The Senate decided to let the States sponsor the health care with federal monies.

Senate panel backs amendment permitting state health-care plans (click title to entry - thank you)
Posted on Thu, Oct. 01, 2009 06:24 PM
By the narrowest of margins, the Senate Finance Committee on Thursday approved an amendment by Sen. Maria Cantwell that would allow other states to establish basic health care plans for low-income residents similar to the one in Washington state, but with the federal government providing the funding.
Cantwell, D-Wash., declined to liken her proposal to a controversial public option, which has become a major sticking point in health care reform. But it does allow the states, if they choose, to negotiate with insurance companies for lower rates on health coverage polices for those living barely above the poverty line and provides federal dollars to pay for it.
Cantwell said her proposal would cover about 75 percent of those who currently don't have health insurance.
The amendment to a health care bill written by Montana Democratic Sen. Max Baucus, the committee chairman, was approved 12-11. All of the committee's Democrats except for Sen. Blanche Lincoln of Arkansas supported Cantwell's amendment, while all of the Republican members opposed it....

My son is getting married on Saturday and the rehearsal dinner is tomorrow evening, so I am a little busy but I will do what I can and will keep one ear to the ground. I would like to be back on track by Monday.

The kids will be on their Honeymoon by then. Lucky, lucky, lucky. I sent them on a shopping spree for Honeymoon clothes as a Bridal Shower Gift. They thought it was a great idea. They only go around once, ya know? My son and I are great friends.

My country, under the leadership of President Obama and my countrymen are important to me, too. I really feel like we are making progress within our democracy again. I am very hopeful about the future in the USA. Barak is a good man.

I just feel with all the viciousness toward him within the country I can't completely take a couple days off. I don't trust the Republicans that far. I just don't. They have hurt this country a great deal and President Obama is making historical strides in solving so many problems. We are going to be okay.

I left off with page 750 of the House Health Care Insurance Reform Bill. I am going to back up a little bit, because there is a section on Medicaid I doubt I covered last time. Might have glossed over it, but, didn't really 'get into it.'

Page 746, beginning with line 5 through 11:

SEC. 1702. REQUIREMENTS AND SPECIAL RULES FOR CERTAIN MEDICAID ELIGIBLE INDIVIDUALS.
(a) IN GENERAL.—Title XIX of the Social Security Act is amended by adding at the end the following new section:
‘‘ REQUIREMENTS AND SPECIAL RULES FOR CERTAIN MEDICAID ELIGIBLE INDIVIDUALS

This continues to discuss the 'public option' in the House Bill. It involves additional provisions to Medicaid. At least that what it appears like at first glance. I haven't read the Senate bill yet. I think it is about 650+ pages. But, perhaps the Senate and House are in agreement more than we thought.

Page 746, lines 12 through 25 and Page 747, lines 1 and 2;

‘‘SEC. 1943. (a) COORDINATION WITH NHI EXCHANGE THROUGH MEMORANDUM OF UNDERSTANDING.—
‘‘(1) IN GENERAL.—The State shall enter into a Medicaid memorandum of understanding described in section 204(e)(4) of the America’s Affordable Health Choices Act of 2009 with the Health Choices Commissioner, acting in consultation with the Secretary, with respect to coordinating the implementation of the provisions of division A of such Act with the State plan under this title in order to ensure the enrollment of Medicaid eligible individuals in accept24
able coverage. Nothing in this section shall be construed as permitting such memorandum to modify or vitiate any requirement of a State plan under this title.

Evidently, the States are going to be conducting the Medicaid portion of the Public Option. They do that now. The State oversees the 'qualification' for Medicaid. That qualification is conducted at the county level usually. It is followed up by a Social Worker, I believe. But, the Federal Government pays for it. Or pays for the majority of it.

The provision goes on to state there are Traditional and Non-Traditional enrollees. The Non-Traditional enrollees receive "affordability credits."

Page 748, lines 15 through 18;

...by the Commissioner of eligibility for affordability credits under subtitle C of title II of division A of the America’s Affordable Health Choices Act of 2009, as specified under such memorandum.

Page 479, lines 3 through 22;

‘‘(3) DETERMINATIONS OF ELIGIBILITY FOR AFFORDABILITY CREDITS.—If the Commissioner determines that a State Medicaid agency has the capacity to make determinations of eligibility for affordability credits under subtitle C of title II of division A of the America’s Affordable Health Choices Act of 2009, under such memorandum—
‘‘(A) the State Medicaid agency shall conduct such determinations for any Exchange-eligible individual who requests such a determination;
‘‘(B) in the case that a State Medicaid agency determines that an Exchange-eligible individual is not eligible for affordability credits, the agency shall forward the information on the basis of which such determination was made to the Commissioner; and
‘‘(C) the Commissioner shall reimburse the State Medicaid agency for the costs of con22
ducting such determinations.

All that is self explanatory. An individual or family applies for 'affordability credits as an 'exchange-eligible individual' and then the application is reviewed and either granted or denied. At any rate, if there is a denial by the State, that denial will go to the Federal government.

I already wrote about the baby thing, whereby, they are presumed eligible at birth to insure their medical care until they can be evaluated, or their parents are evaluated for eligibility. That goes on to at least page 750.

Oh, I'll read the Senate bill. The truth is the truth. Whether it passes or not, understanding the legislation is vital. If the Senate bill is research and written as well as the House bill it will be a good read.

Okay. Under this provision, the State will have jurisdiction over qualifying for enrollment, but, the Federal government sets the 'standard.' The word standard is my word, not theirs.

Page 753, lines 1 through 11;

...quarters beginning after the date of the enactment of this subsection and before CHIP MOE termination date specified in paragraph (3), a State shall not have in effect eligibility standards, methodologies, or procedures under its State child health plan under title XXI (including any waiver under such title or under section 1115 that is permitted to continue effect) that are more restrictive than the eligibility standards, methodologies, or procedures, respectively, under such plan (or waiver) as in effect on June 16, 2009.

Part of what is happening with these bills is an absorption of other health care titles still in enforcement. I thought that would happen. I speculated about that before.

Page 754, lines 1 through 14;

‘‘(A) The Health Choices Commissioner has determined that the Health Insurance Exchange has the capacity to support the participation of CHIP enrollees who are Exchange-eligible individuals (as defined in section 202(b) of the America’s Affordable Health Choices Act of 2009),
‘‘(B) The Secretary has determined that such Exchange, the State, and employers have procedures in effect to ensure the timely transition without interruption of coverage of CHIP enrollees from assistance under title XXI to acceptable coverage (as defined for purposes of such Act).

So, basically the States will be paid as long as they abide by the federal standards for this provision.

The next provision is controversial. It is about cutting the expenses within the Medicaid and Medicare program. It is about reducing the monies paid to the DSH (Disproportionate Share Hospital). I am going to provide a reason why this is not as bad as it seems. But, first the provision, then an article and then I'll follow up with an explanation.

Page 759, lines 8 through 14;

(b) MEDICAID DSH REDUCTIONS.—
(1) IN GENERAL.—The Secretary shall reduce Medicaid DSH so as to reduce total Federal payments to all States for such purpose by $1,500,000,000 in fiscal year 2017, $2,500,000,000 in fiscal year 2018, and $6,000,000,000 in fiscal year 2019.

This is an article from the website for the AHA (American Hospital Association). The AHA is concerned with administrators of hosptials and the monies they receive for operation of hospitals. The AHA is a good organization. It sets all kinds of rules and regs for hospitals, their personnel, etc. The article below outlines the controversy.

Safety-net hospital leaders see DSH cuts as roadblock to health reform (click here)
June 22, 2009
Safety-net hospital leaders say President Obama's proposal to cut $106 billion in Medicare and Medicaid Disproportionate Share Hospital (DSH) payments over the next 10 years marks a wrong turn on the road to health care reform.
"Those cuts would affect our viability … the lifeline of our institution," says John Bluford, president and CEO of Truman Medical Centers (TMC) in Kansas City, MO.
The DSH proposal would reduce TMC's Medicaid reimbursements by nearly $50 million a year. About half of the patients who enter TMC's doors are Medicaid beneficiaries; nearly 30% of its patients are covered by Medicare.
There are not enough efficiencies for us to make up for the loss in that level of funding," Bluford says. "This is about protecting the safety net and providers who represent the medical homes for hundreds of thousands of patients."
The president on June 13 called for the DSH cuts – a 75% reduction in funding for the programs – as part of a proposal to cut health care spending by $313 billion over 10 years to help finance health reform. Of that amount, some $220 billion would be chopped from hospital funding, including $110 billion in across-the-board "productivity adjustments" to Medicare payment increases....

