Thursday, February 25, 2010

2/24/2010 - What do doctors say about health care reform? (Does anybody care?)

2/24/2010 - Liability and Health News Update
What do doctors have to say about health care reform....?
(Does anybody care....?)

by Donna Baver Rovito
Editor, Liability and Health News Update
Author, Pennsylvania's Disappearing Doctors

This LIABILITY AND HEALTH NEWS UPDATE "newsletter" is a free service which I provide, as a volunteer, to help supply medical liability reform and health care reform news and information, legislative updates, and political insight to physicians, patients, liability reform and quality health care advocates. NO ONE pays me to do this.

I am not employed by any physician or health care reform advocacy or liability reform organization, political party or candidate, although I volunteer for several. I am a quality health care, physician and patient advocate, breast cancer survivor, physician's spouse, journalist, political noisemaker, mom, and freelance writer. I am not nor will I ever claim to be unbiased (I am....biased, I mean), unlike many in the mainstream media.

Most information in this newsletter is copied and pasted from other sources, and will always be identified with links. Opinions and clarifications are my own, and do not reflect the official position of any physician or patient advocacy organization, tort reform, or health care reform group unless stated as such. My opinions are placed in double parentheses (("my opinion")), italicized and appear in blue.

This Update is emailed to health professionals, physician and patient advocates, and others interested in ensuring access to quality medical care. Join our Google Group to ensure you get all issues ASAP: It also appears on the following BLOG (when I remember to post it):

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So someone apparently heard the shouting and all of a sudden, DOCTORS will be attending the bipartisan health care summit at Blair House. Details on that follow.

Frankly, doctors, including the 16 doctors in Congress, have had FAR too little to say about the health care reform issue. No, that's not accurate - they've had a lot to SAY, but no one in a position of power has been LISTENING to them or taking their suggestions seriously enough to include in policy choices.

Hey, they're trying to remake our entire health care system - why would they ask doctors what THEY think?

There's a lot of talk about the summit, how Republicans should present themselves, or if they should show up at all. I think they need to be there and present their best ideas, and I think it's quite promising that the GOP will be backed up by several of its physician legislators. The American public will see whether this meeting is really bipartisan by how their ideas are received.

I had an opportunity to ask my own Congressman, Charlie Dent, what he thinks about the President's plan and the summit, and his thoughts weren't a surprise, since he's opposed the House and Senate plans all along: "Rather than starting the health care debate over, the President had presented an eleven page document that appears to be a rehash of the Senate bill with some adjustments. The Senate bill has been rejected by the American people and I'm surprised that the president intends to submit that proposal as his plan. I hope that the Republicans in attendance will be offering substantive and constructive alternatives to the plan offered by the President. The American people are concerned about the cost of health care and are frightened by the fiscal implications of the bills that passed the House and Senate. The President's new plan could not even be scored by the Congressional Budget Office (CBO) because it lacks detail."

Of course, if it HAD details, people wouldn't like them....that was proven once the several thousand page House and Senate plans got out....

The first item is a video which will either make you laugh - or make you sick. As we hear more and more about using "reconciliation" to thwart a potential GOP filibuster of the health care bill, some intrepid researcher thought it might be instructive to see what Democrats had to say about efforts to keep the minority party from using the filibuster WAY back in...2005.

In fact, the outrage expressed by Democrats in the Senate about the Bush administration considering using the "nuclear option" to get judicial appointments approved is SO recent that our President weighed in during his early days as a US Senator....the best line, though, comes from our VICE President....yes, we know that reconciliation and the nuclear option aren't exactly the same thing - but both are legislative tricks to try to diffuse the power of the fillibuster....and the Democratic Senators' outrage against anyone taking away the power of the filibuster, just as the Democrats are doing right now, is visceral....It's quite enlightening....

As I said earlier, doctors' voices have been hard far too little in this debate - but not for lack of trying, or for appropriate vehicles. Many of the following items focus on the groups that represent physicians and patients and advocate for reasonable health care reform. Some you've heard of - like the AMA, the Association of American Physicians and Surgeons (AAPS), and the American College of Surgeons. Some are relatively new, like Take Back, Docs 4 Patient Care (D4PC), Doctors' Advocate, Sermo, Physicians for Reform, the Coalition to Protect Patients' Rights, the Health Reform Hub and Doctors Vote, just to mention a few.

They're ALL valuable and all looking out for physicians and patients. Join one, or join them all. Get involved with one or more. Go to their websites and sign up for their free newsletters. Support their efforts financially. THESE ARE THE GROUPS which are giving voice to physicians' issues and concerns - and in doing so, are standing up for patients as well. Please check them out - you may just find a perfect fit.

On a slightly more personal note - a Pennsylvania based physician advocate is trying to compile patients' stories about the difficulty of having a baby in Pennsylvania, and would like to talk to a pregnant patient who is forced to travel long distances to obtain pre-natal care, or a new mother who has recently delivered a baby at a hospital far from home because the local hospital's maternity ward has closed.

If you know someone like this who might be willing to tell her story, please contact me at This effort could be important in showing the public and legislators the hidden cost of the medical liability crisis....which is NOT over, despite what some folks who live in the Governor's Mansion in Harrisburg might say....

Stay tuned - lots more to come as the year-long health care debate CONTINUES....and continues....and continues.....

Sincere thanks for your support - the phone calls, emails, letters, personal visits, etc. We need to keep it up.



((Fascinating and instructive video...))

Obama & Dems: 51 Vote ‘Nuclear Option’ Is ‘Arrogant’ Power Grab Against the Founders’ Intent...... least it was in 2005.....
Biden: "I pray God when the Democrats take back control we don't make the kind of naked power grab you are doing."


McConnell announces GOP lineup for healthcare summit
By Eric Zimmermann - 02/23/10 01:54 PM ET

Senate Minority Leader Mitch McConnell (R-Ky.) announced this afternoon which GOP Senators that will accompany him to the White House healthcare summit on Thursday.

Besides McConnell, Sens. John McCain (R-Ariz.), Mike Enzi (R-Wyo.), Chuck Grassley (R-Iowa), John Barrasso (R-Wyo.), Lamar Alexander (R-Tenn.), Jon Kyl (R-Ariz.), and Tom Coburn (R-Okla.) will represent Senate Republicans at the meeting.

Enzi and Grassley are ranking members of the committees with jurisdiction over healthcare; Coburn and Barrasso are doctors; Kyl is Republican whip; Alexander is chairman of the Senate Republican conference, and McCain is a member of the HELP Committee.

House Republicans said today they will "crash" the summit, though it's not clear which members they'll bring along to do the crashing.


DJP Update 2-24-2010 addendum regarding doctors at health summit

Re doctors at Health Summit: New info from Republicans and an ABC News article
Will search for info from Democrats.

One article says final list not set yet:

But here is the note from Republicans.


CONTACT: Michael Steel, Kevin Smith - (202) 225-4000
Boehner Names Health Care Summit & “Truth Squad” Participants

WASHINGTON, D.C. – House Republican Leader John Boehner (R-OH) today announced the House Republican participants for the White House health care summit on Thursday, as well as members of the House GOP’s Health Care “Truth Squad” – a team of Republicans ready to fact-check misstatements from Washington Democrats and highlight Republicans’ better solutions to lower health care costs – while the Republican summit team participates at the Blair House. Boehner issued the following statement:

“The American people want Washington to scrap this job-killing health care bill and start over with a step-by-step approach that will lower health care costs. That is not the ‘Republican’ view; it is the view of the American people. We’ve assembled a team of individuals who understand this, because they’ve been listening to the people they were sent to Washington to represent. We’ll be ready to remind our Democratic colleagues of this and discuss the alternative, step-by-step approach Republicans have offered when we go to the White House summit on Thursday.”

Following are House GOP members participating in the White House summit:

Republican Leader John Boehner (R-OH)
Republican Whip Eric Cantor (R-VA)
Energy & Commerce Committee Ranking Republican Joe Barton (R-TX)
Ways & Means Committee Ranking Republican Dave Camp (R-MI)
Education & Labor Committee Ranking Republican John Kline (R-MN)
Rep. Marsha Blackburn (R-TN)
Dr. Charles Boustany (R-LA)
Rep. Peter Roskam (R-IL)
Rep. Paul Ryan (R-WI)

Following are members of the House GOP’s Health Care “Truth Squad”:

· Republican Conference Chairman Mike Pence (R-IN)
· Rep. Roy Blunt (R-MO)
· Rep. Kevin Brady (R-TX)
· Rep. Ginny Brown-Waite (R-FL)
· Dr. Paul Broun (R-GA)
· Dr. Michael Burgess (R-TX)
· Dr. Bill Cassidy (R-LA)
· Dr. John Fleming (R-LA)
· Rep. Jeff Fortenberry (R-NE)
· Dr. Phil Gingrey (R-GA)
· Dr. Parker Griffith (R-AL)
· Rep. Cathy McMorris Rodgers (R-WA)
· Dr. Tim Murphy (R-PA)
· Dr. Tom Price (R-GA)
· Dr. Phil Roe (R-TN)
· Rep. Mike Rogers (R-MI)
· Rep. John Shadegg (R-AZ)

((So there are now 12 doctors involved in the Bipartisan summit - all of them Republicans - even though only three will actually be in the room. Personally, I think everyone should sit down, be quiet, and let Senator Tom Coburn tell 'em how it ought to be done....))


