Obamacare

‘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.

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.

Why not Planned Parenthood? Feds ban some types of providers

For the first time in history, federal health officials said Friday they will ban certain types of Medicare and Medicaid providers in three high-fraud cities from enrolling in the taxpayer-funded programs for the poor as part of an effort to prevent scams.

via Feds ban some types of Medicare providers from enrolling in Miami, Chicago, Houston – The Washington Post.

ObamaCare’s ‘Liar’ Subsidies (but no qualifying)

Who’s surprised that ObamaCare has one more set of freebies for some, costs for all? How about that recent decision to delay employer reporting of benefits? Turns out that the subsidies won’t be delayed — so they will be based on an honor system. The honor of the people applying for the subsidies.

From the Wall Street Journal’s Taranto and “Best of the Web Today:”

 

HHS promises to develop “a more robust verification process,” some day, but the result starting in October may be millions of people getting subsidies who don’t legally qualify.

via Review & Outlook: ObamaCare’s ‘Liar’ Subsidies – WSJ.com.

“No Cost” Contraception (Obama Administration fantasy)

The Obama Administration has published its final rule on health insurance coverage of contraception. “Religious employers” are supposed to be happy with the Obama decree that insurance companies will provide contraception “at no cost.”

We all know that there’s no such thing as “no cost.” Everyone will “share” the cost, since everyone will be forced to buy health insurance.

Here’s the letter, thanks to one of the Conscience groups I follow:

From:   Lauren Aronson
             Director, Office of Legislation
             Centers for Medicare & Medicaid Services
 
Re:       Administration Issues Final Rules on Contraception Coverage and Religious Organizations
 
Today, the Obama administration issued final rules that balance the goal of providing women with coverage for recommended preventive care – including contraceptive services prescribed by a health care provider – with no cost-sharing, with the goal of respecting the concerns of non-profit religious organizations that object to contraceptive coverage.  The final rules reflect public feedback received in response to the Notice of Proposed Rulemaking issued in February 2013. 
 
Today’s final rules finalize the proposed simpler definition of “religious employer” for purposes of the exemption from the contraceptive coverage requirement in response to concerns raised by some religious organizations.  These employers, primarily houses of worship, may exclude contraceptive coverage from their health plans for their employees and their dependents. 
 
The final rules also lay out the accommodation for other non-profit religious organizations – such as non-profit religious hospitals and institutions of higher education – that object to contraceptive coverage.   Under the accommodation these organizations will not have to contract, arrange, pay for or refer contraceptive coverage to which they object on religious grounds, but such coverage is separately provided to women enrolled in their health plans at no cost.  The approach taken in the final rules is similar to, but simpler than, that taken in the proposed rules, and responds to comments made by many stakeholders.
 
With respect to an insured health plan, including a student health plan, the non-profit religious organization provides notice to its insurer that it objects to contraception coverage.  The insurer then notifies enrollees in the health plan that it is providing them separate no-cost payments for contraceptive services for them for as long as they remain enrolled in the health plan. 
 
Similarly, with respect to self-insured health plans, the non-profit religious organization provides notice to its third party administrator that objects to contraception coverage.  The third party administrator then notifies enrollees in the health plans that it is providing or arranging separate no-cost payments for contraceptive services for them for as long as they remain enrolled in the health plan.  The final rules provide more details on the accommodation for both insurers and third party administrators.

 
To view the Final Rule: http://www.ofr.gov/OFRUpload/OFRData/2013-15866_PI.pdf
 
To view technical guidance on the temporary enforcement safe harbor visit: http://cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/preventive-services-guidance-6-28-2013.pdf
 
To view the self-certification form for eligible organizations visit: http://cms.gov/CCIIO/Resources/Forms-Reports-and-Other-Resources/index.html#Prevention
 
If you have any questions, please contact the CMS Office of Legislation. Thank you

House State Affairs disruption #TxLege #HB60 #SB5

“There are many ways to kill a child, and abortion may be the kindest way to do it.”

That first line was not only a statement made by one woman who testified tonight (watch the meeting at the House website, here), it was a recurring theme at the House State Affairs Committee meeting on June 20,2013, even though there is no evidence that increased elective intentional abortion has ever decreased child abuse.

But, the suggestion that it is acceptable to kill children was not what disrupted the meeting of these Texans.  After many, many times of reminding them not to film the proceedings, not to engage in outbursts that broke up the meeting, Chair Byron Cook announced that he would limit the testimony in order to bring up the second Bill on the Agenda. At that point, the crowd began shouting and some tried to speak without being called to their turn. The Chair called a brief recess and testimony resumed. (Personally, I agree with the Chair that the crowd should be better behaved and with the citizens who had signed in that they should be allowed to speak.)

