The DJP Update

DJP Update 2-25-2010 p.m. edition Health Summit – opinions from various sources; LAGNIAPPE: Former Astronaut Dr. James P. Bagian joins The Doctors Company (TDC) board

Here are selected quotes from the Senate_GOP, Washington Post, and Senate Democrats, and more PLUS a link to the tweets #hcr and #healthsummit

Republican selection of quotes from the news:

http://republican.senate.gov/public/index.cfm?FuseAction=Blogs.View&Blog_ID=51c7d4ac-bb81-44eb-8022-6ada4a581ba9&Month=2&Year=2010

WHAT THEY ARE SAYING ABOUT THE HEALTH CARE SUMMIT

“Republicans Certainly Showed Up Ready To Play” “Came In With A Plan,” “The Best Day They Have Had In Years,” “Strong Day”

CNN’S DAVID GERGEN: “Intellectually, The Republicans Had The Best Day They’ve Had In Years. The Best Day They Have Had In Years.” (CNN’s “The Situation Room,” 2/25/10)

· CNN’s DAVID GERGEN: “The Folks In The White House Just Must Be Kicking Themselves Right Now. They thought that coming out of Baltimore when the President went in and was mesmerizing and commanding in front of the House Republicans that he could do that again here today. That would revive health care and would change the public opinion about their health care bill and they can go on to victory. Just the opposite has happened.” (CNN’s “Live,” 2/25/10)

NPR’S MARA LIASSON: “I Think That The Republicans Made Their Arguments Very Well.” (Fox News, 2/25/10)

CNN’S WOLF BLITZER: “It Looks Like The Republicans Certainly Showed Up Ready To Play.” (CNN’s “Live,” 2/25/10)

· CNN’S WOLF BLITZER: “And The Republicans Had Less Speaking Time, But They Took Full Advantage Of Every Minute They Had.” (CNN’s “The Situation Room,” 2/25/10)

THE HILL’S A.B. STODDARD: “I Think We Need To Start Out By Acknowledging Republicans Brought Their ‘A Team.’ They had doctors knowledgeable about the system, they brought substance to the table, and they, I thought, expressed interest in the reform. I thought in the lecture from Senator John McCain and on the issue of transparency, I thought today the Democrats were pretty much on their knees.” (Fox News’ “Live,” 2/25/10)

CNN’s GLORIA BORGER: “The Republicans Have Been Very Effective Today. They Really Did Come To Play. They Were Very Smart.” (CNN’s “Live,” 2/25/10)

· BORGER: “They took on the substance of a very complex issue. … But they really stuck to the substance of this issue and tried to get to the heart of it and I think did a very good job.” (CNN’s “Live,” 2/25/10)

· BORGER: “They came in with a plan. They mapped it out.” (CNN’s “Live,” 2/25/10)

POLITICO: “By The Afternoon, However, Both Sides Took A More Substantive Approach That Played To The Republicans’ Benefit, given Democratic attempts to portray them as unreasonable and partisan.” (“Six Hours Later, Stalemate Remains,” Politico, 2/25/10)

FOX NEWS’ CHARLES KRAUTHAMMER: “The Republicans Really Helped Themselves. The argument against them, it’s the party of no, they have no ideas, they are against anything, they’re nihilists. In fact, they spent seven hours, I think, presenting a very strong case. They’re knowledgeable. They have ideas. They are interested in reform, but they have differences. Lamar Alexander was dazzling, Paul Ryan was rapier sharp in rebutting all of the smoke and mirrors that the democrats had presented.” (Fox News, 2/25/10)

JAMES CARVILLE: “First, In General, You’d Have To Say, By The Most Part Most Of These People Were Pretty Knowledgeable, They Had Done Their Homework … I Thought That Senator Alexander And Senator Coburn Did Great…” (CNN’s “The Situation Room,” 2/25/10)

FOX NEWS’ BRET BAIER: “Republicans Had A Strong Day Making Their Points.” (Fox News’ “Live,” 2/25/10)

WASHINGTON POST’S MICHAEL GERSON: “The Democrats’ Health-Care Ambush Failed”(Michael Gerson, Op-Ed, “The Democrats’ Health-Care Ambush Failed,” The Washington Post, 2/25/10)

———-

Washington Post

http://voices.washingtonpost.com/thefix/white-house/winners-and-losers-from-the-he.html?hpid=topnews

After spending our day watching the high-stakes or, at the very least, high-profile health care summit at Blair House, we came up with a list of our winners and losers from the proceedings.

Those who we think soared and bored are below. Have your own thoughts? The comments section is open for business.

WINNERS

Tom Coburn: The Oklahoma senator is among the most conservative voices in Congress but his remarks emerged as a — rare — rallying point during the day. Coburn’s comments on the necessity of eliminating waste and fraud from the health care system drew nods from the president and kudos from a handful of Democratic and Republican politicians gathered at Blair House. In a room dominated by politicians trying to score political points or vamp for the cameras, Coburn stood out.

