News in REVIEW A PUBLICATION OF NYCHSRO/MEDREVIEW VOLUME 9, NO. 2 JULY - SEPTEMBER 2006 www.medreview.us MedReview Forms Alliance to Recruit Nurses I n recognition of the severe shortage of qualified Registered Nurses in the United States and in the New York area in particular, MedReview has entered into an alliance with Personnel Management Services, LLC to recruit and place foreign-born nurses and other health care professionals with prospective employers in the United States. The main thrust of the initiative is to recruit nurses from the Philippines. The joint program will be called International Healthcare Staffing Solutions and will be directed by Gary Stern who is the President of Personnel Management Services. Mr. Stern has extensive experience in recruitment of professional medical staff, both in the United States and the Philippines. He has an established recruitment office in the Philippines and has successfully recruited more than 600 nurses per year. The program will reach out to the provider community to deter- mine specific provider needs and work closely with providers to ensure that the needs are met. This will include identifying applicants that meet all necessary legal and professional requirements for employment in the United States. The program will then be responsible JOE STAMM AND HELEN MUTCHLER AT to see that all necessary docuA MEETING WITH GARY STERN mentation and licenses that are required by the prospective employees for travel and work in the United States are obtained. Any clients who are interested in participating in this new initiative should contact Helen Mutchler at 212.897.6105. Humanitarian Mission to Israel A t the request of Assemblyman Dov Hikind, MedReview’s CEO Joseph Stamm traveled to war torn Israel on a fact finding and humanitarian mission on July 30, 2006. The four day trip which centered exclusively in the embattled northern region of the country was also attended by Councilman David Weprin, Chairman of the Finance Committee of the New York City Council. The eighteen member group met with the mayors in the northern Israeli towns. The group was particularly interested in how Israel was managing the health care emergency created by the war as well as the bombing of civilian populations in Israel. They were able to schedule a meeting with the CEO and other top administrative staff of Rambam Hospital. Rambam Hospital is the largest hospital in the north and was the triage hospital attending to all of the injuries/casualties of the war. The group also visited with the wounded soldiers and members of relief organizations as well as families and individual citizens in their houses and in their bunkers. The trip left an everlasting impression as to the plight of the Israeli citizens which, for the most part, was never clearly presented in the media. (See accompanying published article by Joseph Stamm on Page 4). Inside This Issue... e MedReview Forms Alliance to Recruit Nurses e Humanitarian Mission to Israel e Healthcare Headline Summaries e MedReview Political Outreach e News In Review Profile: Richard Bonforte, M.D. e Trip of a Lifetime e NYCHSRO Poetry Corner e Memorial Service for Dr. Eric Vanderbush e Obesity Costs e NYCHSRO/MedReview Takes to the Seas Infant Mortality in Voluntary C-sections – New York Times (NYT) – 9/5/2006 – A recent study has found that the risk of death in newborns delivered by Cesarean section is much greater than previously believed. The rate among low-risk women is 1.77 deaths per 1,000 live births while the rate for vaginal deliveries is 0.62 per 1,000. The study included 5,762,037 live births and 11,897 infant deaths in the United States from 1998 through 2001 and encompassed 311,927 Cesarean deliveries among low-risk women. The percentage of Cesarean births has been dramatically on the rise, increasing from 20.7% in 1996 to 29.1% in 2004. While the mortality rate from Cesarean deliveries has always been higher than vaginal deliveries, it has always been assumed that this was due to the high risk nature of Cesarean. This study is the first to reflect a significant higher degree of mortality in a low risk population. The report speculates that part of the reason for the increased mortality may be that labor is beneficial to the baby releasing hormones that promote healthy lung function. The physical compression of the baby during labor is also useful in removing fluids from the lungs and helping the baby prepare to breathe air. Cancer Mortality Trends – Wall Street Journal (WSJ) – 9/6/2006 – The Annual Report to the Nation on the Status of Cancer reported that death rates from cancer are continuing to decline but there has been an unexpected increase in cases of thyroid cancer. For men, overall rates declined 1.6% annually between 1993 and 2003 and the decline was 0.8% for women. However, thyroid cancer rates during that same period increased 9.1% for women from 2000 to 2003. The rate for men also increased