As you may know, at least those of you who have followed my blog, my practice is free of third parties, other than Traditional Medicare. My reasons were many, but one of the main reasons was that Medicare did not put burdensome rules and regulations between me and my patients.
If I need an MRI, I give my patient a prescription. No referral or precertification necessary. So I did not see a reason to stop participation with Medicare, especially as Medicare, in my area of New Jersey, is actually a better payor than other insurers.
But now, we are being threatened with a 21% fee schedule reduction for Medicare. While it may or may not occur, I am getting pretty tired of all the b.llsh.t. There will come a point, and it may be soon, that Medicare, in my office, will no longer be accepted. Medicare accounts for about 15-20% of revenues. If I withdrew participation, I would probably keep about 30-40% of my Medicare patients, similar to the percentage of patients I retained when I terminated other insurers. If other docs stop taking Medicare as well, I would probably retain more. Revenues from "Medicare patients" would probably remain neutral.
Every practice needs to make a decision for themselves. But if you want my advice, and since you are reading this blog, you at least want to read my advice, it is to make plans to opt out of Medicare, as well as all your other insurers as well. Start acting like any other small business, and market your product directly to your customers, who happen to be your patients.
Physicians are responsible for the healthcare mess we are in. We allowed ourselves to be drawn into the third party system, with the hope of growing our practices. We hoped that the third party system would change our incomes for the better.
So I have a question for you.
Just how is all that hope and change working out for you?
Start planning your escape from the third party system. If you are a specialist, who relies on big ticket procedures, start trimming your overhead, and bring your fees to an affordable level, that still allows you to profit. If you are in primary care, it should be an easier adjustment, as primary care usually has less big ticket items. I dropped my practice overhead by 50% when I made the transition. As I had no business background prior to starting my practice in 1998, yet I was able to develop a healthcare business model that works, there is no reason why you can not!
And for all the docs on salary at hospitals or in academia, who do not feel threatened by Obamacare, what will happen to you, and to your salaries, when your hospital system can not afford to stay in business due to lower "reimbursements"? The first place they will go to make up for the cuts will be your salaries or your jobs.
So the physician community must get together, to take back control of our profession, and move it away from third party control, whether from government or insurers. Start your plans to drop Medicare, along with all the third parties, before it is too late!
Friday, March 26, 2010
Letter to NJ Governor Chris Christie
March 26, 2010
Living in New Jersey, we have a new governor, who actually happens to be a republican in a very liberal state. He was elected, he states, to get rid of corruption and to balance a state budget that is billions in debt, without raising taxes, and to make the state an easier place to do business. My fear is that he has focused too much on budget cuts, while not fully researching how Obamacare affects healthcare for New Jersey residents.
I have written a letter to Governor Christie, emailed on Friday, March 26th, 2010, a copy of which is shown below.
-----------------------------------------------------------------------------
To: Chris Christie (R-NJ), Governor
I urge you to take all available actions to protect New Jersey from a federal government takeover of healthcare. Such actions include filing a lawsuit against potentially unconstitutional provisions and securing New Jersey's ability to opt out of federal mandates. More than a dozen states have already filed such lawsuits challenging the individual mandate and Medicaid provisions in the bill. The Medicaid provisions alone will likely cost New Jersey billions of tax dollars we cannot afford.
I urge you to direct your Attorney General, Paula Dow, to join with these other states in doing everything possible to protect my rights to make my own health care choices, and also to protect physicians, so that they can offer the best care possible, without government or insurance interference.
As an independent family physician, I would welcome you to come to my medical office, which has given up all insurance contracts, other than Medicare. You will find that cost-effective high quality care occurs to a greater extent when the insurance companies and the government stay out of healthcare decisions.
I urge you to not repeat the same mistakes that other politicians have made, by listening only to your political appointees. To get a real view of healthcare today, you need to talk to independent physicians, without ties to hospitals or other institutions. Only then can you get enough data to formulate a real-world opinion on the state of healthcare in New Jersey.
-----------------------------------------------------------------------------------
OK.
So let's take a vote.
What response will I get?
A: Form letter
B: None
C: Real response by letter or email
D: Governor Christie acceptance to visit my office
My hope is for choice D, while I expect choice A.
Living in New Jersey, we have a new governor, who actually happens to be a republican in a very liberal state. He was elected, he states, to get rid of corruption and to balance a state budget that is billions in debt, without raising taxes, and to make the state an easier place to do business. My fear is that he has focused too much on budget cuts, while not fully researching how Obamacare affects healthcare for New Jersey residents.
I have written a letter to Governor Christie, emailed on Friday, March 26th, 2010, a copy of which is shown below.
-----------------------------------------------------------------------------
To: Chris Christie (R-NJ), Governor
I urge you to take all available actions to protect New Jersey from a federal government takeover of healthcare. Such actions include filing a lawsuit against potentially unconstitutional provisions and securing New Jersey's ability to opt out of federal mandates. More than a dozen states have already filed such lawsuits challenging the individual mandate and Medicaid provisions in the bill. The Medicaid provisions alone will likely cost New Jersey billions of tax dollars we cannot afford.
I urge you to direct your Attorney General, Paula Dow, to join with these other states in doing everything possible to protect my rights to make my own health care choices, and also to protect physicians, so that they can offer the best care possible, without government or insurance interference.
As an independent family physician, I would welcome you to come to my medical office, which has given up all insurance contracts, other than Medicare. You will find that cost-effective high quality care occurs to a greater extent when the insurance companies and the government stay out of healthcare decisions.
