Sen. Norm Coleman (R-MN), the Senator you can count on when it doesn't matter, is once again challenging for the title of Republican Champion of Oversight. This would be the equivalent of world's sharpest spoon, largest shrimp, tallest midget, etc. He's worked himself up into an a high dudgeon over fraudulent Medicare and Medicaid claims from dead doctors.
“This is simply unacceptable — making sure that the prescribing doctor is alive before paying a claim should be a no-brainer,” Sen. Norm Coleman, the committee’s ranking Republican said in a statement. “It’s time to close this $100 million loophole.”
(Wall Street Journal)
Norm wants to save American taxpayers 2% of what we spend in Iraq each week.
On Monday, John McCain repackaged his previous economic proposals in a mystifying document simply called "Jobs for America." More notable for what it lacked than what it included, McCain's latest rehash unsurprisingly left out his past admissions of ignorance on matters economic, his vision of eBay as Americans' economic future or his belief that the U.S. recession was merely "psychological." But in returning to a previously abandoned promise to magically balance the budget by the end of his first term, John McCain is depending on a 21st century "peace dividend" and unspecified reforms of entitlement programs. Call it McCain's Immaculate Deception.
In my bread-and-butter job, I'm an advocate for home health care. The patients of home health are the frail elderly and the low-income disabled, which means 90% of the revenue stream for home care is Medicare/Medicaid. Those of you who follow health care politics know that this translates into home care sitting on the bottom rung of the health care pay scale. In fact, home care providers qualify as the "working poor."
These working poor make house calls to dispense their care and compassion, which means they drive (especially here in rural Wisconsin). When your drive for your living, you get killed when gas costs go insane, as they are now. When you're poor and you drive for a living, you reach a point when you just can't do it. In this case, that will mean frail elderly patients and low-income disabled will either go without care or be forced into institutional care (where the risks for them and the costs for all of us are higher).
I asked Exxon to help. The reply is below the fold.
In an ongoing effort to make their colleagues unelectable, and to provide Democrats with an unassailable platform in November, House Republicans are dismantling and blocking some of the most popular provisions of the Iraq spending bill. Today they blocked passage of extended unemployment benefits despite rising unemployment. And, as we speak, they are working to remove a moratorium on seven Medicaid Rules changes proposed by Bush.
If they are successful, hospitals and emergency rooms will close in poor urban neighborhoods and throughout rural America. In addition, cuts will severely impact case management services to the elderly, people with behavioral disorders and other vulnerable populations; school-based clinics will be severely cut back; and many Americans including some veterans will find it harder to access rehabilitation services. Graduate Medical Education will be slashed to bits. The next generation of Americans will be a generation without doctors. And we will have little infrastructure to expand to create a nationalized health plan.
George W. Bush appears to desire the complete destruction of the Republican Party for the next forty years even more ardently than he wants to fund his war in Iraq. Or so I am lead to believe by a recent spate of incomprehensible policy decisions. He has given the Democratic Party an arsenal of tools to use against both John McCain, and nearly every Republican incumbent up for re-election in the Senate. It is July 4 in May!
Democrats in the Senate have been unable to pass a series of extremely popular and necessary programs due to stiff opposition from the Bush Administration and Senate Republican leadership. Instead of giving up, Democratic Leadership has attached the programs to the Supplemental Appropriations Bill which funds the War in Iraq. The President, who has suddenly discovered "fiscal responsibility," is threatening to veto the bill unless the offensive amendments are removed. His water carriers, Mitch McConnell (R-KY) and Chuck Grassley (R-IA) are working hard behind the scenes to insure that Republicans uphold the President's veto.
Senate Republicans who are up for re-election in November (or ever) face an unsettling dilemma.
THURSDAY NIGHT IS HEALTH CARE CHANGE NIGHT, a weekly Daily Kos Health Care Series
HOT OFF THE PRESS: Senator Jeff Bingaman's office (D-NM) just called ten minutes ago to inform me that the Senator HAS included all provisions of the moratorium on Medicaid Rules in the supplemental funding bill on Iraq. The president may still shut down public hospitals, emergency rooms, teaching hospitals and school based health clinics as planned, but he'll have to pause the war to do it!
Let's see if he vetoes! More to come under the rainbow (i.e., fold).
I have previously diaried attempts by Bushco to secretly gut our public health safety net through a set of hard-to-understand rules changes. If implemented May 25 as planned, the rules will severely reduce federal subsidies to public hospitals, indigent hospital care, emergency rooms, clinics, school-based health, graduate medical education, case management, rehabilitation, and children's Medicaid enrollment, causing providers to close their doors. I even flew to DC with a few other health care activists, convincing a McClatchy editor to cover the story, and got some help from a professional I met on the web to film a YouTube documentary to alert the public! Other bloggers took up the cause, began calling their Congresscritters and voila! HR 5613, The "Protect Our Medicaid Safety Net Act" was born!
I have previously diaried our mutual efforts to prevent these rules from going into effect. The moratorium on the evil rules goes before the full Senate this week. Mitch McConnell (R-KY), Charles Grassley (R-IA), and administration officials have vowed to kill the moratorium. Find out how you can help below the break.
