Health Care Reform--What You Don't Know but Should!

After hearing the POTUS with the TOTUS blather on in broad generalities about health care reform last night..."we need change , we need it now, the stars are aligned, the system is broken, I and the Congress have the best healthcare on the planet, oh, did I mention that I have the best healthcare on the planet...and I have a doctor that follows me around all of the time and, oh, by the way, you can take the cheap pill.", I received this from Smart Girl Politics about the things that are REALLY in the bill and you can make your own informed decisions. I know that it will take time to read all of this---that is why our legislators don't.... but it is worth it to arm ourselves with facts from the actual bill to combat the misinformation that we are being fed by the axis of evil...er... I meant the administration.

All 1017 pages of HR3200 can be accessed for your bathroom reading enjoyment.


Peter Fleckstein (aka Fleckman) is reading it and has been posting his findings on Twitter. Robert Wenzel from www.economicpolicyjournal.com has summarized Fleckstein's findings in his July 20, 2009 post. (Note: All comments are Fleckman's and remember that they are written for 140 character Tweets).

Pg 22 of the HC Bill MANDATES the Govt will audit books of ALL EMPLOYERS that self insure!!
Pg 30 Sec 123 of HC bill - THERE WILL BE A GOVT COMMITTEE that decides what treatments/benes u get
Pg 29 lines 4-16 in the HC bill - YOUR HEALTHCARE IS RATIONED!!!
Pg 42 of HC Bill - The Health Choices Commissioner will choose UR HC Benefits 4 you. U have no choice!
PG 50 Section 152 in HC bill - HC will be provided 2 ALL non US citizens, illegal or otherwise
Pg 58HC Bill - Govt will have real-time access 2 individs finances & a National ID Healthcard will b issued!
Pg 59 HC Bill lines 21-24 Govt will have direct access 2 ur banks accts 4 elect. funds transfer
PG 65 Sec 164 is a payoff subsidized plan 4 retirees and their families in Unions & community orgs (ACORN).
Pg 72 Lines 8-14 Govt is creating an HC Exchange 2 bring priv HC plans under Govt control.
PG 84 Sec 203 HC bill - Govt mandates ALL benefit pkgs 4 priv. HC plans in the Exchange
PG 85 Line 7 HC Bill - Specs for of Benefit Levels for Plans = The Govt will ration ur Healthcare!PG 91 Lines 4-7 HC Bill - Govt mandates linguistic approp svcs. Example - Translation 4 illegal aliens
Pg 95 HC Bill Lines 8-18 The Govt will use groups i.e., ACORN & Americorps 2 sign up indiv. for Govt HC plan
PG 85 Line 7 HC Bill - Specs of Ben Levels 4 Plans. #AARP members - U Health care WILL b rationed-
PG 102 Lines 12-18 HC Bill - Medicaid Eligible Indiv. will b automat.enrolled in Medicaid. No choice
PG 124 lines 24-25 HC No company can sue GOVT on price fixing. No "judicial review" against Govt Monop
PG 127 Lines 1-16 HC Bill - Doctors/ #AMA - The Govt will tell YOU what u can make.
PG 145 Line 15-17 An Employer MUST auto enroll employees into pub opt plan. NO CHOICE
PG 126 Lines 22-25 Employers MUST pay 4 HC 4 part time employees AND their families.
Pg 149 Lines 16-24 ANY Emplyr w payroll 400k & above who does not prov. pub opt. pays 8% tax on all payroll
pg 150 Lines 9-13 Biz w payroll btw 251k & 400k who doesnt prov. pub. opt pays 2-6% tax on all payroll
Pg 167 Lines 18-23 ANY individual who doesnt have acceptable HC accrdng 2 Govt will be taxed 2.5% of inc
Pg 170 Lines 1-3 HC Bill Any NONRESIDENT Alien is exempt from indiv. taxes. (Americans will pay)
Pg 195 HC Bill -officers & employees of HC Admin (GOVT) will have access 2 ALL Americans finan/pers recs
