Lawrence Kosinski

GI doc for 30+ years, now 100% dedicated to bringing patients, providers and payers together to advance #valuebasedcare. Founder @SonarMD

[Lawrence Kosinski @lrkosinski]

@AnthonyG0528 I could see that happening. They are tough. My 12 year old with no teeth attacked four javelinas

[Occupy Democrats @OccupyDemocrats]

BREAKING: Congresswoman Kim Schrier obliterates quack MAGA Health Secretary RFK Jr. during a viral public hearing by using her experience as a pediatrician to expose his staggering ignorance on vaccines.

This was an absolute masterclass in destroying Republican crackpots...

"Secretary Kennedy on May 27th you posted a 60 second video on your X account unilaterally changing vaccine recommendations without consulting the customary panel of experts," said Schrier. "As a pediatrician I find that extremely alarming so I thought we would talk a little about some vaccine-preventable diseases."

Kennedy is a well-known anti-vaxxer and regularly pushes anti-science beliefs to the American people. He was appearing before the House health subcommittee to testify on the administration's budget request which includes brutal funding cuts to the Department of Health and Human Services.

"Secretary Kennedy — and these are yes or no questions — have you ever treated measles?" Schrier asked him.

"Do I what?" asked RFK.

"Have you ever treated measles?"

"No," he admitted.

"Well, I have. Let me tell you how miserable it is. These kids have high fevers, struggling to breathe, and they are crying," said Schrier. "They suffer. Great news is that there is a vaccine to prevent it. Secretary Kennedy, again a yes or no question, have you ever treated bacterial meningitis?"

"No," he admitted again.

"Well, I have," said Schrier. "These babies are so sick. They come into the ER with high fevers. They are floppy and we have to figure out why. Do you know how we figure out if a baby has meningitis?"

"Excuse me?" said RFK Jr.

"Do you know how we figure out if a baby has spinal meningitis?" asked Schrier.

"How many babies?" he replied, seemingly mishearing the question.

"I'm going to explain how we figure out and determine if a baby has meningitis," said Schrier.

"Okay."

"We insert a needle between vertebrae until the fluid that surrounds the spinal cord drips out into a test tube. It's called a spinal tap," explained Schrier. "We used to do lots of them. Fortunately, we don't have to do very many of these any more because we have three vaccines that prevent childhood meningitis. These are miracles."

"Secretary Kennedy, yes or no, have you ever treated pertussis or whooping cough?" she asked.

"No. I've had it," said Kennedy.

"Well, I have and in infants, in fact the one I treated, weeks old, came in because the baby just stopped breathing and turned blue," said Schrier. "Let me tell you how scared those parents were. And I've treated a bunch of older kids with it. They cough so hard they vomit. They run out of air. They break ribs. And if you don't catch it before two weeks, antibiotics don't even work."

"They cough for months with broken ribs and that is why it is called a hundred day cough," she continued. "But you know what's great? There's a vaccine that prevents this. Of course, here's the thing, vaccines only work if you actually give them. And we know your record on this."

Kennedy couldn't argue because there is no argument to be made. His beliefs and those like him have caused once-dormant diseases like measles to spread like wildfire across the country. People are dying. This man is woefully unqualified for his position and if he had even an ounce of shame left he would resign immediately.

Please retweet and to thank Congresswoman Schrier for crushing RFK Jr!

[Maria T. Abreu @ibddocmaria]

Honored to pass the gavel to my friend and colleague Larry Kim—great clinician, tennis player, skier, and overall cool guy!

[SonarMD @SonarMD]

We're so thankful to connect with amazing provider partners like @midwestdigesthn at @DDWMeeting! At @SonarMD, we're honored to work alongside dedicated GI specialists who share our commitment to helping IBD patients receive the best possible care.

Together, we're making a difference in patients' lives by detecting early symptoms and preventing costly hospitalizations. Our collaborative approach means better outcomes for the IBD community.

https://t.co/gQdBVUF0Dr

Thank you to all our provider partners for allowing us to be an extension of your practice and joining us in our mission to transform digestive care!

#GIcare #IBDcare #DDW2025 #IBDawarenessmonth #Day5

@bahouck @ibdnaik

[Phil Metzger @DrPhiltill]

It seems few people know what an “indirect cost” is or why it has to be 40-60%.

The reason the government forced universities to raise their indirect costs up to (typically) 40-60% was to force a huge amount of regulations on the universities while also minimizing the bookkeeping to comply with those regulations. This includes the work by contract managers, compliance lawyers, accountants, safety management, etc., who are required by the government per the terms of the contract. If universities had to allocate all those categories of labor to each contract hour-by-hour it would require too much bookkeeping, which would waste money. (I’m setting aside for now the question of whether or how much the regulations are wasting money and only discussing how you bookkeep the effort to comply with the regulations.)

So to save money, while also requiring universities to do these types of work, the government requires universities to roll those categories of labor into “cost pools” that must be allocated as a percent of the technical work in each of the contracts. While the actual “overhead” might be only 15%, these pooled labor charges that are required by the government are typically much more.

Second, the government doesn’t allow the universities to figure out their own indirect rates. These rates are determined by the federal government through audits every couple of years. The government then sends a document telling the university what rate to use for its cost pools. For example, the University of Colorado was told by the DHHS to use 54% (https://t.co/zLuEjM75st) and U. Nebraska was told by DHHS to use 55.5% (https://t.co/z2ZQ2cIkLK). 40-60% is not only reasonable to fulfill the terms of the contract, it is the rate that the government tells the university it can charge for all the work the government requires the university to do.

