Friday, April 9, 2010

Pardon the Interruption

I am interrupting my breakdown of the health insurance law to share with all of you a conversation that I had on Twitter the other day. I just want to show how different most conservatives and liberals are when having a discussion. Also, I want to point out the kind of crap that conservatives have to deal with, that no one in the media wants to talk about, but they will run with any negative story about a conservative, without any kind of proof.

I am not including the Twitter handle of the person that I had this conversation with, as I just don't think that's the right thing to do. I have edited their posts so that the foul language is no longer spelled out.

My post: Hey Americans w/ brown skin-tone - Is it teapartiers or liberals calling u names like Oreo, Uncle Tom, etc? #teaparty #tcot @Theblacksphere

Their reply:
Hey AMNs w/ brown skin-tone - Is it teapartiers or libs calling u names lk Oreo, Uncle Tom/Why is "n" word on ur signs, b*tch?

My reply:
(their twitter handle) States that my teaparty signs have the "n" word on them - show me, cause I haven't seen them. Have u? #tcot #912

Their reply: /enjoy

2nd reply: And there's plenty more. You know it, too, you little b*tch. #tcot #gop Like you never saw any of this. LYING SOW.

My reply:
He's not calling black ppl nigger's - he saying Congress is treating us like slave's used 2b treated. I want 2 see "plenty more"

Their reply:
You are dumber than lint if you believe that. Get off my TL, you dumb, racist apologist for evil. F*CK YOU.

2nd reply: Google it. It's everywhere. Everyone knows what the f*ck you baggers are. Go and suck corporate balls, racist.

My reply:
Googled it & only found 1 pic u sent - funny, n conversation about name calling-did conservative or liberal call the other names?

Tuesday, April 6, 2010

Senate Health Insurance Reform Bill Part 3

Pages 728 through 739 are devoted to a new program within Medicare called a Shared Savings Program. It seems to be a program in which a group of providers of services and suppliers that work together to manage and coordinate care for Medicare fee-for-service beneficiaries. These groups will be called Accountable Care Organization (or ACO's) and will be assigned beneficiaries to manage (so, those on Medicare will have even fewer doctors to choose from). I'm just a little confused.....we stopped allowing banks to administer government's student loans to save the money. But we're paying these groups to administer government's health insurance plan in order to save money.

Pages 739 through 752 are devoted to a new pilot program on payment bundling. Basically, the Secretary will choose a mix of conditions that the government will pay one flat rate to the care provider's for, rather than paying for the actual services received. Sounds like a recipe for disaster to me. Granted it's just a pilot program, so it's not that they will necessarily implement the program after the 5 year pilot. We'll see how this one works out.

Pages 752 through 763 are devoted to an Independence at Home Demonstration Program. This program is designed to provide certain Medicare beneficiaries with 24-7 in-home care & medications (not that someone will necessarily be there 24-7, but that they will have someone available to be there at any time 24-7). This is another one of those policies that I'm not against in theory. Those with certain illnesses do need this kind of help, my problem is with the government running it. I know a couple people in two different cities currently receiving in-home care from the government. They receive terrible care and fraud abounds. I think they need to fix their current in-home care system before adding another one.

Pages 763 through 775 are devoted to a Hospital Readmission Reduction Program. Essentially, the Secretary will choose conditions that, if a hospital has a readmission for something relating to that condition, the hospital will not receive full payment for that readmission. Another recipe for disaster that will just raise our health care costs.

Physican assistants will be allowed to order post-hospital extended care services after January 1, 2011 (page 791).

In the years 2010 & 2011, the government will only pay 70% of the charges for a bone density test under medicare (pages 797-799).

$22,290,000,000 is no longer available to the Medicare Improvement Fund (page 800).

Pages 776 through 814 include the formation of, improvements to or extension of programs within the Medicare system. I don't really know how we're going to pay for all these - reduction in dollars to Medicare and expansion of Medicare. Does this make logical sense to anyone?

For the years 2011 & 2012, Medicare will be paying between 25 to 200% more to low-volume hospitals (pages 808-810).

A study will be done on improving payment accuracy which is just a fancy way of saying that they will reform what and how Medicare pays for services. For some services, we just don't know if payments will be going up or down. In other cases, we do know. For example, pages 828 through 832 contain information about Medicare Disproportionate Share Hospitals. Payments to these hospitals will be reduced to 25% and then will be adjusted by some factors that I don't really understand and then by minus 1% of the change in the percentage of individuals who are uninsured.

The Secretary will come up with a process for continually re-evaluating Codes under the Physician Fee Schedule to make sure they're not "misvalued". Part of the process includes repealing Section 4505(d) of the Balanced Budget Act of 1997 which states:

"(d) Requirements for Developing New Resource-Based Practice Expense Relative Value Units.-- (1) Development.--For purposes of section 1848(c)(2)(C)(ii) of the Social Security Act, the Secretary of Health and Human Services shall develop new resource-based relative value units. In developing such units the Secretary shall-- (A) utilize, to the maximum extent practicable, generally accepted cost accounting principles which (i) recognize all staff, equipment, supplies, and expenses, not just those which can be tied to specific procedures, and (ii) use actual data on equipment utilization and other key assumptions; (B) consult with organizations representing physicians regarding methodology and data to be used; and (C) develop a refinement process to be used during each of the 4 years of the transition period"

Monday, March 29, 2010

Senate Health Insurance Reform Bill Part 2

This post is a continuation of this post, breaking down what is in the new Health Insurance law.

