Exam Room One: Next!

Long Beach, no doubt.

2012-01-23T18:59:00.001-08:00

The great outback

2012-01-23T18:32:00.001-08:00

Number 9...

2012-01-23T18:30:00.001-08:00

Pick up stix

2012-01-23T18:27:00.001-08:00

Broke as a Joke

2012-01-12T14:15:00.000-08:00

Broke as a Joke - CNN reports Jan 2012 Doctors are going broke. "A lot of independent practices are starting to see serious financial issues," said Marc Lion, CEO of Lion & Company CPAs, LLC, which advises independent doctor practices about their finances

"This 2012 CNNMoney report is consistent with an AMA report on March 4, 2011 that 51% of doctors in TX are going broke: '51% of Texas doctors dug into personal funds to keep practices afloat in 2010 warned Dr. Zhou.

35mm film container

2011-04-30T02:25:00.001-07:00

Magnify

2011-03-29T02:19:00.001-07:00

Across from King Taco

2011-03-27T19:33:00.001-07:00

As I awoke

2011-03-26T20:40:00.001-07:00

Doc Park

2011-03-26T19:41:00.001-07:00

MRI

2011-03-26T19:40:00.001-07:00

OR

2011-03-26T19:34:00.001-07:00

Myself

2011-03-26T19:28:00.001-07:00

Sky at Jumpa Thai

2011-03-25T21:10:00.001-07:00

2000 Yamaha WaveRunner for Sale 0002

2011-03-05T22:48:00.000-08:00

Health Care Premiums Soar as Coverage Shrinks

2011-03-04T17:44:00.000-08:00

Health Care Premiums Soar as Coverage Shrinks

MANCHESTER, N.H. — Workers at a circuit-board factory here just saw their health insurance premiums rise 20 percent. At Buddy Zaremba’s print shop nearby, the increase was 37 percent. And for engineers at the Woodland Design Group, they rose 43 percent.

Enlarge This Image

Cheryl Senter for The New York Times

Buddy Zaremba, vice president of RAM Printing in Manchester, N.H.

House Votes to Help Small Businesses Comply With Health Bill, but Relief Is Held Up (March 4, 2011)

Enlarge This Image

Cheryl Senter for The New York Times

Robert Woodland, president of Woodland Design Group, which has seen their health insurance premiums rise by 43 percent.

Readers' Comments

Share your thoughts.

The new federal health care law may eventually “bend the cost curve” downward, as proponents argue. But for now, at many workplaces here, the rising cost of health care is prompting insurance premiums to skyrocket while coverage is shrinking.

As Congress continues to debate the new health care law, health insurance costs are still rising, particularly for small businesses. Republicans are seizing on the trend as evidence that the new law includes expensive features that are driving up premiums. But the insurance industry says premiums are rising primarily because of the underlying cost of care and a growing demand for it.

Across the country, premiums have more than doubled in the last decade, with smaller companies particularly hard hit in recent years, federal officials say.

Read full text of article at New York Times.com

Watch President Obama's Full Speech at Tucson Memorial

2011-01-14T00:51:00.000-08:00

Californians' costs for employer-based health insurance soar - latimes.com

2010-12-04T00:46:00.000-08:00

Californians' costs for employer-based health insurance soar - latimes.com

Here we go again 12K average a year costs for health insurance! Even higher in other states!

Healthcare sector loses steam in California - latimes.com

2010-11-21T22:25:00.000-08:00

Healthcare sector loses steam in California - latimes.com

The sector, which employs about 1 in 10 Californians, has stalled at a time when healthcare employment continues to grow nationally...

Doctors limit new Medicare patients - USATODAY.com

2010-11-08T12:44:00.000-08:00

Doctors limit new Medicare patients - USATODAY.com

The number of doctors refusing new Medicare patients because of low government payment rates is setting a new high, just six months before millions of Baby Boomers begin enrolling in the government health care program.

Study: Most physicians still accepting Medicare patients - FierceHealthFinance - Health Finance, Healthcare Finance

2010-11-08T12:43:00.000-08:00

from facebook post by Dr Abbes: I'll let them cut my income by 22% if they cut Chris's income by 22%. Of course we will have to close almost 50 % of area hospitals who depend heavily on that money. You may have to go to Canada and seek asylum if you get sick and need a hospital.. How's your appendix, gallbladder, and cholesterol these days? How about your families', friends' ? Perhaps you have Grand parents, yes? Care about your neighbors, school mates, others much? What if a large earthquake hits LA? What do you do if there are no hospitals? Have you seen what happened in Hati or Katrina? And guess where they train doctors? Yup. Hospitals. So I hope you like your foreign trained docs cause thats all your gonna get. Can you say, "me duele aqui!" Or maybe we can import those from China too.

The health of those that live around you even if you don't care about them is important because TB, typhoid, Dengue fever, cholera, West Nile virus, and the plague don't care who you are. They spread from person to person even if you are rich and will kill you. Let the poor get sick and every body will get sick! Can you say, "bring out your dead!" (the plague killed 30-60 % of the European population). Only 70 -80 percent of doctors accpet Medicare and about 50% Medi Cal (or Medicaid) today. Medicare pays less than 75% of what private insurance pays. Doctors are already dropping it by the boat load. Cut it and you'll kill Grandma for sure!

Study: Most physicians still accepting Medicare patients - FierceHealthFinance - Health Finance, Healthcare Finance

Nursing Shortage Estimates (2010): Public Health Data

2010-11-05T14:04:00.000-07:00

Please notice in this article, and many others, that there is nursing shortage in California alone of 47,000. nurses. Look up your state by clicking here. Then check out how many sick people and what diseases rank highest in California by clicking here if that doesn't shock and scare you enough.

Please stay healthy and don't get sick. I highly recommend vitamins, exercise, sunshine, stress reduction, and balanced healthy diet

If yo do get sick you may not get nursed back to health. click link for full article: Nursing Shortage Estimates (2010): Public Health Data

The odd conundrum is fettered out by the odd statistics below:

Qualified Applicants Turned Away by Nursing Schools in the US - full article

2002-2003= 5,283
2003-2004= 18,105

Patients left in lurch with abrupt closing of La Vida Medical Group - The Daily Breeze

2010-11-05T13:47:00.000-07:00

One doctor is out $280,000 as a result. Our clinic stands to lose over $ 7000.00. Lawsuits against the Insurance management group are pending.

Patients left in lurch with abrupt closing of La Vida Medical Group - The Daily Breeze

What do 50.7 million uninsured mean to physicians?

2010-09-27T03:18:00.000-07:00

What do 50.7 million uninsured mean to physicians?

Washington -- As the number of uninsured Americans spiked in 2009, physicians began offering new payment options, networking with other doctors to boost referrals, and accepting more Medicaid and uninsured patients. Doctors say they're spending more time helping patients who can't afford prescriptions, tests and other needed care.

The uninsured population reached 50.7 million in 2009, according to Census Bureau estimates released Sept. 16 -- the largest number since 1987, when the Census began its current method of estimating the uninsured

Health insurance: Big medical insurers to stop selling new child-only policies - latimes.com

2010-09-22T14:00:00.000-07:00

Anthem Blue Cross shows again that it is a corporate vampire wishing only to insure people that they can make huge profits on and turn away from being a good corporate citizen and allow coverage to sick children. Let me be clear they will not give medical insurance to SICK CHILDREN!!!!.
"Major health insurance companies in California and other states have decided to stop selling policies for children rather than comply with a new federal healthcare law that bars them from rejecting youngsters with preexisting medical conditions."

Health insurance: Big medical insurers to stop selling new child-only policies - latimes.com

Worst Places to get Sick in America

2010-09-20T13:43:00.001-07:00

http://www.bundle.com/article/the-best-and-worst-places-to-get-sick-in-the-US-12551?GT1=33009

California regulators seek up to $9.9 billion in fines from PacifiCare - latimes.com

2010-09-07T16:42:00.000-07:00

California regulators seek up to $9.9 billion in fines from PacifiCare - latimes.com

More Doctors Giving Up Private Practices

2010-03-27T12:33:00.000-07:00

Can you guess why? See the NYT article below

READ FULL Article

Excerpt:

As recently as 2005, more than two-thirds of medical practices were physician-owned — a share that had been relatively constant for many years, the Medical Group Management Association says. But within three years, that share dropped below 50 percent, and analysts say the slide has continued.

For patients, the transformation in medicine is a mixed blessing. Ideally, bigger health care organizations can provide better, more coordinated care. But the intimacy of longstanding doctor-patient relationships may be going the way of the house call.

Doctors Working Less, Earning Less - US News and World Report

2010-02-23T14:22:00.001-08:00

This trend continues and will worsen the lack of healthcare situation in this country. As fewer choose medicine with its declining income as a profession. "Right this way sir the nurse will be removing your kidney today because the doctor has retired!" Yikes!

Doctors Working Less, Earning Less - US News and World Report

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Had Enough Yet? - Premiums jump 14 percent on Medicare Advantage plans

2010-02-19T11:56:00.000-08:00

WASHINGTON — Millions of senior citizens who signed up for popular private health plans through Medicare are facing sharp premium increases this year — another sign that spiraling costs are a problem even for those with solid insurance.

Full article click here

Anthem Blue Cross Raises Rates for California -As Much as 39% - Do You Think We Need Healthcare Reform Now?

2010-02-05T12:21:00.000-08:00

Do you think we need healthcare reform now? Or should we wait till the insurance companies jack up the rates on all of us 35 % or more just like the banks have increased many credit card rates to nearly 30%? Wake up! Your rate is next!

Anthem Blue Cross dramatically raising rates for Californians with individual health policies
Policyholders are incensed over rate hikes of as much as 39%, which they say come on top of similar increases last year. State insurance regulators say they'll investigate.

Kaiser Report Forecasts Pain in Employer-Provided Care

2009-09-16T12:32:00.000-07:00

Here are the quick and dirty stats from the Kaiser survey: 40 percent of employers plan on increasing out-of pocket expenses for workers; about the same are raising annual deductibles and the prescription drug payments; 9 percent plan on tightening eligibility; 8 percent said they plan on dropping coverage completely.

Full article

Insurance Premiums Still Rising

2009-09-16T12:26:00.000-07:00

Insurance companies continue to increase what they charge the average family while profits stay high and consumers get less.

A Nurse’s View of Health Reform

2009-08-19T14:28:00.000-07:00

A Nurse’s View of Health Reform
By Theresa Brown, R.N.

