Shortly before the final vote for passage of the Affordable Care Act, then Speaker of the House Nancy Pelosi famously declared, "We have to pass the bill so that you can find out what is in it.” How right she was. The surprises keep coming, with more sure to appear as the law continues to unfold and be implemented.
Brian Joondeph | All Articles
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Brian C Joondeph, MD, MPS is a Denver based retina surgeon, working both in private practice and academics, including several years in another country with nationalized healthcare. He is a recent graduate of a master's degree program in healthcare leadership from the University of Denver, and an advocate for smaller, more efficient government.
Joondeph has practiced for 23 years as a retina surgeon, working both in private practice and academics, including several years in another country with nationalized health care.
How would the events surrounding the Ferguson shooting have been reported without an alternative media? Suppose Fox News, talk radio, and blogs were shut down due to the Fairness Doctrine. There may have been a different story line if the mainstream media had their way without challenge or transparency. Here is how the Ferguson story might have been reported:
Enterovirus D68 (EV-D68) is one of over 100 non-polio enteroviruses, according to the CDC. For most people infected, it causes flu-like symptoms, mild to severe. It spreads just like the common cold virus, through coughing, sneezing, handshakes, or touching a surface touched by someone with the infection.
No sooner did two state governors wisely institute quarantine procedures for healthcare workers returning from West Africa Ebola “hot zones” then they promptly reversed course after pressure from the White House.
Most students either love or hate math. I fall in the former category, because love it or hate it, it is one of those subjects that is absolute. While there are many wrong answers there only one correct one. Math is not subject to interpretation and does not bend to the winds of political correctness. Numbers do not regard race, religion, gender, or sexual preference.
New Zealand is a small island nation in the South Pacific. They take their biosecurity seriously according to Ministry for Primary Industries: “Pests and diseases pose serious threats to our economy, environment, health and cultural identity.”
Should we be worried about Ebola? That's the question on the minds of many Americans given the first documented case on U.S. soil this week. And now there is a second possible case, someone having contact with Thomas Duncan, the first U.S. case of Ebola.
Thursday night NFL football is a welcome respite from the toil of the work week and from the politics of the 24-hour news shows. A chance to watch a modern day version of ancient gladiators engaged in physical battle to the cheers of a stadium full of supporters. Many fans played football as kids, quitting the game as the players grew in size and skill, until the cream rose to the top in the NFL. Watching the best do battle on Monday or Thursday night or Sunday is eagerly anticipated by millions of football fans eager for a few hours of escape to a form of fantasyland where they can embrace a passion and exuberance that is frowned upon in other areas of their lives.
Ongoing events in Ferguson, Missouri have raised the issue of the militarization of the police. The Department of Defense distributes surplus military equipment to U.S. police departments. In 2013, nearly half a billion dollars of equipment was distributed, ranging from pistols and rifles to armored personnel carriers used in Iraq and Afghanistan. This trend is well outlined in Radley Balko's recent book, Rise of the Warrior Cop. While on the surface this is a disturbing trend, there are other aspects to police militarization that are worth discussing.
American physician Dr. Kent Brantly, infected with the Ebola virus, recently returned to the United States for treatment. While he is improving, according to the director of the Centers of Disease control Dr. Tom Frieden, it is too soon to know whether he will survive this devastating infection. Nancy Writebol, a coworker of Dr. Brantly, also infected with Ebola, will be transported to the U.S. later this week. Should we be worried? Is this a real life version of the new TV series "The Strain"?
We rely on the FDA to protect public health "by assuring the safety, efficacy, and security” of medical drugs and devices. The FDA takes its marching orders from Congress via the legislative process. One such law is the Compounding Quality Act of 2013, passed in response to a series of fatal infections due to improper compounding pharmacy processes. While such oversight is important and well meaning, the unintended consequences may be profound.
Our southern border is leaking like a sieve, with immigrants illegally entering the U.S. from Mexico, Central America, and who knows where. Along with the huddled masses of refugees comes a host of communicable diseases such as tuberculosis, scabies, hepatitis, and chicken pox. The public health implications are staggering as these refugees, along with their diseases, are being sent all over the country, where they can share their pathogens with everyone they come in contact with. Does anyone remember the flu pandemic from almost 100 years ago where 50 million people died, including 675,000 in the U.S?
As the VA scandal unfolds, with continued revelations of secret waitlists and delayed or denied medical care, calls have been building Veterans Affairs Secretary Eric Shinseki to resign. Today he did just that, resigning because, “He had become a distraction as the department struggles.”
Secretary of State John Kerry met with French Foreign Minister Laurent Fabius this week to discuss economic issues. In joint remarks prior to their meeting, one might expect to hear about pressing world economic concerns such as national debt, inflation, or unemployment. Instead the first comment from the French Foreign Minister was about climate change. In French, undoubtedly for the benefit of the French-speaking Mr. Kerry, the Fabius told the gathering, “We have 500 days to avoid the climate chaos.”
A Veterans Administration hospital in Fort Collins Colorado, it was recently revealed, falsified its wait times for outpatient clinic appointments. In order to appear to meet the goal of clinic appointments within 14 days, the hospital taught its clerks how to falsify the appointment records to create the illusion that the appointment goals were being met. Many of the 6,300 veterans treated at this clinic actually waited months for their appointments. Yet the clinic clerks were required to “cook the books” else they were punished by being placed on a “bad boy list.” Aside from the moral outrage of treating our veterans in such a callous manner, this episode provides a glimpse of coming attractions for health care delivery in the US.
IRS agents, delinquent in paying their own taxes, are awarded bonuses and extra time off.
President Obama gloated over the administration's figure that 7.1 million individuals enrolled in Obamacare. Time described his speech as, “A celebratory turn before the cameras.” Remember when the media last swooned over premature presidential comments? How about President George W Bush’s “Mission Accomplished” speech ten years ago?
Peeling back the layers of the Affordable Care Act onion once again reveals another surprise, this time a delay in the individual mandate. This is the same individual mandate that the Washington Post editorial board claimed, “Holds the key to health-care reform.” And the fourth time President Obama has delayed his signature piece of legislation in the same manner he chastised Republicans for trying to do.
Congress enacted the Sustainable Growth Rate (SGR) formula in 1997 as part of the Balanced Budget Act of that same year. Designed to limit the growth in Medicare spending for physician services, it is tied to projected growth in GDP.