This Blog is created to stress the importance of Peace as an environmental directive. “I never give them hell. I just tell the truth and they think it’s hell.” – Harry Truman
(I receive no compensation from any entry on this blog.)
Musadeq Sadeq/Associated Press A billboard for the candidate Abdullah Abdullah towering over a broom seller in Kabul, where many voters said they were leery of a presidential runoff.
Democracy is not always perfect. I am confident in the early years of the USA's thirteen original colonies there was a lot of 'stumbling' when elections were held.
Democracy and the Afghan Constitution is not the enemy to the people, it is corruption that is the enemy to freedom. They cannot abandon the document that brings them qualified candidates to their democracy. They must seek to 'perfect' the process and root out the corruption.
No matter whom wins the 'runoff election' Afghanistan will be in good hands. I believe there will be less corruption than the first election. There are only two candidates, there is less opportunity for dishonest results.
Corruption is fought when there is loyalty to the 'idea' of law and not the current threat of warlords. It is very important the elections go forward and democracy under the Afghan Constitution is 'honored.'
Either candidate is more than qualified. The Afghan people have been well served to date by having two qualified candidates resulting from the first election. They should have fun with their political loyalties and seek to perfect their election process. This is a second chance to practice perfection.It should get easier and easier to master 'the task' each time. Loyalty to the Constitution is the demonstration of the bravery of people deserving of a good life.
The Afghans are very intelligent people. I couldn't make a broom like that.
Basically, I think the world is saying, "Let's not get this wrong."
IAEA, Iran Settle on Date for Qom Inspections Inspectors Will Arrive on October 25 by Jason Ditz, October 04, 2009 In a move that one can only assume will end the constant international “demands” for Iran to provide access to its Qom facility, IAEA chief Mohamed ElBaradei has announced that the agency has finalized talks with Iran and will visit the site on October 25....
Kindly note, this is Al Jezeera making this noteworthy title. There is such a thing as International Law developed by International Treaties. If every country on the planet ignores it and/or walks all over it, the meaning and purpose is lost. I sincerely doubt the Arab nations want a nuclear Middle East. I am sure they would rather have all countries disarm from it.
IAEA: Iran on wrong side of law (click here) Mohamed ElBaradei, the head of the United Nation's nuclear watchdog, has said that Iran was "on the wrong side of the law" by not declaring it had developed a second uranium enrichment plant before last week. The comments from ElBaradei, the director of the International Atomic Energy Agency (IAEA), came a day before talks in Geneva between Iran and six world powers over Tehran's nuclear programme. Iran disclosed the construction of the second plant to the IAEA after Western intelligence agents reportedly discovered its existence....
U.S. boosts spending on bunker-buster bomb (click here) Last Updated: Tuesday, October 13, 2009 1:27 PM CBC News The Pentagon is speeding up the deployment of an enormous bomb designed to destroy hidden weapons bunkers buried deep underground, one that would be the largest non-nuclear weapon in the U.S. arsenal. The 13.6-tonne massive ordnance penetrator (MOP) carries about 2,400 kilograms of explosives and is so heavy only one can be carried aboard a B-2 Stealth bomber. The U.S. Department of Defence's decision to award the $51.9 million US contract to Boeing Co. earlier this month signals a renewed commitment to the weapon, which began testing in 2007 but had languished for two years because of budgetary issues. It is being designed jointly by Boeing and defence contractor Northrop Grumman....
The Swine Flu is NOT to be thought of as simply 'another' virus. The victims are completely atypical. These are young healthy adults in their 30s, they don't usually die from the flu. This is different. I have spoken with a young woman that had the virus and she stated while recovering from the virus she sustained two different bacterial infections as well. She was treated outpatient, but, was quite ill for more time than one would expect. The treatment probably needs antibiotics at the onset as well as fluid support for body organs. It sounds like shock to me. Like, a 'Septic Shock.'
I am completely guessing here, but, it sounds as though the virus hungers for 'high fat content' and results in attacking muscle and releasing myoglobin.
I can't help but wonder what kind of blood tests medical doctors are using to ward off the effects of H1N1. We know this virus loves an obese environment, therefore, it probably has a rapid and high demand on the body for energy at the time of infection. If the body doesn't deliver the energy in high amounts that would be found in the obese immediately it begins to attack muscle tissue in search for its 'best' environment and thus creating artificially what it cannot find otherwise.
By establishing itself inside the body of an organism and establishing a food source such as fat or muscle, it then rapidly replicates and send the victim into shock. There has to be acknowledgement by the populous that once they have the virus they do not 'stay at home' and eat chicken soup. The public should seek immediate medical attention upon realizing they are infected.
There ? can ? be a trend in the 'body types' most heavily effected by this virus. It was stated it has an etiology from a Mexican pig farm. What happened to the pigs? Did they have a sudden collapse or did they go undetected for a period of time? Some of the trend found at the source of the infection might reveal some clues about ultimate treatment, however, we might be seeing mutated strains as the coarse of this virus continues.
Are the people infected with this virus, that die, depleted of healthy body tissue? Are they coming in very sick or slightly sick?
My thoughts are that if the virus has everything it needs by infusing D5 or even D10 it will leave the body tissues alone. The NS will continue to infuse the kidneys and maintain body pressure without compromising the integrity of the myocardium. I can't help but expect most of these folks are autopsied until more is revealed about the virus. Autopsies should include microscopic examination of heart tissue and kidney tissue to find if the virus is setting up its best environment first in those organs.
Both the kidney and the heart have their own supply of adipose tissue that protect them from friction and the like, is it those tissues the virus also finds attractive and therefore effects the outcome of the patient, no different than Vioxx was found to remove fat tissue from around the heart then leading to heart attack and heart failure.
There is a reason for this trend and to 'feed a virus' exactly what it wants might help save the person.
Good luck.
...South Florida hospitals see some of the same trends. (click title to entry - thank you) ``We're finding it in a huge variety of populations,'' said Dr. Lillian Abbo, assistant professor of infectious diseases at the University of Miami Medical School/Jackson Memorial Hospital. ``We're seeing it in young healthy adults we wouldn't expect to get as ill as this.'' The Canadian study looked at 168 swine flu patients in 38 adult and pediatric intensive care units. The patients who arrived at the hospitals with severe cases of flu had an average age of 32.2 years. Thirty-three of them died within 90 days of being admitted to the hospital. ``Our data suggest that severe disease and mortality in the current outbreak is concentrated in relatively healthy adolescents and adults between the ages of 10 and 60 years,'' wrote the study's chief author, Dr. Anand Kumar of the Health Sciences Centre and St. Boniface Hospital in Winnipeg....
...Patients admitted to hospitals in the Canadian study with severe symptoms usually had low levels of oxygen in the blood, fluid in the lungs and, in the most serious, multisystem organ failure, the study said. The patients worsened quickly after being admitted, most being transferred to intensive care units within two days. Most survived after intensive, long treatment....
I am just a little tired of the hypocrisy already. The USA Senate and House are settling this hideous circumstance the American people have to face from now into eternity and the health care insurance industry is expected to be charging far more than THAT prediction by 2019.
...The finance panel bill calls (click title to entry - thank you) for sweeping insurance market reforms, requires most individuals to obtain medical policies and provides tax subsidies to help people afford coverage. The bill also would tax high-cost insurance plans and would place a $500,000 limit on the amount of executive pay that health insurance companies could deduct from taxable income....
If the current 'trends' in Health Care Insurance continues without legislative intervention, the companies will be charging more for their insurance and be insuring far fewer people.