First, what is a DSH? A DSH is a hospital that receives higher than average numbers of indigent people. The DSH receives additional funding for supplying health care to these folks. It is a cut in that extra funding the AHA is complaining about. And, of course, where there is cut in the funding they are concerned they will not be able to provide care to the people they normally treat. Reasonable thought. A little surprising, because, this is not as bad as it seems.

The DSHs of the country are the ones that get a lot of uninsured. Okay? What is this bill going to do? It is going to insure the uninsured. Are you following me here?

Over the next ten years, these bills will provide insurance for the uninsured and the cost to DSH hospitals for the uninsured will come down. As more and more citizens are insured, the hospitals will be getting compensated for their 'actual' costs within the Medicaid and Medicare program. So, if the 'subsidies' to the DSHs continued as well as the uninsured being insured, the hospitals would actually be 'double dipping.'

As much as 25% of the subsides to the DSHs will continue because they also treat people whom are not citizens. The hospitals of the USA are not supposed to turn anyone away at their emergency rooms. So, if illegal aliens come to the ER they are going to receive treatment. That is all uncompensated treatment. So, 25% of the subsides will remain to pick up the slack for those people that still go to the DSHs without insurance.

I am confident, that over time, if the DSHs can provide concrete proof they are still losing more monies than they are being reimbursed, the legislature can readdress the problem, but, I don't believe that will be the case. The AHA needs to regroup in their assessment of these bills and ask their member hospitals to keep good records in regard to this group of people whom receive treatment at these hospitals. I commend the AHA for being as concerned about DSHs as they are all other hosptials.

The provisions of this aspect of this bill are very logical. The largest reductions will be in States with the lowest percentages of uninsured. These States will be better prepared for the reduction when it happens and will be able to control any of the outcomes should they be different than what is expected. I caution here. At the point where reductions to DSHs occur, they will probably be seeing larger revenues from insurances. The reductions will be nearly invisible to the hospital in question.

Each year, in keeping with transparency, the allotment of DSH payments will be published in the Federal Register to insure equity in decision making. The provision goes on to be sure the programs administered by the DSHs are non-discriminatory and July 1, 2010 is the date when this provision would begin to take effect, unless, all safeguards are not in place.

There is a change in subject beginning with Page 765.

Subtitle B—Prevention
SEC. 1711. REQUIRED COVERAGE OF PREVENTIVE SERVICES.

Same page, lines 18 through 25;

‘‘(1)(A) recommended with a grade of A or B by the Task Force for Clinical Preventive Services;
or
‘‘(B) vaccines recommended for use as appropriate by the Director of the Centers for Disease Control and Prevention; and

‘‘(2) appropriate for individuals entitled to medical assistance under this title.’’.

It appears Smoking Cessation medications aren't going to be paid for anymore. There will be home care visits allowed for mothers of newborns and children of abuse/neglect.

Page 768, lines 20 through 24 and page 1 through 14;

‘‘(aa) The term ‘nurse home visitation services’ means home visits by trained nurses to families with a first-time pregnant woman, or a child (under 2 years of age), who is eligible for medical assistance under this title, but only, to the extent determined by the Secretary based upon evidence, that such services are effective in one of more of the following:

‘‘(1) Improving maternal or child health and pregnancy outcomes or increasing birth intervals between pregnancies.
‘‘(2) Reducing the incidence of child abuse, neglect, and injury, improving family stability (including reduction in the incidence of intimate partner violence), or reducing maternal and child involvement in the criminal justice system.

‘‘(3) Increasing economic self-sufficiency, employment advancement, school-readiness, and educational achievement, or reducing dependence on public assistance.’’.
(b) EFFECTIVE DATE.—The amendments made by this section shall apply to services furnished on or after January 1, 2010.

Page 770, lines 3 through 6; The Right Wingers won't like this. This is an opportunity to introduce a concept that provides insight to economical reasons for family planning. Don't prejudge this;

SEC. 1714. STATE ELIGIBILITY OPTION FOR FAMILY PLANNING SERVICES.
(a) COVERAGE AS OPTIONAL CATEGORICALLY NEEDY GROUP.—

Page 771, lines 3 through 11;

(B) by inserting ‘‘, and (XV) the medical assistance made available to an individual described in subsection (hh) shall be limited to family planning services and supplies described in section 1905(a)(4)(C) including medical diagnosis and treatment services that are provided pursuant to a family planning service in a family planning setting’’ after ‘‘cervical cancer’’.

Ever hear of the name Thomas Robert Malthus? He was a British scholar. His works were said to inspire Wallace and Darwin. But, his speciality was not evolution so much as political eonomy and demographics.

Thomas Malthus focused a great deal on population growth. He stated as society improved conditions for life, there was a counter balance such as famine or disease that would stabilize the population. Thomas Malthus was a clergyman. He was called Reverend Thomas Robert Malthus.

He wrote a book in 1798, entitled "An Essay on the Principle of Population." It was a very influential book for its time. It was the 6th edition that was believed to have been read by the collegues Darwin and Wallace. Now, don't close your mind to what he wrote. He was a holy man and just because Darwin and Wallace read his book and found inspiration doesn't mean that Reverend Malthus was a man to be disregarded. Quite the contrary. His writings made too much sense.

Within the book on the Principle of Population there was a section that became known as, Malthus' Iron Law of Population. It theorized that growing population rates would contribute to a rising supply of labour that would inevitably lower wages. In essence, Malthus feared that continued population growth would lend itself to poverty.

See, Malthus was a holy man. He didn't worry about HAVING cheap labor to facilitate profit, he worried about 'the state of living.' The quality of life. He didn't want his flock ending up impoverished because their population had so many members that they became DIRT CHEAP labor.

He's right, you know. The more people there are to provide labor, the less the wages will be. There are examples of that all over the world. Outsourcing of American jobs have went to countries with high population rates, impoverishment and cheap labor. Don't say they haven't, because it is a known fact. So, Reverend Malthus is correct. On all counts.

When I reflected on Reverend Malthus teachings in attempts to stem poverty; I also reflected on the 'state' of the priorities of the Republican Party. See, the Republicans are 'religious' right wingers that believe in uncontrolled population growth while allowing illegal immigration into the USA, unchecked. We know in this country, that for a long time, the porous Texas border was a welcome commodity to the people that would employ the illegal aliens to enhance their profit.

When I reflected on Reverend Malthus and his concern for quality of life with high population rates, I attempted to understand why in the year 2009, after eight years of religious fervor that would like see the end of birth control and abortion while removing sex education from schools; the USA was becoming more and more demoralized within the concept of 'responsible' population growth. After all. An economy is as strong as its participants that purchase the goods of supply and demand.

Why then. With theorists, like Reverend Malthus, whom anyone majoring in economics, especially at Harvard, would there be such wide spread religious fervor unchecked? Why was it not only unchecked, but, emphasized?

Why in an era of a warming planet, food shortages, droughts and water shortages would an entire American political party be so willing to encourage 'irresponsible' child bearing when they knew full well it would lead to wider spread poverty, impoverishment and less ability for any one consumer to purchase items in a 'capitalistic' supply and demand society?

It couldn't possibly be that the Republicans knew Reverend Malthus was more than correct, but, more a pure genius that would show them how to insure having any country rich with cheap labor. That couldn't be, now could it? Why cut off funding for Family Planning clinics in impoverished areas of the world on the first day of office in the year 2000? Why, indeed.

Got a little off the beaten path. So, where was I?

The provision continues that the family planning aspect of the bill is presumptively eligible initially.

That takes me to page 775 and a time of 11:24 PM.

Until later...have a good day.

A Saint He Ain't. Senator John Ensign allowed his parents to pay off his mistress.

