The Taxpayers

I think the photograph says it all!

Hypocrisy at its Best

Here is a post from Deceiver.com that pretty much sums up Obama’s hypocrisy. But, hey, he’s charming and a democrat so that makes it all ok

During appearances last week in Arizona and New Mexico, President Obama spoke out against America racking up too much debt. If you follow the news at all, I don’t need to tell you how funny that is. If not, follow me.

Giving the commencement address at Arizona State University last Wednesday, Obama had this advice for the future of America:

…We gather here tonight in times of extraordinary difficulty, for the nation and the world. The economy remains in the midst of a historic recession, the result, in part, of greed and irresponsibility that rippled out from Wall Street and Washington, as we spent beyond our means and failed to make hard choices…

In the face of these challenges, it may be tempting to fall back on the formulas for success that have dominated these recent years. Many of you have been taught to chase after the usual brass rings: being on this “who’s who” list or that top 100 list; how much money you make and how big your corner office is; whether you have a fancy enough title or a nice enough car.

You can take that road — and it may work for some of you. But at this difficult time, let me suggest that such an approach won’t get you where you want to go; that in fact, the elevation of appearance over substance, celebrity over character, short-term gain over lasting achievement is precisely what your generation needs to help end…

We’ve become accustomed to our economic dominance in the world, forgetting that it wasn’t reckless deals and get-rich-quick schemes that got us there; but hard work and smart ideas — quality products and wise investments. So we started taking shortcuts. We started living on credit, instead of building up savings.

Obama repeated this message of frugality and self-sacrifice the next day in New Mexico:
President Barack Obama, calling current deficit spending “unsustainable,” warned of skyrocketing interest rates for consumers if the U.S. continues to finance government by borrowing from other countries.

“We can’t keep on just borrowing from China,” Obama said at a town-hall meeting in Rio Rancho, New Mexico, outside Albuquerque. “We have to pay interest on that debt, and that means we are mortgaging our children’s future with more and more debt.”

Makes sense, right? Only two problems. Here’s the first one, a chart of projected yearly budget deficits from the Congressional Budget Office:


Here’s a hint: See the line for 2009? Notice how it’s 4 times as long as the line for 2008? That’s deficit spending. Money that we don’t actually have. Spending beyond our means. AKA debt. Notice how even the shortest projected line over the next 10 years is still longer than the longest line over the last 10? I’m no expert, but I’m pretty sure that doesn’t mean the deficit will be less. And this is just an early projection. It just keeps going up and up.

Obama is going around telling everybody that his own plans are going to be a disaster. And apparently they’re all okay with it, because he’s handsome and charming and an above-average public speaker. Why, you might say it’s the elevation of appearance over substance, celebrity over character, short-term gain over lasting achievement. Where have I heard that one before?
Here’s the second problem: Obama hasn’t even practiced what he preaches in his own personal life.

A close examination of their finances shows that the Obamas were living off lines of credit along with other income for several years until 2005, when Obama’s book royalties came through and Michelle received her 260% pay raise at the University of Chicago. This was also the year Obama started serving in the U.S. Senate…

In April 1999, they purchased a Chicago condo and obtained a mortgage for $159,250. In May 1999, they took out a line of credit for $20,750. Then, in 2002, they refinanced the condo with a $210,000 mortgage, which means they took out about $50,000 in equity. Finally, in 2004, they took out another line of credit for $100,000 on top of the mortgage.

Tax returns for 2004 reveal $14,395 in mortgage deductions. If we assume an effective interest rate of 6%, then they owed about $240,000 on a home they purchased for about $159,250.
This means they spent perhaps $80,000 beyond their income from 1999 to 2004.

In other words, he lived exactly the way he’s now telling us all not to live. But he can hardly hold up his own example for us to learn from, can he? “Don’t be like me, kids, or you might just get two best-selling books and the Presidency of the United States out of it. That is, if you can keep a straight face while telling the biggest whoppers anybody’s ever heard.”

Joint Replacement

As some of us baby boomers are increasing in age and noticing those joint changes, we need to be cognizant about the pros and cons of joint replacement procedures.

Patients need to be aware that improved movement and lack of pain in the replaced knee or hip isn't instantaneous, and knowing what to expect from the surgery and subsequent physical therapy can make recovery faster and better.

Here are some general guidelines and things to think about before going under the knife:

Ask yourself: Does joint pain make sleep difficult? Is the pain keeping you from doing what you like to do? Do everyday activities, such as standing up or climbing stairs, hurt? If you answer "yes" to any of those questions, give joint replacement further consideration.

Discuss it: If your health-care provider thinks you would benefit from joint replacement surgery, you'll receive a referral to an orthopedic surgeon.

Learn more: Find out how to prepare for the operation, what the surgery entails, the length of the recovery period and the extent of follow-up physical therapy.

Consider alternative surgery: If available, minimally invasive hip replacement surgery requires fewer and smaller incisions and usually shorter hospital stays and shorter recovery periods.


