Friday, July 31, 2009

An Old Sea Story

Yes, we can learn a lot from an Old Sea Story passed down from generations. The story goes something like this:

There's an old sea story in the Navy about a ship's Captain who inspected his sailors, and afterward told the Chief Bosun that his men smelled bad. The Captain suggested perhaps it would help if the sailors would change underwear occasionally. The Chief responded, "Aye, aye sir, I'll see to it immediately!"

The Chief went straight to the sailors berth deck and announced, "The Captain thinks you guys smell bad and wants you to change your underwear.

Pittman, you change with Jones, McCarthy, you change with Witkowski, and Brown, you change with Schultz. Now get to it!!!"

THE MORAL:

Someone (Obama) may be promising "Change"; with subordinates implementing them (Pelosi, Reid, Frank, etc.) but don't count on things smelling any better!

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Thursday, July 30, 2009

P4P Results not as good

HealthDay News recently reported that the 2004 pay-for-performance scheme for family practices in England resulted in short-term quality of care improvements for asthma and diabetes, but not for heart disease, and ultimately was associated with a long-term slowing in the rate of improvement for all three conditions. The results are published in the July 23 issue of the New England Journal of Medicine.

The researchers analyzed quality of care measures at 42 family practices at two time periods (1998 and 2003) before the scheme implementation and during two time periods (2005 and 2007) after implementation. They found that rates of quality improvement for asthma, diabetes, and heart disease -- regardless of whether or not the aspects of care were associated with incentives -- significantly slowed after 2005.

They summarized it this way; "If the aim of pay for performance is to give providers incentives to attain targets, the scheme achieved that aim," "There may have been unintended consequences, including reductions in the quality of some aspects of care not linked to incentives and in the continuity of care."

This study validates what most physicians already know. The practice of Medicine is an art based on science. Arbitrarily setting goals will not necessarily improve patient care; but it may make the number-crunchers and attorneys in Washington happy.

If Obama and the Dems pass this radical agenda on healthcare, quality will worsen just as it is in other countries

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Wednesday, July 29, 2009

Freedoms lost



In a follow-up to the flowchart posted on monday and tuesday, here is another independent assessment of major concerns related to the Obama health care proposals.

Obama continues to use the straw man fallacy by making statements about having to do it his way or leaving it alone; but no one on the Republican side has ever stated we wanted to leave it exactly as it is.

This is typical Obama rhetoric that the media does not hold him accountable.

There are much better ways to improve our system without destroying it. And as a poster said yesterday, this really isn't about healthcare as much as it is about power and control from Obama and the Democrats.




The CBO also has published these graphs showing the tremendous debt and deficit Obama will cause.

You'll lose 5 key freedoms under Obama's health care plan - Jul. 24, 2009

5 freedoms you'd lose in health care reform

If you read the fine print in the Congressional plans, you'll find that a lot of cherished aspects of the current system would disappear.

By Shawn Tully, editor at large

July 24, 2009: 10:17 AM ET

NEW YORK (Fortune) -- In promoting his health-care agenda, President Obama has repeatedly reassured Americans that they can keep their existing health plans -- and that the benefits and access they prize will be enhanced through reform.

A close reading of the two main bills, one backed by Democrats in the House and the other issued by Sen. Edward Kennedy's Health committee, contradict the President's assurances. To be sure, it isn't easy to comb through their 2,000 pages of tortured legal language. But page by page, the bills reveal a web of restrictions, fines, and mandates that would radically change your health-care coverage.

If you prize choosing your own cardiologist or urologist under your company's Preferred Provider Organization plan (PPO), if your employer rewards your non-smoking, healthy lifestyle with reduced premiums, if you love the bargain Health Savings Account (HSA) that insures you just for the essentials, or if you simply take comfort in the freedom to spend your own money for a policy that covers the newest drugs and diagnostic tests -- you may be shocked to learn that you could lose all of those good things under the rules proposed in the two bills that herald a health-care revolution.

In short, the Obama platform would mandate extremely full, expensive, and highly subsidized coverage -- including a lot of benefits people would never pay for with their own money -- but deliver it through a highly restrictive, HMO-style plan that will determine what care and tests you can and can't have. It's a revolution, all right, but in the wrong direction.

Let's explore the five freedoms that Americans would lose under Obamacare:

1. Freedom to choose what's in your plan

The bills in both houses require that Americans purchase insurance through "qualified" plans offered by health-care "exchanges" that would be set up in each state. The rub is that the plans can't really compete based on what they offer. The reason: The federal government will impose a minimum list of benefits that each plan is required to offer.

Today, many states require these "standard benefits packages" -- and they're a major cause for the rise in health-care costs. Every group, from chiropractors to alcohol-abuse counselors, do lobbying to get included. Connecticut, for example, requires reimbursement for hair transplants, hearing aids, and in vitro fertilization.