but not as significantly. The study also found that Latinos had lower incidence rates than non-Hispanic whites for most cancers but that Latino children have higher incidence rates of leukemia, retinoblastoma, osteosarcoma, and germ cell tumors than do non-Latino white children. Change in Medicare Part B Premium Calculation – (New York Times (NYT) – 9/11/2006 – The Medicare Part B deductible will no longer be a uniform amount for all recipients. Effective in 2007, the Part B premium payments will be graduated based on personal income with wealthier people paying a surcharge to offset the less wealthy. Using income from the Internal Revenue Service from tax returns for 2005, if an individual has modified gross income of $80,000 to $100,000, the surcharge will be 13.3 percent, which will add about $13 to the monthly premium, for a total of about $111.50. For a single person with income of more than $200,000, the surcharge will be 73.3 percent, or about $72 a month, for a total premium of about $170.50. When the transition is fully implemented in 2009, it is anticipated that the wealthiest individuals will pay two to four times as much as the average person. Congressional Review of New York Presbyterian Hospital Costs- New York Sun (NYS) - 9/13/2006 – Senate hearings focused on high charges billed to uninsured patients at nonprofit hospitals were centered on New York-Presbyterian hospital. Senator Grassley, during the hearings, indicated that “Non-profit doesn’t necessarily mean pro-poor patient. Non-profit hospitals may provide less care to the poor than their forprofit counterparts. They may charge poor, uninsured patients more for the same services than they charge insured patients. They sometimes give their executives goldplated compensation packages and generous perks, such as country club memberships. All of this calls into question whether non-profit hospitals deserve the billions of dollars in tax breaks they received from federal, state, and local government.” While Presbyterian wasn’t singled out specifically, some of its practices could generate further questions. At the hearings, NYPH indicated that its list prices for procedures, office visits, and hospital stays represent, on average, a 98% markup from the hospitals costs. Insured patients and their insurance companies almost always get a discount, which averages 47% for private plans. However, NYPH also indicated that it never sees about 82% of the billed amount for uninsured patients notwithstanding recent lawsuit attempts to collect on unpaid bills. The Senate Committee was also advised that NYPH’s CEO, Dr. Herbert Pardes made more than $4.6 millions per year while the hospital’s director and executive vice president made about $3.4 million, not counting retirement contributions. NYPH also indicated that, in addition to undisclosed travel expenses for its top executives, the hospital reimburses Dr. Pardes about $4,300 each year for his membership in an unidentified “private social club”. Health Care Premiums Rise Twice as Fast as Wages and Inflation in 2006 (WSJ) – 9/26/2006 – Average family health insurance premiums rose 7.7% in 2006. After several years of steady increases, the cost for family coverage under an employer health plan is now $11,480. However, this year’s increase was lower than previous years and many large employers expect the downward increases to continue in 2007 to 6%. Most larger firms indicate that they’re adding “consumer directed” plans, which combine deductibles of typically more than $1,000 and some sort of tax-saving account to make employees more of a financial stake in their health care spending. Quality and Cost of Care Disclosure- (WSJ)8/23/2006 - On August 22, 2006, President Bush issued an executive order requiring all federal agencies to disclose the quality and cost of care provided to Medicare beneficiaries, federal employees, the military and veterans. The order also promotes the use of health-care technology and rewards consumers who shop for medical care based on quality and value. President Bush called on private employers, unions and local governments to follow suit. "People deserve to know what their health care costs, how good it is, and the choices available to them…", Secretary of Health Leavitt stated. Some insurers such as Humana and Aetna are already experimenting with giving information to help consumers compare care and may use federal government standards, as they are developed, to become benchmarks in the private sector. MEDREVIEW POLITICAL OUTREACH D • Assemblyman Herman Farrell • Manhattan Borough President Scott Stringer • State Senator Kevin Parker In addition to meeting the political leaders noted, Ms. Mutchler had the unique opportunity to meet Donald Trump. On separate occasions during the past few months, Mr. Stamm and Ms. Mutchler visited with Assemblyman Dov Hikind and Councilmember Melinda Katz. These meetings were a continuation of the ongoing discussions