There’s a very interesting but probably little noted piece at Fox News by Dr. C.L. Gray, who is, interestingly enough, the president of Physicians For Reform. His general premise is that while reform is needed in the medical field, what Congress is chasing is not at all the answer. And he uses Medicare as the vehicle to make his point.
I’m sure you remember the story that came out not long ago about the Mayo Clinic deciding not to take anymore Medicare patients. If you’ve been staying abreast, that’s just a very well known clinic doing what a lot of lesser known clinics and doctors have been doing for quite some time. Gray claims that Mayo lost “840 million” caring for medicare patients.
He lays the physician trend away from Medicare to two overall reasons.
The first is simple—the math:
1) For the past decade Medicare consistently paid physicians 20% less than traditional insurance companies for identical service.
2) On January 1, 2010 Washington made hidden cuts to Medicare by altering its billing codes.
3) Medicare will cut physician reimbursement by another 21% on March 1. The CBO said this cut must take place if the Senate healthcare bill was to “reduced the deficit.”
4) Even more, Congress pledged to cut Medicare by yet another $500 billion. Again, the CBO said this additional cut must take place if the Senate healthcare bill was to “reduced the deficit.”
Many physicians were operating at a loss even before this series of massive cuts. In 2008, Mayo Clinic posted an $840 million loss in caring for Medicare patients. No businesses can survive when patient care expenses exceed revenue.
No business can survive operating at a loss, and that’s essentially what has been happening with Medicare prior to “reform”. With more cuts promised by “reform” it becomes a financial “no brainer”. We’re talking about a business decision. To remain a healthy business, and all practices are businesses, that which is causing a loss and overall negative drag on revenue has to be cut out to bring the revenue flow backto positive in order for the business to survive. That’s called a profit – something it would seem the government finds distasteful. But profit is what allows you to serve your clientele with adequate and appropriate staff, treatment and equipment. Mayo made that decision after it surveyed the impact of that particular group of patients on its bottom line and the impact of their removal. Obviously Mayo felt that continuing to serve that group, at the tremendous loss they were suffering, was effecting their overall ability to deliver the finest health care possible to the rest of their patients.
Expect to see more of that if “reform” is passed.
The second reason Gray gives is much less obvious than the first. But it provides just as powerful an incentive to ditch Medicare as does the first:
The second is more ominous—Washington’s increasingly abusive posture toward physicians.
President Obama reflected this attitude last summer. On national television, he stated as fact a surgeon is paid between $30,000 and $50,000 for amputating a patient’s foot.
In reality, a surgeon is paid between $740 and $1,140 to perform this unfortunate, but often life-saving procedure. This reimbursement must cover a pre-operative evaluation the day of surgery, the surgery, and follow-up for 90 days after surgery—not to mention malpractice insurance, salaries for clinic nurses, and clinic overhead. It is frightening to think our president is so wildly misinformed even as he stands on the cusp of overhauling American health care. But it gets worse.
Given massive federal deficits, Washington now faces increasing pressure to cut Medicare spending. One way to do this is to intimidate physicians into under-billing. To do this Washington intends to spend tax payer dollars to ramp up physician audits using Recovery Audit Contractors (RAC audits) to randomly investigate private physician’s Medicare billing.
Gray characterizes the RAC as unqualified bounty hunters and gives examples of his contention. The most egregious example is this:
For example, one patient the auditor alleged the group had “fraudulently” billed for was a man undergoing a chemical stress test. The allegation was the patient should have undergone a cheaper traditional treadmill stress test. The difficulty with this accusation was this man was a double amputee—he had no legs. This made a traditional treadmill test impossible. The auditors clearly were not trained health care professionals—they were bounty hunters. (It is worth noting the investigators are given legal immunity from a countersuit for conducting a “fraudulent investigation.”)
It is a good example because even the layman can appreciate why this particular case is so absurd. However, the doctors in question had to spend money to defend against this allegation of wrong doing. It brings up a critical point. One of the promises of “reform” is it will help remove the insurance company from between you and your physician. But as is obvious here, in a government plan such as Medicare, there is still someone between you and your physician who is no more qualified than some insurance drone.
