Re: Politics
153Cali:
The comment on that sign was originally made by Sarah Palin.
Anybody that steals Palin's material is alright by me. Even if they are in San Fran.
The comment on that sign was originally made by Sarah Palin.
Anybody that steals Palin's material is alright by me. Even if they are in San Fran.
Re: Politics
154Both sides are a bunch of A**holes.
They bring us brilliance such as this:
http://www.wired.com/dangerroom/2011/12 ... er+Room%29
They bring us brilliance such as this:
http://www.wired.com/dangerroom/2011/12 ... er+Room%29
Re: Politics
155Hillbilly wrote:Cali:
The comment on that sign was originally made by Sarah Palin.
Anybody that steals Palin's material is alright by me. Even if they are in San Fran.
Come to think of it, that does sound Palinesque. The same SUV had a "HurriCain 2012" bumper sticker, and a "Reagan was Right" sticker.
Re: Politics
156VT'er wrote:Both sides are a bunch of A**holes.
They bring us brilliance such as this:
http://www.wired.com/dangerroom/2011/12 ... er+Room%29
Which is ironic. After all, Obama approved of the execution without trial of Anwar al-Awlaki, al-Qaida’s YouTube preacher, based entirely on the unproven assertion that Awlaki was dangerous. Awlaki was an American citizen. So Obama thinks he has the right to kill Americans the government says are terrorists, but he doesn’t want the military to lock them up forever without trial. OK then.
Weirder still, the bill’s chief architect, Sen. Carl Levin (D-Mich.), tried to persuade skeptics that the bill wasn’t so bad. His pitch? “The requirement to detain a person in military custody under this section does not extend to citizens of the United States,” he said on the Senate floor on Monday. The bill would just let the government detain a citizen in military custody, not force it to do that. Reassured yet?
Civil libertarians aren’t. Sen. Al Franken (D-Minn.) said it “denigrates the very foundations of this country.” Sen. Rand Paul (R-Ky.) added, “it puts every single American citizen at risk.”
I suspect they'll get that cleaned up. Conflicting stuff from both sides of the aisle. We all want personal liberties preserved to the max, and we all want the country safe to the max. Those gray areas are tough to resolve, sometimes.
Re: Politics
157http://www.youtube.com/user/TVman1981
This was a short local newscast story on KRON4 in San Francisco this morning.
A "lighthearted" look at "inside Occupy San Francisco."
Interesting when San Francisco on air journalists go forth to discredit the "occupy movement."
This was a short local newscast story on KRON4 in San Francisco this morning.
A "lighthearted" look at "inside Occupy San Francisco."
Interesting when San Francisco on air journalists go forth to discredit the "occupy movement."
Re: Politics
158Santa Claus came to town early this year -- in "secret" fashion -- spreading good tidings of great joy in one unlikely place -- the U.S. Senate.
Most gift-givers would probably give lawmakers lumps of coal at this point -- and the black gem actually did surface in Monday night's mystery gift exchange so common to many workplaces.
But senators participating in the "Secret Santa" exchange kept it mostly safe this season, sticking to their inner circle in a bipartisan manner that seemed to vanquish the partisan Scrooginess -- however fleetingly -- that has haunted the corridors of the Capitol all year.
On Dasher! On Dancer!
One by one, senators gleefully distributed their holiday gifts, most with a home state theme, some modeling their treasure as if it were a Red Rider BB Gun ("with the compass in the stock and this thing which tells time").
Sixty-one members fell under the influence of Yuletide cheer as each unmasked his and her Secret Santa, a creation of Sens. Al Franken, D-Minn., Mike Johanns, R-Neb, and a handful of their colleagues.
Best in show (after all, these are competitive people) has to go to West Virginia's Joe Manchin who gave his fellow Democrat, Chuck Schumer, a natural resource from The Mountain State paired with a little riddle attached to cloak his identity: "With the Senate in a deadlock with 8 percent approval ratings, what we deserve is a lump of coal ... We should be working in a bipartisan way."
Schumer quickly sussed out his Secret Santa and bounced out of the gift room giddy with excitement.
"Look! Carved out of coal!" city-boy Schumer marveled with a wide-eyed smile as he paraded around, a la Vanna White, a tiny donkey and elephant carved from the combustible substance. Reporters, happy to cover something besides the payroll tax, oogled the bounty, noticing that each felt hard and smooth like plastic.
"That's the firing process after they're polished," Manchin schooled the naive city-dwelling press corps.