Oncology nurse Theresa Brown is a regular contributor to Well.
Theresa Brown Theresa Brown, R.N.

I saw a bumper sticker a few days ago that said, “I used up all my sick days so I called in dead.” I liked it because it was absurd, but also because it seemed so apt to the battle raging right now over reforming health care in America.

I could offer a tableau of stories, but instead I will tell just one. A patient we had several months ago was admitted for leukemia treatment. In his 60s, kind and immensely likable, he went through three different rounds of what we call “induction chemo” — the regimen and dose designed to cure. But in trying to cure his leukemia we’d weakened his immune system to such an extent that he no longer had any reserve, and fluids and intravenous antibiotics could not save him from the infection growing in his lungs.

I took care of this patient fairly often, and I got pretty attached to him. I had the privilege of being in his room when he told me, with tears in his eyes, that his first granddaughter had been born that day in a different hospital across town. A Pittsburgh Steelers fan, he hung a “terrible towel” from the TV in his room and grumbled whenever we dislodged it with the I.V. pole. One of his chemo regimens included the drug Topetecan, and the name of this drug led to many jokes: about drinks with little umbrellas called Topetecans, an entire island paradise named Topetecan, even the walks he and his gentle wife took prompted the question, “Are you dancing . . . the Topetecan?”

The dark side of this patient’s visit, in addition to his fight for his life against a very aggressive disease, was that he did not have good health insurance. We talked about it. He was in business for himself selling insurance, but his own personal health insurance was inadequate and didn’t cover all the care he was getting. They were a solidly middle-class family, and he explained that if he had any medical bills in the past he just paid for them out of pocket. Getting leukemia was not part of the plan, and neither was an unexpected six week hospital stay that included thousands of dollars of chemotherapy.

Six weeks is a standard amount of time for new leukemia patients going through their first round of induction chemo. We make them so vulnerable to infection that we keep them in the hospital to ensure quick action if they do get sick. This patient’s six weeks turned into two months, and then three months, as one chemo regimen after another made no headway against his disease.

During periods when he was feeling sort of O.K., he was constantly on the phone and the Internet trying to find a way to pay his mounting hospital bills. He told me, “I know there’s money out there; I just have to find it.” He was confident that he could locate money for his care and that he would “beat” the cancer.

And then I came to work one day, and he was dead as a result of pneumonia. During the fraught and too quick final three months of his life, the cost of his care weighed on him as heavily as his possible death. His wife lost her husband. In addition to mourning him, is she also saddled with a medical debt that will burden her for years to come?

Can we all agree that the worry provoked by any kind of serious illness should not be compounded with the concern that we cannot afford the treatment we need?

I’m a nurse so I’m focused on need, and the treatment required to save someone’s life represents a profound need. It is also a need that is always unanticipated. My patient thought he had planned well for his health care needs. He just never thought he would wake up one day with a diagnosis of leukemia.

But which of us does? And that’s why we need health care reform. My patient was savvy about the business side of health insurance, but not about how cruel and unfair life can be. He was suddenly confronted with an illness, and treatment costs, outside the realm of his imagination. Any of us could wake up tomorrow and find ourselves in the same terrible predicament: really sick, needing treatment we can’t afford.

So I ask the people who oppose health care reform to consider what they would do if they found themselves in my patient’s situation — because they very well could, sooner than they know. Any of us could wake up sick, without the coverage we need, in danger of losing the very job that gives us health insurance. Our lifetime cap on insurance, which we never thought we would approach, can be brought so near that the question of costs cannot be separated from the treatment needed to stay alive.

I have no statistics to support the need for reform; I can only describe what I have seen, because what I have seen brings the discussion of health care reform down to the level of individuals. What do you do when you’ve used up all your sick days and you’re still too sick to go to work? And what if you’ve reached the cap on your health insurance, need a drug that isn’t covered by your plan, or require a scan that you can’t possibly pay for?

We’re not there yet as a country, but if some kind of reform doesn’t happen, the most ill among us, and the most unlucky, may just have to start calling in dead.

Nursing: A Tough Job

2009-07-30T13:30:00.001-07:00

The emergency room can be a dangerous place, if you're a nurse
6:01 AM, July 30, 2009

Emergency News stories, official reports and patient anecdotes frequently highlight the perils and problems encountered by emergency room patients. Considerably fewer stories focus on the perils and problems posed to the people working there. A new study does that.

It found that more than half of emergency nurses say they've been physically assaulted on the job. One in four say it's happened more than 20 times in the last three years. Some have been hit. Others have been pushed or scratched or kicked or spit upon. And verbal abuse? Far, far more common.

Much of the violence was attributed to patients or visitors who were addled by drugs or alcohol, and to psychiatric patients. Contributing factors included crowding, lengthy wait times and a shortage of nurses.

The study's abstract says: "Approximately 25% of respondents reported experiencing physical violence more than 20 times in the past 3 years, and almost 20% reported experiencing verbal abuse more than 200 times during the same period. Respondents who experienced frequent physical violence and/or frequent verbal abuse indicated fear of retaliation and lack of support from hospital administration and ED management as barriers to reporting workplace violence."

Conducted by the Emergency Nurses Assn., the survey was published in the July/August issue of the Journal of Nursing Administration.

Here's the association's release. And a fact sheet on the findings:

Plus a blog from someone who's been there: "madness: tales of an emergency room nurse -- the adventures of a veteran nurse in an inner city ER"

A recent post: "Woman arrives for minor problem. Significant other of woman arrives during visit and drops off 5 children under 6 years old. He disappears. She tells nurse that he abuses her and that they had been living with his mother and she doesn't want them there anymore. In other words, her and five kids have no place to go. It is evening. We can't very well throw woman and five kids under six out on the street with nothing but the clothes on their backs. She has no relatives or friends to go to. Her family lives "up north" about 3-4 hours away."

The study and the first-hand experience reiterate, should it be necessary, that problems in our emergency rooms are not simple or easily fixed.

-- Tami Dennis

RIP MJ -"I'll be your everything, If you make me a Star!"

2009-06-26T22:28:00.001-07:00

Podiatry Services, Mental Health Care Cut from Medi -Cal

2009-06-17T14:49:00.000-07:00

State of California - Health and Human Services Agency - Department of Health Care Services has announced this June 2009 a Reduction of Medi-Cal Benefits in a June 10th newsletter

As of July 1st 2009 Medi-Cal (the California Medicaid program) will no longer pay for treatment to adults over the age of 21 for the following services with some exceptions:

Dental, Speech Therapy, Podiatric Medical Care (the foot doctor), Audiology services, Chiropractic services, Acupuncture services, Optometric and optician services, Psychology services, incontinence creams and washes.

No doubt this will serve to clog up the emergency rooms and primary/family care doctors offices even more than they already are when these patients must now be cared for there instead of referred to these specialists. Good Luck California.

Aiming to slash $1.1 billion from Medi-Cal, Gov. Arnold Schwarzenegger presented a budget plan Thursday that would reduce reimbursement to providers - such as doctors and community clinics - by 10 percent, and cut podiatry, hearing and vision services to adults, among other proposed cuts. Additionally, as part of a proposed $11 million cut in state funding of AIDS programs, certain medications would no longer be covered.

Outraged, many health care experts said that essential services are on the cutting block, critically affecting millions of people, especially poor, older adults and the disabled. The state has 6.6 million people receiving Medi-Cal, nearly 774,000 in the Bay Area.

see full article

Shortage of Doctors- As I have been saying:

2009-04-26T23:13:00.000-07:00

Shortage of Doctors Proves Obstacle to Obama Goals

By Robert Pear - New York Times
Published: April 26, 2009

WASHINGTON — Obama administration officials, alarmed at doctor shortages, are looking for ways to increase the supply of physicians to meet the needs of an aging population and millions of uninsured people who would gain coverage under legislation championed by the president.

The officials said they were particularly concerned about shortages of primary care providers who are the main source of health care for most Americans.

One proposal — to increase Medicare payments to general practitioners, at the expense of high-paid specialists — has touched off a lobbying fight.

Family doctors and internists are pressing Congress for an increase in their Medicare payments. But medical specialists are lobbying against any change that would cut their reimbursements. Congress, the specialists say, should find additional money to pay for primary care and should not redistribute dollars among doctors — a difficult argument at a time of huge budget deficits.

Some of the proposed solutions, while advancing one of President Obama’s goals, could frustrate others. Increasing the supply of doctors, for example, would increase access to care but could make it more difficult to rein in costs.

The need for more doctors comes up at almost every Congressional hearing and White House forum on health care. “We’re not producing enough primary care physicians,” Mr. Obama said at one forum. “The costs of medical education are so high that people feel that they’ve got to specialize.” New doctors typically owe more than $140,000 in loans when they graduate.

Lawmakers from both parties say the shortage of health care professionals is already having serious consequences. “We don’t have enough doctors in primary care or in any specialty,” said Representative Shelley Berkley, Democrat of Nevada.

Senator Orrin G. Hatch, Republican of Utah, said, “The work force shortage is reaching crisis proportions.”

Even people with insurance have problems finding doctors.

Miriam Harmatz, a lawyer in Miami, said: “My longtime primary care doctor left the practice of medicine five years ago because she could not make ends meet. The same thing happened a year later. Since then, many of the doctors I tried to see would not take my insurance because the payments were so low.”

To cope with the growing shortage, federal officials are considering several proposals. One would increase enrollment in medical schools and residency training programs. Another would encourage greater use of nurse practitioners and physician assistants. A third would expand the National Health Service Corps, which deploys doctors and nurses in rural areas and poor neighborhoods.

Senator Max Baucus, a Montana Democrat and chairman of the Finance Committee, said Medicare payments were skewed against primary care doctors — the very ones needed to coordinate the care of older people with chronic conditions like congestive heart failure, diabetes and Alzheimer’s disease.

“Primary care physicians are grossly underpaid compared with many specialists,” said Mr. Baucus, who vowed to increase primary care payments as part of legislation to overhaul the health care system.

The Medicare Payment Advisory Commission, an independent federal panel, has recommended an increase of up to 10 percent in the payment for many primary care services, including office visits. To offset the cost, it said, Congress should reduce payments for other services, an idea that riles many specialists.

Dr. Peter J. Mandell, a spokesman for the American Association of Orthopaedic Surgeons, said: “We have no problem with financial incentives for primary care. We do have a problem with doing it in a budget-neutral way.

