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READER RESPONSE (early August 2011) Print E-mail
Written by Various Readers   
Wednesday, 10 August 2011 10:27

Regarding Examining the Demographic Bulge and the Dynamics of Capitalism:  Why the Pundits are too Gloomy

Well said. I also remain confident. There is no movement without friction. Every generation has had its obligation to overcome immense obstacles at long odds.  America may get a downgrade from S&P and Moodys, but I remain bullish. I think most of us are positive even with the bad news. It's part of our American DNA.  -IDTF Owner, Miami


Regarding ASK BEN

Thank you for publishing Mr. Frosch's columns.  His advice and insights are invaluable. -Practice Administrator, Orlando
Last Updated on Wednesday, 24 August 2011 18:36
 
Examining the Demographic Bulge and the Dynamics of Capitalism: Why the Pundits are too Gloomy Print E-mail
Written by Jeffrey Herschler   
Wednesday, 03 August 2011 13:15

LEARNING TO CRAWL     

It's pretty depressing reading the newspapers these days.  I speak metaphorically when I say "reading the newspapers".  Clearly online reading is replacing traditional print media at an exponential rate.  But more on that later.  According to the experts, we are heading to Hell in a Handbasket because of unfunded entitlement programs, a demographic bulge and anemic growth.   Add to that runaway inflation caused by an historic increase in money supply (see hilarious and cynical video on The Quantitative Easing).  Admittedly the Great Recession and chronic budget deficits have left us with a full plate of challenges.  But it's not as bad as the prophets of doom have made it out to be.  Here's why.  READ MORE.
Last Updated on Wednesday, 03 August 2011 13:40
 
Federal Budget Cuts Threaten Graduate Medical Education Print E-mail
Written by Bernd Wollschlaeger, MD   
Wednesday, 27 July 2011 17:03

In their efforts to reduce the federal deficit the partisan negotiators seem to agree on one issue only: drastic cuts of the Medicare subsidy for postgraduate medical education and funding reduction for advanced equipment that teaching hospitals require to train young doctors.

The recommendations made by the National Commission on Fiscal Responsibility and Reform, currently under consideration, would cut about $5.8 billion in graduate medical education funding from the nation's teaching hospitals. This represents a 53% cut compared to the current $10.9 billion in payments!! The Simpson Bowles Commission, which advised President Obama on debt and deficit reduction, called in December 2010 for reducing "excess" payments to hospitals for medical education. The commission said the payments could be brought in line with the costs of medical education by limiting the direct subsidy to 120 % of the national average salary paid to residents. A second, indirect subsidy, which pays for intensive services and advanced equipment, should also be reduced.  

The proposed draconian cuts will jeopardize the sorely needed expansion of graduate medical education in the U.S. and exacerbate the looming physicians’ shortage. Who will care for the baby boomers seeking medical services? Who will provide primary care physicians once millions of Americans gain access to healthcare coverage in 2014?

The proposed measures are based on penny wise and pound foolish approaches to cover our federal deficit and ignore the long-term investments needed to protect our crumbling healthcare service infrastructure in the U.S. The suggestions were developed by politicians with a limited political life cycle.

I suggest a review of thoughtful proposals such as the Nineteenth Report by the Council on Graduate Medical Education (COGME) entitled "Enhancing Flexibility in Graduate Medical Education" before throwing out the baby with the bath water.