President Obama: Did the president solve the problem of passing a health care bill today? No. But, there was never a reasonable expectation on either side that he would. What Obama did do was paint himself — for anyone who was watching — as someone genuinely interested in compromise and genuinely interested in engaging with his Republican colleagues. (Whether that was a facade or the real thing remains a major point of debate between partisans.) Obama also didn’t let Republicans run rough-shod over him either. He clashed with Sens.Lamar Alexander (Tenn.) and John McCain (Ariz.) — showing a feistiness (albeit a measured feistiness) that is likely to be well received by the party’s base. Obama’s performance saved, to our mind, what could have been a disastrous day for his party as he got relatively little help from his party’s representatives in Congress throughout the day.

Process: While President Obama sought repeatedly to keep the focus on future-oriented policy solutions, the discussion repeatedly devolved into process. Sen. John McCain (Ariz.) dedicated the majority of his remarks to detailing the deals cut during the health care debate while Senate Majority Leader Harry Reid (Nev.) spent much of his time defending the idea of reconciliation to pass major measures of the bill. Senate Minority Leader Mitch McConnell (Ky.) even brought process to the Blair House discussion — noting that Democrats had been given more time to talk than Republicans. (Obama shot back that he had not counted to his own speaking time in the total since he is the president.) The more process coverage, the worse for Democrats who have been hamstrung to date by the focus on how the bill becomes a law rather than the policy guts of the proposal.

The Senate: There was roughly an equal number of House and Senate members gathered at Blair House but it felt very much like a debate between senators. With the exception of Rep. Paul Ryan (R-Wis.) — the GOP’s dedicated policy guy — there was very little serious engagement in the talks from the House side.

Paul Ryan: Speaking of the Wisconsin Republican, it was clear that the president regards him as a serious thinker and adversary while his GOP colleagues often deferred to him on matters of health care and budget policy. Ryan helped burnish his credentials a rising star within the Republican party; he was partisan but drove his attacks using data rather than pure political rhetoric.

C-SPAN: What a day for the Fix’s favorite television network. Full coverage of the summit as well as a flawless Internet feed for those not close to a television. Well done.

LOSERS

Harry Reid: Reid is the consummate behind the scenes player. And, today he reminded us again of why. Reid, who spoke within the summit’s first hour, was extremely combative — a tone that seemed out of step with the overall tenor of the meeting in which most attendees tried to pay at least lip service to the idea of bipartisanship before launching into the attacks. Not Reid. “Let’s make sure we talk about facts,” Reid scolded Sen. Lamar Alexander (R-Tenn.). Later, he interrupted Coburn and said the Oklahoma Senator was trying to “filibuster.”

John McCain: From the start of his remarks around mid-day, McCain seemed on the verge of losing his temper and threw several rhetorical jabs (including one about Obama breaking his campaign promise about holding the health care hearings on C-SPAN) into his speech. (“We’re not campaigning anymore,” Obama shot back at McCain. “The election is over.”) Later, McCain hit Obama again for the special carve out for Florida in the health care bill. Obama agreed with the McCain critique, a move that caught the Arizona Republican off guard and left him speechless. In truth, McCain’s target audience today was not people in the room or the national media but rather conservative Republicans in his home state — the people he needs to beat back a challenge from his ideological right from former Rep. J.D. Hayworth.

Genuine Discussion: With a few exceptions, the bulk of the summit — not surprisingly — was focused on the rehashing of talking points rather than a serious engagement on the issues. Obama repeatedly attempted to keep speakers (of both parties) on topic but the conversation felt like politicians talking at — rather than to — one another. The idea of a serious policy debate was probably sacrificed the moment the summit was televised. But, it was jarring to watch what was purported to be a discussion devolve into a series of (semi)connected stump speeches.

Public Option: House Speaker Nancy Pelosi (Calif.) and House Majority Leader Steny Hoyer (Md.) were the only ones to mention the issue that dominated the health care debate for months on end last fall — and that was in the context of it being sacrificed as a compromise to Republicans. And, as Fix colleague Alec MacGillis pointed out, Obama was very careful to emphasize that people shopping for coverage on the new health insurance exchanges he is proposing would be choosing only among ‘private plans.'”

Cable Networks: With the exception of the Obama-McCain tête à têete, the day was largely devoid of the sort of made-for-TV moments that help drive ratings.

By Chris Cillizza | February 25, 2010; 5:21 PM ET

Senate_GOPs Tweet:

Final #hcrsummit talk tallies: Dems and Obama: 233 minutes; GOP: 110 minutes http://bit.ly/ag6jv0 #tcot #sgp

Senate Democrats statement of Senator Reid: http://democrats.senate.gov/newsroom/record.cfm?id=322570&

February 25, 2010

Reid Statement On White House Health Summit

Washington, DC— Nevada Senator Harry Reid released the following statement at the conclusion of the bipartisan, bicameral White House Health Reform Summit today:

“Today’s meeting was an important exchange that allowed the American people to hear different ideas and I applaud the President for bringing us together. Health reform is not about process or sound bites; it’s about real people like Jesús Gutierrez in Reno who struggle with a health system that too often stands between them and the care they need and deserve. Ideological differences will always exist, but unless we act health care costs will continue to skyrocket and thousands of Americans will continue to lose their coverage or be denied treatment every day.

“I still believe that we can work together and am hopeful that we reach the bipartisan solution to health reform that we’ve always preferred. We are serious about delivering meaningful health reform to the American people, and all options remain on the table to accomplish that.”

