Monday, May 31, 2010

Memorial Day Poetry

Here are a few words from Col. Oliver North

http://www.nragive.com/ringoffreedom/index.html

They Did Their Share

On Veteran’s Day we honor
Soldiers who protect our nation.
For their service as our warriors,
They deserve our admiration.


Some of them were drafted;
Some were volunteers;
For some it was just yesterday;
For some it’s been many years;

In the jungle or the desert,
On land or on the sea,
They did whatever was assigned
To produce a victory.

Some came back; some didn’t.
They defended us everywhere.
Some saw combat; some rode a desk;
All of them did their share.

No matter what the duty,
For low pay and little glory,
These soldiers gave up normal lives,
For duties mundane and gory.

Let every veteran be honored;
Don’t let politics get in the way.
Without them, freedom would have died;
What they did, we can’t repay.

We owe so much to them,
Who kept us safe from terror,
So when we see a uniform,
Let’s say "thank you" to every wearer.

By Joanna Fuchs

Friday, May 28, 2010

The Newest Element

Pelosium

A major research institution has just announced the discovery of the densest element yet known to science.


The new element has been named Pelosium.


Pelosium has one neutron, 12 assistant neutrons, 75 deputy neutrons, and 224 assistant deputy neutrons, giving it an atomic mass of 311.


These particles are held together by dark forces called morons, which are surrounded by vast quantities of lepton-like particles called peons.


The symbol of Pelosium is PU.


Pelosium's mass actually increases over time, as morons randomly interact with various elements in the atmosphere and become assistant deputy neutrons within the Pelosium molecule, leading to the formation of isodopes.


This characteristic of moron-promotion leads some scientist to believe that Pelosium is formed whenever morons reach a certain quantity in concentration.


This hypothetical quantity is referred to as Critical Morass.


When catalyzed with money, Pelosium activates CNNadnausium, an element that radiates orders of magnitude more energy, albeit as incoherent noise, since it has half as many peons but twice as many morons as Pelosium.

Thursday, May 27, 2010

The Daily Grind

In this NEJM article, we see what an average physician does on a daily basis. I can tell you that our numbers are about 50% higher than the ones in this article.

NEJM -- What's Keeping Us So Busy in Primary Care? A Snapshot from One Practice

How would John Q Public respond if we started to bill for every email, phone call, message, letter, note, lab result review and refill in addition to all the prior authorizations, referral, and test approvals. If we billed for the services we provide similar to the lawyers and accountants, things may radically change.

Examining the patient is unfortunately only a small part of the overall care that is rendered on each visit.

Wednesday, May 26, 2010

Disingenuous

We all knew President Obama was disingenuous when he guaranteed that everyone could keep their insurance plans and their doctors with the healthcare takeover. But it is now crystal clear that this promise cannot be kept.

Insurers and physicians are already changing their practices as a result of Obama's plan. The reason behind the changes are because the health reform law caps how much insurers can spend on expenses and take for profits.
  • Starting next year, health plans will have a regulated "floor" on their medical-loss ratios, which is the amount of revenue they spend on medical claims
  • Insurers can only spend 20 percent of their premiums on running their plans if they offer policies directly to consumers or to small employers
  • The spending cap is 15 percent for policies sold to large employers
These regulations are going to have their largest impact on the policies sold directly to consumers. These policies typically cost more to market and have higher medical costs, owing partly to selection by less healthy consumers.

These policies also have high start up costs and if insurers cannot spend more of their revenue getting plans on track, it will lead to fewer new policies being offered and existing ones being eliminated; therefore, patients will not be keeping their insurance.

Other problems created by this takeover are the constraints on how insurance companies can manage their costs:
  • Beginning in 2014, a new federal agency will standardize insurance benefits, placing minimum actuarial values on medical policies
  • There are also mandates forcing insurers to cover a lot of expensive primary-care services in full
  • At the same time, insurers are being blocked from raising premiums -- for now by political jawboning, but the threat of legislative restrictions looms

All of these things will force insurers out of business leading to what was the original plan; a single government entity to offer insurance and dictate care.

Tuesday, May 25, 2010

Fix the Problem

The Deadline is now approaching once again for the 3rd time this year. On June 1, Medicare is threatening to cut physician payments across the board by 21 percent.

Congress will be considering proposals to temporarily patch the cuts yet again - perhaps for as long as five years. But once again they will fail to fix this flawed system and known problem. Physicians have already paid the price twice this year by having payments held for as long as 3 weeks creating ongoing cash-flow problems for the offices.

The temporary fixes enacted by Congress in the past have made future cuts steeper and raised the cost of repealing the SGR exponentially. It began in 2005 when the scheduled Medicare physician payment cut was 3.3 percent. The Congressional Budget Office (CBO) estimated the cost of a 10-year physician payment freeze at $48.6 billion. Today, physicians are facing a 21.3 percent cut and the CBO recently estimated the cost of a freeze to be $248 billion over 10 years.
If Congress were to enact a five-year patch today, physicians would be facing a potential cut of 37 percent in 2015, and the price tag to permanently repeal the SGR could be as much $500 billion.

If Congress couldn’t afford to fix the flawed formula in 2005 or 2010, then how can it afford to fix it when it doubles in 2015?

Ongoing failure to address the long-term stability of the Medicare program will intensify access problems for seniors and military families enrolled in the TriCare program and severely undermine implementation of new practice models and health care delivery innovations. More and more physicians will choose to stop taking any Medicare patients and the existing physician work force shortage will be magnified.

This is a dereliction of the fiduciary responsibilities of the Congress and they should be held accountable.