The Senate bill would require coverage for prescription drugs, mental-health benefits, and substance-abuse services. It also requires policies to insure "children" until the age of 26. That's just the starting list. The bills would allow the Department of Health and Human Services to add to the list of required benefits, based on recommendations from a committee of experts.

Americans, therefore, wouldn't even know what's in their plans and what they're required to pay for, directly or indirectly, until after the bills become law.

2. Freedom to be rewarded for healthy living, or pay your real costs

As with the previous example, the Obama plan enshrines into federal law one of the worst features of state legislation: community rating. Eleven states, ranging from New York to Oregon, have some form of community rating. In its purest form, community rating requires that all patients pay the same rates for their level of coverage regardless of their age or medical condition.

Americans with pre-existing conditions need subsidies under any plan, but community rating is a dubious way to bring fairness to health care. The reason is twofold: First, it forces young people, who typically have lower incomes than older workers, to pay far more than their actual cost, and gives older workers, who can afford to pay more, a big discount. The state laws gouging the young are a major reason so many of them have joined the ranks of uninsured.

Under the Senate plan, insurers would be barred from charging any more than twice as much for one patient vs. any other patient with the same coverage. So if a 20-year-old who costs just $800 a year to insure is forced to pay $2,500, a 62-year-old who costs $7,500 would pay no more than $5,000.

Second, the bills would ban insurers from charging differing premiums based on the health of their customers. Again, that's understandable for folks with diabetes or cancer. But the bills would bar rewarding people who pursue a healthy lifestyle of exercise or a cholesterol-conscious diet. That's hardly a formula for lower costs. It's as if car insurers had to charge the same rates to safe drivers as to chronic speeders with a history of accidents.

3. Freedom to choose high-deductible coverage

The bills threaten to eliminate the one part of the market truly driven by consumers spending their own money. That's what makes a market, and health care needs more of it, not less.
Hundreds of companies now offer Health Savings Accounts to about 5 million employees. Those workers deposit tax-free money in the accounts and get a matching contribution from their employer. They can use the funds to buy a high-deductible plan -- say for major medical costs over $12,000. Preventive care is reimbursed, but patients pay all other routine doctor visits and tests with their own money from the HSA account. As a result, HSA users are far more cost-conscious than customers who are reimbursed for the majority of their care.


The bills seriously endanger the trend toward consumer-driven care in general. By requiring minimum packages, they would prevent patients from choosing stripped-down plans that cover only major medical expenses. "The government could set extremely low deductibles that would eliminate HSAs," says John Goodman of the National Center for Policy Analysis, a free-market research group. "And they could do it after the bills are passed."

4. Freedom to keep your existing plan

This is the freedom that the President keeps emphasizing. Yet the bills appear to say otherwise. It's worth diving into the weeds -- the territory where most pundits and politicians don't seem to have ventured.

The legislation divides the insured into two main groups, and those two groups are treated differently with respect to their current plans. The first are employees covered by the Employee Retirement Security Act of 1974. ERISA regulates companies that are self-insured, meaning they pay claims out of their cash flow, and don't have real insurance. Those are the GEs (GE, Fortune 500) and Time Warners (TWX, Fortune 500) and most other big companies.

The House bill states that employees covered by ERISA plans are "grandfathered." Under ERISA, the plans can do pretty much what they want -- they're exempt from standard packages and community rating and can reward employees for healthy lifestyles even in restrictive states.
But read on.


The bill gives ERISA employers a five-year grace period when they can keep offering plans free from the restrictions of the "qualified" policies offered on the exchanges. But after five years, they would have to offer only approved plans, with the myriad rules we've already discussed. So for Americans in large corporations, "keeping your own plan" has a strict deadline. In five years, like it or not, you'll get dumped into the exchange. As we'll see, it could happen a lot earlier.

The outlook is worse for the second group. It encompasses employees who aren't under ERISA but get actual insurance either on their own or through small businesses. After the legislation passes, all insurers that offer a wide range of plans to these employees will be forced to offer only "qualified" plans to new customers, via the exchanges.

The employees who got their coverage before the law goes into effect can keep their plans, but once again, there's a catch. If the plan changes in any way -- by altering co-pays, deductibles, or even switching coverage for this or that drug -- the employee must drop out and shop through the exchange. Since these plans generally change their policies every year, it's likely that millions of employees will lose their plans in 12 months.

5. Freedom to choose your doctors

The Senate bill requires that Americans buying through the exchanges -- and as we've seen, that will soon be most Americans -- must get their care through something called "medical home." Medical home is similar to an HMO. You're assigned a primary care doctor, and the doctor controls your access to specialists. The primary care physicians will decide which services, like MRIs and other diagnostic scans, are best for you, and will decide when you really need to see a cardiologists or orthopedists.

Under the proposals, the gatekeepers would theoretically guide patients to tests and treatments that have proved most cost-effective. The danger is that doctors will be financially rewarded for denying care, as were HMO physicians more than a decade ago. It was consumer outrage over despotic gatekeepers that made the HMOs so unpopular, and killed what was billed as the solution to America's health-care cost explosion.

