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Time For Critical Action (Read 16808 times)
Charlie
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Re: Time For Critical Action
Reply #100 - Jun 24th, 2009 at 2:16am
 
"What's good for General Motors is good for the USA."

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Re: Time For Critical Action
Reply #101 - Jun 24th, 2009 at 10:10am
 
Batch,

Locally printed, an opinion discussed this question.

Quote:
Was it constitutional?


While I wouldn't assume the article satisfies curiosity about an answer, this little part may say a lot.

Quote:
... the temptation to bend the rules of democracy is always greatest in a crisis.


Explaining further with an example I'm familiar with, the Supreme Court once blocked an executive action.  

Quote:
A presidential decision to federalize a vast sector of the U.S. economy affects the country's vital interests and, potentially, the rights of its citizens. Such an extraordinary measure should rest on the firmest possible foundation of democratic legitimacy. Does President Obama's rescue of GM and Chrysler meet the test?

The classic statement on such matters comes from Supreme Court Justice Robert H. Jackson's opinion in a case about another crisis-driven assertion of executive power: President Harry Truman's seizure of steel mills in 1952. Truman wanted to prevent a strike during the Korean War; the court blocked him.


The theme seems to be "crisis driven."  

Now, being that I've seemed to accept such an extreme measure as a president's suspension of habeaus corpus (sp) in crisis, the non-errorless but impressively-learning commander-in-chief in Lincoln did it.  There are possibilities where it can be surprising to one's self what is common sense.  

I'm not of an unbiased opinion being from the Motor City area where the state's reaching 14% unemployment, opinion can be regional, with also other sources mentioning government ownership perhaps being temporary to the extent of eighteen months, maybe optimistically.  Survival and crisis are now reaching beyond what I remember in the late 70's and early 80's when unemployment was comparable, the government helped Chrysler at the time with a recovery.

It may be that there is a 60 to 90 day period for legal objections yet.  




The writer's not previously familiar, and within the title, "... barely passes legal test" is of course disputable.  Previously worded above, "the firmest possible foundation of democratic legitimacy" may not have been the case with Lincoln's action either, but there are interfering feelings of "war is war" there, and per Sherman: "War is hell".  


A pre-recovery outlook here balanced against possibly reconstituting the American car industry creates a regional bias of opinion, as if viewing Lincoln's executive undertakings while a Virginian at the time might have.


full article opinion:

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Re: Time For Critical Action
Reply #102 - Jun 24th, 2009 at 12:56pm
 
Kevin,

Given yet another scholarly response with understandable bias...  If I hear you right... You are saying its perfectly acceptable for the Administration to trash the Constitution and bypass the required Congressional action as long as the UAW derives the maximum benefit from the bankruptcy of GM and Chrysler at the expense of the other unions...  Teachers, Fire, and Police, and the private investors who put their life savings in GM and Chrysler bonds...  

That sounds like a FUGIGYM to me....

It's funny, but I don't recall anyone doing the same to the Constitution when Boeing tanked in the 70s and that resulted in closed assembly plants and massive layoffs that put the Seattle economy in a tail spin...  There were PhDs driving taxi cabs for years in the Seattle area...

Take care,

V/R, Batch
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Re: Time For Critical Action
Reply #103 - Jun 24th, 2009 at 1:15pm
 
Batch wrote on Jun 23rd, 2009 at 10:42pm:
However, as the administration's prearranged bankruptcies of GM and Chrysler were governed by fiat (there's a pun for you) sans congressional action per Article I, section 8, existing contract laws were abrogated... so it appears trashing of the Constitution did take place...

Take care,

V/R, Batch


No, there were no violations of existing contract laws or the Constitution - all bankruptcy plans are submitted to a court and are subject to laws passed by Congress. The information for these bankruptcy cases is filed here: Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to Login or Register

What happened in these 2 cases is that the federal government offered TARP money (from an authorized Congressional appropriation), and the companies accepted. That gave the government standing in the bankruptcy process, and the car makers were legally bound to submit a restructuring plan meeting certain criteria (they failed to do so).  It is conceivable that GM and Chrysler could have refused the money in the first place, but the outcome would have been less good - probably a total collapse of both companies. The settlement provides for a controlled restructuring where GM and Chrysler have a chance at coming out as smaller, viable manufacturers.  
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« Last Edit: Jun 24th, 2009 at 1:34pm by monty »  

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Re: Time For Critical Action
Reply #104 - Jun 24th, 2009 at 2:05pm
 
Monty,

I was wondering when you would rise to take the latest bait…   Welcome back, it’s been a while…  

I think you’ll find a lot of Constitutional scholars who disagree with the way the bankruptcy proceedings came out…  In particular the inequitable awards to the UAW at the expense of the actual bond holders…  We all want to see GM survive but look what’s happened…  GM will go the way of AMTRAK...   And, with idiot political hacks running the company with no experience in the auto industry…  this is going to be a tax liability until the Federal government gets out of GM…  Just watch what they’ll do to Ford…

So…  how’s that “hopey – changey” thing working out for ya?  Did ya have a good time at the ACORN birthday party last week?  

