The DJP Update

DJP Update 11-23-2010 Ink Wars: Wall Street Journal (WSJ) & American Medical Association (AMA) – “The Doctor Con” vs “Have You No Sense of Decency…”

WSJ tweet found at:  http://twitter.com/wsjopinion

ONLINE.WSJ.COM – The Doctor Con: The AMA gets its payment fix—for all of four weeks. http://on.wsj.com/9CZ9dS

You may be able to find and read the entire article at this link:

http://online.wsj.com/article/SB10001424052748704170404575624643400449172.html

WSJ article:

• REVIEW & OUTLOOK
• NOVEMBER 22, 2010

The Doctor Con

The AMA gets its payment fix—for all of four weeks.

One of the tragi-comic sideshows of passing ObamaCare was the Democratic attempt to buy off the American Medical Association by promising a permanent fix to the Medicare payment formula for doctors. Apparently permanent is four weeks.

That’s the upshot of last Thursday night’s Senate vote to postpone an automatic 23% cut in Medicare physician payments, but only through New Year’s Day. The House plans to approve the same deal next week, and you should think of this as Nancy Pelosi’s housewarming gift for Speaker-presumptive John Boehner.

Democrats got their AMA endorsement of ObamaCare from immediate past president James Rohack, who was last seen leaving the Beltway on a turnip truck. But Democrats left a permanent fix out of the final ObamaCare bill in order to keep the official price tag below $1 trillion. Democrats planned to pass the $250 billion “doc fix” later in a separate bill, but somehow they never got around to it. Even liberals can’t always conjure up a quarter-trillion dollars on demand, and some Democrats wanted the fix “paid for” with other spending cuts, real or invented.

The result has been a string of temporary last-minute reprieves. This will be the fourth this year, which is even worse than the annual “doc fix” fire drill that prevailed under both Democrats and Republicans until ObamaCare sopped up all the easy budget money. The Senate’s latest one-month version costs $1 billion and is paid for by claiming to reduce certain outpatient therapy payments by about $100 million each year for the next decade. Anyone willing to bet on whether those cuts will ever happen? We’ll take the “no” side of that wager.

In sum, Democrats deceived the AMA about the doc fix and are now deceiving voters about how they’ll pay for even this four-week reprieve. And they’re dumping the $250 billion bill on Republicans.

This doctor-payment charade has served both parties since it was created in 1997 as a palm-greaser for campaign contributions and to disguise the real costs of Medicare as part of the Bill Clinton-Newt Gingrich balanced budget deal. But these Democratic abuses are something else. Three of the four stopgaps this year have passed after the deadline set by the previous stopgap, so for a time Medicare simply stopped paying doctors, causing back-office disruptions nationwide. Imagine if a private insurer pulled these stunts.

A more stable payment system that reflects the real costs of delivering medical care while reining in federal health spending would mean dumping the Medicare price-control model that has led to the current mess. A good place to start are Wisconsin Republican Paul Ryan’s Medicare reform ideas, which were endorsed last week by no less than the long-time Democratic budget hand Alice Rivlin. Maybe now that the AMA has been exposed as fools one more time, its new leaders will support genuine reform.

———–

AMA RESPONSE (VIA AMA PRESIDENT)

Blog: On the Road with Dr. Wilson

Have you no sense of decency, sir?”

Posted at 11/23/2010 12:00 PM CST

An editorial in the Wall Street Journal yesterday—denigrating the AMA’s role in the health system reform debate and the current Medicare mess—talked about buy-offs, deception and being treated as fools.  It was obviously an opinion piece and thus unfortunately not necessarily subject to the rules of accuracy or facts. That being said, it was breathtaking in making assumptions and drawing conclusions about events that never happened—that bear no resemblance to reality.

In a time when everyone is castigating politicians for being partisan, it struck a new low in a harsh note of discord that does not add to responsible debate on how this country can improve our health care system. It was a diatribe more suitable to the proverbial muck-raking tabloid than to a venerable news organization.

To set the record straight, Democrats and Republicans share responsibility for the combined steep 25 percent Medicare cuts to physicians that loom ahead. There is bipartisan understanding that the current Medicare physician payment system is fatally flawed, yet both political parties allowed the problem to grow, increasing the cost of permanent reform from $48 billion to more than $250 billion. Both Republicans and Democrats have said the problem needs a real solution but neither has delivered.

The AMA’s focus—before, during and after the health system reform debate—has been to ensure that physicians can continue to deliver high quality patient care. More thoughtful problem-solving and less partisan sniping is the way to make our health system work better for patients and physicians.