((While the Republicans have chosen several of their physician members to participate in this meeting, it remains a fact that none of the physicians in Congress were INVITED by the administration, which apparently doesn't value their input....))

Doctors' Advocate
February 23, 2010


It may shock the conscience of our readers to learn that this week’s so-called Health Care Summit is gearing up to be little more than a battle of buzzwords, bipartisan bickering, and backroom brokering.

And to many, it’s an unmitigated joke.

Why? Imagine a legal reform summit with no lawyers. Or, an armed forces hearing without a single soldier. Perhaps a banker-less budget debate.

While lawyers will have a plentiful presence during Thursday’s summit, doctors are asked to call out sick. Not a single physician has been invited to participate, signaling both the White House and the Congress’s commitment to put personal injury lawyers first and patients last. And they are proceeding in that fashion because doctors, by their silence during this year-plus debate, have given them permission to do so. Trial lawyers have spoken up time and again, and Washington is bowing the knee.

Will we continue to sit back and do nothing? It is one thing to willingly subject ourselves to lawsuit abuse. It is another to put our patients at risk by doing absolutely nothing.

First, do no harm. Do something.
Don’t let frivolous lawsuits destroy your career, your practice, and your family. Call Doctor's Advocate today at 888-362-8202 or email to learn how you can stay in the exam room and out of the courtroom!

© Copyright 2010 Doctor's Advocate. All rights reserved.
Contact Doctor's Advocate:
888-362-8202 Copyright © 2006-2009 Doctor's Advocate


From the Wall Street Journal
FEBRUARY 10, 2010
Ten GOP Health Ideas for Obama

'If you have a better idea, show it to me." That was President Barack Obama's challenge two weeks ago to House Republicans regarding health-care reform. He has since called for a bipartisan forum, not to start over on health reform but to "move forward" on the "best ideas that are out there."

The best ideas out there are not those that were passed by the House and Senate last year, which consist of more spending, more regulations and more bureaucracy. If the president is serious about building a system that delivers more quality choices at lower cost for every American, here's where he should start:

• Make insurance affordable. The current taxation of health insurance is arbitrary and unfair, giving lavish subsidies to some, like those who get Cadillac coverage from their employers, and almost no relief to people who have to buy their own. More equitable tax treatment would lower costs for individuals and families. Many health economists conclude that tax relief for health insurance should be a fixed-dollar amount, independent of the amount of insurance purchased. A step in the right direction would be to give Americans the choice of a generous tax credit or the ability to deduct the value of their health insurance up to a certain amount.

• Make health insurance portable. The first step toward genuine portability—and the best way of solving the problems of pre-existing conditions—is to change federal policy. Employers should be encouraged to provide employees with insurance that travels with them from job to job and in and out of the labor market. Also, individuals should have the ability to purchase health insurance across state lines. When insurers compete for consumers, prices will fall and quality will improve.

• Meet the needs of the chronically ill. Most individuals with chronic diseases want to be in charge of their own care. The mother of an asthmatic child, for example, should have a device at home that measures the child's peak airflow and should be taught when to change his medication, rather than going to the doctor each time.

Having the ability to obtain and manage more health dollars in Health Savings Accounts is a start. A good model for self-management is the Cash and Counseling program for the homebound disabled under Medicaid. Individuals in this program are able to manage their own budgets and hire and fire the people who provide them with custodial services and medical care. Satisfaction rates approach 100%, according to the Robert Wood Johnson Foundation.

We should also encourage health plans to specialize in managing chronic diseases instead of demanding that every plan must be all things to all people. For example, special-needs plans in Medicare Advantage actively compete to enroll and cover the sickest Medicare beneficiaries, and stay in business by meeting their needs. This is the alternative to forcing insurers to take high-cost patients for cut-rate premiums, which guarantees that these patients will be unwanted.

• Allow doctors and patients to control costs. Doctors and patients are currently trapped by government-imposed payment rates. Under Medicare, doctors are not paid if they communicate with their patients by phone or e-mail. Medicare pays by task—there is a list of about 7,500—but doctors do not get paid to advise patients on how to lower their drug costs or how to comparison shop on the Web. In short, they get paid when people are sick, not to keep them healthy.

So long as total cost to the government does not rise and quality of care does not suffer, doctors should have the freedom to repackage and reprice their services. And payment should take into account the quality of the care that is delivered. Once physicians are liberated under Medicare, private insurers will follow.

• Don't cut Medicare. The reform bills passed by the House and Senate cut Medicare by approximately $500 billion. This is wrong. There is no question that Medicare is on an unsustainable course; the government has promised far more than it can deliver. But this problem will not be solved by cutting Medicare in order to create new unfunded liabilities for young people.

• Protect early retirees. More than 80% of the 78 million baby boomers will likely retire before they become eligible for Medicare. This is often the most difficult time for individuals and families to find affordable insurance. A viable bridge to Medicare can be built by allowing employers to obtain individually owned insurance for their retirees at group rates; allowing them to deposit some or all of the premium amount for post-retirement insurance into a retiree's Health Savings Account; and giving employers and younger employees the ability to save tax-free for post-retirement health.

• Inform consumers. Patients need to have clear, reliable data about cost and quality before they make decisions about their care. But finding such information is virtually impossible. Sources like Medicare claims data (stripped of patient information) can help consumers answer important questions about their care. Government data—paid for by the taxpayers—can answer these questions and should be made public.

• Eliminate junk lawsuits. Last year the president pledged to consider civil justice reform. We do not need to study or test medical malpractice any longer: The current system is broken. States across the country—Texas in particular—have already implemented key reforms including liability protection for using health information technology or following clinical standards of care; caps on non-economic damages; loser pays laws; and new alternative dispute resolution where patients get compensated for unexpected, adverse medical outcomes without lawyers, courtrooms, judges and juries.

• Stop health-care fraud. Every year up to $120 billion is stolen by criminals who defraud public programs like Medicare and Medicaid, according to the National Health Care Anti-Fraud Association. We can help prevent this by using responsible approaches such as enhanced coordination of benefits, third-party liability verification, and electronic payment.

• Make medical breakthroughs accessible to patients. Breakthrough drugs, innovative devices and new therapies to treat rare, complex diseases as well as chronic conditions should be sped to the market. We can do this by cutting red tape before and during review by the Food and Drug Administration and by deploying information technology to monitor the quality of drugs and devices once they reach the marketplace.

The solutions presented here can be the foundation for a patient-centered system. Let's hope the president has the courage to embrace them.

Mr. Gingrich is former speaker of the U.S. House of Representatives and founder of the Center for Health Transformation. Mr. Goodman is president and CEO of the National Center for Policy Analysis.

Printed in The Wall Street Journal, page A19


((This group, part of the Association of American Physicians and Surgeons (AAPS), has been doing WONDERFUL work during the health care debate. The Letter to America's Physicians is long, but worth the read. Dr. McKalip puts into eloquent words what health care professionals throughout the nation have been feeling for a while now....))

What Presidential Healthcare Reform Means to You

Three days before the Feb 25 media event, where chosen representatives can say their last words before the nuclear option is set off, The President’s Proposal on “healthcare reform” was released.

These 11 pages do not start with a blank sheet of paper, as Republicans recommended, but with the 2,000-page Senate bill. They are getting a disproportionate amount of commentary, but amount to little difference.

The $100 billion added to the price tag, the total net work of 100,000 millionaires, is but one-tenth of the total $1 trillion. This is not real money residing in a Lock Box in Washington, or even in the bank accounts of currently living taxpayers. It will be created out of nothing, so lack of a Congressional Budget Office pronouncement on it doesn’t matter much.


From Take Back

Take Back Medicine is a project of the Association of American Physicians and Surgeons (AAPS), a national professional association of physicians in private medicine.

Since 1943, the mission of AAPS has been to preserve the sanctity of the patient-physician relationship from third-party intrusion

A member-supported organization, AAPS accepts no government grants, or pharmaceutical or other corporate funding.

An Open Letter to America’s Physicians

June 25, 2009

Doctors of America,

Your profession is facing a certain death and only you can stop it – with your patients at your side. Congress and Obama are proposing to turn doctors into servants of the state, insurance companies, hospitals, and everyone except who matters most: the patient. We will be turned into bean counters, computer entry clerks, dutiful “providers” and will not resemble anything like a “professional”[1].

This letter is long, because there is much to report and much to say. But know this, as a physician, you will not want the kind of medical care that your junior colleagues will provide you when you need it. You must lead the way so our valued Medical profession can be rescued from this abyss and we can usher in a new golden age of medicine using genomics, cancer vaccines, implantable devices, nanotechnology, new pharmaceuticals and good old-fashion time with the patient!