And how about the latest from ACORN…  Did you notice how they’ve changed their name from ACORN to Community Organizers International to the US or (COITUS)… That’s what they’re doing to the US Taxpayers when they end run the legal system and the ballot box with our tax dollars so they can register fraudulent voters…  

I’d think the COITUS folks would jump at the opportunity to learn them Uranium leaders the finer art of community organization...  Chicago style…  I’ll bet that would go over like a pig in a punch bowl.

How about Letterman’s Palin jokes?  Did you get a good laugh?  

Got yer popcorn ready for the ABC, the All Barak Channel infomercial from the White House bully pulpit on Obamacare tonight?

Even the left wing media are reporting there a bunch of Dem’s running around the House and Senate with something warm sliding down their legs over the cost of Obamacare…  

And how about the latest plan from the social progressives to cover a fraction of the real costs by taxing existing employer provided health care benefits, except they’ve cleverly built in a carve out exclusion for unions…  Now that’s real slick political theater and a very transparent first class example of PANDERING FOR VOTES…

But lets not dwell on that stinky bolus just yet…

How about we talk about the really big numbers…  I mean really obscene numbers like the National Debt…  It’s  – $ 11.443 Trillion as of 11:00 EST today.

Then there’s Fiscal Year 2008 (FY08) Federal Budget that shows the U. S. Government spent $412 Billion of your money on interest payments to the holders of the National Debt (Japan and China own a lot).   Interest payments on the National Debt for FY09 looks like they’ll total $550 Billion… and possibly more and the FY 2010 budget will be nothing short of a financial Chernobyl for people who really pay income tax.

By all estimates if the rogue Congress and White House continue at their preset pace, we’ll have a $2 Trillion deficit this year alone and a projection of a continued deficit of $2 Trillion a year for the next 8 years…

And now the idiots in Congress want to saddle us with Obamacare that will increase the National Debt by anywhere from $1 Trillion to $4 Trillion over the next 10 years (depending on which of the 5 versions of “Affordable Health Care” legislation you’re looking at) just to ensure 47 million uninsured [b}residents[/b] of the United States.  And, as pointed out earlier, just so you can wait in line for rationed medical care…

Let’s take a look at how our government takes in revenue… I downloaded the 2008 IRS files…  That year there were 156 million returns filed.  Over 60% (that’s a very conservative number) paid no income tax and 40% of those who filed a federal income tax return paid no income tax but received money from the government.  If you do the math, 63 million folks out of a total population estimated at 307 million paid all the federal income tax in 2008.

Estimated receipts for fiscal year 2008 were $2.66 trillion (The actual figures are at lease 35% lower than estimated) from the following sources.

•      $1.25 trillion - Individual income tax
•      $927.2 billion - Social Security and other payroll tax
•      $314.9 billion - Corporate income tax
•      $68.1 billion - Excise tax
•      $29.2 billion - Customs duties
•      $25.7 billion - Estate and gift taxes
•      $50.7 billion - Other

Total Spending for fiscal year 2008 was $2.902 Trillion.

Will Government run medical insurance result in rationing ? Oh yes…  It’s already started for Medicare recipients…  and if you don’t think Obamacare isn’t going to ration your medical care you gotta be smoking them funny cigarettes all the liberal progressives and pot heads want to legalize… The other dirty little secret is very obvious… If you have private medical insurance now…   You are already paying for people without health insurance with increased premiums to cover the expenses created the uninsured.  Another factoid…  80% of the medical expenses we will incur in our life will come after the age of 55…  Old folks cost more…  Just a fact.

Consider this…  Medicare is already rationing oxygen therapy to COPD sufferers…  Medicare estimates they’ll pay out $1.69 Billion to 1.6 million senior citizens currently receiving coverage for home oxygen therapy, but they expect to cut that figure down to $735 Million by 2011 to over 1.8 million senior citizens in need of oxygen therapy.  So what do they do when that happens?  Taking half as many breaths with oxygen supplement is going to be real tough for COPD sufferers.  And yet…  Medicare WILL NOT COVER THE EXPENSE OF MEDICAL OXYGEN AS AN ABORTIVE FOR CLUSTER HEADACHES !!!

Can you hear it coming?  You should…  If you don’t… BOHICA!  Cause here come BIG NEW   TAAAAAAAAXES…  On everyone!

Don’t get me wrong…  We do need reform in medical care, but there are so many ways to do this without the chosen one and the idiots in congress nationalizing yet another industry with no real plan on how to pay for it.

We need a real panel of experts made up of all the stakeholders from each State to address potential legislative solutions to our heath care problems free of polarized political interference… read politicians in general and Congress and the Administration in particular, then send it to the Supreme Court to adjudicate…  

Congress has the power to do this but they do not want to give up the power and control they have over you…  After all, you can’t be trusted to spend your money wisely and “THEY” know better…

Lets take a look at the problems that will make National Health Care a Nightmare as proposed in any of its present instantiations in no less than five different House and Senate committees.  You need to understand that most of these problems were caused by legislation written by special interest groups not necessarily directly related to medical care and big government trying to “fix” other problems they caused years earlier on both sides of the isle.