Monday, May 24, 2010

Patients in Control

Finally, someone is actually beginning to understand and reiterate what I have been saying. It is time to put patients in control of the healthcare dollar. This is the only way we will truly bring down costs.

Terry Paulson : America Needs a Healthcare Recall! - Townhall.com

President Obama has called for a half-day, bipartisan healthcare summit at the Blair House on February 25th, “I want to…have a large meeting, Republicans and Democrats, to go through systematically all the best ideas that are out there and move it forward.” But the President refuses to start from scratch, and Republicans fear that a half-day event focusing on thousands of pages from a rejected healthcare plan is nothing more than a political trap. Is it time to move beyond complex, expensive healthcare fixes and “recall” America’s healthcare system to make the systemic changes that are necessary?


Toyota has finally faced the need for an agonizing series of recalls and production shutdowns to make the system and assembly changes that are providing real solutions. But as PR expert Albert Tortorella observed, "Before 1982, nobody ever recalled anything. Companies often fiddle while Rome burns." What really makes mistakes expensive is not admitting them right away. Leaders have a tendency to never admit to mistakes but to bury them instead or to blame someone else. They often don’t act until 60 Minutes or lawsuits provide the motivation. Politicians tend to do the same thing, but it’s time to face the need for systemic changes that should have been done years ago.

Obviously, there are no easy fixes. Ultimately, politicians will need to address realistic tort reform, uniform digital records, sane regulatory controls, and coverage for the truly poor. But first, it’s time for government and corporations to get out of the middle. It’s time to put every citizen back in control of their own portable healthcare plan.

Too many Americans are stuck in jobs they hate because they can’t afford to be stuck with expensive COBRA policies they can’t afford. Once coverage is lost, they face underwriting exclusions for the very things they need coverage for. The cost of healthcare coverage for companies and organizations continues to grow at a double-digit rate at a time where everyone is trying to cut costs. Citizens and organizations are both living an exploding healthcare nightmare.

Before World War II, people paid their own medical bills, just as they paid their rent or mortgage payment, bought their own food, and paid for whatever else they wanted. After World War II, the government imposed wage and price controls. Companies who wanted to hire and reward good employees were forbidden to offer higher wages, but they could offer health insurance coverage and call it a business expense instead of a wage. Today, as a result, most medical treatments are paid by third parties, employer-funded insurance or government coverage. The people who are paying for the care are not the people who are using it. The current healthcare model isn’t working, and planned changes just put more bureaucracy and costs between your money and the healthcare services you need.

It’s time to put every American citizen on equal footing with access to the same healthcare coverage opportunities. The money invested in any healthcare benefit that currently comes to you as part of your employment would come to you as added income, and you, not the organization, would own your policy and any tax incentives the government provides. Portability would be ensured because you would own and control your healthcare plan and choices.

Insurers competing across state lines for your healthcare insurance business would have to include a Plan A—a basic, no frills major medical coverage to protect you from catastrophic medical problems. After a certain preset, annual deductible amount, all costs would be paid. No insurer would be allowed to deny coverage for this plan and a waiver of premium component would be included to cover citizens who are unemployed for up to a year. Following the Swiss model, the government could provide secondary insurance to minimize the risk insurance companies would have to shoulder covering all Americans.


If you wanted more coverage, you could add supplemental plan that fits you. But buying insurance to cover all your healthcare costs is no more necessary than having your auto insurance pay for normal maintenance.


There’s an added benefit. When it’s your policy and you pay for your own healthcare, you’ll take your healthcare choices more seriously. Sites like www.pricedoc.com will emerge to help you find the best healthcare services for you. That competition will help improve healthcare quality and help control costs. This already works in holding down the cost for cosmetic surgery not covered by insurance.

The government could provide tax incentives to support your major medical plan and a Medical Savings Account, or MSA. The MSA would allow you to make pre-tax contributions to an interest-bearing account. When minor medical needs arise, you could write a check from that account to pay for what is needed. You could go to your favorite doctor or go to a less expensive clinic. If you didn’t use all your funds for the year, you could roll those funds forward for future healthcare needs.

In short, let’s get radical. It’s time to put you back in control of your own healthcare.

Friday, May 21, 2010

The Obama Cat


Four men demonstrated how smart their cats were.

The engineer's cat took pencil and paper and drew a circle, a square and a triangle.


The accountant's cat divided a dozen cookies into four equal piles.


The chemist's tabby poured a glass of milk without spilling a drop.


And the Obama fat cat?


He ate the cookies, drank the milk, wee-weed on the paper, filed a grievance report for unsafe working conditions, put in for workers compensation then went home the rest of the day on sick leave.

Thursday, May 20, 2010

In the Obama World

Here he is again showing his true ideology. It is funny how he wants to dictate how much money others make but it certainly doesn’t seem to apply to him or his wife.

Who has the right to say how much money an individual can make if they want to work hard, take some risks and invest wisely. Never before have we seen such blatant disregard for the principles that made this country great.

RealClearPolitics - Video - Obama To Wall Street: "I Do Think At A Certain Point You've Made Enough Money"

Wednesday, May 19, 2010

INSPECT Changes

Here is some good news coming from the ISMA related to the Indiana Scheduled Prescription Electronic Collection and Tracking program (INSPECT) program we use every day in our practice.

Beginning July 1, a legal change will permit you to report INSPECT patients to law enforcement, with legal protection when you do so.