PG 203 Line 14-15 HC - "The tax imposed under this section shall not be treated as tax" Yes, it says that
Pg 239 Line 14-24 HC Bill Govt will reduce physician svcs 4 Medicaid. Seniors, low income, poor affected
Pg 241 Line 6-8 HC Bill - Doctors, doesnt matter what specialty u have, you'll all be paid the same
PG 253 Line 10-18 Govt sets value of Dr's time, prof judg, etc. Literally value of humans.
PG 265 Sec 1131 Govt mandates & controls productivity for private HC industries
PG 268 Sec 1141 Fed Govt regulates rental & purchase of power driven wheelchairs
PG 272 SEC. 1145. TREATMENT OF CERTAIN CANCER HOSPITALS - Cancer patients - welcome to rationing!
Page 280 Sec 1151 The Govt will penalize hospitals 4 what Govt deems preventable readmissions. (MY NOTE: THEY ALREADY DO THIS!!)
Pg 298 Lines 9-11 Drs, treat a patient during initial admiss that results in a readmiss-Govt will penalize u.
Pg 317 L 13-20 OMG!! PROHIBITION on ownership/investment. Govt tells Drs. what/how much they can own.
Pg 317-318 lines 21-25,1-3 PROHIBITION on expansion- Govt is mandating hospitals cannot expand
Pg 321 2-13 Hospitals have oppt to apply for exception BUT community input required. Can u say ACORN?!!
Pg335 L 16-25 Pg 336-339 - Govt mandates estab. of outcome based measures. HC the way they want. Rationing
Pg 341 Lines 3-9 Govt has authority 2 disqual Medicare Adv Plans, HMOs, etc. Forcing peeps in2 Govt plan
Pg 354 Sec 1177 - Govt will RESTRICT enrollment of Special needs ppl! WTF. My sis has down syndrome!!
Pg 379 Sec 1191 Govt creates more bureaucracy - Telehealth Advisory Cmtte. Can u say HC by phone?
PG 425 Lines 4-12 Govt mandates Advance Care Planning Consult. Think Senior Citizens end of life
Pg 425 Lines 17-19 Govt will instruct & consult regarding living wills, durable powers of atty. Mandatory! (MY NOTE: THIS WILL PLEASE THE ATTORNEYS!)
PG 425 Lines 22-25, 426 Lines 1-3 Govt provides apprvd list of end of life resources, guiding u in death
PG 427 Lines 15-24 Govt mandates program 4 orders 4 end of life. The Govt has a say in how ur life ends
Pg 429 Lines 1-9 An "adv. care planning consult" will b used frequently as patients health deteriorates
PG 429 Lines 10-12 "adv. care consultation" may incl an ORDER 4 end of life plans. AN ORDER from GOV
Pg 429 Lines 13-25 - The govt will specify which Doctors can write an end of life order.
PG 430 Lines 11-15 The Govt will decide what level of treatment u will have at end of life
Pg 469 - Community Based Home Medical Services=Non profit orgs. Hello, ACORN Medical Svcs here!!?
Page 472 Lines 14-17 PAYMENT TO COMMUNITY-BASED ORG. 1 monthly payment 2 a community-based org. Like ACORN?
PG 489 Sec 1308 The Govt will cover Marriage & Family therapy. Which means they will insert Govt in2 ur marriage
Pg 494-498 Govt will cover Mental Health Svcs including defining, creating, rationing those svcs

These comments get us less than half way into the 1017 page bill...but this is what the Administration does not want we, the commoners, the unwashed masses to find out, which is why there is such a hurry to get this through. SLOW DOWN AND READ THE FINE PRINT.

Cap and Trade from the Small Business Perspective.....the McArthur Saga Continues

St. Louisans are proud of our new hometown hero---no, not Albert Pujols---Dave McArthur. Yesterday evening Dave made his national television debut on Glenn Beck's show on Fox News, but immediately afterward, he was also interviewed on Fox Business Channel's Nightly Scoreboard with David Asman. The common man did himself proud and he has become the next Mr. Smith to take on Washington.




