What needs to be done for true healthcare reform
Well, here I am at 2am finishing up my suggested revisions to Public Law 16-51. My initial version of this was changed a bit as it now appears on the pre-bill form, House Bill 19-04, so I have worked hard to restore key elemental changes. Some of these are:
(1) The separation of the administrative and medical professional arms of the corporation;
(2) Protection of the doctor-patient relationship, self-policed by the medical professional arm only through two peer review committees;
(3) The board of trustees oversees both arms of the corporation;
(4) Eliminates the practice of medicine by the untrained CEO;
(5) Encourages partnering between the public sector CCHC and private doctors so that additional services can spread to Tinian, Rota and Saipan itself;
(6) It really puts Tinian and Rota on the map and pathway for healthcare reform;
(7) Term limits where appropriate;
(8) accountability of the CEO and the board all the way up to the Senate, who are the people’s elected representatives;
(9) Creation of a much-needed Surgeon General since we really don’t have a functioning public health department that is tracking the crucial current needs and future needs of all of the islands. This position may interface with the Peace Corps or military medical personnel. We need redundancy of facilities and providers and expansion into current non-served areas;
(10) To remove unnecessary master’s degree boundaries that legislation would put on candidates because a bachelor’s degree plus many years of education can be equally effective.
Perhaps the most important reason for healthcare reform is to create the oversight and remove the small power-based pockets of control that lie in the hands of non-elected people in our healthcare system.
There are things that both opponents and critics can debate but what we can agree on is that changes need to be made in order to grow healthcare access and services for the CNMI. For self-serving reasons, Mr. Raho, CEO Muna and Sherleen Osman don’t seem to think we need any healthcare reform at all.
The government belongs to the people and in keeping with that basic premise, my proposed changes set a clear chain of command from the people to their elected officials to the board of trustees and then a division to two separate functioning arms of the CHC corporation: the administrative arm and the medical professional arm. This ensures that doctors and patients make their relationship and decisions free from outside and unnecessary influences.
I have spent 28 years in healthcare and, as a surgeon, have never had so much as a malpractice case filed. I currently sit on a board certification examination board of orthopedic surgery in the United States. At the risk of sounding less humble, I have earned a place to propose these healthcare changes.
There are patients whom I operated on that I have never seen again. One was from Tinian. Many patients had so much difficulty getting to the CHCC hospital from the other islands. Orthopedic care is currently reduced to a contract with a doctor from Guam who was run out by the administration and malpractice suits.
Former House representative Ana Teregeyo was mismanaged and sent home with an infection by an orthopedic physician assistant who was not necessarily supervised by an orthopedic surgeon. What has she had to finally correct this? Four subsequent surgeries. It was my honor to snatch her from Saipan and bring her to the mainland where she allowed me to participate in her reconstruction. It would be my humble wish that this is a testament to my character and thus my entrance to correcting the much needed small power bases through healthcare reform. I would like to see a future where what happened to Ms. Teregeyo and what is currently still happening can never happen again to the people of the NMI. Somewhere along the way, if the new oversight means that what happened to me, Dr. Gary Ramsey, and others, then all the better.
We need to expand medical providers not only on Saipan but Tinian and Rota alike. It is no longer safe to put all of our hospital and operating room needs in the hands of one place, the CHC. The government simply does not have the money to go about building surgical centers and mini-hospitals the size of grocery mini-markets on Tinian and Rota and on the other side of Saipan. These energy efficient and low administrative centers are a must for the future of the people of the CNMI. So how do we do it? We build future partnerships between the public and private sectors. We make it easier to attract more private physicians instead of chasing them away.
One thing that I did not put in the bill, mostly because I did not know how to do it legally is to fix the rates on electricity (12 cents per kilowatt hour on the mainland) and water (0.005 cents per gallon on the mainland), from the CUC. This could be subject to increases only by an index fixed to inflation. Everyone needs to do their part to save healthcare and the CUC maybe needs to be mandated to do their part.
