Sep 2009
Back to the Future: REAL Health Care Reform
September/16/2009
This is what really good health care looks like:
This picture of my daughter, Julie, and her grandfather, Dr. James R. Monteith, was made in 1971, just before he retired after having served the community of Annville, PA for over 35 years. For most of those years he was one of only two doctors who cared for all the families in the area, including delivering babies and treating everything, referring only cardiology patients. When he retired, his office visit cost $15, up from the $10 he charged for years, because he had to hire a clerk to take care of the paperwork foisted on doctors during the 1960’s. Today, the two medical practices that cover part of the area my father-in-law served employs 15 physicians and who-knows-how-many others. The cost to visit the doctor today? can’t tell you; it’s practically impossible to get an answer. My co-pay typically is between $20-$30, but it’s a chore to figure out what my insurance company is billed.
One of the reasons why I am so passionate about the current national health care debate, beyond the impact it will have on all Americans and on small business, is because I know the value of a good family doctor. I also know how far away from this ideal our country has strayed since I made this photograph.
But today I was greatly heartened to see Dr. Juilliet Madrigal-Dersch on the Neil Cavuto business program. She was commenting on the Investor’s Business Daily TIPP poll showing that two out of every three practicing physicians oppose the medical overhaul plan under consideration in Washington, and hundreds of thousands would think about shutting down their practices or retiring early if it were adopted. Dr. Madrigal-Dersch has already opted out of the insurance-based medical system and conducts a cash-based practice in Marble Falls, TX. I immediately Googled her and found a YouTube video showing her appearance at an April 19, 2009 Health Care Reform Congressional Briefing in the Russell Senate Office Building. It’s 11 minutes long, but it’s worth every minute to listen to the the wisdom this young doctor, wife, and mother has to impart.
The practice that Dr. Madrigal-Dersch explains is a perfect description of how my father-in-law ran his practice, especially the part about the importance of getting to know what’s going on in the life of patients. I still am stopped on the street by his former patients who tell me that no one could treat their sinus problems as well as Dr. Monteith, and I can vouch for that! Like Dr. Madrigal-Dersch, my father-in-law received payment-in-kind from many patients, including baked goods, fresh produce, and a lot of freshly plucked chickens and ducks that we helped to eat. And once a week he paid pro-bono visits to hospital patients in the local charity hospital that was replaced years ago by the shiny new E.R. clinic that costs a fortune to visit. “Dr. Juliette” understands the power of free enterprise and she practices the same business principles that photographers should embrace because it’s “good medicine.”
So here’s what I hope: When I found the Madrigal-Dersch video on YouTube, the counter was set at just under 600 views. I hope you will forward this article to everyone you know who cares about this issue. Let’s help to make this lady famous! You can copy a link to this article here, or you can copy a link to the video alone here.
And here’s some more information on the good doctor:
Dr. Madrigal-Dersch concludes the second video by telling the doctors in her audience to “Love your patients and let your patients love you. Remember why you went to medical school in the first place and spend every day taking care of patients with the same love and zeal. That’s how it is at our practice and that’s why it’s so much fun. When you go to medical school it’s because you want to take care of people, and that’s what I do every day.”
What a great way to run a medical practice, or a photography business for that matter!
I hope you agree.
This picture of my daughter, Julie, and her grandfather, Dr. James R. Monteith, was made in 1971, just before he retired after having served the community of Annville, PA for over 35 years. For most of those years he was one of only two doctors who cared for all the families in the area, including delivering babies and treating everything, referring only cardiology patients. When he retired, his office visit cost $15, up from the $10 he charged for years, because he had to hire a clerk to take care of the paperwork foisted on doctors during the 1960’s. Today, the two medical practices that cover part of the area my father-in-law served employs 15 physicians and who-knows-how-many others. The cost to visit the doctor today? can’t tell you; it’s practically impossible to get an answer. My co-pay typically is between $20-$30, but it’s a chore to figure out what my insurance company is billed.
One of the reasons why I am so passionate about the current national health care debate, beyond the impact it will have on all Americans and on small business, is because I know the value of a good family doctor. I also know how far away from this ideal our country has strayed since I made this photograph.
But today I was greatly heartened to see Dr. Juilliet Madrigal-Dersch on the Neil Cavuto business program. She was commenting on the Investor’s Business Daily TIPP poll showing that two out of every three practicing physicians oppose the medical overhaul plan under consideration in Washington, and hundreds of thousands would think about shutting down their practices or retiring early if it were adopted. Dr. Madrigal-Dersch has already opted out of the insurance-based medical system and conducts a cash-based practice in Marble Falls, TX. I immediately Googled her and found a YouTube video showing her appearance at an April 19, 2009 Health Care Reform Congressional Briefing in the Russell Senate Office Building. It’s 11 minutes long, but it’s worth every minute to listen to the the wisdom this young doctor, wife, and mother has to impart.