The Wall Street Journal editorial puts me in mind of an event on June 9, 1954, when Sen. Joseph McCarthy was using his position as chair of the Senate Committee on Government Operations to destroy the careers of many people by being “judge, jury, prosecutor, castigator and press agent, all in one.”

This came to a head during one committee hearing when the senator was being particularly vicious in a vendetta against the Army, unfairly attacking a witness and attempting to destroy his reputation. Joseph Welch, the attorney representing the Army (and the witness), went on the offensive against Sen. McCarthy, saying: “Until this moment senator, I think I never really gauged your cruelty or your recklessness. Senator you’ve done enough. Have you no sense of decency, sir? At long last, have you left no sense of decency?”

So, I say to the Wall Street Journal …?

Do you have a question or a concern you would like to be heard? If so, and if you’re an AMA member, join me for my next “Office Hours” at 7 p.m. Eastern time on Wednesday, Dec. 1. Register today.

Editor’s note: To comment on this post, send us an e-mail.

—-

AMA also sent out a tweet about this posting.  It is found at:  www.twitter.com/AmerMedicalAssn

AmerMedicalAssn AMA

#AMAblog Dr. Wilson: an editorial from yesterday’s Wall Street Journal bears “no resemblance to reality.” http://bit.ly/fdSALw

1 hour ago

————

LAGNIAPPE: Meanwhile, this came out of the AMA Interim Meeting as part of AMA’s Strategic Plan.  It needs to be implemented!  Allow private contracts without penalty and get rid of IPAB!

EXCERPT:

There is no question that achieving a lasting and adequate solution to the SGR is a cornerstone to successful innovation with other new payment models.  In collaboration with state and national medical specialty societies, the AMA will continue to press Congress to repeal the SGR and replace it with a stable funding policy that reflects increases in the cost of care. Work is also underway to remove current restrictions in Medicare law to allow patients and physicians to enter into private contracts without penalty to either party.  The federal government should not restrict the ability of patients to spend their personal funds to preserve access to their physician of choice.

Eliminating the Independent Payment Advisory Board (IPAB) authorized by the Affordable Care Act is a top AMA priority in 2011.

——-

Too bad that was not mentioned in AMA’s 11-8-2010 column “On The Road” discussing the strategic plan.

http://www.ama-assn.org/ama/pub/ama-president-blog.shtml?plckController=Blog&plckBlogPage=BlogViewPost&UID=0b90b13b-8074-42d2-be9a-5d263dc8c945&plckPostId=Blog%3a0b90b13b-8074-42d2-be9a-5d263dc8c945Post%3a3653f33d-a47b-4d5e-b65c-d2d44f28fdf1&plckScript=blogScript&plckElementId=blogDest

The above excerpt is in the Board report at Interim Meeting in San Diego but only this gets put into the column:

“2. Next generation physician payment: Aligning incentives with quality of care while covering the cost.”

A top priority of AMA should be mentioned boldly, in my opinion.

Well, still have a wonderful Thanksgiving.  We will overcome.  But we must focus! And execute.  Rhetoric is nice but action defines us.

http://www.ama-assn.org/ama/pub/ama-president-blog.shtml?plckController=Blog&plckBlogPage=BlogViewPost&UID=0b90b13b-8074-42d2-be9a-5d263dc8c945&plckPostId=Blog%3a0b90b13b-8074-42d2-be9a-5d263dc8c945Post%3a3653f33d-a47b-4d5e-b65c-d2d44f28fdf1&plckScript=blogScript&plckElementId=blogDest

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.  Twitter is free and takes minutes to join.  Put email in and pick password.  Great source of breaking news and you don’t flood your email with it.  You can get free app for BlackBerry or IPhone etc and you check on tweets when you want.

Also, recent selected DJP Updates can be found at:  http://donaldpalmisano.com/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 2317 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.

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DJP Update 11-20-2010 America, we are are war!  Time for Congress to shape up

This Thanksgiving, as we give thanks for our many blessings in this great land of opportunity, this EXCEPTIONAL Nation that has shed blood and treasure fighting for freedom around the world since the beginning of the USA, let us also reflect and ponder the current war.  Americans are dying in a far-away land.

There hardly was a mention of this war in the November mid-term elections.

Consider what is happening right now in Task Force Dustoff.

The following excerpt is from an article by Jerome Starkey published today in London in the London Sunday Times and the scene is a US soldier in a Blackhawk helicopter en route to Kandahar airfield.

