http://world-news.newsvine.com/_news/2012/06/24/12381551-ipsos-poll-most-americans-oppose-obama-health-law-but-like-provisions#entercomment ________________________________________________________________________________ "No one ever lost any money underestimating the American public." P.T. Barnum. Well, the American public has spoken again. That is, if you believe (a) pollsters; (b) how polls are worded, asked, conducted, and interpreted; (c) whether the American public (if this is in fact a representative sample) has any idea of what is in its best interest. Why do I say that? Remember when this debate started again during Obama's first term? People would stand up at town halls and tell the moderator, "Keep gummint's hands off my healthcare!" Of course, many of those speaking were seniors, all of whom are covered by Medicare, the government-run healthcare system! How did people get so stupid and/or ignorant about something which is vital to their physical--and fiscal--well being? If this were the 1950s, I'd guess that the Russians had put something in the air and water supply. While that may still be the case--remember Love Canal, the Cleveland River that burned, and the recent mercury emissions controls that the Senate voted down last week--the Russians don't have a hand in it. We are doing just fine poisoning ourselves. One explanation for the collapse of the Roman Empire relates to the lead content of the pipes with which they constructed their system of aquifers. Lead poisoning weakens the brain's cells and their ability to think. Today, while lead is pretty much out of the water, we have fluoride, mandated in every municipal water system in the country in the 1950s to prevent cavities, as a long-standing substitute. As I said above, the powers that be in this country haven't lost a step when it comes to damaging the public's health in their efforts to "protect" it. That's where the Supreme Court comes in. Given the majority's predilection for interpreting the life out of the nearly impenetratable wording of the laws that govern us all, it won't surprise any Court watchers if they deem the individual mandate unconstitutional. A rough analogy would be: They know the cost of everything but the value of nothing. I wish us all good luck!

The Dark Side Of The Force--a.k.a. The GOP--once again showed its mean-spiritedness and insensitivity to the needs of those for whom they work; i.e., us. The House GOPers passed their version of a law designed to eliminate a cost-cutting panel mandated in Obama's healthcare bill and reduce total compensation courts can award to patients harmed by a medical professional or entity. Here's the article: House Republicans combined two ill-conceived health care measures into a single bill and passed it on a largely party-line vote last month. One measure repealed an independent board that is one of the major cost-control measures in the health care reform law. The other imposed restrictions on medical malpractice awards that would limit the ability of patients who have been grievously harmed to receive fair compensation for their injuries. The board, known as the Independent Payment Advisory Board, is supposed to come up with ways to ramp down Medicare spending if its growth rate is projected to exceed a specified target. Despite what Republicans claim, the board, which will include doctors, consumers and patient advocates (misleadingly described by critics as “unelected bureaucrats”) is not allowed to “ration care.” It is largely restricted to recommending cuts in payments to health care providers that would go into effect only if Congress failed to find comparable alternative savings. According to the Congressional Budget Office, repealing the board would drive up federal spending on Medicare by $3.1 billion over a decade. The malpractice measure would make it harder to seek compensation for noneconomic damages such as pain and suffering and would limit awards to $250,000, which is far too little to compensate someone who is paralyzed or blinded for life by medical negligence. It would also limit patients’ ability to file punitive damage suits and limit awards in those suits to $250,000 or twice the amount of economic damages awarded. Malpractice reforms are needed. But there are ways to encourage fair settlements and reduce the amount of malpractice by doctors without limiting the ability of badly injured patients to receive adequate compensation. The Senate needs to reject or bury this legislation. Let's hope the Senate rejects this febrile attempt to eliminate two ways the healthcare law will help and empower people to keep a lid on costs and receive proper compensation for harm at the hands of professionals.

Want to know a big--and continuing--reason why healthcare costs keep going up? Yes, it's that recurring bugaboo, administration. This time, the IRS gets into the act, levying fines for noncompliance with the new health law. Once you know the IRS will be part of the administration of this law, you can expect incompetence, inefficiency, "one-size-fits-all" bureaucracy, and waste. Remember: the IRS fails to collect nearly $400 billion in taxes each year. Why would anyone expect its record on collecting and administering health law financial compliance to be any different? Read the article at http://www.foxbusiness.com/investing/2012/03/29/irs-already-gearing-up-for-health-care-crackdown/?link=mktw and weep!

