In the beginning God created the heavens and the earth. . .By Him all things were created: things in heaven and on earth, visible and invisible, whether thrones or powers or rulers or authorities; all things were created by Him and for Him. He is before all things, and in Him all things hold together. . .The heavens are yours, and yours also the earth; you founded the world and all that is in it...Yours, O LORD, is the greatness and the power and the glory and the majesty and the splendor, for everything in heaven and earth is yours. . .The earth is the LORD's, and everything in it, the world, and all who live in it;
My help comes from the LORD, the Maker of heaven and earth. . . Ah, Sovereign LORD, you have made the heavens and the earth by your great power and outstretched arm. Nothing is too hard for you!
Be exalted, O God, above the heavens; let your glory be over all the earth. . .Holy, holy, holy is the LORD Almighty; the whole earth is full of his glory.
The heavens will vanish like smoke, the earth will wear out like a garment and its inhabitants die like flies. But my salvation will last forever, my righteousness will never fail. . .As long as the earth endures, seed time and harvest, cold and heat, summer and winter, day and night will never cease. . .Heaven and earth will pass away, but my words will never pass away.
Then I saw a new heaven and a new earth, for the first heaven and the first earth had passed away … And I heard a loud voice from the throne saying, "Now the dwelling of God is with men, and he will live with them. They will be his people, and God himself will be with them and be their God. He will wipe every tear from their eyes. There will be no more death or mourning or crying or pain, for the old order of things has passed away."
He who was seated on the throne said, "I am making everything new!" Then he said, "Write this down, for these words are trustworthy and true." He said to me: "It is done. I am the Alpha and the Omega, the Beginning and the End. . .He who overcomes will inherit all this, and I will be his God and he will be my son.”
Gen 1:1, Col 1:16, Ps. 89:11, I Chron. 29:11, Ps. 24:1, Ps. 121:2, Jer. 32:17, Ps. 57:5, Is. 6:3, Is. 51:6, Gen 8:22, Matt. 24:35, Rev. 21
This is our first Easter without my Dad. Every time we pass one of these milestones, it brings a wave of emotion. I have lots of good memories of Easters with Dad. When I was living at home, we took spring vacations at Easter many years. Dad did a lot of traveling working for Ford and accumulated plenty of frequent flier miles and free hotel stays. We reaped the benefits of that during our annual family vacation.
On Easter 1984, Dad delivered our Sunday sermon in our hotel room in Anaheim, CA. I don't remember exactly what he said, but I do remember that the hotel room overlooked Disney Land, where we spent the rest of that day. That was our first really big family vacation. Mom, my brother and I flew out to Phoenix. Dad left the day before and drove straight through, 36 hours so we wouldn't have to rent a car. We toured the southwest - went down a natural water slide in Flagstaff, saw it snow in the desert, spent the night in Vegas, took an amazing boat ride in Utah, saw the Great White Throne, then ended up in California where we went to Disney Land, swam in the ocean and I threw up at the Olympic Stadium. Dad really knew how to plan a vacation!
Easter 1987 was just after we had been in Hawaii for an incredible 2 weeks. After enjoying the beauty there, visiting "Wacky-key Beach," and "seeing parts of Hawaii the average tourist doesn't see," we flew back early on Sunday morning and showed up jet lagged for the services at our home church. Not having slept at all the night before was not a valid excuse for skipping church in our family!
Several Easters after that we spent in Florida - usually Orlando or St. Pete Beach. I can't remember the name of the church we attended there, but I know we were regulars when we were in town. It didn't matter where we were on Easter (or any Sunday, really), worshiping God still took priority. I'm thankful for a Dad who taught us that the things of God are what matter most.
My recent memories of Easter with my Dad include Easter 2003. Mom, Dad, B and I were having Brunch together after church when we gave them the news that we were expecting our first baby. Then we ate a whole lot of really good food!
The next year we went back to that same place for Easter brunch. There was big news that year as well, but not of the happy sort. We grieved together and comforted each other and then ate a whole lot of really good food again.
By the time Easter 2005 rolled around, J was head over heels in love with Papa. We have some really sweet pictures of them together that day. We had brunch together again after church at that same place for the third and final year. Easter 2005, before churchAt Brunch with Papa
Easter 2006 J's first Egg Hunt J and Papa watching the puppet show after the egg hunt
Last Easter turned out to be one month and 2 days before Dad died. It was our last big holiday together. I think it is a fitting one to be the final celebration, because it is the one that gives us the hope of being reunited again one day. Christ's resurrection conquered death for all who trust in Him. My Dad was one of those who did, and because of that, I know I'll see him again.