I urge you to not repeat the same mistakes that other politicians have made, by listening only to your political appointees. To get a real view of healthcare today, you need to talk to independent physicians, without ties to hospitals or other institutions. Only then can you get enough data to formulate a real-world opinion on the state of healthcare in New Jersey.
-----------------------------------------------------------------------------------
OK.
So let's take a vote.
What response will I get?
A: Form letter
B: None
C: Real response by letter or email
D: Governor Christie acceptance to visit my office
My hope is for choice D, while I expect choice A.
Wednesday, March 24, 2010
The Day After
The Day After Obamacare became law.
To anyone reading this blog.
With Obamacare now law, the days of private practice in a third-party dominated system are just about over. If you choose to continue to participate with Medicare, and private insurance payers, you better get real lean, or join a group practice, or even work for a hospital system.
The problem with all the above options are they do not work for the independent minded docs. I did not go into medicine to work for someone else. I went into medicine for the independence.
So I will state again, the days of private practice in a third-party dominated system are just about over.
But......
You can still get out of the third party system, make your office lean and efficient, and work directly with your patients. Work for a single payer system, where the single payer is the patient.
I have been away for awhile, concentrating on other issues. My practice is slowly growing, while my office expenses are slowly being whittled down further. It is amazing at all the fluff offices spend on, that we really do not need.
Start thinking like a businessperson, and remember the customer is always right in a business transaction, not a healthcare decision. Cater to individuals, and prove you are worthy of more than a $10 copay.
There will end up being a two-tiered system this decade. It will consist of the government run large practices and hospital systems, with all their largesse and accompanying overhead, overcrowding, and long waits.
And there will be the remaining independent practices, who cater to no one but their patients. Independent practices that offer cost effective quality care in a timely manner.
So everyone, make your decision , and live with it. Otherwise stop complaining about Obamacare and either get on board, or jump off like I did, and chart your own course!!
I would post more on this blog, if I got any feedback or comments. I do not feel like anyone is listening so the posts have trickled.
BTW, I started a new blog, Healthscare101blog, which can be found here. Let me know what you think.
To anyone reading this blog.
With Obamacare now law, the days of private practice in a third-party dominated system are just about over. If you choose to continue to participate with Medicare, and private insurance payers, you better get real lean, or join a group practice, or even work for a hospital system.
The problem with all the above options are they do not work for the independent minded docs. I did not go into medicine to work for someone else. I went into medicine for the independence.
So I will state again, the days of private practice in a third-party dominated system are just about over.
But......
You can still get out of the third party system, make your office lean and efficient, and work directly with your patients. Work for a single payer system, where the single payer is the patient.
I have been away for awhile, concentrating on other issues. My practice is slowly growing, while my office expenses are slowly being whittled down further. It is amazing at all the fluff offices spend on, that we really do not need.
Start thinking like a businessperson, and remember the customer is always right in a business transaction, not a healthcare decision. Cater to individuals, and prove you are worthy of more than a $10 copay.
There will end up being a two-tiered system this decade. It will consist of the government run large practices and hospital systems, with all their largesse and accompanying overhead, overcrowding, and long waits.
And there will be the remaining independent practices, who cater to no one but their patients. Independent practices that offer cost effective quality care in a timely manner.
So everyone, make your decision , and live with it. Otherwise stop complaining about Obamacare and either get on board, or jump off like I did, and chart your own course!!
I would post more on this blog, if I got any feedback or comments. I do not feel like anyone is listening so the posts have trickled.
BTW, I started a new blog, Healthscare101blog, which can be found here. Let me know what you think.
Saturday, January 2, 2010
Institute For Medical Wellness State of the Practice for 2010
January 2, 2010
---------------------
This is an excerpt from an email newsletter sent to my patient's on the date above. It was met with many smiles, chuckles and approval. I am hearing more from my community how they admire the new practice style, and the growth in new patient's is starting to accelerate. My hope is that this is the year we truly turn the corner, and that other docs get off their a--es and consider returning to treating patient's and not insurances.
=========================================
Institute For Medical Wellness State of the Practice for 2010
I know.
Kind of corny.
But why should only our presidents and governors have all the fun!
Besides, what I write below is factual and truthful, unlike most political speeches, regardless of party, and this state of the practice newsletter will be given without the use of a teleprompter ;)
So here goes.....
My fellow Americans, Wellness Plan members, patients, newsletter subscribers, and anyone and everyone else interested in achieving better health and wellness, I am happy to bring to you the The Institute For Medical Wellness State of The Practice 2010.
Two years ago, in 2008, I was elected, um, scratch that, I founded the Institute For Medical Wellness to provide healthcare like it used to be, without insurance, government, or other third party intrusion. While the transition has been a true learning experience, by the response I have received from my patient's and the community, it is one I have never regretted. I am happy to report that by bypassing the traditional third party route of healthcare, and instead dealing directly with you, we have been able to drastically decrease our overall operating budget, which allows us to continue to offer and expand our services at truly low costs. I am also happy to report that we are not 12 trillion dollars in debt and our budget is fully balanced. Take that Washington, D.C. and Trenton!!
I would now like to share with you some of the proud accomplishments since our founding in 2008.
*Same day appointments are the standard, with new patient visits available same or next day
*60 minute Wellness exams focusing on wellness and illness prevention
*Zero copay Traditional Wellness Plans- a much less expensive version of Concierge or Boutique practices, and now available with monthly payment options
*Greater than 90% of Wellness Plan patient's continue to re-enroll year to year.
*20% growth of patient's enrolled in our Traditional Wellness Plan
*Welcoming back of many patient's who returned to our practice after leaving during our 2008 transition, after they sampled traditional third party healthcare delivery
*Expanding Wellness network affiliates- from Naturopathy to Fitness, Massage and Acupuncture, more choices are now available.