“If there’s less money for hip and knee replacements, fewer of them will be done for people who need them.”

The Association of American Medical Colleges is advocating a 30 percent increase in medical school enrollment, which would produce 5,000 additional doctors each year.

“If we expand coverage, we need to make sure we have physicians to take care of a population that is growing and becoming older,” said Dr. Atul Grover, the chief lobbyist for the association. “Let’s say we insure everyone. What next? We won’t be able to take care of all those people overnight.”

The experience of Massachusetts is instructive. Under a far-reaching 2006 law, the state succeeded in reducing the number of uninsured. But many who gained coverage have been struggling to find primary care doctors, and the average waiting time for routine office visits has increased.

“Some of the newly insured patients still rely on hospital emergency rooms for nonemergency care,” said Erica L. Drazen, a health policy analyst at Computer Sciences Corporation.

The ratio of primary care doctors to population is higher in Massachusetts than in other states.

Increasing the supply of doctors could have major implications for health costs.

“It’s completely reasonable to say that adding more physicians to the work force is likely to increase health spending,” Dr. Grover said.

But he said: “We have to increase spending to save money. If you give people better access to preventive and routine care for chronic illnesses, some acute treatments will be less necessary.”

In many parts of the country, specialists are also in short supply.

Linde A. Schuster, 55, of Raton, N.M., said she, her daughter and her mother had all had medical problems that required them to visit doctors in Albuquerque.

“It’s a long, exhausting drive, three hours down and three hours back,” Ms. Schuster said.

The situation is even worse in some rural areas. Dr. Richard F. Paris, a family doctor in Hailey, Idaho, said neighboring Custer County had no doctors, even though it is larger than the state of Rhode Island. So he flies in three times a month, over the Sawtooth Mountains, to see patients.

The Obama administration is pouring hundreds of millions of dollars into community health centers.

But Mary K. Wakefield, the new administrator of the Health Resources and Services Administration, said many clinics were having difficulty finding doctors and nurses to fill vacancies.

Doctors trained in internal medicine have historically been seen as a major source of frontline primary care. But many of them are now going into subspecialties of internal medicine, like cardiology and oncology.

Podiatrist, Camera, Flowers, Smithsonian!

2009-04-15T11:19:00.000-07:00

Watch CBS Videos Online

Recession Starts to Take Toll on Medical Field Too

2009-04-13T16:00:00.001-07:00

Recession Now Hits Jobs in Health Care

By AVERY JOHNSON and KELLY EVANS

Employment in health care, the only major industry outside the federal government still adding jobs, is succumbing to the recession.

In the latest sign, the president of New York City Health & Hospitals Corp. wrote Friday to community organizations as well as employees and unions at its 11 hospitals and four nursing homes, saying the agency will lay off more workers even after slashing 400 jobs last month.
[health]

"We now project that HHC's deficits will worsen, even if we are spared further state cuts," Alan Aviles wrote to the staff of 39,000. "The challenges will deepen." He blamed the job losses on state cuts in Medicaid payments to the public-health system.

Across the country, hospitals are taking financial hits. They are seeing losses in the portfolios that they rely on for investment income. The number of uninsured patients is rising. Elective procedures -- which reap big profits -- are down at a third of hospitals nationwide. Nursing homes are trimming payrolls. And with state governments continuing to cut budgets and talk of health-care reform from Washington, industry executives are preparing for even leaner times.

More than 16 million people -- one in eight workers on U.S. payrolls -- work in health care today, up from just 1% of the work force 50 years ago. Employment in health care and social assistance -- which includes hospitals, doctors offices, nursing homes and social services such as day care -- has grown by half a million jobs since the recession began in December 2007, while the rest of the economy has shed 5.1 million jobs.

But the pace of job growth in health services has slowed sharply this year. The sector added an average of 17,000 jobs per month in the first three months of the year, less than half last year's pace. Health care usually weathers downturns better than many other industries because consumers tend to cut spending on cars or clothes before they forgo trips to the emergency room or pharmacy. But this recession is the deepest in a generation.

"To the extent that health care might have been recession-proof, it is no longer," said Paul Levy, chief executive of Beth Israel Deaconess Medical Center in Boston, a teaching hospital for Harvard University. The hospital last month announced 140 job cuts, salary freezes, and reductions in vacation allowances and retirement-fund contributions to make up a $20 million budget shortfall.

Mr. Levy began to get worried in October, when Massachusetts cut Medicaid payments to his hospital by $7 million. In November, he noticed researchers weren't applying for grants as actively as usual, anticipating less government funding; that cost another $7 million in revenue for the hospital, which gets some of the grant money to cover overhead. Then in January, patient volume slowed. During the first three months of this year, hospital discharges -- a standard measure of patients treated -- dropped to 112 a day from a targeted 122, which translates into $20 million less in yearly revenue.

Big hospitals such as the University of Pittsburgh Medical Center and Akron General Health System in Ohio have announced layoffs recently. In February, the number of mass layoffs for hospitals was double what it was a year ago, according to government data.

In Tarboro, N.C., Kim King, a 49-year-old contract worker in the hospital laboratory at Heritage Hospital, received a letter from her manager last Monday cutting her contract short by three weeks and asking staff to voluntarily reduce hours. The letter cited the economic pressures facing the hospital. Ms. King isn't sure what she is going to do when her job analyzing blood and other fluids in the hospital lab ends in June. She is looking for work and considering going on unemployment.

She and her ex-husband, a corrections officer, "used to joke that we had the most secure jobs out there, because people always need health care and prisons. It's not true anymore," she says. "I've never seen it so bad. It's the one thing you would think wouldn't be affected by the recession."

Wick Baker, president of Heritage Hospital, says the hospital is being financially responsible by looking at all of its costs, including replacing contract employees with less expensive full-time staff.

The squeeze isn't limited to hospitals. Pharmaceutical firms and health insurers also are shedding jobs. On Thursday, health-care conglomerate Johnson & Johnson said it would lay off 900 workers.

Since the Labor Department began tracking monthly unemployment figures in 1958, there have been nine recessions, but employment in health services has declined only a handful of times. The only significant losses to date occurred in mid-1984, as the industry shed 41,000 jobs, based on slightly different historical data, following the double-dip recession of the early 1980s. Since then, no month has seen a drop of more than 4,000 jobs in health care, and there have been no back-to-back declines.

As manufacturing employment has declined, many cities have come to see health care as the employer of last resort. Rochester, Minn., home to the Mayo Clinic, is one illustration of the industry's power to turn around regional fortunes and revitalize downtowns. Forty years ago, Mayo employed 4,000 workers; today, the international destination for top-tier health care employs some 35,000, more than a third of the city's total work force.

But Mayo, like the rest of the industry, is now struggling to meet it its capital and payroll obligations. Last month, the ratings agency Standard & Poor's downgraded Mayo's debt, citing the hospital system's large unfunded pension liability and break-even operating margins.

Mayo is freezing salaries for doctors and senior administrators, reducing travel and overtime expenses, and cutting capital spending this year by $150 million, says Chief Financial Officer Jeff Bolton. There have been no layoffs, though temporary staff are being pared back and only essential positions are being filled. Mayo is delaying occupying one floor of a new outpatient exam building on the Rochester campus, since finishing the interior of each floor costs $12 million.

The decline, while unusual, is still likely to be a temporary break in the industry pattern. Growth in health-care spending, and thus employment in the sector, is likely to rebound when the recession ends, a function of the enormous advances in medical technology and Americans' strong appetite for health care. President Barack Obama has also named the sector one of his three pillars of the future U.S. economy, alongside energy and education. Health expenditures as a share of gross domestic product have more than tripled in the past 50 years to about 16% today, and the government's Centers for Medicare and Medicaid Services say that figure is likely to hit 20% within a decade.

"It's a long-term shift reflecting changes in technology and what consumers want," says Robert Fogel, a Nobel laureate and professor at the University of Chicago's Booth School of Business. "Health care is the growth industry of the 21st century."

Write to Avery Johnson at avery.johnson@WSJ.com and Kelly Evans at kelly.evans@wsj.com

Erasing TB could take 1,000 years, official says

2009-03-24T23:27:00.000-07:00

Oh yeah, remember what I said two posts ago about how we should not cut off health care to poor or even illegal or even prisoners just to save money. The argument being that it was like cutting off your nose to spite your face. I, then, used the example of how TB (tuberculosis a potentially fatal and highly contagious disease spread by cough or sneeze) scare has hit a local high school twice in the last year prompting the testing of over 500 students, families, teachers, and employees. Well, in case you thought TB was like a disease of the past and the last guy to die of it was Doc Holiday in Tombstone, read this article and think again. "I'm your huckelberry! -Doc Holiday, Tombstone",indeed.

The main thrust of the story:

RIO DE JANEIRO - The number of people infected with both tuberculosis and HIV is twice what researchers previously thought, top health officials said Tuesday.

The World Health Organization’s annual report on TB, presented in Rio, indicates that there were 1.37 million cases of people with both TB and HIV in 2007, the latest year for which statistics are available. About 700,000 people were infected with both in 2006, according to a report released by WHO last year.

The full article: http://www.msnbc.msn.com/id/29864238/

Fear Of Reform or Sphincters Tightening At Insurance Company Boardrooms Across America

2009-03-24T22:51:00.000-07:00

WASHINGTON - The health insurance industry offered Tuesday for the first time to curb its controversial practice of charging higher premiums to people with a history of medical problems.

This I will now attribute to my repeated and relentless incendiary remarks posted here on this blog. They, the insurance company corporations and conglomerates, are, finally relenting!

Full story here: Insurers offer to stop charging sick people more

No doubt the momentum in Washington, lead by President Obama, to reform practices by insurance companies that are wasteful and detrimental to patients and employers and that result in decreasing companies in the USA from competing effectively in a global market. That is insurance company bad! Reform good!

In the letter, the two insurance industry groups said their members are willing to “phase out the practice of varying premiums based on health status in the individual market” if all Americans are required to get coverage.

Golly gee, Batman, I wonder why they would do such a thing?

“The offer here is to transition away from risk rating, which is one of the things that makes life hell for real people,” said health economist Len Nichols of the New America Foundation public policy center. “They have never in their history offered to give up risk rating.”

Yes, Robin, it seems they are up to their old tricks. Trying to win political support for the "don't worry. Look, we're reforming ourselves. See?", argument that has kept 'em from the populist uprising proverbial boot up the you know what til now. You see, Robin, they are just not that into you!

