I am a regular reader of your blog prior to my writing my own blog several times a week. http://www.healthtrain.blogspot.com

This last blog is a great one. So good that I am going to copy and paste it to send to my specialty academy and other leaders in medicine.

It certainly goes to the core of why congress never seems to get it correct. Perhaps democracy does not work well in some areas, and what we need is a ‘Czar’ for national healthcare.

If I were to apply for such a position, I would desire much input from the ‘grassroots’ doctors dealing with CMS, HMOs,patients, hospitals,payors, etc. We all know that you as the head of HHS can advise congress, inform physicians, and patients about where CMS is going.

I know that most physicians are not ‘greedy’ We have learned to live with much less financially, now to the point where it will seriously diminish lack of access to senior citizens.

From my limited experience there is a total disconnect between government programs, on the state and /or federal programs. These are two difficult healthcare worlds. It’s every man for himself….which flies in the face of our Republic.

Ted Kennedy with all his challenges in life has not become a cynic….I strongly admire him although I do not agree with all his politics. He and his family have inspired many Americans to become involved in politics and the leadership of our great nation.
You sir are a patriot of the first order.
I am now semi-retired but still need to work because I was unable to save for retirement in the past 15 years due to my own disability and shrinking reimbursements.
I wish I could find a position which would reimburse me in my area of promoting health information technology , HIE, and EMR.

I believe CMS needs to open direct channels of policy planning with providers. We all deal with intermediaries, which is one sided and misleading. CMS needs to cut ‘our overhead’ It is often stated that CMS overhead is 2%. Largely because providers do much of the work….and have most of the expense (it is said 14% of providers overhead has to do with getting paid by payors, medicare, HMOSs. etc.

Medicare will have much more credibility with providers if some attention is given to this side of the equation instead of merely cutting reimbursements. How about tax credits for charity care? Tax credits for write offs and adjustments.

The idea of CMS acting as an agent for the IRS to collect unpaid taxes from providers goes beyond common sense. It will sink the system and shut down many providers who are good physicians.

Your mother’s pie was divided and distributed with an attitude of fairness. The mindset of many Medicare beneficiaries is that they are spending other peoples money. The medicare pie would last longer if the mindset involved some personal responsibility and personal investment. As a practicing physician, if I do not participate with Medicare, I am currently prohibited from providing medical care for a Medicare patient and presenting him with a bill for my services and a HCFA 1500 form for him to file with his insurance provider, in this case Medicare. If he files the claim, he will not be repaid. This should be changed, allowing a portion of the responsiblity for health care costs to be with the patient. This would have a profound influence on the patient as he makes decisions for healthcare. This influence just isn’t considered when the bill will be paid with other people’s money. It appears to me that we all should be accountable with the Medicare pie before it is gone.

Roger Tall, M.D.
Urologist
Idaho Falls, ID

P.S. I have written this because my son attends your ward in Virginia and says that you read your blog.