Funny enough, that wasn't the only gift of coal.
Pulling his gifts from a brown paper sack worthy of Chinese takeout, Manchin proudly showed off an old, gray gym sock. As reporters looked on quizzically, the former governor extracted a baggie with three large, black lumps.
"Coal!" Manchin hooted enthusiastically. "They have it in Colorado, too!"
Quite the learning experience for the normally cynical scribes, who couldn't help but share in a bit of the excitement, despite the mocking of some even more cynical staffers.
Indeed, The Centennial State's Mark Udall was Manchin's Secret Santa, though he made the gift a little easier to swallow with a six-pack of Colorado "Snow Day" beer and hiking socks (Udall is an avid mountain climber).
For a brief moment, the Mansfield Room just off the Senate floor resembled the living room of Ralphie and Randy -- minus the Zeppelin and pink bunny PJs. Gifts were stacked high on table tops, many certainly in breech of the Secret Santa decree that they be valued under $10, like the $20 Barnes and Noble gift card for Wyoming's John Barrasso. Senators eagerly searched for their loot.
"Wicker! One of those with an 'er'," cried Sen. Dianne Feinstein, D-Calif., as she revealed the recipient of her gift and revealed a slightly-challenged knowledge of her conservative brethren (she first said Vitter).
Sen. Roger Wicker of Mississippi is now the proud owner of "Unbroken" by "Seabiscuit" author Lauren Hillenbrand. It's a World War II true story of survival.
The second prize for the gift of creativity (if not thriftiness) would have to go to Sen. Kent Conrad, D-N.D., though the recipient of his gift likely wouldn't agree.
"Look, I think we have to all tighten our belts ... because of the European debt crisis," the wonky Banking Committee chairman said after delivering an empty box that once housed popcorn (that coal was looking better and better). Conrad actually re-gifted the box to Louisiana's Mary Landrieu -- Dick Durbin's name apparently was still on the present.
For Conrad, his gift was a campaign-related promise fulfilled. The senator once told Kay Bailey Hutchison, if she won her race for Texas governor, he'd take on the job as top cop of her Border Patrol. And though KBH lost to Rick Perry, she brought the chairman a token, anyway -- a black and white hat emblazoned with his would-be employer: Texas Border Patrol. Four gold stars adorned the brim. A card attached read simply, "Keeping my promise."
A little last-minute homework assignment for Secret Santa Schumer resulted in a bottle of the famous Original Anchor Bar buffalo wing sauce for Johanns. The Nebraska Republican's response? "Way cool!"
Sen. Kirsten Gillibrand waved around her "unbreakable Christmas ornament" - a hand-painted, red and white ball.
"Important for a household with a 3-year old," the New York mom said. But her Secret Santa kept up the mystery, with no name tag included. Never fear, though. The crafty press corps, exercising some well-honed (albeit rusty, at this point) reporting skills, discovered an artist's signature card inside the box with the area code "251" - Alabama!
And since this reporter had already spotted Richard Shelby, the senior Alabama senator, with a large, gift-wrapped rectangular box, she deduced Jeff Sessions -- Alabama's junior senator -- had to be the giver.
Reporters marveled at Jay Rockefeller who said he had shopped for his own gift. The millionaire Dem then returned from the gift room with his mouth full, chocolate staining his lips, carrying a red sack with gifts from the Indiannapolis Motor Speedway courtesy of Dick Lugar.
"Dick is now responsible for the 25 pounds I'm going to gain," the West Virginia Dem mumbled, still slurping the sweet treat.
Ohio's Rob Portman, trailing a strong scent of cinnamon, showed off two boxes, one with Moravian (by way of North Carolina) sugar cake and the other with spice cookies from his Secret Santa, Kay Hagan.
"My wife's gonna love this," said the former Bush administration OMB director.
If only his experience on the Super Committee had gone so well. Great Lakes beer from Portman to Rockies' dwelling Mike Bennet. "We make beer!" said the Ohio senator to a skeptical press corps.
From Ben Nelson - a $10 coffee card tucked in a cute little green and red felt mini-stocking for North Dakota's Tim Johnson.
A bottle of Oregon wine for Sen. David Vitter, R-La.
From Dick Blumenthal, cookies for Lugar.
"Merry Christmas!" the Connecticut Dem wished his colleague.
Macadamia nuts and coffee from Hawaii's Dan Inouye for Ben Nelson. Mela Kalikimaka.
