us with the framework to innovate a new system to address

> the

> > concerns of most. There has been discussion in the last few days about

> > individuals making the right choice but are we sure they always can?

> Within

> > the goals of all the plans is a move towards more preventative care

> > including suggestions for increased use of health " coaches " to help

> educate

> > and guide more people to make the right choice. It will be up to us as it

> > always is to make sure that this goes no farther than guidance but the

> > exciting thing is that there are numerous suggestions on how to tackle the

> > problem of individual health choices.

> >

> > The same thing can be said about providing coverage to the current

> uninsured

> > and addressing some of the reasons that they are uninsured in the first

> > place. There are many proposals to meet the goal of eliminating the

> > uninsured. Have pre-existing conditions? Well a goal is to remove this

> > limitation completely.

> >

> > We all need to be involved in the process right now. The time for talking

> > about the problems in health care is passing. The time for talking

> > solutions is passing. What we need is the will to draft an innovative

> > program that addresses the goals we have before us. It will not please all

> > of us but we must have the collective will to go forwards. Let's keep

> > talking solutions but let's all back that up with action in our daily

> lives

> > with the " rights " we have and in political action through continued

> > grassroots action. In the time it takes to post on this listserve, you

> > could write you members of Congress. Have you?

> >

> > Tom Howell, P.T., M.P.T.

> >

> > Howell Physical Therapy

> >

> > Eagle, Idaho

> >

> > thowell@<mailto:thowell%40fiberpipe.net>

> >

> > This email and any files transmitted with it may contain PRIVILEGED or

> > CONFIDENTIAL information and may be read or used only by the intended

> > recipient. If you are not the intended recipient of the email or any of

> its

> > attachments, please be advised that you have received this email in error

> > and that any use, dissemination, distribution, forwarding, printing or

> > copying of this email or any attached files is strictly prohibited. If you

> > have received this email in error, please immediately purge it and all

> > attachments and notify the sender by reply email.

> >

> >

[Guest guest]

Thanks for your thoughtful comments. Medicare patients are often able to

receive more rehab than the HMOs offered by private insurance.

--------- Healthcare reform

> >

> >

> >

> >

> > Hi everyone,

> >

> > I don't think anyone is thrilled to be facing increased government

> > intervention into healthcare but we must keep in mind that there is not a

> > viable choice right now. We have had over 40 years to allow private

> > industry and individuals with " choice " and " rights " to make the right

> > choices and find a way to improve the health of this country and to

> improve

> > healthcare itself. In some ways we have with the tremendous drop in cancer

> > rates and heart disease. On the other hand private industry and

> individuals

> > have not found the solution. Our lives are being bankrupted by healthcare

> > costs and worst of all our health overall is not better. The government is

> > stepping in because those with " rights " and " choices " have failed!

> >

> > With that said, I need also to remind us all to read the goals of

> healthcare

> > reform that the Senate, House and President Obama each have outlined.

> Those

> > goals present us with the framework to innovate a new system to address

> the

> > concerns of most. There has been discussion in the last few days about

> > individuals making the right choice but are we sure they always can?

> Within

> > the goals of all the plans is a move towards more preventative care

> > including suggestions for increased use of health " coaches " to help

> educate

> > and guide more people to make the right choice. It will be up to us as it

> > always is to make sure that this goes no farther than guidance but the

> > exciting thing is that there are numerous suggestions on how to tackle the

> > problem of individual health choices.

> >

> > The same thing can be said about providing coverage to the current

> uninsured

> > and addressing some of the reasons that they are uninsured in the first

> > place. There are many proposals to meet the goal of eliminating the

> > uninsured. Have pre-existing conditions? Well a goal is to remove this

> > limitation completely.

> >

> > We all need to be involved in the process right now. The time for talking

> > about the problems in health care is passing. The time for talking

> > solutions is passing. What we need is the will to draft an innovative

> > program that addresses the goals we have before us. It will not please all

> > of us but we must have the collective will to go forwards. Let's keep

> > talking solutions but let's all back that up with action in our daily

> lives

> > with the " rights " we have and in political action through continued

> > grassroots action. In the time it takes to post on this listserve, you

> > could write you members of Congress. Have you?

> >

> > Tom Howell, P.T., M.P.T.

> >

> > Howell Physical Therapy

> >

> > Eagle, Idaho

> >

> > thowell@<mailto:thowell%40fiberpipe.net>

> >

> > This email and any files transmitted with it may contain PRIVILEGED or

> > CONFIDENTIAL information and may be read or used only by the intended

> > recipient. If you are not the intended recipient of the email or any of

> its

> > attachments, please be advised that you have received this email in error

> > and that any use, dissemination, distribution, forwarding, printing or

> > copying of this email or any attached files is strictly prohibited. If you

> > have received this email in error, please immediately purge it and all

> > attachments and notify the sender by reply email.

> >

> >

[Guest guest]

You raise some good points. However, medicare has tons of hidden costs and

inefficiences in the form of superimposed rules and regs that reduce us to

overeducated technicians. The fact of the matter is that the reimbursement rate

is not the sole source of evaluation of a contract. I would much rather have a

private insurer who allows us to practice within our scope of practice-even if

rate is 95% of Medicare as the cost as a provider is less.

____________________________________

Larry

Larry Benz

13000 Equity Place Suite 105

Louisville, KY 40223

mobile

office

Fax

CONFIDENTIALITY: This message is " Off The Record " . A lot of fancy legal speak

that none of us reads or understands if often contained here.

________________________________

From: PTManager <PTManager >

To: PTManager <PTManager >

Sent: Fri Jun 26 15:43:26 2009

Subject: Re: Healthcare reform

-

Vent away and while your at it do a little research regarding the exceptions

process to the cap, it is relatively easy to follow and a simple process to

implement in your facility. Compare this with trying to get authorization beyond

a policy holders arbitrarily decided apon max # of visits from a private

insurance company and tell me which is easier and more logical. And while

private insurance reimbursement has been in drastic decline in the last decade

for PT services (all while co-pays and premiums go up) Medicare reimbursement

for PT services has actually increased by a few percent (less than cost of

living increase but still an increase) and medicare deductibles have only

increased by 50 dollars in the last decade. Still, dont see how the private

insurance industry as currently constructed is better for the patient, the

provider of the country as a whole.

E. s, PT,DPT

Orthopedic Clinical Specialist

Fellow American Academy of Orthopedic Manual Physical Therapists

www.douglasspt.com

-- In PTManager <mailto:PTManager%40yahoogroups.com>, " Dr. Dan "

wrote:

>

> Are you happy with Medicare? Imagine the entire country having a $1700

> yearly cap on physical therapy. As most of you know I run a

> multidisciplinary group consisting of medical doctors, chiropractors and

> physical therapists. The medical doctors are complaining of the poor

> reimbursement (much less than our Blue Cross, CIGNA or Aetna). Our

> chiropractors complain that only spinal manipulation is covered and

> reimbursement is roughly $30 per visit. Our physical therapists are

> complaining about the $1700 cap per year. Everybody is complaining about the

> paperwork.

>

> How is the government going to pay for this program. Will it be from the

> 40% of people who pay no taxes. Will he 37 million uninsured Americans

> choose to foot the bill or at least pay their share. Or will my taxes the

> increased to cover those who don't pay. I have been in practice for 26 years

> and government reimbursement has been getting worse, paying less and

> requiring more paperwork every year. The government decided how much

> coverage they would cover and how much care we could provide with very

> little or no input from us. And as far as direct access I see no way that

> the government will grant direct access. I'm just venting please feel free

> to delete this without reading it and no response is required.