Insurers are trying to head off the creation of a government insurance plan that would compete with them, something that liberals and many Democrats are pressing for. To try to win political support, the industry has already made a number of concessions. Last year, for example, insurers offered to end the practice of denying coverage to sick people.

Hey, that what I just said!

Insurance companies now charge very high premiums to people who are trying to purchase coverage as individuals and have a history of medical problems, such as diabetes or skin cancer. Even if such a person is offered coverage, that individual is often unable to afford the high premiums. About 7 percent of Americans buy their coverage as individuals, while more than 60 percent have job-based insurance.

Silly, people. Thinking they should be able to get affordable health insurance when they are sick or have an illness. Golly, that's when they need insurance. They should buy insurance when they are healthy and never use it and never go to the doctor so the nice insurance corporation can break all their profit records. And then an Angel gets its wings! Really!

The companies left themselves several outs, however. The letter said they would still charge different premiums based on such factors as age, place of residence, family size and benefits package.

Whoops, I always forget to read that fine print. Gets me every darn time! And I'm sure other factors too: like member size, number of dates in high school, if you ever fantasized about your grade school teacher...I don't feel dirty! etc.

I for one am not buying it. Any corporation that spends less than 60% of the dollars you give them to pay for a service that you could have paid for directly yourself and then denies you the service or denies the person (doctor etc) that gave you the service the money that was intended from them...well you get it...they are middle men...and a little more than self serving...maybe even crooks! Oh yes, quite frequently, crooks. Choosing who lives and dies. And they say doctors have a God complex. Methinks its the bean counting accountants! Except for mine, he's okay. I get to pick a toy off the top shelf every time a do my taxes!

TB Does Not Discriminate Unlike Racists.

2009-03-23T17:01:00.001-07:00

There has been a lot of political wrangling and talk recently about cutting health benefits for illegal aliens. Not to mention the incidents in Florida. (Is FLorida still part of the union or what?) The political momentum against cutting benefits to the underprivileged and under insured changed after the 2008 national election. During the election a concerted effort was made on the part of the Democratic nominees to demonstrate clearly the fact that there was a glaring disparity between the "haves and the have nots" when it came to health care availability. AARP ran a series of infomercials, and a started a website Divided We Fall, depicting real patients telling their own stories of how they became bankrupt after an illness even though they had private insurance coverage at the time of the illness or injury. Then candidate Barrack Obama quoted states on the millions who have shared this fate. The under insured.

It seems that a while back, gradually, insidiously the health insurance corporations have changed the rules and increased the cost of insurance. To keep the rates affordable they simply gave you less and less coverage for the same rate. This has now progressed to the point that many people now have what boils down to a discount card and not "real" insurance. That is are under insured. When presented with any moderate health crisis your share of the health care costs in deductibles and co-payments will overwhelm the vast majority of the families making less than 250,000 a year.

Despite this now there is a group pushing for making sure that illegal aliens do not get any health coverage because we, the taxpayer, are paying for it. Thus reducing costs, goes the arguement for this action, to the State and local municipalities. Sounds great in theory but...not so great in practice. Case in point Long Beach Wilson High School.

It seems the 170 students and faculty at Wilson High School in Long Beach, a city in Southern California, was exposed to a contagious form of Tuberculosis or TB, and must now testing and possible prophylactic treatment with antibiotics to prevent getting TB. Testing involves injecting an altered strain of the TB mycobacteria under the skin of the inner forearm and waiting several days for a reaction. If a reaction occurs chest X-rays and antibiotics may follow. A similar incident was recorded in September when 400 were exposed and required testing at the same school. Just one question? How much does that cost? How much does it cost if you or one of your children get TB or worse are exposed to it and don't find out til much later. TB, by the way is spread through the air. A cough, a sneeze, a handshake and you may acquire a fatal disease. Nice!

TB was on the decline in California, although rates have been higher in California than the rest of the country at 7 per 100,000 people. It is higher in "Racial minorities and foreign-born people continued to be disproportionately affected by the disease. In California, there were 22.9 cases of TB for every 100,000 Asian American residents; 8.7 for blacks; and 7.6 for Latinos. The rate was 1.6 per 100,000 for whites and 1.8 for Native Americans."

This would seem to support, again, the not so new argument repeatedly made by health care professionals, that is more cost effective to treat illegals and the underprivileged if only to save our own hides for being exposed to the contagious and deadly diseases that they will undoubtibely share with us!

The fall from grace of science and well "rational thinking" during the religious rights and Bush reign over policy has been nearly forgotten. But thank the stars or God, we're back baby!

Can we just put these ridiculous arguments to rest and realize that what is good for your neighbor is good for you too! Pray on it please!

PS to Eve re: For many small business owners, health care system is "Sicko"
I must say as a small business owner: I'm still living in fear!

Bernanke Expresses Frustration Over AIG Abuse of System

2009-03-04T13:45:00.000-08:00

Bernanke said no episode in the current financial crisis has angered him more than the need to rescue AIG. He stated without equivocation:

"AIG exploited a huge gap in the regulatory system. There was no oversight of the financial-products division. This was a hedge fund, basically, that was attached to a large and stable insurance company, made huge numbers of irresponsible bets, took huge losses. There was no regulatory oversight because there was a gap in the system." The Wall Street Journal

I know they are gearing up for a fight as we speak. My message to them is this: "So Am I!"

2009-02-28T19:06:00.000-08:00

Geologist Erupts at Jindal's Volcano Question - Science News | Science & Technology | Technology News

2009-02-25T18:03:00.000-08:00

Jindal and GOP Still Don't Get It. Continue to Take Swipes at Anything with Science Involved. Monitoring volcanoes for eruptions that are located near our military bases or citizens...sure that's a terrible idea. And as far as a cool train from anywhere in California to anywhere is a good idea. Calfornia has very little mass transit!
FOXNews.com - Geologist Erupts at Jindal's Volcano Question - Science News \| Science & Technology \| Technology News http://www.foxnews.com/story/0,2933,500267,00.html

rx4feet@aol.com sent this using ShareThis.

Reuters - Health spending takes rising share of U.S. economy

2009-02-24T19:45:00.001-08:00

This article was sent to you from Rx4feet@aol.com, who uses Reuters Mobile Site to get news and information on the go. To access Reuters on your mobile phone, go to:
http://mobile.reuters.com

Health spending takes rising share of U.S. economy

Tuesday, Feb 24, 2009 12:52PM UTC

By Will Dunham

WASHINGTON (Reuters) - Health spending will hit $2.5 trillion this year, devouring 17.6 percent of the economy, as the White House and Congress consider major changes to the healthcare system, U.S. government economists said on Tuesday.

The Centers for Medicare and Medicaid Services, known as CMS, forecast that the share of the economy devoted to health spending will jump a full percentage point from 2008. That would mark the biggest one-year increase recorded since the government began tracking the data in 1960.

Thanks to the recession, public health spending in programs such as the Medicaid program for the poor is ballooning, while private health insurance spending is slowing as more people lose employer-provided coverage, CMS reported.

"We project that the health share of the economy will increase steadily through 2018," CMS economist Christopher Truffer told reporters.

The unbridled growth in projected health spending may add impetus to plans by President Barack Obama and leading lawmakers to make sweeping changes in the healthcare system.

The United States spends more on healthcare than any other country, but its system is widely considered inefficient and it lags many other nations in key quality measures. Past efforts to make major healthcare changes have died in Congress.

The rate of increase in overall health spending -- public and private combined -- was estimated at 6.1 percent in 2008, the same as the previous year, but is projected to slow to 5.5 percent this year due to the effects of the recession.

The report forecast that 2009's increase in private health spending would slip to a 15-year low of 3.9 percent.

Overall U.S. health spending in 2009 will hit $2.5 trillion, continuing a trend in recent decades that has seen healthcare encompass an ever-larger proportion of the economy, CMS said.

By 2018, U.S. health spending will almost double from last year's sum, soaring to $4.4 trillion and making up 20.3 percent of the overall economy, the economists reported in the journal Health Affairs.

Growth in public health spending this year is projected to hit 7.4 percent, amounting to $1.2 trillion, largely due to growth in Medicaid enrollment and spending, the report said.

The current recession began in December 2007 and the report forecast economic conditions would improve beginning in 2010. Health spending growth is projected to surge anew in 2011.

Private health spending growth will leap from 4.2 percent in 2010 to 6.1 percent by 2018, CMS said. Public health spending will surge in the same time frame as the post World War II baby boom generation begins entering the Medicare health insurance program for people ages 65 and up, CMS added.

Public spending was forecast to account for more than half of health spending by 2016 and reach 51.3 percent by 2018.

The report saw slower growth in prescription drug spending, down to 3.5 percent last year from 4.9 percent in 2007. CMS economist Andrea Sisko attributed this to the recession, saying the economic squeeze is making people less apt to fill their prescriptions and more willing to use cheaper generic drugs.

(Editing by Maggie Fox and David Storey)

Reuters - Health spending takes rising share of U.S. economy

2009-02-24T01:24:00.001-08:00

To access Reuters on your mobile phone, go to:
http://mobile.reuters.com

Health spending takes rising share of U.S. economy

Tuesday, Feb 24, 2009 5:13AM UTC

By Will Dunham

WASHINGTON (Reuters) - Health spending will hit $2.5 trillion this year, devouring 17.6 percent of the economy, as the White House and Congress consider major changes to the health care system, U.S. government economists said on Tuesday.

"We project that the health share of the economy will increase steadily through 2018," CMS economist Christopher Truffer told reporters.

The unbridled growth in projected health spending may add impetus to plans by President Barack Obama and leading lawmakers to make sweeping changes in the health care system.

The United States spends more on health care than any other country, but its system is widely considered inefficient and it lags many other nations in key quality measures. Past efforts to make major health care changes have died in Congress.

The report forecast that 2009's increase in private health spending would slip to a 15-year low of 3.9 percent.

Overall U.S. health spending in 2009 will hit $2.5 trillion, continuing a trend in recent decades that has seen health care encompass an ever-larger proportion of the economy, CMS said.

Growth in public health spending this year is projected to hit 7.4 percent, amounting to $1.2 trillion, largely due to growth in Medicaid enrollment and spending, the report said.

The current recession began in December 2007 and the report forecast economic conditions would improve beginning in 2010. Health spending growth is projected to surge anew in 2011.