Dave McArthur is now the person around whom a movement is beginning to coalesce. He has become a champion of small business against the Cap and Trade issue that could sound the death knell for many small businesses, particularly in the Midwest where 85% of our energy is coal based and as a result we will be paying dearly for our energy under Cap and Trade. Midwestern business will be hit hard, but so will all of the families of all economic standings every time they turn on a light, heat or cool their homes or go to the grocery store.

Cap and Trade has narrowly passed the House of Representatives and our voting block can be turned against those representatives who voted for it. 1/3 of the Senate and all of the representatives will be up for election in 2010. Every representative is potentially vulnerable in 2010 and this is the time to do some major house cleaning.

If it has been a while since you thought about the legislative process, think about this...The House of Representatives has a bill introduced. It is sent to committee for consideration, debate, and amendment. When it is in its final form, it is voted on by the committee and if passed, it moves to the floor where it is voted upon. This is how Cap and Trade rapidly moved through the House and was narrowly passed. Now Cap and Trade must go to the Senate for consideration. In the Senate, a similar process occurs and the bill goes to committee where it is again debated, marked up and it may be changed. When it is voted out of committee, it may be significantly different from the bill passed in the House. If the Senate passes a version of the bill that is different from that passed by the House of Representatives, then the bill goes to a conference committee composed of both Senators and Representatives. Here it is "perfected" and differences must be resolved before it is sent to the President for action.

This process gives all of us ample opportunity to be vocal all through the process. Senator Jim DeMint was on Laura Ingraham's radio show earlier this week and he clearly indicated that what gets the ear of a legislator is a barrage of loud voices with one point of view--this is a block of votes! A block of votes is what keeps a politician employed. A block of votes is what can also send a legislator home for good. Dave McArthur has the potential to deliver a block of votes that could send Russ Carnahan home in 2010 if Rep. Carnahan sells his constituents down the river in this Cap and Trade legislation. Those of us who scream at the TV have a new role model in Dave McArthur who got tired of talking to the TV and decided to take his point of view public where he has certainly gotten the ear of legislators and the media. BRAVO DAVE!!!!

St. Louis' Own David and Goliath Story

Since the passage of Cap and Trade in the US House of Representatives, St. Louisans have watched as a local David and Goliath story has been brewing. This story is about a real David who has left a mark on the local political machine. It all started when the House of Representatives rammed through the monstrous Cap and Trade bill on June 26 by a vote of 219-212.

In the brief run-up to passage of the bill, Missouri Representatives leaning toward or favoring the bill were bombarded with faxes, letters and phone calls from constituents asking them NOT to vote for the bill as Missouri (along with most of the central United States) is in the cross hairs of the cap and trade debacle due to the fact that electricity production in this part of the US is primarily coal based. The burden on the central US from cap and trade is predicted to be the most punitive and costly for the regular citizens and for businesses in this area. In the 2nd district of Missouri, Russ Carnahan (D) was one of the Cap and Trade proponents who was begged by constituents NOT to vote for the bill, but to no avail. Rep. Carnahan voted for Cap and Trade and the saga began....

The real David, Dave McArthur, of McArthur's Bakery, a family owned baking business that has been an icon in St. Louis for over 50 years stepped up to sling the first pebble. After Cap and Trade was passed, Dave wrote a letter to Rep. Carnahan expressing his displeasure and went one step further. He put notice on the marquee sign outside of his flagship bakery in South St. Louis County (in Carnahan's district) that "Russ Carnahan voted to ... close us and other ... small business." This salvo was but the first in a story that has snowballed to crescendo with Dave McArthur being enlisted to appear on Glenn Beck's TV show on Fox News on Thursday, 7/9/09.

It was only a very short time until Dave McArthur was contacted by Rep. Carnahan's staff asking that the sign come down and Dave and his brother Randy were invited to meet with Carnahan's staff. Dave told his story on a local talk radio station and garnered a large group of local supporters. Dave's brother Randy McArthur was tagged to speak at the St. Louis Independence Day Tea Party held in Washington Missouri. On 7/7/09, the story was picked up by Fox News and covered nationally. With the national coverage, the McArthur brothers have gained a national following, receiving supportive phone calls and emails from all over the country.

