Physician Patient

MPPA Meeting Monday April 25, 2016 at 6 PM in Central Medical Building, St. Paul

Those present: President Lee Beecher, Don Gehrig, Bob Geist, Mike Ainslie, Doug Smith, Wayne Zuehlke, Dave Racer, Lyle Swenson, Hannelore Brucker, Chris Foley, John English, Scott Jensen.

• March 8 Meeting—Doug Smith and Hannelore Brucker led a discussion of the meeting.
• Rick Morris’s message was read and seemed to sum up the effect of meeting well for the rest of us. Here is an edited copy of Rick’s message to Dr. Sue Bailey, Speaker of the AMA House of Delegates. From Rick: “Our group hasn’t changed its feelings about organized medicine seeming to abandon independents like you and me…what we feel is needed is an undiluted, full-on defense of the profession against the overbearing intrusions of the federal government (and other payers). We think that supporting MACRA [the “doc fix” law] just compounded the mistake of supporting PPACA. I can understand the political difficulties you have, but those of us in that room (and a lot of other “rooms”) are looking for staunch support for our ethical and professional lives, and the patients we serve. We find more compatibility with AAPS, for example…”
2. Report: Meeting places for the future discussion was led by Mike Anslie. Some Lund-Byerlys stores have community rooms which are very suitable. Turns out that our current meeting place may un-expectantly be available again when we want it—let’s see how things go in planning for our next (probable fall) meeting.
3. The focus of MPPA discussions was led by Scott Jensen.
• He wanted to know if there were 3 issues that we might think important for legislation. We suggested that the broad issue of empowering patients needed implementation and that Rep. Tom Price’s 2015 bill of the same name would be a good start for consideration. There are multiple items that might be pertinent here including the Family Medical Account (FMA) program, tax free put-of-pocket expenses, tax free individual policy premiums for equity with business federally qualified premiums, protect small clinics from EHR mandates, etc.
[Not mentioned, but something we’ve previously noted was what ought to be the goals of wise government economic policy. Joseph V. Kennedy (PhD—economics; M.S; J.D.), a noted economist, has written that, “Government policy is far more effective when it channels market forces than when it overrides them”. Individuals owning and controlling the resources that the government shares with them are likely to be prudent, while gaining equity in choice of medical care access and quality. “Ownership of resources is the path to a decent life free of poverty and dependency: a goal for all Americans.”]
• We also discussed how MPPA was started in 1997, and that now, as a think tank, we seek to examine the ideas that will permeate public opinion in order to bring about medical system freedom, safety, and justice for all families.
4. Future agenda presentations—Dave Racer suggested that we set aside a 20 minute briefings on topics pertinent to our discussion. The group approved a trial. At the next meeting Dave will present Reference Based Insurance plans.
5. Business contracting: professional vs. commercial and Direct Patient Contracting discussion was led by Dr. John English. We focused on his MIPA group’s Prima-Care Direct contracting method; a group of varying sized independent primary care practices.
• We had a preliminary background discussion regarding medical practice as being a professional business, which can be distinguished from a commercial Chevy dealer’s business down the street—they function under different laws and have different goals. For example, following passage of the U.S. HMO Act of 1973 there was an accelerating transition from a professional medical marketplace, in which services were sold to patients, to a commercial marketplace in which populations (or “covered lives”) of HMO insurance corporations and government agencies (the mega “payers”) were auctioned to providers for servicing (commonly at prices fixed by “payers”)—the essence of Managed Care 1.0. The Obamacare MC 2.0 cartel era follows in 2010.
• The Prima-Care Direct contracting program was outlined and critiqued at length. In general it was thought a good means to enhance access to patient-centered care: personalization, timeliness, continuity, and trust in care. It may not apply to older populations with more complex problems. Direct contracting through monthly payments as a form of cash practice was thought an idea that could flourish.
6. A pending problem was noted by Chris Foley. There are efforts underway to make filling a patient’s prescription in another state impossible without one having a medical license in that state. He will forward more information later.
7. We did not have time to get updates on: legislation; MN Medicaid federal investigation and MN responses to Hi-Lex v MI Blues case; “Value pay” and MMA “New Initiative on Reducing Health Care Costs”, MMA June 1 Harold Miller (of “evil FFS” fame) on MACRA and ACOs; or profiteering and bribes paper in the AAPS Journal Spring 2016.
8. We will be looking forward to reports on: MPPA website cleanup and support; website library; Briefing on AMA “Health 2047 an innovation Hub”; and further consideration of future 20 minute agenda presentations. For example:
• Feinwachs regarding Medicaid HMO profiteering.
• Robert Thompson, JD. MMIC presentation
• RWG. FMAs for Medicaid [old priority rank #5 (see page 5)]
• John Tyler HCTF presentation
• RWG. Political Malpractice and Profiteering at the bedside [old priority rank # 1]
• Dave Racer – Reference Based insurance plans—planned for next meeting.
9. There is a meeting of John English’s MIPA group on Wed, May 11 at the Embassy Suites Airport Hotel from 9 to 11:30 AM to which all are invited

10. Next meeting will be announced. Please think carefully about possible legislative initiatives for Scott Jensen and how we can help get elected!

Respectfully submitted, Robert W. Geist MD, Secretary pro-tem


1. Kennedy JV. Introduction ix, and Chap. 7 Affordable health care: In: Ending Poverty. Rowan & Littlefield Publishers Inc. Lanham, Maryland. 2008

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