American Elephants

Nearly 500 Hospitals Have Misbehaved, Or Have They? by The Elephant's Child

hospHospitals in 43 states will pay a combined $250 million in fines to settle charges that they violated Medicare requirements when implanting cardiac devices in patients.

The heavy hand of government descended on 457 hospitals accused of implanting cardioverter defibrillators in patients between 2003 and 2010 before Medicare coverage allowed. It seems that Medicare will cover the devices, which cost around $25,000, but only if doctors wait the recommended 40 days after a patient has had a heart attack and 90 days after a patient has had bypass surgery to do the implant. The waiting periods are designed by some bureaucrat to “give the heart an opportunity to improve function on its own to the point that the defibrillator may not be necessary.”

The DOJ said most of the hospitals were named in a lawsuit brought on by whistleblowers under the False Claims Act, which allows private citizens to bring lawsuits on behalf of the United States and receive a portion of the proceeds of any settlement or judgment awarded against a defendant.

The lawsuits were filed by a cardiac nurse and a health care reimbursement consultant in the U.S. District Court for the Southern District of Florida. The DOJ said the whistleblowers received more than $38 million from the settlements.

This may be all on the up and up. Over-cautious doctors disobeying the ordered 40 day wait time and costing Medicare money. The doctors motives for squandering Medicare money? The whistleblowers motives to go for $38 million? Did all or any of the patients survive? Don’t know.

Where are the whistleblowers who get big rewards from stopping, say, the EPA from wasting taxpayer money? With 457 different hospitals, the whistleblowers had no chance to observe incorrect wait times. Perhaps the doctor’s judgement is different?  I make no accusations. I just find it all odd, and sadly, I trust Doctors much more than I trust Medicare bureaucrats.



Obama’s Medicare Plan: Seniors Pay More. Lots More. by The Elephant's Child

It always seemed to me that the fact that the clever people who wrote the execrable bill for ObamaCare had no intention of ever participating in it themselves — was never emphasized enough. It really tells you everything you need to know.

The Obama campaign has tried hard to suggest that Mitt Romney and Paul Ryan will somehow deprive senior citizens of their Medicare. They are actually trying hard to find a way to make good care available to all seniors that need it. The Obama administration, on the other hand, has something else up their sleeves. Over the next five years, current law as amended by the PPACA (ObamaCare) guarantees higher costs for today’s seniors. And they already took $716 billion out of Medicare to prop up the health care bill — that’s  a $716 billion cut in reimbursement to providers, and if you can’t find a doctor, that’s why.

They Call It “Spinning” but There Are Harsher Terms. by The Elephant's Child

—  The government is telling us that the oil from the BP Deepwater Horizon oil rig disaster has dispersed, gone away, can’t find it, nothing to see here.  The damage is much less than expected, beaches not really damaged, not much oil in the marshes.

Scientists, on the other hand are saying — not so fast.  Ian MacDonald, a professor of biological oceanography at Florida State University who has been tracking the flow says “we shouldn’t lift our guard, and we shouldn’t pretend it is over.” He added “There are 10 Exxon Valdez spills still in the water — that has not disappeared but is still in the water being biodegraded.”  The Guardian UK headline reads “Gulf oil spill: White House accused of spinning report.”

Researchers are watching a seafood industry staple and indicator of the ecosystem’s health: the blue crab.  They are finding specks of oil in crab larvae found across the Gulf coast.  This may indicate real damage to the food chain.

— About those claims that TARP money has been paid back with interest.  Not so fast.  The part of TARP that deals with the big banks has largely been repaid: Goldman Sachs, Morgan Stanley, Wells Fargo, BONY have paid back their loans. Citigroup has paid back less than half, and the government took equity for the rest.  We still have billions of dollars’ worth of warrants on equity in 280 companies, almost all of them banks and insurance firms.  The claims that GM made about paying back their loans has already been declared to be hooey, since it was “repaid” out of taxpayer supplied funds.

— Fannie Mae and State Housing Agencies are Offering Little-Money-Down Mortgages. Buy a new house with $1000 down, the ads say. Affordable monthly payments and no private mortgage insurance required.  The pilot program is called “Affordable Advantage” and has been adopted by three states, Massachusetts, Wisconsin and Idaho.  Buyers don’t need to meet the minimum FHA down payment of 3.5%.  But not so fast.  If the housing market turns down even a tiny bit more, homeowners are underwater on their loans.  Nobody learns from history— even recent history. Oh, that’s right, the financial crisis was all Bush’s fault, and Wall Street.  Housing is no problem at all.

— Medicare is sustainable for years to come.  “We’ve made Medicare more solvent by going after waste, fraud and abuse,” Obama said in his weekly radio address.  But not so fast. The ObamaCare bill does not do anything at all about waste, fraud and abuse.  It is quite possible to address.  The major credit card companies do quite a thorough job of it, and very successfully at that.  The Democrats didn’t even try.  Maybe it’s there somewhere in that vast array of offices, bureaus, administrations and so forth.  But then the rules for those haven’t been developed yet, and will not be until administrators for each are named and they hire the thousands of new people they will need, so they can start making rules and regulations.

Study: Government Run Healthcare Denies Twice as Many Claims as Private Market by American Elephant

Once again, the truth is exactly the opposite of what Democrats claim. For months they have been telling us that we need government run care to protect people from big, bad insurance companies denying their claims.