The much awaited meeting happened yesterday, 7/7/09 at Carnahan's district office and Rep. Carnahan did not attend....he sent his minions to meet with the McArthurs. In a rather astonishing exchange, Dave was told...."The bill is not law yet. It has to go to the Senate. In the Senate it will be perfected to be a good bill. The people that you need to talk to are your senators who will be dealing with the bill, Senator McCaskill and Senator Bond's staff." You can hear the entire discussion here at the bottom of the page, under AUDIO... 07.08 Dave McArthur.

Dave and his brother Randy are just ordinary small businessmen in St. Louis. They are not public speakers. They are little people just like Joe the Plumber who was catapulted into the limelight by asking a simple question of then candidate Obama last year. By using the bully pulpit of their marquee sign, they, too, have been thrust into the spotlight and have risen to the challenge by putting themselves and their business on the line for something that they believe in. This is true grass roots activism from the conservative perspective. You can be sure that Russ Carnahan will be watched carefully in the next weeks and months and he will be marked for ouster in 2010 by a growing group of small businessmen and constituents who are very unhappy that he has not served the interests of the people who put him in office.

Sarah Palin Declares Her Independence

Today, in a bombshell of an announcement, Alaska's governor Sarah Palin declared that not only would she not run for re-election for governor in 2010, but she would not finish out her term. In fact, she announced that she would turn over the reins of Alaska's government to Lieutenant Governor Sean Parnell on July 26. The announcement was apparently a huge secret, the press conference was not announced far in advance, and the magnitude of the announcement sent the political wonks, Republican higher ups and Sarah Palin followers in general into a frenzy.

Her detractors gloated predictably

"It was an almost impossible mission, but in resigning from office with 17 months to go in her first term, Sarah Palin has made herself the bull goose loony of the GOP."

and some are waiting for the other shoe to drop ala Mark Sanford. More rational detractors opined that this was political suicide. The DNC already has pointed out that her decision is weak and the fodder for political ads is ready should she run for national office.

Her supporters say that this shows she is a real independent. They argue that her location in Alaskan isolation make any political aspirations all the more difficult to forge. The Governor has a book advance and is able to command speaking engagements which will further her ability to move her political aspirations ahead, but not while she is Governor of a distant state. Her legal expenses incurred in defending herself against frivolous charges have been a drain on the Palin personal resources and her family has borne the brunt of scathing smears from liberal detractors. All apparent reasons why she has taken the gamble of abdication.

A telling phrase from her press conference suggests that she may or may not continue to be a Republican loyalist, (payback for the trashing she received from her own party after the election was lost)

"I WILL support others who seek to serve, in or out of office, for the RIGHT reasons, and I don't care what party they're in or no party at all."

Perhaps she is positioning herself to be a part of an third party effort or an independent candidate.

Whatever the outcome, this is her personal Independence Day. She has rock star appeal when she appears publicly. She has a dedicated following of conservative men and women. She has secured some measure of financial security for herself and her family. She is young and still has a long political future ahead of her should she choose that path. She has paved the way for freedom to learn, write and polish her world view (that Katie Couric and Charlie Gibson felt that she did not possess). Margaret Thatcher, who is a fan of Sarah Palin, had to undergo a reformation to become more polished and properly spoken before she entered politics. Now Sarah Palin has the opportunity to do the same and whether she is a spokesperson or a fundraiser for conservative candidates or a candidate in her own right, Sarah Palin has now been set free.

The YOU SCARE ME Letter

I received this letter in an email from an acquaintance who suggested that I pass it on. It speaks for itself.

AN OPEN LETTER TO PRESIDENT OBAMA

By Lou Pritchett

Dear President Obama:

You are the thirteenth President under whom I have lived and unlike any of the others, you truly scare me.

You scare me because after months of exposure, I know nothing about you.

You scare me because I do not know how you paid for your expensive Ivy League education and your upscale lifestyle and housing with no visible signs of support.