Earlier this week, Representative Jessica Farrar (D- 148, Houston) sent out this email:

Friend,Governor Perry has declared war on women.  Last week he vetoed the Texas Lilly Ledbetter Act because he thinks women should be paid less than men for doing the same work.  Now, he has added bad women’s health bills restricting safe access to abortion to the Special Legislative Session. This week is your only opportunity to speak out against these bills.Come to the State Capitol this Thursday afternoon and evening, June 20th, when the House State Affairs Committee will hold a hearing on these bad bills.  The hearing will begin at 1:00 p.m. or upon adjournment of the House in Room JHR 140.Please prepare a three minute testimony on the subject, and speak from your heart. What you say can make a difference.  Be ready for a long night, as the hearing will go on as long as it takes.You can also fight back against Rick Perry’s war on women by helping to elect Democrats who will stand up for equal pay and women’s health issues. Please consider donating $5, $10, or $25 to the Texas House Democratic Campaign Committee to ensure that our key Democratic legislators return, and that we are able to gain seats in the House.  Your support now will build the foundation we need to ensure this war on women will go no further.Sincerely,Jessica

Pol. Adv. paid for by the Texas House Democratic Campaign Committee, Lon Burnam, Treasurer.
P. O. Box 1925, Austin, TX 78767

Although Rep. Farrar admitted early on Thursday night, that “there are two lives involved” in abortion,   she is the one who suggested that we should abort every child with spina bifida in Committee, back in the regular Session. Below are some of the other continuing themes we’ve heard during testimony in favor of the status quo and against any new restrictions on abortion providers.

Texas has a culture of hate for women, so we should abort children (male and female) in order to prevent a “brain drain.”

A married Social Worker told us that she was “elated” after her abortion to be relieved of a responsibility she never wanted. Another woman said that her friends had abortions between 18 to 24 years old, claiming that it was before they were able to choose their majors in college or decide on an outfit! Many men said that they were “relieved” not to be burdened with unwanted children. One that really stuck out was 24 years old when he enabled the abortion of his own child.

One man, an angry 30 year old unemployed lawyer, echoed the wish of many of those who came at the call of the Texas Democrats. He and the others believe that the Texas Legislature should work on laws that will give him a job, healthcare benefits. (And child day care, Medicaid for all, maybe even an allowance for stay at home women.)

There were the usual complaints that men in the Legislature were trying to control the women of Texas (ignoring that the author of the Bill, many of the co-authors and a great many of the voters who put them in office are women) and the repetitive accusations that only religious bigots are “anti-choice.”

“There are many ways to kill a child, and abortion may be the kindest way to do it.” Maybe, because then the child will never know. But there are no GOOD ways to do it.

Addendum (or a couple of other recurrent themes):

1. The claim that abortion will prevent the consequences of post partum depression. Abortion is never treatment for what is properly called “perinatal” depression. In fact, perinatal depression can be triggered by miscarriage or spontaneous abortion and by elective interventional abortion.

2. Don’t forget that women and children will be harmed most by the limits on abortion and that Texas’ legislature should let President Obama give us free expanded Medicaid and Obamacare!

Update: the video can be viewed, here, at the Texas Legislature Online website.

Edited 6/21/13 at 9:00 AM to add the link to the video and add the ‘tag” HB60 – BBN

Edited 6/21/2013 for typos and to fix the penultimate (how often do I get to use that word?) paragraph “post partum depression,” not “post partum abortion.” (The latter is not possible, yet.) BBN

Dems divided on congressional Obamacare changes – Jake Sherman – POLITICO.com

Democrats are seeking to exempt Congress and their staffers from Obamacare.

http://www.politico.com/story/2013/04/dems-divided-on-congressional-obamacare-changes-90648.html

Florida Senate panel rejects Medicaid expansion | Modern Healthcare

Good for the Florida Legislature!

A Florida Senate committee has essentially killed Gov. Rick Scott’s plan to expand Medicaid coverage to roughly 1 million of Florida’s poorest residents.

Instead, the committee proposed Monday that the state adopt a managed care system that requires patients have a copayment.

*****

A House panel last week also rejected expanding Medicaid.

via Florida Senate panel rejects Medicaid expansion | Modern Healthcare.

Connecting the Dots on Healthcare – Hal Scherz – Page 2

Just one reason that Medicaid expansion is a bad idea. (There are more at the source.)

 

The GOP Governors who are expanding Medicaid at the behest of the federal government are helping to facilitate and accelerate this process, paving the way for full government run healthcare. Insurance companies will be unable to compete with the federal government, which is acting as both a player in the insurance market and also as the referee in the system, until private insurance companies cease to exist in healthcare.

via Connecting the Dots on Healthcare – Hal Scherz – Page 2.

How to comment on latest IRS ObamaCare regulations

Those regulations on penalties and exemptions for not buying insurance are not “final regulations” until after the comment period, which ends May 2, 2013 and a public hearing on May 29, 2013.