The soldier’s face was grey with dust, grass poked out of the stumps where his legs should have been and his skin was charred black where the blast had shredded his forearm.

His Friends thought he was dead by the time the medics flew in…  Barely 20 minutes after the foot patrol in southern Afghanistan was hit by the roadside blast, the soldier and an Afghan colleague, both critically injured, were on their way to Kandahar airfield’s military hospital.

The Afghan soldier lay unconscious, gurgling blood, next to the American amputee.  His lips were missing and his eyes were caked shut with gore.

…

These are the catastrophic injuries that the men and women of Task Force Dustoff deal with almost every day. With record numbers of US and NATO troops suffering unprecedented levels of violence, it is the medics charged with flying into enemy fire to save them who endure the horrors and the hazards of war, far more than ever before.  …At the height of the summer fighting season some flew ten rescue missions a day.  …

In a single day in July, five helicopters flew home with homes in the fuselage from enemy fire.  In June the Taleban (as spelled in article) shot down a US Air Force rescue helicopter, from a different unit, over Sangin, killing all four on board.  The Taleban lay mines where they think helicopters might land and offer bounties to anyone who can shoot them out of the sky.

… Advances in battlefield medicine and the speed with which patients are transferred from the point of injury to a place of surgery have seen survival rates soar.  Unfortunately, this amputee was not so lucky.  The Afghan soldier survived but suffered brain damage.

He may also lose his sight.

—————

DJP Comment:  read the entire article.  It is 980 words long but these excerpts give the essence of what the brave soldiers fighting against terrorism face.  It is located at: http://www.thetimes.co.uk/tto/news/

Exclusive:Task Force Dustoff: blood, guts and a chance of life Jerome Starkey travels with the medics who airlift casualties out of southern Afghanistan

Why mention this article?  Because we must reflect on our role in the world and our approach to fighting terrorism.  In my opinion, there is more attention to the debate about airport security scanners and enhanced pat-downs than the overall approach to the war, a war that is America’s “longest-ever”.

It is a war on terror.  It is not an “Overseas Contingency Operation”.  Let us stop the Humpty-Dumpty changing of the meanings of words or using euphemisms like “Reception Centers”, one of the terms used after President Roosevelt ordered the internment camps where individuals of “foreign enemy ancestry” (Japanese-Americans of the West were affected the most) were placed after the attack on Pearl Harbor via Executive Order 1066 issued February 19, 1942.  And today we have the Fed speaking of  “Quantitative easing”.  Does that mean print more paper money and devaluate our savings?  History might suggest that is a road to disaster.  Let Congress and the Administration call things for what they are.  Use Strunk and White’s “Elements of Style” as a guide.

And so I ask these questions as I make my personal reflection for this Thanksgiving Day holiday.

1- Is not the purpose of war to win?  Do we not have examples from previous wars that America fought?  Was WWII fought differently from the Korean War and the Vietnam War?

My study indicates that whatever it took, that is what was done in WWII.  In the Korean War and the Vietnam War, I see political considerations affecting and impeding the action of brave military men and women.  And the results were different!

Consider President Harry Truman in 1945 in WWII.  He decided that more people would die on both sides by continuing the status quo of war as the invasion of Japan was imminent after the bloodiest battle of the war, namely the Battle of Okinawa in the Pacific, was won by America.  So he made a decision and lived by it.  He demanded surrender of Japan.  They refused.  He dropped an Atomic Bomb “Little Boy” on Hiroshima on August 6,1945.  They did not surrender.  He dropped a second one, “Fat Man”, this time on Nakasaki on August 9.  Then unconditional surrender by Japan occurred.  Think about that.  A Democratic President ordered the dropping of TWO Atomic Bombs.

Do not think I am suggesting we drop Atomic Bombs!  What I am suggesting is President Truman gathered the facts, made a decision, and acted on it.  No “political correctness”.  No checking of the polls.

2- Why did not Congress immediately evaluate the loss of life from IEDs or roadside bombs (Improvised Explosive Devices) in the Middle East battles and get the equipment to protect our soldiers?  A primitive but effective weapon is killing and maiming our troops.  When at war, focus on the war!  A government report of 2006 can be found at: http://www.usembassy.it/pdf/other/RS22330.pdf

Immediate retrofitting of vehicles with armor as soon as the first IED detonated would be a logical approach.  This at least protects those in vehicles.