———–

To see the tweets happening this very moment, go to Google and type in #hcr

or

#healthsummit

and then scroll down to the tweets and click on that. Here is the URL for one.

Example: http://www.google.com/search?q=%23healthsummit+site%3Atwitter.com&tbs=mbl:1&tbo=1&hl=en&client=safari&rls=en&sa=X&ei=nS-HS7_pKMeNlAeZkdTPAQ&ved=0CCMQsQcwCA

——–

AP at Yahoo News:

Excerpt: http://news.yahoo.com/s/ap/20100225/ap_on_bi_ge/us_health_care_overhaul

By RICARDO ALONSO-ZALDIVAR and JENNIFER LOVEN, Associated Press Writers – Thu Feb 25, 6:23 pm ET

WASHINGTON – After a day of debate and disagreement, President Barack Obama concluded Thursday’s unprecedented live talkfest on health care with the bleak assessment that accord between Democrats and Republicans may not be possible. He rejected Republican preferences for seeking a step-by-step solution or simply starting over.

Obama strongly suggested that Democrats will try to pass a sweeping overhaul without GOP support, by using controversial Senate budget rules that would disallow filibusters. And then, he said, this fall’s elections would write the verdict on who was right.

“We cannot have another yearlong debate about this,” Obama said at the end of a 7 1/2-hour marathon policy session.

———–

And the stories go on and on.

By the end of April, any attempt to push the current bills through using reconciliation will stop. Meanwhile, you can bet the folks who are doing polls will be very busy. Much action in Congress will depend on the polls. The eyes always are on the ballot box. But sometimes the racing car fails to make the turn and goes off of the cliff. We shall see.

Stay well. Live long. Exciting times are unfolding.

LAGNIAPPE: Former Astronaut Dr. Jim Bagian joins The Doctors Company (TDC) board (www.thedoctors.com). TDC has a wonderful board and it was a pleasure to see Dr. Jim Bagian join the TDC board today as a new board member. Many of you know Dr. Bagian’s work in patient safety. Of course he is a multitalented leader — an engineer, physician, pilot, and astronaut. After the 1986 CHALLENGER space shuttle explosion, he supervised the capsule’s recovery from the ocean floor, personally diving ninety-five feet into the Atlantic Ocean and discovering the bodies. I feature him as one of the leaders in chapter 16 of my book, “On Leadership – Essential Principles for Success”. I always learn something from Jim and today was no exception as I listened to him during breaks when I attended the TDC board meeting that concluded today.

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates.

Also, recent selected DJP Updates can be found at: http://www.donaldpalmisano.com/html/djp_update/

Will be in the air most of tomorrow heading home form California!

Have a great weekend!

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@donaldpalmisano.com
www.donaldpalmisano.com
www.onleadership.us

This DJP Update goes to 2210 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

DJP Update 2-18-2010 More analysis and less spin needed in Health System Reform debate – one example of analysis by John Goodman (see link below to his article)

DJP comments: Health System Reform. The Upcoming Summit. “Trick” or good faith attempt to gather ideas for workable health system reform? That is the essence of comments in the media now.

What is needed is careful reading of the details of any bill and analysis of the consequences if passed into law. Distinguish experiment from proven performer. Use the techniques of the scientific method and challenge assumptions and claims.

We need less spin from Washington, DC and the talking heads on TV and more analysis. Below is one example of an important example of analysis by John Goodman. You can agree or disagree but if you disagree, don’t attack but instead give cogent analysis of what is wrong, if anything. One of the problems with the current debate is the failure to give proof of error in analysis and instead the person who made a proposal is attacked with name-calling and smears.

Americans are not stupid! Soon they will send a loud message and possibly vote everyone in Congress out of office and start anew. Americans may consider term limits for Congress. They did it for the presidency and Congress is next, in my view. Earlier than the Lord Acton quote in 1887 about the corrupting influence of power is this comment by William Pitt the Elder in a House of Lords speech in 1770:

“Unlimited power is apt to corrupt the minds of those who possess it; and this I know, my lords, that where laws end, tyranny begins.”

DJP comment: Decades in office certainly can lead to arrogance and inability to feel the pain of the Citizens. What about limit of 6 years in the House (Three 2 year terms) and 12 years (two 6 year terms) in the Senate? Think about that!

——-

EXCERPT FROM JOHN GOODMAN’S ARTICLE IN HIS HEALTH POLICY BLOG:

Obama might then say, “Since we agree on the fundamentals, why can’t we iron out the details?”

The answer is that these similarities are only superficial. Although it’s always hazardous to generalize about political parties, if you dig a bit deeper, you will discover a huge gulf separates most Republicans from most Democrats on health reform. Three issues in particular illustrate that fact….

GO TO THE LINK BELOW TO READ THE ENTIRE ARTICLE. If desired, you can place a comment about the article on the blog site as I did.

