Congress overrode Pres. Bush’s veto on the Medicare bill, and so a 10.6% across the board Medicare fee cut is postponed for now. Note, this isn’t an inflation adjusted hold– physicians continue to lose money on Medicare patients as rates aren’t keeping up with inflation, but “budget neutral” requirements (e.g., pay for performance, more paperwork) will continue the need to add expenditures to the declining reimbursement. What this does is add further signal to anyone thinking about caring for our nation’s seniors in a primary care setting to get their head examined:
But Representative Jim McCrery, Republican of Louisiana, said the bill “just kicks the can down the road” and does not fix fundamental flaws in the formula for paying doctors. In 18 months, Mr. McCrery said, doctors will face a 20 percent cut in their Medicare payments.
So, as we stall auction programs to stop overpaying for wheelchairs and medical equipment, our primary care docs get yet another warning that the bleeding continues and at some point the ax will fall.
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Image via Wikipedia“Consult your physician before becoming sedentary” –Chris Roberts
So Chris is a friend of mine and an adjunct professor at UCLA. The approach contradicts the current environment, where the default action is to do nothing. “Consult your doctor before starting an exercise program” is standard legal mumbo-jumbo next to every physical fitness program. However, what exactly is it that we want our doctors to do?
With everything we know, is exercise really that dangerous for our health? Should we prescribe more bed rest or sedentary behavior? Nothing we know would suggest that is the best approach for anyone– humans benefit from exercise and good diet.
Instead, the standard disclaimer is symptomatic of a legal takeover of our health system– it doesn’t matter what the outcome is, as long as I’m not culpable if anything goes wrong.
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Image via WikipediaFrom the Huffington Post, we see a new battleground in reproductive rights and a woman’s right to choose. The AMA, decided to support legislation:
“that helps ensure safe deliveries and healthy babies by acknowledging that the safest setting for labor, delivery, and the immediate post-partum period is in the hospital” or accredited birth center.
So the AMA is against ANY women choosing to give birth at home, which appears to be based more on turf management than evidence.
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