I speak to you as a private practice neurosurgeon who is active in organized medicine and who has worked on the board of my state medical association and at the AMA for years*. I can tell you with certainty that there is one and only one goal of those who would “change” our health system: pay doctors less and force them to provide less medical care. That is why the President has put this item at the top of his goals for health system reform: “reduce costs”. How will Congress do this? They will create rationing boards that are unelected and unaccountable to anyone. Already the Federal Coordinating Council on Comparative Effectiveness has been created and given over $1 billion to spend. They have not one actively practicing doctor on the council and each one is a senior management Federal Employee. They will create so called “quality and efficiency goals” and force doctors to follow them through a “pay for performance” model. Those doctors who serve as dutiful servants to all third parties will be treated somewhat less badly than everyone else. Those who have the audacity to prescribe medical care to their patients based on their professional training and experience and in the best interests of their patient will be chased out of practice.

The bottom line is that doctors will be forced to do what they are told. Doctors will be forced to comply. One need look no further than your current practice environment and to ideas circulating in Congressional committees. Already we have seen “quality” (cookbook medicine) and efficiency (rationing) ratings for doctors that assign a star if you comply. If you are deemed a “good doctor” by the insurance company or the government, you will be paid a little more than another doctor. But at what cost? You must hire staff to make sure the quality measures are reported. You will be told to practice in a defacto capitated model where any dollar spent on patients above the arbitrary threshold of a government or corporate bureaucrat will lead you to be labeled “inefficient” – and penalized. You must buy an electronic medical record system to report your data to the government. Congress says they will give you up to $44,000 over 5 years to do so (if you are a “meaningful user”) but the actual cost is $120,000 over 5 years. If you don’t buy the system that will feed your practice data to bureaucrats – you will be penalized $42,500. I know I will take the penalty since it costs me less and keeps big brother out of my office (mission accomplished for the government – they just “reduced costs”).

Already, hospitals are hungrily pushing a “bundled payment” system so hospital based docs will be paid only if the hospital agrees! Hospital based doctors will be slaves to the hospitals. Global payment for management of chronic diseases are proposed so that a doctor will be paid once for a patient with diabetes and similar diseases. This is all occurring in Massachusetts where their health care reforms of 2006 (individual mandates, subsidized health insurance, state boards and health insurance exchanges) are failing more so every day. This is the model for national health system reform.

Congressman Tom Price is a doctor from Georgia who is fighting for patients and doctors in Congress now. He is right when he says we must not allow a “public option”, “mandates” or allow the “government to define quality”. America must empower our patients financially with good tax relief, health savings accounts, high deductible insurance. We should not grant further power to insurance companies and the government. The problems that the government and insurance companies propose to solve were created by them over the last many decades and we are being asked to grant them more power[2]? Enough is Enough!

Now doctors are told they may “volunteer” to report quality data to earn up to an extra $1,000 from the government. Few have. Soon doctors will be told they must report data to avoid a cut in payment –as was done to hospitals a few years ago and 98% compliance was achieved. Then, as is currently done in hospitals, doctors will be told you must meet a “performance threshold” to avoid a payment cut. This is the same kind of “volunteerism” that was envisioned in “Animal Farm” when the dictator happily announced that people could volunteer to work the crops on Sunday and they were under no obligation to do so, but those who did volunteer could avoid a cut in their rations!

The problem is that this “Pay for Performance” model has been convincingly shown to produce no improvement in outcome for patient. What it does do is to force doctors to spend unpaid time in front of a computer to enter orders, respond to pop-up windows, follow protocols and help the hospital code better (so they get paid better on your work). It causes doctors to avoid non-compliant and high risk patients to ensure that they get a good “report card”. It has a disproportionately negative impact on low income patients and minorities who frequently have more complicated medical problems and will be avoided by doctors –just to make the grade. It turns out that compliance with these measures had been shown to do nothing to improve patient outcomes and has had many adverse effects when doctors over-comply and push bad medical practice on inappropriate patients – for a report card score.

Compliance with these so called quality measures is nothing more than an excuse to find a way to pay doctors less and to create a schism between patients and their doctors. This is not quality, this is cost control through bureaucratic overload. I was in the room at the AMA meeting June 13, 2009 when President Obama pointed out that we would not be allowed to have effective tort reform, but if we simply followed “best practices” then we would somehow find a way to lessen our exposure. He didn’t explain how this will work, but I will here. I was here when he said doctors should not be bean counters but should be healers, yet he proposes to turn us into the biggest bean counters around! This is how you will be treated less badly than your colleagues:

Comply. If you comply with reporting – you won’t be hurt as badly.

Comply. If you comply with government defined “quality” – you might escape a sanction..

Comply. If you comply with rationing protocols – you will be paid slightly more than another doc, but still far less than you should.

Comply. If you follow a so called “best practice” and are labeled a “meaningful user” and a good doctor – you might get a little tort relief.

Comply. If you do what you are told, and keep your mouth shut we may let you keep your licensee, your practice, and your participation on the provider panel - but not your dignity and not your profession.

Comply. Comply. Comply.

I am a professional. I will not comply with cookbook medicine and rationing to satisfy politicians who have made promises that can not be kept. Medicare has an $86 trillion unfunded liability. Instead of reform of that insolvent program, we are asked to ration care. We will be FORCED to ration care and deny valuable treatments to our seniors and to withhold life saving care in the hospital when the government determines they don’t meet the threshold for cost of treatment under a “quality adjusted life year” as is used in Britain now[3].

I am a professional and I will not be told how to practice medicine by a hospital administrator, a corporate CEO or government committee.

I am a professional and I will not be used as a rationing tool to save money for others.

I am a professional and I will set my prices and give my patients the time they deserve to make medical decisions that benefit them.

I am a professional and I can’t be replaced by a nurse practitioner or other provider that claims to be able to practice medicine at a cut rate.

I am a professional and I will work to make sure I hold my colleagues to the high standards we expect of each other and not accept sham peer review and “disruptive physician” star chambers.

But like you, I am also compassionate and will work to make sure that government and charity assistance is there for the needy – and not merely an economically unsustainable entitlement that benefits no one even though they are “covered”. I will provide charity when I can afford to stay in practice for those who are truly in need – not forced to provide free care to anyone the government chooses.

Because I am an American, I am rising up to stop this so called health system reform train. I ask you to join me, because as it turns out DOCTORS ARE THE MOTOR THAT DRIVES THE TRAIN – if we stop providing care, the train stops. If we call to our patients and tell them they are in danger, they will come to our aid. Now is the time for bold action and we must use the tools our forefathers gave us to do so: freedom of speech, freedom of assembly and freedom to petition our government. That is why hundreds of thousands of Americans are marching in the streets in July against government-run medicine. They need your help and your leadership.

So I am calling on you to join your patients, me and other doctors around our nation who want to save your profession from the bureaucrats, bean counters and politicians. Here is how you can help.

Join the fight. Sign up to volunteer at Go to

Spread the word. Write a letter to your patients. Host a town hall meeting in your community together with local groups. They love when doctors come to speak and they will welcome you. Tools will be available for you to use at

March on Congress in Your Community. There are “Healthcare Freedom Tea Parties” organized in Florida on July 2nd ( and nationally on July 17 at Congressional offices ( Join up. Speak there. Bring friends.

Keep the Pressure on Congress and in the Public all summer. You will need to call your Congressman and write them. You will need to write letters to the editor, op. ed. pieces and volunteer for radio shows. Our speakers bureau at can help.

Join the AAPS. The Association of American Physicians and Surgeons has fought since 1943 to protect the private practice of medicine ( You should work to make sure the AMA stands up for private contracting and your rights as a physician, but the AAPS is doing it now by filing lawsuits and warning the public. You can make sure your local or state medical society or specialty society sends representatives to the AMA who will fight for your practice as well.

Take Control of Your Medical Staff Officers. Tell them to stand up for your rights and true quality care. Tell them to stop allowing administration to place endless protocols, computerized work and nonsensical forms on your practice. Have your medical staff hire its own attorney – don’t use the hospital attorney. Incorporate separately from the hospital.

Consider donating. I am writing for myself, so won’t be specific. But it is hard to win against a well funded political machine on blood sweat and tears. Find a group that supports this cause and help them financially.

Consider dropping third party payer contracts and Medicare. At what point will you leave the medical police state? When you are fully chained and in control. You won’t be able to leave then. I have dropped United, Medicaid and am working to drop others – not for the money, but to avoid the control they would place on my practice.

This is your last chance. I hope you will join your patients, your fellow doctors and me and rise up to rescue medicine and usher in a new golden age of medicine that comes from a truly free market.

Then you will be able to trust your doctor when you need them, and your patients will too.

David McKalip, M.D.

