MACRA empowers bureaucracy, not patients and their doctors

Richard Armstrong, MD of https://d4pcfoundation.org/ submitted the following comments to CMS in opposition to the 962-page MACRA proposed rule.  Comments are due 6/27.  Submit yours TODAY at http://bit.ly/macracomment

Good afternoon, Ladies and Gentleman,

My name is Dr. Richard Armstrong. I am a general surgeon who has been in practice for 35 years since completing post-graduate training. I have been in the military, in academics, in private practice and now employed. I have watched the development of the federal medical bureaucracy since 1976 and opposed more government intervention then in public in a letter to the Washington post. I did this as an active duty naval officer and received hundreds of letters of support.

In 2009 after President Obama spoke before a joint session of Congress about health care reform, I wrote to him with a simple specific request. I asked him to please speak with the doctors on the front lines, the dedicated physicians and surgeons who care for all of you and your families day and night…24/7. The fellow human beings who are there for you when you need us and who passionately care about our profession and our patients. Of course, my plea went unheeded, so I joined a group of concerned physicians and traveled to Washington to read my letter in public on October 1st, 2009. This was the beginning of a national movement to return the leadership of our proud profession to those who understand what it is to care for individual human beings, one at a time, face to face, with dedication, compassion and excellence. That movement is growing. Continue reading

LEAD BY EXAMPLE, not by words or emails!

Dr. Steven Horvitz – writes in

I am getting tired of all the bitching and moaning, yet everyone still continues to bend over and get sodomized day in and day out by third parties, government regulations and even worse our own physician societies.

Words, words and more words and yet it only gets worse.

Our patients think we are crying wolf because what actions have we taken to prove we mean what we say?

If you do not act, just forget about it and be assimilated.

Possible actions:

1- Opt out of all insurers. Don’t play their game.

2- Resign from the physician societies that have been screwing you.

3- Get a position in the societies and change them.

4- Start our own physician organizations and bring other docs fed up with the system over to ours. Strength in numbers only if walking the walk!!

5- Retire. I hear WalMart is hiring greeters again.

6- Run for political office and then DO NOT get altered by the system. Politicians think they are the system. Unless we fight back they will continue to think that way.

7- Treat every one of your patients like they were your family and get their support for any and all of the above that you have changed.

Other than that keep just sending emails and keep digging your own grave.

Nobody likes complainers. Our patients will not follow complainers, but they will follow and support leaders.

LEAD BY EXAMPLE, not by words or emails!

Steven Horvitz DO

Thirteen Steps to Save American Medicine – Time Is Short!

Via Dr. Parvez Dara:

  1. Time Is Short!
  2. Opt out CMS & MOC
  3. Simultaneously educate our patients
  4. Bring in like-minded business people and thinkers
  5. Go Concierge or similar FFS.
  6. Treat Indigent patients 10%
  7. Back to black bag, stethoscope doctoring with New Tools.
  8. Build a base that can rise up against the CMS empire when NPI numbers control prescriptions.
  9. Provide Care for 5%-7% of the population in each state (might mean 200-2000 like minded docs in each state) – start proselytizing.
  10. Forget the loonies in DC – they are lobbyist controlled embedded clowns – both sides
  11. Join forces with AAPS, D4PC & all other entities instead of fragmenting – power in numbers
  12. Real care with limited monetary gain in the short term will lead to long term loyalty – passion brings monetary rewards if passion is the driving force.
  13. As Judith says let’s formalize the process.

These Barons are not sitting idle but they are happy in their stupor for now. Use it to our advantage. Time for checking the peeling paint is over. Substance over form. New forces will gather to self-enrich from MACRA.. & time is short!

Revolutions are never easy. Get ready to take the hits!

Buyer’s remorse for H.R. 2 – MACRA, SGR “Fix”

Dr. Chip writes in:

The two lines in the entire argument made in this article“The repeal of the SGR is the carrot; the far-reaching payment reforms that the legislation facilitates are the stick,” is the basis of the discussion we wanted to initiate nearly 4 years ago both at the house of delegates and in discussion through our own Publications in “Saving Private Osteopathic Medicine.” All our journals refused to publish our position for an invitation to have a discussion in a public forum AND NOT BEHIND CLOSED DOORS. Promises were made and never kept. Tyranny reins under circumstances like these. Continue reading

Not everyone in the Osteopathic community is happy about H.R. 2

Robert:

Not everyone in the Osteopathic community is happy about this bill.
Your rah rah support without any mention of the potential negative consequences to independent private practice physicians is very disheartening.

What I have seen over the past 6 years is AOA acceptance of just about whatever govt takeover of healthcare that has come out of Washington. Instead of truly having an open debate on the merits and risks of bills, laws and regulations, is just the AOA following like a lapdog? Continue reading

MACRA/HR2 is a death knell for professional integrity and a danger to patients

Doctor Robert Geist writes his Senators:

Please vote NO on HR-2, the current SGR “doc fix” bill. Repeal is necessary; but not this version.

Here is what the bill really does: “…shifting Medicare reimbursement from fee-for-service to pay- for-performance.” This is Orwellian double-speak for P4P “value” pay; the PPACA cost control stratagem, which only reproduces decades of the failed HMO capitation experiment.

Why is this not good?

1) The bill is a death knell for professional integrity—a serious danger to patients. Doctors at the bedside are literally paid (“bonus rewards”) for restricting use of “payer” money (government/corporate) for patient care under the guise of “stewardship”, “value pay”, “choosing wisely”, or whatever slogans can sell this bedside gatekeeper rationing bill. Continue reading

Three Fixes for SGR

Steven Horvitz, DO writes ACOFP President Carol Henwood, DO

Dr. Henwood:

I just received your email blast about the SGR.

There are three fixes for SGR that come to mind that would immediately solve this never ending recurring problem for physicians.

1- eliminate the SGR entirely
2- advocate that all physicians opt out of Medicare
3- immediately freeze the physician fee schedule where it is AND allow physicians to balance bill patients for anything they want above it.

Continue reading