The point, of course is that the drastically reduced Medicare payments to physicians coupled with increased meddling and second-guessing through RAC has driven doctors to a fish or cut bait point as it pertains to Medicare. They are forced into a business decision which requires them to give their practice a financial physical and cut out the portion which will cause the practice to die if not excised.
It is obviously a tough decision that I’d bet most doctors would prefer not to have to make, but as seen with the Mayo Clinic, they’re being driven to do so. This is the future of medical care if government runs it. Anyone who can’t see the rationing inherent in the “reforms” to Medicare is simply remaining willfully blind to the facts. Government must ration. And physicians must act in their own best self-interest. That means fewer physicians seeing more Medicare patients. The result is inevitable and as usual, the patients are those that will suffer.
Let’s start our week of with the irony impaired. In this case it is Patrick Kennedy (D-RI), explaining why Democrat Martha Coakley – or as he referred to her, “Marcia Coakley” – is in trouble in the Massachusetts Senate Race:
“If you think there’s magic out there and things can be turned around overnight, then you would vote for someone who could promise you that, like Scott Brown,” Kennedy said. “If you don’t, if you know that it takes eight years for George Bush and his cronies to put our country into this hole … then you know we have a lot of digging to do, but some work needs to be done and this president’s in the process of doing it and we need to get Marcia Coakley to help him to do that.”
On to the irony:
“One thing the Democrats have done wrong? We haven’t kept the focus on this disaster on the Republicans who brought it upon us. We’ve tried too hard to do that right thing, and that’s to fix it, as opposed to spend more of our time and energy pointing the finger at who got us [here] in the first place.”
You can’t make this stuff up, folks. Of course one of the reasons this election is a referendum on Democrats in general is because the public at large mostly thinks they haven’t focused on that which is important – employment and the economy – but instead squandered their time on the less important, such as health care reform and cap-and-trade. As for the irony of claiming they haven’t spent any time and energy pointing the finger at others, blaming George Bush is a cottage industry among the Democrats, who spend days finding new and more entertaining ways to blame him for all their woes.
Whether or not Scott Brown ends up winning in Massachusetts on Tuesday, this is as obvious a wake-up call for Democrats as one can issue. Even the NY Times recognizes what’s going on:
This weekend, Democrats are struggling to hang on to a seat held by Mr. Kennedy for 46 years in one of the most enthusiastically Democratic states in the country. Conservatives are enjoying a grass-roots resurgence, and Republicans are talking about taking back the House in November.
As Mr. Obama prepares to come here on Sunday to campaign for the party’s beleaguered Senate candidate, Martha Coakley, Democrats across the country are starting to wonder aloud if they misjudged the electorate over the last year, with profound ramifications for the midterm elections this year and, potentially, for Mr. Obama’s presidency.
The most certainly did misjudge the electorate, because the nation’s situation changed late in the campaign. When it became clear that the economy was in trouble and unemployment was rising, that and not the liberal Democratic agenda, should have become priority one. But it wasn’t. They consciously chose to place the party’s agenda before the nation’s needs and have blindly pursued that agenda in the face of a continuing economic downturn. That has placed them in the position they now occupy – out of touch, running out of time and facing a political bloodbath in November. It was a calculated risk, counting on swift passage of the agenda items, which hasn’t materialized. And, no matter how persistently and consistently they attempt to blame everything on Bush, that opportunity expired many months ago.
This is now about the Democrats and Obama and whether they like it or not the Senate race in Massachusetts is a referendum on their performance to date.
In this podcast, Bruce, Michael and Dale discuss the special election in Massachussetts, the dangers of hyperinflation, and Haiti. The direct link to the podcast can be found here.
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Massachusetts – The Brown/Coakley race: Is the GOP about to steal one? What are the implications of a Brown win?
Haiti – a huge disaster with huge problems facing rescuers.
Currency – Even worse than we thought?
Health care – How close are the Democrats to passing this monstrosity.
And, if we have time, a puppy update.
This gets worse and worse – or better and better, depending on which side of the man-made global warming scenario you come down on. This time it is the Himalayan glaciers:
A warning that climate change will melt most of the Himalayan glaciers by 2035 is likely to be retracted after a series of scientific blunders by the United Nations body that issued it.
Two years ago the Intergovernmental Panel on Climate Change (IPCC) issued a benchmark report that was claimed to incorporate the latest and most detailed research into the impact of global warming. A central claim was the world’s glaciers were melting so fast that those in the Himalayas could vanish by 2035.
