Archive for the ‘healthcare’ tag
Almost as if the healthcare industry (doctors, hospitals, pharmaceutical corporations, insurance corporations) have a vested interest in making profits before healing people. Not that they are trying to harm people, rather that making money is the first motive.
A low-carbohydrate diet was in fact standard treatment for diabetes throughout most of the 20th century, when the condition was recognized as one in which “the normal utilization of carbohydrate is impaired,” according to a 1923 medical text. When pharmaceutical insulin became available in 1922, the advice changed, allowing moderate amounts of carbohydrates in the diet.
Yet in the late 1970s, several organizations, including the Department of Agriculture and the diabetes association, began recommending a high-carb, low-fat diet, in line with the then growing (yet now refuted) concern that dietary fat causes coronary artery disease. That advice has continued for people with diabetes despite more than a dozen peer-reviewed clinical trials over the past 15 years showing that a diet low in carbohydrates is more effective than one low in fat for reducing both blood sugar and most cardiovascular risk factors.
The diabetes association has yet to acknowledge this sizable body of scientific evidence. Its current guidelines find “no conclusive evidence” to recommend a specific carbohydrate limit. The organization even tells people with diabetes to maintain carbohydrate consumption, so that patients on insulin don’t see their blood sugar fall too low. That condition, known as hypoglycemia, is indeed dangerous, yet it can better be avoided by restricting carbs and eliminating the need for excess insulin in the first place. Encouraging patients with diabetes to eat a high-carb diet is effectively a prescription for ensuring a lifelong dependence on medication.
At the annual diabetes association convention in New Orleans this summer, there wasn’t a single prominent reference to low-carb treatment among the hundreds of lectures and posters publicizing cutting-edge research. Instead, we saw scores of presentations on expensive medications for blood sugar, obesity and liver problems, as well as new medical procedures, including that stomach-draining system, temptingly named AspireAssist, and another involving “mucosal resurfacing” of the digestive tract by burning the inside of the duodenum with a hot balloon.
(click here to continue reading Before You Spend $26,000 on Weight-Loss Surgery, Do This – The New York Times.)
Whether or not you have health issues, I believe a diet consisting of as many vegetables and fruits as you can eat is the best for you. Avoid processed foods as much as possible, etc.
The next decade is going to be a continual escalation of these sorts of crimes. Many sectors of corporations have skimped on beefing up their security practices, making data theft easier for criminals to steal consumer data.
patient medical records typically include information not easily destroyed, including date of birth, Social Security numbers and even physical characteristics that make them more useful for things like identity theft, creation of visas or insurance fraud by falsely billing for expensive medical or dental procedures that were either never done or performed on someone else. Some criminals have also tried a form of so-called ransom ware in which they threaten to reveal medical information unless they are paid.
“The whole thing is evolving,” said Barbara Filkins, an analyst with the SANS Institute, which has studied the risk to the health care sector.
Hospital systems, for example, are increasingly asking for photo IDs and driver’s licenses in an effort to block patients who have stolen someone else’s medical identity, said John Barlament, a lawyer at Quarles & Brady in Milwaukee. The use of medical identity fraud is growing, he said. “It’s a one-way trend here,” he said.
(click here to continue reading Data Breach at Anthem May Lead to Others – NYTimes.com.)
From my perspective, I hate when health care providers make copies of my drivers license and write down my social security number and so on. Why? Because I don’t trust that they will keep my data safe. Especially as there is a push to digitize health records, health practitioners need to have stronger data management and destruction policies. Should a dentist I visited once several years ago be able to keep all my information for ever? I guess I need to get a fake ID for these sorts of situations.
The push to digitize patient health records in hospitals and doctors’ offices has also made medical records increasingly vulnerable, according to security experts. Moving medical records from paper to electronic form allows both patients and providers better access, but it has also made patient records susceptible to breaches, whether unintentionally or through a criminal attack.
About 90 percent of health care organizations reported they have had at least one data breach over the last two years, according to a survey of health care providers published last year by the Ponemon Institute, a privacy and data protection research firm. The founder, Larry Ponemon, a security expert, says most were because of employee negligence or system flaws, but a growing number are malicious or criminal.
Last year, 18 health care providers reported data breaches because of some form of hacking. Information at Centura Health was compromised last year after a phishing scheme obtained access to employee email accounts. The data included, in some instances, Social Security numbers, Medicare beneficiary numbers and clinical information for 12,000 patients of the facility, based in Englewood, Colo. In another case, a keystroke logger virus that infected three computers for a few weeks early last year at the student health center at the University of California, Irvine, may have captured patient’s health and dental insurance numbers and diagnoses.
Health care providers have sharply increased their spending on data security in the last year, but they remain technologically far behind other industries, say experts.
(click here to continue reading Data Breach at Anthem May Lead to Others – NYTimes.com.)
