Tuesday, June 30, 2009

Cap and Trade our Jobs oversees

The Cap and trade bill was passed by the House on Friday and Baron Hill and only one other Indiana Representative voted in favor. All other Indiana Representatives were opposed.

This could be because about 95% of our energy in Indiana is coal based and this Bill will significantly increase the cost of energy to every Hoosier.

Why this bill was rushed through is speculation, but it is notable by reports that virtually no one supporting it actually read the bill.

They certainly didn’t read the current thinking of many scientists still questioning the reality of man-made global warming.

As noted in this WSJ article, other countries are actually voting against bills such as these because the science isn’t supported. Strassel: The Climate Change Climate Change - WSJ.com

If this ever passes the Senate, it will be the largest expenditure increase to citizens ever and Hoosiers will pay a very high price.

Monday, June 29, 2009

An Alternate Plan

With the democratic and Obama healthcare plan now upwards of 1.6 Trillion dollars, more and more people are declining to jump on board. After all, the estimates say that with the current plan, it will still leave nearly 2/3 of the uninsured without insurance.

In a recent ABC News/USA Today/Kaiser Family Foundation survey they found that 89 percent of Americans are satisfied with their health care. That translates to 250 million people who are happy with their plans.

Why don’t we consider some other proposals?

1. Reduce the administrative hassles to physicians and other healthcare providers by mandating a single payment form with all of the fields and codes standardized. One form would be sent to all insurers with the same fields utilized by everyone. This would save millions of dollars and simplify the process

2. Mandate every Insurance company who wants to provide insurance to have a minimum policy that covers all of the recommended screening tests at all ages, at least 2-3 sick visits a year and provide for some catastrophic coinsurance coverage for the unexpected.

3. Establish and take bids for a private company to screen for eligibility for patients who cannot afford insurance and the government would pay the company and then allow the patient into subsidized insurance program paid for by the government and tax dollars.

4. For those who qualify, the government would pay up to $5000/year for a policy for these individuals/families. If the government paid $5000 for all 40 million currently reported to be without insurance (which is debatable), we would only have a $220 billion dollar cost compared to the 1.6 trillion. (I think this amount is way more than it would actually cost and could be provided at 3-4000 dollars per year) Patients could choose which company they wanted to get the insurance through and it would provide insurers with capital to cover their costs. Competition would thrive, prices would be lowered because there would be no uninsured and the free market would bring quality and costs in line.

5. Eliminate the state lines for providing insurance and eliminate preexisting clauses.

6. Charge the patients, even those that are subsidized, for high risk behaviors and lifestyles that are known risks. (ie. Smoking and morbid obesity)

7. Insurance companies can offer a range of other health care coverage options above those minimal standards but each would come at a cost to patients and they could choose how much coverage they desired but everyone would have the minimum provided by the government, their companies, or personally.
As a benefit, some companies may choose to offer more than the minimum to the employees and some may offer more at a reduced cost to their employees. If an employee left a company, their minimum insurance would continue as every insurance provider is offering the same benefits. The additional coverage may or may not be lost based on the differing companies.

The government has never run anything more efficiently than the private sector and they should not be involved in this now.

If we allow the free market to work without restrictions and government intervention, we can continue to provide the best healthcare in the world and we can provide coverage to everyone at a much lower cost than the current proposals.

Individuals typically will spend their own money more wisely than the government.

Even stating this, some people may choose to go without insurance and should be allowed to do so. But when they do access the healthcare system, they should then be penalized financially for that decision by having a surcharge to the treatments they are purchasing. This would incentivize them to have coverage which lowers everyone’s cost.

Let the free-market and personal choice work.

Labels:

Friday, June 26, 2009

Blues, Cruise and BBQ


There will be a Blues, Cruise and BBQ this weekend at Northside Christian Church.

The BBQ is a sanctioned event by the KCBS BBQ teams where they earn points toward the championship. There will also be local amateur BBQ’ers competing as well.

There will be many vintage cars and lots of good music.

The event is free, so come on over!

The link below is the flyer and further information

http://www.mynorthside.com/_media/_pdf/BCBBQFoodPantryFlyer.pdf

Labels: ,

Thursday, June 25, 2009

The Obama Way

Here was a scathing article from Dana Milbank who certainly isn’t known to be a conservative’s friend.

She blatantly explains how Obama planted reporters in the news conference with prearranged questions.

The irony here is very troublesome. Isn’t this just a great way to celebrate freedom and to show the Iranians how an independent media works by destroying it through planted questions. This along with his healthcare talk using only NBC at the White House and refusing to allow dissenting views as we discuss one of the largest expenditures in our budget. I’d call this a state-run media. This would never have been allowed under a republican.

Again, who is surprised?

Dana Milbank - Washington Sketch: Welcome to Â?The Obama Show' - washingtonpost.com

Labels: , ,

Wednesday, June 24, 2009

Obama’s Lack of Clarity

Jonah Goldberg describes Obama’s rhetoric very clearly on how he has dealt with the recent international affairs.

Yes, “The One” has basically done nothing, said nothing and stands for nothing in a time of crisis for a country that wishes to have a better future.

But hey, who is surprised!

Obama’s Choice Is Not to Choose on Iran
Maybe the president could lift a finger for democracy?
By Jonah Goldberg

Do it, President Obama, please. Take the side of democracy.

Declare yourself and your nation on the side of hope and change where it is more than a slogan and better than a rationalization for ever-bigger government. Stop measuring the success of your diplomacy with Iran by the degree to which the grinning, hate-filled stooge of a clerical junta will “temper” his rhetoric about the pressing need to destroy Israel and slow his ineluctable pursuit of nuclear weapons.

Instead, choose a higher standard. Look to history. Look to the aspirations of the students risking their lives and livelihoods to protest a sham election. Stop fawning over the mythological Muslim street only when it hates America, and look to the real Iranian street at the moment of its greatest need, when its heart may be open to loving America.

You often invoke President Kennedy’s pledge to put a man on the moon to justify your domestic agenda. You and your supporters invite comparisons to Camelot. Well, what of John F. Kennedy’s most solemn vow? “Let every nation know, whether it wishes us well or ill, that we shall pay any price, bear any burden, meet any hardship, support any friend, oppose any foe, in order to assure the survival and the success of liberty

No, we should not bomb Iran, or invade it. Those prices are too steep; those burdens are too heavy. But maybe you could lift a finger for democracy?