Medical Tort Reform.  We’ve become a litigious society willing to sue over coffee from McDonald's we spill in our laps thanks to Congress (mostly lawyers) and their failure to pass meaningful tort reform and in particular, medical tort reform.   This is another bi-partisan screw up of GIHUGIC proportions…  You heard the chosen one tell the AMA he was not in favor of medical tort reform…  (That got a lot of groans) That’s simply because he gets more campaign donations from slip and fall lawyers and their heavily financed national associations…  than he does from medical providers and payers.

No Government health care reform will be possible without meaningful medical tort reform…    That should be the first step in the critical path of generating meaningful health care reform…  before there are any further related pieces of legislation passed!  A change in Medical Tort Laws would cost taxpayers nothing in new taxes and may even reduce other insurance costs.

Existing shortage of primary care physicians.  There are not enough primary care physicians today.  Primary care physicians who refuse to compromise quality are either driven out of business or to cash-only concierge practices, further contributing to primary care's decline.

Medical students are not blind to this scenario. They see how heavily the reimbursement deck is stacked against primary care.  Whether they opt to become a specialist or a primary care physician, they graduate with the same $140,000 of medical school debt. The recent numbers show that since 1997, newly graduated U.S. medical students who choose primary care as a career have declined by 50%. This trend results in emergency rooms being overwhelmed with patients without regular doctors.

Furthermore, if the Democrats' universal health care proposals come to fruition, the primary care system will be inundated with at least 45 million newly insured patients.  As Massachusetts is finding out in its pioneering attempt to provide universal coverage, our system is not ready for this burden. Universal coverage is useless without primary care access.

Even the local far left fish wrap here in DC, the Washington Post, ran a front-page article below the fold on the present shortage of primary care physicians. Have you seen any of the Porkulus funding stimulate a response to this shortage?  I think not.

Inequitable taxing of health care insurance costs.  The present employer provided health care benefits are tax-exempt (for the moment).  However, if you work for a small company that can’t compete for institutional medical insurance or you’re self employed, your medical insurance costs are fully taxable.  This is another egregious tax law that’s screwed up as Hogan’s goat that could be fixed at no cost to us in new taxes.

Late payments to Providers Treating patients with Medicare & Medicaid. The Centers for Medicare and Medicaid Services (CMS) at HHS don’t actually make payments to medical providers.  They use Medicare Administrative Contractors (MAC) selected in low-ball contract solicitations.  Many of these regional MACs are not equipped to handle the volume of claims from medical providers treating Medicare and Medicaid recipients.  Moreover, the prevailing attitude is delay payments rather than pay on time if there are any questions over the Healthcare Common Procedure Coding System (HCPCS) billing codes. These delays are often so long that some providers must take out loans to meet their expenses.  The bureaucratic nature of the way HCPCS billing codes are administered and changed by CMS.  This is another example of Federal Laws and bureaucratic impediments that could be fixed with common sense legislation without the need for increased taxes.

Shortage of physician’s assistants (PA).  We desperately need more PAs. Most states require at least 2 years of college and some health care experience prior to admission to an accredited PA course of study. All States require that PAs complete an accredited, formal education program, usually 2 years in length, and pass a National exam to obtain a license.   Salaries run around $70,000/year.  Have you seen any of the Porkulus funding stimulate a response to this shortage?  I think not.

Enforce Existing Laws and Deport Illegal Aliens. The Los Angeles County Board of Supervisors, has said that welfare costs for illegal immigrants in LA County were over $37 million in September 2007 and that they had increased $2 million over the previous two months. He also said that 25% of all welfare and food stamp benefits go directly to children of illegal aliens and that the projected annual cost in welfare and food stamps for illegal aliens would be $444 million - including public safety and healthcare, the total cost for illegal immigrants to the County exceeded $1 billion a year - not including the millions of dollars for education.

A RAND study concluded that the total federal cost of providing medical expenses for the 78% illegal immigrants without health insurance coverage was $1.1 billion, with immigrants paying $321 million of health care costs out-of-pocket. The study found that undocumented immigrants tend to visit physicians less frequently than U.S. citizens because they are younger and because people with chronic health problems are less likely to immigrate.  Here is where Congress could fix the “Anchor Baby” problem at no additional tax and save hundreds of millions a year in reduced costs to State and Federal budgets in the process.  That would help reduce our medical insurance premiums.

There are other common sense solution that wouldn’t increase our tax for another massive entitlement.  

The Safeway Plan.  The Safeway plan for medical health insurance is well liked by non-union employees because their premiums are reduced significantly if they demonstrate common sense life-style changes like reduce weight if they are obese, lower blood pressure, lower cholesterol levels, and quit smoking.  This is an excellent model for Medicare Part B and Part C.