Talk about your medications: Before surgery, tell your health-care provider about all over-the-counter drugs, vitamins or herbs you take because they might complicate surgery.


Arrange for recovery: Otherwise-healthy seniors can expect to be discharged from the hospital four to five days after surgery. Plan ahead for help at home with meals, bathing and dressing for the first few days.


Put physical therapy first: Recommended physical therapy is a must if you want a fast and proper recovery.

I routinely tell my patients not to expect getting back to their baseline function for about 6 months after a joint replacement procedure.

These are not quick-fixes for most patients!

AMA Question and Answers

Obama's Health Care agenda is still very worrisome and the AMA really has not given physicians many answers. In an attempt to clarify some of the concerns, the AMA published the following question and answers:


Questions and Answers

AMA’s Commitment to Slowing the Rate of Growth in Health Care Costs

Q: Why did the AMA pledge on May 11 to work with other health organizations to reduce the annual growth rate in total health care spending by 1.5% annually over the next decade?

A: Government and private insurers have traditionally relied on across-the-board payment cuts to physicians and other providers (e.g. Medicare and Medicaid payment cuts) in response to rising health care costs. The AMA believes that empowering physicians to implement strategies to improve the quality of care and avoid inappropriate services is the far better approach, reinforcing the profession’s authority in clinical decision making.

The health organizations did not strike a deal with the Obama Administration on a health system reform plan. Rather, they came together to demonstrate their commitment to doing their part to help pave the way toward a health care system that is financially sustainable.

Q: If reducing the rate of growth by 1.5% translates into savings of $2 trillion or more, does this pledge consign physicians to steep payment cuts in government programs?

A: Absolutely not. The AMA is aggressively advocating with the Obama Administration and Congress to repeal the flawed Medicare payment formula that has produced and continues to threaten steep physician payment cuts. The Obama Administration’s FY 2010 budget proposed a framework to avoid the 21% cut scheduled for January 1 under current law. Large majorities of Democrats and Republicans in Congress have pledged to pass legislation this year to avert Medicare physician payment cuts.

Q: What specific initiatives does the AMA envision being implemented by the medical community?

A: The AMA is highlighting a number of activities that are currently underway. For example, the AMA convened Physician Consortium for Performance Improvement (PCPI) has developed and continues to develop clinical measures to promote appropriate high-quality care. Assuring that the patients get the right care at the right time will improve management of chronic conditions and avoid costly hospitalizations and other interventions. This year, the PCPI is developing measures to address concerns about over-utilization of services. Specific areas of focus include treatment of low back pain, stable coronary artery disease, sinusitis, and elective labor induction in pregnancy. PCPI and other health groups are also developing tools to improve care transitions and avoid hospital readmissions.

The AMA has launched another initiative to improve medication management to avoid adverse drug interactions for patients receiving prescriptions from multiple physicians.

These activities are a good beginning. The AMA will be reaching out to state and national medical specialty societies to explore other possible initiatives to wring unnecessary costs out of the system, such as efforts underway by the American College of Radiology and American College of Cardiology to develop clinical appropriateness criteria addressing overuse of imaging and other services.

Q: What are the insurers putting on the table?

A: America’s Health Insurance Plans (AHIP) has commitments from its member companies to implement policy changes that will streamline and standardize administrative claims processing requirements for physicians, hospitals and patients. This effort promises to reduce costs throughout the system, including physician overhead costs.

Q: Has the AMA agreed to the concept of a single bundled payment for hospitals to share with physicians?

A: Absolutely not. A number of ideas have been proposed involving bundled payments. In fact, surgeons already receive bundled service payments in the form of global surgical fees. The Obama Administration proposed bundling payments for hospitals and post-acute services. The AMA does not support proposals that would mandate a single payment to a hospital to cover both facility services and the physician’s professional fee.

Q: What benefits do you envision from this agreement?

A: We are offering ideas for promoting the fiscal sustainability of the nation’s health care system, which we believe will relieve pressure to implement future cost control strategies that are far more intrusive and onerous for physicians and patients. Health system reform also presents an opportunity to address other longstanding issues. For example, in discussions with the Obama Administration, AMA representatives have repeatedly stressed the need to address the costs of defensive medicine and to provide liability protections for physicians who adhere to best practice guidelines; and, at a recent press conference, President Obama also acknowledged the need to address liability costs.

Q: What about addressing the demand side of the cost issue?

A: In the letter to President Obama, the AMA and other coalition members note that “there are many important factors driving health care costs that are beyond the control of the delivery system alone.” We have called for a “large scale national effort of health promotion and disease prevention to reduce the prevalence of chronic disease and poor health status, which leads to unnecessary sickness and higher health costs.”

A Time to Remember

On May 5, 1868, General John A. Logan issued General Order No. 11 establishing May 30th as a day of honoring the dead. There are a variety of stories about how this originally developed but it was originally known as Decoration Day to commemorate the dead from the Civil War. Over the years, the last Monday of May has become the standard day to recognize this holiday and to remember all U.S. men and women killed or missing in action in all wars.