The legislation should 'help' the insurance companies simply because it requires all people of the country to be insured. It is why the government has to supply a public option to 'contain' the cost of health insurance to the nation.
Any health care insurance company always 'does better' with their 'bottom line' with more subscribers and less liability for payments. Mandating that all Americans carry health care insurance will broaden the base of their enrollment, increase the amount of dollars they receive into their treasuries, therefore, increasing the support for the individuals that have chronic and devastating health care issues.
Example:
If within a 'populous of the insured' there are 100 people being treated for cancer and that treatment costs $25,000 each those costs have less of an impact if the enrollment is 100,000 enrollees rather than 10,000.
That is a simple illustration of what will occur when the Senate and House pass their health care insurance reform bills.
Each private health care company will have increased enrollments of people that they have to accept and their liability for the costs will be shared better than if they continue to limit the populous of their enrollees to few and few individuals. Their 'methodology' makes no sense. The problem they are having is maintaining their exploitive profit margin. That will probably shrink, but, there will still be stockholders to receive payments quarterly.
The reason there has to be a public option is because without it the health insurance companies will exploit the American people for higher and higher profits. Health care is far too important to leave up to the private sector now or in the future. The people of this country have been wounded enough by corrupt practices with unnecessary deaths and those that could not achieve adequate care until they were disabled and on Medicare.
There has to be government regulation of the health care insurance industry so the 'same' practices don't continue to plague this country. They are untrustworthy. Their statements here are lies designed to alienate the electorate from the passage of these bills. They will be regulated and there will be a public option to control costs. Just that simple. This is an example of the ruthlessness of the industry and the extreme disregard they have for the well being of the people of this nation.
Basically, there are no accurate estimations from the insurance company lobbies. Why? Because their current enrollments are askewed. The majority of young people in this country are without health care insurance and as soon as they are added to the rolls the premiums should plummet and not escalate. The good news is, the young people within that population that need health care insurance will have it and they can still pursue the American dream without it being dashed to oblivion because they are diagnosed with an illness they didn't expect.
Young people in the USA need their health insurance no different than older Americans. They need to develop good habits when they are young and carry them through into older adulthood. The 'truth' is the health care insurance industry has no clue to what their cost to income ratio will be because they are so corrupted by faux values and standards they hold so dear now !
Al-Qaida threatens to attack China (click title to entry - thank you) (China Daily)Updated: 2009-10-08 08:56 DUBAI: A prominent Al-Qaida militant on Wednesday threatened to attack Chinese targets in "reprisal" for the July 5 riots in Urumqi, capital of the Xinjiang Uygur autonomous region. He urged Uygurs in Xinjiang to "make serious preparations" for a "holy war" against the Chinese government and called on fellow Muslims for support. Abu Yahya al-Libi, in a video posted on an Islamist website yesterday, called for "a true return to their (Uygurs) religion and ... serious preparation for jihad in the path of God the Almighty and to carry weapons ..."
Those responsible for the uprising in Uygars state they are losing their culture. I doubt that is the case, although any terrorist entity that would be seeking the use of nukes might try that as a propaganda tool. There is a provision in the UN Charter that defines genocide and that includes the loss of culture as well. There has been no history of China leadership seeking to destroy the culture of its people.
Impoverishment and oppression is an enemy to any government. People living with impoverishment are easily swayed to believe anyone that they are better off in uprising than in living their lives painfully filled with daily struggle. It is why the USA's social fabric seeks to advocate for freedom peacefully obtained through elections and why corruption is an enemy.
There were 200 people killed during the rioting and the Chinese military has control. I strongly suggest the Chinese rehabilitate the region before al Qaeda creates a Talibanesque influence within the Chinese borders. China must maintain a benevolent presence in the region and seek to educate and build an economy for the people there. I do not hold the Chinese government for this problem, but, do hold them responsible for the empathy toward this region of China that must follow this traumatic event.
China gives death sentence over Uighur brawl case (click here) Sat Oct 10, 2009 6:12pm IST BEIJING (Reuters) - A court in southern China has handed out a death sentence to a man involved in a brawl in July blamed for being the trigger to deadly riots in the restive far western region of Xinjiang. State media said the fight erupted between a group of Han Chinese and ethnic Uighur workers from Xinjiang at a factory in Shaoguan, Guangdong province, after a rumour spread that some Uighurs had raped two women. The courts in Shaoguan also gave another man life imprisonment, and nine others got sentences ranging from five to eight years in jail, the official Xinhua news agency said. Two Uighur workers were beaten to death in the fight, and three others were severely injured, the report said.....
Pakistani soldiers in Qila Abdullah near the Afghan border. Photograph: Matiullah Achakzai/EPA
Basically, Musharraf was a terrorist. The Taliban and al Qaeda were his buddies and he made more of the 'tribal area' as an uncontrollabe problem because it was convenient to allow the growth of Taliban extremism. Reconstituting the Taliban, if McCann had been elected, would have put a 'handy dissendent military' within the Pakistan rhelm of influence to attack India.
Bush had no desire to stop the escalation of the Taliban, his 'political clout' revolved around the Iraq War. Bush and Cheney figured 'that region of the world' was hopelessly lost to extremism. The fact of the matter is they never bothered to place importance on 'settling' the region into civilization as we know it. It was also costly. Imagine what $700 billion would do to stop al Qaeda? Hm?Bush and Cheney were incompetent and the figure heads to their cronies. 5.30pm GMT Up to 70% of US aid to Pakistan 'misspent' (click here) Declan Walsh in Islamabad guardian.co.uk, Wednesday 27 February 2008 17.49 GMT America's massive military aid package to Pakistan has come under scrutiny after allegations that as much as 70% of $5.4bn in assistance has been misspent. Since 2002, the US has paid the operating costs of Pakistan's military operations in the tribal belt along the Afghan border, where Taliban and al-Qaida fighters are sheltering. Pakistan provides over 100,000 troops and directs the fight; the US foots the bill for food, fuel, ammunition and maintenance. The cash payments — averaging $80m a month — have been a cornerstone of US support for President Pervez Musharraf. But over the past 18 months, as militants seized vast swaths of the tribal belt and repelled a string of Pakistani offensives, the funding has come under the microscope....
There are problems in Pakistan.
The Old Musharraf regime isn't allowing the reverse of the 'social trend' of the Taliban. They demand for the Pakistani government refuse USA aid linked to anti -terror measures.
With a redirected effort under the new leadership in Pakistan the military is attempting another coup. The Pakistani military has a horrible reputation of 'going it alone' outside the influence of its leaders. I strongly suggest the new government replace its military leadership and bring less decent regarding the new Pakistani government and its ally, the USA.
US Congress votes to triple aid to Pakistan (click here) Legislation aimed at quelling anti-Americanism heads to President Barack Obama for his signature Associated Press guardian.co.uk, Wednesday 30 September 2009 20.54 BST Legislation to triple US aid to Pakistan and stem the tide of radicalism and anti-Americanism within the Asian country cleared Congress today and moved to President Barack Obama for his signature. The bill, approved by a voice vote in the House of Representatives, would provide Pakistan with $1.5bn (£938m) in aid a year over the next five years focused on democratic, economic and social development programmes. "The United States has an enormous stake in the security and stability of Pakistan," said House foreign affairs committee chairman Howard Berman, a Democrat. "We need to forge a true strategic partnership with Pakistan and its people, strengthen Pakistan's democratic government and work to make Pakistan a source of stability in a volatile region."...
