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       #Post#: 656--------------------------------------------------
       Profits Over Patients in the "Health" Care Field
   DIR By: AGelbert
       Date: November 12, 2022, 5:18 pm
       ---------------------------------------------------------
       [center]
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       Nov 11 2022
       This commentary is by [b]Patrick Flood, former commissioner of
       the Department of Mental Health and the Department of
       Disabilities, Aging and Independent Living, and former deputy
       secretary of the Agency of Human Services.[/b] He is now retired
       and lives in Woodbury. This is one of three commentaries about
       health care; one was published Nov. 4 and the last will be
       published Nov. 18.
       [center]Patrick Flood: An affordable health care system for a
       healthier Vermont
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       [/center]
       In her recent commentary, Julie Wasserman
  HTML https://vtdigger.org/wp-admin/post.php?post=405704&action=edit<br
       />described in detail how health care reform efforts in Vermont
       have failed over the past six years. They have failed chiefly
       because they have not focused on the right issues and solutions.
       Health reform has been a thinly veiled effort to
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       />
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-010922192452.gifmaintain<br
       />the status quo while tinkering around the edges. Our state’s
       reform effort has been an initiative led by the hospitals,
       primarily the UVM Health Network, to
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       />protect the hospitals’ funding &#128176; and &#129408;
       dominance
       of the health care system.
       The reality is that Vermont will never achieve rational cost
       control, universal access and better health for its population
       [b]until our reform efforts shift dramatically to focus on
       primary care, prevention and other health-related community
       services. [/b]
       It is a well-established fact that most health care systems in
       Europe guarantee universal access to health care as a right and
       achieve better health outcomes for much lower cost. What
       explains the latter? For starters, these health care systems
       dedicate more resources to primary care and to addressing social
       issues (like mental health, hunger and homelessness) that create
       or worsen health problems.
       In this country, including Vermont, we do just the opposite.
       Most of our health care dollars are directed to hospital care
       and high-cost services, much of which can be avoided with more
       medical and social intervention at the community level. As Ms.
       Wasserman pointed out in her commentary, a significant
       percentage of hospital services in Vermont is avoidable.
       There are four things we can do immediately to avoid unnecessary
       hospital treatment and, thus, bring down the cost of health
       care.
       First, expand and strengthen primary care services and remove
       financial barriers, like high deductibles, which prevent people
       from accessing it. Everyone in health care knows that primary
       care is foundational to a high-quality, affordable and equitable
       health care system and we have known it for a long time. Yet,
       primary care capacity in Vermont is grossly inadequate.
       Statewide, we urgently need more primary care doctors, physician
       assistants and nurse practitioners, and nurses. Reimbursement
       rates for primary care need to be increased, working conditions
       improved, and more medical students incentivized to choose
       primary care as a profession. None of this is a mystery or
       complicated.
       Second, expand and improve mental health services. Mental health
       problems like anxiety and depression, left untreated, cause or
       worsen many physical health problems and drive-up costs. Yet,
       our mental health system is also in crisis. More hospital
       treatment beds are not the answer. A more preventive approach,
       including more crisis response, community support and
       counseling, is the answer. It is far cheaper and cost -effective
       to fund prevention and community-based intervention than to
       increase and fill more beds.
       Third, expand and strengthen home health services. Home health
       caregivers regularly care for chronically ill people in their
       homes and reduce the number of unnecessary hospital stays. Home
       health also offers hospice services, which keep terminally ill
       people out of hospitals for expensive end-of-life care that they
       may not want.
       Yet, home health agencies struggle to maintain the staff they
       need due to funding cuts at the federal level and inadequate
       funding at the state level. So, instead, many people needlessly
       spend time, including their final days, in hospitals.
       Fourth, we must effectively address what are called the “social
       determinants of health,” such as hunger, homelessness and abuse.
       These issues have huge impacts on people’s health, yet we treat
       them as if they are separate from the health care system. We
       underfund them, then wait until people have severe and untreated
       medical conditions and end up in the hospital.
       How would Vermont fund such improvements?
       First, the state should stop funding the failed accountable care
       organization, OneCare Vermont, and reassign that funding to
       these initiatives. Seventy-eight percent of OneCare’s operating
       costs are paid with publicly funded Medicaid funds and could be
       redirected to better use.