This is a Web-based system that tracks all schedule II through V controlled substances dispensed in the state and is a very useful tool for physicians. But INSPECT has also raised many questions from physicians, mainly: What do I do with the information once I get it?
Recent changes to the law affecting INSPECT will provide a better answer to that question. The change states, effective July 1, 2010, “A practitioner who in good faith discloses information based on a report from the INSPECT program to a law enforcement agency is immune from criminal or civil liability.”

While you will still not be required to use INSPECT or report information from it to anyone, you will now be permitted to report information to law enforcement and will be legally protected for doing so.

However, Julie Reed, ISMA legal counsel, noted, “The new law only allows disclosure of information based on an INSPECT report. Any other disclosure to law enforcement will likely still require a subpoena.”

The INSPECT database serves as an online tool to help physicians with treating their patients. The database has always been available to law enforcement and state officials.

A 2007 change initiated by the ISMA made it available to doctors and other health care providers. While never required to use INSPECT, physicians are immune from civil liability for an injury, death or loss to a person solely due to their seeking or not seeking information from the database.

Today, you can register and then search your patient's controlled substance history before making treatment decisions. It’s all free.

“Of course, the data cannot be used inappropriately,” noted Reed. “Specifically, it can only be used for providing medical treatment or evaluating the need for providing medical treatment to a patient.”

In recent years, when physicians have asked if they can or should report patients whose INSPECT reports indicate abuse, like doctor shopping or diversion, the answer – to the dismay of law enforcement – has been they should not. That’s because the cornerstone of the physician-patient relationship is confidentiality.

“A treating physician has always been able to share patient information with another treating physician for treatment purposes without patient consent. However, doctors cannot share patient information with physicians who do not have a treatment relationship with that patient or with non-physicians,” Reed explained.

Thus, unless a law requires a disclosure, permits disclosure (paired with immunity), or the patient consents, you must protect the patient’s information. With INSPECT, the new disclosure option will exist starting July 1.

Tuesday, May 18, 2010

More Socialist Power

Here is what happens when you have governments overstepping their powers. At what point will the liberals and socialists stop? What else will they deem to be a “Right”?

They will be stealing more and more from the working folks to pay for these so-called “Rights”.

Vacationing a human right, EU chief says

Monday, May 17, 2010

Surprise, Surprise

Here is a recent post from The Morning Bell related to the new revelation that Obamacare is not going to lower the deficit and will cost an additional $115 billion dollars just for implementation. The real costs and destruction of the system are only beginning to be realized. But you cannot say there wasn’t adequate warning. The Dems need to own this poor decision!

"We have to pass the bill so that you can find out what is in it," Speaker Nancy Pelosi (D-CA) told us just weeks before Congress passed President Barack Obama's health care plan. Well, the nation's post-passage Obamacare education continued yesterday when the Congressional Budget Office (CBO) confirmed that the federal government will have to spend an additional $115 billion implementing the law, bringing the total estimated cost to over $1 trillion. The estimate had been requested before passage of the bill by Rep. Jerry Lewis (R-CA), but the CBO was too overwhelmed with the Democrats' other constant revisions to the law to get back to Lewis before the final vote.

This is by far not the only nasty little surprise that has come back to bite Obamacare after passage. Shortly after it became law, U.S. employers began reporting hundreds of millions if dollars in losses thanks to tax changes in the bill. AT&T and Verizon alone pegged their Obamacare tax losses at around
$1 billion each. At first, Democrats in Congress were outraged by the announcements and threatened to hold hearings persecuting these companies. But then the Democrats not only found out the companies were obligated by law to report their Obamacare related losses, but that the losses were a signal these companies might have to dump their employees' and retirees' health care coverage all together.

Then the Obama administration's own Centers for Medicare and Medicaid Services (CMS) released its
final cost projections for Obamacare, finding that, contrary to White House claims, the legislation will increase national health care spending by $311 billion over the next decade. The CMS report also revealed that: 1) 18 million Americans will pay $33 billion in penalties for failing to comply with Obamacare’s individual mandate and still receive no health care; 2) U.S. employers will pay $87 billion in employer mandate penalties; 3) 14 million Americans will lose their current employer-based health coverage; 4) 7.4 million seniors will lose their current Medicare Advantage benefits; 5) 15% of all Medicare providers will be made unprofitable, thus “jeopardizing access to care for beneficiaries.”

Facing this onslaught of reality, the Obama administration has swooped into full spin mode, devoting the
Weekly Presidential Address to explaining the "real benefits" Obamacare is "already delivering" to Americans. HHS Secretary Kathleen Sebelius then sent letters to House and Senate leaders touting her "progress" in implementing the law. And then last night White House aides Nancy-Ann DeParle and Stephanie Cutter briefed the House Democratic Caucus on the "tangible benefits" of the law. The sales pitch for all three events were the same: 1) "adults" age 26 and younger can be added to their parents' plan (never mind that this drives up their parents' health care costs); 2) new high-risk pools for Americans with pre-existing conditions (never mind that 19 states have rejected working with HHS since Obamacare massively underfunded the pools); 3) supplementing insurance for early retirees (never mind that the Medicare Advantage cuts and tax changes mentioned above are a big reason why seniors will need supplemental coverage).

Democrats know that Americans simply are not buying what they are selling. Rep. Louise Slaughter (D-NY) tells
Politico: "It's just like trying to explain the Encyclopedia Britannica." And John Spratt (D-SC) adds: "You need to know what you're talking about and this is extremely complex. It's really difficult to remember, 'was this in this bill, or was this in the bill Senate side.'" Maybe Spratt should have figured out what was and wasn't in the bill before he voted for it.

