Interesting article in the NY TImes about a pilot project centered around a medical home concept.  The idea being that the insurers would reimburse family practice and primary care practicioners to actively manage their chronically ill patients at a higher level and the docs would also receive a subsidy to bring their office technology up to speed. 

Recently, the House overwhelmingly passed a bill to hold off on the scheduled 10 percent cuts in Medicare premiums.  The Senate voted on it, and the bill failed to pass.  All the Republicans lined up behind Bush, who had promised to veto the bill.

Harry Reid decided to stick it to the Republicans by not bringing the bill back for a vote until after the July 4th holiday.  That means the cuts will go into effect July 1.  

Now... you must be wondering why Bush is threatening to veto the bill.  Does he have something against docs? I don't think so.  Hmmmm.   If you look at the bill and where the spending would have come from it becomes all too clear.  Bush is once again siding with his corporate cronies  in part because it would reduce federal payments to private Medicare Advantage plans, offered by insurers like Humana, UnitedHealth and Blue Cross and Blue Shield companies.   So rather than help seniors by ensuring they will be able to see a doctor with Medicare as their sole coverage, or doctors who face rising liability assoc costs and rising office costs ---in the face of diminishing reimbursement----Bush sides with his buddies.  How predictable!!!!

 Now... will docs drop Medicare ?????

This will be a very interesting few weeks.   

 

[I]t’s simpler to change behavior than attitudes,” Kahn writes. In other words, we won’t get all doctors to respect their patients, but maybe we can get them to act like they do.

 A little bit of etiquette can go a very long way to allay fears and make a hospital stay a tad more "comfortable." Our patients are the ones who are "suffering",---our misery with the state of the healtcare system or our local politics, etc should not affect how we relate to our patients.  They deserve a caring, polite and respectful professional to greet them every day.   

Grounded in research at the Dartmouth Medical School, slow medicine encourages physicians to put on the brakes when considering care that may have high risks and limited rewards for the elderly, and it educates patients and families how to push back against emergency room trips and hospitalizations designed for those with treatable illnesses, not the inevitable erosion of advanced age.

 Nice article in the NY Times today regarding end of life care.... 

I applaud the efforts of the Dartmouth medical community and the folks at the hospice and nursing homes in their catchment area.  Elder care and the money we waste to delay the inevitable consumes an enormous percentage of every health care dollar.  It is obvious now that proper education and a shared decision process can make the entire end of life process more humane.   It also allows the person/patient to maintain their dignity while giving the family and caregivers an active role in the process.   

 

A nice review by the NY Times on the benefits of exercise.  It certainly makes it seem like no one has a choice of whether or not they can or should exercise. 

Cmon.... turn off the computer and go outside !!!