       If properly implemented, these four initiatives would result in
       lower hospital and emergency room admissions by reducing
       avoidable care. That alone would not suffice. However, savings
       from those reductions could be redistributed to further expand
       the initiatives above.
       This redistribution would continue until Vermont reached the
       best balance between funding for hospitals and funding for
       community services and achieved a well-balanced, affordable
       health care system.
       There is no magic to designing a high-quality, affordable and
       fair health care system. We know what needs to be done, and
       we’ve known it for a long time. We need to restructure our
       hospital system to limit its cost (remember how much of the care
       is avoidable) and, instead, reallocate funding poorly spent in
       that system to support the prevention-oriented services and
       programs described above.
       Of course, we need and want an adequately financed, high-quality
       hospital system, and we certainly can have one with all the
       money we are spending on it today. But a lot of that money is
       being spent unwisely and ineffectively. As a result, many
       Vermonters can’t get or afford the care they need. We can do
       better, and we need to begin now.
       On Nov 18, in the third and final installment of these
       commentaries, Mark Hage will describe systemic steps that can be
       taken to restructure hospital funding to make it more equitable,
       affordable and understandable.
  HTML https://vtdigger.org/2022/11/11/patrick-flood-an-affordable-health-care-system-for-a-healthier-vermont/
       #Post#: 889--------------------------------------------------
       Last year, 38% of all insured Vermonters (187,800) were
       determined to be underinsured.
   DIR By: AGelbert
       Date: February 27, 2023, 2:11 pm
       ---------------------------------------------------------
       [center]
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       February 26, 2023 By Bill Schubart
       [center]
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       [center]The University of Vermont Medical Center complex. Photo
       courtesy of UVM Health Network[/center]
       [center]Bill Schubart: The &#127919;
       [glow=teal,2,300]Inversion[/glow]: Make primary care
       [glow=green,2,300]primary[/glow] and hospitals
       [glow=teal,2,300]secondary[/glow]
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-050422145344-560693.png[/center]
       SNIPPETS:
       Research shows increased primary care spending is associated
       with fewer ER visits
  HTML https://www.graham-center.org/content/dam/rgc/documents/publications-reports/reports/Investing-Primary-Care-State-Level-PCMH-Report.pdf,<br
       />fewer hospitalizations, better health outcomes, and lower
       costs.
       But this path will require right-sizing some superfluous
       hospitals as community health centers and moving some of their
       secondary and tertiary services to regional hospitals.
       Hospitals are not a gateway to well-being. Instead, they provide
       lifesaving specialty services that can’t be offered at the
       community level: advanced diagnostics, surgeries, trauma and
       inpatient care.
       But the point of entry into the health care system must be
       community-based [glow=teal,2,300]primary care health
       centers[/glow], not regional emergency rooms, which are the most
       expensive point of entry and are chronically overcrowded and
       understaffed. Emergency rooms are for emergencies, not for
       primary care. ... ...
       — Underinsured Vermonters: :( Last year, 38% of all insured
       Vermonters (187,800) were determined to be underinsured.
       “Underinsured” is defined as “persons with insurance but whose
       policy does not sufficiently cover current medical costs.”
       Although fully insured, they can’t access care due to the high
       cost of co-pays, deductibles and co-insurance. Among the
       underinsured with past-due medical debt, 84% owed money to
       hospitals and 16% to outpatient facilities, and 34,500
       Vermonters have used up all or most of their savings to pay
       medical bills.
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       [glow=red,2,300]Uninsured[/glow] Vermonters 18 to 64 years old
       were three to seven times more likely to defer care due to cost
       than insured Vermonters, depending on the type of care. And in
       2019, Vermont hospitals reported $85 million in medical debt
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-050422182057.gif,<br
       />not including bills paid off with credit cards or put on
       long-term payment plans.