*Increasing number of subscribers to our free email newsletter
My professional objective in founding The Institute For Medical Wellness is to offer the absolute best care - without compromise, and to serve as your primary advocate for health and wellness by combining holistic care and traditional old-fashioned values with true modern day medical expertise. My primary goal is to make certain that our attention is solely focused on YOU, not your insurance or some government bureaucrat.
In today's economy, providing this type of healthcare can be challenging. Many businesses are reducing services to cut expenses. But I have always been a contrarian, so at The Institute For Medical Wellness, I take a different approach. I prefer to expand and make more services available, some of which I will mention below.
1) New more easily individualized Wellness Programs. Last year, in my eagerness to offer many different wellness programs, the choices became a bit confusing, even to me. So starting in 2010, wellness programs will be re-organized in a friendlier way. The Institute For Medical Wellness network affiliates will now be offering individual A-La-Health and wellness programs, which can be purchased separately, or better yet, added to our Traditional Wellness Plan. If added to our Traditional Wellness Plan, you will also receive 20% off all supplements purchased from our office.
2) Our new Healthy Weight Program is now available. This physician supervised weight management programs main focus is on achieving a healthier weight, curbing hunger, while achieving optimum nutrition. It is ideal for treating diet related disorders including high blood pressure, diabetes, obesity, high cholesterol, among many others.
Each individualized program will consist of:
-
Full initial evaluation by Dr Horvitz- medical and diet history, review of labwork to determine your metabolic needs, initial measurements and goal setting.
--Follow-up to review labs and start on program.
---An individualized starter package of nutritional supplements geared to your medical history.
----Monthly supplies of Dream protein
-----Twice-monthly office visits to check on your progress and make any necessary adjustments.
*Big discount if combined with our Traditional Wellness Plan.
*Discount of $75 if combined with our 8-Hour Optimum Results personal training program. *Discounts also available for partners joining together.
*Healthy Weight Programs offered are for 3, 6 and 12 months.
For more information please visit our website here.
3) Nutritional and dietary supplements available at the Institute For Medical Wellness
Nutritional supplements have become a bigger part of The Institute For Medical Wellness. This is not due solely to my health and wellness beliefs, but more to the demands of my patient's. The nutritional supplement industry is not regulated as strictly as pharmaceuticals and there are thousands of supplements available at stores and thru the internet. This is both good and bad. The good is in the greater innovation and less expense in bringing a product to market. The bad is there are less mechanisms in place that make sure you are truly getting what you are purchasing. So at The Institute For Medical Wellness, we only carry supplements from very reputable manufacturers who have put their products through very strict procedures to be certain that you get what you buy. If you want more proof, most of the products we sell have been or are presently being used by myself or my family. Click here for a list of the different supplements we have available. Also note that discounts are available with certain A-La-Health programs.
4) Genetic testing for Breast cancer, Ovarian cancer , Colon cancer and Melanoma are now available at The Institute For Medical Wellness. I have teamed up with Myriad Genetics and Laboratories, a company designed to help patients and healthcare professionals understand how genetic testing can help identify individuals at risk for hereditary cancer.
There are ways to reduce your risk or overcome cancer in your lifetime. If cancer runs in your family, hereditary cancer testing may be an important step for you. Click on this link and take the quiz to see if testing is right for you.
5) Medical Records
Keeping an accurate medical record is one important part of your care. Back in 2004, ahead of most physician practices, I transitioned from paper to electronic health records. While it occasionally makes me pull out what little remaining hair I have, electronic health records also have many positives. One is their ease of access. When we had paper records, the time involved to keep them updated was very costly, both in time and materials. Not as much with electronic records. So we can now offer Wellness Plan patients one digital copy of your medical records per year for personal use if securely emailed as a pdf file. If you prefer a hard copy on a CD, a fee of $15 is required. For all other patients, the fee is $15 for a digital copy and $25 for a hard copy on CD. Please note, fees are different if records are required for legal, transfer or insurance requests.
6) Telephone consults now available
While many patient's take it for granted that doctor's will prescribe treatment over the phone, it is not always good sound medical practice, nor the best for patient care. But many patient's in my practice have strongly requested these consults. Thus, I am adding phone consultations to the services I offer, in the hope that when used in the proper circumstances will be of benefit to you. Phone consultations simply consists of phone time spent with you evaluating your health complaints, and prescribing treatment. For example, if you are feeling ill, but stuck at work or home, you can arrange a phone consultation.
The following fees will be charged dependent upon the time spent on consultation or if treatment is ordered or prescribed:
5 minutes or less without treatment prescribed = No charge
10 minutes or less with treatment prescribed = $45
11-15 minutes with treatment prescribed = $75
Any consultation that would require more than 15 minutes requires an on-office evaluation.
If you are seen in the office for the same illness within one week of your phone consult, you will receive $25 off your in-office follow-up.
Phone consultations will most often be used to evaluate and treat recurrent illnesses such as sinusitis or urinary tract infections. This service is not available to new patient's, nor to any condition Dr Horvitz feels requires an in-office evaluation.
To schedule a phone consult, please call our office at 856-231-0590. A valid credit card or a bank debit arrangement is needed for this service.
These fees are not applicable for the following:
* Quick follow-up phone conversations about a recent office evaluation.
* Wellness plan members, as these services are already included as part of your plan.
* As Medicare rules are vague on telephone consults, this service is not available to Traditional Medicare patients.
* Routine requests such as pharmacy refills, appointments or non-physician requests.
