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What if the Supreme Court Overturns Healthcare Reform? Print E-mail
Written by Lawrence H. Schimmel, MD   
Friday, 04 May 2012 12:42


us supreme court Isn't it ironic that the future of the Affordable Care Act which was crafted in part by lawyers, approved in the House and the Senate primarily by lawyers, and subsequently challenged in the courts by lawyers will now be decided by lawyers who now are justices in the Supreme Court?

In about six weeks, the Supreme curt will render its decision on the constitutionality of the Affordable Care Act (ACA). They can choose to affirm the whole act, rule the whole act unconstitutional, or only rule parts unconstitutional. Their decision will affect all of us involved in the delivery of healthcare even though the vast majority of the change promised in the ACA has not yet even gone into effect.

My initial reaction was that it would not change the life of the average physician if the whole law was reversed in June. We would still get up every day, see our patients, and bill third parties for our services.

However, long-term there will be consequences if the act is overturned. This law was just the first step in what was contemplated to be a change in the delivery and payment for healthcare in our country. What should have been a procedural discussion became a political discussion and the act that is now being reviewed by the Supreme Court is a "politically compromised bill" that evolved so that it could gain the votes necessary for passage. The vision of healthcare reform was to create a system where outcomes driven by best medical practices were rewarded, a system where there would eventually be a seamless interface of communication between physicians utilizing the electronic medical record, and a system where preventive medicine would perhaps drive up costs initially but, in the long-term, reduce the burden as diseases were either prevented or caught earlier in their evolution.  

The mandate, about which we have heard so much, was a key provision in the reform bill. Of the 40-50 million uninsured individuals in our country, the vast majority are under 50 years of age and are working. Unfortunately, they do not have the resources to purchase insurance commercially, have pre-existing conditions that bring up the premium significantly, or they do not have group health insurance offered to them where they work. The mandate required these individuals to purchase some type of insurance from pools that were to be set up specifically for these patients. Their insurance would not be the best of the best nor would it be the worst of the worst. It would however, allow these patients to see a physician who would be compensated for the care they render. The crux of the debate was:  Can the government impose a penalty (tax) on individuals for non compliance?  This article is not to debate the issue, but what is wrong about requiring people to have health insurance? We require people to have auto insurance, have a drivers license, have homeowners insurance if they have a mortgage, etc., etc., etc. Early on we heard about the public mandate. That was eliminated from the bill due to political fighting, but in reality, what would have been wrong if we allowed this group of patients to "purchase" Medicare. The program already provides coverage for any person in the country with a permanent disability irrespective of age. Would it be so bad to allow healthy people to purchase Medicare?

So what happens tomorrow if the law is overturned? There will be immediate issues with the change in the donut hole as it relates to Medicare part D. There will be changes in that the "wellness visit", included in the act, will no longer be paid for by Medicare. How many diseases will be found later since patients will have to decide to pay for the visit or not have it at all? More importantly, what about the associated laws (HITECH Act) and perception of how healthcare is going to be delivered? Does ACO planning stop? Do the doctors who have sold their practice to hospitals and other organizations because they feared reform now develop seller's remorse? Do the purchasers of medical practices take a deep breath and try to determine what the next steps should be? Will health insurance premiums go down now that community-rating standards for underwriting will not go into effect in the future? Or do they go up because the anticipated, expanded risk pool driven by the mandate has now been cancelled?

Unfortunately, if all or part of the act is reversed we will probably go back to the status quo, as it existed in 2009. There is something inherently wrong when healthcare reform and the delivery of care has been changed into a political debate that will be decided by justices appointed to the Supreme court because of their conservative or liberal ideation. I have always believed that we should not let perfect get in the way of better. Let's hope those in Washington would agree.

About the Author:  Dr. Schimmel is the President of Allied Health Advisors, LLC, a boutique healthcare consultancy in Miami.  He can be reached at 305.803.2469 or  

Last Updated on Sunday, 20 May 2012 19:57
Top South Florida Diagnostic Centers Print E-mail
Written by Digital Wire Service   
Tuesday, 24 April 2012 00:00

 philips 1.5 t mri
According to the SFBJ, these are the top imaging centers in the region based on patient volume:

5. Jupiter Medical Center

4. North Broward Medical Center

3. Broward Health Broward General Medical Center

2. Coral Springs Medical Center

1. Memorial Hospital West Outpatient Center

Read More.
Great Place to Work in Healthcare Print E-mail
Written by Jeffrey Herschler   
Monday, 23 April 2012 06:22

According to Becker's ASC Review, these are the 100 Great Places to Work in Healthcare in the U.S. Six Florida companies made the list. They are:

-Baptist Health South Florida (Coral Gables, Fla.)

-BayCare Health System (Tampa Bay, Fla.)

-Doctors Hospital of Sarasota (Florida)

-Harborside Surgery Center
(Punta Gorda, Fla.)

