Thursday, March 31, 2011

Physician Assistant Issues

I do also want to assure my followers, and particularly those who are PA's or PA students that I will still be blogging about practicing as a PA, as well as about legislative and practice issues that are affecting PA's. I have changed the title of the blog only because, as my career has progressed, it has become far more focused on health policy issues. There was no other reason....

Wednesday, March 30, 2011

Fox News and Socialism

Thanks to my friend Bruce Bartlett for pointing this out....

Fox News....Fair and Balanced?????

Start HERE:

In the final stretch of the 2008 campaign, a Fox News executive repeatedly questioned on the air whether Barack Obama believed in socialism.

Bill Sammon, now the network’s vice president and Washington managing editor, acknowledged the following year that he was just engaging in “mischievous speculation” in raising the charge. In fact, Sammon said he “privately” believed that the socialism allegation was “rather far-fetched.”

These remarks, unearthed by the liberal advocacy group Media Matters, raise the question of whether Sammon, who oversees Washington news coverage for Fox News, was deliberately trying to sabotage the Democratic presidential candidate. He has come under fire before for memos he sent to the network’s staff that have seemed less than fair and balanced.

Sammon’s admission came on a 2009 Mediterranean cruise—cabin rates ranged as high as $37,600 per couple—sponsored by conservative Hillsdale College. Here is what he said, according to an audio recording:

MORE at the link...

And, to furthermore make any thinking person trying to simply contemplate the insanity of this feel like it isn't possible, here is some more....

Next Article HERE:

Howard Kurtz contacted Sammon for comment, and here’s how Sammon defended himself:

In an interview, Sammon says his reference to “mischevious speculation” was “my probably inartful way of saying, ‘Can you believe how far this thing has come?’” The socialism question indeed “struck me as a far-fetched idea” in 2008. “I considered it kind of a remarkable notion that we would even be having the conversation.”

He doesn’t regret repeatedly raising it on the air because, Sammon says, “it was a main point of discussion on all the channels, in all the media” — and by 2009 he was “astonished by how the needle had moved.”

That’s pretty remarkable. Sammon is conceding that the idea did indeed strike him as far fetched in 2008, even though he and his network aggressively promoted it day in and day out throughout the campaign. And he’s defending this by pointing out that the idea ended up gaining traction, as if this somehow justifies the original act of dishonesty!

Now, Sammon is also claiming here that Obama’s behavior in office ultimately persuaded him that the original diagnosis of Obama as a socialist turned out to be correct after all. That in itself, of course, is also a ridiculous falsehood. But that aside, the bottom line here is that he doesn’t regret having spread an idea he personally found far-fetched, because so doing helped ensure that the far-fetched idea ultimately gained widespread acceptance. That’s a peculiar attitude for a “news” executive, isn’t it?

So, because you spread a rumor that you didn't believe initially, and people bought into it because you were a "news" reporter, somehow it becomes factual....simply mindboggling.

Angry Bear...

Hi all,

As you've noticed, I have been somewhat lax in my responses, and in my upkeep of this little part of my life. It was not intentional. Over the past period of time, I have been writing extensively, serving on an AAPA council (Leadership and Professional Development), speaking frequently on health policy and reform, conducting 3 different workforce research studies (although, admittedly, two are still in the developmental stage), trying to conceive a mathematical healthcare workforce model accounting for all variables (a request from powers that be), functioning as the guest health policy contributor to "Angry Bear" which is top Wall Street economics blog, and I was recently asked to represent our national Emergency Medicine PA group with respect to legislative affairs.

In short, I've been busy. No disrespect, no excuse. Just an explanation.

(OH, and I've been asked to possibly contribute a chapter to a major economic policy book on health policy this year)

New Look

Decided as I will be here far more often now, that the place needed a new look....hope everyone likes it.


Medical Malpractice Reform: Truth in Advertising Needed (Part three of three)

Crossposted at AngryBear...

So in the first two articles we have addressed the historic effects of tort reform using Texas as an example, and subsequently we reviewed the effects of tort reform on so called “defensive medicine” practices, looking at both the effect of reform measures on physician/provider ordering patterns, as well as the possible effects on patient outcomes or mortality.

Today, we are going to examine the last party in this carousel. The insurance agencies themselves. For starters, I wanted to examine if there was any sort of a relationship between malpractice premiums, and healthcare spending. So, using historic healthcare expenditure rates from the NHE database (CMS), I calculated the rate of healthcare growth, percentage wise, per year from 1995-2008. I then used an ISO database set to examine the growth in insurance premiums per year.

As we can plainly see, there is no correlation, but out of sense of thoroughness, I even ran a simple regression.

But with an R-Squared of 0.021, there is simply little correlation there.

So what causes these random spikes in medical malpractice premiums? Well, according to the AIR (Americans for Insurance Reform) these are due to the economic cycles of insurers and to drops in investment income.

Lastly, I visited THIS article, which found:

1. Inflation-adjusted payouts per doctor not only failed to increase between 2001 and 2004, a time when doctors’ premiums skyrocketed, but they have been stable or falling throughout this entire decade.
2. Medical malpractice insurance premiums rose much faster in the early years of this decade than was justified by insurance payouts.
3. At no time were recent increases in premiums connected to actual payouts. Rather, they reflected the well-known cyclical phenomenon called a “hard” market. Property/casualty insurance industry “hard” markets have occurred three times in the past 30 years.
4. During this same period, medical malpractice insurers vastly (and unnecessarily) increased reserves (used for future claims) despite no increase in payouts or any trend suggesting large future payouts. The reserve increases in the years 2001 to 2004 could have accounted for 60
percent of the price increases witnessed by doctors during the period.

But the real devil, the real devil is in the loss ratios…I’m assuming that we are all familiar with the MLR discussions that raged over the past two years discussing what should be an allowable loss ratio for health insurance. Malpractice also has it’s loss ratios, and oh boy, are they favorable to the insurance industry. 61.1% is the average, in 2007, for the average loss ratios for malpractice insurance companies. To put this another way as per the article: In 2007, medical malpractice insurer profit based just on insurance transactions, that is,just on the premiums they took in, was 24.6%. This was more than double the amount on insurance transactions for the entire industry (11.0%).

If I were a physician who paid my own malpractice, I would be livid over these figures. It is not as though there is a huge advertising market for medical malpractice insurance. 38.9 cents on every dollar are kept as almost pure profit. Surely, administrative costs cannot account for this. Add to this, this last nugget: Inflation-adjusted payouts per doctor not only failed to increase between 2001 and 2004, a time when doctors’ premiums skyrocketed, but they have been stable or falling throughout this entire decade.

It seems, that right now would be a great time to own a malpractice insurance firm. Too bad, that it isn’t so great for everyone else in healthcare.