Since the left can't even figure out what is in the bill they are trying to defend, the latest
Rasmussen Reports shows that 63% of likely voters now believe it will increase the federal deficit, and 56% now favor repeal. Not waiting for this November's elections to change the leadership in Congress, states are leading the way on the road to repeal. According to The Washington Post 33 states have mounted legal and legislative challenges to the new law. Clint Bolick, litigation director of the Goldwater Institute, tells the Post: "This is going to be a long, protracted war of attrition and we haven't even seen the first wave of regulations yet. ... The initial challenges to McCain-Feingold were rejected. But since then, litigators found the vulnerabilities. Likewise, here I think you're going to see a thousand flowers bloom in terms of lawsuits. I'm hoping that this will die a death of a thousand cuts."

Friday, May 14, 2010

New Medical Symbol

With the complete takeover of the Healthcare system by Obama and the radical lefties; we felt there needed to be an updated medical symbol to reflect the reality of the new system.

This symbol accurately displays our new era of healthcare.

Thursday, May 13, 2010

New York Experience

Does anyone want to guess as to why the New York Times just ran this article and not before the vote on the Healthcare Takeover?

New York an Insurance Lab on Skyrocketing Rates - NYTimes.com

Do you think that information like this may have swayed the public opinion even more?

New York mandates insurance companies to cover everyone with pre-existing conditions and the response has been that they have the highest premiums in the nation.

This phenomenon known in the trade as the “adverse selection death spiral” will occur across the nation as more people figure out it is cheaper to pay a penalty and avoid getting insurance until you have a catastrophic illness. Then you just sign up, pay the higher premiums but have your illness covered.

This is not “insurance”.

Wednesday, May 12, 2010

Health Courts Revisited

The need for Tort reform is clearly evident to all physicians and healthcare providers. There are more claims are filed every year, and the average amount of awards has been steadily increasing by as much as 500 percent over the last decade in some areas. This translates into higher medical liability insurance.

I still believe “Health Courts” are a viable option. These would be specialty courts that rely on educated judges, neutral experts, evidence-based proceedings, and a schedule of damages that not only keeps liability costs manageable, but also is better for patients.

The American Bar Association is adamantly opposed to the concept and claim that health courts deny patients access to a jury trial and full compensation. But this argument really doesn’t hold much water since we already use specialty courts in areas such as bankruptcy, workmen’ s comp cases, patent cases, family law, and tax courts.


The big problem with jury trials for medical malpractice cases is that juries can be swayed by emotion and they don’t always understand those facts or their importance. This should not be the basis of an award.


Health courts would use experienced adjudicators who would be used to seeing the same kinds of cases over and over and judges would become accustomed to what injuries are preventable and when a physician is truly liable. An adjudicator with experience in the medical liability area is far less likely than a jury to be misled by inaccurate testimony and sympathy appeals. Since judges aren’t doctors, they need neutral medical experts who can give an honest, unbiased opinion on the medical facts of a case. This is completely different than the paid experts that are now used on both sides and basically are paid to testify to the attorney’s desires.

Current thinking is to have independent experts drawn from outside the court’s geographic area to provide the expert analysis.

Current health court models propose a “schedule” of claim awards where a patient is compensated for his or her specific economic losses (e.g., medical bills, lost wages, etc.) and also according to the extent of damage suffered for noneconomic claims (what is sometimes called “pain and suffering”). This scenario would actually give awards to more claimants and based on the 1991 Harvard Medical Practice Study, they found that less than 2 percent of patients injured due to negligence ever file a claim and of the meritorious claims that are filed, about 25 percent never get paid.

Those few patients who do get compensated, almost 60 percent of the current system’s total costs go to attorney fees, paid expert testimony, and various administrative costs. These cases can drag on for years as attorneys on both sides file motion after motion, appeal after appeal. Health courts could actually remedy the problem of undercompensation that we see in the system right now. What this would eliminate are the very large awards that so many personal injury lawyers like to see. By keeping administrative costs low and adhering to a schedule of awards correlated to injury, health courts not only can provide restitution to patients who deserve it, but they also can expedite the process so that needy patients aren’t kept waiting for years and years. Workers’ compensation courts, which work similarly, often grant awards within six to nine months of filing. Malpractice is there for gross negligence and not necessarily minor mistakes. Doctors are human and will make mistakes and some patients are really ill and will have complications. These are not necessarily malpractice.

The current malpractice system has given rise to a culture of defensive medicine and according to a 2005 study in the Journal of the American Medical Association, more than 90 percent of physicians admitted to ordering unneeded tests and performing unnecessary procedures to protect against the possibility of future malpractice claims. The Department of Health and Human Services puts the cost of these practices at around $60 billion a year.

Investigators at the Harvard School of Public Health envision a system that can collect data on medical injuries and errors that can be used to improve healthcare systems and safety procedures rather than punish or utilize emotional rewards.

New Zealand already has health courts and basically, all injuries due to medical management are compensated, regardless of physician error or whether the injury was avoidable. About three out of every five claims results in compensation, but overall claim rates are fairly low with only around 3,000 claims each year out of a population of four million people. Administrative costs are also very low and account for only 10 percent of the total system cost (as opposed to 60 percent under the current U.S. system). The Scandinavian countries (Sweden, Denmark, Finland, Norway, and Iceland) all use the concept of avoidability in their health courts. In fact, Sweden pioneered the idea in 1975. The system uses expert reviewers and in-house claims adjusters who determine the total amount of awards. Like in New Zealand, the compensation rates under Scandinavian systems are fairly high, with Sweden compensating 40 percent to 45 percent of all claims filed. Actual awards tend to be fairly modest. Most of the claims are resolved with six to nine months of filing. Because of the “no-blame” nature of the system, physicians in Sweden help patients file for compensation in as much as 80 percent of cases.