Use existing sources of revenue to cover the uninsured.  If the idiots in Congress were really concerned about the health care problems caused by the uninsured, they could take payments accruing from all the Bail-Outs to the financial and auto industries and apply them to a fund to cover the uninsured.  Instead they’ll send that money to COITUS and other unfunded programs on their socialist agenda.  This is another example of how Congress could reform health care without any new tax.

The really big, really obscene problem is like the 900 lb gorilla in the room that neither party will acknowledge…  Medicare and Medicaid.  

Both are broken and so is Social Security.  In 2004, Senior Fellow and Social Security and Medicare Trustee Thomas R. Saving reported that:

  • Social Security faces an unfunded liability of $10.4 trillion.
  • Medicare's unfunded liability is $61.6 trillion - six times greater than Social Security's.
  • The prescription drug benefit alone faces a funding gap of $16.6 trillion - more than 50 percent greater than Social Security's.
  • By 2020, the combined deficits in these programs will consume more than one-fourth of all federal income taxes.
  • By 2030, about the midpoint of the baby boomer retirement years, deficits in the two programs will consume more than half of all federal incomes taxes.
  • By 2050, when today's college students will reach retirement age, Social Security and Medicare will require more than three- fourths of all income taxes just to pay benefits currently promised.

Congress has no plan to pay for these promises, and the budget rules actually hide the total cost from Congress and the voters.  This fact alone should give you a spastic colon and give you cause to seek out candidates with common sense come election time.

Now for any of you who think medical care will be better under communism…  You’ve every right to that opinion.  There are hundreds of thousands of American war fighters who’ve died to preserve your right to say that and millions more that support your rights to say that but disagree vehemently.  I’m one of them…  

Just as you have the right to say you want communist medical care, I have the same right to state my opinion…  and here it is…

Demand a refund on your education and if that doesn’t work get a lawyer and sue the schools.  You either received a very poor public education devoid of any US Government, US and World History, or you had Marxist trained community organizers masquerading as teachers using revisionist texts.   If you’re really serious about wanting communist healthcare…  Try Cuba…  It’s real close.

Finally…  Forget all the numbers being thrown around for a minute and look at the numbers that will affect you, your children, and their children for the rest of their lives.  The questions you should be asking yourself and your congressmen follow.  They’re rhetorical…  so I’ll take the liberty of answering them now:

If I already have private health care insurance, will my premiums for that coverage go up if the present heath care legislation passes?  Yes

Will Congress add more Federal mandates to the existing list of required coverage items that will make my private insurance more costly than government run health care insurance/exchanges? More than likely

If I already have private health care insurance, will my taxes go up to pay for the estimated 47 million uninsured? Yes, for you and for generations to come.

Are there provisions to prevent undocumented and illegal aliens from receiving coverage in the present legislation working its way through Congress? Illegal aliens already qualify for free health care in emergency rooms across the US…  You’ve been paying for them all the way along in higher medical costs…  Moreover, they qualify for Medicaid now and if Obamacare passes, they’ll get amnesty and be made US citizens with the stroke of a pen…  [b] The answer is Yes.

Phone the U.S. Capitol Switchboard at (202) 224-3121.

A switchboard operator will connect you directly with the Representative or Senate office you request.  Ask for some common sense and advise them to seek employment elsewhere come election time if they fail to show any.

My conclusion after doing this research and analysis:

In passing the affordable health care legislation presently metastasizing its way through halls of Congress without taking a common sense approach to fix existing problems first, we will end up with Government run health care looking like the existing Medicare and Medicaid on steroids…  

If you think I’m off the mark… Do your own research and draw your own conclusions…  Then come back and tell us what they are…  



Take care…  and BOHICA!

V/R, Batch

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Re: Time For Critical Action
Reply #105 - Jun 24th, 2009 at 4:30pm
 
Quote:
Monty,

I was wondering when you would rise to take the latest bait…   Welcome back, it’s been a while…  


Pardon my unexplained absence ... I've been hiking the Appalachian Trail.

Quote:
I think you’ll find a lot of Constitutional scholars who disagree with the way the bankruptcy proceedings came out…  In particular the inequitable awards to the UAW at the expense of the actual bond holders…


I think the court may find that the UAW has made material concessions over the past decades, and that this is a reason to put them second or third in line when paying creditors (instead of last). Nothing in the US Constitution about that. In fact, I challenge you to show me a complex bankruptcy where all creditors were paid equally - that simply doesn't happen.

Quote:
How about Letterman’s Palin jokes?  Did you get a good laugh?  


No, I don't really like Letterman and don't watch his show ... I did read about the jokes and found them to be in poor taste.

Quote:
Did you notice how they’ve changed their name from ACORN to Community Organizers International to the US or (COITUS)…I’d think the COITUS folks would jump at the opportunity to learn them Uranium leaders the finer art of community organization.


Another joke in poor taste.

