Last Call…

WCS 2010 Financial Summit for Doctors ends at 1PM EST today…

Yesterday was another day with two awesome guests, Dr. David Phillips, and Bruce Goldsmith. George Youssef and I will wrap it all up at 1PM EST. It’s been a great week. A very special thank you to all our guests and docs who have participated.

From a very concerned patient…National Health Plan?? – please read

Subject: National Health Plan?? – please read

Something I felt the need to pass along –
Please forward this to anyone you can think of, Republican or Democrat.Now, onto the doctor’s digest of the bill. If you read anything this year, read this:

The healthcare bill that Congress seems intent on passing is far worse and Orwellian than anything you might have imagined. I am not trying to be histrionic, the way people often get over just about anything. This is life-altering and, unlike most pieces of bad legislation, we will never be able to go back. A doctor (who is a friend of someone I know) has taken the time to read the 1000 page+ bill, something I don’t think a single politician has bothered to do. (Yesterday, John Conyers, a big proponent, actually said this:

“What good is reading the bill if its a thousand pages and you don’t have two days and two lawyers to find out what it means after you read the bill?” You can’t make this stuff up.) This doctor has done the work so we, as citizens, don’t have to all sit down and read the entire thing ourselves. What he found is
frightening in the extreme.

But before I get to his comments, let me disabuse you of one common lie about healthcare: that 46 million Americans are uninsured. Once you remove illegal aliens, the young or well-off who choose to self-insure, and those who are only
lack insurance for temporary periods (less than a year), the real number is closer to 8 million.

Please read what’s in the bill below. After you have read it, I hope you feel the need to call, write, or email your elected representatives. It’s effective, even if you know they won’t likely vote your way. To email, just type the politicians name into your browser, hit the first link, and then hit “contact.” If we can’t be bothered to stand up to something like this, then we truly deserve what we get. The whole process takes maybe 5 minutes.

The citings below are from the proposed house version of the healthcare bill.

[There is a link below to determine who your representatives are in the US House and US Senate. Please take a few minutes in the next day or say and call them to express your displeasure with this bill. Also, please forward this to your friends and ask them to do the same.]

BTW, I saved the best for last.


* Page 16: States that if you have insurance at the time of the bill becoming
law and change, you will be required to take a similar plan. If that is not
available, you will be required to take the govt option!
* Page 22: Mandates audits of all employers that self-insure!
* Page 29: Admission: your health care will be rationed!
* Page 42: The “Health Choices Commissioner” will decide health benefits for
you. You will have no choice. None.
* Page 50: All non-US citizens, illegal or not, will be provided with free
healthcare services.
* Page 58: Every person will be issued a National ID Healthcard.
* Page 59: The federal government will have direct, real-time access to all
individual bank accounts for electronic funds transfer.
* Page 65: Taxpayers will subsidize all union retiree20and community organizer
health plans (example: SEIU, UAW and ACORN)
* Page 72: All private healthcare plans must conform to government rules to
participate in a Healthcare Exchange.
* Page 84: All private healthcare plans must participate in the Healthcare
Exchange (i.e., total government control of private plans)
* Page 91: Government mandates linguistic infrastructure for services;
translation: illegal aliens
* Page 95: The Government will pay ACORN and Americorps to sign up individuals
for Government-run Health Care plan.
* Page 102: Those eligible for Medicaid will be automatically enrolled: you have
no choice in the matter.
* Page 124: No company can sue the government for price-fixing. No “judicial
review” is permitted against the government monopoly. Put simply, private
insurers will be crushed.
* Page 127: The AMA sold doctors out: the government will set wages.
* Page 145: An employer MUST auto-enroll employees into the government-run
public plan. No alternatives.
* Page 126: Employers MUST pay healthcare bills for part-time employees AND
their families.
* Page 149: Any employer with a payroll of $400K or more, who does not offer the
public option, pays an 8% tax on payroll <>BR * Page 150: Any employer with a
payroll of $250K-400K or more, who does not offer the public option, pays a 2 to
6% tax on payroll
* Page 167: Any individual who doesn’t’ have acceptable healthcare (according to
the government)20will be taxed 2.5% of income.
* Page 170: Any NON-RESIDENT alien is exempt from individual taxes
(Americans will pay for them). THIS ALREADY HAPPENS
* Page 195: Officers and employees of Government Healthcare Bureaucracy will
have access to ALL American financial and personal records.
* Page 203: “The tax imposed under this section shall not be treated as tax.”
Yes, it really says that.=2 0
* Page 239: Bill will reduce physician services for Medicaid. Seniors and the
poor most affected.”
* Page 241: Doctors: no matter what specialty you have, you’ll all be paid the
same (thanks, AMA!)
* Page 253: Government sets value of doctors’ time, their professional judgment,
etc. BTW, they do this to an extent now.
* Page 265: Government mandates and controls productivity for private healthcare
* Page 268: Government regulates rental and purchase of power-driven
* Page 272: Cancer patients: welcome to the wonderful world of rationing!
* Page 280: Hospitals will be penalized for what the government deems
preventable re-admissions.
* Page 298: Doctors: if you treat a patient during an initial admission that
results=2 0in a readmission, you will be penalized by the government.
* Page 317: Doctors: you are now prohibited for owning and investing in
healthcare companies!
* Page 318: Prohibition on hospital expansion. Hospitals cannot expand without
government approval.
* Page 321: Hospital expansion
hinges on “community” input: in other words, yet
another payoff for ACORN.
* Page 335: Government mandates establishment of outcome-based measures: i.e.,
* Page 341: Government has authority to disqualify Medicare Advantage Plans,
HMOs, etc.
* Page 379: More bureaucracy: Telehealth Advisory Committee (healthcare by
* Page 469: Community-based Home Medical Services: more payoffs for ACORN.
* Page 472: Payments to Community-based organizations: more payoffs=2 0for
* Page 489: Government will cover marriage and family therapy. Government
intervenes in your marriage.
* Page 494: Government will cover mental health services: defining, creating and
rationing those services.