And he is voting on health reform? Why? All three of these men committed extra-marital affairs, with every indication they still are and they are still in office. This is the party of the Religious Right, huh? I see.

Where are all the angry tea baggers now? If they aren't in bed with their bankers, than they are in bed with their mistresses. I betcha sometimes that is the same thing. Ahhhhhhh, what a life.

Yes, indeed, just one big happy family. The New York Times has a time line and story. Republicans seem to like their 'extramarital affairs' while in office. It is probably the only way they can afford them. Why elect them and tempt them with the opportunity?

Senator’s Aid After Affair Raises Flags Over Ethics (click title to entry - thank you)

By ERIC LICHTBLAU and ERIC LIPTON
Published: October 1, 2009
WASHINGTON — Early last year, Senator John Ensign contacted a small circle of political and corporate supporters back home in Nevada — a casino designer, an airline executive, the head of a utility and several political consultants — seeking work for a close friend and top Washington aide, Douglas Hampton....

...The job pitch left out one salient fact: the senator was having an affair with Mr. Hampton’s wife, Cynthia, a member of his campaign staff. The tumult that the liaison was causing both families prompted Mr. Ensign, a two-term Republican, to try to contain the damage and find a landing spot for Mr. Hampton.
In the coming months, the senator arranged for Mr. Hampton to join a political consulting firm and lined up several donors as his lobbying clients, according to interviews, e-mail messages and other records. Mr. Ensign and his staff then repeatedly intervened on the companies’ behalf with federal agencies in Washington, often after urging from Mr. Hampton.
While the affair made national news in June, the role that Mr. Ensign played in assisting Mr. Hampton and helping the clients he represented has not been previously disclosed. Several legal experts say those activities may have violated an ethics law that bans senior aides from lobbying the Senate for a year after leaving their posts....



One big happy family living on government money. Yep.



Main Content
John Ensign's parents paid $96K to his mistress (click here)
By MANU RAJU 7/9/09 3:11 PM EDT
Updated: 7/10/09 12:19 PM EDT

Sen. John Ensign's parents shelled out big bucks to pay off their son's mistress, the latest twist in an unfolding scandal that has upended the political career of the one-time rising GOP star.

The scandal has also touched Sen. Tom Coburn (R-Okla.), another prominent conservative, who revealed that he had confronted Ensign about the affair and urged him to end it, but says he will refuse to divulge any conversations with Ensign — even under inquiry from ethics investigators.

On Thursday, Ensign's attorney said that the senator's parents gave Doug Hampton, Cynthia Hampton and their two children gifts worth $96,000 in the form of a check. The attorney, Paul Coggins, said that each gift was limited to $12,000 and "complied with tax rules governing gifts."

The disclosure of the April 2008 payment seemed intended to head off growing questions about whether Ensign violated federal law by failing to report what Doug Hampton called a severance package worth more than $25,000 to his wife Cynthia, who left Ensign's campaign staff on April 30, 2008....



Then there is the 'dirty little joke' in California. Messy indeed. Sharing leisure time with female lobbiests in their pantyhose or less.




GOP Lawmaker's Graphic Sex-Bragging Caught On Tape (click here)
Zachary Roth
September 9, 2009, 11:45AM
"She wears little eye-patch underwear. So, the other day she came here with her underwear, Thursday. And
 so, we had made love Wednesday--a lot! And so she'll, she's all, 'I am going 
up and down the stairs, and you're dripping out of me!' So messy!"



Then there is good ole' Governor Sanford of South Carolina. Estranged spouse of soon to be author, Jenny Sanford, still first lady of South Carolina.



Gov. Sanford's use of state planes raises tax questions (click here)
Experts say using state planes for personal and political trips might be unreported income.
By Jim DavenportAssociated Press
Posted: Wednesday, Sep. 30, 2009

COLUMBIA S.C. Gov. Mark Sanford's use of state planes for personal and political trips could open him and the state to federal tax penalties because the flights never were recorded as taxable fringe benefits.
Tax experts who reviewed an Associated Press analysis of more than 100 flights since 2003 said numerous trips could have triggered Internal Revenue Service rules that require adding the value of flights to the governor's wages, making them subject to taxes. The analysis shows nine flights since 2008 alone could be worth $19,019 in taxable benefits.
"The state appears to take the position that they assume that all of these are business flights," said Marianna Dyson, a former IRS fringe benefits lawyer and one of the nation's leading experts on the topic. By doing that, the state "ignored the rules applicable to the use of an employer's aircraft."...



Don't know why Jenny doesn't have a boyfriend yet, the Governor already made up his mind.

Published: Tuesday, Sep. 22, 2009
Updated: Tuesday, Sep. 22, 2009 12:34 PM
Jenny Sanford plans memoir (click here)
Associated Press
COLUMBIA -- The estranged wife of South Carolina Gov. Mark Sanford is writing a memoir.
Ballantine Books, an imprint of Random House Inc., said Tuesday it will publish Jenny Sanford's "inspirational memoir" in May 2010.
The publisher says Sanford "will grapple with the universal issue of maintaining integrity and a sense of self during life's difficult times."...

Long before President Obama was elected, Chicago bid for the Olympics.

The final selection will be made on October 2, 2009, in Copenhagen, Denmark.

Currently, Chicago's rival cities for the hosting of the Games are Madrid, Spain; Rio de Janeiro, Brazil; and Tokyo, Japan.

If Chicago is chosen, the games would be held from July 22 to August 7, with the Paralympics held between August 12 and August 28.

The United States Olympic Committee chose Chicago April 15, 2007. It is only right President Obama advocate for the Olympics to come to the USA and to realize it is doubly sweet as Chicago is the venue.

There is every hope that if Chicago is the hosting city for the 2016 Summer Olympics, there will be more jobs. More jobs and good pay will help lower an escalating crime rate in Chicago.

Chicago won the bid...What's next? (click title to entry - thank you)
Tribune staff report
6:54 p.m. CDT, April 15, 2007
First on the agenda is a lunchtime celebration Monday in Daley Plaza.
Mayor Richard Daley, Chicago 2016 chairman Patrick Ryan and former Olympians are expected to take the stage at noon, celebrating Saturday's news that the Windy City will represent the United States in the worldwide bid for the Games.
Videos produced as part of Chicago's 2016 Olympic application will air on a large television on the northeast corner of the plaza.
And then down to business. The U.S. Olympic Committee must submit Chicago to the International Olympic Committee as a formal applicant for the 2016 Summer Games by Sept. 15. The IOC will select the 2016 host city in October 2009 in Copenhagen.
There is no precise timetable for the various stages of the bid process between those two dates. According to IOC spokesman Emmanuelle Moreau, a timetable will be established after the IOC members pick the 2014 Winter Olympics host city July 4 in Guatemala City....

Updated: October 1, 2009, 6:25 PM ET
Chicago, state get ready for IOC decision (click here)

Associated Press
CHICAGO -- The Picasso is already wearing a medal and a laurel wreath.
Chicagoans plan to show up at the base of the famous Daley Plaza sculpture on Friday to watch the International Olympic Committee decide if their city will get to host the 2016 games.
Surita Mansukhani of Chicago and her mother, Beverly Jordan, plan to be there to score some of the thousands of free T-shirts local organizers plan to hand out.
"We don't have to go halfway around the world to come here," said Jordan, a writer who lives within walking distance of Daley Plaza.
Jumbo television screens will be set up so people can watch live from Copenhagen when the International Olympic Committee announces the 2016 host city. Chicago is a finalist along with Tokyo, Madrid and Rio de Janeiro.
Donna Dukat said she won't be at the downtown rally, but the Chicago native will be pulling for her city to land the games.
"I love the Olympics," said Dukat, a dental hygienist who confessed to recording previous games on television so she wouldn't miss any of the action....

The EPA finally acts on the knowledge Scientists have known for decades.

The chart below is PROOF that the 'tailpipe soot and smokestake soot' won't even begin to curtail the warming of Earth by casting a 'particulate' shadow.


