Don’t let Health Reform Die When Stressing Quality of Healthcare

According to House Minority Leader John Boehner of Ohio , speaking about the healthcare overhaul, “The bottom line is, nobody wants this bill but Washington’s special interests”.

This is clearly not the case according to leaders of the AMA along with physicians, consumer groups and patient advocates. A letter was drafted by representatives of AARP, American Cancer Society, Cancer Action Network, Families USA and Service Employees International Union, stating that “the legislation is not perfect. No bill is. But now is not the time to turn back”.

Certainly the changes stressing disease prevention and increased healthcare quality should be actively sought.

The problems arise when discussing the price tag for this quality and the possibility of rationing care. These tangible issues bring a great deal of emotion attached to them.

What do you think?

Don’t Put All Your Eggs in One (EMR) Basket

Vendors will represent themselves as being “omnipotent”, able to handle all groups within the practice, or all specialties within a healthcare facility and all functions.

While this may come as a welcome relief, it may not actually be the best solution for you.

Check thoroughly to see what specialties and what programs the vendor is capable of providing. You may want to have another vendor who focuses on a particular niche or feature that is not properly represented with the initial seller. Though the principle sounds like it would complicate matters, having more than one vendor, has additional benefits. Each one will want to please you and work harder to fulfill your needs due to competition. If one is not performing up to par in an area, you also have another vendor to fall back on.

Finally, make sure in your contract that your vendor will work with you during the transition phase if you decide to change vendor systems to make a seamless, smooth conversion.

Construct a Back Door for your EMR System

Although everyone is now satisfied with the vendor, the program, the service and the contract, do not sign until there is an “opt out” or cancellation clause inserted.

If the system that you have elected to implement, no longer functions up to your expectations and you see a better system that works for you now or is more affordable, you don’t want to be locked into the system that you loathe. Having no means of opting out translates to having to throw thousands of dollars away to pay a vendor for a commitment while changing. If there is an early termination fee, know about this ahead of time. There should be no unplanned expenditures.

Make out Your Wish List for Electronic Medical Systems

Before signing an agreement with a particular vendor, it is crucial to sit down and outline your wish list- the Request for Proposal (RFP). This is an extensively detailed document, which leaves nothing to chance or guesswork. If it is not written into the document, even if a service was promised to you, it may very well be a service that you do not receive.

The RFP is used to seek bids and proposals from the pool of electronic health record vendors that you will be considering doing business with and as a basis for negotiations of the contract.

In the RFP you need to record all the features and services that you are looking to utilize in your system. Speaking to your colleagues and shopping around with available programs will aid in formulating necessary features for you. It is important to define responsibilities for you as well as the vendor such as who will be supplying the hardware for the system and who the Internet provider will be.

Your RFP will need to include a method of program upgrades, training and delivery expectations.

Now that you have formulated a succinct plan for your practice, you are ready to solicit services from electronic healthcare vendors.

Compare the vendor contract with your RFP. Note how many of their salient features match those that have been designated as important to you. Make sure that ongoing maintenance costs are spelled out in addition to the initial purchase costs and delineate what the cost will be over an extended period of time such as 5 years.

Once you have chosen the possible vendor, it is time to rev up your research.

Explore the opinions of independent references. Research the Internet and speak to your colleagues to see what others are saying about this company. Find out if this vendor is compatible with your server and the hospital system with which you are affiliated.

Obtain the resumes of the trainers that the company will send you to help with program implementation. You should be informed as to what kind of experience the trainers have in the system and how long they have been using it as well as whether or not they have certification in the program. A sample or depiction of a resume for a typical trainer is insufficient. You need the actual resumes. These are the people that will be ironing out the problems for you and answering all your questions. You need to know that they are prepared to do so with a minimum of stress and frustration on your part.

Utilizing a consulting service or program manager to develop your program and the negotiation process, will save time and stress. However, it is still incumbent upon you to be very familiar with the programs under consideration and if the features within the program are those that you consider important.

Do not sign your binding agreement until you have had your legal representative pore over the document to ensure that everything is proper.

New Look at an Old (healthcare) Proposal

The people have sent a clear message on healthcare in Massachusetts by voting in Scott Brown.

Democrats realize that their healthcare overhaul is in jeopardy by losing the senator position to a republican. Apparently President Obama is feeling the pinch as well and may seek to pare back his healthcare plan to obtain bipartisan support.

Key issues that the President would maintain would include health insurance company regulations, banning coverage denial based on pre-existing medical conditions in addition to aid for small businesses for healthcare costs.

These issues are attractive to everyone. However, another concept that has not been addressed would be to allow interstate purchase of health insurance policies. In the spirit of trying to contain escalating costs, allowing Americans to purchase a plan that is more affordable, with more desired options would go a long way toward fostering competition and thereby helping to contain costs.