Public spending was forecast to account for more than half of health spending by 2016 and reach 51.3 percent by 2018.

(Editing by Maggie Fox and David Storey)

US Unemployment December 2008

2009-02-04T13:28:00.000-08:00

(U.S. BUREAU OF LABOR STATISTICS)

OFFICIAL UNEMPLOYMENT: 7.2% [Analysis]

A year earlier, the number of unemployed persons was 7.5
million, and the jobless rate was 4.9 percent. [BLS]

White 6.6%
African American 11.9%
Hispanic 9.2%
Asian** 5.1%
Men 20 years and over 7.2%
Women 20 years and over 5.9%
Teen-agers (16-19 years) 20.8%
Black teens 33.7%

Officially unemployed 11.1 million

HIDDEN UNEMPLOYMENT

Working part-time because can't find a full-time job: 8.0 million

People who want jobs but are not looking so are not counted in official statistics (of which about 1.9 million** searched for work during the prior 12 months and were available for work during the reference week.) 5.5 million

Total: 24.6 million (15.4% of the labor force)

Source: http://www.bls.gov/news.release/pdf/empsit.pdf

California Insurance Commissioner Too Easy on Blue Shield?

2009-01-26T16:55:00.000-08:00

Mr Poisner seems to be acting along Bush era GOP party lines. Didn't we just have two major election cycles where the people rejected these and called for reform to the excesses and abuses perpetrated on the American public in the name of corporate profits. Let's see were did that get us economically, oh yeah a major recession! Apparently some politicians still believe that the American public still hasn't figured out that its time to swing the pendulum the other way. For the greater good of the greatest number of people and not to continue to allow corporations need for increasing there already profitable businesses at the expense of the most vulnerable in our society!

" Poizner said Blue Shield did this to some 700 holders of individual and family policies. (Group policies provided by employers can't be rescinded the same way.) He said the company's "alarming" violations of the law would "completely undermine the public trust in our healthcare delivery system" and promised to seek $12.6 million in fines and penalties.

Yet Poizner's final settlement with Blue Shield, announced Jan. 6, didn't look much like the preview. There was no provision for multi-million-dollar fines. Blue Shield agreed to restore the customers' insurance, waiving the usual exclusions for pre-existing conditions. It agreed to reimburse them for medical procedures performed that would have been covered if their policies hadn't been canceled, although to get the money the customers would have to give up their right to sue.

..feeds into the GOP's pro-business, anti-regulation mind-set, to which Poizner may need to appeal in the next election year. And it has made some consumer advocates wonder whether Poizner's style is ideal for a regulator."

United Healthcare Has Been Overcharging You!

2009-01-14T17:52:00.000-08:00

UnitedHealth Group Settles New York Reimbursement Probe-Reuters
Well if you've been following my comments, then you are not surprised. As anyone ever involved in medical billing or adjudication will tell you insurance companies seemingly from thin air, decide how much your care is worth and how much you will pay. Despite the fact that you have "insurance" your share of the cost can put you in the poor house. You were thinking that you were covered then wham you pay more for your care than they did! Amounting to no more than a discount and not real "insurance!" I'll tell you later about the recent $8.00 check the insurance paid, while the patient paid $35.00 for the service!

Tuesday, 13 Jan 2009 01:45pm EST

Reuters reported that UnitedHealth Group has agreed on to a settlement with the New York State attorney general following a probe into the independence of its database used to set reimbursement rates for patients' medical bills. The agreement followed a year-long investigation by Attorney General Andrew Cuomo, who said that consumers around the country have been forced to pay more than they should have for out-of-network medical services through skewed patient reimbursement rates. The settlement calls for UnitedHealth to shut down its Ingenix medical billing information service and pay $50 million to finance a new independent database to determine market rates for health-care procedures. UnitedHealth will not need to take a financial charge related to the settlement.

Cobra Coverage Costs More than Unemployment Benefits

2009-01-09T14:25:00.000-08:00

In another example of the disconnect of the Health Insurance pricing system: The cost to continue medical coverage after being laid off in Florida is greater than the dollar amount of benefits paid in Floirda.

The Disappearing Doctor

2008-12-15T00:41:00.000-08:00

I'm just gonna keep saying this as I have for several years now. I see this as the next big crisis because I experience it everyday when I try to refer patient's and to cram them into my overburdened, under compensated schedule! Here is a another article on the matter in the NYT.

Health Well:The Disappearing Doctor
By By Tara Parker-Pope
Published: December 11, 2008
A looming shortage of primary care doctors may undermine efforts to create a safety net for the uninsured.

This is just Crazy Medical Stuff - Can You Say: Welcome to the Matrix?

2008-11-18T19:26:00.000-08:00

Watch CBS Videos Online

My Favorite from Fark.com

2008-11-18T18:18:00.000-08:00

Many doctors plan to quit or cut back: survey

2008-11-18T13:23:00.000-08:00

WASHINGTON (Reuters) - Primary care doctors in the United States feel overworked and nearly half plan to either cut back on how many patients they see or quit medicine entirely, according to a survey released on Tuesday.

And 60 percent of 12,000 general practice physicians found they would not recommend medicine as a career.

"The whole thing has spun out of control. I plan to retire early even though I still love seeing patients. The process has just become too burdensome," the Physicians' Foundation, which conducted the survey, quoted one of the doctors as saying.

The survey adds to building evidence that not enough internal medicine or family practice doctors are trained or practicing in the United States, although there are plenty of specialist physicians.

Health care reform is near the top of the list of priorities for both Congress and president-elect Barack Obama, and doctor's groups are lobbying for action to reduce their workload and hold the line on payments for treating Medicare, Medicaid and other patients with federal or state health insurance.

The Physicians' Foundation, founded in 2003 as part of a settlement in an anti-racketeering lawsuit among physicians, medical societies, and insurer Aetna, Inc., mailed surveys to 270,000 primary care doctors and 50,000 practicing specialists.

The 12,000 answers are considered representative of doctors as a whole, the group said, with a margin of error of about 1 percent. It found that 78 percent of those who answered believe there is a shortage of primary care doctors.

More than 90 percent said the time they devote to non-clinical paperwork has increased in the last three years and 63 percent said this has caused them to spend less time with each patient.

Eleven percent said they plan to retire and 13 percent said they plan to seek a job that removes them from active patient care. Twenty percent said they will cut back on patients seen and 10 percent plan to move to part-time work.

Seventy six percent of physicians said they are working at "full capacity" or "overextended and overworked".

Many of the health plans proposed by members of Congress, insurers and employers's groups, as well as Obama's, suggest that electronic medical records would go a long way to saving time and reducing costs.

(Reporting by Maggie Fox; editing by Chris Wilson)

Doctors Not Getting Paid by Medicare in CA

2008-11-08T21:33:00.000-08:00

Tardy Medicare reimbursements are hurting doctors in California, Nevada and Hawaii

An unpaid claims backlog of up to nine months is leading some physicians to reject elderly patients and jeopardizing the solvency of others. Some are owed hundreds of thousands of dollars.
By Kimi Yoshino
November 8, 2008

Hospitals See Fewer Paying Patients

2008-11-08T12:52:00.000-08:00

Business
Hospitals See Drop in Paying Patients
By REED ABELSON
Published: November 7, 2008
In a sign of the economy’s toll on the health care system, some hospitals are seeing fewer paying patients — and more people at emergency rooms unable to pay their bills.

Countdown to the Real United States of America: Applies to Pro America sections too!

2008-11-07T23:46:00.000-08:00

Once In A Lifetime: A President That Just Happens to Black!

2008-11-01T22:58:00.000-07:00

The Election that will Change Everything?

2008-11-01T21:28:00.001-07:00

99213 - The Health Care Crisis: Doctor shortages: Podiatrists Shortage

2008-10-02T20:31:00.000-07:00

It comes as no surprise to me that there is a projected shortage of Podiatrists> The foot care specialists are projected to be less easy to access due to declining admissions and graduates at Podiatric Medical Schools and increasing numbers of the aging population that will need foot care from a physcian. See below excerpt of the article from Podaitry Today Magazine. Read the full article here:

Is There A DPM Shortage On The Horizon?- By Brian McCurdy, Senior Editor

A decline in the number of graduating podiatric medical students combined with increasing demand for podiatric services could result in a shortage of DPMs, according to a recent study in the Journal of the American Podiatric Medical Association (JAPMA).
Study authors note that since the late 1990s, podiatric medical schools have experienced a decline in the number of applications, resulting in a decreased number of DPMs per capita in the United States. The study notes that the number of DPM graduates must increase “dramatically” or the supply of podiatrists will not keep up with the demand for services. Approximately 52 million people, about 19 percent of the U.S. population, experience foot problems every year, according to the study authors.
In 1995-96, 680 students graduated from podiatric medical programs yet this number dropped to 331 in 2006-07, according to the study. In addition, the Bureau of Labor Statistics projects podiatric medicine job growth of about 16 percent between 2004 and 2014.

A new study in JAPMA concludes that the number of current graduates from podiatry schools may not be able to keep pace with the projected future demand for podiatric services.

The study notes several factors in the higher demand for podiatrists. First, the general population is projected to grow by 2.4 million people a year through 2050. Second, the population is aging and experiencing more foot problems, especially as the Baby Boomers begin to pass the age of 65. Third, the Centers for Disease Control and Prevention (CDC) estimate that the incidence of diabetes will increase 82 percent between 2005 and 2020. Finally, the incidence of obesity is increasing. This is projected to more than double between 2005 and 2030.
In order to bolster the number of DPMs to keep up with the demand, the study authors suggest that all podiatric medicine schools "would have to nearly triple their current (number) of graduates." They also advocate the establishment of another podiatry school in addition to the recently established Western University of Health Sciences School of Podiatric Medicine, which will start having classes in the fall of 2009.

