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Special penalties in USVI during shutdown

From that blog post on Obama’s #TemperTantrum:

” However, only one of our beaches is staffed with lifeguards under normal circumstances anyway, and when the Park closes on holidays, beaches are not barricaded, nor are citations issued to beach-goers.  It should also be noted, interestingly, that according to VI Coastal Zone Management Act Section 903 (b) (6), all Virgin Islands beaches are public, from the high tide mark down to the water line…”

There have never been barricades (#Barrycades ) before, but there are under #HarryReidsShutdown?

Nationalization: One step at a time

The people relying on Medicare, Medicaid and Social Security didn’t fail. They (we) were sold a tax scheme (sound familiar, Justice Roberts?) that claimed to be insurance and pension plans.

 

If you’ve ever scoffed at the rumors that the Federal government might confiscate your retirement savings, it’s time to reconsider. And you don’t have to look to the actions of Greece, Ireland, Poland or Cyprus to do so.

I recently read a radical extension of past theories for a Nationalized health care solution to the costs of Medicare and Medicaid for the elderly:  Since many elderly citizens receive more out of Medicare, Medicaid and Social Security than they paid in, and so many eventually rely on Medicaid to pay their bills, it was suggested that our government “nationalize” all Nursing Homes and Assisted Living businesses and confiscate of Senior citizen’s assets. The Feds could then expand the Veterans Administration system in order to provide housing and medical care until death.

 

Isn’t the entire purpose of any insurance a bet that the insured will someday need more than he pays into the fund? Couldn’t the claim be made that many Social Security beneficiaries often receive more money over their lifetimes than they paid into the funds?

Since the Federal government got into the health care business with Medicare, Congress has done everything possible to ensure that Seniors are dependent on what we now know are failures. Everyone who becomes “Medicare eligible” -  turns 65 years old – faces penalties for not signing up with Medicare.  Janet Reno threatened Federal charges and prosecution for any Medicare-eligible senior who dared to pay for their own health care with their own money or entered into “private contracts” with their own doctors. Their doctors faced the penalties that go with “opting out” of Medicare. For anyone planning ahead, Congress wrote laws severely limiting Health Savings Accounts.

In the meantime, Federal (and State) government(s) failed to put money aside for the future of the people who were paying taxes that could have gone into genuine savings or the purchase of real insurance.  Private insurance and pension funds acting the same way would have been shut down and the officers imprisoned for doing the same thing.

Under the “tax” of the ACA, everyone will be forced by law – and the IRS, Federal lawyers, guns and prisons – to buy “insurance” (in reality, pre-paid health care). Since the scheme is rigged to benefit the government-run exchanges, that’s how most will buy their “insurance” – or pay their tax.

When the “Affordable Care” scheme proves to be as false as Medicare and Social Security, what next? Where to stop with “nationalization” and confiscation of property? 401K’s? Private pensions? The family home and Mama’s jewelry?

Edited to clean up punctuation, order of ideas – BBN

Free school meals and food stamps unaffected by “shutdown”

Be sure and look at the bottom of the page in this USA Today story for the “By the Numbers,” graphic, showing that the free school breakfast and lunch programs, as well as food stamps (SNAP) are not shut down (deemed equivalent to panda cams). No wonder the Democrats are comfortable in still demanding all or nothing.

House and Senate Republicans had offered short-term funding plans to keep open national parks, the Department of Veterans’ Affairs, and other government services in the nation’s capital.

via GOP piecemeal plan to mitigate shutdown fails in House votes.

Horrible typo uneffected edited — BBN

Gohmert Refuses to Take Subsidy Others Don’t Get #MakeDCListen

Representative Louie Gohmert (Republican from my old home in East Texas) leads the way: refuse ObamaCare subsidy if you can afford it.

“House Republicans have voted for and sent the Senate two different bills, because we have been offering compromises, even to the extent of compromising with ourselves because Senate Democrats and the President have refused to negotiate at all. They have made clear that they will negotiate with Russians and Iranians, but will not negotiate with Americans.”

via Gohmert Refuses to Take Subsidy Others Don’t Get : U.S. Congressman Louie Gohmert.

Senate Dems Sauntering Toward #HarryReidsShutdown #DCtime

Harry Reid is sauntering toward a Federal gov’t shutdown at midnight, tonight.

Even though the House passed a compromise Continuing Resolution (no longer defunding Obamacare, simply delaying it) just after midnight yesterday (Sunday) morning, Harry refused to allow the Senate to gather until 2PM, DC time, today (Monday).

Then, he made his motion to table the House CR. The motion passed along strict Party lines, 54-36. Then . . . might as well wait for it . . .  he announced “debate” until 4PM, DC time.

Compromise or computers: ObamaCare delay inevitable

 “But in some situations, you may see a redefinition of what ‘start’ means.” (Wall Street Journal quoting Obamacare consultant.)

President Obama and Democrats everywhere should be grateful to the Republicans for saving them from a huge embarrassment. Instead, the Dems continue to dig in, escalating their claims to have won a mandate on ObamaCare in 2012, in spite of the fact that the Republicans won enough seats in the House of Representatives to secure a strong majority.

