Tampa Bay Times from St. Petersburg, Florida • 44

2 Tuesday, August 11, 2009 St. Petersburg Times PAC PAN PAS 'OPINION i tampabay.comopinion -a Health care reform Guest column I Dr. Marc J. Yacht- We can't afford for this effort to fail Guest column I Dr. Rao Musunuru Misconceptions can color decisions Lotsofpeoplequizmeeveryday about my thoughts on health care reform.

I try not to engage in that conversation, as people get very upset when you say something that they do not want to hear. Political posturing aside, responsible Democrats and Republicans cannot deny the need for a radical fix to health care delivery. The American Medical Association is following many state and more self-sufficiency and a more productive work orce. There are vast financial benefits both directly and indirectly with universal coverage. The Europeans have understood that since they started their reforms in 1910.

Can we finally get the message? Yes, there are problems with universal health care, but I doubt you'll see any country with coverage ending it I would further suggest that no citizen of a country with universal health would give up their medical system for ours. True, it's a constant fix and assessment, but that is true in both the private and government sectors in all industries. The question to be asked is how long we can afford to delay action while trying to create an ideal system. Perfection is elusive and of course should be a desired aim. The essentials of universal health care are modeled in Medicare.

Keep administrative costs down. Universally cover the defined population. Minimize the paperwork. Pay adequate reimbursements to providers. Develop effective regulation and oversight Medicare is not perfect and has problems, but it sure works for doctors, hospitals, patients and other providers.

I would suggest that many of Medicare's woes, as is true of any health insurance provider, are directly affected by the burgeoning numbers of uninsured. Responsible politicians and advocacy groups must stop picking apart a long overdue fix to health care reform. They should work constructively with the Obama initiatives and move it forward. The stakes are too high for another failed health reform effort Dr. Marc J.

Yachtis the retired director of the Pasco Health Department long. Universal health access would allow a medical home for everyone. This would not overwhelm but enhance the viability of doctor's practices particularly in hard-hit economic areas where so many are uninsured. Many of the uninsured cannot pay their health bill. As with seniors covered by Medicare, all would be paying patients.

Hospitals would see their "no-pay" patients disappear as would other health care providers. The net effect would be to thwart escalating bad debt to hospitals and stabilize double-digit cost increases to prevent insolvency. Currently, the insured can less afford spiraling premiums, increasing co-pays and denials; hence, more uninsured. Individuals and businesses are trying to get out from under withering health cost increases. Ironically, these increases are necessary to overcome the bad debt.

It is a vicious cycle that must be broken. Thai will occur through mandated health coverage and anyone who understands the economics of health care knows it. It is criminal to posture on the issue. We lose 20,000 lives a year in this country because of lack of health insurance. Tens of thousands more are unable to get needed pharmacy or health care access because of costs both in doctor's offices and in hospitals.

Charitable care, when available, is not equitable care and should not be perceived as such. Those who argue we are moving too quickly are sandbagging the process. That argument has been made for 60 years and 60 years is more than adequate time for a solution. Adequate access to health care means a healthier population, good preventive care and equitable management of chronic conditions. Less disability means even the most tech-sawy physicians cannot believe that it will improve the quality of medical care.

The practice of medicine remains an art, involving human judgment every minute of the day and night Patients need protection and there is no need for tort reform. Physicians are human beings. They do make mistakes and they should be accountable. But outrageously enormous verdicts do not have to destroy professional careers and lives. The fear of these verdicts leads to excessive medical costs through extra fees to cover extraordinarily excessive insurance premiums and through practice of defensive medicine necessitating a lot of unnecessary testing.

Defensive medicine is estimated to increase health care costs at least by 9 percent even though most of the time there is no direct financial gain to the practicing physicians. Physicians make too much money. The government can simply save money by cutting their reimbursements. Physicians are taking care of these 47 million uninsured right now, mostly for free. Considering expensive prolonged responsibility, liability, time commitment and personal sacrifices, one may not find the reimbursements that lucrative or excessive.