So, about that sick joke: What Mr. Romney actually proposes is that Americans with pre-existing conditions who already have health coverage be allowed to keep that coverage even if they lose their job — as long as they keep paying the premiums. As it happens, this is already the law of the land. But it’s not what anyone in real life means by having a health plan that covers pre-existing conditions, because it applies only to those who manage to land a job with health insurance in the first place (and are able to maintain their payments despite losing that job). Did I mention that the number of jobs that come with health insurance has been steadily declining over the past decade?
What Mr. Romney did in the debate, in other words, was, at best, to play a word game with voters, pretending to offer something substantive for the uninsured while actually offering nothing. For all practical purposes, he simply lied about what his policy proposals would do.
Romney’s Sick Joke – NYTimes.com
Our Congress, hard at work…
In the 18 months the 112th Congress has been sworn in, the House has introduced 60 bills to rename post offices. Thirty-eight have passed the House and 26 have become law. During those 18 months, the House has produced 151 laws, 17 percent of which have been to rename post offices, according to Congressional Democrats. Not a single bill has come to the House floor aimed at reforming a Postal Service, which is bleeding billions of dollars because of Congressional mandates. … USPS claims that if Congress does not act, the mail service will default not only on the $5.5 billion payment due [August 1, 2012], but also on another $5.6 billion payment for future retiree’s benefit due September 30. The Postal Service has pleaded with Congress for years to end the requirement that it pre-fund its retiree’s health benefits. But many lawmakers claim that because USPS has such a massive workforce – there are 614,000 Postal Service employees-if it does not pre-fund retirement benefits, it will not be able to pay them in the future.
And as long as these disagreements persist, it looks like naming post offices is the closest Congress will get to passing postal reform.
(click here to continue reading 60 House Bills to Name Post Offices, Zero To Fix Mail Service – Yahoo! News.)
Paul Ryan is one of those time-wasters:
He’s been in Congress for nearly 13 years, but Rep. Paul Ryan (R-Wis.) has only seen two of his bills pass into law during that time.
Ryan, who Mitt Romney has tapped as his running mate, passed a bill into law in July 2000 that renames a post office in his district. Thanks to Ryan, the post office on 1818 Milton Ave. in Janesville, Wis., is now known as “Les Aspin Post Office Building.”
(click here to continue reading Paul Ryan Only Passed 2 Bills Into Law In More Than A Decade.)
and speaking of wasting time, the Republican mouth-breathers in Congress have also wasted taxpayer money with symbolic votes re: the Affordable Care Act a/k/a Obamacare:
What grave business is the House of Representatives undertaking today? It is voting to do away with the Patient Protection and Affordable Care Act—or, as the name of the bill puts it, on the Repeal of Obamacare Act. The title has a certain appealing conciseness, relative to what some of the other partial or entire repeal bills have been called, like the Religious Freedom Tax Repeal Act or the Repealing the Job-Killing Health-Care Law Act—Eric Cantor introduced that one, which stands as a true classic of the bill-title genre. (Reuters has a list of more.)
The names have been the bill-sponsors’ only real accomplishment, even though repeals have passed the House again and again—some thirty times, in various forms, since the G.O.P. got its majority, in 2010. Sometimes it’s been been brazen and loud (the NObamacare Act of 2012—isn’t there a ban on legislative names that rely on capitalization tricks?). And sometimes there’s an amendment that comes to Congress, as the saying goes, on little cat feet, attached to a big bill. All the significant ones have died, though, as everyone knew they would, and as today’s will as well, before getting anywhere near Senate passage, let alone the President’s desk. (If he signed it “NObama,” would that count as a veto?) The Republicans have some legislative options—reconciliation, debt-ceiling-collapsing blackmail—but not good ones. So why do they bother?
(click here to continue reading House Votes on the Repeal of Obamacare Act : The New Yorker.)
Good thing the nation is working perfectly with zero problems of any kind that need fixing so that the fools in Congress can play.
According to Rupert Murdoch’s paper of record, the GOP just needs to stick to their plan of destroying Medicare, and eventually voters will flock to their side. Hmm, well, that’s an option I guess.
Republican lawmakers reaffirmed Wednesday their embrace of a controversial Medicare overhaul despite an electoral setback, ensuring the federal health program will remain a divisive issue through the 2012 election.
Republicans responded to Democrat Kathy Hochul’s Tuesday victory in a traditionally Republican New York Congressional district by saying they needed to attack the Democrats’ Medicare position more forcefully, rather than back off their own plan.
“We need to make it a choice between a do-nothing approach that will ultimately destroy Medicare, and life-saving reforms,” said Rep. Tom Cole (R., Okla.). Added Rep. Cliff Stearns (R., Fla.): “It’s a wake-up call on how you frame it. It obviously wasn’t framed right.”
Democrat Kathy Hochul defeated Republican Jane Corwin in a closely watched House race in western New York State. The race gained national attention when Corwin announced she favored an overhaul of Medicare.