It offends me to think of what Congress has done with the disaster of a law know as PPACA.  The Speaker said we would have to pass so we could find out what was in it.  That is an assault on our intelligence.  Every week more bad effects of the law are being exposed.  And more are asking and getting special dispensation.  And the way it was passed is insulting to Americans.  But I digress again.  Sorry.

Why not focus on the war.  Find out who is corrupt over there.  Stop funding corrupt people.  Teach but let the folks who live in those countries with terrorists take the lead in the local terrain.  Remember, the enemy can move from country to country.  Are we going to be at war in all of these countries that the terrorists move to?

3- If the goal is democracy, liberty, and freedom in the countries we are trying to help, does that become the reason we are there?  If so, what about North Korea, Iran, and on and on.  Do we go to war there?  Money, treasure, and blood does not grow on trees as we all know.  If we resort to bloodletting of our citizens by war, spending money we don’t have, increasing taxes and suppressing the economic engine of our Country, soon America will stop being the Land of the Brave and the Home of the Free.  We will suffer the fate depicted in the poem Ozymandias by Shelley.

If the goal of the war is to stop terrorism, then notify the countries who harbor the terrorists that it is necessary for them to deliver the terrorists or we will be at war with them.  Be strong.  The enemy does not respect weakness.  Stop the “political correctness.”  Negotiate from strength.  Give a consistent message that American is not going to genuflect.  We are going to protect our citizens.

4- Consider the following idea that continues to occur to me:  Every time we go to war, let’s pick at random a certain number of U.S. Senators, perhaps 4, to go to the front lines of battle as embedded folks from Congress.  Just like brave reporters who volunteer to embed with the troops.  But for those in Congress, it will not be voluntary.  Consider it a mandate or condition to serve in Congress.  Congress understands the health insurance mandate so the idea should not be foreign to them.  As for U.S. House of Representatives, let’s pick perhaps 16, and do the same with them.  These individuals will spend 6 weeks in battle, not in some far-back command post, but riding on patrols, etc.

After 6 weeks, pick 4 substitute Senators and 16 replacement Representatives.  Continue that until the war is ended.

What would that do?  Number one, it would allow the members of Congress to experience the risk. The failure to get protective armor on all vehicles would be fixed immediately.  Great bullet-proof vest would be available to all.  Whatever the soldiers wear, the Congress folks would wear.  All will be equal.  No different health plan for the Congress folks.  Same problems for them with the SGR as for Medicare, Medicaid, and Military individuals.  Same rules for all.  No sightseeing tours behind protective well-fortified shelters.  Engage in the battlefield.  I suspect our time at war would come to a close much sooner.  It certainly would eliminate the statement by a senator to the brave General Petraeus at a senate hearing on the war, “I think that the reports that you provide to us really require a willing suspension of disbelief.”

See http://www.politico.com/blogs/thecrypt/0907/Clinton_Believing_Petraeus_and_Crocker_requires_willing_suspension_of_disbelief.html

With my recommendation, the senators could form their own opinion and not suspend anything.  They might want to SUSPEND their presence in the war as well as America’s or get whatever is needed for the troops to get the job done.

5- Finally, let’s consider a constitutional amendment to limit service in the U.S. Senate to two 6-year terms and in the House of Representatives, three 2-year terms.  Forget the arguments that we need the experience of people in office for decades.  That approach has brought us to near bankruptcy.  When folks are in power too long, there is the risk of arrogance.  Perhaps you have noted that from time to time.  Remember, the President of the United States is limited to two terms.  There is no reason not to limit the terms of those in Congress.

LAGNIAPPE:  The SGR.  Send a message that doctors are taking off the chains.  Allow balance-billing.  Allow private-contracting without penalty.  Only a minority of folks in Congress are doctors so there are not enough people in Congress to handle the patient care.  Eloquence is great but does nothing for a ruptured abdominal aortic aneurysm.  Takes more than words to fix that problem!  Patients need their doctors.

And AMA, the doctors of America need strong leadership manifest by action in the days ahead.  The profession of Medicine depends on it.  This is your chance.  Don’t fail!

Happy Thanksgiving!  May you have a joyful and healthy celebration.  And if you are traveling and see soldiers in uniform in the airport, go up to those brave men and women and thank them for their service.  I always do and I feel better for having done it.  Those of us who have had the privilege to serve in the military have witnessed bravery on the part of these loyal Americans.

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.  Twitter is free and takes minutes to join.  Put email in and pick password.  Great source of breaking news and you don’t flood your email with it.  You can get free app for BlackBerry or IPhone etc and you check on tweets when you want.

Also, recent selected DJP Updates can be found at:  http://donaldpalmisano.com/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 2317 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” in subject line.