Click to enlarge image, thank you.
The above figure indicates global average forcing of greenhouse gases (GHGs) and aerosols (click here). While the forcing of heating factors such as GHGs is estimated with low uncertainties, those of aerosols are considered to provide direct and indirect cooling effects; altering the effect of cloud albedo through cloud microphysical process is considered an indirect effect. However, uncertainties in the estimate of the cooling effect are still large. In addition, some theoretical studies tell us that cloud distributions in the warmed world will change and cause heating, not cooling, but predictions of the cloud radiative forcing by current climate models are scattered in both cooling and heating directions. GCOM-C aims to observe long-term trends of horizontal distributions of aerosols and clouds on a global scale over 13 years and to estimate the cooling effects of aerosols with high accuracy in order to contribute to enhancing the accuracy of climate models.

Additionally... Anthropogenic carbon dioxide causing the heating of Earth is also increasing the level of pollens from plants into the air. That means CO2 is directly responsible of increasing the risks from asthma and other lung diseases.

The journal in which this article appears is cited below and can be obtained at any local library with the help from The Reference Librarian through 'Interlibrary Loan." That can probably be accomplished with a phone call or e-mail and a return electronic record to any computer or picked up at the library as a paper copy. Depending on the services provided by the library, a person may not have to even leave the office or home to obtain it.:

Is the Global Rise of Asthma an Early Impact of Anthropogenic Climate Change?
Paul John Beggs 1 and Hilary Jane Bambrick 2
1Department of Physical Geography, Division of Environmental and Life Sciences, Macquarie University, New South Wales, Australia; 2National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia


The increase in asthma incidence, prevalence, and morbidity over recent decades presents a significant challenge to public health. Pollen is an important trigger of some types of asthma, and both pollen quantity and season depend on climatic and meteorologic variables. Over the same period as the global rise in asthma, there have been considerable increases in atmospheric carbon dioxide concentration and global average surface temperature. We hypothesize anthropogenic climate change as a plausible contributor to the rise in asthma. Greater concentrations of carbon dioxide and higher temperatures may increase pollen quantity and induce longer pollen seasons. Pollen allergenicity can also increase as a result of these changes in climate. Exposure in early life to a more allergenic environment may also provoke the development of other atopic conditions, such as eczema and allergic rhinitis. Although the etiology of asthma is complex, the recent global rise in asthma could be an early health effect of anthropogenic climate change. Key words: aero- allergens, anthropogenic cimate change, asthma, carbon dioxide, phenology, pollen, temperature.

Environmental Health Perspectives; Number 113: Pages 915-919 (2005).

doi:10.1289/ehp.7724 available via http://dx.doi.org/ [Online 20 April 2005]


Global Trends in Asthma
...Evidence for the global increase in the burden of asthma has come from studies of incidence, prevalence, and morbidity. Asthma prevalence appears to have increased since the early 1960s (Beasley 2002), with the rise in asthma prevalence occurring among both chil- dren and adults (Beasley et al. 2000) and in a wide range of countries with differing lifestyles (Beasley 2002). Over a similar period, the prevalence of other atopic disorders, such as allergic rhinitis, atopic eczema, and urticaria, has also increased, once again throughout the world (Bach 2002; Beasley 2002). Figure 1 shows increasing prevalence of asthma in several locations. Although different diagnostic definitions have been used in different loca- tions, each location shown is internally consis- tent, and each shows an increase in asthma prevalence.


It has been known for over five decades. Five decades of research. It is hideous to continue to deny the warming of the planet due to the high levels of CO2.

The USA has made some stupid decisions regarding land use under the prior administration as well. It’s pathetic already.

Droughts and destroyed ice fields are everywhere including Greenland which is deteriorating at an accelertating rate. The problem with people that are "The Deniers" is that they actually believe they can live through climage change, and denying the anthropogenic reasons for global warming is to maintain ’status quo’ economics. Life on Earth as we know it will end if the CO2 content of Earth's troposphere is not brought under control. Earth is a planet. It is NOT a toy or some market strategy. I promise you the changes that happen on a dynamic that huge won’t allow humans to survive.

There are no winners in Climate Change. It is a Lose-Lose situation. "Survival of the Fittest" does not apply to Climate Change. Look at it this way, human live in a VERY NARROW window of temperature tolerance. They live with a specific demand for oxygen. Those windows close quickly when the 'biotic content' of Earth is unbalanced.

...The proposed regulations would apply to large-scale industrial sources (click title to entry - thank you) of heat-trapping gases, including power plants, factories and refineries, but not to smaller sources such as new schools, as some critics of EPA action had feared. The rules would force new or substantially modified industrial plants emitting at least 25,000 tons of greenhouse gases a year to employ "best available control technologies and energy-efficiency measures" to minimize emissions. That would cover the sources responsible for 70% of greenhouse gas emissions in the U.S., the EPA said -- primarily carbon dioxide created by burning fossil fuels....

Senator Baucus exhibits NO leadership abilities.

In the Senate the blood is in the water and the Republicanesque environment will continue to hack away at as much of the House Bill as possible, ultimately, reducing it to nothing if possible.


Baucus buys and sells the American people as if they were his personal property to make deals with Wall Street.

46 million uninsured

25 million under-insured

And the USA Senate has sold out to Wall Street.

It is PROFOUNDLY time for a change !

The USA is supposed to be an example of democracy, not demagoguery.

They can’t stop us; we are going to get this done (click title to entry - thank you)
By Melissa DeRosa
September 30, 2009, 6:56 AM
Aflurry of new reports from the Treasury Department, the U. S. Census Bureau, Robert Wood Johnson and the Kaiser Family Foundations underscore something we’ve known in New York for a long time — we can’t wait another year for health insurance reform.
According to recent national data from the U. S. Census, the number of uninsured increased from 39.8 million in 2001 to 46.3 million in 2008. Most of these individuals are in the middle class. In New York, there are now 2.7 million people living without insurance, one accident or illness away from financial disaster. Nearly half of all Americans under 65 will lose their health coverage at some point in the next 10 years.
Over the past 10 years, health premiums increased by 131 percent and the average family policy now costs $13,375 a year. Premiums continue to rise three times faster than wages and eventually the United States will spend more on Medicare and Medicaid than every other government program combined.
President Obama’s health insurance reform plan takes the best from Democratic and Republican proposals to address three broad goals: provide more security and stability for people who have insurance; provide affordable, quality choices for those who don’t; and lower health care costs....

Within the next ten years every Middle Class American will face the choice of keeping their health care coverage or losing their home !

The stimulus is working. A change in USA infrastructure is going to contact before it expands. The USA is shedding jobs that are irrelevant to the future and the change in energy and transportation infrastructure.

The USA, under President Obama, is taking on a 'new face' to combat Climate Change while increasing the focus on education, health care, genetic medicine, natural/environmental aesthetics of life (If not sure what I am referring to, click here) and the arts.

The venues least focused on by the previous administration are actually where growth needs to take place and is the place where change is taking place. This is very good news that will definitively be the trend of the NEW American economy.

U.S. economy shrinks less than expected (click here)
...The world’s largest economy contracted at a 0.7 percent annual rate in the second quarter, its best performance in more than a year, according to a revised final estimate released Wednesday by the U.S. Commerce Department.
Economists had expected GDP to contract at a 1.2 percent annual rate, according to the median forecast in a Bloomberg survey of 78 economists....

Give President Obama a Senate he can work with in 2010 !

The country has a lot of work to do, including the continued recovery from the economic abuse of the Bush/Cheney years.

"...President Obama seems to be out there all alone..."

Washington Post Poll: (click here)

Would you support or oppose having the government create a new health insurance plan to compete with private health insurance plans? Do you feel that way strongly or somewhat?
September 12, 2009-09-29

Support
Net - 55
Strongly - 33
Somewhat - 22

Oppose

Net - 42
Strongly - 33
Somewhat - 22

No Opinion 3

The Public Option is not an OPTION. The Senate sold out today to Health Insurance Lobbyists. That sounds like a 'rhetorical' statement as well, but, it isn't. Let me portray the real issue that will result without the Public Option.

Within the Health Care Reform Bill, Americans will be required to have health insurance no different than they have car insurance. However, without a Public Option, the citizens of the USA are at the mercy of the Insurance Companies that will return to the federal legislature and demand higher rates over and over and over again as they can't make ends meet and they will declare the reform a failure and a 'I told you so.'

