Posted by Suzanne Juptner on Jan 24, 2018

Pledge of Allegiance and Invocation

Pledge of Allegiance was said by all.
 
Mary Murphy gave a beautiful invocation imbued with the perspective of helping a friend while being in an ER until 4 this morning. The gist is that we all need to be kinder, more caring, and nicer with each other as we go about our daily lives. Truly words to live by. 

Guests and Visiting Rotarians

We were happy to see former member Tom Mohr and retired doctor and barbershop tenor Dr. Tom Addison.
 
Visiting from San Mateo Rotary was Joy Morriss and Phillip Larson, former Burlingame Rotary member could not resist visiting us again today.
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Announcements
Past President, Stan Moore recognized and thanked the staff that keeps our luncheon and meeting logistics running smoothly every week.  Thank you to Julietta, Jesus and Omar for their ongoing efforts and we hope they enjoy Rotary’s token of appreciation.
 
Mike Horwitz announced that Peter Comaroto joined the $150 President’s Club.  Membership Chair, Cheri Carr went over the new meeting schedule and format effective March 7th and then every Wednesday going forward. Week 1: Breakfast meeting 7:30am - 8:30am at Poplar Creek. Week 2 and Week 3: Lunch meeting from 12:15pm – 1:30pm at Poplar Creek. Week 4: Community engagement, with time, day and location TBD. Will be followed by a social hour at a local bar/restaurant. Week 5: Dark for months with 5 Wednesdays, which in 2018 are May, August and October. 
More information about the meeting schedule and format is available on the Burlingame Rotary website, Clubrunner and on handouts located at the sign-in desk. So visit the Burlingame Rotary website often.
 
Cartoon Contest for 1/17:    Fritz and Mike Kimball announced the winners of last week’s cartoon caption. Congratulations to 3rd place winner Karen Malekos-Smith, 2nd place winner John Delaney and to 1st place winner Rose Camarena, who won with the caption: “I don’t care, Herbert. Mum’s still coming to stay for the month.” 
 
This weeks contest is on...and extended to Monday, January 29th - send your offering to Emily Matthews at Emily@NolaMarketing.com

Program

Bob Hortop, Executive Director of Mills-Peninsula Medical Group (MPMG) and former Rotarian, explained why physicians join certain medical groups, what physician organizations exist on the Peninsula and how insurance companies contract with physician groups to create their networks.
 
Bob began by explaining the difference between closed system networks and open system networks. Closed system networks like Kaiser are gaining in popularity among the insured due to their lower cost and access to good medical care. Open network systems like MPMG and Palo Alto Medical Foundation (PAMF) allow the insured to choose their doctors and specialists but tend to be more expensive. Within the open network system, doctors choose to be part of a partner-based physician organization like PAMF or to be an independent physician who belongs to the Independent Physicians Association (IPA).
 
The need for PAMF was recognized about 9 years ago when new physician recruiting became difficult in our area. High housing costs, high office rental costs and high staffing costs for nurses and staff help, especially those with computer skills, resulted in many newly minted physicians not wanting to establish their practice in our community. Back in 2009, the thinking was that most doctors would join PAMF and that we would see a steady erosion of IPA doctors. The trend of the past 8 years actually shows that not as many doctors are joining PAMF as expected. The reason is two-fold: 1) the costs associated with transitioning doctors from IPA to PAMF salaried is expensive at $1 million per onboard doctor, and 2) IPA doctors are making a good salary and they want to retain control of their business, of which 60% is overhead cost. Bob believes that this trend will continue and that our community will eventually see close to a 50/50 equilibrium between IPA and PAMF physicians.
 
Regardless of physician group, IPA or PAMF, doctors need to be represented as a collective group to obtain good rates from insurance companies so they can be competitive. This is known as the Health Care Industrial Complex. This has opened the door to a new set of problems, broadly labeled Narrow Network Products. Favored by Union Groups, these products exclude doctors and hospitals within our area that have been deemed as too costly by insurers like Blue Cross and Blue Shield. Bob describes Narrow Network Products as the Kmart of Healthcare.
 
During the Q&A session, Stanford’s local presence was questioned, especially the physical locations in Redwood City (old Excite building), San Carlos, and soon to be in Burlingame (old Radio Shack building). Bob said that Stanford’s strategy for local presence throughout the Peninsula is to become the preferred provider for primary care services and when a specialist and/or hospitalization is needed, Stanford becomes the de facto provider of choice. Universal healthcare with a private rider option was also questioned. Of the G8 countries, the United States is the only country without any form of universal health care, likely due to lobbyists and a hereto now inability to figure out how to maintain doctors incomes and/or salaries.