OBAMA PUSHES BIG MEDICAL PRACTICE CHANGES

8/31/13
The clearest explanation of the Obama administration’s vision for health care reform comes from Harvard Medical School Professor Atul Gawande, who says medicine should be more like engineering, with all doctors following the same script rather than exercising their individual judgments. Gawande argues: “This can no longer be a profession of craftsmen individually brewing plans for whatever patient comes through the door. We have to be more like engineers building a mechanism whose parts actually fit together, whose workings are ever more finely tuned and tweaked for even better performance in providing aid and comfort to human beings.”
Another strong proponent of the Obama administration viewpoint is Commonwealth Fund President Karen Davis. She explains what this will mean for the organization of medical practice: “The legislation also includes physician payment reforms that encourage physicians, hospitals, and other providers to join together to form accountable care organizations [ACOs] to gain efficiencies and improve quality of care. Those that meet quality-of-care targets and reduce costs relative to a spending benchmark can share in the savings they generate for Medicare.”
Millions of dollars have been spent on pilot programs and demonstration projects to find out “what works” so the ACOs can copy them. We’ve had demonstration projects for coordinated care, integrated care, medical homes, electronic medical records, pay-for-performance, and just about every other faddish idea. Unfortunately, the Congressional Budget Office has found in three separate reports that that none of this is working. What I really mean is that projects designed, approved, and paid for by the demand side for the market aren’t working. Many of these techniques actually do work when they are instituted by entrepreneurs on the supply side. But supply-side innovations have nothing to do with ObamaCare. Most of what the administration wanted to happen is not happening. The secretary of Health and Human Services seems to ignore adverse effects but quickly credits the ACA for trends perceived as positive.)
On the negative side, hospitals are merging and they are acquiring doctors. In the process, they are making the market less competitive, gaming third-party payment formulas, and doing other things that make our health insurance premiums and our taxes higher than they otherwise would be. More than half the doctors are now working for hospitals and other institutions, rather than in private practice. Hospitals are using their new doctor employees to get more money out of Medicare. Overseeing Medicare fees, has noticed—although belatedly—that hospitals can charge Medicare more for the same services than doctors can charge if they bill Medicare as independent practitioners.
“Medicare pays $58 for a 15-minute visit to a doctor’s office and 70 percent more—$98.70—for the same consultation in the outpatient department of a hospital. The patient also pays more: $24.68, rather than $14.50.When a Medicare beneficiary receives a certain type of echocardiogram in a doctor’s office, the government and the patient together pay a total of $188. They pay more than twice as much—$452—for the same test in the outpatient department of a hospital. From 2010 to 2011, the commission said, the number of echocardiograms provided to Medicare beneficiaries in doctors’ offices declined by 6 percent, but the number in hospital outpatient clinics increased by nearly 18 percent.”
Major unintended consequence is the boost to consumer-directed health care. In the health insurance exchanges, the cheapest plans are going to have deductibles of $5,000 or more. People are going to choose the cheapest plans, responding with products that seem to be far removed from the accountable care model the administration is pushing. Employers are going for Health Savings Accounts, millions of patients are going to be buying care with their own money, rather than with a third-party payer’s money.
Accenture predicts the number of walk-in clinics is going to double in the next few years. The Obama administration doesn’t like them because they are not part of integrated care/coordinated care/medical homes/etc. Even so, they are doing what the ACOs are unlikely to do: lowering costs, increasing quality, and improving access to care.
Sources—human events, john Goodman, nyt

SATURDAY MORNING ON FOX—8/31/13

IN 2010 Trumka was praising Obamacare thought it was the greatest thing going. But today’s a different tune. There are too many holes in it, too costly, they lose under it, they need relief, waivers, and all of this even after Obama extends the employer mandate. The CBO is still saying that OBC is going to cost more. US now worried about cyber attacks not nukes. Showed unions protesting all over the place asking for $15.00 mim., Wage. My question is if they should get it, how many would that take off of welfare?

National debt rounding 1$6.9 trillion. Remember sequester and the cuts to our military—now we’ve got 4 ships sitting over there and at a cost of around 1.4 million a tomahawks missiles cost they are considering firing a bunch of them—money must have been found for that. So are we in favor of more windmills or missiles? Dems are unset that Obama is the first President to have make these tough decisions in Syria. Snowden said that since 2008, there has been at least 2000-3000 plus a year of NSA spying on Americans. Now the NSA is using the systems to spy of their love ones or personal interest. We’ve are starting to look like Hitler, little things like these latest scandals is how he started, a little bite at a time. The politicians are admitting that nobody actually knows what the NSA is doing—TRANSPARENCY.

