IPALC President Message 
Some Motivation For Doctors11/2013
Today's WSJ article highlights the future of government sponsored health care delivery planning. The link to the WSJ for those who don't subscribe the journal, explains how the private insurance companies are going to cut doctor rates 50-30% going forward with PPACA. This is the new exchange-nice. Access to care is going to get continuously worse and they are going to hammer the doctors every step of the way. 

Last night I attended the Lee County Medical Society's General Membership meeting.  We listened to the many and sundry ways that we can "react" to what I consider other people's agendas. Perhaps some of you were there.  If you were you know that I openly challenged the premises that the doctors are going to have to tow the line, cut costs, ration care and all the other centralist garbage we are floating through. We are also not to blame for the United States expenditures for health care versus the rest of the socialized world. Perhaps our cost are excessive but I suggested the differential in cost has more to do with Americans subsidizing the other nations. Also our level of ingenuity, forward thinking inventions and medication advances do cost more. I do think the patent protection of big pharma lends to added costs but that comes at the benefit of excellent innovations. A free market pricing structure instead of a "hide behind the insurance company billing procedure" would do more to fix the costs of care than ratcheting you and me out of business. 

If you are looking forward to 50% decreased reimbursement and complex patient care for these rates, you are going to love the "planned future".  

We doctors are going to have to get out from behind and start leading. The excuse of "I am too busy" is not an acceptable position to take. We are approaching a critical loss of mass due to physician apathy. We need to design the market of health care.  Health care is a cottage industry, contrary to what the public is being told. We need to start explaining this and acting accordingly. I don't wish to tell the public how the nation should be "designing " health care.  I believe we can only deal with our local market issues and respond to that.  This is why our association is so vital to those of us remaining in private independent practice. Let's offer our services directly to the public. Whether the patient has insurance contract x, w, z or no insurance we should be and can be available to serve. 

Many of you know I and my partners haven't had an inked contract with any of the health insurance companies for over 10 years. I can tell you now that the current situation (see the WJS link above) highlights the virtue of that decision. The system cannot falsely advertise my participation nor coerce me to come to work. The whole exchange is predicated on borrowing networks via existing contracts. If you don't have a contract, they can't borrow you and advertise your availability to the Medicaid for All program which is PPACA. 

Most of you are probably not aware of a video interview that I had given to Frank Gluck, who is the health care correspondent for the Fort Myers NewsPress.  I encourage you to listen to this, as I explain to the public the errors inherent in the government sanctioned corporatism of health insurance company pandering.  We physicians who are and will be patients need to stand up to this nightmare, not cower in our beds at night fretting about who to sell out to, in order to perpetuate a lie/myth being sold the average citizen. 

My call to action for those of you who haven't yet re-upped your membership is to do this.  We have been providing webinars for administrators and doctors to attend. These webinars explain how to update your practice and personal information as well as pay your dues on line. We need broad specialty and primary care membership to be an effective force for good in the local health care market. My prior IPALC newsletter outlined current anticipated projects. I encourage your administrators to provide Cy Anderson, IPALC secretary, their email information so future newsletters go to them.

Raymond Kordonowy MD
Internal Medicine Of Southwest Florida