The future of our healthcare is at stake and politicians must step aside to let experts take charge.    Comment on this Story

Last Updated on Wednesday, 03 August 2011 13:15
 
READER RESPONSE July 2011 Print E-mail
Written by Various Readers   
Thursday, 14 July 2011 09:07

When Ideology Trumps Common Sense and Compassionclick headline to view post in its entirety

In the past week, Florida lawmakers turned down a $2.1 million federal grant that would pave the way for the state to receive $35 million in federal funding that would move elderly and disabled patients from nursing homes to their own homes during the next five years. With the help of this federal funding elderly people could be moved out of nursing homes to independent-living facilities or to support care at home with their families resulting in less money to be spent on nursing-home care. Republican legislators defended their refusal of the latest federal grant, known as the Money Follows the Person funding...Is there any hope that rational thought will prevail in Tallahassee? -Bernd Wollschlaeger, MD

RE:  Medicare Reform 

According to a CNNMoney.com article posted on July 8... "Democrats have spent a lot of time lambasting Republicans for supporting a Medicare reform plan from House Budget Chairman Paul Ryan. They excoriate it as 'destroying Medicare as we know it.'"  When will the Progressives realize that Medicare as we know it is unsustainable and must be destroyed?  Over utilized and plagued with fraud, the Medicare Program's time has come and that's a good thing for young and old, for conservatives and liberals!  -Healthcare Professional, Ft. Lauderdale   

Re:  Doctor Accountability vs. Patient Justice

Medical liability reforms such as HB-479 are bad for everyone except those hospitals and doctors who make mistakes that hurt patients.

Is it fair to limit the recovery of a patient who is the victim of a wrong leg surgery...by a doctor who had performed ANOTHER wrong leg surgery just a year before?

I represented a client in just that situation.

Some claim that the new legislation promotes a friendlier place to practice medicine.

Is "friendly" really what the citizens of Florida deserve or need?

How about safe and accountable?

What do you think?

 -John Leighton, Leighton Law  | www.LeightonLaw.com

888.395.0001 | DearJohn@LeightonLaw.com

Re: Understanding HB 155:  Is this a Joke?

It's not a joke and FAFP has joined in a lawsuit with other medical physician organizations to try and declare the law unconstitutional. These are nasty times.

 -Tad Fisher, Executive VP, Florida Academy of Family Physicians

New Jersey license has a statement on their license renewal to waive your  rights.

 -New Jersey Physician

Re:  Unfunded Entitlements

The Greek debacle is a cautionary tale.  We must face down the budget crisis now to avoid the chaos recently seen in Athens.  Greece has become a nation of corrupt and entrenched bureaucrats, idle rich and a disillusioned workforce that has largely forgotten how to hustle and innovate.  If our leaders don't lead, the US is headed down that same path.  The nation that perfected democracy has to avoid the Hell being endured in the country that invented it.  -Healthcare Executive, Miami

Last Updated on Saturday, 23 July 2011 18:43
 
Playing The Odds: Hedge Funds Finance Medical Malpractice Claims Print E-mail
Written by Jeff Segal, MD, JD, FACS, Michael Sacopulos, JD and Wayne Oliver   
Thursday, 07 July 2011 09:36

IN OUR OPINION

Investors are always looking to earn an easy profit, particularly from well-managed companies. But when the profit is from a hedge fund that finances medical malpractice lawsuits aimed at driving doctors out of the profession, Wall Street may have gone too far.

An entirely new industry has cropped in recent years as trial lawyers set their sights on making money off physicians, corporations and other targets--particularly financing malpractice suits through hedge funds. In 2010, hedge funds invested $1 billion in these types of suits, much of it for medical malpractice cases.

Frivolous lawsuits are helping drive physicians out of the profession and pushing up the cost of health care. A Gallup-Jackson health care survey released last year found that $1 in every $4 spent in health care is for unnecessary tests and procedures that doctors order to prevent from being sued.

Click here to read more.                                   

Forbes.com Commentary - June 23, 2011

 
Drug Test Law May Face Costly Legal Challenges Print E-mail
Written by Bernd Wollschlaeger, MD   
Sunday, 03 July 2011 09:14

IN MY OPINION

Attached a link to an article published recently in the Orlando Sentinel pointing out that a new state law requiring welfare applicants to be drug-tested goes into effect today.

The law stipulates that parents with minor children who request temporary cash assistance must undergo a drug test. The average benefit check per family is $240 a month with a lifetime limit of 48 months.