The IRS publication document can be found here, http://www.irs.gov/PUP/newsroom/REG-148500-12%20FR.pdf

Here’s how to comment

1. “Snail Mail,” or old fashioned paper letters and postcards –
CC:PA:LPD:PR (REG-148500-12), room 5203, Internal Revenue Service, PO Box 7604, Ben Franklin Station, Washington, DC 20044.
2. Hand-deliver your comments –
“Monday through Friday between the hours of 8 a.m. and 4 p.m. to CC:PA:LPD:PR (REG-148500-12), Courier’s Desk, Internal Revenue Service, 1111 Constitution Avenue, NW., Washington, DC.”
3. Send comments by e-mail –
“electronically via the Federal eRulemaking Portal at http://www.regulations.gov (IRS REG-148500-12).”
4. In person at the public hearing:
“May 29, 2013, beginning at 10:00 a.m., in the Auditorium, Internal Revenue Building, 1111 Constitution Avenue, NW, Washington, DC.”

IRS: Cheapest Obamacare Plan Will Be $20,000 Per Family | CNS News

Update 2/3/13: these are not “final regulations” until the comment period has passed. Information on comments to the IRS is appended st the end of this post.

We thought it couldn’t get worse:

(CNSNews.com) – In a final regulation issued Wednesday, the Internal Revenue Service (IRS) assumed that under Obamacare the cheapest health insurance plan available in 2016 for a family will cost $20,000 for the year.

Under Obamacare, Americans will be required to buy health insurance or pay a penalty to the IRS.

via IRS: Cheapest Obamacare Plan Will Be $20,000 Per Family | CNS News.

Send your comments to

CC:PA:LPD:PR (REG-148500-12), room 5203, Internal Revenue Service, PO Box 7604, Ben Franklin Station, Washington, DC 20044. Submissions may be hand-delivered Monday through Friday between the hours of 8 a.m. and 4 p.m. to CC:PA:LPD:PR (REG-148500-12), Courier’s Desk, Internal Revenue Service, 1111 Constitution Avenue, NW., Washington, DC, or
sent electronically via the Federal eRulemaking Portal at http://www.regulations.gov (IRS REG-148500-12).

The comment period ends May 2, 2013, and there will be a public hearing “May 29, 2013, beginning at 10:00 a.m., in the Auditorium, Internal Revenue Building, 1111 Constitution Avenue, NW, Washington, DC.”

The IRS publication document can be found here, http://www.irs.gov/PUP/newsroom/REG-148500-12%20FR.pdf. The examples begin on page 67.

De Tocqueville Moment

The answer to the question I asked back in July, 2011, is “yes.”

Has the United States of America reached the Moment predicted by Alex de Tocqueville when he warned that,”The American Republic will endure until the day Congress discovers that it can bribe the public with the public’s money?”

Worse, Congress has proven that “some animals are more equal than others” and that the majority – or their representatives – can take liberty and property from the minority for the benefit of the majority. (“Life” was already infringed by abortion laws.)

Forget for a moment that nearly half of the people in the US haven’t paid income taxes for years, and in fact, 1/5 don’t pay income taxes or payroll taxes, at all. (Their taxes are “negative,” meaning they get more from the Federal system than they pay.)

“Weary” wink?

Most people who don’t pay taxes understand that it’s wrong to take from others, and that good ethics do not demand that other people give them stuff, no matter how much the “rich” have.   Nevertheless, the Golfing President from Hawaii (not Illinois) demonizes people who “only” pay 35%-40%.

That 39.6% tax rate on “the rich” will effectively be closer to 41%, since personal deductions and itemized deductions are being phased out or eliminated for those earning more than $300,000. Add in the 3.8% “the unearned income Medicare contribution tax,” and we’re creeping toward 50%.

Welcome to Newspeak.

Grover Norquist says a vote for tax increases is a vote for permanent tax decreases. (Yes, some is better than none, but let’s be honest – the Bill is a tax increase that’s not balanced by cuts in spending.)

How about the extension of unemployment benefits for another year or, better yet, retro-active tax benefits for those who use trains, buses, trolleys or trams to go to work? $230 per month for tickets and another $240 or more per month for parking!

Another “back door tax” resulting from the Bill passed by the House and Senate over the last 2 days is a delay in tax refunds. Since many who were taxed under the Alternative Minimum Tax won’t know their real tax rate for 2012 until mid- February or so, they can’t file and can’t get their money back from the IRS.

Obama flies back to Hawaii, Proves that majority can take your property

11:30 p.m. ET – Obama will depart the White House late Tuesday, the White House announced, to resume his vacation in Hawaii. He left his family on the island earlier this week, putting his vacation on hold and returning to Washington to deal with the fiscal cliff negotiations.

via Latest updates: House approves fiscal cliff bill – CNN Political Ticker – CNN.com Blogs.

Review & Outlook: It’s a Mad, Mad, Mad, Mad ObamaCare – WSJ.com

30 day review and comment, dump of regulations, and still no one knows what we’re dealing with, come January 1st:

 

To take one example, for the better part of a year states and groups like the bipartisan National Governors Association and the National Association of Medicaid Directors have been begging HHS merely for information about how they’re required to make ObamaCare work in practice. There was radio silence from Washington, with time running out. Louisiana and other states even took to filing Freedom of Information Act requests, which are still pending.