DJP Update 11-17-2010 Congratulations to U.S. Representative Tom Price MD of Georgia! US Rep. Price elected to GOP leadership position; LAGNIAPPE

Dr. Price was elected chairman of the Republican Policy Committee, the GOP’s fifth-ranking leadership position in the House.

As most of you know, Tom is a member of the AMA House of Delegates and advocates strongly in Congress for the right to privately contract, without penalty, in Medicare.

http://www.macon.com/2010/11/17/1344800/rep-price-elected-to-gop-leadership.html#ixzz15bFKI18Y

http://www.sfexaminer.com/local/ap/rep-price-elected-to-gop-leadership-position-108769004.html#ixzz15a2MKfRw

US Rep. Price elected to GOP leadership position

The Associated Press

WASHINGTON — U.S. Rep. Tom Price of Georgia on Wednesday was elected chairman of the Republican Policy Committee, the GOP’s fifth-ranking leadership position in the House.

The Roswell surgeon will take the helm in January, working alongside key committee chairmen and other leaders to help develop legislation and steer it through Congress.

In a statement, Price said he will work to regain the public trust by focusing on balancing the budget, reducing spending, removing barriers to economic growth, and passing new health care reforms.

He said he intends to “generate bold policy initiatives and make a public case for their adoption.”

Price, a former Senate majority leader in the Georgia Legislature, has made no secret of his leadership ambitions. First elected to Congress in 2004, he has raised his profile and served as a lead attack dog in partisan battles.

He is currently chairman of the Republican Study Committee, the conservative caucus of the House GOP.

He will replace Rep. Thaddeus McCotter, who had argued to shut down the policy committee to save money
.——–

DJP Comment:  Here is an example of Dr. Tom Price’s advocacy:

http://tom.house.gov/html/content.cfm?id=449

H.R. 1384,To amend part B of title XVIII of the Social Security Act to remove limiting charges under the Medicare Program for non-participating physicians with beneficiary notice and to preempt State laws that prohibit balance billing

To amend part B (Supplementary Medical Insurance) of title XVIII (Medicare) of the Social Security Act to remove the limiting charges under the Medicare program for non-participating physicians who provide the beneficiary with a specified notice of non-participation and non-acceptance of Medicare payment on an assignment-related basis, and to preempt state laws limiting charges for physicians’ services.

——–

LAGNIAPPE: Went to Washington, DC yesterday; fly in and fly out same day to interview folks for expanded 2nd edition of my book, “On Leadership…” & then lectured this morning on leadership at 6:30 a.m. at Grand Rounds Tulane Medical School Department of Anesthesiology at the invitation of the Chair, Dr. Frank Rosinia.  Nice folks!  Great new audiovisual set-up in the department.

Tired now!  Have a wonderful and Happy Thanksgiving!  We have so much to be thankful for as Americans.

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.  Twitter is free and takes minutes to join.  Put email in and pick password.  Great source of breaking news and you don’t flood your email with it.  You can get free app for BlackBerry or IPhone etc and you check on tweets when you want.

Also, recent selected DJP Updates can be found at:  http://donaldpalmisano.com/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 2317 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”

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DJP Update 11-4-2010 Noon – Breaking news AMA: Medical Association of Georgia letter regarding AMA leadership; AMA EVP/ CEO departing

DJP Comment:  With the national election results and now this news below, it is unfortunate I can’t make the AMA Interim Meeting in San Diego this week because of the water heater flooding of 1st floor of my home during the night.  This will be first Interim Meeting of AMA I missed since 1984!

Fortunate that contractor was scheduled to be at our home today.  He was extremely helpful with the water mess, making sure no further leaks, and confirming electricity to that heater shut off.  Awaiting plumber and slate person for the floor renovation.  Carpet a mess!  We will have no more carpet on first floor after Katrina and now this!

Thanks for the notes of concern.  And Bob Seligson, EVP & CEO North Carolina Medical Society, is correct when he mentioned in his letter to me today,

“I bet your plumber does not work under the SGR method of reimbursement…but I don’t want to get you started!”

Yes, Bob is correct.  Only doctors, who save lives daily, are price-fixed below the cost of delivering the service.  Now that is something the Democrats & Republicans, & the President can fix if they really want to help patients and maintain access to care!  Get rid of SGR.  Allow private contracting and balance-billing.  We still are a Land of Liberty.  Let’s show it!  That is something that should be emphasized at this AMA Interim Meeting.  Medicine is burning!