-Melbourne Surgery Center

-Memorial Healthcare System
(Broward & Palm Beach County, Fla.)

Florida compared favorably to the other large states. California boasted eight healthcare facilities while Texas had ten and New York contributed only two. From the Midwest, Illinois had six on the list, Michigan four. New Jersey contributed an impressive seven and Pennsylvania was not far behind with five.

According to the web site "The 2012 list was developed through nominations and extensive research, and the following organizations were chosen for their demonstrated excellence in providing robust benefits, wellness initiatives, professional development opportunities and atmospheres of employee unity and satisfaction."

Last Updated on Monday, 23 April 2012 07:20
Physician Job Opportunities Print E-mail
Written by Sponsor   
Saturday, 21 April 2012 00:00
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Last Updated on Sunday, 06 May 2012 09:02
Stop the presses: online ad spending to exceed print this year Print E-mail
Written by Jeff Herschler   
Friday, 20 April 2012 09:46
"U.S online advertising spending, which grew 23% to $32.03 billion in 2011, is expected to grow an additional 23.3% to $39.50 billion this year, pushing it ahead of total spending on print newspapers and magazines," according to the forecast by eMarketer. Tara Pihn, healthcare pundit and futurist says bluntly "Print is dead. The tablet is the game changer." eMarketer reported in December that US adults now spend more time on mobile devices each day than they do with print media.

print is dead revised resizedRolando Valdes, a healthcare marketing professional, working in Dade and South Broward concurs, stating "I go into ten or twelve doctor's offices a day. The patients aren't reading the magazines; they are playing with their smart phones. Pretty soon they all will have tablets." Ms. Pihn sees the trend accelerating, "As tablets proliferate (see Gartner: Tablet Sales to Double This Year) and Wi-Fi becomes ubiquitous, the massive shift in the way we read, which began over a decade ago, will be consummated. This will happen much faster than most people think." See pie chart below which illustrates the transformation:

Average Time per Day Spent with Media by US Adults Dec 2011 (minutes) Source: eMarketer via FHIpics

TV & Video 274

Total Digital (Internet + Mobil) 232

Radio 94

Total Print (Newspapers + Magazines) 44

pie chart digital vs print001

Total Digital (Internet + Mobile) dwarfs Total Print (Newspapers and Magazines). The typical American is spending over five times more time digesting digital content versus traditional print content (232 minutes per day vs. 44 minutes per day). Advertisers will continue to follow the audience. By 2016 eMarketer is predicting an online ad spend of almost double that of print ($62b vs. $32.3b).

And educated professionals such as doctors and healthcare executives have been early adopters in the digital revolution. Remember it was the doctors who gobbled up the first smart phone (the Palm Pilot) back in the '90's. According to Health Practice Media, Physicians and Hospitals are Rapidly Moving to Digital Media. For example, in a recent study 75% of physicians polled have purchased an Apple device such as an iPhone, iPad or iPod. Meanwhile that same study found 38% of physicians intend to buy an iPad this year.

I had a chance to catch up with several leaders in Florida's healthcare community recently and asked them about their advertising budget allocations. According to Diane High, Director, Corporate Marketing and Broward Health Line, Broward Health, "We still allocate a big part of our budget to print and outdoor. That said, digital is our fastest growing category. It was close to zero just a few years ago and now is a significant part of our media mix." Steve Whalen, Marketing Director at Danna-Gracey, a decade old medical malpractice insurance agency in Delray Beach, had this to say ""We are in a digital age, and this is only the beginning. We have traded in a walk down the driveway to get the newspaper for smart phones and tablets for on-the-spot information. If you want to be seen, you can't afford to be yesterday's news." Meanwhile according to Michael Salzhauer, a Plastic Surgeon in Bay Harbor Islands, "I think pure print advertising is going the way of the dodo bird. I spend 95% of my marketing dollars on digital media. The only print I do is charity/non-profit related or else very specific community/demographic targeting via local newsletters and the like. You get a lot more bang for your buck online." Not surprisingly, IOS Health Solutions, a five year old firm providing web-based practice management and EHR solutions, has embraced digital media from the beginning. "Print is definitely not our priority today. Digital media is the most effective way to reach the masses and maintain the message current in a rapidly changing landscape. It allows you to track and measure results quicker and adjust fire if needed. Our client's have also embraced the digital world benefitting from the numerous efficiencies and cost savings our software provides their practices when transitioning to a paperless environment." stated Anthony Lopez, Marketing Director.

The transformative effects of digital media present challenges as well as opportunities. According to Don Silver, Chief Operating Officer at Boardroom Communications, a PR firm in Broward, "The advertising and PR landscapes are certainly evolving...we are integrating a mix of traditional media relations and extending the messaging across social media, blogs, websites and the search engines." Says Pihn, "If you haven't done it yet, you need to reallocate marketing and advertising budgets in favor of digital ASAP."

Last Updated on Sunday, 20 May 2012 19:58
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