The bills do not specifically rule out fee-for-service plans as options to be offered through the exchanges. But remember, those plans -- if they exist -- would be barred from charging sick or elderly patients more than young and healthy ones. So patients would be inclined to game the system, staying in the HMO while they're healthy and switching to fee-for-service when they become seriously ill. "That would kill fee-for-service in a hurry," says Goodman.

In reality, the flexible, employer-based plans that now dominate the landscape, and that Americans so cherish, could disappear far faster than the 5 year "grace period" that's barely being discussed.

Companies would have the option of paying an 8% payroll tax into a fund that pays for coverage for Americans who aren't covered by their employers. It won't happen right away -- large companies must wait a couple of years before they opt out. But it will happen, since it's likely that the tax will rise a lot more slowly than corporate health-care costs, especially since they'll be lobbying Washington to keep the tax under control in the righteous name of job creation.

The best solution is to move to a let-freedom-ring regime of high deductibles, no community rating, no standard benefits, and cross-state shopping for bargains (another market-based reform that's strictly taboo in the bills). I'll propose my own solution in another piece soon on Fortune.com. For now, we suffer with a flawed health-care system, but we still have our Five Freedoms.

Call them the Five Endangered Freedoms.

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Monday, July 27, 2009

The Brady FLOW CHART


Even though the Democrats are attempting to block this chart from being mailed out to Americans, here is Congressman Kevin Brady’s (R-TX) detailed flow chart of the complex health care reform being proposed. Brady is the lead House Republican on the Joint Economic Committee and his chart illustrates and identifies at least 31 new federal programs, agencies, commissions and mandates that accompany the unprecedented government takeover of health care in America.

Brady stated “Why should any patient be forced to give control of their health care over to this Faustian pit of Washington bureaucracy?” “This government takeover has only one guaranteed result: to tell Americans what doctors you can see, what treatments you deserve and what medicines you can have.”

There is not a single example of a government run program that is more efficient and cost effective compared to privately run organizations and businesses.

Don’t allow your healthcare to be taken over by this radical Congress and President!!

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Friday, July 24, 2009

The Congressman

A cowboy named Bud was overseeing his herd in a remote mountainous pasture in California when suddenly a brand-new BMW advanced toward him out of a cloud of dust.


The driver, a young man in a Brioni suit, Gucci shoes, RayBan sunglasses and YSL tie, leaned out the window and asked the cowboy, "If I tell you exactly how many cows and calves you have in your herd, Will you give me a calf?"


Bud looks at the man, obviously a yuppie, then looks at his peacefully grazing herd and calmly answers, "Sure, Why not?"


The yuppie parks his car, whips out his Dell notebook computer, connects it to his Cingular RAZR V3 cell phone, and surfs to a NASA page on the Internet, where he calls up a GPS satellite to get an exact fix on his location which he then feeds to another NASA satellite that scans the area in an ultra-high-resolution photo.


The young man then opens the digital photo in Adobe Photoshop and exports it to an image processing facility in Hamburg, Germany.


Within seconds, he receives an email on his Palm Pilot that the image has been processed and the data stored. He then accesses an MS-SQL database through an ODBC connected Excel spreadsheet with email on his Blackberry and, after a few minutes, receives a response.


Finally, he prints out a full-color, 150-page report on his hi-tech, miniaturized HP LaserJet printer, turns to the cowboy and says, "You have exactly 1,586 cows and calves."


"That's right. Well, I guess you can take one of my calves," says Bud.


He watches the young man select one of the animals and looks on with amusement as the young man stuffs it into the trunk of his car.


Then the Bud says to the young man, "Hey, if I can tell you exactly what your business is, will you give me back my calf?


"The young man thinks about it for a second and then says, "Okay, why not?"


"You're a Congressman for the U.S. Government", says Bud.


"Wow! That's correct," says the yuppie, "but how did you guess that?"


"No guessing required." answered the cowboy. "You showed up here even though nobody called you; you want to get paid for an answer I already knew, to a question I never asked. You used millions of dollars worth of equipment trying to show me how much smarter than me you are; and you don't know a thing about how working people make a living -- or about cows, for that matter. This is a herd of sheep........


Now give me back my dog!

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Thursday, July 23, 2009

More Obama Pandering

Here is another example from our friends at HotAir.com on Obama’s lack of knowledge, failure to research, or just plain deceit as he continually gives speeches for purely political gain. Of course the mainstream media would never question “The One” on any facts.

Never confuse the liberals with facts. It is all emotion for them.