       Full article:
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  HTML https://vtdigger.org/2023/02/26/bill-schubart-the-inversion-make-primary-care-primary-and-hospitals-secondary/
       #Post#: 898--------------------------------------------------
       &#128681; A few other facts and figures to keep in mind as Big
       Insurance thrives:
   DIR By: AGelbert
       Date: February 28, 2023, 4:06 pm
       ---------------------------------------------------------
       Feb 27 2023 Wendell Potter
       [center]BIG INSURANCE
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-010922192452.gif2022:<br
       />Revenues reached $1.25 trillion thanks to sucking billions out
       of the pharmacy supply chain – and taxpayers' pockets
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       [move]Analysis of the 2022 financial statements of
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       />UnitedHealth Group, CVS/Aetna, Cigna, Elevance, Humana,
       Centene,
       and Molina[/move]
       SNIPPET:
       A few other facts and figures to keep in mind as Big Insurance
       thrives:
       &#129318;&#8205;&#9794;&#65039; 27.5 million people remain
       uninsured in the United States. Up to 14 million more will lose
       their Medicaid coverage once the pandemic emergency period ends
       later this year.
       &#129318;&#8205;&#9794;&#65039; 100 million of us – almost one
       of every three people in this country – now have medical debt.
       &#128544; In 2023, U.S. families can be on the hook for up to
       $18,200 in out-of-pocket requirements before their coverage
       kicks in, up 43% since 2014 when it was $12,700.
       Read ALL OF IT:
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       />
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  HTML https://wendellpotter.substack.com/p/big-insurance-2022-revenues-reached
       #Post#: 1087--------------------------------------------------
       Re: Profits Over Patients in the &quot;Health&quot; Care Field
   DIR By: AGelbert
       Date: June 7, 2023, 4:38 pm
       ---------------------------------------------------------
       JUN 6, 2023 by [glow=green,2,300]BILL MCKIBBEN[/glow]
       A powerful new study from Stand.earth shows that the biggest
       healthcare providers have billions invested in
       [glow=maroon,2,300]fossil fuels[/glow], even though their
       combustion causes one death in five on this
       planet.[glow=red,2,300] Burning hydrocarbons[/glow] is like
       [glow=red,2,300]burning cigarettes[/glow]:&#9760;&#65039; unsafe
       for human health, and yet “the Mayo Clinic, Kaiser Permanente,
       Ascension Health System, and the nation’s largest health system
       HCA Healthcare have over $4.6 billion invested in
       [glow=red,2,300]fossil fuels[/glow].”
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       Read more:
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  HTML https://billmckibben.substack.com/p/free-hong
       #Post#: 1101--------------------------------------------------
       Patients on public insurance have a right to know if they're
       being treated differently
   DIR By: AGelbert
       Date: June 11, 2023, 1:07 pm
       ---------------------------------------------------------
       [center]
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       June 8, 2023 by Rosa Mino, PhD, and Amanda Masino, PhD
       [color=navy]Rosa Mino, PhD, and Amanda Masino, PhD, are biology
       professors.
       [center]Oh, You Have &#128579; Medicare? We'll Skip That Test.
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-040422164519-508103.gif[/center]
       [center]— Patients on public insurance have a right to
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       />know if they're being treated
       [glow=maroon,2,300]differently[/glow][/center]
       SNIPPET:
       *Patient's name has been changed
       Magda* was 70 years old when she suffered a mild stroke. She was
       taken to a hospital, where the emergency department and critical
       care unit ran the appropriate tests and sent her home with
       medicine and a monitor for irregular heartbeats.
       Practice guidelines for stroke follow-up advise providers to
       evaluate stroke cause, which includes, for patients like Magda,
       noninvasive cervical carotid imaging to evaluate any stenosis.
       If present, cervical artery stenosis must be addressed. This
       would include revascularization when appropriate, or medication
       and lifestyle modification. Magda was not told this. If not for
       a knowledgeable family member who categorically requested the
       necessary imaging, she may have gone untreated.
       The oversight was almost catastrophic. She had
       [glow=red,2,300]severe stenosis[/glow]. It could have taken her
       life.
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       There are many possible reasons why the attending physician
       decided not to proceed with imaging tests. Perhaps they felt it
       was clinically unnecessary. But then why, once it was requested,
       did they perform the test without any objections? Magda suspects
       it happened because of her insurance: she is covered by
       Medicare.
       Unfortunately, Magda's experience is not unique. Private
       insurance generally pays healthcare providers more than
       federally funded programs like Medicare or Medicaid. Public
       insurance beneficiaries report they feel that they don't have
       the same level of access to high-quality care as privately
       insured patients. This apprehension is not imaginary.
