As an emergency physician in California, I am VERY concerned about the executive order to ban balance billing. It is amazingly obvious that those that have proposed these types of legislation are aligned with insurance companies and their lobbyists. Anyone that sees what goes on on the “front lines” on emergency departments knows how ill our system has become. Hospitals and clinics bill for more than their services cost so that when they finally get reimbursed by the insurance companies or MediCal, they come close to even covering operating costs! Our services are constantly shortchanged and some offices need to hire full time staff just to argue with insurance representatives with minimal or no medical training that refuse claims on testing that is deemed necessary by physicians. It is amazing that current legislation allows patient care to become limited with these types of practices.
Although balance billing sounds like it is unfair to patients when they get an additional bill, it is actually unfair to physicians and hospitals who are not getting reimbursed enough to cover costs, let alone make a living! Being able to bill a patient for what an insurance company does not wish to pay for keeps the patient in the loop as a self advocate. If they get this bill, they can protest it and eventually the insurance company is forced to pay what they are contracted to pay rather than cheating the hospitals and shirking their responsibilities to patients.
By taking away our ability to do this, you give insurance companies an open door to take advantage of already struggling healthcare providers and hospitals by paying out whatever they want
The patient needs to know that they are being cheated by their insurance company so they can stand up for themselves and force the company to fulfill their contractual obligation. In my opinion, insurance companies should all be non-profit, then we take away the great motivator – money. It is clear that insurance companies have a great deal of money and lobbying power to get these kinds of measures passed through. We, as physicians, healthcare providers, clinics and hospitals, do not have this kind of money to sink into convincing politicians to do what is in our interests. We only ask that as a politician, you do what is in the patients’ best interests, not the insurance companies.
Thank you for reading, I am an idealistic, enthusiastic environmentalist and ER doctor and have many perspectives on healthcare and energy policy that I would be happy to share. Please let me know if I can be of any assistance to the state.
Clint Slaughter, M.D.
Archive for July, 2006
Greenpeace has put out an excellent video advertisement against the “City Gas Guzzler”. You know, the people who drive their SUVs around town and never or rarely take them off-road or into territory where the extra gas consumption might be justified. We do have a “pseudo-suv”, a Honda Element. We generally drive our biodiesel-powered mercedes wagon around as much as possible, but because of it’s utility, we use the Element fairly frequently for surfing, camping, and travel to mountains and such. Although we can do better, at least it gets 22mpg and is considered a LEV (low emissions vehicle).
Thanks to Fred, Eric, and Ben for a fantastic Vegas-style bachelor party. Nothing too out of control, no secrets from Laura or anything, but there were a few nights with too many free drinks at the blackjack table. We made it back home, though, and ready to get back to work and resume a little training. I’m offsetting the CO2 produced from my flight with Terrapass, but I can only imagine the CO2 that Vegas produces. Although guitily fun once in a while, Vegas is to me the epitome of American excess and opulence. It’s no wonder other countries hate us – that city produces so much waste from consumption and wastes power and water like no other place in the world. Although I don’t remember seeing one recycling bin in any casino, at the very least the power is relatively green – I think the Hoover Dam powers that monstrosity.
Anybody up for a recycling project in Vegas?
From Green Car Congress:
Researchers Assess Life-Cycle Impact of Soy Biodiesel and Corn Ethanol11 July 2006
According to a recent analysis by University of Minnesota researches, Biodiesel is significantly better than Ethanol in multiple ways:
“The researchers tracked all the energy used for growing corn and soybeans and converting the crops into biofuels. They also looked at how much fertilizer and pesticide corn and soybeans required and how much greenhouse gases and nitrogen, phosphorus, and pesticide pollutants each released into the environment.
The study showed that both corn grain ethanol and soybean biodiesel produce more energy than is needed to grow the crops and convert them into biofuels. This finding refutes other studies claiming that these biofuels require more energy to produce than they provide. The amount of energy each returns differs greatly, however. Soybean biodiesel returns 93% more energy than is used to produce it, while corn grain ethanol currently provides only 25% more energy.
Still, the researchers caution that neither biofuel can come close to meeting the growing demand for alternatives to petroleum. Dedicating all current US corn and soybean production to biofuels would meet only 12% of gasoline demand and 6% of diesel demand. Meanwhile, global population growth and increasingly affluent societies will increase demand for corn and soybeans for food.
The authors showed that the environmental impacts of the two biofuels also differ. Soybean biodiesel produces 41% less greenhouse gas emissions than diesel fuel whereas corn grain ethanol produces 12% less greenhouse gas emissions than gasoline.
Soybeans have another environmental advantage over corn because they require much less nitrogen fertilizer and pesticides, which get into groundwater, streams, rivers and oceans. These agricultural chemicals pollute drinking water, and nitrogen decreases biodiversity in global ecosystems. Nitrogen fertilizer, mainly from corn, causes the dead zone in the Gulf of Mexico.”
It’s great to see feasibility projections for biofuels being done and hopefully taken seriously. We need to be able to predict how these models fit into our current and future energy use to see where we need to expand our possible solutions and learn where we need to focus our efforts.
Treehugger (one of my favorite all-time websites) has a “Green Epiphany” comment going where people are telling the brief version of the time they “started thinking about the environment” or however you’d like to describe it.
It hit me really hard last spring when I was getting more and more angry about Iraq and the things that our country has been doing both here and abroad. Someone started talking about biodiesel and it suddenly clicked – every individuals consumption of resources contributes to these wars and this destruction. We need to take an individual stand against supporting these practices and show others what we’re doing. I started making biodiesel, reading treehugger.com, and voraciously learning about the current state of our environment and what we can do about it. Nice work everyone!
I hope more and more people are having “Green Epiphanies” these days. When those that have had these realizations take action and more people in current power see how important these issues are to the immediate future, we’ll see more and more pressure to make useful and effective changes to our environmental policies.