General Logan’s order required all men throughout his organization to spend some portion of the day policing the gravesites and decorating them and observing such ceremonies as their duties allowed and it was his hope that the general population would follow their lead.

FREEDOM IS NOT FREE

I watched the flag pass by one day.

It fluttered in the breeze.

A young Marine saluted it,

and then he stood at ease.

I looked at him in uniformSo young,

so tall, so proud,

He'd stand out in any crowd.

I thought how many men like himHad fallen through the years.

How many died on foreign soil?

How many mothers' tears?

How many pilots' planes shot down?

How many died at sea?

How many foxholes were soldiers' graves?

No, freedom isn't free.

I heard the sound of taps one night,

when everything was stillI listened to the bugler play

And felt a sudden chill.

I wondered just how many times

That taps had meant "Amen,"

When a flag had draped a coffin

Of a brother or a friend.

I thought of all the children,

Of the mothers and the wives,

Of fathers,

sons and husbands

With interrupted lives.

I thought about a graveyard

At the bottom of the sea

Of unmarked graves in Arlington..

No freedom isn't free.

~LCDR Kelly Strong, USCG~

Things to Ponder

Think about this:

1. Cows
2. The Constitution
3. The Ten Commandments

COWS

Is it just me, or does anyone else find it amazing that during the mad cow epidemic our government could track a single cow, born in Canada almost three years ago, right to the stall where she slept in the state of Washington? And, they tracked her calves to their stalls. But they are unable to locate 11 million illegal aliens wandering around our country. Maybe we should give each of them a cow.

THE CONSTITUTION

They keep talking about drafting a Constitution for Iraq .... Why don't we just give them ours? It was written by a lot of really smart guys, it has worked for over 200 years, and we're not using it anymore.

THE 10 COMMANDMENTS

The real reason that we can't have the Ten Commandments posted in a courthouse or Congress is this -- you cannot post 'Thou Shalt Not Steal' 'Thou Shalt Not Commit Adultery' and 'Thou Shall Not Lie' in a building full of lawyers, judges and politicians ………….. it creates a hostile work environment.

Smoking and Pets

Pet owners who smoke are placing their pets at risk from secondhand smoke exposure and may be willing to quit when given information according to a report published online Feb. 10 in Tobacco Control.

This survey was done using a Web-based mechanism to evaluate the attitudes and behavior of pet owners who smoke. There were 3,293 adult pet owners who participated in the survey.

The results showed that 21 percent smoked currently and 27 percent resided with at least one smoker and when asked for their reaction if told that secondhand smoke could harm their pet, 28.4 percent of smokers stated that they would try to quit smoking and 11.3 percent would think about quitting smoking. Nearly one-quarter (24.2 percent) of non-smoking participants who lived with a smoker responded that they would ask people in the home to stop smoking indoors.

How many smokers will quit for the benefit of their pets will likely be very small, but each one would be a benefit.

Rashes and Pets

There have been times when families are told to have their animals checked for certain problems when kids develop rashes.

Some skin rashes caused by dermatophytes may be thought to originate from animals, but current thinking is that the examination of the family dog is probably not necessary and can be an expensive recommendation.

Ringworm is one of these skin rashes we see in kids and it is considered a zoonotic infection that can be passed to and from both dogs and cats.

However, the causative organism is also ubiquitous in our environment. Other people as well as surface contact are more commonly the source of infection.

Moreover, the zoonotic type and the one that most often causes ringworm in dogs and cats is the species Microsporum canis. This species is a relatively uncommon cause of human infection in the United States and M canis accounts for only about 3% to 4% of cases of ringworm in humans. Instead, most human cases are caused by Trichophyton rubrum (41% to 55%), Trichophyton tonsurans (31% to 45%), or Trichophyton mentagrophytes (6% to 9%).

With the exception of Yorkshire terriers and long-haired cats, such as Persians, very few dogs and cats are asymptomatic carriers of ringworm.

The cost of evaluation and treatment of these infections in animals can be considerable, and infections often persist despite treatment, especially in long-haired cats and in households with multiple pets.

A better approach would be to only have pets evaluated when they are symptomatic with skin lesions such as patches of alopecia. Physicians can obtain a fungal culture in the patient and refer those pets whose owners are positive for M canis. Frequent recurrence of ringworm in a pet owner and owning a high-risk pet (such as a Yorkshire terrier or long-haired cat) are also indications for a veterinary evaluation of the pet when no other sources can be identified.

Go Ahead, Kiss your Dog

Are pet owners at risk when the sleep with their animals or allow licking of faces etc.?

In a recent study, it was found that people who let their dogs sleep with them or allow them to lick their faces are no more likely than other dog owners to have the same strains of E. coli bacteria as their dogs

A researcher at the Kansas State College of Veterinary Medicine said it's known that diseases can be shared between dogs and people and that about 75% of emerging diseases are transferable between humans and other animals.