During the campaign you mocked those who belittled your rhetoric as “just words.” Well, what you’ve offered so far is less than just words. You’ve put a fresh coat of whitewash on Iran’s sham “democracy.” On Monday, you proclaimed yourself “troubled” by the events in Iran, before hinting that you’d negotiate with Mahmoud Ahmadinejad no matter what an official investigation into his “landslide” victory found. (Would you trust Mafia internal audits, too?)

Before the sham election, you cheered Iran’s “robust debate.” But that debate has been robust only if you are grading on a curve. Ahmadinejad’s main opponent, Mir Hossein Mousavi, was an accidental reform candidate. The mullahs had disqualified about 400 others, leaving in the race only four presumed hacks deemed pliant enough not to rock the boat. Mousavi’s popular support and the robustness of the debate he ignited were an unintended consequence of a rigged election and a clerical politburo indifferent to its people’s desires, not the intention of a democratic regime.

Reportedly, you are biding your time, waiting to see what happens, as if it is a great mystery. Your campaign lived and breathed YouTube. Check it now, check it often. You and your team promised “soft power” and “smart power.” How about moral power? Because by not clearly picking a side, it appears you have chosen the wrong side.

Do you fear antagonizing the powers-that-be in Iran? That ship has sailed. Though I am sure they’re tickled by your eagerness not to roil the seas around them. Is it because you think “leader of the free world” is just another of those Cold War relics best mothballed in favor of a more cosmopolitan and universal awe at your own story?

“Enough about those people bleeding in the street. What do you think of me?” Is that how it is to be?

During the Bush years, what was best about liberalism had bled away. One of the worst things about the Republican party has always been its Kissingerian realpolitik, the “it’s just business” approach to world affairs that amounted to a willful blindness to our ideals beyond our own borders. The Democratic party may not have always gotten the policies right, but it had a firm grasp of the principle.

In the 1990s, liberals championed “nation building,” and many conservatives chuckled at the naïveté of it. Then came Iraq, and Republicans out of necessity embraced what liberals once believed out of conviction. The result? Liberals ran from their principles, found their inner Kissingers and championed a cold realism whose chill emanated from the corpse of their ideals.

Labor unions, such as the AFL-CIO, once battled tyranny abroad on the grounds that workers everywhere need democracy. Today, the president turns a blind eye to the independent labor movement in Iran, and the unions and Democrats spend their time trying to figure out how to eliminate the secret ballot in the American workplace.
So far, “hope and change” has meant spending trillions we do not have on expanded government we do not need. Meanwhile, the huddled masses of Iranians yearning to breathe free think hope and change means something more. But the new American colossus stands all but silent, her beacon dimmed, her luster tarnished.

Please, Mr. President, prove me wrong. Stop voting “present” on democracy.

Labels:

Tuesday, June 23, 2009

WSJ paid advertisement

Here is the The unedited version of the ad placed in the Wall Street Journal recently.

A Public Apology and Plea to all AIG Associates
[ including bonus recipients ]

Thoughtful Americans – people of common sense and good will – know exactly what is going on today in American Politics.

Whether or not the proposed absurd, onerous tax penalties are eventually signed into law, we share the outrage you must feel for the utter hypocrisy, heavy handedness, and pure idiocy of our elected officials. There is nothing new about the concept of politicians identifying scapegoats to divert attention from their own ineptness, but they have now taken it to a preposterous level.

These polished, practiced hypocrites, aided by the media, are staging a vicious charade aimed at stirring anger amongst a naturally vindictive, vocal segment of our population – either oblivious or non-caring of the impact of this furor on you and your families.

• We have a permanently unpopular and irreparably out-of-touch Congress – both Republicans and Democrats – shamelessly pandering to an uninformed electorate – wasting taxpayer dollars treating private citizen CEOs like convicted felons – investigating everyone but themselves. It was they who passed legislation promoting sub prime mortgages and the latest ‘stimulus’ package which provided for the bonuses.

• We have a populist President – in his own words – “channeling our anger in a constructive way”. His idea of “constructive” demeans his role as the leader of all Americans – specifically: his unnecessary divisive remarks that treat all people of wealth as greedy; his broadside attacks on excessive executive compensation as if all CEOs in Corporate America are overpaid; his sweeping, counterproductive vilification of Wall Street’s “excessive greed” -- combined with his terribly misguided advice to young folks not to pursue careers there; and, his constant, classless whining about the mess he inherited and his predecessor’s mistakes. He says he is angry about all of the above, yet sees no problem in incurring the wrath of sensible Americans by running up trillion dollar deficits.

• And, no surprise, the New York and Connecticut State Attorney Generals are now piling on – issuing subpoenas.

• We are appalled that, before our very eyes, they are systematically demeaning and dismantling America’s financial services sector – a proven facilitator of wealth and job creation. This national asset, with all of its flaws, is irrefutably the very best in the world.

Elections have consequences – but caring Americans, regardless of their ideology, must not remain silent on the sidelines and allow this lunacy to continue.

• The bonuses in question were voted by Congress and signed into law by the sitting President.

• Retroactive use of the tax code to punish any private citizen is an absurd, vindictive, small minded act by political hacks!!

• The money legally belongs to the bonus recipients regardless of their role in AIG. What’s done is done – let’s all move on to address real issues: the deficit, jobs, and economic prosperity!

For the sake of your own dignity and out of respect for your Country, do not succumb to this insanity which, if allowed to prevail, will most certainly propagate the lawless power of our Federal government.

A special message to bonus recipients: If after reading this, you are still overcome with guilt – please don’t give the money back to proven, profligate spenders – donate it to a useful charitable cause.

Labels: ,

Monday, June 22, 2009

Physician survey

In another recent survey conducted by physician recruiting firm Merritt-Hawkins for The Physicians’ Foundation there is more distressing news that is being cited by more news organizations. This survey (find the complete document here) was funded by a grant and was mailed to every primary care physician in the nation, as well as many specialty doctors.

This survey was broken down by states and it confirmed findings of the ISMA in its member surveys of 2004 and 2005 regarding a looming physician shortage.

This administration’s ambitious goals of expanding access through universal health care will have to deal with the harsh reality that there will not be enough doctors to handle the increased number of patients.

Physician respondents reported widespread frustration because of increased time dealing with non-clinical paperwork, difficulty obtaining reimbursement and burdensome regulations. If these issues aren’t addressed and you add a lot more patients into the system, it will get a lot worse.

Physicians did not join the profession to fill out forms or spend long hours on hold trying to pre-certification, prior authorizations for medications or arguing about a needed test with some high school educated person working at the insurance company.

Physicians are tired of playing games with insurance companies and we are seeing many leaving the profession earlier and earlier.