The best of the best:

* Page 30: A government committee will decide what treatments and benefits you
get (and, unlike an insurer, there will be no appeals process).


* Page 354: Government will restrict enrollment of SPECIAL NEEDS individuals.
Can’t wait for them to decide only blue-eyed and blond haired people deserve
* Page 425: More bureaucracy: Advance Care Planning Consult: Senior Citizens,
assisted suicide, euthanasia?
* Page 425: Government will instruct and consult regarding living wills, durable
powers of attorney, etc. Mandatory. Appears to lock in estate taxes ahead of
* Page 425: Government provides approved list of end-of-life resources, gui
you in death.
* Page 427: Government mandates program that orders end-of-life treatment;
government dictates how your life ends.
* Page 429: Advance Care Planning Consult will be used to dictate treatment as
patient’s health deteriorates. This can include an ORDER for end-of-life plans.
* Page 430: Government will decide what level of treatments you may have at

Blueberries, vegetables and exercise, or cigars, sex and coffee…

The Secret of self-actualized life- is it blueberries, vegetables and exercise, or cigars, sex and coffee…

This past weekend, I finally got to wind down after our months long SuperConference build-up. It was a great event; most docs were ecstatic with the content and opportunities, despite the very harsh realities of private practice today. It was great to be with all my special friends who helped make this event so powerful.

In any event, another very special friend Dennis invited me on the water all day Friday and Patti and I to his Yacht Club Friday night. (Turns out, we’ll be joining!)

Friday morning, the fishing was great again, just off the Boston Harbor hotels, and airport runways. It’s a fabulous place, with tons of revolutionary war (and before) history, forts, burial grounds, etc.

Friday night, the four of us cruised the inner harbor, back on land for a couple drinks then had a fabulous dinner back at the club and tons of laughs together.

Then, Dennis asked me if I wanted to smoke a cigar with him. I must have had one hell of an expression, because he immediately began to tell me about studies on cigar smoking and longevity???

Huh? I read research every morning, but I missed that one!

So Dennis says “Its stress that kills us. Those that socialize, and have fun, maybe smoke a cigar and sip Scotch together, laugh and stay engaged, live longer, happier and healthier lives”.

So don’t you know it, look up the studies on centenarians in Cuba, and other countries too?

My take after reading these studies? They live simply, stay engaged in life fully for the moment only, and have moderate habits, nothing to excess. Interestingly, in Cuba, they smoke cigars, drink coffee, and still enjoy sex.

But most of all, they ENJOY all of life. Especially simple pleasures, friends and family. Most every day.

And thats it.

Boy, can we screw this one up, big time.

Look at the craziness some of us see everyday, people stressed out, never disengaged, or never shut off the cell phones and TV, bitch about everything, live sedentary, not outside enough.

Or some Docs that continually stress, never disengage long enough to really figure out who’s in charge of their life and practice, who they care or work for. No good systems or organization that really serves them, and their goals and dreams.

What a mess we are capable of creating!

But, there is an antidote. And it’s the very first step I often end up taking with new clients.

That is, to develop and work on and truly develop the essence of Practice by Design ™.

But if it’s really this simple, why do so many of us as very intelligent docs especially every practice day struggle with it?

I’m not really sure, but I can tell you a few things.

First, YOU have got to have complete design control in practice. This is really the most valuable part for me personally while working with my docs.

Next, staff needs firm, but still fun environments and goals. Very easy systems that still work (by design) when we all have those “no brain” days. And the government has made this one harder.

Three, patients need guidance, and the choice to accept or reject advice. When you can see them, what your game rules are. This must of course include finances. And, if they choose to reject your advice, why would you ever keep them under your care?

And you know what, it can be as simple as these three basic

But you must have the certainty, intestinal fortitude and underlying tools to pull this all off.

To that end, as Mr. Spock admonished me 40+ years ago, “live long, and prosper.”