Moreover, physicians' reimbursements account for only a small portion of total health care expenditure. If one cannot reduce the overhead to less than 50 percent and face an extra 30 to 40 percent cut in the reimbursement, one does not have to be too smart to figure out whether it is worth continuing to work. Dr. Rao Musunuru is a practicing cardiologist and is the recipient of the Tampa Bay Business Journal 2007 Healthcare Heroes, Lifetime Achievement Award. 1 It is because of many more billions of profit that these partners are counting on, by providing services to the more than 40 million people with newfound coverage (which obviously does not control the overall health care expenditure).

New insurance coverage will improve overall health status of the country and wul help the economic recovery. Even though it is a necessary step, there is no guarantee that all the newly insured will use it for preventive or early medical care. Most of them may not even want to or can afford to have health insurance, unless it is totally and absolutely free (which will be ideal, but may not be realistic, considering the current economy and growing deficit). It is not right that most of the healthcare dollars are spent during the last few days or weeks of life for the elderly. Obviously, people are the sickest when they are older and before they die.

Would we rather have everybody die suddenly to save money? Or anybody above a certain age not be provided any expensive medical care, because they may die soon? We have the most expensive health care (with the best knowledge, facilities, technology, research and equipment), but our outcomes are not any better than most of the worlds Why then, do all the people from the rest of the world (who can afford it) come to the United States for medical care? Could it be that the portion of the population that does not care for themselves and abuse their God-given good health contribute to skew the outcome numbers? Do we have accurate ways to measure quality of life? The billions of dollars being spent on promoting electronic medical records will help solve most of the problems. It may help in many ways, but specialty associations calling for reform. This signal from the AMA is long overdue and represents a response to physician members who have Yacht tired of busi ness as usual. The Florida Medical Association, still under the grip of ultra conservatives, seems to prefer a head-in-the-sand approach. They will lose more members as they rail against efforts for reform.

President Barack Obama continues to take the high road on the issue with his town hall meetings and the overwhelming public mood for a fixed health care system. As always, the devil is in the details. However, Blue Dog Democrats, feeling constituent heat for their behavior, are well on their way to a health plan agreement with the administration. Hopefully, the American people will see a bill that meets their needs and not one crafted by the health insurance industry. Such legislation would further sour the public on government initiatives.

Elected officials looking for dollars need go no further than their resident health insurance lobbyist. However, elected officials will have much to answer for at home and they know it As the saying goes, "You can fool some of the people all the time and all of the people some of the time, but you can't fool all the people all the time." What can we expect from good health care reform? The list is There are a lot of problems with health care delivery in this country, including expense and access. It did not happen overnight and there is a lot of blame Musunuru to go around. Surely, something needs to be done. But there are a lot of misconceptions about the present proposals.

Here are some myths: HeaUhcarerqformmeans providing insurance coverage for all people, guaranteeing prompt care with the best outcomes, without increase in health care expenditure. It is a perfect pill, but too big to swallow. We cannot get something for nothing. Do the right thing. Take poli-.

tics out of it. Politics is an integral part of democracy. Politicians earn their jobs by promising certain future accomplishments to the majority of their constituents. Understandably, to keep their jobs, they have to keep those promises, which automatically become "the right thing." It helps to stop the fraud, abuse and waste. There are already plenty of needed laws on the books to curb fraud, curtail abuse and eliminate waste.

They need to be enforced to control greed, which permeates every aspect of health care, like every other industry. We may not need new laws to enforce the existing laws. All partners of the health care industry are volunteering billions of dollars to contribute to the success of health care reform. Around the Simeons! tampabay.com for more news from neighboring counties Volunteers complete their tours of '1. ff iJf I RON THOMPSON Times Spatula in hand, Burke removes cookies after they've cooled.

Every month, her group baked between 250 dozen and 350 dozen cookies to send to the troops. 1 SUNC CAS HTllKLUllir Effective June 8, 2009 Depart 11:00 AM 3:30 PM 7:00 PM Return 5:30 PM 9:00 PM i 12:00 AM 1.1 duty i if 7 if RON THOMPSON last week. Times thanking them for their military service. Burke said her group has received about 300 responses-from military personnel who have opened packets from the Hernando do-gooders. The gist of the messages, said Burke, "is that it means so much to them that people back home are thinking of them, especially strangers.