As you know, I feel passionately about this and I have put about 100 hours into the thought processes of this. I will readily make myself available to the senators and to the Senate Healthcare Committee via FaceTime in order to give my testimony.
Thank you for believing in this project. The CNMI needs this healthcare reform!
Dr. Grant Walker
via email
I wonder if this guy is dating Ms. Teregeyo! Or does he have some ulterior motives? Dude, the CNMI can hire other orthopedic surgeons, why are you constantly barking about what goes on here in the CNMI? Look for something else out there, I am sure there’s hundreds of facilities that “would” hire someone like you.
I don’t think he could be hired somewhere else in the mainland U.S.A.
It isn’t about me. It is about people being hurt, access to services and oversight. So in your language, “dude, it’s your homeland, what would you do to help your healthcare system”? It isn’t about me. It is about you. There is a bill before the Senate, Senate Bill 19-04. It can help your people. So do you not care about the issues? It is easy to use personal attacks, the are weak. Let us please hear what you would do on the issues if it isn’t too much work from your armchair?
BYW, it is ok to be suspicious if that is your nature. I haven’t any trouble working so even if I never return I say to you that I have no motive other than to help good folks there. I have 28 years of experience with healthcare in America under a system that works. The NMI’s sustem cannot work and it is fundamentally flawed by PL 16-51. So, it befalls upon me to speak up so the have’s that post like they are in denial or rutle cheap defensive personal derrogatory comments, don’t speak louder than the have-nots who keep sending me hundreds of emails. So, lead, follow or get out of the way. This reform is needed and your cheap shots do nothing to offer suggestions about what can be done better. I write this where I live in relative luxury as compared to most in the NMI. I own 2 clinics here. It isn’t about me. It is about your people. Will you own your kinship or just grumble?
Wow, there Gee Dubya! You OCD is getting the best of you. Please forgive us poor naïve islanders you know we simply are suspect of rich Ho_ _lies living in luxury in Idaho that have spent all of one month on our islands then being all knowing and dictating what reform we need to do here in the CNMI.
Now tell the truth Gee is it health care reform you are so passionate about or is it simply a matter of vindictiveness and getting some payback:
http://www.saipantribune.com/index.php/c26c7285-1dfb-11e4-aedf-250bc8c9958e/
What!! Would you mind shedding your perspective on the “inappropriate gesture” to that minor patient – wow I must have missed that doozy!!!
Dubya, if you are really true to your word and your OCD is really an outcome of your passion for health care here in the CNMI then stay there in the good old US of A, get a much higher paying job the great board certified surgeon that you are, pay you taxes like a loyal patriotic American then redirect your letter to the US Congress to insist they channel you tax dollars here to the CNMI health care system. Now that is the reform we need and would like from you.
Keep painting Gee, the picture you are painting is becoming a master piece!
Nader
BASTA MANA LASTIMA I TEMPOMU YA UN CHOGUE I CHECHO MU!
You keep using the word “we.” Dude, you’re there. We’re here. Let’s keep it that way. We’ll deal with this issue as we see fit. Move on and take your sour grapes with you. Nothing worse than a disgruntled ex-employee who can’t exit gracefully.
Hundreds of emails to me say different. U continue with empty high school girl like cheap personal attacks but u won’t step up to the plate and say what u wd do for ,”we Americans?” Is that b,/c u haven’t anything important to say here publically to the people on how u wd fix things? In all of your negative posts u have not uttered one word to the people of what YOU would do? So, you have said that nothing is wrong and u don’t offer any solutions? ,Who is a sour grape, sir? PS. I have never been an employee of CHCC, despite your derrogatory comment. Do something with your life. Step out of the shadows. Tell us who u r and how u can help the people or what you wd suggest for reforms? I chaalenge you, or r u just full of hate, rudeness and hot air? Don’t look for me to stoo. This is too important!
BananaRude
BASTA MANA LASTIMA I TEMPOMU YA UN CHOGUE I CHECHO MU!