       Patients must be able to determine not only whether a provider
       accepts Medicaid/Medicare, but also if that provider treats
       patients who have publicly funded insurance with the same level
       of care. One part of the solution could be transparent and
       easily accessible information about patient demographics
       (information that includes data by patient insurance type).
       A Medicare or Medicaid patient's first challenge is in finding a
       healthcare provider that will take their insurance. Many
       providers do not accept federally funded insurance coverage,
       although some get certified because, despite the lower revenue,
       they expect more consistency in payments. (Unfortunately, claim
       denials and billing problems often stymie these expectations.)
       Full article with info on the most Socially Responsible
       Hospitals:
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  HTML https://www.medpagetoday.com/opinion/second-opinions/104912
       #Post#: 1131--------------------------------------------------
       That was the testimony that got Kentucky to pass prior
       authorization rules that say once something is authorized, it's
       a
   DIR By: AGelbert
       Date: June 20, 2023, 1:49 pm
       ---------------------------------------------------------
       AGelbert NOTE: This addresses the rampant corporate greed
       seriously [glow=red,2,300]undermining [/glow]the medical
       profession in the U.S.:
       [center]
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       June 16, 2023
       [center]Medicare Pay and Prior Authorization Among Priorities
       for AMA President-Elect[/center]
       [move]— Bruce Scott, MD, sits down for an exclusive interview by
       Joyce Frieden, Washington Editor, MedPage Today [/move]
       SNIPPET:
       What magnifies the problem is that
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-040622202719-14071062.gifhttps://soberthinking.createaforum.com/gallery/soberthinking/1-040622210450-1415528.gif<br
       />[glow=red,2,300]private payers[/glow], years ago, figured this
       whole thing out, and they have [glow=red,2,300]linked their
       contracts[/glow] to the Medicare pay rate. So in effect, they
       save money because they don't give us any kind of an
       inflationary increase [because Medicare doesn't]. I had a major
       health insurance company offer us a contract that is based upon
       80% of Medicare. And they offered us surgical rates that we
       pointed out to them were [b]less than the rates they paid us in
       2017
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-120422122316-661919.bmp[/b].<br
       />This
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-040622202719-1406786.gifhttps://soberthinking.createaforum.com/gallery/soberthinking/1-110422205132-6451602.gifhttps://soberthinking.createaforum.com/gallery/soberthinking/1-010922192452.gifcompany<br
       />has 60% of the private-pay market in this city and in this
       region. Three months ago, we started trying to negotiate with
       them, and they have stonewalled us ever since ... Their
       &#128520; attitude is "take it or leave it." I wish I could tell
       you that it was just this one company and no one else is like
       this, but this is standard operating procedure right now.
       Our options at this point are to say no to the contract, but
       that leaves our patients out in the cold. That also financially
       hurts our practice; we can't walk away from 60% of our business.
       And our other alternatives are to become employed by the
       hospital, which is something we've not been wanting to do, or to
       walk away from our patients, or alternatively tell our patients
       that they're going have to pay us out-of-network. So we have no
       good choice here.
       That is unfortunately happening across America, and this is why
       you have one out of five doctors saying that they want to look
       for a different career or retire in the next 2 years. That's a
       crisis.
       Full interview:
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-040422164647-5372345.gif<br
       />&#128064;
  HTML https://www.medpagetoday.com/publichealthpolicy/generalprofessionalissues/105063
       #Post#: 1190--------------------------------------------------
       &#128226; Every year ~ 795,000 Americans die or become
       permanently disabled from diagnostic error
       &#129318;&#8205;&#9794;&#65039;
   DIR By: AGelbert
       Date: July 18, 2023, 1:11 pm
       ---------------------------------------------------------
       [move]An estimated 795,000 Americans die or become
       [glow=maroon,2,300]permanently disabled[/glow] every year due to
       [glow=red,2,300]misdiagnosed diseases[/glow], according to a
       study in BMJ Quality & Safety.[/move]
       [img
       width=150]
  HTML https://journals.bmj.com/sites/default/themes/bmjj/img/logos/logo-bmj-journals.svg[/img]
       July 16, 2023
       [center]Burden
       &#128073;
  HTML http://renewablerevolution.createaforum.com/gallery/renewablerevolution/1/3-120818185039-1657732.gif<br
       />of serious harms from diagnostic [glow=red,2,300]error[/glow]
       in
       the USA
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-070822230414-163943.png<br
       />
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-050422145533-5671050.gif[/center]
       SNIPPET: &#128064;
       Results &#128073;  Annual US incidence was [glow=red,2,300]6.0 M
       vascular events, 6.2 M infections and 1.5 M cancers[/glow]
       &#129318;&#8205;&#9794;&#65039;. Per ‘Big Three’ dangerous
       disease case, weighted mean error and serious harm rates were
       11.1% and 4.4%, respectively. Extrapolating to all diseases
       (including non-‘Big Three’ dangerous disease categories), we
       estimated total serious harms annually in the USA to be
       795&#8201;000 (plausible range 598&#8201;000–1 023 000).