This study focused on E. coli which is common in the gastrointestinal tracts of both humans and dogs. Fecal samples from dogs and their owners were examined and it was found that 10% of human-dog pairs had the same E. coli strains and that these strains were more resistant to common antibiotics than expected. However, owners had more multiple drug-resistant strains than their dogs.

This certainly makes us think that dogs are not likely to spread multiple drug-resistant E. coli to their owners, but perhaps owners may spread them to their dogs. And our overuse of antibiotics may actually produce more resistant strains putting our animals at a higher risk.

Again, there was no evidence from the study that owners who sleep with their dog or allow face licking were more likely to have shared strains of E. coli but the study did find an association between antibiotic-resistant E. coli and owners who didn't wash their hands after petting their dogs or before cooking meals.

The bottom line appears to be that close human-dog bonding behaviors aren't more likely to spread germs and this is good news because of the physical and psychological benefits of pet ownership.

Future research might look at cat owners and shared E. coli. More Americans own cats than dogs, and cats interact with people in different ways than dogs.

Not Recognizing and Understanding History

In between Obama apologizing for the United States and continually blaming prior administrations for everything, he recently made the following statement while in Turkey: "We do not consider ourselves a Christian nation or a Jewish nation or a Muslim nation. We consider ourselves a nation of citizens who are bound by ideals and a set of values."

I’d like to hear him elaborate on exactly what ideals and values we are bound by and where exactly these values originate.

What is the foundation for these ideals and values? They have to be based on something if they are to have any meaning or relavence.

I’d say that looking at the Preambles of ALL 50 states; these historically have come from a belief in a supreme being and the values that are implied by those beliefs.

Alabama 1901, Preamble We the people of the State of Alabama, invoking the favor and guidance of Almighty God, do ordain and establish the following Constitution...

Alaska 1956, Preamble We, the people of Alaska , grateful to God and to those who founded our nation and pioneered this great land.

Arizona 1911, Preamble We, the people of the State of Arizona , grateful to Almighty God for

our liberties, do ordain this Constitution...

Arkansas 1874, Preamble We, the people of the State of Arkansas , grateful to Almighty God for the privilege of choosing our own form of government...

California 1879, Preamble We, the People of the State of California , grateful to Almighty God for our freedom...

Colorado 1876, Preamble We, the people of Colorado , with profound reverence for the Supreme Ruler of Universe...

Connecticut 1818, Preamble. The People of Connecticut, acknowledging with gratitude the good Providence of God in permitting them to enjoy.

Delaware 1897, Preamble Through Divine Goodness all men have, by nature, the rights of worshipping and serving their Creator according to the dictates of their consciences...

Florida 1885, Preamble We, the people of the State of Florida , grateful to Almighty God for our constitutional liberty, establish this Constitution...

Georgia 1777, Preamble We, the people of Georgia , relying upon protection and guidance of Almighty God, do ordain and establish this Constitution...

Hawaii 1959, Preamble We , the people of Hawaii , Grateful for Divine Guidance ... Establish this Constitution.

Idaho 1889, Preamble We, the people of the State of Idaho, grateful to Almighty God for our freedom, to secure its blessings.

Illinois 1870, Preamble We, the people of the State of Illinois, grateful to Almighty God for the civil , political and religious liberty which He hath so long permitted us to enjoy and looking to Him for a blessing on our endeavors.

Indiana 1851, Preamble We, the People of the State of Indiana, grateful to Almighty God for the free exercise of the right to choose our form of government.

Iowa 1857, Preamble We, the People of the St ate of Iowa, grateful to the Supreme Being for the blessings hitherto enjoyed, and feeling our dependence on Him for a continuation of these blessings, establish this Constitution.

Kansas 1859, Preamble We, the people of Kansas, grateful to Almighty God for our civil and religious privileges establish this Constitution.

Kentucky 1891, Preamble... We, the people of the Commonwealth are grateful to Almighty God for the civil, political and religious liberties...

Louisiana 1921, Preamble We, the people of the State of Louisiana , grateful to Almighty God for the civil, political and religious liberties we enjoy.

Maine 1820, Preamble We the People of Maine acknowledging with grateful hearts the goodness of the Sovereign Ruler of the Universe in affording us an opportunity .. And imploring His aid and direction.

Maryland 1776, Preamble We, the people of the state of Maryland , grateful to Almighty God for our civil and religious liberty...

Massachusetts 1780, Preamble We...the people of Massachusetts, acknowledging with grateful hearts, the goodness of the Great Legislator of the Universe In the course of His Providence, an opportunity and devoutly imploring His direction

Michigan 1908, Preamble. We, the people of the State of Michigan, grateful to Almighty God for the blessings of freedom, establish this Constitution.

Minnesota, 1857, Preamble We, the people of the State of Minnesota, grateful to God for our civil and religious liberty, and desiring to perpetuate its blessings

Mississippi 1890, Preamble We, the people of Mississippi in convention assembled, grateful to Almighty God, and invoking His blessing on our work.