>

>

>

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

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

> Of s

> Sent: Wednesday, June 24, 2009 10:19 AM

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

> Subject: Re: Healthcare reform

>

>

>

>

>

>

>

>

>

>

> This is the post I have been waiting for, as a private practice owner, an

> advocate for the profession and the patient and also as the father in a

> family of five I have looked at this matter from various sides, each side

> presents different challenges. Yes, i want a plan that keeps private

> practice in Physical Therapy as a viable option, no I dont want to become

> and employee of the government. Yes, I want affordable health insurance for

> all of my patients and potential patients, like the 24 year old girl, double

> amputee, s/p 51 surgeries for osteomyelitis who cant get insurance coverage

> here in Florida because of pre-existing conditions (duh?) but can in her

> home state of Indiana because of different state regs (I agree with you

> Jim). The prior administration did a lot to the benefit of the insurance

> industry, the Medicare HMO policies took money directly out of the providers

> hands and handed it to an insurance company middle man, neither the patient,

> nor the providers benefited, only the insurance companies. We must create

> competition for the Insurance industry, they need to be held accountable for

> their actions (and inactions) on a Federal level so that they cant just run

> to the states that treat them the best. I have liked most of what I have

> heard from the current administration, if you avoid listening to the

> rhetoric on both sides and actually listen to what is coming from the White

> House it at least sounds like they are looking to put the patient and

> providers ahead of the insurance and pharmacuetical giants of the world.

> Finally, however, I dont see costs coming down sufficiently unless we deal

> with tort reform and limits on malpractice and the current administration

> has refused to adress this at all. Thanks for the discussion, I will be

> attending the Rally tonight, should be interesting.

>

> E. s, PT, DPT

> Orthopedic Clinical Specialist

> Fellow American Academy of Orthopedic Manual Physical Therapists

> www.douglasspt.com

>

> >

> >

> > These have all been interesting comments. What though this all comes down

> to is whether as a society we feel healthcare is a right or a benefit. In a

> recent NYT survey, over 70% want a public plan option. I think they have

> voiced that they feel it is a right. why? I think its becasue all of the

> private options have increasingly shifted the risk to the patient and

> created burocracies and hoops to jump to that more than rival those that

> people are concerned about with a public plan. the private insurers want to

> have a level playing field in competing against a public plan. well if that

> public plan has ease of access, portability between jobs and no pre

> exisiting condition stuff or variable medical neccessity definitons ... sign

> me up! And so if the public plan is competitive, then the private's have to

> react to that or lose market share .... oops there goes those CEO bonuses!

> We have to get the double digit stockhoder return expectations out of the

> health insurance business. What I am hearing so far from Washington is

> positive.

> >

> > Jim Dunleavy PT, MS

> >

> >

> >

> >

> >

> >

> >

> > Healthcare reform

> >

> >

> >

> >

> > Hi everyone,

> >

> > I don't think anyone is thrilled to be facing increased government

> > intervention into healthcare but we must keep in mind that there is not a

> > viable choice right now. We have had over 40 years to allow private

> > industry and individuals with " choice " and " rights " to make the right

> > choices and find a way to improve the health of this country and to

> improve

> > healthcare itself. In some ways we have with the tremendous drop in cancer

> > rates and heart disease. On the other hand private industry and

> individuals

> > have not found the solution. Our lives are being bankrupted by healthcare

> > costs and worst of all our health overall is not better. The government is

> > stepping in because those with " rights " and " choices " have failed!

> >

> > With that said, I need also to remind us all to read the goals of

> healthcare

> > reform that the Senate, House and President Obama each have outlined.

> Those

> > goals present us with the framework to innovate a new system to address

> the

> > concerns of most. There has been discussion in the last few days about

> > individuals making the right choice but are we sure they always can?

> Within

> > the goals of all the plans is a move towards more preventative care

> > including suggestions for increased use of health " coaches " to help

> educate

> > and guide more people to make the right choice. It will be up to us as it

> > always is to make sure that this goes no farther than guidance but the

> > exciting thing is that there are numerous suggestions on how to tackle the

> > problem of individual health choices.

> >

> > The same thing can be said about providing coverage to the current

> uninsured

> > and addressing some of the reasons that they are uninsured in the first

> > place. There are many proposals to meet the goal of eliminating the

> > uninsured. Have pre-existing conditions? Well a goal is to remove this

> > limitation completely.

> >

> > We all need to be involved in the process right now. The time for talking

> > about the problems in health care is passing. The time for talking

> > solutions is passing. What we need is the will to draft an innovative

> > program that addresses the goals we have before us. It will not please all

> > of us but we must have the collective will to go forwards. Let's keep

> > talking solutions but let's all back that up with action in our daily

> lives

> > with the " rights " we have and in political action through continued

> > grassroots action. In the time it takes to post on this listserve, you

> > could write you members of Congress. Have you?

> >

> > Tom Howell, P.T., M.P.T.

> >

> > Howell Physical Therapy

> >

> > Eagle, Idaho

> >

> > thowell@<mailto:thowell%40fiberpipe.net>

> >

> > This email and any files transmitted with it may contain PRIVILEGED or

> > CONFIDENTIAL information and may be read or used only by the intended

> > recipient. If you are not the intended recipient of the email or any of

> its

> > attachments, please be advised that you have received this email in error

> > and that any use, dissemination, distribution, forwarding, printing or

> > copying of this email or any attached files is strictly prohibited. If you

> > have received this email in error, please immediately purge it and all

> > attachments and notify the sender by reply email.

> >

> >

[Guest guest]

You raise some good points. However, medicare has tons of hidden costs and

inefficiences in the form of superimposed rules and regs that reduce us to

overeducated technicians. The fact of the matter is that the reimbursement rate

is not the sole source of evaluation of a contract. I would much rather have a

private insurer who allows us to practice within our scope of practice-even if

rate is 95% of Medicare as the cost as a provider is less.

____________________________________

Larry

Larry Benz

13000 Equity Place Suite 105

Louisville, KY 40223

mobile

office

Fax

CONFIDENTIALITY: This message is " Off The Record " . A lot of fancy legal speak

that none of us reads or understands if often contained here.

________________________________

From: PTManager <PTManager >

To: PTManager <PTManager >

Sent: Fri Jun 26 15:43:26 2009

Subject: Re: Healthcare reform

-

Vent away and while your at it do a little research regarding the exceptions

process to the cap, it is relatively easy to follow and a simple process to

implement in your facility. Compare this with trying to get authorization beyond

a policy holders arbitrarily decided apon max # of visits from a private

insurance company and tell me which is easier and more logical. And while

private insurance reimbursement has been in drastic decline in the last decade

for PT services (all while co-pays and premiums go up) Medicare reimbursement

for PT services has actually increased by a few percent (less than cost of

living increase but still an increase) and medicare deductibles have only

increased by 50 dollars in the last decade. Still, dont see how the private

insurance industry as currently constructed is better for the patient, the

provider of the country as a whole.