House Republicans passed a new Continuing Resolution that compromises on Obamacare, by changing from refusing funding altogether to setting up a one year delay. Included in the Bill is a measure that would ensure that our military is paid in the event of a shutdown. The Bill also repeals the 2.3% tax on medical devices and the mandate that business owners with religious objections buy insurance that includes controversial “free” contraception.

The Wall Street Journal, in addition to reporting the redefinition of “start,” outlines the many ways that the Federal and State exchanges are not ready to launch Obamacare on October 1:

In the District [of Columbia], people who use the online marketplace will not immediately learn if they are eligible for Medicaid or for subsidies.

In Oregon, people will not initially be able to enroll in an insurance plan on the Web site.

In Vermont, the marketplace will not be ready to accept online premium payments until November.

In California, it could take a month for an insurer to receive the application of someone who applies for coverage on the exchange on Oct. 1.

. . . But as the launch nears, more delays are occurring. On Thursday, the administration announced a delay in the online shopping system for small businesses and confirmed that the Spanish-language site for signing up for coverage will be delayed until mid-October. Earlier in the week, officials said Medicaid applications will not be electronically transferred from the federally run exchange to states until November.

Federal budget: No real Republican divide

If you only read the headlines and first paragraphs of – or the inflamed comments on – the media coverage of the debate over the Federal budget, you might believe that Republican leaders in the Senate are caving to the Democrats on funding Obamacare. In fact, Senators Mitch McConnell and John Cornyn and Senate Republicans recognize and support the House Continuing Resolution which fully funds the Federal government while defunding Obamacare.

There aren’t just two sides to the story. In fact, the media reports obscure that there are three factions: Harry Reid’s Dems, Republicans who support for the House continuing resolution, and In fact, there are three factions: Harry Reid’s Dems, the Republicans who are garnering support for the House continuing resolution, and the Republican efforts led by Senator Ted Cruz to block even the House Bill by filibuster. Hopefully, Senator Cruz will acknowledge that the House CR makes his filibuster unnecessary.

The House Continuing Resolution is a good Bill, allowing the continuation of the Federal government into December. It’s true that the whole budget debate will continue — but wouldn’t it any way?

PolitiFact Texas on Barry Smitherman, “guarantee” to escape poverty

“. . . graduate from high school, keep your first job for over 1 year, get married and stay married.”

Common sense, right? Okay, it’s not as easy as 1-2-3, and association doesn’t equal causation, but who would argue, right?

“Politifact Texas” would. The Politifact.com website claims to fact check political news and news makers’ comments, and has a Texas Edition. In my opinion, they tend to hit such comments from the Left of center. In this case, they seem to go out of their way to prove Texas Rail Road Commissioner Barry Smitherman wrong, but – even by stressing the importance of the economy in the equation – they prove him right.

Take a few steps, Barry Smitherman said, and you won’t live in poverty. Smitherman, seeking the 2014 Republican nomination for Texas attorney general, put his point this way in prepared remarks for an Aug. 26, 2013, appearance before the Texas Alliance for Life: “Several years ago, the Economist magazine published a piece which said that you only have to do three things to guarantee that you will live above the poverty line—graduate from high school, keep your first job for over 1 year, get married and stay married.”

via PolitiFact Texas | Smitherman partly captures virtual guarantee to escape poverty, but theory also relies on economy being strong.

 

The rest of the article traces the history of the publications that make the claims to which Commissioner Smitherman refers.

“Choosing Wisely: Five Things Physicians and Patients Should Question”

Bookmark this page: “Choosing Wisely: Lists.”

Whether you are seeing your doctor for a cold, a routine physical or a “new patient visit,” or when you suspect that he’s offering you the famous notorious “blue pill or red pill,” how do you as a layman know whether a medical test or procedure is needed? Will it lead to a treatment decision or just more tests? Does it help? Or does it actually cause harm?

Or politically, will ObamaCare cost cuts and rationing deny you a procedure, test, or treatment that would be helpful?

The American Board of Internal Medicine Foundation asked the various physician sub-specialty organizations in the US to list tests, treatments and procedures that don’t help or might actually hurt patients. The lists are published on the “Choosing Wisely” website.

Remember, there’s a difference between screening tests that look for something you might have, and diagnostic tests to explain a symptom from your history or chief complaint, a finding on an exam or to determine whether a treatment is working or harming. And there’s certainly a difference between starting a treatment, doing a procedure or ordering a test that leads to more risk than the disease or condition we’re treating just because . . . of money, out-of-date knowledge, or patient desire. Or because we can.

Whatever health care problem or concern you have, take a look at the list from the medical specialty for the pertinent body part or organ system. Which tests and procedure do you need, and which have you had that are on these lists?

I don’t quite agree with all the items on all the lists. After all, patient care is not a recipe from a given cookbook – and besides, patients’ bodies can’t read the books to follow the recipes.

Let’s talk! Ask me questions and/or let me translate the jargon.

Dr. Jeffrey Singer: The Man Who Was Treated for $17,000 Less – WSJ.com

Health Care DollarsNothing in the world is free, but we’re being told that a lot of expensive health care will be, thanks to ObamaCare. Why would anyone think that this time, government interference will result in anything different?

