So I was up watching President Obama deliver his speech with his usual eloquence and charisma when I began really paying attention to him. Not just his looks or his mannerisms, but instead to the words he was saying.

Why? Because what he was saying may have an impact on

1. My patients
2. My future as a physician
3. My family

I began to realize, OMG this issue can either affect every person, or just those who don't have insurance.

Most people who have insurance don't want it taken away. Most people who don't have insurance are young people, those who don't care about their health or those who can't afford it.

Why are people freaking out at town halls, because they could be affected negatively and are scared of this. Should they be? Well, maybe.

Medicare for example has a fee schedule for each state, you can look at CT here It is traditionally the lowest PAYOR OF ALL!!!

I am sick of hearing "Medicare is a popular program"

What is the alternative for someone greater than 65? Free or pay out the nose for medical insurance? I am SURE that this is why the program is popular.

Let me tell you a little secret. You mess up and miscode for an Insurer, you get audited and pay them back.

You mess up and miscode for the Government Plan, you have effectively committed a felony that could ruin your career forever.

Make sense? Not really.

Ask the doctors who do the coding if Medicare is popular. They will vehemently say no. Doctors everywhere are dropping Medicare because it

1. Doesn't pay enough
2. Exposes you to legal risk
3. Can punish you for not doing what they say

Corporate Insurance does Number 1 and Number 3. But they do not put you into number 2.

Why should we be felons? Any other governmental plan is likely to have the same statutes..

But, I did like the speech. I just hope he can back up the words.

But the answer here is simple. Someone takes other people's money and then takes some for themselves and their administration, then they pay for other people's healthcare.

Take less for administration. My guess is most of what is done could be automated by technology.

I got so fired up I emailed, Jim Himes, My congressman, from Greenwich.

I was in such a frenzy that I decided to comment on the Human Genetic Commission at the British Department of Public Health. This too was a diatribe. So I wish the UK all the best.

Why the UK? Timothy Allistar made me do it. After watching him brief the National Academies I began to say, here is a really smart guy, who thinks DTC Genomics is Not medicine.

I needed to get my point across. Now granted I am no Muin Khoury, but I wonder if Muin has commented on the site....

So I took this as my task as well. Needless to say, I am extremely exhausted. My points for DTC Genomics you have heard.

My Points to Jim Himes are as follows.

1. If you want to cover the uncovered, make it mandatory and give subisidies (Nice job Obama)
2. If you want insurances to stop being profit centers, create a NON Governmental Not For Profit like a Mutual of Omaha, etc. Fast track credentialing for them, but don't subsidize.
3. Don't cut payments to physicians, they already are getting killed by your lack of pay raise
4. You have to focus on a few things at a time. Play your hand wisely, or we won't vote for you again.

The Sherpa Says: True, no genetics today, other than the UK commentary (HT David)