The problem is that medicare denies nearly twice as many claims as the private market:

According to the American Medical Association’s National Health Insurer Report Card for 2008, the government’s health plan, Medicare, denied medical claims at nearly double the average for private insurers: Medicare denied 6.85% of claims. The highest private insurance denier was Aetna @ 6.8%, followed by Anthem Blue Cross @ 3.44, with an average denial rate of medical claims by private insurers of 3.88%

In its 2009 National Health Insurer Report Card, the AMA reports that Medicare denied only 4% of claims—a big improvement, but outpaced better still by the private insurers. The prior year’s high private denier, Aetna, reduced denials to 1.81%—an astounding 75% improvement—with similar declines by all other private insurers, to average only 2.79%.

Maybe there’s something to be said for the need to keep your customers satisfied in order to make that profit after all.

(h/t Say Anything via Hot Air)

What is So Wrong With Our Health Care System That it Requires 1,990 Pages of Mandates? by The Elephant's Child

Polls tell us that most Americans who have health insurance are quite satisfied with it.  Most Americans are well satisfied with the health care that they receive, including a lot of people who are uninsured.  So what is so wrong with our health care system that requires reorganizing one sixth of our economy?

  • Some Americans are uninsured and cannot afford health insurance.
    The first number was 46 million uninsured. Then it went down to 30 million when illegal immigrants were excluded from the list.  When you remove those who are already entitled to insurance from an existing program, and remove those who can afford health insurance but choose not to purchase it, you are left with somewhere around 9 to 12 million who need help. The current House bill  still leaves something over 20 million people still uninsured.
  • Some people are uninsured for only fairly short periods between jobs.
    Many of these folks find Cobra Coverage too expensive. Nothing in the bills addresses this problem.
  • There are huge amounts of fraud and waste in Medicare — estimated at $60 billion Completely  unaddressed.  Medicare funding is being sharply cut ($150 billion) to reduce the cost of the legislation.  Medicare is going broke.  That is also unaddressed.
  • Health insurance just costs too much.
    Private insurance premiums could triple under ObamaCare.  Government health insurance premiums could increase by $4,000 per family by 2020. Unaddressed.
  • Health care just costs too much.
    It will cost far more under ObamaCare. Things that are proven to reduce costs like medical liability (defensive medicine) are not only not included in the bills, they are specifically excluded.  Trial lawyers are second only to labor unions in their financial support for Democrats.  Some of the increased costs will come in the form of taxes.  The Senate bill proposes a brand new tax on medical devices like heart valves, pacemakers, stents, artificial hips, insulin pumps; a ten-year $400 billion tax on all implements that retail for $100 or more. It works out to an $11,000 surcharge on every worker employed in that industry. Consequences —massive job losses, squashed innovation.
  • Health insurance can’t follow a person to a new job, it’s not portable.
    This is completely unaddressed.
  • Health insurance cannot be purchased across state lines, and in some states there is little choice among insurers.
    Unaddressed, since the object of ObamaCare is to funnel everyone into single-payer government-run health care.
  • States must bear much of the cost of Medicaid, and they are going broke. ObamaCare funnels many more people into Medicaid, increasing costs to the states without reimbursing the states.  Unaddressed.

What is it that is known to cut costs, improve ways of doing things, increase innovation and preserve and prolong life?  In the vast history of the world, it has always been freedom and the free market. People create when there are potential rewards for their innovations.  Doctors devise new treatments when they are not restricted by 1,990 pages of rules and mandates that punishes them for not following the rules, but interacting with patients.  The word “shall” appears in the House bill 3,425 times — each time a mandate about what one must do.

Democrats believe that 111 new agencies, programs and bureaucracies filled with smart people (like their supporters and friends) can fix all the things that are wrong with health care.

Health care takes place only between doctor and patient — those bureaucrats wandering around the halls of Congress can’t fix your hurts, no matter how much they tinker with legislation.

It took years of study, learning and practice to produce the physicians who can fix our hurts and do their damnedest to cure our diseases and prolong our lives. Each of us is different.  We are not the same — but products of our genetics and our environment and our habits, and we cannot be healed by either Nancy Pelosi’s or Harry Reid’s efforts to control our lives.

Democrats have not learned from evidence.  People who have experienced government health care in countries around the world have urged us: “Don’t do what we did.” Democrats ignore countries who are going broke from their efforts to control health care.  They do not learn from countries that are unnecessarily killing their citizens by rationing care.  And so they are repeating those errors.  The Democrats will ration.  It is inevitable.  It is the only way they have left, because they will not do any of the things that would cut costs.

It was never about health anyway.  It is only about control.

You Want to Be Careful When You Start Messing With the Old Folks. by The Elephant's Child
October 15, 2009, 6:14 pm
Filed under: Economy, Health Care, Law, Politics, Taxes | Tags: , , ,

The old folks are not happy. Democrats have been working since January to find a way to adopt government-run health care that does not bankrupt the economy.  Their solutions all depend on spending less money on Medicare. $500 billion less is the most often mentioned sum.

They propose dropping Medicare Advantage plans, which many seniors really like.  They propose cutting payments to heart specialists and cancer doctors.  They suggest that when the old folks get sick, they simply cost too much, and the money is better spent on young healthy adults.  Democrats  plan to tax medical devices like wheelchairs, stents, dialysis machines, pacemakers — that sort of thing.

The old folks are, understandably, opposed to ObamaCare. They had the idea that the purpose of health care was to care for those who get sick, not to lavish health care on those who do not need it.  Everybody dies, but the government is not entitled to rush us into it.

There is, however, one very interesting thing about older Americans.  They vote.  They vote reliably and consistently.  President Obama has noticed.  He called on Congress yesterday to approve $250 payments to 50 million seniors who will not be receiving a cost-of-living increase in their Social Security payments this year or next year.

So you can call it a bribe, or you can call it a second Stimulus Bill.  The money— $ 13 billion — will simply increase the national debt a little more, and won’t create a single job.

You really want to be careful when you start messing with the old folks.

(h/t: wattsupwiththat)

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