Dick Durbin bought "Lincoln's War" for fellow Dem Bob Casey. A long note inside clearly touched the Pennsylvania senator, who held the book tightly, saying only, "Oh that's very nice. Very nice."
A three-pack of salsa from the Lone Star State's John Cornyn to Chris Coons, who often exercises with the Texas Republican. "Very generous but profoundly subversive to my dietary aspirations," joked the Delaware Dem.
Sen John Hoeven, R-N.D., got ear buds in the shape of bees.
Pure milk chocolate almond bark to Sen. Amy Klobuchar from Massachusetts Scott Brown, made by his state's famous Trappistine Nuns.
"Wishing you a wild and scenic Christmas," read the card on the Penguin wrapping paper enveloping the gift from Klobuchar. The Minnesota Dem arrived too late for recipient Jeff Bingaman of New Mexico. No hints at the box's content.
All in all, the event appeared to be a smashing success. If only the end-of-year legislative process could go so well.
O Come All Ye Faithful...
Most gift-givers would probably give lawmakers lumps of coal at this point -- and the black gem actually did surface in Monday night's mystery gift exchange so common to many workplaces.
But senators participating in the "Secret Santa" exchange kept it mostly safe this season, sticking to their inner circle in a bipartisan manner that seemed to vanquish the partisan Scrooginess -- however fleetingly -- that has haunted the corridors of the Capitol all year.
On Dasher! On Dancer!
One by one, senators gleefully distributed their holiday gifts, most with a home state theme, some modeling their treasure as if it were a Red Rider BB Gun ("with the compass in the stock and this thing which tells time").
Sixty-one members fell under the influence of Yuletide cheer as each unmasked his and her Secret Santa, a creation of Sens. Al Franken, D-Minn., Mike Johanns, R-Neb, and a handful of their colleagues.
Best in show (after all, these are competitive people) has to go to West Virginia's Joe Manchin who gave his fellow Democrat, Chuck Schumer, a natural resource from The Mountain State paired with a little riddle attached to cloak his identity: "With the Senate in a deadlock with 8 percent approval ratings, what we deserve is a lump of coal ... We should be working in a bipartisan way."
Schumer quickly sussed out his Secret Santa and bounced out of the gift room giddy with excitement.
"Look! Carved out of coal!" city-boy Schumer marveled with a wide-eyed smile as he paraded around, a la Vanna White, a tiny donkey and elephant carved from the combustible substance. Reporters, happy to cover something besides the payroll tax, oogled the bounty, noticing that each felt hard and smooth like plastic.
"That's the firing process after they're polished," Manchin schooled the naive city-dwelling press corps.
Funny enough, that wasn't the only gift of coal.
Pulling his gifts from a brown paper sack worthy of Chinese takeout, Manchin proudly showed off an old, gray gym sock. As reporters looked on quizzically, the former governor extracted a baggie with three large, black lumps.
"Coal!" Manchin hooted enthusiastically. "They have it in Colorado, too!"
Quite the learning experience for the normally cynical scribes, who couldn't help but share in a bit of the excitement, despite the mocking of some even more cynical staffers.
Indeed, The Centennial State's Mark Udall was Manchin's Secret Santa, though he made the gift a little easier to swallow with a six-pack of Colorado "Snow Day" beer and hiking socks (Udall is an avid mountain climber).
For a brief moment, the Mansfield Room just off the Senate floor resembled the living room of Ralphie and Randy -- minus the Zeppelin and pink bunny PJs. Gifts were stacked high on table tops, many certainly in breech of the Secret Santa decree that they be valued under $10, like the $20 Barnes and Noble gift card for Wyoming's John Barrasso. Senators eagerly searched for their loot.
"Wicker! One of those with an 'er'," cried Sen. Dianne Feinstein, D-Calif., as she revealed the recipient of her gift and revealed a slightly-challenged knowledge of her conservative brethren (she first said Vitter).
Sen. Roger Wicker of Mississippi is now the proud owner of "Unbroken" by "Seabiscuit" author Lauren Hillenbrand. It's a World War II true story of survival.
The second prize for the gift of creativity (if not thriftiness) would have to go to Sen. Kent Conrad, D-N.D., though the recipient of his gift likely wouldn't agree.
"Look, I think we have to all tighten our belts ... because of the European debt crisis," the wonky Banking Committee chairman said after delivering an empty box that once housed popcorn (that coal was looking better and better). Conrad actually re-gifted the box to Louisiana's Mary Landrieu -- Dick Durbin's name apparently was still on the present.