Rep. Paul Ryan (R., Wis.), who authored the Medicare plan, said Democratic attacks on his plan were effective in Tuesday’s election to fill an open House seat near Buffalo. “They are shamelessly demagoguing and distorting it,” Mr. Ryan said, adding that Republicans would have a better chance to make their case over the next 18 months.
(click here to continue reading GOP Sticks to Plan on Medicare – WSJ.com.)
The GOP continued its bloody walk into the Medicare buzzsaw Wednesday, when 40 out of 47 Senate Republicans voted in support of the House GOP budget, and its plan to phase out and privatize the popular entitlement program.
The test vote failed by a vote of 57-40. But the roll call illustrates that Medicare privatization — along with deep cuts to Medicaid and other social services — remains the consensus position of the GOP despite the growing political backlash against them.
Voting with all of the Democrats against debating the plan were Sens. Scott Brown (R-MA), Olympia Snowe (R-ME) — both 2012 incumbents — along with Sens. Susan Collins (R-ME) and Lisa Murkowski (R-AK). Rand Paul (R-KY) voted against it because it wasn’t radical enough.
Sens. Chuck Schumer (D-NY), Pat Roberts (R-KS), and Kay Bailey Hutchison (R-TX) did not vote.
Democrats intentionally scheduled the vote less than 24 hours after a Democrat won a special election in New York’s 26th — and heavily Republican — congressional district, on the strength of defending Medicare from a GOP onslaught. The outcome of that election heightened the political stakes, but sent few Republicans bolting for the exits.
“I’ve been surprised a lot of the times about how they’re voting here,” said Senate Majority Leader Harry Reid at a press conference after the vote.
(click here to continue reading Senate Republicans Vote Overwhelmingly To End Medicare | TPMDC.)
Parenthetical point: the WSJ used to attempt to be neutral in its non-editorial pages, but since Murdoch purchased it, that’s been scrapped. WSJ now operates in the Fox News model: note how many Democrats are quoted in the above article versus how many Republicans, and also notice that half the rest is regurgitated GOP talking points. Too bad. I dropped my print subscription, but am hanging on to the online WSJ because there is good business news there, sometimes.
Queue the Nelson Muntz laugh 1. Looks like Senator Reid is finally scheduling the Senate vote on Paul Ryan’s Destroy Medicare To Give Tax Breaks to Oil Corporations Bill. Perfect timing since the topic is getting a lot of news coverage.
When they proposed just last month to overhaul Medicare, House Republicans were confident that the wind of budget politics was at their backs and that the country’s looming fiscal problems provided justification to begin reshaping the increasingly costly social welfare system. Blogs
But the last six weeks have left Republicans pointed into a stiff headwind. With polls and angry town hall meetings suggesting that many voters were wary if not opposed to the Medicare overhaul, party unity and optimism gave way to a slow-motion backtracking in the House and, in the Senate and on the presidential campaign trail, a bit of a Republican-on-Republican rumpus.
Even before the Republican loss Tuesday night in the race for a vacant House seat from New York — a contest fought in large part over the Medicare proposal — Democrats were clinging to the developments like koalas to eucalyptus trees, hoping that the plan’s toxicity among many voters would give them a shot at retaining control of the Senate and, in their most vivid dreams, taking back the House majority.
Eager to press their advantage, Senate Democrats will stage a vote on the Medicare plan as soon as Wednesday, forcing Senate Republicans into a yes-or-no choice that both sides know will become the basis of countless campaign commercials over the next year and a half.
Republicans have asked to have alternatives budgets also come up for an initial vote. Those alternatives include a plan crafted by Senator Patrick J. Toomey of Pennsylvania that contains many of the same cuts as Mr. Ryan’s plans but leaves Medicare out of the picture, and another by Senator Rand Paul of Kentucky, which includes a vast elimination of government services.
The Republicans would also like to write a bill reflecting Mr. Obama’s initial 2012 budget, which became an albatross for his party because it did not cut spending. However, because the Ryan plan already passed the House, Senator Harry Reid of Nevada, the majority leader, could send the Ryan plan for votes alone, without bringing up other budget bills.
(click here to continue reading G.O.P. on the Defensive as Voters Resist Medicare Plan – NYTimes.com.)
But we’re hearing that Sen. Reid will likely call a vote this afternoon on the Ryan Medicare Phase Out plan. In a press briefing a short time ago, Sen. Reid (D) said that the vote could come as early as 5 PM. And his office tells our Brian Beutler that the vote is “very likely” to happen as scheduled.
Late Update: And it’s confirmed. Vote will be held at 5 PM along with votes on Obama, Toomey and Paul budgets.
(click here to continue reading Senate to Vote on Ryan Plan | Talking Points Memo.)Footnotes:
- you know, the kid from the Simpsons [↩]
Republicans don’t seem to have the strength of their convictions, already flip-flopping on their planned destruction of Medicare. Maybe they’ll regroup later this summer.
