HEALTHPLANUSA.net QUARTERLY NEWSLETTER
Community For Affordable Health Care Vol IV, No 3, October, 2005
Utilizing the $1.4 Trillion Information Technology Industry
To Transform the $1.7 Trillion HealthCare Industry into
Affordable HealthCare
In This Issue:
1. Featured Article: Heed the New Health-Care Crisis
2. In the News:
Fixing Healthcare from the Inside, Today
3. International Medicine: Counterfeit Drugs Threaten Europe
4. Medicare:
Opting out of Mainstream, Health Insurance, Medicare System of Reimbursement
5. Lean
HealthCare: Massachusetts General Looks to Lean
6. Health Plan
USA: Health Care Needs a Dose of Competition by Michael F. Cannon
7. Medical
Myths: Embryonic Stem Cell Research Holds All the Answers
8. Overheard on
Capital Hill: Those American Doctors Are Killing People with Poor Quality of
Care
9. Individualized
Health Care - Regaining Control of Your Body
* * * * *
1. Featured Article: Heed the New Health-Care Crisis by Robert Goldberg,
There will be
time enough — at the right time — to re-evaluate the nation's preparedness for
natural disasters. But today,
The public and private health system in
Many in Congress are using this public
health crisis to seek huge — and permanent — expansion of existing federal
health programs to oppose fundamental reforms of Medicaid. We must avoid the
nationalization of the health-care system that followed in
All survivors will be eligible for
Medicaid or state-run children's health plans and can sign up in a matter of
minutes through computerized or online registration. Federal and state
governments have issued vouchers to patients to pay for prescription drugs and
other survivors in the interim. The Public Health Service is using online
technology and links to major health sites such as WebMD and Medscape to
recruit and deploy thousands of physicians, surgeons, and psychologists at a
per-diem basis who will be deployed as local need requires.
Many managed care plans have waived all sorts
of restrictions: Wellpoint Health Care will cover any doctor or hospital —
without restrictions — willing to provide care. Even as Congress considers
trying to save Medicaid money by charging the poor a co-pay for their drugs,
Wellpoint is eliminating them to insure that people actually get the medicines
they need. . . .
Sustaining medical assistance in the wake
of Katrina will require more money, but funds should not be used to simply
expand existing entitlements. The goal should be to allow people to carry
medical information and health insurance wherever they settle. The Department
of Health and Human Services can accelerate the effort to establish wireless
and Web-based communication systems in conjunction with electronic patient
records. It should make its new EPR software available and create a
public-private health information technology (IT) "strike force" to
obtain, install and operate the systems. It should allocate demonstration
grants for health IT to the Katrina relief effort. This would supplement the
nearly 3000 Red Cross IT volunteers spread out throughout the South. . . .
Long after the headlines fade,
Robert Goldberg is director of the
Manhattan Institute's Center for Medical Progress.
* * * * *
How can health
care professionals ensure that the quality of their service matches their
knowledge and aspirations? As a number of hospitals and clinics have discovered,
learning how to improve the work you do while you actually do it can deliver
extraordinary savings in lives and dollars.
Steven J. Spear
reports: Last year on Christmas day, a 32-year-old Belgian woman celebrated the
birth of a healthy daughter. Nothing remarkable about that, you might say,
except that seven years prior, this same woman had been diagnosed with
Hodgkin’s lymphoma. Because doctors feared that chemotherapy would leave her
infertile, they surgically removed, froze, and stored her ovaries. Once her
treatment was concluded, with her cancer sufficiently in remission, they thawed
the tissue and returned it to her abdomen, after which she was able to conceive
and deliver.