*Dr. McKalip is a private practice brain and spine surgeon in St. Petersburg, Florida. He is the President-elect of the Pinellas County Medical Association, President of the Florida Neurosurgical Society, serves on the Board of the Florida Medical Association (FMA) and is on the Florida Delegation to the AMA’s key policy making body, the House of Delegates. He serves as the Chairman of the Council on Medical Economics for the FMA and lead the effort to write a health system reform plan for the FMA that focuses on individual financial empowerment of patients. Dr. McKalip founded Doctors for Patient Freedom and is working to ensure that individual savings, choice and competition create better and more affordable medical care for Americans. Dr. McKalip has written and spoken on the unintended consequences of expanded government and corporate control of health care financing and medical decision making including rationing, cookbook medicine, unsustainable economic models for government and unaffordable or unavailable private insurance products and financing options for patients.”

[1] Dr. William Plested, a liberty-loving past president of the AMA stood apart from many and pointed out the characteristics of our Profession in 2006. Long years of intensive education and training established by the members of the profession; Standards of behavior and ethics established by the members of the profession; Disciplinary procedures and actions that are established and enforced by the members of the profession and, The valuation of professional services established by the members of the profession.

[2] While an insurance mandate may sound good at first, it is soon to be followed by a mandate for doctors to take the insurance – no matter what it pays or what onerous regulations it imposes on medical practice. The state of Massachusetts now must spend $869 million to subsidize people to buy insurance, there are long waits for primary care doctors, the public hospitals are being paid less and there is intense pressure to impose cost control policies on doctors like bundling, global payments and efficiency measures!

[3] Dr. Ed Annis warned us of this when, the night after President Kennnedy gave the worse speech of his career in support of Medicare, in an empty Madison Square Garden he warned Americans about Medicare. “This Bill would put the government smack into your hospitals! Defining services, setting standards, establishing committees, calling for reports, deciding who gets in and who gets out-what they get and what they don't-even getting into the teaching of medicine-and all the time imposing a federally administered financial budget on our houses of mercy and healing. It will create an unpredictable burden on every working taxpayer. It will undercut and destroy the wholesome growth of private voluntary insurance and prepayment health plans for the aged which offer flexible benefits in the full range of individual needs. It will lower the quality and availability of hospital services throughout our country. It will stand between patients and their doctors. And it will serve as the forerunner of a different system of medicine for all Americans." Medicare was killed that year and was only passed on a slim margin in 1965 with President Johnson trading on the image of the “martyred President” and using his classic strong arm tactics.


Feb. 24, 2010

Here's your regular update on efforts by the American Medical Association (AMA) to work with lawmakers in reforming the nation's health care system in a way that provides quality, affordable health care for all.

((As many of you know, I've been a little...well, "put out" with the AMA over the past several months as a result of its seemingly unconditional support of Senate and House Health Care bills. A lot of other people have been put out with AMA leadership as well. Some physicians have cancelled their membership - but I encourage disgruntled AMA members not to leave the oldest, most effective physician and patient advocacy organization over this disagreement. Rather, I encourage physicians to stay members, or join at the local level, get into positions of leadership, which isn't all that hard, as new leadership is desperately needed, and become part of the groups that SET POLICY. Why throw away a perfectly good car because it needs a new steering wheel? Several former AMA presidents are spearheading an effort to "take back" the AMA, and doctors who are unhappy with the group right now can be part of that....RIGHT NOW, though, I don't see anything that I object to in the AMA's messaging on the summit and the President's here it is....))

President unveils proposed health reform outline
President Barack Obama released his health system reform proposal on Monday, Feb. 22, for discussion at a bipartisan summit meeting scheduled for tomorrow, Feb. 25. The proposal is described as bridging the gap between bills passed already by the U.S. House of Representatives and the U.S. Senate, using the Senate-passed bill as its base. It addresses policy disagreements between the two bills and adds new priorities with respect to making health insurance premiums more affordable, including closing the Medicare Part D prescription drug benefit "donut hole," expanding anti-fraud and abuse efforts and other issues. However, the proposal is silent on key AMA concerns with the Senate bill, including the creation of an Independent Payment Advisory Board, development of a value-based payment index and permanent repeal of Medicare's sustainable growth rate (SGR) formula. Elements of the proposal can be viewed on a special White House Web page. The summit itself, scheduled to run for six hours starting at 10:00 a.m. Eastern, will be broadcast live on C-SPAN and can also be viewed via live streaming video at

AMA and specialties urge summit attendees to reach agreement on key issues
The AMA and 76 other national specialty organizations sent a letter (PDF) on Feb. 23 to U.S. senators, representatives, and administration officials scheduled to attend the bipartisan health reform summit. The letter urged summit attendees to reach a bipartisan agreement on medical liability reform. The letter notes that meaningful reforms can lower health care costs, reduce the federal deficit, improve access to physician services and provide fair compensation to patients who are truly harmed by medical negligence.

AMA President J. James Rohack, MD, sent a separate letter (PDF) to summit attendees today, urging congressional leaders from both political parties and the administration to work diligently and expeditiously to refine and pass meaningful health system reforms that empower patients and their physicians. Dr. Rohack told summit attendees, "You know full well the problems facing patients and the physicians who treat them."

In particular, Dr. Rohack urged those attending the summit to focus on provisions that improve patient access to high-quality medical care; remove barriers to care through common sense insurance reforms; reduce health system costs; and sustain the vital patient-physician relationship. He also offered several specific recommendations to improve the health care system, including: (1) a mix of proven medical liability reforms and new initiatives; (2) permanent repeal of Medicare's long-outdated SGR formula; and (3) assuring patient choice and the right of patients and their physicians to enter into private agreements without penalty.

Letter from AMA President James Rohack to the President:

February 24, 2010
The President
The White House
1600 Pennsylvania Avenue, NW
Washington, DC 20500

Dear Mr. President:

Health system reform is one of the most important and complex issues on the national agenda. Difficult issues require our elected officials to go the extra step to address documented problems and unsustainable trends in our current health care system.

What we cannot and will not support is stalemate. Our message to those attending the Summit is: You know full well the problems facing patients and the physicians who treat them. Focus on the provisions that improve patient access to high-quality medical care; remove barriers to care through common sense insurance reforms; reduce health system costs; and sustain the vital patient-physician relationship.

One sure-fire way to significantly reduce health system costs is to expand and adopt medical liability reforms. Many respected budget and policy experts have long concluded that defensive medical procedures, prompted by the threat of litigation, add substantial costs for individuals, private and public payers. The current legal environment runs counter to efforts to improve value and appropriate utilization of health care services. A mix of proven medical liability reforms and new initiatives will correct this perverse legal environment, benefit patients on several levels, and ensure that injured patients are fairly and promptly compensated. It has taken far too long for the greater good to prevail over the interests of the trial bar in our nation’s capital.

Permanently repealing the long-outdated Medicare Sustainable Growth Rate (SGR) formula is yet another way that Congress can address health care reform in a fiscally responsible way. At this moment, political brinksmanship is eroding access to care and creating needless anxiety for Medicare and TRICARE patients and their physicians.

For years, Democrats and Republicans have acknowledged that the Medicare SGR formula is bad policy. The longer Congress procrastinates on tackling this issue the higher the price tag will be for the American taxpayer. Before Congress and the federal government incur new commitments under the reform umbrella, they most surely should honor existing obligations to America’s seniors and military families.

Finally, at the heart of any successful health system reform legislation must be continuing recognition of the need to remove barriers to patient choice. Reform proposals must assure that treatment decisions are made by patients and their physicians, not insurers or government officials.
Patients and their physicians should have the freedom to enter into private agreements without penalty by third party payers or the government.

Physicians, not unlike the broader community of voters, have sharply divergent views about pending reform plans. Yet, the overwhelming majority of physicians know without doubt that major reforms to our nation’s health system are necessary. For that reason, the AMA will continue to work with Congress and the Administration to secure vital improvements to pending proposals.

We strongly encourage Congressional leaders from both political parties and the Administration to work diligently and expeditiously to refine and pass meaningful reforms that empower patients and their physicians.

J. James Rohack, MD


Sermo - the Physicians' online community

Guest Column by Richard A. Armstrong, MD, for DocsforPatientCare (D4PC)

America's Physicians...WAKE UP!

As this weeks health care "summit" approaches and the President meets on television with Democratic and Republican leaders it is time to remind all physicians to pay close attention to the meeting and the events that follow. The President and Speaker Pelosi have made it quite clear to the American public that their agenda for health care reform, representing a massive bureaucratic government takeover of the health care industry, must move forward. According to Ms. Pelosi, this will move ahead even if they have to pole vault it through Congress to the President's desk. This is because, in spite of polls that show that a majority of Americans oppose their plans, they still believe that they have the right plan for America and it should pass by any means necessary.

Physicians should not be complacent after the recent victory of Scott Brown derailed the Democrat's plan to ram their legislation through the Senate. There are many legislative options open to the Obama/Reid/Pelosi triumvirate. Among them is reconciliation, originally designed to reconcile the differences between expected revenues and expenditures, but possible in this case to get the Democrat's bill through to the President's desk with only 51 votes in the Senate, not the usually required 60. Ms. Pelosi, in setting the stage for reconciliation, has worked with Senator Reid on a number of "fixes" that could be passed in the House and the Senate. These fixes could be passed and sent to the President at the same time that the House passes the original Senate bill intact and forwards it to the President. By signing both into law, the President passes his health care reform bill while bypassing the Senate rules. Political trickery!