Some of the survey results are as follows:

• 78% of respondents believe the U.S. has a shortage of primary care doctors.
• 49%, more than 150,000 doctors nationwide said in the next three years they plan to reduce their patient loads or stop practicing.
• 60% of doctors would not recommend medicine as a career.
• 94% said the time they spend on paperwork has increased in the last three years.
• 82% said their practices would be “unsustainable” if proposed cuts to Medicare pay are made.

Labels: ,

Friday, June 19, 2009

OBAMA-CARE

Here are a few of the many cartoons pointing out some of the obvious problems with the Obama Healthcare plan. But rather than making jokes, why isn't anyone talking about the economic facts of the deficit even before the healthcare bill is added in?







Labels: , ,

Thursday, June 18, 2009

AMA finally may get involved seriously

More controversy is coming and it appears that the Public insurance plan that Obama is pushing for may be the single issue that gets the AMA more actively involved in squelching this radical change in our healthcare system. A.M.A. Opposes Government-Sponsored Health Plan - NYTimes.com

Government run insurance will be the destruction of the private sector and will lead to lower quality, higher costs, and rationing of healthcare. Looking at this picture, it certainly doesn't appear that "The One" tolerates disagreement well.

In addition, we cannot afford it.

As of now, you could tax 100% of the money everyone makes over $250,000 and we still could not pay for the massive debt Obama has already cost us and certainly could not afford this health care change.

But the Democrats just keep digging our hole deeper and deeper.

Labels: ,

Wednesday, June 17, 2009

More Problems on Obamacare

The editors of National Review Online posted this yesterday (reprinted below) and it is worth reading. For Republicans, a Health-Care Opportunity by The Editors on National Review Online. In addition, the Congressional Budget Office posted this letter related to the Obama Healthcare Plan
http://cbo.gov/ftpdocs/103xx/doc10310/06-15-HealthChoicesAct.pdf

All of this adds up to more government control, more expense and bigger problems created!

It is received wisdom among Democrats that President Clinton’s health-care plan failed in 1994 in part because he gave his opponents too much time to publicly dissect it. President Obama has been skilful in applying that lesson while hustling through his own health-care package this year. The administration has worked closely with congressional allies to keep the grim reality of what they have in mind out of public view for as long as possible.

But this kind of political maneuvering has its limits. As key Senate committees rush to push through the legislation before the July 4 recess, it is no longer possible to hide the ball. Details have started to emerge in recent days, and it is no coincidence that the political terrain has started to shift perceptibly. And the more the broader public learns about what the Democrats are contemplating, the less likely it is that the bill will pass.

The Kennedy-Dodd draft bill was the first to find its way into the public domain, and it is wall-to-wall government regulation, mandates, subsidies, and entitlement spending. Here’s one example of the massive governmental overreach it represents: The bill would allow states to block licensed, qualified insurance companies from offering coverage to citizens in the “gateways,” which are single-state or multistate insurance exchanges intended to help connect consumers with a broad selection of competing providers. The states’ability, in effect, to bar some competitors from the marketplace is guaranteed to become an instrument for protecting politically connected insurance interests while stifling innovation, shortchanging consumers, and inflating costs.

Then there’s the elephantine expense of the program. The Democratic plans envision providing new subsidies for the purchase of insurance. The Kennedy-Dodd bill would allow households with incomes of up to 500 percent of the poverty line (meaning $110,250 for a family of four in 2009) to qualify for federal support. Most estimates put the cost of such a program at well over $1 trillion over ten years.

For months, President Obama has said he would pay for this new entitlement by “bending the cost curve,” but he has so far failed to present any credible plan to do so. Instead, on Saturday, he proposed to cut Medicare and Medicaid reimbursements by an additional $313 billion over ten years — on top of the $309 billion in cuts he proposed in his 2010 budget plan.

Imagine that a Republican president had tried to cut Medicare and Medicaid spending by $625 billion over a decade. We doubt the story would have been relegated to the back pages of the major newspapers, as President Obama’s proposal was yesterday. Moreover, in the unlikely event these cuts should be adopted by Congress, that would not fulfill the president’s commitment to curb rising health-care costs, as a Washington Post story claimed yesterday. These cuts in Medicare and Medicaid payments are nothing more than reimbursement reductions with no empirical or economic basis to justify them. They will not bend the cost curve; instead, they will shift even more costs onto consumers as doctors and hospitals fleeced by the feds look to make up the difference elsewhere.

Fortunately, some hospital executives and other players with skin in the game are starting to grasp that the president’s budget-cutting proposal provides a bitter foretaste of what can be expected after a takeover by Washington. The government always promises painless savings through trimming waste and inefficiency, but what it always delivers is a regime of arbitrary price controls. The result will be to drive doctors out of the profession and hospitals out of business, meaning fewer choices, higher real prices, and longer waits for care.

The primary alternative to deep cuts in Medicare and Medicaid fees is Senator Baucus’s proposal to impose taxes on employer-paid health-insurance premiums. Fixing the tax treatment of health insurance is necessary to build a true marketplace, but Senator Baucus’s main interest is raising revenue for a government takeover, not offering market-based reform through which revenue would be returned to consumers. And to bring in real money, Senator Baucus will have to tax the middle class and unions as well as the high earners.

Speaking at the American Medical Association yesterday, President Obama promised a painless plan with no costs to the middle class and protections that would allow anyone who likes his current coverage to keep it. The details of what Democrats are pushing through Congress tell another story. To pay for Obamacare, Congress must either impose deep, cost-shifting cuts in Medicare, thereby raising insurance premiums, or they must raise taxes on the middle class. Neither measure will be easy to pass. Moreover, employers, not consumers, will get to decide where their workers get coverage. In practice, that means that tens of millions of people are going to be forced out of their current plans, which they generally like, and into a government program.

In short, Congress’s deeds are at odds with Obama’s words; it is little wonder that fissures are starting to emerge in the Democratic coalition. President Obama has made a lot of fine promises on health care; Nancy Pelosi and Harry Reid are getting ready to stick a shiv in them. Republicans should bear witness, and then get to work producing better solutions.

Labels: ,

Tuesday, June 16, 2009

AMA joins lawsuit against Wellpoint

It has been recently announced that the AMA is among several medical societies filing a class action lawsuit against WellPoint, Inc. This is an expansion of efforts to expose and prohibit an industry-wide health insurance scheme to defraud patients and physicians of proper reimbursement.