For Conrad, his gift was a campaign-related promise fulfilled. The senator once told Kay Bailey Hutchison, if she won her race for Texas governor, he'd take on the job as top cop of her Border Patrol. And though KBH lost to Rick Perry, she brought the chairman a token, anyway -- a black and white hat emblazoned with his would-be employer: Texas Border Patrol. Four gold stars adorned the brim. A card attached read simply, "Keeping my promise."
A little last-minute homework assignment for Secret Santa Schumer resulted in a bottle of the famous Original Anchor Bar buffalo wing sauce for Johanns. The Nebraska Republican's response? "Way cool!"
Sen. Kirsten Gillibrand waved around her "unbreakable Christmas ornament" - a hand-painted, red and white ball.
"Important for a household with a 3-year old," the New York mom said. But her Secret Santa kept up the mystery, with no name tag included. Never fear, though. The crafty press corps, exercising some well-honed (albeit rusty, at this point) reporting skills, discovered an artist's signature card inside the box with the area code "251" - Alabama!
And since this reporter had already spotted Richard Shelby, the senior Alabama senator, with a large, gift-wrapped rectangular box, she deduced Jeff Sessions -- Alabama's junior senator -- had to be the giver.
Reporters marveled at Jay Rockefeller who said he had shopped for his own gift. The millionaire Dem then returned from the gift room with his mouth full, chocolate staining his lips, carrying a red sack with gifts from the Indiannapolis Motor Speedway courtesy of Dick Lugar.
"Dick is now responsible for the 25 pounds I'm going to gain," the West Virginia Dem mumbled, still slurping the sweet treat.
Ohio's Rob Portman, trailing a strong scent of cinnamon, showed off two boxes, one with Moravian (by way of North Carolina) sugar cake and the other with spice cookies from his Secret Santa, Kay Hagan.
"My wife's gonna love this," said the former Bush administration OMB director.
If only his experience on the Super Committee had gone so well. Great Lakes beer from Portman to Rockies' dwelling Mike Bennet. "We make beer!" said the Ohio senator to a skeptical press corps.
From Ben Nelson - a $10 coffee card tucked in a cute little green and red felt mini-stocking for North Dakota's Tim Johnson.
A bottle of Oregon wine for Sen. David Vitter, R-La.
From Dick Blumenthal, cookies for Lugar.
"Merry Christmas!" the Connecticut Dem wished his colleague.
Macadamia nuts and coffee from Hawaii's Dan Inouye for Ben Nelson. Mela Kalikimaka.
Dick Durbin bought "Lincoln's War" for fellow Dem Bob Casey. A long note inside clearly touched the Pennsylvania senator, who held the book tightly, saying only, "Oh that's very nice. Very nice."
A three-pack of salsa from the Lone Star State's John Cornyn to Chris Coons, who often exercises with the Texas Republican. "Very generous but profoundly subversive to my dietary aspirations," joked the Delaware Dem.
Sen John Hoeven, R-N.D., got ear buds in the shape of bees.
Pure milk chocolate almond bark to Sen. Amy Klobuchar from Massachusetts Scott Brown, made by his state's famous Trappistine Nuns.
"Wishing you a wild and scenic Christmas," read the card on the Penguin wrapping paper enveloping the gift from Klobuchar. The Minnesota Dem arrived too late for recipient Jeff Bingaman of New Mexico. No hints at the box's content.
All in all, the event appeared to be a smashing success. If only the end-of-year legislative process could go so well.
O Come All Ye Faithful...
Re: Politics
159VT'er:
Remember a while back I was venting about activist judges and we talked about it a little bit?
As you may know, Newt made a controversial comment about this subject in last weeks Fox News Debate, and there has been alot of talk about it the last several days.
http://www.newt.org/news/mentioned-deba ... ist-judges
I dunno if you might be interested but Newt and his staff has written a 50+ page paper on this subject. I think whether you agree with him or not it is very interesting reading. And educational.
Thought I'd share in case anybody has some time to kill and is interested...
http://www.newt.org/sites/newt.org/files/Courts.pdf
Remember a while back I was venting about activist judges and we talked about it a little bit?
As you may know, Newt made a controversial comment about this subject in last weeks Fox News Debate, and there has been alot of talk about it the last several days.
http://www.newt.org/news/mentioned-deba ... ist-judges
I dunno if you might be interested but Newt and his staff has written a 50+ page paper on this subject. I think whether you agree with him or not it is very interesting reading. And educational.