7) Help with insurance reimbursement We realize that medical billing can be very frustrating, which is one of the many reasons my office stopped working with insurers. But just as medical billing is frustrating to my office, it can be equally frustrating to my patient's awaiting insurance reimbursement. So in 2010, we will now be submitting paid office charges to your insurance to help you with reimbursement. For this process to run smoothly, please make sure we have an updated copy of the front and back of your health insurance cards, as well as your signed authorization.
8) Beginning January 1st, 2010, there will be a $25 charge added to your first office visit each calendar year, with a $40 maximum per family. The reasons for this fee is as follows.
-
Upgrading our medical records systems due to the stricter government regulations concerning these systems.
--Increased insurance submission costs. This charge will hopefully be more than offset by any insurance reimbursement you receive by having your paid office visit fees submitted electronically to your insurer.
---Complying with the government's new privacy payment plan law due to take effect in 2010.
*Please note that this fee is not applicable if you are enrolled in our Traditional Wellness Plan or for Traditional Medicare patients.
*This fee is applicable irrespective of whether you have insurance coverage.
9) The Institute For Medical Wellness can now be found on Twitter at http://twitter.com/IMWHorvitz
I anticipate utilizing twitter for notification of office updates including interesting health, medical and wellness information, availability of flu vaccine, and inclement weather closings. Don't worry, you will not be tweeted about what I ate for lunch today, although I can say, it was probably low in processed carbohydrates, very filling, and very tasty ; )
I would like to thank everyone for their confidence in my professional abilities and referrals of new patient's to the practice as well as to the Wellness Plans. If you are presently in the Traditional Wellness Plan, and refer a new patient to this plan, you will receive 1 month added on to your plan for the first referral, and two months added on for every other new patient you refer. Just my way of saying Thank You for your confidence!!
It is always nice to get good feedback. Good feedback tells me that I am definitely moving in the right direction! So please check out the recent patient testimonials sent to our office.
My New Years Resolution is that you allow The Institute For Medical Wellness to help you make 2010 a healthy and prosperous year!!
This concludes the Institute For Medical Wellness State of The Practice 2010 newsletter. I will now leave the stage quickly, and you will not hear the media pundits restating over and over again what you have just read. Anyhow, it does not matter to me what others say about The Institute For Medical Wellness. As my primary goal is your individual health, the only one that matters when you are in my office, is YOU!!!
To Good Health and a prosperous 2010!!
DoctorSH
---------------------
This is an excerpt from an email newsletter sent to my patient's on the date above. It was met with many smiles, chuckles and approval. I am hearing more from my community how they admire the new practice style, and the growth in new patient's is starting to accelerate. My hope is that this is the year we truly turn the corner, and that other docs get off their a--es and consider returning to treating patient's and not insurances.
=========================================
Institute For Medical Wellness State of the Practice for 2010
I know.
Kind of corny.
But why should only our presidents and governors have all the fun!
Besides, what I write below is factual and truthful, unlike most political speeches, regardless of party, and this state of the practice newsletter will be given without the use of a teleprompter ;)
So here goes.....
My fellow Americans, Wellness Plan members, patients, newsletter subscribers, and anyone and everyone else interested in achieving better health and wellness, I am happy to bring to you the The Institute For Medical Wellness State of The Practice 2010.
Two years ago, in 2008, I was elected, um, scratch that, I founded the Institute For Medical Wellness to provide healthcare like it used to be, without insurance, government, or other third party intrusion. While the transition has been a true learning experience, by the response I have received from my patient's and the community, it is one I have never regretted. I am happy to report that by bypassing the traditional third party route of healthcare, and instead dealing directly with you, we have been able to drastically decrease our overall operating budget, which allows us to continue to offer and expand our services at truly low costs. I am also happy to report that we are not 12 trillion dollars in debt and our budget is fully balanced. Take that Washington, D.C. and Trenton!!
I would now like to share with you some of the proud accomplishments since our founding in 2008.
*Same day appointments are the standard, with new patient visits available same or next day
*60 minute Wellness exams focusing on wellness and illness prevention
*Zero copay Traditional Wellness Plans- a much less expensive version of Concierge or Boutique practices, and now available with monthly payment options
*Greater than 90% of Wellness Plan patient's continue to re-enroll year to year.
*20% growth of patient's enrolled in our Traditional Wellness Plan
*Welcoming back of many patient's who returned to our practice after leaving during our 2008 transition, after they sampled traditional third party healthcare delivery
*Expanding Wellness network affiliates- from Naturopathy to Fitness, Massage and Acupuncture, more choices are now available.
*Increasing number of subscribers to our free email newsletter
My professional objective in founding The Institute For Medical Wellness is to offer the absolute best care - without compromise, and to serve as your primary advocate for health and wellness by combining holistic care and traditional old-fashioned values with true modern day medical expertise. My primary goal is to make certain that our attention is solely focused on YOU, not your insurance or some government bureaucrat.
In today's economy, providing this type of healthcare can be challenging. Many businesses are reducing services to cut expenses. But I have always been a contrarian, so at The Institute For Medical Wellness, I take a different approach. I prefer to expand and make more services available, some of which I will mention below.
1) New more easily individualized Wellness Programs. Last year, in my eagerness to offer many different wellness programs, the choices became a bit confusing, even to me. So starting in 2010, wellness programs will be re-organized in a friendlier way. The Institute For Medical Wellness network affiliates will now be offering individual A-La-Health and wellness programs, which can be purchased separately, or better yet, added to our Traditional Wellness Plan. If added to our Traditional Wellness Plan, you will also receive 20% off all supplements purchased from our office.