regarding ways to alleviate the health care crisis in New York. MedReview was also honored by the surprise visit of Yitzchuk Pindrus, Mayor of Beitar, Israel. Mr. Stamm has developed a long and close relationship with the Mayor and has floated a number of interesting programs intended to enhance the quality of health care in Beitar. These proposals are currently under review by the Mayor. uring the third quarter of 2006, MedReview continued its efforts to reach out to political figures in an effort to educate them regarding the continuous spiraling health care expenditures and its impact on health insurance coverage as well as quality of care concerns. The most significant was the gala birthday party celebrating Congressman Charles Rangel’s 78th birthday. This event, which took place on August 9, 2006, was held at Tavern on the Green. MedReview CEO Joseph Stamm and Executive Vice President, Helen Mutchler took advantage of the presence of many dignitaries who attended to pay homage to Congressman Rangel by briefly discussing issues of concern and seeking follow-up meetings with them. The dignitaries contacted included: • Attorney General Elliot Spitzer (New York’s new Governor) • City Comptroller Bill Thompson • Former Governor Mario Cuomo • Former Mayor David Dinkins News In Review Profile Richard J. Bonforte F M.D.,F.A.A.P. or the past eight years, prior to his recent retirement, Dr. Richard J. Bonforte was Senior Vice-President for Medical Affairs, Vice President and Chairman of the Department of Pediatrics, and Medical Director of the Children’s Medical Center of Hudson County at the Jersey City Medical Center, Jersey City, NJ. He continues to be active at the Mount Sinai School of Medicine where is Professor of Pediatrics and Director of the Cystic Fibrosis Center. Prior to his recent employment at Jersey City Medical Center, Dr. Bonforte was named Chairman Emeritus of the Department of Pediatrics at Beth Israel Medical Center, New York, NY, a department he headed for over 17 years. Dr. Bonforte is a graduate of the Georgetown University School of Medicine, and completed his internship, residency TOP: AT CONGRESSMAN RANGEL’S BIRTHDAY PARTY LEFT: JOE STAMM AND HELEN MUTCHLER WITH BEITAR MAYOR PINDRUS. RIGHT: COUNCILWOMAN MELINDA KATZ WITH ANNE AND JOE STAMM and fellowship training at the Mount Sinai Hospital, New York. Following his training and his military service as a Major in the U.S. Army Medical Corp in the Panama Canal Zone, Dr. Bonforte joined the fulltime faculty of the Department of Pediatrics at Mount Sinai where he became Director of the Division of Pediatric Ambulatory Care and Director of the Cystic Fibrosis Center. In 1977, Dr. Bonforte was awarded a grant from the Department of Health and Human Services, Division of MaternalChild Health, to establish a Pediatric Pulmonary Center. At that time he also became Director of the Division of Pediatric Pulmonology, and recruited its first interdisciplinary faculty. The Pediatric Pulmonary Center is in its 30th year of funded operation and is a nationally recognized clinical, training and research center of excellence in the care of children with acute and chronic respiratory illnesses. Dr. Bonforte has served on the committees and boards of a variety of local and national organizations, including the American Academy of Pediatrics, the New York Academy of Medicine, the Cystic Fibrosis Foundation and the American Lung Association. He is a consultant both to the New York State Department of Health Office of Professional Medical Conduct and to the New York State Attorney General’s Office. Dr. Bonforte has been actively involved with NYCHSRO and MedReview since its inception, and currently serves as Secretary of the Board of Directors. He is the author of over 65 articles, chapters and abstracts; a member of a number of peer societies and organizations; and the recipient of numerous honors and awards. Poetry Corner Memorial Service for Dr. Eric Vanderbush GEORGE BRAMAN, M.D., A REVIEW PHYSICIAN IN THE HOME CARE REVIEW DEPARTMENT IS MORE THAN JUST AN ACCOMPLISHED PHYSICIAN. IN ADDITION TO HIS ACTIVITIES FOR NYCHSRO AND HIS OTHER MEDICAL PRACTICE, HE IS A PUBLISHED POET. THE FOLLOWING IS A POEM FROM THE PUBLISHED WORKS OF DOCTOR BRAMAN: Entitlements Middle age comes upon us unaware, The years begin to slide by unannounced, The extra breath it takes to climb the stair, The lost or misplace key, the graying hair, The familiar phrase blocked or mispronounced. Middle age comes upon us unaware. Like tax returns we need time to prepare, Life-long pleasures take time to be renounced. The extra breath it takes to climb the stair, The modest paunch, the cautionary air, All apply in reckoning our accounts; Middle age comes upon us unaware. We need to take out time to get us there, We need to deal in debits and amounts, The extra breath it takes to climb the stair. We need a moment, coming up for air, To pause, to measure, even