Now post-election, new regulations are pouring out from HHS—more than 13,000 pages so far and yet nuts-and-bolts questions are still unanswered. Most of what we know so far comes from a 17-page question-and-answer document that HHS divulged this week, though none of the answers have the force of law and HHS says they’re subject to change at any moment.

HHS is generally issuing rules with only 30 days for public comment when the standard is 60 days and for complex regulations 90 days and more. But the larger problem is that HHS’s Federal Register filings reveal many of the rules were approved in-house and ready to go as early as May. Why the delay?

****
In other implementation hilarity, no fewer than 18 Democratic Senators and Senators-elect came out last week against ObamaCare’s $28 billion tax on medical device sales—and not just the usual penitents from Massachusetts and Minnesota. The list includes Chuck Schumer, Dick Durbin and Patty Murray.

“With this year quickly drawing to a close, the medical device industry has receive little guidance about how to comply with the tax—causing significant uncertainty and confusion for businesses,” they write about the tax most of them voted for.

The last entitlement to get off the ground was President Bush’s Medicare prescription drug benefit. Those rules were tied up with a bow by January 2005, giving business and government nearly a year to prepare—and that was far simpler than re-engineering 17% of the economy. No one knows where the current magical mystery tour is headed, especially not HHS. via Review & Outlook: It’s a Mad, Mad, Mad, Mad ObamaCare – WSJ.com.

New Payroll Tax Marriage Penalty Under ObamaTax (for the “rich”)

Just in time for all those same-sex newly-weds in the state of Washington, the Obama Administration and Democrat-pushed ObamaCare taxes will kick in, taxing married couples as one for the first time since Social Security and Medicare taxes were instituted as “payroll taxes.”

From the New York Times:

Among the most affluent fifth of households, those affected will see tax increases averaging $6,000 next year, economists estimate.

The NYT article advises us all, that since our employers may not (!) know how much our spouses make, we need to make sure our employers take out enough taxes each pay period or to begin making extra estimated payments on our own.

Sinking Economy? Obama says sink it faster

Hitting the debt ceiling, borrowing 40 cents of every dollar we spend, and about to go over the “fiscal cliff” if a compromise isn’t worked out. The Obama strategy is to spend more, borrow more and pretty much sabotage the “bipartisan” deal.

How grand is that?

And who does the New York Times blame?

via Republicans Balk at Obama’s Short-Term Stimulus – NYTimes.com.

The Obama administration is arguing that the sluggish economy requires a shot in the arm, and it included tens of billions of dollars of little-noticed stimulus measures in its much-noticed proposal to Congressional leaders last week. But Republicans have countered that the country cannot afford to widen the deficit further, and have balked at including the measures in any eventual deal.

Read it and weep (and pray): US liability is $86.8 T

Maybe they could tax all lottery winnings at 100%?

The actual liabilities of the federal government—including Social Security, Medicare, and federal employees’ future retirement benefits—already exceed $86.8 trillion, or 550% of GDP. For the year ending Dec. 31, 2011, the annual accrued expense of Medicare and Social Security was $7 trillion. Nothing like that figure is used in calculating the deficit. In reality, the reported budget deficit is less than one-fifth of the more accurate figure.

Why haven’t Americans heard about the titanic $86.8 trillion liability from these programs? One reason: The actual figures do not appear in black and white on any balance sheet. But it is possible to discover them. Included in the annual Medicare Trustees’ report are separate actuarial estimates of the unfunded liability for Medicare Part A the hospital portion, Part B medical insurance and Part D prescription drug coverage.

As of the most recent Trustees’ report in April, the net present value of the unfunded liability of Medicare was $42.8 trillion. The comparable balance sheet liability for Social Security is $20.5 trillion.

via Cox and Archer: Why $16 Trillion Only Hints at the True U.S. Debt – WSJ.com.

Rick Perry via USAToday editorial: ‘Another federal power grab’

Governor Rick Perry explains why Texas won’t create a State Obamacare health insurance exchange:

 

Setting aside the obvious fact that health insurance is readily available under current conditions — the problem has been price, not availability — these exchanges represent nothing more than another federal power grab in the guise of a supposedly free market.

States were given the option to set up and execute their own exchanges — at their own expense. The fine print, however, specified that the exchanges would have to follow all rules and guidelines imposed by the federal government, with little to no flexibility. The kicker: Many of these rules and regulations are unknown.

Again, this is par for the course as we continue down the road to fiscal disaster at the hands of ObamaCare.

In Texas, Medicaid spending already accounts for nearly 25% of our general revenue spending, and its costs are only expected to continue skyrocketing.

While the president has promised to subsidize states for Medicaid costs in the near term, in the long term, states are going to be on their own.

