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AARP - Are They Supporting Their Members?
Healthcare has dominated the media outlets during the past
month. Last year I finally registered as a AARP member. This
organization speaking for approximately 40 million 50 plus
Americans, has recently been in conflict with the interest
of its membership over health care. The AARP position was
underscored to me earlier this month in an e-mail from Barry
Jackson of AARP, with the subject "MUST READ: Don't believe
them."
I read the e-mail and looked up the internet site which Mr.
Jackson claimed was in the AARP members best interest. I found
the recommended webpage HealthActionNow.Org to be under the
auspices of two former Clinton Administration operatives.
The website campaigned for the single payer health care option.
This option provides health care services from a single source
created and controlled by the government.In other words, "socialized
medicine." I sent a prompt response to Mr. Jackson with the
following:
Barry - Your recommended website is essentially a campaign
for socialized medicine. It would appear AARP has taken a
position which is contrary to the interest of its membership.
Barry you are lobbying, not communicating. Where are the surveys,
the data to support your position? It's like an architect
who designs by change order. Let's do the job the right the
first time. Mimicking the Wizard of Oz, "Don't pay attention
to (those who criticize you) the man behind the curtain is
not winning you any points.
I received a form response inviting me to speak with them
if I agreed with their campaign. More recently, I looked up
the webpage; and it has changed. The AARP logo is provided
several times on the front page along with a request to place
your name and e-mail address on their petition. Unlike the
earlier webpage, there is no information and only campaign
slogans to support AARP's position on health care reform.
HEALTH CARE - AN INDUSTRY LIKE NO OTHER
By Dr. Theodore Topolewski
A number of people believe the current Administration's
rhetoric that the healthcare industry can be remedied by
government restructuring in the same manner as the financial
and automotive industries. Thus far the formula for economic
recovery of troubled and misaligned industries has been
burdened with squandered funds and lack of oversight. The
political and media spin is the nation will ultimately benefit.
The next several years will reveal the "spinmeisters'" prophecy.
The domestic automotive industry encompasses auto makers,
parts suppliers and dealers. The automotive industry represents
a sizable portion of the GDP. However, the industry boxed
itself firmly into an economic corner in one Congressional
room in Washington. Three CEOs appeared before Congressional
committees which utilized a combination of brow beating
and carrot dangling hyped by media spin.
While, the Banking/Finance industry is far larger than the
automotive industry, the government has long regulated Banking/Finance
industry under the jurisdictions of the Treasury Dept.,
Federal Reserve and SEC. Instead of three financially desperate
automotive CEOs before Congress, at most ten to twelve Banking/Financial
CEOs with hat in hand put on display will bring about the
industry wide changes.
The Health Care Difference
Rolling the dice by throwing money at the problem will not
achieve the desired result with health care. Health care
creates giant logistical problems if the President and Congress
pursue the automotive and Banking/Financial industry models.
There is no congressional chamber big enough to accommodate
the movers and shakers of the health care industry for a
brow beating secession. Even a sports arena filled with
health care industry CEOs would not adequately address the
health care industry. Unlike the gentlemen CEO clubs of
automotive and banking/finance, those gathered in the arena
would not be an intimate group, as: (a) most would not know
each other; (b) some would have no idea of the inner workings
and problems of various industry sectors and; (c) a number
would for competitive reasons dislike each other. Health
care as a whole is profitable with some companies earning
vast sums. Unlike automotive and banking/finance, no government
hand out government is needed. As a result, many of the
above would not feel the need to appear unless lawfully
required.
The Fab Five
Health care is actually five large separate sector industries.
Each industry contributes a critical function to the health
care delivery system which represents over $2.5 trillion
dollars or 16% GDP. This number is expected to grow to 20%
of GDP within five to seven years. The five sectors are
the hospital, private practitioner, third-party-insurer,
long-term-care/rehab and pharma/biomed sectors. Two of these
sectors, hospitals and long-term-care/rehab facilities (of
which there are thousands) are essentially standalone. These
CEOs could fill a rather large chamber by themselves.