E. s, PT,DPT

Orthopedic Clinical Specialist

Fellow American Academy of Orthopedic Manual Physical Therapists

www.douglasspt.com

-- In PTManager <mailto:PTManager%40yahoogroups.com>, " Dr. Dan "

wrote:

>

> Are you happy with Medicare? Imagine the entire country having a $1700

> yearly cap on physical therapy. As most of you know I run a

> multidisciplinary group consisting of medical doctors, chiropractors and

> physical therapists. The medical doctors are complaining of the poor

> reimbursement (much less than our Blue Cross, CIGNA or Aetna). Our

> chiropractors complain that only spinal manipulation is covered and

> reimbursement is roughly $30 per visit. Our physical therapists are

> complaining about the $1700 cap per year. Everybody is complaining about the

> paperwork.

>

> How is the government going to pay for this program. Will it be from the

> 40% of people who pay no taxes. Will he 37 million uninsured Americans

> choose to foot the bill or at least pay their share. Or will my taxes the

> increased to cover those who don't pay. I have been in practice for 26 years

> and government reimbursement has been getting worse, paying less and

> requiring more paperwork every year. The government decided how much

> coverage they would cover and how much care we could provide with very

> little or no input from us. And as far as direct access I see no way that

> the government will grant direct access. I'm just venting please feel free

> to delete this without reading it and no response is required.

>

>

>

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

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

> Of s

> Sent: Wednesday, June 24, 2009 10:19 AM

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

> Subject: Re: Healthcare reform

>

>

>

>

>

>

>

>

>

>

> This is the post I have been waiting for, as a private practice owner, an

> advocate for the profession and the patient and also as the father in a

> family of five I have looked at this matter from various sides, each side

> presents different challenges. Yes, i want a plan that keeps private

> practice in Physical Therapy as a viable option, no I dont want to become

> and employee of the government. Yes, I want affordable health insurance for

> all of my patients and potential patients, like the 24 year old girl, double

> amputee, s/p 51 surgeries for osteomyelitis who cant get insurance coverage

> here in Florida because of pre-existing conditions (duh?) but can in her

> home state of Indiana because of different state regs (I agree with you

> Jim). The prior administration did a lot to the benefit of the insurance

> industry, the Medicare HMO policies took money directly out of the providers

> hands and handed it to an insurance company middle man, neither the patient,

> nor the providers benefited, only the insurance companies. We must create

> competition for the Insurance industry, they need to be held accountable for

> their actions (and inactions) on a Federal level so that they cant just run

> to the states that treat them the best. I have liked most of what I have

> heard from the current administration, if you avoid listening to the

> rhetoric on both sides and actually listen to what is coming from the White

> House it at least sounds like they are looking to put the patient and

> providers ahead of the insurance and pharmacuetical giants of the world.

> Finally, however, I dont see costs coming down sufficiently unless we deal

> with tort reform and limits on malpractice and the current administration

> has refused to adress this at all. Thanks for the discussion, I will be

> attending the Rally tonight, should be interesting.

>

> E. s, PT, DPT

> Orthopedic Clinical Specialist

> Fellow American Academy of Orthopedic Manual Physical Therapists

> www.douglasspt.com

>

> >

> >

> > These have all been interesting comments. What though this all comes down

> to is whether as a society we feel healthcare is a right or a benefit. In a

> recent NYT survey, over 70% want a public plan option. I think they have

> voiced that they feel it is a right. why? I think its becasue all of the

> private options have increasingly shifted the risk to the patient and

> created burocracies and hoops to jump to that more than rival those that

> people are concerned about with a public plan. the private insurers want to

> have a level playing field in competing against a public plan. well if that

> public plan has ease of access, portability between jobs and no pre

> exisiting condition stuff or variable medical neccessity definitons ... sign

> me up! And so if the public plan is competitive, then the private's have to

> react to that or lose market share .... oops there goes those CEO bonuses!

> We have to get the double digit stockhoder return expectations out of the

> health insurance business. What I am hearing so far from Washington is

> positive.

> >

> > Jim Dunleavy PT, MS

> >

> >

> >

> >

> >

> >

> >

> > Healthcare reform

> >

> >

> >

> >

> > Hi everyone,

> >

> > I don't think anyone is thrilled to be facing increased government

> > intervention into healthcare but we must keep in mind that there is not a

> > viable choice right now. We have had over 40 years to allow private

> > industry and individuals with " choice " and " rights " to make the right

> > choices and find a way to improve the health of this country and to

> improve

> > healthcare itself. In some ways we have with the tremendous drop in cancer

> > rates and heart disease. On the other hand private industry and

> individuals

> > have not found the solution. Our lives are being bankrupted by healthcare

> > costs and worst of all our health overall is not better. The government is

> > stepping in because those with " rights " and " choices " have failed!

> >

> > With that said, I need also to remind us all to read the goals of

> healthcare

> > reform that the Senate, House and President Obama each have outlined.

> Those

> > goals present us with the framework to innovate a new system to address

> the

> > concerns of most. There has been discussion in the last few days about

> > individuals making the right choice but are we sure they always can?

> Within

> > the goals of all the plans is a move towards more preventative care

> > including suggestions for increased use of health " coaches " to help

> educate

> > and guide more people to make the right choice. It will be up to us as it

> > always is to make sure that this goes no farther than guidance but the

> > exciting thing is that there are numerous suggestions on how to tackle the

> > problem of individual health choices.

> >

> > The same thing can be said about providing coverage to the current

> uninsured

> > and addressing some of the reasons that they are uninsured in the first

> > place. There are many proposals to meet the goal of eliminating the

> > uninsured. Have pre-existing conditions? Well a goal is to remove this

> > limitation completely.

> >

> > We all need to be involved in the process right now. The time for talking

> > about the problems in health care is passing. The time for talking

> > solutions is passing. What we need is the will to draft an innovative

> > program that addresses the goals we have before us. It will not please all

> > of us but we must have the collective will to go forwards. Let's keep

> > talking solutions but let's all back that up with action in our daily

> lives

> > with the " rights " we have and in political action through continued

> > grassroots action. In the time it takes to post on this listserve, you

> > could write you members of Congress. Have you?

> >

> > Tom Howell, P.T., M.P.T.

> >

> > Howell Physical Therapy

> >

> > Eagle, Idaho

> >

> > thowell@<mailto:thowell%40fiberpipe.net>

> >

> > This email and any files transmitted with it may contain PRIVILEGED or

> > CONFIDENTIAL information and may be read or used only by the intended

> > recipient. If you are not the intended recipient of the email or any of

> its

> > attachments, please be advised that you have received this email in error

> > and that any use, dissemination, distribution, forwarding, printing or

> > copying of this email or any attached files is strictly prohibited. If you

> > have received this email in error, please immediately purge it and all

> > attachments and notify the sender by reply email.

> >

> >

[Guest guest]

,

Might it be that Medicare looks good because it represents an unreal world? I am

no promoter of so-called private insurances (at least as currently

configured---rules, regulations, and anti-market manipulations make them only

marginally private enterprises) but they certainly reflect medical care's

financial realities more accurately than a welfare program like Medicare.

Last night I sat in a dinner meeting hosted by a local orthopedist and a medical

device rep describing the benefits and protocols of kyphoplasty. Clinically it

was an interesting talk, but for me the most intriguing moment came when a local

physician asked the presenters what the procedure costs. For a moment there was

silence, then the rep repeated the question, with some incredulity, as if to

say, " You're really asking us what it costs? Is that relevant? " Such a pregnant

moment could happen only in a world in which providers believe that medical care

should have no limits.