Such medical
miracles—improvements in fertility treatment, cancer cures, cardiac care, and
AIDS management among them—are becoming so commonplace that we take them for
granted. Yet, in the
How can this be
in the country that leads the world in medical science? It’s not that
caregivers don’t care. Quite the contrary: Health care professionals are
typically intelligent, well-trained people who have chosen careers expressly to
cure and comfort. For that reason, perhaps, many policy makers and management
scholars believe that the problems with American health care are rooted in
regulatory and market failures. They argue that institutions and processes
mandated by law and custom are preventing demand for health care from matching
efficiently to those most capable of providing it. In this view, the best
treatment for what ails the
I won’t dispute
the benefits of these reforms. The efficiency of health care markets may indeed
be gravely compromised by poor regulation, and economic incentives should
reinforce health care providers’ commitment to their patients. But I fear that
the exclusive pursuit of market-based solutions will cause professionals and
policy makers to ignore huge opportunities for improving health care’s quality,
increasing its availability, and reducing its cost. What I’m talking about here
are opportunities that will not require any legislation or market
reconfiguration, that will need little or no capital investment in most cases,
and—perhaps most important—that can be started today and realized in the near
term by the nurses, doctors, administrators, and technicians who are already at
work.
The scale of the
potential opportunities can be seen in the results of a number of projects I’ve
been following over the past five years at various hospitals and clinics in
Other hospitals
have dramatically lowered the incidence of infections arising from surgery and
of pneumonia associated with ventilators. Still others have improved primary
care, nursing care, medication administration, and a host of other clinical and
nonclinical processes. All of these improvements have a direct impact on the
safety, quality, efficiency, reliability, and timeliness of health care. Were
the methods these organizations employ used more broadly, the results would be
extraordinary. In fact, you could read an entire issue of HBR, even several,
and during that time the number of fatalities would be close to zero. (See the
exhibit “The Health Care Opportunity.”)
Steven J. Spear (sspear@ihi.org)
is a senior fellow at the Institute for Healthcare Improvement in
http://harvardbusinessonline.hbsp.harvard.edu/hbrsa/en/issue/0509/article/R0509D.jhtml?type=F
* * * * *
3. International Medicine: Counterfeit Drugs
Threaten
NCPA Daily
Policy Digest, Health Issues: Counterfeit Drugs Threaten
Due to insufficient
cross-border cooperation, counterfeit Viagra, antibiotics and other drugs in
Counterfeit
medicines often are packaged like the genuine product and are hard to detect.
Lifestyle drugs and essential medicines are particularly popular with
counterfeiters, but there's an increase in the field of contact lenses and
materials like surgical mesh.
Since there is
no recognized central reference point in
* Counterfeit medicines make up approximately
10 percent of the European pharmaceutical market -- up from zero 10 years ago
-- and often are supplied by international criminal rings.
* In
* Experts warn that purchasing health
products over the Internet poses a major health risk since many of those drugs
have not been approved by a competent health authority.
* A study by the U.S. General Accounting
Office in 2004 found that four out of 21 medicines ordered from Web sites
outside the
Law enforcement
officers, doctors and pharmaceutical experts from
www.ncpa.org/newdpd/dpdarticle.php?article_id=2312&PHPSESSID=3721407068d37f21a85eeeedc564c7e4
Source:
Associated Press, "Counterfeit Drugs Deemed Threat in
For text: www.foxnews.com/story/0,2933,170150,00.html.
* * * * *
4. Medicare: Opting out of Mainstream, Health Insurance, Medicare
System of Reimbursement
Panel studies retainer care, practice trends by Joel B
Finkelstein, AMNews staff,
What will it
take to get physicians excited about practicing medicine again? That was the
question Sen Robert F Bennett (R, Utah) asked a panel of physicians testifying
recently before the Joint Economic Committee. Their answer: Opting out of the
mainstream, health insurance-oriented system of reimbursement.
Like these
physician panelists, a seemingly growing number of physicians are eschewing
insurers and Medicare in favor of cash payments and retainer practices, also
called boutique practices.
The American
Medical Associations’ Council on Ethical and Judicial Affairs last year
determined that the trend is not necessarily a bad thing.