Bad habits die hard ! This level of anarchy within the Pakistan military that see The Taliban as a legitimate authority among the people has to stop. Controlling the rebuilding of Pakistan to stop the Taliban influence is wrong and the people will side with those that improve their quality of life. It is time get started. The people of this region live in large refugee camps that have existed for over three decades. They are tribal because they don't have cities, education and an economy. It is time to break the back of the Taliban camel.
Pakistan's military rejects US aid bill (click here) (China Daily) Updated: 2009-10-09 08:10 ISLAMABAD: Pakistan's powerful military rejected US attempts to link billions of dollars in foreign aid to increased monitoring of its anti-terror efforts, complicating American attempts to strike Al-Qaida and Taliban fighters on the Afghan border. Although the US-backed government of President Asif Ali Zardari has the final say on whether to accept the money, the unusual public criticism threatens to force its hand and undermine military cooperation with the Americans just as the Pakistani army prepares for what could be its most important offensive against extremists since the US-led anti-terror campaign began exactly eight years ago. Any breakdown in intelligence sharing and other types of cooperation would hurt the American fight against a resurgent Taliban in Afghanistan. US and NATO commanders say the war there cannot be won unless Islamabad does more to tackle extremists on its side of the border.
In Washington, President Barack Obama met with his national security team for a strategy session on Afghanistan after signaling that he was not considering a troop withdrawal. The session came amid new polls showing waning support for the war in the United States. The military's criticism of the bill came in a brief written statement that said senior commanders, including the army chief, "expressed serious concern regarding clauses impacting on national security." Among other strings, the bill conditions US aid on whether Pakistan government maintains effective control over the military, including its budgets, the chain of command and top promotions. Some analysts said the military's statement had little to do with genuine dislike of a bill that stands to help crumbling schools, roads and hospitals. They said the army was sending a message to the Pakistani and US governments about the limits of civilian control in a country that's been subject to military rule for about half of its 62-year history....
FOX is well endowed enough fiscally to be able to 'buy' their eyewitness and experts. As a result they frequently have content others do not and others have to purchase FOX footage which in turn pays for the 'high end' exclusivity of their content.
However, the reason FOX does this is to 'entrap' viewers into believing their point of view is the most correct and the most informed. They do this to exploit air time with 'commentators' that exploit the issue by lacing it with lies as 'commentators' are not journalists and are not bound to any ethical standard.
In other words, FOX fits the facts to the crime rather than other way around. I don't watch them. I listen to local broadcasts whenever a radio is nearby to stay up on the exploitation of their 'airwaves' so I know 'what they are up to.' But, I don't listen for facts. If there are any events broadcast on FOX that is news, I always turn to a better source for 'the truth.'
Twenty-four years ago, Murdock gave up his Australian citizenship to build a better empire. As an Aussie he was limited to the extent he could play politics within the content of news. He wanted 'a hand' in the big game. Australia had and has small wars compared to the extent the USA can be involved. He wanted to 'wheel and deal' power and he didn't care who was who in politics. He felt he should and could back anyone he chose and push them into power and he was successful doing exactly that in Great Britain. Tony Blair was elected as a Labour Party candidate because Murdock threw in with him, either by Blair's consent or not.
This desire of Murdock's News Corp. to 'play politics' with the news is 'his style.' He doesn't care. He wants to be King of the World and that is exactly what he sets out to do. He is dangerous and he does not play by the rules. He has news media control on three 'fiscally significant' continents on the planet; Europe, North America and Asia.
He dines with heads of state on personal levels and relishes the moment. Like what? It is corruption and anyone that is within the realm of government found dining with Murdock should be on the front page of The National Enquirer. He is a dangerous person and quite frankly The Wall Street journal was obtained by him to control 'the markets.' The Wall Street Journal, in all honesty has become another Murdock rag. It is exploitive and now 'sponsors' Right Wing extremists such as Rove on a regular basis.
I am sure Murdock would say, "At least they can come to us when no one wants to hear what they have to say." Really? That is important? We need to hear from former government officials that have run illegal wars, destroyed the global financial infrastructure and 'play head games' with the electorate of a ? democracy ? I don't think so.
There is a huge difference between 'the tone' of a newspaper's reporting and its 'siding' with a particular party. Since Murdock existed in the media business in Australia he has done nothing but 'play politics' with the power of journalism and the media. He takes sides and espouses particular vernaculars of speech and structuring. His 'commentators' are disciplined in 'towing the line.' They are paid well for it.
FOX isn't a reliable news reporting station, it is a news entertainment station and so are their radio stations. They toy with fantasy more than facts and their listeners and viewers like it and 'go along for the ride' because there is usually a 'bottom line' in it for them.
One might say, people have a right to conduct themselves and their businesses as they see fit, but, when a 'news entertainment' media portrays themselves as 'real and factual' there are all kinds of problems in the greater world. Climate Change and the profound denial by 'corporate' entities and how that translates into power over the electorate is a 'clear danger' and no one bothered to stop it.
Facts are facts and when they are 'clouded' with innuendo and 'covert purpose' it effects the outcome to people that isn't at all in their best interest, nor, the national security of any country.
I don't like him.
I think he is a jerk.
And reminds me of a child out of control with a very powerful tool he has no intention of being responsible 'to' or 'for.'
In the hands of a 'quality corporation' News Corp could be a miracle worker rather than a war rag.
There is definately a pattern and the White House is exactly correct. The question is what are they going to do besides talk about it.
16 Kids Die of Swine Flu in 1 Week (click here) By MIKE STOBBE, AP ATLANTA (Oct. 9) - Health officials said Friday that 76 children have died of swine flu in the U.S., including 16 new reports in the past week — more evidence the new virus is unusually dangerous in kids. The regular flu kills between 46 and 88 children a year, according to Centers for Disease Control and Prevention data.
Symptoms of Swine Flu (click title to entry) -Fever, -Cough, -Sore throat -Runny nose -Body aches -Headache -Chills -Fatigue. -Many people with swine flu have had diarrhea and vomiting. -Nearly everyone with flu has at least two of these symptoms.
With the symptoms of vomiting and diarrhea comes fluid depletion of healthy body fluid balance. Anytime there is diarrhea and/or vomiting there is loss of 'electrolytes.' The loss of fluid and electrolytes from the body cause higher chances of severe illness, hospitalization and death.
Fluid depletion in children make any illness far worse and more likely to cause hospitalization of the child.
Who is at highest risk from H1N1 swine flu? Most U.S. cases of H1N1 swine flu have been in children and young adults. It's not clear why, and it's not clear whether this will change. But certain groups are at particularly high risk of severe disease or bad outcomes if they get the flu: Pregnant women are six times more likely to have severe flu disease than women who are not pregnant. Young children, especially those under 2 years of age People with cardiovascular conditions (except high blood pressure) People with liver problems People with kidney problems People with blood disorders, including sickle cell disease People with neurologic disorders People with neuromuscular disorders People with metabolic disorders, including diabetes People with immune suppression, including HIV infection and medications that suppress the immune system, such as cancer chemotherapy or anti-rejection drugs for transplants Residents of a nursing home or other chronic-care facility Elderly people are at high risk of severe flu disease -- if they get it. Relatively few swine flu cases have been seen in people over age 65. People in these groups should seek medical care as soon as they get flu symptoms. A striking number of adults who developed severe swine flu complications have been morbidly obese. However, obesity itself does not seem to be the issue. The vast majority of extremely obese people suffer respiratory problems and/or diabetes, which seem to be the underlying reason for their severe flu complications....
