Sunday, October 18, 2009

Public Option will increase all taxes beyond the actual costs of the Bill

Consider - one of the health care bill proposals has a 2 year unemployment insurance clause for displaced insurance company employees.

If you think the point I am about to make is not valid - ask yourself why the above provision is in a bill that includes a public option.

Bottom line
- if 15% of the US economy goes from private insurance to a federal insurance program
- the remaining taxpayer and business will have to replace the local, state and federal income and property taxes that are lost when the Fed controls a program.

Before you scoff at these issues - read on to the end
and for those who think this is not an issue - 15% of the economy going from private to public sector will need to see at least a 20% tax increase on the private sector to replace lost revenues

... Today on Fox News Sunday and (I think also not sure) on ABC/ Stefanopoulos show, the figures for 'overhead' by the health insurance industry, ie the amount actually NOT paid out for delivery of health care services, ranged as high as 20%. That would mean up to 20% of a premium payment goes to marketing, salaries, bonuses, and other ancillary expenses...up dramatically from 1990 level. "

Government care - Medicare A is claimed to be a 5 - 8% overhead rate
Government care - Medicare B, and D added in takes total government overhead to somewhere close to 15%

for this dialog let's accept the conservative
15% overhead for government insurance
20% for private insurance overhead,
both sides can argue up to 30% for the other, but it does not matter for this review

Government overhead for insurance pays 0.00 to get buildings or renovate them - GSA pays for building remodeling services and for new facilities in a separate account
those grounds and buildings are not subject to state property taxes
Private insurance hires people or companies to build facilities and remodel them,
those contractors pay taxes that add to government revenue
those grounds and buildings, and the improvements are subject to local and state property taxes
(real property, real land, real assets)

Government overhead for insurance pays 0.00 to facilities management - GSA pays for building services and facilities management in a separate account
Private insurance hires people or companies to manage facilities management,
and those service providers pay taxes that add to local, state and federal government revenue
(boilers, AC, power, light, parking lots etc)

Government overhead for insurance pays 0.00 to property taxes
Private insurance pay local, state's property taxes that add to government revenue

Government overhead for insurance pays for the clerical employees in CMS to manage the program - but the government employee and employer do not pay all of the FICA and tax burdens to federal and state coffers a private person and employer do
the government worker has part of his/her health insurance paid for by taxpayers
the government workers have a part of their retirement funded by the taxpayer
Private insurance hires people to manage all aspects of the insurance program, and the employer pays for unemployment insurance, FICA, and state and federal payroll taxes
the individuals do not have government (taxpayer) funded retirement, so they invest their monies
the individuals pay for their health insurance, at a discount

Government overhead for insurance pays minimal for enrollment, and sub-contracts some work - as most is done thru federal and state employees in other agencies, funded by federal and state taxes, but not paid for by the government insurance agency
(social services is not a part of CMS or Medicare, it's paid for by taxpayers)
Private insurance hires people to manage enrollment into the insurance program, and hires 1099 workers to sell policies
the employer pays for unemployment insurance, FICA, and local, state and federal payroll taxes
the employed individuals pay for their health insurance, at a discount
the 1099 employee pay local, state and federal taxes and FICA, pays property taxes

Government overhead for insurance pays 0.00 toward profit
Private insurance pays taxes on profit that add to local, state and federal government revenue

Government overhead for insurance pays 0.00 toward mandatory reserves and set-asides
to meet financial needs it borrows money and prints money
Private insurance pays toward mandatory reserves and set-asides which make banks profitable, as the interest paid is less than the interest earned in lending those funds
that keeps the economy going
Banks and bank employees pay local, state and federal taxes, and fund the FDIC

Government overhead for insurance pays 0.00 toward mandatory fees, licenses, regulatory costs, audits or market conduct reviews, and pays no fines for non-payment of claims
(6.9% decline rate for part A)
Private insurance pays all costs born by states toward mandatory fees, licenses, regulatory costs, audits or market conduct reviews
Private insurance pays tort costs
Private insurance has a lower decline rate than Government
look up the AMA report for actual numbers

Government insurance is not held accountable for compliance to laws and state regulations
so it never pays a fine
Private insurance is held accountable for compliance to laws and state regulations, and pays state and federal fines when it is found to have not meet those guidelines and laws

Government insurance is not liable - so it rarely gets sued
Private insurance is held accountable for any tort issues, and pays fines when it is found to have not meet those guidelines and laws
the lawyers pay taxes, filing fees, and taxes on settlements that enrich local,state and federal coffers

after you read the analysis, consider if that 20% does go away - from a public option or a Universal mandate
notice all of the taxes and fees that local, state and federal government will have to replace from someone else

can you afford 20% more in taxes on top of what the insurance program would cost?

Saturday, September 5, 2009

you want to know who to blame for high insurance premiums?

you want to know who to blame for high insurance premiums?

the majority of your premium actually pays taxes

those of you who ran a business - so you should already know this

anyone who took economics should know this

costs always flow to the end consumer

here are the government costs you pay for in your insurance premiums:
taxes on the insurance company for payroll,
taxes on insurance company property
taxes on insurance company profit
taxes (fees) for insurance company licenses
taxes (fees) to insurance regulatory offices
taxes imposed on insurance companies to fund government programs
taxes paid by insurance employees on income thru wages
taxes paid by insurance employees on property thru wages
taxes paid by insurance employees in sales tax thru wages
taxes paid by doctors and nurses on income
taxes paid by doctors and nurses on property
taxes paid by doctors and nurses offices in sales tax
taxes (fees) by doctors and nurses for licenses
taxes (fees) by doctors and nurses to regulatory offices
taxes paid by hospitals and clinics on income
taxes paid by hospitals and clinics on property
taxes paid by hospitals and clinics in sales tax
taxes paid by hospitals and clinics employees on income
taxes (fees) by hospitals and clinics employees for licenses
taxes (fees) by hospitals and clinics employees to regulatory offices
taxes paid by suppliers to hospitals and clinics on income
taxes paid by suppliers to hospitals and clinics on property
taxes paid by suppliers to hospitals and clinics in sales tax
taxes (fees) by suppliers to hospitals and clinics for licenses
taxes (fees) by suppliers to hospitals and clinics to regulatory offices
taxes paid by suppliers employees on income

so now you know why your insurance premium is so high

and you want even more government to manage your costs

ROFLMAO at the stupidity of that idea

Wednesday, August 5, 2009

Canadian Health Care is NOT single payer

there seems to be an inconvenient truth that exposes a lie in the gazillion comments being made to further health care reform

it seems there is a thriving private insurance industry in Canada

from:
http://www.marketwatch.com/story/balyasny-bets-against-healhcare-reform-2009-08-04#comment2591443

"While the health-care system in Canada ensures that virtually everyone living here has access to medical services in any part of the country, it doesn't cover everything. That's where private, or extended, health insurance comes in – it is meant to pick up where your government plan ends. Private health insurance is not the same as emergency health – or travel medical – insurance that you may consider purchasing when you travel outside Canada. Rather, it covers the day-to-day surgeries and treatments that can add up to big bills."

and from
http://www.insurance-canada.ca/health-products/health-dental/health-dental.php

"Directory of Health and Dental Insurance Providers

A certain amount of health and dental expense will be incurred every year by individuals and families. However, health and dental emergencies can prove quite expensive and personal or family health and/or dental insurance can be a big help in reducing the impact of unexpected costs.