Sorry, Bob,  your note did get me started!

And now the update.

——

MEDICAL ASSOCIATION of GEORGIA (MAG) LETTER OF “NO CONFIDENCE”

POLITICO Pulse – POLITICO.com

Nov 4, 2010 … POLITICO.com Logo – Click to return to home page …. GEORGIA HAS NO CONFIDENCE IN AMA— The Medical Association of Georgia has voted “no …

Medical Association of Georgia October 27, 2010 letter to AMA Board Chair posted at Politico:

Letter at this link:  http://www.politico.com/static/PPM156_action_hod_deloach_to_hoven_confidence.html

EXCERPT:

(But read entire letter at link above.)

——–

ITEM TWO: “American Medical Association CEO Michael Maves to Leave in June”

http://blogs.wsj.com/health/2010/11/04/american-medical-association-ceo-michael-maves-to-leave-in-june/

Go to Web to have the links in story active.

WSJ BLOGS

Health Blog

WSJ’s blog on health and the business of health.

• NOVEMBER 4, 2010, 11:18 AM ET

American Medical Association CEO Michael Maves to Leave in June

By Katherine Hobson

The American Medical Association says its CEO, Michael Maves, will leave the organization at the end of June.

In a statement, the AMA said the decision was mutual. “As we enter into a new era that is redefining the way health care is delivered, both Dr. Maves and the Board of Trustees share the belief that new top leadership is required to address these challenges and to ensure the rights of patients and physicians are passionately and effectively protected,” said Ardis Hoven, chairman of the AMA’s board of trustees, in the statement.

The AMA backed health-care overhaul legislation but was frustrated that a permanent fix to the payment formula for reimbursing physicians wasn’t included. Instead, a series of piecemeal “doc fixes” has prevented increasingly drastic cuts to physician reimbursement. In June Congress approved a fix granting a 2.2% reimbursement increase, but that’s good for only six months.

And that means that we’re about to have the whole debate all over again, with a lame duck Congress. If no action is taken, cuts will go into effect Dec. 1. The AMA is holding a news conference on Monday on this topic.

Fixing the formula would be expensive. Earlier this year the CBO said that even freezing payment rates would cost almost $276 billion over the next decade. And the problem only gets bigger as the cuts are kicked further down the road.

Photo: Associated Press

—-

AMA Website press release: http://www.ama-assn.org/ama/pub/news/news/maves-to-leave-ama.shtml

Michael Maves, MD, MBA, Executive Vice President and CEO, to Leave the AMA on June 30, 2011

For immediate release:

Nov. 4, 2010

Read entire statement at link above.

Also see: http://www.suntimes.com/news/metro/2865654,ama-ceo-is-out-110410.article

——–

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.  Twitter is free and takes minutes to join.  Put email in and pick password.  Great source of breaking news and you don’t flood your email with it.  You can get free app for BlackBerry or IPhone etc and you check on tweets when you want.

Also, recent selected DJP Updates can be found at:  http://donaldpalmisano.com/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 2317 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”

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DJP Update 11-2-2010 Election Day: Vote! & some Op-Eds; Lagniappe: ABA Journal & comics

DJP Comment:  There still is time to vote.  Vote for the person of your choice.  But do your homework and act.  Failure to vote causes the acts of those who gave us our freedoms to be ignored and their sacrifices wasted.  Exercise your power to vote for individuals who adhere to principles and do not act like the souls in the Vestibule of Hell graphically by Dante.  He gives the fate of those opportunists who are not wanted in Heaven or Hell.  I discussed this issue in my book, “On Leadership…”.  So go and vote. Vote freedom and liberty.  Avoid coercion.
Here is an excerpt of what I said in 1985 in my outgoing speech as president of the Louisiana State Medical Society (LSMS) when I quoted Cyrano:
So, when I win some triumph, by some chance,

——- End of Excerpt

First Op-Ed: Donna Baver Rovito Op-Ed
DJP Comment:  Opinion of a physician’s wife, an Alliance member,  follows.  Donna Ravito is the bright lady I mentioned in my AMA Inaugural Address in 2003 for her outstanding reporting on the medical liability crisis in Pennsylvania.  She doesn’t grouse around the coffee pot.  She has the courage to gather the facts and act.

11/2/2010 – Liability and Health News Update ELECTION DAY EDITION – Protect your Health;

Support candidates who oppose ObamaCare

by Donna Baver Rovito

Editor, Liability and Health News UpdateAuthor, Pennsylvania‘s Disappearing Doctors

Commentary on Today’s Election

Today’s election will have a huge impact on your health.