* * * * *
5. Lean HealthCare: Massachusetts General
Looks to Lean
In 2001,
Massachusetts General Hospital (MGH) opened the
The Northeast
Proton Therapy Center (NPTC) emerged from pioneering work at the Harvard
Cyclotron Laboratory,
“Proton therapy
is a highly sophisticated component of radiation oncology,” describes Kathy
Bruce, technical director for radiation oncology at MGH. “It uses a particle
beam comprised of protons that are accelerated to a rapid pace, and once they
hit tissue they have some special physical properties that are very beneficial
in terms of radiation dosage to the area we want to treat vs. the area we want
to protect. In many cases, tumors are adjacent to critical structures where the
sensitivity of those structures limits the amount of dose we can give through
conventional [radiation] means. But because of the physical property of the
protons, we can do it differently and protect those structures.”
From the time
NPTC opened its doors it sought to expand patient mix and volume, but while
enhancements occurred, there continued to be pent-up demand for proton
treatment. Last year 25 to 30 patients were treated per day, while the initial
target for the center was 40 to 50 patients per day. “We had to look at the way
were doing things to see how we could speed up the process without compromising
the quality,” says Bruce.
While more
patients with access to the proton beam can mean more opportunities to save
lives, it’s not simply a matter of increasing throughput. Proton therapy is a
complicated amalgam of medicine, physics, engineering, and compassion and
involves treatment processes that few people will ever encounter and an
incredible array of professions, processes, steps, and handoffs. Dr. Jean
Elrick, MGH senior vice president of administration, says there are more people
and disciplines involved in the proton center’s therapeutic identification,
planning, and implementation processes than in any other facet of care at MGH.
The process includes engineers, physicists, nurses, therapists, doctors,
residents and fellows on teaching missions, anesthesiologists for children, and
a machine shop — all in a new
facility working with new technology. “And that’s just the clinical part, let
alone all of the surrounding pieces of support that go into that clinical
process, which makes it all the better place for lean because of how quickly on
a relative basis that very complex, multiperson, multifactorial process could
be so clearly laid out.”
The Proton Therapy Process
NPTC’s 230 MeV
proton beam originates at a cyclotron, a machine that accelerates particles to
their multimillion electron-volt energy level. The beam is steered with huge
magnets through concrete tunnels the length of a football field into one of
three patient-treating areas — two gantries and one stationary treatment area.
The beam peels off the main line and serves one treatment area at a time.
The gantries are
massive 110-ton spherical structures that slowly rotate to any 360-degree angle
within one millimeter of accuracy around a stationery patient. Patients, fitted
with specially designed masks and molds, are positioned to within one-half
centimeter of their calculated treatment position. The proton beam is targeted
from any angle into three dimensions to match the shape of a patient’s tumor.
Apertures and compensators are incorporated between the beam and patient, which
direct and constrain the protons to the desired 3D areas; one patient may
require multiple devices.
The beam-on time
for a patient typically is between one minute and two minutes per field (the
targeting of the beam from a given direction), and a patient may require from
one to seven fields during their treatment session, says Susan Michaud, RTT,
assistant chief radiation therapist of radiation oncology and supervisor at
NPTC. Some complicated pediatric cases take more than one hour to set up and
treat. . . .
The Lean Approach
Patient time
under the proton beam is minutes, and offers no opportunity for time-savings.
But the preparation time prior to patients receiving their therapy, the intake
process to identify and schedule proton patients, and the treatment planning
process were ripe for improvement and could lead to greater patient volumes.
NPTC’s need to
increase capacity also coincided with a multipronged strategic plan at MGH,
instituted under president Peter Slavin, which focused on process improvements
and cost-savings hospitalwide. Dr. Elrick, the chair for the
process-improvement strategic planning committee, had reviewed various
improvement approaches, including lean, and attended a presentation by the Lean
Enterprise Institute (LEI). She selected the proton center as a lean pilot
project and “volunteered” Nancy Corbett, senior administrative director for the
radiation oncology department to set lean in motion; Carey Palmquist,
administrative director of practice operations, and Kathy Bruce supported
Corbett.