Obesity is a 'co-morbidity' with this virus because 'genetically' it has two components of swine, one of human and one of avian. It is the avain part of the virus that is making it more virulent, in my opinion. Obesity doesn't mean it predisposes a person to the virus, but, once having been infected the illness will have a greater severity due to the 'double measure of swine' component to the virus.
Viruses are nasty things. They aren't autonomously able to reproduce, they use the host's cells RNA to replicate. So, obese people have a more 'homey' environment to this virus and find it easier to replicate and cause more stress on the host.
With escalating deaths this early in the season it will increase exponently and there is absolutely no reason to 'play' with thing. Take the regular vaccine for The Flu and take the Swine Flu vaccine when it is available.
I realize it is a new vaccine and the absolute outcome is unknown, but, what is known is that people are beginning to die from this virus in numbers that should be a red flag.
US, other nations stop counting pandemic flu cases (click here) By MIKE STOBBE (AP) – 1 day ago ATLANTA — U.S. health officials have lost track of how many illnesses and deaths have been caused by the first global flu epidemic in 40 years. And they did it on purpose. Government doctors stopped counting swine flu cases in July, when they estimated more than 1 million were infected in this country. The number of deaths has been sitting at more than 600 since early September. Health officials had previously counted lab-confirmed cases, though the tally was skewed because many people who got sick never were tested. Other nations have stopped relying on lab-confirmed cases, too, and health officials say the current monitoring system is adequate. But not having specific, accurate counts of swine flu means the government doesn't have a clear picture of how hard the infection is hitting some groups of people, said Andrew Pekosz, a flu expert at Johns Hopkins University....
It is going to take some time to 'right' it again. One has to believe that the world wants peace. If one doesn't believe other nations are sincere, there can be a door left open to debate about the Nobel Peace Prize.
I know the world wants peace. I am confident the world wants peace. How? Easy.
The United States and Russia have been moving toward this venue of peaceful coexistance for quite some time now. It has been difficult through the years of The Cold War to stop both the USSR and the USA from posturing at each other. It was such a joke. The Cold War was like throwing stones at each other and it didn't make sense. The only thing The Cold War did was to allow the growth of hatred and fuel the industrial complexes of war machines. It is insane.
The USA and Russia share a program where by missiles armed with uranium are disarmed and the uranium is returned to be processed into fuel for energy. We have been doing that a long time.
The USA and Russia has been sharing the International Space Station as 'comrades' for a long, long time.
There are former leaders of Russia (at the time it was the USSR) that teach in the USA. They are friends to our society and stand as examples of vast outreach to bring understanding to us and to the leaders such as Prime Minister Putin and the current President Dmitriy Anatolyevich Medvedev.
China has never truly been confrontation to the USA. They have been allies of Russia since at least the year 2000 and more like for as long as they shared a border. There has never truly been a threat from China so much as they securing their own borders. Countries are allowed a 'National Defense Strategy.'
In many ways, that is what Iran is doing. They are solely the only major Shi'ite nation on Earth and they want to be 'as homeland status' no different than Israel. The Shi'ites had it very tough under the rule of Hussein. They will feel more comfortable when the USA footprint in Iraq is gone or near gone and they can feel as though their people will be secure on Earth as well. The problem with the Iranian issues is somewhat the same as with North Korea, Pakistan and India and Israel in that they should NOT have nuclear weapons. And of course, Israel will deny it. Someday Israel too will have to face the fact that their 'National Security' is better served without these weapons.
There are only five 'legal' nuclear countries and they have the right to 'contain' the growth of proliferation. It was an agenda before all this mess got out of control and out of control it is. Absolutely. It isn't as though President Obama has some strange and foreign 'pie in the sky' idea. This is a path that was abandoned for the past eight years. It is a well worn path for most of the major nations of Earth. It is time to return to that path, but, it had to be 'secured' by the words of the President of the USA. If we aren't a partner in Non-Proliferation, no one else will be either.
What is so incredibly unbelievable about the aggressive demands of the Bush/Cheney years is they claim to be Christians. There is such a thing as"The Christian Doctrine of Peace" (click here). The Neocons of the USA liked to bask in the light of their religious zealotry, but, they never wanted to practice it. They had no plans to, they wanted the domination of the world's resources. China was never viewed as a country to trust with ouR debt, it was viewed by the Neocons, the Right Wing, the Republicans as a National Security Issue now that they carried so much of the USA debt.
The willingness of China to extend the USA credit was viewed as a weakness by the Republicans and their people a place for fiscal exploitation by The West. There is the belief by many that have money, it takes war to obtain more. More control, more resources to exploit, more domination of the 'world forum' and the ability to do exactly what occurred last year at the end of the Bush White House.
Some lessons are learned hard in this world. It is my sincere hope and desire the people of the USA find the confidence they need again to believe peace and prosperity are possible. They have to demand it through their elections. What is so unbelievable is that people still think they did the right thing by lying to so many others as demonstrated by the health care issue and defaming the Democrats and the President when everything they stated was true. The Right Wing of the political system of the USA likes to say, "Who drank the Kool-Aid?" They need to look in the mirror and realize how victimizing they are, how out of touch they are and how misdirected their value system truly is.
But, I like Mike's letter. It is sincere as is most of his life. He has been pivotal stopping the unfettered escalation of hate in the USA and leanings toward violence. "Bowling for Columbine" is an absolutely magnificent portrayal of the extremes of violence in the USA culture and how it fuels permission for our out of control military industrial complex that needs justification by the act of war. He opened my eyes. I, no different than he, no different than many others in the USA want the wars to end. But, we have to believe in a man in the White House that sincerely wants peace and the end of violence just as much if not more than we do.
I'll say it again. President Barak Obama is a man of peace. He is not a man of 'weakness.' He has been walking this path for many, many years. He has dedicated himself through achievement that should have set him on a different path, but, he never left us. We never knew he was coming. But, he was determined to arrive.
It is too good to be true. But, now that it is true, we need to embrace what is rightfully ours to embrace that we have advocated and marched and died for along the way. Those students at Kent State would be proud of their President and now we can more proud of them than ever before. We need to remember whom we are in this world and we need to trust the men and women that have never been deterred from the path.
The Right Wing is attempting to 'game' the award for political gain.
It won't happen. Granted the Obama award is about government and its role in the world, it puts weight in his favor in 2012, however, the Nobel Peace Prize wasn't awarded to President Obama because of his accomplishments to date. It was awarded to him because of his Doctrine.
Why am I not surprised the Neocons are mocking a peace doctrine? It might actually cut into the profits of the USA Military Industrial Complex and the cronies of the party. The Republican Party and Michael Steele are making fools of themselves.
A United States of America President is awarded the Nobel Peace Prize for advocating Nuclear Non-Proliferation at the very time Iran is a ticking time bomb and Michael Steele and the Republican Bozos are mocking the effort.
Dear God, what next?
They ought to be ashamed of themselves. Both for the insult it pays this country to the world and using it as a marketing tool. What as the GOP come to?
President Obama's Nobel Peace Prize win mocked in GOP fundraising letter (click here) BY Samuel Goldsmith DAILY NEWS STAFF WRITER Updated Saturday, October 10th 2009, 3:02 PM The GOP is using President Obama's Nobel Peace Prize as a fundraising tool, by mocking the award in a send-money letter to Republicans. Russia's president congratulated Obama on Saturday for the surprising honor, and even Cold War foe Fidel Castro said he was happy for him. But Republican National Committee head Michael Steele is bristling with outrage, saying in a letter that Obama won the prize "for awesomeness." It shows "how meaningless a once honorable and respected award has become," he wrote, asking for contributions of $25 to $1,000 for the RNC....
