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If you have questions about how the Daily News makes editorial decisions, this blog has the answers. Editorial page editor Matt Zencey and writers Frank Gerjevic and Rosemary Shinohara will discuss what they're working on, answer questions and ask your perspective on issues facing Alaska.


Contributors

Matt Zencey

Matt Zencey joined the Daily News as an editorial writer in 1985 and was named editorial page editor in May 2007. He has won several. "Best editorial writing" awards from the Alaska Press Club and was a Nieman Fellow in Journalism at Harvard University. He lives on the west side of Anchorage, where he enjoys the best weather in town and easy access to the Coastal Trail. E-mail Matt at mzencey@adn.com

Frank Gerjevic

Frank Gerjevic has worked at the Daily News since 1978, where he's been sports editor, copy editor, reporter and columnist. He's been an editorial writer since 1998. He began his newspaper career with the Anchorage Times in 1975. E-mail Frank at fgerjevic@adn.com

Rosemary Shinohara

Rosemary Shinohara is an editorial writer who has lived most of her life in Alaska. She has spent most of her career as a reporter or editor at the Daily News. She covered construction of the Alaska oil pipeline, the Legislature, schools and urban affairs. She has also been an editor for NPR's All Things Considered, and has written for the Associated Press. E-mail Rosemary at rshinohara.com

Archive

A fond farewell to Howard Weaver - 12/4/2008 12:18 pm

Reaction to "Palin's Georgia pal" - 12/3/2008 6:09 pm

Alaska Notebook: Palin's Georgia pal - 11/28/2008 4:38 pm

How to produce oil from ANWR and preserve it too - 11/21/2008 11:35 am

Conservative pundits RE: Palin - 11/18/2008 3:52 pm

Whoops, that column was Bill Kristol, not Nick Kristoff - 11/18/2008 9:03 am

Interesting theory" Why McCain picked Palin - 11/17/2008 7:57 am

Where's Pete Dunlap-Shohl now? - 11/14/2008 5:00 pm

Bugged about the bailout? - 11/13/2008 9:59 am

More from Lower 48'ers about Palin - 11/12/2008 4:05 pm

Monegan's lawyer re: Petumenos Troopergate report - 11/11/2008 2:52 pm

Worth reading - 11/11/2008 1:38 pm

More on Elijah - 11/10/2008 2:03 pm

Reaction to Elijah's story - 11/6/2008 3:49 pm

Ask Joe Contraire...about TASERGATE! - 11/4/2008 3:29 pm

No, we didn't endorse Don Young, too - 11/3/2008 2:53 pm

Another zinger of a letter - 11/3/2008 12:27 pm

Hilarious comment on ADN endorsements - 11/3/2008 9:31 am

Ask Joe Contraire (He's baaaack!) - 10/31/2008 5:33 pm

Funny letter re Obama - 10/31/2008 1:03 pm

Thanks for talking sense - 10/30/2008 4:15 pm

Talk sense to Frank! - 10/24/2008 9:25 am

full archive »

Speed doctoring

Posted by editorial_views

Posted: June 4, 2008 - 1:49 pm

From Rosemary Shinohara:

Dr. George Rhyneer, a cardiologist, and some other Alaska doctors have an idea for taking care of Medicare patients, who face a nearly impossible task finding primary care doctors.

It seems kind of drastic -- but let's see what you think.

Many primary care doctors turn away the elderly because the feds pay doctors so little. It's only around $30 a visit, says Rhyneer. He and his group are trying to design a new style of clinic where the low pay would suffice.

Here's how it would work: A Medicare patient comes in with a bunch of ailments. A nurse or assistant would spend the most time with the patient, getting records in order and determining the main problem of the day. The doctor would then spend five minutes diagnosing and treating only one problem. Then the doctor moves to the next patient.

For a second problem, and a second Medicare charge, a patient could come back the next day. And the next day. And the next day.

Dr. Rhyneer's group is planning to contract out for a study to see if it might work. Thoughts, anyone?


