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Bill Johnson,
Port Townsend, WA
 
Sorry, not sure what happened to the link to NEJM - This should work, or Google The New England Journal of Medicine.  It is free full text.
 
http://content.nejm.org/cgi/content/full/NEJMp0903872?query=TOC

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From: UVM Flownet on behalf of Johnson, Bill
Sent: Wed 5/13/2009 5:55 PM
To: [log in to unmask]
Subject: Re: Medicare, the Q and You and me, too



Bill Johnson
Port Townsend, WA

Bob,
While I agree with your assessment that the language in the Senate Finance Committee document is "hopeful", and I know your concern about these issues is not at all superficial, I am somewhat leery of "improvements" that rely on increasing government involvement.  I cannot disagree with the concept that our healthcare system needs a vast amount of work, much of which only the government can do.  But it is like HIPPA.  I believe in patient confidentiality, but do not see how signing a piece of paper when they are offered a copy of our privacy policy goes far to protect their privacy.  It does, however, increase our costs to implement this act.  Yes, parts of that act do increase accountability, which is good, but could we do better?

The estimate in the document you referenced, that we may be spending 20% of our gross domestic product (GDP) on healthcare in 2017 is certainly not encouraging.  Especially when it was reported two days ago in many newscasts that the Medicare hospital funding would run out in 2017.  Furthermore, estimates in the Senate document that fraud costs more than $60 billion a year are chilling.  Obesity and diabetes are on the rise.  Is this a train wreck?  Can I get off?

The New England Journal of Medicine (5/14/09) has a good article;  Building Momentum as Democrats Forge Health Care Reform <http://exchange.pacificvascular.com/exchweb/bin/redir.asp?URL=http://click2.nejm.org/cts/click?q=137%253B67200113%253BVG%252F7pkcOj%252FJDBDwiWQxsTrSzetBo%252FrvqehrP47qxRNc%253D>  Free Full Text <http://exchange.pacificvascular.com/exchweb/bin/redir.asp?URL=http://click2.nejm.org/cts/click?q=137%253B67200113%253BVG%252F7pkcOj%252FJDBDwiWQxsTpxPH70vAbCaehrP47qxRNc%253D>  you might want to read also. 

This is certainly a very big issue right now, and it is encouraging to note it is a major piece on our President's agenda.  The fact we spend more of our GDP than any other industrialized country, but still the quality of care, and access to care is lacking in many areas, is enough impetus in itself to make change a priority.  Couple that with the state of our economy and the millions that are losing jobs and health benefits, clearly creates a huge incentive to do something.  But there are a lot of players and many interests.  What should be about patient outcomes might become more about dollars.  I hope for the best, for all our sakes.

I refuse to worry though, Social Security will last until 2037.  Wait, I will only be 89!  What will I do for the next 11 years?  Do we have an Old Vascular Technologist's Home?

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From: UVM Flownet on behalf of ROBERT KANE
Sent: Wed 5/13/2009 1:20 PM
To: [log in to unmask]
Subject: Medicare, the Q and You


On April 29,2009 the Senate Finance Committee released a "Description of Policy Options" titled 'Transforming the Health Care Delivery System: Proposals to Improve Patient Care and Reduce Health Care Costs'.I am posting this with the link so that you all have an opportunity to read it.

Frankly it soothed my soul with sections like, Linking Payment to Quality Outcomes, Establishment of a Hospital Value-Based Program (VBP), Transparency and Evidenced-Based Decision-Making for Imaging Services, Extension and Expansion of the Medicare Health Care Quality Demonstration Program, Improving Quality Measurements, Proposal on Development of a National Workforce Strategy, Linking Payment to Quality and Provider Compliance and Penalties.

After having read this document I was filled with hope, after years of wondering if our Health Care System would ever get it right. Finally now I believe someone has a clue. I am not foolish enough to think that all of our problems are going to be solved by this body of work, but all I was looking for was a little hope.

The meaning of the word Quality has been diluted to the point where I don't think, as a Country, we understand its essence. As a wise man once taught me 'the essence of Quality is it's inconvenience'. Finally, I have hope in my 'Bob Equation' that time plus knowledge can equal accuracy and accuracy plus attitude equals patient care. So in the end Quality Patient Care will be recognized for what it ACTUALLY is...... less expensive.
That's right Quality Care Costs Less. And now the government knows it!

I am not a technologist, but have come to respect and understand the vital role your artistry plays in making sick people get the care they need.Hope you find hope through reading this. The link is

finance.senate.gov/sitepages/legislation.htm

The actual date on the site is 4/28/09.

Bob Kane

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