Tax on those that earn more than $200,000 is more than appropriate and protects the Middle Class from exploitation of the entites that are 'too big to fail.' If the wealthy are going to play the game Elizabeth Warren explains so well here and demonstrated by Former Secretary Paulson, then it is up to them to fund their own failures, NOT The Middle Class of the USA !!!!
There have been other USA Presidents that have won the Nobel Peace Prize, but, NONE with less than a year of time in office. Barak Obama is a remarkable man. A brave, truthful and sincere leader.
I could not be more proud of our country at this moment. He bravely stepped 'out of the box' and put it on the table. There will be peace and there will be non-proliferation. Isn't that what the USA is all about?
I also don't believe we can foresake the peace of the people of Afghanistan either. Peace sometimes comes with a price and it sometimes means securing the USA away from any future 'infrastructure' failures, while, building alliances that will perpetuate a future of our children and Earth.
From the New York Times:
In Surprise, Nobel Peace Prize to Obama for Diplomacy (click title to entry - thank you) ...The award cited in particular Mr. Obama’s effort to reduce the world’s nuclear arsenal. “He has created a new international climate,” the committee said....
From the Chicago Tribune:
Obama: Nobel Prize for Peace Posted October 9, 2009 7:55 AM by Mark Silva and updated President Barack Obama, who has pledged to place diplomacy ahead of confrontation and reached out to a skeptical world with offers of mutual understanding, was awarded the Nobel Peace Prize today for what the committee called "his extraordinary efforts to strengthen international diplomacy and cooperation between peoples."...
From the Washington Post:
Barack Obama Wins Nobel Peace Prize (click here) By Debbi Wilgoren and Scott Wilson Washington Post Staff Writers Friday, October 9, 2009; 9:44 AM President Obama was awarded the 2009 Nobel Peace Prize Friday for his work to improve international diplomacy and rid the world of nuclear weapons -- a stunning decision to celebrate a figure virtually unknown in the world before he launched his campaign for the White House nearly three years ago....
From the Los Angeles Times:
President Obama wins Nobel Peace Prize (click here) The Nobel committee notes 'his extraordinary efforts to strengthen international diplomacy and cooperation between peoples.' By Mark Silva Los Angeles Times October 9, 2009 4:46 a.m. Reporting from Washington — President Obama, who has pledged to place diplomacy ahead of confrontation and reached out to a skeptical world with offers of mutual understanding, was awarded the Nobel Peace Prize today for what the committee called "his extraordinary efforts to strengthen international diplomacy and cooperation between peoples." Obama is only the third sitting U.S. president to win the Nobel Peace Prize -- President Theodore Roosevelt won the award in 1906, President Woodrow Wilson in 1919....
President Barack Obama wins Nobel Peace Prize (click here) By KARL RITTER and MATT MOORE Associated Press Oct. 9, 2009, 8:12AM ...Nobel observers were shocked by the unexpected choice so early in the Obama presidency, which began less than two weeks before the Feb. 1 nomination deadline. White House press secretary Robert Gibbs said Obama woke up to the news a little before 6 a.m. EDT. The White House had no immediate comment on the announcement, which took the administration by surprise. The Norwegian Nobel Committee decided not to inform Obama before the announcement because it didn't want to wake him up, committee chairman Thorbjoern Jagland said. "Waking up a president in the middle of the night, this isn't really something you do," Jagland said....
From the Miami Herald:
In a surprise, Obama wins Nobel Peace Prize (click here) ..."Only very rarely has a person to the same extent as Obama captured the world's attention and given its people hope for a better future," Jagland said. Obama's election and foreign policy moves caused a dramatic improvement in the image of the U.S. around the world. A 25-nation poll of 27,000 people released in July by the Pew Global Attitudes Project found double-digit boosts to the percentage of people viewing the U.S. favorably in countries around the world. That indicator had plunged across the world under President George W. Bush. Still, the U.S. remains at war in Iraq and Afghanistan, the U.S. Congress has yet to pass a law reducing carbon emissions and there has been little significant reduction in global nuclear stockpiles since Obama took office. "So soon? Too early. He has no contribution so far. He is still at an early stage. He is only beginning to act," said former Polish President Lech Walesa, a 1983 Nobel Peace laureate....
I don't believe Walesa was ever nominated.
From the Boston Globe:
In a surprise, Obama wins Nobel Peace Prize (click here) By Karl Ritter and Matt Moore Associated Press Writers / October 9, 2009 ...The award appeared to be a slap at Bush from a committee that harshly criticized Obama's predecessor for his largely unilateral military action in the wake of the Sept. 11 terror attacks. The Nobel committee praised Obama's creation of "a new climate in international politics" and said he had returned multilateral diplomacy and institutions like the U.N. to the center of the world stage. "You have to remember that the world has been in a pretty dangerous phase," Jagland said. "And anybody who can contribute to getting the world out of this situation deserves a Nobel Peace Prize."...
I am pleased to see the newspapers are covered by AP, but, there needs to be some legislation somewhere that helps revitalize the art of journalism. Freedom of Speech also includes having newspapers as our Fourth Arm of Government, but, if that 'speech' boils down to 'one voice' regardless of how correct and benign that voice is there is danger to our right under the First Amendment.
The USA is just about the most powerful nation in the world by military standards. When their leadership makes a clear stance for the pursuit of peace, when even 'the concept' hung in the balance of extinction before, that speaks loudly of the people of our nation as well as our 'incubator' for leadership.
President Obama has reaffirmed the USA as a benevolent nation and one centered on justice and peace. He has taken the question of our ability to govern with peaceful intent out of question. He is a great man that looked into the future and saw a world of colleagues and not enemies. It is possible, very possible for the world's leaders to rid this planet of any malice, either through sovereignty, sustainability and environmental. It is possible.
President Obama took on the challenges he faced when entering the White House with determination and energy. He has brought the hopes and dreams of the International Community to life and within the realm of possibility. He has many years in his ambitions to accomplish some of the greatest tasks any USA President has adopted to his administration. Let there be no doubt, it will happen.
I can't say it enough, Barak Obama pursued a path to greatness and never before in history has a man of this caliper graduated as President of Harvard Law Review, shrugged off the opportunities to wealth and embarked on venues of change working with the grassroots of our society. He is an incredible individual with unmistakable vision and commitment. I am proud of him, his journey to date and the future he is promising.
It's content is more along the lines of "Bowling For Columbine."
By Adam Satariano and Beth Jinks Oct. 6 (Bloomberg) -- Goldman Sachs Group Inc., JPMorgan Chase & Co. and Intel Corp. may lead companies worldwide to the first profit increases in more than two years this quarter, ending the longest earnings recession on record. Buoyed by finance and semiconductors, profits at the world’s biggest companies are projected to grow 63 percent in the final three months of 2009, snapping nine straight quarterly declines....
At least JP Morgan Chase knows how to say 'thank you.'
The FDIC is still busy. I thought Bush and Paulson were conducting a Bank Bailout. Why didn't these banks get bailed out?