In the past few days the scientists behind the warning have admitted that it was based on a news story in the New Scientist, a popular science journal, published eight years before the IPCC’s 2007 report.
It has also emerged that the New Scientist report was itself based on a short telephone interview with Syed Hasnain, a little-known Indian scientist then based at Jawaharlal Nehru University in Delhi.
Hasnain has since admitted that the claim was “speculation” and was not supported by any formal research.
Yet it found its way into a science journal, and later was included in the IPCC’s 2007 report as an alleged scientific finding? How many scientists signed that report? And why, now that the CRU and NASA’s GISS data (the basis for the AGW hypothesis) has been called into question and we find the glacier “scientific fact” was based on speculation, not research, should we ever take anything they say seriously?
This is an excellent example of the worth of anything called “scientific consensus”. Cherry-picked and manipulated data along with claims based in pure speculation.
That’s science? That’s what we should base life-changing political policies on?
AGW is dead. I just wonder how long it will take politicians and the religious “environmental” zealots to finally realize that?
Perhaps the most important political story this week – possibly this year – is the Senate race in Massachusetts. The vote is Tuesday. And, at the moment, it appears the Democrats are in trouble in a solidly blue state. The reasons are many. How much each reason contributes to the whole is debatable, but watching the reaction of Democrats to this unexpected and developing debacle has been somewhat comical.
Of course one of the reasons is the Democratic candidate. Mass Attorney General Martha Coakely has conducted a campaign – and I use the term “conducted” very loosely – that will most likely become the case study on how to lose an election in a state in which your party is the prohibitively dominant party. And a seat that has been in Democratic hands for almost 50 years. She’ not only a politically unattractive candidate, she is about as inept a politician as one can find. Combine all of that with a campaign that has mostly been missing in action and you can begin to understand why she’s trailing in the polls. I mean who else but the clueless would call beloved Red Sox pitcher Curt Schilling a “Yankees fan”. Her campaign is trying to sell that as a joke gone wrong, but in Red Sox mad Massachusetts, you just don’t joke about some things.
So even with all of that going against her, other politicians have run poor campaigns in states which heavily favored their party and still won. Why couldn’t that happen in Massachusetts? Well, it could – let’s not fool ourselves. But in this case as inept and poor a candidate Martha Coakley has been, Scott Brown, the Republican, has been a good candidate. He’s been on message, on target and all over the place. The little known Republican, prior to the race, is pretty well known in the state now. And polls have him up slightly (by a point or three). Even internal Democratic polls show Brown with a lead.
This has prompted Democrats, over the last couple of weeks, to go from being a bit antsy to outright panic. First it was sending in operatives from the DNC. Then it was escalated to having Bill Clinton do a little campaigning for Coakley. And now the big boss, Barack Obama, has been summoned to the fray in an effort to somehow revive the flagging Coakely campaign.
It may be too little too late – one of the things I’ve been pointing too and I’ve seen others cite is an apparent “enthusiasm gap” among the two side. Scott Browns supporters are very enthusiastic about his candidacy and his chances of winning. Martha Coakley’s – not so much. In fact Blue Mass Group, a Massachusetts Democratic group blog recently entitled a post “I know it sucks but vote for Coakley” or words to that effect. A ringing endorsement if ever I’ve seen one. Enthusiasm is what drives voter turnout. And obviously voter turnout is the key. The enthusiasm the Democrats had for their brand just a few short months ago, has gone with the wind.
Secondly – independents aren’t staying under the Democratic umbrella. In fact, polls show them deserting in alarming numbers. Again, not a good sign for Democrats in general, but surely not a good sign for Coakley.
And, during my reading this past week (sorry no cite) I remember a poll which said about 20% of Democrats in Massachusetts don’t like the state’s health care program and are leaning heavily toward Brown. That means it may be Democrats who put the final nail in the Coakley coffin.
That brings up the question that is constantly asked and consistently denied by David Axelrod – is this election a referendum on the Democrats and the Obama agenda?
How could it not be? Look at the state. Look at the stakes (Brown means the HCR bill is dead). It is fraught with national political implications. To contend otherwise is simply whistling past the graveyard. If Brown wins the US political world is turned upside down. It will energize the right as has no recent election anywhere – a Republican in the “Ted Kennedy seat?” Are you kidding? That would be like electing Ariel Sharon to the presidency of Egypt.