       Sensitivity analyses using more conservative assumptions
       estimated 549&#8201;000 serious harms. Results were compatible
       with setting-specific serious harm estimates from inpatient,
       emergency department and ambulatory care. The [glow=red,2,300]15
       dangerous diseases[/glow] accounted for
       [glow=red,2,300]50.7%[/glow] of total &#9760;&#65039; serious
       harms and the [b]top 5 ([glow=red,2,300]stroke, sepsis,
       pneumonia, venous thromboembolism and lung cancer[/glow])
       accounted for [glow=red,2,300]&#9760;&#65039; 38.7%[/glow].[/b]
       Conclusion &#128073;  An estimated 795&#8201;000 Americans
       become permanently disabled or die annually across care settings
       because dangerous diseases are misdiagnosed. Just 15 diseases
       account for about half of all [glow=red,2,300]serious
       harms[/glow], so the problem may be more tractable than
       previously imagined.
       Read more:
  HTML https://media.tenor.com/images/5423e809b1a22096b6925bf9bc3fd1cb/tenor.gif
  HTML https://qualitysafety.bmj.com/content/early/2023/07/16/bmjqs-2021-014130
       #Post#: 1208--------------------------------------------------
       The ratio of doctors to other healthcare workers is now 1:16, up
       from 1:14 two decades ago. 
   DIR By: AGelbert
       Date: July 31, 2023, 5:45 pm
       ---------------------------------------------------------
       [center]
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       Commentaries are opinion pieces contributed by readers and
       newsmakers. VTDigger strives to publish a variety of views from
       a broad range of Vermonters. Commentaries give voice to
       community members and do not represent VTDigger’s views. To
       submit a commentary, follow the instructions here.
       July 30, 2023, 7:07 am This commentary is by Lee Russ of
       Bennington, a retired legal editor who was the lead
       editor/author of both the third edition of “Couch on Insurance”
       and the Attorneys Medical Advisor.
       [center]Lee Russ: In health care, it’s &#128520;&#128176; 10 to
       1 [glow=red,2,300]against[/glow] us &#128534;[/center]
       [move]Tell people: 10-to-1. Tell everyone you know. Tell your
       legislators over and over again until they really understand how
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-050422182057.gif<br
       />[glow=red,2,300]disastrous[/glow] this is.[/move]
       Imagine for one minute that the repair shop to which you take
       your car has two mechanics who work on the cars, but 20 people
       who work in the office making appointments, creating work
       orders, etc. How much would it cost to get a simple tuneup or
       oil change?
       Now imagine that this situation existed in the health care
       field.
       Surprise! You don’t have to imagine; that’s the reality in
       American health care. There are now 10 health care
       administrators for every doctor: “The ratio of doctors to other
       healthcare workers is now 1:16, up from 1:14 two decades ago. Of
       those 16 workers for every doctor, only six are involved in
       caring for patients — nurses and home health aides, for example.
       The other 10 are in purely administrative roles.”
       How does this insanity come to pass? It’s what happens when a
       health care system is fractured into several discrete and
       competing interests. Each zealously pursues its own interests —
       insurers, drug companies, pharmacy benefit managers, device
       manufacturers, for-profit providers, private equity shark
       investors — where are the patients?