"They don't expect anything from a non-family member, just a citizen to take the time out to express their gratitude is huge to them." Burke couldn't guess the number of hours she has devoted to Treat the Troops. "I have no idea. Countless." Eager to pass the credit on, she said, "When you think of the hours the ladies have been baking, it has to be in the thousands." Moving to South Carolina, the national headquarters of the grass roots Treat the Troops program, BurkS said she'll put aside her organizational duties but continue to bake cookies. rv Barbara Burke, left, and Linda Heady prepare another dozen cookies BY BETH N. GRAY Times Correspondent SPRING HILL A shipment of homemade cookies this month to military personnel serving in Iraq and Afghanistan will mark the last hurrah for the local Treat the Troops endeavor, founder Barbara Burke has announced.

Burke, who launched the program in advance of Christmas 2007 with a major bake-off of homemade cookies sent to overseas troops, is moving soon to South Carolina to be closer to two sisters who live there. Since the effort's inception, a consistent group of a dozen volunteers and occasional helpful bakers have packed and shipped a whopping 78,462 cookies. "Everybody just bakes to the time they have," Burke noted. But the effort has taken a toll on the volunteers who "are running out of steam" and have decided not to continue, she said. The August shipment will be their last, Burke said.

Burke said she wasn't aware that Army Spc Justin Dean Coleman of Hernando Beach was deployed to a war zone until she read in the St Petersburg Times of his death July 24 during a fire-fight near the Afghan-Pakistani border. Had the Treat the Troops cadre known of him, she said, Coleman certainly would have been on their mailing list The bakers are asking all Hernando County residents to come forward with names and addresses of service personnel to add to their recipient roster. "It would be nice to concentrate on men and women who are deployed, who are from Hernando County or have ties to Hernando County, such as parents and grandparents," Burke said "With (Coleman) in mind, how many other local soldiers are serving (whom) we don't know about?" she asked. The final batch of cookies will target these recipients, she declared. "HTith it being local, I think it will really make the bakers excited and motivated to make SunCruz PORT RICI1EY DAS'Dftl tary personnel Hundreds of cool scarves, filled with a sweat-absorbing material for tying around the forehead or neck, were stitched by volunteers to be included in the treat boxes, Burke said.

Cash donations came in to buy and ship 30 cases of Girl Scout cookies this year. Burke's group also launched this year the Star project, in which embroidered stars were clipped from worn-out or faded U.S. flags, then tucked into the treat boxes headed overseas and further handed out to veterans of all stripes with a brief missive Can you help? 1 To submit a potential recipient for Treats for Troops, homemade cookies and more, send name and APO address to barbara treatthetroops.org or telephone (352) 799-9750. lb make financial donations for purchase of cookie ingredients or postage to send packages to troops serving in Iraq and Afghanistan, mail to Treat the Troops, 14466 Tamarind Loop, Spring Hill, 34609. A s- i The Bay Area's ONLY Casino That Offers ROULETTE and DICE Plus Other Amazing Las Vegas Style Games Including: Over 325 Slot Machines! Blackjack! Let It Ride! 3-Card Poker, Video Poker Nickel Slots! AND MORE! FREE FOODAKD DRSNXS WHILE GAMBLING! this a grand finale," Burke said.

More than homemacle cookies have poured from the local Treat the Troops effort. Trees for Troops efforts in 2007 and 2008 provided about 450 miniature imitation Christmas trees and stockings, funded by donors, sent to deployed military personnel. Children from all of the county's elementary schools and a couple of middle schools, plus volunteers, made decorations that were included in those box shipments. School students creat ed some 3,500 holiday cards and letters to enclose or to be sent individually to mili $5.00 IN SLOT TOKENS FREE 8 Off A FREE $10.00 TABLE MATCH PLAY! 'Coupon ffvqufrwf Lifml One fj) coupon perperww per cruis ErrwM 09 WW) LOCATED IN PORT RICHEY. NEXT TO HOOTERS 727-043-3423 C00-464-3423 rrv mm nynt to cmtrtn cnanq or rwvnm or any promotion si any nm nonet..