Quote:
Medicare estimates they’ll pay out $1.69 Billion to 1.6 million senior citizens currently receiving coverage for home oxygen therapy, but they expect to cut that figure down to $735 Million by 2011 to over 1.8 million senior citizens in need of oxygen therapy


Yes, the government is trying to control costs by reducing overpayments. It's not some Obamanific Marxist conspiracy to pull the plug on sick people, it is a bit of stream-lining that was put into motion in 2006, when someone else was president:

Quote:
A 2006 report prepared for CMS calculated that the agency was paying an excessive amount to private companies to supply oxygen equipment and services -- on average about $200 a month per patient. The average cost to purchase an oxygen concentrator was $587 and the equipment required little maintenance, the report concluded.

Laurence Wilson, director of CMS's chronic-care policy group, says the agency felt it could reduce payments to suppliers after three years because the oxygen equipment should be fully paid for by that time. After that, suppliers receive minimal payments for occasional follow-up visits and other services.

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So it isn't about denying services to people with a serious disease - it is about paying companies fairly instead of extravagantly. Of course, the oxygen providers are screaming that they will go broke and this means they will stop providing service.  Not likely - the efficient, honest companies won't turn down an opportunity for a larger piece of the pie, even if the % profit is not as high as under the old rules.  People with COPD will continue to get the Oxygen they need.  But keep trying to scare people - it is amusing. The collapse of the GOP is tied to the fact that they rely so heavily on scare tactics ... that sometimes works in the short run, but in the long run, the public catches on.  


Quote:
And yet…  Medicare WILL NOT COVER THE EXPENSE OF MEDICAL OXYGEN AS AN ABORTIVE FOR CLUSTER HEADACHES !!!


Actually, Medicaid already covers it, and Medicare is reviewing their rules. It should be covered.  And let the record show that not all private insurance covers it.  So making political hay on the assumption that government won't provide it while the private sector always will is erroneous.

Quote:
3.2.11.3 Cluster Headaches


Medicaid may pay for oxygen for participants with a diagnosis of cluster headaches.


Note: Prior approval is required from Medicaid. Include the PA number on the claim. Lab studies are not required. PA requests must have physician orders that demonstrate the following medical necessity criteria:

• Other measures, such as Dehydroergotamine and Sumatriptan (Imitrex), have been tried and found to be unsuccessful.

• Oxygen therapy must have been proven successful on a trial basis for at least one treatment in the emergency room or in the physician’s office before it can be authorized for home use.

If both criteria are met, authorization will be given for a six month period. Documentation of successful use and continued need must be received from the attending physician for subsequent PA.
If more than two months elapse without an incidence of a cluster headache, the oxygen authorization will be discontinued until the headaches start again.

When billing for oxygen that is necessary to treat cluster headaches:

• Bill with a paper claim.
• Attach a CMN indicating that the oxygen is for cluster headaches.

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The fact that oxygen is not reimbursed as a first choice is unfortunate, as is the expiration after 2 months remission -  but those are also common conditions for private insurance policies as well - it reflects current medical 'consensus' and not the informed opinion of those specialists who work with clusters every day.

Quote:
If you’re really serious about wanting communist healthcare…  Try Cuba…  It’s real close.


You give great advice, I'm sure, but forgive me for not taking you up on it.  I really prefer the Canadian model of insurance as a starting point, or the Scandinavian model, or the UK model.  I am not interested in communism as a goal, I have no problems with a mixed economy, and think that government should only get involved when the private sector can't or won't do the job right .... and I think that when we look at the medical insurance industry, either they can't or they won't.
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« Last Edit: Jun 24th, 2009 at 6:50pm by monty »  

The outer boundary of what we currently believe is feasible is far short of what we actually must do.
 
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Re: Time For Critical Action
Reply #106 - Jun 24th, 2009 at 6:44pm
 
Batch wrote on Jun 24th, 2009 at 12:56pm:
You are saying its perfectly acceptable for the Administration to trash the Constitution and bypass the required Congressional action...


I recall you posting that Lincoln and Truman were your favorite presidents.  Was this not known about them or were you ok with their actions to "trash" the Constitution, one successful, the other not.  Or was this known and yet still they were admired as favorites.  Within this thread, this might seem an important point of evaluation.  When is it ok and when is it not, when other accomplishments make one overlook this "trashing" to favor, and if not so accomplished in one's mind, the overriding rememberance is the "trashing"?  Or a preferencial bias?



Quote:
I don't recall anyone doing the same to the Constitution when Boeing tanked in the 70s and that resulted in closed assembly plants and massive layoffs that put the Seattle economy in a tail spin...


Today there will be many, many, failed companies without government help with degreed talent working at McDonalds.  Was it Lehman (Bear Stearns was in there somewhere) who was allowed to fail yet AIG not?  I'm not privy to the picking and choosing and assessment of crisis potential in the decision-making.  Controversially, the airlines were gov assisted after 9/11.  Previous to that, the unionized employees of United took an ownership portion of that airline in a time of the industy's financial crisis.  