       Patients have no organization similar to America’s Health
       Insurance Plans (AHIP), the Pharmaceutical Research and
       Manufacturers of America (PhRMA), or the Partnership for
       America’s Health Care Future (PAHCF). The PAHCF alone includes
       over 100 individual organizations.
       The combined financial power of these organizations, all of
       which profit greatly from the current 10-to-1 system, puts the
       resources of individual patients to shame. It is always these
       organizations that are the “players” who get “a seat at the
       table.”
       All of which has gotten us to this point where the cost of
       health care is crushing people. A veteran health care journalist
       reports that “I’ve seen patients’ faith shaken. They’re tired of
       shocking medical bills they didn’t expect and can’t afford. And
       they’re disgusted by the collection notices, the threatening
       phone calls, and the appointments they can’t get because they
       owe money.”
       A practicing doctor writes in The New York Times that “There’s
       nobody measuring the time spent on the phone plus lost wages
       plus complications from delayed care for every single patient in
       the United States.” And certainly no one even attempts to
       identify/quantify the psychological and emotional toll of the
       anxiety that all this causes people trying to navigate the
       labyrinth while sick and worrying that the delays will kill
       them.
       Again: Ten administrators for every doctor. None of the current
       health care “reform” proposals addresses this problem except
       Medicare for All.
       And despite the fact that the problem affects everybody, the
       executive director of the Vermont Democratic Party told me not
       long ago that health care was not a hot topic for voters when
       candidates speak to them. &#129318;&#8205;&#9794;&#65039;
       If true, we have to make it a &#128226; hot topic.
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-220922210716-19901449.pnghttps://soberthinking.createaforum.com/gallery/soberthinking/1-090422150144.png<br
       />
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-050422133654.gif<br
       />Tell people: 10-to-1. Tell everyone you know. Tell your
       legislators over and over again until they really understand
       how[glow=red,2,300] disastrous [/glow]this is.
  HTML https://vtdigger.org/2023/07/30/lee-russ-in-health-care-its-10-to-1-against-us/
       #Post#: 1233--------------------------------------------------
       MORE Cruel, AND SENSELESS, Cuts to Medicare by Corporate
       Corrupted &#128013; CMS
   DIR By: AGelbert
       Date: August 11, 2023, 11:24 am
       ---------------------------------------------------------
       [center]
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-040623141651.png[/center]
       August 10, 2023 by Nikesh Patel, PT
       Patel is a physical therapist.
       [center]
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-050422133654.gif<br
       />[glow=red,2,300]Deeper[/glow] Medicare Cuts Won't Reduce the
       $50B Spending on Older Adult Falls[/center]
       [move]Cutting physical therapy reimbursement is
       [glow=red,2,300]bad[/glow] for patients [glow=red,2,300]and
       bad[/glow] for spending[/move]
       Falls among seniors pose a significant public health challenge,
       leading to 3 million emergency room visits and more than 36,000
       deaths &#128542; each year. By prioritizing physical therapy as
       a preventive measure, we can address this issue proactively and
       promote healthier aging for our senior
       population.
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-090422150144.png
       Helping seniors build strength and balance is not only good for
       patients, but also, it is cost-effective and helps save the
       Medicare system money. So, it is alarming that Medicare has
       proposed yet another round of cuts to physical, occupational,
       and speech therapy. These cuts, if implemented, would have
       severe consequences for seniors' access to vital care and
       threaten the effectiveness and affordability of treatment.
       Congress must take immediate action to prevent these cuts and
       protect the well-being of our aging population as we tackle the
       immense problem of senior falls.
       Over the years, the
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-040622210450-1415528.gif<br
       />[glow=maroon,2,300]Centers for Medicare & Medicaid
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-040622202719-14071062.gif<br
       />Services (CMS)[/glow] has consistently announced plans for
       [glow=red,2,300]deep cuts[/glow] to specialty
       services,[glow=red,2,300] including[/glow] physical therapy
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-120422122257-6582083.bmp.<br
       />Planned &#128520; cuts to physical therapy services have
       [glow=red,2,300]compounded on top of one another
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-050422182057.gif,<br
       />reaching 9%[/glow] between 2020 and
       2024
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-040622153115-1384130.png.<br
       />The Medicare Physician Fee Schedule Proposed Rule for CY2024,
       released on July 13, continues this trend by proposing to cut
       payments for these services by at least 3.36% -- and even higher
       in some parts of the country due to the highly technical
       &#128521;&#128520; formula
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-040622202719-1406786.gif<br
       />[glow=red,2,300]CMS[/glow] uses to determine reimbursement. If
       allowed to go into effect next year, these cuts will place an
       extraordinary burden on providers and undermine their ability to
       deliver quality care to older Americans. Even more worrying, the
       cuts will endanger the ability of seniors to access the
       community-based therapy services that are essential for their
       well-being.