It would also be the death knell of the liberal attempt to pass their agenda in Congress as the filibuster proof Senatorial majority would exist no more. Axelrod knows that. Obama knows that. And so do Nancy Pelosi and Harry Reid.
The next day or so should see a spin up of the dirty tricks department like none in recent memory. Already the DCCC has released a smear mailer that simply isn’t supported by facts (and that FactCheck.org has specifically refuted). More to come I’m sure.
But the bottom line is that there is a good chance that Scott Brown will win this thing. And per the GOP’s attorneys, if he does, Paul Kirk, the interim appointee there to fill the seat until the special election, may not be eligible to vote after Tuesday. What a wrench that throws, if true, into the machinations of the Harry Reid scheme to pass the bill before Brown could be seated.
This has the possibility of being a game changer of an election if Brown succeeds. And I’ve got to tell you, I’m ready for the game to change, that’s for sure.
After the scandal concerning the CRU at the University of East Anglia, this may be the sound of the second shoe dropping.
Data from the National Climate Data Center (NCDC) in Asheville, North Carolina and the NASA Goddard Institute for Space Studies (GISS) at Columbia University in New York City, both associated with the US Government and the UN’s IPCC, have come under fire from two researchers. Programmer E. Michael Smith and Certified Consulting Meteorologis Joseph D’Aleo have combed through the data and the programming from which conclusions were made about man-made global warming and claim the data used was both cherry-picked and manipulated to produce findings that supported the hypothesis that man was responsible for climate change.
For E. Michael Smith this project was quite a test of his computer programming skills. “Opening, unraveling and understanding what is happening in a complex FORTRAN computer code, with 20 years of age and change in it, is a difficult and grueling task,” he says, “and the deeper I dug the more amazing the details revealed. When doing a benchmark test of the program, I found patterns in the input data from NCDC that looked like dramatic and selective deletions of thermometers from cold locations.” Smith says after awhile, it became clear this was not a random strange pattern he was finding, but a well designed and orchestrated manipulation process. “The more I looked, the more I found patterns of deletion that could not be accidental. Thermometers moved from cold mountains to warm beaches; from Siberian Arctic to more southerly locations and from pristine rural locations to jet airport tarmacs. The last remaining Arctic thermometer in Canada is in a place called ‘The Garden Spot of the Arctic,’ always moving away from the cold and toward the heat. I could not believe it was so blatant and it clearly looked like it was in support of an agenda,” Smith says.
Here are the numbers behind the startling findings of the new research paper. The number of actual weather observation points used as a starting point for world average temperatures has been reduced from about 6,000 in the 1970s to about 1,500 in the most recent years. Still, more stations are dropped out in related programs and in the final NASA/GIStemp data file, it drops to about 1,000. That leaves much of the world unaccounted for,” says Joseph D’Aleo of ICECAP.us and SPPI.org, who has released a research study of the global temperature pattern today. “Think of it this way,” he continues, “if Minneapolis and other northern cities suddenly disappeared but Kansas City and St. Louis were still available, would you think an average of Kansas City and St. Louis would provide an accurate replacement for Minneapolis and expect to use that to determine how Minneapolis’ temperature has changed with any hope of accuracy?”
E. Michael Smith pointed out that the November 2009 “anomaly map” from GISS shows a very hot Bolivia, which is covered by high mountains. “One small problem: there have been no temperatures recorded in the NCDC data set for Bolivia since 1990. NASA/GISS have to fill in or make up the numbers from up to 1200km away. This is on the beach in Peru or in the Amazon jungle,” he said.
Given these revelations, and assuming they’re accurate, it calls into question the entire AGW hypothesis since the supporting data is apparently invalid. I have to wonder, other than the sound of crickets, what reaction Al Gore and the rest of the warmist cabal will have to say about this?
I wonder if Michael Moore has seen this story about the Cuban health care system he so highly touted in his “documentary” about health care – “Sicko”?