House Republicans signaled Thursday that they were backing away from the centerpiece of their budget plan — a proposal to overhaul Medicare — in a decision that underscored both the difficulties and political perils of addressing the nation’s long-term fiscal problems. While top Republicans insisted that they remained committed to the Medicare initiative, which had become the target of intense attacks by Democrats and liberal groups in recent weeks, the lawmaker who would have to turn the proposal into legislation said he had no plans to do so any time soon.
The lawmaker, Representative Dave Camp, Republican of Michigan and chairman of the Ways and Means Committee, said that while he still supports the party’s Medicare approach, opposition from Democrats made it pointless to proceed.
“I’m not interested in talking about whether the House is going to pass a bill that the Senate shows no interest in,” Mr. Camp said in an appearance at the National Press Club. “I’m not interested in laying down more markers. I am interested in solutions.”
Coupled with remarks by other House Republican leaders, his statement suggested that the party’s Medicare proposal had been shelved, even though the party’s lawmakers had taken a risky vote to pass the budget in the House just last month, and in the past two weeks had attempted to sell it to constituents in often-stormy town hall meetings.
(click here to continue reading Republicans Shelve Medicare Overhaul Plan – NYTimes.com.)
Still, Senator Harry Reid should bring the bill to the Senate floor as he planned so that Senate Republicans can embarrass themselves too. Why should House GOP have all the fun? Especially since the rank and file Republicans were still supporting the plan:
Some members — especially freshmen from districts with steep re-election hills to scale — were upset to hear that the plan could be scotched after they had voted for the budget proposal and then invested so much hard work trying to sell it back home over the spring recess.
“I would be very disappointed if we didn’t follow through,” said Representative Joe Walsh, whose district lies in the Chicago suburbs. “We have spent, gosh, a month or two now trying to educate the American people to a pretty good reception. I appreciate the chairman’s notion, but I would continue to respectfully challenge him to get this thing through committee.”
Representative Bobby Schilling of Illinois said backing down now would be giving in “to lies and deceit told by the other side.”
“We’ve just got to address this problem,” he said. “Is it going to be perfect? No, but it needs to be addressed.”
How many low-information voters regret their votes for economy-destroying, Medicare-ending, environment-despoiling Republicans now? Even some of the Teabaggers wish they had paid a bit more attention to the lying Republicans who asked for their votes…
Katrina Vanden Heuvel reports:
It’s been a common refrain of politicians in Washington for as long as the capitol has been unpopular: “It’s good to get outside the beltway, good to go get back to the real America.” But in recent days that cliché might feel a bit stale for Republican House members, who voted last month for Rep. Paul Ryan’s budget proposal. Inside the beltway, Ryan is called “courageous,” a “visionary,” a “serious man,” for having the bravery to put forth a budget that pays for tax cuts for the wealthy by ending Medicare as we know it. Back home in his district, he’s becoming known as the leader of the most serious assault on seniors since President Bush’s attempt to privatize Social Security.
In April, Ryan was greeted, not with the outsized praise of New York Times columnist David Brooks at his town hall in Milton, Wisconsin, but instead, with sustained boos. On Friday, according to Politico, he asked police to remove a man from his town hall because the man refused to stop yelling about the impact the Ryan budget would have on Medicare.
He’s not alone. In New Hampshire, the first six questions posed to Rep. Charlie Bass (R-NH) were about his vote in favor of Ryan’s budget. “I’m not surprised it’s controversial,” said Bass of his vote. But for a man who won his seat during the 2010 Republican wave by a little more than 3,000 votes, it’s an open question as to whether his career can afford such controversy.
In addition to Ryan and Bass, at least six other GOPers have faced pointed questions and outright protest at town halls, reminiscent of the tea party anger seen at Democratic town halls in 2009. Rep. Daniel Webster (R-FL) arrived at his town hall greeted with signs that said “Hands Off Medicare.” The meeting became so contentious that police officers intervened to quiet the crowd. The New York Times described one such town hall as approaching “near chaos.” The Orlando Sentinel described another as reaching the level of “bedlam.”
Already, some members are backing away from their votes. By the end of Charlie Bass’s town hall, he already seemed to be wavering. “If there are certain facets of the budget that are manifestly unpopular, I think that should be taken into consideration… this is the beginning of a long conversation.” How manifestly unpopular is Ryan’s plan for Medicare? A recent Washington Post-ABC News poll showed that more than 80 percent of all Americans disapprove of cuts to the program. A whopping 70 percent of Republicans opposed them, as well, making it one of the most unpopular positions supported by a national party in modern memory.
(click here to continue reading Keep Your Hands Off My Medicare! | The Nation.)
Amusing to contrast/compare the media and fake media1 response to contentious Town Halls in 2008 versus now. I don’t recall any police throwing out teabaggers.