Honesty requires that we wonder... Could the expectation of endless funding be

partly to blame for the astounding rise in medical care costs (way over the rate

of inflation) over the past 30 or 40 years. Or the seemingly unstoppable

increases in per capita utilization? Or perhaps even explain, at least partly,

why such serious diseases as diabetes and cancer have increased so dramatically

while disease " management " ---medical care's oft-declared central purpose---is

making many physicians rich? (It is worth noting that surveys of medical

students find that an expectation of personal wealth is one of the top reasons

they choose the profession.)

We all know that medical care is to some degree a business. Many would argue

that it is driven largely by business concerns. And we all know that business

carries motivations not always in perfect synchrony with the highest ethical

standards. Link that fact with a powerful government interest, and watch out! As

Albert Nock once said, " “The simple truth is that our businessmen do not want a

government that will let business alone. They want a government they can use. "

Incidentally, the meeting presenters were not entirely sure what a kyphoplasty

costs once all the players have gotten their due, but the estimate was in the

neighborhood of twenty thousand dollars.

Dave Milano, PT

________________________________________

From: PTManager [PTManager ] On Behalf Of

s [dosrinc@...]

Sent: Friday, June 26, 2009 3:43 PM

To: PTManager

Subject: Re: Healthcare reform

-

Vent away and while your at it do a little research regarding the exceptions

process to the cap, it is relatively easy to follow and a simple process to

implement in your facility. Compare this with trying to get authorization beyond

a policy holders arbitrarily decided apon max # of visits from a private

insurance company and tell me which is easier and more logical. And while

private insurance reimbursement has been in drastic decline in the last decade

for PT services (all while co-pays and premiums go up) Medicare reimbursement

for PT services has actually increased by a few percent (less than cost of

living increase but still an increase) and medicare deductibles have only

increased by 50 dollars in the last decade. Still, dont see how the private

insurance industry as currently constructed is better for the patient, the

provider of the country as a whole.

E. s, PT,DPT

Orthopedic Clinical Specialist

Fellow American Academy of Orthopedic Manual Physical Therapists

www.douglasspt.com

-- In PTManager <mailto:PTManager%40yahoogroups.com>, " Dr. Dan "

wrote:

>

> Are you happy with Medicare? Imagine the entire country having a $1700

> yearly cap on physical therapy. As most of you know I run a

> multidisciplinary group consisting of medical doctors, chiropractors and

> physical therapists. The medical doctors are complaining of the poor

> reimbursement (much less than our Blue Cross, CIGNA or Aetna). Our

> chiropractors complain that only spinal manipulation is covered and

> reimbursement is roughly $30 per visit. Our physical therapists are

> complaining about the $1700 cap per year. Everybody is complaining about the

> paperwork.

>

> How is the government going to pay for this program. Will it be from the

> 40% of people who pay no taxes. Will he 37 million uninsured Americans

> choose to foot the bill or at least pay their share. Or will my taxes the

> increased to cover those who don't pay. I have been in practice for 26 years

> and government reimbursement has been getting worse, paying less and

> requiring more paperwork every year. The government decided how much

> coverage they would cover and how much care we could provide with very

> little or no input from us. And as far as direct access I see no way that

> the government will grant direct access. I'm just venting please feel free

> to delete this without reading it and no response is required.

>

>

>

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

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

> Of s

> Sent: Wednesday, June 24, 2009 10:19 AM

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

> Subject: Re: Healthcare reform

>

>

>

>

>

>

>

>

>

>

> This is the post I have been waiting for, as a private practice owner, an

> advocate for the profession and the patient and also as the father in a

> family of five I have looked at this matter from various sides, each side

> presents different challenges. Yes, i want a plan that keeps private

> practice in Physical Therapy as a viable option, no I dont want to become

> and employee of the government. Yes, I want affordable health insurance for

> all of my patients and potential patients, like the 24 year old girl, double

> amputee, s/p 51 surgeries for osteomyelitis who cant get insurance coverage

> here in Florida because of pre-existing conditions (duh?) but can in her

> home state of Indiana because of different state regs (I agree with you

> Jim). The prior administration did a lot to the benefit of the insurance

> industry, the Medicare HMO policies took money directly out of the providers

> hands and handed it to an insurance company middle man, neither the patient,

> nor the providers benefited, only the insurance companies. We must create

> competition for the Insurance industry, they need to be held accountable for

> their actions (and inactions) on a Federal level so that they cant just run

> to the states that treat them the best. I have liked most of what I have

> heard from the current administration, if you avoid listening to the

> rhetoric on both sides and actually listen to what is coming from the White

> House it at least sounds like they are looking to put the patient and

> providers ahead of the insurance and pharmacuetical giants of the world.

> Finally, however, I dont see costs coming down sufficiently unless we deal

> with tort reform and limits on malpractice and the current administration

> has refused to adress this at all. Thanks for the discussion, I will be

> attending the Rally tonight, should be interesting.

>

> E. s, PT, DPT

> Orthopedic Clinical Specialist

> Fellow American Academy of Orthopedic Manual Physical Therapists

> www.douglasspt.com

>

> >

> >

> > These have all been interesting comments. What though this all comes down

> to is whether as a society we feel healthcare is a right or a benefit. In a

> recent NYT survey, over 70% want a public plan option. I think they have

> voiced that they feel it is a right. why? I think its becasue all of the

> private options have increasingly shifted the risk to the patient and

> created burocracies and hoops to jump to that more than rival those that

> people are concerned about with a public plan. the private insurers want to

> have a level playing field in competing against a public plan. well if that

> public plan has ease of access, portability between jobs and no pre

> exisiting condition stuff or variable medical neccessity definitons ... sign

> me up! And so if the public plan is competitive, then the private's have to

> react to that or lose market share .... oops there goes those CEO bonuses!

> We have to get the double digit stockhoder return expectations out of the

> health insurance business. What I am hearing so far from Washington is

> positive.

> >

> > Jim Dunleavy PT, MS

> >

> >

> >

> >

> >

> >

> >

> > Healthcare reform

> >

> >

> >

> >

> > Hi everyone,

> >

> > I don't think anyone is thrilled to be facing increased government

> > intervention into healthcare but we must keep in mind that there is not a

> > viable choice right now. We have had over 40 years to allow private

> > industry and individuals with " choice " and " rights " to make the right

> > choices and find a way to improve the health of this country and to

> improve

> > healthcare itself. In some ways we have with the tremendous drop in cancer

> > rates and heart disease. On the other hand private industry and

> individuals

> > have not found the solution. Our lives are being bankrupted by healthcare

> > costs and worst of all our health overall is not better. The government is

> > stepping in because those with " rights " and " choices " have failed!

> >

> > With that said, I need also to remind us all to read the goals of

> healthcare

> > reform that the Senate, House and President Obama each have outlined.

> Those

> > goals present us with the framework to innovate a new system to address

> the

> > concerns of most. There has been discussion in the last few days about

> > individuals making the right choice but are we sure they always can?

> Within

> > the goals of all the plans is a move towards more preventative care

> > including suggestions for increased use of health " coaches " to help

> educate

> > and guide more people to make the right choice. It will be up to us as it

> > always is to make sure that this goes no farther than guidance but the

> > exciting thing is that there are numerous suggestions on how to tackle the

> > problem of individual health choices.