Twenty-six patients at a mental hospital died during a cold snap this week, the government said Friday. A Health Ministry communiqué blamed “prolonged low temperatures that fell to 38 degrees,” but the ministry also said it was starting an investigation that could lead to criminal proceedings. The independent Cuban Commission on Human Rights said that at least 24 patients at the Psychiatric Hospital in Havana died of hypothermia, and that the hospital did not do enough to protect them because of problems like faulty windows.
Hypothermia? At 38 degrees? Look, it’s certainly possible as witnessed by these deaths, but hypothermia doesn’t happen at the snap of a finger at 38 degrees. It takes a while, and could most likely have been avoided by a little foresight, a blanket or two and some attention to the patients and their needs. Apparently that didn’t happen. If 26 died, you have to wonder how many more came close.
Cuba claims the deaths were from natural causes, but CCHR disputes that:
Commission head Elizardo Sanchez said that so many patients dying of hypothermia was “absurd in a tropical country” and claimed the deaths could have been prevented if the government had granted long-standing requests from international aid groups to tour Cuba’s medical facilities, including the capital’s 2,500-bed mental hospital.
Yeah, not going to happen – only sickos like Moore get such tours. As usual, the Cuban government blames the problems on the “American embargo”, an embargo that has so many holes and is so laxly enforced that for anyone else in the world, it’s business as usual. Apparently Cuba would like you to believe it the the fault of the US that they didn’t have blankets or that they were unable to fix “faulty windows”.
Anyway, I’ll not hold my breath waiting for Moore to condemn the obvious negligence that was a major cause of these deaths. This is his preferred model when it comes to health care. I’m sure we won’t hear a peep from the man.
Suppose I told you that there is an organization which claims to have worldwide jurisdiction (literally, “where the law speaks”) over all matters of criminal law and justice, regardless of who a person is? No I’m not referring to the ICC, but instead to the Obama administration.
The Obama administration is considering a criminal trial in Washington for the Guantanamo Bay detainee suspected of masterminding the bombing of a Bali nightclub that killed 202 people, a plan that would bring one of the world’s most notorious terrorism suspects just steps from the U.S. Capitol, The Associated Press has learned.
Riduan Isamuddin, better known as Hambali, was allegedly Osama bin Laden’s point man in Indonesia and, until his capture in August 2003, was believed to be the main link between al-Qaida and Jemaah Islamiyah, the terror group blamed for the 2002 bombing on the island of Bali.
It’s not readily apparent what charges would be brought against Hambali, but a real question exists as to exactly what power our civil judicial system would have over him. In order to pass judgment on anyone, a court must have personal jurisdiction over the defendant, which essentially means that he has some nexus with the place where his trial takes place. With respect to Khalid Sheikh Mohammed, there is at least a good argument that his alleged activities with respect to the 9/11 attacks and the World Trade Center bombings creates a connection with the court of record in New York City. In contrast, Hambali does not, as far as anyone has alleged, have any connection whatsoever with the District of Columbia, nor with anywhere else in the United States. So on what basis can a DC court claim to have any power over his person?
Yet that’s just what the Obama administration proposes to do. It is considering trying Hambali in a federal civil court, supposedly for his terrorist actions (which are legion, to be sure) elsewhere in the world. Most famously, Hambali is thought to be the mastermind behind the devastating bombings in Bali back in 2002. But Bali is in Indonesia, not the United States. Indeed, Jemaah Islamiya, of which Hambali is known to be the operations coordinator and chief liason to al Qaeda regarding its Southeast Asia conquests, has not been alleged to be involved in any actions in America or her protectorates. All of which should lead to the inexorable conclusion that our federal courts have no jurisdiction over Hambali.
Perhaps no real harm would come from a court reaching such a decision. It wouldn’t lead to a release of the prisoner, necessarily, since the question of guilt or innocence would never be addressed. But what if, instead, a ruling is made that there is personal jurisdiction over Hambali? Stranger things have happened — witness the vast expansion of judicial power created in Boumediene v. Bush, where the Supreme Court found that its jurisdiction for habeas corpus purposes extended to any person within America’s exclusive control. Should a DC court find it does have personal jurisdiction over a person who has no connection to America except for being captured by her soldiers, that would be paramount to declaring American law and jurisprudence the law of every land. In other words, we would be claiming that our laws “speak” everywhere and for everyone, whether you like it or not.