Inside Insights From Educators
"I have for years preached that demand for podiatric services would increase to the point that it would outstrip our ability to supply a sufficient number of podiatric physicians," says Jeffrey Page, DPM, the Director and Professor of the Arizona Podiatric Medicine Program at Midwestern University.
"A reader might quibble with the exact numbers in the study, but when considered in the context of the nationwide physician shortage, you can readily see that the primary conclusion of the article is right on: we need more podiatrists."
Dr. Page notes that the number of applications to podiatry schools bottomed out in 2000-01 and has modestly increased since then. He projects that the number of applications will be in the 400s in 2009.
Dr. Page says some in the profession forget the average age of practicing podiatrists is about 45 and although Baby Boomer DPMs are considering retiring, there are too few graduating colleagues to take over their practices. He says the public's growing awareness of who podiatrists are and what they can offer fuels demand.
Terence Albright, DPM, supports the JAPMA authors' conclusions based on federal census documents that project an increase in both the population and in the number of people age 60 and up. Dr. Albright also notes the continuing maldistribution of healthcare providers, including podiatrists, in the U.S.
"The profession can increase the number of graduates but the need for services will increase and be met by other providers if our graduates do not serve in areas that do not have a podiatrist," says Dr. Albright, the Dean of the Scholl College of Podiatric Medicine at Rosalind Franklin University.
Given that the aforementioned census projects that minorities will be in the majority by 2050, Dr. Albright also emphasizes that the profession needs to recruit more minority students to serve the future need for podiatric services.

The Next Big Financial Crisis: Health Care

2008-09-30T15:12:00.000-07:00

From the Los Angeles times 9/30/2008; http://www.typepad.com/t/trackback/816965/34002849

...chronic diseases eat up 75% of all healthcare costs. That's three-quarters of the total $2.2 trillion spent on healthcare in the United States. That comes to $1.65 trillion...

That's more than two Wall Street bailouts.

America can't wait for another segment of the economy to collapse before doing something about it, they said. "There's some concern that given the current state of the economy, taking on healthcare might be too much, too big," said Thorpe. "I would argue the opposite. Failure to act on the issue of making healthcare more affordable is a recipe for disaster. This issue is too important to ignore. As wages slow down and the deficits rise, we've got to find places in the public budgets and in the private sector to make healthcare affordable for families and businesses."

99203 - Why You Doctor Only Has 5 Minutes to Cure Your Rare Disease.

2008-09-14T17:07:00.001-07:00

The following story deals with the looming shortage of internists and family practice doctors which I have made a recurring theme in my blog and feel everyone should be aware of when making political and economic judgements of the future of their lives and our nation. More stories about why your doctor only spends 5 minutes with you on your visit and your for profit insurance company may be to blame.

Fewer US med students choosing primary care

By CARLA K. JOHNSON, Associated Press Writer Tue Sep 9, 7:33 PM ET

CHICAGO - Only 2 percent of graduating medical students say they plan to work in primary care internal medicine, raising worries about a looming shortage of the first-stop doctors who used to be the backbone of the American medical system.

The results of a new survey being published Wednesday suggest more medical students, many of them saddled with debt, are opting for more lucrative specialties.

Just 2 percent of nearly 1,200 fourth-year students surveyed planned to work in primary care internal medicine, according to results published in the Journal of the American Medical Association. In a similar survey in 1990, the figure was 9 percent.

Paperwork, the demands of the chronically sick and the need to bring work home are among the factors pushing young doctors away from careers in primary care, the survey found.

"I didn't want to fight the insurance companies," said Dr. Jason Shipman, 36, a radiology resident at Vanderbilt University Medical Center in Nashville, Tenn., who is carrying $150,000 in student debt.

Primary care doctors he met as a student had to "speed to see enough patients to make a reasonable living," Shipman said.

Dr. Karen Hauer of the University of California, San Francisco, the study's lead author, said it's hard work taking care of the chronically ill, the elderly and people with complex diseases — "especially when you're doing it with time pressures and inadequate resources."

The salary gap may be another reason. More pay in a particular specialty tends to mean more U.S. medical school graduates fill residencies in those fields at teaching hospitals, Dr. Mark Ebell of the University of Georgia found in a separate study.

Family medicine had the lowest average salary last year, $186,000, and the lowest share of residency slots filled by U.S. students, 42 percent. Orthopedic surgery paid $436,000, and 94 percent of residency slots were filled by U.S students.

Meanwhile, medical school is getting more expensive. The average graduate last year had $140,000 in student debt, up nearly 8 percent from the previous year, according to the Association of American Medical Colleges.

Another likely factor: Medicare's fee schedule pays less for office visits than for simple procedures, according to the American College of Physicians, which reported in 2006 that the nation's primary care system is "at grave risk of collapse."

Lower salaries in primary care did not deter Dr. Alexis Dunne of Chicago, who is 31 and carrying $250,000 in student debt.

Last year, a parade of specialists couldn't solve the mystery of her mother's weight loss, fevers and severe anemia. Finally, an internist diagnosed a rare kidney infection. The kidney was removed, and Dunne's mother has felt fine since.

Watching her mother go through the health crisis affirmed her decision to go into primary care. She also enjoys being "the point person" for her patients.

"You become so close to them you're almost like a family friend," said Dunne, who completed her residency at Chicago's Northwestern Memorial Hospital in July.

She also found inspiration from the doctors she met during training: "They were the ones who would sit at a patient's bedside and spend more time with them rather than running off to surgery."

A separate study in JAMA suggests graduates from international medical schools are filling the primary care gap.

About 2,600 fewer U.S. doctors were training in primary care specialties — including pediatrics, family medicine and internal medicine — in 2007 compared with 2002. In the same span, the number of foreign graduates pursuing those careers rose by nearly 3,300.
"Primary care is holding steady but only because of international medical school graduates," said Edward Salsberg of the Association of American Medical Colleges, a co-author of the study. "And holding steady in numbers is probably not sufficient when the population is growing and aging."
And as American students lose interest, teaching hospitals will probably become less interested in offering primary care programs, said Dr. David Goodman, associate director of the Center for Health Policy Research at Dartmouth Medical School.
In a JAMA editorial, Goodman called on Congress to create a permanent regulatory commission to encourage training for needed specialties. U.S. teaching hospitals now receive $10 billion a year from the government to train doctors "with virtually no accountability," he said.
The coordinated care provided by primary care doctors can keep costs down by preventing harmful drug interactions, unneeded medical procedures and fragmented specialty care, Goodman said.
The Web-based survey was done at 11 medical schools with demographics and training choices similar to all U.S. medical students.

High Heels for Tots?

2008-09-13T13:45:00.000-07:00

Debate afoot over high heels for tots - Parenting & Family - MSNBC.com 1:14pm

Source: www.msnbc.msn.com

Some people are getting a big kick out of an emerging fashion trend for babies — high heel crib shoes for girls too young to walk. Others are certain it’s yet another sign that the republic really is going to perdition in a handbasket. ( See full story)

Creepy? How about unhealthy, neurotic, bordering on the ancient Chinese foot binding practice long since discontinued. How about crazy wrong! Where is this type of thinking originating from? Mothers competing to make a fashion statement and using their babies to do it. I liked it better when they just carried around ridiculously small dogs or sub dogs or whateever.

Ladies of the "The View" Fire with Both Barrels - Candidate McCain

2008-09-12T12:59:00.000-07:00

McCain Gets an Earful on 'The View' | The Trail | washingtonpost.com 12:29pm

Source: voices.washingtonpos...

McCain says Palin never sought earmarks from Congress as governor of Alaska, even though she asked for about $200 million for projects in her state.

Aye we witches three...bubble, bubble, toil, and trouble...The ladies of the view call out McCain on bold face campaign deceptions. To his face. I know! Yes they did! Republicans continue to lie in the face of video and other evidence to the contrary but I haven't seen the candidate confronted before like these strong women did on the view .

Palin is an "American Idol" like Candidate

2008-09-11T23:47:00.000-07:00

Holy Moses! I never thought I would read one of the most clear and concise explanations of the "Palin Phenomenon" from a movie critic but here it is. Ebert catches what her appeal is and demystifies it to arrive at the best conclusion on what to do about her candidacy and why. Pick smart leaders people! Vote for the smart one! Not the good looking one. Not the one that's like you unless you are White House executive material and if you think you are then what are you doing reading this, run for something. Vote for the one who has had a opinion for a period longer that 4 weeks! Dr Edgar Abbes, DPM

Roger Ebert on Sarah Palin: The American Idol candidate

suntimes.com

Made Popular: 8 hours ago - I don't want a vice president who is darned near good enough. I want a vice president who is better, wiser, well-traveled, has met world leaders, who three months ago had an opinion on Iraq. Someone who doesn't repeat bald- faced lies about earmarks and the Bridge to Nowhere.

» Full Story on suntimes.com

Gov't officials probed about illicit sex, gifts

2008-09-10T13:23:00.000-07:00

Oh. I'm lovin' this story about our wonderful moral and religious administration and the one that wants to "drill, drill, drill'. Just not sure what they want to drill exactly or should I say who they want to drill.

&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;br&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;

Gov't officials probed about illicit sex, gifts from Associated Press

Science Fiction & Social Commentary - Planet Wa Ha Loop

2008-09-07T20:28:00.000-07:00

For those of you who have never consumed science fiction in any of its many forms, let me allow you in on a little device the writers of science fiction have for a long time employed. They have known, for a long time now, that they could make social commentary more palatable, skirt public criticism or even being hanged depending on the era, and avoid censorship while reaching a broader if unsuspecting audience by setting their story in a fictional setting. The more remote and outlandish the less the audience suspected that the underlying message was being gently passed on to them.

To the reader or viewer the normally hotly debated or outright banned issues could be presented in a distant "galaxy far, far, away" or "where no man has gone before" suddenly become palatable by the suspension of disbelief we all submit too when reading a story or watching a movie.

Its kind of like when you ask someone an embarrassing question and cloak in with the "Its not for me doctor, but I have a friend who has this unspeakable rash what should he do?"

"Well, he should take this medication and if he were here I would give him this prescription."

"Oh, well, if you give it to me I'll be sure he gets it."

At the risk of sounding sexist I know that most of the women, with exceptions like the phenomenal Felicia Day (feliciaday.com) in the audience have tuned out by now, but we will press on despite this.

Notable examples have been seen in literature and movies alike. 'The Day the Earth Stood Still', (the remake starring Keanu Reeves soon to be released) more recently 'Idiocracy" multiple Star Trek episodes, novels like HG Wells 'The Time Machine" just to mention a few.

One which I'm sure exemplifies what I am getting at and I'm sure all will agree is a classic example is seen in the TV episode of Star Trek, " Let That Be Your Last Battlefield" when the crew encounters two hated adversaries locked in an eternal chase and mortal combat, being equally match neither ever seems to get an advant age. When asked why they continue t o battle and not try to settle their differences and why they hate each other so much each reply: "Well, look at him he's not like me. I mean he's half black and half white, whereas I am half white and half black." The characters were in fact made up one with the left side black and the right side white and the other with the left side white and the right side of his face white! Classically obvious to all was how silly their distinction was.