Physicians should be wondering if the President, Mr. Reid and Ms. Pelosi have been listening to the American people. It is apparent that physicians have had minimal to no input. It is our position that physicians should be central in the health care reform process. We need to do everything possible to stand up for American physicians and their patients.

This was the primary reason that Docs4PatientCare was formed by Dr. Hal Scherz and his colleagues from Atlanta, Georgia, and continues to be a primary objective of the organization. Although its origin grew from concern that physicians were not being represented in the reform process, Docs4PatientCare realized early on that no organization was truly representing the interests of physicians and patients, not just in the health care debate, but in the general arena of health care policy. Specialty societies were speaking up for the niche interests of their members, but the organization that should have been standing strong for doctors, the AMA, chose instead to forsake American doctors in favor of back room deals and compromises that effectively sacrifice physicians for the corporate interests of the AMA.

Dr. Scherz and the executive board of D4PC met in December and decided to change the structure of the organization to become a vibrant alternative to the American Medical Association. They realized correctly that American physicians needed true representation with a strong commitment to the sanctity of the doctor-patient relationship, and effective opposition to the intrusive policies of the government and private insurance industry into medical practice.

Docs4PatientCare believes that reform of the massive dysfunctional health care system in America is necessary. However, these reforms can be accomplished with common sense initiatives that do not increase federal regulation, break the federal budget, infringe the rights of citizens, or effectively assume control of 1/6th of the economy.

These common sense reforms are available for review at which is the original political advocacy website soon to be updated to reflect the new mission of the organization.

These basic ideas, among others, need to be discussed openly, debated and considered as part of the "other good ideas" that the President has stated publicly that he would consider. However, physicians should not be complacent. Now is not the time for relief that the election in Massachusetts has provided a break in the action. We are certain to see meetings continue behind closed doors, with new deals brokered and legislation slipped through Congress away from the eyes of the public.

This is not a process that should make us proud, rather political trickery that has never been used in Congressional history to pass legislation of this magnitude and with such far reaching effects. The medical profession and the nation's health care system are in peril. It is time that physicians unify and be represented by an organization that will stand strong for our profession. Docs4PatientCare, Dr. Scherz and over 3000 physicians nationwide have stepped up and are leading this effort. I encourage all of you to join with us and make history for American medicine.

Richard A. Armstrong MD FACS for D4PC


This article, currently featured on the Human Events website, is written by Hal Scherz, MD, a pediatric urological surgeon at Georgia Urology and Children’s Health Care of Atlanta, faculty member of Emory University Medical School and president and cofounder of Docs4PatientCare.

Docs 4 Patient Care -- Time for a New Look for Doctors
by Hal Scherz

When healthcare became the centerpiece of the Obama legislative agenda in early 2009, it appeared that the government takeover of 1/6 of our economy was imminent. A big part of the reason for optimism on the part of the Democrat leadership was the absence of any meaningful resistance. A frequent question posed by the opponents of this policy was where are the doctors in this debate? Indeed.

The doctors were conspicuously absent and this was the problem. Their absence had led many to conclude that physicians didn’t have an opinion on this subject, or worse, were in agreement with this scheme. The truth was quite the opposite. Doctors were frustrated, angry and concerned about the future of their profession and the fate of their patients. There was a palpable need for doctors to have a voice in this debate because up until this point, it was nonexistent.

It was assumed that the American Medical Association (AMA) provided the platform for doctors to air their views. It came as a shock to most people when it was revealed that this was not the case, and in fact, only 17% of all doctors were members. To compound the problem, the AMA betrayed the very people that it was ostensibly meant to represent. This was to protect its $100M medical coding franchise that the federal government grants the AMA as the basis by which doctors and hospitals get paid by insurance companies and the federal government -- a major incentive for the group to endorse state-run medicine.

Docs 4 Patient Care attempted to fill this vacuum. This doctor run organization was born in Atlanta, Georgia in late May 2009 with 40 concerned individuals coming together with a simple concept; to give physicians a platform to broadcast their views, to inform the public and their patients what was really happening in Washington, and to empower them to do something about it. Not quite 9 months and 3000 doctors later, this group has members in every state in the US. It has gone from a regional group with a mission to stop the government takeover of healthcare, to a national group determined to do more. The window of opportunity has been cracked open and now there is a real chance to knock the AMA off its perch to provide real leadership and representation to the American doctors. ((Personally, I don't think the AMA needs to be knocked off its perch as much as it needs to be straightened out - by having new people in policy-making positions....))

The majority of doctors want to see changes in healthcare. This means responsible reform. The system requires remodeling, not demolition. Patients are tired of the partisan politics and want the specific problems addressed, not using the identification of these problems as an excuse to do something far more insidious. We at Docs 4 Patient Care would agree. Doctors don’t take care of Democrats or Republicans. We take care of patients, and they deserve something better from Washington than what they have receiving.

We are determined to grow our organization so that physicians have a voice in the media, in Congress and with insurance companies. We see no reason why with this platform, we couldn’t see D4PC grow to 50,000 doctors by the end of the year. We also need the help of non physicians and invite them to join us on this quest as affiliate members. Their concerns as patients are important to us and we are committed to keep their needs at the heart of everything that we do.

Docs 4 Patient Care has not forgotten why the group was created; to prevent the government takeover of healthcare. This possibility is still very real and if we have learned anything during this debate, those who are in power in Washington are capable of doing anything to make their dream a reality. The longer this goes on without resolution, the more desperate and reckless they become. We will continue to advocate for a responsible resolution which is based on a patient centered, market driven approach where doctors and patients remain unencumbered in medical decision making. The solutions should not be political or ideological. Docs 4 Patient Care believes that it is not a matter of right or left; it’s about right or wrong.


Physicians for Reform
((I've only recently become aware of Physicians for Reform, and am extremely impressed with the group and its founder, Dr. C.L. Gray. Visit the website and sign up - there's no charge. But every advocacy effort requires financial support, and you can support THIS fine effort online....or if there's a group out there which would like to get involved in a more substantive way, or would like more information about Dr. Gray's group and goals, please contact me at and I'll arrange it....))
Friday, February 12, 2010

Hippocrates and The New Cincinnati -- Doctors Rushing To The Aid of the Republic

A terrific piece in Fox Forum this morning from Dr. C.L. Gray, writing about the need to elect more doctors to Congress, and citing three physician-candidates in his home state of North Carolina: Dr. B.J. Lawson, Dr. James Taylor, and Dr. Dan Eichenbaum.

In making his argument, Gray cites the wisdom of Hippocrates, who reminds us why medicine is so highly revered--because doctors have earned that reverence, not only by saving lives, but by suffering with their patients:

In "Precepts" Hippocrates once wrote, “For if love of men is present, love of the art is also present.” In "On Breaths" he added, “The physician sees terrible things, touches what is loathsome, and from others’ misfortunes harvests troubles of his own.” For the Hippocratic physician, the well-being of the individual was of primary concern—not power, not money, not personal gain, and most assuredly, not the supremacy of the State. The Hippocratic physician was born to serve his fellow man.

Gray is 100% right--at its Hippocretean best, medicine is surely the noblest of professions. So is it a bit paradoxical to see doctors running for political office? Maybe. And most Americans would agree that politicking is a lower estate than doctoring.

But occasionally, the political situation becomes so egregiously bad that honorable citizens must put down their plows, as did Cincinnatus of Roman antiquity, rushing to the aid of the republic.

That duty to serve the commonwealth includes honorable doctors; they, too, should step forward into the public square, bringing their medical credibility to improve the political discourse and to reach better policy solutions. That's not to say that doctors are always right, about health and medical policy or anything else. But for reasons best put forth by Hippocrates, 2500 years, ago, doctors have credibility; as the legendary Greek physician said, “For if love of men is present, love of the art is also present.” Not many doctors, who love their art--and, in turn, are loved by their patients--would ever seek to demote medicine as the Obamans have, seeking to reduce the healing arts to just another bureaucratic subset of the federal government.

And so, most likely, we will be hearing more from Drs. Lawson, Taylor, and Eichenbaum.

Posted by James P. Pinkerton at 9:26 AM
Updated February 12, 2010 -
We Need a Doctor In the House -- And the Senate
By C.L. Gray, M.D.

Historically, practicing physicians have shunned politics. If our democracy is to survive, these times demand thoughtful solutions and difficult decisions. Few individuals are better suited to the task than the Hippocratic physician.

Behind the scenes, a quiet and unassuming movement is afoot destined to reshape the future of American health care—and possibly the entire landscape of American politics.

The House currently has fourteen physicians. The Senate has two. This means less than 3% of our elected officials in Washington come from one of the most trusted professions in America—medicine. But that is about to change.