The lawsuit, filed in Los Angeles federal court, alleges WellPoint colluded with others to underpay physicians for out-of-network medical services, resulting in patients paying an excessive portion of the medical bill. The AMA filed similar class action suits against Aetna Health, Inc. and CIGNA.

This has been a conspiracy by the insurance companies for far too long and the AMA and others have recognized it and are challenging it in court.

The three AMA lawsuits claim each insurer conspired with Ingenix, a unit of United Health Group, on a price-fixing scheme that relied on an obscure database to set artificially low reimbursement rates for out-of-network care. An investigation by the New York attorney general confirmed the Ingenix database is intentionally rigged to allow insurers to shortchange reimbursements.

A spokesman stated; “Now that the underlying scheme has been exposed, health insurers are doing the right thing by cutting their ties with the flawed Ingenix database. However, serious damages resulting from prior use of the Ingenix database still need to be addressed.”

The AMA and partnered medical societies seek reforms for the invalid payment system and relief for physicians harmed by long-term use of Ingenix.

This WellPoint lawsuit is supported by AMA and State Medical Societies including the California Medical Association, Connecticut State Medical Society, Medical Association of Georgia and North Carolina Medical Society.

Labels: , ,

Monday, June 15, 2009

Nicotene and Cancer Risk

With another study recently released, we see that nicotine chewing gum, lozenges and inhalers that people use to kick their smoking habits may actually have the potential to cause cancer.

This recent study, funded by the Medical Research Council of Queen Mary, University of London, found that the effects of a genetic mutation that is common in mouth cancer can be worsened by nicotine in the levels that are typically found in smoking cessation products.

The risk may be increased by prolonged use of the nicotine supplements and may indicate that nicotine itself may be more carcinogenic than had previously been appreciated.

The researchers still agree that smoking is far more dangerous but overuse of these products are certainly not risk-free.

Although nicotine is acknowledged as the addictive element in cigarettes its role in cancer has long been disputed and it is not as potent a carcinogen as other chemicals found in tobacco smoke, such as tar.

The gene currently being studied is called the FOXM1 gene. Mutations that increase the activity of this gene can be found in many tumors and seems to be increased with prolonged nicotine use.

Working with this gene may lead to new ways of diagnosing mouth cancer while it is still in its early stages and make it easier to treat.

For now, the recommendation remains to stop smoking and utilize these nicotine replacement products sparingly and for short periods of time.

Labels: , ,

Friday, June 12, 2009

We Can only Wish

A Tourist walked into a Chinese curio shop in San Francisco. While looking around at the exotic merchandise, he noticed a very lifelike, life-sized, bronze statue of a rat. It had no price tag, but was so incredibly striking the tourist decided he must have it.

He took it to the old shop owner and asked, "How much for the bronze rat?"

"Ahhh, you have chosen wisely! It is $12 for the rat, $100 for the story," said the wise old Chinaman.

The tourist quickly pulled out twelve dollars. "I'll just take the rat, you can keep the story".

As he walked down the street carrying his bronze rat, the tourist noticed that a few real rats had crawled out of the alleys and sewers and had begun following him down the street. This was a bit disconcerting so he began walking faster.

A couple blocks later he looked behind him and saw to his horror the herd of rats behind him had grown to hundreds, and they began squealing.. Sweating now, the tourist began to trot toward the Bay.

Again, after a couple blocks, he looked around only to discover that the rats now numbered in the MILLIONS, and were squealing and coming toward him faster and faster.

Terrified, he ran to the edge of the Bay and threw the bronze rat as far as he could into the Bay. Amazingly, the millions of rats all jumped into the Bay after the bronze rat, and were all drowned. The man walked back to the curio shop in Chinatown.

"Ahhh," said the owner, "You have come back for story?"

"No sir," said the man, "I came back to see if you have a bronze Democrat."


Labels:

Thursday, June 11, 2009

Recent Health Reform Meeting

Representatives from the AMA met recently during a health system reform at the White House and it included about 35 representatives from medical specialties and academic health centers. There was a strong voice that stressed the need to include antitrust relief and liability reform in the health system reform effort. Also discussed was the problem associated with the Medicare sustainable growth rate issue and it was urged that officials continue pursuing efforts to replace the flawed formula with a more coherent system that provides a stable funding base. If this flawed formula isn’t fixed, physicians will not be able to make the necessary investments in staff and health information technology needed to participate in quality improvement and value enhancement initiatives that are key to health system reform. The Impacts of Medicare physician payment cuts in Indiana are as follows:

• The Medicare Improvements for patients and Providers Act of 2008 (MIPPA) replaced scheduled double-digit Medicare cuts with a 1.1% increase for 2009. However, on January 1, 2010, Indiana physicians face an across-the-board cut of 21%, producing a loss of $290 million for the care of elderly and disabled patients. On average, each Indiana physician is facing a Medicare cut of $21,000 next year.
• This 21% cut will grow to about 40% in cumulative cuts by 2016 unless Congress acts soon to replace the flawed payment update formula and reform Medicare’s physician payment system. Otherwise, by 2016 the state’s physicians will lose $4.4 billion for the care of elderly and disabled patients.
• 64,908 employees, 865,792 Medicare patients and 90,439 TRICARE patients in Indiana will be affected by these cuts.
• Compared to the rest of the country, Indiana, at 14 percent, has an above-average proportion of Medicare patients and, at 15 practicing physicians per 1,000 beneficiaries, Indiana has a below-average ratio of physicians to Medicare beneficiaries, even before the cuts take effect.
• 41 percent of Indiana’s practicing physicians are over 50, an age at which surveys have shown many physicians consider reducing their patient care activities.
• MIPPA also extended a temporary increase in Medicare geographic adjustments for certain areas which will expire at the end of 2009. In 2010, therefore, Indiana physicians face cuts of an additional 0.8% on top of the 21% cuts across the country

Other issues raised during the discussion included the need to strengthen primary care, provide adequate financing for graduate medical education, develop Medicare payment alternatives and simplify administrative requirements.

Labels: ,

Wednesday, June 10, 2009

More from Hennessey on the House version

Today is a followup from Keith Hennessey on the House version of the bill to reform the Healthcare system. The house version differences are colored.

Another perspective can be found here: The New Atlantis » Diagnosis

Here are 15 things to know about the draft Kennedy-Dodd health bill and the House bill outline.