So, please suspend your disbelief and indulge in the following original tale of fiction written by me. Look for the underlying social commentary.

(story under construction. please check back later)

Medical Pricing. How Do Doctors Arrive At Those Large Charges You See On Your Bill.

2008-09-06T15:04:00.000-07:00

I mostly, agree with this writer, but I did not like his spin on the burden that reporting actual expenses would place on doctors. He seems to imply that it should be no big deal to turn overt this information. I beg to differ. Have you ever peaked into the private office space in your doctors clinic? If you have you can atest to the piles of charts and records requests and letters to and from insurance copanies that your eyes will be assailed by.

It should be noted that most doctors offices cannot be run like a Costco or a Walmart with sophistcated wireless inentory tracking, laser read bar coding, custom software designed specifically for each task, army of accountants, and large underpaid staff. Solo practitioners and small doctors groups simply cannot afford this expense and don't use this approach. Large medical groups and hospitals do and, hence have higher fees to cover the hundreds of thousands of dollars it takes to implement these strategies.

In addition the amount that an insurance agrees to pay the doctor, usually pre negotiated, is proported to have been derived by factoring in the doctors ancillary costs, however, one cost that is never factored in by these corporate giants is the expense doctors incur to collect thier money from the insurance companies. Delaying payments to doctors with a cornicopia of non payment strategies from "We never recieved a bill. Please resubmit.", "We need medical records to evaluate this fee." (For an ingrown nail? Please! This is tantamount to "I'll need a written request as to why you want to buy this hamburger before we can serve it to you, Mr. Abbes. Oh yeah, and after we get the written request, we still might not give you the hamburger or it may arrive within the next serveral months" Right!), to "We never recieved the medical records you sent. Please resubmit them". Don't believe me? Talk with your doctors and see if they don't share this experience as well. It is not unusual to recieve a payment for a service performed over 12 months ago. To assasinate the metaphor: It would be like eating a hamburger at McDonalds and paying McDonals for it one year later! (I'm sure they'll let you do that. Or not!)

In addition I should add that a consultation and an office visit have two different prices. If your doctor sends you to a specialist, he expects a lengthy report and recommendations sent to him by the specialist. For this reason a consult is more expensive than an office visit, generally. In addition most doctors of a lesser God charge between 250 - 500 for a consult, but you had to see the nice UCLA doctor. Andalé pues! Pay up Gringo! Don't you think his rent and UCLA pedigree cost him (or should I say his Republican parents) more?

Below article from the L. A. Times:

Medical pricing makes the head spin

"It began with a dizzy spell. Before long, though, what really had my head spinning was the inscrutable way that healthcare providers and insurers put a dollar value on medical services -- and how that leaves patients unable to determine a fair price for any treatment.

I woke up about a month ago with my bedroom feeling like the Mad Hatter's teacup ride at Disneyland. The sensation left me sick to my stomach and basically useless for hours.

My endocrinologist at UCLA's Gonda (Goldschmied) Diabetes Center advised me to speak with an ear, nose and throat specialist, and I booked an appointment with a physician whose office was down the hall.

The consultation went like this: We chatted for a few minutes, then he held me at awkward angles several times and promptly diagnosed me with benign positional vertigo -- a tendency to get dizzy if my head is in a certain position.

This took 20 minutes. The doctor performed no fancy tests or procedures. He prescribed no medication.

Last week I received a statement from my insurer, Blue Cross of Illinois, informing me that the doctor had billed $975 for the visit. The statement also said Blue Cross was paying just $243.64.

I contacted Anthem Blue Cross, which handles its Illinois counterpart's business in California, and asked if I was responsible for the outstanding $731.36.

"Oh, don't worry about that," a service rep cheerfully replied. "Because of our contract with them, the provider is writing that off."

So, was the treatment I received worth nearly $1,000, as the doctor apparently believed, or just a quarter of that amount, as Blue Cross had concluded? How can the provider and the insurer be so far apart in pricing a fairly routine medical service?

"It's a Byzantine system," said Jim Lott, executive vice president of the Hospital Assn. of Southern California. "There's no question about that."

Peggy Hinz, a spokeswoman for Anthem Blue Cross, said the insurer "relies on the latest medical pricing data and experts in the field" to determine how much it will pay for specific services.

"We always strive to reimburse a fair amount based on a provider's cost and based on what is reimbursed to other providers for like services," she said.

The ear, nose and throat specialist declined to discuss specifics of his billing. He said only that he had nothing to do with setting prices for his practice or negotiating contract terms with insurers.

Lott at the hospital association, which represents UCLA and about 170 other medical facilities, said patients are wrong to think that the charge on their bill reflects the actual cost of treatment.

Rather, he said, hospitals use a "cost-plus" system by which charges include both the cost of a service and a portion of general overhead, including treatment of uninsured people who can't afford the provider's cost-plus prices.

At the same time, insurance companies, along with state and federal authorities representing Medi-Cal and Medicare members, negotiate lower rates in return for delivering thousands of patients to a particular clinic or hospital.

The upshot is that providers are overcharging insured patients because they have no other way of meeting total expenses, while insurers are paying significantly less than the billed amount because they know they're being hit up for unrelated costs.

Insurers' underpayments, in turn, only force providers to increase bills even more. It's a system that both condones and perpetuates inflation while all but eliminating transparency in the marketplace.

It also spells doom for the 45 million Americans lacking health coverage, who have no choice but to pay the full amount of a hospital's cost-plus charges and thus can be wiped out financially by a major medical problem.

"Healthcare is the one sector where market mechanisms work least," said Peter Lindert, an economics professor at UC Davis who specializes in public-health issues. "Prices are whatever you can get away with."

As my colleague Jordan Rau reported last week, state lawmakers managed to pass some bills in the latest session that address healthcare problems but came up well short of their goal of reforming the system to make it friendlier -- and more accessible -- to patients.

Among legislation torpedoed by lobbyists for doctors and hospitals was a bill that would have given the state new powers to collect information on prices charged by healthcare providers.

Support for the bill dwindled after lobbyists managed to exempt doctors from the reporting requirement and inserted language recognizing the "tremendous burden" that revealing actual costs would be for providers.

Score that a win for the status quo and a setback for anyone who thinks healthcare costs are out of control.

"We are rapidly approaching a time where important policy discussions are going to have to be had on this issue," said Santiago Munoz, associate vice president of clinical services development in the UC president's office.

No, we're there already. What's needed is a massive infusion of political courage to tackle genuine healthcare reform.

No telling what that would cost, though.

Consumer Confidential runs Wednesday and Sundays. Send your tips or feedback to david.lazarus@latimes.com. "

----------------
Now playing: The Jon Spencer Blues Explosion - Can't Stop
via FoxyTunes

Broker Fired Over Health Insurance Bundling

2008-09-06T00:52:00.000-07:00

Oh I love this story. Please read it. It points, again, to the disingenuous nature of the medical insurance industry. It tells the tale of insurance broker fired by Blue Shield of California for selling plans that would reduce costs to employers while keeping coverage to employees. click this link for original article : State Department of Insurance is investigating the termination.

Why Medical Insurance Is Only A Discount And Not Insurance

2008-09-04T17:16:00.000-07:00

Medical Insurance Is Becoming a Discount Plan And Not An Insurance Plan

(There is supposed to be a difference. Please see the Federal Trade Commission consumer alert for their warning and advice by clicking this link: FTC Consumer Alert)

I have been saying this for years now. The list of medical insurance woes is a very long interweaving laundry list with historical nuances and beyond a short blog post. It is the story of multiple books since its complex and compound details simply cannot be confined to just a few. Bearing this in mind, however, lets just take a quick jaunt through some salient and some recent developments that have come to the battlefront and stirred considerable political debate. Lets pull back the curtain and let me give you a bit of the benefit of my 21 years of industry exposure from a Podiatrists perspective, from an admittedly anecdotal view, and via the application of simple deductive analysis, i.e. common sense.

Medical insurance is quickly becoming a discount plan and not real insurance in the sense that we have all grown accustomed too. A recent article in the AP news wire service quotes a recent study that forecasts deductibles, co-payments, and out of pocket expenses will rise again next year. That means you the patient pay more of the share of the cost and the insurance company pays less. However your insurance bill will not go down. I don't know how the insurance companies continue to get away with increasing the cost on both sides of the balance sheet while reducing what they pay doctors and hospitals to the point where many hospitals, emergency rooms, and doctors are going out of business. In the face of this the insurance companies have reported record profits until this year! ("WellPoint Boosts Premiums to Bolster Profits") It seems that bleeding your clients dry in the face of decreasing job market, increased energy costs, and increasingly undertreated epidemic chronic diseases is not a good strategy. You just don't kill the cow if you want to get any milk.

While some relief of suspect health insurance company reimbursement practices is finally coming to California from Sacramento lawmakers it is certainly too little and certainly too late for many.

"The Legislature's major healthcare accomplishments involved several high-profile, though relatively uncommon, practices that afflict consumers and patients. Lawmakers agreed to stop insurers from retroactively canceling policies of sick customers..."

"Legislators also voted to require insurers to spend at least 85% of the premiums they collect on medical care rather than overhead and profits. If signed by Schwarzenegger, that measure could turn out to be the nation's most stringent, although there are doubts that it will lead to lower premiums. In addition, lawmakers decided that insurers must pay for maternity care , orthodontics cleft palate treatment and the purchase of medical equipment such as wheelchairs ."

These changes appear to this observer as hardly earth shattering. If anything they are common sense changes that should have been enacted long ago. Good God I think that my health insurance should spend more than a mere 85% of what they get to take care of the sick. If anything why is there a limit at all. Ah yes, of course profit. And the almighty profit is worth more that the health of your mother, or sister, or daughter. Sure that makes sense. (cyniscism and snarkiness borrowed from Republic National Convention) Pay for a wheelchair! I'll bet you thought that was a given. Surprise, its not! (Limp or crawl home if you can't afford one or beat up that week retard down the street and take his wheelchair. Great.)

All of the measures await action by the governor, who has until Sept. 30 to sign or veto bills from this session.