Rising from the ranks of my home state, three North Carolina physicians are running for Congress to address our nation’s daunting challenges. Dr. B. J. Lawson, Dr. James Taylor, and Dr. Dan Eichenbaum seek to represent the 4th, 6th, and 11th Congressional districts. Should they be elected, North Carolina would have a larger physician representation than any state in the Union—three of thirteen Congressional seats, nearly 25%. But why should America care?

In "Precepts" Hippocrates once wrote, “For if love of men is present, love of the art is also present.” In "On Breaths" he added, “The physician sees terrible things, touches what is loathsome, and from others’ misfortunes harvests troubles of his own.” For the Hippocratic physician, the well-being of the individual was of primary concern—not power, not money, not personal gain, and most assuredly, not the supremacy of the State. The Hippocratic physician was born to serve his fellow man.

But such servant leaders are in short supply in Washington today. An air of entitled aristocracy permeates our political class. Rather than guarding hard-earned taxpayer dollars with sacred trust, politicians spend with reckless abandon. Rather than leaving Washington to live under the laws they pass, most politicians cling to power for as long as possible.

Washington has become a city where pork and payoffs rule the day. Where backroom deals and buried earmarks are accepted as they way things get done. Where health care reform becomes about politics, power, and payoffs, not patient care. Americans chafe against this sad perversion of power. To reclaim our representative government, We the People must find new leadership.

Historically, practicing physicians have shunned politics—and for good reason. As we open the clinic door or push aside the emergency room curtain, our patient’s political leanings never cross our mind. Nor should they.

However, our nation now moves into complex and perilous waters. Trillions of dollars of unfunded Medicare, Medicaid, and Social Security obligations must be addressed. The exploding American debt now threatens our very independence. If our democracy is to survive, these times call for thoughtful solutions and difficult decisions. Few individuals are better suited to make these difficult decisions than the Hippocratic physician.

To save the patient the surgeon must sometimes cut to cure. To fight some cancers the oncologist must prescribe chemotherapy. Physicians must not only understand the details of a complex system and make the correct diagnosis, they must treat the illness, even if the patient does not want to hear what the physician has to say. Physicians know that alleviating symptoms does not address the disease, that more is needed however difficult.

The behavior of two prominent physician/politicians, Senators Bill First and Tom Coburn demonstrate the credibility of the physician statesman. In sharp contrast to today’s permanent political aristocracy, Senator First stepped down after achieving the position of Senate Majority Leader. Why? He had promised the voters he would serve for 12 years and no more—he kept his word. Few individuals can walk away from such power. In contrast to Washington’s common but corrupt practice of earmarks, Senator Coburn has opposed wasteful spending (by both parties) so aggressively he earned the nickname Dr. No. Like Senator First, he too has pledged to relinquish power after 12 years of service.

In the fall of 2010, North Carolina may serve as a bell-weather state. North Carolina’s state motto, "esse quam videri"—to be, not to seem to be, distinguishes the politician from the statesman. The politician is concerned with perception; the statesman is driven by character. Voters must decide if these three physicians can be statesmen. If elected, these three men must prove that they are.

Facing overwhelming debt, we need politicians willing to make tough decisions. In dealing with a subject as complex as health care reform, we need men and women who understand how decisions in Washington impact patient care at the bedside. Americans desperately seek elected officials committed to financial responsibility, Constitutional fidelity, and the sanctity of the patient/physician relationship. Two questions remain:

1) Will such servant/leaders rise to the fore?
2) Will We the People recognize who they are and send them to Washington?

C. L. Gray, M.D., is president of Physicians for Reform.

Who We Are

Physicians for Reform is a non-profit organization founded by Dr. C. L. Gray in December of 2006 to find solutions for American healthcare. Working together, physicians, patients, and the business community can recapture the heart of medicine and secure a political platform to reform American healthcare.

The loss of the patient/physician relationship is central to the decline of medicine we face today. America offers the most sophisticated healthcare in the world. Yet, neither patient nor physician is content.

Patients in America view physicians with growing distrust. They often schedule appointments months in advance only to get five minutes with a doctor they don’t know. Physicians view patients as potential plaintiffs. Trapped by forms, litigation, and a bewildering array of regulations, they contemplate abandoning the practice of medicine altogether.

Physicians for Reform provides solutions to this escalating dilemma.

Mission Statement:

Physicians for Reform is a 501-(c)(4) non-profit, non-partisan, advocacy group designed to organize physicians, patients, and the business community in an effort to shape the nation’s healthcare debate. It seeks to keep the patient’s welfare the central focus of medicine, not the fluctuating interests of government. Specifically, Physicians for Reform seeks to:

Make health insurance affordable for every American.

Place the patient at the center of American healthcare.

Reduce the cost of healthcare without restricting access.

Reform today’s broken medical/legal system.

Restore the patient/physician relationship.

Using non-tax-deductible charitable donations, Physicians for Reform will underwrite educational materials, seminars, advertising, and media promotions on healthcare issues, and testify at governmental hearings to advocate these positions.

Real Solutions for American Healthcare - Brief Overview

America must move beyond partisan rhetoric and thirty-second sound bites. We must find solutions for the real problems faced by modern medicine. If an idea sounds too good to be true, it is. If you are promised something for nothing, rest assured your freedom is slipping through your fingers.

Addressing the Fundamental Problems

When providing critical care, physicians always begin with the ABC's of emergency medicine—Airway, Breathing, and Circulation. Though other interventions are necessary, the patient must be stabilized first. The same is true for our ailing healthcare system.

Three fundamental reforms are needed to stabilize American healthcare. If any one of them is neglected, patient-centered healthcare will not survive. We must correct the inefficiencies or our present system, not simply spend more money on a system destined to fail.

Insurance Reform
Tax Reform
Tort Reform

Taken together these reforms will:

Pay for themselves. In fact, these reforms may actually decrease federal spending.

Make health insurance affordable for every American.

Place the patient at the center of American healthcare.

Reduce the cost of healthcare without restricting patient care.

Provide transportability. Patients may keep their health insurance when changing jobs.

Encourage transparency. Patients and physicians can know the cost of care.

Secondary Reforms

Once the above reforms stabilize American healthcare, several secondary measures can build on this foundation:

Standardized electronic medical record

Preventative medicine initiatives

Smoking cessation incentives

Weight loss incentives

"Ask about generics" campaign

Encourage end of life discussion between patients, families, and physicians. However, these conversations must remain strictly optional, completely confidential, and entirely removed from government influence.

Join our team


Putting Patients First -

Working to ensure American doctors and patients – not government bureaucrats – make healthcare decisions

“We have the best healthcare system in the world, and we must work together to expand access to affordable healthcare to the uninsured. However, in the process of expanding care, we cannot create a weaker system for the 80 percent of Americans who are happy with their coverage.” Dr. Donald Palmisano, Former President, American Medical Association

The Coalition to Protect Patients’ Rights is a nonpartisan, grassroots coalition of patients, healthcare professionals, advocacy groups, and engaged citizens who are concerned about the current healthcare debate going on in Washington.

The Coalition to Protect Patients’ Rights believes that the government should not be involved in the private, personal discussion between a doctor and patient as they decide the best course of medical treatment. The Coalition was formed to ensure that healthcare reform builds on the healthcare system we enjoy today where patients can choose the health plan, physician and course of treatment that best fits their individual needs.

The Coalition is dedicated to pursuing a patient-centered and consumer-driven approach to healthcare reform that will improve patient care by:

1. Protecting the patient-provider relationship,
2. Promoting the use of health IT provided that patient confidentiality is protected,
3. Supporting comparative effectiveness research (CER) policies that strengthen patient and physician decision-making,
4. Encouraging continued medical innovation and research, and
5. Focusing on disease prevention and overall wellness.
6. While there are many lawmakers who desire a single-payer system, it is generally recognized that the majority of Americans oppose such an approach.

The Congressional Budget Office (CBO) recently estimated that the public option would cost $1 trillion and cover 16 million individuals currently without health insurance but also force a staggering 23 million people with private health insurance onto a government plan.

The Coalition to Protect Patient’s Rights will strongly oppose any “reform” efforts that could lead to the disruption of insurance coverage for millions of Americans. We will also vigorously oppose drastic cuts to Medicare and Medicaid such as those recently proposed by the Administration and Members of Congress as they seek ways to pay for the public option.

“….we must find ways to expand access to affordable health care to the uninsured. But his [Obama’s] plans won’t improve our nation’s healthcare system. They will only put more patients at risk of not getting the treatment they need….in countries all around the world with government-controlled healthcare systems, patients are told – by their government – what treatments they can and cannot have. Medical decisions are being taken out of the doctor’s office and put into a bureaucrat’s office. We cannot allow that to happen here.” Dr. Donald Palmisano

For more information, visit

Visit to tell your members of Congress “NO to government-run healthcare.”

Additional information available at and

((This is a recent edition of Dr. Palmisano's email newsletter to health care leaders all over the far as I'm concerned, Dr. Palmisano is the finest voice out there speaking for America's patients and physicians - HE should be at the health care summit at Blair House.))

