Can Organized Medicine Say Goodbye to Bias?

As physicians are saying goodbye to organized medicine maybe organized medicine should realize it is time to say goodbye to bias.

In a recent email “Update” the NJ Association of Osteopathic Physicians and Surgeons trumpeted a headline copied directly from the Governor’s press release:

Governor Murphy Announces Impact of New Jersey’s Actions to Stabilize Health Insurance Market

Can’t we at least report the news without bias and have the debate and discussion in our newsletter rather than a rosy review a Partisan headline?

The recitation of the Governor’s talking points continued:

The reduction in health insurance rates is the direct result of New Jersey’s first-in-the-nation action to continue an individual mandate, after the elimination of the mandate by the Trump Administration at the federal level, and to implement a reinsurance program beginning in 2019. The two laws, signed by Governor Murphy in May, were cited by the Center for American Progress in its listing of New Jersey as the national leader among states for having taken action to protect consumers from federal sabotage of the Affordable Care Act.

Why isn’t the headline, “Governor Murphy forces mandatory tax payer bailout of insurance companies per ACA.” ACA 2010 forces taxpayers to bailout insurance companies and their cronies under penalty of law and IRS.
We can objectively and comparatively report on what health insurance cost in 2009 when basic and essential (B&E) coverage by Horizon was inexpensive before it was canceled due to ACA. For many New Jerseyans, their premiums, deductibles and out-of-pocket costs doubled due to ACA since 2010.

Can’t we at least Report the news without bias and have the debate and discussion in our NJAOPS newsletter rather than a rosy review a partisan headline directly from Trenton?

We do credit NJAOPS for excising this sentence from its version of the Governor’s missive:

“Our work is based on the core belief that health care is a right – not a privilege,” said Governor Phil Murphy. “

 

We also credit NJAOPS with responding positively to this inquiry that they will try to improve their reporting in the future

However, IP4PI will take this opportunity to educate NJ Governor Murphy:

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Insurance denials must stop!

To: Lily Tyson, Chief Health Insurance Bureau
NJ Department of Banking and Insurance

Re: Horizon BCBS discrimination

Dear Chief Tyson,

This letter is to make you aware that Horizon BCBS and its affiliates are harming a patient with their precertification, prior authorization, appeal and denial of services processes. The patient indicated below has diabetes and multiple medical conditions, which he diligently and routinely follows up at our office. For the past three months, the patient and I have aggressively pursued a continuous glucose monitoring device to assist both of us in getting his blood glucose under best control.

Despite the fact that the patient and I agree on this, Horizon BCBS and its affiliates have denied the patient this medically necessary item. Further, while the Endocrinology Society, The American Association of Clinical Endocrinologists and the American diabetes association clinical societies all recommend continuous glucose monitoring for best management of diabetes Horizon BCBS and its affiliates insist on harming the patient by denying him this medically necessary tool.

Furthermore, Horizon BCBS medical directors have denied this patient the necessary medical monitoring device, thereby potentially causing their insured harm, and may be liable as they are making care decisions and denial of care decisions for the patient.

I ask:

  1. Do they have the patient’s informed consent to make care decisions?
  2. Are they licensed physicians in NJ?
  3. What is their malpractice coverage for this activity?
  4. Are they specialty trained in endocrinology?
  5. As employees of Horizon BCBS, do they have a conflict of interest?

Horizon BCBS precertification, prior authorization, appeal and denial of service processses are harmful to both patients and physician providers of medical services.  Please put Horizon BCBS on notice to case and desist making clinical care decisions for patients through their onerous and harmful money making processes. This is especially critical in light of the pending NJ law that would mandate the purchase of insurance products like those offered by Horizon BCBS.

Sincerely,

Craig M. Wax, DO, Family Physician

CEO Pay Watch: United Health CEO $27 Million in 2017

$27 Million earned in one year for UnitedHealth’s outgoing CEO, reports the Star Tribune. That’s a lot of moohlah, right?