ObamaCare has already begun to affect many companies, too, with some publicly announcing plans for layoffs in order to make up for increased insurance-related costs.

via Rick Perry: ‘Another federal power grab’.

Office of the Governor Rick Perry – [Press Release] Gov. Perry: Texas Will Not Implement State Insurance Exchange Under Obamacare

Governor Rick Perry wrote a letter to Secretary of Health and Human Services, Kathleen Sibelius:

Gov. Perry’s letter said. “It would not be fiscally responsible to put hard-working Texans on the financial hook for an unknown amount of money to operate a system under rules that have not even been written.”

via Office of the Governor Rick Perry – [Press Release] Gov. Perry: Texas Will Not Implement State Insurance Exchange Under Obamacare.

Medical Regulation, Texas Style

The Texas Institute for Health Care Quality and Efficiency Draft Report is posted for public comment.

You only have a day and a half to comment, since the next meeting of our Board of Directors is Thursday, November 15th. All comments should be sent by 1 PM on Wednesday, November 14th.

Report to the Texas Legislature on Activities to Improve Health Care Quality and Efficiency
Report Number: 2012-001

The following downloads are available:
Report 2012-001: 2012-001-Draft-Report.pdf
Appendix E: AppendixE.pdf
Appendix F: AppendixF.pdf

Instructions on submitting your comments are here.

Now, for a few comments on my observations as a Board member:

Believe it or not, the time frame from the passage of the legislation in SB 7 last June, 2011, to today and in anticipation of preparing for legislation beginning in January, 2013, is too tight. The Institute’s staff and coordinators did a good job of herding cats in the Board. In addition, the Board members worked hard to make all the meetings, to participate, and to contribute. We have met at least once a month, sometimes more than twice, since our appointment. The Board isn’t paid or even reimbursed for expenses by the State, and many gave up work in order to attend meetings far from their homes.

I haven’t commented on the draft until now, because the Board received our first full copy for review and comment on November 2, and comments were due by 5 PM, Election Day, November 6th. We’re all appointed by the Governor — it stands to reason that a few of us would be actively involved in the election and campaigns. I didn’t even open the email until Nov. 7.

I’m not happy with the length of the report, but I guess the nuances of our discussions over the last few months needed to be documented somewhere. Go to the page 34 in the pdf, numbered “26” in the Draft, for the actual recommendations made by vote in the Board meetings.

Finally, my main concern has been with the bureaucracy and regulation that the members of the Board have sometimes appeared to support. In the end, I believe that we have limited recommendations for regulation and “hassle factors” more than some would like. My hope is that the Legislature will decide to focus initially on implementing any new measures in our own State health plans and not interfere directly in private health care practice and systems, except where and when the State foots the bill.

Since President Obama won reelection, I believe that the ability of the 83rd Texas Legislature to adapt and react to Federal Regulations  – Obamacare – will be improved by the work of the Institute.

Texas victory on Women’s Health Program. BTW: It’s our money!

Next stop: getting our money back from the Feds!

Granted a legal victory Thursday by a federal appeals court, state officials said they will begin working quickly to exclude Planned Parenthood from the Women’s Health Program, which provides contraceptives and health care to low-income women.

The state also reversed course on funding for the health program, saying it would seek to have the federal government continue funding it, rather than switching to a state-funded program as planned.

“In Texas we choose life, and we will immediately begin defunding all abortion affiliates to honor and uphold that choice,” Gov. Rick Perry said.

Thursday’s ruling by the 5th U.S. Circuit Court of Appeals was expected because it reaffirmed an August opinion that said Texas could legally exclude Planned Parenthood — or any organization that provides abortions or promotes the procedure — from the program.

But in a new wrinkle, state officials said the court victory will prompt them to press the federal government to continue providing money for the program — a reversal of U.S. policy that could save tens of millions of dollars in state money but is unlikely to happen without a fight.

via Texas seeks to keep federal money for women’s health program | www.statesman.com.

A Survey of America’s Physicians: Practice Patterns and Perspectives

Think you can keep your doctor under ObamaCare? Look around at how many of your neighbors have lost their docs just this year, due to the new hassle factors, including mandates for electronic medical records, constant threats of cuts, and repeated delays in payment and changes in the rules.

For the last 10 to 20 years, the question has been whether your doc would keep seeing you after you turned 65 and became Medicare eligible.

Over the next couple of years, the question will be whether your doc will still practice. If he or she does, the question will be whether he will be allowed by law to continue to see you and how the local hospitals divide up all the ObamaCare “exchange” patients. If you’re very lucky, your doc, who will be forced to chose one and only one of the “Accountable Care Organizations,” will choose the same one you’re assigned to.

The Physician Foundation surveyed over 13,000 doctors about their plans for practicing as the regulations and requirements for ObamaCare kick in. The result of the survey, the largest in U.S. history, reveal that over the next 4 years, more than 50% of docs are planning to cut back their hours or services, change to a concierge, cash only, practice or quit the practice of medicine altogether.