ONE MONTH in the CNMI and this “Dude” is going whack about our islands and health care! What in the world are you thinking? LEAVE our ISLAND and PEOPLE alone! Ever wonder what crawling up his sleeves? Stay there in your “Luxury” life and your 2 clinics.
Hey, I googled you and found something from years ago! Check it out yourself…Good Bye GRANT WALKER….Concentrate with your CLINICS in the great state that you’re in!
Taotaotano,
BASTA MANA LASTIMA I TEMPOMU YA UN CHOGUE I CHECHO MU!
I understand we, Chamorros, tend to take things to heart; because it is the way we are raised. If not respect, then it is hospitality we show to our fellows. We repeatedly offer food even when you have a plate full… another beer in your hand, when the one you hold is barely half-empty. We refuse to take that last bite from a serving plate, because we like to think someone else could use it, unless of course, we happen to be the last person in line for that long trail of food. We are generous, and easily offended at slights to our system. What we should walk away from are personal insults; what we should walk away from are the “juicy” stories we do not fully comprehend or have personal knowledge of. Any sort of media from the radio or television or newspaper, can to their extent, INFORM us of the events that take place, and sometimes, we are left to speculations over facts that happen and we may comfort ourselves with reasons that grant excitement to our lives. We may never really fully know the events that took place for Dr. Grant’s dismissal, that is privy to Esther and Dr. Grant, hence we must advocate for objectivity when a professional opinion is given. We must advocate for an answer to the question, “What lesson have we learned from this?” We must advocate for an answer to the question, “What can we try to do better?” or even a “How can we fix this?” We must not look too far ahead to realize that our future starts with a change in ourselves to affect change in our community. We need to look at the bigger picture, and glean what we can from the past, to figure out what we can do better.
So Dr. Grant gives an opinion. We see him, as a third party, and he offers a professional opinion over what should be done. We need to look past his history, the scandal, and examine what he is saying. Does it help our people? Would it help our people?
Yes, what you say is accurate and true. If perhaps Dr. Walker was a physician in good standing at CHC or in the private sector and had spent any significant time here in the CNMI, more than just one month, as a productive member of our community then I would agree and respect his negative criticisms as professional and welcome stimulus of though of how we may improve.
But that fact remains that something significant must have occurred to cause his dismissal after such a brief employment at the Hospital. True we may never know what really happen other than some disturbing allegations published in the newspaper. However we as discerning individuals can put two and two together to gain a clearer picture of Dr. Walker, his motivations and objectives that betray his concern for health care reform here in the CNMI and cause question of the credibility of his so called professional criticism. He has no vested interest in our community living in luxury in Idaho.
Re- reading all of his posts and related news reports give a picture of a disgruntled dismissed employee with an ax to grind. Reminds of a person suffering from obsessive compulsive disorder and delusions of grandeur, a psychoanalyst’s dream. There is information on the net that there have in fact been trouble in the past, see above contributor’s post which give some credence to Muna’s allegations and subsequent actions. His posts are interspersed with derogatory side swipes at Muna, Osman, Kotheimer and anybody else that he feels slighted by. There is a failure to acknowledged any contribution that he may have had in his own demise at CHC.
And then to poorly veil all of this as some heart felt compassion for the poor unfortunate ignorant islanders whom cannot discern for themselves what is necessary to improve upon their own situation and desperately need Him to come to our rescue. Despite delusions of grandeur and being all knowing, as to be expected for someone whom has only been here for a month, his daily or more appropriately his “knightly” crusades are only so much indicative of his ignorance, superficiality and incomprehension of the total health care picture and the total reform that might be necessary for change.
By the way of his frequent letter’s to the editor, he himself opens to door to inspection and criticism so must we sit idlely by and swallow his criticism without introspect or retort?
I don’t buy it, just a disgruntled ex-employee looking for some payback for a bruised delusional ego of grandeur.
To use Dr. Walker’s own allegory: “it just sticks like pig poo”…..