2) Our new Healthy Weight Program is now available. This physician supervised weight management programs main focus is on achieving a healthier weight, curbing hunger, while achieving optimum nutrition. It is ideal for treating diet related disorders including high blood pressure, diabetes, obesity, high cholesterol, among many others.
Each individualized program will consist of:
-
Full initial evaluation by Dr Horvitz- medical and diet history, review of labwork to determine your metabolic needs, initial measurements and goal setting.
--Follow-up to review labs and start on program.
---An individualized starter package of nutritional supplements geared to your medical history.
----Monthly supplies of Dream protein
-----Twice-monthly office visits to check on your progress and make any necessary adjustments.
*Big discount if combined with our Traditional Wellness Plan.
*Discount of $75 if combined with our 8-Hour Optimum Results personal training program. *Discounts also available for partners joining together.
*Healthy Weight Programs offered are for 3, 6 and 12 months.
For more information please visit our website here.
3) Nutritional and dietary supplements available at the Institute For Medical Wellness
Nutritional supplements have become a bigger part of The Institute For Medical Wellness. This is not due solely to my health and wellness beliefs, but more to the demands of my patient's. The nutritional supplement industry is not regulated as strictly as pharmaceuticals and there are thousands of supplements available at stores and thru the internet. This is both good and bad. The good is in the greater innovation and less expense in bringing a product to market. The bad is there are less mechanisms in place that make sure you are truly getting what you are purchasing. So at The Institute For Medical Wellness, we only carry supplements from very reputable manufacturers who have put their products through very strict procedures to be certain that you get what you buy. If you want more proof, most of the products we sell have been or are presently being used by myself or my family. Click here for a list of the different supplements we have available. Also note that discounts are available with certain A-La-Health programs.
4) Genetic testing for Breast cancer, Ovarian cancer , Colon cancer and Melanoma are now available at The Institute For Medical Wellness. I have teamed up with Myriad Genetics and Laboratories, a company designed to help patients and healthcare professionals understand how genetic testing can help identify individuals at risk for hereditary cancer.
There are ways to reduce your risk or overcome cancer in your lifetime. If cancer runs in your family, hereditary cancer testing may be an important step for you. Click on this link and take the quiz to see if testing is right for you.
5) Medical Records
Keeping an accurate medical record is one important part of your care. Back in 2004, ahead of most physician practices, I transitioned from paper to electronic health records. While it occasionally makes me pull out what little remaining hair I have, electronic health records also have many positives. One is their ease of access. When we had paper records, the time involved to keep them updated was very costly, both in time and materials. Not as much with electronic records. So we can now offer Wellness Plan patients one digital copy of your medical records per year for personal use if securely emailed as a pdf file. If you prefer a hard copy on a CD, a fee of $15 is required. For all other patients, the fee is $15 for a digital copy and $25 for a hard copy on CD. Please note, fees are different if records are required for legal, transfer or insurance requests.
6) Telephone consults now available
While many patient's take it for granted that doctor's will prescribe treatment over the phone, it is not always good sound medical practice, nor the best for patient care. But many patient's in my practice have strongly requested these consults. Thus, I am adding phone consultations to the services I offer, in the hope that when used in the proper circumstances will be of benefit to you. Phone consultations simply consists of phone time spent with you evaluating your health complaints, and prescribing treatment. For example, if you are feeling ill, but stuck at work or home, you can arrange a phone consultation.
The following fees will be charged dependent upon the time spent on consultation or if treatment is ordered or prescribed:
5 minutes or less without treatment prescribed = No charge
10 minutes or less with treatment prescribed = $45
11-15 minutes with treatment prescribed = $75
Any consultation that would require more than 15 minutes requires an on-office evaluation.
If you are seen in the office for the same illness within one week of your phone consult, you will receive $25 off your in-office follow-up.
Phone consultations will most often be used to evaluate and treat recurrent illnesses such as sinusitis or urinary tract infections. This service is not available to new patient's, nor to any condition Dr Horvitz feels requires an in-office evaluation.
To schedule a phone consult, please call our office at 856-231-0590. A valid credit card or a bank debit arrangement is needed for this service.
These fees are not applicable for the following:
* Quick follow-up phone conversations about a recent office evaluation.
* Wellness plan members, as these services are already included as part of your plan.
* As Medicare rules are vague on telephone consults, this service is not available to Traditional Medicare patients.
* Routine requests such as pharmacy refills, appointments or non-physician requests.
7) Help with insurance reimbursement We realize that medical billing can be very frustrating, which is one of the many reasons my office stopped working with insurers. But just as medical billing is frustrating to my office, it can be equally frustrating to my patient's awaiting insurance reimbursement. So in 2010, we will now be submitting paid office charges to your insurance to help you with reimbursement. For this process to run smoothly, please make sure we have an updated copy of the front and back of your health insurance cards, as well as your signed authorization.
8) Beginning January 1st, 2010, there will be a $25 charge added to your first office visit each calendar year, with a $40 maximum per family. The reasons for this fee is as follows.
-
Upgrading our medical records systems due to the stricter government regulations concerning these systems.
--Increased insurance submission costs. This charge will hopefully be more than offset by any insurance reimbursement you receive by having your paid office visit fees submitted electronically to your insurer.
---Complying with the government's new privacy payment plan law due to take effect in 2010.
*Please note that this fee is not applicable if you are enrolled in our Traditional Wellness Plan or for Traditional Medicare patients.
*This fee is applicable irrespective of whether you have insurance coverage.
