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Doctors brace for possible big Medicare pay cuts

2010-11-13T07:48:00.000-08:00

WASHINGTON – Breast cancer surgeon Kathryn Wagner has posted a warning in her waiting room about a different sort of risk to patients' health: She'll stop taking new Medicare cases if Congress allows looming cuts in doctors' pay to go through.
The scheduled cuts — the result of a failed system set up years ago to control costs — have raised alarms that real damage to Medicare could result if the lame-duck Congress winds up in a partisan standoff and fails to act by Dec. 1. That's when an initial 23 percent reduction would hit.
Neither Democrats nor newly empowered Republicans want the sudden cuts, but there's no consensus on how to stave them off. The debate over high deficits complicates matters, since every penny going to make doctors whole will probably have to come from cuts elsewhere. A reprieve of a few months may be the likeliest outcome. That may not reassure doctors.
"My frustration level is at a nine or 10 right now," said Wagner, who practices in San Antonio. "I am exceptionally exhausted with these annual and biannual threats to cut my reimbursement by drastic amounts. As a business person, I can't budget at all because I have no idea how much money is going to come in. Medicine is a business. Private practice is a business."
The cuts have nothing to do with President Barack Obama's health care overhaul. They're the consequence of a 1990s budget-balancing law whose requirements Congress has routinely postponed. But these cuts don't go away; they come back for a bigger bite.
Doctors have muddled through with temporary reprieves for years. This time, medical groups estimate that as many as two-thirds of doctors would stop taking new Medicare patients, throwing the health program for 46 million older and disabled people into turmoil just when the first baby boomers will become eligible.
Health care for military service members, families and retirees also would be jeopardized because Tricare payments are tied to Medicare's.
Former Medicare administrator Gail Wilensky, a leading Republican policy expert, says lawmakers coming back to Washington next week better take note. "We simply cannot let physicians take a 23 percent reduction in payment and think that we are not going to seriously disrupt access for beneficiaries," Wilensky said.
Yet there's no agreement among lawmakers and the Obama administration on how long a reprieve to grant or whether the cost — about $1 billion per month — should be added to the deficit or paid for with spending reductions elsewhere.
The last reprieve, in June, was paid for after a struggle to come up with offsets acceptable to Democrats and Republicans. The deadline for congressional action expired, plunging Medicare's claims system into confusion for weeks.
How did it get to be such a big mess?
There's widespread recognition that the way Medicare pays doctors is flawed because it rewards sheer volume of services, not quality results. But there's no agreement on a better way.
So in the 1990s lawmakers devised a formula for cuts as an automatic braking system to keep Medicare humming along at a sustainable growth rate.
Except every time costs went up, they hit the override button. Repealing the formula now would cost more than $280 billion over 10 years.
The American Medical Association is calling for a 13-month reprieve that would give Congress time to work on a new payment system; the administration supports that approach.
"The single biggest step we can take to strengthen Medicare ... is to make sure these disruptive cuts don't take effect," said Health and Human Services Secretary Kathleen Sebelius. "We will ultimately need a permanent fix ... but in the meantime, we don't want any doctor to be stuck in a limbo where they don't know week to week how much they'll be paid."
The AMA and Obama would settle for adding the cost to the deficit. Most Republicans and many conservative Democrats want it paid for.
Aides to the Senate Finance Committee chairman, Sen. Max Baucus, D-Mont., say he's working toward the longest possible extension that will get the 60 votes needed to pass the Senate.
Last summer, when Congress missed the deadline for an extension, Wagner had to tap her line of credit to pay the salaries of her nurses and office staff. Medicare is only a fraction of her practice, but the cancer surgeon said private insurance companies also held up payments waiting to see what would happen. "I didn't get a check in the mail for almost a month," she said.
As a doctor, she recognizes there could be grave consequences if she follows through on not taking new Medicare patients. Older women are more likely to have malignant disease than younger patients. "Those are cancers that are waiting at the door," Wagner said. She would continue to see established patients.
But she's getting closer and closer to the breaking point with Medicare.
"Stick me with a fork," said Wagner. "I'm done."

Electronic Cigarettes: Are They Really Better For Your Health? Is This the Death of Big Tobacco?

2010-11-13T06:20:00.000-08:00

E lectronic cigarettes have recently grabbed the attention of countless tobacco users across the United States. Also known as the “E-Cigarette,” these groundbreaking devices are raising a lot of eyebrows. Are they really a healthier and cheaper alternative to traditional cigarettes? Creators say these devices are very different from the traditional cigarette, and thousands of smokers have already made the switch with hopes the device will be better for their health. But can this clever looking contraption live up to all the hype? Is there any scientific evidence that electronic cigarettes truly are the #1 smoking alternative?