> >

> > The same thing can be said about providing coverage to the current

> uninsured

> > and addressing some of the reasons that they are uninsured in the first

> > place. There are many proposals to meet the goal of eliminating the

> > uninsured. Have pre-existing conditions? Well a goal is to remove this

> > limitation completely.

> >

> > We all need to be involved in the process right now. The time for talking

> > about the problems in health care is passing. The time for talking

> > solutions is passing. What we need is the will to draft an innovative

> > program that addresses the goals we have before us. It will not please all

> > of us but we must have the collective will to go forwards. Let's keep

> > talking solutions but let's all back that up with action in our daily

> lives

> > with the " rights " we have and in political action through continued

> > grassroots action. In the time it takes to post on this listserve, you

> > could write you members of Congress. Have you?

> >

> > Tom Howell, P.T., M.P.T.

> >

> > Howell Physical Therapy

> >

> > Eagle, Idaho

> >

> > thowell@<mailto:thowell%40fiberpipe.net>

> >

> > This email and any files transmitted with it may contain PRIVILEGED or

> > CONFIDENTIAL information and may be read or used only by the intended

> > recipient. If you are not the intended recipient of the email or any of

> its

> > attachments, please be advised that you have received this email in error

> > and that any use, dissemination, distribution, forwarding, printing or

> > copying of this email or any attached files is strictly prohibited. If you

> > have received this email in error, please immediately purge it and all

> > attachments and notify the sender by reply email.

> >

> >

[Guest guest]

,

Might it be that Medicare looks good because it represents an unreal world? I am

no promoter of so-called private insurances (at least as currently

configured---rules, regulations, and anti-market manipulations make them only

marginally private enterprises) but they certainly reflect medical care's

financial realities more accurately than a welfare program like Medicare.

Last night I sat in a dinner meeting hosted by a local orthopedist and a medical

device rep describing the benefits and protocols of kyphoplasty. Clinically it

was an interesting talk, but for me the most intriguing moment came when a local

physician asked the presenters what the procedure costs. For a moment there was

silence, then the rep repeated the question, with some incredulity, as if to

say, " You're really asking us what it costs? Is that relevant? " Such a pregnant

moment could happen only in a world in which providers believe that medical care

should have no limits.

Honesty requires that we wonder... Could the expectation of endless funding be

partly to blame for the astounding rise in medical care costs (way over the rate

of inflation) over the past 30 or 40 years. Or the seemingly unstoppable

increases in per capita utilization? Or perhaps even explain, at least partly,

why such serious diseases as diabetes and cancer have increased so dramatically

while disease " management " ---medical care's oft-declared central purpose---is

making many physicians rich? (It is worth noting that surveys of medical

students find that an expectation of personal wealth is one of the top reasons

they choose the profession.)

We all know that medical care is to some degree a business. Many would argue

that it is driven largely by business concerns. And we all know that business

carries motivations not always in perfect synchrony with the highest ethical

standards. Link that fact with a powerful government interest, and watch out! As

Albert Nock once said, " “The simple truth is that our businessmen do not want a

government that will let business alone. They want a government they can use. "

Incidentally, the meeting presenters were not entirely sure what a kyphoplasty

costs once all the players have gotten their due, but the estimate was in the

neighborhood of twenty thousand dollars.

Dave Milano, PT

________________________________________

From: PTManager [PTManager ] On Behalf Of

s [dosrinc@...]

Sent: Friday, June 26, 2009 3:43 PM

To: PTManager

Subject: Re: Healthcare reform

-

Vent away and while your at it do a little research regarding the exceptions

process to the cap, it is relatively easy to follow and a simple process to

implement in your facility. Compare this with trying to get authorization beyond

a policy holders arbitrarily decided apon max # of visits from a private

insurance company and tell me which is easier and more logical. And while

private insurance reimbursement has been in drastic decline in the last decade

for PT services (all while co-pays and premiums go up) Medicare reimbursement

for PT services has actually increased by a few percent (less than cost of

living increase but still an increase) and medicare deductibles have only

increased by 50 dollars in the last decade. Still, dont see how the private

insurance industry as currently constructed is better for the patient, the

provider of the country as a whole.

E. s, PT,DPT

Orthopedic Clinical Specialist

Fellow American Academy of Orthopedic Manual Physical Therapists

www.douglasspt.com

-- In PTManager <mailto:PTManager%40yahoogroups.com>, " Dr. Dan "

wrote:

>

> Are you happy with Medicare? Imagine the entire country having a $1700

> yearly cap on physical therapy. As most of you know I run a

> multidisciplinary group consisting of medical doctors, chiropractors and

> physical therapists. The medical doctors are complaining of the poor

> reimbursement (much less than our Blue Cross, CIGNA or Aetna). Our

> chiropractors complain that only spinal manipulation is covered and

> reimbursement is roughly $30 per visit. Our physical therapists are

> complaining about the $1700 cap per year. Everybody is complaining about the

> paperwork.

>

> How is the government going to pay for this program. Will it be from the

> 40% of people who pay no taxes. Will he 37 million uninsured Americans

> choose to foot the bill or at least pay their share. Or will my taxes the

> increased to cover those who don't pay. I have been in practice for 26 years

> and government reimbursement has been getting worse, paying less and

> requiring more paperwork every year. The government decided how much

> coverage they would cover and how much care we could provide with very

> little or no input from us. And as far as direct access I see no way that

> the government will grant direct access. I'm just venting please feel free

> to delete this without reading it and no response is required.

>

>

>

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

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

> Of s

> Sent: Wednesday, June 24, 2009 10:19 AM

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

> Subject: Re: Healthcare reform

>

>

>

>

>

>

>

>

>

>

> This is the post I have been waiting for, as a private practice owner, an

> advocate for the profession and the patient and also as the father in a

> family of five I have looked at this matter from various sides, each side

> presents different challenges. Yes, i want a plan that keeps private

> practice in Physical Therapy as a viable option, no I dont want to become

> and employee of the government. Yes, I want affordable health insurance for

> all of my patients and potential patients, like the 24 year old girl, double

> amputee, s/p 51 surgeries for osteomyelitis who cant get insurance coverage

> here in Florida because of pre-existing conditions (duh?) but can in her

> home state of Indiana because of different state regs (I agree with you

> Jim). The prior administration did a lot to the benefit of the insurance

> industry, the Medicare HMO policies took money directly out of the providers

> hands and handed it to an insurance company middle man, neither the patient,

> nor the providers benefited, only the insurance companies. We must create

> competition for the Insurance industry, they need to be held accountable for

> their actions (and inactions) on a Federal level so that they cant just run

> to the states that treat them the best. I have liked most of what I have

> heard from the current administration, if you avoid listening to the

> rhetoric on both sides and actually listen to what is coming from the White

> House it at least sounds like they are looking to put the patient and

> providers ahead of the insurance and pharmacuetical giants of the world.

> Finally, however, I dont see costs coming down sufficiently unless we deal

> with tort reform and limits on malpractice and the current administration

> has refused to adress this at all. Thanks for the discussion, I will be

> attending the Rally tonight, should be interesting.