THURSDAY NIGHT IS HEALTH CARE CHANGE NIGHT, a weekly Daily Kos Health Care Series
I first diaried the Bush administration's surreptitious effort to shred our public health system through obscure Medicaid Rules Changes in December of 2007. At the time, I had been frantically calling local and national papers to draw attention to the story. No one wanted to pick it up. So I travelled to Washington DC to collaborate with Marty Sonnenburg, a film-maker I met on the web, and he shot this YouTube video for me:
We posted it on Daily Kos, ePluribus Media and My DD (we figured we'd alert the Hillary crowd, too), as well as on progressive blogs in key Republican states. Find out how it played out, and how you helped to save the day after the jump!
This is the fight the Schiavo case should have been. Not for a woman a decade dead but held in limbo by machines, but a living breathing fighting woman who has suffered greatly and survived but is now being denied food - the very basis of life - by Medicare. Nyceve has talked about murder by spreadsheet, and it is hard to imagine a case in colder blood than this.
Susan Spicer will die because some insurance bureaucrat thinks her only source of nutrition is "supplemental."
I rocked out a test and got done about 3 hours faster than I thought I would have so I am going to tell you a dirty little secret about subtle physician bias due to compensation for Medicare Part A-C (part D really doesn't affect us that much except for if costs get too high we (and I am speaking as a future physician) have to find other acceptable alternatives or push to supplemental coverage which is really the domain of social workers/family. Information is from various proprietary sources such as a power-point from the University of MN and a chapter of a public health text book (I'd love to circulate it but it is against copyright law).
Three months ago I created a sock puppet for myself, choosing the name One Brave Kossack for it, a name that nyceve bestowed on me in this diary. I wasn't making trouble, I just didn't want my personal stuff intermingled with the Stranded Wind Initiative's news, but the powers that be here didn't see it the same way, so it's now shut down.
I had intended it to be a simple GBCW in the truest sense of the word, a one diary only Kossack with some words of thanks to nyceve for all her help in this area, both for everyone, and for me specifically when I sent her an email begging for help. Those words were written, left with a good friend who would post them, and it was only when I realized I had the makings of a nice series that I started writing that series of six diaries.
The One Brave Kossack series died, I might have but did not, but the story isn't over , and this time I'm actually going to ask for help from the community.
The Bush administration issued a grim report on the financial outlook for Medicare and Social Security on Tuesday, but said that, by two important measures, the condition of the programs had not deteriorated since last spring.
The new reports, like those issued last April, said that Medicare’s hospital insurance trust fund would be exhausted in 2019, while Social Security’s reserves would be depleted in 2041.
"Medicare poses a far greater financial challenge," said Treasury Secretary Henry M. Paulson Jr., the managing trustee of Medicare and Social Security.
I mean screw things up even more. In 2005, the then majority Republicans in Congress went looking for a way to make sure those pesky brown people from below the southern border weren't destroying Medicaid, you know, by signing up for Medicaid for when they were sick, stuff like that. They did this by passing a rule that mandates that states check specific documents as proof of citizenship; such as a passport or birth certificate, driver's license or military record. Never mind that states have always been required to check a Medicaid applicant's eligibility, which includes citizenship. They just wanted to make sure, you know those Republicans. What have been the results? Follow me below the fold.
This Diary was originally a comment on a thread about a story on 60 Minutes about an organization that travels around providing health care to indigent or uninsured people. It was heartbreaking to see people who have been completely defeated by our system. It spurred me to think about my 21 year history in the healthcare delivery universe.
The following is a fairly comprehensive look at how I see it....
A wonderful Kossack named Rogneid brought this uniquely American and deeply demoralizing story to my attention.
You can honestly mutter in revulsion as you read this, "only in America".
Though some Americans are able to cobble together a little healthcare. Others succumb.
But don't take my word.
Do heed the grim statistic from the highly-regarded Institute of Medicine . "Lack of health insurance causes roughly 18,000 unnecessary deaths every year in the United States."
I want to tell you what goes through my mind when I read crap like this. I think our country, the leadership, our elected representatives are without an ethical center, a moral compass or a sense of shame. Personally, I feel nothing but anguish and despair for our nation. And I wonder why the American people tolerate such a primitive and Third World state of affairs to exist in the 21st century.
The Bush Administration has published a list of twelve proposed Medicaid Rules changes which will cut at least $15 billion over five years from our public health budget. If the rules changes go into effect in March and May as scheduled, they will result in closures or scaling back of Emergency Rooms, outpatient clinics, teaching hospitals, school based clinics, public hospitals, services to the disabled and case management. I have previously diaried the rules changes in detail here.
These new rules will make it even more difficult for disabled veterans to access rehabilitation services. And they will close many of our public hospitals.
While most of us are focused on universal care, the Bush Administration has been incrementally shredding our existing public health safety net in ways that have yet to become apparent. The most recent assault on our public health care infrastructure is escaping the notice of mainstream media and citizen journalists alike, probably because it is not easily explained. I am referring to a proposed set of arcane regulation changes by the Center for Medicaid and Medicare Services (CMS) which, if enacted, will result in $15 billion dollars in cuts over five years to service providers.
The damage that Bush has not been able to inflict through legislation is now being secretly implemented through an administrative back door. Even if Congress rejects the cuts Bush proposed to public health in his most recent budget, changes in regulations will insure that funding is not available for specific programs and activities.