The report is here, and this is the Executive Summary:
Executive Summary: American patients are likely to experience significant and increasing challenges in accessing care if current physician practice patterns trends continue, according to a comprehensive new survey of practicing physicians. One of the largest physician surveys ever undertaken in the U.S., the research was commissioned by The Physicians Foundation.

Physicians are working fewer hours, seeing fewer patients and limiting access to their practices in light of significant changes to the medical practice environment, according to the research, titled “A Survey of America’s Physicians: Practice Patterns and Perspectives.” The research estimates that if these patterns continue, 44,250 full-time-equivalent (FTE) physicians will be lost from the workforce in the next four years. The survey also found that over the next one to three years, more than 50 percent of physicians will cut back on patients seen, work part-time, switch to concierge medicine, retire, or take other steps likely to reduce patient access. In addition, should 100,000 physicians transition from practice-owner to employed status over the next four years (such as working in a hospital setting), the survey indicates that this will lead to 91 million fewer patient encounters.

via A Survey of America’s Physicians: Practice Patterns and Perspectives.

Texas Medical Association @TexMed “Friendly Incumbent” rule

A fellow Texas Medical Association member asked me today how I felt about TexPAC – was it even worth giving them money and “what about their endorsements for judges?” He had been surprised to notice the TMA’s endorsement of some Democrat candidates after the Judicial endorsements caught his eye. (He even asked whether the list was just a pet of some of the more wealthy docs in the TMA.)

I explained that, while the TMA generally opposes ObamaCare, the Association unfortunately has what they call the “friendly incumbent” rule.  I also agreed that the policy doesn’t explain all of the choices on the TexPAC list. But for the most part, It’s virtually a given that the PAC endorses the incumbent in a race, even if the candidate doesn’t agree with the TMA on such vital issues as ObamaCare and the (Un-) Sustainable Growth Rate (“SGR”) or even the “RAC audits.” (“Recovery Audit Contractors” – *private* contractors who audit Medicare “providers” – doctors and hospitals, and earn more for finding more “fraudandabuse.”)

The policy – along with the heavy-handedness of some of the leaders of the PAC –  leads to such debacles as their mistaken endorsement of Jeff Wentworth, who opposed tort reform, over  Dr. Donna Campbell, the eventual winner (by a 2 to 1 vote!) of the Texas Senate District 25 Republican Primary,

I suggested that he include a note about his disagreements with the PAC in any check he writes in the future. As for this election, I advised my friend – who is very opposed to ObamaCare – to ignore any recommendation that didn’t have an “R” for “Republican” in front of the candidate’s name – especially when it comes to the candidates for our Third Court of Appeals: Scott Fields is a much better choice for conservative voters than the incumbent. (I could say the same about Congressional District 35, where I hope my neighbors will vote for Susan Narvaiz, rather than Layoff Lloyd Doggett.)

Articles: Systemic Medicare Fraud Under Houston’s Sheila Jackson Lee

Did you hear about the 90 people, doctors and nurses, and “healthcare professionals” who were arrested for $430M in Medicare fraud? About a fourth of that money went to the Houston hospital where Mrs. Jackson-Lee’s husband is on the Board of Directors.

Since her days on the Houston City Council, Jackson Lee has pushed to use city funds to keep Riverside’s doors open. At that time, the councilwoman suggested that the facility was a good investment for the city.

Jackson Lee’s interest in Riverside goes back to the ’80s when her husband Elwyn C. Lee, now University of Houston vice-chancellor (see video), served on Riverside’s board from 1981-1988. In his last year at Riverside, Mr. Lee was made chairman of that board, and over the years, husband and wife have been influential in keeping the financially strapped hospital open. Jackson Lee was voted into Congress in 1994, representing the 18th district, where Riverside is located.

The president of Riverside, his son, and five others were arrested on October 4 as part of a nationwide Medicare fraud sweep. Earnest Gibson III, chief executive officer of Riverside General Hospital for 30 years, has been charged with bilking $158 million out of Medicare over the last seven years.

His son, Earnest Gibson IV, was charged with thirteen counts, including money-laundering and conspiracy to commit health care fraud. The older Gibson became president around the same time Jackson Lee’s husband was appointed to the board in the early ’80s.

Friday’s arrests at Riverside came nine months after the arrest of Mohammad Khan, the hospital’s acting administrator, who pled guilty to his role in the Medicare fraud scheme and is now serving time.

via Articles: Systemic Medicare Fraud Under Houston’s Sheila Jackson Lee.

 

The Directors haven’t been charged with any crime, but don’t you think they should have been aware of questionable billing practices?

Sally C. Pipes, Founder of the Benjamin Rush Society, at Docs4PatientCare @D4PC

Health care policy expert, Sally C. Pipes, spoke to our @D4PC meeting this morning about the Benjamin Rush Society. The Society is an organization that she founded in order to inform and enable medical students and residents to defend the traditional medical ethic that the doctor should work for the patient, not a  third party, and “certainly not one that wields the coercive force of law.”