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  4     June 20, 2008 - 5:54pm | Reenie

One complaint per visit

Dr. Rhyneer has a good idea...for now. Unfortunately, Medicare will simply create a new regulation that will once again stop physicians from achieving any profit from providing medical care. Medicare patients are already finding it difficult in the Valley to obtain primary care and this situation will only get worse July 1st 2008 when Medicare is scheduled to implement a 10% payment reduction on the already low fee schedule. I suspect more physicians across the US will opt out of Medicare. Every person does deserve appropriate medical care regardless of their ability to pay. Unfortunately, medical practices, like any business, need to make money to pay for overhead and expenses.

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  3     June 5, 2008 - 1:04pm | rallenenglish

Speed Doctoring

Other states have laws that prohibit doctors from refusing to accept Medicare patients. That seems like the easiest solution to the problem of your primary health insurance coverage becoming useless once you turn 65 and are forced to accept Medicare as your primary coverage.

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  June 5, 2008 - 4:41pm | julietml55

Every Patient Deserves Healthcare

Every patient deserves health care.
For those "national health" paranoids, I say," get over it."
Question: How come my Canadian friends are not crying the blues? (These are college educated professionals in the private sector.)

I can only suggest that every member of Congress (House and Senate) relinquish their
"Oh-La-La Private Congressional Care" and
step down to the "Joe Blow/Jane Doe" health care. They will become are real americans like you and I.

"Walk a mile in our shoes."

Remember your federal taxes pay for the
US Senate's and US House of Representative's private health care.

Tic-toc everyone turns 65 years of age is forced into Medicare A and B. Tic-toc, tic-toc...The clock runs for everyone.

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  June 5, 2008 - 5:23pm | TheSdog

juliet

Before you start talking about how great Canada is you may want to check the census in hospitals in Buffalo and Detroit and even Seattle. When a Canadian needs something done in a reasonable period of time they high tail it across the border.

Canada has a great system unless you are actually sick.

You can look across the world at socialized systems and there is one common thread. Those systems do not d everything. They ration care. They do things like limit dialysis, actually let brain dead people die, cut back on screenings and other expensive practices. You try any of that in the US and the lawyers will beat you down hard.

The US actually would have better life expectancy than most countries if we did not have our youths killing each other in the street. We also calculate infant mortality differently than much of the world making the number look higher.

The truth is people without insurance can get care in this country. It happens every day in this city.

And you may want to look into the US Congress heath care plan a little. It is very good but the members do actually pay into it. You can argue that their pay is tax dollars but nobody works for free.

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  June 5, 2008 - 6:41pm | julietml55

The Medical Expert?

Are you Canadian? Probably not.
I am mistaken you are the expert.

Are you an Alaska Native (the one with the
US DOI Bureau of Indian Affair's Certificate of Indian Blood)? Probably not.

Why do I ask? Well I utilize the services
of ANMC (Alaska Native Medical Center).
Sure they bill my primary private insurance.
I can go anywhere in Alaska and the lower
48 for my medical services. It is not free.

The ANMC's services have greatly improved in the past few years. Remember Indian Health Care is a treaty with the Alaska Natives and American Indians. Don't like it? Well run for US Congress and undue the treaty.

My Canadian friends don't complain as much as you claim. Since you are the expert, I will let you "win" this opinion.

I only claim to have average intelligence. You are "uber" smart.

And if you think the American health care system is perfect...just continue to drink the Kool-aide.

Remember all of us will be 65 years of age. Some of us will be at the Medicare crossroads sooner.

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  June 5, 2008 - 7:58pm | TheSdog

If you think

ANMC provides top of the line care you obviously are not an expert. You also lily do not even have average intelligence like you claim. And who said anything about the Native health care system?

Did I say the US system was perfect? No, it needs change but go ahead and put up a straw man if it makes you feel good.

And I think you meant to use "undo" and not "undue." That's okay though because some of us can actually get meaning even when someone stumbles over every word they type.

As far as "Kool-aid(e)," maybe you should put down the six pack instead of chugging it down before you blog or if that is not the problem you could learn how to read and stay on topic.

I did live in Canada for 2 years. I also have taken care of many Canadians (as well as citizens from other countries) as a physician in US hospitals. It is a left wing fallicy that Canada's system (or any sociallized system) works well. When people want the best care and they want it fast they come to the US from all over the world.

Canadians tolerate long waits for health care. We do not.

Canadians have a reasonable legal system when it comes to malpractice. We do not.

Like I said, take a look at how many Canadians come across the border for care. Americans may buy drugs from Canada but they certainly do not cross the border to see MDs or get tests.