The People of Massachusetts have Spoken

The fact that Republican Scott Brown has taken the senate seat away from Democrats in Massachusetts may potentially cripple efforts to push through a healthcare reform bill.

Nancy Pelosi states “our eye is on the ball of passing legislation.  In order to do that we will have to dissolve differences, establish some priorities , make some decisions and that’s what we’re doing. Whatever happens in Massachusettes, we have to do that”.

Not everyone is that fatalistic. Possible  measures are under discussion to avoid the necessary 60 votes in the senate.

The President is pushing to bypass the senate by having the house simply voting on the exact bill that passed the senate before instead of the compromise being worked on by Congressional negotiators to meld both House and Senate bills.

There is an option suggested whereby Mr. Brown’s swearing in is delayed with Mr Kirk (democrat) still holding Kennedy’s seat until the health care compromise clears the Senate floor.  Most people find this repugnant if not totally unfair.

Perhaps we should be opening our eyes as to why Scott Brown won in the first place.  The majority of people in the state of Massachusetts are saying (with their vote) that they are unhappy with the proposed healthcare reform.  It’s not that we don’t want people to have affordable healthcare coverage.  It may be that the cost of change is too dear.

The 3 Bares-Not Too Much, Not Too Little and Not Just Right

Many Americans are going bare in terms of healthcare coverage- 47 million according to statistics.

One of the main reasons for reforming the current healthcare coverage is in fact to address this issue.

Unfortunately, the current proposals intended for utilization by these uninsured, would squeeze a large segment of the population in the middle who do not have discretionary funds.

Congress proposes expanding Medicaid for the poor and providing subsidies for others to aid in private coverage purchase. Many will be earning too much for the cutoff and not enough to purchase the steep coverage, even with the subsidy, and can ill afford the copays and incurred costs.

Judith Solomon, a senior fellow at the Center on Budget and Policy Priorities in Washington agrees.

Despite the Medicaid expansion, 7.2 million adults would earn too much for eligibility. This translates to $21,000 for an individual and $44,000 for a family of four. Millions have earnings only just above this tier.

Richard Curtis, president of the Institute for Health Policy Solutions in Washington stresses that this segment of the American population will be forced to choose between healthcare coverage and bare necessities such as room and board as well as the expenses that arise in raising a family.

If forced to spend for the insurance, ask yourself what good having healthcare coverage will be if the person starves to death.

Senior Healthcare solution according to Maxine

Senior health care solution according to Maxine


Senior Health Care Solution

So you’re a senior citizen and the government says no health care for you, what do you do?


Our plan gives anyone 65 years or older a gun and 4 bullets.  You are allowed to shoot 2 senators and 2 representatives.  Of Course, this means you will be sent to prison where you will get 3 meals a day, a roof over your head, and all the health care you need!  New teeth, no problem..  Need glasses, no problem.  New hips, knees, kidney, lungs, heart?  All covered.


And who will be paying for all of this?  The same government that just told you that you are too old for health care.  Plus, because you are a prisoner, you don’t have to pay income tax anymore.


IS THIS A GREAT COUNTRY OR WHAT?!


Yet Another Problem with Taxing Cadillac Health Plans

Most people do not argue with “taxing the rich”- a reflection of Robin Hood’s motto,” stealing from the rich and giving to the poor”. Indeed, the House bill proposes this to fund a healthcare reform with coverage to all.

Unfortunately, the tax net thrown out by the Senate (and supported by the president) is catching far more than just the wealthy.

Labor leaders are up in arms over the more expensive insurance plans. They point out that union members have accepted good health benefits in lieu of salary increases and this new tax would directly hit them.

Thus, the tax on the Cadillac plans is directly involving the working class. Although many House legislators oppose this, the Senate is enthusiastically supporting it.

Melding of both House and Senate plans will be a tall (medical)  order.

Let’s tax the seniors, the Sick and the ones we have depended on the most

Did you know that a “Cadillac” insurance plan is not always based on the excellent benefits that a superior coverage offers?

The term “Cadillac” to describe a plan is based on an expensive model. While one would expect that to mean you are buying a plan with excellent benefits covering even the most expensive therapy or low deductibles, it can also translate into a mediocre plan with high premiums due to the insured’s age, sex or prior health problems.

Not everyone with a Cadillac plan is rich or even comfortable in the middle class. Some are just the average worker, the older or sicker one that you may find in the workplace.

This would not matter to the Senate.

The healthcare proposal by the Senate recommends taxing insurers for plans with premiums above a certain level- more than $8,500 for a single person or $23,000 for a family. High-risk careers like firefighting, policemen and longshoremen would also command taxes, as the premium is higher. Again, there is an inequity in states with 17 of them having a high cost over other states.

Note- the issue of being able to buy out-of-state insurance (which would decrease costs by competition) is deliberately not being addressed.

In a rush to push a healthcare plan through, those who have been depended on and respected, will be the ones to suffer.