 

The savings talked about in this article aren’t an option for anyone eligible for Medicare, because few doctors and virtually no surgical facilities are willing to take their cash since any “provider” who enters into these cash-pay contracts must “opt out” of Medicare for two years.

 

Jeffrey Singer writes about the benefits of self-pay medicine and the hazards of involving a third party in the Wall Street Journal:

 

This process taught us a few things. First, most people these days don’t have health “insurance.” They have prepaid health plans. They pay premiums to take advantage of a pre-negotiated fee schedule arranged for and administered by a third party. My patient, on the other hand, had insurance.

Second, even with the markdown for upfront “cash-pay” patients, none of the providers was losing money on my patient. Otherwise they wouldn’t have agreed to the prices. With the third-party payer taken out of the picture, we got a better idea of the market prices for the services. It is the third-party payment system that interferes with true price competition, so “market clearing prices” can’t develop.

Take the examples of Lasik eye surgery or cosmetic surgery. These services are not covered by insurance. Providers compete on the basis of quality, outcomes and price. And prices have continually dropped as quality and services have improved—unlike the rest of health care.

When my patient returned for his post-op visit we discussed the experience. It was clear to both of us that the only way to make health care more affordable is to diminish the role of third-party payers. Let consumers and providers interact through market forces to drive down prices and drive up quality, like we do when we buy groceries, clothing, cars, computers, etc. Drop the focus on prepaid health plans and return to the days of real health insurance—that covers major, unforeseen events, leaving the everyday expenses to the consumer—just like auto and homeowners’ insurance.

A little history: Before I went to Medical school, my husband and I felt lucky to have major medical insurance, to cover hospital bills and some procedures. We paid cash for office visits – less than we pay for co-pays now. My first childbirth wasn’t covered by insurance, but we paid less than $1000, including the hospital and the $300 to the doc. Twenty years ago, I received $1100 (Medicaid) to $1800 (Insurance) for pregnancy and delivery Obstetrical care and the hospital charged about the same. Today, the total is $20,000 or more. (In Texas, 55% of those babies are paid for by you, the taxpayer, through Medicaid.)

While some people think our National problems began back when employers first started offering insurance, at least that was insurance and medical costs remained fairly stable until the late 1960′s. The real problems began when Medicare allowed Congress to collect taxes with a promise of a (hospital, Part A) safety net for those over 65, but spent all the money by “loaning” it to the general budget. From the beginning, Medicare inflated costs by encouraging doctors to raise their fees 10% a year. Private health care costs followed or leaped ahead.

Less than 10 years later, the Democrat Congress invented HMO’s in a failed attempt to control costs – but they still didn’t stop spending Medicare and Social Security dollars. A few years later, there was the very mistaken attempt to limit training to cut the numbers of doctors. The Hill-Burton Act, Stark laws, HIPPA, and on and on, further increased the actual costs, the hassle factors, and government ownership of medical care, while promising more by adding outpatient and drug coverage. Bill Clinton’s Attorney General Janet Reno not only armed Donna Shalala’s Health and Human Services Inspectors, she threatened to prosecute Medicare-eligible patients for contracting private pay agreements with their doctors. She and Shalala held “fraud rallies” in football stadiums with the Director of the FBI, to teach Medicare patients how to turn in their doctors for fraud.

If there is to be a government “solution” (short of getting out of the way), future laws should support innovations like “Direct Primary Care” combined with patient-owned major medical *insurance,* rather than pre-paid health care. For those who truly need help, give tax credits similar to the child credit or even the earned income credit.

Just take care of the patient

Focus on Health, Healthcare will follow 2What causes a frail elderly person to become a patient in the hospital and can we do something in the home to prevent that event?  What causes some people to develop chronic illnesses and can other people intervene to prevent the consequences of those illnesses?

What if healthcare reformers asked these questions rather than focusing (or appearing to focus) only on costs? Better yet, what if they recognized the system changes that work, rather than insisting that all doctors must become employees of mammoth organizations, touting the business opportunities inherent in expensive, user-unfriendly electronic medical records and/or forcing an even more expensive change from the 5-digit medical diagnosis codes in ICD-9 to the 7-digit ICD-10 codes?

The source for the graph above is a report by the Oliver Wyman Healthcare Innovation Center, reviewed in Forbes Magazine last January by author Dave Chase. Yes, 5% of patients are responsible for 45% of the costs. What works to lower costs? Taking care of the patient:

In 2008, when physicians from CareMore, an independent medical group based in Cerritos, California, heard news reports of a brutal heat wave, they began contacting their elderly emphysema patients. Physicians worried that the scorching heat would drive their at-risk Medicare Advantage patients to the emergency room. So when patients said they had no air conditioner, the physicians purchased units for them. The theory was that the roughly $500 cost paled in comparison to the cost of an emergency-department admission. As it happened, this non-medical “intervention” kept CareMore’s patients out of the hospital. But if they had needed to go and lacked transportation, CareMore would have offered a free ride.
CareMore has an expansive, counter intuitive approach to healthcare. The group fends off falls by providing patients with regular toenail clipping and by removing shag rugs—a common household risk for the elderly. Patients engage in iPhone conference calls with healthcare professionals and are remotely monitored with devices that feed data automatically to doctors;  for example, patients with congestive heart failure are given a wireless scale that reports their weight on a daily basis—a key step in preventing hospitalization. They have singing pillboxes that chime when it’s time to take medications.