       The continuous cuts to reimbursement rates jeopardize the
       stability of all specialty sectors, including physical therapy,
       and raise concerns about the potential closure of practices and
       restricted access for Medicare beneficiaries. If Congress does
       not act, this would profoundly impact seniors who rely on
       physical therapy to maintain their health, independence, and
       quality of life.
       If cost savings are the most important factor, let's point to
       the runaway financial burden if the senior falls epidemic is
       left unaddressed. By CDC estimates, about $50 billion is spent
       on medical costs related to nonfatal fall injuries each year,
       and $754 million is spent connected to fatal falls. According to
       a report by the American Journal of Lifestyle Medicine, the
       annual cost will skyrocket to $100 billion spent on fall
       treatment care by 2030.
  HTML https://www.medpagetoday.com/opinion/second-opinions/105834
       #Post#: 1285--------------------------------------------------
       Violence in Healthcare: Why Are People So Angry?
   DIR By: AGelbert
       Date: September 4, 2023, 6:31 pm
       ---------------------------------------------------------
       [center]
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-040623141651.png[/center]
       September 3, 2023 by Amy Faith Ho, MD, MPH, an emergency
       physician, published writer, and national speaker on issues
       pertaining to healthcare and health policy.
       [center][glow=red,2,300]Violence[/glow] in Healthcare: Why Are
       People So
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-040622153109-13672051.gif<br
       />[glow=red,2,300]Angry[/glow]?
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-070822230414-163943.png[/center]
       [center]The healthcare system has failed us all when we needed
       it most[/center]
       SNIPPET:
       We entered medicine to save lives, not to have our own lives
       taken away. We're sworn to do no harm, but there is harm
       increasingly directed at us.
       Unfortunately, there is no simple solution, just like there is
       no simple solution to violence as a whole.
       Police and security officers, metal detectors, panic buttons,
       "de-escalation training," "zero tolerance" signs, increased
       penaltiesopens in a new tab or window for violence -- I've
       worked at places that do them all. And yet, there is still
       violence.
       It begs the question: in the field of healing, why are people so
       angry?
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-090422150144.png<br
       />For the same reasons we, in healthcare, are
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-080422121331.gif<br
       />angry too: because the healthcare system failed us when we
       needed it the most.
       Staffing shortages, drug shortages, prior authorization,
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-040622210450-1415528.gif<br
       />extortionist middlemen, long wait times, high prices, rampant
       health disparities and inequities, feeling
       [glow=red,2,300]gouged[/glow] and powerless when we are at our
       most vulnerable. We're all angry about the same things:
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-050422133654.gif<br
       />[glow=red,2,300]failures[/glow] of a system we depended on.
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-050422135315.png
       We want to connect directly and compassionately, not through
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-010922192452.gif<br
       />middlemen like insurers and their
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-110422205132-6451602.gif<br
       />required approvals and networks.
       We want the autonomy to seek, give and receive care, not limited
       by bureaucracy or colored by polarizing politicization.
       We want empathy, understanding, compassion -- and most
       importantly, the time to do so in a [glow=blue,2,300]genuine
       way[/glow].
       We want to trust a system that has wronged us so badly in the
       past.
       We want healthcare to be about care again -- not the
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-040622210450-1415528.gifhttps://soberthinking.createaforum.com/gallery/soberthinking/1-040622210509-141844.gif$4.3<br
       />trillion
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-120422122619-6812456.gif<br
       />[glow=red,2,300]business[/glow] it has
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-050422182057.gif<br
       />become.
       Full article (Don't miss the Comments!):
  HTML https://soberthinking.createaforum.com/gallery/soberthinking/1-120422122733-6851207.png
  HTML https://www.medpagetoday.com/opinion/second-opinions/106148
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