For this reason many people not covered by an employer or group plan will consider their own health and dental insurance."

and, last but not least:
http://www.insurance-canada.ca/health-products/health-quotes/health-quotes.php

"Directory of Online Health Quotes Providers

When you decide to buy health insurance, the sales organization - broker, agent, company - must be licensed to do so in your province. Providers will make product information, coverages, pricing and applications available in numerous ways -- in local offices, through the mail, via telephone and/or on the web over the Internet."

Thursday, July 30, 2009

Compare Health proposals

Pass the word - summary level information on all of the health proposals

Sites Compare Proposals


If you want to keep tabs on the major congressional health proposals but are starting to get dizzy, the Henry J. Kaiser Family Foundation has a chart for you.

The Menlo Park, Calif., foundation has posted a frequently updated health proposal comparison chart here.

The chart includes President Obama’s health reform principles, the Senate Finance Committee proposal, the Senate Health, Education, Labor and Pensions Committee proposal, and the House “tri-committee” Affordable Health Choices Act of 2009.

The chart also includes a number of other proposals, such as the Patients’ Choice Act of 2009, which was proposed by Sen. Thomas Coburn, R-Okla., and Rep. Devin Nunes, R-Calif., and the American Health Security Act, which was introduced by Sen. Bernard Sanders, I-Vt.


http://www.kff.org/healthreform/sidebyside.cfm

Wednesday, July 15, 2009

Congress exempt from the Public option?

any plan that allows Congress to exclude themselves should be refused by the people

If it’s not good enough for Congress to take it as their own coverage, it’s not good enough for the people

you should all wonder why Congress does not take it for their own coverage, just like they do not take Medicare

if they have their way, the elite government worker will have a super plan, and the masses will be stuck with something doctors already do not like - Medicare

How can anyone expect Congress to fix and maintain a program they do not live by

they have no skin in the game, and so really do not care how poorly or well it works, compared to if they actually lived by the laws of the land

after all - they are the Government, there to help you


right!


with friends like that - who needs more enemies.

Monday, July 13, 2009

Health Care Reform - why so expansive?

Can someone tell us why Congress is making this issue so expensive and complicated?

Look at how the cost has come down and the quality has gone up on vision correction surgery, with no federal or state intervention
Only basic regulations are in place, and tort laws were not reformed
think about that example, while you read this

Part of the problem is that Congress wants to take 500 - 1500 pages to establish some simple, 1 to 2 page issues.
They seem to like 1500 pages, because they can then slide other things into a bill, and leave parts unwritten, like with Cap and Trade

what would change the whole system in a gradual manner, and not add tons more debt would be the following:

- eliminate the pre-existing clause for health issues, like has been done in multiple states already
now people can get coverage - no matter what the issue

- allow reduced premiums for healthy lifestyles, so smoking and unhealthy lifestyles only penalize the ones who have them, such as the industry already does
If you want to be a chain smoker, and gain 300 lbs - go for it - the only one you hurt is you

- mandate coverage on all citizens, using a basic catastrophic plan as a minimum, such as the existing HSA approved plan structure, which are high deductible and no cap plans
now no one goes bankrupt because they have no coverage, or capped coverage

- phase out employer health plans, since the overall cost per person is higher than individual plans, and layoffs and terminations cause so many to loose coverage going from employer to individual coverage
Now no one looses insurance because of job issues - it's your coverage, so you pay for it
mandate Disability riders in the policy if need be - so a permanently injured person has coverage for the 36 months it takes to go on SSI
Employers are free to compete on the global economy, employees do not have salary caps that automatically factor in health care costs - even when they decline coverage

- make transference of cost illegal, so that private plans are not forced to pay the non-reimbursed costs that Medicare and Medicate do not cover: I should not have to pay for the federal government's refusal to pay.
If Medicare and Medicaid's payment schedule is not enough, providers can choose not to participate, which is the free market system

- set up a fail safe program, that allows people to move to Medicare and Medicaid when legitimate changes in income happen.

- keep the existing COBRA rules in place until the laws take effect

- Keep SCHIP in place to cover lower income children,

- keep means testing, so only people with a real need qualify for assistance


those simple changes will eliminate all but about 16 million uninsured,
those 16 million are here without legal documentation, and that is a different issue to resolve first

net cost to the tax payer - almost nothing

the states can continue to manage plans and benefits, but some federal intervention will be needed to keep things like hair transplants and fertility treatments for 60 year olds of of the mandated coverage list, so that costs stay in line

If you think this is crazy - and it can't be this simple

remember what happened when it really is a free market - like vision correction surgery, like cosmetic surgery, with no federal or state intervention

Thursday, July 9, 2009

Our leaders are missing the issue

Our leaders are missing the issue

the economy is in the tank because people do not spend

People are not going to spend
they can not, until an outside force gives them more cash

we have primarily a service based economy

a service based economy can only operate for so long -

to explain the point to your children, try this

envision a self contained community
the baker uses the barber that uses the laundry that....etc

even if everything one needs for day to day function is available in the community,
and utopia spending is reached, where no one holds a dollar

only if the value of purchased breads, haircuts, washes matches perfectly will it work perfectly
there is a natural lag and lid on the community controlled by the least spending person

if: something has to be sold out side of the community, and something has to be bought and brought into the community, then the dollar flow also has to balance

the moment the bought items exceed the sold items (trade deficit) a financial disparity exists

soon the dollars passed around the community decrease, so the community has to print more

since there is a natural loss of value, when that happens, it creates a cycle of printing more, and them having less value outside the community

that's what we have

and we are progressively eliminating our manufacturing options, thru legislation, higher scale of wages, etc

so - although we could delay the inevitable, and print more dollars

unless this country produces something the rest of the world will pay for,

we are done - the only discussion is when

Wednesday, July 8, 2009

what does the Cap and Trade really do?

let's hear it from a Congressman:

Thank you for contacting me about The American Clean Energy and Security Act of 2009, which includes a cap and trade system to address climate change and a Renewable Electricity Standard to increase the generation of electricity from renewable sources. I appreciate the opportunity to respond.

As you may know, I have been recognized as one of our nation's strongest advocates of renewable, domestic sources of energy. I have led efforts to change our national energy policies to encourage energy conservation and improve energy efficiency to reduce threats to our national security, economic prosperity and environment. During the last Congress, I worked closely with Senators Maria Cantwell (D-WA) and John Ensign (R-NV) and succeeded in extending tax credits for renewable energy and energy efficiency.

I'm a scientist and I've studied this issue very carefully. I agree that emissions, primarily carbon dioxide (CO2) from burning fossil fuels to produce electricity and for transportation, damage our global environment. However, our dependence upon oil, especially imported oil, poses a far graver and more urgent threat to Americans' economic prosperity and our national security.