These unusual tactics produce enviable outcomes: CareMore’s  hospitalization rate is 24 percent below average, hospital stays are  38 percent shorter than average, and the amputation rate among diabetics is 60 percent below average. Overall member costs are roughly 18 percent below the Medicare average.

The electronic medical record helped CareMore identify patients at risk, but the EMR is a minor tool compared to the minds of the innovators who recognized the real problems and acted in the best interest of the patients.

Obamacare Consumer Cost Protections–Delayed! | National Review Online

Or, as my granddaughter said, “Was he BORN dumb?” We, the people, will now pay more than we were promised!

The Obamacare “train wreck” continues. Now, the NYT reports, the caps on out-of-pocket expenses–you know the “affordable” part of the Affordable Care Act–are being delayed a year

via Obamacare Consumer Cost Protections–Delayed! | National Review Online.

Why not “delay” the whole thing?

Obamacare months behind in testing IT data security: government

Just in case you thought we were exaggerating:

The missed deadlines have pushed the government’s decision on whether information technology security is up to snuff to exactly one day before that crucial date, the Department of Health and Human Services’ inspector general said in a report.

As a result, experts say, the exchanges might open with security flaws or, possibly but less likely, be delayed.

****

 

IDENTITY THEFT?

When people try to enroll in health insurance starting on October 1 for insurance plans taking effect in 2014, their identity, income and other information they furnish with their application will be funneled through a federal “data hub.”

The hub is like a traffic circle for data. It does not itself store information, but instead has digital spokes connecting to the Internal Revenue Service and other agencies that will allow it to verify information people provide. Opponents of Obamacare have repeatedly raised concerns that sensitive personal information could be stolen.

 

Read more of the story via Obamacare months behind in testing IT data security: government | Reuters.

Hat Tip to Congressman Michael Burgess and today’s “TMA Member Physician’s Daily”

Podcast: Stop ObamaCare – Greg Abbott

From the Greg Abbott Campaign website:

Communications Director Matt Hirsch speaks with Dr. Beverly Nuckols on location at The Texas Mailhouse in Austin about the negative impact ObamaCare is having on small businesses and the health care industry, while U.S. Secretary of Health and Human Services tries to sell an unworkable, expensive healthcare takeover in Texas.

via Podcast: Stop ObamaCare – Greg Abbott.

(I’m a doctor, not an audio/visual expert. And I certainly can’t afford one. Since I can’t get the podcast to embed, so please go to the site. While you’re there, volunteer, donate, help out!)

Freedom2Care: Now Secretary of Health and Human Services Kathleen Sebelius is not radical enough to work at Rite Aid

Conscience? More “Trust me, I’ll violate my conscience” news:

Tolerance. Diversity. Broad-mindedness. Those are the words.

Bullying. Discriminating. Compelling. Those are the deeds.

The contradictory words and deeds often come from one and the same individuals–and in a case I learned about today, companies. Turns out the words of tolerance, diversity and broad-mindedness only apply to those who comply with the dogma and submit to the will of the speakers.

Here’s an email I received this morning from a pharmacist member of the Christian Medical Association:

“Subject: Forced to resign over mandate to sell the morning after pill.

“Just to let you know that Rite-Aid corporation came out with a stricter policy on July 5, 2013 that requires all employees to accommodate the sale of the morning-after pill to all comers, of either gender and of any age.”

Read more via Freedom2Care: Now Secretary of Health and Human Services Kathleen Sebelius is not radical enough to work at Rite Aid.

While I don’t believe that Plan B is an abortifacient, I do believe it’s a powerful drug and that adolescents shouldn’t be able to buy it over the counter. I also find it hard to trust someone who will agree to go against their conscience!

Dr. Wes: A Case of (Medicare) “Fraud”

A real-life, real medicine tale of the risk that doctors face – and are willing to face – when taking care of our patients under arbitrary and often outdated Medicare regulations. It will only get worse under ObamaCare and the IRS.

He was a slender-framed man, mid- to late-sixties, with a kind of ridden-hard-put-away-wet complexion.  It was clear the years had not always been good to him, but being the kind soul that he was, he had plenty of friends.  It was a beautiful summer day to spend with friends for a barbecue, but he arrived feeling puzzled why he collapsed at home earlier in the day.

He stopped at the keg and poured himself a beer in a red solo cup, and as he approached his friends with a smile, he did it again, this time which such gusto that his beer went flying and the thud he made when he hit the ground made everyone gasp.  He laid motionless for a moment face down on the ground while his friends rushed to his aid.  An ambulance was summoned as others rolled him over onto his back.  He began to move – slowly at first – then more purposefully.  As sirens approached, he asked his friends, “What just happened?’

Read the rest of the story here.

The author’s comments:

It is becoming abundantly clear that conflicts between the [sanctity] of human life will confront the government’s unwillingness to pay for procedures. No where is this more clear than with approval of payment for the implantation of an ICD, which might run in excess of $200K for the procedure at some instituions. As a result, doctors who strive to provide state-of-the-art care to their patients will continue to confront similar ethical dilemmas that risk their legal standing (and credentials) as they care for their sickest arrhythmia patients.