———–

Here is my tweet about John Goodman’s article of today:

———

http://twitter.com/djpNEWS

DJPNEWS

Need analysis like this & no spin by Congress-Why Repubs & Dems can’t get together #hsr by #JohnGoodman http://tinyurl.com/yzm7fdp

———-

Conventional link is: http://www.john-goodman-blog.com/why-cant-republicans-and-democrats-get-together-on-health-reform/?utm_source=newsletter&utm_medium=email&utm_campaign=HA

LAGNIAPPE: Reminder that I will do interview on health system reform and upcoming health summit this Saturday morning 2-20-2010 on the Rob & Cari Show in Steamboat Springs, CO on KBCR (11:00 a.m. Eastern; 10:00 a.m. Central; 9:00 a.m. Mountain etc.)

You can listen in live at the Website: http://www.cariandrob.info/listen-live-now

—-

Stay well,

Donald

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates.

Also, recent selected DJP Updates can be found at: http://www.donaldpalmisano.com/html/djp_update/

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@donaldpalmisano.com
www.donaldpalmisano.com
www.onleadership.us

This DJP Update goes to 2210 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

DJP Update 2-13-2010 Some fun! Saints parade photos; Lagniappe: a special connection

I posted a few of the photos I captured at the Saints parade on 2-9-2010, two days after the World Champion Saints won the Super Bowl.

You can view them at:

http://twitpic.com/photos/DJPNEWS

Here is the tweet:

DJPNEWS

My #photos of #Saints parade #NewOrleans 2-9-2010 after #SuperBowl win!http://twitpic.com/photos/DJPNEWS See #SeanPayton etc

LAGNIAPPE: We all know that the trophy in Coach Sean Payton’s hand in the photo I took is the LOMBARDI TROPHY, the trophy named after the famous Coach Vince Lombardi. It is given to the National Football League’s winner of the Super Bowl Championship Game.

But did you know that Vince Lombardi’s grandson, Joe Lombardi, is the Saints quarterback coach! More background info about this at:

http://www.greenbaypressgazette.com/article/20100205/PKR01/100205021/Grandson-of-Vince-Lombardi–New-Orleans-Saints-quarterbacks-coach-Joe-Lombardi–gets-his-shot-at-Super-Bowl

The Lombardi connection is another wonderful part of the Who Dat Nation story that gave a city hope. I also want to share what I recorded from Steve Sabol, head of NFL film and a man who has filmed all 44 Super Bowls, as he spoke on TV immediately after the game:

“Tell me the truth and I will believe; Tell me a fact and I will learn; But tell me a story and it will live in my heart forever. This Super Bowl goes instantaneously into American folklore. It is triumph that symbolizes a city’s rebirth, the growing stardom of Dree Brees, and the bravado and the fearless decision-making of the coach, Sean Payton.”

Amen! Happy Mardi Gras! This year will be a photographer’s delight.

Stay well and more on the health system summit soon!

Donald

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates.

Also, recent selected DJP Updates can be found at: http://www.donaldpalmisano.com/html/djp_update/

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@donaldpalmisano.com
www.donaldpalmisano.com
www.onleadership.us

This DJP Update goes to 2210 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

DJP Update 2-10-2010 late night Breaking News: The Coalition of State Medical & Specialty Societies Charter & Mission

This Charter & Mission approved tonight.

——————————–

THE COALITION OF STATE MEDICAL AND NATIONAL SPECIALTY SOCIETIES

CHARTER AND MISSION

The undersigned State Medical Societies and National Specialty Societies hereby come together as a Coalition with a common commitment to preserve the practice of medicine as a profession, and to preserve the time-honored patient-physician relationship keeping it free of outside interference. In furtherance of these objectives, all members pledge to publicly and actively promote the basic principles of this Coalition as defined herein.

The Right to Privately Contract: Access to quality health care can only be ensured by fundamentally reforming our broken medical payment system. The right to privately contract for services is a touchstone of American freedom and liberty. Patients and physicians must be allowed to freely exercise this right without third party interference or penalty.

Determination of Quality Medical Care. The determination of the quality of medical care must be made by the profession of medicine, not by the government or other third party payers.

Medical Liability Reform: Medical liability reform is essential to ensure access to quality, affordable health care for all patients. Such reform should be based on proven policies.

Membership in the Coalition: Any state medical society or any national specialty society that is a recognized component of the American Medical Association House of Delegates may become a member of the Coalition. With the approval of a majority of the members, individuals may also be invited to participate as an associate of the Coalition.

Governance: Each member organization in the Coalition shall designate one person as its representative and be entitled to one vote. The representatives will elect a chairman who will conduct the meetings of the Coalition and serve as its primary spokesperson.

Financing: Member organizations shall pay dues as determined by the Coalition. An annual accounting of expenditures shall be made.

Dues

Dues for 2010 shall be $1,000.

——————–

Contact Person for more details and to join:

David A. Cook

Executive Director/CEO

Medical Association of Georgia

1849 The Exchange, Suite 200

Atlanta, Ga. 30339

678-303-9251

dcook@mag.org

www.mag.org

———————–

Stay well,

Donald

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates.

Also, recent selected DJP Updates can be found at: http://www.donaldpalmisano.com/html/djp_update

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@donaldpalmisano.com
www.donaldpalmisano.com
www.onleadership.us

This DJP Update goes to 2203 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

DJP Update 2-10-2010 recent & upcoming radio interviews by DJP re White House Health Summit; Lagniappe

Here is an update on some of the recent and upcoming radio shows I am doing on health system reform. Some you can listen to them live regarding of where you live by going to Website or downloading “WUNDERRADIO” IPhone App. The App is terrific.