You scare me because you did not spend the formative years of youth growing up in America and culturally you are not an American.

You scare me because you have never run a company or met a payroll.

You scare me because you have never had military experience, thus don't understand it at its core.

You scare me because you lack humility and 'class', always blaming others.

You scare me because for over half your life you have aligned yourself with radical extremists who hate America and you refuse to publicly denounce these radicals who wish to see America fail.

You scare me because you are a cheerleader for the 'blame America' crowd and deliver this message abroad.

You scare me because you want to change America to a European style country where the government sector dominates instead of the private sector.

You scare me because you want to replace our health care system with a government controlled one.

You scare me because you prefer 'wind mills' to responsibly capitalizing on our own vast oil, coal and shale reserves.

You scare me because you want to kill the American capitalist goose that lays the golden egg which provides the highest standard of living in the world.

You scare me because you have begun to use 'extortion' tactics against certain banks and corporations.

You scare me because your own political party shrinks from challenging you on your wild and irresponsible spending proposals.

You scare me because you will not openly listen to or even consider opposing points of view from intelligent people.

You scare me because you falsely believe that you are both omnipotent and omniscient.

You scare me because the media gives you a free pass on everything you do.

You scare me because you demonize and want to silence the Limbaughs, Hannitys, O'Relllys and Becks who offer opposing, conservative points of view.

You scare me because you prefer controlling over governing.

Finally, you scare me because if you serve a second term I will probably not feel safe in writing a similar letter in 8 years.



Lou Pritchett



Note: Lou Pritchett is a former vice president of Procter & Gamble whose career at that company spanned 36 years before his retirement in 1989, and he is the author of the 1995 business book, Stop Paddling & Start Rocking the Boat. Mr. Pritchett confirmed that he was indeed the author of the much-circulated "open letter." “I did write the 'you scare me' letter. I sent it to the NY Times but they never acknowledged or published it. However, it hit the internet and according to the ‘experts’ has had over 500,000 hits

Good Nurses Make Good Doctors

While surfing the internet for sites with medical flavor, I was pleased to find a great site for nurses. SCRUBS is a refreshing and bright ezine where the needs of today's nurse are addressed. When I was a medical student and later a resident in obstetrics and gynecology, medicine was different th an it is practiced today. There was less technology and lots more hands on interaction with the patients. Some of the most valuable bedside lessons that I learned, however, did not happen at the hands of my professors, but rather from the nurses who spent hours at the patient's bedside. Old school nurses taught me to "read" the patient's body language as it changed in the course of their illness or labor, to talk with them in general conversation to find out more about their attitudes and personalities, and to individualize my care to the patient and try to define ways to make them compliant under hardship.

Today it is a different world in the field of health care and, in certain ways, the change has not been for the better. The role of the physician and the nurse are modified in ways that we could hardly have predicted 30 years ago. The nurse and the physician have new rules to abide by in terms of patient length of stay and appropriate testing. Much more is required of both physicians and nurses in our litiginous society. Technology has enabled both physicians and nurses to be impersonal with telemetry at the nursing station and the EMR, with its cookie cutter phrases and check marked boxes, replacing carefully written notes.

Scrubs provides information for all aspects of the nurse's life. There are health, money, humor and lifestyle features, inspirational stories and even a sassy doctor/nurse point/ counterpoint column in which a doctor and a nurse address a specific topic so that you can get inside the other's head and see where they are coming from! With Showtime's Nurse Jackie being promoted heavily in print and even on billboards, there are also an entertainment area. To check the pulse of the readership, polls are sprinkled over the site. For the nurse who is stretched too thin due to "staffing for census" or fatiqued from 12 hour shifts, this site is an oasis for rejuvenation and a reminder of why we chose the medical field in the first place.



Scrubs

License Bureau, Post Office...Healthcare???

As Barack Obama rolls out his ambitious agenda for the USSA and continues to spend our way to oblivion, some have questioned whether he will have to put some of his projects on the back burner as public sentiment and buyer's remorse starts to set in. Some have said that Cap and Trade may have to go on the back burner for the time being, but that health care may be "fixed" this year.