Workers at North American Aviation in 1941 were sided by federal troops to keep them at their stations on the job.  A decision in crisis also, but yet not at war.  Not so American-sounding, yet perhaps a contribution toward freedom later while FDR proposed lending a neighbor a fire hose resulting in England sustaining the good fight.  There are disagreeing factions toward action in crisis.  
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« Last Edit: Jun 24th, 2009 at 7:19pm by Kevin_M »  
 
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Re: Time For Critical Action
Reply #107 - Jun 24th, 2009 at 7:26pm
 
Quote:
Will Government run medical insurance result in rationing ?


You're way behind Batch. There is no way the government could hope to match the heartless level of rationing that insurance companies do all day long. The government is not going to ration health care. On the contrary, when insurance companies have competition, rationing by them won't be profitable.

The only thing we have to fear is fear perpetrated by the GOP and insurance company lobbiests. The estimate is that drug companies and the medical providers have six lobbiests for every legislator running around Washington.

Charlie
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Re: Time For Critical Action
Reply #108 - Jun 24th, 2009 at 7:34pm
 
Monty,

-------- Original Message --------
Subject:      RE: CMS Policy for DME-Oxygen Coverage for Cluster Headache Sufferers
Date:      Wed, 06 May 2009 16:37:17 -0400
From:      Stiller, Jean M. (CMS/OCSQ) <Jean.Stiller@cms.hhs.gov>
To:      Pete Batcheller
CC:      Webster, Susan L. (CMS/CMM) <Susan.Webster@cms.hhs.gov>

Medicare does not cover the home use of oxygen for the treatment of cluster headaches.

Jean Stiller

Centers for Medicare and Medicaid Services
7500 Security Blvd,
Baltimore, MD  21244-1850
410-786-0708

Jean is a nice lady.  Giver her a call.  BTW, I've checked with all the DME MACs and they say the same thing...  NO COVERAGE.

Take care,

V/R, Batch
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monty
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Re: Time For Critical Action
Reply #109 - Jun 24th, 2009 at 9:08pm
 
That is correct - MediCARE does not currently reimburse for oxygen for clusters. If I am not mistaken, the VA does, and some MedicAID programs do (it varies from state to state).  And the MediCARE program is likely to change in the near future ... like some private insurers, they have not seen fit to update their policies to reflect recent research.

I think that Medicare can and will ultimately provide oxygen to clusterheads as a medical necessity. And how do you propose fixing this problem:??

Quote:
Furthermore, my experience with O2 Therapy has demonstrated to me beyond a reasonable doubt that it is an effective, non-obtrusive means to abort a cluster. Unfortunately, I, as well as other Cluster Headache sufferers who do not have private medical insurance have a difficult time accessing pure oxygen outside of a trip to an emergency room.

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« Last Edit: Jun 24th, 2009 at 10:11pm by monty »  

The outer boundary of what we currently believe is feasible is far short of what we actually must do.
 
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Re: Time For Critical Action
Reply #110 - Jun 25th, 2009 at 12:26am
 
Quote:
Medicare does not cover the home use of oxygen for the treatment of cluster headaches.


So you suppose that I'd have a fighting chance to get Blue Cross, etc. to cover this?

Charlie
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Re: Time For Critical Action
Reply #111 - Jun 25th, 2009 at 1:30am
 
Blue Care Network covers my O2 100%. In the Obama healhcare conferience i saw one mention of private insurance. That they are behind the plans talked about. Why? Because they will pay less and will be able to donate more to someones political agenda?

Will we really pay less for better healthcare??? The real problems weren't mentioned. Why does it cost $4,000 for a colonoscopy. Why was it $1,800 for me to go to the E.R, and get a shot of DHE that cost the Hospital $28???? Yes I do know what it cost.

Is it because they don't get enough patients? No. Is it because I have insurance? Is it because they had to pay for someone else?

Why were'nt these issues mentioned?? Maybe because all involved have much more money to support politicians. (ALL politicians in office.)

Excuse me, but I'm an American,  Don
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Re: Time For Critical Action
Reply #112 - Jun 25th, 2009 at 2:25am
 
Quote:
Why does it cost $4,000 for a colonoscopy.


Because fee for service larcenous MDs send you for lots of tests to places where they own part of the serivce. They also schedule way too many visits and followups.  I don't let them get away with it.

Here, a colonoscopy is about $2000 but that's way too much as it is. With Medicare, it's $125...also$125 too much.

Bring on the government. I'm doing just fine with them.

Charlie
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Re: Time For Critical Action
Reply #113 - Jun 25th, 2009 at 7:40am
 
Don,

Can't you see that Batch, Charlie, and Monty are trying to have a private conversation?

Grin

(I'm just messin' with ya)
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Re: Time For Critical Action
Reply #114 - Jun 25th, 2009 at 7:49am
 
Bill,

Ya left out Kevin... I've got a 1 vs 3 (Dissimilar) going...   What a hoot...  Some folks might even learn something...  then again...  maybe not...