You know my #1 issue: Our broken health care/health insurance system. I've been inveighing against the way we do things for over 25 years. But, you know what. Back then, the problem/the solution/the lack of political will were EXACTLY THE SAME as they are today. Gutless politicians on the payroll of insurance/big pharma/healthcos, people who count things determining how doctors practice medicine and who gets--and does NOT get--treatment all result in the 99%--that's US--getting screwed!! Read this article: http://usnews.msnbc.msn.com/_news/2012/03/29/10926817-hospital-mom-booted-from-er-to-die-in-jail-was-treated-appropriately?ocid=twitter It's just one example of how "the best health care in the world" caused yet another person's death.

http://www.nytimes.com/2012/03/07/business/aarp-study-says-price-of-popular-drugs-rose-26.html?_r=1&emc=tnt&tntemail1=y The clue to why this report is important comes, no surprise, at the very end. Note the mention of the "doughnut hole." If you are not familiar with that term, it's the you-couldn't-make-this-stuff-up part of the prescription drug bill, written by a big pharma executive and passed during the 2nd administration of He Who Shall Not Be Named. The real effect of the doughnut hole is to repay to big pharma all the $$$ saved by seniors on their first $2,500 or so of prescription drug coverage. At that threshold, the doughnut hole opens, and seniors have to pay the full price of their drugs until the hole closes at about $5,000. THE FULL PRICE OF THEIR DRUGS!! Only in America could such a mean-spirited, head-up-the-ass provision pass. As the reporter notes, the increases reported by the AARP mean that seniors are propelled faster toward the yawning maw of the doughnut hole, so big pharma gets its $$$ even faster! The other point worth noting is generics. Any doctor or pharmacist will tell you, if asked, that many generics are less potent or efficacious than the full-strength name brand variant. So, no surprise that they cost less. Pay special attention, too, to the fact that insurance companies report paying out more for name-brand drugs. Who do you think will make up this "loss" experienced by the insurance companies? IT'S ALL OF US!! Read this article and understand an important reason why health care and health insurance costs continue to rise.

Each time I read a story like the one that follows, I start bouncing off the ceiling. Who could cobble together such a convoluted, outright mean-spirited, and stupid, plan for offering--and withholding--treatment and stiffing the providers of that care. Of course, it's the people who know the price of everything and the value of nothing. These are people who make Scrooge seem like Santa by comparison. But, you know, that is too kind a tone. These cretins are vile little shits who dole out treatment while withholding compassion. They besmirch the compact between the people and their government and its elected officials, all the while imagining that whatever cost-cutting measures they take will somehow improve health care delivery and the quality of care. The rest of the world looks on in amazement and disgust. Medicaid Cuts Rile Doctors Hospitals Also Fight Washington State's Drive to Trim Emergency-Room Visits By ANNA WILDE MATHEWS A plan by Washington state's Medicaid agency to stop paying for certain emergency-room visits is prompting pushback from hospitals and doctors, who say they will be stuck with bills for vital care they often are legally required to provide. The new cuts, set for April 1, focus on about 500 diagnoses including common infections, mild burns, strains and bruises. If an enrollee comes to an emergency room and is diagnosed with one of these conditions, the Washington Medicaid program won't pay the hospital and doctors. Doctors and hospitals are up in arms about a Washington state Medicaid cut that will deny coverage if beneficiaries go to the ER for any of about 500 conditions including a number of common infections. Anna Mathews has details on The News Hub. Instead, the state will pay a screening fee of about $50 if the patient is in a private-plan version of Medicaid, which currently enrolls about 60% of beneficiaries and is slated to grow. Patients won't be charged. The move would be the latest cut to Medicaid programs as states struggle to reduce health-care costs—and as the downturn has boosted Medicaid's ranks. Some 43 states have Medicaid initiatives designed to deter unnecessary use of emergency rooms, according to the Kaiser Family Foundation, a nonpartisan, nonprofit organization that studies health issues. Several states now charge patients copays for nonemergency services in an ER. The Washington policy is being watched by other states, said Alan Weil, executive director of the National Academy for State Health Policy, a nonpartisan research organization. Washington's legislature last spring ordered the Medicaid agency to cut spending on unnecessary ER visits, spurred by a budget shortfall then projected at $2 billion. Officials say too much routine care is given in ERs, often the most expensive setting, and that this plan would save the state $17 million a year. Doctors and hospitals, which got an earlier version of the plan blocked on procedural grounds after suing the state, say the new effort goes too far. They say the cuts would put them in a bind because federal law requires them to screen and stabilize all patients, which may involve imaging and lab tests. Stephen Brashear for The Wall Street Journal Stephen Anderson, head of Washington state's emergency-physicians group, says a new policy would saddle hospitals and doctors with unpaid bills. Moreover, because of ethical and liability concerns, hospitals often will have to treat some conditions the state considers nonurgent, such as urinary-tract infections, they say. The upshot, they say, is they will be forced to do unpaid work, and the costs ultimately could be shifted to private health-care payers. "If you fall down the stairs, and your ankle is twice its normal size, and I X-ray it and it's broken, they'll pay me, and if I X-ray it and it's not broken, they won't," said Stephen Anderson, president of the Washington chapter of the American College of Emergency Physicians. The doctors say that patients, even though they face no bills themselves, may feel pressure to avoid coming to the hospital even if they urgently need care due in part to publicity about the state's effort. They also argue that a number of diagnoses on the list are relatively serious conditions, such as candidal endocarditis, which involves fungal infection of the heart. State officials say procedures such as pregnancy tests don't belong in the ER. State officials say that for many situations, emergency-room staff can make a quick assessment and steer patients toward a lower-cost venue, like an urgent-care clinic, without extensive testing. For ankle pain, for example, doctors have evaluation guidelines, and "screening procedures don't need to go on to X-rays" in all cases, said Jeff Thompson, chief medical officer of the state agency that oversees Medicaid, the Health Care Authority. "We will be happy to work with doctors and hospitals to ensure care is done appropriately and in the appropriate time frame," Dr. Thompson said. He said if a patient with the heart infection had symptoms that required hospital admission, that would be paid, but a chronic case without symptoms might not be covered in an emergency visit. The agency also will cooperate with providers to ensure the excluded diagnoses are appropriate, and it plans to add and subtract from the list it issued, Dr. Thompson said. He said procedures such as pregnancy tests and most well-baby exams shouldn't occur in an emergency room. The state also is focused on Medicaid beneficiaries with histories of frequent emergency-room use or narcotics abuse, and visits by these people will get a special review. Stephen Brashear for The Wall Street Journal Dr. Nathan Schlicher at St. Joseph Medical Center in Tacoma, Wash. A spokesman for the Centers for Medicare and Medicaid Services, the federal agency that oversees Medicaid, said it is "in touch with Washington state officials regarding their plans." Washington state's emergency-physicians group, as well its medical and hospital associations, are lobbying legislators and officials to halt the initiative. The groups have outlined an alternative plan to save money, which includes boosting use of generic drugs and monitoring frequent ER users. Other states are taking similar tacks. Since July in Tennessee, Medicaid pays only a $50 ER screening fee for diagnoses considered nonurgent, though it excludes children under two. Iowa in September launched a tiered plan that cuts payment for emergency visits for nonurgent conditions, but it doesn't apply to enrollees younger than 21, among other groups. The earlier version of the Washington policy, which was blocked by a state court in November after the doctor and hospital groups sued the state, would have allowed three nonemergency ER visits before the program refused to pay. "States are looking for any possible way to reduce spending," said Diane Rowland, executive vice president of the Kaiser Family Foundation. Medicaid beneficiaries go to the ER more often than others, according to an analysis from the Centers for Disease Control and Prevention, partly because they don't always have access to other doctors. But by and large, states have limited levers to trim their Medicaid tabs: The federal health overhaul law generally forbids them from reducing the populations they cover, and states are required to provide certain benefits. The number of people eligible for the program is expected to expand sharply in 2014 under the health overhaul. Federal and state laws often require that insurers cover ER visits that occur for reasons that a "prudent layperson" would consider an emergency, said Thomas Barker, an attorney at the firm Foley Hoag. That standard applies to all plans provided by employers that are self-insured, as well as private-plan versions of Medicare and Medicaid. It doesn't necessarily apply to traditional Medicaid, though, he said. Regardless of what they are paid, hospitals are obligated under a different federal law, the Emergency Medical Treatment and Labor Act, to provide a "medical screening examination" to anyone who asks, Mr. Barker said, and if the person has an "emergency medical condition" the hospital either must stabilize it or arrange to transfer the patient to another hospital that can do so.