Still waiting for Harry Reid to schedule a Senate vote on the Ryan ridiculousness so that Senate Republicans can face similar tough questions.
And the Ryan plan doesn’t do much, really, besides shift the burden the state level…
Enter the House Republicans’ budget proposal. Instead of a commitment to insure as many people as meet the criteria, it would substitute a set amount per state. Starting in 2013, the grant would probably equal what the state would have received anyway through federal matching funds, although that is not spelled out. After that, the block grant would rise each year only at the national rate of inflation, with adjustments for population growth.
There are several problems with that, starting with that inflation-pegged rate of growth, which could not possibly keep pace with the rising cost of medical care. The Congressional Budget Office estimates that federal payments would be 35 percent lower in 2022 than currently projected and 49 percent lower in 2030.
To make up the difference, states would probably have to cut payments to doctors, hospitals or nursing homes; curtail eligibility; reduce benefits; or increase their own payments for Medicaid. The problems do not end there. If a bad economy led to a sharp jump in unemployment, a state’s grant would remain the same. Nor would the block grant grow fast enough to accommodate expensive advances in medicine, rising demand for long-term care, or unexpected health care needs in the wake of epidemics or natural disasters. This would put an ever-tightening squeeze on states, forcing them to drop enrollees, cut services or pump up their own contributions.
This is not the way to go. The real problem is not Medicaid. Contrary to most perceptions, it is a relatively efficient program — with low administrative costs, a high reliance on managed care and much lower payments to providers than other public and private insurance.
The real problem is soaring medical costs. The Ryan plan does little to address that. The health care law, which Republicans have vowed to repeal, seeks to reform the entire system to deliver quality care at lower cost.
(click here to continue reading The Ryan Plan for Medicaid – NYTimes.com.)
- aka Fox News [↩]
I don’t let Lupus define me. Most of the people I encounter everyday don’t know I have it. But, I do, and for the first time since I was diagnosed 10 years ago, I am speaking up.
The fall of 2000 and the beginning of 2001 was a busy time for me. I was planning a March wedding, in college full-time, had both an internship and a part-time job. For most of that time, i was feeling run down and achy, which I attributed to my hectic life. However, I then developed what looked like a rash on my legs. After a week or so, when it didn’t go away, I had it checked out by my family doctor. He referred me to a specialist, a hematologist. The hematologist examined me, ran several tests and since the “rash” was actually inflamed blood vessels, he gave me a prescription for a corticosteroid (Wikipedia: prednisone). A few days later, while with my brother picking up his groomsmen tuxedo for my wedding, my Dr. called me with the results. All the test results pointed to Lupus (Wikipedia). He told me to enjoy my wedding and I would see him again a few weeks later. That was the first (of many) occasions where I told myself to bear up and focus on the positive.
Over the years, I have seen the specialist at least twice a year and have controlled a fairly mild case of the chronic disease. I have had two, healthy children, hold a full-time job that I love and lead a fairly normal life. However, there have been many days of pain. My joints are arthritic and achy. I run low-grade fevers often. I can’t spend much time in the sun and I sometimes am so fatigued that I can’t get enough sleep. Recently, I have had new symptoms that include pain and a heavy, tingly feeling in my legs. This may be from arthritis in my spine. (I’m waiting to get some lab work back.)
Besides a handful of short rounds of prednisone over the years, the drug that has given me the most relief has been Celebrex (Wikipedia). Celebrex is classified as a Cox2 inhibitor non-steroidal anti-inflammatory drug (NSAID). It suppresses the inflammation, so fevers, arthritis, and fatigue aren’t a problem while I am on the medication.
I was recently denied coverage of Celebrex by my health insurance company, Aetna. When the nurse called me with the news, I was shocked. My first thought was: how can I live the rest of my life in pain? My doctor’s office is still fighting the insurance company, but I am starting to lose hope that the drug will ever be covered. The out of pocket cost is $180/month. Aetna has specific criteria the patient must meet for the expensive drug to be covered. One of them is having documented gastrointestinal bleeding. In other words, I have to be bleeding internally from taking cheaper medications, in order to be on a more expensive one. Make sense? No.”
I would describe our healthcare system in one word: broken. Why should anyone, including the health insurance companies, make a profit from people being sick? Why aren’t more politicians trying to change this? I don’t want to fight this problem for the rest of my life. People who are really ill don’t have the time (and many don’t have the resources) to do so.
While I know that this blog post won’t change the system or make my pain go away, it feels good to put it in words.
Medicare costs are one budget item that needs to be reigned in. Especially when fraud by doctors and insurance brokers is part of the cause. Case in point:
There are plenty of reasons why Medicare often fails to stop questionable payments up front. To protect law-abiding doctors and hospitals—the vast majority—Medicare is required to pay nearly everybody within 30 days. Medicare says it is reluctant to suspend payments to providers who may have made honest mistakes, out of concern that beneficiaries might go without needed treatment. Law-enforcement agencies and Medicare contractors, overwhelmed by the sheer volume of Medicare fraud cases, can’t investigate and prosecute them all. Sometimes, prosecutors and investigators ask Medicare to keep paying so as not to tip off targets of an investigation.