Arbitration is another model for reform and it uses an experienced adjudicator and, usually, neutral expert testimony. It also keeps administrative costs lower than the typical malpractice court system. Health insurers are really taking the lead on using arbitration to lower costs, and many health plans already offer or require arbitration. The Kaiser Permanente managed care health plan in California, for example, requires all members of the plan to settle injury disputes through its own independent arbitration board. And the Utah Medical Insurance Association, which provides medical liability insurance for physicians, offers a discount for physicians who merely offer arbitration as an alternative to their patients.



Documentation is part of the physician’s battle when it comes to malpractice claims. But better documentation won’t eliminate medical mistakes in their entirety although it may minimize the number of cases that are brought not because a mistake was made but because a doctor didn’t write something down.

As medical liability insurance costs skyrocket and malpractice awards get even more out of hand, the idea of health courts could become increasingly popular. Based on the idea of workers’ compensation courts, a health court system proposes the following advantages:


· Experienced judges. Malpractice cases are too often decided by juries who are easily swayed by emotion. An experienced judge can make a determination based on facts.


· Neutral experts. Everyone knows that current “expert” opinions are often bought, but neutral experts can provide honest and unbiased reviews of cases to help judges make final determinations.


· Scheduled awards. Under the current system, a very small percentage of claims receive large damage awards. Health courts would ensure that reasonable awards were made to a larger number of deserving patients.


· Foregoing negligence. The current standard of negligence encourages a culture of secrecy and defensive medicine. Changing the standard not only saves money, it could even lead to an improvement of best practices.

Tuesday, May 11, 2010

The Litigation Explosion

The current bill that was passed and will hopefully be repealed for the most part will certainly expand the litigation as Curt Levey explains in the following article. This was written before the bill was passed and compares some of the plans. But as it stands now, attorneys win on both sides of the legal issues when it comes to litigation.

Curt Levey: Health-Care Reform Could Create a Litigation Explosion - WSJ.com

President Obama wants to convene a bipartisan meeting later this month to discuss health reform—"to go systematically through all the best ideas out there," as he said to CBS's Katie Couric in a pre-Super Bowl interview. "How do you guys want to lower costs?" he said he'd ask Republicans.


If he is sincere, the president should consider how the health-care bills his party has on the table right now will drive up the legal costs that are draining the health-care system we currently have.


By creating new federally enforceable rights and obligations, layers of complex federal regulations, and dozens of new programs and agencies—not to mention 50 newfangled "exchanges"—ObamaCare would guarantee a flood of litigation. That means more money wasted on attorney fees, physicians focused on legal rather than medical considerations, and growing delays in our already-overburdened courts.


The first court battles will focus on the constitutionality of requiring individuals to buy health insurance. Assuming the statute survives, subsequent litigation will put Americans' health in the hands of federal judges who will effectively write health-care policy as they divine the meaning of thousands of pages of statutory language and accompanying regulations.


The sources of litigation will be many, ranging from individual coverage disputes to other constitutional claims explored below. In between, there's enough vague and ambiguous statutory language to keep lawyers employed for decades. One example: the compromise abortion provision contained in the Senate bill. Fervent disagreement over its meaning presages bitter court fights.


Consider also the legislation's prohibition of a deductible for "preventive services" recommended by the United States Preventive Services Task Force. The recent firestorm over the Task Force's mammogram recommendations is but a glimpse of the legal battles that will ensue when such recommendations gain new legal status under the statute.


To implement the legislation currently on the table, federal bureaucrats will necessarily generate thousands of pages of regulations. Under the Administrative Procedure Act, trial lawyers—as well as attorneys for industry, the medical profession, and countless interest groups—will challenge not only the substance of the regulations, but also the procedures used to generate them.


For example, the bills command the Secretary of Health and Human Services (HHS) to "define the essential health benefits" that insurance plans must contain. Imagine the mischief trial lawyers can make by claiming that the resulting regulations fail to fully "take into account the health-care needs of diverse segments of the population," as the Senate bill requires. Lawyers will also challenge some of HHS's rule-making as an improper delegation of congressional authority.


The greatest number of lawsuits may come from individuals flexing their new-found right to essential health benefits by challenging insurance companies' coverage decisions in court after internal appeals are exhausted. The Senate and House bills will inevitably produce, but do nothing to mitigate, an increase in the variety and complexity of such litigation.


Now that the federal government is inserting itself between you and your insurance company, we'll also see coverage disputes in which the feds are among the defendants. HHS might even wind up as a defendant in medical malpractice lawsuits.


The Constitution applies to government actions, so the feds' dramatically expanded role in health care promises an explosion of constitutional claims, driven both by financial gain and interest group agendas. Lawsuits claiming equal protection violations will be limited only by the human capacity to feel discriminated against.


Women's groups will likely sue if HHS requires coverage for erectile dysfunction but not breast augmentation. Gay-rights groups will litigate if they don't like the way HHS defines "family" for insurance purposes. People 30 and over will file suit because only the young are permitted to purchase catastrophic coverage. Hispanics will go to court if they are disproportionately asked to prove citizenship before receiving insurance subsidies. And white folks will sue because of the various racial preferences in the bills.


Death panels or not, greater federal involvement in health care, including end-of-life care, triggers the constitutional requirement that government afford due process when life is at stake. Liberals who complained about the interference of federal courts in the Terri Schiavo case may wind up regretting their push to federalize health care.


