Coach underlines importance of national team

first_imgWinfried Schäfer said Jamaica’s players must embrace the opportunities presented in the national team to make advances at club level.  Schäfer, head coach of Jamaica’s senior men’s national team, made the comments after it was revealed yesterday that Michael Hector had been awarded a five-year contract by English Premier League champions Chelsea FC. “You see how important the national team is for the players. Our player, Hector, after the Copa America and the Gold Cup, is going to Chelsea,” Schäfer remarked. “He played against Argentina, Uruguay and Paraguay. He was out, then returned and played very well against the States, and now Chelsea takes him in and gives him a contract,”  Schäfer said. The 23-year-old Reading FC defender first played for Jamaica at the Copa America in June, where the Caribbean champions were invited as a guest participant. The tall centre-half played against Uruguay, Paraguay and Argentina. Jamaica lost all three matches 1-0. Just weeks later, Hector also played for Jamaica at the CONCACAF Gold Cup tournament. He did not start in the first two games, but came off the bench to replace Jermaine Taylor at the seventh minute of the third group match, against El Salvador. Jamaica won 1-0, and Hector was largely outstanding in respective quarter-final and semi-final wins over Haiti and the United States. His only blip came in the final, where he made two blunders that led to goals against Mexico, which won 3-1. “The national team is important when you want to take the next big step,” Schäfer said. “All players have to prepare and must be fit. Gray (Hughan) is now in Finland,” he outlined of the former Waterhouse FC utility player, who has secured a contract at VPS Vaasa. Arnett Gardens’ Premier League striker, Andre Clennon, is also now attached to the Finnish club. “The players have to work in the clubs for very good fitness, for tactical work and then they can go outside (overseas). Kemar Lawrence is the best example. I saw him in the small match first at Harbour View, and he works very hard. Now he’s at Red Bulls in New York, and maybe he has a chance to go to England. “I saw Mattocks play his last match. Watson (Je-Vaughn) plays, Demar Phillips plays,” Schäfer continued, noting Jamaican nationals who are now commanding a spot in professional teams. All the players listed, Hector included, are in the island for Friday’s crucial first-leg World Cup Qualifying match against Nicaragua. The home-and-away tie, which sees Jamaica travelling for a return match next week Tuesday in Nicaragua, will decide which of the countries advance to the CONCACAF Semi-finals (group stage) elimination series for the 2018 World Cup Finals in Russia. fitness & tactical worklast_img read more

Barber Bernstein AllAmerican lineup for VSO season opener

first_imgThe Vancouver Symphony Orchestra will celebrate its 40th season with an all-American lineup that features popular works by two big names, Samuel Barber and Leonard Bernstein, plus a brand-new piece by composer Nicole Buetti, a member of the orchestra’s bassoon section. Barber’s Violin Concerto has an interesting history. In 1939, Samuel Fels, who made millions selling soap, such as the popular laundry soap Fels-Naptha, commissioned Barber to write a concerto for his violin-playing son. Fels gave Barber a down payment of $500 with another $500 due upon completion of the piece. Barber created two movements with gorgeous, lyrical passages, but the son wanted something really flashy. Barber responded with an exciting finale that put the soloist in constant motion. The heir thought the finale was unplayable. So Barber brought another violinist who demonstrated to the father that it could be performed. The father agreed with Barber, paid him the rest of the money, and informed his son that another violinist would perform the world premiere. Afterward, Barber liked to refer to the concerto as the “Concerto da Sapone,” the Soap Concerto. It has become one of the most famous violin concertos of the 20th century. Japanese violinist Mayuko Kamio, who electrified the audience with a stellar performance of Tchaikovsky’s Violin Concerto two years ago, will be the featured soloist in Barber’s Violin Concerto. The 32-year-old virtuoso vaulted into the limelight when she won the gold medal of the 2007 International Tchaikovsky Competition at the age of 21.last_img read more