The so-called “Patient Protection and Affordable Care Act” (PPACA) won’t accomplish any of the things its title implies and has already begun to accomplish exactly the opposite.

Insurance premiums are going up, people won’t be able to keep their plans, and quality will decline as millions of new patients are dumped into an already physician-starved system.

Access to care will suffer because a Medicaid or Medicare card is useless if patients can’t find a doctor who can afford to accept it because reimbursements don’t cover the cost of care.

The deficit will grow as hidden costs are revealed, and there will be direct or indirect “tax increases” for everyone, not just “rich” people.

America’s health care system (not the quality of its practitioners) needs reform – but in its haste to rack up a legislative win, a blatantly partisan Congress rammed bad medicine down our throats, and now the nation’s most powerful arbiter of health is a former trial lawyer lobbyist who wouldn’t know the difference between a scalpel and a bone saw.

Today, we must elect people who will roll back this disaster of social engineering and replace it with consumer protections, free market cost savings, tax fairness, and real choice and competition.  We need to elect people who support a common sense plan the American people can also support, instead of 2,700 incomprehensible pages of legislation and an estimated 50,000 pages of regulations yet to be written by an unelected Czarina of Health (HHS Secretary Kathleen Sibelius) and an unconfirmed doctor (Donald Berwick) who’s “romantic” about England’s disastrous National Health Service and favors rationing “with our eyes open.”

Pennsylvanians need to elect Pat Toomey for US Senate, Tom Corbett for Governor, and Congressional candidates who support Defunding, Repealing, and Replacing the PPACA with common sense measures that will keep the federal government out of your doctor’s exam room and your hospital’s operating room.

For a complete list of where Pennsylvania’s Congressional candidates stand on the PPACA, go here:

http://liabilityandhealthnewsupdate.blogspot.com/2010/11/vote-voter-guide-pa-governor-us-senate.html For a nationwide list of how members of Congress voted on the PPACA, go here: http://www.leagueofamericanvoters.com/CongressmenVotes.aspx And if you have questions about who supports Pennsylvania’s health in the General Assembly races, go here:

http://liabilityandhealthnewsupdate.blogspot.com/2010/11/1112010-liability-and-health-news.html

Americans need to do whatever it takes to counteract the toxic prescription forced on patients and physicians on March 23, 2010.  According to the latest Rasmussen poll, a staggering 58% of us want the PPACA repealed, while only 36% oppose repeal, despite a $3 million taxpayer funded advertising campaign, months of misinformation, demands of “compliance” and threats of “re-education” from the Czarina of Health herself.

The American people will NOT comply, Madame Secretary, and it is the Democratic Congress and administration who will be “re-educated” on Election Day.

Unapologetically,

DJP Comment:  Today, while the Nation is excited about the National Elections and correctly so, the FDA is holding a hearing today and tomorrow, November 2-3, on biologicals and biosimilars.  Hope your organization has weighed in on this important topic!  Too bad the hearing is on Election Day!  AMA has good policy about this topic.  I gave you some of the policy in a recent DJP Update.  There is lots of good AMA policy buried in the PolicyFinder.  We just need to make sure it is advocated in all of the important issues that come before regulatory agencies and Congress.  Below is my Op-Ed in the Times-Picayune online published yesterday.

The key message is:  …”they must design regulations that ensure patient safety, provide incentives for innovation and protect the ultimate independence of physicians.”
Here is my tweet with the link: www.twitter.com/DJPNEWS

DJP Op-Ed: Understanding the Challenges of Next Generation Medicine  http://tinyurl.com/27etgan #FDA #HCR #PPACA #CPPR #biologics

about 22 hours ago via web

——–

Also the direct link on Web is: http://www.nola.com/opinions/index.ssf/2010/11/understanding_the_challenges_o.html

Contributing Op-Ed columnist
The English writer Aldous Huxley once said that humanity has “an absolute and infinite capacity for taking things for granted.” I think about that as I consider the remarkable achievements we’ve made in medicine over the past century from discoveries like penicillin and insulin to the ability to transplant an organ.

The pediatric textbook that I studied from in 1963 said that childhood leukemia was 100 percent fatal. Now the majority of children with leukemia are cured! The science fiction of yesterday is frequently the cure of today. And within our grasp are the miracles of tomorrow.