I wrote last week that Barack Obama’s speech in Cairo last week provided a cornucopia of Obamateurisms, and this is yet another example. In his haste to butter up the Egyptians and the wider Muslim audience, Obama gave the Islamic world credit for an invention for which they don’t even get runner-up status:

As a student of history, I also know civilization’s debt to Islam. It was Islam – at places like Al-Azhar University – that carried the light of learning through so many centuries, paving the way for Europe’s Renaissance and Enlightenment. It was innovation in Muslim communities that developed the order of algebra; our magnetic compass and tools of navigation; our mastery of pens and printing; our understanding of how disease spreads and how it can be healed.


I’ll skip the vacuous but ambiguous credit Obama gives Al-Azhar for the Renaissance and Enlightment; the Irish will have some complaints about the former, and the rest of Europe over the latter. Specifically, though, Muslims didn’t invent the magnetic compass. Credit for that
usually goes to the Chinese, who experimented with needles and lodestones as far back as the second century BC. They built a complete compass by the early 12th century, and eventually Marco Polo would bring one back on his travels.

In fact, the Muslims didn’t even come in second. Europe developed the magnetic compass at the end of the 12th century, while the Arabic compass would come decades later.

Doesn’t the White House do research and fact-checking on Obama’s speeches? No, of course not. If they don’t do it for their economic policies, why bother to do it for foreign panderfests?

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Wednesday, July 22, 2009

New Medical Terminology



In the era of being politically correct the term "shaken baby syndrome" is being replaced by "abusive head trauma".

The American Academy of Pediatrics (AAP) wants the term used as they feel it is more scientific and the new terminology takes its name from the effect (trauma to a developing brain) and not the cause (in this case, shaking a newborn with weak neck muscles.)
Changing the names of disease has been a regular practice in Medicine as we gather more information about the underlying causes of diseases. Historically, other diseases such as consumption, lock jaw, apoplexy, and blood poisoning, although still around, have been replaced with tuberculosis, tetanus, stroke, and septicemia.

Precision with the description is helpful as there are forms of child abuse that cause the same brain abnormality without actually shaking the infant. Jurors hearing the term “shaken baby syndrome” oftentimes infer it is the only way to cause the injury and makes the burden of proof more difficult.

The AAP announced its policy statement in the May issue of Pediatrics.

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Tuesday, July 21, 2009

Broken Promises or a Reality Check

In this article, O’s Broken Promises BETSY MCCAUGHEY points out several more very disturbing facts related to the Obama healthcare plan and more of the radical socialization the Democrats have planned.

July 17, 2009 --

PRESIDENT Obama promises that "if you like your health plan, you can keep it," even after he reforms our health-care system. That's untrue. The bills now before Congress would force you to switch to a managed-care plan with limits on your access to specialists and tests.

Two main bills are being rushed through Congress with the goal of combining them into a finished product by August. Under either, a new government bureaucracy will select health plans that it considers in your best interest, and you will have to enroll in one of these "qualified plans." If you now get your plan through work, your employer has a five-year "grace period" to switch you into a qualified plan. If you buy your own insurance, you'll have less time.

And as soon as anything changes in your contract -- such as a change in copays or deductibles, which many insurers change every year -- you'll have to move into a qualified plan instead (House bill, p. 16-17).

When you file your taxes, if you can't prove to the IRS that you are in a qualified plan, you'll be fined thousands of dollars -- as much as the average cost of a health plan for your family size -- and then automatically enrolled in a randomly selected plan (House bill, p. 167-168).

It's one thing to require that people getting government assistance tolerate managed care, but the legislation limits you to a managed-care plan even if you and your employer are footing the bill (Senate bill, p. 57-58). The goal is to reduce everyone's consumption of health care and to ensure that people have the same health-care experience, regardless of ability to pay.

Nowhere does the legislation say how much health plans will cost, but a family of four is eligible for some government assistance until their household income reaches $88,000 (House bill, p. 137). If you earn more than that, you'll have to pay the cost no matter how high it goes.

The price tag for this legislation is a whopping $1.04 trillion to $1.6 trillion (Congressional Budget Office estimates). Half of the tab comes from tax increases on individuals earning $280,000 or more, and these new taxes will double in 2012 unless savings exceed predicted costs (House bill, p. 199). The rest of the cost is paid for by cutting seniors' health benefits under Medicare.

There's plenty of waste in Medicare, but the Congressional Budget Office estimates only 1 percent of the savings under the legislation will be from curbing waste, fraud and abuse. That means the rest will likely come from reducing what patients get.

One troubling provision of the House bill compels seniors to submit to a counseling session every five years (and more often if they become sick or go into a nursing home) about alternatives for end-of-life care (House bill, p. 425-430). The sessions cover highly sensitive matters such as whether to receive antibiotics and "the use of artificially administered nutrition and hydration."
This mandate invites abuse, and seniors could easily be pushed to refuse care. Do we really want government involved in such deeply personal issues?


Shockingly, only a portion of the money accumulated from slashing senior benefits and raising taxes goes to pay for covering the uninsured. The Senate bill allocates huge sums to "community transformation grants," home visits for expectant families, services for migrant workers -- and the creation of dozens of new government councils, programs and advisory boards slipped into the last 500 pages.