Some doctors patients balk at Medicares flat fee payment proposal

first_imgMartha Bebinger, WBUR: marthab@wbur.org, @mbebinger This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente. Jul 31 2018The Trump administration announced a plan Friday that would affect about 40 percent of the payments physicians receive from Medicare. Not everybody’s pleased.The Centers for Medicare & Medicaid Services calls its proposed plan a historic effort to reduce paperwork and improve patient care. But some doctors and advocates for patients fear it could be a disaster.The CMS plan, published in Friday’s Federal Register, is now open for public comment until early September. It would combine four levels of paperwork required for reimbursement, and four levels of payments, into one form and one flat fee for each doctor’s appointment (although there would still be separate filing systems for new and established patients).In a letter previewing the plan to doctors earlier this month, CMS Administrator Seema Verma said that physicians waste too much time on mindless administrative tasks that take time away from patients.“We believe you should be able to focus on delivering care to patients,” Verma wrote, “not sitting in front of a computer screen.”Initially, that sounded pretty good to Dr. Angus Worthing, a rheumatologist in Washington, D.C. Then he tested the claim with his own analysis.During a typical 15- to 45-minute appointment with a patient, Worthing figured, “I might spend one to two minutes less in front of the computer, documenting and typing.”Dr. Kate Goodrich, CMS’ chief medical officer, noted that “saving one to two minutes per patient adds up pretty quickly over time.”But Worthing said the small savings in time is not worth the reduced payment he’d get. The CMS plan would offer a flat fee for each office visit with a patient, whether the doctor is a primary care physician or a specialist.Rheumatologists, in general, could expect a 3 percent reduction in Medicare’s reimbursement because they typically see and bill for more complicated patients, said Worthing, who chairs the government affairs committee for the American College of Rheumatology.And he noted that his personal net income from Medicare patients would drop even more — by about 10 percent. That’s because 70 percent of his costs — for rent, payroll and other expenses — are fixed or rising.Worthing is leading efforts by rheumatologists to persuade CMS to adjust its funding formula before the plan goes into effect in January.“The proposal is well-intentioned but it might cause a disaster,” he said, if it leads to fewer medical students going into rheumatology and other specialties that require doctors to manage complex patients. And physicians might stop taking Medicare patients altogether, or avoid those with more difficult problems.Al Norman, a 71-year-old Medicare patient, said he can see that disaster coming.“If you’re frail or if you are very healthy, you’re worth the same to a doctor [under the proposed plan], and obviously that means that the people who are more disabled or frail are less desirable patients,” said Norman, who worked on elder care issues in Massachusetts before retiring last year.Many doctors predict that the proposed payment changes would establish a financial incentive to see fewer Medicare patients. Goodrich, the Medicare official, disagrees.“That’s an unintended consequence we wanted to mitigate on the front end and avoid,” Goodrich said. Under the proposed system, doctors who need more time with patients could file for an “add-on” payment of $67 per appointment. That would require a small amount of additional documentation, she admitted, but would still reduce a doctor’s keyboard time, according to CMS estimates.Related StoriesMedicare Advantage overbills taxpayers by billions a year as feds struggle to stop itMedicare system aimed at improving care, lowering costs may not be having as much impact as thoughtMedicare recipients may pay more for generics than their brand-name counterparts, study findsThis “add-on” payment is “intended to ensure that physicians are being appropriately compensated for seeing the most complex patients,” Goodrich said.Still, critics of the plan say there are other unintended consequences CMS may not have anticipated.Dr. Paul Birnbaum, who has been practicing dermatology in the Boston area for 32 years, said he’s worried that paying doctors a reduced fee per appointment would translate to lots of short visits.“You would just see more people,” Birnbaum said. “You’d move people through faster. And so you have somebody come back for repeat office visits. And that, over time, would be inflationary.”More frequent trips to the doctor would mean more copays for patients and higher costs for Medicare, he said.The Trump administration is not suggesting the payment changes would save Medicare money. In her letter to doctors, Verma said some physicians would see their Medicare payments increase.And it’s not just doctors who treat elderly patients who are likely to be affected. If the Medicare payment changes take effect, private insurers might follow suit, in part because it’s easier for all insurers to use common billing procedures.Theoretically, obstetrician-gynecologists would be among the biggest winners; they treat fewer complex Medicare patients. Still, many OB-GYNs are worried about the coming changes, too.“There will be winners and losers, and my real fear is it’s not the physicians [who will lose the most]. My real fear is that it’s the Medicare beneficiaries,” said Dr. Barbara Levy, vice president for health policy at the American College of Obstetricians and Gynecologists.Some Medicare advocates are urging CMS to postpone these changes and consider a trial run.“If we’re going to talk about this kind of wholesale, large-scale reconfiguration of the way reimbursement is given to doctors,” said Joe Baker, president of the Medicare Rights Center, “it’s probably best to do that in a demonstration project where we can closely study the ramifications.”CMS hopes to enact any changes to Medicare fee schedules on Jan. 1, 2019.The main challenge remains convincing patients and physicians that the changes are worth doing in the first place.This story is part of a partnership that includes WBUR, NPR and Kaiser Health News.last_img read more