Helen Zak, COO
of LEI, and Guy Parsons, an LEI faculty member, reviewed the NPTC operations
and its capacity challenges. They presented an approach of how lean principles
could jumpstart improvements in the center via three days of workshops that
involved a scoping session with leadership and value-stream mapping and
action-plan sessions by a lean team. The leadership of the NPTC (Dr. Thomas
DeLaney, medical director; Dr. Hanne Kooy, associate director and manager of
radiation physics at the NPTC; and Dr. Jacob Flanz, technical director of the
center) bought into the lean plan, says Corbett, once they were convinced that
lean could “subtract” things that got in their way of providing the best
possible care for patients.
Parsons was able
to impress upon Dr. Elrick and NPTC staff the means to improve processes
without touching and tampering with the caregiving component. He assured them
that the initiative would “not talk about appropriateness of care. We don’t know
about it. It’s everything else.” Everything else in lean terminology was the
“waste” in the processes, the issues and obstacles that frustrated NPTC staff
and prevented them from administering therapy in the most efficient and
highest-quality manner.
The LEI
approach, adds Dr. Elrick, also was dissimilar from the armies of well-dressed
consultants who conduct interviews, distribute reports, offer copious
recommendations, and link efforts to information technologies or long-term
engagements. “I’ve been doing change management for 12 years; it has to come
from within. This has to be us, not you. . . . ”
Lean Kickoff
The lean
initiative kicked off in September 2004 with the scoping session during which
NPTC leadership identified what could and should be goals for the effort and
who should be involved in the subsequent two days of value-stream mapping and
action planning. “We didn’t pick people that would be immediately agreeable,”
says Bruce. “We picked people who would be key to the success going forward, who
we knew would be difficult to persuade, who really owned it. Every discipline
was represented.”
“It was not
optional to come for part of the day if you were on the proton center team,”
adds Corbett. “It was two days, beepers off, no answering pages. Participants,
including physicians, had to have someone cover them for the full two-day
commitment.”
For two days, a
15-member team of physicians and clinical and non-clinical staff drew a
current-state map of the process, developed future-state maps, and set action
steps and responsibilities that would move NPTC from the current state into the
future.
Lean at
Lean in Healthcare: To learn more about lean work promoted
throughout the healthcare industry by the Lean Enterprise Institute, contact
The Lean Enterprise Institute (LEI) Chief Operating Officer Helen Zak at
617-713-2900 or emailing hzak@lean.org. The
Lean Enterprise Institute, Brookline, MA, is a nonprofit research, training,
and publishing company organization founded in 1997 to promote the principles
of “lean thinking” in every aspect of business and across a wide range of
manufacturing and service industries.
www.lean.org - Lean Enterprise Institute,
* * * * *
6. Health Plan
Hurricane Katrina
has brought to the fore the strengths and weaknesses of
Why the
discrepancy? Entrepreneurs and private charities often respond much faster than
government because they are more agile and flexible. Just as important, they
avoid wasting valuable resources, allowing help to go where it's needed the
most.
These
considerable advantages emerge from the fact that government must follow
cumbersome rules, and that individuals are more careful with their own
resources than with other people's. There is a lesson here for
In many sectors
of the economy, market competition consistently improves quality while reducing
costs. Health care is an exception, but not because competition cannot work. In
fact, the recent rise in cash-paying patients traveling abroad for medical care
shows that market competition makes even urgent, high-cost acute care more
affordable.
Rather, health
care is an exception because market competition is not allowed to work. Market
competition requires three key elements: (1) a large pool of actual and
potential producers with new ideas; (2) consumers who are free to choose
different products; and (3) consumers who weigh the costs and benefits of those
products. At every turn, government tax, spending, and regulatory policies
thwart these necessary conditions of a free market.