2009 certainly has not been a good year for banking. The FDIC closed 3 more banks this weekend bringing the total number of bank failures to 98 this year. FDIC projections put the number of failures to reach the 100 mark within a couple of weeks. Continuing bank failures have mirrored the poor health of the country’s financial institutions. Three more banks joined the list of recent bank failures. The FDIC announced this Friday that it has included Southern Colorado National Bank of Pueblo, Colorado; Jennings State Bank of Spring Grove, Minnesota and Warren Bank of Warren, Michigan in its list of bank closures.
Costs of Failures The FDIC has estimated that the recent bank failures will be putting a dent in their funds of at least $850 million. This will put an increased strain on the dwindling funds which previous bank failures have cost. The FDIC projects that over the next 5 years losses could reach $70 billion. In more troubling news, figures also show that problem banks rose to 416 from 305 the previous quarter. Analysts predict that the total bank failures this year could reach 150. This is a turnaround from 2005 – 2006 figures which posted no bank failures....
Chairman Ben S. Bernanke
At the Federal Reserve Board Conference on Key Developments in Monetary Policy, Washington, D.C.
By using our balance sheet, the Federal Reserve has been able to overcome, at least partially, the constraints on policy posed by dysfunctional credit markets and by the zero lower bound on the federal funds rate target. By improving credit market functioning and adding liquidity to the system, our programs have provided critical support to the financial system and the economy. Moreover, we have carried out these programs responsibly, with minimal credit risk and with close attention to the exit strategy. Our activities have resulted in substantial changes to the size and composition of our balance sheet. When the economic outlook has improved sufficiently, we will be prepared to tighten the stance of monetary policy and eventually return our balance sheet to a more normal configuration.
Climate - The climate of Washington varies within each region. (click here) The Cascades split the state and alter the weather patterns. The terrain east of the mountains, which includes Moses Lake State Park, receives approximately 12 inches of rainfall per year (rainfall map, click here), generally much less than west of the mountains. Since the area east of the mountains is landlocked, temperatures in this region are lower during the winter months. Frequent winds coming down from the mountains also contribute to the low temperatures of eastern Washington.
...According to local news, (click title to entry - thank you) the storm brought strong winds gusting to 43 miles per hour in places that propelled the dust across the southeast corner of the state. After numerous multi-vehicle accidents, sections of Interstate 90 near the town of Moses Lake and several local roads had to be closed for several hours. A thick, rippling plume of dust runs northeast to southwest through the center of the image. Dust stretches as far south as the cities of Pasco and Kennewick, which sit on opposite banks of the Columbia River. In the north, the dust seems to rise primarily from the pale golden squares of fields farmed using dryland agriculture (That is a lot of lost top soil.), a common practice in arid eastern Washington. The dryland fields are larger and less colorful than the bright green and gold fields of irrigated agriculture near the Columbia and Snake Rivers in the center of the image. Dryland farmers rely entirely on rainfall to sustain their crops, and as a result, do many things to preserve moisture in the soil. Some of these practices—leaving a field fallow after harvest to allow water to build in the soil for a year or covering the field with dry soil to prevent underlying moisture from evaporating—make dryland agriculture very prone to dust storms. These fields are likely either fallow or newly planted, probably with winter wheat, a common dryland crop in eastern Washington. The dust storm persisted for several hours...
I-90 in E. Washington reopened after dust storm closure (click here) 01:57 PM PDT on Monday, October 5, 2009 By NWCN.com and Associated Press MOSES LAKE, Wash. - Authorities reopened Interstate 90 between Moses Lake and Ritzville at about 8:30 p.m. Sunday, 19 hours after it was closed due to blowing dust....
Pacific Ocean 'dead zone' in Northwest may be irreversible (click here) Oxygen depletion that is killing sea life off Oregon and Washington is probably caused by evolving wind conditions from climate change, rather than pollution, one oceanographer warns. By Kim Murphy October 9, 2009 ...But the dead zone off the Northwest is one of the few in the world -- and possibly the only one in North America -- that could be impossible to reverse. That is because evolving wind conditions likely brought on by a changing climate, rather than pollution, are responsible, said Jack Barth, professor of physical oceanography at OSU."I really think we're in a new pattern, a new rhythm, offshore now. And I would expect [the low-oxygen zone] to show up every year now," Barth said at a news conference.Thursday's briefing coincided with the release of a National Science Foundation multimedia report that said the number of dead zones worldwide was doubling every decade.In the Pacific Northwest, the report said, the areas of hypoxic, or low-oxygen, water that long have existed far offshore began to appear closer to land in 2002, a phenomenon that may mean they are even deadlier to sea life that exists near the ocean floor....
Suicides rates in Police Officers are higher for the same reason many suicides occur, it is an act of opportunity. They have the guns, they are distraught and they kill.
Guns are the problem.
Officers should not carry weapons home with them. If they own their own personal weapons there is little that can be done to stop a person that is determined to kill.
Suicide is a killing, not just a desperate act of passion or dispair. Stop the ability to kill and stop the suicide. The 'opportunity' is just as much a part of this as the act itself.
If guns didn't 'free flow' through this society, there would be less suicides and murders. Just that simple. The NRA will use statistics to validate their greed, but, the truth of the matter is guns kill.
Someone killed someone else here as well as themselves. The gun was the weapon.
The warning signs that police officer Steve Martin was a suicide risk (click here) were clear enough in hindsight: erratic behavior, disgust with his job, heavy drinking, a strained marriage. But the lack of foresight is what leaves his wife, Debbie, angry more than a year later.... ...Suicide rates for police — at least 18 per 100,000 — are higher than for the general population, according to Audrey Honig, chief psychologist for the Los Angeles County Sheriff's Department....
LEBANON, Pa., Oct. 8, 2009 Gun-Toting Soccer Mom, Husband Found Dead Meleanie Hain, Who Became Voice of Gun-Rights Movement, Part of Apparent Murder-Suicide A suburban mother who became a voice of the gun-rights movement when she openly carried a loaded pistol to her daughter's soccer game was fatally shot Wednesday along with her parole-officer husband in an apparent murder-suicide at their home in Pennsylvania Dutch country, authorities said. Police released scant details about the deaths of Meleanie Hain, 31, and Scott Hain, 33, but said more information would be released Friday after their autopsies. "I'm devastated. I lost my daughter. I lost my best friend. The children lost their parents," Jenny Stanley, Meleanie Hain's mother, told WGAL-TV. Stanley added that the three children, ages 2, 6 and 10, are "hanging in there." The children were at a neighbor's house by the time police arrived to answer 911 calls from neighbors, said Lebanon City Police Chief Daniel Wright. "What they did or did not see as part of this is not something we're going to release," Wright said. Neighbors said the children ran outside and said their father had shot their mother, but Wright declined to disclose what investigators have concluded about how the deaths occurred....
I am getting overwhelmingly tired of others questioning President Obama's integrity and his ability to understand issues and convey THE TRUTH to the nation. From the beginning of his proposed Health Care Insurance Reform he has openly stated there would be no addition to the deficit by the bill he was proposing.
The Right Wing of this country has done NOTHING but insult his integrity by complaining about absolutely insane issues created by their media. They have done nothing but complain about the cost and over and over and over again the President of the United States of America promised the bill would never add a dime to the US Deficit.
Enough already. Vote the measure into the laws of this country and do it NOW !!!!
Congressional budget analysts gave an important political boost Wednesday to a Senate panel's health-care overhaul, projecting that the $829 billion measure would both dramatically shrink the ranks of the uninsured and keep President Obama's pledge that doing so would not add "one dime" to federal budget deficits....