The practice that Dr. Madrigal-Dersch explains is a perfect description of how my father-in-law ran his practice, especially the part about the importance of getting to know what’s going on in the life of patients. I still am stopped on the street by his former patients who tell me that no one could treat their sinus problems as well as Dr. Monteith, and I can vouch for that! Like Dr. Madrigal-Dersch, my father-in-law received payment-in-kind from many patients, including baked goods, fresh produce, and a lot of freshly plucked chickens and ducks that we helped to eat. And once a week he paid pro-bono visits to hospital patients in the local charity hospital that was replaced years ago by the shiny new E.R. clinic that costs a fortune to visit. “Dr. Juliette” understands the power of free enterprise and she practices the same business principles that photographers should embrace because it’s “good medicine.”
So here’s what I hope: When I found the Madrigal-Dersch video on YouTube, the counter was set at just under 600 views. I hope you will forward this article to everyone you know who cares about this issue. Let’s help to make this lady famous! You can copy a link to this article here, or you can copy a link to the video alone here.
And here’s some more information on the good doctor:
- Click here to see her contact information on DoctorsScordcard.com.
- Click here to read her spirited opinion of what’s wrong with the portion of the health-care system in which she practices. It appeared as a letter to the editor in the June 2004 issue of Emergency Medicine News.
- Click here for a longer Google video presentation on how she runs her cash-based practice. I think this presentation is priceless because she demonstrates the clarity that comes when you “know your numbers.” Bless you, Juliette!
Dr. Madrigal-Dersch concludes the second video by telling the doctors in her audience to “Love your patients and let your patients love you. Remember why you went to medical school in the first place and spend every day taking care of patients with the same love and zeal. That’s how it is at our practice and that’s why it’s so much fun. When you go to medical school it’s because you want to take care of people, and that’s what I do every day.”
What a great way to run a medical practice, or a photography business for that matter!
I hope you agree.
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9-11, 2009: "America, Say a Prayer."
September/11/2009 Random Thoughts
I fell asleep around 2 A.M. this morning with the television on. I’ve been working late on a long project for several evenings, and I didn’t even realize that it was September 11 when I woke up to a rebroadcast of the terrible events, exactly 8 years ago. Once again I heard the soft, chilling words of newscaster Jon Scott when he said: “The loss of life will be terrible; America, say a prayer.” I watched the familiar coverage for a few moments, until collapse of the first World Trade Center building, then I turned it off.
When I got to my office computer, I found a Wall Street Journal article I had been reading just before I went to bed. It was by Norman Podhoretz, conservative writer, foreign policy advisor to Mayor Rudolph Giuliani during his run for the presidency, and a holder of the Presidential Medal of Freedom. I had highlighted the paragraph below in which Podhoretz describes his view of what divides liberals and conservatives today. Somehow his words resonate particularly on this dreadful day of remembrance:
Of course in speaking of the difference between left and right, or between liberals and conservatives, I have in mind a divide wider than the conflict between Democrats and Republicans and deeper than electoral politics. The great issue between the two political communities is how they feel about the nature of American society. With all exceptions duly noted, I think it fair to say that what liberals mainly see when they look at this country is injustice and oppression of every kind—economic, social and political. By sharp contrast, conservatives see a nation shaped by a complex of traditions, principles and institutions that has afforded more freedom and, even factoring in periodic economic downturns, more prosperity to more of its citizens than in any society in human history. It follows that what liberals believe needs to be changed or discarded—and apologized for to other nations—is precisely what conservatives are dedicated to preserving, reinvigorating and proudly defending against attack.
America, say a prayer.
When I got to my office computer, I found a Wall Street Journal article I had been reading just before I went to bed. It was by Norman Podhoretz, conservative writer, foreign policy advisor to Mayor Rudolph Giuliani during his run for the presidency, and a holder of the Presidential Medal of Freedom. I had highlighted the paragraph below in which Podhoretz describes his view of what divides liberals and conservatives today. Somehow his words resonate particularly on this dreadful day of remembrance:
Of course in speaking of the difference between left and right, or between liberals and conservatives, I have in mind a divide wider than the conflict between Democrats and Republicans and deeper than electoral politics. The great issue between the two political communities is how they feel about the nature of American society. With all exceptions duly noted, I think it fair to say that what liberals mainly see when they look at this country is injustice and oppression of every kind—economic, social and political. By sharp contrast, conservatives see a nation shaped by a complex of traditions, principles and institutions that has afforded more freedom and, even factoring in periodic economic downturns, more prosperity to more of its citizens than in any society in human history. It follows that what liberals believe needs to be changed or discarded—and apologized for to other nations—is precisely what conservatives are dedicated to preserving, reinvigorating and proudly defending against attack.
America, say a prayer.
