Setting the Record Straight on Horizon BCBS

Dr. Wax writes NJ.com columnist Susan Livio  in repsonse to her February 16, 2106 article, “See why Horizon paid $3M in bonuses to N.J. doctors.” 

Dear Ms. Livio

Your article on Horizon insurance’s program to incentivize physicians was not a balanced view of the program or company.  It also misrepresented the so-called “affordable care act.” Neither entity has done anything to bring down the high cost of health insurance but to force Americans to buy it from profiteering high overhead entities under penalty of law.

Horizon Blue Cross Blue Shield of New Jersey is notoriously one of the most difficult insurance companies to deal with. Their denial rates for payment, denial rates for medications and tests, and poor communications skills are just a few of their issues. Both their patient and “provider” help desks are located off shore in the Philippines or India, despite their massive holdings in the state of New Jersey. One must not forget their bankruptcy in the 1990s, where they were forced to change their company from New Jersey Blue Cross Blue Shield to “Horizon.” 

Saving the Principle Upon Which the Country Was Founded – Liberty

I’m not really trying to save the country…trying to save the principle upon which the country was founded…Liberty

The Federal Government should be removed from every aspect of interference it has unconstitutionally grabbed in the last 100 years: Social Security, Medicare, Medicaid, Income Tax, Federal Reserve, education funding , litany of Federal Agencies etc. etc., etc.,

Never was there a country on Earth (and there will never be one) with massive central government programs that are not either bankrupt and/or corrupted morally and politically, We indeed see that in our face after 100 years of creeping socialism….

Complete decentralization means living within your means locally …health care, education….everything!

Short of this the country will break up soon.

Jack Iannantuono, CFP®, ChFC®, MSFS, AIF® | Indicon, Inc.
Chief Executive Officer

The Insidious Takeover of Medical Decision-Making

Guest Post from Gene Uzawa Dorio, M.D.:

Behind national statistics is a lingering fact healthcare in our country will deteriorate. This will come over the next decade and slowly be recognized by the public as a threat to hospitalized patients.

Please read the following commentary to protect yourself and loved ones from the insidious takeover of medical decision-making when greed and business devalues those who are vulnerable in our society.

Gene

Declining Life Expectancy

Many nations proudly tout “Life Expectancy” as a reflection of healthcare. In our country, this statistic has continually edged upward due to expanding technology, doctors/patient education, and vibrant emphasis on healthy lifestyles. A shift is occurring though as this number is destined to decline with hospital administrators, not physicians, making medical decisions impacting those who are the most vulnerable: Elder seniors in the ICU.

$23 Million Hospital Propaganda Against Doctors

Guest Post from Gene Uzawa Dorio, M.D.

When well-educated medical professionals have no voice, and hospital administrators control public relations, swaying opinions can be harmful to patient care.

Below is my recent posting revealing intentional finger pointing away from the true cause of poor healthcare in our country. It is nationwide, and should be examined in your community.

Thank you for listening.

Gene

$23 Million Hospital Propaganda Against Doctors

On occasion, I feel compelled to put in my two cents at Santa Clarita City Council meetings. Recently there was a five hour meeting about whether the city should subsidize the artsy Laemmle theatre as an anchor to revitalize business in Old Town Newhall.

This is what I said:

As a physician, my job is to weigh risks and benefits.

Advancing technology and research has improved my ability to practice medicine. We don’t give children cough syrup laced with morphine or heroin anymore. Blood letting has been discontinued. Lobotomies are now only reserved for Washington D.C. politicians.

Resolved: End Re-certification Abuse

Resolution on Re-Certification Sent to NJAOPS HOD

To:       Robert Bowen, Executive Director, NJAOPS

Paul Morris, D.O. Speaker of the House, NJAOPS
Robert Pedowitz, D.O.,President, NJAOPS
Michelina Desantis, D.O., President-Elect, NJAOPS
Ira Monka, D.O., Member, AOA Board of Trustees
Al Talone, D.O., Chairman, JOPAC

Re:        Proposed Resolution on Re-Certification

Date:    Feb 10, 2016

RESOLUTION

Whereas Board Certification was always intended to be a one time accomplishment based upon completion of a course of intensive training, clinical experience and study, followed by an examination and

My Story: Changing to the Direct Primary Care Model at age 50. ~M. AVILES, M.D.

By MARIBEL AVILES, M.D.  President and Physician at Innova Medical Care, P.A. The First Direct Primary Care in Orlando JANUARY 24, 2016 –  I am a  51 years old family doc. After 20 plus years of practice  and having worked in my traditional solo practice, several health care companies-  big and small, hospital based and […]

http://directprimarycarejournal.com/2016/02/14/my-story-changing-to-the-direct-primary-care-model-at-age-50-m-aviles-m-d/

OMT – Is there an app for that?

I had a student who wanted to create an app for PAs and NPs with counterstrain positioning, codes, and paymehts electronic records and insurance coding send all rolled into one so non-DOs can use and code for OMT(osteopathic manual treatment).

As his teacher, I was more than a little disappointed. This ‘all you gotta do’ attitude and get rich quick off creating an osteopathic app was shallow and disrespectful of Osteopathic practices and I refused to participate. As a D.O., our students get 1000 extra hours of osteopathic principles, practices and treatment experience than our other physician colleagues.  We are in a period where this type activity will increase and trivialize the value of OMT if THIS is what it comes to mean. By sheer volume this over simplified version of OMT could become what they think it IS. This is dangerous and we should issue policy and position statements carefully as a profession.

I knew this type activity was in the works, so I am not surprised, but I am a little dismayed that THIS is what has come to Osteopathy.

Carlisle Holland, D.O.
Holonomic Institute
Sebastopol, California 95472
Holonomics are the Principles of Integrative Medicine

 

Without the Patient-Physician Relationship there is NO Quality Care

Open letter to patients, physicians and lawmakers from Sharon S. Jellinek  M.D.,

This is the first letter I have ever written to a political figure and I pray that someone on your staff will bring this letter to your attention.

I have been a physician for close to 30 years. I am a second-generation pediatrician struggling to keep an independent solo practice alive. Not one politician has addressed what I feel is the major threat to health care…the physician-patient relationship. Without this, there is no quality of care no matter what you do.  Physician patient relationships require time with the patient. Most of my diagnosis is derived from my patient-parent interview and a “hands on exam” of the child. You cannot possibly read a cookbook of medical questions and treatments and have the same result. The current insurance treadmill model of primary care makes this impossible. There is a hemorrhaging exodus of well-trained physicians unwilling to jeopardize this patient relationship.

Total betrayal by AOA of ALL its members.

Your AOA dues are hard at work promoting the Interstate Medical License Compact.  This will mean mandatory certification for all new graduates before obtaining a license.  And the claim that OCC isn’t required for licensure through the Compact is pure smokescreen.  Does the AOA underestimate the intelligence of its members? Or perhaps AOA staff overestimates their own?

Is OCC required for licensure through the Compact?  “The answer to this question is ‘no,'” states the Commission. Yet a few sentences later they explain, “a physician must demonstrate current certification to be eligible for licensure via the Compact.”

Except for “grandfathers,” osteopathic physicians must pay in time and dollars for OCC compliance if they want to maintain their certification. OCC IS required for Compact participation.  Q.E.D.