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ICD-10: Whose Bright Idea was this, Anyway?


The future implementation of the ICD-10 code changes - delayed again - will range from about $83,000 for a small practice to as high as an estimated $2.7 million for a large practice, according to a HIT consulting firm.

— The future implementation of the ICD-10 code changes — now happily delayed again — will range from about $83,000 for a small practice to as high as an estimated $2.700 million for a large practice, according to Nachimson Advisors.

How about an indefinite delay, at least until the day after I retire?

— Someone went to the trouble to determine that CPR on television resulted in 67% of the people surviving to go home.

"In reality, a 2010 study of more than 95,000 cases of CPR found that only 8% of patients survived for more than one month and only 3% ended up leading a normal life," The Wall Street Journal reported.

Even worse, in my own medical career, I have never performed, or even witnessed, a successful CPR.

— I read somewhere that there are now at least 13,000 medical apps and counting. A recent NBC story by Nancy Snyderman, MD, covered how these apps will change the face of how medicine is practiced. Aside from telemedicine, payment by check or credit card, full patient records and expansive diagnostic algorithms, how about home monitoring ofEKGs, ECHOs, vital signs and blood sugars? These are all available now. How many do you use?

— While you are merrily doing your taxes and visions of charitable deductions fill your head, consider this IRS ruling, which is being enforced: every charitable gift over $250 has to be backed by a note from the charity with the 11 Magic Words "No goods or services were received in exchange for the contribution." Rats.

I used to watch doctors line up to bid for high-end vacations at charity dos and then write off the whole big check in the name of the Good Cause.

— Charles Schwab, which holds a major chunk of America's IRAs, reports that 22% of them leave the money in a money market fund, which pays essentially nothing. If you do this too, then you lose to annual fees, to inflation over time and, importantly, you lose opportunity as the market has reached a historic high.

Look at your account folks. If money market limbo has been your habit, then this is a good time to review why and what else you could be doing to achieve your long-term economic life goals.

— I happened to see a 2009 Sports Illustrated article that reported 78% of former NFL players had gone bankrupt or experienced financial distress within a mere two years of their retirement. This has happened in spite of required league financial counseling for rookies and maybe because of the swarm of advisors, agents and other entourage hangers-on who seem to infest locker rooms.

— Here is some cold comfort for those of you who are envious of the mega-returns for venture capitalists in Silicon Valley that the media reports on daily. The Kaufman Foundation reports that only 20% of VC funds in its portfolio beat the public market equivalent over 20 years. The public narrative of high-profile successes is a sliver of the actual experience for most start-ups, thousands of which fail annually.

— In 1967, the richest 1% made 9% of the nation's total income and paid a top tax rate of 79%. Now the richest 1% makes more than 20% of the nation's income and pays a top rate of 39%. Forbes’ list of the 400 richest Americans have more wealth than the bottom 150 million of us combined.

— Lastly, a congressional study has found that 2,400 tax filers reporting incomes over $1 million tapped the U.S. government of $21 million in unemployment benefits in 2009. ’Nuff said.

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