9) The Institute For Medical Wellness can now be found on Twitter at http://twitter.com/IMWHorvitz
I anticipate utilizing twitter for notification of office updates including interesting health, medical and wellness information, availability of flu vaccine, and inclement weather closings. Don't worry, you will not be tweeted about what I ate for lunch today, although I can say, it was probably low in processed carbohydrates, very filling, and very tasty ; )
I would like to thank everyone for their confidence in my professional abilities and referrals of new patient's to the practice as well as to the Wellness Plans. If you are presently in the Traditional Wellness Plan, and refer a new patient to this plan, you will receive 1 month added on to your plan for the first referral, and two months added on for every other new patient you refer. Just my way of saying Thank You for your confidence!!
It is always nice to get good feedback. Good feedback tells me that I am definitely moving in the right direction! So please check out the recent patient testimonials sent to our office.
My New Years Resolution is that you allow The Institute For Medical Wellness to help you make 2010 a healthy and prosperous year!!
This concludes the Institute For Medical Wellness State of The Practice 2010 newsletter. I will now leave the stage quickly, and you will not hear the media pundits restating over and over again what you have just read. Anyhow, it does not matter to me what others say about The Institute For Medical Wellness. As my primary goal is your individual health, the only one that matters when you are in my office, is YOU!!!
To Good Health and a prosperous 2010!!
DoctorSH
Tuesday, December 29, 2009
Obamacare and Bernie Madoff
Obamacare and Bernie Madoff
December 29, 2009
Obamacare and Bernie Madoff
Sorry again about another healthcare reform related newsletter, but I get mildly agitated when people not in the healthcare field, especially politicians, try to tell me how to do my job.
We all have heard about Bernie Madoff, and his, how can I say it, not exactly stellar accounting. Bernie Madoff by way of his ponzi scheme, led what may soon be known as the second biggest swindle in the nation. The first will be either the Senates or House of Representatives healthcare reform bills, which if either of them becomes law, will forever be known as the ObaMadoff healthcare plan.
Understand that our politicians do not play by the same rules that ordinary citizens abide by. We put money in the bank, and can only withdrawal what we have. On the other hand, our politicians, both democrat and republican, spend our money, and more than we have.
Oh, but they can raise more money to pay for all their pet programs you say.
You are correct.
But the politicians do not earn money like we do.
They raise money in a few ways.
1) They increase the taxes we have to pay.
2) They borrow money from other countries and ask we, the taxpayers to pay the interest.
3) They turn on the printing presses and print more money, diluting the worth of the dollar and making our money less valuable.
In other words, they spend our hard earned money like there is a never-ending supply!
So what does this have to do with healthcare?
I'll tell you.
Our country is deep in debt, due to all the money spent by our politicians over the past four decades. At last count, our country is over 12 trillion dollars in debt, not counting current and future entitlement obligations. So now, our politicians want us to go further in debt and add a new entitlement to reform the healthcare system, and they will raise the money to finance these reforms in the three ways mentioned above.
So how does this differ from what you and I do to access healthcare?
1) To pay for healthcare, we as individuals have to work and earn income. We can not collect tax money from others to pay for our care.
2) We can borrow money from banks and credit cards, but we are held individually responsible for our debt. Our politicians are not responsible for the debt they place our country in. We are, along with our children and grandchildren.
3) I think we would go to jail if we had a printing press printing money we did not earn. So why does our government get away with it?
This healthcare reform is not the change we believed we were getting during the 2008 presidential campaign.
Let us take a look at the president's healthcare campaign promises and how they have changed by looking at the present healthcare bills, their costs and how they are paid for.
House Bill:
Who is covered?
It is estimated that about 94% of legal residents under the age of 65 will be covered. Presently about 83% are covered. There will still be about 24 million people under the age of 65 not insured, with an estimated 8 million of those being illegal immigrants.
Cost:
871 Billion dollars over ten years. That is $871,000,000,000 dollars. That's alot of zeroes.
How It's Paid For:
Fees or taxes on the following: Insurance companies, pharmaceutical manufacturers, medical device manufacturers, medicare payroll tax increase on income over $200,000 for individuals, or $250,000 for couples, 10% sales tax on tanning salons, excise tax on high cost insurance plans, and fees for employers whose workers receive government subsidies. I am certain there are more fees and taxes still hidden in the bill that have not yet been discovered.
Cuts to Medicare and Medicaid
Fines on people who fail to purchase coverage.
Senate Bill:
Who is covered?
About 96% of legal residents under the age of 65, leaving an estimated 18 million people under the age of 65 not insured, with an estimated 8 million of those being illegal immigrants.
Cost: 1.2 trillion dollars over 10 years. That is $1,200,000,000,000 dollars. That's even more zeroes.
How It's Paid For:
Taxes on the following: New income taxes on single people making more than $500,000/year and couples making more than $1 million dollars a year, an estimated $20 billion from new taxes on medical device makers, limiting contributions to flexible healthcare spending accounts. As with the House bill, I am certain there are more fees and taxes still hidden in the bill that have not yet been discovered.
Cuts of more than $400 Billion to Medicare and Medicaid.
Fines on individuals and employers who do not obtain health insurance coverage.
-----
OK, so that is a synopsis, and definitely not the whole enchilada. But let me start breaking this down to what it means for you and how it differs from the 2008 promises made by the president during the 2008 presidential election campaign.
Promise #1 : No Individual Mandate
In both of the above bills, there is an individual mandate for insurance coverage or a fine is imposed. And as we still do not know the extent of government subsidies to help purchase insurance, it appears that many individuals will be coerced or forced by the government to purchase coverage that they may not want, or face the wrath of government fines. In essence, the government wants to pass a law forcing individuals to purchase something against their will.