By publishing this case scenario, my hope was to draw attention to these ethical dilemmas that are becoming increasingly prevalent in medicine as a result of these outdated, inconsistent, and incomplete coverage decisions, guidelines for care, and “appropriateness use” criteria. Further, the potential for legal action against physicians y imposes real fear for do

ctors if they stray at all from these outdated decisions. This fear is to the point where it might do actual harm – and even cause death – to patients who are left without appropriate treatment as a result.

via Dr. Wes: A Case of Fraud.

CANCELLED: UN Medical Women International Association Prolife Drs’ Presentations

Prolife OBGYNS – AAPLOG – American Association of Pro-life Obstetricians & Gynecologists » MWIA ConfrontationLast weekend, organizers cancelled officially scheduled scientific presentations at the United Nations sponsored Medical Women International Association (MWIA) meeting in Seoul, Korea.

 

The American Association of Pro-Life Obstetricians and Gynecologists have reported the information and published the women doctors’ planned presentations on their blog.

 

According to the published official press release (available in Word format) by the President of MWIA, Ghana’s Dr. Afua Hesse, she personally “intervened” to cancel “listed speakers at our 29th International Congress of MWIA who would deny women their basic right to choice.” She further claimed that the presentations had “no scientific merit and threaten women’s reproductive rights and therefore do not belong at our triennial meeting.”

 

Dr. Donna J. Harrison, an OB/Gyn and member of AAPLOG, was one of the three presenters who found out that their presentations were cancelled only after arriving at the site. The other two presenters were OBGyn Dr. Mary L Davenport, MD, FACOG and Psychiatrist Dr. Martha Shuping, M.D.  After their session was cancelled, Dr. Anna Choi, Chair of the Public Relations Committee of the MWIA 2013 Organizing Committee, invited the three to speak at a press conference.

Canadian Family Physician Dr. Shelly Ross, Secretary-General to the United Nations for MWIA, physically intervened in an attempt to stop a press conference to which the three were invited. Here’s an excerpt from Dr. Davenport’s letter to AAPLOG members about the confrontation:

“They put the three of us up front like a “panel” discussion, and the reporters started asking us questions about our presentation, allowing us an opportunity to talk about what we came to present. About 20 minutes into the interview, the Secretary General of MIWA, a Canadian woman, burst into the room (I kid you not. …and all of this is on camera), and came up to the table and said “What presentation is this? Donna Harrison said “it’s not a presentation”. So she snarled “Why are you being interviewed? At that point, the answers were left to Anna, our host. Anna said that this was a requested interview by the press.

“The SecGen then said “Who gave you permission to interview these people?” And the reporters said “We are the press, we don’t need anyone’s permission. We have freedom of the press” And the Sec Gen snarled at Anna and said “Did you arrange this? Did you talk to the organizing committee?” And Anna said “I am on the organizing committee. I don’t need to talk to anyone.” And the Sec Gen stood in front of the camera, and refused to move, and said “The interview is over.” Then the reporters said “You can’t do this. We have the freedom of the press. You are interfering with the freedom of the press.” But the Sec Gen would not move and said “The interview is over.””

If you’ve never been to one of these big conferences, I’ll explain how they are set up. The tentative schedule is published months in advance. The separate presentations are grouped with similar- or same-topic presentations per “breakout” session, and many separate sessions may be held at one time. In this case, the final schedule of talks and even the signs (as you can see above) had been printed and posted.

I have viewed the three presentations and found them scientifically sound. They’re in PowerPoint format and easy to read, with great graphics and the first, by Dr. Davenport, is excellent and includes the bibliography of her references.

Texas Still Fighting Funding to Planned Parenthood!

In spite of repetitive fraud, in spite of Texas’ laws prohibiting sending money to affiliates of abortionists, in spite of all our work.

Planned Parenthood clinics could be facing a legal fight that could keep them from receiving funding for impoverished Medicaid patients.

When the state passed the Women’s Health Program in 2005, legislators said the intent was to provide more family planning services, but not abortions, to low-income Medicaid patients.

State Sen. Bob Deuell said due to a loophole in the law, Planned Parenthood is part of the program, but thinks they shouldn’t be. As such, he has requested the attorney general clear up the matter.

*****

While Sen. Deuell admits he isn’t in favor of Planned Parenthood, he said his “goal is to provide comprehensive care and — abortion issue aside — the Planned Parenthood clinics don’t provide comprehensive care.”

It could take Attorney General Greg Abbott months to give his opinion.

In a brief HHSC officials sent to Abbott, they told him if the agency limits providers based on the way the law currently reads, the state risks violating Medicaid rules. State health officials said that could result in a loss of federal funding for the program.

via AG to rule on Planned Parenthood funding question – YNN – Your News Now.

Every Slice of Drug-Rep Pizza Counts Starting Aug. 1

It’s possible that I can be bought, and no one’s come up with the right amount of money (or pens or pizzas), yet.

Or maybe, just maybe, I’m honest. Of course not!

I’m assumed to be guilty (where’s the opportunity to prove innocence, much less their duty to prove me guilty?) of all sorts of fraud by authors of the Physician Payments Sunshine Act included in the thousands of pages of PPACA – otherwise known as Obamacare:

From now on, companies must keep track of virtually every payment and gift bestowed on each clinician and report them to the Centers for Medicare & Medicaid Services (CMS), which will report them to the world.