In the big picture it’s chump change. Get your barf bag ready:

The CEOs of 70 of the largest U.S. health care companies cumulatively have earned $9.8 billion in the seven years since the Affordable Care Act was passed, and their earnings have grown faster than most Americans’ during that time, according to an Axios analysis of federal financial documents.

https://www.axios.com/the-sky-high-pay-of-health-care-ceos-1513303956-d5b874a8-b4a0-4e74-9087-353a2ef1ba83.html

And the above numbers don’t even include 2017.

$10 Billion would pay for a year of Direct Primary Care memberships for over 11 million Americans; that’s almost everyone enrolled in an ACA plan on the individual market.

Anyone wonder where your healthcare dollar and Obamacare ACA tax money is going?

Call your congressman and demand the repeal of ACA Obamacare and let’s let the free market bring up quality and prices down! Capitol Hill Switchboard: (202) 224-3121.

 

Promoting Choice and Competition to Empower Patients and their Physicians

A friend of IP4PI writes in:
I just read President Trump’s executive order on choice and competition across state lines. It has these amazing provisions which have not been discussed in the media at all!! These provisions go to the heart of a competitive market-based healthcare system.
“(c) My Administration will also continue to focus on promoting competition in healthcare markets and limiting excessive consolidation throughout the healthcare system. To the extent consistent with law, government rules and guidelines affecting the United States healthcare system should:
(i) expand the availability of and access to alternatives to expensive, mandate-laden PPACA insurance, including AHPs, STLDI, and HRAs;
(ii) re-inject competition into healthcare markets by lowering barriers to entry, limiting excessive consolidation, and preventing abuses of market power; and
(iii) improve access to and the quality of information that Americans need to make informed healthcare decisions, including data about healthcare prices and outcomes, while minimizing reporting burdens on affected plans, providers, or payers.”
The whole order can be read here: https://www.whitehouse.gov/the-press-office/2017/10/12/presidential-executive-order-promoting-healthcare-choice-and-competition . I love the title to promote choice and competition.  I don’t think the order was overreach, because the language is to ” PRIORITIZE three areas for improvement in the near term: association health plans (AHPs), short-term, limited-duration insurance (STLDI), and health reimbursement arrangements (HRAs).” and “FOCUS on promoting competition in healthcare markets and limiting excessive consolidation “.  I did note this part:” Public Comment. The Secretaries shall consider and evaluate public comments on any regulations proposed under sections 2 through 4 of this order.”
Stay tuned for opportunities to comment!

How can we motivate Congress to act on ACA? End their illegal exemption!

From our friends at Independent Women’s Voice:

For the Senate to pass ObamaCare repeal and replace with only 51 votes, they’ll need to take action by September 30th.

How can we motivate Congress to act? By President Donald J. Trump ending Congress’ illegal exemption from ObamaCare.

Here’s what you need to do STAT:

  1. Sign the petition at www.NoWashingtonExemption.com
  2. Write President Trump and tell him to end the illegal exemption: https://www.whitehouse.gov/contact
  3. Read this explainer from Michael Cannon of CATO to become an expert on this crucial issue: http://www.washingtonexaminer.com/congress-illegal-and-egregious-obamacare-exemption-explained/article/2633383

Remember when the AOA worked for their members?

Gina Reghetti, DO shares her response to the AOA’s email alert opposing the repeal of ObamaCare:

Dear Dr. Buser:

I am writing in response to your “Urgent Action” email that I received on July 22, 2017, regarding the repeal of the PPACA, which is attached below.

I do not agree with your position that if the PPACA is repealed it would “significantly jeopardize our heath care system.” Since you represent the AOA as its president, I feel that you are using your position to influence political agendas that are not in the best interest of American patients and their doctors.