Also, most of the stations post PodCasts of the interviews.

Meanwhile, another missed opportunity for our AMA to mention Private Contracting without Penalty. See my tweet and link to AMA comments:

DJPNEWS tweet posted at: http://twitter.com/djpNEWS

No mention PrivContracting?! RT AMAblog: AMA Pres J. James Rohack, MD, ..need Medicare’s #SGR formula to be repealed. http://bit.ly/drAe43

—–

Radio Interviews:

TUESDAY

Date: Tues Feb 9

Time: 2:00 ET

Show: Inga Barks on KERN in Bakersfield, CA

Topic: Health care summit

Website: http://www.kernradio.com/pages/5860237.php?

Date: Tues Feb 9

Show: Greg Corombos, Radio America

Topic: Health care summit

Website: http://dateline.radioamerica.org/?page_id=2

PODCAST of interview is at: http://dateline.radioamerica.org/index.php?submit.x=41&submit.y=18&s=palmisano

WEDNESDAY

Date: Wed Feb 10

Time: 4:20pm ET

Show: Steve Malzberg on WOR in NYC

Topic: Health care summit

Website: http://www.malzbergtalk.com/site/?page_id=17

Date: Wed Feb 10

Time: 7:30 PM ET (20 mins, call-ins)

Show: Lars Larson, Guest host: Mike Siegel

Info on Mike Siegel: http://info.jpost.com/C002/Supplements/AmericasVoices/msl_01.html

Lars’ website: http://www.larslarson.com/

SATURDAY 2/20

Date: Saturday Feb 20

Time: 11:00am ET

Show: Rob & Cari in Steamboat Springs, CO on KBCR

Topic: Health care summit

Website: http://www.cariandrob.info/listen-live-now

——-

LAGNIAPPE: Have you seen the news reports and email traffic that the Saints will win the Super Bowl when Hell freezes over? Then there is a photo of the Saints winning the Super Bowl following by the freeze and snow storm covering Washington, DC. Also noted is an Igloo home for Vice-president Gore near the Capitol. “Sen. Inhofe, the ranking Republican on the Senate Environment and Public Works Committee, told Roll Call newspaper that his family’s ironic tribute to Gore was “really humorous.” Lots of controversy on many issues!

Meanwhile, free discussion of issues difficult in some places around the world. This just in with an Iraniam official stating government control action on Internet in Iran is meant to build trust. With “Big Brother” watching you, can it be far behind that someone knocks on your door if you have a dissenting view? Long live America and Freedom of the Press! Express your view and back it up with facts, not spin.

Technology Alert

from The Wall Street Journal

Iran’s telecommunications agency announced what it described as a permanent suspension of Google’s email services, saying a national email service for Iranian citizens would soon be rolled out.

It wasn’t clear late Wednesday what effect the order had on Gmail services in Iran. Iranian officials have claimed technological advances in the past that they haven’t been able to execute.

Google didn’t have an immediate comment about the announcement.

An Iranian official said the measure was meant to boost local development of Internet technology and to build trust between people and the government.

The measure was announced on the eve of the culmination of celebrations to mark the 31st anniversary of the Islamic Republic. Competing plans for pro-government and antigovernment demonstrations have set the stage for clashes between authorities and opposition protesters, who have taken to the streets repeatedly since contested presidential elections in June.

http://online.wsj.com/article/SB10001424052748704140104575056972514372994.html?mod=djemalertTECH

———-

Finally, Saints parade last night was wonderful! I attended and got some fun photos. The city continues to party and the costumes on Mardi Gras will be fascinating this year! Mardi Gras (Fat Tuesday) will be February 16 this year.

Stay well,

Donald

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates.

Also, recent selected DJP Updates can be found at: http://www.donaldpalmisano.com/html/djp_update/

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@donaldpalmisano.com
www.donaldpalmisano.com
www.onleadership.us

This DJP Update goes to 2205 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

DJP Update 1-26-2010 AMA letter of today by AMA President has right to privately contract without penalty! Thanks!! Now we are advocating AMA policy.

This went to President Obama and Congress today. I hope ads to the public also will be done.

Good job, Dr. Rohack!

Except from letter:

See full letter in attachment.

Stay well,

Donald

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates.

Also, recent selected DJP Updates can be found at: http://www.donaldpalmisano.com/html/djp_update/

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@donaldpalmisano.com
www.donaldpalmisano.com
www.onleadership.us

This DJP Update goes to 2194 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

DJP Update 1-25-2010 Health System Reform: AMA “says it’s still on board”

The question is, “on board” for what? The American public has clearly rejected the Senate and House bills. AMA needs to be very specific about what it supports. If AMA still supports the House and Senate bills, then AMA also has not listened to the physicians of America and has not learned the lessons of the recent elections, especially the Massachusetts race for U.S. Senate.

