山东女性也会得痛风吗(济南痛风治疗需多少钱) (今日更新中)

With health care costs on the rise, a growing number of Americans are throwing out the old way of seeing a doctor and turning to a membership model. A monthly or annual fee gets you direct access to a doctor, no insurance needed.Twenty years into her career, bogged down by red tape, too many patients and long days, Dr. Shaila Pai-Verma was looking for a better way to practice medicine.“I was just miserable,” she said. “The joy of medicine is gone and then you're just doing paperwork.”So, a year ago, she started a new primary care practice with a new business model.“The patient basically has a direct contract with the physician and they take insurance companies out of it,” she explained.Patients pay a flat monthly or yearly fee. In exchange, they receive a broad range of primary care services and quick, unlimited access to their doctor via in-person office visits, phone or by text.“Everyone wants everything immediate. And so, I think this is it. It's good, especially in this time for people to have access,” said Pai-Verma.Membership fees range from about 5 to 0 per month on average – about 0 less than having typical health insurance. Most patients still carry catastrophic coverage for emergency treatments and hospitalizations, but that insurance is usually only -100 a month, so patients still save money.For Bonnie Micheli and her family, it was all about access.“With this, it's just so much easier to just know that I can contact directly here within a few hours for any issues that I'm having,” said Micheli.In late September, a bipartisan proposal was introduced in Congress that would expand access to the model and allow people to use their health savings account for direct primary care (DPC).Because they see fewer patients than traditional practices, some critics say the model could worsen the shortage of primary care physicians, a trend that’s already driven by burnout.But according to a recent study, DPC members had 25% lower hospital admissions and the cost of emergency room claims was reduced by 54%.“There's less ER visits and you know, better health care for the patient,” said Pai-Verma.While there is still debate, for a growing number of Americans, like Micheli, it’s becoming a simplified health insurance alternative.“Honestly, it’s just so nice to know what I'm paying every month or if you do the annual, what you're getting for that money, and you know exactly who to go to when you have a problem.” 2467

When it's one hundred degrees in Washington D.C., it's hard to get outside to do anything. But for supporters of the late Congressman John Lewis, the opportunity to pay respects to the civil rights icon is worth the sweat. "We knew before coming out here that the heat index would be 105," Lenora Simpson said. "He never stopped, he never gave up, he was always fighting," Simpson added. "I always tell my grandchildren if it wasn’t for the pioneers we don’t know where we would be," Simpson added. Simpson, like so many men and women lining up outside the U.S. Capitol, never met Lewis. They just know his legacy as a fighter for equality. 27 year-old Joshua Maxey, however, did meet Lewis five years ago during an interview. He stood in line Monday thinking of the advice Lewis gave the man. "[He said] now it’s your time, It’s your generations time to pick up the mantle, obviously those words are still stuck with me today," Maxey said. 949