But a central problem is that Medicare hasn’t fully exploited its most valuable resource: its claims database, a computerized record of every claim submitted and every dollar paid out.
“That’s really the crux of the issue,” said Kimberly Brandt, who led Medicare’s antifraud efforts from 2004 through June of this year. She said the program is “definitely on the right path” to making better use of its database, “but it’s not going to be a flip of the switch or an easy transition.”
The Wall Street Journal originally identified Dr. Wayne and the other medical providers discussed in this article through a Medicare database that is much more limited than the one available to fraud investigators. The database, obtained in conjunction with the nonprofit Center for Public Integrity, contains records only through 2008, and includes the claims of just 5% of randomly selected Medicare beneficiaries.
Under a three-decade-old court decision protecting physician privacy, Medicare is prohibited from releasing to the public details of doctors’ billings. The Journal agreed not to publish individual physician billing information obtained solely through the database as part of its arrangement with the Centers for Medicare and Medicaid Services, or CMS. Billing figures for doctors named in this article were obtained from the providers themselves or from others familiar with their businesses.
(click to continue reading Confidentiality Cloaks Medicare Abuse – WSJ.com.)
Mark Schoofs and Maurice Tamman did find a few questionable cases, such as:
Christopher G. Wayne doesn’t look like a typical family-practice doctor. Known to admirers as the “Rock Doc,” he wears his hair spiked, punk style, and festoons himself with chains, bangles and leather bracelets.
He uses his upscale Miami Beach home as a production studio for Playboy photo spreads, and his MySpace page shows him posing with celebrities such as Paris Hilton and Aerosmith’s Steven Tyler.
There’s something else about Dr. Wayne that doesn’t resemble a normal family-practice doctor: his earnings from Medicare, the government insurance program for the elderly and disabled. Dr. Wayne took in more than $1.2 million from Medicare in 2008, according to a person familiar with the matter, a large portion of it from physical therapy. That’s more than 24 times the Medicare income of the average family doctor, according to a Wall Street Journal analysis of Medicare-claims data.
•A physical therapist in Brooklyn who billed for so much therapy—more than $2.5 million in 2008 alone—that it would have been virtually impossible for him to have performed it all within state and Medicare guidelines, fraud experts say. Medicare has continued to pay him, shelling out nearly a million dollars through July of this year.
•A second doctor in Florida who pocketed more than $1.8 million from Medicare in 2007, much of it from physical therapy on patients with an extremely rare condition. Even after a Medicare antifraud contractor flagged this doctor, the agency paid him at least $6.7 million over more than two years.
•A Houston doctor whose Medicare billing under her provider number spiked from zero to more than $11.6 million in less than a year. At the time, this doctor was being investigated for misconduct in a company owned by a Nigerian with an alleged history of fraud.
Or this guy
One Florida physician—not Dr. Wayne—made almost all his money from physical therapy, according to the Journal’s analysis of the 5% database. According to separate billing totals reviewed by The Wall Street Journal, this internal-medicine doctor took home more than $8.1 million from Medicare from 2007 through 2009.
The Journal cannot name this doctor because the paper was able to learn a crucial piece of information about his practice—the type of disorder he billed for—only from the database, not from any other source.
From 2006 through 2008, more than 40% of this doctor’s patients in the database were described as suffering from brachial neuritis. That’s a rare nerve-and-muscle condition estimated to occur in about three out of every 100,000 Americans. In 2008, the Florida doctor earned at least 25% more from brachial neuritis patients than any other provider, according to the Journal’s database analysis.
Read the rest of this long article, and tell me what the solution is, other than making this data publicly available (website with patient information redacted, perhaps?)
One objection the Rethuglicans have to the James Zadroga 9/11 Health and Compensation Act is of funding. Faux deficit hawks like Tom Coburn want the costs of the bill to be paid for by reducing a social service, or gutting EPA, or something along those lines. Senators Gillibrand and Schumer proposed instead:
Summary of New Offsets for 9-11 Health Care Act (HR 847) In the substitute amendment planned for HR 847, three offsets will replace the House-passed bill’s “treaty swapping” provision. The offsets, described below, contain no new taxes or fees on the American taxpayers or American businesses. Furthermore, the substitute amendment is estimated to reduce the deficit by $57 million over 10 years.
1. Savings Generated by Reducing Future U.S. Government Procurement Payments by 2 Percent to Companies Located in non-GPA countries ($4.59 billion over 10 years) Every year, the United States spends between $35 billion to $40 billion per year on procurement of goods and services from foreign manufacturers and companies located abroad in countries that are not members of the Agreement on Government Procurement (GPA) instead of from American companies.