To mention just
one example, heavy government subsidies (through programs such as Medicare and
Medicaid) and tax penalties (for workers who do not let an employer purchase
their health care) discourage patients from weighing costs against benefits. As
a result, Americans pay for more of their medical care through third parties
(86 percent) than patients in 17 other advanced countries, including
Time and again,
free markets have proven an effective framework for making products of
ever-increasing quality available to an ever-increasing number of consumers. To
make high-quality care available to more Americans, we need reform that will
allow markets to work in health care. That should include:
* More flexible health savings accounts.
Though promising, this new health
insurance option is too restrictive. Congress should create large HSAs that are
more flexible and give workers ownership of all their health care dollars and
decisions.
* Injecting choice, competition, and
ownership into Medicare.
This federal program for the elderly
engenders enormous waste and will soon impose a crushing tax burden unless we
act soon. Congress should give seniors greater choice of health plans, and
allow workers to save their Medicare taxes in personal accounts for their health
care needs in retirement.
* Reforming Medicaid as Congress reformed
welfare.
This federal-state program for the poor
creates the same harmful incentives as the welfare system Congress reformed in
1996. Those reforms should be applied to Medicaid.
* Health insurance deregulation.
Costly state regulations make health
insurance too expensive for many, and each state prohibits the purchase of
coverage licensed in other states. Congress should tear down those barriers.
* Provider deregulation.
Regulation of medical professionals
(e.g., licensing, scope-of-practice, and telemedicine laws) and facilities
(e.g., certificate-of-need laws) restrict the availability of medical care,
particularly for the poor. Those laws should be relaxed. . . . To read the
original article, please go to www.cato.org/pub_display.php?pub_id=5070.
Michael F.
Cannon is director of health policy studies at the Cato Institute, and
co-author of Healthy Competition: What's Holding Back Health Care and How to
Free It from which this article is adapted.
*
* * * *
7. Medical Myths: Embryonic Stem Cell (ESC) Research Holds All
the Answers
Last month, David
Prentice, PhD, Sr Fellow in Life Sciences, Family Research Council, at
"There is a
lot of misinformation out there," he began. "There is something
fascinating about science. One gets such wholesale returns of conjecture by
people thinking embryonic stem cells can be directed into any type of tissue or
organ. Many think it would be about like going to a parts department and asking
for a new femur for a 57-year-old patient with aseptic necrosis of the femoral
head. True, ESCs are totipotent– they can grow into any type of tissue
including tumors and cancers. But they are difficult to direct. The number of
volunteer donors may be enormous. For instance, to treat 17 million diabetics
with ESC would require 170 million human eggs."
Dr Prentice
cited a number of examples of adult stem cells, from the umbilical core or
nasal stem cells, that are already being used to treat spinal cord injuries,
Parkinson's, myocardial damage from infarction and pulmonary injuries. He went
on to explain how adult stem cells circulate between various organs for repair
and maintenance of tissues. Adult Stem Cells, like Embryonic Stem Cells,
progress to Progenitor Cells that differentiate into cells that heal injured
tissue.
Adult Stem Cells
are the most promising source for treatment, according to Dr Prentice.
"They are able to generate virtually all adult tissues. They can multiply
almost indefinitely, providing numbers sufficient for clinical treatments. They
have proven success in laboratory tissue culture. They have proven success in
animal models of disease. They have proven success in current clinical treatments.
They are able to “home in” on damaged tissue. They avoid problems with tumor
formation. They avoid problems with transplant rejections. They also avoid the
current ethical quandary."
As to the
question of why we are hearing all this emphasis on Embryonic Stem Cells, Dr
Prentice replied: Since there is not much in the way of better treatment, and
the risks are greater, the big push for ESC research is primarily money, not
human good. There may eventually be benefits, but the ground work can be done with
Adult Stem Cells, and the few ESC lines already authorized with the human risks
which should be more than adequate for all the basic work required for many
years.