This accounting exercise stems from a provision in the Affordable Care Act (ACA) that seeks to expose the financial dealings between industry and physicians and discourage conflicts of interest for the latter that might skew education, research, and clinical decision-making. Under the ACA provision, called the Physician Payments Sunshine Act, drug and device makers must report any “transfer of value” of $10 or more made to a physician. Transfers of value under $10 — a cup of coffee, say — aren’t reportable unless they add up to more than $100 in a year. Companies also must disclose whether physicians have any ownership stake in them.

via Every Slice of Drug-Rep Pizza Counts Starting Aug. 1.

Of course lawmakers assume that we’re being bribed – that’s what they do! Why aren’t the limits at least as high as those our Senators and Representatives are allowed? Like Democrat Senator Harry Reid, can we form a “Friends of Dr. Practice” and get more, as long as we don’t accept donations at our office?

BTW,  there’s an app available to help doctors keep up with the bribes.

‘Obamacare’ National Marketing Campaign To Cost Nearly $700 Million « CBS DC

In the meantime, doctors who still accept Medicare (not hospitals or other “providers”) are facing decreased payments and increased hassles.

As President Barack Obama’s health care law moves from theory to reality in the coming months, its success may hinge on whether the best minds in advertising can reach one of the hardest-to-find parts of the population: people without health coverage.

The campaign won’t come cheap: The total amount to be spent nationally on publicity, marketing and advertising will be at least $684 million, according to data compiled The Associated Press from federal and state sources.

via ‘Obamacare’ National Marketing Campaign To Cost Nearly $700 Million « CBS DC.

Democratic Congressman: ‘Not Fair’ To Subject Congress To Obamacare Just Like Everyone Else – Forbes

Brain drain? In DC? Oxymoron?

Now that the time to sign up for exchange coverage is nearing, a Democratic member, Rep. John Larson (D., Conn.), is saying that “this is simply not fair” – as key staff members head for the exits to avoid Obamacare.

Politico reports that “many on Capitol Hill fear it could lead to a brain drain” and notes that “[t]he problem is far more acute in the House, where lawmakers and aides are generally younger and less wealthy.

via Democratic Congressman: ‘Not Fair’ To Subject Congress To Obamacare Just Like Everyone Else – Forbes.

Protect the right to life – San Antonio Express-News

I wrote this to the San Antonio Express News, in response to an “Other Views” Commentary a couple of weeks ago that claimed our pro-life HB2 violated the “separation of church and state.” It was rife with errors, easily corrected:

1. Abortion isn’t “private.” It is performed by licensed doctors in licensed abortion facilities, under laws regulating the practice of medicine passed by the elected Legislature of the state of Texas.

2. Women’s health and family planning clinics that offer federal and state funded health and cancer screenings and contraception are prohibited by both state and federal law from performing elective abortion. These clinics aren’t licensed abortion facilities and aren’t affected by HB2.

3. After Pennsylvania, Virginia and Missouri passed laws requiring safety standards similar to those in HB2, most abortion facilities in those states remained open.

4. Abortion facilities are allowed 16 months to come up to standard. If abortion facilities close, it will be because business owners decide not to invest in their facilities.

5. HB2, like earlier Texas laws, protects the mother if her life is endangered by continuing the pregnancy.

6. HB2 doesn’t create any criminal charges for the mother, only for physicians who perform illegal abortions after five months.

HB2 does require doctors who perform abortions to have admitting privileges in case their patients have complications requiring hospitalization and abortion facilities to meet building standards known to improve patient safety.

More, including some philosophy, via Protect the right to life – San Antonio Express-News.

Abortion and Informed Consent: American Thinker

#Stand4Life: As only a woman with first-hand experience can tell us:

If a woman tells her doctor she wants to have a double mastectomy, the doctor won’t assume she’s made a sound decision. He or she will want to review her health history, get a detailed family history, find out if the woman has tested positive for the gene that will put her at increased risk, and so forth.

Similarly, when a woman expresses her desire to have an abortion, the health care provider should not assume she’s making a sound decision. It is their duty to make sure she understands her Carbaby’s development, including a way for her to see an image of her baby. And if that’s not possible, at least an image of a baby at the same developmental stage. Pregnant women deserve exposure to as much information as possible. I would argue that there is no more serious matter than the creation of a new life, save the destruction of it. This is no time to withhold vital information and resources.

As a point of comparison, several years ago my routine screening mammogram showed something abnormal. The immediate follow up diagnostic mammogram confirmed an abnormal mass. The radiologist brought me into her office to discuss the images with me. She showed me the area of concern. Explained the difference in color and shadow and what that meant. She also discussed why the image suggested a mass that was hard, and why that added to her concern. She recommended we move forward with an ultrasound and a fine needle aspiration. Throughout the entire discussion she checked in to make sure I understood everything. She invited questions. During the fine needle aspiration, she showed me the image on the monitor as she was guided with the needle to the area in question. When she withdrew the contents of the mass, she showed it to me and explained, to our great relief, that it appeared that I had nothing more than a benign cyst.