NOW is the time for AMA to say:

——-

Yes, we need health system reform and we have SPECIFIC AMA policy developed over many years that will lower costs, cover the uninsured, fix the broken medical liability system, and keep the patient in control of his/her medical decisions with the doctor as trusted advisor. After reflection, we realize that the Senate and House bills will not lower costs and will lead to rationing and a decrease in the quality of Medicine in addition to creating unsustainable deficits. We stand ready to give you our specific plan and we refer you to our AMA PolicyFinder on our AMA Website. It is full of policy developed in a transparent and democratic way that we find, upon reflection, sorely lacking in the recent activities in Congress. Liberty is an essential part of America and Congress must return the right of patients and physicians to privately contract without penalty. Allow balance-billing. Allow doctors to forgive the copay if the patient and physician agree. Eliminate coercion. Price-fixing always leads to loss of availability or service or product. Just like gravity, the consequences do not disappear by wishing it away on Earth. And yes, see summary of AMA policy in JAMA May 12, 2004 article detailing Individual ownership, tax credits, market enhancements (such as purchasing health insurance across state lines, etc.) and more.

——

Of course, AMA did not say that. But there is still time. Rarely do circumstances give one a second chance to correct a mistake. But the time is now. See article excerpts below about “on board.” Now the best way to clarify “on board” is to say: Yes, we are on board, but (then repeat the paragraph I gave above about specific AMA policy.)

http://blogs.marketwatch.com/healthmatters/2010/01/25/with-health-reform-in-limbo-groups-issue-call-to-arms/

• January 25, 2010, 7:21 PM EST

•

See WSJ affiliated HEALTH MATTERS HOME PAGE »

With health reform in limbo, groups issue call to arms

KRISTEN GERENCHER’S Health Matters

EXCERPTS FROM ARTICLE

——

Health-care reform hangs in the balance after last week’s Massachusetts special election changed the balance of power in Washington. Now many interest groups that spent much of the last year negotiating with lawmakers are in wait-and-see mode ahead of President Obama’s State of the Union address on Wednesday. But groups representing doctors, seniors and women rallied their troops Monday, urging lawmakers to press on with reform efforts despite tough new political realities.

The merits of the bills haven’t changed, AARP Spokesman Jim Dau said….

The American Medical Association, which represents about a fourth of U.S. doctors and endorsed the House bill in November, says it’s still on board.

“The Massachusetts Senate election has complicated the prospects for comprehensive health reform, but the crisis of the uninsured remains very real to millions of Americans who have reduced access to health care because they don’t have coverage,” AMA President J. James Rohack said in a prepared statement. “Our nation still needs reform of the health-care system, and AMA will stay engaged in the process to get the best outcome for patients and physicians.”

On Monday, the American Academy of Family Physicians, American College of Physicians and American Osteopathic Association sent a letter to Obama and Democratic leaders expressing continued support for health-reform legislation, including ensuring a “sufficient supply of primary-care physicians and other specialties facing shortages.” The letter also mentioned malpractice reform, which may gain renewed favor if Obama wants to court Republican support for a revamped attempt.

The doctor groups also are pressing for separate resolution of a scheduled payment cut, the product of a longstanding problem known as the sustainable growth rate formula.

The American Public Health Association went on record Monday as well.

—–

Meanwhile, while we wait for such an AMA statement that I suggested above, more Congressional upsets will be set into motion and the doctors who wait in vain for the SGR price-fixing formula to be eliminated will face daily the burdens of trying to keep the medical office open as draconian cuts are implemented and consultation codes are eliminated. Also, various medical coalitions will get more active and specialty societies will become more active as the AMA becomes tossed into the losing column and dues revenue is rapidly lost like the water breaking the levees in New Orleans during Hurricane Katrina. That was a disaster and the aftermath of AMA’s actions will be another disaster. Historians will one day ask, what happened to the AMA? By the way, do you think the AMA letter sent today had what we have discussed multiple times and is among AMA’s highest advocacy priorities, namely, the right to privately contract… Check it out. I could not find it on AMA Website with AMA search engine but I did find this info about the letter and ad at AARP. The goal is to fix the SGR but it doesn’t say anything about the right to privately contract. Too bad. Another lost opportunity. Why write about privately contracting in “On the Road” discussed in recent DJP Update if we are not going to advertise it to the public. AMA policy states AMA must advocate private contracting with out penalty publicly!

http://www.aarp.org/aarp/presscenter/pressrelease/articles/aarp_ama_sgr_ad.html

and watch video at AARP Website: http://www.aarp.org/health/insurance/articles/new_aarp_ama_ad_calls_on_congress_to_fix_physician_pay.html

BREAKING NEWS: Two items:

-President Obama to Push 3-Year Spending Freeze on Non-Security Discretionary Spending

DJP comment: wonder if that will affect the “doctor fix” regardless of what the official word is emerging from the negotiating table hidden from CSpan and the public. Hmm…

-Meanwhile, 90 prominent Shreveport, Louisiana physicians took out a half-page newspaper ad today in the Shreveport Times and included their names.

A Shreveport doctor summarized the wording in the ad when he sent me the ad:

“This is an open letter to the Citizens of Northwest Louisiana regarding Health System Reform, signed by 90 of Shreveport’s prominent physicians.

Note the salient points:

• The AMA does not speak for us on Health System Reform.

• The House and Senate Bills are faulty on their merits and in their scope.

• Physicians are not alone in opposition to these Bills.