Take care,

V/R, Batch
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Re: Time For Critical Action
Reply #115 - Jun 25th, 2009 at 7:57am
 
My apologies, Pete. Kevin, you too.

(And yes, I'm learning as I watch)
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Re: Time For Critical Action
Reply #116 - Jun 25th, 2009 at 9:17am
 
No apologies need be issued from the rhythmic keyboard of the below middle C staff.   Wink    I seem to partake just to mine the shimmer and shine of Charlie stretching his legs in his studio.

Charlie wrote on Jun 16th, 2009 at 6:38pm:
OOPS. ... No mind though. My stuff is always gold.


I'm still LOL going back to grab this solid gold riff.   Cheesy


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Re: Time For Critical Action
Reply #117 - Jun 25th, 2009 at 9:34am
 
Charlie wrote on Jun 25th, 2009 at 12:26am:
So you suppose that I'd have a fighting chance to get Blue Cross, etc. to cover this?

Charlie


Are you in upstate New York?  Here are the BC-BS guidelines for that region:

2.  Cluster headaches when other treatment fails.

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Insurance companies (private and government) were denying oxygen PRN (as needed) because they said it was not medically appropriate.  Changes in medical thinking have led to increasing recognition that oxygen is an appropriate treatment for cluster headache, and those policies are starting to change.

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« Last Edit: Jun 25th, 2009 at 9:38am by monty »  

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Re: Time For Critical Action
Reply #118 - Jun 25th, 2009 at 9:51am
 
monty wrote on Jun 25th, 2009 at 9:34am:
Insurance companies (private and government) were denying oxygen PRN (as needed) because they said it was not medically appropriate.  Changes in medical thinking have led to increasing recognition that oxygen is an appropriate treatment for cluster headache, and those policies are starting to change.

I suppose rational minds might come to the conclusion that oxygen is a "drug" that would be pretty difficult to abuse.

Unless you're a welder, in which case it might be nice to get the Feds to pay for it.

Imagine that - we buy welder's O2 because it's cheaper, and welder's get medical O2 because it's cheaper. What's wrong with this picture? Grin
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Re: Time For Critical Action
Reply #119 - Jun 25th, 2009 at 11:50am
 
Charlie,

Sorry, but Monty is off the mark on Medicare when it comes to a change in the CMS policy on home oxygen therapy any time soon…  There is no coverage for home oxygen therapy under Medicare Part B per my last on this topic.  If you’re paying for an additional health care policy under Part C, and depending on your policy, you may have a chance.  

Medicaid is a different entitlement program all together…  It’s for individuals and families with low incomes.  It’s controlled by the States running on a mix of State and Federal funds.  The funding mix is determined by the federal medical assistance percentage (FMAP) that varies from State to State.  Coverage is means tested and requires prior approval.  I’m working with several folks receiving home oxygen therapy under Medicaid at this time.

We've also been working with House Minority Leader John Boehner and his staff for nearly two years trying to bring pressure on CMS to have Medicare cover the expense of home oxygen therapy for cluster headache sufferers.   It’s been heavy sledding with no real progress…

In our conversations and correspondence with CMS and the DME MAC representatives regarding home oxygen therapy, it's not a matter of updating policy and they're far from being behind.  True, their present guidance is to reduce coverage for compressed oxygen to the maximum extent possible using oxygen concentrators.  However, what Monty missed is there’s also a planned reduction in coverage for oxygen concentrators and portables.  They’re doing this to meet planned cost reductions for all forms of home oxygen therapy...  see the CMS chart below from their 2009 plan:

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If you read the chart carefully you’ll see a reduction in coverage for oxygen concentrators and portables over the 4-year plan...  

What's more disturbing is the dark side of this chart where they accrue the cost savings through a reduction in the actual number of Medicare beneficiaries using home oxygen each year.  

You can read this part of the chart any number of ways, but none bring any comfort…  

The bottom line should be clear…  even to die-hard social progressive liberals if that’s possible…  Plan on even more rationing with government run health care.  The government rations it now.  

If they’re allowed to continue the present plan, by 2013, the CMS will have reduced Medicare coverage on home oxygen therapy for senior citizens suffering from COPD by 97%, (A reduction in home oxygen therapy expenses from $1,698,942,207 in 2009 down to $51,623,840 in 2013).

And…  While all this is happening, the taxpayer funded S-CHIP will provide $9.895 Billion worth of “free” medical insurance in FY 2010 to children… In some cases up to the age of 21 depending on the State…  (See (H.R. 2) entitled ‘‘An Act to amend title XXI of the Social Security Act to extend and improve the Children’s Health Insurance Program, and for other purposes.’’ - January 29, 2009)

Want to guess how many of these children are illegal alien anchor babies???

I found an estimate that’s as good as any…  Using the March 2005 Current Population Survey, the Pew Hispanic Center estimated in 2006, there were 3 million U.S.-born children of illegal immigrants in the U.S.

The way I see it, the social progressive liberals in Congress don’t really care about us old folks...  and they never did.  