It seems difficult to understand why all Americans aren't clamoring for health care insurance reform. But, if I reflect on the fact that our current dysfunctional system of health care 'delivery' has been dominated by 'insurance delivery priorities' for the past three decades, it gets easier to understand how many Americans don't 'understand' a different reality.
Doctors aren't supposed to work for health insurance companies, but, to the draconian way health insurance 'delivery' is administered that is exactly whom they work for and they feel impuned at delivering the best care to their patients.
Health care delivery at one time was not as heavily weighted on insurance 'permission' to treat so much as appropriate diagnosis and the power of physicians and surgeons to deliver care. A 'fiscal' constraint was placed on hospitals and doctors in the 1980s called DRGs and that was a game changer.
Then, for the first time in American Medical History, the insurance companies had more power than the physician or surgeon. DRGs literally dictated the length of a patient stay and their course of treatment. In actuality, it was an outrageous reality that was subscribed to by allowing CEOs to determine the diagnosis and outcomes of patients. Not all people are created exactly the same. There are complications depending on genetics, wellness and physical condition. Why is it that a 60 year old with Congestive Heart Failure has a poorer prognosis than a 25 year old trauma victim with a flailed chest? The reason is the age, physical condition and ability to heal without complications, that is the difference.
According to Wiki, in 1991, the top 10 DRGs overall comprising 30% of DRGs were: normal newborn, vaginal delivery, heart failure, psychoses, cesarean section, neonate with significant problems, angina pectoris, specific cerebrovascular disorders, pneumonia, and hip/knee replacement. Of the top ten, four or forty percent are regarding the birth of a newborn. There is dearly little that can be done to change childbirth.
One would think that after 18 years of consistent use of these DGRs they would be a 'science' by now, but, they aren't. We have witnessed the drastic lack of compassion by CEOs toward women giving birth which required legislation to correct. We know that Pre-Mature delivary of an infant takes tens of thousands of dollars US to achieve a viable human being that can live off a neonatal unit. Strokes are still an issue in the society requiring more rehab today than ever. We learned through medical research that long term rehab literally retrains the brain to function. There are more hip and knee replacements today than ever in an active society that demands to have access to their lives through ambulation and activity. There are no drugs or livestyles that stop arthritis.
The point is, CEOs haven't got a clue as to the future of 'health care delivery' in the USA. They didn't know in the 1980s and they don't know today. The 'state of American health care' is fluid and not a 'commodity.' The development of DRGs were punitive. It stated that hospitals and doctors and surgeons didn't know what they were doing and they needed to be focused and controlled. Basically, the Health Care Insurance Companies took on a 'patriarchal' approach to doctors, physicians and patients. It was draconian and uncompassionate. They had no right to 'talk down' to MDs and yet still today they do exactly that.
I don't mind if society wants to streamline recordkeeping to limit repeated tests, it is better we aren't exposed to repeated blood draws or x-rays; but; don't get in the way of a physician that feels as though there is a need for a repeated test when someone's well being is on the line. I don't know of many MDs that actually disregard 'the cost' to a patient when writing perscriptions or ordering diagnostics or treatments. They are people that care for people and while some might have bedside manners not of the best finishing school, they do interact with piers that will inform them of their demeanor and potential misstep.
The DRG experience in the USA took away the 'trustworthiness' of the Medical Profession and Professional and stated Corporate America knew better how to administer care than they did. It is the biggest farce for money this country has ever experienced and it has gone on from the 1980s through 2009. Three decades of 'managed' care through insurance companies that throw off their enrollments those people that aren't producing a 'profit.'
There is greatness in this country. There is greatness within the practice of medicine. There is greatness in the hands of a surgeon and I want this mess to stop and I want it to stop now. Women were protected from draconian insurance CEOs when they needed a hospital and MD to assist their infant to life outside the womb with a legislative action, it is time to recall the draconian form of 'insurance delivery' of health care and put it back in the hands of the physicans and surgeons that best understand it and the person they administer their art.
I think I life off with Page 775 of the House Bill:
There is a delineation to "presumed" eligible for a State policy and "determined" to be qualified. I mentioned this before. In the case of a newborn, it is considered eligible for any assistance at the time of birth, until qualified for disqualified for public assistance with their health insurance needs. On page 776, lines 1 thorugh 8 it states there is 30 days from what I call a percipitating event to move from 'presumptive' to 'qualified.'
‘‘(3) APPLICATION FOR MEDICAL ASSISTANCE.—In the case of an individual described in subsection (a) who is determined by a qualified entity to be presumptively eligible for medical assistance under a State plan, the individual shall apply for medical assistance by not later than the last day of the month following the month during which the determination is made.
During the coarse of this bill there are repeative statements to bring the law to bear. One of those 'repeative statements' is called a 'Conforming Amendment.' It states where in existing law the words will be changed. Page 776, lines 22 through 25 and Page 777, lines 1 through 5 is one of those statements. So, I'll include it here as an example:
(2) CONFORMING AMENDMENTS.— (A) Section 1902(a)(47) of the Social Security Act (42 U.S.C. 1396a(a)(47)) is amended by inserting before the semicolon at the end the following: ‘‘and provide for making medical assistance available to individuals described in subsection (a) of section 1920C during a presumptive eligibility period in accordance with such section’’.
Relatively mondane, boring and standard issue of wording. Why would the wording appear in a Medicare law? Because it is these laws that are being extended to 'eligible' individuals under age 65 in the Public Option. It has nothing to do with people already eligible.
Sorry, interruptions happen. Page 778. ;lines 9 and 10:
Subtitle C—Access SEC. 1721. PAYMENTS TO PRIMARY CARE PRACTITIONERS.
There are some language adjustments in this section, but, basically the reimbursement to them will be 80% of applicable services. That is a good rate of payment as far as I am concerned.
Page 778; lines 21 through 25 and page 779; lines 1 through 11:
‘‘(C) payment for primary care services (as defined in section 1848(j)(5)(A), but applied without regard to clause (ii) thereof) furnished by physicians (or for services furnished by other health care professionals that would be primary care services under such section if furnished by a physician) at a rate not less than 80 percent of the payment rate applicable to such services and physicians or professionals (as the case may be) under part B of title XVIII for services furnished in 2010, 90 percent of such rate for services and physicians (or professionals) furnished in 2011, and 100 percent of such payment rate for services and physicians (or professionals) furnished in 2012 or a subsequent year;’’.
This provision goes on to include more explanations of services, some reimbursalbe at 100%. The rates of payment or reimbursement are not less than 80%. States will be allowed to apply for a Medical Home Pilot Program that can have a life of upto 5 years.
Page 781, 7 through 18:
(1) IN GENERAL.—A pilot project is a project that applies one or more of the medical home models described in section 1866E(a)(3) of the Social Security Act (as inserted by section 1302(a)) or such other model as the Secretary may approve, to high need beneficiaries (including medically fragile children and high-risk pregnant women) who are eligible for medical assistance under title XIX of the Social Security Act. The Secretary shall provide for appro16 priate coordination of the pilot program under this section with the medical home pilot program under section 1866E of such Act.
The section is followed by definitions, evaluations, reports and provisions for interpretor services. Accurate interpretors are vitally important. Here is a story, it is profoundly truthful and does not have to do with HIV/AIDS.
There was a Hispanic woman, about 62 years old came in the hospital for a hysterectomy. She was evaluated by the physicians and an irregularity was found in the EKG of her heart. She was referred to a cardiologist who did a cardiac catherization. It was found she had coronary artery disease and it would have to be dealt with in open heart surgery before any other surgery could be performed.
