Health Care Policy

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

Nothing 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

What 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!)

ObamaCare’s effects difficult to measure: USA Today

From the USAToday, August 8, 2013:

When California announced that individual premiums in its health insurance exchange could be 29% lower than expected, President Obama cheered. When Indiana announced premiums might be 72% higher than before, state officials predicted doom. So who is right? Are health insurance premiums going up or down?

We don’t know, at least in part, because both sides are playing with the numbers. To be sure, natural variation exists in how state insurance markets will be affected, but consumers should also be aware of how premium comparisons are twisted to reach predetermined results. Here are five ways they have been slanted: . . .

read more via ObamaCare’s effects difficult to measure: Column.

Edited 8-9-13 – Changed the title and post to make it more clear that this is from the USAToday, not my own writing. BBN

Texas or DC: Who do you want regulating your doctor?

Peggy Fikac once again proves that she’s not a reporter, and most certainly not anything like a fair and balanced media representative.

From the Houston Chronicle’s coverage of events in Austin, today:

“Obamacare is the wrong prescription for American health care, and I will never stop fighting against it,” Abbott said, joined by small business people and a doctor who also oppose the law at a company, the Texas Mailhouse.

One reason that Abbott gave for fighting the law came in response to a doctor who asked him from the audience about what Texas could do to keep the federal law from interfering with doctors’ judgment about the best way to treat their patients.

“You’re raising one of the more challenging components of Obamacare, and a hidden component in a way, and that is government is stepping in between the doctor-patient relationship and trying to tell you what you can and cannot do, interfering with both your conscience and your medical oath to take care of your patient,” said Abbott, who is campaigning to succeed Gov. Rick Perry.

That is similar to arguments raised against tighter abortion restrictions approved in special session, including a ban on the procedure at 20 weeks, along with stricter regulations on clinics and abortion-inducing drugs.

 

I am that doctor from the audience. Ms. Fikac is correct that I voiced concern over the Federal interference between the patient and the doctor. She’s flat wrong about Texas regulation of medicine by bring abortionists up to standards being equivalent to the

I prefaced the question by noting that it is the State of Texas that properly regulates Texas Doctors and medicine. At the State level, patients and doctors have more influence on our elected officials and the people they appoint to write regulations and enforce the law than we do on the Federal level.

I also noted that because of the increasing interference over the years by Medicare, I am concerned about the reach that this new set of regulations will have, including ever-invasive micro-reporting of patient’s private medical conditions. (I named the upcoming move to the ICD-10, which will be a nightmare, requiring doctors to make distinctions between medical conditions, out to five (5) decimal places.

As bad as the bureaucracy of the Office of the Inspector General for the Federal Health and Human Services and the Centers for Medicare and Medicaid Services have been in the past, I don’t look forward to the additional layer of IRS income verification, audits and enforcement.

We could stick closer to home, with the Texas Health and Human Services, the Texas Medical Board, and the Texas Insurance Commission!

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

Last 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.

Texas Planned Parenthood pays $4.3M (but media attacks Greg Abbott)

The $1.4 Million previously reported was the part that Texas will receive, not the total. Can you guess how the (very few) media reports (if you can find them) are playing the story?

From the July 30, Houston Chronicle:

Planned Parenthood Gulf Coast Tuesday settled a whistle-blower lawsuit that alleged the Houston nonprofit engaged in fraudulent Medicaid billing for $4.3 million – nearly $3 million more than was announced last week by Texas Attorney General Greg Abbott.

Yes, Planned Parenthood is quoted as claiming that the settlement for the AG’s finding that they are guilty of over $30M in fraud is “baseless” and simply a way to end harassment and to avoid turning over the (altered) medical records of patients. But the spin on the story is that Texas’ Attorney General, Greg Abbott, didn’t report the total and sent out his announcement before the settlement was signed by all parties.

My news search yields some op-eds and stories by Texas’ newspapers and a few more on pro-life sites.

‘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.

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.

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.

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.

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.