There are 310 million people in this country, and I would guess that most of them go to a dentist at one time or another. Since the administrative labyrinth for dental coverage and services is quite complex, you can appreciate how much $$$ could be saved on health care if those expenses could be either reduced or eliminated. Here's a micro example of what many in the macro populace face every day. My HBSM--Healthcare Bullshit Meter--looked like a tachometer displaying 7,000 RPM in 1st gear when I received a call from my dentist just now. The billing person wanted to know what kind of dental coverage I have. It seems they have to contact Blue Cross Blue Shield before my appointment on Monday to find out what coverage I've got--a.k.a. how much $$$ the dentist can expect to receive from BCBS--whether there are any exclusions, etc. Luckily, I was able to reassure her that, if worse came to worse, I would pay for the procedure myself. While this dentist is perfectly competent to perform this onlay--she's done three others for me--the woman who runs the practice is totally $$$ focused, which, of course, plays into the insurance companies' hands perfectly. They want practitioners dependent upon their underwriting allowances. The hope is that practitioners will in turn put the financial squeeze on their patients to get payment. This of course means hiring professional office people WHO WENT TO SCHOOL TO LEARN MEDICAL BILLING. You will appreciate that this also drives up the cost of delivering quality care and reduces the amount of time available to the dentist to do so. There is a better way. You know my themes: Universal, Cradle-to-Grave, Single Payer. These concepts, when realized in this society for the benefit of every American, will cut costs, increase quality of care, do away with the fee-for-service model, cut insurance companies and HMOs out of the equation, and make situations like the one I am about to enter into a thing of the past. If you saw the movie "Sicko," you'll remember the scene in which Michael Moore wanders around a hospital in France asking for directions to the billing office. No one understands his request. That is the way it should be in the United States. Take the people who studied medical billing, never mind those folks who got PhDs in Taxation (I am not making this up, such a degree exists), teach them new skills in areas that actually produce something tangible so they can become productive members of society. Let me know your thoughts.