Missouri 1845, Preamble We, the people of Missouri, with profound reverence for the Supreme Ruler of the Universe, and grateful for His goodness. Establish this Constitution...

Montana 1889, Preamble. We, the people of Montana, grateful to Almighty God for the blessings of liberty establish this Constitution...

Nebraska 1875, Preamble We, the people, grateful to Almighty God for our freedom. Establish this Constitution.

Nevada 1864, Preamble We the people of the State of Nevada, grateful to Almighty God for our freedom, establish this Constitution...

New Hampshire 1792, Part I. Art. I. Sec. V Every individual has a natural and unalienable right to worship God according to the dictates of his own conscience.

New Jersey 1844, Preamble We, the people of the State of New Jersey, grateful to Almighty God for civil and religious liberty which He hath so long permitted us to enjoy, and looking to Him for a blessing on our endeavors.

New Mexico 1911, Preamble We, the People of New Mexico, grateful to Almighty God for the blessings of liberty...

New York 1846, Preamble We, the people of the State of New York, grateful to Almighty God for our freedom, in order to secure its blessings.

North Carolina 1868, Preamble We the people of the State of North Carolina, grateful to Almighty God, the Sovereign Ruler of Nations, for our civil, political, and religious liberties, and acknowledging our dependence upon Him for the continuance of those...

North Dakota 1889, Preamble We , the people of North Dakota , grateful to Almighty God for the blessings of civil and religious liberty, do ordain...

Ohio 1852, Preamble We the people of the state of Ohio , grateful to Almighty God for our freedom, to secure its blessings and to promote our common.

Oklahoma 1907, Preamble Invoking the guidance of Almighty God, in order to secure and perpetuate the blessings of liberty, establish this

Oregon 1857, Bill of Rights, Article I Section 2. All men shall be secure in the Natural right, to worship Almighty God according to the dictates of their consciences

Pennsylvania 1776, Preamble We, the people of Pennsylvania, grateful to Almighty God for the blessings of civil and religious liberty, and humbly invoking His guidance....

Rhode Island 1842, Preamble. We the People of the State of Rhode Island grateful to Almighty God for the civil and religious liberty which He hath so long permitted us to enjoy, and looking to Him for a blessing...

South Carolina , 1778, Preamble We, the people of he State of South Carolina grateful to God for our liberties, do ordain and establish this Constitution.

South Dakota 1889, Preamble We, the people of South Dakota, grateful to Almighty God for our civil and religious liberties ...

Tennessee 1796, Art. XI...III. That all men have a natural and indefeasible right to worship Almighty God according to the dictates of their conscience...

Texas 1845, Preamble We the People of the Republic of Texas , acknowledging, with gratitude, the grace and beneficence of God.

Utah 1896, Preamble Grateful to Almighty God for life and liberty, we establish this Constitution.

Vermont 1777, Preamble Whereas all government ought to enable the individuals who compose it to enjoy their natural rights, and other blessings which the Author of Existence has bestowed on man...

Virginia 1776, Bill of Rights, XVI Religion, or the Duty which we owe our Creator can be directed only by Reason and that it is the mutual duty of all to practice Christian Forbearance, Love and Charity towards each other

Washington 1889, Preamble We the People of the State of Washington, grateful to the Supreme Ruler of the Universe for our liberties, do ordain this Constitution

West Virginia 1872, Preamble Since through Divine Providence we enjoy the blessings of civil, political and religious liberty, we, the people of West Virginia reaffirm our faith in and constant reliance upon God ...

Wisconsin 1848, Preamble We, the people of Wisconsin, grateful to Almighty God for our freedom, domestic tranquility...

Wyoming 1890, Preamble We, the people of the State of Wyoming , grateful to God for our civil, political, and religious liberties, establish this Constitution...

I think the words of William Penn are very appropriate:

“Those people who will not be governed by God will be ruled by tyrants.”

Visual Confusion

Can the eye and mind play tricks on a person. The answer is clearly shown here.

Are any of these items moving? Or are they perfectly still??

Pictures such as these are reportedly used to test the level of stress a person can handle.

The slower the pictures move, the better your ability of handling stress.


There are some reports that criminals who were tested see these pictures as spinning around madly; however senior citizens and kids see them standing still.

It is important to note that none of these images are animated. All of these pictures are perfectly still.

As a side note; if you do happen to see the images spinning around madly, please take me off your friend list.

Ivy Tech adding paramedics program

Our local Ivy Tech College in Sellersburg is embarking on an expansion project described in the following link:

http://www.ivytech.edu/sellersburg/mIndex/mCapitalProject/CampusExpansionProject01.pdf

In addition to this, there are several new course offerings and one is described in the press release below.

Prospective paramedics will have a new school for training beginning in the Fall of 2009. Ivy Tech Community College Southern Indiana, located in Sellersburg, will begin offering an Associate’s Degree in Paramedic Science.

