Doing It All!

Hello DPT Bloggers,

So, just when you think you haven't seen it all, and just when you think that life couldn't get any worse, I challenge you to read this article and watch this video on a young many who refuses to let cancer and the amputation of his leg get him down!

Adam can Do It All! We must always remember that God gives us the power to be thankful!

Together with you in His service.

slesh

More Injuries in the News

Hey DPT Bloggers,

You may not have remembered this event back in the spring when Albert Pujols of the St. Louis Cardinals lined a ball off the face of San Diego Padre pitcher Chris Young, but here is a story of recovery from the terrible event. As I was reading it, I could not help but think of the PT evaluation process. When you read the article, can you determine what is wrong by the symptoms that the pitcher describes?

Together with you in His service,

slesh

Politics & Physical Therapy

Hello DPT Bloggers,

For those of you who are not astute to the world of politics, a very interesting series of events happened over that past couple of weeks that directly impacts you as a future professional and the entire Medicare System. This system, of course, is part of the landmark legislation passed in 1965 that extended government funded health care to all people over the age of 65 and to those who are disabled. The "pay as you go" funding system comes from a tax placed on the paychecks of current workers and is matched by employers.

You may know that there has been a proposed cap on medicare services, one for Occupational Therapy, and a second combined cap for Physical Therapy and Speech Therapy. In these rule changes a few other items are being included such as cuts in Physician fee structure. For the past decade, the APTA has been fighting the implementation of these rules as it would directly impact the ability to provide services to clients. A cap means a limitation in terms of dollars paid, but that means by default a limitations of services provided. A series of extensions or exceptions have been passed by Congress to delay the implementation.

July 1, 2008 was a watermark date in the history of these rule changes. The extensions were set to expire. On June 24, 2008, the House of Representatives overwhelmingly passed a bill (HR 6331 - the Medicare Improvements for Patients and Providers Act) to delay the process yet another time. The vote was 355-49 which in a sense was a fast track vote to get the process moving quickly and on to the other Congressional chamber. 

The Senate however took another position. Tire of delaying these rules. They decided it was time to fish or cut bait. The process was not to be steamrolled through the upper chamber even though the impending deadline was approaching. On June 26, 2008, Sen. Reid tried to force a vote by cloture which would end debate. The 3/5 vote needed to close debate was not obtained. It looked like the therapy caps would be implemented finally. No more delays. And indeed July 1, 2008 did arrive and the therapy caps and fee limitations were implemented. No more laws to provide exemptions.

Sometimes, life is the best teacher if you just take the time to watch and learn. Not giving up, Sen. Reid continued to work on stopping the debate and force a vote. July 9, 2008 it happened. With a vote of 69-30 the cloture happened closing debate. Many things did happen quickly on HR 6331 that day, but uniquely the Senate left the bill alone and kept it free from amendments. So, together the House and Senate sent the legislation to the White House to be enacted into law on July 10, 2008.

The story does not end there, however. In our country, to become law, bills passed by the House and Senate must be signed by the President. President Bush vetoed the bill on July 15, 2008. It looked like the delaying action would fail. The caps that had been in effect for two weeks would continue. The bill was sent back to the House and the Senate, who promptly and simultaneously (on the same day as the Presidential veto!) over road the veto with the required 2/3 vote! The House vote was 383 - 41 and the Senate vote was 70 26. The bill became law and the therapy caps were once again delayed until December 31, 2009.

Many interesting things happened in this most recent day time drama from Capitol Hill and as future physical therapy professionals, you should be alert and supportive of these legislative efforts. To inform yourself, please read all the APTA publishes on the therapy caps and on Medicare. When called upon, act! Call your Congressman. Write letters to your Senators.

As a student of history, I was amazed at how fast the process happened! I was amazed that we saw overwhelming bipartisan support in the House. I was amazed to see cloture first fail and then succeed. The Senate is notorious for killing bills on the floor with debate (filibuster). Then we got to see the power of the Presidential veto, but more amazingly, and on the same day, in both houses, we saw Democrats and Republicans unite to send an overwhelming message to a lame-duck President about who is really in charge!?!? Possibly too, no Congressman or Senator who is up for election this year wants to be on record for voting for something that cuts Medicare benefits 

Through it all, the billing for Medicare remains a complicated issue that has not been solved, only delayed. Someday, we must come to a real and permanent solution to this issue!

Together with you in His service,

slesh

Bad Break!

SBU DPT Bloggers,

For those of you interested in sports medicine and enjoy watching the pursuits of athletes on the field, here is a bit of a medical story for you to follow. Abby Wambach, a true star in the soccer sports world, fractured her leg in the final match leading up to the Olympics. After a collision on the field, they had to carry her in a stretcher off the field and to a local hospital. Both the tibia and fibula have been reported broken and they are speaking now of a complex surgery, titanium rods, and a long road to recovery.

My thoughts and prayers are with her for a speedy recovery.

slesh