35 states are paying more in welfare that a person could make on mim wage, add the 14 million on disability and somebody is going to have to pay for all of this. AZ has just busted up the biggest food stamp fraud in the nation. There is an estimate of at least 30% increase in fraud over the last few years. Look at the Welfare benefits packages in these states: HI–$49,175.00, DC–$43,099.00, MA–$42,515.00, CT-$38,761.00 and NJ- $38,728.00, RI-$38.632.00, NY-$38,004.00.
Add to this that the government is now selling our personal information to marketing services—now you know where your “junk” mail is coming form.
Food stamps in 2009- 38.4 million people at $50.3 billion, 2010—40.3 million on it, @ $64.7 billion, 2011-44.7 million on it @$71.8 billion, 2012-46.6 million costing $74.6 billion.
The cost of welfare in 1964 was $5 billion today its at $565 billion. One reason that the disability rolls are increasing is people are finding doctors willing to put them on it. $170 million in fraud due to this
REMEMBER WE DO NOT HAVE A SPENDING PROBLEM

ABORTION AND GUN MURDER—

8/31/13

THE GUN MURDER LISTED BELOW OCCURRED AT SCHOOLS BUT NOT ALL OF THE DEATHS WERE STUDENTS. MANY WERE SUICIDES, ACCIDENTS, FAMILY, AND TEACHERS AND WORKERS AT THE SCHOOLS.
SOURCES-NEWS NOW—MINNESOTA ABORTIONS, PLANNED PARETNHOOD, CHARLIE SPIERINGLIFE INSTITUTE, WIKEPEDIA

ABORTIONS: Planned Parenthood
2011—333,964
2010—329,445
2009—332,278
they did one every 94 seconds.
They show a total of 55,808,387 since 1973
Life issues—reports that 46.1% of all abortion were performed on women who had at least one previous abortion. Approximately 3,200 babies die everyday in the US.
Every 23 seconds a baby is killed by abortion.
Planned PH accounts for about 27% of all American abortions. 40.2% of abortion in the US are performed on African American women, while black population is around 13% in the US.
Approx. 52% of all African American pregnancies now end in abortion.
86% of all abortions are done for the sake of convenience.
The average cost of first trimester abortion (10 weeks) is $451.00.
The average cost of a vaginal birth in the US is now over $9000.00.
HHS reports in January 2012 said “that if your are anti-abortion, you are a potential terrorist.
Gosnell slaughtered hundreds of living breathing newborns by severing their spinal cords or slitting their necks.
Some clinic have been caught selling aborted baby parts to medical researchers.
PPH’s ,Marget Sanger “the most merciful thing that a family does to one of its infant members is to kill it”. She also said “Birth control must lead ultimately to a cleaner race”
PPH performs more that 300,000 abortion every year.
A staggering 72% of PPH customers have incomes that are either equal to or beneath 150% of the federal poverty level.
There are 30 PPH executives that make more than $200,000 a year, and few of them make more than $300,000 a year. PPH has received more that $487 million from the federal government during 2010.
Our politicians talk about how we need to spread our values to the rest of the world, but what kind of “values” do we really have when we have such little respect for human life?

GUN KILLINGS—REMEMBER THESE ARE NOT JUST STUDENTS BUT ANYBODY KILLED AROUND THE SCHOOL AND MANY ARE SUICIDES.
I FOUND REPORTS THAT GO BACK TO 1927—43 KILLED, the total from 1927 thru 2013 is 279.
Then one report had numbers back to 1760 @11, 1850’s-1, 1860’s-3, 1870’s-2, 1880’s-1, 1890’s-15, 1900’s-30, 1910’s-11, 1920’s-55, 1930’s-16, 1940’s-17, 1950’s-17, 1960’s-36, 1970’s-31, 1980’s-35, 1990’s-66, 2000-9’s-81

SO WHICH ONE IS KILLING MORE BABIES (KIDS)