Thought I'd share in case anybody has some time to kill and is interested...
http://www.newt.org/sites/newt.org/files/Courts.pdf
Re: Politics
160Wish I had time to read the longer thing ... maybe in a couple of weeks.
I'm not sure it's so obvious that there is one exact proper balance of the powers of the three branches, so there will always be disagreement. in this sense I think Gingerich's position is valid. That is, it's fine to say, Let the Congress make the laws; have the Executive branch see that they are carried out; call in the Courts when there seems to be an inappropriate law, or lack of appropriate enforcement. There will always be disagreements about HOW much activism by the courts is TOO much. There is justifiable criticism from both sides, too, not just from the right. (Of course, it looks to me as if most court activism is an attempt to be "progressive" and hence is aligned with the goals of the left.)
I must say, the struggle for the Repub nomination is much more interesting when Gingerich is involved.
I'm not sure it's so obvious that there is one exact proper balance of the powers of the three branches, so there will always be disagreement. in this sense I think Gingerich's position is valid. That is, it's fine to say, Let the Congress make the laws; have the Executive branch see that they are carried out; call in the Courts when there seems to be an inappropriate law, or lack of appropriate enforcement. There will always be disagreements about HOW much activism by the courts is TOO much. There is justifiable criticism from both sides, too, not just from the right. (Of course, it looks to me as if most court activism is an attempt to be "progressive" and hence is aligned with the goals of the left.)
I must say, the struggle for the Repub nomination is much more interesting when Gingerich is involved.
Re: Politics
161J.R.:
In response to your message to Cali in the articles folder ....
One of these days we are going to have to talk about the power of consumer activism.
Search up "Peter Lewis" one of these days. He inherited the progressive insurance company from his father and is still chairman of the board of Progressive Corporation. He has given tens of millions of dollars to far left enterprises. From some of the more main stream like the ACLU and Move On, to more of the extreme like projects by the thugs at SEIU and ACORN.
He earmarked a large portion of money he gave the ACLU to be used in law suits against school districts who have drug testing policies and has worked hard for legalizing marijuana. (Which always made some of us wonder if he minded if his employees at Progressive showed up stoned and drove those white company cars around)
He was a spoiled stoner 60's rich kid who has made a lifetime out of destroying what many of us Americans hold dear. So don't be shocked if there are a few guys like me and Cali around who wouldn't give that guy or anything associated with him a dime.
In response to your message to Cali in the articles folder ....
One of these days we are going to have to talk about the power of consumer activism.
Search up "Peter Lewis" one of these days. He inherited the progressive insurance company from his father and is still chairman of the board of Progressive Corporation. He has given tens of millions of dollars to far left enterprises. From some of the more main stream like the ACLU and Move On, to more of the extreme like projects by the thugs at SEIU and ACORN.
He earmarked a large portion of money he gave the ACLU to be used in law suits against school districts who have drug testing policies and has worked hard for legalizing marijuana. (Which always made some of us wonder if he minded if his employees at Progressive showed up stoned and drove those white company cars around)
He was a spoiled stoner 60's rich kid who has made a lifetime out of destroying what many of us Americans hold dear. So don't be shocked if there are a few guys like me and Cali around who wouldn't give that guy or anything associated with him a dime.
Re: Politics
162But Progressive paid for the naming rights for the field. I don't think they make any money if anyone shows up or not. Also, I have a few friends and relatives who have good jobs with them. Politics is, was and always will be about money.
Re: Politics
163Thanks, Hillbilly.
I appreciate the backup, but in all honesty that's a bit deeper than my on the cuff intent.
I just get sick of seeing "Flo" in inane commercials for Progressive all the time. Nearly as much as I hate seeing that damned Brit accent lizard for Geico over and over again....AND hearing on the radio.
Don't get me started on the AFLAC duck.
I'm all for business, but damn those "insurance" companies have large budgets for advertising.
I appreciate the backup, but in all honesty that's a bit deeper than my on the cuff intent.
I just get sick of seeing "Flo" in inane commercials for Progressive all the time. Nearly as much as I hate seeing that damned Brit accent lizard for Geico over and over again....AND hearing on the radio.
Don't get me started on the AFLAC duck.
I'm all for business, but damn those "insurance" companies have large budgets for advertising.
Re: Politics
164http://finance.yahoo.com/news/small-bus ... 00127.html
Small Business: Doctors going broke
CNNMoney.com
By Parija Kavilanz | CNNMoney.com – 22 hours ago
Doctors in America are harboring an embarrassing secret: Many of them are going broke.