This was complete sabotage by the Senate. Mike is correct, the movement for reform needs to be heard loud and clear. The Pubic Option has to stand as a part of this legislation. It is vital and no joke. By demanding the American Public have health care by statue it overwhelmingly opens them to exploitation by Wall Street and the CEOs of the insurance companies that will complain about their profit loss because they can't throw '? risky ?' clients off their enrollments.

Today the Senate sold the people of the USA to Health Care Insurance Companies, it is up to the President and the House to stop this complete idiocy. Every Senator that voted against the Public Option needs to be scrutinized for re-election. Candidates should be elected in 2010 that have favored it regardless of the outcome of the Reform Bill.

The film loop below is a poor example and 'spinelessness' of Senate Democrats. They are a joke.

New York Times / CBS Poll (click here)
Would you favor or oppose the government offering everyone a government administered health insurance plan – something like the Medicare coverage, something like the people 65 and older get, that would compete with private health insurance plans?

September 19-23, 2009

Favor – 65%

Oppose – 26%

Don’t know/ NA – 9%

The Economist / YouGov Poll (click here)

9. Do you favor or oppose having a “public option” which would allow individuals to purchase health care insurance coverage”

Favor – 47%

Oppose – 32%

Not sure – 21%

Where's the bill?

David Lewis
Muncie
September 28, 2009
Why did the Senate vote to keep the health-care bill from being released to the Internet? (click title to entry - thank you) Do you think it is because we Hoosiers can't read? Or would there be some other motive such as protecting us from information we would not want to know?

Isn't this the Senate Bill? (click here)

I believe I left off with Page 700 of the House bill or something like that.

I am more than curious about this topic. Page 704, lines 17 through 20;

Subtitle C—Enhanced Program and Provider Protections
SEC. 1631. ENHANCED CMS PROGRAM PROTECTION AUTHORITY.

This is a quality assurance provision. Basically, after the law is in effect there will be a review of participating entities as decided by the Secretary. This is simply the House giving the Secretary of Health and Human Services the 'right' to conduct whatever review of providers that is needed. It is a way for the House of Representatives saying, they approve any action necessary to be sure providers are well intended and qualified. I don't see that it is a mandate and the Secretary has to institute reveiws. At least now yet. I need to read through a few pages to be sure.

‘‘(a) CERTAIN AUTHORIZED SCREENING, ENHANCED OVERSIGHT PERIODS, AND ENROLLMENT MORATORIA.—
‘‘(1) IN GENERAL.—For periods beginning after January 1, 2011, in the case that the Secretary determines there is a significant risk of fraudulent activity (as determined by the Secretary based on relevant complaints, reports, referrals by law enforcement or other sources, data analysis, trending information, or claims submissions by providers of services and suppliers) with respect to a category of provider of services or supplier of items or services, in15
cluding a category within a geographic area, under title XVIII, XIX, or XXI, the Secretary may impose any of the following requirements with respect to a provider of services or a supplier (whether such provider or supplier is initially enrolling in the program or is renewing such enrollment):

This provision empowers the Secretary to work with states for quality assurance of providers. They can do background checks and unannounced visits, etc. The paragraph here sums up the provision. Page 709, lines 8 through 18:

‘‘(d) PROGRAM INTEGRITY.—A State child health plan shall include a description of the procedures to be used by the State—

‘‘(1) to enforce any determination made by the Secretary under subsection (a) of section 1128G (relating to a significant risk of fraudulent activity with respect to a category of provider or supplier described in such subsection through use of the appropriate procedures described in such subsection); and ‘‘(2) to carry out any activities as required by the Secretary for purposes of such subsection.’’.

The ultimate outcome is on Page 711, lines 8 through 14;

‘‘(3) AUTHORITY TO DENY PARTICIPATION.—If the Secretary determines that there has been at least one such affiliation and that such affiliation or affiliations, as applicable, of such provider or supplier poses a serious risk of fraud, waste, or abuse, the Secretary may deny the application of such provider or supplier.’’.

This is law. This is legislating every detail in order to facilitate the benefits for the people. This is what DC, the State, county and local municipalities are all about. This is being sure the person that will carry out the law is equipped with tools outlined in the legislation. That is what most of this provision provides. It empowers the Secretary the ultimate right to deny participation if a provider is found to be unworthy and/or harmful.

A lot of people involved in the health care industry don't like this empowerment of the government. They like their money no matter what quality of services are provided. Once money changes hands it is too late. The quality has to be in place before payment, otherwise, that will be monies poorly spent. It doesn't have to be fraud either, just plain 'lousy' quality.

They aren't going to like this either. It is a modifer to alter payment amounts to providers if there is duplication of services. Page 713, lines 1 through 14:

‘‘(p) PAYMENT MODIFIER FOR CERTAIN EVALUATION AND MANAGEMENT SERVICES.—The Secretary shall establish a payment modifier under the fee schedule under this section for evaluation and management services (as specified in section 1842(b)(16)(B)(ii)) that result in the ordering of additional services (such as lab tests), the prescription of drugs, the furnishing or ordering of durable medical equipment in order to enable better monitoring of claims for payment for such additional services under this title, or the ordering, furnishing, or prescribing of other items and services determined by the Secretary to pose a high risk of waste, fraud, and abuse. The Secretary may require providers of services or suppliers to report such modifier in claims submitted for payment.’’.

The provision goes on in the usual manner, implementation, assignment of responsibilites, what standards will be applied, enforcement for non-compliance. This is new. There is a 'expiration' to filing for a claim.

SEC. 1636. MAXIMUM PERIOD FOR SUBMISSION OF MEDCARE CLAIMS REDUCED TO NOT MORE THAN 12 MONTHS.
(a) PURPOSE.—In general, the 36-month period currently allowed for claims filing under parts A, B, C, and, D of title XVIII of the Social Security Act presents opportunities for fraud schemes in which processing patterns of the Centers for Medicare & Medicaid Services can be observed and exploited. Narrowing the window for claims processing will not overburden providers and will reduce fraud and abuse.

I am a little concerned. There is a loophole that needs to be closed with this provision, unless, I simply haven't read it yet. I think the provision is good. Twelve months is more than enough time for providers to file a claim for payment, HOWEVER, what if that time period goes by and individuals lose their benefits because it. Can the provider then bill and insist payment from the client/individual without the benefit of any insurance payment?

There needs to be more incentive to be sure providers file for payment in a timely fashion. There has to be an understanding that if their claim period expires and this is a claim that would carry a payment with the insurance, then the provider loses all income from that lost opportunity to receive payment.

To ignore billing an insurance in a 'reasonable' time period should also become part of a review process with brevity. It is a form of negligence. It is equivalent to 'financial abuse.' As an example, the elderly can be protected from people that care for them when they are being exploited for money. There are criminal penalites for such abuse of the elderly. That same logic should apply to this provision. If a provider is negligent in sending in claims for payment and then in turn attempts to collect the debt portion of the cost that would normally be billed to the insurance it is fiscal abuse of the insured.

The provision goes on with the usual statements, effective date, enforcement and submitting documentation, including a copy of a written order, of claims upon request of the Secretary.

Section 1640 delegates investigation authority to the Inspector General of Health and Human Services. That is pretty much standard throughout these provisions. I just hadn't stated it before, so I wanted to be sure I mentioned it at least once. There is no sense in making this entry as boring as the reading of the law itself. So, there it is. The Inspector General will carry out investigations.

Ah, a provision that requires honesty. Overpayment. Gee, they have to give it back? Not like Christmas or anything? A birthday surprise maybe? No?

Page 726, lines 7 through 12;

‘‘(c) REPORTS ON AND REPAYMENT OF OVERPAYMENTS IDENTIFIED THROUGH INTERNAL AUDITS AND REVIEWS.—
‘‘(1) REPORTING AND RETURNING OVERPAYMENTS.—If a person knows of an overpayment, the person must—

Ya got sixty days to give the monies back to the Secretary. So, that should happen, take the money to Goldman Sachs and have them backroll it into some derivitive and make a few bucks. If you lose the money, however, it might not be insured, ya know? Sixty days to make it all happen for yourself.

Page 726, lines 21 through 26 and Page 727, lines 1 and 2.