Government intervention also elevates privacy issues to a constitutional level. The bills single out smoking as a justification for higher insurance premiums, potentially raising the constitutional issue of how far federal bureaucrats enforcing the new premium rules can go in determining whether you smoke in your home.


Creative trial lawyers will be aided by those activist judges more interested in making than interpreting the law. The four corners of, say, the Senate bill and its accompanying regulations will be just a starting point for a panoply of judge-made entitlements, "rights," and federal obligations that will themselves trigger a further expansion of health-care litigation.


"Litigation has several features at odds with sound health policy—including its cost, its hindsight bias, and its adversarial character," William Sage, Vice Provost for Health Affairs at the University of Texas, warned us seven years ago in the Journal of Health Politics, Policy and Law. Under ObamaCare, health care will become even more costly and adversarial, with patients' concerns crowded out as doctors focus on avoiding lawsuits and federal investigations, and insurance companies and regulators blame each other for every problem.


And if you think insurance companies take too long to make decisions when lives hang in the balance, just wait to see the delays in patient care caused by the federal bureaucracy and an overburdened court system.


Supporters of the legislation favored by the president and most of his party point to socialized medicine in Europe as evidence that federalizing health care won't be the disaster that many predict. But European nations are not nearly as litigious as our own. The uniquely American combination of bureaucrats, trial lawyers, and judges running our health-care system will prove more costly and deadly than anyone can imagine.

Monday, May 10, 2010

The Fiscal Farce

More rhetoric and failures along with the mistruths and deceptions from this administration. Morning Bell: The Obama Fiscal Responsibility Farce Continues The Foundry: Conservative Policy News.

Today President Barack Obama’s National Commission on Fiscal Responsibility and Reform will convene for the first time at the White House. Tasked with making recommendations to Congress that would put the budget in primary balance by 2015 and “meaningfully improve” our nation’s long-term fiscal outlook, the commission meets a little over a month after Congress approved a new $2.5 trillion health care entitlement that the Obama administration now confirms will increase our nation’s total health care spending.

This is a now familiar pattern for the White House: first enact record breaking levels of deficit spending, then turn right around and promise austerity sometime in the future. This February, after signing
the largest single-year increase in domestic federal spending since World War II, President Obama held a “fiscal responsibility” summit designed to “send a signal that we are serious” about putting the nation on sounder financial footing. The Washington Post’s Dana Milbank quipped at the time: “Holding a ‘fiscal responsibility summit’ at the White House in the middle of a government spending spree is a bit like having an Alcoholics Anonymous meeting at a frat house on homecoming weekend.”

The leftist majorities in Congress are no better. Congress has now missed its April 15 deadline for enacting a budget resolution, which is one of the few pieces of legislation that Congress must pass annually. If Speaker Nancy Pelosi (D-CA) fails to pass a budget it will be the first time since the 1974 Congressional Budget Act that the House has failed to do so.
All over the country, recession-weary families are examining their income and spending, making difficult decisions, and setting family budgets. Yet Congress—despite a $1.5 trillion deficit in 2010 and historic deficits as far as the eye can see—cannot manage to set any budget framework for the next few years.

Some may argue that Congress does not need to pass a budget since President Obama’s commission will be making all the tough choices. But this would only make our fiscal crisis worse: Congress is under deadline to finance the FY 2011 spending bills before September 30—well before the commission is even scheduled to release its report. Without a budget, Congressional appropriators are completely free to ignore all caps on discretionary spending for fiscal year (FY) 2011. Worse, the commission itself is
fatally flawed since: 1) its recommendations are not guaranteed a vote in Congress; 2) its recommendations will be considered by a lame duck Congress; 3) there is no indication the commission will take any input from public hearings.

Last week, Pew Research Center released a
survey showing just 22% of respondents said they trust the federal government almost always or most of the time. Last March Pew found by 54% to 37%, people favored the government exerting more control over the economy. Now, by 51% to 40%, a majority of Americans say they want less government control. If President Obama’s fiscal responsibility commission is to have any credibility with the American people, the first item on its agenda must be the full repeal of the President’s $2.5 trillion health care entitlement.

Friday, May 7, 2010

Depression over Obamacare



Depression!


Over five thousand years ago, Moses said to the children of Israel " pick up your shovel, mount your asses and camels, and I will lead you to the Promised Land".


Nearly 75 years ago, Roosevelt said, "Lay down your shovels, sit on your asses, and light up a camel, this is the Promised Land".


Now Obama has stolen your shovel, taxed your asses, raised the price of camels, and mortgaged the promised land!



Furthermore, I was so depressed last night thinking about Health Care Plans, the economy, the wars, lost jobs, savings, Social Security, retirement funds, etc.


I called Lifeline, the suicide help line.



Got a freakin' call center in Pakistan .


I told them I was suicidal.



They got all excited and asked if I could drive a truck.

Thursday, May 6, 2010

Wednesday, May 5, 2010

Obama's Transparency

Coverups, scams and just outright withholding of information is what this article shows. It is ironic that Obama campaigned on transparency. Here is an excerpt from the article related to the healthcare bill.

"We know a copy was sent to the White House via their legislative affairs staff," says the HHS staffer, "and there were a number of meetings here almost right after the analysis was submitted to the secretary's office. Everyone went into lockdown, and people here were too scared to go public with the report."

The American Spectator : What Lies Beneath

OFFICE POLITICS
The economic report released last week by Health and Human Services, which indicated that President Barack Obama's health care "reform" law would actually increase the cost of health care and impose higher costs on consumers, had been submitted to the office of HHS Secretary Kathleen Sebelius more than a week before the Congressional votes on the bill, according to career HHS sources, who added that Sebelius's staff refused to review the document before the vote was taken.