President Barack Obama proposed a cap and trade system for C02 emissions in order to reduce threats from climate change and a Renewable Electricity Standard to require 25% of electricity to be generated by renewable sources by 2025. It is a shame that the House majority chose to pursue a purely partisan process that produced a complex, convoluted, monstrosity of a bill.

On March 31, 2009, Reps. Henry Waxman (D-CA) and Ed Markey (D-MA) released a 650-page draft of H.R. 2454. Centerpieces of the draft were mandated reductions in C02 emissions in the United States through a cap and trade system and a Renewable Electricity Standard. Significant details in H.R. 2454 were purposely omitted. These details became the subject of intense lobbying by special interest groups.

After a series of hearings, the committee approved a 900-page version with four Democrats opposing it and only one Republican supporting it. H.R. 2454 requires CO2 emissions to be reduced 20 percent by 2020 and 83 percent by 2050. It also includes a Renewable Electricity Standard requiring utilities to produce 6% of their electricity from renewable sources by 2012 and 20% by 2020.

The requirements under H.R. 2454 to achieve emissions reductions through a cap and trade system in combination with renewable electricity generation are significantly more aggressive than Maryland's existing commitments. Estimates of the amount vary, but H.R. 2454 would increase the price of energy for households and businesses in Maryland. Rep. John Dingell (D-Michigan) observed, "Nobody in this country realizes that cap and trade is a tax, and it's a great big one."

Unless there is an international agreement with mechanisms for measurable and verifiable reductions in C02 emissions, self-imposed C02 emissions reductions by the United States will not necessarily reduce global emissions that are contributing to global warming. Increasing energy prices in the United States from capping emissions could very well encourage energy-intensive manufacturing industries to move these factories and their jobs to countries which don't or won't reduce their emissions. Lower emissions from the U.S. could be more than offset by increased global emissions from as a result of higher emissions from other countries. Affected industries include automobiles, steel, cement, glass, industrial/medical gases, pharmaceuticals and aluminum among others.

H. R. 2454 includes tariffs that would result in a lose-lose dilemma for the United States. The new tariffs would impose tax increases upon the imports from countries that did not impose similar emissions reductions upon their industries. The tariffs would attempt to level the playing field to protect American jobs and factories from being outsourced to countries, such as India or China, where top officials have said they won't reduce their emissions unless the U.S. pays them to do so. However, such punitive tariffs would likely spark a debilitating trade war that would reduce trade and economic growth worldwide. That is what happened after Congress approved Smoot-Hawley tariffs that provoked the Great Depression of the 1930's. Perhaps that is why President Obama said that he opposes these tariffs in H.R. 2454.

There were hundreds of pages of changes in the two days before the House voted on H.R. 2454. A 1,201 page version, H.R. 2998, was published on June 23, 2009. Members offered 224 changes. However, only a single manager's amendment by Rep. Waxman was allowed by Speaker of the House Nancy Pelosi. This 341-page list of changes was made to the bill at 3:09 am just hours before the House voted on H.R. 2454 on June 26, 2009. The final 1,428 page version of H.R. 2454 deserves to be rejected because of the political games and back room deals that produced it.

I've never voted for a tax increase. That is the main reason why I could not support H.R. 2454. The Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) estimated that H.R. 2454 would force a massive federal government-imposed redistribution of approximately $1 trillion over the next ten years. Specifically, CBO/JCT estimated that over the next ten years federal tax revenues would increase by about $846 billion while federal government spending would increase by about $821 billion. The net result, CBO/JCT estimated would be an increase in federal government revenues of $24 billion. Most of the increase in revenues would come from the cap and trade system in H.R. 2454. CBO found that H.R. 2454 would also impose annual unfunded mandated spending increases of $69 million upon state and local governments and $139 million upon private businesses and individuals beginning in 2009.

My constituents clearly understood that H.R. 2454 is a gigantic hidden tax that they would end up paying. That's why they were overwhelming opposed to it. H.R. 2454 was narrowly approved 219 - 212. 211 Democrats and 8 Republicans voted yes. I was among the 44 Democrats and 168 Republicans who voted no.

The Senate has taken a completely different approach to energy and environment policy legislation. Sens. Jeff Bingaman (D-NM) and Lisa Murkowski (R-AK) have led a bipartisan consensus in approving more than two dozen energy-related bills. They intend to combine them into a comprehensive energy bill that would not include a cap and trade system. Sen. Barbara Boxer (D-CA) said that she hoped to use the cap and trade system in H.R. 2454 as the basis for similar legislation.

It remains to be seen how the Senate will act concerning energy and environment legislation. However, President Obama and House Democratic leaders favor a single bill similar to H. R. 2454 that would include a cap and trade system. In any event, a conference committee of House and Senate members would have to resolve differences between H.R. 2454 and any legislation approved by the Senate. That compromise Conference Report would have to be approved by both the House and the Senate before a bill could be sent to the President for his consideration.

I believe it is important that legislation to reduce C02 emissions complements rather than conflicts with policy changes to reduce America's oil imports. I also believe that legislation to reduce C02 emissions must not make American workers and businesses less competitive in the world economy while failing to reduce global emissions. I will continue to support policy changes that will encourage energy conservation, increase energy efficiency, reduce energy costs, promote domestic, renewable sources of energy, and reduce reliance upon fossil fuels, especially oil for transportation. I am hopeful that bipartisan efforts in the Senate will lead to legislation I can support that will reduce CO2 emissions and our dependence upon fossil fuels, especially imported oil, without the federal government taking more money from taxpayers.

Thank you again for sharing your views. I look forward to hearing from you regarding any issues you may find important in the future. I encourage you to review more facts about energy at http://www.bartlett/house.gov/energyupdates. You may also sign up for email updates at my website: http://www.bartlett.house.gov.


Sincerely, Roscoe Bartlett
Member of Congress

Wednesday, June 24, 2009

Here we go again

Here we go again

It does not matter what party or political interest you choose - all of us should be outraged that a bill, of almost 1,000 pages, without "escape" clauses, is being voted on, without being read.

that alone is enough reason to call your congress person.

by the way - the number is 202-224-3121

Why call?!

Congress is going to push another package of legislation without reading and comprehending it

what follows is a 2008 summary, before it got Congressional-ized

It's called Cap and Trade, or the Waxman-Markey bill

now is the time to call Congress and voice your position, but be better than a Congressperson, and at least read the summary before you call

Please especially note:
the possible barring of imports - including FOOD - they are working to exempt American farmers

the possible fines on you and I at 25,000 per day

the projected increases in cost for electricity

a nice place to start


Note - the last part was the summary, done in 2008, before it had swelled to almost 1,000 pages

the following link gives a general overview of the points
note that there will be new Federal Agencies established to control state issues
http://www.grist.org/article/2009-06-03-waxman-markey-bill-breakdown/

current articles include:
http://www.washingtonpost.com/wp-dyn/content/article/2009/05/31/AR2009053102077.html
which points out a cost per household per year of 1,600.00 more

here is the Congressional Budget Office's comments to Kerry, addressing the 1,600 per household cost
http://www.cbo.gov/ftpdocs/103xx/doc10307/06-12-Ltr_CapTrade_Kerry.pdf


This week, submitted amendments allowing the bill to be nullified if
too many jobs are lost,
if electricity prices go too high,
or if China and India do not rein in their emissions,

All failed.