THE REAL FED SWEEPSTAKES—POLICY NOT PERSONALITIES

8/29/13

Guessing who the appoint as the next chairman of the FED will be either Janet Yellen or Larry Summers. Summers with intellectual prowess and invaluable experience, not to mention (but they always do) his connections with Obama’s closest advisers on economic and financial matters.
Even as the president emphasizes wealth inequality as the defining problems for a nation unable to regain its economic footing and start growing again despite four years of unprecedented fiscal and monetary stimulus. 7/24 at Knox College Obama says “when middle class families have less to spend, businesses have fewer customers,” these unstable bubbles are the result of excessive money creation by the FED, he was expounding on growing wealth inequality, reduced returns on savings accounts an made it possible for Wall Street investors to reap huge capital gains form stock market increases. In the loose money/tight credit environment that has been in effect since Obama came to power., gains hedge funds and major corporations enjoy access to near-zero cost financing, while small business borrowers are turned away or charged punitive interest rates. To describe the impact of government policies on prosperity, does the work “monetary” show up? Nope!
The money policies engineered under Bernanke, have been the chief factor in disbursing unequal financial rewards. Stock market fueled by the fed’s serial programs of quantitative easing. The wealthiest 1% of Americans own 52% of all directly owned publicly traded stocks in the US, the top 5% own 82% of directly held stocks.
Explain to the American people that the fed’s cash injections to the economy through monthly purchases of $85 billion in Treasury Bonds and mortgage-backed =securities dwarf by a dozen times over the amount of a year of the sequester, some $85 billion in total—which obama described last week as a meat cleaver. The president roundly condemned our “winner-take all economy where a few do better and better while everybody else just treads water”
The fact that the Board of Governors of the federal reserve system is a federal agency whose seven members are appointed by the president and confirmed by the senate. Too bad we can’t choose someone with the same qualities that should characterize management of the money supply; someone wonderfully boring, predictable and reliable.
For those of us who thinks the fed extraordinary interventions are dong more harm that good—distorting market signals and misallocation capital tot the detriment of productive economic activity—is that both Yellen and Summers would continue with the dovish policies of pumping in excess liquidity in the vain hope of reducing unemployment. They both embrace the notion that monetary illusion can induce real economic gains; they both accept the broadest mandate for the fed to justify its dominance in determining economic outcomes.
Federal reserve is attempting to do too much, taking on “responsibilities that it cannot reasonably meet with the appropriately limited power provided.” Volcker criticized the idea that monetary policy should be directed toward achieving both price stability and full employment.
If the dems appoint Yellen because of their concerns about Summers having favored banking deregulation be drawn to the man behind the eponymous “Volcher Rule” that would prevent banks from engaging in speculative trading for their own accounts using depositors money? Instead of engaging in feverish whisper campaigns to slide favored appointees into the worlds’ most powerful financial position, what we should be discussing is whether the feds outsized role in determining the price and availability of credit is beneficial to economic performance.
And when obama claims that “we’re cleared away the rubble form the financial crisis and begun to lay a new foundation for stronger, more durable economic growth”. let’s challenge him with a fundamental question: how can you lay a foundation for stronger, more durable economic growth without first laying a foundation for sound money?

Source—weekly standard, judy shelton

NO KIDDING

8/29/13

On July 23, a hearing was held by the House subcommittee on immigration and border security to discuss the “KIDS ACT”, touted by Cantor and Goodlatte as a way to address the concerns of young people who are here illegally through no fault of their own. Yhere is as yet no legislation to discuss!
Anyone who doubts that should listen to subcommittee chairman Trey Gowdy’s striking opening statement at the hearing, delineating how the rule of law applies to adults and to children. Dems have rejected it as inadequate. As house dems caucus chairman Xavier Becerra declared, “there is not reason why dems should be part of the political game that republicans are playing.” Suddenly, it’s the dems who are rigid and unyielding.
It is difficult for the advocacy groups that have been supporting the push for “comprehensive immigration reform” to compromise and agree on fallback positions.
Schrag also highlights that compromise is difficult for immigrant advocates because they feel a “sense of stewardship for the interest or constituents they represent, most of whom did not choose their representatives, even in the fictitious sense that stockholders choose their boards of directors.” Immigrant advocates are consequently left “wondering if they have sold out the interest they claimed to represent. Advocates personally doubt their right to take less than absolutist positions, even when it is clear that advocating an absolutist position will result in worse legislation than seeking a compromise.
Many of the 32 or so Hispanic-majority congressional districts include substantial numbers of illegal immigrants.
It is worth asking how; exactly such officials determine what is in the best interest of such “constituents”? in the prolonged debate over what eventually became the Immigration Reform and Control Act (IRCA) of 1986.
25 years after IRCA granted an outright amnesty to 2.7 million illegal immigrants, including the option of full citizenship, we know from Homeland Security data that most of those beneficiaries—fully 60% have become permanent legal residents and have opted not to exercise their right o become citizens.
Most illegal immigrants, especially those form Latin America arrive here not intending to stay. Yet there are few disincentives for dems to pursue citizenship for illegals at all costs, even at the risk of illegals remaining in their current predicament.