The most recent ABC News/Washington Post poll (June 21) finds that 83 percent of Americans are very satisfied or somewhat satisfied with the quality of their health care, and 81 percent are similarly satisfied with their health insurance.

They have good reason to be. If you're diagnosed with cancer, you have a better chance of surviving it in the United States than anywhere else, according to the Concord Five Continent Study. And the World Health Organization ranked the United States No. 1 out of 191 countries for being responsive to patients' needs, including providing timely treatments and a choice of doctors.

Congress should pursue less radical ways to cover the uninsured. We have too much to lose with this legislation.

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Monday, July 20, 2009

The Obama Parable

Once upon a time, I was invited to the White House for a private dinner with the President.

I am a respected businessman, with a factory that produces memory chips for computers and portable electronics.

There was some talk that my industry was being scrutinized by the administration, but I paid it no mind. I live in a free country. There's nothing that the government can do to me if I've broken no laws. My wealth was earned honestly, and an invitation to dinner with an American President is an honor.

I checked my coat, was greeted by the Chief of Staff, and joined the President in a yellow dining room. We sat across from each other at a table draped in white linen. The Great Seal was embossed on the china. Uniformed staff served our dinner.

The meal was served, and I was startled when my waiter suddenly reached out, plucked a dinner roll off my plate, and began nibbling it as he walked back to the kitchen. "Sorry about that," said the President. "Andrew is very hungry." "I don't appreciate..." I began, but as I looked into the calm brown eyes across from me, I felt immediately guilty and petty. It was just a dinner roll. "Of course," I concluded, and reached for my glass. Before I could, however, another waiter reached forward, took the glass away and swallowed the wine in a single gulp. "And his brother Eric is very thirsty," said the President. I didn't say anything. The President is testing my compassion, I thought. I will play along. I don't want to seem unkind.

My plate was whisked away before I had tasted a bite. "Eric's children are also quite hungry." With a lurch, I crashed to the floor. My chair had been pulled out from under me. I stood, brushing myself off angrily, and watched as it was carried from the room. "And their grandmother can't stand for long." I excused myself, smiling outwardly, but inside feeling like a fool.

Obviously I had been invited to the White House to be sport for some game. I reached for my coat, to find that it had been taken. I turned back to the President. "Their grandfather doesn't like the cold." I wanted to shout - that was my coat! But again, I looked at the placid smiling face of my host and decided I was being a poor sport. I spread my hands helplessly and chuckled.

Then I felt my hip pocket and realized my wallet was gone. I excused myself and walked to a phone on an elegant side table. I learned shortly that my credit cards had been maxed out, my bank accounts emptied, my retirement and equity portfolios had vanished, and my wife had been thrown out of our home.

Apparently, the waiters and their families were moving in. The President hadn't moved or spoken as I learned all this, but finally I lowered the phone into its cradle and turned to face him.

"Andrew's whole family has made bad financial decisions. They haven't planned for retirement, and they need a house. They recently defaulted on a sub-prime mortgage. I told them they could have your home. They need it more than you do."

My hands were shaking. I felt faint. I stumbled back to the table and knelt on the floor. The President cheerfully cut his meat, ate his steak and drank his wine. I lowered my eyes and stared at the small grey circles on the tablecloth that were tear drops.

"By the way," He added, "I have just signed an Executive Order nationalizing your factories. I'm firing you as head of your business. I'll be operating the firm now for the benefit of all mankind.

There's a whole bunch of Erics and Andrews out there and they can't come to you for jobs groveling like beggars." I looked up. The President dropped his spoon into the empty ramekin which had been his Crème Brule. He drained the last drops of his wine. As the table was cleared, he lit a cigarette and leaned back in his chair. He stared at me as I clung to the edge of the table as if it were a ledge and I were a man hanging over an abyss.

I thought of the years behind me, of the life I had lived. The life I had earned with a lifetime of work, risk and struggle.

Why was I punished?

How had I allowed it to be taken?

What game had I played and lost?

I looked across the table and noticed with some surprise that there was no game board between us. What had I done wrong?

As if answering the unspoken thought, the President suddenly cocked his head, locked his empty eyes to mine, and bared a million teeth, chuckling wryly as he folded his hands.

"You should have stopped me at the dinner roll," he said.

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Wednesday, July 15, 2009

Save our Healthcare


Free Our Health Care Now Online Petition

As Obama and his radical democratic congress attempts to destroy our nation and our healthcare, we want to do whatever it takes to combat the onslaught of his socialistic philosophy.

With that in mind, I am posting the link to the petition to save our healthcare and plan to leave it up for several days so concerned individuals will have the opportunity to sign it and become more educated on the drastic changes that Obama and the Democrats are proposing

Free Our Health Care Now Online Petition

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Tuesday, July 14, 2009

Medicare Scam

The Indiana State Medical Association sent this recent update on the ongoing Medicare scam and a reminder to guard against identity theft

The Centers for Medicare & Medicaid Services (CMS) has become aware of a scam whereby perpetrators send faxes to physician offices posing as the Medicare carrier or Medicare Administrative Contractor (MAC); the contractor for Indiana is National Government Services, Inc. (NGS).

