KASIH SAYANG SEORANG PEMBANTU

Ckckck...anak jaman sekarang mah asli parah...

Gambar disamping itu candid dri slh satu tmn gw. gebleknya, dipertanyaan kedua si anak menjawab pertanyaan kasih sayang ibu sebagai kasih sayang pembantu lantaran gambar yang diberikan dalam pertanyaan tersebut memakai kebaya dan dikonde layaknya jaman2 rengasdengklok.

P.S: kalo gw lahir taun 2011 mungkin gw bakalan jawab ''kasih sayang seorang romusha" kali ya...

waspadalah! waspadalah!

Denied insurance claims- the bane of patients AND doctors

I started this post 2 weeks ago and got inspired by yesterday's goofy "health summit" between President Obama and Congress. Excuse the juxtaposition of the two subjects, but I think in the end they are related.

The issue of health insurance denying authorization for surgery or denying claims for procedures already performed is one of the most frustrating parts of being in practice. The New York Times featured a story on this entitiled , "Fighting Denied Claims Requires Perseverance" as it related to a patient fighting her insurer for coverage of an arthroscopic hip surgery.

To me the article is less about a hip operation, but rather represents the collisions of four forces


1. Insurers trying to control their cost and make money by limiting care
2. The people who pay for employee's health care trying to control their expenses by restricting unlimited utilization
3. Patients who want what they want, when they want it (but are removed from the actual costs of these procedures)
4. Physicians who are interested in advanced techniques and technology for procedures (who are slightly less, but still somewhat removed from the costs of these procedures)

As a society, America has not learned to reconcile our desire for expensive (and often futile) treatments with the fact that someone has to pay for all this. The congressional healthcare "summit" yesterday was a grotesque kabuki theater filled with political spin and lip service to the tough choices that have to be made to make the health care system sustainable. In summary: Democrats reflexively refuse to offend unions and ambulance chasers while afraid to limit or trim entitlement growth, while Republicans offer tepid (but useful) reform at the margins and refuse to budge on likely required tax increases.

The article about some advanced new orthopedic technique parallels the series the Times ran this week on an advanced melanoma treatment which described (what I presume) what was a very expensive palliative treatment which offered no cure and "worked" such that lifespan was extended for short periods of time. This kind of treatment is not sustainable for our health system, and focusing on it adds little value for considering "bending the curve" of costs. Ultimately, we'll have to decide whether we want society to pay for such exotic medical care, or expect patients to finance their own surgeries and treatments that go above and beyond approved evidence-based medicine (EBM) treatments.

Rob

Olympic Track Star Removes $13K Breast Implants

Photo: paperchaserdotcom.ning.com

Can you imagine paying $13K for a breast augmentation, only to pay for ANOTHER surgery to have the implants taken out 14 months later?

That's exactly what Australian track star Jana Rawlinson did, according to the Paper Chaser website.

Even though the sports star "loved" her new girls, she felt encumbered by them - and feared they were getting in the way of making the best race times.

If you're an athlete - or even just super active - you absolutely need to consider size when going for a breast augmentation!

Anything larger than a full B cup can get in the way of speed times and balance - and may even be a risk if your sport involves lots of body contact.

I figure skated competitively for many years, and am a bit of a fitness freak. I "wore" my size around for three months before my breast augmentation with a padded push-up bra to make sure that I was never uncomfortable while working out or being active.

I highly recommend you do the same - a size that you think looks gorgeous in the mirror may actually turn out to be in your way while doing the things you most love to do.

And you don't want to have to pony up $13K + for that lesson..

Related letter to the editor on Mayo Clinic model and Medicare

In January, I wrote about the Mayo Clinic's satellite in Arizona dropping Medicare patients claiming it was financially unsustainable. (see "The Mayo Clinic decision signals the health care bill is "One Big Ass Mistake, America"). Besides being embarrassing for the Obama administration as he'd held it up as his model health delivery vehicle, it produced a lot of teeth gnashing. For many people, they always assumed nearly all doctors accepted Medicare, and certainly an institution like the Mayo Clinic would accept Medicare rates (no questions asked).

Mayo exists as a really weird historical quick of American Medicine. It established a reputation for excellence generations ago and managed to make that name a "franchise" for medical care. While Mayo has some fine clinicians, it's kind of well known among most surgeons that a place like Mayo has had a hard time keeping the talent happy in terms of compensation and selling rural Minnesota as a destination to live. It takes a certain kind of personality to accept the trade-offs of that clinic system, but security of such a protected & salaried position is certainly going to become more common.

Exactly how Mayo operates as to your insurance has always been confusing to many people, and the Medicare announcement had a lot of people looking for answers. I found a great letter to the Editor in a Boston Globe article that is the most succinct summary to date

I am a surgeon practicing in Phoenix, Arizona. I also grew up in Rochester, MN where my father was a physician at Mayo for 35+ years. It's time to set the record straight on the misconceptions of the Mayo Clinic as a model for efficiency.