When we first inspected the electronic cigarette, it was easy to see that the device in fact does look and feel like a traditional cigarette. Creators and product users are claiming that you can now enjoy a healthier cigarette without the bad smells, second-hand smoke, or cancer causing chemicals. Plus they claim you can still get your nicotine fix. Sounds almost too good to be true right? That's what we thought as well. So we had our own Vanessa Michaels test these incredible claims. And the results, to say the least, were very shocking. Here are just a few of the benefits that South Beach Smoke™ electronic cigarettes have been claiming on their website:

No tar, tobacco, carbon monoxide, or ash.
Get the same amount of nicotine as a regular cigarette.
Each cartridge costs less than $2 and is equivalent to an entire pack of cigarettes.
You can save over Thousands of $$$ each year.
You won't "smell" like a smoker any longer.
Different flavors are available.
No more second-hand smoke.

When Vanessa received her electronic cigarette trial kit, she passed the device around so everyone could take a closer look. Sure enough, the product looked and felt like a cigarette. The device was also very well made and seemed safe to use. When Vanessa took her first few drags on the device, we all stared in amazement. It looked like Vanessa was smoking in the office, but with one huge difference. There was no tobacco smell and no second-hand smoke. Just a harmless vapor.

We were also able to confirm the money savings claims. Each cartridge was equivalent to approximately 1 pack of cigarettes at a cost of only a couple of dollars each, meaning that smokers who smoke 1 pack per day can easily save over $1,000 per year. Since the device satisfied Vanessa's nicotine cravings, we knew that we had found a product that actually works.

We decided to research exactly what expert medical doctors and product users had to say aboute-cigarettes like the South Beach Smoke™ electronic cigarette. The results were surprising. In fact, the United Health Organization concluded that "In the short time that electronic cigarettes have become popular, the number of people who have been able to quit smoking and stay cigarette free have risen by an estimated 300%. No other methodology has proven so successful in such a short period of time."

A New U.S. Health Trend?

Four very well known doctors, from the popular TV show “The Doctors”, have shared great insight with us on the topic of the electronic cigarette. The electronic cigarette was featured as one of their top 10 key health trends for 2009.

“The greatest issue with cigarettes is the 500+ other ingredients added, not just the nicotine. Do we recommend this for non-smokers? Of course not, but for current smokers this is the most revolutionary device to date” - Dr. Travis Stork

The Doctors, Clockwise, from left to right. Dr. Travis Stork, Dr. Jim Sears, Dr. Lisa Masterson and Dr. Drew Ordan.

None of the doctors on the show are smokers, so they used a female smoker, Beverly, as a case study. Beverly had struggled with smoking for 15 years. By day 2, this former "heavy smoker" had eliminated the use of regular cigarettes all together, and was pleased to report that she now only uses her electronic cigarette. She admits that the E-Cigarette is very satisfying and definitely recommends it to other smokers.

How Does The South Beach Smoke™ E-Cigarette Work?

Technology has enabled engineers to create a safer cigarette for everyone. Using the device is simple enough. If you know how to smoke a regular cigarette, then you'll know how to smoke an electronic cigarette.

A Look Inside The Electronic Cigarette

Here's a simplified explanation of the 4 step process that occurs when you enjoy an electronic cigarette:

Step #1: A flow sensor will detect that air is traveling through the e-cigarette when the user inhales.
Step #2: Liquid nicotine and flavoring contained in the cartridge goes into the atomization chamber while the Smart Chip controls the amount.
Step #3: The Heating Vapor Coil "atomizes" the liquid creating a rich vapor very similar to smoke. While this vapor is enjoyed, the indicator light is signaled.
Step #4: When the smoker finishes inhaling, the LED in the indicator light fades out. The smoker is free to partake in additional drags on the device.

We are pleased to report that all of this occurs in an extremely safe manner. In fact, it is virtually impossible to unintentionally start a fire with an electronic cigarette, another huge benefit that can potentially save lives.

Smoking In Banned Locations

As part of our in-depth investigation, we wanted to study if e-cigarette users would be able to actually smoke an e-cigarette in locations that have been off-limits to smokers like public offices, restaurants, movie theaters, planes etc. We learned that these new devices are not encompassed by most smoking bans and regulations. This is because an e-cigarette are not lit by flame, and no harmful smoke is produced. The smoke you see is simply a harmless vapor mist. In fact, some airports and hospitals have even welcomed indoor electronic cigarette smoking enthusiastically. But this doesn't necessarily mean that you might catch grief from some security guards or other public building managers.

Many employers are now even allowing e-cigarette use in the office

"Because e-cigarettes do not produce second hand smoke, there is no public health hazard to smoking them in public areas. And there are lowered personal risks to you. We have interviewed many users who report that they are able to smoke in more places and get that same 'nicotine fix' they crave. Many of them have completely given up traditional cigarettes...