I would hope that the AOA does not use doctors’ membership dues and board certification fees to support such agendas that do not support the Osteopathic Philosophy of independent, private, practice osteopathic doctors that deliver one-on-one direct, private care to their patients without government or third party intruders, and that stay true to the practice of Osteopathy, as Andrew Taylor Still, D.O., M.D., founded.

Your stance appears not to support the Free Markets in the USA, and direct pay practices which are far better solutions than a government controlled healthcare system.

I take great insult that the AOA, through your voice as president, uses osteopathic doctors’ hard earned money to push agendas that are not reflective of the American way, and I believe that it constitutes just another AOA federal violation.

I am also very concerned as to why the AOA cashed my ninety dollar check for my board certification dues, yet the website displays that my board certification is inactive for the public to view, when that is incorrect since my board certification is dated to expire in 2022; although it should be a lifetime certification. Worse yet, the message to the public is to indicate that if osteopathic doctors do not hold board certifications through the AOA then they are somehow less qualified to practice medicine. I find this to be very defaming, and I request that this serious issue be corrected immediately and removed from the public website.

I remember when the AOA worked for their osteopathic physicians and surgeons and supported Osteopathy, but over the many years that role does not appear to be so any longer. Rather the AOA uses their power to lobby, such agendas, that are against the osteopathic oath and training of osteopathic physicians and surgeons here in the USA.

The AOA does not correctly reflect the opinions of their doctors; especially, when emails as yours are sent. There is no room for Politics in Medicine!

I would highly recommend that you, and the AOA, cease immediately from sending emails out that reflect your political stance rather than the Osteopathic Profession’s.

I strongly oppose your views as do the majority of practicing physicians and surgeons across this great nation.

Let us keep the United States of America a free nation for all and let us keep the government out of peoples’ lives, and especially out of healthcare, since it will only do more harm than good.

I thank you for your understanding and immediate attention to this serious matter.

I look forward to hearing from you to inform me that my Inactive board status is corrected back to Active status as it should be.

Respectfully,

Gina Reghetti, D.O.
AOA #64509
Attached: Dr. Buser’s email below:

 

 

 

Advocacy Action Alert


Dear Colleagues:

As you may have heard, the Senate will soon vote to repeal the Patient Protection and Affordable Care Act (PPACA) without a legislative alternative. Should this vote be successful, it would significantly jeopardize our heath care system, and result in a loss of coverage and access to care for up to 32 million Americans, and the potential for significant increase in premium costs.

Senators Lisa Murkowski (R-AK), Susan Collins, (R-ME), and Shelley Moore Capito (R-WV) have expressed their opposition and concerns about this plan. It is critical for any health care legislative proposals to achieve a high-quality, patient-centered, and cost-efficient system that meets the needs of our patients. I urge you to contact your senator to express your support for her pragmatic approach to health care reform and her vocal opposition to repealing PPACA without a legislative alternative, in order to ensure our patients have the continued access to health care.
The time is now to write to your senator and support her pragmatic approach to health care to ensure that our aforementioned goals on transforming the health care system focus on our patients.

Boyd R. Buser, DO

AOA President

 *Wondering how the AOA has developed its position on health care reform and the AHCA to date? Watch our webinar that explains the process.

Dear Senator: The opportunity to fix our broken system rests at your feet. Do It Right.

Marcy Zwelling, MD, Co-Chair of the National Physicians Council for Healthcare Policy, http://npchcp.org/, shares her urgent letter to the United States Senate.

Dear Senator:

The opportunity to fix our broken healthcare system rests at your feet. You and your republican colleagues should look at this legislative opportunity as your moment in history to step up and do it right.

America’s healthcare delivery system was broken long before the ACA. Returning to a pre-ACA state of affairs should not be your goal. Your efforts should be visionary not reactionary. It’s time you show America’s patients that you are the party of better practical ideas.

Healthcare reform is about designing a system of healthcare delivery that works to maximize access, decrease cost and minimize the regulations that obstruct America’s physicians from doing our job. Continue reading