1)Mayo does not take Medicare, as outlined in the article.
2)Mayo does not take Medicare supplements for new patients.
3)Mayo has never emphasized primary care and in fact closed their family practice program here in Phoenix at a time of acute shortage in our state, citing costs. Primary care is labor intensive
4)Mayo refuses to provide care to citizens of Phoenix, the city in which they reside, in need of specialty care in situations where their specialists have availability and where there are acute shortages in the community. Their decisions for taking patients is made by administrators, not doctors, based solely on insurance. Doctor to doctor requests are frequently denied.

5)The Dartmouth Study, touted by many as the proof of efficiency of the Model compared Medicare expenditures county by county, throughout the country. Mayo Rochester resides in a rural farming community, where Medicare usage would be expected to be low. But since Mayo does cares for virtually none of these Medicare patients, extrapolating the cost efficiency of Mayo is simply wrong.
6) Mayo's model is very much a boutique model, catering to the wealthy, those willing to pay extra or out of pocket for their care or those with very good indemnity insurance coverage. Mayo is not in network for virtually every HMO and PPO plan, based simply on the high reimbursements demanded by Mayo. Mayo quotes 2-4 times the cost for surgical procedures that those in the community at large get paid.
7)Mayo relies heavily on the$ 200-300M/year in endowment money each year, to supplement their payrolls, build their buildings, fund research, and fund their pension plan. The cost structure of the Mayo Clinic is prohibitive without this additional funding. In this recession, Mayo is having considerable difficulty because it has been having appealing to those who used to come out of pocket for perceived more individualized care.
7) Community physicians in Jacksonville and Phoenix/Scottsdale assume virtually all the care for those in need, regardless of ability to pay.

I have always been of the belief that Mayo has the perfect right to practice Medicine the way in which they believe. Their doctors are dedicated to their mission and contribute each and everyday to the growth of medical knowledge.

Please, however be honest about what the Mayo model is: exclusive medical care for those with means and those willing to pay considerably more for their services.

Cheers!

Rob

How To Protect Yourself From Dangerous Plastic Surgeons

Photo: http://www.radiancesanantonio.com/

Just a couple days ago, a jury found Plastic Surgeon Dr. Marco Loiacono guilty of professional misconduct in his treatment of a 33 year old breast augmentation patient, Catherine McCormack of Dublin, reports The Irish Times.

The lowdown?

Catherine's left breast became infected a few days after her breast augmentation at the Advanced Cosmetic Surgery (ACS) clinic in Dublin back in October 2006. When the mom of three went to see the doctor about the situation, she was red, inflamed and - get ready for this - oozing. These are all symptoms of a severe infection, which at that advanced stage can call for immediate hospital admittance, intravenous antibiotics and possibly removal of the implant.

Instead, Dr. Lociacono stitched the wound together, put her on your typical ho-hum antibiotics, and sent Catherine on her way - a response that the surgeon amazingly continued to stand by in court.

Also discussed in court was the fact that Dr. Lociacono didn't see Catherine for a whole 20 days after her initial surgery; his defense is that nurses saw her in the days following her surgery.

Catherine ultimately had to have her left breast removed, leaving her disfigured and ill with a significant recovery from the nasty infection.

Dr. Lociacono moved and continued to perform cosmetic surgeries in Brazil and Italy. Nice, huh?

Now this all brings up a very important point that I discuss in depth in my eBook, The Boob Job Bible: 10 Steps To A Sexy, Safe Breast Augmentation. YOU need to "interview" any plastic surgeon you consult with to make sure he's going to be your number one advocate, and that you'll be safe and completely cared for under his guidance.

While there are reckless and poor plastic surgeons out there, the one good piece of news is that they're pretty easy to pick out if you know what to look for.

Just a couple out of several points my eBook addresses that could have prevented this situation:

1. At your consultation, ALWAYS ask who will be seeing you for your follow up appointments right after surgery. Anyone other than the surgeon performing the breast augmentation on you is unacceptable, and you should never hire someone who gives you less than that.

2. While infections are rare, the signs to look for: Redness, skin that feels "hot" and any kind of oozing. If you so much as SUSPECT an infection, get in to see your plastic surgeon immediately. Not his nurse, not a phone call - him personally. If he finds that you DO have an infection, you'll want to ask if it's necessary to make a hospital trip for intravenous antibiotics and whether there is a risk that you may need to remove the implant. Infections are nothing to mess with. And you most certainly don't hang out with one for over 20 days, with no further treatment.

And this is the kind of story that scares women straight out of ever getting a boob job.

But if you do your homework, ask the right questions, and hire a great board-certified plastic surgeon - you can protect yourself from these kinds of craptastic doctors who give the whole industry a bad name.

2010 Super Bowl Live stream: Super Bowl 44 Commercials, Halftime show

It's game time. It's Super Bowl 2010 this Sunday. Super Bowl 44 live in Dolphin Stadium, Miami Gardens, South Florida is one of the most awaited sports events this 2010. The Champions of the American Football Conference and the National Football Conference battle against each other in Super Bowl 44 (XLIV) live on February 7, 2010. The final game of the NFL Season will see the AFC Champion