"The reason we were given was that they did not want to influence the vote," says an HHS source. "Which is actually the point of having a review like this, you would think."

The analysis, performed by Medicare's Office of the Actuary, which in the past has been identified as a "nonpolitical" office, set off alarm bells when submitted. "We know a copy was sent to the White House via their legislative affairs staff," says the HHS staffer, "and there were a number of meetings here almost right after the analysis was submitted to the secretary's office. Everyone went into lockdown, and people here were too scared to go public with the report."

In the end, the report was released several weeks after the vote -- the review by the secretary's office reportedly took less than three days -- and bore a note that the analysis was not the official position of the Obama administration.

OBAMA'S MINES
The irony of President Barack Obama visiting Beckley, West Virginia, Sunday to read a eulogy at the memorial service for those who died in the Upper Big Branch Mine accident, has not been lost on some White House aides. "If we had our way we'd be mourning the mining industry, not miners," says a White House aide. "As an environmental issue, we want the majority of these mining related industries just to go away."

In fact, the White House and some Obama Administration staffers at the Department of Energy and the Environmental Protection Agency have been coordinating with left-wing environmental groups to launch protests in West Virginia over such techniques as "mountaintop removal mining." This enabled the EPA to cite such protests as support for their new rulemaking. Earlier this month, the agency imposed rules sharply curtailing that form of strip mining in such states as West Virginia. The rules may end up costing several hundred West Virginians their jobs.
Now the Obama Administration is looking for ways to reward those groups they coordinated with. According to sources inside the EPA, the agency is attempting to find ways to get funding to several organizations it worked with on the mountaintop mining and other efforts, including Appalachian Voices and Coal River Mountain Watch. Meanwhile, the administration is attempting to identify ways to fund a much more influential "pass through" organization, the Appalachian Community Fund, an organization run out of Knoxville, Tennessee.


"Appalachian Community Fund is like the ACORN of West Virginia, Kentucky and Tennessee," says a Commerce Department political employee. "If we can get it just a few hundred thousand dollars, it can organize for us down there in ways to help us politically, and it's done great things for us with the EPA and other entities."

MEAN MORRIS
Some California conservatives were scratching their heads over an email being sent around by longtime Democrat and Clinton adviser Dick Morris, telling California Republicans not to support Senate candidate Tom Campbell, who has been leading a number of different polls, and who has declined to sign the Americans for Tax Reform pledge to not support tax increases.

"Guess Campbell didn't take any of Morris's advice or a phone call," joked one California political consultant. Morris has gained the reputation for using his emailed newsletter and Fox News appearances to criticize candidates he has attempted to rope into any number of entities he consults for, including the League of American Voters organization. In his email, Morris encouraged Republicans to support either Chuck Devore or Carly Fiorina. Of the latter two, Devore appears to be the one candidate showing momentum leading into June 8 primary.

PAYBACK BIG TIME
One of the reasons the Obama Administration has stepped up its public criticism of Wall Street isn't just its opposition to the regulatory reform legislation on Capitol Hill, say New York-based executives for such firms as Goldman Sachs, JP Morgan Chase, and Bank of America. It's because the firms have largely been pushing back against a number of requests from the White House in the past several months.

According to these executives White House political advisers, such as Valerie Jarrett and David Axelrod, have been calling senior management of those and other firms demanding that the banks step up hiring. "They don't think we're hiring enough of their people or people in general while we're making profits," says one executive with Bank of America. "And for several months now, they've been pushing us to do more to help them on the employment front."

Jarrett and Axelrod's requests have been met with little enthusiasm from B of A CEO Brian Moynihan, J.P. Morgan Chase CEO James Dimon, and Goldman Sachs Chairman Lloyd Blankfein, among others, say the executives, in part, because they don't feel stepping up hiring and recruitment is wise. Other executives say that even as he has led the Capitol Hill lobbying effort for Wall Street regulation, Treasury Secretary Tim Geithner, has also been making calls to firm executives encouraging them to help the administration on its job creation and stimulus efforts.

REVOLVING TIMES
One hire that Goldman has made was former New York Times reporter Stephen Labaton, who covered economic issues and sometimes conservative politics for the paper. Labaton, who is married to Miriam Sapiro, a bundler for Obama's presidential campaign and now a senior official in Obama's U.S. Trade Representative office, took a buyout from the Times late last year and immediately began offering his services to many of the companies he previously had reported on, offering to assist them in gaining access to his friends in the media. At least one company, according to Labaton friends at the Times, took him up on the offer, paying him more than $7,500 a month for his advice, believing that his wife's close ties from her fundraising days to such Obama Administration officials as FCC Chairman Julius Genachowski and Commodity Futures Trading Commissioner Chairman Gary Gensler, and special adviser on Afghanistan-Pakistan Richard Holbrooke, might help them. Now Labaton is a full-time consultant to the Wall Street firm on regulatory and legislative issues. Who says journalism isn't a profitable business any more?

Tuesday, May 4, 2010

More Bailout Policies

The bad news continues to come as this Radical Administration is destroying the country with burdensome debt and bailouts.

Here is a recent post from the Morning Bell: CBO Confirms You’re on the Hook for Wall Street Bailout Bill The Foundry: Conservative Policy News.

President Barack Obama’s favorite rhetorical device is to lecture the American people about what are and are not “legitimate” public policy arguments. So throughout the health care debate, President Obama insisted that it was “not legitimate” to claim that “a public option is somehow a Trojan horse for a single-payer system.” This despite the fact that Reps. Barney Frank (D-MA), Jan Schakowsky (D-IL), Anthony Weiner (D-NY) [2] and Nobel Prize winning New York Times columnist Paul Krugman were all caught on video [3] explaining to single-payer advocates that the public option was exactly that.