# 570
June 2008



The Lieberman-Warner Cap and Trade Bill: Quick Summary and Analysis

by Casey Lartigue and Ryan Balis


Introduction and summary
The United States Senate will soon begin debate on America's Climate Security Act of 2007, popularly referred to as the Lieberman-Warner bill after its chief sponsors, Senators Joseph Lieberman (I-CT) and John Warner (R-VA).
The legislation ostensibly is intended to cut U.S. industrial emissions of greenhouse gases in an effort to reduce the risk of catastrophic global warming. Senator Lieberman has estimated the bill would reduce overall U.S. greenhouse gas emissions by up to 63% by 2050.1 The policies the legislation would impose, however, have little hope of meeting this target and would likely have little impact on the climate even if it did.
Lieberman-Warner would, however, significantly slow the U.S. economy and increase the cost of energy and consumer products. It also would disrupt international commerce.

Background
America's Climate Security Act of 2007 (S. 2191) was introduced in the Senate on October 18, 2007 by Senators Joseph Lieberman (I-CT) and John Warner (R-VA). The bill states as its purpose: "[P]rompt, decisive action is critical, since global warming pollutants can persist in the atmosphere for more than a century."
Congress is demanding "prompt, decisive action" even though there is still disagreement among scientists about the level, cause and consequences of global warming. On May 19, 2008, for example, Dr. Arthur Robinson of the Oregon Institute of Science and Medicine announced that more than 31,000 scientists had signed a petition rejecting the theory of human-caused global warming. A significant number of scientists, climatologists and meteorologists have expressed doubt about the danger of global warming and whether or not humans are having a significant impact for the worse on the climate. Others, including renowned scientists, have suggested that there are approaches to deal with global warming that would not necessitate slowing the economy.
S. 2191 was approved by the Senate Environmental and Public Works Committee on December 5, 2007 in an 11-8 vote. On May 21, a substitute bill incorporating America's Climate Security Act, S. 3036, was introduced by Senator Barbara Boxer (D-CA). Senate debate on that bill is expected to begin June 2.
The Act would fine any person who violates any part of the law $25,000 per day for each violation and make it easier for the government to take citizens to court for not complying with new global warming laws.
The legislation would require the Administrator of the Environmental Protection Agency (EPA) to establish:

(1) A federal greenhouse gas (GHG) registry to monitor compliance with the Act;
(2) A GHG emission allowance transfer system for covered facilities;
(3) An international reserve allowance program.

The bill would create a national "cap and trade" policy for greenhouse gas emissions. Companies would be allocated right-to-emit credits based on how much greenhouse gas they currently emit.

Cap-and-trade
The proposal -- frequently referred to as a cap-and-trade plan -- would establish an emissions trading system that would permit companies that emit fewer greenhouse gases than they are allowed to sell the excess portion to companies that exceed their allowances. The Act's sponsors estimate the bill would reduce U.S. greenhouse gas emissions by up to 63% by 2050. The initial limits between the years 2005 and 2012 would cap emissions at 5,200 million metric tons of CO2 equivalent to estimated levels during 2005. Between 2012 and 2020, emissions would be further reduced two percent per year, resulting in a 15% reduction below 2005 levels.
Lieberman-Warner would establish:

(1) A domestic offset program, allowing regulated facilities to meet up to 15% of their compliance obligation in any given year with allowances generated through domestic offset projects certified by the EPA. They could meet their emissions limits, provided they receive approval from the EPA, by purchasing credits on the international emission trading market or by borrowing from credits they would normally receive in future years.
(2) The Bonus Allowance Account, established using 4 percent of all emission allowances for calendar years 2012 through 2035, that would be used to reward firms that sequester their carbon emissions in geological formations.
(3) The Carbon Market Efficiency Board to monitor and report on the national GHG emission market.

Within the Treasury Department, it would establish:

(4) The Energy Assistance Fund to provide funds to the low-income home energy assistance program and to the rural energy assistance program;
(5) The Climate Change Worker Training Fund to provide job training to any workers displaced by this Act and assistance to workers in need of training or re-training;
(6) The Adaptation Fund to help various fish, wildlife, plants and associated ecological resources in adapting to and surviving the effects of climate change;
(7) The Climate Change and National Security Council to submit annual reports to the President, Senate and House of Representatives the extent to which other countries are reducing greenhouse emissions through mandatory programs; the threat of climate change to sensitive populations, national resources and political stability; and potentially destabilizing impacts of climate change on national security;
(8) The Climate Change Credit Corporation to auction emission allowances.


International Reserve Allowance Program
The Act would require the President to establish an interagency group to determine whether foreign countries have addressed GHG reduction. Before being allowed to trade, any U.S. importer of covered goods must submit approved international allowances. With a few exceptions, failure to make a CO2 emissions declaration (in writing to the administrator of U.S. Customs and Border Protection) for each import would result in the import being barred from entry.

Futility of Lieberman-Warner
The sharp GHG reduction requirements are dependent on significant technological innovations -- innovations that simply can't be mandated.
Even if they could be, Lieberman-Warner would have virtually no effect on the climate, according to Dr. Patrick Michaels, a former president of the American Association of State Climatologists and now senior fellow in environmental studies at the Cato Institute: "Say the U.S. actually does what the law says, though no one knows how to. The result is an additional 0.013 degrees (C) of 'prevented' warming," says Michaels.
According to Michaels, such a small change is too small to measure, as natural temperature variation from year-to-year is many times higher.2
Furthermore, China has surpassed the United States as the largest emitter of greenhouse gases and its emissions growth is currently several times larger than the emissions growth of the United States. The emissions of other developing nations, such as India, are also growing at a rate much higher than those of the United States.3

