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At the time his blood work revealed triglycerides of 567 and total cholesterol of 317. He was immediately started on Lipitor and Lovaza. Within two months, his repeat blood work revealed that his triglycerides were down to 190 and total cholesterol was down to 161. He quit smoking and today, four years later, he is doing well. The amazing thing to me is that to this day, my husband does not believe that he had a "silent heart attack". He had no symptoms. Even more amazing to me is that if this had not been picked up on an abnormal EKG he might not be around today. My husband is living proof to me that the services and care provided by cardiologists are invaluable and we were extremely fortunate to have such excellent professionals providing for his care.

There will be 50 percent staff cuts, putting 10-12 employees on unemployment. I will be forced to send patients to the emergency room for evaluations due to lack of staffing. And interventional procedures will skyrocket because physicians in a hospital will test and treat. The most valuable tests in this practice, nuclear stress and echocardiograms, are being cut by a devastating 37 percent, and up to 57 percent if all goes through. There won't be less testing, only less offices able to stay on top of the ever changing medical world; maintaining accreditation and continuous updating, training, and educating. Seventy-six percent of people with symptoms already have irreversible heart damage. Cardiac deaths outweigh any other disease eight times over. It is a fact that the physicians in this area are part of the baby boomer era and will retire. There will be no healthcare in this area with such a large elderly population. Good healthcare will fall by the wayside. Patients will wait until symptoms are so bad that they will be admitted to hospitals.

Preventative care costs a couple of thousand dollars. When it's too late, cardiac care costs hundreds of thousands of dollars. Does the elimination of necessary screenings for people over 75 mean that they are no longer of value? Are they a way to reduce costs? In this area, 75 is young. We have many active adults well-established in their 80s, 90s, and a few in their 100s! Populations that are not Medicare-based will not be affected as much as this area. If it was your mother/father, grandmother/grandfather, sibling, or yourself we were discussing, how would you feel?

This is simply unacceptable. I have over $150 thousand in student loans, and nine years of education after college-and I am going to be without a job because of these cuts.

I support of healthcare reform. But it must be done in a way that doesn't turn into just cutting of physician reimbursement.

Having acquired >$200,000 in debt through obtaining academic cardiology training, while my college classmates earned top salaries in finance, law, and private industry – I make no apology and boldly complain about my anticipated drastic reduction in earnings written into my career path by the CMS Rule.

I have strived to fulfill my top potential as a clinical cardiologist, and best serve my future patient population through academic education. Countless cups of coffee, sleepless nights on the inpatient wards, and diligent study in more libraries than I can count were all par for the course. With a predictable profitability as the light at the end of the tunnel, an intelligent pupil could pursue this career path despite meager means.

As a graduating fellow I sought employment this year. Few practices are hiring with current legislation, as the CMS rule threatens many practices' financial futures. Recruiters estimated 1/3rd the usual number of practice opportunities were available. In fact, an impressive CV and a sincere interest in improving patients' well-being has proven insufficient for securing an offer of employment, for several of my highly-trained colleagues.

The proposed legislation not only threatens my financial security, it ensures that in the future our brightest pupils will no longer seek careers maintaining and improving the health of the population as physicians. Rather, I suspect they will pursue careers in law or business...as lack of tort reform and generous bail-out expenditures have clearly demonstrated where this administration's priorities lie!

I would add one final word. I have long held an interest in cardiovascular MRI and CT, obtaining advanced training in both. The new rule particularly threatens these valuable technologies, which are often the sole method for making vital diagnoses. As it stands now, Cardiac MR/CT are both consistently underutilized, as they are under-reimbursed. The new CMS Rule will make these vital techniques unavailable (except, perhaps, in major academic centers where they can operate at a loss). If limiting access to essential care is the goal of the proposed legislation, it succeeds on all accounts.

How are the people in the world suppose to better themselves when people are taking everything away? So does the goverment want me to lose hope that I will never be able to afford this? Someones dream you take away. So if I was not working and got state help I could have everything paid for? How does this make since???? Why do the middle class people always have to suffer? I am 25 years old and I can't try to better myself without going in debt. What do you think that does for people that are trying to make a living. People that actually care about what they are doing? Instead we would rather pay for inmates to live a free life in jail for things that they have done wrong. What does that mean? Do we all have to do something wrong in order to have things given to us. As a young person in the world I don't see where the things that CMS want to do is going to help. I am not very up to date on all of it either however I hate to even watch it because it is very scary. You are not just messing with the doctors that worked very hard to get there degree but the employees that work for him. Let alone the patients. I thought that the heart was the most important thing in a human body but the way the goverment talks it as if it means nothing. What if all cardiologist just said hey ya know I will just not do this there is no reason too cause in the long run I will be broke. There goes your doctor and your care. How is any of this fair????

What the goverment is not understanding is there has been enough jobs in sussex county that have been taken away why do you want to make take more away? More people will be on un employment. Is this really what the goverment wants? So instead of keeping the payment the same as it is you want to take the money you will save and pay people un employment. Just doesn't make since. I am the only one working in my household because my husband is laid off. I barley make it as it is and now I have the fear that with this passing that I will lose my job. Then I will not be able to further my education which I thought was something that the goverment wants us to do. I will not only lose my job but I will lose everything. Thats depressing. There are many good reasons why you shouldn't do this its not only the employess. Its the patients and doctors too. How would you feel if your grandmother was a patient and only had Medicare like my grandmother does and our office may one day say we can not accept Medicare because of the cost. There goes the patient. They are already on limited amount of money that they have. Its as if you want them to die. If anyone really sat back and took this into consideration they would understand that this is one of the worst things you can do.

Each day we are faced with the possiblity of having no job. It is a very intense and trying time here for us. We have many dedicated and loyal workers however, we are all frightened not knowing how many more will have to be let go from this practice in order to cut expenses.

These people like many, have mortgages, car payments, college loans, children and countless expenses. These jobs are what they have depended on for their livelihood. We had a lady from here just yesterday who is one year from retirement. She is now down to two days per week and will not be able to keep up with many of her accomplishments. She will struggle to keep the mortgage, hang onto her car and hoepfully find a job. . We all grow up with the idea of getting a good education in order to get a good position in a solid company so one does not have to flounder through life. This is what our culture instills upon us and now for her, for what reason? To have it all taken away?.

My point is that not only the CMS cut force doctors to reevalutate the treatment of their patients, it also forces them to be in a situation of not having adequate skilled workers to help them care for the patients properly. I have expressed to many that the realization is that "without the heart" (the engine) to the car working properly, no other organ can funtion. This is fact. Washington "WAKE UP"!!! What are you doing? Please take a step back and look at what is happening. Please consider the effect is has not only on our elderly population with heart problems but how it effects the rest of us too.