This quiet reality, which is spreading nationwide, is claiming a wide range of casualties, including family physicians, cardiologists and oncologists.
Industry watchers say the trend is worrisome. Half of all doctors in the nation operate a private practice. So if a cash crunch forces the death of an independent practice, it robs a community of a vital health care resource.
"A lot of independent practices are starting to see serious financial issues," said Marc Lion, CEO of Lion & Company CPAs, LLC, which advises independent doctor practices about their finances.
Doctors list shrinking insurance reimbursements, changing regulations, rising business and drug costs among the factors preventing them from keeping their practices afloat. But some experts counter that doctors' lack of business acumen is also to blame.
Loans to make payroll: Dr. William Pentz, 47, a cardiologist with a Philadelphia private practice, and his partners had to tap into their personal assets to make payroll for employees last year. "And we still barely made payroll last paycheck," he said. "Many of us are also skimping on our own pay."
Pentz said recent steep 35% to 40% cuts in Medicare reimbursements for key cardiovascular services, such as stress tests and echocardiograms, have taken a substantial toll on revenue. "Our total revenue was down about 9% last year compared to 2010," he said.
"These cuts have destabilized private cardiology practices," he said. "A third of our patients are on Medicare. So these Medicare cuts are by far the biggest factor. Private insurers follow Medicare rates. So those reimbursements are going down as well."
12 entrepreneurs reinventing health care
Pentz is thinking about an out. "If this continues, I might seriously consider leaving medicine," he said. "I can't keep working this way."
Also on his mind, the impending 27.4% Medicare pay cut for doctors. "If that goes through, it will put us under," he said.
Federal law requires that Medicare reimbursement rates be adjusted annually based on a formula tied to the health of the economy. That law says rates should be cut every year to keep Medicare financially sound.
Although Congress has blocked those cuts from happening 13 times over the past decade, most recently on Dec. 23 with a two-month temporary "patch," this dilemma continues to haunt doctors every year.
Beau Donegan, senior executive with a hospital cancer center in Newport Beach, Calif., is well aware of physicians' financial woes.
"Many are too proud to admit that they are on the verge of bankruptcy," she said. "These physicians see no way out of the downward spiral of reimbursement, escalating costs of treating patients and insurance companies deciding when and how much they will pay them."
Donegan knows an oncologist "with a stellar reputation in the community" who hasn't taken a salary from his private practice in over a year. He owes drug companies $1.6 million, which he wasn't reimbursed for.
Dr. Neil Barth is that oncologist. He has been in the top 10% of oncologists in his region, according to U.S. News Top Doctors' ranking. Still, he is contemplating personal bankruptcy.
That move could shutter his 31-year-old clinical practice and force 6,000 cancer patients to look for a new doctor.
Changes in drug reimbursements have hurt him badly. Until the mid-2000's, drugs sales were big profit generators for oncologists.
In oncology, doctors were allowed to profit from drug sales. So doctors would buy expensive cancer drugs at bulk prices from drugmakers and then sell them at much higher prices to their patients.
"I grew up in that system. I was spending $1.5 million a month on buying treatment drugs," he said. In 2005, Medicare revised the reimbursement guidelines for cancer drugs, which effectively made reimbursements for many expensive cancer drugs fall to less than the actual cost of the drugs.
"Our reimbursements plummeted," Barth said.
Still, Barth continued to push ahead with innovative research, treating patients with cutting-edge expensive therapies, accepting patients who were underinsured only to realize later that insurers would not pay him back for much of his care.
"I was $3.2 million in debt by mid 2010," said Barth. "It was a sickening feeling. I could no longer care for patients with catastrophic illnesses without scrutinizing every penny first."
He's since halved his debt and taken on a second job as a consultant to hospitals. But he's still struggling and considering closing his practice in the next six months.
"The economics of providing health care in this country need to change. It's too expensive for doctors," he said. "I love medicine. I will find a way to refinance my debt and not lose my home or my practice."
If he does declare bankruptcy, he loses all of it and has to find a way to start over at 60. Until then, he's turning away new patients whose care he can no longer subsidize.
"I recently got a call from a divorced woman with two kids who is unemployed, house in foreclosure with advanced breast cancer," he said. "The moment has come to this that you now say, 'sorry, we don't have the capacity to care for you.' "
Small business 101: A private practice is like a small business. "The only thing different is that a third party, and not the customer, is paying for the service," said Lion.
"Many times I shake my head," he said. "Doctors are trained in medicine but not how to run a business." His biggest challenge is getting doctors to realize where and how their profits are leaking.