Financial Burden
Meeting the goals of the Lieberman-Warner cap-and-trade plan would impose enormous financial strain on Americans, according to four independent econometric studies.
A study commissioned by the National Association of Manufacturers (NAM) and the American Council for Capital Formation (ACCF) projects that by 2014 retail gasoline prices would increase between 13 and 50 percent; residential electricity prices would rise between 13 and 14 percent; and natural gas prices would increase between 18 and 21 percent. The study, "Analysis of the Lieberman-Warner Climate Security Act (S.2191) using the National Energy Modeling System (NEMS/ACCF/NAM)," also projects that the U.S. economy will suffer employment losses of 850,000 jobs by 2014 and between 1.2 and over 1.8 million more lost jobs in 2020.4
Moreover, households stand to lose between $1,010 and $2,779 of income each year by 2014. The economy would suffer Gross Domestic Product (GDP) losses of between $135 billion and $269 billion by 2014.5 Estimates are based upon 2007 baseline energy prices and produced a range of estimated price increases depending on the future availability of energy technologies and various socio-political constraints.
The Massachusetts Institute of Technology's Joint Program on the Science and Policy of Global Change projects that, if Lieberman-Warner becomes law, in 2015 gasoline prices would increase 29 percent, electricity prices would jump 55 percent, and natural gas prices would be pushed up 15 percent. The MIT study, titled an "Assessment of U.S. Cap-and-Trade Proposals," is based on 2005 baseline energy prices and accounts for subsidies for carbon capture and storage (CCS), as well as 15 percent of emissions covered by the trading mechanism.6
An assessment by the Nicholas Institute for Environmental Policy Solutions at Duke University estimates that in 2015 gasoline prices would cost up to six percent more, electricity would be roughly 18 percent more expensive and natural gas prices would increase about 15 percent.7 Moreover, the study projects economy-wide GDP losses of $75 billion in 2015 and $245 billion in 2030.8 The 2007 study, "The Lieberman-Warner America's Climate Security Act: A Preliminary Assessment of Potential Economic Impacts," considers credit trading as well as domestic offsets in its projections.
Finally, the Heritage Foundation's Center for Data Analysis projects that Lieberman-Warner would cripple the future economic health of the United States. GDP losses are estimated to be between $45.7 billion and nearly $170 billion in 2015 (2000 dollars)9 - totaling as much as $4.8 trillion of lost GDP by 2030.10 In addition, Heritage analysts estimate annual employment drops could be as high as 901,000 as early as 2016 and will exceed 500,000 per year before 2030.11 By 2030, skyrocketing energy prices will mean the average household will spend an extra $608 for heating oil, $647 for electricity and $303 for natural gas per year from projected 2012 levels.12

Public Support
Regardless of which one of these studies is closer to the mark, the Lieberman-Warner proposal would impose costs unacceptable to the American people. Public support is presumably critical to any government program, but especially one that is intended to govern economic activity over the next 42 years.
A recent survey conducted by Wilson Research Strategies for the National Center for Public Policy Research found that 65% of the public is unwilling to spend more for gasoline to reduce greenhouse gas emissions. Another 13% say they are unwilling to spend more than 5% more for their gasoline. That's less than the amount projected by the Duke University study, which provided the most optimistic forecast of the Lieberman-Warner proposal's effect on gas prices of the studies noted above.
The poll also found that 71% of Americans are unwilling to pay any more for their electricity to reduce greenhouse gas emissions, with an additional 16% opposed to paying more than 12% more. This amount, again, falls under the most optimistic projections of electricity price increases from the studies noted earlier.
When gasoline and electricity prices are taken together, 90% of Americans reject the Lieberman-Warner plan's costs - even the low-range projection.13

Conclusion
Imagine if, in 1966, then President Lyndon B. Johnson had tried to determine what the emissions levels of America should be 42 years into the future. Even if he had gotten together the best and brightest minds of the day, it is unlikely that his advisers would have come up with data that could have anticipated either our energy needs or our standard of living today. Although some lawmakers may be reluctant to admit it, policymakers today are similarly handicapped when it comes to predicting our future needs, technologies and circumstances.
Lieberman-Warner would embark Americans on an unprecedented and large-scale manipulation of the national economy that would depress economic growth and have both short- and long-term unintended consequences. Lieberman-Warner's "cap-and-trade" could hamstring Americans for decades.

- Casey Lartigue and Ryan Balis are policy analysts at the National Center for Public Policy Research.

Webmaster note: Due to a production error, this paper was originally posted without one of the author's names. We regret the error.


Footnotes:
1 Joseph Lieberman, "Fighting Global Warming the Right Way," Hartford Courant, October 22, 2007.
2 Patrick Michaels, "Cato Scholar Comments on Warner-Lieberman Climate Security Act," The Cato Institute, May 30, 2008, available at http://www.cato.org/pressroom.php?display=ncomments&id=34 as of May 30, 2008.
3 Ben Lieberman, "Five Myths About the Lieberman-Warner Global Warming Legislation," The Heritage Foundation, May 30, 2008, available at http://www.heritage.org/Research/EnergyandEnvironment/wm1940.cfm as of May 30, 2008
4 The National Association of Manufacturers and the American Council for Capital Formation, "Analysis of the Lieberman-Warner Climate Security Act (S.2191) using the National Energy Modeling System (NEMS/ACCF/NAM)," March 2008, p. 8, available at http://www.accf.org/pdf/NAM/fullstudy031208.pdf as of May 28, 2008.
5 Ibid.
6 Sergey Paltsev, et al., "Assessment of U.S. Cap-and-Trade Proposals," MIT Joint Program on the Science and Policy of Global Change, Report No. 146, April 2007, Appendix D, p. D21, available at http://w3.mit.edu/globalchange/www/MITJPSPGC_Rpt146_AppendixD.pdf as of May 28, 2008.
7 Brian C. Murray and Martin T. Ross, "The Lieberman-Warner America's Climate Security Act: A Preliminary Assessment of Potential Economic Impacts," Nicholas Institute for Environmental Policy Solutions, Duke University, October 2007, p. 10, available at http://www.nicholas.duke.edu/institute/econsummary.pdf as of May 28, 2008.
8 Ibid., p. 5.
9 William W. Beach, et al., "The Economic Costs of the Lieberman-Warner Climate Change Legislation," Heritage Center for Data Analysis, Heritage Center, May 12, 2008, p. 4, available at http://www.heritage.org/Research/EnergyandEnvironment/upload/cda_0802.pdf as of May 28, 2008.
10 Ibid., p. 2.
11 Ibid.
12 Ibid., p. 18.
13 National Center for Public Policy Research, "Overwhelming Majority of Americans Oppose Lieberman-Warner Global Warming Proposal, New Poll Suggests," May 28, 2008, available at http://www.nationalcenter.org/PR-Poll_Lieberman_Warner_052808.html as of May 30, 2008.

Saturday, June 20, 2009

Medical Problems Could Include Identity Theft

The article published in the NY times says it all.

The last paragraph is the consumer's punch line.

So - the new electronic age in medicine may cut some costs, but please check your credit reports regularly.

Remember - those medical records contain birth date, ss#, address, full name, health and insurance data. These are all anyone needs to take your medical identity.


from

http://www.nytimes.com/2009/06/13/health/13patient.html

Medical Problems Could Include Identity Theft
Published: June 12, 2009

Brandon Sharp, a 37-year-old manager at an oil and gas company in Houston, has never had any real health problems and, luckily, he has never stepped foot in an emergency room. So imagine his surprise a few years ago when he learned he owed thousands of dollars worth of emergency-service medical bills.

Brandon Sharp, of Spring, Tex., learned he was a victim of medical I.D. theft only when he applied for a mortgage and discovered debts on his credit report for emergency room visits at places in the country he had never been.

Mr. Sharp, as it turned out, was a victim of a fast-growing crime known as medical identity theft.

At the time, Mr. Sharp was about to get married and buy his first home. Before applying for a mortgage he requested a copy of his credit report. That is when he found he had several collection notices under his name for emergency room visits throughout the country.

“There was even a $19,000 bill for a Life Flight air ambulance service in some remote location I’d never heard of,” said Mr. Sharp, who made this unhappy discovery in 2003. “I had emergency room bills from places like Bowling Green, Kan., where I’ve never even visited. I’m still cleaning up the mess.”