"(2) TIMING.—An overpayment must be reported and returned under paragraph (1)(A) by not later than the date that is 60 days after the date the person knows of the overpayment. Any known overpayment retained later than the applicable date specified in this paragraph creates an obligation as defined in section 3729(b)(3) of title 31 of the United States Code.

A little bit of an enforcement issue here, page 727, lines 3 through 13;

‘‘(3) CLARIFICATION.—Repayment of any overpayments (or refunding by withholding of future payments) by a provider of services or supplier does not otherwise limit the provider or supplier’s potential liability for administrative obligations such as applicable interests, fines, and specialties or civil or criminal sanctions involving the same claim if it is determined later that the reason for the overpayment was related to fraud by the provider or supplier or the employees or agents of such provider or supplier.

There must be a significant amount of 'double dipping' with the ownerships of these free standing, speciality clinics. Page 728, lines 18 through 25 and 729, lines 1 through 6;

SEC. 1643. ACCESS TO CERTAIN INFORMATION ON RENAL DIALYSIS FACILITIES.
Section 1881(b) of the Social Security Act (42 U.S.C. 1395rr(b)) is amended by adding at the end the following new paragraph:
‘‘(15) For purposes of evaluating or auditing payments made to renal dialysis facilities for items and services under this section under paragraph (1), each such renal dialysis facility, upon the request of the Secretary, shall provide to the Secretary access to information relating to any ownership or compensation arrangement between such facility and the medical director of such facility or between such facility and any physician.’’.

Let me see if I can explain this clearly, because it is very important. This isn't government being difficult, it is being vigilant of the USA Treasury and the cost of private health insurance.

Let's say my name is Dr. Zebra. I am making rounds in the hospital during the early morning hours and have ordered 'hemo' dialysis on a patient for the very first time in an outpatient facility, as they are being discharged and are to report to their dialysis facility after leaving the hospital for their first outpatient treatment.

I am paid for that service. I am paid for my evaluation of the necessity of the order and its brevity to the patient.

I have late evening office hours where I will see patients. I have late evening office hours once per week. So, I leave the hospital, after making rounds, at about 1:00 PM.

I stop at the Hemodialysis Clinic that I have a partnership in ownership with another physician. While there, the patient I discharged comes into the facility. I review the orders I wrote and might modify them a bit to change the amount of fluid that is being removed considering the blood pressure of the patient.

I am paid for that service. I am paid for my evaluation of the necessity of the order and its brevity to the patient.

I leave the facility, grab a bite to eat and head to the office. While the patient was receiving hemodialysis, she had an adverse reaction, but, not so severe that she needs to return to the hospital, so I tell the clinic, which I own in partnership with another physician, to have the patient come to the office for evaluation. The patient complies and stops into the office where I examine the patient and realize there was too much fluid removed and she needs replacement, so I order her to take three glasses of water while in my office.

I am paid for that service. I am paid for my evaluation of the necessity of the order and its brevity to the patient. I incurred expenses at the office with support personnel that are periodically checking the patient's blood pressure for a reasonable recovery.

The patient then goes home and she is to report for re-evaluation after her next dialysis treatment in two days.

Dr. Zebra received three payments from three different locations for his services regarding one patient. As a partner to the Dialysis Clinic he also was paid for the time the patient was receiving dialysis. Now, one can debate as to whether that is abuse of the system or not, but, it seems fairly clear to me there needs to be a better way of tracking the actual practice of a physican and the monies received to them, especially when there is a huge conflict of interest in their ownership of free standing clinics or nursing homes.

Are there ethical issues? Good question.'

The 'key' to the issue, in my opinoin, is 'the quality of a physician's practice' and 'the trend in the practice' in treatment of patients. In other words, is this a routine that frequently appears.

Page 729, lines 12 through 18;

‘‘(D) BILLING AGENTS AND CLEARING HOUSES REQUIRED TO BE REGISTER UNDER
MEDICARE.—Any agent, clearinghouse, or other alternate payee that submits claims on behalf of a health care provider must be registered with the Secretary in a form and manner specified by the Secretary.’’.

Okay. This is a provision to bring brevity to accuracy by billing agents. By having them register with the government, they can be tracked to their performance by a simple code or registration number. The volume of billing they do and how many times the same service is being billed will make finding and prosecuting fraud a lot easier.

Page 731, lines 3 through 9;

‘‘(13) knowingly makes, uses, or causes to be made or used, a false record or statement material to an obligation to pay or transmit money or property to a Federal health care program, or knowingly conceals or knowingly and improperly avoids or decreases an obligation to pay or transmit money or property to a Federal health care program;’’; and

There a many definitions to this section, as well as improvements in the wording of the law. Page 735, lines 3 thorugh 6;

‘‘(9) The term ‘material’ means having a natural tendency to influence, or be capable of influencing, the payment or receipt of money or property.’’.

This is a compliance issue. It provides for access to records.

Page 735, lines 7 through 11;

Subtitle D—Access to Information Needed to Prevent Fraud, Waste, and Abuse
SEC. 1651. ACCESS TO INFORMATION NECESSARY TO IDENTIFY FRAUD, WASTE, AND ABUSE.

Page 740, lines 1 through 8 (of the same provision).

SEC. 1653. COMPLIANCE WITH HIPAA PRIVACY AND SECURITY STANDARDS.
The provisions of sections 262(a) and 264 of the Health Insurance Portability and Accountability Act of 1996 (and standards promulgated pursuant to such sections) and the Privacy Act of 1974 shall apply with respect to the provisions of this subtitle and amendments made by this subtitle.

I wish Congress would review the HIPPA laws. I don't believe they are good laws. I believe the old standards were far better. The enforcement of HIPPA laws requires more paperwork and more personnel time and in some instances can delay patient care. They aren't good laws. An understanding about privacy, enforcable through negligence of abiding by a patient's right to privacy is all the public needs. In my opinino, HIPPA adds to health care 'overhead' costs.

Page 740, lines 9 through 17;

TITLE VII—MEDICAID AND CHIP
Subtitle A—Medicaid and Health Reform
SEC. 1701. ELIGIBILITY FOR INDIVIDUALS WITH INCOME BELOW 133-1⁄3 PERCENT OF THE FEDERAL POVERTY LEVEL.

(a) ELIGIBILITY FOR NON-TRADITIONAL INDIVIDUALS WITH INCOME BELOW 133 PERCENT OF THE FEDERAL POVERTY LEVEL.—

This is the reference to The Public Option. These words appear several times to each of the defining paragraphs of the updates to existing laws. Page 743, lines 9 through 24 and Page 744, lines 1 abd 2:

(C) by adding at the end the following new subclause:

‘‘(IX) who are under 65 years of age, who would be eligible for medical assistance under the State plan under one of subclauses (I) through (VII) (based on the income standards, methodologies, and procedures in effect as of June 16, 2009) but for income and who are in families whose income does not exceed 1331⁄3 percent of the income official poverty line (as defined by the Office of Management and Budget, and revised annually in accordance with section 673(2) of the Omnibus Budget Reconciliation Act of 1981) applicable to a family of the
size involved;’’.

One hundred and thirty-three and a third of the poverty level is in the ballpark of about $23,000 annually. Right? One hundred percent would be about $17 - $18,000 annually. Then add one third more as qualifying income brings it to somewhere around $23,000. That is a very low income for folks under 65 years of age and an exceptionally low income for any family. That is ridiculous. There should be access to free health care, without question, to these people. Absolutely.

This is basically adding the parents of SCHIP children. That's what it seems like to me.

I could tell you a story here, but, I don't know if I want to. Give me a minute.

Okay, what the heck. This is protecting the 'innocense' of the unborn. This goes back to mid-1990s in Newark, New Jersey at UMDNJ's obstetric HIV/AIDS clinic. Yes, it is about AIDS again, but, it is a stark example.

Oh, what about the news about a vaccine? Pretty good, ah?

Okay. I stated before the children in Lowell, Massachusetts were receiving gammaglobulin in transfusions to stop the effects of HIV/AIDS on their growth and development. Well, the MD that headed up the clinics at UMDNJ in regard to women and children took that one step further. When a woman was diagnosed with HIV and was pregnant, they would get gammaglobulin transfusions for the length of the pregnancy. The idea was to bring relief to the fetus while developing in utero.