Americans have access to the best health care in the world. We have it because each generation of doctors, researchers, scientists, and inventors stand on the shoulders of their predecessors. The medical miracles of today are only possible because of the time, effort, and yes, failures of the past. So to the miracles of tomorrow, like treatments and cures for horrific diseases like cancer and ALS (Lou Gehrig’s disease) will only be possible if we continue to make investments in research and discovery.

This very moment, researchers and scientists are in laboratories across the United States seeking the next great breakthrough. And many of those breakthroughs will come as next-generation biologics. Biologics are much more complex than traditional drugs. They are manufactured from living cells, using unique processes resulting in complex mixtures that are not easily characterized and virtually impossible to reproduce outside of the strict laboratory setting.

These medicines are so complex and so narrowly tailored to target specific cells in the body, small differences in their structure — which may involve molecules with hundreds of compounds — can change their effectiveness and potentially the safety of the medicine. It is because of this complexity that developing and manufacturing an identical generic version of biologics is not possible. However, after passage of the healthcare reform bill, Congress empowered the FDA to develop a pathway to approve similar, less expensive versions of biologics for patients.

Specifically, the health reform law directs the FDA to develop a system for introducing biosimilars into the market. But don’t let the name confuse the issue: The difficulty with replicating biologics cautions us to remember that similar is not the same. Unlike most traditional pharmaceutical generics, biosimilars are similar to, but not the same as the original biologic. That’s because they do not use the same cell line, production process, or raw material as the drug from which they are modeled.

Part of the FDA’s testing process must include an understanding of what scientific and technical factors the government should consider when determining whether a proposed biosimilar is “highly similar” to its brand counterparts.

That’s easy in theory, but probably much more difficult in practice. The major hurdle in biologic manufacturing is that no two molecules from different production processes can be the same. Some differences may be unimportant or trivial, others extremely important and critical to the health of the patient. The best way to understand the variances is to do clinical evaluations over time to understand precisely how a biosimilar under development may work differently than the biologic that was developed originally.

Although it is still under the radar, in early November the FDA will begin working to shape an approval process for follow-on biologics or biosimilars. As the FDA is considers this pathway, they must design regulations that ensure patient safety, provide incentives for innovation and protect the ultimate independence of physicians.

Additionally, doctors need to have confidence that the biosimilars are safe and effective for their patients. Thus, the process that the FDA undertakes needs to be thoughtful, deliberative, and science-based. The final decision on what medications ultimately are prescribed must remain between a doctor and patient — not legislators, insurers, or pharmacists. And there should be no substitution – by a pharmacist — without the treating physician’s approval.

As most will appreciate, manufacturers have to get biologic composition exactly right. Lives depend on it. And, until adequate science is in place to ensure patient safety, the standard for allowing a biosimilar to be used instead of the biologic it attempts to replicate must remain high.

Biologics are the fastest-growing segment of the pharmaceutical market and some of these promising new formulations will become the “miracle drugs” of the future. But we have to get this right. As we formulate new policies for biosimilars, we have to put the well-being and safety of patients first. That’s good policy for anyone seeking to improve America’s healthcare.••••••••

Donald Palmisano, M.D., is a former president of the American Medical Association and is the spokesperson for the Coalition to Protect Patients’ Rights.  His e-mail address is djp@donaldpalmisano.com.

———

LAGNIAPPE / DJP Comment: I have been a member of the American Bar Association since 1982, longer than a member of the AMA.  I get the ABA Journal each month.  In the November 2010 issue on page 10, there is an article entitled, “Comic-Con”.  It displays examples of the Yale exhibit called “Superheroes in Court!  Law and Comic Books”.  My favorite comic book example in the article is the cover that shows Batman and Robin in court.  The judge is the Joker and the jurors are more Jokers.  The text balloon from Batman says, “A JOKER judge and a JOKER jury!”  The text balloon from the judge says, “Yes, BATMAN, I’m giving you a FAIR TRIAL! HA-HA-HA!”  You can see the image and read the article at:

http://www.abajournal.com/magazine/article/comic-con/

I suspect some doctors feel that way with the broken medical liability system when they enter court.

—–

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.  Twitter is free and takes minutes to join.  Put email in and pick password.  Great source of breaking news and you don’t flood your email with it.  You can get free app for BlackBerry or IPhone etc and you check on tweets when you want.

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Donald J. Palmisano, MD, JD

Intrepid Resources® / The Medical Risk Manager Company

5000 West Esplanade Ave., #432Metairie, Louisiana USA 70006

504-455-5895 office

504-455-9392 fax

DJP@donaldpalmisano.com

www.donaldpalmisano.comwww.onleadership.us
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