Promise #2 : Complete Transparency
Need I actually go into this one?
Candidate Obama promised that health care deliberations with Congress and special interests would be transparent to the extreme. To quote candidate Obama: "That's what I will do in bringing all parties together, not negotiating behind closed doors, but bringing all parties together, and broadcasting those negotiations on C-SPAN so that the American people can see what the choices are," Mr. Obama said during his Jan. 31, 2008 debate with Clinton. "Because part of what we have to do is enlist the American people in this process. And overcoming the special interests and the lobbyists who -- Senator Clinton is right. They will resist anything that we try to do."
OK.I had my TIVO set up as a season pass to record all healthcare negotiations on C-SPAN. Funny thing. Nothing recorded. I called TIVO and asked what the problem was with their service. I found out it was not TIVO. There were not any negotiations broadcast on C-SPAN.
So what actually occured? Politics as usual, but on steroids. Both bills have been written along party lines, with mucho mucho special interests involved. These special interests do not represent you. They represent their corporations and their businesses. Now in a free market capitalistic economy, that is fair game. But were'nt we promised transparency and an overcoming of the special interests???
Promise #3 : Lower Premiums by $2,500 for a Family of Four
For this one, I'll believe it when I see it. I am pretty good at math, but not an accountant or mathematician. But to add 20-30 million more people into health insurance, and at the same time lower the cost of insurance premiums, you need to be a magician, not a mathematician.
Now back to who is covered, the cost and how it is paid for.
If we go midway between both the House and Senate bills, we will still be left with about 14 million uninsured, at a cost of over a trillion dollars over ten years, paid for by cuts to Medicare and Medicaid and large taxes on many segments of the healthcare industry and individuals. The healthcare industry segments will end up passing along the increased taxes as higher costs to you.
As employers and individuals, who, unlike the federal government can not print money, will pay higher taxes, and they will have less money in their budgets to expand their businesses and hire more workers. So the trickle down effect of higher taxes ends up costing everyone, not just those who pay the taxes, while still leaving about 20 million people uninsured.
Question 1: If you are unemployed, do you prefer being forced to purchase health insurance, or do you prefer to get help finding a job?
Question 2: With cuts to Medicare and Medicaid, and more people enrolled in these programs, how do we improve care for individuals with these two government plans?
Now, I will attempt to do some math.
Assuming midway between the House and Senate plan, we add 34 million people to the health insurance rolls. The taxes and fines start in year one, while the insurance coverage does not start until years 4 through 6. I will estimate 6 years of insurance coverage for 34 million people at a cost of 1 trillion dollars. That comes out to about $5,000 per year for insurance coverage for each individual, or just under $420 per month. The premiums I pay now are much less than that, and I am not mandated by any government to purchase it!
Question 3: Is the healthcare reform debate about doing what is right, or more about politics?
I'll let you answer that one.
Call your Senator and congressmen and tell them to put a halt to this healthcare reform debacle before it is too late. The legislation currently before Congress was crafted more out of political desperation and not the needs and desires of the large majority of the American people.
One thing I have learned from this debate is that elections do mean something and they do have consequences. Sometimes good, sometimes not.
My hope is that these reforms get stopped, and we reboot the debate and start over. First step, follow the president's campaign guidelines for reforming the healthcare system with true transparency, and a lack of special interests at the table. The table should consists of patient's and healthcare providers and the reforms should focus on individuals and not politics. We can then reform the system one step at a time and move in a direction that helps everyone without adding any costs to the system.
DoctorSH
December 29, 2009
Obamacare and Bernie Madoff
Sorry again about another healthcare reform related newsletter, but I get mildly agitated when people not in the healthcare field, especially politicians, try to tell me how to do my job.
We all have heard about Bernie Madoff, and his, how can I say it, not exactly stellar accounting. Bernie Madoff by way of his ponzi scheme, led what may soon be known as the second biggest swindle in the nation. The first will be either the Senates or House of Representatives healthcare reform bills, which if either of them becomes law, will forever be known as the ObaMadoff healthcare plan.
Understand that our politicians do not play by the same rules that ordinary citizens abide by. We put money in the bank, and can only withdrawal what we have. On the other hand, our politicians, both democrat and republican, spend our money, and more than we have.
Oh, but they can raise more money to pay for all their pet programs you say.
You are correct.
But the politicians do not earn money like we do.
They raise money in a few ways.
1) They increase the taxes we have to pay.
2) They borrow money from other countries and ask we, the taxpayers to pay the interest.
3) They turn on the printing presses and print more money, diluting the worth of the dollar and making our money less valuable.
In other words, they spend our hard earned money like there is a never-ending supply!
So what does this have to do with healthcare?
I'll tell you.
Our country is deep in debt, due to all the money spent by our politicians over the past four decades. At last count, our country is over 12 trillion dollars in debt, not counting current and future entitlement obligations. So now, our politicians want us to go further in debt and add a new entitlement to reform the healthcare system, and they will raise the money to finance these reforms in the three ways mentioned above.
So how does this differ from what you and I do to access healthcare?
1) To pay for healthcare, we as individuals have to work and earn income. We can not collect tax money from others to pay for our care.
2) We can borrow money from banks and credit cards, but we are held individually responsible for our debt. Our politicians are not responsible for the debt they place our country in. We are, along with our children and grandchildren.
3) I think we would go to jail if we had a printing press printing money we did not earn. So why does our government get away with it?
This healthcare reform is not the change we believed we were getting during the 2008 presidential campaign.
Let us take a look at the president's healthcare campaign promises and how they have changed by looking at the present healthcare bills, their costs and how they are paid for.