The fax instructs physician staff to respond to a questionnaire by providing an account information update within 48 hours to prevent a gap in Medicare payments. The fax may have the CMS logo and/or the NGS logo to enhance the appearance of authenticity.

Medicare fee-for-service providers, including physician offices, are advised to be wary. If you receive a request for information in the manner described above, please check with NGS at (866) 276-8129 and also e-mail the ISMA’s
Jeri Biedenkopf or call her at (317) 454-7729, (800) 257-4762.

The bigger pictureNGS advises that a group of unknown individuals is soliciting personal identification information from physicians through various corrupt schemes. Once obtained, the personal information is being used to complete fraudulent Medicare provider applications for new practice locations.

After the new provider number is established, these individuals rapidly submit a large volume of claims to the Medicare carrier for payment.

Are you a victim and don’t know it?In one instance, a provider received a fax on what appeared to be the carrier’s letterhead. The fax, labeled “CMS File Update,” asked for documents, including copies of the physician’s medical license and driver’s license. The physician faxed the requested information to a toll-free “877” number.

The unknown party then submitted a Medicare provider application (CMS 855) under the provider’s name and set up a fake office in another city. The real physician discovered the fraud when a third-party insurer contacted him for a refund on a patient that was not his.
In another scenario, advertisements were placed in newspapers seeking resumes and other personal information. Prospective job applicants completed applications and submitted copies of medical and/or drivers’ licenses. This information was then used to establish new Medicare provider numbers and open bank accounts in the physicians’ names without their knowledge.
Protect your identity! If you recently received a phone call or fax from an alleged contractor employee asking for a “CMS File Update,” please contact the provider enrollment department immediately for verification.

If you have responded to an employment opportunity, which in retrospect seems suspicious, again contact the provider enrollment department so the information may be forwarded to the Program Safeguard contractor.

If you suspect you are the victim of provider identity theft, contact the OIG Hotline at 1-800-HHS-TIPS (1-800-447-8477) or
e-mail them.

Common sense tips:

Perform rigorous research when making application for joint venture opportunities with companies unknown to you.

Remove any unnecessary personal identifying information from outgoing correspondence.

Do not post your resume online, especially if it contains any confidential personal identifying information.

Remember no one from Medicare will contact you to verify your Medicare numbers; they already have this information.

Don’t leave laptops or other gateways into your personal information unattended.
Cancel computer access immediately when a person leaves your employment.

Perform rigorous research about a prospective employer prior to sharing any personal information.

Check with your carrier to see what practice locations are listed for you.


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Monday, July 13, 2009

Preventive Care to Improve Healthcare

It is a pleasure to have a guest author submit a blog posting on healthcare. Please visit her site as well. The link is at the end of the posting.

There’s a lot of discussion and debate going on about how healthcare facilities in this country can be improved. The problem with most of these arguments is that they all focus on treatment and care to be provided to patients and their associated costs. Hardly anyone raises their voice in favor of raising awareness about the preventive measures that can help reduce disease and illness by as much as 50 percent. If we are to bring about a significant improvement in the way our healthcare system is managed, we need to first:

· Educate people about preventive care: More programs must be developed to increase awareness about how preventive measures can help keep disease at bay. People should also learn that by preventing disease, they are helping to bring down the cost of healthcare all over the country. To this end, they need to be educated about the importance of a healthy diet, regular exercise, avoidance of stress, alcohol, drugs and cigarettes, and regular screenings and checkups for good overall wellbeing. Care should be taken to teach people about health aspects relating to every part of the body, from head to toe. Most diseases are expensive to treat because they are not diagnosed early; if people knew what the risk factors are for diseases like cancer, diabetes, strokes, cardiac arrests, hypertension and cholesterol (some of the most rampant and common health problems), they would be more aware of them and come in for diagnostic tests that could catch the disease at an early stage and thus facilitate a quicker recovery. In case of cancer, the earlier the tumor is detected, the better the chances of survival.

· Catch them young: The young of today become the old of tomorrow. It’s easier to teach them when they’re young because they’re more open to ideas and suggestions. Besides, the youth are aware of the problems the elderly face, and so are more receptive to trying out preventive measures that help keep disease at bay. Youngsters must be taught the value of good health early on so that they form good habits that last a lifetime. When relevant programs are developed and enforced all over the country, the efforts will bear fruit within a few years, and the healthcare costs of the country will definitely decrease with the decrease in the incidence of disease.

By-line:

This article is written by Kat Sanders, who regularly blogs on the topic of
how to become a radiology technician at her blog The Overwhelmed Student Blog. She welcomes your comments and questions at her email address: katsanders25@gmail.com.