Looking back, I now realize that I knew more about the cyst in my breast than the 3-month old baby who once grew inside me. And that is dreadfully wrong. Not because I knew too much about the cyst. But because I knew too little about my baby.

via Articles: Abortion and Informed Consent.

Edited – title for typo – 8/1/13 at 7:45 AM — BBN

Wrinkle in Health Law Vexes Lawmakers’ Aides – NYTimes.com

Oh! What a tangled web we weave . . .

Under a wrinkle that dates back to enactment of the law, members of Congress and thousands of their aides are required to get their coverage through new state-based markets known as insurance exchanges.

But the law does not provide any obvious way for the federal government to continue paying its share of the premiums for the comprehensive coverage.

via Wrinkle in Health Law Vexes Lawmakers’ Aides – NYTimes.com.

Medicaid Expansion: money, politics, and plain talk

Ross Ramsey of the Texas Tribune only sees the political debate behind both HB2′s restrictions on abortion and Medicaid expansion.

The state didn’t expand its Medicaid program, and you’ll still find legislators across the spectrum thinking about the consequences, good or bad.

This summer’s debate on abortion restrictions turned entirely on politics. It wasn’t about the money.

via The Economic Debate Behind the Political Debate | The Texas Tribune.

Lay aside the silliness that any Conservative considers abortion simply about the money or politics. Let’s look at the Medicaid debate.  Rather than the TT’s simplistic view of “9 Federal dollars for every 1 dollar the State spends,” remember that the operative word in “Medicaid expansion” is “expansion.”

Under the expansion, the only criteria would be income. Any asset test or obligation to look for work would be forbidden by Federal law.

Healthy men and women who choose not to work, not those on disability – and even those whose employers offer some sort of health insurance would have come under the State’s Medicaid.  Many more would find it “cheaper” to quit work or avoid work and go under Medicaid and other benefits.(Back when I was delivering babies, I had several two-income families who found it better for mom to quit work after she became pregnant, since Medicaid picked up the cost of insurance and co-pays for her and the kids.)

I remember a tall, healthy-appearing (I’m qualified to judge, BTW) 30-year-old man who testified against HB2 and all its precursors. He not only showed up for repeated Committee meetings, he was there every time there for the House and Senate hearings. He loudly claimed to be a Texas law school graduate who is (STILL!) unemployed – and criticized and ranted at our Legislators for not “giving” him a job and benefits. Who wants to pay his Medicaid?

The expansion wouldn’t significantly cut the oft-quoted high rate of uninsured in Texas, even according to TT’s own numbers. Over 1/2 of Texas’ uninsured make too much money for Medicaid, and 1/3 make more than $50,000 a year.  Lawbreaking immigrants (someone’s bound to be insulted if I use the term “illegal immigrants”) make up 1/4 of the uninsured, but they wouldn’t be covered without breaking a few more laws. The disabled, low-income mothers and children and the elderly in nursing homes would have continued to be covered under current programs – at least as long as the money holds out.

We Paid for Those Abortions | National Review Online

A question for @GregAbbott_Tx: When will charges be filed?

Planned Parenthood has been found to be guilty of Medicaid fraud including altering medical records and even making taxpayers pay for abortions!  History from California in 2004, New York in 2008, others in New Jersey and Washington state. And now, a settlement for $1.4 Million in 2013 in Texas.

“[W]hat are we to make of a consistent pattern of overbilling and fraud across several states, involving millions upon millions of dollars of taxpayers’ money? Given the impenitent attitude of the Texas affiliates and the Planned Parenthood central command, perhaps it is time to inform Cecile Richards & Co. that orange is the new black.”

via We Paid for Those Abortions | National Review Online.

Planned Parenthood settles Medicaid Fraud (Update 2 on 8-5-13)

Good news for Texas, but it seems there should be more penalties for falsifying records!

Texas Attorney General’s Office Obtains $1.4 Million Settlement against Planned Parenthood Gulf Coast for Medicaid Fraud

Planned Parenthood Gulf Coast fraudulently billed Texas Medicaid program for products, services either not provided or not necessary

HOUSTON – The Texas Attorney General’s Office today concluded the State’s Medicaid fraud investigation into Planned Parenthood Gulf Coast, Inc. Under today’s agreement, Planned Parenthood Gulf Coast must pay $1.4 million for fraudulently overbilling the taxpayer-funded Medicaid program.

After a whistleblower lawsuit was filed alleging improper billing practices by Planned Parenthood Gulf Coast, an investigation was opened by the Texas Attorney General’s Office and the Texas Health and Human Services Commission’s Office of Inspector General. The State’s investigation revealed that Planned Parenthood Gulf Coast improperly billed the Texas Medicaid program for products and services that were never actually rendered, not medically necessary, and were not covered by the Medicaid program – and were therefore not eligible for reimbursement. For example, state investigators determined that Planned Parenthood Gulf Coast falsified material information in patients’ medical records in order to support fraudulent reimbursement claims to the Medicaid program.

via Texas Attorney General.

Update: Of course, PP is saying the claims are “baseless,” and that they paid all that money to rid themselves of a nuisance suit! (See Texas Tribune’s “reporting”  here.)

Update 2 on August 5, 2013: The total that PP agreed to pay is actually $4.3 Million. The first number was just that portion that will be paid to Texas.