House Bill:
Who is covered?
It is estimated that about 94% of legal residents under the age of 65 will be covered. Presently about 83% are covered. There will still be about 24 million people under the age of 65 not insured, with an estimated 8 million of those being illegal immigrants.
Cost:
871 Billion dollars over ten years. That is $871,000,000,000 dollars. That's alot of zeroes.
How It's Paid For:
Fees or taxes on the following: Insurance companies, pharmaceutical manufacturers, medical device manufacturers, medicare payroll tax increase on income over $200,000 for individuals, or $250,000 for couples, 10% sales tax on tanning salons, excise tax on high cost insurance plans, and fees for employers whose workers receive government subsidies. I am certain there are more fees and taxes still hidden in the bill that have not yet been discovered.
Cuts to Medicare and Medicaid
Fines on people who fail to purchase coverage.
Senate Bill:
Who is covered?
About 96% of legal residents under the age of 65, leaving an estimated 18 million people under the age of 65 not insured, with an estimated 8 million of those being illegal immigrants.
Cost: 1.2 trillion dollars over 10 years. That is $1,200,000,000,000 dollars. That's even more zeroes.
How It's Paid For:
Taxes on the following: New income taxes on single people making more than $500,000/year and couples making more than $1 million dollars a year, an estimated $20 billion from new taxes on medical device makers, limiting contributions to flexible healthcare spending accounts. As with the House bill, I am certain there are more fees and taxes still hidden in the bill that have not yet been discovered.
Cuts of more than $400 Billion to Medicare and Medicaid.
Fines on individuals and employers who do not obtain health insurance coverage.
-----
OK, so that is a synopsis, and definitely not the whole enchilada. But let me start breaking this down to what it means for you and how it differs from the 2008 promises made by the president during the 2008 presidential election campaign.
Promise #1 : No Individual Mandate
In both of the above bills, there is an individual mandate for insurance coverage or a fine is imposed. And as we still do not know the extent of government subsidies to help purchase insurance, it appears that many individuals will be coerced or forced by the government to purchase coverage that they may not want, or face the wrath of government fines. In essence, the government wants to pass a law forcing individuals to purchase something against their will.
Promise #2 : Complete Transparency
Need I actually go into this one?
Candidate Obama promised that health care deliberations with Congress and special interests would be transparent to the extreme. To quote candidate Obama: "That's what I will do in bringing all parties together, not negotiating behind closed doors, but bringing all parties together, and broadcasting those negotiations on C-SPAN so that the American people can see what the choices are," Mr. Obama said during his Jan. 31, 2008 debate with Clinton. "Because part of what we have to do is enlist the American people in this process. And overcoming the special interests and the lobbyists who -- Senator Clinton is right. They will resist anything that we try to do."
OK.I had my TIVO set up as a season pass to record all healthcare negotiations on C-SPAN. Funny thing. Nothing recorded. I called TIVO and asked what the problem was with their service. I found out it was not TIVO. There were not any negotiations broadcast on C-SPAN.
So what actually occured? Politics as usual, but on steroids. Both bills have been written along party lines, with mucho mucho special interests involved. These special interests do not represent you. They represent their corporations and their businesses. Now in a free market capitalistic economy, that is fair game. But were'nt we promised transparency and an overcoming of the special interests???
Promise #3 : Lower Premiums by $2,500 for a Family of Four
For this one, I'll believe it when I see it. I am pretty good at math, but not an accountant or mathematician. But to add 20-30 million more people into health insurance, and at the same time lower the cost of insurance premiums, you need to be a magician, not a mathematician.
Now back to who is covered, the cost and how it is paid for.
If we go midway between both the House and Senate bills, we will still be left with about 14 million uninsured, at a cost of over a trillion dollars over ten years, paid for by cuts to Medicare and Medicaid and large taxes on many segments of the healthcare industry and individuals. The healthcare industry segments will end up passing along the increased taxes as higher costs to you.
As employers and individuals, who, unlike the federal government can not print money, will pay higher taxes, and they will have less money in their budgets to expand their businesses and hire more workers. So the trickle down effect of higher taxes ends up costing everyone, not just those who pay the taxes, while still leaving about 20 million people uninsured.
Question 1: If you are unemployed, do you prefer being forced to purchase health insurance, or do you prefer to get help finding a job?
Question 2: With cuts to Medicare and Medicaid, and more people enrolled in these programs, how do we improve care for individuals with these two government plans?
Now, I will attempt to do some math.
Assuming midway between the House and Senate plan, we add 34 million people to the health insurance rolls. The taxes and fines start in year one, while the insurance coverage does not start until years 4 through 6. I will estimate 6 years of insurance coverage for 34 million people at a cost of 1 trillion dollars. That comes out to about $5,000 per year for insurance coverage for each individual, or just under $420 per month. The premiums I pay now are much less than that, and I am not mandated by any government to purchase it!
Question 3: Is the healthcare reform debate about doing what is right, or more about politics?
I'll let you answer that one.
Call your Senator and congressmen and tell them to put a halt to this healthcare reform debacle before it is too late. The legislation currently before Congress was crafted more out of political desperation and not the needs and desires of the large majority of the American people.
One thing I have learned from this debate is that elections do mean something and they do have consequences. Sometimes good, sometimes not.
My hope is that these reforms get stopped, and we reboot the debate and start over. First step, follow the president's campaign guidelines for reforming the healthcare system with true transparency, and a lack of special interests at the table. The table should consists of patient's and healthcare providers and the reforms should focus on individuals and not politics. We can then reform the system one step at a time and move in a direction that helps everyone without adding any costs to the system.
DoctorSH
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