The last time federal data on the crime was collected, for a 2007 report, more than 250,000 Americans a year were victims of medical identity theft. That number has almost certainly increased since then, because of the increased use of electronic medical records systems built without extensive safeguards, said Pam Dixon, executive director of the nonprofit World Privacy Forum and author of a report on medical identity theft.

And uncountable, Ms. Dixon said, are the people who do not yet know they are victims. They may not know that their medical information has been tampered with for months or even years until, as in Mr. Sharp’s case, it shows up in collections on a credit report.

Medical identity theft takes many guises. In Mr. Sharp’s case, someone got hold of his name and Social Security number and used them to receive emergency medical services, which many hospitals are obliged to provide whether or not a person has insurance. Mr. Sharp still does not know whether he fell victim to one calamitous perp who ended up in several emergency rooms or a ring of accident-prone conspirators.

In another variant of the crime, someone can use stolen insurance information, like the basic member ID and group policy number found on insurance cards, to impersonate you — and receive everything from a routine physical to major surgery under your coverage. This is surprisingly easy to do, because many doctors and hospitals do not ask for identification beyond insurance information.

Even more common, however, are cases where medical information is stolen by insiders at a medical office. Thieves download vital personal insurance data and related information from the operation’s computerized medical records, then sell it on the black market or use it themselves to make fraudulent billing claims.

In a widely reported case in 2006, a clerk at a Cleveland Clinic branch office in Weston, Fla., downloaded the records of more than 1,100 Medicare patients and gave the information to her cousin, who in turn, made $2.8 million in bogus claims.

When people are not aware their medical identities have been stolen, insurance companies may simply continue to pay the fraudulent claims without the victim’s knowledge. The person might learn of the fraud only when trying to make a legitimate claim, and the insurance company informs them they have reached their lifetime cap on benefits.

Or victims may eventually discover erroneous information in their medical files during a doctor or hospital visit. And that may pose a bigger danger than the financial risks. The medical records may now contain vital information like blood type, allergies, prescription drug use or a history of disease that is just plain wrong. In an emergency, doctors could treat you based on this erroneous information.

And there are none of the consumer protections for medical identity theft victims that exist for traditional identity theft. Under the Fair Credit Reporting Act you can get a free copy of your credit report each year, put a fraud alert on your account and get erroneous charges deleted from your record. If your credit card is stolen and the thief goes on a spending spree, you’re not liable for more than $50 worth of the charges.

With medical identity theft, though, the fraudulent charges can remain unpaid and unresolved for years, permanently damaging your credit rating. Under the federal law known as Hipaa — the Health Insurance Portability and Accountability Act — you are entitled to a copy of your medical records, but you may have to pay a hefty fee for them.

Worse, Hipaa privacy rules can actually work against you. Once your medical information is intermingled with someone else’s, you may have trouble accessing your files. Privacy laws dictate that the thief’s medical information now contained in your records must be kept confidential, too.

Even when you are able to correct a record, say in your doctor’s office, the erroneous information may have been passed on to dozens of other health care providers and insurers. Victims must track down and resolve these errors largely on a case-by-case basis, Ms. Dixon says.

Medical providers contend that they are taking precautions against identity theft. At Cleveland Clinic, for example, security personnel routinely audit electronic medical record systems and all records are password-protected. Many Blue Cross Blue Shield insurers use software to screen for spikes in claims from providers that look suspicious. They also work with providers on encrypting medical files and carrying out data access restrictions, said Calvin Sneed, senior antifraud consultant at the Blue Cross and Blue Shield Association.

And some medical centers and doctors’ offices now require patients to show photo ID and attach photos to patient charts.

But privacy advocates worry that these steps do not go nearly far enough, especially in light of President Obama’s plans to spend $20 billion to increase the use of electronic medical records nationwide as part of the stimulus package. “Without aggressive safeguards, we could be building an infrastructure for massive medical fraud,” said Ms. Dixon.

Friday, June 19, 2009

Dissecting the Kennedy Health Bill

Printed in The Wall Street Journal, page A15

Dissecting the Kennedy Health Bill

No, you won't be able to keep your insurance if you like it.


Ms. McCaughey is chairman of the Committee to Reduce Infection Deaths and a former lieutenant governor of New York state.

Last September Sen. Barack Obama promised that under his health-care proposal "you'll be able to get the same kind of coverage that members of Congress give themselves." On Monday, President Obama repeated that promise in a speech to the American Medical Association. It's not true.

The president is barnstorming the nation, urging swift approval of legislation that is taking shape in Congress. This legislation -- the Affordable Health Choices Act that's being drafted by Sen. Edward Kennedy's staff and the Health, Education, Labor and Pensions Committee -- will push Americans into stingy insurance plans with tight, HMO-style controls. It specifically exempts members of Congress (along with federal employees; the exemptions are in section 3116).

Members of Congress "enjoy the widest selection of health plans in the country," according to the U.S. Office of Personnel Management. They "can choose from among consumer-driven and high deductible plans that offer catastrophic risk protection with higher deductibles, health saving/reimbursable accounts and lower premiums, or fee-for-service (FFS) plans, and their preferred provider organizations (PPO), or health maintenance organizations (HMO)." These choices would be nice for all of us, but they're not in the offing. Instead, if you don't enroll in a "qualified" health plan and submit proof of enrollment to the federal government, you'll be tracked down and fined (sections 3101 and 6055).

For a health plan to count as "qualified," it has to meet all the restrictions listed in the legislation and whatever criteria the Secretary of Health and Human Services imposes after the bill becomes law. You may think you're in a "qualified" plan, but the language suggests that only plans with managed-care controls such as the "medical home" will meet the definition (sections 3101 and 2707).

"Medical home" is this decade's version of HMO-style insurance, according to the Congressional Budget Office, with a primary-care provider to manage your access to costly services such as visits to specialists and diagnostic tests. Medical home providers in "qualified" plans, states the Kennedy bill, will have a "payment structure" based on "incentives" rather than payments for each doctor visit or procedure (section 3101).

These requirements are reminiscent of the unpopular controls HMOs imposed two decades ago that caused public outrage and led to state laws reining in abuses. In December 2008, a Congressional Budget Office report evaluating early drafts of major federal health insurance proposals noted that "medical homes" were likely to resemble the HMO gatekeepers of 20 years ago if cost control is a priority.

That report specifically referred to a payment incentive called the "withhold." When HMOs became dominant in the early 1990s, they would withhold 10% or more of physicians' fees until the end of the year and give it back only to the physicians who met targets for limiting how many referrals to specialists or diagnostic tests their patients used.

The targets were so stringent that, if they were exceeded, what a doctor prescribed for you came out of your doctor's own pocket at the end of the year. This set up a conflict of interest between you and your doctor.

Mr. Obama tried to put a positive spin on such cost controls in his June 13 weekly radio address. He said "if doctors have incentives to provide the best care, instead of more care, we can help Americans avoid unnecessary hospital stays, treatments and tests that drive up costs." Fair enough -- if you want your doctor paid to police your care and to be financially penalized for that extra test or referral you get.