to denounce (Middle age comes upon us unaware) The extra breath it takes to climb the stair. The U.S. Census Bureau estimates that about 58 million American adults (26 million men and 32 million women) are obese. The National Institutes of Health calculate that overweight and obese individuals cost the country approximately $122.9 billion per year – a figure comparable CLINICAL CATEGORY to smoking related results. Obesity and related ailHeart Disease ments result in at least $62.7 million in doctors’ Osteoarthritis visits and $39.3 million in lost workdays each year. The condition varies by Hypertension age and race with AfricanAmerican women and the Gallbladder disease middle-aged population the most affected. Breast cancer Childhood obesity is also on the rise. Meanwhile, Endometrial cancer surgical procedures and drugs to reduce obesity Colon cancer have become increasingly A memorial service for Dr. Eric Vanderbush was held at Harlem Hospital on Friday, September 15, 2006. Dr. Vanderbush spent most of his professional career at Harlem Hospital after graduating from Columbia’s College of Physicians and Surgeons. He served as a physician consultant for NYCHSRO/MedReview for over 25 years and was also a member of the Board of Directors of NYCHSRO. The tribute for Dr. Vanderbush was well attended by Harlem Hospital staff; Columbia University faculty; and various distinguished physician from around the world such as Dr. Mathew Hurley, President United Doctors Association; Dr. Edward Healton, Sr. Vice President and Medical Director National Rehabilitation Hospital and Professor Neurology at Columbia Presbyterian Hospital and Harlem Hospital; Dr. Norbert Rainford, Medical Director, Empire Medicare Services; Dr. Aloysius Cuylet, Director Obesity Costs DIRECT COSTS INDIRECT COSTS 8.8 billion N/A 21.2 billion 5.3 billion 4.1 billion N/A 3.4 billion 3.2 billion 2.9 billion 1.1 billion 933 million 310 million 3.5 billion 1.3 billion and Chairmen Department of Medicine, Nassau University Medical Center; B.Walver Kong,Ph.D.,J.D. CEO, Association of Black Cardiologists. Dr. Alfred Ashford, Chief and Director Department of Medicine at Harlem Hospital; and countless others. There were also many representatives from NYCHSRO/MedReview who came to pay tribute to their colleague and friend. The services included music from the ARC Choir of Harlem and very moving memories by friends, colleagues and his sister, Toni Wiarda. There are no words to express the tremendous loss felt by all of us who had the pleasure of working with Eric and the privilege of calling him our friend. Dr. V gave so much to so many, evidenced by his involvement with so many issues concerning clients and staff at NYCHSRO/MedReview. His shoes can never be filled; his influence was far reaching and ever-lasting. Dr. V will remain in our hearts and minds, never to be forgotten. popular (Xenical and Reductil are the two most prevalent anti-obesity drugs), as the population grapples with this persistent problem. In fact, RAND Corp. has found that obese individuals actually use more healthcare services and medications than smokers or heavy TOTAL COSTS drinkers. The annual cost of N/A overweight and obese individuals: $122.9 15.9 billion billion. Direct cost: $ 64.1 billion. Indirect cost: $58.8 billion N/A (comparable to the economic costs of 0.2 billion cigarette smoking). The following chart 1.8 billion shows the costs of common diseases but 623 million only as they relate to weight problems and 2.2 billion obesity: The Trip of a Lifetime: Assemblyman Dov Hikind’s Chizuk Mission to Northern Israel By, Joseph B. Stamm, President CEO., MedReview, Inc. hat started out as a routine trip to Israel Saturday night, 7/29/06 quickly turned into the trip of a lifetime. A group of eighteen fearless or perhaps “foolish” people led by Assemblyman Dov Hikind went on a mission to show solidarity and support to Israel in general and to the brave Israeli soldiers in particular. You could feel that this trip was going to be special when it began with prayers for peace on the plane. After an uneventful flight which landed us in Lod Airport Sunday afternoon, the Israeli customs were shocked to learn that we were on a mission exclusively to the North where Hezbollah missiles were falling, with our first destination being Haifa. The customs agent could not comprehend why we were travelling against the tide with 30% of the residents of Haifa and 70% of the residents of Tzefat leaving to safer destinations (Eilat, Jerusalem). She asked me, “Do you want to die in Haifa?” Realization set in early on with our arrival at Lot Hotel in Haifa, finding soldiers and the press were the only guests at the hotel. Channel 7 news reporter N.J. Burkett who was reporting live from Northern Israel was surprised to learn that we were not even equipped with helmets and bullet proof vests. The truth is we did come with 50 vests and helmets but they were for the Zaka