"On average, there's a 10% to 15% profit leak in a private practice," he said. Much of that is tied to money owed to the practice by patients or insurers. "This is also why they are seeing a cash crunch."
My biggest tax nightmare!
Dr. Mike Gorman, a family physician in Loganvale, Nev., recently took out an SBA loan to keep his practice running and pay his five employees.
"It is embarrassing," he said. "Doctors don't want to talk about being in debt." But he's planning a new strategy to deal with his rising business expenses and falling reimbursements.
"I will see more patients, but I won't check all of their complaints at one time," he explained. "If I do, insurance will bundle my reimbursement into one payment." Patients will have to make repeat visits -- an arrangement that he acknowledges is "inconvenient."
"This system pits doctor against patient," he said. "But it's the only way to beat the system and get paid."
--- Are you a doctor who has made financial decisions you came to regret?
E-mail Parija Kavilanzand you could be part of an upcoming article. Click here for CNNMoney.com comment policy.
Small Business: Doctors going broke
CNNMoney.com
By Parija Kavilanz | CNNMoney.com – 22 hours ago
Doctors in America are harboring an embarrassing secret: Many of them are going broke.
This quiet reality, which is spreading nationwide, is claiming a wide range of casualties, including family physicians, cardiologists and oncologists.
Industry watchers say the trend is worrisome. Half of all doctors in the nation operate a private practice. So if a cash crunch forces the death of an independent practice, it robs a community of a vital health care resource.
"A lot of independent practices are starting to see serious financial issues," said Marc Lion, CEO of Lion & Company CPAs, LLC, which advises independent doctor practices about their finances.
Doctors list shrinking insurance reimbursements, changing regulations, rising business and drug costs among the factors preventing them from keeping their practices afloat. But some experts counter that doctors' lack of business acumen is also to blame.
Loans to make payroll: Dr. William Pentz, 47, a cardiologist with a Philadelphia private practice, and his partners had to tap into their personal assets to make payroll for employees last year. "And we still barely made payroll last paycheck," he said. "Many of us are also skimping on our own pay."
Pentz said recent steep 35% to 40% cuts in Medicare reimbursements for key cardiovascular services, such as stress tests and echocardiograms, have taken a substantial toll on revenue. "Our total revenue was down about 9% last year compared to 2010," he said.
"These cuts have destabilized private cardiology practices," he said. "A third of our patients are on Medicare. So these Medicare cuts are by far the biggest factor. Private insurers follow Medicare rates. So those reimbursements are going down as well."
12 entrepreneurs reinventing health care
Pentz is thinking about an out. "If this continues, I might seriously consider leaving medicine," he said. "I can't keep working this way."
Also on his mind, the impending 27.4% Medicare pay cut for doctors. "If that goes through, it will put us under," he said.
Federal law requires that Medicare reimbursement rates be adjusted annually based on a formula tied to the health of the economy. That law says rates should be cut every year to keep Medicare financially sound.
Although Congress has blocked those cuts from happening 13 times over the past decade, most recently on Dec. 23 with a two-month temporary "patch," this dilemma continues to haunt doctors every year.
Beau Donegan, senior executive with a hospital cancer center in Newport Beach, Calif., is well aware of physicians' financial woes.
"Many are too proud to admit that they are on the verge of bankruptcy," she said. "These physicians see no way out of the downward spiral of reimbursement, escalating costs of treating patients and insurance companies deciding when and how much they will pay them."
Donegan knows an oncologist "with a stellar reputation in the community" who hasn't taken a salary from his private practice in over a year. He owes drug companies $1.6 million, which he wasn't reimbursed for.
Dr. Neil Barth is that oncologist. He has been in the top 10% of oncologists in his region, according to U.S. News Top Doctors' ranking. Still, he is contemplating personal bankruptcy.
That move could shutter his 31-year-old clinical practice and force 6,000 cancer patients to look for a new doctor.
Changes in drug reimbursements have hurt him badly. Until the mid-2000's, drugs sales were big profit generators for oncologists.
In oncology, doctors were allowed to profit from drug sales. So doctors would buy expensive cancer drugs at bulk prices from drugmakers and then sell them at much higher prices to their patients.
"I grew up in that system. I was spending $1.5 million a month on buying treatment drugs," he said. In 2005, Medicare revised the reimbursement guidelines for cancer drugs, which effectively made reimbursements for many expensive cancer drugs fall to less than the actual cost of the drugs.