It is reasonable to require that people who accept a government subsidy for health insurance tolerate cost controls to protect taxpayers. But according to the terms of the Kennedy bill, you must enroll in a "qualified" plan or face a fine, even if you and your employer are paying the entire cost of the plan you already have (section 161).

The president has promised that if you like your plan you can keep it. Mr. Kennedy's bill says that too. It's doubletalk, as the consequences of nonenrollment make clear. How big a fine will you face? The bill doesn't specify or set a limit. It says the fine will be enough to "accomplish the goal of enhancing participation in qualifying coverage" (section 161).

If legislation similar to the Kennedy bill lands on Mr. Obama's desk, he has an obligation to keep his promises to the American people and veto it. And whatever health-insurance law is passed should apply to members of Congress. If it isn't good enough for them, it shouldn't be imposed on the rest of us.

Ms. McCaughey is chairman of the Committee to Reduce Infection Deaths and a former lieutenant governor of New York state.

Printed in The Wall Street Journal, page A15

Thursday, June 18, 2009

Why does a medicine cost so much?

most people are clue less

the American governments regulations on health care providers, pharmacies, health care facilities and ancillary services is so counter productive, that cost containment is impossible

Here is an easy way to prove it to yourself
try to get a common antibiotic like penicillin
add in the cost of the doctor's visit, and the trip to the pharmacy
those simple common meds become a 60.00 investment, if YOU PAY CASH

big pharma and lobbies had nothing to do with it

it was ALL GOVERNMENT REGULATIONS

we let it become so cumbersome in the U.S.

we allowed GOVERNMENT to CONTROL everything

all that record keeping, CYA documentation, meeting of regulations took a 4.00 prescription to a 60.00 total cost

and if you need a "controlled substance" medication - the cost doubles

You want to know why it costs so much

go look in a mirror

Tuesday, June 16, 2009

Bill to reduce uninsured by 16M carries $1T price tag

As we get closer to the Congressional proposals being made into law, it's the cost that is staggering to grasp, much less to afford

these are numbers for JUST the next 10 years, from the Congressional Budget Office.

Anyone know how we can pay for this?

And am I the only person who thinks these numbers are nuts?

1,000,000,000,000 / 10 years =
100,000,000,000 / year to provide coverage for a net gain of 16,000,000 more people

= $ 6,250 in cost /insured person /per year for adding 16 million into the coverage

(by the way - if you think 1 trillion is correct - coverage for a 52 yo male at the levels planned is close to 1,500 per month, or 18,000 per year )

and that still leaves somewhere around 30 million to go (46 million uninsured - 16 million)

these numbers could go higher, given that coverage will extend to people making up to 500% of the poverty level

which is:

2008 Countable Income Limits
500% FPL
Family Size Gross Annual Income Gross Monthly Income
1 52,000 4,335
2 70,000 5,835
3 88,000 7,335
4 106,000 8,835
5 124,000 10,335


Bill to reduce uninsured by 16M carries $1T price tag

By Dan Bowman

Is reducing the number of uninsured people in the United States by 16 million worth $1 trillion over a 10-year time span? That's what the Congressional Budget Office estimates a bill to reform healthcare in the United States will accomplish should it pass as is, according to the Washington Post.

A letter to Sen. Edward Kennedy (D-MA) points out that "based on major provisions" in "an incomplete draft of the bill," 23 million individuals would wind up without insurance--15 million who were formerly covered through employers, and another 8 million covered by "other sources." However, 39 million people overall would become covered through other exchanges, creating a net of 16 million individuals covered.

CBO Director Douglas Elmendorf did write that the $1 trillion price tag could rise, considering the organization did not account for "proposals" offering federal subsidies to individuals making between 150 and 500 percent of the federal poverty level, according to Modern Healthcare. "Taking all of its provisions into account could change our assessment of the proposal's effects on the budget and insurance coverage rates though probably not by substantial amounts relative to the net costs already identified," wrote Elmendorf.

Monday, June 15, 2009

American Indians receiving 'substandard' healthcare

Gee - is this the future?

Why should we presume that the federal system will treat anyone else better?


American Indians receiving 'substandard' healthcare

By Dan Bowman

In a sad, but all too true case of healthcare negligence in the United States, the Associated Press reports that the Indian Health Service System's level of care for it's 2 million patients in 35 states is "grossly substandard" a good portion of the time. Among other reportable statistics, death rates for American Indian infants were found to be 40 percent higher than their white counterparts.

Many qualified American Indians don't apply for services such as Medicare and Medicaid because they don't have access to the sign-up process, says the Associated Press. A lack of federal dollars also is a big reason for the poor health statistics of American Indians; Congress approved a budget of $3.6 billion for the Indian Health Service System for this year, not nearly enough to attract top-tier doctors, or purchase top-of-the-line equipment.

Heck, even inmates in federal prison have it better when it comes to healthcare: 2005 data points out that one-third more is spent, per capita, on the healthcare of felons in federal prison than on healthcare for reservations. While Sen. Byron Dorgan (D-ND) has attempted to bring this issue to light, he has not had any luck getting any legislation passed. Furthermore, a problem of political "clout" exists: Ron His Horse is Thunder, chairman of the Standing Rock tribe, pointed out to the Associated Press that his tribe is "not one congruent voting bloc in any one state or area."

Thursday, June 11, 2009

Universal / National health Care and health Care reform are touted as saving money

Universal / National health Care and health Care reform are touted as saving money

why then are these NEW TAXES being researched by the current administration?

"HOW TO PAY FOR IT - Here, of course, is where the "rubber meets the road." It looks like the Senate Finance Committee will take the lead on developing strategies to pay for health care reform. Possibilities include:

* Limiting the income tax exclusion on employer-provided health care coverage.
* Either repealing the itemized deduction for medical expenses or raising the floor from 7.5% of adjusted gross income so fewer taxpayers can claim it.
* Curbing HSAs and FSAs.
* Requiring all state and local government employees to pay the Medicare tax.
* Clamping down on nonprofit hospitals.
* Hiking the tax on alcoholic beverages.
* Imposing a tax on sugar-sweetened beverages.

VAT TAX – The Administration has launched a trial balloon for a new national Value-Added Tax (VAT) to pay for health care. Ezekiel Emanuel, whose book on health care uses a VAT to fund the new government program and brother of White House chief-of-staff Rahm Emanuel, has been hired by the White House budget office to help design the health care plan."

Tuesday, June 9, 2009

I want the United States Government to be my source for health care.

I want the United States Government to be my source for health care.

It will provide great care, and all of the services I could ever need, in a timely manner.