Wisconsin Republicans moved overnight to strip power from newly elected Democratic leaders, advancing legislation that would limit early voting, enact Medicaid work requirements and potentially block the incoming attorney general from withdrawing the state from a lawsuit over Obamacare.The measures are all expected to be signed by lame-duck Republican Gov. Scott Walker, effectively preventing his successor, Gov.-elect Tony Evers, and Attorney General-elect Josh Kaul from delivering on the promises that lifted them to victory in November.Nearly a day after the legislature's "extraordinary session" began, the state Senate and Assembly concluded their work, passing a raft of legislation designed to curtail authorities enjoyed by Walker and outgoing Republican Attorney General Brad Schimel. Democrats are expected to challenge a number of the measures in court.There is no indication when Walker will take up the legislation, but pending his approval, Wisconsin is now expected to reduce its number of early voting days, restrict gubernatorial influence over a powerful economic agency Evers sought to disband, and require legislative backing for certain decisions traditionally made by the attorney general and governor -- a move that would likely block Kaul from pulling the state out of a federal lawsuit against Obamacare.The legislature will also be able to hire its own lawyers to defend state law in court, diminishing the attorney general's power.During the campaign, both Evers and Kaul took their Republican opponents to task over healthcare issues, in particular the state's participation in the legal challenge which would end coverage protections for people with pre-existing medical conditions. Walker had promised to call a special legislative session to reimplement the rule on a statewide level if the suit succeeded, but questions lingered over how robust those new protections would be. A GOP measure that included lifetime coverage caps was rejected by Senate Democrats and a pair of Republicans early Wednesday.One of the bills passed earlier in the session would require permission from the legislature before the state's executive branch could make waivers or changes to public assistance programs, including work- and drug-testing requirements for "able-bodied" adults, putting into effect Walker's controversial Medicaid work requirements and requiring Evers to get Republican support if he sought to end them.Divided along party lines, the GOP-run state budget committee in Wisconsin had a day earlier advanced many of the controversial measures after less than 12 hours of debate and amid growing protests in and around the capitol in Madison.As the Senate session opened Monday, the public gallery was packed. After some muted laughter, the entire gallery was kicked out -- resulting in more protests."They can only win by cheating. That's what they're doing in there right now," Kathy Kennedy, a state employee who took the day off to protest in Madison, told CNN. "They're a bunch of cowards."Before the committee vote, Evers, in prepared testimony, called the legislation and the process behind it "unfettered attempts to override and ignore what the people of Wisconsin asked for this November.""This is rancor and politics as usual," Evers said. "It flies in the face of democratic institutions and the checks and balances that are intended to prevent power-hungry politicians from clinging to control when they do not get their way."Walker denied on Monday that the moves were a partisan power grab."Much of what we did over the last eight years is work with the Legislature," he told reporters, "not at odds with the Legislature."State Senate Majority Leader Scott Fitzgerald, a Republican, has been more open about the partisan machinations in play."I don't have any problem highlighting that right now," Fitzgerald said on Monday. "I want people to understand that, that there's going to be a divide between the legislative and executive branch."In a statement Tuesday, Democratic Legislative Campaign Committee Executive Director Jessica Post called the GOP lawmakers' actions "shameful.""Just because Republicans in Wisconsin and Michigan don't like the outcome of the election does not give them (the) right to put power over people and disregard the will of the voters," Post said. "After years of voter suppression laws enacted by Republican legislators who were elected on their own gerrymandered lines, this partisan gamesmanship has reached a new low."Republicans are pulling from a playbook popularized in North Carolina two years ago, when Republicans in the Legislature responded to GOP Gov. Pat McCrory's defeat by taking action -- after the election but before his replacement could be sworn in -- to reduce incoming Democratic Gov. Roy Cooper's appointees and require his Cabinet picks to be confirmed by lawmakers.The American Civil Liberties Union excoriated North Carolina Republicans at the time, calling their actions then "a shameful partisan trick." But the lawmakers ignored the backlash and McCrory signed off on a plan to curtail his successor's authorities, setting a precedent for Midwestern Republicans, who suffered heavy defeats in 2018.The-CNN-Wire? & ? 2018 Cable News Network, Inc., a Time Warner Company. All rights reserved. 5314

WHITESTOWN, Ind. -- Family and friends gathered Saturday to salute and lay to rest a Whitestown, Indiana veteran who was buried in the wrong grave for nearly 12 years. Family members discovered the casket of Charles Bovenschen missing when they went to bury his wife in the same burial plot earlier this year at the Lincoln Memorial Gardens. Bovenschen passed away in 2006. His wife, Mary, died on February 18. A few days later, the cemetery found Bovenschen's casket buried in the wrong plot. The cemetery covered the costs of Saturday's ceremony, even providing a new casket for Bovenschen for him to be laid to rest next to his wife. Charles and Mary are now together forever.The troubling discovery could be the result of the business practices of the previous cemetery operator which oversaw several sites including Lincoln Memory Gardens. 892

With election day looming, the candidates vying to replace Duncan Hunter in East County's 50th Congressional District say they are leaving no stone uncovered.The race is pitting Republican Darrell Issa against Democrat Ammar Campa-Najjar. The two want to fill the seat Hunter vacated in January, when he resigned after pleading guilty to one felony campaign fraud charge. Campa-Najjar narrowly lost to a then-indicted Hunter in 2018 and is running again in 2020."The whole district, we're just going to be traveling across town, meeting people at local diners and saying 'hey, I'm here for you,'" Campa-Najjar said Monday. Issa represented coastal North County's 49th for nearly two decades. In 2018, he decided not to run for re-election as that district shifted blue. This year, however, Issa launched a campaign for the seat in the 50th after Hunter resigned. The district comprises much of East County, and stretches into south Riverside County. It is the only district in San Diego County in which Republicans outnumber Democrats. Issa said his campaign made 10,000 calls Sunday and knocked on more than 1,500 doors. He said if he is elected to Congress, he'd use his experience to help move the country forward. "Many of my Republican and Democratic friends are coming back after two years of very little progress and a lot of hostility," he said. "I'm hoping to get past that with people I have a working relationship with and get some things done."After months of polling showing the two neck-and-neck, an Oct. 27 ABC-10 Union-Tribune poll showed Issa with an 11 point lead over Campa-Najjar. Thad Kousser, a political scientist at UC San Diego, said, however, that Tuesday's early results could show Campa-Najjar starting in the lead due to increasingly Democratic early voting."Things are going to look good for Ammar Campa-Najjar by 8:05, 8:15, the next set of returns that come in are going to be the ones between 9 and 10:30 that will come from polling places," he said. noting that could be as much as a 10 or 15 point swing for Issa, until the rest of the balance come in. 2096

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