Christian Medical Association on HB2

Here’s my piece for the Christian Medical and Dental Association’s “The Point,” a weekly newsletter on current events. (This isn’t a 250 word discussion — I snuck in 275 words!)

“At what point do humans become human enough to have the right not to be killed? How should society balance protection for women who choose to abort their children with the burden imposed by that protection?

“While 62 percent of Texasⁱ and 59 percent of U.S. votersⁱⁱ support a ban after 20 weeks, opponents of the bill stormed the Capitol, disrupted hearings and threatened lawsuits that will likely decide whether the law is enforced. In the middle of the noise, both sides told legislators painful stories about the effect of abortion on their lives.

“Texas’ new law bans abortion after 20 weeks, based on the possibility that the fetus can feel pain at the lower limit of viability since the lower brain structures are in place, the thalamo-cortical connections are developing and primitive memory and learning have begun.ⁱⁱⁱ There are exceptions for life and permanent injury for the mother and severe fetal anomalies. The law also requires that abortion facilities meet guidelines required of facilities that do similar procedures like D&Cs. Doctors performing abortions must obtain hospital privileges within 30 miles of the facility and follow FDA guidelines for medical abortions.

“Christian doctors are in a unique position to guide the public conversation toward one of ethics, rather than popular opinion, science or law. We must also demonstrate Christ’s healing love and forgiveness to those who are in pain because of abortion.”

 

Links and more references, here.

Texas DPS director on “Tampon Gate”

Evidently, there were men who tried to enter the Senate Gallery ith tampons. Sounds suspicious to me!

“The possession of these and other items is not a crime, and therefore, there was no basis to arrest and detain visitors who possessed such items; however, they were denied access unless they discarded the items,” McCraw wrote. “The Department never took possession of these items and had no justification to do so.”

No officer questioned by the San Antonio Express-News or the Texas Tribune could confirm they had confiscated feces or urine or that they had any knowledge of such items being in the Capitol.

McCraw explained the basis for which officers did not allow feminine hygiene products including tampons and sanitary napkins into the gallery.

“The arbitrary prohibition of feminine hygiene products, for example, on its face would seem absurd,” McCraw wrote. “However, the Department received reports that some visitors planned to throw feminine hygiene products onto the Senate floor. One woman attempted to enter the Senate gallery with approximately 100 feminine hygiene products and she was denied access, as were two men who possessed approximately 50 feminine hygiene products each.”

He also said names of visitors with “suspicious jars or other items” were not documented because they did not commit a crime by possessing them and ”it would be unreasonable to document names of visitors based on what they might or might not do.”

Howard responded to McCraw’s with “disappointment with the lack of clarity that he provides.”

“At the end of the day, we are still left with unsubstantiated claims, allegations of suspicious jars but no actual evidence,” she said. “The lack of onsite documentation or eyewitnesses — either from officers or members of the public — seems to undercut the assertions laid out in DPS’ original press release and now their response letter. To be frank, it doesn’t pass the smell test. ”

McCraw added to the list of items that were confiscated and discarded by police including ”paint, confetti, glitter, bottles of bubbles, bags of balloons (not inflated), handheld air horns, a bag full of tomatoes” and two bricks, which were being used to prop doors open and were not going to be used as projectiles, he said.

The Express-News has requested records from the Department of Public Safety regarding the July 12 searches and items discarded.

Standing for Life – The Unfinished Story | Twisted Conservative

Those who #Stand4Life should get to know Jason Vaughn; as one of the effective leaders for life in Texas, he’s making history!  Here’s his recount of the events of last week:

Late Friday night we won the battle to reduce abortions in Texas! It was a great night and I am so excited to be a part of history. I’ve said before that the world may never know my name, but perhaps one day I will hear my God say, “Well done my good and faithful servant. You see that man there? I used you to save him from being aborted and I used him to change the world.”

It was a long and tiring week. There were some nights when I fell asleep in my clothes from the day. I had the privilege to work amazing men and women who love the people of Texas and want to see the end of abortion.

For those interested I want to walk you through the week.