The Federal government has demonstrated it’s ability, with a proven record of accomplishment, it’s resume is worthy of consideration for management of any position, and that is demonstrated by:
The war on poverty
The war on illiteracy
The war on drugs
The war on crime
The war on pollution
Eliminating violence
Eliminating discrimination
Eliminating racism
Eliminating sexual harassment
Providing good quality health care for those over 65

Providing above average health care for the American Indian

Providing good quality health care for all who served in the military
The quality of life for those living on government programs is superb
Our seniors living on social security want for nothing
The health care for our former government workers is the best they can find, and they had to contribute nothing towards it
CHIP has made sure all children have health care
Those in prison are well cared for
They do their time with no risk
The Social Security trust fund is solvent
The Medicare trust fund is solvent
The IRS is efficient and collects properly from everyone who owes
There is no financial mismanagement
There is no corruption
The controls the government places on private financial institutions are correct and just
Special interests cannot influence the government
All laws and practices are fair and equal to all
Our government officials always serve the people
Our government officials always put the citizen’s needs first
Our government is the most efficient and productive entity that exists
Our government agencies are a pleasure to do business with
The services the government provides are timely and above average
The immigration process is the best in the world
The safety and security of its people is above any other country’s
The government’s process are transparent and above reproach
The laws apply to all equally
The members of government live under the same laws and benefits they choose for us
The justice system never makes a mistake
The executive branch makes no unjust laws
The financial branch manages monies well
The government can account for every dollar it spends

After reviewing this list, I am sure you can see why the United States Government, by the people and for the people, is the best qualified to decide what and how to provide health care for you and I

Now – to be fair – please reply and list the programs and services that I missed that are worthy of consideration.

Would you retain the services of any company that failed so often, and so magnificently?
If so - why not hire me - because I could exceed your expectations by showing up for work half the time and failing only half the time

People - hope and dreams and wishes do not make it a workable idea

Those other countries have systems that do work better than ours, they have much smaller governments

and the bureaucrats have to live in the system they create

Monday, May 25, 2009

Medicare Waste Could Total $2.8 Billion

By MATTHEW PERRONE
,
AP
posted: 27 MINUTES AGO
filed under: Financial Crisis
Text SizeAAA
WASHINGTON (May 18) - A federal program with a history of making billions of dollars in erroneous payments for wheelchairs, oxygen machines and other medical equipment continues to grossly underestimate its own mistakes, according to federal investigators.
The Medicare program spends about $10 billion annually in payments to suppliers of medical equipment for the elderly and disabled. For years, federal inspectors have documented payment errors that expose the program to fraud and abuse. Last year the inspector general who oversees Medicare estimated the waste could be as high as $2.8 billion annually.
A sampling of payments for fiscal year 2008 conducted by an outside contractor found that roughly 70 percent should not have been approved, according to a new report by the inspector general for the Department of Health and Human Services. But Medicare estimated the error rate at less than 10 percent, citing its own contractor, AdvanceMed of Richmond, Virginia. The review was not comprehensive and consisted of a sample of just 250 payments.
Peter Ashkenaz, a spokesman for the Centers for Medicare and Medicaid Services, said Tuesday that the agency "has made significant changes to how it measures the error rate and, in addition, has clarified its medical review instructions for contractors."
Ashkenaz added that AdvanceMed is reviewing fiscal 2009 payments to make sure all errors are accurately counted. A company spokesman could not immediately comment on the report Tuesday afternoon.
Sen. Charles Grassley, R-Iowa, requested the review after uncovering similar discrepancies with the agency's fiscal 2006 error numbers.
"This report reveals that the way the government is tracking erroneous Medicare payments for durable medical equipment still isn't working," Grassley said in a statement. "Medicare officials owe it to taxpayers and beneficiaries to get a handle on the level of waste, fraud and abuse."
Medicare officials estimated their total payment error rate for fiscal 2008 was 3.6 percent. That figure includes payments to doctors and hospitals, along with payments for medical equipment.
An error does not necessarily mean the government was defrauded, but it can leave the program open to fraud.
More than 100,000 companies are registered as suppliers for Medicare. Acting as government contractors, they generally handle the logistics of submitting a claim and obtaining government payment for patients' medical equipment.
The largest equipment suppliers include companies like Lincare Holdings Inc., which provides home oxygen equipment, and Invacare Corp., which distributes wheelchairs, adjustable beds and other supplies.
The majority of last year's errors occurred because Medicare contractors reimbursed suppliers despite incomplete documentation that the the equipment was necessary, according to the inspector general. Instead of relying on patient medical records and physician prescriptions, Medicare's contractors often used documents from supply companies and prior Medicare claims.
Medicare's own rules state that information from a patient's medical records must show the need for the reimbursed device.
However, Medicare officials acknowledged those rules are "vague," when it comes to how contractors may interpret medical information.
"Contractors have interpreted the manuals differently, especially regarding the use of clinical judgment," Charlene Frizzera, acting head of the Centers for Medicare and Medicaid Services, said in a letter responding to the report.
Frizzera said the agency plans to clarify how much interpretation contractors are permitted when processing payments. She also said the agency plans to bolster its review of claims that are most vulnerable to fraud — including those for scooters and oxygen machines — by conducting interviews with the requesting patients. She added, however, that "it would be very resource-intensive for us to do this type of review" for all types of equipment.
Copyright 2009 The Associated Press. The information contained in the AP news report may not be published, broadcast, rewritten or otherwise distributed without the prior written authority of The Associated Press.
2009-05-18 16:50:36

IRS Sets HSA Amounts


Study: Disability Discriminates


Tuesday, May 5, 2009

When you hear advocates of Universal Health Care...

...think about this:

Who amongst us would:
- take a car back to a mechanic who already screwed up the last service, and made it worse each and every time he messed with it;
- take laundry to a laundry mat where the washers stained the last batches of clothes;
- go eat where the service is lousy and the food tastes worse each time we go?

Am I missing something here?

Yes - I agree the current health insurance system is not working to the best level it could.
But I'd rather be on it than the current Universal Care System for the over 65, called Medicare, or Medicaid, for the under 65.

We sometimes forget, in all the hype that anyone who needs Emergency care can still get it if they go to a hospital.
Note that because of what is happening, this may change in UTAH

People who want Universal Health Care need to be asked to explain why the following is happening with the Government Universal Health Care system we already have.

They should also be reminded that before we do a political biased change to scrap what we have now, and create another Government system, prudence and (un?) common sense would point out that we need to get the current Government systems fixed, first.

If not, Doctors, Nurses and Providers that are not enslaved to the Government have the right to refuse to treat patients. Hospitals that are not federally owned will have the right to refuse all but emergency care to those on Medicare.

Here is the current Universal Health Care system at work:


UT hospitals struggling under Medicaid cuts

By Anne Zieger

Hospitals in Utah are reeling under a 25 percent Medicaid reimbursement cut that was much larger than anticipated, and now are warning that they might be forced to offset costs by increasing fees on insured patients or cutting back on charity care.

Hospital association leaders said the hospitals failed to factor in the effects of using a funding stream to offset the cuts occurring in 2009. Meanwhile, technical changes in the payments to hospitals for "nonphysicians services" such as nursing care also had an impact on such reimbursement. To help address this huge change in funding, the state is looking at increasing its tobacco tax or imposing a tax on hospital stays.

If the state can't come up with a solution, state hospitals could theoretically refuse to treat Medicaid beneficiaries entirely, observers note.

To learn more about Utah's Medicaid situation:
- read this Kaiser Daily Health Policy Review item