The Audacity of Elitism

July 22, 2009

When the Obama administration couldn’t slip in and out of Louisiana with a secret Town Hall meeting with the public er rather ACORN, they were highly upset. In fact, so disappointed in what the public opinion is, they’ve decided to even give the public a shorter notice (read only want taxpayer funded ACORN there) so that you can have a second and third chance to tell them how much you really love the plan. Of course you’re not really invited, they don’t really want to know what you think because after all, the people are simply just too stupid to know what’s good for them, and you’re too stupid to figure out that these Town Halls that the Obama Administration is putting on is slanted in their favor. Here’s the information on the next two events.

Wednesday, July 22 at 10am

Hale Boggs Federal Building ( New Orleans , LA )
500 Poydras Street
New Orleans, LA 70130

Thursday, July 23 at 10am

Federal Building ( Baton Rouge , LA )
707 Florida
Baton Rouge, LA 70801

I’ve got a few questions and comments that I’d like to see asked, if any of you have a chance to ask them.


“Are you folks deaf? We told you how we felt about your health care.”

“I came here on my own dime which I happily paid. I see ACORN is here, I’m pretty sure they came on my dime too, I’m not so happy about that.”

“What is the percentage of total federal government revenue that is paid directly to interest on the national debt?”

“If it turns out Obama was indeed born in Kenya, can we declare his actions as President null and void?”

“Why did Senator Kennedy chose the private American option instead of the superior Canadian Public Option and had the U.S. Government reimburse Canada for it?”

“Why is the Obama administration being so secretive about Town Hall meetings on health care that you’re hosting?”

“If President Obama happens to get re-elected, is he going to try to end term limits?”

“Have you had the chance to visit Obama’s home country Indonesia?”

“Are you planning on visiting all 57 states too?”

“I’m glad to see you don’t need a teleprompter every time you speak, can we have you for President instead?”

“Don’t forget to tell Kommadante Obama, it will be a cold day in hell before he socializes my country!”


If you are unable to attend either of the events, CALL SENATOR MARY LANDRIEU and let her know how you feel, and let her know that the Obama administration’s actions are a reflection of her and that he’s not doing her any favors by being so secretive. You can find Mary Landrieu’s contact information by clicking this link. We can not stress enough the importance of getting out there on such a short notice.


The Boston Globe (Boston, MA) April 21, 2004 | Liz Kowalczyk, Globe Staff Four doctors’ groups in Eastern Massachusetts have taken the unusual step of merging, saying their larger size will allow them to increase profits but also improve medical care for their nearly 600,000 patients. here south shore medical center

The deal includes an odd twist: All the groups agreed to become nonprofits, which allows them to pump more of their revenue back into operations a competitive advantage rather than paying it toward taxes.

Harvard Vanguard Medical Associates with 500 doctors, one of the largest multispecialty physician practices in the state has been pursuing the merger for more than two years. The new group of doctors, which has organized under a parent organization called HealthOne Care System, includes about 700 physicians.

The doctors are following an example set by hospitals during the 1990s, when more than 1,000 US hospitals merged, generally to gain financial clout against powerful managed-care companies.

In recent years, doctors increasingly have complained about flat or falling salaries while squeezing in more patients to meet demand and keep pace with the cost of running their offices. Meanwhile, many doctors say they are unable to afford electronic medical records and other cutting-edge technology to improve patient care and safety.

According to the most recent figures from the Center for Studying Health System Change, a nonprofit research organization in Washington, doctors’ salaries fell 5 percent between 1995 and 1999, increasing just slightly in 2000, when taking into account inflation and cost of living. As a result, according to a study the center published last month, physicians are using a variety of strategies to increase their incomes, including offering patients bone densitometry tests, positron emission tomography, or PET, scans, and endoscopy tests in their offices; opening ambulatory surgery centers; and merging into larger groups.

The impact on patients is unclear. Critics say physicians’ business practices are contributing to the public’s rising use of unnecessary medical services and to growing costs. But other health specialists say larger doctor groups may operate more efficiently and are better at coordinating patient care.

Kenneth Paulus, Harvard Vanguard’s chief executive, said he was looking for a way to boost revenue for doctors and improve patient care at the same time. Doctors in Massachusetts, he said, are seeing “15 to 20 percent more patients than they did 10 years ago,” while they earn about the same, an average of $150,000 for an internist.

“When you consider inflation, that’s a significant hit on income,” he said. “Doctors also want to go back to spending more time with their patients. I hear physicians talking about it every day.” The doctors formed HealthOne partly “to help us survive these difficult economic times,” Paulus said.

The new group, formed in January, also includes Dedham Medical Associates, Southboro Medical Group, and South Shore Medical Center, which is also a doctors’ group. Concord Hillside Medical Associates and Lynnfield Medical Associates already joined Harvard Vanguard during the past two years.

The group is the largest independent doctors’ group in Massachusetts that is not aligned with a particular hospital network. It’s smaller than the physicians’ group associated with Partners HealthCare System, the parent organization of Massachusetts General and Brigham and Women’s hospitals, which has about 1,100 primary care doctors, 2,000 community cardiologists, gastroenterologists, and other specialists, and 2,000 specialists at the two teaching hospitals, many of whom do research part time and treat patients part time. But HealthOne is now significantly bigger than Lahey Clinic, a group practice with about 450 doctors.

Paulus said HealthOne will have more buying power to implement electronic patient medical records, as well as the resources to open an outpatient surgery center, and two additional imaging centers. Harvard Vanguard opened an imaging and endoscopy center last year at its Kenmore Square location, and already has electronic medical records. Imaging and endoscopy centers bring in extra revenue for doctors, and Paulus said that by owning their own, the doctors can keep better track of their patients’ results.

“Right now, we’re referring out to for-profit imaging centers. Patients go all over the place,” he said. “There’s very little integration of information and data. We think we can significantly improve patient care and safety.” Dr. Michael Lee, a pediatrician with Dedham Medical Associates, said it would have cost his group $1 million a year for seven years to implement electronic medical records, electronic prescribing, e- mail communication with patients, and other Internet-based medical information systems. “We were eager to go forward with this, but we could never make that leap,” he said. here south shore medical center

Harvard Vanguard already was a nonprofit group, but the other physicians’ groups converted to nonprofit status as part of the affiliation. This allows them to keep more nontaxable money in reserves, which they then can invest in new services and systems.

The doctors also will be able to negotiate fees jointly with health insurers.

In the study published last month, researchers at the Center for Studying Health System Change said they are concerned that doctors’ groups that offer profitable ancillary services will be more likely to refer patients for unnecessary tests because they stand to profit from them.

“The main issue the public worries about is the conflict of interest that could lead to overuse of services,” said Paul Ginsburg, president of the organization. “But I worry about this more with a small group of 10 physicians than I do with a large organization where the financial benefit to each individual doctor is more diffuse. This new organization could be good for patients; large groups do much better at integrating care for their patients.” But hospital executives worry that this new physicians’ group, as well as other doctors’ groups providing ancillary services, will lure away a growing portion of hospitals’ best-paying business. Physicians are not required to treat the uninsured, and tend to attract patients with private insurance and simpler problems to their MRI and endoscopy centers. This has the potential to leave hospitals with the more complex cases, and more poor patients.

“Hospitals have to care for anyone who walks though the door,” said David Ball of the Massachusetts Hospital Association. “The proliferation of these providers makes it more difficult to do that, and puts more pressure on hospitals.” Liz Kowalczyk can be reached at

Liz Kowalczyk, Globe Staff


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