The Kennedy-Dodd bill would create an individual mandate requiring you to buy a “qualified” health insurance plan, as defined by the government. If you don’t have “qualified” health insurance for a given month, you will pay a new Federal tax. Incredibly, the amount and structure of this new tax is left to the discretion of the Secretaries of Treasury and Health and Human Services (HHS), whose only guidance is “to establish the minimum practicable amount that can accomplish the goal of enhancing participation in qualifying coverage (as so defined).” The new Medical Advisory Council (see #3D) could exempt classes of people from this new tax. To avoid this tax, you would have to report your health insurance information for each month of the prior year to the Secretary of HHS, along with “any such other information as the Secretary may prescribe.”

The House bill also contains an individual mandate. The outline is less specific but parallel:

Once market reforms and affordability credits are in effect to ensure access and affordability, individuals are responsible for having health insurance with an exception in cases of hardship.”
The Kennedy-Dodd bill would also create an employer mandate. Employers would have to offer insurance to their employees. Employers would have to pay at least a certain percentage (TBD) of the premium, and at least a certain dollar amount (TBD). Any employer that did not would pay a new tax. Again, the amount and structure of the tax is left to the discretion of the Secretaries of Treasury and HHS. Small employers (TBD) would be exempt.

The House bill outline also contains an employer mandate that appears to parallel that in Kennedy-Dodd: “Employers choose between providing coverage for their workers or contributing funds on behalf of their uncovered workers.”

In the Kennedy-Dodd bill, the government would define a qualified plan:

All health insurance would be required to have guaranteed issue and renewal, modified community rating, no exclusions for pre-existing conditions, no lifetime or annual limits on benefits, and family policies would have to cover “children” up to age 26.

The House bill outline is consistent with but less specific than the Kennedy-Dodd legislative language. The House bill outline would “prohibit insurers from excluding pre-existing conditions or engaging in other discriminatory practices.” I will keep my eye on what “other discriminatory practices” means in the legislative language. Does that mean that a health plan cannot charge higher premiums to smokers?

Like the Kennedy/Dodd bill, the House bill outline would preclude health plans from imposing lifetime or annual limits on benefits: “Caps total out-of-pocket spending in all new policies to prevent bankruptcies from medical expenses.” This would raise premiums for new policies.
The House bill outline “introduces administrative simplification and standardization to reduce administrative costs across all plans and providers.” I don’t know what this means, but suggest keeping an eye on it.


A qualified plan would have to meet one of three levels of standardized cost-sharing defined by the government, “gold, silver, and bronze.” Details TBD.

Same: “… by creating various levels of standardized benefits and cost-sharing arrangements…”. It also contains this addition relative to Kennedy-Dodd: “… with additional benefits available in higher-cost plans.”

But note the “various levels of standardized benefits.” This appears to be more expansive government control of health plan design than in the Kennedy-Dodd draft.

Plans would be required to cover a list of preventive services approved by the Federal government.

This is unspecified in the House bill outline. We’ll have to wait to see legislative language. The House bill would require plans to “waive cost-sharing for preventive services in benefit packages.”

A qualified plan would have to cover “essential health benefits,” as defined by a new Medical Advisory Council (MAC), appointed by the Secretary of Health and Human Services. The MAC would determine what items and services are “essential benefits.” The MAC would have to include items and services in at least the following categories: ambulatory patient services, emergency services, hospitalization, maternity and new born care, medical and surgical, mental health, prescription drugs, rehab and lab services, preventive/wellness services, pediatric services, and anything else the MAC thought appropriate.

This appears parallel but is less specific for now: “Independent public/private advisory committee recommends benefit packages based on standards set in statute.” I find the “standards set in statute” interesting. It suggests that provider and disease interest groups will have two fora in which to lobby for their benefits to be mandated: Congress, and the advisory committee.

The MAC would also define what “affordable and available coverage” is for different income levels, affecting who has to pay the tax if they don’t buy health insurance. The MAC’s rules would go into effect unless Congress passed a joint resolution (under a fast-track process) to turn them off.

The House bill outline is silent on this.

Health insurance plans could not charge higher premiums for risky behaviors: “Such rate shall not vary by health status-related factors, … or any other factor not described in paragraph (1).” Smokers, drinkers, drug users, and those in terrible physical shape would all have their premiums subsidized by the healthy.

The House bill outline says it would “prohibit plans [from] rating (charging higher premiums) based on gender, health status, or occupation and strictly limits premium variation based on age.” If the bill were to provide nothing more, this would appear to parallel the Senate bill and preclude plans from charging higher premiums for risky behaviors.

Guaranteed issue and renewal combined with modified community rating would dramatically increase premiums for the overwhelming majority of those Americans who now have private health insurance. New Jersey is the best example of health insurance mandates gone wild. In the name of protecting their citizens, premiums are extremely high to cover the cross-subsidization of those who are uninsurable.

The House bill outline is silent on guaranteed issue and renewal. I’m going to make an educated guess that the bill includes these provisions as part of “other discriminatory practices,” and they have just left them out of the outline. Given the philosophy behind this outline (with which I disagree), it would be a striking omission. But for now, the outline says nothing specific on these topics.

The bill would expand Medicaid to cover everyone up to 150% of poverty, with the Federal government paying all incremental costs (no State share). This means adding childless adults with income below 150% of the poverty line.

The House bill outline “expands Medicaid for the most vulnerable, low-income populations,” so we have no specifics other than that there’s an expansion. I cannot tell if this is expanding eligibility or benefits. The outline also “improves payment rates to enhance access to primary care under Medicaid.” I assume this means the bill would expand the Federal share paid of each dollar spent by a State Medicaid program on primary care, rather than the Federal government actually mandating specific payment rates to be implemented by States. Federal micromanagement of specific Medicaid provider payment rates was eliminated in the mid 1990’s.

People from 150% of poverty up to 500% (!!) would get their health insurance subsidized (on a sliding scale). If this were in effect in 2009, a family of four with income of $110,000 would get a small subsidy. The bill does not indicate the source of funds to finance these subsidies.
The House bill outline has a sliding scale up to 400% of poverty. If this were in effect in 2009, a family of four with income of $88,000 would get small subsidy.

People in high cost areas (e.g., New York City, Boston, South Florida, Chicago, Los Angeles) would get much bigger subsidies than those in low cost areas (e.g., much of the rest of the country, especially in rural areas). The subsidies are calculated as a percentage of the “reference premium,” which is determined based on the cost of plans sold in that particular geographic area.

The House bill outline is not specific on this point. I would not expect it to be – this is something you can tell only from legislative language.

There would be a “public plan option” of health insurance offered by the federal government. In this new government health plan, the federal government would pay health care providers Medicare rates + 10%. The +10% is clearly intended to attract short-term legislative support from medical providers. I hope they are not so naive that they think that differential would last.

