facility fees going to go bye-bye?

http://www.nytimes.com/2015/02/07/upshot/medicare-proposal-would-even-out-doctors-pay.html?mabReward=A3&action=click&pgtype=Homepage®ion=CColumn&module=Recommendation&src=rechp&WT.nav=RecEngine&_r=2&abt=0002&abg=0 Interesting article. Hospital facility fees do put considerable $$ into the hospital coffers, not to the docs. Would hospitals jettison docs as employees if they could NOT recoup facility fees? Maybe the less productive docs would be booted?

Smell the desperation

NYTimes: Apple’s War on Samsung Has Google in Crossfire http://nyti.ms/1dIkHuo

Medical changes continue

http://www.foxnews.com/politics/2013/12/09/obamacare-exchanges-give-limited-access-to-top-hospitals/

CCF will only accept Med Mutual exchange product

http://dailycaller.com/2013/11/25/top-4-u-s-hospital-laying-off-staff-due-to-obamacare/

CCF cutting jobs given ObamaCare

Sad times at play. CCF shrinks in response to broader health coverage?
Fascinating to watch it all unfold

Medicine changes

http://news.yahoo.com/obamas-health-law-finally-gets-124027369.html People fearing Obamacare. With a limited amount of money, you cannot cover all and expect the cost to not increase - unless the benefits for the currently insured drop back to even out the pool. I have seen/predicted this for some time. A colleague told me some CCF docs got a form letter telling them 1) your salary is cut 3% and 2) you will be working more hours/shifts. Insult meet injury. Scary issues for all. Physician salaries will certainly fall with all the changes going about. The European system is coming. Docs will be competing to care for well insured patients (20% of populus in Germany), and still expected to care for those on the public plan with poor (i.e., break even) reimbursement. I still enjoy what I do - working with patients and operating, but the system becomes more difficult all the time. Will docs retire or switch career? Likely some, but unclear. Take me as an example - what could I feasibly do outside of medicine? Teach HS science? Maybe. I think docs are more likely to keep practicing medicine, albeit with less satisfaction. The replacement of these docs will be the problem - the bright students of today will see the problems in medicine and opt for another career track. Watch for the pysician shortages to really become apparent 10y from now.

some ACA ramblings

http://www.crainscleveland.com/article/20131027/SUB1/310279980/1007/newsletter12 Hospitals worry they'll be stuck with more bills under Obamacare's high-deductible plans; this article points out that many with high deductible (cheap, bronze) plans will skip out on their costs once they develop an issue that their cheap plan does not cover. Maybe this is why CCF is laying off people? CCF will have insured patients, but if a large portion are "bronze" then they will (often?) either not do expensive care/surgery, or do it and then not pay the bill. We are seeing employers drop hours back to 29 so as to avoid paying a penalty for not covering an employee with 30+ hours. No one knows how the ACA will all shake out, but it will be an interesting process. I just wish my livelihood were not tied up in the mess...

Medical slide to European model starting

http://mobile.businessweek.com/news/2013-09-17/walgreen-joins-in-exodus-to-obamacare-like-private-exchanges

Private insurance will fade. Exchanges are an attempt for insurance to remain relevant.
The coverage will be stripped down, equivalent to medicaid.

Say hello to lines and limited services/meds.

Apple slide to oblivion

http://www.forbes.com/sites/petercohan/2013/04/18/7-reasons-apple-is-more-doomed-than-you-think/

Itunes 11 with its partner in failure ios 6, have convinced me that 

apple is on a downward spiral.

Their innovation is mainly directed as ways to lock customers into their system, 

removing choice or individuality.

When it became apparent to replace my work blackberry with a more functional 

phone, i thought of the Iphone. I had

An iPad and thought an iphone would be the logical step. But the ipad updates were problematic. 

I realized that the updates were not to better my experience as a customer, but rather to better 

control me as

A customer. Apple wants everything to be bought through itunes

Some of us consider a product to be ours once we buy it, not partly still 

owned by the maker

I went with a galaxy s4 and i am very glad i did

I needed to add in a few .mov files to a ppt presentation (OR movies = not through itunes). 

Guess what? The

Updates make it nearly impossible to get an .movfile into the camera roll 

for keynote to access.

I called apple and they confirmed this and suggested i look at 3rd party apps 

as a work around

With much aggravation i did get 2 45 sec .mov files into keynote. 

Something that should be a simple

No brainer became a 6 hour headache

Thanks apple

I will watch your fall with interest. I have forbade my investment 

people from any apple stock

update: got a Samsung note 8 to replace ipad, improvement!