While the topic of the talk was the Benjamin Rush Society, Ms. Pipes also discussed her own experience as a former citizen of Canada and about her mother’s death from colon cancer after being refused a colonoscopy under the Canadian health care system. The reason given was that “Seniors” weren’t given colonoscopies and that those under 65 years old had a several months long waiting period, even if bleeding. When Ms. Pipes’ mother began bleeding from the colon, she spent 3 days in the Emergency Department and passed away 2 weeks later with metastatic colon cancer.

There were also comments from members in the audience about the United Kingdom’s National Health Service, which has even longer wait times for services, including heart surgery.

Ms. Pipes is married to Charles Kesler, whose book, I AM the Change, Barack Obama and the Crisis of Liberalism, will be released on September 11. Mr. Kesler spoke to out group yesterday.

Another reason to vote Romney

Robin Alta Charo, the lawyer/ethicist-for-hire, one time Clinton advisor turned Obama transition advisor then FDA consultant, has been appointed to 2 new positions at the National Institutes of Health.

In her new role, Charo will advise on ethical and regulatory issues raised by translational research, such as privacy and civil rights concerns raised by research using human tissues residing in large biobanks or public health implications of deploying genetics and personalized medicine to target drug development toward narrower segments of the population. She will also participate in overseeing the peer review process for research proposals submitted to NCATS.

Ms. Charo, the inventor of the “Endarkenment,” supports sex-selection abortion, believes cloning will finally prove there’s no God, and frequently writes op-eds for the New England Journal of Medicine, specializing in her opposition to conscience rights. She likens Medicine to a “public utility, obligated to provide service to all who seek it. Claiming an unfettered right to personal autonomy while holding monopolistic control over a public good constitutes an abuse of the public trust — all the worse if it is not in fact a personal act of conscience but, rather, an attempt at cultural conquest.”

Docs 4 Patient Care @D4PC Annual Meeting

“By Doctors . . . For Patients.”  It’s about the patient, who is the only boss the doctor should have, other than his or her own conscience and integrity.

I’m attending my first annual meeting of Docs4PatientCare this weekend, in Crystal City, Virginia, just over the river from Washington, DC.  I stumbled upon D4PC following links from American Doctors for Truth last March.

Doctors 4 Patient Care stands in stark contrast to – and as a viable alternative to – the American Medical Association. The AMA has become a partner with the US government through the publication and sale of mandatory  “code books,” and increasingly with its advocacy for government funded healthcare coverage, especially by its endorsement of “ObamaCare,” even before the law (much less the ever-evolving regulations) was written.

So far this morning, we’ve heard from the founder of D4PC Dr. Hal Scherz, an advocate for reaching medical students through the Benjamin Rush Society, Beth Haynes, an expert on Media Strategy and Training, Ernest DelBuono, Sr., and two speakers on reforming medical liability (tort reform), Dr. Jeff Segal of “Medical Justice,” and Rick Jackson of “Patients for Fair Compensation.” 

I’ll post more through the weekend. In the meantime, read a some of the D4PC literature, “Like” Docs4PatientCare on Facebook and/or follow @D4PC on Twitter. Watch a few of the D4PC videos on YouTube.  Consider supporting the efforts of the group and/or to donating money. There’s even an alliance membership for non-physicians.

Texas Medical Association wants you to pay for elective abortions @texmed @texasallianceforlife #pro-life #tcot

Not all of the members of Texas Medical Association agree with the TMA on this.

The San Antonio Express News published an editorial August 9th, by O. Ricardo Pimentel, entitled, “Texas tries to get between you, your doctor:”

For them, the issue isn’t abortion; it’s about the doctor-patient relationship, patient health and the ability to put everything on the table that needs to be discussed. Even if it’s abortion.

In a recent letter to the state, the Texas Medical Association, joined by other medical groups, said Texas is about to embark on a plan for providing medical care to low-income women that will impose a “gag order” on discussing abortion even on doctors working with patients not in the program.

Other groups, weighing in during the public comment period on proposed state rules, have similar concerns.

It’s a plan, they say, that will ensure not enough doctors for this program willing to provide care, including family planning services. And this, they say, will guarantee more unintended pregnancies, more abortions and more illness that might have been prevented for low-income women.

Among those also commenting on the rules were the Center for Public Policy Priorities, and leaders of Planned Parenthood entities in the state, South Texas groups among them.

Trust me, for everyone who is mentioned above, it’s about abortion. The law doesn’t stop anyone from discussing or even promoting true contraception that doesn’t end the life of our youngest children of tomorrow.

And it is about “elective abortions:” those that are performed on health babies in healthy mothers. We’re not talking about the more controversial abortions in cases of rape and incest, much less in the cases of congenital disorders that are “not compatible with life outside the womb and certainly not in cases where the mother’s life is in danger. Since when do elective abortions “need to be discussed?”

