On behalf of the Florida Section Advisory Council, I send summer greetings to all of our ACOG Fellows, Junior Fellows, and FOGS members. Hopefully your summer is unfolding nicely and your practices are enduring the continuing economic pressures of these times. Many of you have asked me about the ongoing effort to convert Florida Section to a District. So, in this issue I would like to bring you up to speed about the current "Districtization" process. But first, I want to talk to you a little about lunches.
Sherry and I recently returned from a 40th anniversary trip to Spain. While we were there, we tried to immerse ourselves in Spanish culture–eat, sleep, walk, drive and speak Spanish. For the most part we did accomplish that and sampled many varieties of gazpacho, fish, veggies, and of course culture. We also learned a bit about Spanish healthcare (read: "free healthcare"). We spoke at length with our tour guides and several new friends in Spain who were more than willing to talk about their experiences. As in many European countries, the socialized system provides free or low cost health care. The bad news is that the waiting time to obtain routine care is interminably long and often the Spanish resort to going to their local pharmacies where they are able to, without a prescription, obtain a wide variety of drugs, antibiotics, etc. Pharmacists often recommend various herbal "cures." Sometimes the pharmacists try to assist, sometimes not.
In other words, one is often "on your own." In terms of hospitalization, be prepared to have your family help with some comfort and basic hygiene needs as many public hospitals in Spain are overcrowded and do not provide the level of care to which most Americans are accustomed. In fact, Spanish healthcare specialists have noted that... "public [participation in healthcare] must be limited in the face of potentially unlimited demand. The public sector in healthcare is the largest and continues to grow. In 1991, there were 354 public hospitals, 149 private hospitals, and 312 private business hospitals. The public health sector contracts a significant number of beds from both types of private hospitals. As of 1999, there were an estimated 3.1 physicians and 3.9 hospital beds per 1,000 people. Recent programs have created special residences for elderly and retired people, eye clinics, a network of government health centers in the principal cities.1. As is usually the case in these type of systems, the use of magnetic resonance imaging, tomography, and even routine breast imaging studies are more limited and for many, out of the question. The simple fact is that many Spaniards take it upon themselves personally to manage their own healthcare, finding frustration with government run care. Many others, especially the less economically independent, rely heavily on the National Health Service on the Iberian Peninsula. That's where "free lunch" comes in.
We had many delicious lunches in Spain, sampling the lovely variety of local fish, vegetables, and spices. Not one of those lunches was free. Not one. Therein lies that admonition about no such thing as a free lunch. Here is what else you should know about Spain: There is a 35 percent income tax. In addition, everything, including food and medical care is taxed with a value added tax (VAT). This generally is in the range of 17 percent!Another item: The money spent on road and building maintenance in Spain is obviously lacking. We drove almost 1,000 km in that country and saw it for ourselves. Police on the highways? Never saw one in four days of driving. Emergency facilities? Good luck. And fees? Well, on one drive we went from Barcelona to Granada–about the equivalent of driving from the Florida Panhandle to Miami and the tolls amounted to the equivalent of $US92! (Using the Florida Turnpike and related toll roads it would be difficult to spend more than $20 on an equivalent jaunt). Fuel was the equivalent of about $5.11/ gal. (about 0.9 liter/Euro). I could goon and on about this, but the bottom line is that Spain is going broke! It is literally on the verge of bankruptcy and hopes to be bailed out by other nations of the European Union who as we know, have problems of their own. These constraints are serious impediments to economic growth and prosperity. No individual or nation can spend more than it earns indefinitely and not have it catch up with them at some point. When thinking about healthcare spending in this country, consider these questions: What other services will suffer because of diversion of funds?
Where will the money come from? How long can a nation sustain unlimited spending? Other than that, Spain was terrific! You really should sample the gazpacho.
A Districtization Update
By now you know that a referendum vote was taken recently regarding conversion of Florida Section to a District–District XII of ACOG. Because the background material including advantages and disadvantages have been explained already, I shall omit that for now. Suffice to say that the vote was affirmative with more than a 10:1 ratio. Since then, behind the scenes effort has been happening to move the process along to achieve our conversion date by mid-2012. At that point, the Congress Executive Board will allow the process to come to fruition. We will truly be a very new and different entity. Florida will take its place among the three other most populous states as their own districts—California, New York, and Texas–on the Congress Advisory Council with an increased national voice and access to the Committee participation and other advantages inherent in District Status. We will also have within our structure our own Sections–probablysix—established by both geographic and population-based determinants. We are going to be establishing elections for Section officers and this is a great opportunity for many of you who have wanted to participate in your College/Congress to become seriously involved. We surely will need some dedicated people!
At the Fontainebleau Hotel this August 6—8 we will be having the annual FOGS/ACOG Section Meeting. As usual, on Friday morning prior to the program opening, we will hold the annual Section Advisory Council Meeting. And the day before, we will hold the next Transition ("Districtization") Committee meeting. In advance of that latter session, we will hold a special focus group to examine the economics of our transition to District status. We will be fortunate enough to have Drs. Ralph Hale and Al Strunk visiting us from the Congress in DC, as well as Immediate Past President Jerry Joseph, and District XI (Texas) Chair John Jennings. Rich Bailey, from the Financial Service Center of ACOG will be on hand, as will the entire Executive Committee of District IV. Needless to say, there are complexities to be ironed out and as always, we invite input from all of you. If you have further questions, would like to provide input, or are interested in taking a leadership role in the emerging District XII, please contact any of the Section officers (Drs. Shelly Holmstrom, Ed Carney, BobYelverton, Karen Harris, or myself) and by all means let us know of your interest.
In the meanwhile, from our home and all of us in the Advisory Council to all of you, best wishes for a wonderful summer, and we are looking forward to seeing you at the lovely Fontainebleau Hotel in August!
íQue disfrutan ustedes el verano!
References
- Encyclopedia of Nations; Health in Spain 2000.
- Health—Spain–average, system, sector http://www.nationsencyclopedia.com/Europe/Spain-HEALTH.html#ixzz0rU3kdGel
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