He concluded
that it really appeared that the proponents of embryonic stem cell research and
funding really want a class of human cloned embryos without rights that they
can use for whatever experiments they want without human rights disclosure.
After our visit
to Capitol Hill in
For more
information: DO NO HARM, The coalition of American Research Ethics can be found
at www.stemcellresearch.org.
* * * * *
8. Overheard on Capital Hill: Those American Doctors Are Killing
People with Poor Quality of Care
Dr Thomas commenting on his visit to
Dr Richard: But poor quality in health care is
government induced. American doctors have always had the highest standards of
excellence with physicians logging more continuing medical educational credits
on a yearly basis than any place else in the world. The federal government
promoted managed care where bureaucrats, who are basically medical illiterates,
tell physicians how to practice medicine by telling them they are spending too
much time with patients. They allege that we should be able to see, examine,
evaluate, and treat a patient in 10 or at most 15 minutes. Artificially
limiting the exchange of health information between doctor and patient would
obviously lead to missing many important details that would increase the errors
in making the diagnosis.
Dr Harriet: By making doctors look bad, they are de-professionalizing the
medical profession and making them look like school children that need remedial
work, rather than focusing on the bureaucratic etiology. Quality will
automatically increase as the government steps aside. After all, quality has
always been our middle name. In an open Medical MarketPlace, patients will
always choose the best doctors, nurses and hospitals and the worse doctors
would have to improve their quality or they might be looking for other
employment. In government or bureaucratic medicine, the worst doctors get paid
the same as the best doctors and obviously the quality of care will gradually
deteriorate to that given by the incompetent.
Dr Thomas: After my experience in
* * * * *
9. What's New in Health Care: Regaining Control - The Ownership
Society and Health Care
Most would agree
that people are less careful about what they purchase or how much it costs when
spending someone else’s money.
For example, a
decade-long health insurance experiment found that people given “free” medical
care consumed 43 percent more care, yet saw little or no benefit in terms of
health. In contrast, those who had money set aside for the first few thousand
dollars of their medical expenses, bore the full consequences of their
decisions. They demanded value in return for their money.
* Government encourages and even requires
Americans to turn their health care dollars over to their employer or the
government itself.
* That’s why roughly 86 percent of all
medical bills in
* As a result, patients quite reasonably
act as though they are purchasing health care with someone else’s money.
In 2004,
Congress took a first step toward establishing an ownership society by creating
Health Savings Accounts, or HSAs. HSAs remove many of the incentives that
encourage Americans to turn their health care dollars over to an employer.
Here’s how they work:
HSAs promote an
ownership society by fostering:
* Personal Responsibility: Because they
own the money that purchases their routine medical care, HSA holders take the
time to become more savvy consumers and take greater care of their own health.
* Freedom: HSAs re-establish the freedom
to choose one’s doctor, to choose one’s health insurance, to own one’s health
insurance policy, and to save for future medical needs. HSA funds follow
workers from job to job and provide coverage in
between jobs.
They can even empower workers to purchase health insurance policies that also
stay with them through job changes.
* Competition: Individual ownership will
make health care markets more competitive. Providers must work harder to win
the dollars of consumers who face trade-offs between medical care and other
items.
Click
here to learn how Congress can further promote the Ownership Society
through HSAs.
Most people
would also agree that assets are safer when they are under the direct control
of the person they are meant to benefit. Yet elderly Americans don’t have the
protection of ownership when it comes to their health care. . . .
The tax burden
of the Medicare program is growing. It may soon reach the point where workers
refuse to pay the high taxes necessary to provide promised benefits.
Rising health
care costs and a shrinking ratio of workers to beneficiaries are increasing the
tax burden that Medicare places on every worker.