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Friday, July 10, 2009

The Obama Frontier


Yes, a picture is worth a thousand words!

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Thursday, July 09, 2009

Obama the Deceiver


Here is a posting from Deceiver.com on the recent "Town Hall" meeting of Obama's on healthcare

Once again, his true color comes through. He truly is a deceiver but the liberal media continues to let him slide.
What exactly is a Town Hall Meeting? I checked with Professor Wikipedia and learned:
A town hall meeting is an informal public meeting derived from the traditional town meetings of New England. Similarly to those meetings, everybody in a community is invited to attend, voice their opinions, and hear the responses from public figures and elected officials.

Now that we’re all on the same page, let’s talk about President Obama’s “
Town Hall Meeting” yesterday.

The idea was to discuss Obamacare in an open forum where people could voice their opinions and ask questions. BUT it turns out all of the question-askers (and attendees, actually) were hand-picked, pre-screened Obama supporters. Even if you wanted to attend as a member of the voting public, no such luck.

Some of Obama’s questioners Wednesday were from friendly sources, including a member of the Service Employees International Union and a member of Health Care for America Now, which organized a Capitol Hill rally last week calling for an overhaul.

So much for being open and transparent and encouraging participation from the public…
Debby Smith, 53, told Obama of her kidney cancer and her inability to obtain health insurance or hold a job. The president hugged her — she’s a volunteer for his political operation — and called her “exhibit A” in an unsustainable system that is too expensive and complex for millions of Americans.

I have a lot of issues with this. One: Not only could she not obtain health insurance, but she couldn’t hold a job. Is Obamacare going to give people jobs too? I had no idea the plan was so magical.

Two: Does the president hugging her mean she was miraculously cured of cancer? I’ve heard that hope and belief in change can really work miracles in our lives. I don’t mean to be insensitive but hugging cancer patients really isn’t my idea of a solid plan for healthcare in America.

Three: A campaign volunteer!? Really?? Couldn’t Gibbsy or whoever planned this shindig have found a cancer patient who didn’t work on the campaign? It really just kills any hope one might have had for a genuine town hall meeting.

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Wednesday, July 08, 2009

Autisms newest reports

In a new report from HealthDay News, there is a new study indicating that Autistic children may be at risk for serious nutritional deficiencies and may have significantly different red blood cell fatty acid composition than non-autistic children.

This study lends more support to contradict the irrational belief by many that autism is caused by immunizations.

Michelle Zimmer, M.D., of the Cincinnati Children's Hospital Medical Center, and colleagues presented two studies. The first compared food variety scores from 19 autistic children and 20 controls. The children with autism had decreased food variety compared to controls (37 versus 53 foods per month), and 89 percent of the autistic children with a low food variety score were found to have a serious nutritional deficiency versus 11 percent of autistic children with normal food variety.

In the second study, the researchers compared red blood cell and plasma fatty acid composition in 21 autistic children ages 3 to 18, 10 of their non-autistic siblings, and 20 age-matched controls. Although there were no group differences in dietary intake, the researchers found that the autistic children had significantly lower levels of red blood cell docosahexanoic acid (2.15 versus 3.9) and total omega-3 fatty acids (3.1 versus 5.3). They also found that autistic children showed a trend toward higher red blood cell levels of monounsaturated fatty acids (15.4 versus 14.2). They observed no group differences in plasma fatty acid composition.

These results provide some evidence for the hypothesis of abnormal fatty acid metabolism in children with autism which is not caused by immunizations but rather part of their genetic makeup.

More studies into brain fatty composition, metabolism and its role in the pathophysiology of autism are warranted.

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Tuesday, July 07, 2009

Tick Removal Method



This has been a tremendous year for tick bites and we have seen more than the average compared to other years. Why is still unknown.
Here is a tick removal method passed along, but I cannot verify if it truly works. I see no downside in trying it. Other remedies include the match trick, tweezers, and excision.

This can be used on your children or your pets.

Apply a glob of liquid soap to a cotton ball.

Cover the tick with the soap-soaked cotton ball and swab it for a few seconds (15-20), the tick will come out on its own and be stuck to the cotton ball when you lift it away.

This technique has supposedly worked for some people consistently.

It is much less traumatic for the patient and pretty easy for anyone to try. So unless you have soap allergy, give it a shot now that we are in the tick season.

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Monday, July 06, 2009

Obamopoly


There is a new game in town and whether you like it or not, you are going to play.

The object of the game is to destroy American capitalism by having the governments take over everything!

In typical Obama fashion, you can choose a token that includes a bus, a teleprompter, a sprig of arugula or a waffle iron.

The real problem with the game is that nobody wins!

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Friday, July 03, 2009

Happy 4th


Let’s take time to celebrate the 4th of July and all of the sacrifices made for the freedoms we enjoy; even if they are short-lived under our current President and his radical agenda

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Thursday, July 02, 2009

New Laws for 2009

There have been more than 2,000 bills filed during the 2009 Indiana General Assembly, but only 183 of them were passed by both houses and sent to Gov. Daniels for consideration.

