Charleston-Gazette August 9, 2011

Surgeon General Regina Benjamin and DHHS Secretary Sebelius recently announced a major new prevention initiative.  The goals are laudable.

Having been conditioned by years of groveling “grantsmanship”, many health agencies will be awaiting the announcement of federal funding opportunities to launch the initiative.  Such funding will require more deficit spending and debt, a serious quagmire the Country is trying to address. Instead, why don’t we ask what we can do locally to advance the spirit of the initiative without more borrowing from China? Below is an idea...MORE

Charleston Gazette,  July 8. 2011

Bernie Madoff is chuckling in his cell reading about Oregon’s budget plan to avert a fiscal crisis by cutting Medicaid payments to practitioners and hospitals by 11.5% and imposing a 1.69% tax on all hospital revenues. He would recognize the scam, suspecting Medicaid and total hospital revenues will actually increase.  See how, below.....MORE

Charleston Gazette on June 9, 2011

Recently I applauded CMS Administrator, Dr. Donald Berwick, for his honesty, knowledge and transparency. I am concerned by his recent Wall Street Journal comments that the reform of Medicare/caid such as proposed by Congressman Paul Ryan is not the right way to go.

Berwick essentially infers that these programs can be maintained and even expanded without incurring additional debt through the initiation and augmentation of quality and organizational performance improvement initiatives through more federally imposed mandates and monetary incentives...MORE.

CHARLESTON, W.WV 

My daughter was upset by a remark I made that I wish Michelle Obama had picked something other than nutrition as her activism focus. She praised the first lady’s efforts and questioned my motivation. I responded that Ms. Obama’s dedication and personal examples were laudatory but certain of her words, e.g., “dessert is not a right” and actions, e.g., champion of a recently enacted federal nutrition bill, might contribute more to promoting ideological rancor than health....MORE

October 1, 2010 

CHARLESTON, W.VA - Following enactment of Obamacare, some good things have happened and some folks are having fun. However, there has been little progress towards meaningful health system reform.

The situation can be described by an example drawn from a recent article by Ching-Ching Ni from the Los Angeles Times describing how visiting Chinese youths discovered “fun” attending U.S. summer camps. As one child stated, “This was pure fun. I have never played like this before. In China our parents want us to think all the time.” Another added, “Even when we play basketball, we have to use our brains. Here you just throw the ball and don’t have to think. I like the American way.”  MORE

After arriving in the Kanawha Valley in 2000, a major preconceived myth I held about health care delivery within West Virginia was dispelled by my public health and medical peers throughout the State.  The State faces enormous social, educational, behavioral, cultural and other barriers to improving health delivery and status. However, basic geographical and economic access to early primary and preventive care - by and large - is not a major impediment, although such access to specialty care remains a major challenge. MORE.. 

The claims were compelling.

“This bill will touch the lives of every American.”  “No one will ever go broke because they got sick.” “Never again will anyone die because they can’t afford the treatment they need.”

Such were the bold promises from America’s elected leaders concerning the much-heralded healthcare legislation. Confronted with such a grandiose sales pitch, I was curious about the actual contents of the legislation. Most importantly, would it address the true enemy of our healthcare system: inefficiency, waste and errors?

I consulted multiple resources to explore this question. My conclusion? The hope for the health system lies somewhere other than Washington … somewhere much closer to home. MORE....

Historically, physicians –respecting the autonomy of each individual to direct his or her own destiny - focused on maintaining and improving the health status of their patients, not providing services. Patients, the public and policy makers aver physicians should continue – or refocus – on doing so. In reality, many initiatives over the last few decades (including the current reform proposal) promote the opposite. More...

Probably the greatest opportunity for elevating the public’s health status and saving resources centers on a group of individuals who participate in the health system only when they are acutely ill or injured. Some opt not to participate by choice for many reasons. Others fail to do so because of barriers beyond their control.

The end result is usually reduced health status and increased costs for these individuals or society, probably partially avoidable if they had altered their life-style behaviors and received recommended services in a timely manner.  This group represents the greatest challenge to society but we have elected to ignore many aspects of this challenge. More... 

CHARLESTON, W.Va. - Dr. James Felsen got his start as a physician making house calls on horseback at the bottom of the Grand Canyon.

He treated elderly American Indians as a doctor with the Indian Health Service in Arizona in the late 1960s. At the time, he realized the tremendous potential of community public health programs. He was making a difference.

So he abandoned plans to become an orthopedic surgeon or emergency medicine doctor, and dedicated his life to public health.......