Sent: 2/24/2010 3:55:27 A.M. Eastern Standard Time
Subj: DJP Update 2-24-2010 Item one: Blog Posting by Richard L. Reece, MD; Item two

DJP Update 2-24-2010 Item one: Blog Posting by Richard L. Reece, MD;
Item two: Washington DC in the news again on health system reform;

Blog Posting by Richard L. Reece, MD is below. He interviewed me for
a Modern Medicine article. It was a delight to do an interview with
Dr. Reece.

Another Interview

I like to interview important national figures in the know because I
always learn from them. A few days ago, I interviewed Donald
Palmisano, MD, JD, a New Orleans surgeon who served as President of
the AMA in 2003-2004.

Among doctors and executives in organized medicine, Palmisano is
considered to be an articulate icon. For good reasons. He speaks his
mind, he speaks forcefully, and he speaks plainly.

In our interview, which will appear sooner or later in, he said American health care had reached a

Either we speak out now for patients and ourselves, or government will
take control. He fears present government policies will be disastrous
– driving up costs, depriving patients and doctors alike of their
autonomy, depriving physicians of freedom to privately contract, and
dramatically lowering patients’ access to care.

Physicians, Palmisano asserts, will simply be unable to afford to see
patients because lower reimbursement from third parties will not meet
costs of doing business. Price-fixing by third parties will force
physicians to stop seeing new Medicare, Medicaid, and certain HMO/PPO
patients because they can’t afford to see them. Price-fixing has never
worked, and it will not work now.

Furthermore, doctor will be unable to pay high medical liability
premiums and their staff, further limiting physicians ability to see
new patients from low-paying third party programs.

Palmisano believes solutions lie in market-based solutions with
patients and physicians making the fundamental clinical decisions,
This can be made possible by tax credits for all, an array of choices,
tort reforms, low-cost health savings accounts, high deductibles with
catastrophic lids, coverage of pre-existing conditions rendered
feasible through large voluntary associations, defined contributions
for Medicare recipients with vouchers.

To make these things happen, he says doctors must speak out to their
Congressional Representatives and Senators, tell them the negative
consequences of the present system, encourage their patients to do the
same, and elect new members of the House of Delegates and new
President of the AMA from grunts on the ground, not from current
members of the AMA establishment.

((That could be any of YOU physicians out there....))



ITEM TWO: Washington DC in the news again on health system reform

Is the Administration and Congress going through the motions without
any hope of health system reform? Is the meeting on Thursday just
political posturing? Is the "new" health bill outline dead and the
Thursday meeting just a move to shift blame when nothing gets done in
Congress? One more thing: imagine sending in an intern to be the
surgeon and operate on a patient with a ruptured abdominal aortic
aneurysm. Of course not. But at least the intern would know where
the aorta is. At the Thursday meeting, there are no doctors!

((Word was recently released by House and Senate Republicans that the two doctors in the Senate and one physician from the House WILL be among the GOP's representatives to the summit. The remaining Republican physician members of Congress will be available for a reality check...))

Imagine that. Let those in the meeting start doing the repairs of the
ruptured abdominal aortic aneurysms. They soon may have to learn
because of the disaster they are about to inflict on the patients and
doctors of America. Soon the hit song will be, "Where have all the
doctors gone?". Soon Congress may meet and decide they know from
their legislative experience that they have the knowledge to built a
space ship to Mars. That also will be a disaster.

The conventional wisdom is that the House bill, the Senate bill, and
the President's outline bill will not get passed. The public now
understands what these bills will do and it isn't the needed
solution. So there will be lots of rhetoric but little action. Then
there is a minority view that this position is a trick to lower
everyone's guard and the bill will be rushed through using behind the
scenes deals and arm-twisting.

Which view will prevail? My thought is anything can happen and
constant vigilance is essential. Just as in the Super Bowl, the end
result occurs sometimes because of a couple of key plays. Most
likely, the folks up for re-election in November 2010 will not want to
touch anything that looks like a dancing live wire that could
electrocute them and their chances for re-election.

Meanwhile, the 21% Medicare cut in physicians' fees by the onerous
price-fixing SGR formula looms ahead in April. It is my view that
Congress will not let that happen as the loss of access to care will
have seniors going to Washington to remove the Congress. But will
there be a return to liberty and the right of private contract without
penalty? Highly unlikely. And all Democrats and Republicans who
oppose that one item of private contracting should be removed from
office on election day. There is no reason why the hallmark of the
Free Enterprise, the right of private contract, should be denied to
law-abiding citizens. Regardless of what happens, doctors should not
genuflect or grovel to Congress. We are an honorable profession.
Don't trade shackles. Get rid of them. Live free! Be brave!

As for medical liability reform, watch out for window dressing that is
not effective and may harm current effective laws in place in some

LAGNIAPPE: Think about the June elections at AMA. Imagine the power
of the message if folks not on the board got elected to office,
including president-elect. Think about it. Election from the floor!
Do something about it. Let's continue to try and save AMA by showing
doctors AMA can recover from serious mistakes made by AMA in this
health system debacle.

Stay well.

P.S. Stop by 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:

Donald J. Palmisano, MD, JD

Intrepid Resources® / The Medical Risk Manager Company


American College of Surgeons

One of the core principles of the American College of Surgeons is access to care - enabled by an adequate surgical workforce. This core principle is being threatened. Please call your U.S. Representative and Senators today and tell them that inaction on the Medicare physician payment system is unacceptable and WILL threaten patients' ability to access high quality surgical care. In just 7 days, Medicare payments will be cut by 22 percent unless Congress intervenes. Congress must immediately and PERMANENTLY eliminate the sustainable growth rate (SGR). We cannot support another short-term "patch" that only temporarily prevents Medicare payment cuts.

All Fellows need to be an advocate for their profession, for their patients and for their employees. With one week before the devastating cut takes place, Congress does not have an apparent pathway to fix the crisis and, to date, very few surgeons have voiced their objection. To send a message to Congress that reflects the urgency of this situation, we must take collective action. Congress will only care as much as you do, so please do your part in helping to ensure an adequate surgical workforce so that patients can continue to access care. Your calls do make a difference!

Call your Representative and Senators today - even if you have already called! Urge your colleagues and staff members to call. Tell Congress that they must act now to permanently repeal Medicare's sustainable growth rate (SGR) formula before a 22 percent pay cut goes into effect on March 1.

Call your members of Congress toll-free 1-877-996-4464.

You will be asked to enter your zip code and will then be connected to your Representative and Senators' offices. Once you are connected, tell them you are a constituent and leave your name, phone number, and address, along with the suggested message below.


*As a surgeon and as your constituent, I urge Congress to enact a permanent solution to the flawed Medicare physician fee schedule. A short-term solution is unacceptable.

*Without a fix by Congress, access to care for millions of patients, especially our nation's seniors and military families, is threatened as a result of this flawed Medicare policy.

A few surgeons cannot carry the burden for the tens of thousands of surgeons across the country. We urge you to join Fellows across the country in advocating today for our patients.


Brent Eastman MD, FACS, Chair of the ACS Board of Regents
Michael Zinner, MD, FACS, Chair of the ACS Board of Governors
LaMar McGinnis, MD, FACS, President of the American College of Surgeons
Andrew Warshaw, MD, FACS, Chair of the ACS Health Policy and Advocacy Group
David Hoyt, MD, FACS, ACS Executive Director
Christian Shalgian, Director, Division of Advocacy and Health Policy


Association of American Physicians and Surgeons, Inc.
A Voice for Private Physicians Since 1943
Omnia pro aegroto
Pres. Obama announces price controls, tax hikes, and sweetheart deals for everyone.
February 22nd, 2010

Undeterred by public rejection of “comprehensive healthcare reform,” today President Obama released an 11-page report outlining his healthcare proposal. He claims it “contains new ideas from both parties” and that it will “give the American people and small business owners more control over their health care choices.”

The reality is that his new deal, (according to our friends at contains price controls, tax hikes, and “sweetheart deals” for everyone.

Here are some resources for a look at what is really in his proposal:

John Goodman’s Health Policy Blog:

Family Research Council:

Republican Policy Committee:
President Obama’s Health Care Proposals Make a Bad Senate Bill Worse

Heritage Foundation:


Wall Street Journal:
Obama Renews Health Push

Democrats are planning to try to push through the president’s plan, after a show summit with Republican leaders on Feb 25. They apparently plan to bend to their purposes a tricky maneuver called “budget reconciliation” (a trillion-dollar bill does affect the budget) – which is aptly called the “nuclear option.” It blasts away the usual defenses such as hearings, debates, or filibustering. It would also turn traditional American medicine and insurance into a smoldering ruin—not the objective they advertise!

The first two rails of total government control have already been laid, observes long-time AAPS member Lee Vliet, M.D., in the “stimulus bill.” These are computerized medical records and comparative effectiveness research. The third rail, the one that powers the train by controlling the money, is called “insurance reform.” Read full article by Dr. Vliet: .

ACTION ITEMS:(from our friends at the American Grassroots Coalition).