Sources—weekly standard, peter skerry

A PHONY BALONEY

8/28/13

In Galesburg, Il., Obama suggested Washington should stop focusing on an “endless parade of distractions and political posturing and phony scandals”. He repeated the line about “phony scandals on 7/25, 7/27. It’s his administration strategy to change the subject. Jay Carney cautioning Washington not to be “buffeted about” by “fake scandals”. The next day, Carney spoke about “phony scandals” that have “captured the attention of many here in DC. Carney told MSNBC’s Joe Scarborough: “it shouldn’t be on the skirmishes that cause gridlock, it shouldn’t be on the phony scandals that have consumed so much attention here, all to come ton naught.” Which scandals. Exactly are the phony ones?? Is one of them the IRS extra scrutiny of conservatives? Dan Pfeiffer says, is what Obama and Carney mean by calling the scandal phony: it’s grounded in anti-Obama politics, not substance.
Investigations are still underway, but what it’s revealed since the scandal broke doesn’t square with Pfeiffers explanation. IRS employees testified that Loris Lerner “ordered Tea Party cases to got through a multilayer review that included her senior adviser and the IRS chief counsel’s office. The chief counsel is on of two positions at the IRS appointed by the president, and incumbent William Wilkins met with the president at the white house several times. It there’s no connection what so-ever between the IRS’ s malpractice and the white house, the principals in the administration haven’t been forthcoming with evidence to that effect.
Jack Lew refused to say whether he had asked Wilkins about his role in targeting conservative groups. ”I am leaving the investigation to the proper people who do investigations.” But testimony from IRS employees and testimony form IRS employees and the public silence of Lerner and Lew have led republicans to push for more information. “if it were phony then why did Lois Lerner take the 5th.
Obama himself didn’t always consider the IRS scandal phony. In May he called the “misconduct” uncovered by the agency’s inspector general “inexcusable”.
“Americans are right to be angry about it and I am angry about it”, the president said, “I will not tolerate this kind of behavior in any agency, but especially in the AIRS, given the power that it has and the reach that it has into all of our lives”. Obama added he would direct Lew to ask the acting IRS commissioner to step down. Steven Miller resigned, Joseph Grant retired early. If as the administration now contends the scandals was nothing more than republicans trying to score points, why did it force these officials out?
The administration refers to phony scandals” in the plural, they’ve shut up about Benghazi.

Source—weekly standard, michaeal warren,foxnews

OBAMA AND REID KILL TAX REFORM

8/28/13

Tax reform is dead; obama killed it with an assist form Reid. To be exact, its officially dead now for this year and next. Obama rejected the one thing that makes tax reform politically possible: revenue neutrality. It allows the tax base to be broadened and tax rates to be lowered. He wants reform that raises taxes revenues. He would kill tax preferences and loopholes, then use the windfall this produces to fund his favorite spending programs.
The president has been publicly committed to revenue-neutral reform of corporate taxes for years. The white house would happily go along with neutrality, but they insisted this was a concession on Obama’s part and would have to be matched by GOP concessions. For corporate reform to be neutral, republicans would have to agree to raise revenue with higher taxes on individuals. He proposed to cut the corporate rate to 28% from 35% through reform that would leave him with a bundle of money to spend. That’s not revenue neutrality. He also called for a permanent tax on profits that Americans companies keep profits in foreign countries to avoid corporate taxes here. He suggested a tax hike of $1 trillion, as called for in the budget endorsed by senate dems.
They regard the 1986 tax reform in which the top rate on individuals dropped to 28% as the holy grail of tax legislation. He’ll insist he agreed to bipartisan compromise to cut the corporate rate, only to have republicans refuse to cooperate. All he wanted in return, Obama will say was tax revenues to “invest” in roads, education, and job training and boost the economy
Obama operates under the illusion that government spending boosts the economy and produces a wave of new jobs. The government spent at record levels in his first term and produced a lame recovery and a serious decline in he percentage of Americans in the workforce. As a liberal ideologue who has now killed a proven spur to the economy: tax reform that cuts rates without adding more taxes.
Douglas Holtz-Eakin former CBO director wrote “the current rules were fine when US exports dominated a global economy…but they are ill-suited for digital age of intense competition.” David Camp wants to cut the top corporate and individual rates to 25%.

Sources—weekly standard, Politico, fred barnes