>

> E. s, PT, DPT

> Orthopedic Clinical Specialist

> Fellow American Academy of Orthopedic Manual Physical Therapists

> www.douglasspt.com

>

> >

> >

> > These have all been interesting comments. What though this all comes down

> to is whether as a society we feel healthcare is a right or a benefit. In a

> recent NYT survey, over 70% want a public plan option. I think they have

> voiced that they feel it is a right. why? I think its becasue all of the

> private options have increasingly shifted the risk to the patient and

> created burocracies and hoops to jump to that more than rival those that

> people are concerned about with a public plan. the private insurers want to

> have a level playing field in competing against a public plan. well if that

> public plan has ease of access, portability between jobs and no pre

> exisiting condition stuff or variable medical neccessity definitons ... sign

> me up! And so if the public plan is competitive, then the private's have to

> react to that or lose market share .... oops there goes those CEO bonuses!

> We have to get the double digit stockhoder return expectations out of the

> health insurance business. What I am hearing so far from Washington is

> positive.

> >

> > Jim Dunleavy PT, MS

> >

> >

> >

> >

> >

> >

> >

> > Healthcare reform

> >

> >

> >

> >

> > Hi everyone,

> >

> > I don't think anyone is thrilled to be facing increased government

> > intervention into healthcare but we must keep in mind that there is not a

> > viable choice right now. We have had over 40 years to allow private

> > industry and individuals with " choice " and " rights " to make the right

> > choices and find a way to improve the health of this country and to

> improve

> > healthcare itself. In some ways we have with the tremendous drop in cancer

> > rates and heart disease. On the other hand private industry and

> individuals

> > have not found the solution. Our lives are being bankrupted by healthcare

> > costs and worst of all our health overall is not better. The government is

> > stepping in because those with " rights " and " choices " have failed!

> >

> > With that said, I need also to remind us all to read the goals of

> healthcare

> > reform that the Senate, House and President Obama each have outlined.

> Those

> > goals present us with the framework to innovate a new system to address

> the

> > concerns of most. There has been discussion in the last few days about

> > individuals making the right choice but are we sure they always can?

> Within

> > the goals of all the plans is a move towards more preventative care

> > including suggestions for increased use of health " coaches " to help

> educate

> > and guide more people to make the right choice. It will be up to us as it

> > always is to make sure that this goes no farther than guidance but the

> > exciting thing is that there are numerous suggestions on how to tackle the

> > problem of individual health choices.

> >

> > The same thing can be said about providing coverage to the current

> uninsured

> > and addressing some of the reasons that they are uninsured in the first

> > place. There are many proposals to meet the goal of eliminating the

> > uninsured. Have pre-existing conditions? Well a goal is to remove this

> > limitation completely.

> >

> > We all need to be involved in the process right now. The time for talking

> > about the problems in health care is passing. The time for talking

> > solutions is passing. What we need is the will to draft an innovative

> > program that addresses the goals we have before us. It will not please all

> > of us but we must have the collective will to go forwards. Let's keep

> > talking solutions but let's all back that up with action in our daily

> lives

> > with the " rights " we have and in political action through continued

> > grassroots action. In the time it takes to post on this listserve, you

> > could write you members of Congress. Have you?

> >

> > Tom Howell, P.T., M.P.T.

> >

> > Howell Physical Therapy

> >

> > Eagle, Idaho

> >

> > thowell@<mailto:thowell%40fiberpipe.net>

> >

> > This email and any files transmitted with it may contain PRIVILEGED or

> > CONFIDENTIAL information and may be read or used only by the intended

> > recipient. If you are not the intended recipient of the email or any of

> its

> > attachments, please be advised that you have received this email in error

> > and that any use, dissemination, distribution, forwarding, printing or

> > copying of this email or any attached files is strictly prohibited. If you

> > have received this email in error, please immediately purge it and all

> > attachments and notify the sender by reply email.

> >

> >

[Guest guest]

And what about the arbitrary $45 cap from UHC and their Medicare programs...with

visit caps (forget the billions they have received in government incentives).

Some of our patients pay as much as $30 copay. We only see UHC because our

primary referral source takes them. Fortunately it is a very small percentage.

Medicare paperwork ? Much less than most insurers. Notes and documentation are

the same. We all have to justify our CPT's to everybody. Our care plans for

Medicare can extend to 60 days and in the vast majority of patients in the Ortho

environment, that is plenty. We are careful to write a care plan that meets the

needs of a diagnosis. 30, 45, 60 ... whatever works. We have been accountable

for many years and I for one don't wan to be a slave to our government. If the

insurance companies wan to keep their business, they need to do the same. Some

of their schemes for their cherry picking screams of the mortgage crisis.

Mike , PT

Jasper, Al

-- In PTManager , " s " wrote:

>

> -

> Vent away and while your at it do a little research regarding the exceptions

process to the cap, it is relatively easy to follow and a simple process to

implement in your facility. Compare this with trying to get authorization

beyond a policy holders arbitrarily decided apon max # of visits from a private

insurance company and tell me which is easier and more logical. And while

private insurance reimbursement has been in drastic decline in the last decade

for PT services (all while co-pays and premiums go up) Medicare reimbursement

for PT services has actually increased by a few percent (less than cost of

living increase but still an increase) and medicare deductibles have only

increased by 50 dollars in the last decade. Still, dont see how the private

insurance industry as currently constructed is better for the patient, the

provider of the country as a whole.

>

> E. s, PT,DPT

> Orthopedic Clinical Specialist

> Fellow American Academy of Orthopedic Manual Physical Therapists

> www.douglasspt.com

>

>

> -- In PTManager , " Dr. Dan " <Drdan@> wrote:

> >

> > Are you happy with Medicare? Imagine the entire country having a $1700

> > yearly cap on physical therapy. As most of you know I run a

> > multidisciplinary group consisting of medical doctors, chiropractors and

> > physical therapists. The medical doctors are complaining of the poor

> > reimbursement (much less than our Blue Cross, CIGNA or Aetna). Our

> > chiropractors complain that only spinal manipulation is covered and

> > reimbursement is roughly $30 per visit. Our physical therapists are

> > complaining about the $1700 cap per year. Everybody is complaining about the

> > paperwork.

> >

> > How is the government going to pay for this program. Will it be from the

> > 40% of people who pay no taxes. Will he 37 million uninsured Americans

> > choose to foot the bill or at least pay their share. Or will my taxes the

> > increased to cover those who don't pay. I have been in practice for 26 years

> > and government reimbursement has been getting worse, paying less and

> > requiring more paperwork every year. The government decided how much

> > coverage they would cover and how much care we could provide with very

> > little or no input from us. And as far as direct access I see no way that

> > the government will grant direct access. I'm just venting please feel free

> > to delete this without reading it and no response is required.

> >

> >

> >

> > From: PTManager [mailto:PTManager ] On Behalf

> > Of s

> > Sent: Wednesday, June 24, 2009 10:19 AM

> > To: PTManager

> > Subject: Re: Healthcare reform

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> > This is the post I have been waiting for, as a private practice owner, an

> > advocate for the profession and the patient and also as the father in a

> > family of five I have looked at this matter from various sides, each side

> > presents different challenges. Yes, i want a plan that keeps private

> > practice in Physical Therapy as a viable option, no I dont want to become

> > and employee of the government. Yes, I want affordable health insurance for

> > all of my patients and potential patients, like the 24 year old girl, double

> > amputee, s/p 51 surgeries for osteomyelitis who cant get insurance coverage

> > here in Florida because of pre-existing conditions (duh?) but can in her

> > home state of Indiana because of different state regs (I agree with you

> > Jim). The prior administration did a lot to the benefit of the insurance

> > industry, the Medicare HMO policies took money directly out of the providers

> > hands and handed it to an insurance company middle man, neither the patient,

> > nor the providers benefited, only the insurance companies. We must create

> > competition for the Insurance industry, they need to be held accountable for

> > their actions (and inactions) on a Federal level so that they cant just run

> > to the states that treat them the best. I have liked most of what I have

> > heard from the current administration, if you avoid listening to the

> > rhetoric on both sides and actually listen to what is coming from the White

> > House it at least sounds like they are looking to put the patient and

> > providers ahead of the insurance and pharmacuetical giants of the world.