About 4,000 Floridians each month may be affected by the new law. The 93,000 state residents already receiving such benefits would not be affected unless they reapply. In addition all parents who test positive for drugs — including legal drugs not prescribed for the parent — will be reported automatically to the state's abuse hotline. Applicants will have to pay for the drug tests themselves, though those who test negative will be reimbursed in the first benefit check they receive. Those who test positive also would have the chance to get a second, more-sophisticated screening — at their own expense of up to $100 — and have an official medical review of the testing (MRO) .It is still unclear whether those expenses would be reimbursed if the applicant is ultimately cleared. The law may violate the constitutional standard requiring that the government must have reason to believe an individual is using drugs before demanding a test. Michigan, the only other state to pass a similar law, had it struck down in court. Therefore, it most probably will face a costly legal challenge on taxpayers’ expense!! Furthermore, by implementing this policy the state government should have provided drug treatment options for those welfare recipients with children who test positive for drugs. The new law falls short of this option, too.

In my opinion this new law is a bad idea which will face a long and costly court battle and will further divert scarce state resources from more important issues such as drug use prevention and treatment programs.

Last Updated on Thursday, 07 July 2011 09:47
 
New Florida Law You Won't Believe Print E-mail
Written by Michael Sacopulos, JD   
Tuesday, 28 June 2011 00:00

ASK MIKE 

Medical Justice: Medico-Legal Q&A 

Q:         I've recently heard that the Florida legislature has passed a law prohibiting physicians from asking their patients about alcohol consumption and firearms. Is this a joke?

Bill in Tallahassee

A:         Bill, what you heard is partially correct. The Florida legislature recently passed a law (HB 155) prohibiting physicians from asking patients about their firearm ownership. The impetus for this law remains unclear to me. Perhaps there was a fear that patients would be denied access to care if they admitted to owning a firearm.

            The part of your question relating to alcohol consumption is false. No law has been passed (or to the best of my knowledge even been proposed) prohibiting physicians from questioning patients regarding alcohol consumption. This part of your question may have come from someone misinterpreting an article that substitute the term "alcohol consumption" for the term "firearm ownership" in the new law. The article was written as a persuasive piece against the new law. It attempted draw attention and raise emotions to the issue by substituting terms.

            Personally, I've never had a physician question me regarding gun ownership. It is difficult for me to even to imagine where during the history and physical that such a question would be launched. So it would be easy for me to say that the law, while peculiar, is essentially irrelevant. That would be a mistake.

            I think the larger issue is an interference with communication between physician and patient. For centuries, the law has recognized the importance of physician patient communications. Privilege extends over those communications such that a physician may not be compelled to disclose information obtained from a patient without that patient's permission or a court order. The idea here is to give patients confidence and comfort in discussing highly personal matters with their physician. Similar privileges exist between lawyers and clients and clergy (known as the priest/penitent privilege). It seems to me that the Florida law does harm to physician patient communication because it begins to regulate the communication instead of protecting it.

            The timing of this legislation seems particularly poor.  On May 26th, Florida transplant surgeon Dmitriy Nikitin was gunned down by a former patient in a parking garage.  Dr. Nikitin was shot multiple times.  The former patient, Nelson Flecha, then shot himself.  By all accounts, Dr. Nikitin was a young  (41), gifted surgeon that specialized in liver, kidney, pancreas and intestinal transplants. 

              The matter of firearms discussion in Florida exam rooms seems far from resolved. Four different physician groups have joined together to challenge the constitutionality of this new Florida law. It will be some time before this case works its way through the Florida courts.

Michael J. Sacopulos is a Partner with Sacopulos, Johnson & Sacopulos, in Terre Haute, Indiana. His core expertise is in medical malpractice defense and third party payment disputes. Sacopulos may be reached at mike_sacopulos@sacopulos.com

Last Updated on Sunday, 03 July 2011 09:24
 
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