The House bill outline “creates a new public health insurance within the Exchange … the public health insurance option competes on ‘level field’ with private insurers in the Exchange.” There are no specifics on how the public plan would work, or on provider payment rates.

Group health plans with 250 or fewer members would be prohibited from self-insuring. ERISA would only be for big businesses.

The House bill outline is silent on this point.

States would have to set up “gateways” (health insurance exchanges) to market only qualified health insurance plans. If they don’t, the Feds will set up a gateway for them.

The House calls it an Exchange rather than a Gateway. While the Senate bill would tell each State, “Create a Gateway or we’ll create one for you,” the House bill outline says to each State, “We’re creating a single new national Exchange. You’re in it unless you develop your own State or Regional Exchange.”

Health insurance plans in existence before the law would not have to meet the new insurance standards. This creates a weird bifurcated system and means you would (probably) be subject to a different set of rules when you change jobs.

The House bill outline appears to parallel the Kennedy-Dodd draft: “Phases-in requirements to benefit and quality standards for employer plans.” This means that new plans will be more expensive than old plans. It also means they’re creating a bifurcated system with all sorts of perverse unintended consequences for employment flexibility.

The bill does not specify what spending will be cut or what taxes will be raised to pay for the increased spending. That is presumably for the Finance Committee to determine, since it’s their jurisdiction.

The House bill outline lists specific topics for changes to Medicare reimbursement:
Changing (how?) the Medicare reimbursement for doctors, called the “Sustainable Growth Rate” (SGR).


“Increasing reimbursement for primary care providers”

“Improving” the Medicare drug program. I won’t be surprised if, when I see the specifics, I disagree that their changes are “improvements.” In the past this has meant having the federal government mandate specific prices for drugs.

Cutting payments to Medicare Advantage plans.

Expanding low-income subsidies for seniors and eliminating cost-sharing for all preventive services in Medicare.

The House bill outline also uses positive language to describe things that might generate budgetary savings from Medicare and/or Medicaid. The hospital readmissions point is specific. The first two points could increase or decrease federal spending, depending on the specifics.

“Use federal health programs … to reward high quality, efficient care, and reduce disparities.”
“Adopt innovative payment approaches and promote[s] better coordinated care in Medicare and the new public option through programs such as accountable care organizations.”
“Attack the high rate of cost growth to generate savings for reform and fiscal sustainability, including a program in Medicare to reduce preventable hospital readmissions.”

The bill defines an “eligible individual” as “a citizen or national of the United States or an alien lawfully admitted to the United States for permanent residence or an alien lawfully present in the United States.”

The House bill outline is silent on this point.

The bill would create a new pot of money for state gateways to pay “navigators” to educate people about the new bill, distribute information about health plans, and help people enroll. Navigators receiving federal funds “may include … unions, …”

The House bill outline is silent on this point.

Labels: ,

Tuesday, June 09, 2009

Kennedy-Dodd Health Bill

Keith Hennessey has done a review of the Kennedy-Dodd health bill that was leaked to the press over the weekend. Although this is just a draft, it certainly clarifies the direction that this administration is heading.

Scary would be much to kind of a word to use for the changes they are proposing.

Here are 15 things to know about the draft Kennedy-Dodd health bill.

1. The Kennedy-Dodd bill would create an individual mandate requiring you to buy a “qualified” health insurance plan, as defined by the government. If you don’t have “qualified” health insurance for a given month, you will pay a new Federal tax. Incredibly, the amount and structure of this new tax is left to the discretion of the Secretaries of Treasury and Health and Human Services (HHS), whose only guidance is “to establish the minimum practicable amount that can accomplish the goal of enhancing participation in qualifying coverage (as so defined).” The new Medical Advisory Council (see #3D) could exempt classes of people from this new tax. To avoid this tax, you would have to report your health insurance information for each month of the prior year to the Secretary of HHS, along with “any such other information as the Secretary may prescribe.”

2. The bill would also create an employer mandate. Employers would have to offer insurance to their employees. Employers would have to pay at least a certain percentage (TBD) of the premium, and at least a certain dollar amount (TBD). Any employer that did not would pay a new tax. Again, the amount and structure of the tax is left to the discretion of the Secretaries of Treasury and HHS. Small employers (TBD) would be exempt.

3. In the Kennedy-Dodd bill, the government would define a qualified plan:

A. All health insurance would be required to have guaranteed issue and renewal, modified community rating, no exclusions for pre-existing conditions, no lifetime or annual limits on benefits, and family policies would have to cover “children” up to age 26.

B. A qualified plan would have to meet one of three levels of standardized cost-sharing defined by the government, “gold, silver, and bronze.” Details TBD.

C. Plans would be required to cover a list of preventive services approved by the Federal government.

D. A qualified plan would have to cover “essential health benefits,” as defined by a new Medical Advisory Council (MAC), appointed by the Secretary of Health and Human Services. The MAC would determine what items and services are “essential benefits.” The MAC would have to include items and services in at least the following categories: ambulatory patient services, emergency services, hospitalization, maternity and new born care, medical and surgical, mental health, prescription drugs, rehab and lab services, preventive/wellness services, pediatric services, and anything else the MAC thought appropriate.

E. The MAC would also define what “affordable and available coverage” is for different income levels, affecting who has to pay the tax if they don’t buy health insurance. The MAC’s rules would go into effect unless Congress passed a joint resolution (under a fast-track process) to turn them off.

4. Health insurance plans could not charge higher premiums for risky behaviors: “Such rate shall not vary by health status-related factors, … or any other factor not described in paragraph (1).” Smokers, drinkers, drug users, and those in terrible physical shape would all have their premiums subsidized by the healthy.

5. Guaranteed issue and renewal combined with modified community rating would dramatically increase premiums for the overwhelming majority of those Americans who now have private health insurance. New Jersey is the best example of health insurance mandates gone wild. In the name of protecting their citizens, premiums are extremely high to cover the cross-subsidization of those who are uninsurable.

6. The bill would expand Medicaid to cover everyone up to 150% of poverty, with the Federal government paying all incremental costs (no State share). This means adding childless adults with income below 150% of the poverty line.

7. People from 150% of poverty up to 500% (!!) would get their health insurance subsidized (on a sliding scale). If this were in effect in 2009, a family of four with income of $110,000 would get a small subsidy. The bill does not indicate the source of funds to finance these subsidies.