Read the rest and see the pictures and videos he uses to document Texas’ #Stand4Life, via Standing for Life – The Unfinished Story | Twisted Conservative.

Rep. Jason Villalba Closing Speech on HB 2 (#Stand4Life )

Texas Alliance for Life has posted the video of the speech given in the Texas House of Representatives by Representative Jason Villalba (District 114, Dallas) in favor of life and HB2. It’s a beautiful testimony to love and humanity, and an answer to all the claims that this Bill is simply a political ploy. Watch for the sonogram picture of the Villalba’s 13 week son and the Representative’s declaration that he will fight for his son and all the babies destroyed by elective abortion.

“Planned Parenthood web ad blurs distinctions” (DMN Fact Check)

So, after telling us all these years that they don’t spend money from tax funds for their abortion business, Planned Parenthood is now saying that their facilities are often in the same buildings as the “separate” affiliates that don’t do abortions and that meeting the standards of an ambulatory care center will shut down both businesses.

Planned Parenthood operates 10 abortion clinics in the state that would be mandated to raise to the new standards. The abortion clinics, by law, are separate entities and must be separately funded from health centers where cancer screenings take place.

Planned Parenthood officials acknowledged that, but said some abortion clinics and health centers are housed within the same buildings. She suggested that if it were too expensive to upgrade the abortion clinics, then it could also force a shut-down of the health care clinics in the same building.

Officials could not say how many of the 10 abortion clinics are adjacent or within the same building as health care centers.

Dawn Laguens, executive vice president of Planned Parenthood Action Fund, responded by email and cited 55 health care centers already have been shuttered in Texas.

That assertion is based on legislative funding cuts from two years ago and is not related to the pending legislation.

And the previously closed health centers are not related to the assertion made in the advertisement.

Health centers that do not provide abortions would not be affected by the legislation.

via Fact check: Planned Parenthood web ad blurs distinctions | Trail Blazers Blog.

Scientific Huffington Post (!) Poll: Ban Abortion After 20 Weeks

20 week ultrasound

#Stand4Life across the US: 59% support a Federal ban on abortion after 20 weeks, even though the question didn’t include an exception for the life of the mother!

Remember that University of Texas/Texas Tribune Poll that showed that 63% or 62% (depending on whether the question mentioned pain or not) of registered voters in Texas wanted a ban on abortion after 20 weeks? Well, it seems that most US voters agree.This poll found that 59% of voters would support a ban, while only 30% oppose it.

The Huffington Post, not a conservative website at all, solicited a scientific poll by the same group that did the UT/TT poll, YouGov. These results agree with last month’s Gallup poll revealing that 64% of Americans believe that abortion should be illegal in the second 3 months of pregnancy and 80% would make it illegal in the last 3 months.

The HuffPost isn’t making a big deal out of the poll, focusing on the conflicting views of the public rather than on the results of the poll itself. In fact, from my GoogleNews search, it doesn’t appear that (as of 7 AM today) anyone other than a couple of blogs (at the Washington Post and the Weekly Standard),  National Right to Life, and LifeNews.com are reporting the poll!

Pro-abort McClendon Amendment Redefines “Child”

. . .as someone whose mother chose not to abort him!

Democrat Ruth McClendon, from District 120 of San Antonio, proposed an Amendment to HB 2 today that she thinks is necessary, “if we’re not going to allow women to control their own bodies.” The Amendment would re-define “child” as one,

B. whose mother declares in writing in accordance with rules adopted by the executive commissioner of the Health and Human Services Commission, that, because of Section 245.010 (a), Health and Safety Code, or Subchapters C and D, Chapter 171, Health and Safety Code, the mother chose not to or did not have access to a facility to exercise her right to an abortion at the time the child was born.

Isn’t it obvious that the mother of each and every born child chose not to abort them? Whether or not there’s a “constitutional right?”

And, please, “at the time the child was born?” Does that mean the mother chose not to abort at birth or that she made the declaration at the time of birth?

Representative Kenneth Sheets, Republican from the Dallas-area District 107, explained that his family is going through adoption and that he knows that the same benefits are available to his family and to everyone.