The evening before her surgery her son came to visit with her. He happened to stop at the desk on his way out off the unit and asked when his mother would be going for her hysterectomy.
I was called to speak to him as he spoke perfect English. I reviewed the chart and realized she was going to have open heart surgery. The consents were signed and witnessed by an employee from the kitchen of the hospital that was supposed to have spoken Spanish well. I asked him what made him believe his mother was going to have a hysterectomy. He stated that is why she came to the hospital and it was his understanding that was what was to occur.
I asked him if he spoke Spanish well enough to speak to his mother and we went into the room. It was a double occupancy room. The husband to the woman was at her bedside. The son asked his mother what kind of operation was being conducted that she consented to and she and her spouse stated a hysterectomy. No lie.
I called around to the nursing units in the hospital until I found a Spanish speaking RN and she reported to the patient's room. She conversed with the patient and the husband who had been at her side the entire time. She stated, the patient and her spouse was under the impression she was having a hysterectomy in the morning.
I then telephoned the surgeon and explained the consent that was signed was invalid because the interpreter was not a licensed individual and did not convey the brevity of the expected surgery to the patient. He immediately cancelled the surgery. The next day, a certified interpretor was ordered in his orders and the hospital had to secure one from a nearby university that had a few on staff.
The woman would have had surgery on her heart, been admitted to a SICU after surgery and the spouse would have never realized that a minor procedure was actually a major surgical procedure that was far more life threatening than a minor procedure.
Needless to say if the son hadn't stopped to visit his mother before her surgery there would have been drastic consequences to any of the surgery because it would have occurred and the following orders without prior consent. There probably would have been legal issues as well as ethical ones.
So, the 'idea' that accurate and certified interpreters are a luxury and not a requirement in any medical setting is hideous.
Page 783, lines 19 and 20:
SEC. 1724. OPTIONAL COVERAGE FOR FREESTANDING BIRTH CENTER SERVICES.
The option to experience a birth outside a hospital is an option. Page 784, lines 7 through 18:
‘‘(29) freestanding birth center services (as defined in subsection (l)(3)(A)) and other ambulatory services that are offered by a freestanding birth center (as defined in subsection (l)(3)(B)) and that are otherwise included in the plan; and’’; and (2) in subsection (l), by adding at the end the following new paragraph: ‘‘(3)(A) The term ‘freestanding birth center services’ means services furnished to an individual at a freestanding birth center (as defined in subparagraph (B)), including by a licensed birth attendant (as defined in subparagraph(C)) at such center.
There are definitions and effective dates that follow.
Page 785, lines 13 and 14:
SEC. 1725. INCLUSION OF PUBLIC HEALTH CLINICS UNDER THE VACCINES FOR CHILDREN PROGRAM
I think that is fairly self explanatory. Page 786 is a new major Subtitle, lines 1 through 3:
Subtitle D—Coverage SEC. 1731. OPTIONAL MEDICAID COVERAGE OF LOW-INCOME HIV-INFECTED INDIVIDUALS.
There are no extra allowances for HIV infected people. They have to meet the same requirements for service as everyone else. The provision does state a specific time frame for enactment of this portion of the bill which is no later than January 1, 2013. There are exceptions for USA Territories. They can qualify individuals differently and somewhat more generously. There is a two year extention for Transitional Medicaid Assistance (TMA) until December 31, 2012 simply to allow States to get their act together.
Page 789, lines 1 and 2:
SEC. 1733. REQUIREMENT OF 12-MONTH CONTINUOUS COVERAGE UNDER CERTAIN CHIP PROGRAMS.
This states that once a child is found to be eligible for Medicaid recertification does not take place for a year. The idea is to cut down on 'middle management' costs. Rarely do these children move off assistance that quickly anyway. The parents or guardians are required to report changes in circumstances and income during that period of time anyway. It is a requirement of receiving assistance. They have to report those changes or there can be consequences, but, they don't have to be scrutinized by government.
Page 789, lines 19 through 21:
Subtitle E—Financing SEC. 1741. PAYMENTS TO PHARMACISTS.
(a) PHARMACY REIMBURSEMENT LIMITS.—
Page 790, lines 1 through 6:
‘‘(5) USE OF AMP IN UPPER PAYMENT LIMITS.—The Secretary shall calculate the Federal upper reimbursement limit established under paragraph (4) as 130 percent of the weighted average (determined on the basis of manufacturer utilization) of monthly average manufacturer prices.’’
That is fair reimbursement. What that states is the manufacturer charges whatever they charge for the medication and the pharmacist can charge 30% above what it cost them. So if a drug cost $1.00 per pill the pharmacist can charge $1.33 per pill.
There are other cost provisions by manufacturers that are to be reported within 30 days to the Secretary that help sculpt the Average Manufacturer Price (AMP) to whole distributors, including mail order pharmacies that are not open to all members of the public, such as rebates from manufacturers, discounts or price concessions so long as they are not passed through to the retail pharmacist or cost reimbusement for the return of defective or damaged medications.
The idea here is to prevent higher prices to the consumer when in fact there are lower prices to wholesalers.
There is a transparency provision for the public. There is also rebates allowed for 'single source' medications. Single source are new formulations under patent. There are provisions that they will be allowed to provide rebates to enhance the marketability of the initial introduction to the market. The States are going to be required to attend to all this recordkeeping. They want to know the public monies used in Medicare are within reason while still allowing physicians to order the necessary and perhaps new medication if the patient needs it.
Page 797, lines 5 through 12:
‘‘(C) REPORTING ON MMCO DRUGS.—On a quarterly basis, each State shall report to the Secretary the total amount of rebates in dollars received from pharmacy manufacturers for drugs provided to individuals enrolled with Medicaid managed care organizations that contract under section 1903(m).’’; and (3) in subsection (j)—
Page 797, lines 21 and 22:
SEC. 1744. PAYMENTS FOR GRADUATE MEDICAL EDUCATION
Page 798, lines 5 through 8:
‘‘(1) IN GENERAL.—The term ‘medical assistance’ includes payment for costs of graduate medical education consistent with this subsection, whether provided in or outside of a hospital.
Page 798, lines 13 through 24:
‘‘(A) the State submits to the Secretary, in a timely manner and on an annual basis specified by the Secretary, information on total payments for graduate medical education and how such payments are being used for graduate medical education, including— ‘‘(i) the institutions and programs eligible for receiving the funding; ‘‘(ii) the manner in which such payments are calculated; ‘‘(iii) the types and fields of education being supported;...
This provision goes beyond just three topics of interest, but, what it boils down to is a reporting by the States of monies spent on medical education and where the money is going including the 'specialty' areas being pursued. It is a 'tracking' of the trends in medical education to insure the country have enough graduates to fill the need, in the areas where need is expressed.
The Secretary and the Advisory Committee on Health Workforce Evaluation and Assessment then reviews the information and then make changes in where funds will be distributed to further enhance graduates to choose fields of greater need.
Page 801, lines 4 through 8:
Subtitle F—Waste, Fraud, and Abuse SEC. 1751. HEALTH-CARE ACQUIRED CONDITIONS.
(a) MEDICAID NON-PAYMENT FOR CERTAIN HEALTH CARE-ACQUIRED CONDITIONS
This provision takes nosocomial infections beyond the hospital into 'health care acquired' conditions. I've discussed before the dangers and increased costs to infections and conditions acquired due to exposure to the hospital environment.
I'll end here for today. There are a total of 1018 pages, so its nearly complete.