8. People in high cost areas (e.g., New York City, Boston, South Florida, Chicago, Los Angeles) would get much bigger subsidies than those in low cost areas (e.g., much of the rest of the country, especially in rural areas). The subsidies are calculated as a percentage of the “reference premium,” which is determined based on the cost of plans sold in that particular geographic area

9. There would be a “public plan option” of health insurance offered by the federal government. In this new government health plan, the federal government would pay health care providers Medicare rates + 10%. The +10% is clearly intended to attract short-term legislative support from medical providers. I hope they are not so naive that they think that differential would last.

10. Group health plans with 250 or fewer members would be prohibited from self-insuring. ERISA would only be for big businesses.

11. States would have to set up “gateways” (health insurance exchanges) to market only qualified health insurance plans. If they don’t, the Feds will set up a gateway for them.

12. Health insurance plans in existence before the law would not have to meet the new insurance standards. This creates a weird bifurcated system and means you would (probably) be subject to a different set of rules when you change jobs.

13. The bill does not specify what spending will be cut or what taxes will be raised to pay for the increased spending. That is presumably for the Finance Committee to determine, since it’s their jurisdiction.

14. The bill defines an “eligible individual” as “a citizen or national of the United States or an alien lawfully admitted to the United States for permanent residence or an alien lawfully present in the United States.”

15. The bill would create a new pot of money for state gateways to pay “navigators” to educate people about the new bill, distribute information about health plans, and help people enroll. Navigators receiving federal funds “may include … unions, …”

This would have severe effects on the more than 100 million Americans who have private health insurance today:
The government would mandate not only that you must buy health insurance, but what health insurance counts as “qualifying.”

Health insurance premiums would rise as a result of the law, meaning lower wages.

A government-appointed board would determine what items and services are “essential benefits” that your qualifying plan must cover.

You would find a tremendous new disincentive to switch jobs, because your new health insurance may be subject to the new rules and would therefore be significantly more expensive.

Those who keep themselves healthy would be subsidizing premiums for those with risky or unhealthy behaviors.

Far more than half of all Americans would be eligible for subsidies, but we have not yet been told who would pay the bill.

The Secretaries of Treasury and HHS would have unlimited discretion to impose new taxes on individuals and employers who do not comply with the new mandates.

The Secretary of HHS could mandate that you provide him or her with “any such other information as [he/she] may prescribe.”

I'd say these are 15 very worrisome points that would radically change the way healthcare is delivered in the United States.



Labels: ,

Monday, June 08, 2009

Indiana Supreme Court sides with the ISMA

In a recent court case with the summary listed here from the ISMA’s website Indiana State Medical Association, the Indiana Supreme Court unanimously ruled in favor of the Patient’s Compensation Fund (PCF) in the case of Atterholt v. Herbst. The Court’s decision confirmed the right of the PCF to reduce its damages when a health care provider only slightly contributed to the patient’s injury. The ISMA participated in the case.

“This legal case helped preserve the PCF’s right to challenge damages awards, especially in difficult cases,” said Julie Reed, ISMA legal counsel. “The ISMA is very pleased to have contributed to such an important case on behalf of Indiana physicians.”

Details of the case

Jeffrey Herbst, age 34, presented to his doctor March 6, 2002, with a fever, congestion, nausea, loss of appetite and decreased urine output. His physician diagnosed him with bilateral pneumonia and sent him to the hospital. Herbst died within 11 hours due to fulminant myocarditis. His estate then sued for wrongful death.

The medical review panel concluded that the doctor had failed to meet the standard of care, but that the failure was not a factor in Herbst’s death. The doctor and hospital settled the case for $250,000. Plaintiffs then sued the Patient’s Compensation Fund for excess damages of $1 million.

At trial in Marion County, the judge would not allow the PCF to introduce expert testimony indicating that even with proper care, Herbst had a less than a 10 percent chance of surviving hospitalization, and if he survived, he would have been unable to return to work.

The court’s decision was based on a controversial provision in the Medical Malpractice Act, which states that once a case is settled, liability has been established and cannot be argued by the PCF.

Plaintiffs argued – and the trial court agreed – that the expert testimony was an impermissible attempt to argue liability. The court concluded that damages exceeded $2.5 million and awarded the estate the statutory maximum of $1 million from the PCF.

The Court of Appeals affirmed the trial court. However, the PCF appealed to the Indiana Supreme Court, and the ISMA filed an amicus curiae brief as an interested third party. The Supreme Court accepted the case.

Subsequently, the Supreme Court agreed with the PCF that its expert testimony was improperly excluded, noting the patient’s increased risk of death could be considered both liability and damages arguments.

The ISMA argued it was both legally improper and unfair to hold the physician liable for damages his actions did not cause. Again, the Supreme Court agreed.

The court ruled that assuming “…any malpractice by either provider increased his chance of harm by no more than 10 percent,… the Fund is liable for only 10 percent of the value of his survival. Moreover, if with proper care Herbst still had no chance of working in the future, no lost wages are recoverable from the Fund.”

Reed noted, “Here, the plaintiff was seeking 100 percent damages from a doctor who was, perhaps, only 10 percent responsible for the outcome.”

The court speaks

The court noted that Indiana’s Medical Malpractice Act was “plainly not intended to expand recovery for medical malpractice,” as plaintiffs had attempted to do. The Court of Appeals had noted the “potential for unjust outcomes” in these types of cases but suggested that providers “should not be overly eager to settle such claims.”

The Supreme Court squarely disagreed and stated these are the exact types of cases providers are incentivized to settle. Therefore, relying on doctors to refuse to settle claims does not constitute an “adequate safeguard against invasion of the Fund.”

The case has been remanded to the trial court for a damages determination.

“The Supreme Court’s opinion sends a strong message that damages must always be proportionate to a physician’s liability,” said Reed. “This case fairly restored physicians – as well as the PCF – to the same playing field as other tortfeasors and helped protect the integrity of the Fund.”

This is a benefit to all physicians practicing in Indiana and keeps rewards proportionate to fault.

Labels: ,

Friday, June 05, 2009

Maybe it's early dementia

The teleprompter must have been broken during this speech as our fearless leader appears to be reading from some notes. The problem is; he doesn’t even know the names of some of his closet cabinet members.

Hot Air » Blog Archive » Obamateurism of the Day

Yes, Mr. President, Robert Gates is your Secretary of Defense and Bill Gates owns Microsoft!

He is either hanging around Biden too much or he just isn’t as smart as people think!