We need to look past his history and scandal? Dang, you must be living in LaLa land! What if CHC get him back and the Federales say no more Medicaid or Medicare because of him! What if?
You know, I don’t believe there is a LaLa land, geographically speaking. I’ve toured half of Europe, visited 2 countries in Central America, traveled across the US on numerous occasions, but I don’t believe I know where LaLa land is!
To address the bigger issue, the Federal government does not allocate the diversion of funds from Medicaid or Medicare on account of one man. So there is no, ‘what if’, that you pose. CHCC also, is a privatized industry, I hear, not a public one, although it does provide public services.
Here’s an interesting link…http://www.gpo.gov/fdsys/pkg/USCOURTS-idd-4_06-cv-00013/pdf/USCOURTS-idd-4_06-cv-00013-1.pdf
Looks like he has a history of unprofessionalism. Stop while you are ahead doctor or find yourself hanging on to what’s left of your career.
Dismissed. Anyone can sue a “rich doctor”, which what some people think. If you continued to check then you would have seen that the judge dismissed it. I don’t mind transparency but the real key thing is how to help the CNMI so do you offer a suggeston for Health Care Reform?
To Ralphie Nadir, Taotao, Bananarepublic & local
BASTA MANA LASTIMA I TEMPOMU YA UN CHOGUE I CHECHO MU!
LOCAL:
BASTA MANA LASTIMA I TEMPOMU YA UN CHOGUE I CHECHO MU!
You embarrass yourself DMA as the attached dismissal will show.
You also embarrass yourself further by saying I worked for Bingham Memorial Hospital or Louis Kraml, which neither is true. Is this the best you can do to truly help the people of the CNMI? You look foolish as you try to keep the old guard in place by your derogatory personal attacks. I’ve seen it before on various world stages of politics by idiots who can’t argue facts so they resort to childish personal slanders. My gosh, do some people ever grow up?. Now obviously you seem to have access to my CHCC credentialing file (another CHCC privacy example) so you can see that in private practice and owning the Idaho Spine Center. Bingham Memorial Hospital was one facility that I held clinical privileges and declared that I knew of Louis Kraml who yes is a crook as evidence by his two 2013 convictions. I do not care for that man, nor what he and your prev. CEO did to the people of the CNMI. But then again, I do not care for you and your inaccurate and derogatory insults that necessitate a reply since someone as Disqus thinks they deserve space herein.
Now you argue on my credibility but my credibility has nothing to do with my suggestions to help the CNMI with healthcare reform. In fact by trying to help the CNMI for free, perhaps you could see where my honor is cast from. You continue elected to offer no healthcare reform suggestions so then I can only assume that since you don’t think mine are any good and you don’t offer any then you think nothing should be done or let the same people keep going on with their patches and fixes as they have been doing. So then you are part of the problem! I will refrain from giving you the respect of any additional replies as you offer nothing but inaccurate derogatory personal attacks. However something good can come of this:. Good idea on the philanthropy thought. IF I have to sue Esther Muna and Sherleen Osmin then I hereby pledge 100% of any award be donated equally to Tinian and Rota for new hospitals to be built there. Even to you, a dumb squirrel occasionally finds a nut.
Mr. Local, you are obviously not a local because you don’t speak the native language so I will repeat myself in English, “shut up”. You do not speak for us. You embarrass our warm culture.
Baloney!
Again, with the personal attacks??!! I expected better. Please tell me …any of you, besides, Dr. Grant, why we should not separate the administrative and medical professional arms of CHCC??? Has anyone seen Grey’s Anatomy?? It’s on Netflix! 🙂 A board of doctors being in charge of a hospital (this happens in the later seasons!) No bureaucratic micromanagement, as in terms of an administrative professional, unless they have an MD/MBA??? Does our administrative professionals possess one of these??? Tell me, why is it a good idea to NOT separate these two arms of CHCC?? Is it working?? Who is it benefiting?