Thousands Of Smokers Are Making The Switch

Jill Kershaw, from Tucson, Arizona used to smoke 5 packs of cigarettes a day until just she tried electronic cigarettes. She told us that "I was unable to quit and my health was suffering as a result”. To her amazement, when she started smoking “e-cigarettes”, she was able to stop smoking her regular cigarettes just 3 days later. Jill told us, "I can't tell you how much better I actually feel. I've tried gum, patches and everything else to try and quit over the years, but the e-cigarettes have made my goal to try and quit smoking much easier... I feel like I've been given a "get out of smoking jail" free card, and couldn't be happier!"

The testimonials like this one have been coming into our offices here with increasing frequency, and all of them have been positive thus far. We are confident that as more Americans learn about this new smoking technology, that more smokers will make the switch.

Electronic cigarettes can be used with real nicotine cartridges or without nicotine to facilitate the ease of quitting for users desiring to do so. Our interviews and research concluded that the electronic cigarette will quickly become the #1 choice for smokers looking to lead a healthier lifestyle. With the high cost of smoking traditional cigarettes (new smoking taxes are being levied almost yearly), and with the danger cigarettes bring to your health, we also give our recommendation and "thumbs up" to anyone looking to give these devices a try.

We have found South Beach Smoke™ to be one of the most trusted and quality suppliers of electronic cigarettes from all the companies we've researched. Customer reviews have been consistently positive and South Beach Smoke™ is so confident in their product that they are offer a Risk-Free 30 day Money Back Guarantee and a Lifetime Replacement Warranty*. Click Here to access this exclusive offer. We thank South Beach Smoke™ for providing smokers with the opportunity to try risk free. We encourage all of our readers who currently smoke to give the electronic cigarette a try for their health, and for the health of their friends, families, and co-workers.

Did Jessica Simpson Swipe Something From Under Mariah's Xmas Tree?

2010-11-13T03:57:00.001-08:00

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Did Jessica Simpson Swipe Something From Under Mariah's Xmas Tree?

Posted Fri Nov 12, 2010 10:52am PST by Caryn Ganz in Amplifier

When Jessica Simpson started to become more famous for fashion faux pas and bon mots than her music career (which, you may have forgotten, is how she entered pop culture in the first place), her handlers guided her to country music. Her 2008 Nashville disc "Do You Know," however, performed about as well as her sister did at the Orange Bowl. Her camp seemed to think a Christmas disc was a safe way to edge back into the music world, but there are already big troubles with that plan:
Simpson is unleashing "Happy Christmas" on November 22nd, one of the most crowded release dates of the year, where it will certainly be dwarfed by highly anticipated discs from Kanye West, Nicki Minaj, and My Chemical Romance. And just hours after its first single, "My Only Wish," debuted, its similarities to another huge holiday pop tune -- Mariah Carey's "All I Want For Christmas Is You" -- became glaringly obvious.
Musically, both songs feature choppily banged piano chords, the ever-present jingling of sleigh bells, the deeper toll of tubular bells, a retro '50s swing, frequent few-second pauses before the song revs back up, and final giant crescendos into a belted "you!" Thematically, they're about the same topic: eschewing material goods in favor of the priceless gift of love. Lyrically, they're dangerously close: "My only wish for Christmas is you" sings Simpson; "All I want for Christmas is you," croons Carey. Simpson offers to give up fancy decorations and her mother's pumpkin pie; Carey says she'll do without hanging her stocking and waiting to hear the reindeer on the roof. While the songs aren't identical -- the production on Carey's track is far brighter and uptempo, and Simpson's bridge breaks down into just piano and voice -- they're close enough to be kissing cousins.
Carey, who co-wrote "All I Want for Christmas Is You" with Walter Afanasieff for her 1994 album "Merry Christmas," recently released an updated "extra festive" version of the tune on her second holiday album, "Merry Christmas II You" (which, ironically, will compete with Simpson's disc on the charts). It's unclear who wrote and produced Simpson's "My Only Wish," though she spoke about hitmakers The-Dream and Tricky Stewart working on her latest disc during an interview with Ryan Seacrest yesterday during which she debuted the song.
[Video: Mariah Carey tumbles mid-concert]
"This one's different because it's under my complete control," Simpson said of "Happy Christmas." "It's the first record I"m putting out on Eleven Eleven Records, which is my new record company." Talking about how she prepared to record the album, she said, "I'm on iTunes, looking around, who's done what Christmas songs and what arrangements they did." Carey's album is one of the most successful Christmas releases ever, selling five million copies in the U.S. alone.
[Photos: See more of Jessica Simpson]
It may be wise for Simpson to back away from the "My Only Wish" controversy and start chatting about some of the other tracks on "Happy Christmas": "I'll Be Home for Christmas" is a duet with an active-duty U.S. serviceman named John Britt who Simpson met on a visit to the Persian Gulf, and Willie Nelson pops up on "Merry Christmas Baby." Simpson also tackles John Lennon and Yoko Ono's "Happy Xmas (War Is Over)" ... but considering how Beatles fans reacted when Lady Gaga dared to touch the deceased rocker's piano, maybe she shouldn't play that one up after all.