States will no longer be allowed to require that individuals that becoming eligible for or remaining eligible for State medical assistance apply for enrollment employer-sponsored coverage (pages 422-423). In other words, an individual may be able to get coverage through their employer at the same cost to them as through the government, but we cannot even check to see if that is possible. But I do understand this section, in that, States are REQUIRED to automatically enroll individuals in government programs if they are found eligible for them.

Medicaid will be extended to former foster children until the age of 25 (pages 424-425).

The Federal government will increase payments to the States for CHIP by 23%, but the States cannot have eligibility standards are are more restrictive than the Federal government's standards (pages 432-434). Nowhere does it say that a States does not have to take this increase and, thus, CAN set eligibility standards more restrictive than the Federal government's. The income standards for CHIP will be set according to modified gross income - not net income (page 436).

Currently there is a sunset for reimbursement of Medicare part B services furnished by certain Indian Hospitals & Clinics. Because I do not have the Social Security Act in front of me, I do not know when these payments are suppose to end. But, now this sunset has been removed and they will forever receive these payments (page 560). Just another example of how sunsets almost never come to pass. Also, I see nothing in here about how much this will cost, thus was not figured in the CBO estimate.

Each States is required to conduct a statewide needs assessment within the next 6 months that identifies high risk communities (premature births, poverty, crime, substance abuse, etc), the quality & capacity of existing programs for early childhood home visitations in the State and the State's capacity for providing substance abuse treatment and counseling services (pages 561-563). If the state does not conduct this assessment and report to the Federal government, they will not receive their fair share of the money that the citizens of that State have paid in tax dollars to the Federal government.

This is exactly why the Federal government should not be redistributing our tax dollars. Stop taking our tax dollars and only giving them back to us, if you deem us worthy.Who's suppose to have the power in this country, the Fed's or the People? And the point of these assessments? So the Federal government can have more control over the States via grants to States for Early Childhood Home Visitation Programs. A State can refuse the grants, but, then the Federal government just implements a Early Childhood Home Visitation program through a non-profit organization (page 582). What in the Constitution gives the Federal government authority to do any of this? Why do we continue to allow the Federal government to take our money? Why do we continue to allow the Federal government have so much control over the way our States deal with State issues?

Everyone is eligible to receive these Early Childhood Home Visitations, but priority will be given to the poor (another redistribution of wealth social program). It doesn't say what these Early Childhood Home Visitations consist of, but it will all boil down to the government telling you what you should and should not do as a parent. Do we really want to give the government the power to enter our homes and tell us how to parent? Sure, you won't be required to participate in these visitation services, right now. But States will be required to improve according to their assessment, eventually leading to mandatory visitations. I have so much more I could say, but on with what more is in the bill.......

The government will now be conducting research & development on postpartum depression (pages 588-589). Again, what give the Federal government the authority to do such a thing? Who does better R & D, then those that have a stake in the cure (like making a profit by creating an effective cure)?

The Director of the National Institute of Mental Health will conduct research on the consequences for women of resolving a pregnancy and will again be providing grants to States to provide services to individuals with a postpartum condition (pages 590-591). Then there's a section that states "The Secretary shall conduct a study on the benefits of screening for postpartum conditions" (page 596). So, what kind of system will be implemented by the government to screen us for postpartum conditions?

The bill goes on into more allotment's & grant's that contain more Federal requirements and reporting on Personal Responsibility Education Programs (pages 596-602). A Personal Responsibility Education Programs are designed to educate adolescents on sex ed and "Adulthood Preparation Subjects (pages 602-604). Adulthood Preparation Subjects are relationships, self-esteem, friendships, dating, romantic involvement, marriage, healthy attitudes & values about adolescent development, body image, racial & ethnic diversity, parent-child communication, developing skills for employment, independent living, work-place productivity, goal-setting, decision making, interpersonal skills, stress management, etc (pages 604-605). These things are the parents responsibility to teach, NOT the government's. What horrible subjects to give our Federal government the power to teach our children! Parents should be outraged.

Of the funds set aside for the above allotment's & grant's - 5% are required to go to grants for Indian Tribes or Tribal Organizations (page 606). So much for all races be equal.

Pages 613 to 642 devoted to a Hospital Value-Based Purchasing Program, but I don't really understand it, so I cannot tell you what it means. Well, except that on page 631 states "The Secretary shall promulgate regulations to carry out the Program". Another section devoted to enacting more government regulations.

Doctor's payment's will be reduced if they do not satisfactorily submit data on quality measures (page 645-646). How many more doctor's will those on government run health care loose due to further government regulations?

I do not understand the next number of pages, but I see that the government will be making public reports on doctors, hospitals, care providers, etc available to the public. You could say that this isn't such a bad thing, except it gives too much power to the government (do what we say or we'll post a negative report).

Section 3012 (a) says "The President shall convene a working group to be known as the Interagency Working Group on Health Care Quality" (page 688). I don't understand why the PRESIDENT is convening a working group. Why are we giving the President this power? I'm suspicious. This group will consist of senior level representatives from a number of government agencies, departments, etc including the Federal Trade Commission, the National Highway Traffic Safety Administration, the Department of Labor and any other agencies & departments as determined by the President (page 690).

Pages 692 through 706 address the expansion Medicaid Quality Measurement Program and providing grants for this program. I don't really know what this program is, except that the services must be provided free of charge.