organization, the brave individuals who are on the scene of every tragedy that occurs in Israel. Assemblyman Hikind, in a moving ceremony, presented Zaka with more than $25,000 for vests and helmets (which he quickly accumulated after announcing on the Dov Hikind Show that he was collecting money for that purpose.) Throughout our mission, whether at a debriefing by military personnel as to the current status of the war against the Hezbollah, or in talking with local officials e.g. the mayors of Haifa, Nahariya, Maalot, Kiryat Shmona and Metulla, the unifying theme was that Israel, must complete its mission, the destruction of Hezbollah. In discussion with the local residents throughout northern Israel, it was clear that all were prepared to endure hardships and continue staying in bunkers despite the economic losses due to no tourism, no farming, and no commerce. Israel’s actions were necessary to once and for all achieve security from the constant bombardment of artillery shells from the Hezbollah cowards who use innocent civilians as human shields. What was most disturbing was the one-sidedness of the news W THE VUES • BROOKLYN • 718.377.8016 coverage particularly Sky News and CNN who continuously showed the plight of the Lebanese population; the elderly , the children who were being indiscriminately massacred by the “ruthless” Israeli army despite conflicting reports that proved this was not true. The shameless statement of the UN Secretary General Kofi Annan which accused the Israeli army of deliberately bombing the UN peace keeping personnel was a continuation of the one-sided reporting that prevailed throughout our mission. Nothing was mentioned of the direct hits on the innocent Israeli population or the devastating impact on the Israeli economy which was enduring a complete halt of tourism, most notably in the north during the height of tourism season. Nothing was mentioned about the cramped bunkers where innocent Israeli families, men, women and children, had to stay for more than 3 weeks. Children who were looking forward to spending their summer vacation on trips throughout the country had to endure the nightmare of constant bombardment. For one brief period the members of the mission, which included City Councilman David Weprin, Rabbis Gershon Tannenbaum and Rabbi David Algazi, were forced to run for cover due to the Hezbollah rockets landing nearby. Unfortunately, this is the same situation Israeli families had to endure for weeks. On the positive side was the overwhelming outpouring of unity among around the world and in Israel. The thousands of volunteers throughout the country who came to assist the plight of the northern residents, civilians, and soldiers alike, was heartening. The mission gave the participants the opportunity to see first hand the constant attacks that Israel endured. Over 1,100 homes received direct hits from Hezbollah rockets. Our visit with wounded soldiers in Rambam Hospital in Haifa was moving and greatly appreciated by the wounded soldiers. Most notable, however, was our visit with the Israeli soldiers stationed in Maalot; how appreciative they were in receiving 500 pairs of socks and underwear from Assemblyman Hikind in another humanitarian presentation. The soldiers were given refreshments and drinks, but most of all they appreciate receiving moral support, knowing that they were not alone and that world Jewry was behind them. For those who attended the mission it was a trip of a life time. With special thanks to our leader Assemblyman Dov Hikind who had the foresight and tenacity to undertake this “crazy” mission. AUGUST 12 to AUGUST 18, 2006 NYCHSRO/MEDREVIEW Takes to the Seas YCHSRO/MedReview continued its tradition of a summer outing with a fun-filled boat ride around Manhattan. Staff members from all over the New York area gathered at the Circle Line pier on a hot and sunny day in July to participate in this special event. The weather was perfect and the scenery spectacular as the boat circled lower Manhattan, giving everyone views of the Statue of Liberty, the New York City skyline, and the NYCHSRO/MedReview office. An elaborate luncheon was served (including delicious kosher meals) and there were drinks and fun for everyone. The entertainment included a D.J. who provided music which had many of the NYCHSRO/MedReview family up and dancing. Others just sat back on deck and relaxed, enjoying the view and the sun. The summer outing is always a special day for staff members, particularly those who do not work in the central office. It gives them the opportunity to renew old acquaintances and meet new employees who have joined the organization since the last event. The boat ride was a huge success and everyone went home looking forward to next summer when they can participate in another exciting outing. N NYCHSRO/MedReview One Seaport Plaza 199 Water Street, 27th Floor New York, NY 10038
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