Governor Daniels vetoed three of these bills.

From a medical standpoint, here are some of the bills pertaining to health care that may be interest. All of these will become Law effective 1, 2009.

HB 1300 - Health plan requirements and study

This new law will require insurers to include with payment to the insured a notice in 24-point bold type instructing the insured that payment must be used to reimburse the provider if charges have not already been paid in full. The notice must state that paying the health care provider is the responsibility of the insured, and failure to make payment violates the law and may result in collection proceedings.

Also, the Indiana Department of Insurance (IDOI) will collect information regarding costs of initiation and operation to recognize assignment of benefits. The IDOI will report later this summer to the Health Finance Commission on its actuarial findings. The commission also will study the effect of open access clauses in insurance contracts as well as a provider’s ability to control patient panel mix.

SB 342 - Compensation for victims of violent crimes and wrongful death or injury of a child

With the signature of the governor, the Wrongful Death Act has now been expanded to include a fetus that has obtained viability – instead of a child who has taken its first breath.

The ISMA opposed this bill because of its potential impact on the Patient’s Compensation Fund. By modifying the definition of a child, the new law may create a second cap if the fetus is determined to be viable. The language does not define a viable fetus. That will be left up to the courts to decide.

HB 1210 - Psychiatry Loan Repayment Program

Aimed at attracting psychiatrists, psychologists, psychiatric nurses and public sector psychiatrists to practice in Indiana, several new mental health programs will be created. Among them are loan forgiveness programs, which will be administered by a mental health services development programs board.

However, there is no funding mechanism for these programs and there will be little direct effect on the efforts to encourage more medical students to enter these fields of practice. The new law does create the administrative structures to oversee these programs once funding becomes available.

HB 1573 - Various professions matters

This new law relieves physicians from liability for health records destroyed in a natural disaster, unless failure to maintain the records was caused by negligence of the provider. It also exempts from state license requirements sports physicians who provide treatment for their out-of-state teams.

HB 1593 - Practicing as a surgical technologist

As a surgeon, this statute will permit you to use a non-certified surgical technologist to assist with surgeries in facilities that allow non-certified surgical technologists to practice. This was the compromise language, instead of the original language that would have required use of a certified surgical technologist only to assist you with your procedures.

HB 1572 - Medicaid Managed Care

This law creates the Medicaid Managed Care Quality Strategy Committee, which will study issues with managed care organizations. The ISMA hopes to use the committee as a venue to address other physician concerns with Medicaid, such as low reimbursement, administrative red tape and overutilization of emergency department services.

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Wednesday, July 01, 2009

The Liberal Blame Game on Health Care

The Liberal media is at it again. In this article, CP24- Parents separated from baby after transfer to US hospital because they lack passports - CTV News, Shows and Sports -- Canadian Television, they only give information they want you to know and make it look as if the USA is this horrible country keeping families apart.

What they didn’t tell you is that Stinson has a criminal record. But since this is a real medical crisis you would think that the US and Canada could agree to temporary measures that would allow the parents to cross the border, even if under embassy supervision and security, to join their child.

But why is this reporter putting the blame on the USA? The real problem is access to the appropriate care in Canada with the Canadian healthcare system.

The entire country of Canada does not have enough neonatal intensive care beds precisely because of the rationing and the government run healthcare system. Sure they guarantee care, but in this case, they had to transfer across the border to the USA because we actually work on a free market system of supply and demand.

Let’s think about the healthcare system that caused this problem and compare it to the USA. This child would have gotten care in the US regardless of insurance status. Everyone in the USA gets emergency care regardless if they can pay. There is a difference between health insurance and access to care that some people elide for purposes of political argument. With EMTALA laws, no one in the USA gets turned away from emergency care for lack of ability to pay and this includes illegal aliens.

The question the reporter should have asked is why there wasn’t a NICU bed for the child in the entire country of Canada? The simple answer is that the government of Canada won’t pay for more. Socialized medicine doesn’t exist to expand supply to meet demand as we do in the United States. Their single-payer system exists to ration care as a cost-saving mechanism. In our free-market system, supply expands to meet demand, which is exactly why Canada was able to subcontract care out to a US hospital and save this child’s life.

The author writes as if it was mere luck that an NICU bed happened to be open when in actuality, the bed was available because of the function of our superior healthcare system.
These parents were separated from their child because of the fault of the Canadian government and their healthcare system.

This was not the fault of the US or our rules governing who can enter our country without a passport.

This should be taken as a key teaching point for all of congress and Americans as the Obama administration attempts to push a systemic overhaul of the US health-care system that will cost trillions and push us towards the same kind of single-payer system that Canada has.

Where would this child have been if the USA wasn’t there to once again save another country from their own reckless policies?

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