Easter 2009
"But Christ has been raised to life! And He makes us certain that others will also be raised to life because of Christ. Adam brought death to all of us, and Christ will bring life to all of us. But we must each wait our turn. Christ was the first to be raised to life, and His people will be raised to life when He returns...These bodies will die, but the bodies that are raised will live forever...Our dead and decaying bodies will be changed into bodies that won't die or decay...Then the Scriptures will come true, 'Death has lost the battle! Where is it's victory? Where is it's sting?'...But thank God for letting our Lord Jesus Christ give us the victory!" I Corinthians 15:20, 23, 42, 53-55 (CEV)
Medicare payments are being slashed by 21.2% beginning April 1. An article I received today illustrates the impact this will have on physicians and Medicare patients. This is some of the advice being given to doctors on how to survive the crisis this creates. I've posted some excerpts below, with my comments in italics.
Medscape Business of Medicine, "What to do on Day 1 after the Medicare cuts," Leslie Kane, MACC
Introduction
As of this moment, draconian Medicare cuts will be imposed on April 1 because the Senate failed to pass a bill extending the effective date of the cuts to May 1…Many believe that these drastic Medicare cuts will ultimately not occur. But if this devastating scenario does take place, it won't be business as usual for doctors. Physicians will need to take immediate "staunch the bleeding" actions as well as making longer-term "how will we survive" changes.
The cuts will actually occur. Congress has recessed without correcting the problem. It is possible that they will correct it when they reconvene, and may possibly make the correction retroactive, but for now the cuts are in place.
Day One: Key Actions to Start Off
1. Get Your Lines of Credit in Order
Whether the Medicare cuts stick or not, you're going to have no cash flow from Medicare. If you don't have a line of credit, get one set up and make sure you know how to access it. If you have one in place, make sure it hasn't expired. Look also to any personal lines of credit you have or could get quickly.
This got my attention right off – the first suggestion is to go into debt to keep the doors of your practice open – and not just business debt – personal debt! Doctors tend to be a committed bunch, but putting your family into debt in order to keep working?
2. Hold Off on Funding Your Pension and Making Nonessential Purchases
I suppose as long as you’re putting your business and family into debt in order to continue caring for patients, there’s nothing left over to plan for your future or help stimulate the economy.
3 Get All Hands on Deck to Attack Accounts Receivable
If you have 3 people at your front desk, I would be taking someone off and putting that person on the accounts receivable. If you do this, the office phones might ring a little longer than usual. You may need to explain to patients that you have your staff working on a special project right now, and your staff is tied up.
In case you’re wondering why it’s harder than usual to get through when you call your doctor, it’s because everyone is scrambling to try to find some cash to pay the bills.
4. Collect All Co-payments at the Time of the Visit -- No Exceptions
If your office doesn't currently require the co-payment before seeing the doctor, get your front desk staff to phone every patient scheduled to come in over the next few weeks. Tell them what your new co-pay policy is, so they will be sure to bring cash or a check.
I’m not sure where the staff is going to find the time to call every patient to make sure they show up cash-in-hand when they don’t even have time to answer the phone.
Longer Term Actions
1. Restructure or Reschedule Medicare Patient Encounters
It's too extreme for most doctors to eliminate all Medicare patients from their practice, and many would not want to. But doctors can still allocate fewer resources to that patient.Physicians who can replace Medicare patients with other patients should limit appointment exposure to Medicare patients and give better service, quicker availability, to the patients with better paying plans. Doctors have to ask themselves, "How many hours of the week can we afford to see patients paying 21.2% less than they were yesterday?"
You could allocate certain times to see just Medicare patients, such as Tuesday and Thursday mornings. When Medicare patients call for appointments, the staff would say, "We will put you in on the next Medicare clinic day." Or you might consider hiring a nurse practitioner to see the Medicare population.
*As the child of someone on Medicare, this is what terrifies me the most about all this. It will be increasingly difficult for people on Medicare to get the health care that they need. Fewer doctors will be able to afford to see Medicare patients. Those who do may have fewer appointments available for them, spend less time with them during their visit, or delegate their care to ancillary providers instead.
2. Look at Getting an EMR Even If You Don't Like the Idea
If you purchase and implement an EMR system, you can get incentive money available to you from the government.
More reliance on the government – isn’t that what got us in this situation in the first place?
3. Re-examine Your Staffing Needs
If your practice situation becomes really dire after Medicare cuts, you may eventually have to cut some staff. However, instead of letting people go, you may want to put some people on a part-time schedule.
More bad news for an already fledgling economy.
What Does This All Mean?
Potential impending changes to payment rates could indeed be catastrophic for many -- if not most -- physicians. But after reconnoitering, medical life could reach a new "normal."
A "normal" which, I'm afraid, will include a lot fewer physicians in this country.
I will proclaim the name of the Lord. Oh, praise the greatness of our God! He is the Rock, His works are perfect, and all His ways are just. A faithful God who does no wrong, upright and just is He.