The 9/11 rescue worker bill would impose a 2 percent excise fee on foreign manufacturers/companies located in non-GPA countries receiving government disbursements made pursuant to future procurement agreements. This proposal would both legally and practically operate to prohibit companies from raising their prices to offset the new fee. Imposing this new fee will create short-term and long-term savings. In the short term, savings will materialize from competitive foreign contracts as companies offering substitute products and substitute processes will agree to digest all or some portion of the 2 percent fee decrease to attract/maintain lucrative U.S. procurement business. In the long term, foreign countries will be incentivized to sign the GPA and the U.S. will be incentivized to look to domestic sources to fill procurement needs.
Even though the cost of procurement to the U.S. Government might initially increase when we purchase U.S. goods and services, net revenues to the government will increase when U.S. employees and U.S. companies pay taxes on the procurement contracts they receive (as opposed to foreign companies and employees receiving these contracts who pay less/no taxes).
2. Continuation of H-1B and L-1 Visa Fee for Outsourcing Companies ($800 million over 10 years) As part of the Emergency Border Security Appropriations Act of 2010, which passed the Senate unanimously in August 2010, fees were raised on H-1B and L-1 visas for companies who have more than 50 percent of their employees on these visas (this affects outsourcing companies such as: Wipro, Tata, Infosys, Satyam—but does not affect American companies such as: Microsoft, Oracle, Intel, Apple, etc). This fee was set to expire on September 30, 2014. This bill will extend this fee until September 30, 2021 to continue leveling the playing field between companies that follow the Congressional intent behind these visa programs and companies that use these visas to outsource American jobs.
3. Continuation of Travel Promotion Fee ($1 billion over 10 years) The Travel Promotion Act, which passed the Senate 78-18 in 2010, placed a small travel promotion act fee on certain travelers to the United States that was set to expire in 2015. This fee will simply be extended until 2021 and sunsets at that point.
(click to continue reading Gillibrand, Schumer: New Momentum For 9/11 Health Bill | WKBW News 7: News, Sports, Weather | Buffalo, NY | Local.)
Oklahoma Republican Sen. Tom Coburn will not allow a proposal that would cover health-care costs for Ground Zero workers to go through the Senate before Christmas, a Coburn aide told Washington Wire this morning.
Mr. Coburn wants the package to be funded through spending cuts, the aide said. He and others in his party have questioned whether the money would overlap with workers’ compensation and other aid provided to Sept. 11 first responders. Mr. Coburn told Politico he wants the measure to work its way through committee rather than being fast-tracked, which would make it tough for senators to finish their work in the next few days.
Surprising to nobody, yet still somehow depressing. Funny how the Tea Baggers don’t care that the GOP is bought and paid for many times over by the insurance corporations, and others of their ilk. Talk about corruption of the elites…
— Faced with wide-ranging new requirements in the health care law, the insurance industry is pouring money into Republican campaign coffers in hopes of scaling back regulations while preserving the mandate that Americans buy coverage.
Since January, the nation’s five largest insurers and the industry’s Washington-based lobbying arm have given three times more money to Republican lawmakers and political action committees than to Democrats.
That is a marked change from 2009, when the industry largely split its political donations between the two parties, according to federal election filings.
The largest insurers also are paying hundreds of thousands of dollars to lobbyists with close ties to key Republican lawmakers who could be shaping health policy in January, records show.
(click to continue reading Health insurers: Insurance companies pour money into GOP campaigns – chicagotribune.com.)
The other thing is, how do insurance companies have so much profit anyway to piss away on lobbyists? From insanely high premiums, right? If their profit is regulated at 15%, suddenly the money spigot dries up.
Caterpillar Inc. of Peoria has jumped to the forefront of manufacturing companies complaining about the cost of the federal health care overhaul. On March 18 the company sent a letter to Speaker Nancy Pelosi and Representative John A. Boehner, the Republican leader, saying mandated changes would cost it “$100 million in the first year alone.”
According to a regulatory filing by the company last week, the $100 million figure is Caterpillar’s estimated total cost for as long as the newly enacted Patient Protection and Affordable Care Act remains in effect. And the $100 million charge is an accounting change, a noncash cost that has no affect on the company’s operations.
In addition, the $100 million figure does not arise from changes to decades-long practices at Caterpillar. Rather, it comes about because the new law removes a tax break codified in 2003.
No company sneezes at the elimination of a $100 million tax break. But in 2008, Caterpillar had $51 billion in sales, and profits topped $3.5 billion for the third straight year. The projected profits for 2010 are a relatively weak $1.56 billion, and the $100 million tax charge would mean an additional 6 percent reduction.