The greater Louisville area has few educational programs for people who want to become paramedics, explained Dr. Marilyn Faulkenburg, Vice Chancellor of Academic Affairs for Ivy Tech Southern Indiana. Ivy Tech can meet the need by enrolling prospective paramedics in medical courses already offered at the college and by adding a few extra classes to create the program for the degree, Faulkenburg said. Paramedics are often the first responders in emergency medical technicians and can be employed by hospitals, ambulance services, fire departments and other similar organizations.

Faulkenburg anticipates an enrollment of about 25 students in the new program in the fall, and that the program will grow from there.

“As our population ages, we need programs to teach specific medical skills,” Faulkenburg said. “Training programs for paramedics are not widely available in the area and the need is growing for people in this specialty. We believe the program will be in demand and once word gets out, we expect enrollment to grow.”

Ivy Tech is offering paramedic science programs at several of its campuses. The program requires 66.5 credit hours. The program requires clinical and classroom instruction as well as a field internship. Emergency medical technicians can enroll in the program to work up to another level in their workplace.

About Ivy Tech

Ivy Tech Community College is the state’s largest public post-secondary institution and one of the nation’s largest singly-accredited statewide community college systems with more than 120,000 students enrolled annually. Ivy Tech has campuses throughout Indiana. It serves as the state's engine of workforce development, offering affordable degree programs and training that are aligned with the needs of its community along with courses and programs that transfer to other colleges and universities in Indiana. It is accredited by the Higher Learning Commission and a member of the North Central Association.

Physician Profiling

Last year Attorney General Cuomo announced landmark settlements with insurers operating in New York over the issue of physician profiling. Resulting from these settlements, the insurers are now required to submit the rating criteria they use to place physicians in tiered networks, in which members pay lower co-pays or receive discounts for seeing favored physicians. Before this ruling, physicians were unable to learn how they were rated, what criteria were used, how data was collected and really had no way of refuting the results.

Since then, members of the Consumer-Purchaser Disclosure Project adopted The Patient Charter for Physician Performance Measurement, Reporting and Tiering Programs. Under this voluntary agreement, health insurers will follow a set of standards, hire an independent entity to audit their programs to ensure they use valid measures to rate physicians, and work toward pooling their data.

The AMA contends all physician-profiling programs must follow standards that require valid methodologies, promote transparency at all levels and assure accurate results and to encourage legislation on physician profiling programs, the AMA developed a model bill, which mandates profiling programs:

Adhere to a set of standards
Use valid quality standards
Properly adjust for risk
Use sufficient sample sizes
Correctly attribute episodes of care

In addition, insurers must fully disclose the methodology used to profile physicians and its limitations and they must profile physicians at the group level, establish a reconsideration or appeal process, and hire an independent third party to oversee the program.

Since New York took this step, Colorado Gov. Bill Ritter has signed legislation aimed at regulating the physician rating systems used by many of his state’s health insurers.
Although there is no perfect system, these regulations and documents such are essential to help ensure the physician performance information health insurers provide patients is both reliable and meaningful. They establish processes that temper some of the inherent risks that can result from physician profiling.

Incorrect and misleading information can tarnish a physician’s reputation and it is unfair to patients who may consider it when choosing a physician. Erroneous information can erode patient confidence and trust in physicians, and can disrupt patients’ longstanding relationships with doctors who know them and have cared for them for years.

Reliable, accurate information that is reproducible and transparent with mechanisms in place for rectifying mistakes will go a long way to help everyone utilizing healthcare.

Annual Sports Physicals

It is that time of year again when we offer sports physicals to the students of Highland Hills and Floyd Central High School as a fundraiser for the Renaissance program. As a reminder to those that may be new to the area or the blog, here is a summary on the program.

The Renaissance Education Foundation was started as a way to motivate students to attain a higher level of academic success. FCHS began in the 1993-94 school year to join more than 2,000 other Renaissance schools in the United States. These schools, through this program, are attempting to break through the paradigms of today's educational system by offering numerous recognition and incentive programs to reward both student and teacher performance.

Part of the program consists of a Student of the Month program and a program to recognize outstanding faculty or staff. Sr. high success cards, which recognize grade point average, attendance, and/or improvement, are issued to deserving students. These may be given to a student that has brought a D up to a C grade. They are incentives for all successes. These cards entitle the holder to various privileges and discounts at school and at local businesses. There are anywhere from 40-60 "students of the month" each month and each month PTO/Renaissance recognizes a teacher from the Sr. High as "Teacher of The Month." This teacher is given balloons, gift certificates, and goodies as well as having his/her picture displayed in the Sr. High offices.

Renaissance is a cooperative effort between parents, teachers, administration, and business partners.

There are many other things that PTO/Renaissance assists with during the year. Parents assist with test proctoring and registration. Parents serve on several committees at the school and help apply for grants and reward programs. They supply refreshments for Open House and Building Committee meetings, and they work closely with the Student Renaissance committee and sponsor some other activities.

Just as all of the sports programs have parent boosters, the Renaissance consider themselves academic boosters. They want every student to reach or exceed their potential.