Here are three action steps you can take in the next few days before Thursday’s “Healthcare Summit”

1. Sign the Petition demanding that the Republicans stand firm and not make any concessions. Please forward to family, colleagues, neighbors, and friends to sign. There is power in numbers and we all need to stand strong together.

2. Contact the Senators listed at the bottom of this email to let them know that you expect them to stand firm and not make any concessions on a government takeover of health care. If you are not their constituent, you should tell them that their vote represents the American people, as well as their constituents, and you expect them to listen to and represent the American people.

3. Contact the Republican Leadership and let them know that we are watching and waiting. We expect every single member of the Republican party to stand on principles and values, while representing the American people.

The Republican Leadership in the House is committed to stand firm and wants to start from scratch. We need to support their efforts and let them know we are standing behind them. We should thank them for listening to the American people.

Congressman John Boehner
Congressman Eric Cantor
Congressman Mike Pence

We are not hearing the same things come from the Republican Leadership in the Senate. We need to contact the Republican Leadership in the Senate and let them know what we expect from them. They need to know that we expect all Republicans to insist that all negotiations start over with a blank sheet of paper.

Senator Mitch McConnell
Senator Jon Kyl

We all thought this this health care legislation was dead after the election of Scott Brown in Massachusetts because he was the 41st vote. Well, not so fast. He is the 41st vote only if all of the other Republicans in Washington stand firm and do not cave or make any concessions.

We must make it clear to ALL of our elected officials that we want NO part of the Senate or House bills to be proposed or accepted. The American people want these bills rejected and to start over with a clean slate. We will accept nothing less.

This entry was posted on Monday, February 22nd, 2010 at 4:28 pm and is filed under health care reform. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

RSC response to ObamaCare
Tuesday, February 23, 2010 at 3:39PM

A newly updated compilation of 70 healthcare bills introduced by RSC Members this Congress:

A conservative analysis of flawed Democrat solutions on healthcare and resources for gathering more detailed information:

An analysis of the President's healthcare proposal released yesterday (same document as recently circulated by RSC staffer Emily Murry):

A one-stop shop of RSC healthcare documents and resources:

michael ostrolenk Post a Comment Share Article

The Health Reform Hub: Participate in the Debate to Take Back Health Care From Politicians
A Project of the Galen Institute,

"The Health Reform Hub provides a central access point for the latest news and information about market-based ideas in the health reform debate. The Hub provides a portal to critical analyses and insights from leaders in the health policy community and their assessments of major health reform proposals being considered by policymakers in Washington and around the country.

The Health Reform Hub is a project of the Galen Institute, a non-profit research organization that works to promote ideas that advance individual freedom, consumer choice, and competition in the health sector. The Galen Institute also facilitates the work of the Health Policy Consensus Group, an affiliation of health policy experts from the leading market-based think tanks.

This site highlights research and analyses produced by Galen Institute experts, Health Policy Consensus Group members, and others who are committed to a patient-centered approach to health reform.

Through its integrated use of media tools, including up-to-the-minute audio and video broadcasts and Ning chat rooms, the Hub allows visitors to stay informed and engaged. The site offers the latest in news about free market ideas, including the latest commentaries, studies, or blog postings.

The Hub also provides a forum for visitors to the site to create their own communities and discuss health reform solutions and ways to participate in the debate. Americans are engaged as never before in a pivotal debate over how to solve the serious problems facing our health sector.

There is widespread agreement that we must find ways to make health care and coverage more affordable and help millions of uninsured Americans to get health insurance.

The Hub is your portal to ideas and experts devoted to market-based health policy solutions that restore power over health care decisions to doctors and patients.


Senate Doctors Show:

Senator John Barrasso, M.D., and Senator Tom Coburn, M.D., are seeking your questions as Congress debates health care reform. We want you to be a part of this important debate. Send us your questions and comments by e-mail, Facebook, YouTube, or Twitter. Senators Barrasso and Coburn will respond to some of them in future episodes, which air every Tuesday and Thursday at 5 pm EST.

Republican Health Care Plans:

Focus on health coverage for all 300 million Americans, including the 47 million uninsured.
Are health care plans you can afford.

Allow you and your doctor to make your health care decisions, not some Washington bureaucrat.
Emphasize prevention and wellness.

Give low-income Americans the same opportunities and choices that most Americans already have.

Don’t make it harder for American businesses to compete in the world marketplace by adding to their costs.

Won’t saddle your children and grandchildren with trillions of dollars of debt.

Should be enacted at a pace that lets us do it right.


Doctors Vote
What do doctors think about government control of health care?

About Us
Few issues are more important than health care. Both branches of the US Congress have passed bills that will completely transform this vital marketplace. There has been virtually no attention focused on what the doctors think. The doctor has been the forgotten person in this debate. This website exists to give them a platform to voice their opinion and intentions. Only doctors may participate in the survey but all may view the results.

Some random comments:

Healthcare reform is not going to be easy. Most of the medical profession is going to take a hit. We are going to be paid less and taxed more. The government, at the very least could have included tort reform to the healthcare bill, firstly as it provides a fifty BILLION dollar saving over a period of three (or was it 10) years, (President Obama himself acknowledged that there is a problem, but since he has refused to go any further with this, I am inclined to think this is so-called reform is nothing more than politics as usual and has nothing to do with real reform) and it would allow the physicians to practice medicine appropriately rather than defensive medicine, and it would also ease the financial burden the physicians are having to bear.


I believe government intervention is one of the major causes of the current crisis in health care delivery. The interventions proposed will make things worse.


Unfortunately this change is coming with or without the reform package. The CMS changes in coding will force most of the PMD's and subspecialty people to look for employment. Given the loss of revenue that I expect my practise to suffer this year maybe the last year as a private practitioner.

The "HealthCare reform action" fails to address or even consider the most basic problems in the health care industry. Medicare their paradigm is going out of business and already fails to reimbuse doctors at a level that lets them cover exorbedant med malprctice premiums.Insurance company policies are certainly problematic and need reform. I fell sorry fro patients in the future


Americans for Free Choice in Medicine

The All-out Government Assault on Doctors

Richard Ralston Executive Director of Americans for Free Choice in Medicine
has an important op-ed on it in the Orange County Register, reprinted below.

"The debate on health care reform is starting to turn ugly. Those
who want to increase government power to rule American medicine
are adding physicians to their list of "enemies of the people."

We hear frequently that insurers and drug companies are inefficient and
greedy businesses that must be replaced by efficient, enlightened
and compassionate government bureaucracies. Now doctors are
coming under attack for daring to resist government attempts to tell
them how to practice medicine.

In an editorial last month in the New York Times, readers were
told, "Doctors have been complicit in driving up health care costs."
"Complicit" is an ominous term, often used in a legal or criminal
context. Such language is obviously intended to intimidate
physicians into submission.

How are doctors "complicit" in rising costs? The Times tells us
they are to blame because "doctors largely decide what medical or
surgical treatments are needed," which makes many of them
"unabashed profiteers."

Such a statement provides two keys to understanding the debate on
health care reform.

The first and most obvious is that reform advocates in government
want the legal power to prevent doctors from deciding "what
medical or surgical treatments are needed." They think that role
must be reserved for politicians and government officials.
Physicians must not be allowed to prescribe a drug if the
government decides it helps only some but not all patients and is
thus not "comparatively effective."

Physicians must conform to new government "protocols" in
providing treatment, not their own judgment. If they do not, the
government will make them more liable to malpractice suits for not
doing it the government way. They are now forced to computerize
their patients' medical records and turn them over to the
government - without the patients' permission - to better help the
government supervise their practice.

Also revealed by the Times' editorial is the attempt to disarm
doctors morally and politically so they will do what they are told.
Any attempt to protect their ability to practice medicine as they
think best will just prove that they are greedy profiteers, like
businessmen. Anyone who makes a living or runs a profitable
business that does not need to be bailed out by the government may
be condemned.

Conversely, greed for power is a saintly virtue for those who want
to instruct physicians how to run their practices.

From other quarters we hear arguments that doctors should just do
what they are told and accept what the government pays them, even
if it does not cover their costs, because they owe us all for their
medical education. Never mind the huge debts with which most
MD's graduate from medical school. Never mind the long years and
long hours of medical education and internship. If they went to a
public school, never mind the taxes their parents paid to support it.
If the government gives you an education, these politicians say that
you owe that government your life. Are we now discovering the
true purpose of government-controlled education?

Doctors are probably coming under attack now because even the
American Medical Association - not known in recent years for its
resistance to government incursion in medicine - is showing a bit of
backbone in opposing proposals such as a new "public option" for
medical insurance. The AMA is to be encouraged. If physicians do
not take a stand to defend their rights to their own lives, their
careers and their freedom to practice medicine, and, yes, to decide
with their patients "what medical or surgical treatments are
needed," who will?

We will not preserve our freedoms or our health if we as physicians
and patients surrender our rights to politicians in return for their
promises to take care of us."

Richard Ralston, Executive Director
Americans for Free Choice in Medicine


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