If you are inclined to believe that holding enemy combatants at GITMO directly aids al Qaeda’s recruitment efforts, how do you think the terrorist organization and her adherents will take to our claim that they, and everyone else in the world, are subject to our civil laws? How will the rest of the world view such an arrogant statement? Beyond satisfying some petty political aims, by taking such a misguided step as this the Obama administration is not doing the U.S. any favors, and is likely damaging our interests.
There is a lot of analysis going on about Obama’s first year and why, it seems, his job approval numbers are so dismal. And why, given the promise he brought to the White House, at least according to the PR faithfully pushed by his campaign, are Democrats looking at the possibility of large net losses in both houses of Congress?
The first hints of the dissatisfaction of the electorate came in the Virginia and New Jersey gubernatorial races where Republicans won – in VA handily. The Democrats claimed their candidate there ran a lack luster campaign and it wasn’t at all a referendum on the Obama administration and the Democratic agenda. But now, the very same thing is happening in Massachusetts with an unknown GOP state legislator giving the Democratic candidate for the “Ted Kennedy” seat, a run for her money (and, in the latest poll, up by 4 points over the Democrat).
Is this too the result of just a lackluster campaign and a poor candidate? Certainly a case can be made for that – except in this case, it is reliably and overwhelmingly Democratic Massachusetts. It doesn’t work quite as well there as it might in VA. It is beginning to sound like a bit of whistling past the graveyard.
In fact, as with VA, it is a reflection of some deep-seated dissatisfaction with Democrats in Congress and yes, with Obama as well. Charlie Cook nails the problem today in his analysis of why the Democrats are in such deep electoral trouble:
Honorable and intelligent people can disagree over the substance and details of what President Obama and congressional Democrats are trying to do on health care reform and climate change. But nearly a year after Obama’s inauguration, judging by where the Democrats stand today, it’s clear that they have made a colossal miscalculation.
The latest unemployment and housing numbers underscore the folly of their decision to pay so much attention to health care and climate change instead of focusing on the economy “like a laser beam,” as President Clinton pledged to do during his 1992 campaign. Although no one can fairly accuse Obama and his party’s leaders of ignoring the economy, they certainly haven’t focused on it like a laser beam.
Cook is actually minimizing the problem somewhat. In fact, Obama and his party leaders have given little but lip service to the economy, unemployment and job creation while they’ve spent enormous time on agenda items which mean very little to a country suffering the depth of joblessness and economic hardship now prevalent. Add to that their extremely obnoxious handling of what they have focused on, the blatant partisanship in which they’ve conducted their “business” and the total lack of transparency in that process and you have a pretty toxic picture painted of Democrats in general.
Why, then, did Obama’s promise fail to materialize in his administration – at least in the first year? Well there are many reasons. Among them is a rookie politician (Obama) who got rolled by an experienced Democratic leadership that saw a small and closing window of opportunity to pass huge social welfare agenda items that had repeatedly failed in the past and chose to tackle them while ignoring the obvious elephant in the room. My guess is they miscalculated in more than just the way Cook contends. With their majorities, I’m sure they thought they could quickly put these bills together and pass them, leaving plenty of time to work on the economy. But, of course, given the diversity of opinion and interests even among Democrats, that wasn’t the case. It has dragged into the new year while work on the economy has been essentially non-existent (they threw a $787 billion pork bill out there and called it “stimulus”, figuring their usual panacea – throwing money at a problem – would work. Unsurprisingly, it hasn’t).
Voters are mad about that. Rightly or wrongly, they blame the government for what does or doesn’t happen on their watch economically. For the most part, government can best affect the economy by making it easier for markets to expand and create jobs – tax cuts, less regulation, etc. Spending rarely sets up the conditions to do that. But regardless, of what action the government takes, voters expect the economy to be the absolute focus of government in times of economic crisis.
That has not been the case at all with this administration or Congress. And, it appears, they’re going to pay a huge price for that in 2010 and possibly 2012. What was a bright Democratic future less than a year ago has now become a scouting trip for a good place in the “wilderness” for Dems. If, as many economists expect, unemployment remains at 9% through 2012, we may be reading the obligatory columns about the “Death of the Democratic Party”. And while Obama’s personal popularity may remain high (while his job approval numbers tank), that doesn’t mean such perceived economic negligence will be rewarded with a second term.