> > Finally, however, I dont see costs coming down sufficiently unless we deal

> > with tort reform and limits on malpractice and the current administration

> > has refused to adress this at all. Thanks for the discussion, I will be

> > attending the Rally tonight, should be interesting.

> >

> > E. s, PT, DPT

> > Orthopedic Clinical Specialist

> > Fellow American Academy of Orthopedic Manual Physical Therapists

> > www.douglasspt.com

> >

> > >

> > >

> > > These have all been interesting comments. What though this all comes down

> > to is whether as a society we feel healthcare is a right or a benefit. In a

> > recent NYT survey, over 70% want a public plan option. I think they have

> > voiced that they feel it is a right. why? I think its becasue all of the

> > private options have increasingly shifted the risk to the patient and

> > created burocracies and hoops to jump to that more than rival those that

> > people are concerned about with a public plan. the private insurers want to

> > have a level playing field in competing against a public plan. well if that

> > public plan has ease of access, portability between jobs and no pre

> > exisiting condition stuff or variable medical neccessity definitons ... sign

> > me up! And so if the public plan is competitive, then the private's have to

> > react to that or lose market share .... oops there goes those CEO bonuses!

> > We have to get the double digit stockhoder return expectations out of the

> > health insurance business. What I am hearing so far from Washington is

> > positive.

> > >

> > > Jim Dunleavy PT, MS

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > > Healthcare reform

> > >

> > >

> > >

> > >

> > > Hi everyone,

> > >

> > > I don't think anyone is thrilled to be facing increased government

> > > intervention into healthcare but we must keep in mind that there is not a

> > > viable choice right now. We have had over 40 years to allow private

> > > industry and individuals with " choice " and " rights " to make the right

> > > choices and find a way to improve the health of this country and to

> > improve

> > > healthcare itself. In some ways we have with the tremendous drop in cancer

> > > rates and heart disease. On the other hand private industry and

> > individuals

> > > have not found the solution. Our lives are being bankrupted by healthcare

> > > costs and worst of all our health overall is not better. The government is

> > > stepping in because those with " rights " and " choices " have failed!

> > >

> > > With that said, I need also to remind us all to read the goals of

> > healthcare

> > > reform that the Senate, House and President Obama each have outlined.

> > Those

> > > goals present us with the framework to innovate a new system to address

> > the

> > > concerns of most. There has been discussion in the last few days about

> > > individuals making the right choice but are we sure they always can?

> > Within

> > > the goals of all the plans is a move towards more preventative care

> > > including suggestions for increased use of health " coaches " to help

> > educate

> > > and guide more people to make the right choice. It will be up to us as it

> > > always is to make sure that this goes no farther than guidance but the

> > > exciting thing is that there are numerous suggestions on how to tackle the

> > > problem of individual health choices.

> > >

> > > The same thing can be said about providing coverage to the current

> > uninsured

> > > and addressing some of the reasons that they are uninsured in the first

> > > place. There are many proposals to meet the goal of eliminating the

> > > uninsured. Have pre-existing conditions? Well a goal is to remove this

> > > limitation completely.

> > >

> > > We all need to be involved in the process right now. The time for talking

> > > about the problems in health care is passing. The time for talking

> > > solutions is passing. What we need is the will to draft an innovative

> > > program that addresses the goals we have before us. It will not please all

> > > of us but we must have the collective will to go forwards. Let's keep

> > > talking solutions but let's all back that up with action in our daily

> > lives

> > > with the " rights " we have and in political action through continued

> > > grassroots action. In the time it takes to post on this listserve, you

> > > could write you members of Congress. Have you?

> > >

> > > Tom Howell, P.T., M.P.T.

> > >

> > > Howell Physical Therapy

> > >

> > > Eagle, Idaho

> > >

> > > thowell@<mailto:thowell%40fiberpipe.net>

> > >

> > > This email and any files transmitted with it may contain PRIVILEGED or

> > > CONFIDENTIAL information and may be read or used only by the intended

> > > recipient. If you are not the intended recipient of the email or any of

> > its

> > > attachments, please be advised that you have received this email in error

> > > and that any use, dissemination, distribution, forwarding, printing or

> > > copying of this email or any attached files is strictly prohibited. If you

> > > have received this email in error, please immediately purge it and all

> > > attachments and notify the sender by reply email.

> > >

> > >

[Guest guest]

And what about the arbitrary $45 cap from UHC and their Medicare programs...with

visit caps (forget the billions they have received in government incentives).

Some of our patients pay as much as $30 copay. We only see UHC because our

primary referral source takes them. Fortunately it is a very small percentage.

Medicare paperwork ? Much less than most insurers. Notes and documentation are

the same. We all have to justify our CPT's to everybody. Our care plans for

Medicare can extend to 60 days and in the vast majority of patients in the Ortho

environment, that is plenty. We are careful to write a care plan that meets the

needs of a diagnosis. 30, 45, 60 ... whatever works. We have been accountable

for many years and I for one don't wan to be a slave to our government. If the

insurance companies wan to keep their business, they need to do the same. Some

of their schemes for their cherry picking screams of the mortgage crisis.

Mike , PT

Jasper, Al

-- In PTManager , " s " wrote:

>

> -

> Vent away and while your at it do a little research regarding the exceptions

process to the cap, it is relatively easy to follow and a simple process to

implement in your facility. Compare this with trying to get authorization

beyond a policy holders arbitrarily decided apon max # of visits from a private

insurance company and tell me which is easier and more logical. And while

private insurance reimbursement has been in drastic decline in the last decade

for PT services (all while co-pays and premiums go up) Medicare reimbursement

for PT services has actually increased by a few percent (less than cost of

living increase but still an increase) and medicare deductibles have only

increased by 50 dollars in the last decade. Still, dont see how the private

insurance industry as currently constructed is better for the patient, the

provider of the country as a whole.

>

> E. s, PT,DPT

> Orthopedic Clinical Specialist

> Fellow American Academy of Orthopedic Manual Physical Therapists

> www.douglasspt.com

>

>

> -- In PTManager , " Dr. Dan " <Drdan@> wrote:

> >

> > Are you happy with Medicare? Imagine the entire country having a $1700

> > yearly cap on physical therapy. As most of you know I run a

> > multidisciplinary group consisting of medical doctors, chiropractors and

> > physical therapists. The medical doctors are complaining of the poor

> > reimbursement (much less than our Blue Cross, CIGNA or Aetna). Our

> > chiropractors complain that only spinal manipulation is covered and

> > reimbursement is roughly $30 per visit. Our physical therapists are

> > complaining about the $1700 cap per year. Everybody is complaining about the

> > paperwork.