The issue of health care in the USSA has been a topic of great debate for literally decades. My father passed away in 1989 and years before that, in the early years of my career in medicine, he gave me a bumper sticker that said "If You Like the Post Office You Will Love National Health care." The issue of health care and what is wrong with it is complicated, crosses multiple sectors of the economy and I don't have the solution. What I do have is a caution.

Friday, 4/17/09, Red State's Jeff Emanuel had a post entitled, "Who Should have the Final Say About Your Medical Care: Your Doctor, or Government Bureaucrats?" In the article a young woman in Georgia who was severely disabled from birth and required intensive home care had her benefits cut by 15% over the objections of her physician. These benefits were from federal and state medicaid. The suit has been in the courts for several years and has worked its way to the 11th US Circuit Court of Appeals where the ruling was overturned and the courts ruled that the physician and not the bureaucratic machine should determine the patient's care.

Rhonda Meadows, commissioner of Georgia’s Department of Community Health,
immediately appealed the ruling to the 11th U.S. Circuit Court of Appeals on behalf of the Peach State. Her argument was that state officials, not doctors, should have final say in what treatments and care patients within their purview require. Florida and Alabama, which fall under the 11th Circuit’s jurisdiction and will have to abide by its ruling, filed an amicus brief with the Atlanta-based court.

Is this a glimpse of what government health care would look like? Those who are heavy weight on the system are cut back and left to wither and die?

Many hospitals today are employing ethicists. These ethicists are doctors who are employed to "help" families faced with end-of-life issues work through the emotional mine field of decision making . While at times, these decisions may seem clear, they become muddled when the ethicist is called in on behalf of the hospital to meet with the families because the patient's care has become long and costly...those high ticket patients whose hospitalizations have languished over long times, without an end in sight....these are patients who have become respirator dependent after a catastrophic event like a heart attack or stroke, who have had multiple complications after emergency major surgery or who have multiple comorbid conditions complicating what otherwise would have been a much simpler procedure. Many of these patients have Medicare or Medicaid and the reimbursement for their care is low. Many of these patients are patients for whom the hospital will have to eat large amounts of the bill. The growing use of the ethicist physician is in some ways a disturbing trend that could become more widely used in a government health system where rationing of resources must, by default, be used. What better group to ration but the "big ticket" patient who is burning through resources without an end in sight. The ethicist can be used to gently "help" the family see the folly of continuing the fight for an unworthy life and justify withholding of supportive measures. Where the line is to be drawn is anyone's guess, but it could well be a line that moves depending on the number of people to be served and the amount of resources available. Is a preemie's stay in the NICU justified? How about a 60 year old patient who needs coronary artery surgery? What if that same patient also is obese? What if that patient also has Type II diabetes? Where is the line drawn when a patient has a hip fracture or needs a hip replacement? What about a 300 pound woman who needs knee replacement due to wear and tear from chronic obesity? And where do organ transplants fall in the rationing plan? What about infertility treatments?

We have the best health care system in the world and we serve people from many countries who come here to have their medical care because they can't get it in a timely manner in their own countries. This has to say volumes about the present state of health care in America. Fixing it, like we have just "fixed" Chrysler and GM, will put government bureaucrats in charge of what you can get, where you can get it and when you will be able to get care. What will government single payer health care do to the access to drugs? Will we be regimented to a strict formulary where one medication fits all? As a resident, I trained in the City and County Hospitals where there was a government formulary and the number of medications available for our patients was severely limited. For example, there was one hormonal replacement medication. There was one brand of birth control pills available to patients. There were charcoal pills for post-op gas relief. If they worked, it was fine, but if not, too bad.

I hardly think that this kind of regimentation will be acceptable to the vast majority of American consumers who are accustomed to individualized treatment for most conditions and are accustomed to rapid access to expensive technology and diagnostic tests, but unless we wake up and smell the coffee, this could be your lot in life in the not too distant future.