The hope was that infants would be born without the disease. In fact, there were some infants born positive, but, converted to negative about a month after their birth. In other words, when they started producing their own blood through their own bone marrow outside the uterus of the mother. Truly. It didn't happen every time, but, there were occassions when it did. Now, whether they remained healthy is another question. They might have reinfected after a long time.

But, this isn't about them. It is about their parents.

It was almost ludicrous to walk into the OB Clinic at UMDNJ. There were healthy mothers waiting to be seen and there were HIV mothers waiting to be seen. There was no difference in their appearance, because the HIV mothers were relatively healthy during their pregnancy. Good body weight, 'secondary' diseases in check. In appearance they looked no different than the healthy mothers.

So, then what was so ludicrous, right?

What was so ludicrous was the appearance of the fathers. They were usually under weight and appearing rather ill. There were remarkable differences between the healthy fathers and the HIV fathers. Of course, there was also the sadness the HIV fathers might not live to see their children born if they became ill with a severe secondary infection. It was a stressor to the HIV mothers and difficult to live with knowing their transfusions would end with the birth of the child. They were discouraged at all costs not to breastfeed. The HIV parents had a very different reality than the healthy parents. It was a tough environment to be in somedays.

Oh, yes, the fathers would accompany the mothers. This was Newark. There were safety issues and bonding issues. The fathers were absolutely a part of this picture.

The point is, where there are children there is a need for parents. If we as a society state the children are important enough to provide health care for, then aren't we obligated, MORALLY, to provide every opportunity for the well being of their parents? Isn't a child allowed to be raised by parents that will be healthy and able to support them? Do they have to live in a parallel universe whereby their parents may not be healthy enough to participate in their lives all their lives?

There are many eligibility certification statements under this provision. Admitting 'non-traditional' patients to Medicaid/Medicare is a mutual relationship between the federal and state governments. Both the states and federal government provide benefits to some predetermined formula. The provision in this part of the bill tells the states about certification of people eligible for benefits. How they can certify, where the law changes and how often people certify.

There is a special set of statements regarding non-traditional newborns. In other words, a newborn can receive benefits immediately until certification processes are complete and they are either covered by the Public Option or another form of insurance.

The purpose of this section is obvious.

A child has to receive medical care immediately at the time of birth. There may not be any insurance in place when the child is born, so this provides coverage at the time of birth so any child will not be compromised. The eligibilty is waved at this point until all the certifications can be completed. I would think that would be accomplished 'in house' by the Social Service department in the facility in a day or so.

This is page 750 and I am going to end here for tonight. I do read other things than bills.

Until later...

As an endorsement to the Afghan people, none of the winning parties in the election to date were Taliban.

If I had to go through this to vote I doubt I would. The Afghan people want their democracy.

The third place winner in the elections state his vote is clean and only of the people, believing of course, he should then be granted his right place in the Afghan Presidency.

...The EU estimates focused on polling sites (click title to entry - thank you) where more than 90 percent of the vote went to a single candidate. Bashardost scoffs at the notion that he was pulling in fraudulent ballots, saying he lacked the bribe money or government officials willing to falsify his ballots.
"My vote is clean," Bashardost says. "It is absolutely a vote of the people."
During the election, Bashardost did have an advantage with one ethnic voting bloc. He's a Hazara, a central Afghanistan ethnic group whose people traditionally have been persecuted, and suffered several massacres during the Taliban era.
Bashardost's roots are in Kabul, where his father had a small automobile parts shop. After the Soviet invasion of Afghanistan in 1979, Bashardost made his way to Iran and finally to France. There, he lived for 22 years, earning a doctorate in political science and law as he published a book about Afghan constitutional law.
Returning to Afghanistan in 2003, Bashardost served briefly as Karzai's minister of planning in 2004.
There, he proudly claimed to have angered his ethnic Hazara constituency by rejecting their pressure to stack his bureaucratic appointments with their ethnic bloc. "I said 'I'm a minister of Afghanistan, not Hazarajat," Bashardost said...

Afghanistan is not another South Vietnam. The stakes are much higher.

U.S Gen. Stanley McChrystal

General McChrystal is honest, forthright, dedicated and the list goes on. I have not witnessed in any other commander or general in the eight years in Afghanistan with this level of pure dedication to country and purpose. I believe he walks the talk and I believe he has the troops in mind when he issues opinion to his staff. He is well credentialed in defeating the men that would see civilization destroyed. He has successfully confronted the 'terrible' and brought them to justice or death.

He's right. I remember an assessment of Afghanistan by Representative John Murtha whom stated it would require 600,000 troops to be successful in Afghanistan. That seemed like such an unrealistic number, but, in his interview on CBS, General McChrystal stated, Afghanistan needs to have a fighting force of 400,000 of their own troops.

A fighting force of 400,000 Afghanistan troops isn't assembled overnight. It takes many people to recruit and train them.

In an interview today, Secretary Gates stated that last time there was a 'strategy' for Afghanistan was 1980. That is a lot of neglect. There was no real strategy for Afghanistan following September 11, 2001. There was a 'holding' pattern to make the Karzai government seem intact.

When President Obama ordered a strategy for Afghanistan little did anyone realize how much the Taliban had reconstituted its opposition to an organized government. President Obama, Secretary Gates went forward with the idea of securing the democracy in Afghanistan by hoping to succeed with elections. Little did anyone realize, the only 'surviving democracy' in Afghanistan was a Constitution and a exoskeleton of an infrastructure. Basically, President Karzai was a figure head to the issues of the country and the sincere structure of this democracy was gutted by violence as the Taliban were allowed to plunder Afghanistan with the cooperation of a very weak President/General Musharraf.

The corruption that besets Afghanistan is a direct result of the violence. Anarchy in a warlord domain is perfect for developing power brokers of 'mini-nations' of ethnic groups within the borders of the country. In order to stop the corruption, the Afghanistan government has to stop the violence. The two entities contribute to each other and one cannot exist without the other.

Afghanistan cannot be abandoned, unfortunately. It is in a sensitive region of the world that allows the nurturing of international criminals among a populous of people that sincerely want a democracy that values many of the qualities of life civilization values. If Afghanistan had a glut of oil between the rocks of the mountains, it would be occupied until every ounce was extracted. That isn't the case and Afghanistan through decades of neglect has devolved from a once reasonably peaceful society into one dominated by a bizarre culture nurtured by al Qaeda and given legitimacy by the Taliban.

The region has to find stability. The last eight years hasn't resolved the violence or dominated the culture by values of civilized countries because the 'real war' was sidelined to Iraq where there is significant oil deposits extracted to the last drop by injecting water into the oil wells at a time when humanity is suffering from a warming Earth and CO2 toxication while experiencing the worst droughts in history. To say the values here is bizarre is an understatement. The 'idea' of using water to inject into oil wells when people at the surface can't find potable water to drink is an unbelievable reality in Iraq.

But, Iraq is not the topic, the stabilization of Afghanistan is the reason for this entry. I believe we are committed to this conflict, it does have a resolve and we have the best talent in the military heading the effort. If the Congress of the USA can't see the forest for the trees than they have failed AGAIN to resolve turbulence that will revisit the USA. If politics defeats General McChrystal and his assessment I will think less of those that act against his dedication and his remarkable abilities. He is one of the bravest men I have ever witnessed in regard to these last eight years, able to stare down international criminals, hunt them down and insure their demise. He is a rare talent at a time when it is needed most.

At the United Nations this week we witnessed incredible cooperation between countries. We had the exceptional pleasure of witnessing the one and a half hour speech by a Libyan leader that stands testament to the power of non-proliferation. No different than the abandonment of Afghanistan since 1980, the USA diplomatic corps have abandoned a denuclearized nation in efforts to further the outreach to the Libyan people and its economy.