I Love Lucy
September/08/2009
Persnickety in the Spotlight
September/04/2009 About Pernsickety
Remembering a Giant
September/02/2009
Small Health Bill
September/01/2009
October 7
“Small Bill” Proposal for Sensible Health-Care Reform
To make health insurance more accessible, affordable, and portable — without threatening the quality of care or the preexisting insurance of millions of Americans:
1. End the unfair tax on the uninsured (and self-insured), giving them a tax-break similar to that which is already available to those with employer-provided insurance. Provide refundable and advanceable tax-credits of $2,000 per person, up to $5,000 per family. LEAVE EMPLOYER-PROVIDED INSURANCE, ITS TAX-EXEMPT STATUS, AND THE REST OF THE TAX CODE, INTACT. (Increase in government spending: none. Average reduction in taxes: $34.5 billion/year (see * below), offset by using unallocated economic stimulus funds.)
2. Allow Americans to buy insurance across state lines. Allow Americans to shop for coverage from coast to coast — whether from lower-mandate states at lower prices, or from higher-mandate (additional-coverage) states at higher prices. Allow plans bought in one state to be transported to another. (Increase in government spending: none.)
3. Expand Americans’ ability to keep their insurance when they leave their job. COBRA allows former employees to pay the costs of their insurance premiums (including the employer’s former share) and thereby keep their insurance in effect, but only for 18 months. Expand COBRA by 12 months, allowing people to keep their insurance for up to 30 months if they have not yet secured a new job with an employer-sponsored plan. (Increase in government spending: none.)
4. Allow lower premiums for healthier lifestyles. Existing federal regulations ban private companies from offering more than a 20 percent discount to those who eat and drink in moderation, exercise, or don’t smoke. Such regulations handcuff private efforts to reward healthier lifestyles and to thereby cut health costs — and they should be eliminated. (Increase in government spending: none.)
5. Cut costs by preventing runaway malpractice lawsuits. Relieve doctors from having to practice defensive medicine, by capping punitive damages at $250,000 per provider and $750,000 total, while continuing to allow unlimited economic damages to compensate for financial loss. (Increase in government spending: none.)
“Small Bill” Proposal for Sensible Health-Care Reform
To make health insurance more accessible, affordable, and portable — without threatening the quality of care or the preexisting insurance of millions of Americans:
1. End the unfair tax on the uninsured (and self-insured), giving them a tax-break similar to that which is already available to those with employer-provided insurance. Provide refundable and advanceable tax-credits of $2,000 per person, up to $5,000 per family. LEAVE EMPLOYER-PROVIDED INSURANCE, ITS TAX-EXEMPT STATUS, AND THE REST OF THE TAX CODE, INTACT. (Increase in government spending: none. Average reduction in taxes: $34.5 billion/year (see * below), offset by using unallocated economic stimulus funds.)
2. Allow Americans to buy insurance across state lines. Allow Americans to shop for coverage from coast to coast — whether from lower-mandate states at lower prices, or from higher-mandate (additional-coverage) states at higher prices. Allow plans bought in one state to be transported to another. (Increase in government spending: none.)
3. Expand Americans’ ability to keep their insurance when they leave their job. COBRA allows former employees to pay the costs of their insurance premiums (including the employer’s former share) and thereby keep their insurance in effect, but only for 18 months. Expand COBRA by 12 months, allowing people to keep their insurance for up to 30 months if they have not yet secured a new job with an employer-sponsored plan. (Increase in government spending: none.)
4. Allow lower premiums for healthier lifestyles. Existing federal regulations ban private companies from offering more than a 20 percent discount to those who eat and drink in moderation, exercise, or don’t smoke. Such regulations handcuff private efforts to reward healthier lifestyles and to thereby cut health costs — and they should be eliminated. (Increase in government spending: none.)
5. Cut costs by preventing runaway malpractice lawsuits. Relieve doctors from having to practice defensive medicine, by capping punitive damages at $250,000 per provider and $750,000 total, while continuing to allow unlimited economic damages to compensate for financial loss. (Increase in government spending: none.)
| 6. Provide further help for those who are uninsured and have expensive preexisting conditions, by increasing federal support for state-run high-risk pools. | Thirty-four states already have pools to help those who have been denied affordable coverage because of prohibitively expensive preexisting conditions, and we should incentivize their establishment in all 50 states. (Federal (DSH) funds currently covering emergency-room care would gradually fund the pools, as reliance on emergency-room care is reduced. Increase in government spending: $15 billion in the first year, gradually dropping to $0.) (See ** below.) 10-Year ScorecardBaucus Bill | "Small Bill" | Spending Increases | $856 billion | $75 billion |
| Tax Increases | $354 billion | $0 | |||
| Tax Cuts | $2 billion | $345 billion* | |||
| Increased Fines | $47 billion | $0 | |||
| % Americans Insured | 95% | 95% | |||
| 20-Year Scorecard | Baucus Bill | "Small Bill" | Spending Increases | $2.9 trillion** | $0.1 trillion |
| Tax Increases | $2.0 trillion** | $0 | |||
| *All for the uninsured or self-insured | **According to CBO projections |