So if the government wants to reduce the indirect rate to 15%, then it needs to do one of these two things:

Either

(A) eliminate all the federal regulations that force the universities to do those categories of work (compliance, accounting, management, safety management, tracking harmful chemicals, etc.)

Or,

(B) stop requiring universities to pool those real costs into the “indirect cost” category and allow universities to include them in the “direct costs” of the contract.

If the government chooses (A), then the safety rails have been entirely removed. (Even if the government lowers the regulations without entirely eliminating them, the costs they impose will still be real costs that probably come out to more than 15%.)

Or, if it chooses (B), then the direct costs will go way up and research will actually be less efficient because all the bookkeeping, not more efficient.

But if the government caps the indirect rate at 15% without doing either (A) or (B), then it will be impossible to do research for the federal government without going bankrupt. That’s the worst possible choice. It will kill research in the US. Is that what we want?

I can explain it for you but I can’t understand it for you. It’s up to the reader not to be ignorant.

[Health IT Answers @healthitanswers]

#sonarscope with host @lrkosinski @SonarMD & guest Dr. Mark McClellan, a leading voice in value-based care and director of the Duke-Margolis Center for Health Policy
https://t.co/fUHBVqE44y

[Art Candee 🍿🥤 @ArtCandee]

"Bohemian Trumpsody" from @marshsongs may just be the best thing I've seen all day.

Not only are the lyrics spot on, but man they can saaaaaaang!

[Lawrence Kosinski @lrkosinski]

Wow! Now that’s a birthday cake. Buon complains

[American Gastroenterological Association (AGA) @AmerGastroAssn]

There's no better way for a GI extraordinaire like @ibddocmaria to celebrate her birthday than with an impressive cake like this! Help us wish our Madam President @ibddocmaria a very happy birthday today! 🍰🥳

[Lawrence Kosinski @lrkosinski]

I had to get Tim Lash on the show. Value Based Care Solutions for seniors, what a tremendous funding idea.

[Health IT Answers @healthitanswers]

Building Value-Based Care for Seniors #sonarscope with host @lrkosinski @SonarMD & his guest Tim Lash, MBA, President @WestHealth
https://t.co/1PSYucAwJn

[Lawrence Kosinski @lrkosinski]

We need to communicate with health plans so we can collaborate and co-create solutions for value based care.

[AJG - The American Journal of Gastroenterology @AmJGastro]

📕In the #RedJournal

Dr. Maria Abreu @ibddocmaria & Dr. Larry Kosinksi @lrkosinski

"How Did It Get So Difficult to Care for Patients With #IBD?"

https://t.co/2sX0T2okF9

[Puppies & Positivity @Puppieslover]

Adorable dog loves to watch horse racing 🏇

[Lawrence Kosinski @lrkosinski]

I'll be at #OW2024 in San Antonio! Let's connect 🤝 https://t.co/QS6UAhc0sL

[Lawrence Kosinski @lrkosinski]

This is why we left in 2022. We lived on that block

[CWBChicago @CWBChicago]

ICYMI: A man was shot and critically injured while walking near the governor's home in the Gold Coast overnight.

https://t.co/hPnayol5Cl

[Lawrence Kosinski @lrkosinski]

Yes. Fed my microbiome

[Lynn Robinson @Lrobllc1955]

@lrkosinski @AmerGastroAssn Oh no, not the bean soup!🫣

[Lawrence Kosinski @lrkosinski]

@AmerGastroAssn @SenBillCassidy @KathleenTeixei2 @SenBillCassidy always has time for us. We talked over lunch in the Senate lunchroom. We discussed the wonderful work we are doing a @PFPMTAC. The bean soup was fantastic.

[Lawrence Kosinski @lrkosinski]

The Senator is the best. Always has time for us. We had lunch in the Senate lunchroom and discussed PTAC as well as his Primary Care Hybrid Bill. Great opportunity to discuss value based care. The bean soup was fantastic.

[American Gastroenterological Association (AGA) @AmerGastroAssn]

.@lrkosinski had a great meeting with @SenBillCassidy today!

It was a productive conversation about our efforts to improve access to patient care and alleviate provider burdens.

Thank you to the Senator for his time as we advocate on behalf of GI. #AdvocacyMatters

[American Gastroenterological Association (AGA) @AmerGastroAssn]

.@lrkosinski had a great meeting with @SenBillCassidy today!

It was a productive conversation about our efforts to improve access to patient care and alleviate provider burdens.

Thank you to the Senator for his time as we advocate on behalf of GI. #AdvocacyMatters

[SonarMD @SonarMD]

https://t.co/cT8csUiXF4

A major cause of inflammatory bowel disease (IBD) has been discovered by UK scientists. This significant development could lead to novel treatments for Crohn's disease and ulcerative colitis, offering hope to millions affected. 🌟

[Maria T. Abreu @ibddocmaria]

It’s a wrap! Just had champagne toast with my IBD family in LA after officially becoming AGA president. Grateful and excited. Now get to work cooking! ⁦@AmerGastroAssn⁩ ⁦@umiamimedicine⁩ ⁦@GIdietitian⁩

[American Gastroenterological Association (AGA) @AmerGastroAssn]

Let’s move GI forward! ➡️ You’re invited to join @lrkosinski, @gastrodoc12, @drsethinyc, and all GI innovators and previous #AGATech Summit attendees at our #DDW2024 meetup.

📅 May 21, 11 a.m.
📍 AGA Central (L Street Bridge)

Sign up: https://t.co/o9cHXHHdPP