The rhetoric of Colonel Muammar al-Gaddafi is a result of the in appreciation of the disarmament of his nation without conflict and the realization he did authorize a horrible crime of murder of over two hundred people. All that is taken for granted that The West had a right to accomplish such a feat without appreciation that it was actually accomplished without confrontation and with realization the Libyan people needed to be further included in the world of openness and peaceful resolve. The rhetoric of al-Gaddafi is due to the lack of forgiveness.
When efforts to secure the world away from violence and nuclear armament succeed there needs to be more than a flag of victory planted, there needs to be connectedness of the people of any nation willing to commit to peace and mutual economy. The war strategy for Afghanistan cannot end with simply stating 'we tried' or 'we won' it needs someone to change the face of the nation that is so willing to go where we lead. Libya was willing to go where The West lead it, but, abandoned appreciation of the effort by the people to cooperate.

If the USA had not abandoned Afghanistan in 1980 there wouldn't be the level of violence within that country and we would never have experienced the attacks of September 11, 2001. By abandoning Afghanistan now that we realize how powerful a violent and oppressive regime that is the Taliban can become, we are only setting up the USA to be endangered by those same elements again and the Afghan people to lives of servitude to international criminals again.

If the USA believes it can simply turn its back and walk away hoping Afghanistan will simply remain a containable haven for these criminals, realize that Colonel Muammar al-Gaddafi at the age of 67 is not finished with his focus. He headed up the African Union for a long time and saw it develop into an organization with economic realities and potential. He is not a stupid man that simply bends his knee to The West. He is now asking for a 'one state' solution to unite Africa and South America. I remind South America has its own 'world bank' now. Col. al-Gaddafi isn't settling back to rest his former priorities in an easy chair into retirement, quite the contrary. He sees a bigger picture and one that might manifest in the destruction of Western culture should the opportunity present itself and 'the need' arise. There is no good feeling when leaders are faced with 'illegal' invasions by a certain political party in the USA.

For the USA to abandon these accomplishments and allow fear to breed hatred is a foolish game. To commit to Afghanistan to make the reality of stability of the region a success will add to the legitimacy of the intentions of the USA on a scale that no one can ignore under the leadership of a Secretary of Defense and a general of exceptional ability. To turn our backs on the victory that is guaranteed by such exceptional men at this point will be to lose every potential of repeating the ability of securing the USA.

There is the chance there will not be another General McChrystal. If that is the case and the 'freshness' of his ability to 'know' the enemy and defeat them is lost to political concerns will be to lack the ability to insure the best outcome for the USA and its allies in the future.
If we consider the world burgeoning on a path to sustainable peace with non-proliferation a reality, it is all regions of the world that will have to be stable and not just those that suit the wealth merchants of Wall Street. I am confident strong alliances can be sustained with Pakistan and nurtured again with Russia bringing all pressure to bear to stabilize Afghanistan. Both of these countries are cooperating with all the requests of the USA and seek a region more secure and more democratic.

The Afghan people are wonderful people who are willing to accept our leadership, we can't betray them and allow them to be disposable lives falling again victims to oppression and violence. I stand with General McChrystal and his assessment. I believe in him. It isn't easy for me to make that commitment either. I believe there will be less causalities with a stronger military force under his leadership.

The ACORN issue will be dismissed in any legal action. There is nothing to the allogations.

Bertha Lewis, the CEO of ACORN.

The exploitive film of a fired ACORN worker is not admissible evidence in court. It was planned that way.

Steven Crowder and his associate Hannah Giles took it on themselves to mastermind a 'scenario' to provide something that looked like a system wide corruption of ACORN. One incident does not a systemic problem make.

The victimization was organized in Maryland to further embarass 'government' as an entity to trust. Maryland requires two party consent for taping. The entire mess is to create a Right Wing Circus for media exploitation that hopefully will tarnish the Democratic Party.

Any and all pursuits to this 'hideous' scenario should be dropped. If ACORN has suffered losses due to this 'Made for Republican Politics' movie it should pursue relief through the courts, including the media that facilitated it.

This is outrageous already. This is the Republican Right Wing media at its best. It was a completely fictious pursuit and someone at ACORN fell into the trap. The scenario should be investigated as should any potential corruption of ACORN, but, to allow this kind of 'game playing' to provide political volleys when nothing substanitive ever existed before is simply outrageous.

If the FBI has the time to investigate under age prostitution and finds instances where any organization has assisted same then they should do so. I mean are there kidnappings in the country by pips? But, in all honesty I would rather the FBI pursue justice to 'real life' realities such as angry men intent on killing others and destroying infrastructure to satisfy some strange ideological philosophy.

This is another one of those 'census' issues. Does ACORN report its successes to the federal government? If any entity is receiving federal or state monies, the results of their programs should be reported to the agencies receiving the services. I am assuming ACORN has reported on all its programs to someone. Are the ACORN projects successful?

Census should cut SEIU ties because of ACORN, Kirk says (click title to entry - thank you)

September 25, 2009

BY ABDON M. PALLASCH

Political Reporter/apallasch@suntimes.com
Since the U.S. Senate voted 83-7 earlier this month to cut off funding for ACORN, the activist/voter registration group has become so controversial that some are calling for sanctions against groups associated with it.
The debate is invading the race for U.S. Senate in Illinois.
Republican U.S. Rep. Mark Kirk announced Friday he will hold a news conference calling on the U.S. Census Bureau to sever its ties to Illinois’ largest union, the Service Employees International Union, because, Kirk says, the group is too close to ACORN.
The union endorsed Kirk’s front-running Democratic rival for the Senate seat, Democrat Alexi Giannoulias, the previous day.
Up until ACORN became controversial for alleged vote fraud during last year’s presidential election, even Republican administrations funded the group.
Kirk himself voted in 2005 to approve a $140,000 earmark for ACORN’s New York office to fight teen delinquency, SEIU's political director Jerry Morrison said....

The 'idea' behind the Republican Right Wing media is to 'revolutionize' government and prove its inability to function and therefore legitimize private enterprise over government run anything. Of course, like Medicare Advantage all the private enterprises receive tax dollars as their primary income.

The Right Wing assault against ACORN is no different than their other media events. They are contemplated and staged to appear legitimate. They aren't and this 'episode' with the Right Wing Media is simply another example of them creating 'an issue' where none existed before. I want to know how many prostitution houses ACORN has financed.

Iran's strategy is to strike Israel with its first test of its long range missiles. Nothing can be left to chance, stop Iranian aggression.

The Iranian government has proven it has never acted in good faith toward the International Community. It is covert and its aggression is obvious. While 'calm' surmounts reality in an understanding that sanctions will work, even tougher sanctions than has worked to date, there is an element of risk that has to be faced regarding the potential for a 'risky' first strike at the opportunity to test Iranian long range missiles.

In my opinion, the USA has no other choice but to maintain a nuclear submarine presence within striking distance of Iran. The Iranians under its current leadership are too unpredictable, which brings all to clear the uproar following the last elections. The Iranian leadership of the opposition would know of the aggressive strategy against Israel and knows all to well the response by The West and potentially Russia and China in retaliation.

The elections resulted in riots due to the impending doom the opposition realized is inevitable under the current regime.


Sept. 25: A view of what is believed to be a uranium-enrichment facility near Qom, Iran, is seen in this satellite photograph. Iranian President Mahmoud Ahmadinejad said Friday the United States, Britain and France would "regret" accusing Iran of hiding a nuclear fuel facility, saying it was not a secret site (Reuters).

Iran plans to test-fire missiles capable of hitting targets (click title to entry - thank you) across the Middle East tomorrow, in a show of defiance before Thursday's pivotal talks on the country's nuclear programme.
The test of the Shahab-3, following trials of short-range missiles today, is likely to raise tensions across the region. Iran claims the missile, based on a North Korean design, has a range of 1,500 miles – far enough to reach Israel and Iran's other Middle East rivals Egypt, Saudi Arabia and Turkey....

The only way the Iranians should be tolerated in allowing any missile testing is for complete and immediate inspection of all its nuclear facilites. The Iran regime in power is completely untrustworthy and all safeguards to prevent confrontation are necessary. Iran cannot be contained without the dismantling of their nuclear intentions. It doesn't need nuclear power for peaceful purposes. Its energy needs can be obtained through solar and wind projects.



If Iran was to be the saviors of the Shi'ite acting in peace they should have never covertly conducted expansion of their nuclear facilities. This is NOT the way to secure a 'Shi'ite' presence on Earth, it is sure to destroy any of its chances at survival.
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