* According to Cato Institute economist
Jagadeesh Gokhale, Congress would have to increase the Medicare payroll tax by
500 percent to finance future benefits. By 2008, an increase of 700 percent
would be necessary.
* Before long, workers will resist such
dramatic tax increases, which will jeopardize seniors’ access to medical care.
It doesn’t have
to be that way.
Congress can
increase the security of seniors’ access to medical care by giving seniors
ownership of their Medicare benefits. Congress should permit workers to save a
portion of their Medicare taxes in a Retirement Health Savings Account that
will grow over their working lives and provide for their health care in
retirement.
To read the
entire article, go to http://www.cato.org/special/ownership_society/boaz.html
John and Alieta Eck, MDs, for their first-century
solution to twenty-first century needs. With 46 million people in this country uninsured,
we need an innovative solution apart from the place of employment and apart
from the government. To read the rest of the story, go to www.zhcenter.org. Stay tuned for
their next innovative move in designing the healthcare system for the entire
country of
Michael J. Harris, MD - www.northernurology.com - an active
member in the American Urological Association, Association of American Physicians
and Surgeons, Societe' Internationale D'Urologie, has an active cash'n carry
practice in urology in Traverse City, Michigan. He has no contracts, no
Medicare, no Medicaid, no HIPAA, just patient care. Dr Harris is also
nationally recognized for his medical care system reform initiatives. To
understand that Medical Bureaucrats and Administrators are basically Medical
Illiterates telling the experts how to practice medicine, be sure to savor his
article on "Administrativectomy: The Cure For Toxic Bureaucratosis"
at www.northernurology.com/articles/healthcarereform/administrativectomy.html.
PATMOS EmergiClinic - where Robert Berry, MD, an emergency physician and internist states:
"Our point-of-care payment clinic makes acute and chronic primary medical
care affordable to the uninsured of our community by refusing to accept any
insurance (along with the hassles and crushing overhead that inevitably come with
it). Read the rest of the story at www.emergiclinic.com.
Dr Vern Cherewatenko has success in restoring private-based
medical practice that has grown internationally through the SimpleCare model network. Dr Vern calls
his practice PIFATOS – Pay In Full At Time Of Service, the “Cash-Based
Revolution.” The patient pays in full before leaving. Because doctor charges
are anywhere from 25 – 50 percent inflated due to administrative costs caused by
the health insurance industry, you’ll be paying drastically reduced rates for
your medical expenses. In conjunction with a regular catastrophic health
insurance policy to cover extremely costly procedures, PIFATOS can save the
average healthy adult and/or family up to $5000/year! To read the rest of the
story, go to www.simplecare.com.
Dr. Nimish Gosrani has set up a blend between concierge
medicine and a cash-only practice. “Patients can pay $600 a year, plus $10 per
visit, to see him as many times in a year as they want. He offers a financing
plan through a financing company for those unable to plop down $600 all at
once.” Patients may also see him on a simple fee-for-service basis, with fees
ranging from $70 for a simple office visit to $300 for a comprehensive
physical. Dr. Gosrani reports that he saves two hours per day that he used to
spend dealing with insurance company paperwork. To read more, go to http://cgi.photobooks.com/scripts/troll.cgi?dbase=moses&page=2&setsize=10&practice=Nimish+C.+Gosrani%2C+MD&pict_id=2001670.
Dr. Elizabeth Vaughan is another
* * * * *
Stay Tuned to the MedicalTuesday.Network and the HealthPlanUSA.Network
and have your friends do the same.
Del Meyer
Del Meyer, MD, CEO & Founder
HealthPlanUSA, LLC
Words
of Wisdom
Government is the great fiction, through which everybody
endeavors to live at the expense of everybody else. – Frederic Bastiat,
French political economist, (1801-1850) Essays
on Political Economy, 1846.
This
Month in History
October is the
month to commemorate the founding of
October is also
the month in which we celebrate the anniversary of the discovery of
So this October,
let’s set out to discover