Cross sector cooperation for the general good of American
health care is noticeably lacking. How often does your family
physician have a complimentary word about a third-party-insurers?
Hospitals and private practice admitting physicians often
disagree on medical protocols as to inpatient length of
stay or medical supplies and ancillary tests used. Further,
some physicians compete with hospitals by providing radiology
and laboratory testing and independent surgery centers.
Third-party-insurers often appear to be at war with the
other sectors and the consumer in attempting to limit payments
to providers (thus enhancing profits) claiming coverage
exclusions.
Each sector believes it is in charge. Yet there is a symbiotic
relationship between and among the five sectors in American
health care. The lack of inter-sector cooperation creates
an economic inefficiency adversely impacting patient care
to health care providers over the last several decades.
The various methods of reimbursement (payment plans) to
health care provider over the last several decades are designed
to provide economic benefit to the sectors on top. e.g.:
managed care, capitation plans, out-of-pocket, out-of-network,
in-network, PPO, pre-authorization as proof. It is a one
competitive financial war for the fab five to divide up
the $2.5 to $3 trillion spent annually on health care.
Tinker With Them All Or Not
At All Dividing up the health care spending pool has not
been a zero sum game with the public paying more each year
to feed the five sectors. That is the reason health care
costs have been consistently higher than inflation. Political
hype and loose mandates certainly will not stop this level
of economic escalation. Further, tinkering with one or two
sectors via regulation on finances or delivery systems will
cause an unintended, adverse, domino affect on the other
sectors.
What's a nation to do? As with anything large and complex,
go slow, make sure you know how the parts interact with
the whole. The issues (problems) must be thoroughly defined
across all reporting lines. There is no quick fix, which
few silver bullets and government mandates can remedy. It
took decades to create the health care mess and it will
take decades to fix. Thus, it is impossible to adequately
address the health care sector in a single term of office.
Dr. Theodore Topolewski is a hospital administrator and
consultant to the health care industry. He can be reached
at ttopolewski@charter.net
Review of:
Dungeon, Fire and Sword: The Knights Templar in the Crusades
By John J. Robinson
Dungeon, Fire & Sword is one of the best Christmas gifts
I have ever received. Reading it was pure joy. I became
interested in the Knights Templar after one of my visits
to the South of France and to the castle fortress of Carcasonne.
John J. Robinson paints a spell-binding, comprehensive picture
of the middle ages and its impact on today. Mr. Robinson
takes us through the origin, the exploits and the ultimate
demise of the Knights Templar - OR did the Knights Templar
simply disperse and go underground? This is but one of the
mysteries addressed in the book. Mr. Robinson ties in the
"holy" alliance in the formation of the crusades with the
medieval catholic church hierarchy and the politics and
royalty of Europe. He draws in famous figures and their
role during this time period including St. Francis of Assisi,
Thomas Aquinas and Marco Polo. As if this were insufficient,
Mr. Robinson provides a parallel history of the Middle East,
Asia Minor and even Asia with Genghis Kahn. The result is
a neatly wrapped history of the known world during the reign
of the Knights Templar.
There are many side stories including the meaning of words.
I found myself writing notes in the page margins. For example
the word "slaves" was an outgrowth of the word "slavs" who
upon defeat were cast into bondage. There are a number of
church and state issues which I somehow missed while attending
parochial school as a youth. Priests were married until
a papal decree in the year 1000. King John of Magna Carta
fame imposed a "sin" tax on priests who still maintained
mistresses during the 1200s. The underlying strategy and
politics occasionally delayed papal elections for years.
This book is very even-handed in its approach to the events
(and the corresponding personalities) which took place while
the Knights Templar were in vogue. Mr. Robinson does not
favor, detract from or otherwise reveal a bias that I could
detect toward any one group, religion or political entity.
Dungeon, Fire & Sword is simply a well written and interesting
history of a lesser known time period. The battles for Europe,
Byzantium, the Middle East and the merchant trade alliances
are intertwined with the economies of war over the Holy
Land. It is a book worth reading a second time and indispensable
for any family library.
Lane J. Biviano
Rutherford, NJ
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