Now the President is bringing the same audacity to the financial regulatory debate, telling [4] a handpicked audience at New York’s Cooper Union: “Now, there is a legitimate debate taking place about how best to ensure taxpayers are held harmless in this process. But what is not legitimate is to suggest that we’re enabling or encouraging future taxpayer bailouts, as some have claimed. That may make for a good sound bite, but it’s not factually accurate.”

Before President Obama continues to go around accusing others of lacking legitimacy, he should read the official cost estimate [5] of the financial regulation bill released by the Congressional Budget Office last Thursday. Assessing the budgetary impact of the $50 billion that “systemically important financial firms” would have to pay in assessments to pay for the bill’s “Orderly Resolution Fund,” the CBO writes:

The total amount collected from assessments is estimated to be about $58 billion through 2020. But such assessments would become an additional business expense for companies required to pay them. Those additional expenses would result in decreases in taxable income somewhere in the economy, which would produce a loss of government revenue from income and payroll taxes that would partially offset the revenue collected from the assessment itself.

In other words, these financial firms have to get that $58 billion dollars from somewhere, and that somewhere is you. Now the Obama administration may argue that they actually oppose the creation of the resolution fund. But American taxpayers should be even more frightened when they find out why the Obama administration opposes it. The New York Times [6] reports: “The Obama administration does not support the $50 billion fund, partly out of concern that more money may be needed if one or more big financial firms ever collapse and that creating a fund could make it difficult to authorize more money.” AEI’s Peter Wallison details [7] CBO how this provision could put taxpayer on the hook for much larger sums:

If the Dodd-Obama resolution plan is ever actually put to use, the direct or indirect costs could be many times greater. For example, the bill authorizes the Federal Deposit Insurance Corporation to borrow from the Treasury “up to 90 percent of the fair value of assets” of any company the FDIC is resolving. Yet one institution alone—Citigroup—has assets currently valued at about $1.8 trillion. The potential costs of resolving it (not to mention others) would be spectacularly higher than $50 billion. In short, the $50 billion in the resolution fund is a political number—a fraction of what the FDIC is authorized to borrow and spend.

Why would this vast sum be necessary? The Dodd bill has one answer. It says that the FDIC “may make additional payments,” over and above what a claimant might be entitled to in bankruptcy, if these payments are necessary “to minimize losses” to the FDIC “from the orderly liquidation” of the failing firm.

In other words, the agency would be able to borrow huge sums so that it could make more generous payments to creditors than they would receive in a bankruptcy. Generous payments to creditors would certainly make unwinding a firm “orderly”—but it would also encourage lending to the too-big-to-fail financial institutions while disadvantaging smaller, less favored institutions. This in itself will have a profound and destructive effect on competition.

This is the core problem of the Dodd-Obama Wall Street Bailout Bill: it gives the same regulators that missed the beginning of the last crisis the authority to engineer the exact same politically motivated bailouts (see General Motors [8], Chrsyler [9]) for the next one.

There is a better way [10]. Congress should modernize bankruptcy laws to create an expedited method to restructure and close large and complex financial firms. Such an approach would not give regulators virtually unlimited powers and would free the process from political interference by giving control to an unbiased court system that already has extensive experience with complex modern firms.

Monday, May 3, 2010

More Mis-truths from Obama

Here is the recent post from the Daily Policy Digest about those lower costs the Democrats and Obama stated repeatedly when they passed the healthcare takeover. It is referring to the following article ObamaCare Mulligan: Readying Price Controls for Insurance - WSJ.com

I certainly hope we all remember this in November

ABOUT THOSE LOWER INSURANCE COSTS WE PROMISED

When President Obama signed his health care reform last month, he declared it will "lower costs for families and for businesses and for the federal government." So why, barely a month later, are Democrats scrambling to pass a new bill that would impose price controls on insurance, asks the Wall Street Journal?

In now-they-tell-us hearings on Tuesday, the Senate health committee debated a bill that would give states the power to reject premium increases that state regulators determine are "unreasonable." The White House proposed this just before the final ObamaCare scramble, but it couldn't be included because it violated the procedural rules that Democrats abused to pass the bill, says the Journal.

Some 27 states currently have some form of rate review in the individual and small-business markets, but they generally don't leverage it in a political way because insolvent insurers are expensive for states and bankruptcies limit consumer choices.

One exception is Massachusetts; Gov. Deval Patrick is now using this regulatory power to create de facto price controls and assail the state's insurers as cover for the explosive costs resulting from the ObamaCare prototype the Bay State passed in 2006.

National Democrats now want the power to do the same across the country, because they know how unrealistic their cost-control claims really are. Democrats are petrified they'll get the blame they deserve when insurance costs inevitably spike. So the purpose of this latest Senate bill is to have a pre-emptive political response on hand, says the Journal.

ObamaCare includes several new cost-driving mandates that take effect immediately, including expanding family coverage for children as old as 26 and banning consumer co-payments for preventive care. Democrats are bragging about these "benefits," but they aren't free and their cost will be built into premiums. And those are merely teasers for the many Washington-created dysfunctions that will soon distort insurance markets, says the Journal.
In Massachusetts, Gov. Patrick says his price-control sally will be followed by reviewing what doctors and hospitals charge -- or in other words for price controls on the medical services that make up most health spending. ObamaCare will gradually move in the same direction, says the Journal.