With the volunteer help of local physicians we are able to donate all of the proceeds to the Renaissance Program. In about 2 hours, we perform around 200 complete athletic physicals based on IHSAA standards. This year, we have a physical therapist who will help provide information on sports related injuries and exercises.

The PTO/Renaissance helps coordinate the event and supplies all of the parent volunteers. The physicians all donate their time and services. The fee is basically all profit for the PTO/Renaissance and is used to support all the academic Renaissance programs.

It is their single major source of funding over the years. The event is tonight at my office and we again look to have 200 plus students take advantage of this opportunity.

We are very lucky to have these dedicated parents supporting this program in a time when sports seem to take most of everyone’s time, efforts and money.

More Prescription Pad Changes

The Indiana Board of Pharmacy has made more changes and recently reduced its list of approved prescription pad printers from nearly 300 to six. The pharmacy board also announced that printers who were not approved by March 1 could not reapply until August 2009.

Since this ruling caused such an uproar, the pharmacy board has changed its position and is now allowing printers to reapply up to two times before August 2009.

The official list of approved printers is constantly changing and can be seen at the following site. Approved printers.

For the past few years, Physicians have been required by Indiana law to write controlled substance prescriptions on compliant security paper to help combat the problem of forgeries and abuse.

Physicians using prescription pads from a printer not on the approved list should check their paper for compliance and contact their printers. A template for prescription pad paper is on the pharmacy board Web site. Although these prescription pads do help combat fraud, it is another hassle for offices and rules are changed without adequate notice in many instances.

The Decline of the Party

Great Orators of the Democratic Party

'One man with courage makes a majority.'
Andrew Jackson

'The only thing we have to fear is fear itself.'
Franklin D. Roosevelt

'The buck stops here.'
Harry S. Truman

'Ask not what your country can do for you;
ask what you can do for your country.'
John F. Kennedy

And from today's Genius Democrats

'It depends what your definition of 'IS' is?''
Bill Clinton

'That Obama - I would like to cut his NUTS off.'
Jesse Jackson

'Those rumors are false .... I believe in the
sanctity of marriage.'
John Edwards

'I invented the Internet'
Al Gore

'The next Person that tells me I'm not religious,
I'm going to shove my rosary beads up their ASS.'
Joe Biden

'America is--is no longer, uh, what it--it, uh,
could be, uh, what it was once was...uh, and
I say to myself, 'uh, I don't want that
future, uh, uh for my children.'
Barack Obama

'I have campaigned in all 57 states.
Barack Obama (Quoted 2008)

'You don't need God anymore, you
have us Democrats.'
Nancy Pelosi (Quoted 006)

'Paying taxes is voluntary.'
Sen. Harry Reid

'Bill is the greatest husband and father
I know. No one is more faithful, true,
and honest than he.'
Hillary Clinton (Quoted 1998)

HOW LUCKY CAN WE BE TO HAVE SUCH BRILLIANT
MINDS IN CHARGE OF OUR ONCE GREAT COUNTRY

Socialism in simplified terms

An economics professor said he had never failed a single student before but had, once, failed an entire class.

That class had insisted that socialism worked and that no one would be poor and no one would be rich, a great equalizer.

The professor then said OK, we will have an experiment in this class on socialism.

All grades would be averaged and everyone would receive the same grade so no one would fail and no one would receive an A.

After the first test the grades were averaged and everyone got a B.

The students who studied hard were upset and the students who studied little were happy.

But, as the second test rolled around, the students who studied little had studied even less and the ones who studied hard decided they wanted a free ride too; so they studied little.

The second test average was a D! No one was happy. When the 3rd test rolled around the average was an F.

The scores never increased as bickering, blame, name calling all resulted in hard feelings and no one would study for the benefit of anyone else.

All failed, to their great surprise, and the professor told them that socialism would also ultimately fail because when the reward is great, the effort to succeed is great; but when government takes all the reward away; no one will try or want to succeed.

Could not be any simpler than that.

Tired of the Obama Apologies

Yes, there are many of us getting really tired of the Obama rhetoric and here is another wonderful commentary: http://www.peterheck.com/columns/2009_articles/view/99/arrogant_americans__mr__president_

Arrogant Americans, Mr. President?
As I was sitting in church waiting for the start of the service, my grandpa came walking towards me pointing his finger. No matter how old I get, and no matter how long he's been out of the U.S. Navy, that's still an intimidating sight. As he approached me, his voice quivered as he said, "We saved that continent twice...how dare my president apologize for this country's arrogance." My grandpa is right. Americans need not apologize to the world for their arrogance; rather, Americans should apologize to their forefathers for the arrogance of their president.

Barack Obama's first foreign trip as President of the United States has confirmed the naiveté so many of us feared during the election cycle. But worse than that, it has also demonstrated that our president suffers from either a complete misunderstanding of our heritage and history, or an utter contempt for it. Neither is excusable.

