Earlier this month (December 2014) ABIM President and CEO Richard Baron, MD took the stage to defend MOC before a group of PA physicians overwhelmingly opposed to MOC in a debate hosted by the Pennsylania Medical Society. (Note: PAMED has taken a strong stand against mandatory MOC.) PAMED has made a video of the debate available so you can see what you missed:
Bob Maurer, D.O. writes:
To My Fellow Osteopathic Physicians: It is incredible how dysfunctional many of the AOA administrative departments have become. One of the biggest problem with the AOA is the empire that John Crosby built over the past ten years. It is an empire that the AOA directors do not recognize and do not know how to dismantle.
A prime example is the AOA administrative leader who told us that a lecture on the use of the new defibrillator was inappropriate for practicing osteopathic physicians.
The AOA has become a regulatory agency of its own, many times more dangerous than our own federal and state governments. It is overloaded with top level administrators, many of whom have the sole function of creating regulatory requirements that are detrimental to you and I and our fellow AOA members. Continue reading
While I am an unapologetic advocate of free markets and know, truly know, that the mutually beneficial exchange of unfettered competition is the only moral and utilitarian method for humans to trade, I must admit that I was in awe watching this process unfold at our inaugural Free Market Medical Association (FMMA) conference. It was one thing to hope that the various buyers and sellers would find one another. It was quite another thing to witness the speed with which the parties found each other and also how rapidly and naturally actual solutions emerged after these introductions were made.
My friend, Dr. Lee Gross, told the audience that rather than finding himself in a group of malcontents, he was amidst problem solvers. This, I think, is why the energy was palpable at every moment in our two-day event. “Who knows what will come of this next?!” I found myself saying…
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A healthcare lesson from old German Proverb, “Who’s bread I eat, him song I sing.”
There is an old German proverb that states, “Whose bread I eat, his song I sing.” That saying was a colorful way to explain the loyalty or service that was due a benefactor from a debtor. It encompassed everyone from traveling musicians to the serfs performing and serving at the behest of a gracious, or often a demanding, lord.
As we gradually assumed the role of “providers” for insurance networks over the past 40 years, physicians have been obliged to sing someone else’s tune due to the precariously lopsided terms of our once ostensibly beneficial contractual agreement with managed care payers. We have essentially become subcontractors for, or de facto employees of, the insurance company as evidenced by the reality that every interaction with a patient falls under the purview of a third-party who dictates the terms of the encounter. Doctors are obligated to document our compliance regarding charting criteria…
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Herb Kunkle, MD writes in:
The addiction to middlemen and conscription to the Fourth Branch of Govt and regulatory bodies probably began ~ 1929 when the first insurance company, covering Dallas/Ft Worth teachers was formed.
50 cents every other paycheck, only for catastrophic care, a simpler time.
-1944- With salaries and other benefits frozen during WWII, businesses start offering HC ins to retain/recruit employees.
-1965- Medicare/Medicaid/Govt begins to insert itself as you describe. HC costs, at that time 3-4% of GNP begin to soar. Approaching 20% today, and as E Bowles says- ‘The vapor that is driving our economy into the abyss.’ Continue reading
Dr. Ken Fisher (@KennethAFisher) previews his new book coming soon to bookshelves near you:
In my upcoming book tentatively titled, “If You Really Want To Understand Health Care”, chapter six, Issues of Access & Insurance: 1913-1964: The AMA Fails To Lead, discusses in detail the acrimonious debate within the AMA regarding mandatory Social Insurance. It was first introduced in Germany by Chancellor Otto Von Bismarck as a counter to Marx & Engel in 1883 and then a similar plan was initiated by David Lloyd George in Great Britain in 1911. Theodore Roosevelt running for the Presidency in 1912 had mandatory health insurance as part of his , “Bull Moose” platform. The AMA by then the major voice in American Medicine, began seriously debating this issue starting in 1913. At first the AMA was supportive, but was concerned about third party control of medicine so it then grew to oppose any form of universal coverage. Unfortunately, the debate then as now presented two alternatives: no universal coverage or third party dominated care. The concept of patient-directed health care via premium support for all via some form of tax credit was not introduced till many decades later. This would allow universal coverage yet retain patient control of their own care. The question we face today, can we finally break away from the German model of 3rd party dominated medicine with all its problems and move to a more modern and personal style of patient-directed medicine available to all, is yet to be resolved.
DECEMBER 17, 2013
“Those who cannot remember the past are condemned to repeat it,” declared philosopher George Santayana. The U.S. “health care cost crisis” didn’t start until 1965. The government increased demand with the passage of Medicare and Medicaid while restricting the supply of doctors and hospitals. Health care prices responded at twice the rate of inflation (Figure 1). Now, the U.S. is repeating the same mistakes with the unveiling of Obamacare (a.k.a. “Medicare and Medicaid for the middle class”).
Figure 1: An Indexed Comparison of Health Care Inflation and Consumer Price Index in US from 1935 to 2009 (Source: US Census 2013) Nobel Prize-winning economist Milton Friedman wrote that medical price inflation since 1965 has been caused by the rising demand for health-care coupled with restricted supply (Friedman 1992).