Monday, August 24, 2009

I left off with page 256, payment for efficient Areas

The article below illustrates the degree health care is already paid for by public funds. The leap to insure the uninsured isn't all that much of a fiscal burden. It is already paid for taxpayer funds. It is just that it is in emergency rooms rather than physician examining rooms where costs are higher and care is fragmented without a consistent physican.


By Michael Martz

Published: August 23, 2009


Almost half of the patients treated at VCU Health Center don't have private health insurance or depend on Medicaid services for the poor.

An additional one in four of the 32,484 patients treated last year in the hospital were covered by Medicare, the federal health program for the elderly.

All of these patients depend on big government subsidies for their care. VCU received $118 million in federal and state funds last year, primarily to treat the uninsured. While VCU is reimbursed better than most hospitals for the Medicaid patients it treats, the health center and its doctors lost almost $32 million last year on Medicare patients.

"It's a big burden," said Dr. Sheldon M. Retchin, chief executive officer of the VCU Health System. He agrees the way people receive and pay for medical care in the United States needs to change, especially to ensure that tens of millions of Americans without health insurance are able to get universal coverage for primary medical care, drugs, and mental-health treatment....


Page 256 starting with line 1 addresses the payments made to physicians that change their record keeping to electronic records. Basically, physicians will receive a 5% increase in their rates when they change their records to electronic. The participation is decided based on geographic location as to the number of participating physicians to receive the increase. One physician in any region that is alone changing to electronic medical records without peers or hospitals able to participate with them is not what the system needs to expedite care and streamline diagnosis without repeated tests.

The increased fee schedule is to begin January 1, 2011 but no later than January 1, 2013. The idea is to bring all physician records on line by 2013.

The discussion of the particulars of reimbursement and quality reports goes on for quite a few pages.

The pages continue to help modify the efficiency of care, it also clarifies power driven wheelchairs and their and defining their necessity as part of a rehab environment. There is a discussion about home infusion therapy to be included as a payable component of Medicare.

There is a provision for reporting of operations of surgical centers and periodic audits of use and costs. There is inclusion of "Adjustment for Cancer Hospitals." There is removal of a 'surety bond' to pharmacies that provide durable medical equipment.

There is continuation of oxygen supply and equipment by any supplier past three year term should there be a liquidation of a supply company. The purchaser may continue the therapy with another supplier for another three years without disruption.

Page 280 discussions DRGs for the first time in relation to discharges and preventable hospital readmissions. There will be a fee adjustment to any facility if there are excessive readmissions to a facility. There is a section that discusses the fee adjustment to physicians for repeated admissions to facilities. Basically the emphasis to this section is to discharge the patient and then have the outpatient facilities pick up the care of the patient to prevent readmission including home care visits. Those equations and schedules and effective dates to all the way to Page 299 where I will end this entry.

There is an emphasis in these 50 pages to streamlining care and reducing costs. There is nothing about limiting care. If care is needed it is to be given, but, the provisions wants patients treated more often than not out of the hospital and home or otherwise non-hospital to improve quality of life while reducing costs. I find nothing neglectful about these provisions.

Good night.

As "Bill" dissipates into Arctic Waters, it leaves behind the death of two people.


August 24, 2009
0915z
UNISYS Water Vapor GOES East Satellite (click here for 12 hour loop)

7-year-old girl Clio Axilrod killed by large wave in Maine is daughter of New York banker (click title to entry - thank you)
BY
Melissa Grace AND Helen Kennedy
DAILY NEWS STAFF WRITERS
Updated Monday, August 24th 2009, 3:55 PM

A New York investment banker was hospitalized Monday in Maine after a huge freak wave swept him and his beloved 7-year-old daughter out to sea Sunday, drowning the girl.
Clio Dahyun Axilrod spent more than three hours in turbulent 55-degree waters before she was located by a helicopter and recovered by a Coast Guard motorboat.
She could not be revived.
"When we picked her up, she was unconscious and unresponsive," said paramedic Jimmy Wilmerding, who also treated her father. "She was hypothermic."
Peter Axilrod, 55, who just had a heart bypass operation, was in intensive care at the Eastern Maine Medical Center in Bangor.
Video released by the Coast Guard showed him screaming in pain as, strapped to a stretcher to protect his spine, he was transferred from a rescue boat.
Friends said he doted on Clio, who was adopted from China as a baby, and would have dived into the stormy seas to save her if the monster wave hadn't taken him away, too.
The girl's mom, Sandra Kuhach, 51, was also hospitalized, according to the Maine Marine Patrol. Her injuries were unknown....

I'll be back in a few hours to read more of the House Health Care Bill. There is some 'guessing' coming out of the Murdock Mess of news print that 'requirements' to participate or pay a fine is a violation of The Commerce Clause of the USA Constitution.

Right Wingers always say that. They always scream 'Commerce Clause' just so they have something to talk about. It's Murdock, what does anyone expect?

I am sure if there were Constitutional issues with such legislated requirements, States that already have such provisions such as Massachusetts would have been in line for a hearing at the Supreme Court. It hasn't happened.

Why change horses in midstream? Mr. Durham is already investing the destruction of CIA videotapes that Cheney put through is shredder...

...why not put the missing evidence in the same hands of the man that will determine in inappropriate nature of the CIA Interrogations. Water boarding must be an interesting topic in his office. It makes too much sense, that the man that seeks missing evidence and its brevity to its importance simply puts the rest of the puzzle together. I wouldn't doubt that Mr. Durham requested the job.

I look forward to his work. The entire Bush/Cheney Era of this country has produced a disaster for all of us. It is time someone with conscience starts to piece together one of the most underhanded administrations this country has ever witnessed in modern times. I appreciate Mr. Durham's willingness to take on the challenge. I hope he can achieve justice for Americans that sincerely feel as though their government was missing in action for eight long arduous years of lies, deceptions and power plays.



...He picked career federal prosecutor John Durham, who was already investigating the CIA’s destruction of interrogation videotapes. While he’s not exactly a household name, the investigation has only just begun....

I demand a recount.

"...before this last administration, we had a budget surplus..." (click title to entry for video - thank you)


Senator Sherrod Brown of Ohio

"...He wants to make sure everyone has access and is able to count on coverage even if an illness pops up down the road.
Don Burnard has children and a grandchild who don't have health coverage. For him, the plan is a step in the right direction...."


I believe Senator Brown makes a very valuable statement when he refers to the Democratic Administration of Bill Clinton. The Clinton White House left the country with a budget surplus. That is rarely realized by those that oppose the change the Obama Administration is bringing to the country. Senator Brown, like President Obama, opposed the Iraq War. Senator Brown also has made the point that I believe is the correct approach to Afghanistan in that, "Are we seeing results?"

Afghanistan has a 'high bar' to meet. It has deteriorated into corruption and an expanding insurgency since the diversion of American forces into Iraq. The war that was to be Afghanistan never occurred. Bush/Cheney/Rumsfeld surrendered to Musharraf as soon as the invasion began.

The Pakistani military under its new leadership has proven to be exccptionally effective. It is a nuclear nation that cannnot be abandoned to 'chance.' The war in that region is successful, the question is can Afghanistan be reclaimed after the defeat of NATO and the virtual abandonment by the USA ?

I don't live in denial of 'the truth.' Perhaps. The media of the USA would rather do that. Maybe they aren't comfortable with actually pointing a finger at the past adminisration for all its sins and defeats. One can only wonder why.