• Reform is still needed, but more limited legislation will work.

• It is time to start over on Health System Reform.”

——–

The practicing physicians in America are not going to take it anymore. They will mobilize for action. The ad is just one example of the frustration.

Stay well,

Donald

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates.

Also, recent selected DJP Updates can be found at: http://www.donaldpalmisano.com/html/djp_update/

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@donaldpalmisano.com
www.donaldpalmisano.com
www.onleadership.us

This DJP Update goes to 2194 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

DJP Update 1-22-2010 Dramatic news from AMA! Hallelujah! Private contracting & balance billing in today’s AMA President’s blog

Here is an exciting development about the AMA policy to privately contract without penalty and balance bill as per long-standing AMA policy. As you know, I lamented in the DJP Update 1-21-2010 that AMA was not advocating this policy in the media and in the letter to Senator Reid that was sent out yesterday. I also could not find the letter on the AMA Website.

A specialty society legislative director found the letter about SGR fix on AMA Website and sent me the link:

http://www.ama-assn.org/ama/pub/health-system-reform/ama-aarp-moaa-house-call.shtml

Unfortunately, as was my concern, there is nothing about private contracting without penalty!

HOWEVER, TODAY AMA PRESIDENT DR. JIM ROHACK WROTE HIS COLUMN ENTITLED: “BLOG: ON THE ROAD WITH DR. ROHACK” AND ALSO SENT OUT A TWEET WITH A LINK TO HIS ARTICLE OF TODAY, 1-22-2010. The title of the article is “How we should pay physicians for medical care”.

http://www.ama-assn.org/ama/pub/road-doctor-rohack.shtml?plckController=Blog&plckBlogPage=BlogViewPost&UID=21ae8cdf-e382-40c9-87cf-32c8561d0531&plckPostId=Blog%3a21ae8cdf-e382-40c9-87cf-32c8561d0531Post%3a7186ac13-6afb-4718-8cbc-d35d4c94684e&plckScript=blogScript&plckElementId=blogDest

or get to it by the tweet shorter URL: http://bit.ly/89JmiD

Full tweet is:

AmerMedicalAssn

#AMABlog: AMA President J. James Rohack, MD, talks about how physicians should be paid for medical care. http://bit.ly/89JmiD

And Hallelujah, the article states in part,

——

It’s pretty clear to me. Those who vote against fixing the SGR permanently want to ration care by denying access. This may appear to be harsh but it is the only realistic conclusion.

One way to deal with the increasing volume of medical services is to make sure access to those services is limited. Some say that the National Health Service in the United Kingdom controls costs by having only 30 percent of physicians who are non-primary care specialists, practice in regional hospitals.

——

But we have seen physicians take a different approach by dropping out of Medicare and privately contracting with their patients for professional services. The penalty is that has to be done for two years and effects all patients.

Before 1997, physicians had the ability to bill Medicare patients the difference between their fee needed to keep their office viable and what Medicare paid for the services. As the cost for office upkeep measured by the Medicare Economic Index has continued to rise while Medicare payment has not kept pace (currently 20 percent less in 2009 fees compared to what should be paid), the financial problems are only getting worse.

If Congress would lift that ban on private contracting for the full fee for services and allow the physician to provide services on an individual basis and get paid to keep their office viable and not have to drop out of the Medicare program, it would allow accountability to occur at the point of contact.

———–

End of excerpts.

Wow! Thank you, Dr. Jim Rohack! Now send that blog article to everyone in Congress!! That public communication with copies to Congress is exactly what the AMA House of Delegates mandated. Let’s do it! Let’s restore liberty to patients and physicians.

Last night I said in the DJP Update 1-21-2010:

——

“The ship of Congress is in chaos at this moment and AMA needs to cut loose our towed AMA ship before it hits the shoals with the current majority. Let it not be said that AMA membership got so low in 2010 that AMA ceased to exist as a membership organization. AMA needs to exist and it needs the current leadership to stand tall and stop giving the impression of genuflecting for political expediency.

——

Today’s article by AMA President Dr. Rohack gives hope that the tow ropes have been cut! ONWARD!

And thanks to Dr. Jim Rohack!

This is a week to remember!

Stay well,

Donald

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates.

Also, recent selected DJP Updates can be found at: http://www.donaldpalmisano.com/html/djp_update/

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@donaldpalmisano.com
www.donaldpalmisano.com
www.onleadership.us

This DJP Update goes to 2198 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

DJP Update 1-21-2010 AMA sent letter today to Senator Reid regarding SGR; But what about private contracting without penalty!!

Background: AMA also sent letter on December 21, 2009 to Senator Reid supporting H.R. 3590, the “Patient Protection and Affordable Care Act,” as amended.

The complete AMA letter can be found at: http://www.ama-assn.org/ama/pub/health-system-reform/ama-supports-hr-3590.shtml

Nothing in that posted letter at the link above about AMA policy of the right of patients and physicians to privately contract without penalty. That policy is among the AMA highest advocacy priorities.