> >

> > How is the government going to pay for this program. Will it be from the

> > 40% of people who pay no taxes. Will he 37 million uninsured Americans

> > choose to foot the bill or at least pay their share. Or will my taxes the

> > increased to cover those who don't pay. I have been in practice for 26 years

> > and government reimbursement has been getting worse, paying less and

> > requiring more paperwork every year. The government decided how much

> > coverage they would cover and how much care we could provide with very

> > little or no input from us. And as far as direct access I see no way that

> > the government will grant direct access. I'm just venting please feel free

> > to delete this without reading it and no response is required.

> >

> >

> >

> > From: PTManager [mailto:PTManager ] On Behalf

> > Of s

> > Sent: Wednesday, June 24, 2009 10:19 AM

> > To: PTManager

> > Subject: Re: Healthcare reform

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> > This is the post I have been waiting for, as a private practice owner, an

> > advocate for the profession and the patient and also as the father in a

> > family of five I have looked at this matter from various sides, each side

> > presents different challenges. Yes, i want a plan that keeps private

> > practice in Physical Therapy as a viable option, no I dont want to become

> > and employee of the government. Yes, I want affordable health insurance for

> > all of my patients and potential patients, like the 24 year old girl, double

> > amputee, s/p 51 surgeries for osteomyelitis who cant get insurance coverage

> > here in Florida because of pre-existing conditions (duh?) but can in her

> > home state of Indiana because of different state regs (I agree with you

> > Jim). The prior administration did a lot to the benefit of the insurance

> > industry, the Medicare HMO policies took money directly out of the providers

> > hands and handed it to an insurance company middle man, neither the patient,

> > nor the providers benefited, only the insurance companies. We must create

> > competition for the Insurance industry, they need to be held accountable for

> > their actions (and inactions) on a Federal level so that they cant just run

> > to the states that treat them the best. I have liked most of what I have

> > heard from the current administration, if you avoid listening to the

> > rhetoric on both sides and actually listen to what is coming from the White

> > House it at least sounds like they are looking to put the patient and

> > providers ahead of the insurance and pharmacuetical giants of the world.

> > Finally, however, I dont see costs coming down sufficiently unless we deal

> > with tort reform and limits on malpractice and the current administration

> > has refused to adress this at all. Thanks for the discussion, I will be

> > attending the Rally tonight, should be interesting.

> >

> > E. s, PT, DPT

> > Orthopedic Clinical Specialist

> > Fellow American Academy of Orthopedic Manual Physical Therapists

> > www.douglasspt.com

> >

> > >

> > >

> > > These have all been interesting comments. What though this all comes down

> > to is whether as a society we feel healthcare is a right or a benefit. In a

> > recent NYT survey, over 70% want a public plan option. I think they have

> > voiced that they feel it is a right. why? I think its becasue all of the

> > private options have increasingly shifted the risk to the patient and

> > created burocracies and hoops to jump to that more than rival those that

> > people are concerned about with a public plan. the private insurers want to

> > have a level playing field in competing against a public plan. well if that

> > public plan has ease of access, portability between jobs and no pre

> > exisiting condition stuff or variable medical neccessity definitons ... sign

> > me up! And so if the public plan is competitive, then the private's have to

> > react to that or lose market share .... oops there goes those CEO bonuses!

> > We have to get the double digit stockhoder return expectations out of the

> > health insurance business. What I am hearing so far from Washington is

> > positive.

> > >

> > > Jim Dunleavy PT, MS

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > > Healthcare reform

> > >

> > >

> > >

> > >

> > > Hi everyone,

> > >

> > > I don't think anyone is thrilled to be facing increased government

> > > intervention into healthcare but we must keep in mind that there is not a

> > > viable choice right now. We have had over 40 years to allow private

> > > industry and individuals with " choice " and " rights " to make the right

> > > choices and find a way to improve the health of this country and to

> > improve

> > > healthcare itself. In some ways we have with the tremendous drop in cancer

> > > rates and heart disease. On the other hand private industry and

> > individuals

> > > have not found the solution. Our lives are being bankrupted by healthcare

> > > costs and worst of all our health overall is not better. The government is

> > > stepping in because those with " rights " and " choices " have failed!

> > >

> > > With that said, I need also to remind us all to read the goals of

> > healthcare

> > > reform that the Senate, House and President Obama each have outlined.

> > Those

> > > goals present us with the framework to innovate a new system to address

> > the

> > > concerns of most. There has been discussion in the last few days about

> > > individuals making the right choice but are we sure they always can?

> > Within

> > > the goals of all the plans is a move towards more preventative care

> > > including suggestions for increased use of health " coaches " to help

> > educate

> > > and guide more people to make the right choice. It will be up to us as it

> > > always is to make sure that this goes no farther than guidance but the

> > > exciting thing is that there are numerous suggestions on how to tackle the

> > > problem of individual health choices.

> > >

> > > The same thing can be said about providing coverage to the current

> > uninsured

> > > and addressing some of the reasons that they are uninsured in the first

> > > place. There are many proposals to meet the goal of eliminating the

> > > uninsured. Have pre-existing conditions? Well a goal is to remove this

> > > limitation completely.

> > >

> > > We all need to be involved in the process right now. The time for talking

> > > about the problems in health care is passing. The time for talking

> > > solutions is passing. What we need is the will to draft an innovative

> > > program that addresses the goals we have before us. It will not please all

> > > of us but we must have the collective will to go forwards. Let's keep

> > > talking solutions but let's all back that up with action in our daily

> > lives

> > > with the " rights " we have and in political action through continued

> > > grassroots action. In the time it takes to post on this listserve, you

> > > could write you members of Congress. Have you?

> > >

> > > Tom Howell, P.T., M.P.T.

> > >

> > > Howell Physical Therapy

> > >

> > > Eagle, Idaho

> > >

> > > thowell@<mailto:thowell%40fiberpipe.net>

> > >

> > > This email and any files transmitted with it may contain PRIVILEGED or

> > > CONFIDENTIAL information and may be read or used only by the intended

> > > recipient. If you are not the intended recipient of the email or any of

> > its

> > > attachments, please be advised that you have received this email in error

> > > and that any use, dissemination, distribution, forwarding, printing or

> > > copying of this email or any attached files is strictly prohibited. If you

> > > have received this email in error, please immediately purge it and all

> > > attachments and notify the sender by reply email.

> > >

> > >

[Guest guest]

Mr. s,

Thank you for the posting. Although I disagree, I'm always open to

considering the views of others. I'm disappointed that the posting that

I submitted two weeks ago was not sent out on the list serve. Clearly,

my posting portrayed an opposing position on this issue and I can only

hope that it was an unintentional oversight. I will attempt to resubmit

it.

Thanks again,

-Curtis

________________________________

From: PTManager [mailto:PTManager ] On

Behalf Of s

Sent: Wednesday, August 12, 2009 12:09 PM

To: PTManager

Subject: Healthcare Reform

Hello all, hope this finds you well,

I wanted to share a link to an interview with Wendell Potter, former

vice-president of Cigna. I urge all of you with an interest in the

outcome of the current healthcare debate to take the time to watch this

interview and to then forward it to your patients, friends and families.

It is far time that we rescue health care from the grips of the

insurance industry. I am very interested to hear your opinions on this

piece. Thank you.

http://www.pbs.org/moyers/journal/07312009/watch.html

<http://www.pbs.org/moyers/journal/07312009/watch.html>

Sincerely,

E. s, PT, DPT

Orthopedic Clinical Specialist

Fellow American Academy of Orthopedic Manual Physical Therapists

www.douglasspt.com