Primary Care
I am now on my third Primary Care provider since March of this year. My U of M Primary Care physician retired in June, and my nurse practitioner primary care provider in Petoskey has left her practice. Today, I signed up for a new primary care provider, another NP here in Petoskey.
Primary care is in a crisis. The shortage is having a major impact on health care. Medical students are choosing other specialties which are higher paying. Some primary care providers are moving to “concierge services”, where patients pay a monthly fee for access to a primary care physician. For seniors, it is approximately $100 per month or more. Concierge services allow for immediate access to appointments, improved telemedicine options as well as other amenities. None of the services are covered by Medicare.
Per the Washington Post, Robert F. Kennedy Jr. and his advisers are considering an overhaul of Medicare’s decades-old payment formula, a bid to shift the health system’s incentives toward primary care and prevention, said four people who spoke on the condition of anonymity to discuss private deliberations.
The discussions are in their early stages, the people said, and have involved a plan to review the thousands of billing codes that determine how much physicians get paid for performing procedures and services.
The coding system tends to reward health-care providers for surgeries and other costly procedures. It has been accused of steering physicians to become specialists because they will be paid more, while financial incentives are different in other countries, where more physicians go into primary care — and health outcomes are better.
I am not saying this is the best answer, but something needs to be done. If not, health outcomes in the country will continue to decline as ERs and urgent care centers will become the primary care provider of choice. Continuity of patient care will be a thing of the past.
Let’s Talk Football
University of Michigan: I could hardly believe what I was seeing on Saturday. Michigan, one of the least productive offenses of the power four conferences, was putting up 50 points, while holding Northwestern to two field goals as Michigan won 50-6. All phases of their offense were working as Michigan moved up and down the field all day.
It couldn’t have come at a better time as U of M travels to OSU on Saturday. Michigan would love to knock OSU out of the B!G title game with a victory over the Buckeyes. If nothing else, the victory over Northwestern gives Michigan confidence that their offense is getting better and with a few breaks they could pull the upset.
Detroit Lions: The 24-6 victory on the road against the Indianapolis Colts was not pretty, but it was effective. The Lions’ defense, which has lost five starters to injury, continues to surprise everybody but themselves. They have now gone 10 quarters without giving up a touchdown. Their record of 10-1 leads the NFC going into their Thanksgiving Day game on Thursday against the Bears. The Lions have not won on Thanksgiving Day since 2016, a seven-year losing streak. I look forward to the Lions ending their losing streak in an all-important division game.
Field Goal Kickers Supreme: We are watching field goal kicking like we have never seen before.
Lions’ first year kicker Jake Bates is a perfect 16 for 16 in field goals this year, with five field goals over 50 yards, including a 59-yarder. At U of M, Dominic Zvada is a semifinalist for the Lou Groza Award for the nation’s top kicker. Zvada is 15 for 16 and has made six field goals this season of 50 yards or more — 52,53, 55, 53, 56, 56 — a Michigan record.
It is amazing how the art of kicking field goals has evolved over the last ten years.
Who’s the Band
When my granddaughter Alexis or Lex, as she is now known, was much younger I used to show her clips of some of the old comedy skits, like the Honeymooners and I Love Lucy. One of the clips I showed her was the original Abbot and Costello skit, Who’s on First.
Once she stopped laughing, she decided to memorize the whole skit. She spent the next couple of hours sitting in my lounge chair working on getting it right. When she finished, she was so proud of herself. She could name each player on the team and the position they played.
Fast forward eight years later to Saturday. Lex forwarded me a “reel” for my viewing pleasure. It is my Video of the Day. Enjoy.
I love it.
From Nolan Finley, Detroit News Opinion November 24: Perhaps Trump never wanted Gaetz in his Cabinet but just wanted him out of Congress. While he is a MAGA devotee, he is also unpredictable and broadly disliked by the congressional Republicans Trump will need to press his agenda in place.
Now, Congress will convene in January minus one pervert. And in Florida AG Pam Bondi, Trump gets the replacement he likely wanted all along.
If that was the outcome Trump sought and this was all a diabolical scheme to get rid of Gaetz, he shouldn’t stop there. A few cabinet spots are still to be filled that have Rep. Marjorie Taylor-Greene’s name all over them.
From My Blog on November 14-A Perfect Choice for AG: One of the subscribers of my blog told me today the choice of Gaetz may have been a perfect setup. We all know that Trump was not happy when Gaetz was the last one to cave allowing Kevin McCarthy to win the speaker position on the 15th ballot in January 2023.
The theory is that Trump and his MAGA friends in the House saw Gaetz as someone they could not trust after the McCarthy vote. Trump knew that Gaetz would not get approved by the Senate. By offering the AG job to Gaetz with the condition that he resign from the House immediately, Gaetz is no longer in the House and Florida Governor DeSantis can appoint a Trump/MAGA supporter into Gaetz’s vacant position. When Gaetz does not get approved by the senate, Gaetz will be without a position of power and will be left groveling for support, which will not come.
One can only hope.
Thank you to my good friend Dan, who first floated this idea two weeks ago when I included it in my post. I love it when my subscribers are out in front of the professional news media.
Substack Transition
I continue to work on transitioning my blog to Substack from Blue Host/Wordpress. I am finding that Substack is much easier to work with, it provides real time data, and it is used by many of the leading bloggers.
In the first few weeks the results have been tremendous. The number of subscribers has doubled to over 100 and the number of views per blog is three and four times the number I was getting on Blue Host. The share function and sign-up functions are so easy to use on Substack.
By the end of December, I will be closing out of the Blue Host/Wordpress platform.
I am looking forward to continuing to grow my blog by offering a good product on an easy-to-use platform that readers are willing to share with friends and family. There is no better way to grow than through the referrals of readers of the blog. If you like what I am doing, please share it with your friends and family members.
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Quotes of the Day: “I still think it’s the Detroit Lions, but Philly is closing the gap. Yesterday wasn’t a great performance by (the Lions), and they still won by almost 20 points…They’re a complete football team — offense, defense, special teams — they can beat you in so many different ways. That run game is absolutely lethal, and they do have two guys, so they’re going to be fresh throughout the playoffs.” Former NFL head coach and current ESPN analyst Rex Ryan.
Orchid of the Day: Devin Gardner, Inkster High School and University of Michigan graduate and former M quarterback, who is now a football analyst for Fox Sports. He was on the crew doing the Michigan/Northwestern game on Saturday. He was outstanding. It is great to see a local kid do so well. He has a great future as a sports analyst.
Onion of the Day: The U.S. Justice Department. They had four years to build their case against Trump. Yet here we are four years later, and they are dropping the two cases against him because he has won a second term as president. It is a major stain on the history of this country that what occurred on January 6, 2021, will go unpunished by the person most responsible for the insurrection and attack on our Capitol. Trump is back in office because the Senate and Justice Department did not do their jobs when they had a chance.
Question of the Day: Since Matt Gaetz was re-elected to his seat in the House of Representatives which is effective January 2025, what are the chances he will try to take office again in January?
Video of the Day: A big thank you to my granddaughter Lex for sharing this with me. It brings back such great memories.
Feel free to share my blog with others. To receive the blog in your email, please use the subscribe/sign-up button which is located at the bottom of the blog below the Video of the Day or send an email to me at thomasdbiggs@gmail.com and I will start the process for you.