Book Review: The Secret Knowledge: On the Dismantling of American Culture

The Secret Knowledge

“Success in life comes not from the ability to choose between the four presented answers, but from the rather more difficult and painfully acquired ability to formulate the questions.”  Mamet, David (2011-06-02). The Secret Knowledge: On the Dismantling of American Culture (p. 28). Sentinel Trade. Kindle Edition.

I’m reading “The Secret Knowledge: On the Dismantling of American Culture,” by David Mamet. Those of you who follow me on FaceBook or Twitter have probably seen a few quotes that I’ve shared.

I’m afraid that I might be indulging in the same thing Mr. Mamet accuses the Liberal Left of doing: surrounding myself with like-minded thinkers and writers. If so, Mr. Mamet at least expresses himself differently than most of the Conservative writers I read.

As an example, I was struck by his description of the new love story, in which two people who don’t even like each other are thrown together by fate and somehow decide they are meant for each other. This is in contrast to the traditional love story in which a couple first falls in love but are separated by outside forces, finally triumphing by their will to be together. (Compare “Sleepless in Seattle” with the movie it references, “An Affair to Remember.”) The difference is subtle, but one of fatalism vs. making a deliberate, conscious choice.

Mr. Mamet is critical of Liberal Arts education, socialism, “change” and “hope.” He explains why Conservatism is better than Liberalism in phrases that go far beyond sound bites and the bumper sticker he sometimes refers to.

From Amazon’s “Popular Highlights:”

“The Good Causes of the Left may generally be compared to NASCAR; they offer the diversion of watching things go excitingly around in a circle, getting nowhere.”

“The essence of socialism is for Party A to get Party B to give something to Party C.”

“. . . Wrights, Cyrus McCormick, Henry Ford, Tesla, Tom Edison, Meg Whitman, Bill Gates, Burt Rutan, and Steve Jobs. How would they and American Industry have fared had Government gotten its hands upon them at the outset—if it had taxed away the capital necessary to provide a market for their wares; if it had taxed away the wealth, which, existing as gambling money, had taken a chance on these various visionaries? One need not wonder, but merely look around at the various businesses Government has aided.”

“Government itself, where waste is the end product.”

 

Mr. Mamet’s central point is that culture is the unconscious and pre-verbal adaptation of people that creates predictability, allowing us to get along with one another. When we throw out our culture and try to create a new one, the “change” leads us to uncertainty and the necessity to weigh each new stimulus because we don’t know what it means under the new conditions.

“The tool of culture is the capacity to predict the operation of the social environment—a property right little different from a right in land or wealth. This cultural right exists not limitlessly—for any property right is limited, by chance, death, inflation, erosion, theft, laws, confiscation, etc. but, as with a material property right, founded upon an abstract concept: predictability, which differs from omniscience, but is of immeasurably greater worth than ignorance. Culture exists and evolves to relegate to habit categories of interactions the constant conscious reference to which would make human interaction impossible.”

(Mamet, David (2011-06-02). The Secret Knowledge: On the Dismantling of American Culture (pp. 12-13). Sentinel Trade. Kindle Edition.)

He compares the new situation to “The First Night in A New Home,” where each creak or thump is unfamiliar, and could mean danger or nothing. No one gets any rest, many will get angry, and far too many will simply stop evaluating those noises for themselves. In societies, those who stop questioning and wish only for peace, end up ceding their will and ability to innovate and create to the herd.

Kindle will let you read the first chapter, free. (I don’t profit from promoting the book.)

La. already has Texas abortion limits | The Town Talk | thetowntalk.com

Louisiana has many of the same restrictions on the books, but they passed with few significant fights in the Legislature and none of the massive protests. The state has added nearly any legal limit it can find on abortion — and several that courts have said weren’t legal.

As they have added new statutes, the bills passed with overwhelming and bipartisan support and with Louisiana lawmakers acknowledging that they hope to lower the number of abortions with each restriction.

Unlike in Texas, Louisiana’s debates don’t showcase a deep divide between Republicans and Democrats. A handful of Democrats oppose the abortion restrictions, but often far more of Louisiana’s Democrats vote to support the measures. A few individuals show up to committee hearings to complain about the latest proposed abortion restrictions, but the bills don’t attract widespread outrage.

via La. already has Texas abortion limits | The Town Talk | thetowntalk.com.

DPS Director Responds to Letter on Security Report | The Texas Tribune

File under “no good deed goes unpunished.”

Officers simply gave visitors the choice to throw away their goods and come in or to take them away and leave, he said. No arrests were made, and no jars were confiscated.

via DPS Director Responds to Letter on Security Report | The Texas Tribune.

Similarly, most of the people who were detained before the night of July 12th were released by police at the Capitol exit door, and allowed re-entry. At least 5 who were arrested for disrupting a House session on July 10th, were released without charges and within 5 hours, according to the Houston Chronicle, when the Magistrate found “insufficient probable cause.” What does that say about Austin/Travis County justice system, that a DPS can arrest a woman, that there are videos all over the ‘Net, and yet the Magistrate can’t find “probable cause?”

Update: one of those women arrested on July 12th was one of the 5 released on the 10th, also according to the Houston Chronicle.

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