Life is a Song68856

Healthcare providers, particularly those with a large mix of Medicare related transactions, are in for a cash and profit squeeze. Refinancing existing medical and office equipment leases can be a way to ease the pressure. According to AMA President Jeremy Lazarus, 45% of physicians in the American Medical Association plan to decrease or stop the acceptance of new Medicare beneficiaries if Congress does not act to stop a 5% decrease in Medicare payments. These payment reductions are scheduled to go into effect in 2007. According to Lazerus "Over the next nine years, Medicare will cut physician payments 37%, unless Congress acts before January 1, 2007", adding, "at the same time, the cost of caring for those patients will increase 22%, and that math just doesn't add up". The cuts, which would reduce payments by $2.8 billion over five years, are included in a 2006 deficit reduction package.

Should the projected cuts hold up, providers will need to become more operationally and financially efficient. One way to offset the decreased cash flow is to refinance equipment. Many providers are making very large monthly payments because they have opted to execute four or even three year leases. There are now medical equipment financing options available that can spread those payments out over a 96 month period. For example, a physician needed $500,000 of equipment to start his practice and signed a 48 lease. Payments on the lease, assuming an 8% interest rate, would be approximately $12,200 per month. If that equipment were refinanced at the beginning of year two, the balance would be approximately $380,000. Refinancing that balance over 96 months would result in payments of $5,400 per month, a cash savings of $6,800 per month or $81,600 per year.

The provider should carefully review the equipment being used to determine if he is a good candidate for long term refinancing or even buying new equipment for longer amortizations. If the medical equipment is likely to withstand an onslaught of technical advances, a refinancing could be the ticket to helping offset the specter of Medicare payment deductions.

Over the last few weeks Ive tried to get an interview with a high White House official. I was not successful in this, but I did catch Jose Caliente when he got off work. When he came out onto Pennsylvania Avenue, I said, Ho! Jose!

He stopped and looked at me and said, Do you know me?

I said, Why, of course. You are the White House gardener. Everybody working in the White House is famous.

He smiled with those beautiful white teeth like most immigrants have. He said, I wish I was the gardener. I just do what the gardener says. He says to go plant a flower, I plant the flower. If he says to trim the bush, I trim the bush. If he says to shovel the

I raised my hand. You are too modest, Jose. I did a little checking on you, Jose. (You must do a bit of checking of those engaging in high governmental interviews.) You were born in Tijuana, right?

San Juan!

I was wondering, Jose. If a guy from Mexico wanted to get a Puerto Rico birth certificate, how much would it cost?

Three hundred and seventy-five dollars. Thats what I heard anyway.

Hmmnn, I said. Jose, do you ever talk to the president.

Jose shook his head. He said, I got to be going now.

I said, Is there a good Puerto Rican restaurant around here?

No, he said, but there is a humdinger of a Mexican restaurant just up the street.

I took the opportunity: Well, maybe we can talk over dinner, have a few cervezas, just shoot the bull.

At dinner, Jose told me he was born in Tucson, Arizona and that his name was Tony Rodriquez. I said, You are an American citizen then! I thought you talked funny.

He wiped a drop of cerveza off his lip with his napkin and said, I had to lie to get my job at the White House.

It does seem to be an avant-garde job quality, I said.

You dont understand. They want minorities in government so they hire minorities to clean the toilets and other important stuff like that. Thats how I got on the White House yard gang.

It was time to get to the meat of things. I said, Jose, what do you think of Bush War II?

Its okay with me as long as Im not over there choking on the dust and wondering if the next car that goes by will explode and blow me bit by bit to Hermosillo.

I asked Jose about the cars.

Jose, why can anyone in Iraq load up a car with explosive and blow the hell out of everybody? Cant they control who gets a car? Cant they have secured parking lots so that not just anybody can get to them?

Cars are part of the new freedom.

I said, They had cars before the war. Jose. Why do you think it is that we have never been able to secure the Iraq borders?

Can we secure our own borders? Jose stuffed a bite of tamale into his mouth.

I shifted to armaments. Jose, why do you think we never got control of the weapons in Iraq?

Do we have control of weapons here?

Well, Jose had me there. I said, We decided to get Saddam because he tried to kill the presidents parents in Kuwait, right?

Oil!

Hmmnn, I said.

I decided to ask the one obvious question before I left Jose. I said, "I felt sorry for Powell at the U.N."

"Why? He is a big boy."

"Yeah but having to look like an uninformed"

Jose pulled a big Cuban out of his pocket and lit up. "Powell practiced on the White House lawn."

Now, I had what I was after. A big story that surly would be syndicated all over the world! I was ELATED!

Jose blew smoke in my face and said,"Gotcha!"

by John T. Jones, Ph.D.

The End

copyrightJohn T. Jones, Ph.D. 2005

John T. Jones, Ph.D. (tjbooks@hotmail.com)is a retired R&D engineer and VP of a Fortune 500 company. He is author of detective & western novels, nonfiction (business, scientific, engineering), poetry, etc. Former editor of international trade magazine. More info: http://www.tjbooks.com Business web site: http://www.bookfindhelp.com (wealth-success books / flagpoles) Article Source: http://EzineArticles.com/?expert=John_T_Jones,_Ph.D.