It also appears the CMS cost reduction plan for home oxygen therapy reflects the handy work of tax cheat Tom Daschle who said, “health-care reform will not be pain free.”  “Seniors should be more accepting of the conditions that come with age instead of treating them.” That means we…  the elderly, will bear the brunt.  This must be terribly frightening to COPD sufferers…

The dirty little secret is the liberals would rather pander to children and parents of low income families as potential voters using the taxpayer’s money for S-CHIP rather than on the old folks… “hoping of course, ” the parents of these children will vote the liberal ticket…  and...  when these children reach voting age, they'll do the same...

Unfortunately the idiots on the right side of the isle haven’t been able to stop this egregiousness…

Take care…   and BOHICA,

V/R, Bach
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Re: Time For Critical Action
Reply #120 - Jun 25th, 2009 at 1:01pm
 
Quote:
There is no coverage for home oxygen therapy under Medicare Part B per my last on this topic.


Medicare part B has more to do with insuring drug companies from having to make reasonable deals with Medicare. Bush's little excursion into drug coverage is sweet. The bill specifically prevents Medicare from negotiating prices. It caused more harm than good and I've seen the bizarre mess created.

While not true that government will ration, it would never come close to the current rationing by insurers of doctors, hospitals, clinics and tens of thousands of patients which prevent them from getting the health care necessary unless they don't eat or forego utilities.........or get out of the way by dying so only those that don't need insurance can keep corporate insurers happy.

Charlie
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Re: Time For Critical Action
Reply #121 - Jun 25th, 2009 at 1:14pm
 
Batch wrote on Jun 25th, 2009 at 11:50am:
You can read this part of the chart any number of ways, but none bring any comfort…  


Batch,

you have consistently been a hysterical hyper-partisan figure, and your (mis) interpretation of the graph above is consistent with that.

It is impossible to find any credible sources that agree with your analysis of the table ... business journals say there may be minor disruptions in coverage as the rules change and there are changes in the provider landscape ... but in my experience with a relative on a respirator provided by non-medicare insurance, I can tell you that they have had their service provider changed and have seen such disruptions from non-government insurance decisions.

No one except you, Batch,  is warning that 1/2 or 2/3 of people getting oxygen from Medicare will be cut off.  Because it isn't going to happen.

These 2009 changes to medicare oxygen are the result of a 2005 bill (Republican President/Republican Senate/Republican House) that decided it made no sense to pay $7000 in rental fees over 3 years for a device that can be bought for $600.  And I agree!  By trimming those type of excessive markups, it is possible to reduce costs by 50% or more without reducing the number of people covered or the quality of service.  It may mean fewer vacations and smaller boats for the corporados that make their money from overcharging Medicare, but so what?? 

Quote:
If you read the chart carefully you’ll see a reduction in coverage for oxygen concentrators and portables over the 4-year plan... 


No, what we see is a reduction in spending. This graph shows the phase-in of a 3 year/5 year cycle of funding for people with various oxygen equipment ... medicare insurance is reducing payments for the first 3 years, years 4 and 5, the devices are considered 'paid for' and no rental fees are paid (only service/maintainence) and after 5 years, the device is considered essentially obsolete, and a patient is eligble for a new device and restarting the cycle.
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Re: Time For Critical Action
Reply #122 - Jun 25th, 2009 at 1:40pm
 
Quote:
One Congresscritter


I like that one Brew.
Of the government,by the government, and for the government.
Self serving idiots all of them. Smiley Smiley
the bb
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Re: Time For Critical Action
Reply #123 - Jun 26th, 2009 at 8:57pm
 
Monty,

How predictable…  Let’s go over your responses with the Huffington Social-Progressive Liberal Check List of Politically Correct Phraseology and Tactics.

Cherry Pick questions                          – Yes
Nit Pick questions                                – Yes
Avoid the question                               – Yes
Obfuscation                                         – Yes
Ad-hominem attacks                            – Yes
Change topic to inconsequential            – Yes
Argue points irrelevant to topic             – Yes
Camouflage confessions as accusations – Yes

Problems solved only by Liberals in Congress spending lotsa our money – You Bet

"No amount of money, influence, persuasion or words can possibly paint Elitist Left-wing Social-Progressive Liberals in a worse light than they gladly portray themselves!"
                                                ~ Keith Martin

Most folks will see there’s no hysterical hyper-partisan figure here…  only a person with common sense, a love for our great Nation, and a clear recognition of how social progressive liberals think and react.  We've got their play-book...  Trix are for kids!

Take care.  And Monty.. I’m really glad you thought Letterman’s Palin jokes were in poor taste.  We can agree on that.

V/R, Batch

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Re: Time For Critical Action
Reply #124 - Jun 26th, 2009 at 10:56pm
 
The right wing could use some elitism. The Sarah Palins have only so much appeal.

When it comes to obfuscation, the Democrat's attempt at it pales to insignificance when compared to the GOP.

Charlie
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