Labels: ,

Thursday, June 04, 2009

Lou Dobbs Report

With the ongoing spending by the Obama administration along with his other radical ideas, I wonder where we stand with the amnesty program that was part of the stimulus package. I am not sure how many people saw this CNN special report by Lou Dobbs several weeks ago but it is worth replaying to look at just how ludicrous some of Obama's ideas are.



Obama's ideas are killing America. The Democrats are taking this opportunity to pass many failed bills they have been unable to pass before and using this difficult recession to pass more radical socialist agendas.

We will be paying for this for decades. Anyone critisizing how much money was spent on the war had better be questioning these provisions and policies

Besides ruining Healthcare, they are destroying our country and prolonging the financial problems for our grandchildren and great-grandchildren.

Labels: , ,

Wednesday, June 03, 2009

More on the Medicaid Cuts Proposed

The ISMA’s Physician Medicaid Task Force met Jan. 21 with Jeffrey Wells, M.D., director of the Office of Medicaid Policy and Planning (OMPP). Initial discussions centered on the proposed 5 percent holdback in reimbursement for physicians set for July 1. (See Jan. 5, 2009 ISMA Reports or visit here.)

Because of state budget constraints, OMPP plans the rate cut and a prescription drug carve-out that will place all Medicaid managed care organizations under one standardized drug list controlled by the state agency. The carve-out will net the state about a 35 percent rebate from drug suppliers, which would mean revenue of $40 million a year.

Dr. Wells told the task force members he believes the holdback to physicians would be unneeded if the pharmacy carve out moves forward.Michael Rinebold, ISMA director of Government Relations said the ISMA is waiting to learn more before lending support to the carve-out proposal. “Information is flowing daily between the ISMA and the Daniels’ administration,” Rinebold noted. “We also are awaiting committee hearings on these issues that will have an impact on the final outcome.”

Along with other key ISMA staff, Rinebold has met with Ann Murphy, the newly appointed Family and Social Services Administration secretary. Murphy replaced Mitch Roob who departed early in January.

I met with Baron Hill last week and he had minimal details on any specifics related to healthcare changes. But he did say that whatever Obama does, he supports him and it will be paid for.

**Information obtained from the ISMA

Labels: , ,

Tuesday, June 02, 2009

Vaccine Court Decision

On February 12, 2009 the federal "vaccine court" rejected claims that either the measles/mumps/rubella vaccine or thimerosal in vaccines caused children's autism.

The vaccine court which is shorthand for the Office of Special Masters of the U.S. Court of Federal Claims, administers a system that since 1988 has overseen all claims for compensation due to injury from vaccinations.

This ruling is a major setback for the more than 5,000 cases in which families claim that the MMR vaccine, either alone or due to the mercury-based thimerosal preservative in the vaccine, caused a child's autism.

Lawyers for the families and Department of Health and Human Services (the defendant in the suit) agreed to argue three test cases. In these cases, the vaccine court agreed to decide whether there was sufficient evidence to blame vaccines for autism -- and whether to pay damages to the families.

The decision, in all three cases, is no. The court formally rejected arguments that either the MMR vaccine or thimerosal caused the children's autism.

Although huge amounts of scientific evidence were heard in the case, the vaccine court's decision is a legal ruling and not scientific proof although the overwhelming amount of scientific studies have also supported this decision.

Labels:

Monday, June 01, 2009

The Newest Vaccine-Autism Study

The most recent review on vaccines and their non-link to Autism has been published in the February 15 issue of Clinical Infectious Diseases.

This study reaffirms what we have been stating for years; the new review shows no link between vaccines and autism. There are now more than 20 studies showing no link between vaccines and autism.

Although people should be reassured by these studies, there are still a group of parents who hold that vaccines cause autism and there is no factual information that is going to get them to change their irrational beliefs.

But continuing to educate the public is important to prevent further disease resurgence among children whose parents have refused vaccination based on this unfounded fear.

This current review describes how the three specific hypotheses that have been offered to suggest a theoretical link between vaccines and autism originated and summarizes the pertinent epidemiological data which refute them.

The first theory concerned the Measles-Mumps-Rubella (MMR) vaccine; the second, that it wasn't the MMR vaccine specifically, but a mercury-containing preservative, thimerosal; and the third, that the simultaneous administration of many vaccines is just too much for a young child's immune system.

The first hypothesis is that the combination MMR vaccine damages the gastrointestinal lining, thereby permitting the entrance of encephalopathic proteins and causing autism. After publication of a 1998 study in The Lancet suggesting an association between MMR vaccine and autism, 13 subsequent studies performed in 5 different countries showed no such link. The reviewers concluded that no data supported any causal connection between the MMR vaccine and autism, and that any apparent association was coincidental, because the MMR vaccine is typically administered at the age when symptoms of autism first emerge.

"While rates of immunization have been constant or declined, the incidence of autism has increased, and the rate of autism in vaccinated and unvaccinated children is the same," said Dr. King, who is professor and vice chair of Psychiatry and Behavioral Sciences and director of Child and Adolescent Psychiatry at University of Washington and Seattle Children's Hospital. "Neither the timing of onset, nor the severity of autism, differ whether or when a child gets immunized,"
The second hypothesis is that thimerosal, an ethyl mercury–containing preservative used for more than 50 years in some vaccines, causes central nervous system toxicity. However, the review describes 7 studies from 5 countries demonstrating that autism rates were not affected by the presence or absence of thimerosal in vaccines.

These 20 epidemiologic studies showing that neither thimerosal nor MMR vaccine causes autism were conducted by many different investigators, using a variety of epidemiologic and statistical methods.

The third hypothesis is that giving multiple vaccines simultaneously overwhelms or weakens the immune system. In rebuttal, the review authors point out that the immune system in childhood routinely processes far more antigenic material than the relatively small amount contained in vaccines, and that it is biologically implausible that vaccines overwhelm a child's immune system, even if the system is still immature.

Finally, the review authors note that autism is not triggered by an immune response but probably a more biological basis.

As I have written before, the risks of not being vaccinated are real and sometimes fatal but many of these parents who are now refusing to vaccinate their children have never witnessed first-hand these diseases and do not appreciate the risk of resurgence.

At some point we will have to ask when do we reach the tipping point and allow parents to not vaccinate their children. When do we say that exempting from vaccines is creating a problem not only for those children whose parents choose not to vaccinate but for those children in the community?

I believe in individual rights and parents can choose not to vaccinate their children. But from a society standpoint, we may have to say these children cannot attend a public school because the risk becomes too high and unnecessary.

All choices come with consequences and parents will need to accept the consequence of their decisions.

Irrational fears should not jeopardize those individuals who choose compliance!

Labels: ,