Today I have been informed that AMA and AARP sent a letter to Leader Reid and Speaker Pelosi today calling for permanent repeal of the Sustainable Growth Rate (SGR) formula. To that end, Sen. Reid has placed the House-passed SGR bill (H.R. 3961) on the Senate calendar. These efforts come in advance of the expiration of the two-month SGR “patch” included in last year’s Defense appropriations bill (P.L. 111-118); the patch expires February 28, triggering cuts of over 21 percent in Medicare physician payment levels absent further action.

Have you seen the letter? It is not on AMA Website as of tonight and doesn’t show up with search engine on AMA site or on Internet. Do you think you will find AMA policy about the right of patients and physicians to privately contract without penalty in that letter? I doubt it! If not, then AMA fails to learn the lesson of the need to publicly advocate for this policy as mandated by the AMA House of Delegates. I look forward to reading the letter. If you have it, please send me a copy.

I did get a fax from AMA yesterday urging a call to my senators asking them to permanently repeal the SGR. But there was no mention in the fax of the substitute price-fixing formula and no mention of private contracting. I assume the letter was sent to all AMA members.

Of course the SGR needs to be thrown out. But to replace it with another price-fixing formula does not solve the problem. We need the right of Americans to privately contract without penalty. Why should patients and doctors be denied this part of our liberty? Let Congress decide what it can pay for services delivered to patients on government programs and then get out of the way of liberty and Free Enterprise. With private contracting without penalty there won’t be the difficulty of finding a doctor! Let competition reign.

The upset in the U.S. Senate race came about, in my opinion, because Congress refused to listen and used the power of the majority to force bills through the Senate and the House. To me that represents the arrogance of power and the consequences are seen in the Massachusetts election. When will AMA make the point to Congress and in ads to the public about the AMA policy of private contracting? We wait in vain. How long must AMA members tolerate this? So sorry to continue repeating myself!

AMA prestige has been diminished greatly by the actions of supporting bills in Congress that almost 500,000 physicians are on record in Congress as opposing. Health System Reform is needed but use AMA specific policy previously quoted in other DJP Updates. The ship of Congress is in chaos at this moment and AMA needs to cut loose our towed AMA ship before it hits the shoals with the current majority. Let it not be said that AMA membership got so low in 2010 that AMA ceased to exist as a membership organization. AMA needs to exist and it needs the current leadership to stand tall and stop giving the impression of genuflecting for political expediency.

———

Medpage Today has an article today on the topic of the SGR entitled: “With Time Running Low, AMA, AARP Push Permanent SGR Fix”

http://www.medpagetoday.com/Washington-Watch/Washington-Watch/18094

Some excerpts:

WASHINGTON — The American Medical Association (AMA) was hoping the momentum of healthcare reform would carry along legislation that would finally repeal the much-despised sustainable growth rate (SGR) formula that governs Medicare payments to doctors.

——

The SGR was developed in 1997 as a way to prevent Medicare payments from growing too quickly. The formula indexes reimbursements to changes in the gross domestic product (GDP). But healthcare spending has been growing much faster than GDP, so applying the SGR formula would have resulted in actual reimbursement cuts year after year.

——

“We’ve had assurances from Sens. Reid and Baucus that now is the time for a permanent fix,” he said, referring to Majority Leader Harry Reid (D-Nev.) and Finance chairman Max Baucus (D-Mont.).

—–

The “doctor payment fix” bill passed by the House — which would replace the SGR formula a with an annual payment increase equal to 1% more than the growth in the GDP (2% more for primary and preventive care physicians) was placed on the Senate’s legislative calendar on Wednesday, but there is no indication of when the measure will be taken up.

——-

The AMA and AARP, along with the Military Officers Association of America, hosted a Webcast Thursday with representatives in states where new TV ads will air, urging constituents to contact their senators to ask them to fix how doctors are paid under Medicare.

——-

Both the AMA and AARP publicly supported healthcare reform. And both groups said they remain hopeful that reform will still pass, even if it takes longer than anyone expected.

——

And see CBO report on this issue of H.R. 3961 and the SGR: http://cbo.gov/ftpdocs/107xx/doc10704/hr3961.pdf

—

And so it goes. Exciting times. There will be winners and losers. Let’s hope patients and physicians are not the main casualties.

Stay well,

Donald

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates.

Also, recent selected DJP Updates can be found at: http://www.donaldpalmisano.com/html/djp_update/

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@donaldpalmisano.com
www.donaldpalmisano.com
www.onleadership.us

This DJP Update goes to 2198 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

Subject: DJP Update 1-19-2010 News bulletin: Scott Brown wins in Massachusetts; Listen up, Washington, DC

8:25 p.m. Central Time

It all started in Massachusetts prior to the Declaration of Independence. Now Massachusetts does it again.

Scott Brown wins. Martha Coakley concedes the election for US Senate seat from Massachusetts in Special Election for seat formerly occupied by Senator Kennedy. At this moment results show Brown ahead by 6%. AP also projects Brown winner with 84% of vote counted.

Time for Washington, DC to listen up. Pay attention to the people and do health system reform in a transparent manner with input from all.

Never give up!!

Stay well,

Donald

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates.

Also, recent selected DJP Updates can be found at: http://www.donaldpalmisano.com/html/djp_update/

——–

Stay well, Donald

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates.

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@donaldpalmisano.com
www.donaldpalmisano.com
www.onleadership.us

This DJP Update goes to 2198 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.