[Click to continue reading Chicago News Cooperative – The Pulse – Scrutinizing the Numbers in Caterpillar’s Complaint – NYTimes.com]
So really Caterpillar’s complaint boils down to whining about a removal of a tax break enacted when Republicans controlled the Congress and the White House. Cry me a river…Footnotes:
- 2010 contributions- 24% to Democrats, 76% to Republicans, 2004 contributions -11% to Democrats, 89% to Republicans [↩]
To be sure, it was enjoyable watching Representative Devin Nunes, a Republican of California, warn that by passing health reform, Democrats “will finally lay the cornerstone of their socialist utopia on the backs of the American people.” Gosh, that sounds uncomfortable. And it’s been a hoot watching Mitt Romney squirm as he tries to distance himself from a plan that, as he knows full well, is nearly identical to the reform he himself pushed through as governor of Massachusetts. His best shot was declaring that enacting reform was an “unconscionable abuse of power,” a “historic usurpation of the legislative process” — presumably because the legislative process isn’t supposed to include things like “votes” in which the majority prevails.
A side observation: one Republican talking point has been that Democrats had no right to pass a bill facing overwhelming public disapproval. As it happens, the Constitution says nothing about opinion polls trumping the right and duty of elected officials to make decisions based on what they perceive as the merits. But in any case, the message from the polls is much more ambiguous than opponents of reform claim: While many Americans disapprove of Obamacare, a significant number do so because they feel that it doesn’t go far enough. And a Gallup poll taken after health reform’s enactment showed the public, by a modest but significant margin, seeming pleased that it passed.
[Click to continue reading Paul Krugman – Going to Extreme – NYTimes.com]
I do hope nobody actually gets hurt in this days of pseudo-rage, and Rethuglican threats. Other than that, I’ve enjoyed the spectacle as well. Fun when the GOP doesn’t get its way, elections matter, remember?
From the Kansas City Star Editorial Board:
Even some elected officials have stepped over the line of reasonable debate. GOP Rep. Devin Nunes, of California, noted: “When you use totalitarian tactics, people, you know, begin to act crazy…I think that people have every right to say what they want. If they want to smear someone, they can do it.”
[Click to continue reading Tea party’s lunatic fringe is alarming | Midwest Voices]
Greg Sargent on Mitt Romney supporting what he now opposes:
Here’s the key exchange:
MODERATOR: “You seem to have backed away from mandates on a national basis.”
ROMNEY: “No, no, I like mandates. The mandates work.”
To be clear, the individual mandate wasn’t the lightening rod for the right back then that it is these days. Romney appears to have merely been trying to appear consistent on the issue. But now that Obamacare has elevated the issue into an important one on the right, Romney is depicting the Federal mandate as a frightening abuse of power.
All this said, in a way the details of Romney’s position, or positions, aren’t really the point. Rather, the real problem for Romney here is that every time he goes on TV to bash Obamacare, he’s going to be asked to explain why he’s slamming a provision he signed into law himself.
[Click to continue reading Did Romney Endorse Federal Mandate? | The Plum Line]
The Gallup poll mentioned:
Nearly half of Americans give a thumbs-up to Congress’ passage of a healthcare reform bill last weekend, with 49% calling it “a good thing.” Republicans and Democrats have polar opposite reactions, with independents evenly split.
[Click to continue reading By Slim Margin, Americans Support Healthcare Bill’s Passage ]
If you use the same reasoning the Rethuglicans are using against implementing the individual insurance mandate, then George Washington was a socialist too
Joe Conason writes:
One of the favorite complaints against the healthcare reform bill is that the founding document doesn’t permit the federal government to order anyone to buy a product or service. That supposedly renders illegitimate the individual insurance mandate that is part of the bill.
As every fervent advocate of gun rights ought to know, however, that argument suffers from a glaring historical flaw. Only a few years after the nation’s Founding Fathers ratified the Constitution, Congress approved the Militia Act of 1792, which was duly signed by George Washington, then the president and commander in chief.
Establishing state militias and a national standard for their operation, the Militia Act explicitly required every “free able-bodied white male citizen” between the ages of 18 and 45, with a few occupational exceptions, to “provide himself with a good musket or firelock, a sufficient bayonet and belt, two spare flints, and a knapsack, a pouch with a box therein to contain not less than twenty-four cartridges, suited to the bore of his musket or firelock, each cartridge to contain a proper quantity of powder and ball; or with a good rifle, knapsack, shot-pouch and powder horn, twenty balls suited to the bore of his rifle, and a quarter of a pound of powder..”
Within six months, every citizen enrolled and notified of his required militia service had to equip himself as specified above. There was spirited debate in Congress as to whether the state ought to subsidize the purchase of arms for men too poor to afford their own, so that everyone could serve his country. Subsidized or not, however, the founders saw no constitutional barrier to a law ordering every citizen to buy a gun and ammo.
[Click to continue reading So George Washington was a socialist, too! – Joe Conason – Salon.com]
Ru-oh! Better warn the Texas Board of Education so they can scrub mention of George Washington from any textbooks…