It is not unusual for a patient to visit my office, have a bill sent to their insurance company for the $65 office visit, the insurance pays me, the doctor, $9.00, and the patient is liable for the remaining $45, with an $11 negotiated discount for seeing a participating provider in your insurance plan. It is also common for a patient to present to my office and pay a $35 or $45 co-payment at the time of visit and after sending the bill to the insurance company for $65 they, the insurance company, pay $ 1-10 (Or even less. I have seen checks in the amounts of 0.40 cents. Don't believe me? Ask your doctor. E-mail Dr Sanjay Gupta if you please. Click here for Dr. Gupta's Blog) This means you pay $45 they pay $5 or $10 dollars for a visit to the doctor that costs $65. All this, while you send them $500 to $800 a month for what they call health insurance. That's not insurance my friends that's a medical discount card.

The average income of a family practice doctor is around $180,000 a year. No joke. Although that seems like a decent wage in comparison to other jobs, the years of study and the average student loan debt of over $150, 000 (mine was closer to $200,000 and the average Podiatrist income in Los Angeles is placed at some at around $ 150,000) incurred by doctors it may not be so attractive. I have met sales reps making the same amount and never had to endure the long years of study and student loan debt. Article after article has been written about and by doctors sharing their discontent but more importantly students are being deterred from studying medicine, especially family care, as a result of these dissincentives. Why should they toil taking difficult pre-med courses in college, struggle through difficult medical school programs, suffer long hours in residency and internships, and incur great debt only to struggle to make ends meet and under the pressure of mountains of debt for years? It is much shorter and easier for the these intelletuals in our society to pursue some other mor profitable venture. The result doctor shortages while an increase in patients due to the aging baby boomer population will create medical care crisis already being felt in parts of Canada and discussed with respect to Medicare costs.

"American health care is now largely delivered via a government-subsidized private health insurance industry operating parallel to and within Medicare. A recent nationwide poll of physicians published in the Annals of Internal Medicine utilizing the AMA physician database demonstrated that 60 percent of doctors support a single-payer national health plan based on the most efficient and effective Medicare system.

This national health plan currently before Congress (HR 676) would provide medical care and low-cost prescription drugs to all Americans - including the 47 million uninsured and 50 million underinsured citizens - while maintaining the private-practice quality of physicians, hospitals, clinics and therapists.

The lower overhead costs of the most efficient Medicare insurance plan, which already treats more than 40 million people, would provide substantial cost savings to all Americans and businesses while maintaining quality private physician practices and hospitals. A majority of physicians in this country can't be wrong in their support of a single-payer national health insurance plan such as HR 676. - HOWARD A. GREEN, M.D."

Watch actual persons tell their story of medical insurance woes in person in an AARP TV Ad Campaign which hits the nail on the head by clicking on this link. Unless you are a human with a reptile nervous center you will be moved by these true stories (requires flash palyer)

(Blue and underlined words indicate a link to a source article or video, double click to view these. Quotes are in italics.)

Ghosts of Katrina use Gustav to get Payback on Republicans

2008-09-01T12:57:00.000-07:00

The ghosts of the dead from Katrina may be speaking to the Republicans thru Gustav. I can't wait to see if the evangelists will say that God sent Gustav to cleanse like they did when Katrina hit. This time it seems that God has sent Gustav to disrupt the Republican National Convention which will shorten its schedule to 4 days and has had speeches by Bush and Cheney cancelled! Perhaps Bill Clinton was prophetic when he said that Barack Obama would win the presidential election because he "has history on his side."

Newsflash McCain orders convention curtailed for Gustav - The Ghost of Katrina?

2008-08-31T14:32:00.000-07:00

I find it completely fitting and apropos that the Republican National Convention is being delayed by a Hurricane. The ghost of hurricane Katrina? Almost as if in retaliation for the seemingly laissez faire attitude in the handling of Hurricane Katrina disaster. "Browny, you're doing a good job" Indeed!

Text of Sen. Barack Obama's speech

2008-08-29T13:39:00.000-07:00

From the Los Angeles Times

August 28, 2008
Sen. Barack Obama's speech

Full Speech Text Here

My favorite part of Obama's speech, shown below, is where he addresses the evils of the health insurance companies from first hand experience. Those of you who have had to deal with these uncaring corporations either as an insured or as a doctor trying to collect from them or trying to get them to authorize treatments for you patients, you know what he is talking about! And, soon, everyone will know not just Michael Moore

"Now is the time to finally keep the promise of affordable, accessible health care for every single American. If you have health care, my plan will lower your premiums. If you don't, you'll be able to get the same kind of coverage that members of Congress give themselves. And as someone who watched my mother argue with insurance companies while she lay in bed dying of cancer, I will make certain those companies stop discriminating against those who are sick and need care the most." - B. Obama

Lake Elsinore 2008

2008-08-25T00:31:00.000-07:00

Comic Touch: Yee Haw!

2008-08-22T12:30:00.001-07:00

Comic Touch: Yee Haw!
Originally uploaded by rx4feet

Dominican Day Celebration featuring Dr Camilo Jorge

2008-08-22T10:41:00.001-07:00

Dominican Day Celebration featuring Dr Camilo Jorge
Originally uploaded by rx4feet

Anaheim High School Reunion get the book

2008-08-07T11:39:00.000-07:00

Anaheim High S...

Thirty Year Reunio...

By Photos by Dr. E A ...

Book Preview

Anaheim High School Class of 1978 30 Year Class Reunion

2008-08-03T15:59:00.000-07:00

View photos, add, download, forward the link to your friends at: Class of 1978 30 year reunion photos

Anaheim High School Class of 1978 Reunion

Something Less Painful, more techy, nerdy, geeky, horrble, but FUN: Dr. Horrible's Sing along Blog!!!!!!

2008-07-29T01:16:00.000-07:00

The Last Lecture

2008-07-26T13:19:00.000-07:00

Watch the full lecture at Carnegie Mellon University in California here: Achieving Your Childhood Dreams

4th of July on any street in Garden Grove, CA

2008-07-05T00:14:00.000-07:00

Life's a ...well you get it.

2008-06-06T23:42:00.000-07:00

I took the picture but nature made the cherries. Yes, they were quite tasty and no surprise to me, quite addictive. In the sense, that is, that you can't eat just one. It just seems that since every cherry is different, I kept eating until I would get that one cherry that was just tart and sweet in the right proportions to send my taste buds and salivary glands into overdrive and cherry Nirvana. Then, naturally, the next cherry would be a disappointment, not giving me that sensory high that I, by now, craved. All ends well, however, when by the end of the bowl I feel satiated and not overindulged. Thank you mother nature!

R.A.M.O.N.E.S for President!

2008-05-19T22:53:00.000-07:00

Another Reason to Hate the French? No!

2008-05-10T21:42:00.000-07:00

Power Words or A Window

2008-04-06T14:53:00.001-07:00

"From My Cold Dead Hand!" Heston passes at 84.

2008-04-05T21:33:00.000-07:00

You Maniacs! You blew it up! Ah, damn you! God damn you all to hell! ....

Si, Se Puede! Yes, We Can

2008-02-08T23:42:00.001-08:00

Its Christmas Again!

2007-12-23T17:06:00.000-08:00

Golden West JC Wins Southern California Waterpolo Championship

2007-11-16T13:30:00.000-08:00

Golden West College Aquatics - Water Polo Tourniment

2007-09-09T20:08:00.000-07:00

The Beach Heats Up

2007-07-17T19:43:00.000-07:00

The tan eye candy was out in force on the beach in early July. Huntington Beach, CA.

Flag Day

2007-06-16T00:42:00.000-07:00

Yesterday was flag day and the price of premium at this Anaheim, CA gas station is seen here.

Bus Stops, Garden Grove, CA

2007-04-23T19:46:00.000-07:00

Pardon Me Sir, Do You Have Any Grey Poupon?

2007-04-22T01:01:00.000-07:00

I took this photo today while stopped at a traffic light. This big hound gets a little air as he rides down Newland St heading south near Huntington Beach, California. He did it with such an air of regality that I felt he would next turn to me and ask: Pardon me sir, but do you have any Grey Poupon.

Eerie Sunset

2007-04-19T19:17:00.000-07:00

And just one more shot of that eerie sunset as my tribute to the same.

2007-04-19T19:02:00.000-07:00

On April 19th the flag at Paramount City Hall flies at half mast in deference to the fallen.

2007-04-16T23:28:00.000-07:00

Here's a photo of my father, who was instrumental my appreciation of photography by lending me his Nikon FTN camera when I was a teenager, taking a photo. This is one of my favorites of those we took last Sunday at Huntington Beach, California (April 2007)

Exam Room One: Next!

Long Beach, no doubt.

The great outback

Number 9...

Pick up stix

Broke as a Joke

35mm film container

Magnify

Across from King Taco

As I awoke

Doc Park

MRI

OR

Myself

Sky at Jumpa Thai

2000 Yamaha WaveRunner for Sale 0002

Health Care Premiums Soar as Coverage Shrinks

Health Care Premiums Soar as Coverage Shrinks

Cheryl Senter for The New York Times

Related

House Votes to Help Small Businesses Comply With Health Bill, but Relief Is Held Up (March 4, 2011)

Cheryl Senter for The New York Times

Readers' Comments

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RIP MJ -"I'll be your everything, If you make me a Star!"

Podiatry Services, Mental Health Care Cut from Medi -Cal

Shortage of Doctors- As I have been saying:

Podiatrist, Camera, Flowers, Smithsonian!

Recession Starts to Take Toll on Medical Field Too

Erasing TB could take 1,000 years, official says

Fear Of Reform or Sphincters Tightening At Insurance Company Boardrooms Across America

TB Does Not Discriminate Unlike Racists.

Bernanke Expresses Frustration Over AIG Abuse of System

I know they are gearing up for a fight as we speak. My message to them is this: "So Am I!"

Geologist Erupts at Jindal's Volcano Question - Science News | Science & Technology | Technology News

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Reuters - Health spending takes rising share of U.S. economy

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My Favorite from Fark.com

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Countdown to the Real United States of America: Applies to Pro America sections too!

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The Next Big Financial Crisis: Health Care

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High Heels for Tots?

Ladies of the "The View" Fire with Both Barrels - Candidate McCain

Palin is an "American Idol" like Candidate

Roger Ebert on Sarah Palin: The American Idol candidate

Gov't officials probed about illicit sex, gifts

Science Fiction & Social Commentary - Planet Wa Ha Loop

Medical Pricing. How Do Doctors Arrive At Those Large Charges You See On Your Bill.

Medical pricing makes the head spin