How difficult is it to understand that Texas taxpayers should not pay for “promotion” of abortion? Or that we most certainly do not want our State tax funds to go to doctors who perform elective abortions on healthy babies and healthy mothers?

While I don’t speak for the Society, I am an elected delegate for my County Medical Society to the TMA House of Delegates and I believe that most of our members would agree with me on this. I am very much in favor of restricting payment from our limited State funds to only those doctors and organizations that provide comprehensive and continuing medical care for the whole woman and her whole family. With Texas Family Doctors, Internal Medicine Docs, Pediatricians and OB/Gyns reeling from the lack of increasing fees from Medicare and decreases in Medicaid funding, why not help keep them in business by adding the availability of billing the State for screening tests like pap smears, exams for breast masses, diabetes and high blood pressure?

In fact, that’s what the Legislature decided: that money would be prioritized. First come the comprehensive care docs, hospitals, and county and city clinics. Planned Parenthood is never mentioned, although there is a section of the law that absolutely prohibits the State from contracting with anyone who “promotes” abortion *if there are other qualified providers available.*

Texas DHS has already identified more than enough doctors and clinics that qualify under the law. These doctors can actually treat the diseases for which the Texas Women’s Health Plan screens. Our Texas Legislature made a wise decision when they agreed that it doesn’t make sense to send our few dollars to a clinic that treats a very narrow medical spectrum in an intermittent manner.

And the law has already saved human lives: Austin city and Travis County taxes once paid for 400 elective abortions each year. A year ago, the law achieved what the taxpayers who protested this use of their money couldn’t do: Austin and Travis County health clinics were forced to stop funding those abortions.
If you have a family doctor, consider a polite call to his or her front desk asking them to let the TMA know their views on using Texas’ tax funds to support Planned Parenthood and other abortion providers.

You might also consider contacting Texas Alliance for Life and/or you local Crisis Pregnancy Center to let them know that you support their efforts to keep your State (and federal) tax funds from paying for the ending of lives of our Texans of tomorrow.

Action: Women Speak 4 OURSELVES @WomenSpeak2012 #tcot #pro-life

Based on the Declaration of Independence, the Constitution of our United States is designed to secure our rights to life, liberty and property for every human being, not just the ones who can speak out. Those of us who can speak, should join in the effort to protect the rights of all, including the unborn children of tomorrow, male and female, and everyone who objects to government-sponsored efforts to end their lives. The recent Obama mandate that infringes on the First Amendment protection of the right of free exercise of religion and their on-going efforts to force Texas to fund Planned Parenthood with State taxes is in direct violation of the Bill of Rights.

I received an email tonight from the group, “Women Speak for Themselves” asking for comments on next Saturday’s Washington, DC rally sponsored by pro-abortion, anti-family and anti-First Amendment rights groups:

This Saturday, on the National Capitol lawn, Think Progress (a George Soros funded group) is hosting a “We Are Women” rally. Soros’ group, along with some of their co-sponsors, the usual—the National Organization of Women, Planned Parenthood, and the National Women’s Political Caucus—along with some more peculiar groups—Rock The Slut Vote, The National Center for Transgender Equality, and the Reformed Whores entertainers, among others—have a specific goal in mind.

“Our mission,” their website reads, “is to bring national attention to the ongoing war on women’s rights…”

Not surprisingly, the language on their website gives the appearance that they’re claiming to speak for all women on matters of healthcare, family, and freedom…which makes this just the type of event at which we need to make our voices heard! And so, here’s where YOU come in.

Prior to the rally, we’ll be releasing a statement to the press, informing them that there are women with alternative views on these matters, should the press wish to include us in the discussion. We’d like to add YOUR voices to that statement.

Send us a brief statement (2-3 sentences), articulating why as a woman you stand for and believe freedom includes protection for life, family, and/or religion. Be sure to include your full name, city and state, and your occupation, if you’d like—along with permission for us to include your information and quote in our press release.

If you’re not sure where to start, feel free to use our two sets of talking points for ideas (though your statement need not be solely focused on the HHS mandate), and try to stay focused on why you’re FOR our view of women’s freedom, as opposed to AGAINST the view of women’s freedom being put forth by Soros and cohorts.

Thanks for your help with this….I look forward to your statements!

My best to you,
Helen

http://womenspeakforthemselves.com/
https://www.facebook.com/WomenSpeakForThemselves
https://twitter.com/womenspeak2012

P.S. I’m told some pro-lifers will be gathering at the North Capitol Lawn on Saturday, to hold a counter protest. The rally starts at 11am, I believe, so feel free to head on over, with signs and pro-life gear, if you’d like to be a joyful example of the alternative.

 

I wish I could attend the counter protest, but I’m committed to a meeting for the Christian Medical and Dental Association that day. If you can attend, please do. Either way, send a message to http://womenspeakforthemselves.com/ or @womenspeak2012!