You know who else crosses the border and gets free health care? Mexican nationals do it large numbers. It is amazing how many babies in border states are born to Mexican mothers.

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  June 6, 2008 - 4:13pm | julietml55

You are the brilliant one. Wow. Everyone take note.

Love the 6 pack comment. Any other anti-native slurs? I love the Mexican comment too. What next Cubans and Jews in your racist opinions?

Maybe you should switch to de-caf.

I really feel sorry for you. Your heart and soul is full of hate. It is reflected in your opinions.

All health care can improve.

Since you are the leading authority in the world, well I will kindly step aside. I wonder what it is like to be the smartest person? Where have you been?

Try some tolerance and compassion, it might make you a nice person.

As far as I am concern, I am done with replying to your postings. I have a rule never to argue with bigots and idiots.

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  June 6, 2008 - 8:49pm | TheSdog

Typical

You take shots using "Kool-Aid(e)" and then cry racist because I used alcohol. Who cares if you are Natve? I suppose you do since calling somebody a racist is easier then actually formulating a response.

The only reason I used Mexican nationals is because a number of years back I saw a statistic that California was spending $3B a year on services provided to them. This was of course due to unfunded federal mandates.

Now, if you want to go out and actually do some research then possibly you will have something worthwhile to say. Until then, please do not respond to my posts because the only thing you seem capable of is emotional rants.

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  June 7, 2008 - 3:01pm | akgen

good grief sdoggie

you care if one is Native, that way you can sling a slur. It is much eaiser than actually formulating a response. Classic sdoggie.

Thank the aurora for systems of socialized medicine. Again another example of those practicing in a socialized system can actually practice medicine, rather than develop schemes to sell their medical debts.

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  June 7, 2008 - 1:10am | julietml55

Kool-Aid(e)" is Bill

Kool-Aid(e)" is Bill Oreilly's line. Oh you must not have dishnetwork or direct tv or cable...
Are you ripping off your neighbor's service?
Ya cheapskate.

Hey Mr. Research...What have you published?
I am sure Forbes and the New York Times will print all your research - rants.
Plus everyone enjoys you race specific comments like those Mexicans! What next?
The Jews?

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  June 7, 2008 - 2:18pm | TheSdog

"Kool-Aid(e)"

was around as a charged phrase well before Bill O'Reilly.

It is not completely clear but much of the believed recent origin goes back to Jonestown but someone may be able to clarify. You may want to think about what you are saying by using it when you consider the Jonestown reference.

And by the way it is "Kool-Aid." Amazing that you did not pick up on that no matter how kind the attempt to make the point to you was.

Now go back to whining and calling people names.

There are a dozen publications on my CV by the way. There are also a handful of other things I have done that have been in print over the years.

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  June 6, 2008 - 12:15pm | rfn

Yes, no question

The U.S. has reasonably good medical care for those who have sufficient insurance, the income to pay for that insurance, or don't need insurance because they can afford almost anything. Oh yes, also for those who meet poverty standards. Which raises the question of how long people will devote much energy to work once someone in the family needs "medical care" or why they should.

If you thought you wouldn't like Hillary care, think again. Health care is soon to become another obamanation!

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  2     June 5, 2008 - 7:26am | wodat

Well

that's what we all would have to look forward to should the Socialist succeed in shoving "National Healthcare" down our throats. But, I'm still trying to figure out where the "right to health care at the expense of your fellow citizens" is in that lil old document we call the Constitution.

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  1     June 4, 2008 - 8:35pm | TheSdog

George

is a great guy.

I have even spoken with him about this plan.

I remain skeptical because it just does not seem like a model that will work very well.

Medicare patients can be complicated. There are plenty of studies out there tat suggest mid-level providers (PAs and ANPs) do okay with standard stuff but their effectiveness drops off with complicated patients. In this case, it would not even be people at the level mid-levels experience getting the history.

There are plenty of other problems as well. Many treatments reuire monitoring and follow-up. This solution seems too disjointed to me.

There have been single problem clinics run on this model. When I was a resident we had a clinic where literally in 2-3 min you looked at labs, current medications, and a lipid profile and changed meds. The thing is all the patients enrolled also had primary care doctors.

This might be better than nothing but we need to know the final plan.

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