"Our reimbursements plummeted," Barth said.
Still, Barth continued to push ahead with innovative research, treating patients with cutting-edge expensive therapies, accepting patients who were underinsured only to realize later that insurers would not pay him back for much of his care.
"I was $3.2 million in debt by mid 2010," said Barth. "It was a sickening feeling. I could no longer care for patients with catastrophic illnesses without scrutinizing every penny first."
He's since halved his debt and taken on a second job as a consultant to hospitals. But he's still struggling and considering closing his practice in the next six months.
"The economics of providing health care in this country need to change. It's too expensive for doctors," he said. "I love medicine. I will find a way to refinance my debt and not lose my home or my practice."
If he does declare bankruptcy, he loses all of it and has to find a way to start over at 60. Until then, he's turning away new patients whose care he can no longer subsidize.
"I recently got a call from a divorced woman with two kids who is unemployed, house in foreclosure with advanced breast cancer," he said. "The moment has come to this that you now say, 'sorry, we don't have the capacity to care for you.' "
Small business 101: A private practice is like a small business. "The only thing different is that a third party, and not the customer, is paying for the service," said Lion.
"Many times I shake my head," he said. "Doctors are trained in medicine but not how to run a business." His biggest challenge is getting doctors to realize where and how their profits are leaking.
"On average, there's a 10% to 15% profit leak in a private practice," he said. Much of that is tied to money owed to the practice by patients or insurers. "This is also why they are seeing a cash crunch."
My biggest tax nightmare!
Dr. Mike Gorman, a family physician in Loganvale, Nev., recently took out an SBA loan to keep his practice running and pay his five employees.
"It is embarrassing," he said. "Doctors don't want to talk about being in debt." But he's planning a new strategy to deal with his rising business expenses and falling reimbursements.
"I will see more patients, but I won't check all of their complaints at one time," he explained. "If I do, insurance will bundle my reimbursement into one payment." Patients will have to make repeat visits -- an arrangement that he acknowledges is "inconvenient."
"This system pits doctor against patient," he said. "But it's the only way to beat the system and get paid."
--- Are you a doctor who has made financial decisions you came to regret?
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Re: Politics
165The class warfare being waged by the left is taking a toll on some doctors. The cuts in medicare are extremely worrisome. Alot of doctors are simply going to have to quit seeing medicare patients if cuts keep up.
J.R.:
With the holidays & stuff I got doing other things and forgot about your post. When I came here to read Cali's article I saw it and remembered. Just wanted to say you are right. It's not like Progressive is making any money from ticket sales. I just assume, and apparently wrongly, that Cali was like me and hated the Progressive name on the park for personal reasons. Wouldn't stop me personally from going to the park but I have always hated the name change. Wouldn't hurt my feelings if some refused to go for that reason. Peter Lewis is absolutely the epitome of what is wrong with this country, IMO.
Cali:
Pardon me for assuming you had a well thought out and intelligent reason for hating the Progressive Company. My apologies.
What company does have good commercials nowadays? I wear my DVR out and rarely watch live TV anymore cause I love fast forwarding through the lame ass commercials.
I tell you who takes the cake for absolute worse .... McDonalds. My goodness how far they have fallen. Their ads are so freakin lame anymore. Not funny, not witty, not .... man, I dunno, just total boring and lame. They need to fire their ad company and start over. That dingbat in the Progressive Commercials is extremely entertaining compared to what McD's is doing.
J.R.:
With the holidays & stuff I got doing other things and forgot about your post. When I came here to read Cali's article I saw it and remembered. Just wanted to say you are right. It's not like Progressive is making any money from ticket sales. I just assume, and apparently wrongly, that Cali was like me and hated the Progressive name on the park for personal reasons. Wouldn't stop me personally from going to the park but I have always hated the name change. Wouldn't hurt my feelings if some refused to go for that reason. Peter Lewis is absolutely the epitome of what is wrong with this country, IMO.
Cali:
Pardon me for assuming you had a well thought out and intelligent reason for hating the Progressive Company. My apologies.
What company does have good commercials nowadays? I wear my DVR out and rarely watch live TV anymore cause I love fast forwarding through the lame ass commercials.
I tell you who takes the cake for absolute worse .... McDonalds. My goodness how far they have fallen. Their ads are so freakin lame anymore. Not funny, not witty, not .... man, I dunno, just total boring and lame. They need to fire their ad company and start over. That dingbat in the Progressive Commercials is extremely entertaining compared to what McD's is doing.