Garnering cheers from the French of all people, President Obama declared, "In America, there is a failure to appreciate Europe's leading role in the world. Instead of celebrating your dynamic union and seeking to partner with you to meet common challenges, there have been times where America has shown arrogance and been dismissive, even derisive." Consider that Obama spoke these words just 500 miles from the beaches of Normandy, where the sand is still stained with 65 year old blood of "arrogant Americans."

Indeed, columnist Mark Whittington observes, "One should remind Mr. Obama and the Europeans how America has 'shown arrogance' by saving Europe from itself innumerable times in the 20th Century. World War I, World War II, the Cold War, and the wars in the Balkans were largely resolved by American blood, treasure, and leadership." But all that appears lost on the president's seemingly insatiable quest to mend fences he imagines have been tarnished by the bullish George W. Bush.

If Obama wishes to continue trampling the presidential tradition of showing class to former office holders and publicly trash Bush for his own personal gain, so be it. But all Americans should make clear that no man - even if he is the president - will tarnish the legacy of those Americans who have gone before us. Ours is not a history of arrogance. It is a history of courage, self-sacrifice, and honor.

When abusive monarchs repressed the masses, Americans resisted and overthrew them. When misguided policies led to the unjust oppression of fellow citizens, Americans rebelled and overturned them. When millions of impoverished and destitute wretches sought a new beginning, Americans threw open the door and welcomed them. When imperial dictators were on the march, Americans surrendered their lives to stop them. When communist thugs threatened world peace, Americans bled to defeat them. When an entire continent was overwhelmed with famine and hunger, Americans gave of themselves to sustain it. When terrorist madmen killed the innocent and subjugated millions, Americans led the fight to topple them.

This is the legacy that generations of Americans have left. If President Obama seeks stronger relations with the world community, perhaps he should begin by reminding them of these very truths, rather than condemning his own countrymen on foreign shores.

This "obsessive need to put down his own country," has caused blogger James Lewis to call President Obama a "stunningly ignorant man" who has evidently never spoken to a concentration camp survivor, a Cuban refugee, a boat person from Vietnam, a Soviet dissident, or a survivor of Mao's purges.

Unfortunately, I can no longer bring myself to give Mr. Obama that benefit of the doubt. Not after looking at the pain in my grandpa's eyes...a man who still carries shrapnel in his body from his service to this country.

As a student and teacher of history, I recognize that America has made mistakes...plenty of them, in fact. But one of the great things about our people has been their courage and humility in admitting and correcting those mistakes. God willing they will prove that willingness again in four years and correct the mistake that is the presidency of Barack Obama.

New Drug for Multiple Sclerosis

Multiple sclerosis is a devastating disease and those affected have a very difficult time. There is no known cure for MS. Current MS treatments must be given by injections and have varying success rates.

There is a new pill that shows promise, and drug maker Merck Serono says it will submit cladribine tablets for registration in the United States and Europe later this year. Known side effects of cladribine, currently used to treat leukemia, include fatigue, anemia and increased risk of infections.

The reports so far showed that MS patients taking the pills had an almost 60 percent lower relapse rate than those taking a placebo based on a two-year study that included more than 1,300 patients. The study was paid for by Merck and therefore there is inherent bias.

But even if some of the results are accurate, the news is promising.

If these results are accurate, cladribine is twice as effective as current primary treatments for MS and that could be very good news for the patients and families that suffer with the disease.

Obama's EHR Plan

In a recent article from Medical Economics, two healthcare information technology experts have written a letter to President Obama, warning him against investing too many federal dollars in existing electronic health records systems.

Their statement which I totally agree with are that existing EHR systems are too expensive, difficult to implement, disruptive to practice workflows, not proven to improve patient care, and don’t do a good job of sharing information with each other.

If all physicians decided to implement one of the dozens of systems they chose themselves, it would be similar to the Biblical times during the tower of Babel and disruption of languages. Little communication would occur among the various systems.

Obama made the statement “We will make sure that every doctor’s office and hospital in this country is using cutting-edge technology and electronic medical records so that we can cut red tape, prevent medical mistakes, and help save billions of dollars each year,” during a December radio address.

There is a bill under consideration in the U.S. House of Representatives presently that calls for incentive payments up to $41,000 over five years beginning in 2011 for physicians who adopt EHR systems.

Before millions of dollars are spent on this endeavor by the government, the industry needs to set communication standards that all software vendors conform to in order to allow transfer of information. As of now, this does not occur. So a lab value in one system may not appear in the same computer field in another system. Names, addresses, and all other pertinent information have to be standardized with the same nomenclature before full implementation can be completed.

Better use of the money would be to standardize payment systems with a single form for all insurers are required to use and to increase the adoption of electronic patient referrals, and online “patient portals” that allow for electronic communication between doctors and patients.

Throwing money at a problem without investing in the infrastructure and the standardization will only exacerbate the problem and create more hassles and cost!

Obama Prompter Problems

Yes, being too reliant on technology can be a problem for our new Commander-in-Chief!